DC/TMD taxonomic classification for temporomandibular disorders (only TMJ disorders).
\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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Federal Rural da Amazônia",institutionURL:null,country:{name:"Brazil"}}},{id:"314489",title:"Ms.",name:"Beatriz Martinelli",middleName:null,surname:"Lima",fullName:"Beatriz Martinelli Lima",slug:"beatriz-martinelli-lima",email:"biamartinelli13@gmail.com",position:null,institution:{name:"Universidade Federal Rural da Amazônia",institutionURL:null,country:{name:"Brazil"}}}]},book:{id:"8004",title:"Nitrogen Fixation",subtitle:null,fullTitle:"Nitrogen Fixation",slug:"nitrogen-fixation",publishedDate:"April 8th 2020",bookSignature:"Everlon Cid Rigobelo and Ademar Pereira Serra",coverURL:"https://cdn.intechopen.com/books/images_new/8004.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"39553",title:"Prof.",name:"Everlon",middleName:"Cid",surname:"Rigobelo",slug:"everlon-rigobelo",fullName:"Everlon Rigobelo"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"11725",leadTitle:null,title:"The Erythrocyte - A Unique Cell",subtitle:null,reviewType:"peer-reviewed",abstract:"
\r\n\tThe Erythrocyte is unique and forms a model for studying various situations/ physiological conditions.
\r\n\tThis cell has evolved an effective defense system to counteract the challenges as it is always in an oxygen-rich environment. The evolution of hemoglobin and deformability of erythrocyte membrane adapting to its function in circulation is especially striking. Erythrocyte aging and eryptosis strike a balance - the mixed population of cells and constant recycling every 120 days is a very distinct feature. Its metabolic shunt pathways and metabolites/enzymes alter and adapt with age and changes in the microenvironment.
\r\n\tErythrocyte and its cytoskeleton responses to various situations such as infections, hypoxia, hypothermia, intrigues researchers and biologists alike. This book aims to throw light on the significance of erythrocyte and its characteristic nature and survival in different physiological situations as it plays a very crucial role.
\r\n\r\n\tThis book hopes to bring different perspectives from various aspects and provide insights into the effective mechanisms evolved by erythrocytes, to counteract the challenges faced in its oxidation environment and the further research approaches.
",isbn:"978-1-80356-732-7",printIsbn:"978-1-80356-731-0",pdfIsbn:"978-1-80356-733-4",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"1b6073b9ff3f8f63004943bd263cd04e",bookSignature:"Dr. Vani Rajashekaraiah",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11725.jpg",keywords:"Erythrocyte, Hemoglobin, Erythrocyte Aging, Pathways, Metabolites, Deficiencies, Membrane Changes, Band 3, Deformability, Hemolysis, Disease Conditions, Free Radical Initiators",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 24th 2022",dateEndSecondStepPublish:"May 26th 2022",dateEndThirdStepPublish:"July 25th 2022",dateEndFourthStepPublish:"October 13th 2022",dateEndFifthStepPublish:"December 12th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Vani Rajashekaraiah, Associate Professor, JAIN (Deemed-to-be University), Bangalore has 20 years of research experience in Oxidative Stress Physiology and Hematology and 16 years of teaching experience. She has authored numerous journal papers and book chapters and has one published patent. She has received CSIR research fellowship and is a Member of the Society for Free Radical Research, India.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"352876",title:"Dr.",name:"Vani",middleName:null,surname:"Rajashekaraiah",slug:"vani-rajashekaraiah",fullName:"Vani Rajashekaraiah",profilePictureURL:"https://mts.intechopen.com/storage/users/352876/images/system/352876.jpg",biography:"Teaching Experience: 16 years\n•\tAssociate Professor in Biotechnology, School of Sciences, Block I, JAIN (Deemed-to-be University), Bengaluru from May 2018 till date. (Courses: Molecular Genetics, Molecular Biology and Genetic Engineering). \n Research Experience: 20 years in the field of Oxidative Stress Physiology and hematology.\n Current Research focus: Blood Storage (erythrocytes, platelets) and Drug-induced Thrombocytopenia\n Total publications in SCOPUS / Web of Science: 27 and International book chapters: 04.\n Research guidance: 3 PhD students (completed); 3 PhD students guiding currently.\n \t \n Six years of research experience as JRF (CSIR) and SRF (CSIR) in the field of High Altitude Physiology and Biochemistry, specialization in Oxidative Stress Physiology, from August 2002 to 2008. \no\tPursued research under the guidance of Dr. S. Asha Devi, Professor, Dept. of \n Zoology, Bangalore University, Bangalore-560056, towards Ph.D in Zoology.\n Title of the thesis- “Studies on Oxidative Stress in Erythrocytes of Rats Exposed to \n Intermittent Hypobaric Hypoxia”.",institutionString:"Jain University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Jain University",institutionURL:null,country:{name:"India"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"185543",firstName:"Maja",lastName:"Bozicevic",middleName:null,title:"Mrs.",imageUrl:"https://mts.intechopen.com/storage/users/185543/images/4748_n.jpeg",email:"maja.b@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"6550",title:"Cohort Studies in Health Sciences",subtitle:null,isOpenForSubmission:!1,hash:"01df5aba4fff1a84b37a2fdafa809660",slug:"cohort-studies-in-health-sciences",bookSignature:"R. Mauricio Barría",coverURL:"https://cdn.intechopen.com/books/images_new/6550.jpg",editedByType:"Edited by",editors:[{id:"88861",title:"Dr.",name:"R. Mauricio",surname:"Barría",slug:"r.-mauricio-barria",fullName:"R. 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Therefore, living species including plants, animals, and humans have evolved to cope with and rely upon gravity equal to 1 g. Throughout the history of the Earth, all living organisms adapted their cellular and behavioral function to this particular physical environment characteristic for our home planet. Gravity—as a permanent and constant vector-calibrated stimulus—led to various gravity-perceiving systems in organisms that control growth or influence movement and behavior. But what happens if this constant stimulus is changed?
Future challenges in terms of long-term interplanetary manned space missions moved the adaptability of living organisms and their vital systems to heterogravitational habitats into scientific focus [2]. With emphasis on our astronomical neighbors Mars and Moon with a reduced gravitational force of approximately a third and a fifth of the Earth’s gravitation, it became apparent that orbital or interplanetary space explorations require knowledge about gravity-perceiving systems, which determine movement, cognition, and survival [3]. In the past decades, space research manifested a significant gravity dependency for various biological processes and vital systems. A special focus lies on the animal and human nervous system (NS) as it is crucial for integration of sensory input, for example, from the vestibular system, movement control, and terrestrial locomotion on Earth. The NS governs muscle contraction enabling the body to counteract the gravitational force and controlling locomotor patterns and reflexes during the evolutionary shift from aqueous to terrestrial life. For interplanetary and orbital missions in future human space flight, knowledge about the gravity sensitivity of the NS is crucial to anticipate major challenges, train the astronauts, and prepare adequate countermeasures to conserve elementary sensorimotor skills during long-term partial-gravity exposure.
The NS is a network of neurons and fibers which transmits nerve impulses between parts of the body. It is composed of interconnected nerve and supporting glial cells. The mechanism of neuronal communication is based on electrochemical coupling, the modulation of intra- and extracellular ions to modify the electrical properties of a cell (intracellular signaling), and the controlled release of transmitters (intercellular communication). Resulting action potentials (APs) are the basic communication unit, and their conduction frequency serves as the coding for the stimulus’ intensity.
One of the fundamental circuits within the central nervous system (CNS) to control muscle contraction is the monosynaptic reflex arch [4]. These reflexes are neuromuscular reactions in response to an external stimulus, which lead to fast muscle contractions. The magnitude of muscle contraction depends on the magnitude of sensory input. Allowing mobility of terrestrial life, sensory input from the vestibular and visual systems and proprioception is processed by the NS, and by means of muscle innervation, appropriate forces are generated to control simple posture or movement [5, 6, 7, 8, 9, 10]. These sensorimotor competencies are crucial for life. Since the first manned spaceflight of Yuri Gagarin in 1961, the effect of microgravity on the human body has been intensively investigated. In the decades since his first spaceflight, many experiments have been performed which made gravity-induced changes on astronauts and cosmonauts apparent. With an emphasis on weightlessness and our astronomical neighbors Mars and Moon [2, 5], the authors found directly related health effects, among others a persistent modulation in the sensory [7, 11] and motor system [12] and the resulting structural loss of muscle [13] and bone mass [14]. In addition, there are modulations in the neuromuscular system underlying those health-related changes that open up many questions on how the variation of gravity influences the NS. These questions led to numerous experiments to investigate the effect of varying gravity conditions on the different levels of organization, from the molecular and cellular level, up to the whole NS and its interconnection with movement control and mobility. The functional properties of these levels were thoroughly investigated, however, with barely any interconnection.
This chapter systematically reviews results on how changes in gravity affect neurons of human and animal as well as temporal and spatial characteristics of complex sensorimotor responses. For that purpose, the subject of this chapter is divided in three subthemes: the gravity dependence of subcellular and cellular parameters associated with neuronal activation is followed by an outline of the sensitivity of the human NS to gravitational variation in the context of movement. To interconnect these transdisciplinary findings, a working model is introduced on how the effects observed on the molecular and biophysical level may impact the sensorimotor control of the NS. The chapter ends with a conclusive statement that refers to movement in terms of long-term interplanetary manned space missions.
A variety of life science experiments executed in gravity conditions different from Earth gravitation, 1 g, have been executed in cellular model systems. With an emphasize on subcellular and cellular parameters and the associated biophysical attributes, most of the
From experiments with unicellular organisms [15] and various cell types as immune cells [16] and neuronal cells [17], it is well established that single cells react to changes in gravity even though they do not have dedicated gravity-sensing structures. One of the major components that all these cell types and organisms have in common is the cell membrane. These complex structures are mainly composed of proteins and lipids [18].
To communicate, cells of the nervous system are able to modify their membrane potential. This ability is based on the activity of integrated membrane proteins as ion channels and ion pumps. But it is well known that the physicochemical state of the lipid membrane can directly modify the function of membrane proteins [19, 20]. In non-space-related experiments, it was shown that the closed-state probability of nicotinic acetylcholine receptors (nAChRs) increased with a decreased membrane fluidity [21]. These nAChRs are a major player in the sensorimotor system as they are located in the motor end plates that form the interface between the neuronal system and the muscles.
