WHO-based classification of osteogenic tumors of the bone.
\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
\n'}],latestNews:[{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"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"6065",leadTitle:null,fullTitle:"Modern Railway Engineering",title:"Modern Railway Engineering",subtitle:null,reviewType:"peer-reviewed",abstract:"Since the advent of steam engines and higher throughput railways during the early nineteenth century, the rate of development has been rather steady and incremental. The development of advanced electronic control and command systems, increasing levels of automation, and electrified high-speed railways over the past few decades have transformed the rail transportation posing it as a competitor to aviation. Modern railways are no longer the sole forte of civil and mechanical engineering and involve a broad multidisciplinary engineering disciplines from advanced computing, telecommunications, and networking to big data analytics and even AI. This volume addresses the diverse, evolving, and advanced engineering disciplines including enabling practices and processes involved in shaping modern railways.",isbn:"978-953-51-3860-0",printIsbn:"978-953-51-3859-4",pdfIsbn:"978-953-51-4024-5",doi:"10.5772/68005",price:119,priceEur:129,priceUsd:155,slug:"modern-railway-engineering",numberOfPages:228,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:"77a5fae5e9451d4e52e9f7cd8f39bdcb",bookSignature:"Ali Hessami",publishedDate:"March 7th 2018",coverURL:"https://cdn.intechopen.com/books/images_new/6065.jpg",numberOfDownloads:15863,numberOfWosCitations:11,numberOfCrossrefCitations:5,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:12,numberOfDimensionsCitationsByBook:1,hasAltmetrics:0,numberOfTotalCitations:28,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 27th 2017",dateEndSecondStepPublish:"March 20th 2017",dateEndThirdStepPublish:"September 22nd 2017",dateEndFourthStepPublish:"October 22nd 2017",dateEndFifthStepPublish:"December 22nd 2017",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"108303",title:"Prof.",name:"Ali G.",middleName:null,surname:"Hessami",slug:"ali-g.-hessami",fullName:"Ali G. Hessami",profilePictureURL:"https://mts.intechopen.com/storage/users/108303/images/system/108303.jpeg",biography:"Ali Hessami is Director of R&D and Innovation at Vega Systems. He is an expert in systems assurance and safety, security, sustainability, and knowledge assessment/management methodologies and has a background in the design and development of advanced control systems for business and safety-critical industrial applications. He chairs the Institute of Electrical and Electronics Engineers (IEEE) 7000 Technology Ethics standard and is the vice-chair of the Ethics Certification ECPAIS Programme at IEEE.\n\n\n\nDr. Hessami is a visiting professor at London City University’s Centre for Systems and Control and at Beijing Jiaotong University School of Electronics and Information Engineering. He is also a fellow of the Royal Society of Arts (FRSA), a fellow of the UK Institution of Engineering and Technology (IET), and a Life Senior Member of IEEE.",institutionString:"Vega Systems",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"5",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"City, University of London",institutionURL:null,country:{name:"United Kingdom"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"830",title:"Railway Engineering",slug:"railway-engineering"}],chapters:[{id:"56770",title:"Railways’ Stability Observation by Satellite Radar Images",doi:"10.5772/intechopen.70464",slug:"railways-stability-observation-by-satellite-radar-images",totalDownloads:1573,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Remote sensing has many vital civilian applications. Space-borne Interferometric Synthetic Aperture Radar has been used to measure the Earth’s surface deformation widely. In particular, Persistent Scatterer Interferometry (PSI) is designed to estimate the temporal characteristics of the Earth’s deformation rates from multiple InSAR images acquired over time. This chapter reviews the space-borne Differential Interferometric Synthetic Aperture Radar techniques that have shown their capabilities in monitoring of railways displacements. After description of the current state of the art and potentials of the available radar remote sensing techniques, one case study is examined, pertaining to a railway bridge in the Campania region, Italy.",signatures:"Davod Poreh, Antonio Iodice, Daniele Riccio and Giuseppe Ruello",downloadPdfUrl:"/chapter/pdf-download/56770",previewPdfUrl:"/chapter/pdf-preview/56770",authors:[{id:"207255",title:"Dr.",name:"Davod",surname:"Poreh",slug:"davod-poreh",fullName:"Davod Poreh"}],corrections:null},{id:"57844",title:"Vibration Mitigation of Railway Bridge Using Magnetorheological Damper",doi:"10.5772/intechopen.71980",slug:"vibration-mitigation-of-railway-bridge-using-magnetorheological-damper",totalDownloads:1431,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The purpose of this study is to analyze the railway bridge vibrations and control their negative effects through semi-active magnetorheological (MR) damper. Dynamic analysis of a railway bridge subjected to the moving load is performed. The real structural parameters are used, and the six-axle train is simulated as moving loads. The railway bridge is modeled as Euler-Bernoulli beam theory, and it is discretized through Galerkin method. To mitigate the bridge vibrations, MR damper with a fuzzy logic-based controller (FLC) is positioned at the ends of the bridge. The simulations of the system are performed by MatLab software. Finally, the results are examined both in the time and frequency domains.",signatures:"Muzaffer Metin, Arif Ulu, Mahmut Paksoy and Murat Emre Yücel",downloadPdfUrl:"/chapter/pdf-download/57844",previewPdfUrl:"/chapter/pdf-preview/57844",authors:[{id:"144884",title:"Dr.",name:"Muzaffer",surname:"Metin",slug:"muzaffer-metin",fullName:"Muzaffer Metin"},{id:"222685",title:"MSc.",name:"Arif",surname:"Ulu",slug:"arif-ulu",fullName:"Arif Ulu"},{id:"222686",title:"MSc.",name:"Mahmut",surname:"Paksoy",slug:"mahmut-paksoy",fullName:"Mahmut Paksoy"},{id:"222687",title:"M.Sc.",name:"Murat Emre",surname:"Yucel",slug:"murat-emre-yucel",fullName:"Murat Emre Yucel"}],corrections:null},{id:"56754",title:"Wheel-Rail Impact by a Wheel Flat",doi:"10.5772/intechopen.70460",slug:"wheel-rail-impact-by-a-wheel-flat",totalDownloads:1606,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The finite element method (FEM)-based wheel-rail rolling contact model with a fresh wheel flat was built to investigate the wheel-rail impact responses, where a comprehensive dynamic explicit algorithm was employed. Two basic dynamic effects (i.e., inertia effect and strain-rate effect) and temperature effect during the wheel-rail sliding process were considered. Influences of train speed, flat length and axle load on the wheel-rail impact responses were discussed in terms of wheel-rail impact force, von Mises equivalent stress, equivalent plastic strain and XY shear stress. Simulation results demonstrate that the FEM-based wheel-rail rolling contact model can well describe the strong nonlinearities in geometry, contact and material. The strain rate effect contributes to elevate the maximum von Mises equivalent stress and restrain the plastic deformation. The initial thermal stress can decrease the maximum von Mises equivalent stresses and maximum XY shear stresses, but can aggravate the plastic deformation. Furthermore, the flat-induced wheel-rail impact force, von Mises equivalent stress, equivalent plastic strain and XY shear stress are revealed to be sensitive to train speed, flat length and axle load.",signatures:"Lin Jing",downloadPdfUrl:"/chapter/pdf-download/56754",previewPdfUrl:"/chapter/pdf-preview/56754",authors:[{id:"199850",title:"Dr.",name:"Lin",surname:"Jing",slug:"lin-jing",fullName:"Lin Jing"}],corrections:null},{id:"59302",title:"Model-Based Fault Analysis for Railway Traction Systems",doi:"10.5772/intechopen.74277",slug:"model-based-fault-analysis-for-railway-traction-systems",totalDownloads:1367,totalCrossrefCites:1,totalDimensionsCites:5,hasAltmetrics:0,abstract:"Fault analysis in industrial equipment has been usually performed using classical techniques such as failure modes and effects analysis (FMEA) and fault tree analysis (FTA). Model-based fault analysis has been used during the last several years in order to overcome the limitations of classical methods when complex industrial equipment has to be analyzed. In railway and automotive sectors, the development and validation of new products are based on hardware-in-the-loop (HIL) platforms. In this chapter, a methodology to enhance classical FMEAs is presented. Based on HIL simulations, the objective is to improve the results of the fault analysis with quantitative information about the effects of each fault mode. In this way, the impact of the fault analysis in the design of the traction system, the development of new diagnostic functionalities and in the maintenance tasks will increase.",signatures:"Jon del Olmo, Fernando Garramiola, Javier Poza and Gaizka\nAlmandoz",downloadPdfUrl:"/chapter/pdf-download/59302",previewPdfUrl:"/chapter/pdf-preview/59302",authors:[{id:"149511",title:"Dr.",name:"Gaizka",surname:"Almandoz",slug:"gaizka-almandoz",fullName:"Gaizka Almandoz"},{id:"149644",title:"Dr.",name:"Javier",surname:"Poza",slug:"javier-poza",fullName:"Javier Poza"},{id:"235660",title:"Dr.",name:"Jon",surname:"Del Olmo",slug:"jon-del-olmo",fullName:"Jon Del Olmo"},{id:"241062",title:"Mr.",name:"Fernando",surname:"Garramiola",slug:"fernando-garramiola",fullName:"Fernando Garramiola"}],corrections:null},{id:"58986",title:"3D Digital Simulation for Material Damage Mechanism Identification in a Railway Carriage Pressure Vessel",doi:"10.5772/intechopen.73233",slug:"3d-digital-simulation-for-material-damage-mechanism-identification-in-a-railway-carriage-pressure-ve",totalDownloads:1165,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Digital simulation approaches applied to railway engineering allow to investigate different railway scenarios via 3D digital twins of real objects, motion simulation, and collision detection to identify the root causes of critical damage and estimate the most likely sources of railway accidents. In this work, a digital simulation approach is applied to a real catastrophic train accident in which a railway carriage carrying a pressure vessel collided with an obstacle that generated a cut in the pressure vessel casing. This cut initiated a liquefied petroleum gas leakage that expanded in the environment and caused the explosion and blaze responsible for human casualties. Traditional railway accident reconstruction procedures identified two potential objects accountable for the cutting of the pressure vessel casing: a wing rail and a track reference stake. Based on digital terrain models and reconstructed models of the railway carriage, 3D digital simulation scenarios were created to detect every possible collision of the pressure vessel with the infrastructure environment and investigate whether the shape of the cut in the pressure vessel wall fits the damage visible on the obstacles and whether the interference between obstacle and pressure vessel wall could generate the chip through an interaction similar to metal cutting.",signatures:"Alessandra Caggiano and Roberto Teti",downloadPdfUrl:"/chapter/pdf-download/58986",previewPdfUrl:"/chapter/pdf-preview/58986",authors:[{id:"125771",title:"Prof.",name:"Roberto",surname:"Teti",slug:"roberto-teti",fullName:"Roberto Teti"},{id:"205931",title:"Dr.",name:"Alessandra",surname:"Caggiano",slug:"alessandra-caggiano",fullName:"Alessandra Caggiano"}],corrections:null},{id:"57840",title:"Advanced Train Positioning/Communication System",doi:"10.5772/intechopen.71768",slug:"advanced-train-positioning-communication-system",totalDownloads:1644,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"In the past, in order to ensure train positioning as well as ground-to-train information exchange, railways have adopted various technologies. Over time, each new generation of equipment enriched the global information exchange but, as a consequence, necessitated higher data rate transfers. For the positioning functionality, the existing localisation systems are still limited, since most of them require an infrastructure installation with constraints such as laying equipment between the rails or having high database maintenance requirements and computational costs. Moreover, some of them accumulate errors (odometers and inertial sensors) or offer limited coverage in shadowed areas (GNSS, etc.). Currently, in railway applications, a widely used localization system is based on proprioceptive sensors embarked in the train. This on-board system is coupled to the use of balises located at ground between the rails. These balises are kilometre markers. They are used to compensate for the drift of the localization information computed using the proprioceptive sensors alone, when the train moves. The balises provide absolute localization information whenever the train passes over them. They can also provide spot communication during the short period of time when trains are passing over them. In the first part of this chapter, techniques for achieving train positioning and data exchanges between trains and infrastructure are introduced. In the second part, a new balise is proposed. Particular attention is paid to the contribution of this new solution in terms of localization error and communication performances.",signatures:"Fouzia Elbahhar and Marc Heddebaut",downloadPdfUrl:"/chapter/pdf-download/57840",previewPdfUrl:"/chapter/pdf-preview/57840",authors:[{id:"140822",title:"Dr.",name:"Fouzia",surname:"Elbahhar",slug:"fouzia-elbahhar",fullName:"Fouzia Elbahhar"}],corrections:null},{id:"57056",title:"Transmission-Based Signaling Systems",doi:"10.5772/intechopen.70617",slug:"transmission-based-signaling-systems",totalDownloads:3024,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In this chapter, we describe the principal communication systems applied to the transmission-based signaling (TBS) systems for railways. Typical examples are communication-based train control (CBTC), European Rail Traffic Management System (ERTMS), and distance to go (DTG). Moreover, to properly address some of the challenges that need to face these systems, we will provide a deep insight on propagation issues related to all the environments (urban, suburban, rural, tunnel, etc.). We will highlight all the communication-related issues and the operational as well. Finally, a detailed survey on the directions of research on all these topics is provided, in order to properly cover this interesting subject. In this research, hot topics like virtual coupling are explained as well.",signatures:"Cesar Briso-Rodríguez, Juan Moreno García-Loygorri and Lei Zhang",downloadPdfUrl:"/chapter/pdf-download/57056",previewPdfUrl:"/chapter/pdf-preview/57056",authors:[{id:"171013",title:"Dr.",name:"Cesar",surname:"Briso",slug:"cesar-briso",fullName:"Cesar Briso"},{id:"216915",title:"Dr.",name:"Juan",surname:"Moreno Garcia-Loygorri",slug:"juan-moreno-garcia-loygorri",fullName:"Juan Moreno Garcia-Loygorri"},{id:"216916",title:"Dr.",name:"Lei",surname:"Zhang",slug:"lei-zhang",fullName:"Lei Zhang"}],corrections:null},{id:"59331",title:"Application of Multicriteria Decision-Making Methods in Railway Engineering: A Case Study of Train Control Information Systems (TCIS)",doi:"10.5772/intechopen.74168",slug:"application-of-multicriteria-decision-making-methods-in-railway-engineering-a-case-study-of-train-co",totalDownloads:1311,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"In order to improve its position in the transport market railway, as a complex system, it has to fulfill a number of objectives such as increased capacity and asset utilization, improved reliability and safety, higher customer service levels, better energy efficiency and fewer emissions, along with increased economic viability and profits. Some of these objectives call for the implementation of maximum values, while some of them require minimum values. Additionally, some can be expressed quantitatively, while some, for example, customer service, can be described qualitatively through a descriptive scale of points. The application of MCDM in railway engineering can play a significant role. Therefore, the major objective of this chapter is the review of the application of MCDM methods in railway engineering. As one of the means in achieving the objectives of railways and above all the utilization of capacity are Train Control Information Systems (TCIS). Based on that, the aim of this chapter is the evaluation of the efficiency of TCIS in the improvement of railway capacity utilization through defined technical-technological indicators. The non-radial Data Envelopment Analysis (DEA) model for the evaluation of TCIS efficiency in improvement of utilization of railway capacity using the selected indicators is proposed. The proposed non-radial DEA model for TCIS efficiency evaluation in using railway capacity could be applied to an overall network or for separate parts of railway lines.",signatures:"Boban Djordjević and Krmac Evelin",downloadPdfUrl:"/chapter/pdf-download/59331",previewPdfUrl:"/chapter/pdf-preview/59331",authors:[{id:"32772",title:"Dr.",name:"Evelin",surname:"Krmac",slug:"evelin-krmac",fullName:"Evelin Krmac"}],corrections:null},{id:"59304",title:"Improving Feasibility of High-Speed Train Project: Creating Added Value",doi:"10.5772/intechopen.74288",slug:"improving-feasibility-of-high-speed-train-project-creating-added-value",totalDownloads:1451,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Infrastructure plays a significant role in increasing economic development by providing access of transportation and improving connectivity. High-speed train (HST), one of mega infrastructure projects, has a positive impact on economic development of a nation. However, the project feasibility requires the maximum value for money and an acceptable risk to attract private investors. This study aims to improve the feasibility of the project by producing a conceptual design of Jakarta-Surabaya high-speed train in Indonesia. Value engineering will be used to evaluate both technical and financial aspects of the project. The methodology uses both qualitative and quantitative approaches through a case study, in-depth interviews, and life-cycle cost analysis. The result shows an optimum route sketching for the project and potential added value to the project. It consists of the solar cell, fiber optic, tourism, and transit-oriented development. The output also generates the division of responsibility between the government and business entity during the project lifecycle regarding the project financing. The institutional scheme will regulate the position and roles for each related stakeholder that was involved in the HST project development.",signatures:"Mohammed Ali Berawi",downloadPdfUrl:"/chapter/pdf-download/59304",previewPdfUrl:"/chapter/pdf-preview/59304",authors:[{id:"207251",title:"Dr.",name:"Mohammed Ali",surname:"Berawi",slug:"mohammed-ali-berawi",fullName:"Mohammed Ali Berawi"}],corrections:null},{id:"57196",title:"Concurrent Engineering Implementation in Design-Build Railway Projects",doi:"10.5772/intechopen.71033",slug:"concurrent-engineering-implementation-in-design-build-railway-projects",totalDownloads:1292,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Design-build as a procurement method is increasingly being used in the design and construction of greenfield rail networks, and that is despite the complexities that characterise rail networks—rail infrastructure projects involves significantly more complex systems such as safety, telecommunications, signalling and electrification. One of the key drivers for this choice of procurement method for the delivery of rail networks is that the design-build contractor commits to an aggressive schedule and implements strategies to enable the works to be completed to time and cost. One of such strategies is the application of concurrent engineering principles to the design and construction works. This Chapter gives an overview of concurrent engineering as applicable to design-build rail projects, focusing mainly on the design as an activity. It identifies factors that impact the application of concurrent engineering as well as mitigations that can be applied for the successful application of concurrent engineering principles in design-build rail projects.",signatures:"Ade Ogunsola",downloadPdfUrl:"/chapter/pdf-download/57196",previewPdfUrl:"/chapter/pdf-preview/57196",authors:[{id:"206138",title:"Dr.",name:"Ade",surname:"Ogunsola",slug:"ade-ogunsola",fullName:"Ade Ogunsola"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"7573",title:"Perspectives on Risk, Assessment and Management Paradigms",subtitle:null,isOpenForSubmission:!1,hash:"799ce26efc776b46b7b9f3aedff16edc",slug:"perspectives-on-risk-assessment-and-management-paradigms",bookSignature:"Ali G. 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The purpose of a thin film is to provide distinct optical, electronic, magnetic, chemical, mechanical, and thermal properties that bulk solid materials do not possess. Depending on the materials used and the desired properties, thin films can be fabricated by various deposition processes. These include physical methods (e.g. sputtering, E-beam evaporation, pulsed laser deposition, cathodic arc deposition, molecular beam epitaxy, and evaporation), and chemical methods (e.g. chemical vapor deposition, sol-gel, spray pyrolysis, atomic layer deposition, and electroplating). Thin films are widely used for many industrial applications, including as optical coatings (antireflective, and self-cleaning coatings) for lenses, windows, and optoelectronic devices; for energy generation (e.g. thin-film photovoltaics) and storage (thin-film batteries and supercapacitors); in gas- and bio-sensors; in electronic semiconductor devices (e.g. transistors); as hard coatings on cutting tools, modules and dies; as decorative coatings; and as bio-compatible coatings for medical implants and thin-film drug delivery. The prevalence of thin films across so many fields of research leads to a rapidly evolving technology where many impactful strides to optimize deposition processes and realize novel applications have been made recently.
\r\n\r\n\tThis book intends to provide a comprehensive overview of the fundamentals, challenges, and trends in thin-film technologies, the recent advances in thin film deposition techniques, as well as the characterization and applications of thin films.
",isbn:"978-1-80356-456-2",printIsbn:"978-1-80356-455-5",pdfIsbn:"978-1-80356-457-9",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,hash:"9c10a55203c2f0f7d47c743e6cfa2492",bookSignature:"Dr. Dongfang Yang",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11484.jpg",keywords:"Thin-Film Photovoltaics, Thin-Film Batteries, Plasmonic Devices, Semiconductors, Organic Electronics, Superconductor Oxide Films, Growth Mechanisms, Epitaxy, Uniformity, Grain Size, Sputtering, Pulsed Laser Deposition",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 2nd 2022",dateEndSecondStepPublish:"March 30th 2022",dateEndThirdStepPublish:"May 29th 2022",dateEndFourthStepPublish:"August 17th 2022",dateEndFifthStepPublish:"October 16th 2022",remainingDaysToSecondStep:"2 months",secondStepPassed:!0,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Dr. Yang is a distinguished senior researcher and expert in laser materials processing, pulsed laser, and e-beam deposition of thin films. Previously affiliated with the University of Ottawa, University of Brunswick, and the University of Guelph, where he was awarded his Ph.D. degree in 1995. Dr. Yang was awarded the title of World's Top 2% Scientists by Stanford University and IAAM Scientist Award and Medal in 2021.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"177814",title:"Dr.",name:"Dongfang",middleName:null,surname:"Yang",slug:"dongfang-yang",fullName:"Dongfang Yang",profilePictureURL:"https://mts.intechopen.com/storage/users/177814/images/system/177814.jpg",biography:"Dongfang Yang received his Ph.D. in Physical Chemistry from the University of Guelph in 1995. He joined the National Research Council Canada in London Ontario in 2001 and is now a Senior Research Officer. His current research interests include laser materials processing; pulsed laser, sputtering and e-beam deposition of thin films; new materials development for energy storage devices; chemical and optical sensors development; and electrochemical studies of organic adsorption and self-assembly monolayer. He is currently serving as an editor or editorial board member for ten scientific journals and was listed among the top 2% most-cited scientists according to a Stanford study in 2020. 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Shaheer Akhtar and Hyung-Shik Shin",coverURL:"https://cdn.intechopen.com/books/images_new/6517.jpg",editedByType:"Edited by",editors:[{id:"52613",title:"Dr.",name:"Sadia",surname:"Ameen",slug:"sadia-ameen",fullName:"Sadia Ameen"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6188",title:"Solidification",subtitle:null,isOpenForSubmission:!1,hash:"0405c42586170a1def7a4b011c5f2b60",slug:"solidification",bookSignature:"Alicia Esther Ares",coverURL:"https://cdn.intechopen.com/books/images_new/6188.jpg",editedByType:"Edited by",editors:[{id:"91095",title:"Dr.",name:"Alicia Esther",surname:"Ares",slug:"alicia-esther-ares",fullName:"Alicia Esther Ares"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6656",title:"Phase Change Materials and Their Applications",subtitle:null,isOpenForSubmission:!1,hash:"9b257f8386280bdde4633d36124787f2",slug:"phase-change-materials-and-their-applications",bookSignature:"Mohsen Mhadhbi",coverURL:"https://cdn.intechopen.com/books/images_new/6656.jpg",editedByType:"Edited by",editors:[{id:"228366",title:"Dr.",name:"Mohsen",surname:"Mhadhbi",slug:"mohsen-mhadhbi",fullName:"Mohsen Mhadhbi"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6805",title:"Electrical and Electronic Properties of Materials",subtitle:null,isOpenForSubmission:!1,hash:"f6b6930e7ae9d0704f68b5c180526309",slug:"electrical-and-electronic-properties-of-materials",bookSignature:"Md. Kawsar Alam",coverURL:"https://cdn.intechopen.com/books/images_new/6805.jpg",editedByType:"Edited by",editors:[{id:"199691",title:"Dr.",name:"Md. Kawsar",surname:"Alam",slug:"md.-kawsar-alam",fullName:"Md. Kawsar Alam"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"67824",title:"Differential Diagnosis of Osteogenic Tumors in the Context of Osteosarcoma",doi:"10.5772/intechopen.85190",slug:"differential-diagnosis-of-osteogenic-tumors-in-the-context-of-osteosarcoma",body:'\nPrimary neoplasm of the bones is relatively uncommon. Among these tumors, the osteosarcoma is the commonest primary malignant tumor, comprising of approximately 35% of all bone malignant tumors, followed by others like chondrosarcoma (25%), Ewing sarcoma (EWS) (16%), and chordomas (8%). This malignant tumor can arise from any bone, mainly usually in the metaphyseal (growth plates) long bones of the extremities, but the jaw, pelvis, and ribs may be the sites of origin [1].
\nThe nomenclature of bone tumors are described in “the World Health Organization (WHO)” classification system [2]. We are adopting a table from this classification to review the pathological diagnostic criteria of these lesions. A number of variants of osteosarcoma exist, including conventional types (osteoblastic, chondroblastic, fibroblastic, telangiectatic, multifocal, parosteal, and periosteal) (Table 1) [3].
\nBenign | \nIntermediate | \nMalignant | \n
Osteoma | \nOsteoblastoma | \nLow-grade central osteosarcoma (OS) | \n
Osteoid osteoma | \n\n | Conventional OS Chondroblastic OS Fibroblastic OS Osteoblastic OS | \n
\n | \n | Telangiectatic OS | \n
\n | \n | Small cell OS | \n
\n | \n | Parosteal OS | \n
\n | \n | Periosteal OS | \n
\n | \n | High-grade surface OS | \n
\n | \n | Secondary OS | \n
WHO-based classification of osteogenic tumors of the bone.
The histological pictures of bone tumors alone are not enough to make a differentiation between osteosarcoma and benign tumors or other malignancies of the bone; therefore, radiological and clinical help is needed to make the final diagnosis of osteogenic sarcoma. Therefore, the chapter will not only address osteosarcoma but will also discuss all osteogenic tumors stepwise [1].
\nThis chapter will mainly focus on general clinical, imaging, and histopathological characteristics, which will aid in diagnosis but may add a little to advances in tumor biology or treatment of the multitude of bone tumors described in this chapter.
\nThe exact cause of osteosarcoma is unknown. However, a number of risk factors, like genetic predisposition, some existing (Paget disease, fibrous dysplasia, enchondromatosis, and hereditary multiple exostoses and retinoblastoma) bone diseases, environmental risk factors, and radiations, have been identified.
\nKeeping in mind the importance of this malignancy, it is therefore important to understand the other osteogenic tumors before reaching the importance of osteosarcoma; we will describe the differential diagnosis of osteogenic tumors in the context of osteosarcoma.
\nIt is a benign neoplasm exclusively seen in flat bone of skull and face. Microscopically it consists of the mature lamellar bone. Multiple osteomas are associated with Gardner’s syndrome (colonic polyposis). Sometimes it involves other than the skull and face, as surface lesions of parosteal type (Figure 1 and Tables 1 and 2) [4].
\nRadiological aspect of osteoma, (A) shows sharply radiodense lesions (black ring), (B) photomicrograph (H&E 40x) similar to normal cortex, revealing mature bone (arrow), with less stroma and no atypia.
Features | \nOsteoma | \nOsteoid osteoma | \nOssifying fibroma | \nParosteal osteosarcoma | \n
---|---|---|---|---|
Site and location | \nCortex of metaphysis (skull, facial bone) | \nMetaphysis | \nMetaphysis of the same bones | \nMetaphysis of long bone | \n
Age in years | \n40–60 more in males | \n10–20 more in males | \n1–70 (wide range), and more in females | \n30–60 year (older age) | \n
Clinical symptoms | \nNo pain | \nWith pain | \nNo pain | \nPain | \n
Radiology | \nWell-circumscribed radiodense and without destructive features | \nA single <1.5 cm nidus that may be radiolucent or ossified and surrounded by a reactive bone | \nWell-demarcated radiolucent in the early stages and then progressive calcification | \nContinuity with the medullary component of the parent bone is not present. Appears to be attached to the surface of the parent none | \n
Histology | \nNodular or dome-shaped, dense cortical bone Consists of dense lamellar bone with or without Haversian canals and usually without a medullary component Medullary component consists of hematopoietic or fibroadipose tissue Regular large ossicles of mature bone | \nLamellar bone with prominent osteoblastic rimming Osteoma may have focal areas of reactive bone with similar features but not cellular as compard to OO, see also (Table 3) | \nThe stroma is fibrous and more cellular Small ossicles and irregular bony trabeculae, much less mature bone Psammoma bodies | \nTumor osteoid is arranged in parallel arrays and separated by a bland fibroblastic stroma. With minimal atypia. Cartilage may be seen. Genetically, amplification of 12q13-15 seen with CDK4 and MDM2 genes. See also (Table 9) No other benign lesions seen (See Table 9) | \n
Differential diagnosis of osteoma with osteoid osteoma, ossifying fibroma, and parosteal osteosarcoma.
It is a benign tumor of medullary metaphysis origin with a <2 cm lucent nidus, encompassed by the solid periosteal reaction. The characteristic features are its association with nocturnal pain (due to release of prostaglandin via Cox-1 and Cox-2 pathway) which can be relieved by aspirin, a salicylate analgesic. Histologically it comprised of three zones, nidus, fibrovascular stroma, and mineralized sclerotic bone. The nidus is composed of interconnected newly formed blood vessels and new bone-forming cells (osteoblasts and osteoid) [5, 6, 7] (Table 3, Figure 2). These tumors should be differentiated from osteomyelitis, stress fractures, osteoblastoma, osteosarcoma, and other lesions [8, 9].
\nFeatures | \nOsteoid osteoma | \nOsteomyelitis | \nStress fracture | \nOsteoblastoma | \nOssifying fibroma | \nOsteosarcoma | \n
---|---|---|---|---|---|---|
Site and location | \nCortex of metaphysis | \nNot site specific | \nNot site specific | \nMedulla of metaphysis | \nSame bones | \nMetaphysis of long bone | \n
Age in years | \n5–30 More in males | \nAny age | \nOld age | \nMean age 20 (10–73) More in females | \nWide range (1–70) | \nOlder age | \n
Clinical symptoms | \nSevere pain | \nPain, fever | \nPain | \nNot severe pain | \nNo pain | \nPain | \n
Radiology | \nA single <1.5 cm nidus that may be radiolucent or ossified and surrounded by a reactive bone | \nBone scan demonstrates central area of reduced uptake representing an avascular area of purulent material | \nPositive findings include sclerosis, periosteal reaction/elevation, cortical thickening, and a fracture line | \nWell-circumscribed nondestructive but sometimes with secondary ABC changes Some have central nidus >2 cm The lesions are predominantly lytic, with a rim of reactive sclerosis | \nWell-demarcated radiolucent in the early stages and then progressive calcification | \nContinuity with the medullary component of the parent bone is not present. Appears to be attached to the surface of the parent noneMRI and CT are more helpful | \n
Histology | \nIrregular trabeculae of lamellar bone with prominent osteoblastic rimming Loose fibrovascular stroma See also (Table 2) | \nNo central nidus Presence of neutrophils, lymphocytes, macrophages, etc. (acute or chronic inflammatory cell infiltrate) | \nZonal pattern with central, more mature, denser bone and peripheral woven bone Cartilage with endochondral ossification may be present | \nIrregular anastomosing trabeculae of osteoid and woven bone Variable mineralization and thickness of woven osteoid trabeculae. No central maturation like nudus Intralesional hemorrhages like ABC and numerous osteoclast-like giant cells No peripheral rim of fibrovascular tissue like in nidus Epithelioid aggressive variant with large atypical epithelioid like osteoblasts may confuse with OS, but take guidance from radiology. See (Tables 2 and 4) | \nThe stroma is fibrous and more cellular Small ossicles and irregular boneTrabeculae, much less mature bonePsammoma bodies | \nTumor osteoid is arranged in parallel arrays and separated by a hypocellular fibroblastic stroma The spindle cells between bony trabeculae instead of fat and hematopoietic tissue as seen in OSLacks the fibrovascular stroma and osteoblastic rimming of osteoid osteomaMay show cartilage component. See (Tables 4– | \n
Differential diagnosis of osteoid osteoma with osteomyelitis, stress fracture, osteoblastoma, ossifying fibroma, and osteosarcoma.
Radiology of the osteoid osteoma (A) shows sharply radiodense lesions with nidus (black ring), similar to normal cortex, (B) photomicrograph (40X) of osteoid osteomas reveals irregular trabeculae of lamellar bone with prominent osteoblastic rimming and loose fibrovascular stroma (arrows).
It arises from the medullary metaphysis, but most cases arise from spongiosa of the bone. It is a rare benign tumor of the bone. These tumors are now considered in intermediated groups as they may be locally aggressive and tend to affect the axial skeleton more often than osteoid osteoma. They are less painful and have poor response with aspirin [10, 11]. These have many osteoclasts like giant cells and less rimming with osteoblasts, osteoid, and rich vascularity as compared to osteoid osteoma (Table 4, Figure 3) [6, 12, 13]. This is also called giant osteoid osteoma more than 2 cm in size; it does not have the surrounding reactive bone as compared to osteoid osteoma and is not associated with nocturnal aches [13].