Due to these findings, experiments have been performed to monitor the changes of membrane viscosity in micro- and hypergravity with several models (artificial asolectin vesicles and human neuronal SH-SY5Y cells). In all models, the membrane fluidity significantly increases in microgravity and decreases in hypergravity, but in a different distinctness [22]. The difference in distinctness might be explained with the absence of a cytoskeleton in artificial membranes or a different lipid composition.
Nevertheless, this finding, that the membrane fluidity is gravity-dependent, will have a huge impact on biological and medical gravity research, as this is a basic physical mechanism that affects every cell in an organism [23].
Ion channels are crucial for neuronal communication. They form controllable pores through the cell membrane. Charged ions can diffuse through these pores, following electrical and chemical gradients, changing the electrical properties of the cell. Ion channel parameters as open- and closed-state probability have been investigated by using pore-forming peptides which can be used as ion channel analogs. Until now, no native ion channel proteins have been used for gravity research.
The open-state probability of porin channels from
Similar findings have been made with alamethicin, a pore-forming peptide from
The effect on ion channels is—similar to changes in membrane fluidity—fully reversible and fast. With the onset of a different gravity condition, the open-state probability is changed, returning to normal as soon as the experiment returns to normal 1 g gravity.
By having a stable-resting potential, a cell is able to communicate. By changing the activity of relevant ion channels, the membrane potential can be modulated. During parabolic flight, the resting potential of human neuronal cells is significantly depolarized in microgravity and it is hyperpolarized in hypergravity. During microgravity, the depolarization is about 3 mV [27]. This gravity dependence of resting potential is not limited to excitable cells as neuronal cells; it was also found during a drop-tower mission in SF21 cells, an ovary cell line from the insect
Again in parabolic flight, in microgravity, the transmembrane currents in oocytes from
Action potentials (APs) are the basic communication unit in the nervous system. The intensity of a stimulus is frequency-coded: while the amplitude of APs remains constant, their frequency differs dependent on the stimulus strength. In microgravity obtained by drop tower, the rate of action potentials triggered by spontaneous active leech neurons is significantly increased [29]. This means on the level of single cells, more action potentials are generated in weightlessness.
Simultaneously, the conduction velocity of APs on the axonal level is decreased in microgravity and increased in hypergravity. This was demonstrated in parabolic flight missions
In addition to the abovementioned molecular and cellular experiments, a variety of studies have been conducted to investigate the effect of gravity on the nervous system in humans [4, 10, 30, 31, 32, 33, 34]. In the context of movement control, it becomes apparent that the biophysical attributes underlying cell communication and the nervous capacity to inhibit and facilitate neural pathways are of fundamental importance to activate and control the skeletal muscle, allowing the living organisms to displace themselves. On the complex sensorimotor level, the gravitational force determines human movement control, and its impact is considered to be of major relevance for the astronaut’s safety management in scenarios that require spontaneous or chronic adaptation to an astronomical environment different from the Earth. Not only are short-term platforms as parabolic flights and centrifuges used for this research, the experiments are also conducted during long-term space missions or exploration class missions (up to 1.5 years).
A frequently used technique is the peripheral nerve stimulation (PNS) as it is a noninvasive and reliable approach, providing information about nerve communication including temporal and spatial characteristics of direct motor (M-wave) and reflector responses (Hoffmann(H)-reflex) of the skeletal muscle [35, 36]. By external electrical stimulation, neurons, axons, or cell bodies are depolarized, and the bipolar potential difference of the muscle is measured and interpreted [4]. The nerve
The shaping of the potential difference includes peak-to-peak amplitudes normalized to the input stimulus and is associated with the magnitude of the muscle output [37]. Furthermore, the stimulation threshold corresponds to the threshold for axonal excitation with a minimal current evoking a muscle contraction [4].
The needed electrical stimulation to depolarize an axon to generate a constant muscle response can be interpreted as the responsiveness of a nerve to external stimuli. In reduced gravity conditions, similar to Moon (0.16 g) and Mars (0.36 g), generated in parabolic flights, higher stimulation currents for PNS were needed to depolarize the neurons. In hypergravity (1.8 g), the needed currents were smaller [4]. Although the respective partial-gravity level lasts only 24–33 s [10] and effects are reversible within seconds, it can be concluded that the stimulation threshold is acutely increased in reduced gravity and decreased in hypergravity.
The H-reflex amplitude describes the neuronal output signal of the reflectory reaction of muscles and is proportional to the muscle contraction after peripheral electrical stimulation of sensory fibers in their innervating nerves. Gravity dependency has been reported in cross-sectional study designs with neuroplastic changes for amplitudes of H-reflexes and stretch reflexes [10, 30, 31, 32, 33, 34]. The peak-to-peak amplitudes increased during hypergravity, independently from the method of stimulation [10, 33].
In micro- and reduced gravity, the results are more inhomogeneous. Experiments in Mars and Moon gravity showed a gravity dependence in the decrease of peak-to-peak amplitudes of Hmax. Less gravity resulted in a higher decrease in Hmax amplitude [4]. Nevertheless, in microgravity, the H-reflex was either not changed [10, 34] or it was increased [30, 31, 32, 33]. A long-term experiment on the International Space Station (ISS) revealed a decrease of H-reflexes in space [38]. This decrease was found for 5 months in space, but it was recovered shortly after the return to Earth.
The inhomogeneous findings might be explained by (1) active adaptation processes during long-term missions and (2) mainly due to differences in methodology [4].
The amplitudes of the different sections of the H-reflex depend on the stimulation threshold. As the threshold is gravity-dependent, this has to be taken into account when a constant stimulus intensity is used during the experiments [30, 31, 32, 33]. H/M-wave recruitment curves are independent of stimulation threshold [10, 34]. As a consequence, gravity-induced changes in H-reflex amplitudes elicited with a constant and submaximal stimulus are rather attributed to threshold shifts than changes in gravity [30, 31, 32, 33].
Temporal characteristics of motor and reflectory responses are characterized by latencies relying on the nerve’s conduction velocity [39], duration, and inter-peak intervals (IPI) associated with the conduction speed along the muscle fibers at the neuromuscular junction where the nerve interconnects with the muscle [40].
Neuromuscular latency describes the time between a given stimulus and the measured muscle response. The latency of H-reflex and M-wave in the
By interpreting the IPI between the negative and the positive maxima of the biphasic amplitude, information about the conduction velocity from the motor end plate to the muscle fibers can be gained. The motor end plates (or neuromuscular junction) are the interface between the nervous system and the muscles. It could be showed that the IPIs of the peak
The duration of the H-reflex is established as the interval from the first rise of the electromyographic signal until return to baseline. Ritzmann et al. demonstrated a gradual decrease in H-reflex duration with increasing gravitation from lunar to Martian to earth gravitation to hypergravity [4]. Accordingly, the duration of the M-waves showed a strong tendency to decline with increasing gravitation. As the duration of the motor and reflectory responses cover information about the conduction velocity of signal transmission from the motor end plate to the muscle fibers, results indicate a major impact of gravity on the temporal characteristics of sensorimotor responses.
The following model integrates the results from the various experiments that have been carried out in the past decades from cellular level up to the neuromuscular interface. To avoid long-term adaptation processes, only immediate effects have been taken into account. The model was designed in a bottom-up approach, starting at the very base level of gravity dependence. Therefore, it can be used as a framework for future—more complex data—as long-term adaptation processes and the gravity dependence of for example, the human brain.
Micro- and hypergravity change the biophysical properties of biological membranes in every cell in the body. This is not due to some biological effect or process, it is a change in thermodynamic properties of biological membranes [20]; therefore, this can be seen as the basic principle of how gravity affects cells as neuronal cells, for example.
On Earth, it is well known that the properties of membrane-integrated proteins as ion channels depend on the physical state of the membrane. Lateral pressure or membrane fluidity is an important component, for example, the open state of alamethicin pores clearly depends on the lateral pressure of the membrane [41], and the pore activity increases with an increased lateral pressure. An increased lateral pressure can be interpreted as decreased membrane fluidity. This was also shown for other ion channels, for example, the closed-state probability of nicotinic acetylcholine receptor channels increases (the open-state probability decreases) toward decreased membrane fluidity [21].
The pore activity of alamethicin and the open-state probability of ion channels is also gravity-dependent [24, 25]. In microgravity, the open-state probability decreases, whereas in hypergravity, it increases.
As membrane fluidity is affected by gravity and due to the fact that ion channels are affected by membrane fluidity, the first part of the model can be described as follows:
In microgravity, the membrane fluidity is increased. This changed membrane fluidity decreases the open-state probability of ion channels. This effect is inversed in hypergravity: membrane fluidity decreases and the open-state probability of ion channels increases (Figure 1).
The biophysical gravity dependence of cell membranes and incorporated ion channel proteins. Modified from [
It was shown that cells slightly depolarize in microgravity—the membrane potential gets more positive—and they hyperpolarize in hypergravity. With a light depolarization of the resting potential, the threshold to trigger action potentials is reached more easily. This effect was demonstrated in spontaneous active leech neurons. The rate of APs increased in microgravity.
With these findings, the model of gravity dependence on the molecular level can be extended to explain the cellular gravity dependence of single (neuronal) cells (Figure 2).
The gravity dependence of a single neuronal cell. Modified from [
The influence of different gravity conditions on neuronal tissue is clearly visible. In isolated single axons as well as in living animals and in human test subjects, the propagation velocity of APs is decreased in microgravity and it is increased in hypergravity.
Neuromuscular reflex arcs in humans are influenced by gravity. In microgravity, increased latencies can be measured. An increased latency can be explained with a decreased conduction speed—the APs are slower in microgravity.