\nFeatures | \nOsteoblastoma | \nOsteoid osteoma | \nOsteosarcoma | \nGiant cell tumors | \nAneurysmal bone cyst (ABC) | \n
---|---|---|---|---|---|
Site and location | \nMedulla of metaphysis | \nCortex of metaphysis | \nMetaphysis | \nMetaphysis of epiphysis | \nDiaphysis | \n
Age in years | \nMean age 20 (10–70) More in females | \n5–30 More in males | \n10–25 | \n>20 Up to 40 | \nYounger 10–20 | \n
Clinical symptoms | \nNot severe pain | \nSevere pain | \nPain | \nNo pain | \nNo pain | \n
Radiology | \nWell-circumscribed nondestructive but sometimes with ABC changes Some have central nidus >2 cm. The lesions are predominantly lytic, with a rim of reactive sclerosis | \nA single <1.5 cm nidus that may be radiolucent or ossified and surrounded by a reactive bone | \nRadiographically, osteosarcoma is poorly circumscribed with cortical destruction and evidence of periosteal reactive bone Permeative pattern of growth at the periphery | \nSoap bubble appearance | \nLytic but demarcated Both processes may have similar presentations and radiographic findings and tend to involve the vertebra | \n
Histology | \nIrregular anastomosing trabeculae of osteoid and woven bone Variable mineralization and thickness of woven osteoid trabeculae. No central maturation like nidus Intralesional hemorrhages like ABC and numerous osteoclast-like giant cells No peripheral rim of fibrovascular tissue like in nidus | \nIrregular trabeculae of lamellar bone with prominent osteoblastic rimming Loose fibrovascular stroma | \nTumor osteoid is arranged in parallel arrays and separated by a hypocellular fibroblastic stroma. Atypia is common The spindle cells between bony trabeculae instead of fat and hematopoietic tissue as seen in OS Lacks the fibrovascular stroma and osteoblastic rimming of osteoid osteoma May show cartilage component | \nSheets of giant cells and more in number and contain more nuclei Giant cell tumors contain mononuclear stromal cells | \nSmall foci of reactive osteoid may be present in aneurysmal bone cysts, which should not be confused with osteoblastoma | \n
Differential diagnosis of osteoblastoma with osteoid osteoma, osteosarcoma, giant cell tumors, and ABC.
(A) Radiology (left ankle bone) shows osteoblastoma, with well-circumscribed nondestructive but sometimes with ABC changes (ring). The lesions are predominantly lytic, with a rim of reactive sclerosis. (B) Photomicrograph (H&E 40X) showing irregular anastomosing trabeculae of osteoid and woven bone, variable mineralization, and thickness of woven osteoid trabeculae (thick arrows). Numerous osteoclast-like giant cells (thin arrow). No peripheral rim of fibrovascular tissue like in nidus.
It is a rare variant of osteoblastoma, which commonly arises from the vertebrae, long bones, and bones of jaws; it is characterized by the presence of epithelioid osteoblasts in the stroma with aggressive behavior. The tumor has propensity for local invasion and recurrence, but still no metastasis has been seen in any case in the literature [14, 15].
\nIt is the most common primary bone tumors (20%) of mesenchymal origin second to multiple myeloma; the main histologic feature of this tumor is direct production of malignant osteoid from malignant cells without normal osteogenic process through fibrous and cartilage way; the cartilage or fibrous tissue may present elsewhere or in other osteogenic portions. Malignant osteoid is the characteristic finding of all types of OSs, and it is a eosinophilic, homogenous, glassy appearing lacelike material [16, 17].
\nOsteosarcoma is very rare in young children (0.5 cases per million per year in children <5 years). However, the incidence increases steadily with age [13].
\nIt can affect all ages, but 75% appears in young age, it can affect all bones most commonly in metaphysis of long bones, and knee joint is commonly involved (60%). There is no gender difference, but males are affected more as compared to females [13].
\nThere are many morphological variants of OS with anastomosing, reticular osteoid and oval, spindled to epithelioid stromal cells. The cells may form rosettes to small sheets in different patterns. There are several subtypes of OS, which can be, differentiated on the basis of the site, degree of histological differentiation, and association with underlying disease [12, 13, 16, 17].
\nThis type of OS shows the male predominance and bimodal age, pediatric and adult sarcoma. It has some association with hereditary effect, e.g., with mutation of RB gene, Li-Fraumeni syndrome, Ollier disease, fibrous dysplasia, and Paget disease (secondary OS). Radiation also plays a role in its pathogenesis. The long bones are commonly involved showing classical “Codman triangle” to moth-eaten picture due to permeation and destruction of medullary as well as cortical bone on radiology [18, 19].
\nIt is composed of hyperchromatic cells forming sarcomatous component around the classical osteoid (Figure 4). This comprised of chondroblastic OS (25%), fibroblastic OS (25%), and osteoblastic OS (50%). Other subtypes are small cell-type OS, giant cell-rich OS, telengiactatic-type OS, surface-type OS, periosteal OS, and parosteal OS. Histologically it has two grades, low- and high-grade OS. Immunohistochemistry has some role in its differentiation from cartilage and other bone tumors, i.e., ALK, VIM, variable SMA, and desmin. The S100 is always negative except there is chondroid differentiation. EMA and keratin are negative in tumors [16, 20, 21, 22, 23].
\nRadiological examination (A) showing intramedullary OS of left lower tibia with osteolytic and sclerotic lesion in lower end above ankle joint (rings). There is a medullary and cortical destruction of bone. The photomicrograph of (B & C) (40X with H&E) based characteristic of conventional osteosarcoma, is the identification of osteoid (arrows), which is a dense, pink, amorphous extracellular material containing large amounts of collagen type I. (C) The tumor cells (atypical osteoblast) and cytoplasm are eosinophilic, are larger than normal osteoblasts (arrows), and vary in size with nuclear atypia.
Sometime fracture callus may be confused with OS, because there is formation of spindle cells and cartilage with new bones, but all these elements are arranged with orderly maturation as compared to haphazard and abrupt arrangement in OS (Table 5). Postmenopausal women may have insufficiency fractures in the pelvis resembling metastatic carcinoma [24, 25].
\nFeatures | \nConventional osteosarcoma (NOS) | \nFracture callus | \nEwing’s sarcoma | \nGiant cell tumors (GCT) | \nChondroblastoma | \n
---|---|---|---|---|---|
Site and location | \nLong bone | \nNot specificCan be of any site and any bone | \nMedulla of diaphysis and metaphysis | \nMetaphysis and epiphysisRarely in vertebrae body | \nEpiphysis | \n
Age in years | \n10–25 | \nAny age | \nChildren 4–20 | \n>20 up to 40 | \nYounger age 10–30 | \n
Clinical symptoms | \nPain | \nMay be pain | \n\n | No pain | \nPain | \n
Radiology | \nRadiographically, osteosarcoma is poorly circumscribed with cortical destruction and evidence of periosteal reactive bone Permeative pattern of growth at the periphery | \nThere may be increased translucency of the fracture during this stage, due to bone resorption | \nMetaphyseal or diaphyseal tumor with a predominantly lytic appearance. No bone matrix is radiographically identified Onion skin appearance in ES on radiology | \nSoap bubble appearance | \nSharp and lytic lesions Fine calcification | \n
Histology | \nTumor osteoid is arranged in parallel arrays and separated by a hypocellular osteoblastic stroma. Atypia and mitosis are commonThe small cells between bony osteoid. CD99, LCA, CK, and S-100 are negative | \nThere is spindle cell proliferation with cartilage and bone, but orderly maturation is present in fracture callus and stress fractures | \nSmall round blue cells with regular size, primitive-appearing cellst(11;22)(q24;q12) chromosome rearrangementand CD99+ve | \nSheets of giant cells and mononuclear stromal cells | \nBenign-appearing chondrocytes, without osteoid differentiationNuclear groovesChicken wire vascular stroma | \n
Differential diagnosis of conventional osteosarcoma (NOS), fracture callus, Ewing?s sarcoma, GCT, and chondroblastoma.
The osteoid and maturation level are the main difference between two lesions. The osteoid of the callus woven bone is mature and shows a parallel pattern with prominent osteoblastic rimming. Malignant osteoid is a eosinophilic, amorphous, fibrillary deposit between individual tumor cells or group of tumor cells. There are two types of tumor osteoid, early-tumor osteoid, lacelike pattern around tumor cells, and late-tumor osteoid, a mineralized one having an appearance of a woven bone, but an important feature is that tumor osteoid is not rimmed by osteoblasts [16].
\nOsteomyelitis is an important cause of morbidity and mortality in children and adults due to acute and chronic bacterial infection. More common sites are the metaphysis and epiphysis of the lower limbs and vertebrae [26, 27, 28].
\nPrimary (hematogenous) osteomyelitis is associated with fever and local painful mass and may have fistula formation. A history of recent trauma with open fracture is significant for secondary osteomyelitis. The radiology and MRI are more helpful in the diagnosis of these lesions [26]. The C-reactive protein and erythrocyte sedimentation rate (ESR) are markedly elevated. Biopsy shows necrotic bone, fibrotic marrow, and chronic inflammation with or without an acute inflammatory component. Reactive bone is usually produced as part of an associated periosteal reaction, readily differentiated using histological features [24] (Table 6).
\nIt is a benign osteoid-producing tumor with roughly the same age and sex distribution as osteosarcoma. In conventional radiography, there is a well-defined round expansile mass with central radiolucent zone (>1.5 cm) and a peripheral rim of sclerosis (sclerosis may not be as extensive as in osteoid osteoma). On biopsy, there is an irregular interlacing network of osteoid with prominent osteoblastic rimming and features of woven bone; the differential diagnosis from OS is sometimes difficult when the OS is well differentiated and OB is showing bizarre osteoblasts due to degenerative activities [24] (Table 4).
\nABC has the same age range and location as osteosarcoma. It presents with pain and occasional pathological fracture. Secondary aneurysmal bone cysts can be seen in older patients, superimposed on other primary neoplasms. Conventional radiographs show radiolucent expansile bone lesion. MRI shows fluid levels on T2-weighted images. Biopsy can differentiate from telangiectatic osteosarcoma (TOS), which displays obvious histological features of malignancy (marked cellular pleomorphism, high and abnormal mitotic activity) (Figure 5) [24, 29] (Table 7).
\n(A) Radiological examination of telangiectatic osteosarcoma revealing a lytic/expansile, (ring) permeative lesion in the proximal fibula metaphysis with a wide zone of transition and cortical destruction, (B&C) histological examination of the photomicrographs (B; 5X and C; 400X, H&E) blood-filled spaces (thin arrows), separated by septa containing highly malignant cells (small arrows).
It is a nonneoplastic intramedullary condition, associated with two forms, monostotic (seen in the ribs, femur, and tibia in young adults) and polyostotic (endocrine dysfunctions). The presentation of polyostotic fibrous dysplasia commonly includes bone deformity and pathological fracture. It has wide age range at presentation and no gender preference. The radiographs show a fusiform expanded swelling with thinning of cortex not associated soft with tissue mass. There are generally no aggressive radiographical features. Pathological fracture may be seen [24].
\nMicroscopically, there are curved and irregularly shaped trabeculae-like fishhook configuration. These are interspersed in fibrous stroma of variable cellularity. These poorly moralized bony trabeculae have no rimming of osteoblasts, and cartilaginous islands are present in 10% of cases [30].
\nIt should be differentiated from other bony lesions, cemento-ossifying fibroma (rimming of osteoblast), chondrosarcoma (binucleation), Paget’s disease (mosaic pattern bone histologically), non-ossifying fibroma (metaphyseal fibrous defect in tibia with the absence of osteoid), simple bony cyst, and osteofibrous dysplasia/ossifying fibroma (exclusively seen in the tibia almost, with anterior bowing of the bone, in the cortex; rimming is seen around lamellar bony trabeculae) [30].
\nSome immunomarkers are helpful in the diagnosis of FD. Fibroblastic cells in FD and ossifying fibroma show strong Runx2 expression in the nucleus, while osteocalcin is seen in calcified regions in FD, and G protein genes (GNAS) are positive in extragnathic FD. FD shows GNAS (G protein gene) mutation not seen 15 in other lesions. FD is negative for osteocalcin [31, 32] (Table 6).
\nIt is the second commonest primary malignant bone tumor of the childhood after osteosarcoma. It typically arises from the medullary cavity and invades the Haversian system. Radiologically, It presents as moth-eaten and destructive permeated lucent lesions in the shaft of the long bones. It appears typical onionskin appendence due to periostitis. It may also involve flat bones and appears sclerotic in up to 30% of cases [33].
\nSame age range and predilection for males. Type II symptoms (e.g., fever, night sweats) are usually seen. Conventional radiographs show a metaphyseal or diaphyseal tumor with a predominantly lytic appearance. No bone matrix is radiographically identified. Onionskin appearance in ES on radiology. MRI shows a large soft tissue mass.
\nBiopsy shows small round blue cell tumor with no osteoid production. Cytogenetic and/or molecular studies show the typical translocations/molecular aberrations of Ewing sarcoma family of tumors and help rule out small cell osteosarcoma (a rare subtype of osteosarcoma with very little osteoid production). CD 99 is positive in EWS [6, 33] (Table 5).
\nThe GCT is usually benign and arises from long bone epiphysis and metaphysis. It is rare in vertebrae, but when they occur in a vertebra, the body and not the arch is usually involved [35]. The pathogenesis of GCT is accredited due to overexpression of a tumor necrosis factor receptor (RANK/RANKL) which results in a hyper-proliferation of osteoclasts [16]. Histologically, the GCTs are characterized by the presence of osteoclast-like, giant cells and round-to-oval polygonal mononuclear cells. Frequent mitotic figures in the mononuclear cells may be seen, especially in pregnant women or those on the oral contraceptive pill (due to increased hormone levels) [16, 35]. Important features are given below (Table 5).
\nThis lesion is most common in skeletally mature women with closed epiphysis which usually presents with bone pain and sometimes pathological fractures. It involves epiphysis and extends to joint articular cartilage. Conventional radiographs show tumor with an osteolytic appearance located in the epiphysis of long bones, with the distal femur and proximal tibia being the most commonly affected. No doubt it is benign but is locally aggressive. This translates radiographically into the absence of an osteosclerotic rim at its periphery as well as the presence of a soft tissue mass. No bone/osteoid formation is identified. Radiology is soap bubble appearance. Biopsy shows typical appearance of evenly distributed giant cells in a mononuclear stroma. The nuclei of the giant cells resemble the nuclei of the histiocytes. There is atypia or mitosis, potentially malignant with 50% recurrence rate and 10% metastasis [32].
\nThese are rare manifestation than secondary lymphoma involving the bone. It is rare, accounting for <5% of bone tumors and <1% of non-Hodgkin lymphoma. It is more common in old age males as compared to OS. The patient presents with type II general symptoms like night sweatings, fever, and weight loss. The conventional radiographs may be normal (tumor cells tend to grow between patient’s bony trabeculae with little bone destruction). There may be multiple or single bone involvement. MRI shows focal change in the marrow signal. Bone marrow biopsy is usually the confirmatory test. Flow cytometric studies should be considered in patients suspected of having lymphoma. Leukocyte common antigen (LCA) is positive in lymphomas while negative in OS [24, 36]. Usually it should be differentiated from infections, small cell OS, Ewing’s sarcoma, eosinophilic granuloma, and metastatic lesions [36, 37].
\nIt is a multisystem but rare disease. It is associated with a wide and heterogeneous clinical spectrum and extent of multisystem involvement. The age range is 5–15 years, more common in the children and early teens. The males are more affected than females (M/F ratio is 3:2) [38, 39]. It has a predilection for the bones of the skull, the calvarium, but any other bone like the humerus, femur, and ribs can be involved. There is local pain and swelling. Radiographically there are multiple lytic lesions with significant periosteal reaction. Biopsy shows a proliferation of neoplastic Langerhans cells in an inflammatory background [24] (Table 6).
\n\nFeatures | \nOsteosarcoma | \nOsteomyelitis | \nLangerhans granuloma | \nFibrous dysplasia | \n
---|---|---|---|---|
Site and location | \nLong bone | \nEpiphysis (neonates) Metaphysis (children) | \nMetaphysis or diaphysis | \nMedulla of diaphysis | \n
Age in years | \n10–25 | \nAny age, more in children | \nMore common in children 5–15 years | \n1–30 years > males | \n
Clinical symptoms | \nPain | \nPain, fever, discharges | \nLocal pain | \nNo pain | \n
Radiology | \nRadiographically, osteosarcoma is poorly circumscribed with cortical destruction and evidence of periosteal reactive bone Permeative pattern of growth at the periphery | \nThe earliest radiological changes are seen in adjacent soft tissues +/− muscle outlines with swelling and loss or blurring of normal fat planes. An effusion may be seen in an adjacent joint. MRI is more helpful | \nMultiple lytic lesions with significant periosteal reaction | \nThe conventional radiographs show ground glass appearance with no associated soft tissue mass. There are generally no aggressive radiographical features | \n
Histology | \nTumor osteoid is arranged in parallel arrays and separated by a hypocellular fibroblastic stroma. Atypia is common The spindle cells between bony trabeculae instead of fat and hematopoietic tissue as seen in OS Lacks the fibrovascular stroma and osteoblastic rimming of osteoid osteoma May show cartilage component | \nIn acute cases, neutrophils and necrotic bony trabeculae, in TB, granulomas, and in chronic nonspecific cases, lymphocytes and macrophages are more common | \nThere is monoclonal proliferation of Langerhans cells (distinctive cells of monocyte–macrophage lineage) and should be considered a malignancy although its biological behavior is very variable. EM shows Birbeck granules. Express CD1a, S100, HLA-DR | \nThere is large fibrous matrix with scattered curvilinear irregularly shaped trabeculae of immature, inadequately mineralized bone. There is no rimming by osteoblasts GNAS +ve, osteoclastin +ve Run-X-2 +ve, see also (Table 9) | \n
Differential diagnosis of osteosarcoma, with osteomyelitis, Langerhans granuloma, and fibrous dysplasia.
Generally it occurs in older age group than osteosarcoma. There is usual history of a primary malignancy known to metastasis to bone, such as breast, lung, thyroid, kidney, and prostate. Conventional radiographs and radionuclide scans usually show osteolytic lesions (rarely osteoblastic) involving multiple bones. CT imaging may reveal other organs affected by metastatic disease. Biopsy usually confirms the diagnosis [35].
\nIt is an uncommon variant of OS in the second decade with a mean age of 20 years. It comprises of 2.5–12% of all osteosarcomas. Almost all osteosarcomas have telangiectatic component. In order to diagnose telangiectatic osteosarcoma, there should be more than 90% component with telangiectatic features. It is more common in males like conventional OS (with a ratio of 2:1 for male to female) [24] better than conventional OS [13].
\nMultiple cyst-like spaces resemble an aneurysmal bone cyst, except that the septa of the cysts contain stromal cells (mononuclear and multinucleated) with cytologically malignant changes. Mitotic figures are present, including atypical forms. Sometimes the malignant stromal cells are floating in the center of the large hemorrhagic cysts; identification of the stromal cells may be difficult, requiring multiple sections. The TOS may arise in other bony diseases like fibrous dysplasia, Paget’s disease, or postradiation therapy. Malignant osteoid can be difficult to identify, usually focal and found in a delicate lacelike pattern [24, 40] (Figure 5 and Table 7).
\nFeatures | \nTelangiectatic osteosarcoma (TOS) | \nConventional OS | \nAngiosarcoma | \nABC | \nGiant cell tumors | \n
---|---|---|---|---|---|
Site and location | \nMetaphysis | \nMetaphysis | \nNot specific | \nMetaphysisFlat bones, vertebrae, long bones | \nMetaphysis of epiphysis | \n
Age in years | \nMean age 20 years | \n10–25 | \nOld age | \nYounger 10–20, slightly more in females | \n>20 up to 40 | \n
Clinical symptoms | \nDull pain | \nDull pain | \nNo pain | \nNo pain | \nNo pain | \n
Radiology | \nLytic bony lesions, geographic bony destruction with wide zone of transition tends to be more common than permeative bony destruction | \nSclerotic lesions and cortical destruction | \nSoft tissue mass | \nLytic but demarcated Both processes may have similar presentations and radiographic findings and tend to involve the vertebraCT and MRI show fluid level | \nSoap bubble appearance | \n
Histology | \nIt is consist of vascular sinusoids surrounded by thin septae, osteoid matrix and cells with significant pleomorphism and high mitotic rate | \nMalignant osteoblasts and malignant osteoids IHC:SATB2 and AKP are positive, TP53 alteration and MDM2 amplification | \nBlood vessels are lined by malignant endothelial cells | \nSmall foci of reactive osteoid may be present in aneurysmal bone cysts, which should not be confused with osteoblastomaIHC shows rearrangement of USP6, gene present of Ch 17,t(16;17)(q22;p13). Fusion of USP6 with CDH11 | \nSheets of giant cellsand mononuclear stromal cells. Sometimes, may appear with blood-filled spaces | \n
Differential diagnosis of telangiectatic osteosarcoma (TOS) and, conventional osteosarcoma, angiosarcoma, ABC, and GCT.
Note: ABC; Aneurysmal bone cyst, GCT; Giant cell tumors, OS; Osteosarcoma, IHC; Immunohistochemistry, Ch; chromosome.
The aneurysmal bone cysts are usually seen in young age with slight female preponderance in flat and vertebral areas but may involve long bones. Radiology shows a lucent expansile lesion in the metaphysis of long bones with thin reactive covering of periosteal bone. CT and MRI show some fluid levels in the ABC. Microscopically, thin blood filled spaces. These spaces are not lined by endothelium but only fibroblastic cells are there. The stroma of the ABC may be cellular but typically lacks cytological atypia and atypical mitoses and may contain reactive bone with atypical osteoblasts. Cytologic malignant features and atypical mitoses are absent (Figure 6, Table 7).
\n(A) Radiological examination reveals (ring) homogenous cystic areas (aneurysmal bone cyst) without cortical destructions. (B) Photomicrograph (H&E 10X) revealing cystic lesions (arrow), with giant cells (red arrow) separated by fibrous septa (black arrows), alternating with solid areas and septa lined by fibroblasts, myofibroblasts, and histiocytes but not endothelium (C).
Radiographically, these tumors are not purely lytic. Intramedullary osteosarcoma may contain focal telangiectatic areas, which should not be overinterpreted (Table 8).
\n\nFeatures | \nOsteosarcoma | \nMFH | \nLymphoma | \nOsteoblastoma | \n
---|---|---|---|---|
Site and location | \nMetaphysis of long bone | \nMetaphysis of the long bones | \nMetaphysis | \nMetaphysis | \n
Age in years | \n10–25 | \n10 to 60, commonly seen in the second decade | \n50–60 | \nYounger age and more in females 10–30 | \n
Clinical symptoms | \nPain | \nDull pain but may be associated when arising from other primary bone lesions, like Paget’s disease, radiation, giant cell tumor, and bone infarction | \nLocalized pain and swelling | \nPain | \n
Radiology | \nRadiographically, osteosarcoma is poorly circumscribed with cortical destruction and evidence of periosteal reactive bone Permeative pattern of growth at the periphery | \nPurely osteolytic permeative lesions without a periosteal reaction and without mineralization | \nThe most common is a lytic pattern with permeative bone destruction and a wide zone of transition | \nWell-defined lytic lesions | \n
Histology | \nTumor osteoid is arranged in parallel arrays and separated by a hypocellular fibroblastic stroma. Atypia is common The spindle cells between bony trabeculae instead of fat and hematopoietic tissue as seen in OS Lacks the fibrovascular stroma and osteoblastic rimming of osteoid osteoma May show cartilage component | \nNo extensive osteoid formation. Some osteoid osteogenic sarcomas may have a predominant histologic pattern of malignant fibrous histiocytoma; the presence of osteoid formation requires the diagnosis of osteosarcoma They are heterogeneous fibroblastic tumors formed by poorly differentiated fibroblasts, myofibroblasts, histiocyte-like cells with high degree of pleomorphism and characteristic storiform pattern and also demonstrating bizarre multinucleated giant cells Run-X-2 negative | \nDLBCL is the most common subtype. The bony pelvis and femur are the most common locations | \nThey manufacture abundant osteoid, but they are not composed of atypical and pleomorphic osteoblasts | \n
Differential diagnosis of osteosarcoma with malignant fibrous histiocytoma, lymphoma, and osteoblastoma.
DLBCL; Diffuse large B cell lymphoma, MFH; Malignant Fibrous Histiocytoma.
The low-grade OS is a rare subtype of osteosarcoma, usually occurring in young adults in their tibia and femur. Microscopically, there may be components of heavy osteoid and fibrocollagenous stroma, and the cells appear benign but with invasion of cortex and surrounding soft tissue. The spindle cells are with mild atypia, marked collagen production, scant atypia, and abundant osteoid production (Figure 9). The patients present with pain and swelling in older people. It arises from metaphysis of long bone of lower extremity, while other sites are uncommon. Radiologically, there are irregularly sclerotic lesions with poorly defined sclerotic margins, and mineralized matrix is common (Figure 7A–C).
\n(A) Radiological examination showing medullary and cortical bone destruction wide zone of transition (ring and arrow), permeative or moth-eaten appearance. (B) Photomicrograph of (10X H&E) of conventional
Chondroblastoma is a rare primary bone tumor of young people that typically arises at the ends of the long bones. Radiologic investigations show a small, circumscribed, lytic lesion. The tumor is characterized histologically by the proliferation of chondroblasts along with areas of mature cartilage, giant cells, and, occasionally, secondary aneurysmal bone cyst formation. Chondroblastoma, however, may also present with atypical features, such as prominent hemosiderin deposition, numerous giant cells, or the presence of a large aneurysmal bone cyst component.
\nA rare variant of osteosarcoma with CB features may be seen and can be difficult to distinguish from CB, as both tumors can present in young patients as a lytic lesion in an epiphyseal location. Histologically, this OS may reveal small round-oval cells with eosinophilic cytoplasm and scattered giant cells and therefore may cause confusion with CB, especially on a small biopsy specimen. Clues to the appropriate malignant diagnosis include a more aggressive, infiltrative lesion on radiological studies, and the presence of nuclear atypia, atypical mitoses, and/or malignant osteoid production on histologic examination (Table 5).
\nIt is usually seen in young ages (10?30 years) and more common in males. It is commonly found in metaphysis, diaphysis of ribs, jaw, skull, tibia, and femur. It is locally aggressive tumor and may be monostotic or polyostotic and associated with endocrine disorders. Radiologically, it is circumscribed radiolucent lesions, within the medullary cavity.
\nThere are irregularly shaped bony trabeculae without rimming of osteoblasts.
\nThe osteoids are of mature woven bones, and irregular in FD, while mature osteoids are present in WDIOS. There is no cortical destruction on X-rays seen in FD, while there are irregularly sclerotic lesions with poorly defined sclerotic margins. The mineralized matrix is common in WDIOS while lacking in FD (Tables 6 and 9).
\nUsually seen in young persons, it is a benign lesion. Microscopically, no osteoid and bony trabeculae but only storiform spindle stroma, giant cells, and hemosiderin-laden microphages are seen. Radiologically, these are eccentric sharply defined lytic lesions in metaphyseal cortex in young people.
\nThis infrequent variant occurs in a juxtacortical position in the metaphyses of long bones and grows very slowly. It grows, as a lobulated mass around the bone shafts as a low-grade malignant bone tumor with well-formed bony trabeculae, osteoid, variable cartilage, and highly fibrous spindle cell stroma in disorganized manner. In some cases there may be hypocellularity, but there is always mild atypia in the stroma. These tumors have a slight female predominance, with a male-to-female ratio of 1:1.5, and occur predominantly in the third decade. About three fourths of cases involve the distal posterior femur, with the proximal tibia as the second most common site. Clinically it presents as a painless mass of long duration; pain may occur late in the course of this tumor but is not evident initially. Microscopically, there is disorderly arrangement of well-formed bony trabeculae and osteoid and exceptionally osteoclast-like giant cells. There are spindle-shaped stroma with mild atypia and variable amount of cartilage (
X-ray of parosteal osteosarcoma (ring) showing surface-attached mass (A). Photomicrograph (H&E 20X) revealing continuously branching bony trabeculae (thick arrow) with spindle cell proliferation of malignant cells (thin arrow) (B and C).
It is a benign disorder where the medullary spaces contain adipose tissue or marrow hematopoietic tissue with cartilaginous cap. The bony trabeculae are normally arranged as compared to the PAOS.
\nThe myositis ossificans (MO) is distinguished from PAOS by its orderly pattern of maturation. Radiologically, things appear inverse in the MO as compared to PAOS. There is the dense ossification in the center in MO and opaque bone at the periphery, making it eggshell in appearance. Histologically there is zonal arrangement. Maturation toward lamellar bone and marrow adipose tissue begins peripherally and extends centrally in this proliferative process, which is the reverse in parosteal osteosarcoma [41].
\nThe osteochondroma shows continuity of corticomedullary areas of the tumor and the underlying medullary canal, but these features are lacking in PAOS. Medullary spaces contain adipose tissue or marrow hematopoietic tissue, cartilaginous cap.
\nAbundant cartilage is present. Higher-grade osseous component and evidence of periosteal reaction.
\nThis malignant bone tumor is commonly seen in routine biopsies, entirely different from PAOS (juxtacortical OS) despite its similarity with terminology. It arises on surface of long bones (upper tibia and femur). The PEOS affects a slightly older age group (10–20 years) as compared to conventional osteosarcoma. Malignant osteoid must be present, but the predominant pattern of tumor is represented by lobulated chondromatous tissue with cytologic features of grade 2 or 3 chondrosarcoma. Tumor is located on the surface of the bone and may extend into soft tissue. The lesions are limited to the cortex and rarely invade the medullary cavity. The tumor appears perpendicular to the shaft. Sometimes high-grade anaplastic sarcomatous spindle cell component may separate lobules of the malignant chondroid component [24] (Figure 9 and Table 10) [20, 42].
\nX-ray of periosteal osteosarcoma (ring) showing broad-based lesion thickening of cortical areas of the femur (A). Photomicrograph (H&E 40X) revealing bony trabeculae with spindle cell proliferation (arrow) of malignant cells and cartilage (red arrow) differentiation (B and C).
Features | \nPAOS | \nCOS | \nPEOS | \nOsteochondroma | \nMyositis ossificans | \nParosteal lipoma | \n
---|---|---|---|---|---|---|
Site and location | \nMetaphysis | \nMetaphysis | \nMetaphysis | \nMetaphyseal | \nNOS | \nNOS | \n
Age in years | \n10–25 | \n10–25 | \n10–25 | \n10–30 | \nAny age | \nAny age | \n
Clinical symptoms | \nDull pain | \nDull pain | \nDull pain | \nNo pain | \nPain | \nNo pain | \n
Radiology | \nRadiodense, bosselated, or mushroom-shaped mass arising on the surface of a bone; in long-term lesions, tumor may encircle the bone | \nDiffuse cortical destruction like Codman’s triangle, osteoblastic features | \nBroad-based surface soft-tissue mass causing extrinsic erosion of thickened underlying diaphyseal cortex and perpendicular periosteal reaction extending into the soft-tissue | \nMetaphyseal lesions grow in direction opposite to adjacent joint. Cortex and medulla are continuous with underlying bone | \n\n | Lytic lesions without bony destructions | \n
Histology | \nTumor osteoid is arranged in parallel arrays and separated by a hypocellular fibroblastic stroma that exhibits minimal cytologic atypia and minimal mitotic activity without atypical forms | \nThis is a higher-grade osteosarcoma involving the medullary cavity. Periosteal osteosarcoma does not involve the medullary cavity | \nOsteosarcoma with prominent cartilaginous component. The cartilage in lobules with peripheral spindling and central bone formation. Little no. of mitosis Malignant osteoid/bone is present but may be focal | \nBony trabeculae appear normal | \nOrderly maturation, not attached to underlying bone; more active histologically | \nLipocytes, no osteoid | \n
Differential diagnosis of parosteal osteosarcoma, conventional osteosarcoma, periosteal osteosarcoma, osteochondroma, myositis ossificans, and parosteal lipoma.
Note: Parosteal Osteosarcoma, PAOS; Conventional Osteosarcoma, COS; Periosteal osteosarcoma, PEOS.