In Mars and Moon gravity, a higher stimulus has to be given to get the same Hmax as in 1 g, and the peak-to peak amplitude of the H-reflex is decreased (with heterogeneous data at real microgravity). Unfortunately, as the methods of single-cell electrophysiology and peripheral nerve stimulation are different, their results cannot be compared directly. Nevertheless, a decreased propagation velocity of APs in the axons can also explain the decrease in Hmax in microgravity. Less APs per time arrive at the muscle, which leads to a reduced contraction. Two findings support this explanation: first, the decrease can be compensated with a higher stimulus. Due to the frequency coding of sensory input, a higher stimulus generates more APs per time. With more APs per time arriving at the muscle, the contraction force is increased. Second, the decrease in inter-peak intervals of the H-reflex indicates a decreased signal speed at the neuromuscular junction. In increased gravity, these effects are reversed (Figure 3).
The gravity dependence of a multicellular network, connected via synapses as the sensorimotor system. Modified from [
In microgravity, the rate of action potentials is increased, while at the same time, the propagation speed of APs is decreased. This might look like an inconsistency, but it is not. It can be explained with a mathematical equation. Matsumoto and Tasaki developed a mathematical model to calculate the conduction speed of APs in unmyelinated axons [43]. This equation can also be used to estimate the conduction velocity of APs in myelinated axons
where vaxon = conduction velocity, C = membrane capacity, d = diameter of the nerve, R* = resistance of the membrane, and ρ = axoplasmic resistance.
By integrating the data from gravity research and Matsumoto and Tasaki’s model, at first view, the inconsistent findings from single-cell electrophysiology and the data from PNS can be brought together quite nicely to a working model on how the sensorimotor system adapts to changes in gravity.
The increased membrane viscosity in microgravity decreases the open-state probability of ion channels, leading to a slightly depolarized membrane potential. With a reduced open-state probability, the resistance of the membrane (R*) is increased. If axoplasmic resistance (ρ), membrane capacity (C), and the diameter of the axon (d) are treated as constant in changed gravity, the increased resistance of the membrane leads to a decreased conduction velocity of APs (vaxon) while simultaneously APs can be triggered more easily.
To sum up, the described effects are a gravity-dependent decrease in neuronal conduction velocity–or, more general, an increase in electrical and chemical time constants—under reduced gravity and vice versa in hypergravity.
In the decades since the first manned space mission, many
Findings are of major functional relevance in the application field of manned space flight as well as countermeasure development. As more and more space agencies and private space companies are planning long-term missions into space, for example, to Mars, the effect of gravity—and its absence—on the human organisms has to be understood overreaching all vital body systems to minimize the risks for space-faring humans [2]. Today, scientific outcomes of life science experiments executed in samples of astronauts and cosmonauts encompass a variety of long-term adaptation in regard to their sensory perception, motor execution, and planning as well as complex body motion. They are interrelated to neural adaptation to varying gravity and have been verified as follows (for review, see [44]): a recalibration of sensory perception, vestibular and proprioceptive dysfunction [7, 11], changes in muscle synergies and coordination, a decline of muscle force as well as deficits in posture control [6], locomotion, and functional mobility [8]. Reduced and delayed reflex responses and a decline in intramuscular and intermuscular function occur concomitantly with an increased muscle weakness, fatigue concomitant with a higher fall, and injury prevalence [40, 44]. With a persistency beyond the acute period of space flight, these adaptations are of clinical relevance as manifested by significant adverse effects which entail fragility and bone fractures [14, 44].
To reduce health and life risk throughout long-term exposure to low gravity during manned space explorations, scientists and space agencies developed intelligent exercise technologies and efficient interventions validated in cohorts of space crew members to prevent the human body from deconditioning [2]. Empirical outcomes subject to the NS and its adaptability to changes in gravity are included in the concepts of ancient and future countermeasures as manifested, for instance, for strength or jump exercises, vibration treatment, sensorimotor training, and artificial gravity [44].
Although great efforts have been made to optimize countermeasures, limitation on the cellular level such as changes in membrane fluidity as well as complex adaptations on the spinal level encompassing mechanisms of facilitating and inhibiting is of major relevance and cannot be diminished by countermeasures, only [4, 10, 23].
As astronauts traveling to Mars will live in the absence of gravity for approximately 2 years with transition between weightlessness and planetary gravitational forces at the beginning, middle, and end of the mission, further research and countermeasure development considering the gravity dependency of the NS will be obligate to assure a safe space travel and Earth return in the future [44].
The research was supported by the German Aerospace Center (DLR), the European Space Agency (ESA), and Novespace.
The temporomandibular joint (TMJ) is the movable articulation of the bone head. Its structure and morphology share common features with other synovial joints; however, it also presents particularities that make it unique. In fact, deep knowledge of the anatomy and function of the TMJ is a central challenge for clinicians and scientists, since many of the pathological conditions that affect this articulation can be explained based on its morphological and physiological aspects.
\nThe TMJ is a synovial joint composed of two articular surfaces [1, 2, 3, 4] (\nFigure 1\n). The inferior articular surface is given by the mandibular articular surface, which is part of the mandibular head. Structurally, the mandibular head is formed by two surfaces, anterior and posterior, both separated by a ridge that follows the same axis of the mandibular head [5, 6, 7]. The anterior portion of the mandibular head is relatively convex in contrast with the posterior surface which is characterized for being flat and vertical [7, 8] (\nFigure 2\n). On the other hand, the superior articular surface of the TMJ is given by the horizontal portion of the squama of the temporal bone, which is organized forming two highly relevant structures: the mandibular fossa and the articular eminence of the temporal, also called temporal condyle [1, 2, 7, 8, 9, 10, 11]. The mandibular fossa corresponds to a concave surface with its greater axis in the transverse diameter [2, 7, 8, 12] and the temporal condyle corresponds to a convex bony elevation with its major dimension at the transverse axis, formed by an anterior and posterior surfaces without a clear boundary between the two of them [8, 9, 11]. Additionally, in the TMJ, it is possible to observe an articular disc, which allows fitting the temporal condyle and the mandibular head [1, 5]. It is avascular and not innervated at its center, which coincides with the area of greatest work [2, 6, 8, 13]. Like the mandibular fossa and head, its greater dimension is at the transverse axis and adapts closely to the adjacent surfaces [2, 6, 7, 8].
\nAnatomical characteristics of the temporomandibular joint (TMJ). Sagittal section of TMJ. Mandibular head (MH) articulating with temporal condyle (TC) and mandibular fossa (MF). Between the two joint surfaces the articular disc (AD) is interposed. The middle portion of the thinner disc portion being located in the work area; the anterior articular disc is continuous with the fibers of the lateral pterygoid muscle (LP), which is also inserted into the pterygoid fossa (PF) of the mandibular condyle neck; the back of the disc is related to the vascularized tissue in the retrodiscal area (RA). TMJ localizes superior to the middle cranial fossa (MCF) and posterior to the internal auditory canal (IAC).
Anatomical characteristics of the temporomandibular joint. (A) Lateral, (B) frontal, and (C) superior view of the mandibular head. This is formed by two poles, the lateral pole (LP) and the medial pole (MP), the latter being larger. In a side view, it is possible to observe the morphology of the anterior surface (AS) (convex) and posterior surface (PS) (flat) of the mandibular head. In the lower portion of the mandibular head at its point of junction with the condylar neck (CN), the pterygoid fossa can be seen (PF), where the lateral pterygoid muscle is inserted.
Mandibular movements are limited by a number of structures, which actively or passively avoid excessive mandibular displacement and consequently limit the movements within the joint. The main protective and customizing element of the joint complex relates to the joint capsule. This structure consists of thick organized bundles of collagen fibers that are upholstered with several proprioceptors that report changes in mandibular dynamics, thereby limiting the mandibular border movements [6]. Anteriorly, the capsule is inserted in the articular eminence [7, 8]. Laterally, the capsule strongly adheres to the longitudinal root of the zygoma and is continued backwards in tympanosquamous fissure [7, 8, 14]. The medial insertion is less extensive, inserted mainly in the sphenoid spine. The inferior insertion of the capsule extends along the condyle neck as a ring that is down on the backside of condylar process neck [7, 8, 14].
\nThere is a set of ligaments that meet a similar role to the capsule, functionally and structurally reinforcing the TMJ [6, 7, 8]. The main reinforcement ligament capsule corresponds to temporomandibular ligament which is located lateral to it. From this point of insertion the temporomandibular ligament lateral band descends obliquely and posteriorly, and finally inserts onto the posterior surface of condylar neck [7]. The medial band is horizontal, presenting a similar cranial origin to the lateral band, and is inserted into the lateral side of the mandibular head [11]. Portions of the temporomandibular ligament execute a different role within the mandibular dynamics [6].
\nAdditionally, there are a number of ligaments in the TMJ that are not structural or for its reinforcement, however limit the mandibular dynamics and hence the joint function. The stylomandibular, sphenomandibular, pterygomandibular and pterygospinous ligaments meet this role [7, 14]. The stylomandibular ligament is a segment of the muscular structures and it is originated in the styloid process forming the styloid bouquet [7]. Since its origin, the stylomandibular ligament descends obliquely to finally insert on the posterior and inferior border of the ramus. In the case of the sphenomandibular ligament, this appears as a thickening of the interpterygoid fascia, which inserts cranially into the sphenoid spine and in the mandibular lingula [7, 14, 15]. Its thickness and extent varies between the individuals and in its upper portion penetrates into the middle ear throughout the petrotympanic fissure being continued as the anterior ligament of the malleus [10, 16, 17, 18]. The pterigomandibular ligament originates from the pterygoid hamulus of the medial lamina of the pterygoid process of the sphenoid bone and from that point is inserted into the lateral lip of the mandibular retromolar trigone [7]. It is inserted in the buccinator muscles anteriorly and the superior constrictor muscle of the pharynx posteriorly. Finally, the pterygoespinous ligament, like the sphenomandibular, corresponds to a thickening of the interpterygoid fascia. It is reported that this ligament may undergo calcifications, which could produce alterations in the transmission of the mandibular nerve, because of its intimate relationship with the mandibular foramen determining nerve compression [19].