Features | \nWD intramedullary OS | \nPAOS | \nCOS | \nPEOS | \nFibrous dysplasia | \n
---|---|---|---|---|---|
Site and location | \nMetaphysis | \nMetaphysis | \nMetaphysis | \nMetaphysis | \nMedulla of diaphysis. | \n
Age in years | \n10–20 | \n10–25 | \n10–25 | \n10–25 | \n1–30 years > males | \n
Clinical symptoms | \nPain and swelling, patients older | \nDull pain | \nDull pain | \nDull pain | \nNo pain | \n
Radiology | \nIrregularly sclerotic lesions with poorly defined sclerotic margins, mineralized matrix common | \nRadiodense, bosselated, or mushroom-shaped mass arising on the surface of a bone; in long-term lesions, tumor may encircle the bone | \nDiffuse cortical destruction like Codman’s triangle, osteoblastic features | \nBroad-based surface soft-tissue mass causing extrinsic erosion of thickened underlying diaphyseal cortex and perpendicular periosteal reaction extending into the soft-tissue | \nThe conventional radiographs show ground glass appearance with no associated soft tissue mass. There are generally no aggressive radiographical features | \n
Histology | \nHeavy osteoid component, fibrocollagenous stroma with minimal atypia | \nTumor osteoid is arranged in parallel arrays and separated by a hypocellular fibroblastic stroma that exhibits minimal cytologic atypia and minimal mitotic activity without atypical forms | \nThis is a higher-grade osteosarcoma involving the medullary cavity. Periosteal osteosarcoma does not involve the medullary cavity | \nOsteosarcoma with prominent cartilaginous component. The cartilage in lobules with peripheral spindling and central bone formation. Malignant osteoid/bone is present but may be focal | \nThere is large fibrous matrix with scattered curvilinear irregularly shaped trabeculae of immature, inadequately mineralized bone. There is no rimming by osteoblasts differentiating feature from cement-ossifying fibroma. Cartilaginous islands are present in 10%, differentiating feature from chondroblastoma | \n
Differential diagnosis of WD intramedullary osteosarcoma, parosteal osteosarcoma, conventional OS, periosteal osteosarcoma, and fibrous dysplasia.
Note: Well-differentiated intramedullary osteosarcoma (WDIOS), parosteal osteosarcoma (PAOS), fibrous dysplasia (FD), conventional osteosarcoma (COS).
It is usually smaller and better defined and composed of benign chondroid tissue and does not contain malignant tumor osteoid [24].
\nRadiographically, it contains “popcorn” calcifications, and histologically, it is a low-grade chondrosarcoma containing no tumor osteoid [20, 24].
\nRadiographically, this tumor is more radiodense, and histologically this is a low-grade malignant fibro-osseous tumor without chondroid differentiation [20, 24].
\nThis is a higher-grade osteosarcoma involving the medullary cavity. Periosteal osteosarcoma does not involve the medullary cavity [24].
\nThis is a high-grade osteosarcoma with similar histological features to those of conventional intramedullary osteosarcoma. The tumor grows on the surface and lacks significant medullary involvement. Radiographically it mimics periosteal osteosarcoma, except it has cumulus cloud-like patterns of mineralization. It is a large, lobulated surface mass with variable consistency ranging from soft to firm and may contain hemorrhagic areas. It should not significantly involve the medullary region [13, 24].
\nIt usually has residual low-grade malignant fibroblastic stromal component. Parosteal osteosarcoma lacks high-grade anaplastic appearance [12, 24].
\nSignificant medullary component (minimal medullary component in a high-grade surface osteosarcoma) [24].
\nOsteosarcoma (OS) is a high-grade malignancy of the bone with high-mortality rate. The exact cause of the condition is unknown, and presently, it is not possible to prevent an osteosarcoma occurrence. It is mainly divided into two types, primary and secondary, based on etiology, while based on where they occur, osteosarcoma is classified as medullary osteosarcoma (occurring in the bone cavity) and surface osteosarcoma (occurring on the bone surface). OS has a bimodal age distribution, having the first peak during adolescence and the second peak in older adulthood, while a little bit more common in males. Some genetic mutations, like mutation of RB and P53 genes, are associated with osteosarcoma. Radiation affected persons, patients of Paget’s disease of the bone, fibrous dysplasia, osteoblastoma, Ollier disease, and chemotherapy, are other conditions and disorders that are thought to be associated with Osteosarcomas. The tumor grows slowly in the initial phase of the tumors and may be asymptomatic. Then tumors grow at a moderate rate, and then they suddenly start to rapidly progress. Pathological fractures are commonly seen in long bones.
\nThree parameters are used for its diagnosis, physical examination with medical history, radiological support (X-rays, CT, MRI), and biopsy for microscopic examination. To approach the remedy of patient, grading and staging with good differential diagnosis are very important to save the life of the patient.
\nNone.
\nNil.
\nRacial or ethnic minorities (REM) in the United States (US) are particularly vulnerable to experiencing mental illness. The US Census Bureau describes the term “race” as people who identify as “White, Black or African American, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, or Other Race” and ethnicity as “Hispanic or Latino or “Not Hispanic or Latino.” [1]. While REM report the lowest lifetime risk of mental illness and fewer psychological concerns as compared to non-Hispanic Whites, they are more likely to experience persistent illness [2]. For example, experiences of depression among Blacks and Hispanics are reported as lower than Whites, yet Blacks and Hispanics indicate more persistent symptomatology. In a 2020 screening for most prevalent mental health concerns of Americans (
Social determinants of health (e.g., health disparities, racial discrimination, racialized violence) exacerbate REM’s experiences of mental illness as well as their access to treatment and services [2, 3, 5, 7]. REM are also least likely to access culturally competent care and when they do seek the treatment they are improperly assessed, misdiagnosed, and receive poor care [6, 7, 8]. And thus, when REM seek treatment it is essential that counselors are culturally competent and use culturally appropriate interventions. Practitioners are trained and encouraged to utilize evidence-based treatments (EBTs), demonstrated in eliciting therapeutic change in providing care and treatment to their clients [9]. The cultural relevance of EBTs is debated and prescriptive clinical practice is criticized; some practitioners argue for more inclusive and culturally sensitive use of EBTs [10, 11]. Like most EBTs, the efficacy of mindfulness-based interventions has been investigated primarily on White people. Mindfulness-Based Stress Reduction (MBSR) is an evidence-based intervention shown to reduce stress for a few REM groups [12, 13]. A culturally adapted MBSR program has the potential to treat REM suffering from mental health conditions and improve quality of life.
REM are particularly vulnerable to experiencing mental health conditions. In the year 2020, about 331.4 million people live in the US and the racial or ethnic statistics show a composition where 61.6% identify as White, 18.7% as Hispanic or Latino/a, 12.4% as Black or African American, 10.2% as two or more races, 6% as Asian, 1.1% as American Indian/Alaska Native, and 0.2% as Native Hawaiian/Other Pacific Islander [1]. Though there are more people who identify as White than all REM groups combined, research suggests that REM are at a significantly higher risk of experiencing mental health conditions in part due to the impact of social determinants of health [8, 14].
The Hispanic or Latino population differs in ethnicity and culture, which makes this population unique. Skin tones vary considerably, and it is not uncommon for non-Hispanic or -Latino/a people to confuse someone of Hispanic descent, as being White American or African American. Because of the significant differences, it is important to understand that while all Hispanics may encounter mental health disparities some groups of Hispanics are affected at even greater rates than others. Overall little difference in the prevalence of mental health disorders exists between Hispanic or Latinos/as and non-Hispanic Whites. One major issue Hispanic children grapple with is suicidality. Hispanic youth are more likely to consider, plan, and attempt suicide than both Black and White youth [15]. However, when comparing Hispanics born in the US with Hispanics who identify as foreign-born, the data shows that US-born Hispanics experience mental health disorders more frequently [16]. As seen many times in the marginalized populations, Hispanics are not likely to seek therapy due to lack of access, resources, stigma, and discrimination and if they do seek therapy, it is often when their condition is at its worst [17, 18]. Instead of seeking treatment, Hispanics are more likely to adopt unhealthy coping behaviors (e.g., excessive alcohol consumption, poor eating habits, smoking, and illicit drugs), which affect the body negatively and can lead to serious and life-threatening medical conditions [18, 19].
Black or African Americans suffer from mental health conditions at about the same rate as Whites. However, they consistently are misdiagnosed and underexamined due to culturally incompetent practitioners, and thus left untreated [20]. In fact, Black or African Americans are less likely than White Americans to seek counseling or treatment and more likely to struggle including persistent emotional distress with feelings that life requires too much effort, worthlessness, hopelessness, and despair [21]. Furthermore, the report of somatic or physical complaints is common for Black people, as is, often failing to recognize that the underlying cause of their complaints is likely connected to an untreated or undiagnosed mental illness. Like Hispanics, Black or African Americans are not likely to seek treatment and when they do, the condition is severe or in crisis and may require intensive treatment (e.g., hospitalization) [6]. Only one in three Black or African Americans who need mental health treatment will obtain it. Undoubtedly, apprehension to seeking treatments likely influences the prevalence of depression that exists among Black or African Americans. For some, depression is accompanied by suicidal thoughts. As of 2019, the 2nd leading cause of death among Black or African Americans between ages 15 and 24 is suicide. Poverty is a social determinant that exacerbates the prevalence of mental illness and impacts access to treatment. For Black Americans, living below poverty increases the risk of experiencing serious psychological distress at three times a higher rate than when not living in poverty. Lastly, because Black or African Americans are relentless targets of violent crimes, discrimination, and racialized violence, the likelihood of developing a traumatic stress disorder is higher than the general population [21].
Asians are a diverse group that includes many distinct cultures, nationalities, diverse countries of origin, and mental health challenges. Asian Americans and Pacific Islanders comprise about 6.1% of the US population and of that nearly 15% reported experiencing a mental illness in the last year [22]. According to the American Psychological Association, Asian Americans are less prone than White Americans to seek help for any mental health or emotional concerns they experience [23]. Attempting and completing suicide is a prevalent issue within the Asian community and is identified as the 10th leading cause of death for Asian Americans. Women between the ages of 15 and 24 as well as 65 and older have the highest suicides rates across all racial and ethnic groups [24]. Asian Americans reported the increased vulnerability to mental health conditions are due to a range of factors including parental pressure to excel academically, discrimination, cultural attitudes as it relates to mental health care, difficulty with balancing cultures, and difficulty developing their sense of self while navigating multiple cultures [25]. Social determinants of health that exacerbate mental health conditions include discrimination, prejudice, racialized violence, problems related to immigration, cultural trauma, and model minority myth/stereotypes [22, 26]. Systemic barriers that serve as obstacles to treatment include misdiagnoses or under-diagnosing due to culturally incompetent practitioners, lack of multilingual services in healthcare, poor access to health insurance, and treatment costs [22, 26]. Because talking about mental health concerns are usually considered taboo, it is more likely for Asian American to seek support within their personal network.
Though American Indians and Alaskan Natives only make up 1.3% of the US population, over 19% indicated experiencing a mental health condition in the last year [27]. In fact, they report experiences of psychological distress at a rate of 1.5 times higher than all other racial groups. Historically, American Indians survived systemic trauma, such as forced relocation and family separation, death by way of war, and sickness and death due to exposure to infectious diseases, which likely impacts their mental health as well [28]. American Indians and Alaskan Natives have a substantially higher rate than the other racial or ethnic groups of experiencing post-traumatic stress disorder, suicide, substance use disorder, and attachment disorders [29]. Children and adolescents have the highest rates of suicidality as those between ages 15-19 have double the death rate than non-Hispanic Whites [27]. Furthermore, American Indians and Alaskan Natives use and abuse substances at younger ages and at higher rates than all other racial groups [7]. Major depression episodes and self-reported depression are three times higher than the US population. Additionally, American Indians and Alaskan Natives are still dealing with the consequences of past trauma and current detrimental policies as well as other social determinants, such as high poverty (e.g., 26.6% live in poverty), and other irreversible setbacks [27]. American Indians and Alaskan Natives are also twice as likely to experience unemployment their White counterparts. The cultural mistrust that exists is understandable yet has a negative effect on seeking mental health treatment, which in turn significantly increases the risk of mental illness. Systemic barriers that affect help-seeking include poverty rate, lack of access due to distance and language barriers, and lack of health insurances coverage [29].
Native Hawaiians and Pacific Islanders are yet another marginalized group that experienced historical trauma and are still coping as well as healing from the effects of the trauma today. The extent of the mental health disparity for this marginalized group is understudied, and thus, the prevalence of mental illness is a work in progress [26]. What is known is 10.1 % of Native Hawaiians and Pacific Islanders reported experiencing psychological distress as compared to 12.7% of non-Hispanic Whites. The leading cause of death between the ages of 15–24 among Native Hawaiians and Pacific Islanders was suicide in 2019 [30, 31]. Social determinants that exacerbate mental illness include multigenerational trauma, discrimination, poverty, housing inequities, and disparities in education and social capital [30, 31]. Like the other racial groups, there are several systemic barriers that exist to serve as an obstacle in receiving mental health treatment. One of the main barriers include the lack of access to care and health insurance [30]. In fact, Native Hawaiians and Pacific Islanders are three times less likely than non-Hispanic Whites to receive mental health services as well as prescriptions that treat psychological disorders. Although Native Hawaiian and Pacific Islanders do not report serious psychological distress at higher rates than Whites, male Native Hawaiian/Pacific Islanders between the ages of 25–44 report higher rates of death by suicide than White Americans [30].
Multiracial/Mixed Race populations are unique because they are most likely to struggle with identity development and feelings of ostracization, which directly affects their mental health [32, 33]. Adolescents who identify as multiracial or mixed are at a higher risk of suicide, substance use, and depression as compared to adolescents who identify with being in a single race or ethnic category [33, 34]. Additionally, mixed-race adolescents are at a higher risk than White adolescents of having overall poor mental health and to have significantly fewer protective factors [34]. The main social determinants that multiracial or mixed-raced people experience that exacerbates mental health include familial discrimination, racial discrimination, and racial identity invalidation [35].
Risk factors known to contribute to the prevalence and vulnerability of mental illness within REM communities are vast, and entail coping with significant life events, while simultaneously managing systemic barriers that are unique to their race. Examples of life events experienced by the majority include bereavement, a lack of access due to finances or distance, and poverty, while examples of unique systemic barriers include having minimal or inaccurate knowledge about mental health care, cultural mistrust, cultural attitudes towards mental health care, stigma, and lack of proper assessment and care due to multicultural incompetence, and social determinants (e.g., racial or ethnic discrimination, implicit bias, racialized violence, etc.) [14, 23, 36]. Common cultural barriers are discussed in the next section. As there is diversity among REM, there is also diversity in the risk factors that make these groups vulnerable to mental illness.
There are a variety of systemic barriers that REM minorities experience when seeking mental health treatment. A few common barriers are cultural mistrust, stigma, lack of access or knowledge of treatment, and financial difficulties [5, 37]. Cultural mistrust, also known as healthy cultural paranoia, refers to an inclination of distrust or skepticism that people of color have about White people when interacting within multiple contexts, such as education, healthcare, business, criminal justice system, etc [38]. The cultural mistrust that exists in communities of color stems from a history of racism, violence, and other social oppressions, which continue to inform US systems (e.g., medicine, education), industries (e.g., healthcare), and policies [38]. Even within the history of medical research, oppression was prevalent, such as the inhumane treatment conducted on REM minorities for the sake of medical advances. The US has a long history of marginalizing Black and Brown people for experimentation. In the 1840s, Dr. Marion Sims, “the father of gynecology” performed several surgeries on female slaves without anesthesia to better understand the female reproductive system [39].
Several historical studies revealed how the science and medical communities dissected and mutilated Black Americans and other ethnic minorities for decades under the guise of medical treatment and development. The Tuskegee Syphilis Experiment withheld antibiotics and without consent, which allowed the disease to run its course on groups of Black men serving as participants. During the 1970s, the University of Southern California-Los Angeles Medical Center sterilized Puerto Rican women by misinforming and forcing them into participation [39]. As a mechanism of scientific experimentation, REM developed a healthy skepticism about the true motive of White people in Western medicine and the intent of science, which continues to exist today [39]. As a result, REM attitudes toward seeking treatment for physical or mental health problems are informed by distrust, which in turn makes them reluctant to obtain help. As well, as racism and oppression continue to be embedded in US medical science, providers without cultural competence, humility, and sensitivity further marginalize REM through the improper assessment and treatment of REM. “Over 30% of Black people, 20% of Latinx people, and 23% of Indigenous people report avoiding medical care because of experiences of personal discrimination due to their race or ethnicity in health care settings” [40]. The fears of seeking help due to cultural insensitivity are transmitted across generations. Thus, cultural mistrust serves as a direct systemic barrier for REM’s decision-making about seeking treatment, which exacerbates mental illness in these communities.
When exploring the multidimensional nature of mental health stigma within communities of color, it is essential to exercise sensitivity and to understand that communicating intimate, familial issues to a stranger can feel like one is crossing cultural boundaries. Mental health stigma refers to derogatory or demeaning attitudes one has about mental illness; it is described as a) personal stigma, b) self-stigma (e.g., internalized attitudes), or c) institutional stigma (e.g., reflected in systemic or mainstream society) [41]. Cognitive processes, stereotypes, affective processes, prejudices, and behavioral processes, or discrimination inform one’s experience of stigma as the “stigmatizer” or the “stigmatized” [42]. There are differences in how mental health stigma affects REM and their mental health [42]. Among some Asian Americans, stigma may include upholding the “save face” mentality by not seeking psychological treatment to protect their family’s reputation [43]. Stigma may derive from individuals in their own community given the constant flow of misinformation about mental illnesses [41]. In some REM communities, people who choose to seek help may become the object of ridicule in their communities, which can lead to even more reluctance or apprehension to seek treatment [42]. To avoid shame and denial, some Black or African Americans may abuse substances as a means to cope with mental illness instead of seeking help [44]. In order to address the stigma that exists in these communities, there must be increased awareness and easier access to education about mental illness and mental healthcare.
There is a complex relationship between the utilization of mental health treatment and poverty-stricken neighborhoods [21, 27]. The adverse social conditions in certain geographic locations contribute to the vulnerability or manifestation of some psychological disorders [45]. As REM are more likely to reside in impoverished neighborhoods, they are more likely to lack accessibility to the education or resources needed to access psychological treatment [45]. Many Native Americans, for example, live in rural or isolated areas that do not offer the needed services, and transportation can be a deterrent to seeking treatment if one does not have a car or needs to spend a long time traveling to receive services [43]. Black or African Americans living in rural areas may believe there are better resources available in larger, more urban cities and may think the resources provided in their rural communities are either of poor quality or nonexistent [46].
Financial barriers play a considerable role in people’s reluctance to seek therapy. Some individuals are fearful they cannot afford mental health treatment and may never get help. While some REM lack the health insurance coverage necessary to see mental health professionals, others may have health insurance but may reside in a community where the majority of practitioners are self-pay only [47]. Due to a lower percentage of Latino/a with access to health insurance coverage, they are unable to financially afford mental health services [48]. As compared to their White counterparts, Black or African Americans and Latino/as earn lower incomes, receive less education, are least likely to have health insurance coverage, are more likely to be underinsured, and have a higher probability of being involved with the public- or social-service agencies [47]. And thus, each of these systemic barriers has an impact on the capacity to seek and obtain mental health services. These barriers need to be addressed on a systemic scale so that policy and funding can be allocated for the development of a mental health system that is inclusive and representative of all ethnic minorities.
In the US, nationwide health disparities and systemic barriers impede REM access to quality mental health services [49, 50]. REM are less likely to seek and engage in mental health services as compared to their White counterparts [49, 50, 51]. Additionally, those who opt to engage in mental health services believe that evidence-based is culturally appropriate, or report dissatisfaction from treatment engagement [49, 51, 52]. Evidence-based practices (EBPs) are defined as the combination of empirical research, clinical expertise, and the lived experiences, values, and identities of participants [9, 11, 53, 54]. Evidence-based treatments (EBTs) refer directly to the clinical interventions, supported by scientific research, that are implemented to promote positive therapeutic outcomes [9, 49, 53, 54]. EBTs are often utilized to treat anxiety disorders, depression, posttraumatic stress, trauma, chronic pain, eating disorders, and other mental health conditions [52, 55, 56, 57, 58, 59, 60]. Examples of clinical interventions include Cognitive Behavioral Therapy (CBT), Narrative Exposure Therapy (NET), Eye Movement Desensitization and Reprocessing (EMDR), and Cognitive Processing Therapy (CPT) [52, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69].
CBT is an empirically supported therapeutic treatment that is guided by the basic principle that exposing, challenging, and reshaping distorted thoughts, modifying behavioral patterns, and managing affective processes can increase positive coping skills and improve mental health [70]. Research demonstrates the effectiveness of CBT in the treatment of a variety of mental health conditions, to name a few: anxiety, depression, stress, substance use disorders, and chronic pain management with people throughout their lifespan [56, 71].
NET is a short-term, trauma-focused, therapeutic treatment that was originally developed for those experiencing trauma due to exposure to disaster, war, and torture [63, 72]. A significant component of NET is the perception that trauma is not an isolated event but is interwoven into an overlapping network of various traumas that contribute to distorted sensory and cognitive information and can lead to the development of posttraumatic stress [63, 72, 73]. NET assists individuals in processing these traumas through creating a narrative that chronologically maps traumatic events across their lifetime, rather than focusing on a single traumatic event [63, 73]. NET is effective in the treatment of posttraumatic stress disorder (PTSD), anxiety, depression, insomnia, and other trauma-related disorders [72, 73, 74, 75].
EMDR is an empirically supported therapeutic intervention that was developed in the late 1980’s when researcher, Francine Shapiro, observed that engaging in saccadic eye movements, while recalling traumatic memories, significantly reduced the intensity of anxiety associated with these disturbing thoughts [65, 76]. EMDR is proven to be effective in mitigating the impact of traumatic stress, anxiety, and depression through aiding participants in processing dysfunctional memories and developing more adaptive cognitive processes [52, 66, 76, 77, 78].
CPT is an evidence-based cognitive therapy that is commonly utilized to treat PTSD [79]. CPT provides participants with psychoeducation about trauma, stress, and cognitive skill-building to aid in the identification of “stuck points” that form distorted thought processes that contribute to symptoms of posttraumatic stress [79, 80].
Despite widespread acceptance in the treatment of trauma and other mental health conditions, EBTs are often critiqued for a lack of cultural relevance [11, 81]. Historically, REM have been underrepresented in the scientific research that informs the efficacy of these interventions [49, 53, 54, 82, 83]. Researchers believe that this underrepresentation compromises the efficacy of these treatments among minority populations, and may negatively influence participant engagement, outcomes, and treatment satisfaction [49, 53]. Researchers investigate and address this disparity through the implementation of culturally competent programmatic modifications to traditional EBTs [52, 60, 79, 84, 85]. And thus, it is essential that practitioners be conscientious of cultural factors that inform REM perceptions of mental illness, the nature of their presenting concerns, and their desire or propensity to seek help; the EBTs that are utilized will not account for or address the nuances these individuals experience.
In one empirical study, researchers modified CBT interventions to be culturally inclusive for Mexican American women struggling with binge eating disorders. Findings suggested the eating habits of Latina women were significantly affected by both the cultural meaning of food and cultural beliefs surrounding help-seeking behaviors [60]. The women were less likely to be motivated by thinness ideals than their White counterparts and were more likely to engage in binge eating behaviors due to food signifying love, community, and other factors of their culture. In other words, the Latinas’ experiences were informed by cultural beliefs that implied they should be considerate of others before caring for themselves, which made them less likely to engage in treatment for their eating disorders [60]. Adaptations for the CBT intervention included guiding participants in navigating culturally specific social interactions about food, assisting participants in navigating culturally relevant healthy food options, and advocating for culturally competent service delivery.
Furthermore, it is necessary to implement cultural modifications to meet the unique needs of specific populations, such as refugee survivors [64]. Another common EBT, NET, is often used with diverse populations, such as refugees who experience trauma by exposure to war, torture, political unrest, anxiety, and depression [63, 64, 74, 75]. In another investigation of the cultural appropriateness of EBTs, NET was empirically examined and modified to address the specific needs of Cambodian survivors. The research adapted a NET intervention to meet the needs of Cambodian survivors of the Khmer Rouge genocide [86]. The adaptation included the implementation of traditional spiritual practices, such as chanting, protection rituals, and the presence of Buddhist monks to supplement the traditional NET intervention format [86]. The participants were responsive to this treatment approach.
It is common for some investigators to examine the efficacy of traditional EBTs on specific minoritized populations. For example, one study attempted to examine the efficacy of a traditional EMDR intervention with Black or African American clients [52]. Several themes emerged that inform future adaptions to EMDR as an efficacious intervention for Black or African American clients. More specifically, the findings indicated the participants had insufficient psychoeducation on EMDR, which contributed to fear, uncertainty, and feelings of powerlessness regarding participation in the intervention. Additionally, the participants lacked trust and felt they were unable to identify with the White treatment providers who administered the intervention [52]. Combine these findings with Black or African Americans’ experience of systemic barriers; not only will they be less likely to seek treatment, but also their mental health conditions will deteriorate. An example of a study where researchers made cultural adjustments to an EMDR intervention to meet the needs of Syrian refugees includes implementing a translation of program materials into the local language, adjusting to a scheduled time (preferred evening schedules), and providing a discreet location for intervention services to decrease the possibility of stigmatization for receiving mental health services [55].
Spanish-speaking Latino populations face unique barriers when treated with EBTs. Shortages of Spanish-speaking clinicians, lack of access to bilingual program material, and limited protocol about culturally appropriate adaptations to EBTs are examples of unique barriers that Spanish-speaking Latino populations experience that can exacerbate their mental health or deter them from seeking help [85]. When seeking to culturally adapt a CPT intervention to meet the needs of Spanish-speaking Latinos managing PTSD, one study found that participants reported a lack of language accessibility of materials, difficulty understanding psychological terms, and poor integration of cultural values in program materials to be challenging [85]. Findings from a similar empirical study identified comparable barriers when adapting a CPT intervention for Native American women diagnosed with Human Immunodeficiency Virus (HIV), PTSD, and who were engaged in high-risk sexual activities [87]. These barriers included difficulty understanding scientific language presented in program materials as well as lack of spiritual and cultural relevance. Another CPT intervention was modified to address the needs of Kurdish trauma survivors living in Iraq [84]. Adaptations to the CPT manual and materials included the removal of American cultural idioms, reduction of psychological terms, translation of materials into Kurdish language, adjustment of language to create greater accessibility across literacy levels, and implementation of culturally appropriate case examples.
Today, researchers advocate for more culturally competent clinicians and propose cultural modifications to EBTs to help improve outcomes for REM who are participants in these interventions [52, 57]. As well, more REM need to be invited to participate in clinical trials when examining the efficacy of EBTs. Challenging clinicians to be creative in their clinical work, such as using clinical tools like the Multidimensional Model for Developing Cultural Competence (MMDCC) to guide practice can also improve psychological outcomes for REM clients [88]. The components of the MMDCC include cultural awareness, cultural knowledge, cultural knowledge of behavioral health, and cultural skill development and the components examine how these factors intersect at the individual, clinical, and organizational levels. Additionally, adaptations of intervention language are widely accepted as a culturally competent adjustment to EBPs [89]. There is presently no universal protocol for the culturally competent modification of EBTs [57, 89].
MBSR was originally developed to reduce psychological and emotional stressors experienced by people with chronic health issues [12, 90]. MBSR has been administered to a wide range of populations in different settings, such as hospitals, schools, and prisons [90]. An advantage of MBSR is its format as a group training program that are led by either one or two trained instructors who facilitate group sessions [91, 92]. In order for MBSR to be most effective, instructors should have competency in teaching the program, embody qualities of mindfulness, commit to good practice, and be engaged in the learning process [90].
For participants, a potential benefit of MBSR is the shared experience of addressing various psychosocial stressors in a supportive group setting. Specifically, MBSR is administered as an 8 to 10-week training program intended to reduce stress through the systematic application of mindful-based practices [12, 91, 92]. Groups can range from 10 to 40 participants who meet weekly for a 2.5 hour MBSR training session. Activities for each session often include mindfulness meditation, mindful awareness, yoga, and mindfulness practice for stressful events [12, 92]. As a requirement of MBSR, participants are assigned a 45-minute homework task. These daily homework assignments include practicing different mindful-based exercises learned in each session. Mindfulness is developed through regular and repeated practice, which helps people readily access the techniques during stressful events [92].
The application of MBSR is an effective non-pharmacological method toward managing stress deriving from chronic physical illnesses (e.g., cancer, diabetes, hypertension, HIV) [93]. In fact, studies found that the practice of MBSR enhances coping skills while being used as an alternative medical treatment for clinical patients [92, 93]. For treatment of physical health conditions, reportedly MBSR decreases patient complaints of sensory pain, physical impairment, and medical symptoms. Furthermore, even non-clinical populations indicate improved quality of life after participating in MBSR [12, 92]. Overall, empirical findings suggest that MBSR can be utilized as a healthy coping strategy to manage a range of physical ailments.
In terms of mental health treatment, MBSR is found to be an effective approach in reducing symptoms related to anxiety disorders (e.g., generalized anxiety, social anxiety, panic attacks); more specifically, symptoms that relate to worrying and future-oriented cognitions [94, 95]. Furthermore, individuals with anxiety disorders report improvements in transdiagnostic symptoms (e.g., emotion dysregulation, avoidance, cognition) after completing a course of MBSR [94]. These participants indicated that MBSR was a beneficial activity to reduce their anxiety, helped them feel at ease, and gave them the confidence to do more activities. Based on these findings, MBSR is a clinical intervention that can be utilized to guide individuals toward change and acceptance of their anxiety [94].
Although, the clinical efficacy of MBSR extends beyond the treatment of various anxiety disorders and physical ailments. Among both clinical and non-clinical groups, MBSR has been found to be moderately effective at reducing depressive symptoms and psychological distress [12, 92, 96]. Moreover, MBSR is shown to decrease depressive symptoms and slightly improved cognitions among individuals with mild cognitive impairment. These results indicate that MBSR can be used as a supplemental treatment for mild to moderate depressive disorders [96].
Additionally, the effectiveness of MBSR as an alternative treatment for clinical ailments may be attributed to neurological change. In one study, neuroimaging data indicated increased connectivity in the visual and auditory networks of participants who completed an 8-week course of MBSR [97]. Likewise, the increased neurological connectivity was associated with improved attentional focus, sensory processing, and awareness of sensory experiences [97]. Similar neuroimaging studies found increased connectivity in the hippocampal region of participants after completing MBSR [98]. As a result, the findings suggested increased hippocampal connectivity from mindfulness may improve stress resilience and fear extinction (e.g., worry) [98]. And thus, MBSR as a clinical treatment promotes beneficial neurological growth and regeneration, which positively affects physical and mental health outcomes.
The efficacy of MBSR as an EBT for physical and mental health conditions is well documented. However, there is a dearth of research that promotes mindfulness-based interventions as a treatment for REM populations. There are a few studies that demonstrate MBSR as a potential culturally appropriate treatment for a wide range of clinical ailments. For example, Native American, Latinx, and Black communities often uphold values that honor the mind-body and spiritual connection. Mindfulness-based techniques are inclusive of historical, social, and cultural perspectives or ideologies, which align with the needs of REM communities. And thus, the mindfulness-based interventions can promote communal coping (e.g., community or collectively) and healing (e.g., prayer, meditation, other spiritual rituals) [99].
In another example, MBSR can serve to reduce health disparities for Black or African American females experiencing the stress or traumatic stress deriving from sexism and racism [100]. In turn, MBSR can help Black women overcome harmful cultural or racialized stereotypes such as the Superwoman schema and the Strong Black woman script. A recent investigation found that prediabetic Black or African Americans notable decreases in diabetes risk (i.e., lower A1C) after completing an MBSR program [13]. These participants reported increases in spiritual well-being and reductions in perceived stress, BMI, and fat. These studies indicate that MBSR served as a culturally appropriate treatment for African Americans experiencing psychosocial stressors.
The benefits of mindfulness-based interventions (MBI) such as MBSR and mindfulness-based cognitive therapy (MBCT) have also been examined for REM and age demographics. A recent study found that culturally adapted mindfulness-based interventions for Latinx populations were correlated with improvements in depression, stress, and chronic illness [101]. Similarly, MBSR and MBCT were found to reduce depressive and anxiety symptoms among various Asian communities [102]. After participating in MBSR, low-income older African Americans reported decreased stress, depression, and anger and decreased blood pressure [103, 104]. Findings also indicated that young African Americans with HIV that completed MBSR experienced decreased hostility and improvements in social relationships, academic achievement, and physical health [105]. Thus, there is evidence that mindfulness-based interventions are culturally sensitive and inclusive, which aligns with the needs of REM coping with mental health conditions.
REM are at a particularly high risk of experiencing mental health conditions. Social determinants of health, such as poverty, racialized violence, or discrimination exacerbate REM mental health and quality of life. REM are less likely than White people to seek and receive treatment. Furthermore, REM are more likely to experience systemic barriers, such as cultural mistrust, mental health stigma, lack of access, and lack of financial resources, further complicating their willingness and capacity to seek treatment. While EBTs are identified as empirically supportive to treatments for a range of mental health conditions, there is skepticism about their cultural appropriateness and relevance for REM populations. Clinicians must be culturally competent and use clinical tools (e.g., Multidimensional Model for Developing Cultural Competence) to assist in promoting cultural competence. Practitioners must be conscientious and knowledgeable about the pitfalls of EBTs when working with REM. Mindfulness-based techniques, such as MBSR, are culturally sensitive and inclusive of historical, social, and cultural ideologies that align with the needs of REM. MBSR has the potential to offer holistic coping given its effectiveness in promoting neurological, physical, and psychological healing.
There are no acknowledgments to disclose for this work.
There are no conflicts of interest pertaining to the authors to report or special circumstances for this work.