\nTemporomandibular disorders (TMDs) are the most widely accepted term to designate the musculoskeletal alterations of the TMJs. All TMDs share similar signs and symptoms, traditionally described as a triad of pain (TMJs, muscles, and tooth pain), interferences during mandibular movement (frequently associated with joint noises), and/or movement range limitation [20]. Bell developed the first classification of TMDs in 1986, and it was based on an orthopedic-mechanical model [21]. This classification was composed of four major categories (masticatory pain, restriction of mandibular movements, joint interference during mandibular movements, and acute malocclusion) and identified five muscular processes (myositis, muscle spasm, myofascial pain, late-onset muscle irritation, and protective co-contraction or protective stiffness). However, it was not until 1990 that the American Academy of Craniomandibular Disorders (AACD), along with the International Headache Society (IHS), developed the first taxonomic system of classification [22]. The main contributions were the distinction of two major categories (joint disorders and muscle disorders) and the possibility of establishing multiple diagnoses.
\nIn 1992, a new taxonomic classification system was developed and termed “The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)” [23]. This system was based on the biopsychosocial model of pain, and included the Axis I (physical assessment using reliable and well-operationalized diagnostic criteria), and Axis II (assessment of psychosocial status and pain-related disability) [23]. The main purpose of this classification system was to establish standardized criteria for research, and to provide simultaneously a physical diagnosis in order to identify other patients’ characteristics that could modify the expression and eventually the management of their TMD [22].
\nSince 2014, the new DC/TMD Axis I and Axis II provide an evidence-based assessment protocol also based on the biopsychosocial model (\nFigure 3\n) that can be directly applied in the clinical and research setting [24]. In this consensus, the information required for fulfilling the Axis I diagnostic criteria is obtained from a specified examination protocol in conjunction with the core self-report instruments that assess pain symptoms involving the jaw, jaw noise and locking, and headache. Axis II core assessment instruments assess pain disability, pain intensity, jaw functioning, parafunctional behaviors, psychosocial distress, and widespread pain. All of these incorporations and changes in the core patient assessment instrument set serve as a broad foundation for patient assessment and further research [24].
\nBiopsychosocial model of disease applied to temporomandibular disorders. Axis I refers to the severity of the patient’s biological factors, including physical disorders. Axis II refers to the severity of psychosocial and behavioral factors, including interference in functioning because of pain. Two possible types of patients are depicted, each situated according to disease severity on the respective axes: Patient A has a mechanical temporomandibular joint (TMJ) disorder without secondary factors; and patient B has a pain diagnosis and clinically significant disruption in overall function and mood.
The DC/TMD also includes changes to original RDC/TMD TMJ diagnoses. An important consideration was the low sensitivity for the diagnostic algorithms for disc displacement (DD) and degenerative joint disease (DJD) (osteoarthritis and osteoarthrosis) in RDC/TMD that can provide only provisional diagnoses [24]. This is due to the fact that some DD with reduction do not have clinically detectable noise, and the disorder will not be diagnosed using the clinical criteria (positive history of noise and the presence of clicking noises) [25]. DD with reduction is highly prevalent, and crescent data suggest that internal derangement, such as DD with reduction, is likely to progress to osteoarthritis [20, 26, 27]. However, based on the evidence, DD with reduction is probably without clinical consequences unless pain occurs with noises or functional limitations, such as limited opening or interference in mastication. Nonetheless, the DC/TMD suggests that imaging using MRI is required for a definitive diagnosis of TMJ DD [24].
\nThe differential diagnosis with the other TTMs is very important in the clinical assessment. The DC/TMD taxonomic classification for TMDs is divided in four major groups: temporomandibular joint disorders, masticatory muscle disorders, headache, and associated structures. Of these, the temporomandibular joint disorders main group includes two subtypes of joint pain, three subtypes of joint disorders, and seven different subtypes of joint disease (\nTable 1\n). The clinical procedures to evaluate DD with reduction, DD without reduction without limited opening, and DJD lead to clinical diagnoses based on procedures that exhibit low sensitivity but well to excellent specificity. Thus, for treatment decision in selective cases, confirmation of presumptive diagnostic requires imaging. In contrast, clinical algorithm for assessing DD without reduction with limited opening has good sensitivity and specificity (80 and 97%, respectively) [28], being enough with the clinical evaluation for the initial working diagnosis [24].
\n\n | \n
a. Joint Pain | \n
i. Arthralgia | \n
ii. Arthritis | \n
b. Joint Disorders | \n
i. Disc disorders | \n
1. Disc displacement with reduction | \n
2. Disc displacement with reduction with intermittent locking | \n
3. Disc displacement without reduction with limited opening | \n
4. Disc displacement without reduction without limited opening | \n
ii. Hypomobility disorders other than disc disorders | \n
1. Adhesions/adherence | \n
2. Ankylosis | \n
a. Fibrous | \n
b. Osseous | \n
iii. Hypermobility disorders | \n
1. Dislocations | \n
a. Subluxation | \n
b. Luxation | \n
c. Joint diseases | \n
i. Degenerative joint disease | \n
1. Osteoarthrosis | \n
2. Osteoarthritis | \n
ii. Systemic arthritides | \n
iii. Condylysis/idiopathic condylar resorption | \n
iv. Osteochondritis dissecans | \n
v. Ostronecrosis | \n
vi. Neoplasm | \n
vii. Synovial chondromatosis | \n
d. Fractures | \n
e. Congenital/developmental disorders | \n
i. Aplasia | \n
ii. Hypoplasia | \n
iii. Hyperplasia | \n
DC/TMD taxonomic classification for temporomandibular disorders (only TMJ disorders).
DC/TMD made some changes to the diagnostic procedures of RDC/TMD for DD and DJD. TMJ noise by history is one of the recommended criteria for the intra-articular disorders of DD with reduction and DJD. The patient’s report of any joint noise (click or crepitus) during the 30 days prior to examination should be met by the history criterion or the patient’s detection of any joint noise with jaw movements during the clinical examination. Furthermore, DD with reduction diagnosis requires examiner detection of clicking, popping, or snapping noises during examination. In DJD diagnosis requires examiner detection of crepitus (e.g., crunching, grinding, or grating noises) during the examination, and distinction between fines versus coarse crepitus is not necessary. For DD without reduction, the subtype depends on an assisted opening measurement (including the amount of vertical incisal overlap): if is <40 mm it is “with limited opening” subtype, and if is ≥40 mm it is “without limited opening” subtype. In this category, joint noise does not affect the diagnosis of DD without reduction as long as the required criteria for DD without reduction are met (\nTable 2\n) [24].
\n\n | \n
a. In last 30 days, any noise present” applicable to disc displacement with reduction with and without intermittent locking, and degenerative joint disease. | \n
b. In last 30 days, jaw locks with limited mouth opening and then unlocks” applicable to disc displacement with reduction with intermittent locking. | \n
c. “Ever has jaw lock or catch so that it would not open all the way” and “interfered with eating” applicable to disc displacement without reduction with and without limited opening. | \n
d. In last 30 days, when you opened your mouth wide, jaw locked or caught so that it would not close all the way” applicable to subluxation. | \n
\n | \n
\n | \n
1. Report by patient of any joint noise (click or crepitus). | \n
2. Click detection (# of opening/closing cycles required for click) (1 of 3). | \n
3. Click detection during lateral and protrusive movements. | \n
\n | \n
\n | \n
1. Assisted opening* < 40 mm. | \n
\n | \n
1. Assisted opening* ≥ 40 mm. | \n
\n | \n
1. Report by patient of any joint noise (click or crepitus). | \n
2. Crepitus (either fine or coarse) with palpation. | \n
DC/TMD diagnostic procedures for disc displacements and degenerative joint disease with new history-based diagnosis of subluxation.
Measurement of opening includes interincisal opening plus vertical incisal overlap.
The DJD includes osteoarthritis and osteoarthrosis (\nTable 1\n). While the DD with reduction was described as “
In summary, the DC/TMD assessment protocol has both screening and confirmatory tests for the most common Axis I physical diagnoses and for Axis II contributing factors (\nTable 3\n). However, an important remark is the poor diversity of diagnostic tools available until now. The DC/TMD raise a useful systematic imagenological and clinical diagnostic tool, but with no usefulness in the study of disease progression and/or prediction. Several studies suggest some biological markers of degenerative joint disease, such as certain cytokines or proinflammatory mediators [29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42], and could be useful in the elaboration of complementary tools for diagnostic purposes with potential in the study of disease prediction/progression. Thereby, the development of diagnostic/prognostic devices based on these molecular markers is an interesting research field that could significantly improve the precision of osteoarthritis diagnosis.
\n\n | Axis I: Physical diagnosis | \nAxis II: Psychosocial status | \n||
---|---|---|---|---|
\n | Pain diagnoses | \nJoint diagnoses | \nDistress and pain disability | \n|
Application | \nClinical or research | \nClinical | \nClinical or research | \n|
Screening test | \nTMD pain screener | \nDC/TMD for disc displacements, degenerative joint disease, and subluxation | \nPHQ-4 and GCPS | \nPHQ-9, GAD-7, PHQ-15, and GCPS | \n
Confirmatory test | \nDC/TMD for myalgia, arthralgia, and headache attributed to TMD | \nImaging: MRI for disc displacements, CT for degenerative joint disease, and panoramic radiographs, MRI, or CT for subluxation | \nConsultation with mental health provider | \nStructured psychiatric or behavioral medicine interview | \n
Clinical and research applications of selected DC/TMD Axis I and Axis II tests.
Patient Health Questionnaire-4 (PHQ-4), Graded Chronic Pain Scale (GCPS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15).
Computed tomography (CT) and magnetic resonance (MRI) are widely useful tools for imaging the TMJ region of TMD patients, in particular for assessing degenerative bony changes, disc position and configuration, inflammatory pathological changes in the posterior disc attachment, the presence of effusion in joint spaces, and bone marrow edematous involvement [43]. Cone beam computed tomography (CBCT) allows the visualization of the TMJ in all three planes with high resolution, minimal distortion, and great precision for identifying condylar cortical changes [44]. The TMJ imaging by CBCT also allows the evaluation of the integrity of the bony structures when a degenerative disease is suspected, and to confirm the extent and progression of any bony changes [45].
\nThe degenerative changes of bone in DJD are more frequent in the mandibular condyle than in the mandibular fossa or the articular eminence, and the characteristic pathological bony changes are erosion, osteophytes, and deformity; and adaptive bony changes are marginal proliferation, flattening, concavity, sclerosis, and sub-chondral cyst [46, 47, 48, 49]. All of these anomalies are considered, for diagnostic purposes, as signs of osteoarthritis and frequently are observed in joints with long-standing DD without reduction [47].
\nSome imaging technologies such as CT [49, 50, 51], CBCT [46, 52, 53], and MR [47, 54, 55, 56] have been widely used for diagnosing DJD such as TMJ osteoarthritis. However, is CBCT, a fairly new imaging technology, that has the possibility to create images of high diagnostic quality using lower radiation doses than CT [53]. CBCT imaging has shown to be very helpful for depicting abnormal bony changes such as the cortical margin of the surface and sub-chondral cancellous trabecular structure present in the mandibular condyle, where the conventional radiography has shown difficulties to analyze successfully [30]. Conventional tomography also has difficulties in detailed assessment of changes in the surface morphology of the condyle and fossa, due to the thickness of the slices (1.0–3.0 mm) [57].
\nAnother interesting imaging technique for the diagnosis of TMJ osteoarthritis evaluated in the evidence is the bone scintigraphy [58, 59, 60, 61]. This technique shows a correlation with signs and symptoms with very good sensitivity, specificity, and accuracy (100, 90.91, and 96.97%, respectively) [59]. Interestingly, some radiographic changes seen by follow-up CBCT, MRI, and scintigraphy suggested that osteonecrosis may be the initial phase of an osteoarthritic process [30]. Thus, knowing all the potential imaging findings of every imaging modality is very important to make right imaging diagnostics (\nTable 4\n).
\nImaging modality | \nImaging findings | \n
---|---|
Medical CT and cone beam CT | \nPathological bony changes such as erosion, osteophyte and deformity | \n
\n | Osteochondritis disseccans | \n
Static MR imaging | \nDisc positional abnormalities | \n
(1) DD without reduction | \n|
(2) DD with reduction | \n|
(3) Sideways disc displacement | \n|
\n | Joint effusion presence of marked effusion | \n
\n | A higher T2 signal of the posterior disc attachment | \n
\n | Bone marrow abnormalities | \n
(1) Bone marrow edema | \n|
(2) Bone marrow osteonecrosis | \n|
\n | Tumor involvement and inflammatory diseases into the TMJ | \n
region and the surrounding structures | \n|
\n | Autoimmune processes such as rheumatoid arthritis | \n
\n | A closer proximity between the TMJ disc and the mandibular nerve | \n
Dynamic MR imaging with contrast material | \nProminent contrast enhancement of the posterior disc attachment | \n
\n | Contrast enhancement of effusion | \n
Magnetization transfer contrast imaging | \nDetection for the edematous and ischemic changes in the muscles | \n
Magnetic resonance spectroscopy | \nAscending of insular glutamine levels by 1H MRS | \n
Functional MR imaging | \nThe regions and the network of brain activation associated with TMD | \n
Ultrasonography | \nMuscular edema by low-level contraction | \n
Bone scintigraphy | \nDetection for early changes on the osseous reaction of OA | \n
A rating of the usefulness of each imaging modality related to TMJ pain, MM pain and fatigue.
TMJ, temporomandibular joint; MM, masticatory muscle; DD, disc displacement; TMD, temporomandibular disorders; OA, osteoarthritis.
Cytokine studied | \nAuthors | \nStudy groups | \nMeasuring technique | \nOutcomes of study | \n
---|---|---|---|---|
\n | \nKaneyama et al. [33] | \nGroup 1: DID with clicking. (n = 8) | \n\n | \nGroups 1, 2 and 3 > Group 4. | \n
\n | \n | Group 2: DID with locking. (n = 52) | \n\n | \n |
\n | \n | Group 3: OA. (n = 57) | \n\n | \n |
\n | \n | Group 4: Control. (n = 7) | \n\n | \n |
\n | Kaneyama et al. [32] | \nGroup 1: DID (n = 24) | \n\n | \nNo differences among the groups. | \n
\n | \n | Group 2: OA (n = 26) | \n\n | \n |
\n | \n | Group 3: Control (n = 5) | \n\n | \n |
\n | Kaneyama et al. [35] | \nGroup 1: Control (n = 5) | \n\n | \nGroups 2, and 3 > Group 1. | \n
\n | \n | Group 2: DID (n = 41) | \n\n | \n |
\n | \n | Group 3: OA (n = 14) | \n\n | \n |
\n | Kubota et al. [36] | \nGroup 1: DID and OA (n = 22) | \n\n | \nGroups 1 > Group 2. | \n
\n | \n | Group 2: Control (n = 12) | \n\n | TMJs with OA > TMJs with DID. | \n
\n | \n | Group 3: OA of Knee (n = 10) | \n\n | \n |
\n | Takahashi et al. [39] | \nGroup 1: DID with clicking (n = 8) | \n\n | \nIL-1β presented the higher incidence. Strong correlation between the presence of IL-1β and TMJ pain in groups 1, 2, and 3. | \n
\n | \n | Group 2: DID with locking (n = 25) | \n\n | No cytokines were detected in Group 4. | \n
\n | \n | Group 3: OA (n = 18) | \n\n | \n |
\n | \n | Group 4: Control (n = 6) | \n\n | \n |
\n | Vernal et al. [40] | \nGroup 1: OA (n = 12) | \n\n | \nGroup 1 > Group 2. | \n
\n | \n | Group 2: Control (n = 6) | \n\n | \n |
\n | \nKaneyama et al. [33] | \n* | \n\n | \nGroups 1, 2 and 3 > Group 4. | \n
\n | Kaneyama et al. [32] | \n* | \n\n | \nNo differences among the groups. | \n
\n | Kaneyama et al. [35] | \n* | \n\n | \nGroups 2, and 3 > Group 1. | \n
\n | \n | \n | \n | TNF-α level was positively correlated with those of IL-6, sTNFR-I and sTNFR-II. | \n
\n | Takahashi et al. [39] | \n* | \n\n | \nTNF-α presented the lower incidence. | \n
\n | \n | \n | \n | No cytokines were detected in Group 4. | \n
\n | Vernal et al. [40] | \n* | \n\n | \nGroup 1 > Group 2. | \n
\n | \nKaneyama et al. [33] | \n* | \n\n | \nGroups 1, 2 and 3 > Group 4. | \n
\n | Kaneyama et al. [34] | \nGroup 1: Control (n = 7) | \n\n | \nIn groups 2 and 3 was significantly higher in joints with osseous changes in the condyle. | \n
\n | \n | Group 2: DID (n = 39) | \n\n | No cytokines detected in group 1. | \n
\n | \n | Group 3: OA (n = 22) | \n\n | \n |
\n | Kubota et al. [36] | \n* | \n\n | \nGroups 1 > Group 2. | \n
\n | \n | \n | \n | TMJs with OA > TMJs with DID. | \n
\n | Takahashi et al. [39] | \n* | \n\n | \nGroup 1, 2 and 3 presented at least 1 of the cytokines in 64.5% of the cases. | \n
\n | Vernal et al. [40] | \n* | \n\n | \nGroup 1 > Group 2. | \n
\n | \nKaneyama et al. [34] | \n* | \n\n | \nDetection rate of IL-17 was low, and there was no association between the concentration of IL-17 and the presence or absence of osseous changes. | \n
\n | Vernal et al. [40] | \n* | \n\n | \nGroup 1 > Group 2. | \n
\n | \nKaneyama et al. [33] | \n* | \n\n | \nGroups 1, 2 and 3 > Group 4. | \n
\n | Takahashi et al. [39] | \n* | \n\n | \nGroup 1, 2 and 3 presented at least 1 of the cytokines in 64.5% of the cases. | \n
\n | \nFang et al. [29] | \nGroup 1: DID (n = 12) | \n\n | \nGroup 2 > Group 1. | \n
\n | \n | Group 2: OA (n = 15) | \n\n | \n |
\n | \n | Group 3: Control (n = 4) | \n\n | \n |
\n | \nKaneyama et al. [34] | \n* | \n\n | \nIn groups 2 and 3 was significantly higher in joints with osseous changes in the condyle. | \n
\n | \n | \n | \n | \n |
\n | \nWakita et al. [42] | \nGroup 1: DID with reduction (n = 25) | \n\n | \nNo significance difference in RANKL concentration between group 4 compared to the rest of groups. | \n
\n | \n | Group 2: DID without reduction (n = 39) | \n\n | RANKL/ OPG ratio in group 3 was increased. | \n
\n | \n | Group 3: OA (n = 53) | \n\n | \n |
\n | \n | Group 4: Control (n = 13) | \n\n | \n |
\n | \nFang et al. [29] | \n* | \n\n | \nUndetectable in all the groups. | \n
\n | Vernal et al. [40] | \n* | \n\n | \nGroup 2 > Group 1. | \n
\n | \nKaneyama et al. [32] | \n* | \n\n | \nGroup 3 > Group 2. | \n
\n | Wakita et al. [42] | \n* | \n\n | \nGroup 4 > Groups 1, 2, and 3. | \n
\n | \n | \n | \n | RANKL/OPG ratio in group 3 was increased. | \n
Molecular mediators proposed as associated with signs and symptoms of TMJ disorders.
When the clinical diagnosis of DD with reduction or with reduction with intermittent locking needs imaging confirmation, the DC/TMD suggests positive detection of the following: “(1)
The DC/TMD criteria consider a positive diagnostic of DJD when the TMJ-CBCT is positive for at least one of the following: sub-chondral cyst(s), erosion(s), generalized sclerosis, or osteophyte(s). An important difference between RDC/TMD and DC/TMD is in flattening and/or cortical sclerosis, because while the first consider as positive findings, the second consider indeterminate findings and possible sign of normal variation, aging, remodeling, or a precursor to frank DJD [24].
\nThe great sensitivity and specificity of TMJ-CBCT in the DJD diagnoses compared with the clinical assessment was well demonstrated in the work of Bakke et al., that shows 21 TMJ-CBCTs positive for osteoarthrosis while only two were clinically positive for the disease [62]. The high frequencies of bony changes in the CBCT images of pain-free subjects in this study were in accordance with the findings of Krisjane et al. indicating that radiographic signs of osteoarthritis are a poor indicator of pain [63]. Furthermore, several studies have demonstrated that there is a poor correlation between condylar bony changes including pathological changes, adaptive changes and/or remodeling and pain symptoms in TMJ osteoarthritis [55, 56, 64, 65, 66]. These results support the idea that many times the bony changes are not associated with the clinical diagnoses (\nFigure 4\n), and that good diagnoses comprehend history of the patient, and clinical/imaging diagnostic, although, new assessment tools are necessary for accuracy of the diagnoses.