Thank you to all the authors who came together to get our message out. I would like to express my sincerest gratitude to the students who helped me.
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We conclude this chapter by expressing personal perspective on the probable challenges and developments of the controllable synthesis of CeO2 nanomaterials for various applications.",book:{id:"5510",slug:"functionalized-nanomaterials",title:"Functionalized Nanomaterials",fullTitle:"Functionalized Nanomaterials"},signatures:"Adnan Younis, Dewei Chu and Sean Li",authors:[{id:"191574",title:"Dr.",name:"Adnan",middleName:null,surname:"Younis",slug:"adnan-younis",fullName:"Adnan Younis"}]}],mostDownloadedChaptersLast30Days:[{id:"38951",title:"Carbon Nanotube Transparent Electrode",slug:"carbon-nanotube-transparent-electrode",totalDownloads:3985,totalCrossrefCites:3,totalDimensionsCites:5,abstract:null,book:{id:"3077",slug:"syntheses-and-applications-of-carbon-nanotubes-and-their-composites",title:"Syntheses and Applications of Carbon Nanotubes and Their Composites",fullTitle:"Syntheses and Applications of Carbon Nanotubes and Their Composites"},signatures:"Jing Sun and Ranran Wang",authors:[{id:"153508",title:"Prof.",name:"Jing",middleName:null,surname:"Sun",slug:"jing-sun",fullName:"Jing Sun"},{id:"153596",title:"Ms.",name:"Ranran",middleName:null,surname:"Wang",slug:"ranran-wang",fullName:"Ranran Wang"}]},{id:"49413",title:"Electrodeposition of Nanostructure Materials",slug:"electrodeposition-of-nanostructure-materials",totalDownloads:3733,totalCrossrefCites:1,totalDimensionsCites:7,abstract:"We are conducting a multi-disciplinary research work that involves development of nanostructured thin films of semiconductors for different applications. Nanotechnology is widely considered to constitute the basis of the next technological revolution, following on from the first Industrial Revolution, which began around 1750 with the introduction of the steam engine and steelmaking. Nanotechnology is defined as the design, characterization, production, and application of materials, devices and systems by controlling shape and size of the nanoscale. The nanoscale itself is at present considered to cover the range from 1 to 100 nm. All samples prepared in thin film forms and the characterization revealed their nanostructure. The major exploitation of thin films has been in microelectronics, there are numerous and growing applications in communications, optical electronics, coatings of all kinds, and in energy generation. A great many sophisticated analytical instruments and techniques, largely developed to characterize thin films, have already become indispensable in virtually every scientific endeavor irrespective of discipline. Among all these techniques, electrodeposition is the most suitable technique for nanostructured thin films from aqueous solution served as samples under investigation. The electrodeposition of metallic layers from aqueous solution is based on the discharge of metal ions present in the electrolyte at a cathodic surface (the substrate or component.) The metal ions accept an electron from the electrically conducting material at the solid- electrolyte interface and then deposit as metal atoms onto the surface. The electrons necessary for this to occur are either supplied from an externally applied potential source or are surrendered by a reducing agent present in solution (electroless reduction). The metal ions themselves derive either from metal salts added to solution, or by the anodic dissolution of the so-called sacrificial anodes, made of the same metal that is to be deposited at the cathode.",book:{id:"4718",slug:"electroplating-of-nanostructures",title:"Electroplating of Nanostructures",fullTitle:"Electroplating of Nanostructures"},signatures:"Souad A. M. Al-Bat’hi",authors:[{id:"174793",title:"Dr.",name:"Mohamad",middleName:null,surname:"Souad",slug:"mohamad-souad",fullName:"Mohamad Souad"}]},{id:"54226",title:"Localized Surface Plasmon Resonance for Optical Fiber-Sensing Applications",slug:"localized-surface-plasmon-resonance-for-optical-fiber-sensing-applications",totalDownloads:2265,totalCrossrefCites:2,totalDimensionsCites:5,abstract:"It is well known that optical fiber sensors have attracted the attention of scientific community due to its intrinsic advantages, such as lightweight, small size, portability, remote sensing, immunity to electromagnetic interferences and the possibility of multiplexing several signals. This field has shown a dramatic growth thanks to the creation of sensitive thin films onto diverse optical fiber configurations. In this sense, a wide range of optical fiber devices have been successfully fabricated for monitoring biological, chemical, medical or physical parameters. In addition, the use of nanoparticles into the sensitive thin films has resulted in an enhancement in the response time, robustness or sensitivity in the optical devices, which is associated to the inherent properties of nanoparticles (high surface area ratio or porosity). Among all of them, the metallic nanoparticles are of great interest for sensing applications due to the presence of strong absorption bands in the visible and near-infrared regions, due to their localized surface plasmon resonances (LSPR). These optical resonances are due to the coupling of certain modes of the incident light to the collective oscillation of the conduction electrons of the metallic nanoparticles. The LSPR extinction bands are very useful for sensing applications as far as they can be affected by refractive index variations of the surrounding medium of the nanoparticles, and therefore, it is possible to create optical sensors with outstanding properties such as high sensitivity and optical self-reference. In this chapter, the attractive optical properties of metal nanostructures and their implementation into different optical fiber configuration for sensing or biosensing applications will be studied.",book:{id:"5721",slug:"nanoplasmonics-fundamentals-and-applications",title:"Nanoplasmonics",fullTitle:"Nanoplasmonics - Fundamentals and Applications"},signatures:"Pedro J. Rivero, Javier Goicoechea and Francisco J. Arregui",authors:[{id:"69816",title:"Dr.",name:"Javier",middleName:null,surname:"Goicoechea",slug:"javier-goicoechea",fullName:"Javier Goicoechea"},{id:"188796",title:"Dr.",name:"Pedro J.",middleName:null,surname:"Rivero",slug:"pedro-j.-rivero",fullName:"Pedro J. 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Piezoelectric materials are capable of transforming mechanical strain and vibration energy into electrical energy. This property allows opportunities for implementing renewable and sustainable energy through power harvesting and self-sustained smart sensing in buildings. As the most common construction material, plain cement paste lacks satisfactory piezoelectricity and is not efficient at harvesting the electrical energy from the ambient vibrations of a building system. In recent years, many techniques have been proposed and applied to improve the piezoelectric capacity of cement-based composite, namely admixture incorporation and physical. The successful application of piezoelectric materials for sustainable building development not only relies on understanding the mechanism of the piezoelectric properties of various building components, but also the latest developments and implementations in the building industry. Therefore, this review systematically illustrates research efforts to develop new construction materials with high piezoelectricity and energy storage capacity. In addition, this article discusses the latest techniques for utilizing the piezoelectric materials in energy harvesters, sensors and actuators for various building systems. With advanced methods for improving the cementations piezoelectricity and applying the material piezoelectricity for different building functions, more renewable and sustainable building systems are anticipated.",book:{id:"10511",slug:"multifunctional-ferroelectric-materials",title:"Multifunctional Ferroelectric Materials",fullTitle:"Multifunctional Ferroelectric Materials"},signatures:"B. Chandra Sekhar, B. Dhanalakshmi, B. Srinivasa Rao, S. Ramesh, K. Venkata Prasad, P.S.V. Subba Rao and B. Parvatheeswara Rao",authors:[{id:"335022",title:"Dr.",name:"B. Chandra",middleName:null,surname:"Sekhar",slug:"b.-chandra-sekhar",fullName:"B. 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Ramesh"},{id:"422024",title:"Dr.",name:"K.Venkata",middleName:null,surname:"Prasad",slug:"k.venkata-prasad",fullName:"K.Venkata Prasad"},{id:"422025",title:"Dr.",name:"P.S.V",middleName:null,surname:"Subba Rao",slug:"p.s.v-subba-rao",fullName:"P.S.V Subba Rao"},{id:"422026",title:"Dr.",name:"B.Parvatheeswara",middleName:null,surname:"Rao",slug:"b.parvatheeswara-rao",fullName:"B.Parvatheeswara Rao"}]}],onlineFirstChaptersFilter:{topicId:"1169",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"81438",title:"Research Progress of Ionic Thermoelectric Materials for Energy Harvesting",slug:"research-progress-of-ionic-thermoelectric-materials-for-energy-harvesting",totalDownloads:23,totalDimensionsCites:0,doi:"10.5772/intechopen.101771",abstract:"Thermoelectric material is a kind of functional material that can mutually convert heat energy and electric energy. It can convert low-grade heat energy (less than 130°C) into electric energy. Compared with traditional electronic thermoelectric materials, ionic thermoelectric materials have higher performance. The Seebeck coefficient can generate 2–3 orders of magnitude higher ionic thermoelectric potential than electronic thermoelectric materials, so it has good application prospects in small thermoelectric generators and solar power generation. According to the thermoelectric conversion mechanism, ionic thermoelectric materials can be divided into ionic thermoelectric materials based on the Soret effect and thermocouple effect. They are widely used in pyrogen batteries and ionic thermoelectric capacitors. The latest two types of ionic thermoelectric materials are in this article. The research progress is explained, and the problems and challenges of ionic thermoelectric materials and the future development direction are also put forward.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Jianwei Zhang, Ying Xiao, Bowei Lei, Gengyuan Liang and Wenshu Zhao"},{id:"77670",title:"Thermoelectric Elements with Negative Temperature Factor of Resistance",slug:"thermoelectric-elements-with-negative-temperature-factor-of-resistance",totalDownloads:71,totalDimensionsCites:0,doi:"10.5772/intechopen.98860",abstract:"The method of manufacturing of ceramic materials on the basis of ferrites of nickel and cobalt by synthesis and sintering in controllable regenerative atmosphere is presented. As the generator of regenerative atmosphere the method of conversion of carbonic gas is offered. Calculation of regenerative atmosphere for simultaneous sintering of ceramic ferrites of nickel and cobalt is carried out. It is offered, methods of the dilated nonequilibrium thermodynamics to view process of distribution of a charge and heat along a thermoelement branch. The model of a thermoelement taking into account various relaxation times of a charge and warmth is constructed.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Yuri Bokhan"},{id:"79236",title:"Processing Techniques with Heating Conditions for Multiferroic Systems of BiFeO3, BaTiO3, PbTiO3, CaTiO3 Thin Films",slug:"processing-techniques-with-heating-conditions-for-multiferroic-systems-of-bifeo3-batio3-pbtio3-catio",totalDownloads:96,totalDimensionsCites:0,doi:"10.5772/intechopen.101122",abstract:"In this chapter, we have report a list of synthesis methods (including both synthesis steps & heating conditions) used for thin film fabrication of perovskite ABO3 (BiFeO3, BaTiO3, PbTiO3 and CaTiO3) based multiferroics (in both single-phase and composite materials). The processing of high quality multiferroic thin film have some features like epitaxial strain, physical phenomenon at atomic-level, interfacial coupling parameters to enhance device performance. Since these multiferroic thin films have ME properties such as electrical (dielectric, magnetoelectric coefficient & MC) and magnetic (ferromagnetic, magnetic susceptibility etc.) are heat sensitive, i.e. ME response at low as well as higher temperature might to enhance the device performance respect with long range ordering. The magnetoelectric coupling between ferromagnetism and ferroelectricity in multiferroic becomes suitable in the application of spintronics, memory and logic devices, and microelectronic memory or piezoelectric devices. In comparison with bulk multiferroic, the fabrication of multiferroic thin film with different structural geometries on substrate has reducible clamping effect. A brief procedure for multiferroic thin film fabrication in terms of their thermal conditions (temperature for film processing and annealing for crystallization) are described. Each synthesis methods have its own characteristic phenomenon in terms of film thickness, defects formation, crack free film, density, chip size, easier steps and availability etc. been described. A brief study towards phase structure and ME coupling for each multiferroic system of BiFeO3, BaTiO3, PbTiO3 and CaTiO3 is shown.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Kuldeep Chand Verma and Manpreet Singh"},{id:"78034",title:"Quantum Physical Interpretation of Thermoelectric Properties of Ruthenate Pyrochlores",slug:"quantum-physical-interpretation-of-thermoelectric-properties-of-ruthenate-pyrochlores",totalDownloads:74,totalDimensionsCites:0,doi:"10.5772/intechopen.99260",abstract:"Lead- and lead-yttrium ruthenate pyrochlores were synthesized and investigated for Seebeck coefficients, electrical- and thermal conductivity. Compounds A2B2O6.5+z with 0 ≤ z < 0.5 were defect pyrochlores and p-type conductors. The thermoelectric data were analyzed using quantum physical models to identify scattering mechanisms underlying electrical (σ) and thermal conductivity (κ) and to understand the temperature dependence of the Seebeck effect (S). In the metal-like lead ruthenates with different Pb:Ru ratios, σ (T) and the electronic thermal conductivity κe (T) were governed by ‘electron impurity scattering’, the lattice thermal conductivity κL (T) by the 3-phonon resistive process (Umklapp scattering). In the lead-yttrium ruthenate solid solutions (Pb(2-x)YxRu2O(6.5±z)), a metal–insulator transition occurred at 0.2 moles of yttrium. On the metallic side (<0.2 moles Y) ‘electron impurity scattering’ prevailed. On the semiconductor/insulator side between x = 0.2 and x = 1.0 several mechanisms were equally likely. At x > 1.5 the Mott Variable Range Hopping mechanism was active. S (T) was discussed for Pb-Y-Ru pyrochlores in terms of the effect of minority carrier excitation at lower- and a broadening of the Fermi distribution at higher temperatures. The figures of merit of all of these pyrochlores were still small (≤7.3 × 10−3).",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Sepideh Akhbarifar"},{id:"77635",title:"Optimization of Thermoelectric Properties Based on Rashba Spin Splitting",slug:"optimization-of-thermoelectric-properties-based-on-rashba-spin-splitting",totalDownloads:124,totalDimensionsCites:0,doi:"10.5772/intechopen.98788",abstract:"In recent years, the application of thermoelectricity has become more and more widespread. Thermoelectric materials provide a simple and environmentally friendly solution for the direct conversion of heat to electricity. The development of higher performance thermoelectric materials and their performance optimization have become more important. Generally, to improve the ZT value, electrical conductivity, Seebeck coefficient and thermal conductivity must be globally optimized as a whole object. However, due to the strong coupling among ZT parameters in many cases, it is very challenging to break the bottleneck of ZT optimization currently. Beyond the traditional optimization methods (such as inducing defects, varying temperature), the Rashba effect is expected to effectively increase the S2σ and decrease the κ, thus enhancing thermoelectric performance, which provides a new strategy to develop new-generation thermoelectric materials. Although the Rashba effect has great potential in enhancing thermoelectric performance, the underlying mechanism of Rashba-type thermoelectric materials needs further research. In addition, how to introduce Rashba spin splitting into current thermoelectric materials is also of great significance to the optimization of thermoelectricity.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Zhenzhen Qin"},{id:"75364",title:"Challenges in Improving Performance of Oxide Thermoelectrics Using Defect Engineering",slug:"challenges-in-improving-performance-of-oxide-thermoelectrics-using-defect-engineering",totalDownloads:214,totalDimensionsCites:0,doi:"10.5772/intechopen.96278",abstract:"Oxide thermoelectric materials are considered promising for high-temperature thermoelectric applications in terms of low cost, temperature stability, reversible reaction, and so on. Oxide materials have been intensively studied to suppress the defects and electronic charge carriers for many electronic device applications, but the studies with a high concentration of defects are limited. It desires to improve thermoelectric performance by enhancing its charge transport and lowering its lattice thermal conductivity. For this purpose, here, we modified the stoichiometry of cation and anion vacancies in two different systems to regulate the carrier concentration and explored their thermoelectric properties. Both cation and anion vacancies act as a donor of charge carriers and act as phonon scattering centers, decoupling the electrical conductivity and thermal conductivity.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Jamil Ur Rahman, Gul Rahman and Soonil Lee"}],onlineFirstChaptersTotal:6},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:98,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:287,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:10,numberOfPublishedChapters:103,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343",scope:"Biomedical Engineering is one of the fastest-growing interdisciplinary branches of science and industry. The combination of electronics and computer science with biology and medicine has improved patient diagnosis, reduced rehabilitation time, and helped to facilitate a better quality of life. Nowadays, all medical imaging devices, medical instruments, or new laboratory techniques result from the cooperation of specialists in various fields. The series of Biomedical Engineering books covers such areas of knowledge as chemistry, physics, electronics, medicine, and biology. 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Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:7,paginationItems:[{id:"7",title:"Bioinformatics and Medical Informatics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",slug:"slawomir-wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",biography:"Professor Sławomir Wilczyński, Head of the Chair of Department of Basic Biomedical Sciences, Faculty of Pharmaceutical Sciences, Medical University of Silesia in Katowice, Poland. His research interests are focused on modern imaging methods used in medicine and pharmacy, including in particular hyperspectral imaging, dynamic thermovision analysis, high-resolution ultrasound, as well as other techniques such as EPR, NMR and hemispheric directional reflectance. Author of over 100 scientific works, patents and industrial designs. Expert of the Polish National Center for Research and Development, Member of the Investment Committee in the Bridge Alfa NCBiR program, expert of the Polish Ministry of Funds and Regional Policy, Polish Medical Research Agency. Editor-in-chief of the journal in the field of aesthetic medicine and dermatology - Aesthetica.",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",slug:"alexandros-tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",slug:"lulu-wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:null,institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",slug:"reda-r.-gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",slug:"adriano-andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",biography:"Dr. Adriano de Oliveira Andrade graduated in Electrical Engineering at the Federal University of Goiás (Brazil) in 1997. He received his MSc and PhD in Biomedical Engineering respectively from the Federal University of Uberlândia (UFU, Brazil) in 2000 and from the University of Reading (UK) in 2005. He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). He was the head of the undergraduate program in Biomedical Engineering of the Federal University of Uberlândia (2015 - June/2019) and the head of the Centre for Innovation and Technology Assessment in Health (NIATS/UFU) since 2010. He is the head of the Postgraduate Program in Biomedical Engineering (UFU, July/2019 - to date). He was the secretary of the Parkinson's Disease Association of Uberlândia (2018-2019). Dr. Andrade's primary area of research is focused towards getting information from the neuromuscular system to understand its strategies of organization, adaptation and controlling in the context of motor neuron diseases. His research interests include Biomedical Signal Processing and Modelling, Assistive Technology, Rehabilitation Engineering, Neuroengineering and Parkinson's Disease.",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",slug:"hitoshi-tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",slug:"marcus-vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",slug:"ramana-vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",slug:"luis-villarreal-gomez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",biography:"Dr. Luis Villarreal is a research professor from the Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Tijuana, Baja California, México. Dr. Villarreal is the editor in chief and founder of the Revista de Ciencias Tecnológicas (RECIT) (https://recit.uabc.mx/) and is a member of several editorial and reviewer boards for numerous international journals. He has published more than thirty international papers and reviewed more than ninety-two manuscripts. His research interests include biomaterials, nanomaterials, bioengineering, biosensors, drug delivery systems, and tissue engineering.",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",slug:"cecilia-cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",slug:"gil-goncalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",slug:"johann-f.-osma",fullName:"Johann F. 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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. 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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. 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He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNVJQA4/Profile_Picture_2022-03-07T13:23:04.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. His research interests include biochemistry, oxidative stress, reactive species, antioxidants, lipid peroxidation, inflammation, reproductive hormones, phenolic compounds, female infertility.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Associate Prof.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/15648_n.jpg",biography:"Dr. Mohd Aftab Siddiqui is currently working as Assistant Professor in the Faculty of Pharmacy, Integral University, Lucknow for the last 6 years. He has completed his Doctor in Philosophy (Pharmacology) in 2020 from Integral University, Lucknow. He completed his Bachelor in Pharmacy in 2013 and Master in Pharmacy (Pharmacology) in 2015 from Integral University, Lucknow. He is the gold medalist in Bachelor and Master degree. He qualified GPAT -2013, GPAT -2014, and GPAT 2015. His area of research is Pharmacological screening of herbal drugs/ natural products in liver and cardiac diseases. He has guided many M. Pharm. research projects. He has many national and international publications.",institutionString:"Integral University",institution:null},{id:"255360",title:"Dr.",name:"Usama",middleName:null,surname:"Ahmad",slug:"usama-ahmad",fullName:"Usama Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255360/images/system/255360.png",biography:"Dr. Usama Ahmad holds a specialization in Pharmaceutics from Amity University, Lucknow, India. He received his Ph.D. degree from Integral University. Currently, he’s working as an Assistant Professor of Pharmaceutics in the Faculty of Pharmacy, Integral University. From 2013 to 2014 he worked on a research project funded by SERB-DST, Government of India. He has a rich publication record with more than 32 original articles published in reputed journals, 3 edited books, 5 book chapters, and a number of scientific articles published in ‘Ingredients South Asia Magazine’ and ‘QualPharma Magazine’. He is a member of the American Association for Cancer Research, International Association for the Study of Lung Cancer, and the British Society for Nanomedicine. Dr. Ahmad’s research focus is on the development of nanoformulations to facilitate the delivery of drugs that aim to provide practical solutions to current healthcare problems.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"30568",title:"Prof.",name:"Madhu",middleName:null,surname:"Khullar",slug:"madhu-khullar",fullName:"Madhu Khullar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/30568/images/system/30568.jpg",biography:"Dr. Madhu Khullar is a Professor of Experimental Medicine and Biotechnology at the Post Graduate Institute of Medical Education and Research, Chandigarh, India. She completed her Post Doctorate in hypertension research at the Henry Ford Hospital, Detroit, USA in 1985. She is an editor and reviewer of several international journals, and a fellow and member of several cardiovascular research societies. Dr. Khullar has a keen research interest in genetics of hypertension, and is currently studying pharmacogenetics of hypertension.",institutionString:"Post Graduate Institute of Medical Education and Research",institution:{name:"Post Graduate Institute of Medical Education and Research",country:{name:"India"}}},{id:"223233",title:"Prof.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/223233/images/system/223233.png",biography:"Xianquan Zhan received his MD and Ph.D. in Preventive Medicine at West China University of Medical Sciences. He received his post-doctoral training in oncology and cancer proteomics at the Central South University, China, and the University of Tennessee Health Science Center (UTHSC), USA. He worked at UTHSC and the Cleveland Clinic in 2001–2012 and achieved the rank of associate professor at UTHSC. Currently, he is a full professor at Central South University and Shandong First Medical University, and an advisor to MS/PhD students and postdoctoral fellows. He is also a fellow of the Royal Society of Medicine and European Association for Predictive Preventive Personalized Medicine (EPMA), a national representative of EPMA, and a member of the American Society of Clinical Oncology (ASCO) and the American Association for the Advancement of Sciences (AAAS). He is also the editor in chief of International Journal of Chronic Diseases & Therapy, an associate editor of EPMA Journal, Frontiers in Endocrinology, and BMC Medical Genomics, and a guest editor of Mass Spectrometry Reviews, Frontiers in Endocrinology, EPMA Journal, and Oxidative Medicine and Cellular Longevity. He has published more than 148 articles, 28 book chapters, 6 books, and 2 US patents in the field of clinical proteomics and biomarkers.",institutionString:"Shandong First Medical University",institution:{name:"Affiliated Hospital of Shandong Academy of Medical Sciences",country:{name:"China"}}},{id:"297507",title:"Dr.",name:"Charles",middleName:"Elias",surname:"Assmann",slug:"charles-assmann",fullName:"Charles Assmann",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/297507/images/system/297507.jpg",biography:"Charles Elias Assmann is a biologist from Federal University of Santa Maria (UFSM, Brazil), who spent some time abroad at the Ludwig-Maximilians-Universität München (LMU, Germany). He has Masters Degree in Biochemistry (UFSM), and is currently a PhD student at Biochemistry at the Department of Biochemistry and Molecular Biology of the UFSM. His areas of expertise include: Biochemistry, Molecular Biology, Enzymology, Genetics and Toxicology. He is currently working on the following subjects: Aluminium toxicity, Neuroinflammation, Oxidative stress and Purinergic system. Since 2011 he has presented more than 80 abstracts in scientific proceedings of national and international meetings. Since 2014, he has published more than 20 peer reviewed papers (including 4 reviews, 3 in Portuguese) and 2 book chapters. He has also been a reviewer of international journals and ad hoc reviewer of scientific committees from Brazilian Universities.",institutionString:"Universidade Federal de Santa Maria",institution:{name:"Universidade Federal de Santa Maria",country:{name:"Brazil"}}},{id:"217850",title:"Dr.",name:"Margarete Dulce",middleName:null,surname:"Bagatini",slug:"margarete-dulce-bagatini",fullName:"Margarete Dulce Bagatini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217850/images/system/217850.jpeg",biography:"Dr. Margarete Dulce Bagatini is an associate professor at the Federal University of Fronteira Sul/Brazil. She has a degree in Pharmacy and a PhD in Biological Sciences: Toxicological Biochemistry. She is a member of the UFFS Research Advisory Committee\nand a member of the Biovitta Research Institute. She is currently:\nthe leader of the research group: Biological and Clinical Studies\nin Human Pathologies, professor of postgraduate program in\nBiochemistry at UFSC and postgraduate program in Science and Food Technology at\nUFFS. She has experience in the area of pharmacy and clinical analysis, acting mainly\non the following topics: oxidative stress, the purinergic system and human pathologies, being a reviewer of several international journals and books.",institutionString:"Universidade Federal da Fronteira Sul",institution:{name:"Universidade Federal da Fronteira Sul",country:{name:"Brazil"}}},{id:"226275",title:"Ph.D.",name:"Metin",middleName:null,surname:"Budak",slug:"metin-budak",fullName:"Metin Budak",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226275/images/system/226275.jfif",biography:"Metin Budak, MSc, PhD is an Assistant Professor at Trakya University, Faculty of Medicine. He has been Head of the Molecular Research Lab at Prof. Mirko Tos Ear and Hearing Research Center since 2018. His specializations are biophysics, epigenetics, genetics, and methylation mechanisms. He has published around 25 peer-reviewed papers, 2 book chapters, and 28 abstracts. He is a member of the Clinical Research Ethics Committee and Quantification and Consideration Committee of Medicine Faculty. His research area is the role of methylation during gene transcription, chromatin packages DNA within the cell and DNA repair, replication, recombination, and gene transcription. His research focuses on how the cell overcomes chromatin structure and methylation to allow access to the underlying DNA and enable normal cellular function.",institutionString:"Trakya University",institution:{name:"Trakya University",country:{name:"Turkey"}}},{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",slug:"anca-pantea-stoian",fullName:"Anca Pantea Stoian",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",biography:"Anca Pantea Stoian is a specialist in diabetes, nutrition, and metabolic diseases as well as health food hygiene. She also has competency in general ultrasonography.\n\nShe is an associate professor in the Diabetes, Nutrition and Metabolic Diseases Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. She has been chief of the Hygiene Department, Faculty of Dentistry, at the same university since 2019. Her interests include micro and macrovascular complications in diabetes and new therapies. Her research activities focus on nutritional intervention in chronic pathology, as well as cardio-renal-metabolic risk assessment, and diabetes in cancer. She is currently engaged in developing new therapies and technological tools for screening, prevention, and patient education in diabetes. \n\nShe is a member of the European Association for the Study of Diabetes, Cardiometabolic Academy, CEDA, Romanian Society of Diabetes, Nutrition and Metabolic Diseases, Romanian Diabetes Federation, and Association for Renal Metabolic and Nutrition studies. She has authored or co-authored 160 papers in national and international peer-reviewed journals.",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",country:{name:"Romania"}}},{id:"279792",title:"Dr.",name:"João",middleName:null,surname:"Cotas",slug:"joao-cotas",fullName:"João Cotas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279792/images/system/279792.jpg",biography:"Graduate and master in Biology from the University of Coimbra.\n\nI am a research fellow at the Macroalgae Laboratory Unit, in the MARE-UC – Marine and Environmental Sciences Centre of the University of Coimbra. My principal function is the collection, extraction and purification of macroalgae compounds, chemical and bioactive characterization of the compounds and algae extracts and development of new methodologies in marine biotechnology area. \nI am associated in two projects: one consists on discovery of natural compounds for oncobiology. The other project is the about the natural compounds/products for agricultural area.\n\nPublications:\nCotas, J.; Figueirinha, A.; Pereira, L.; Batista, T. 2018. An analysis of the effects of salinity on Fucus ceranoides (Ochrophyta, Phaeophyceae), in the Mondego River (Portugal). Journal of Oceanology and Limnology. in press. DOI: 10.1007/s00343-019-8111-3",institutionString:"Faculty of Sciences and Technology of University of Coimbra",institution:null},{id:"279788",title:"Dr.",name:"Leonel",middleName:null,surname:"Pereira",slug:"leonel-pereira",fullName:"Leonel Pereira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279788/images/system/279788.jpg",biography:"Leonel Pereira has an undergraduate degree in Biology, a Ph.D. in Biology (specialty in Cell Biology), and a Habilitation degree in Biosciences (specialization in Biotechnology) from the Faculty of Science and Technology, University of Coimbra, Portugal, where he is currently a professor. In addition to teaching at this university, he is an integrated researcher at the Marine and Environmental Sciences Center (MARE), Portugal. His interests include marine biodiversity (algae), marine biotechnology (algae bioactive compounds), and marine ecology (environmental assessment). Since 2008, he has been the author and editor of the electronic publication MACOI – Portuguese Seaweeds Website (www.seaweeds.uc.pt). He is also a member of the editorial boards of several scientific journals. Dr. Pereira has edited or authored more than 20 books, 100 journal articles, and 45 book chapters. He has given more than 100 lectures and oral communications at various national and international scientific events. He is the coordinator of several national and international research projects. In 1998, he received the Francisco de Holanda Award (Honorable Mention) and, more recently, the Mar Rei D. Carlos award (18th edition). He is also a winner of the 2016 CHOICE Award for an outstanding academic title for his book Edible Seaweeds of the World. In 2020, Dr. Pereira received an Honorable Mention for the Impact of International Publications from the Web of Science",institutionString:"University of Coimbra",institution:{name:"University of Coimbra",country:{name:"Portugal"}}},{id:"61946",title:"Dr.",name:"Carol",middleName:null,surname:"Bernstein",slug:"carol-bernstein",fullName:"Carol Bernstein",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/61946/images/system/61946.jpg",biography:"Carol Bernstein received her PhD in Genetics from the University of California (Davis). She was a faculty member at the University of Arizona College of Medicine for 43 years, retiring in 2011. Her research interests focus on DNA damage and its underlying role in sex, aging and in the early steps of initiation and progression to cancer. In her research, she had used organisms including bacteriophage T4, Neurospora crassa, Schizosaccharomyces pombe and mice, as well as human cells and tissues. She authored or co-authored more than 140 scientific publications, including articles in major peer reviewed journals, book chapters, invited reviews and one book.",institutionString:"University of Arizona",institution:{name:"University of Arizona",country:{name:"United States of America"}}},{id:"182258",title:"Dr.",name:"Ademar",middleName:"Pereira",surname:"Serra",slug:"ademar-serra",fullName:"Ademar Serra",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/182258/images/system/182258.jpeg",biography:"Dr. Serra studied Agronomy on Universidade Federal de Mato Grosso do Sul (UFMS) (2005). He received master degree in Agronomy, Crop Science (Soil fertility and plant nutrition) (2007) by Universidade Federal da Grande Dourados (UFGD), and PhD in agronomy (Soil fertility and plant nutrition) (2011) from Universidade Federal da Grande Dourados / Escola Superior de Agricultura Luiz de Queiroz (UFGD/ESALQ-USP). Dr. Serra is currently working at Brazilian Agricultural Research Corporation (EMBRAPA). His research focus is on mineral nutrition of plants, crop science and soil science. Dr. Serra\\'s current projects are soil organic matter, soil phosphorus fractions, compositional nutrient diagnosis (CND) and isometric log ratio (ilr) transformation in compositional data analysis.",institutionString:"Brazilian Agricultural Research Corporation",institution:{name:"Brazilian Agricultural Research Corporation",country:{name:"Brazil"}}}]}},subseries:{item:{id:"7",type:"subseries",title:"Bioinformatics and Medical Informatics",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine",scope:"Bioinformatics aims to help understand the functioning of the mechanisms of living organisms through the construction and use of quantitative tools. The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11403,editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",slug:"slawomir-wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",biography:"Professor Sławomir Wilczyński, Head of the Chair of Department of Basic Biomedical Sciences, Faculty of Pharmaceutical Sciences, Medical University of Silesia in Katowice, Poland. His research interests are focused on modern imaging methods used in medicine and pharmacy, including in particular hyperspectral imaging, dynamic thermovision analysis, high-resolution ultrasound, as well as other techniques such as EPR, NMR and hemispheric directional reflectance. Author of over 100 scientific works, patents and industrial designs. Expert of the Polish National Center for Research and Development, Member of the Investment Committee in the Bridge Alfa NCBiR program, expert of the Polish Ministry of Funds and Regional Policy, Polish Medical Research Agency. Editor-in-chief of the journal in the field of aesthetic medicine and dermatology - Aesthetica.",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,series:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343"},editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",slug:"alexandros-tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",slug:"lulu-wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:null,institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",slug:"reda-r.-gharieb",fullName:"Reda R. 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