\nImagenological characteristics of the temporomandibular joint affected with osteoarthritis. (A) Sagittal CBCT images of a TMJ of a patient with DC/TMD diagnosis of osteoarthritis but without bony osteoarthritic changes (erosions and osteophytes). (B) Sagittal CBCT images of a TMJ of a patient with a DC/TMD diagnosis of osteoarthritis and with bony osteoarthritic changes (erosions and osteophyte). CBCT: Cone beam computed tomography, TMJ: temporomandibular joint, DC/TMD: diagnostic criteria for temporomandibular joint. White arrow: osteophyte; black arrow: flattening; dot pattern arrow: erosion; asterisk: sclerosis.
Finally, \nFigure 5\n shows the decision tree made in the DC/TMD consensus summarizes the algorithm made for the diagnosis of degenerative joint disease and intra-articular joint disorders with history, clinical, and imagenological features.
\nDiagnostic criteria for temporomandibular disorders (DC/TMD): diagnostic decision tree. Schematic diagnostic decision tree made to summarize the algorithm of diagnostic for intra-articular disorders (disc displacement with reduction, disc displacement with reduction with intermittent locking, disc displacement without reduction with limited opening, or disc displacement without reduction without limited opening), or degenerative joint disease (osteoarthritis or osteoarthrosis), including history, clinical examination, and imaging.
TMJ-OA is a disease having a great deal of variation in progression, symptoms, epidemiology, pathophysiology, and presentation. The rate of progression from a healthy joint to a severe TMJ-OA can vary from weeks to decades and TMJ-OA affects all of the tissues of the joint, including the articular cartilage, synovium, sub-chondral bone, capsule, ligaments, peri-articular muscles, and the sensory nerves innervating the tissues.
\nMany factors have been proposed as responsible for the TMJ-OA development, such as genetic factors, over-loading, unilateral chewing, bruxism, and internal derangement; however, the molecular basis of the TMJ-OA aetio-pathogenesis remains unclear [67, 68, 69, 70].
\nDuring TMJ-OA, a complex inflammatory response is developed, involving the synthesis of different cytokines by resident cells (e.g., synovial fibroblast, chondrocytes, and macrophages) and inflammatory cells that infiltrate the joint tissues [71, 72]. This inflammatory response could be triggered as result of the tissue breakdown and the consequent release of damage-associated molecular patterns (DAMPs), such as low molecular weight hyaluronan (LMW-HA), high-mobility group protein 1 (HMGB1), and S100 proteins [73, 74], activating resident inflammatory cells, including dendritic cells and macrophages [75]. At initial stages of the disease, functional overload induces oxidative stress that initiates cartilage disruption [76, 77] and activation of MMPs and aggrecanases, promoting the secretion of DAMPs and the activation of the immune response [75]. During the disease progression, there is a local imbalance between the expression of specific cytokines, their receptors, and regulatory soluble receptors, which may be critical in the biological activity of the cytokine network [35]. Under these conditions, both fibroblast and synovial cells are activated to express MMPs and bone-associated cytokines that control the formation/destruction of articular cartilage and bone, determining the clinical outcome of the OA-TMJ (\nFigures 6\n and \n7\n). In fact, higher levels of interleukin (IL)-1β, IL-6, IL-17, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, prostaglandin E2 (PGE2), matrix metalloproteinase (MMP)-2, MMP-9, aggrecanase-1, superoxide dismutase, substance P, and receptor-activator of nuclear factor-κB ligand (RANKL) have been detected in synovial fluid from TMJ-OA patients as compared with disc displacement with reduction (DDWR), disc displacement without reduction (DDWOR), or healthy subjects \nTable 5\n [35, 40, 42, 68, 69, 78, 79, 80, 81, 82, 83, 84, 85, 86].
\nPhases in progression of the degenerative joint disease of the temporomandibular joint. (1) Fibrocartilage and bone tissue in physiological state, (articular disc in correct position). (2) The presence of functional overload or individual susceptibility generates hypoxia and compression of the articular tissues, resulting in apoptosis of chondrocytes and fibroblasts of the fibrocartilage, and DAMP’s release, such as ATP, ROS, TIMPs, fragments of collagen and low molecular weight hyaluronic acid. In addition to cytokines and chemokines, these molecules produced by synoviocytes allow the migration of immune cells into the joint, such as dendritic cells that generate the environment leading to the polarization of T cell populations towards Th1, Th22, and Th17 phenotypes. These polarized cells in turn will allow the differentiation and activation of osteoclasts that will degrade the articular surface establishing the degenerative and destructive pathology (3).
Chemotaxis of immune cells to the subarticular space. Synoviocytes, fibroblasts and chondrocytes produce cytokines, chemokines, intracellular DAMPs, and extracellular matrix derivatives that facilitate the migration of immune cells from the bloodstream into the joint. VEGF and CCL5 facilitate the overexpression of CD44 in endothelial cells and T cells. These molecules, together with low molecular weight hyaluronic acid fragments (sandwich effect), facilitate the diapedesis of lymphocytes through the vessels, enhancing the inflammatory stage of the disease in progress.
Certain cytokines such as IL-1β, IL-6, and TNF-α has been associated with signs and symptoms of TMJ-OA, in particular, synovitis and arthralgia [39]. In addition, TNF-α and IL-6 have been described as markers of pain and successful clinical outcomes in TMDs [87, 88]. However, a study assessing the relation between the scores from a visual analog scale of pain and the levels of IL-1β, IL-6, and TNF-α reported no positive correlation [35]. Differences among different studies results could be due to variability in the selection criteria of subjects, sampling techniques, and/or analysis methods.
\nIL-17 plays a key role in the pathogenesis of rheumatoid arthritis by inducing the synoviocyte-dependent IL-6 secretion [89]. In addition, TNF-α and IFN-γ augment the IL-17 activity and IL-17 activity has been associated with synovitis, chondral degradation, and inhibition of chondrocyte proliferation [89]. The presence of IL-17 in the TMJ synovial fluid could be an important pathophysiological biomarker of TMJ-OA [40]. In fact, bone resorption associated with an increased osteoclast activity is a central phenomenon in the pathophysiology of autoimmune and inflammatory arthritis, and it is also related to IL-17 presence, mainly through T lymphocyte-associated direct and indirect regulation [90, 91]. RANKL is the main molecule involved in the direct regulation of osteoclast activity, through the direct activation of osteoclast precursors [92]. Conversely, the indirect regulation depends on the secretion of IL-17, IL-1β, and TNF-α by synoviocytes, cytokines that in turn induce the RANKL expression on synovial fibroblast and osteoblasts [92]. Recently, it has been reported that IL-17, rather than IL-12 or IFN-γ, is critical for the onset of autoimmune arthritis [91, 92]. Thereby, the role of IL-17 in bone metabolism-associated diseases has been extensively defined, and this role is mainly associated with the induction of proinflammatory cytokines, chemokines, and matrix metalloproteinases that leads pathological bone and/or cartilage damage [89, 93, 94].
\nOur recent data revealed that higher levels of IL-1β, IL-17, and IL-22, associated with the Th1, Th17, and Th22-pattern of immuno-inflammatory response, were detected in TMJ-OA as compared with DDWR. Increased cytokine levels significantly correlated with an enhancement of RANKL expression and the detection of imagenological signs of articular bone degeneration [95]. IL-22 plays a proinflammatory role through the synergistic activity with IL-1β and TNF-α [96, 97, 98] and IL-22 can indirectly induce osteoclastogenesis and bone resorption by the induction of Th17 lymphocyte activity and IL-17 production [99]. In fact, previous reports have detected over-expressed levels of IL-22 in rheumatoid arthritis synovial fibroblasts, demonstrating a pathogenic role of IL-22 in the rheumatic joint inflammation and destruction through the modulation of the IL-1β and IL-17R expression [100, 101]. In general terms, we believe that the Th1/Th17/Th22 immuno-inflammatory cell pathways, associated with the production of IL-1β, IL-17, and IL-22, play a central role in the pathogenesis of the TMJ-OA. Similarly, the role of the Th2/Th9/T regulatory cell pathways, responsible for the production of IL-4, IL-9, and TGF-β1, respectively, could be associated with TMJ-OA disease healing.
\nAt the beginning of 1980s, the existence of a suppressor T cell population was proposed, suggesting that these T cells restrict the induction or expression of effector T cells and thereby prevent and control exaggerated immune response and autoimmune disease development [102]. The modern view of suppressor cells began with the observation that the transfer of T cells depleted of the IL-2Rα+ (CD25+) cell subpopulation induced multiorgan autoimmunity in recipient mice [103]. Nowadays, suppressor T cells have been renamed and are currently known as T regulatory cells (Tregs). These cells have been isolated from mice and humans and their regulatory functions have been demonstrated not only
Natural Tregs are CD4+ T cells that develop and mature in the thymus carry out their regulatory function during normal surveillance of self-antigens [106]. On normal individuals, they represent 5–10% of the peripheral CD4+ T cell population and are characterized by the constitutive expression of high levels of CD25 and low levels of CD45RB [107]. In turn, adaptive Tregs represent CD4+ T cells that acquire their regulatory activity during activation [106]. Unlike natural Tregs, which came out from the thymus as CD4+CD25+ cells, adaptive Tregs originate from peripheral naïve T cells [106]. They are derived from CD4+CD25− T cells and show variable expression of CD25 during their mature phenotype, depending on the disease and the site of regulatory activity [108] Induced Tregs require TCR stimulation for induction of regulatory functions and have demonstrated limited proliferation
Although induced Tregs and effector Th17 cells play different roles during the immunity, reciprocal developmental pathways have been demonstrated for their generation. Naïve T cells exposed to TGF-β1 up-regulate Foxp3 and become induced Tregs; however, when cultured with TGF-β1 and IL-6, naïve T cells generate IL-17 secreting Th17 cells with pathologic activities [110, 111]. Thus, when the immune response is not activated, TGF- β1 favors the generation of induced Tregs, which suppress inflammation; however, when the inflammatory process is established, IL-6 is synthesized during the innate immune response, inhibiting the generation of Tregs and inducing the differentiation of proinflammatory of Th17 cells in presence of TGF-β1 [112]. Thus, induced Tregs and Th17 lymphocytes may arise from the same precursor cell and selective differentiation would depend on the local cytokine milieu, which would determine the predominance of either Tregs with suppressor activity or Th17 cells with pathologic activities, determining the outcome of the disease [112].
\nThe therapeutic potential of Tregs has created a lot of expectations and a large number of publications have assayed their properties either
"Open access contributes to scientific excellence and integrity. It opens up research results to wider analysis. It allows research results to be reused for new discoveries. And it enables the multi-disciplinary research that is needed to solve global 21st century problems. Open access connects science with society. It allows the public to engage with research. To go behind the headlines. And look at the scientific evidence. And it enables policy makers to draw on innovative solutions to societal challenges".
\n\nCarlos Moedas, the European Commissioner for Research Science and Innovation at the STM Annual Frankfurt Conference, October 2016.
",metaTitle:"About Open Access",metaDescription:"Open access contributes to scientific excellence and integrity. It opens up research results to wider analysis. It allows research results to be reused for new discoveries. And it enables the multi-disciplinary research that is needed to solve global 21st century problems. Open access connects science with society. It allows the public to engage with research. To go behind the headlines. And look at the scientific evidence. And it enables policy makers to draw on innovative solutions to societal challenges.\n\nCarlos Moedas, the European Commissioner for Research Science and Innovation at the STM Annual Frankfurt Conference, October 2016.",metaKeywords:null,canonicalURL:"about-open-access",contentRaw:'[{"type":"htmlEditorComponent","content":"The Open Access publishing movement started in the early 2000s when academic leaders from around the world participated in the formation of the Budapest Initiative. They developed recommendations for an Open Access publishing process, “which has worked for the past decade to provide the public with unrestricted, free access to scholarly research—much of which is publicly funded. Making the research publicly available to everyone—free of charge and without most copyright and licensing restrictions—will accelerate scientific research efforts and allow authors to reach a larger number of readers” (reference: http://www.budapestopenaccessinitiative.org)
\\n\\nIntechOpen’s co-founders, both scientists themselves, created the company while undertaking research in robotics at Vienna University. Their goal was to spread research freely “for scientists, by scientists’ to the rest of the world via the Open Access publishing model. The company soon became a signatory of the Budapest Initiative, which currently has more than 1000 supporting organizations worldwide, ranging from universities to funders.
\\n\\nAt IntechOpen today, we are still as committed to working with organizations and people who care about scientific discovery, to putting the academic needs of the scientific community first, and to providing an Open Access environment where scientists can maximize their contribution to scientific advancement. By opening up access to the world’s scientific research articles and book chapters, we aim to facilitate greater opportunity for collaboration, scientific discovery and progress. We subscribe wholeheartedly to the Open Access definition:
\\n\\n“By “open access” to [peer-reviewed research literature], we mean its free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited” (reference: http://www.budapestopenaccessinitiative.org)
\\n\\nOAI-PMH
\\n\\nAs a firm believer in the wider dissemination of knowledge, IntechOpen supports the Open Access Initiative Protocol for Metadata Harvesting (OAI-PMH Version 2.0). Read more
\\n\\nLicense
\\n\\nBook chapters published in edited volumes are distributed under the Creative Commons Attribution 3.0 Unported License (CC BY 3.0). IntechOpen upholds a very flexible Copyright Policy. There is no copyright transfer to the publisher and Authors retain exclusive copyright to their work. All Monographs/Compacts are distributed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Read more
\\n\\nPeer Review Policies
\\n\\nAll scientific works are Peer Reviewed prior to publishing. Read more
\\n\\nOA Publishing Fees
\\n\\nThe Open Access publishing model employed by IntechOpen eliminates subscription charges and pay-per-view fees, enabling readers to access research at no cost. In order to sustain operations and keep our publications freely accessible we levy an Open Access Publishing Fee for manuscripts, which helps us cover the costs of editorial work and the production of books. Read more
\\n\\nDigital Archiving Policy
\\n\\nIntechOpen is committed to ensuring the long-term preservation and the availability of all scholarly research we publish. We employ a variety of means to enable us to deliver on our commitments to the scientific community. Apart from preservation by the Croatian National Library (for publications prior to April 18, 2018) and the British Library (for publications after April 18, 2018), our entire catalogue is preserved in the CLOCKSS archive.
\\n\\nOpen Science is transparent and accessible knowledge that is shared and developed through collaborative networks.
\\n\\nOpen Science is about increased rigour, accountability, and reproducibility for research. It is based on the principles of inclusion, fairness, equity, and sharing, and ultimately seeks to change the way research is done, who is involved and how it is valued. It aims to make research more open to participation, review/refutation, improvement and (re)use for the world to benefit.
\\n\\nOpen Science refers to doing traditional science with more transparency involved at various stages, for example by openly sharing code and data. It implies a growing set of practices - within different disciplines - aiming at:
\\n\\nWe aim at improving the quality and availability of scholarly communication by promoting and practicing:
\\n\\n\\n"}]'},components:[{type:"htmlEditorComponent",content:'
The Open Access publishing movement started in the early 2000s when academic leaders from around the world participated in the formation of the Budapest Initiative. They developed recommendations for an Open Access publishing process, “which has worked for the past decade to provide the public with unrestricted, free access to scholarly research—much of which is publicly funded. Making the research publicly available to everyone—free of charge and without most copyright and licensing restrictions—will accelerate scientific research efforts and allow authors to reach a larger number of readers” (reference: http://www.budapestopenaccessinitiative.org)
\n\nIntechOpen’s co-founders, both scientists themselves, created the company while undertaking research in robotics at Vienna University. Their goal was to spread research freely “for scientists, by scientists’ to the rest of the world via the Open Access publishing model. The company soon became a signatory of the Budapest Initiative, which currently has more than 1000 supporting organizations worldwide, ranging from universities to funders.
\n\nAt IntechOpen today, we are still as committed to working with organizations and people who care about scientific discovery, to putting the academic needs of the scientific community first, and to providing an Open Access environment where scientists can maximize their contribution to scientific advancement. By opening up access to the world’s scientific research articles and book chapters, we aim to facilitate greater opportunity for collaboration, scientific discovery and progress. We subscribe wholeheartedly to the Open Access definition:
\n\n“By “open access” to [peer-reviewed research literature], we mean its free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited” (reference: http://www.budapestopenaccessinitiative.org)
\n\nOAI-PMH
\n\nAs a firm believer in the wider dissemination of knowledge, IntechOpen supports the Open Access Initiative Protocol for Metadata Harvesting (OAI-PMH Version 2.0). Read more
\n\nLicense
\n\nBook chapters published in edited volumes are distributed under the Creative Commons Attribution 3.0 Unported License (CC BY 3.0). IntechOpen upholds a very flexible Copyright Policy. There is no copyright transfer to the publisher and Authors retain exclusive copyright to their work. All Monographs/Compacts are distributed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Read more
\n\nPeer Review Policies
\n\nAll scientific works are Peer Reviewed prior to publishing. Read more
\n\nOA Publishing Fees
\n\nThe Open Access publishing model employed by IntechOpen eliminates subscription charges and pay-per-view fees, enabling readers to access research at no cost. In order to sustain operations and keep our publications freely accessible we levy an Open Access Publishing Fee for manuscripts, which helps us cover the costs of editorial work and the production of books. Read more
\n\nDigital Archiving Policy
\n\nIntechOpen is committed to ensuring the long-term preservation and the availability of all scholarly research we publish. We employ a variety of means to enable us to deliver on our commitments to the scientific community. Apart from preservation by the Croatian National Library (for publications prior to April 18, 2018) and the British Library (for publications after April 18, 2018), our entire catalogue is preserved in the CLOCKSS archive.
\n\nOpen Science is transparent and accessible knowledge that is shared and developed through collaborative networks.
\n\nOpen Science is about increased rigour, accountability, and reproducibility for research. It is based on the principles of inclusion, fairness, equity, and sharing, and ultimately seeks to change the way research is done, who is involved and how it is valued. It aims to make research more open to participation, review/refutation, improvement and (re)use for the world to benefit.
\n\nOpen Science refers to doing traditional science with more transparency involved at various stages, for example by openly sharing code and data. It implies a growing set of practices - within different disciplines - aiming at:
\n\nWe aim at improving the quality and availability of scholarly communication by promoting and practicing:
\n\n\n'}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. He has contributed in stochastic estimation of control area especially, in the Multiple Target Tracking and Interactive Multiple Model (IMM) research, Ball & Beam Control Problem, Robotics, Levitation Control. He has contributed in developing Algorithms for Fingerprint Matching, Computer Vision and Face Recognition. He has been supervising Pattern Recognition, Formal Languages and Distributed Processing projects for several years. He has reviewed many books on Management, Computer Science. Currently, he is an active and permanent reviewer for many international conferences and symposia and the program committee member for many international conferences.\nIn teaching he has taught the core computer science subjects like, Digital Design, Real Time Embedded System Programming, Operating Systems, Software Engineering, Data Structures, Databases, Compiler Construction. In the Engineering side, Digital Signal Processing, Computer Architecture, Electronics Devices, Digital Filtering and Engineering Management.\nApart from his Academic Interest and activities he loves sport especially, Cricket, Football, Snooker and Squash. He plays cricket for Esbjerg city in the second division team as an opener wicket keeper batsman. 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Taiar",coverURL:"https://cdn.intechopen.com/books/images_new/7543.jpg",editedByType:"Edited by",editors:[{id:"157376",title:"Prof.",name:"Mario",middleName:null,surname:"Bernardo-Filho",slug:"mario-bernardo-filho",fullName:"Mario Bernardo-Filho"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6772",title:"Occupational Therapy",subtitle:"Therapeutic and Creative Use of Activity",isOpenForSubmission:!1,hash:"0f6de90c02282919494d6254e473defe",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",bookSignature:"Meral Huri",coverURL:"https://cdn.intechopen.com/books/images_new/6772.jpg",editedByType:"Edited by",editors:[{id:"171525",title:"Dr.",name:"Meral",middleName:null,surname:"Huri",slug:"meral-huri",fullName:"Meral Huri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5711",title:"Occupational Therapy",subtitle:"Occupation Focused Holistic Practice in Rehabilitation",isOpenForSubmission:!1,hash:"38180e287b6cb09b8002b7ab485de2c2",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",bookSignature:"Meral Huri",coverURL:"https://cdn.intechopen.com/books/images_new/5711.jpg",editedByType:"Edited by",editors:[{id:"171525",title:"Dr.",name:"Meral",middleName:null,surname:"Huri",slug:"meral-huri",fullName:"Meral Huri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:3,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"55163",doi:"10.5772/intechopen.68799",title:"Virtual Reality and Occupational Therapy",slug:"virtual-reality-and-occupational-therapy",totalDownloads:2642,totalCrossrefCites:4,totalDimensionsCites:6,abstract:"Virtual reality is three dimensional, interactive and fun way in rehabilitation. Its first known use in rehabilitation published by Max North named as “Virtual Environments and Psychological Disorders” (1994). Virtual reality uses special programmed computers, visual devices and artificial environments for the clients’ rehabilitation. Throughout technological improvements, virtual reality devices changed from therapeutic gloves to augmented reality environments. Virtual reality was being used in different rehabilitation professions such as occupational therapy, physical therapy, psychology and so on. In spite of common virtual reality approach of different professions, each profession aims different outcomes in rehabilitation. Virtual reality in occupational therapy generally focuses on hand and upper extremity functioning, cognitive rehabilitation, mental disorders, etc. Positive effects of virtual reality were mentioned in different studies, which are higher motivation than non‐simulated environments, active participation of the participants, supporting motor learning, fun environment and risk‐free environment. Additionally, virtual reality was told to be used as assessment. This chapter will focus on usage of virtual reality in occupational therapy, history and recent developments, types of virtual reality technologic equipment, pros and cons, usage for pediatric, adult and geriatric people and recent research and articles.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Orkun Tahir Aran, Sedef Şahin, Berkan Torpil, Tarık Demirok and\nHülya Kayıhan",authors:[{id:"172938",title:"Prof.",name:"Hulya",middleName:null,surname:"Kayihan",slug:"hulya-kayihan",fullName:"Hulya Kayihan"},{id:"183079",title:"Ph.D.",name:"Sedef",middleName:null,surname:"Şahin",slug:"sedef-sahin",fullName:"Sedef Şahin"},{id:"196848",title:"M.Sc.",name:"Orkun Tahir",middleName:null,surname:"Aran",slug:"orkun-tahir-aran",fullName:"Orkun Tahir Aran"},{id:"197159",title:"Mr.",name:"Tarık",middleName:null,surname:"Demirok",slug:"tarik-demirok",fullName:"Tarık Demirok"},{id:"197312",title:"M.Sc.",name:"Berkan",middleName:null,surname:"Torpil",slug:"berkan-torpil",fullName:"Berkan Torpil"}]},{id:"61806",doi:"10.5772/intechopen.78312",title:"Executive Functions and Neurology in Children and Adolescents",slug:"executive-functions-and-neurology-in-children-and-adolescents",totalDownloads:1759,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"This chapter discusses the theoretical and methodological issues of creating a developmental perspective on executive function (EF) in childhood and adolescence. Focusing on school periods, this section outlines the development of the basic components of EF—inhibition, working memory, and attention. Cognitive and neurophysiological evaluations show that despite the emergence of EF in the first few years of life, it continues to grow significantly in childhood and adolescence. The components vary slightly according to their developmental sequence. The chapter links findings to long-standing developmental issues (i.e. developmental sequences and processes) and suggests the necessary research to establish a developmental framework covering early childhood throughout adolescence.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Gokcen Akyurek",authors:[{id:"197265",title:"Dr.",name:"Gokcen",middleName:null,surname:"Akyurek",slug:"gokcen-akyurek",fullName:"Gokcen Akyurek"}]},{id:"55024",doi:"10.5772/intechopen.68463",title:"Occupational Therapy in Oncology and Palliative Care",slug:"occupational-therapy-in-oncology-and-palliative-care",totalDownloads:2699,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Cancer is a chronic disease that may occur in both children and adults. Occupational therapy focuses on the activity limitations and participation problems in their life. Oncology rehabilitation involves in helping an individual with cancer to regain maximum physical, psychological, cognitive, social, and vocational functioning with the limits up to disease and its treatments in an interdisciplinary team concept. These treatment options are associated with the risk of some side effects, including fatigue, pain, cognitive problems, decrease in bone density and muscle endurance, weight loss, and stress- or anxiety-related psychosocial problems. Occupational therapy approaches are a holistic view in a client center and use training in activities of daily living, assistive technology, education of energy conservation techniques, and management of treatment-related problems, such as pain, fatigue, and nausea. In palliative and hospice care, occupational therapists support clients with cancer by minimizing the secondary symptoms related to cancer and its treatments. At the end of life, occupational therapy offers to identify the roles and activities that are meaningful and purposeful to the client with cancer and try to determine the barriers that limit their performance. Clients with cancer who have childhood cancer or adult cancer can face problems about body structure and functions, activity, and participation, which may limit their participation to their daily life.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Sedef Şahin, Semin Akel and Meral Zarif",authors:[{id:"183079",title:"Ph.D.",name:"Sedef",middleName:null,surname:"Şahin",slug:"sedef-sahin",fullName:"Sedef Şahin"},{id:"183078",title:"Dr.",name:"Burcu Semin",middleName:null,surname:"Akel",slug:"burcu-semin-akel",fullName:"Burcu Semin Akel"},{id:"198859",title:"Dr.",name:"Meral",middleName:null,surname:"Zarif",slug:"meral-zarif",fullName:"Meral Zarif"}]},{id:"56049",doi:"10.5772/intechopen.69101",title:"Measurement of Participation: The Role Checklist Version 3: Satisfaction and Performance",slug:"measurement-of-participation-the-role-checklist-version-3-satisfaction-and-performance",totalDownloads:2823,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Participation in society is an area of interest to both clinicians and population researchers. Measurement of participation is therefore important, yet differences in definition, in terms of both content and scope, have made general agreement on one instrument tool elusive. What is recognized is the need for a theoretically based tool that captures both the insider and the outsider perspective. The outsider perspective, inclusive of the generally held views of a society, supports the utility for aggregating population data, whereas the insider perspective provides the internally held views of an individual needed for client-centered treatment planning. The Role Checklist Version 3 modifies one of the most commonly used assessment tools in occupational therapy practice, has good preliminary psychometric properties, and is theoretically consistent with both the ICF and the Model of Human Occupation. The Model of Human Occupation is the most widely used theoretical model in occupational therapy. This chapter provides an overview of the theoretical development, empirical testing, and implications for use of this participation measure by occupational therapists along with implications for population researchers.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Patricia J. Scott, Kelsey McKinney, Jeff Perron, Emily Ruff and Jessica\nSmiley",authors:[{id:"195495",title:"Dr.",name:"Patricia J",middleName:null,surname:"Scott",slug:"patricia-j-scott",fullName:"Patricia J Scott"},{id:"208801",title:"Dr.",name:"Kelsey G.",middleName:null,surname:"McKinney",slug:"kelsey-g.-mckinney",fullName:"Kelsey G. McKinney"},{id:"208802",title:"Mr.",name:"Jeffrey M.",middleName:null,surname:"Perron",slug:"jeffrey-m.-perron",fullName:"Jeffrey M. Perron"},{id:"208803",title:"Dr.",name:"Emily G.",middleName:null,surname:"Ruff",slug:"emily-g.-ruff",fullName:"Emily G. Ruff"},{id:"208804",title:"Dr.",name:"Jessica L.",middleName:null,surname:"Smiley",slug:"jessica-l.-smiley",fullName:"Jessica L. Smiley"}]},{id:"55018",doi:"10.5772/intechopen.68315",title:"Psychomotor Therapy for Patients with Severe Mental Health Disorders",slug:"psychomotor-therapy-for-patients-with-severe-mental-health-disorders",totalDownloads:2274,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"Psychomotor therapy is defined as a method of treatment based on a holistic view of the human being that is derived from the unity of body and mind. Assessments (observation and/or evaluation) are essential to achieving concrete psychosocial objectives methodically. Psychomotor therapy uses movement, body awareness and a wide range of movement activities to optimize movement behaviour as well as the cognitive, affective and relational aspects of psychomotor functioning (i.e. the relationships between physical movements and cognitive and social-affective aspects). Consequently, the approach to this type of therapy integrates the physical, cognitive and emotional aspects of functioning in relation to the capacity of being and acting in a psychosocial context in order to achieve clearly defined goals in consultation with the patients. Psychomotor therapy framework consists of three different approaches: a health-related approach, a psychosocial approach and a psychotherapeutic approach, which can be embedded in several psychotherapeutic approaches. Through the implementation of both systematically planned evaluations and individually targeted interventions in group, the psychomotor therapist strives to broaden the general action competences and specific skills and to stimulate a positive self-image and personal well-being in balanced social relationships. Today, there is sufficient evidence that psychomotor therapy has a major contribution to both well-being and mental health of patients with severe psychiatric problems. In Flemish psychiatric hospitals, psychomotor therapy is imbedded in different treatment programmes. In this chapter, the theory behind this approach and some practical examples will be provided.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Michel Probst",authors:[{id:"196227",title:"Prof.",name:"Michel",middleName:null,surname:"Probst",slug:"michel-probst",fullName:"Michel Probst"}]}],mostDownloadedChaptersLast30Days:[{id:"55080",title:"Life Skills in Occupational Therapy",slug:"life-skills-in-occupational-therapy",totalDownloads:6076,totalCrossrefCites:4,totalDimensionsCites:1,abstract:"Occupational therapy is a health profession that uses the purposeful activities to achieve multiple and complex rehabilitation aims. The main goals of the occupational therapy are to support the reintegration of individuals in daily living skills as well as to increase their independence and autonomy. Interventions of occupational therapists have primarily focused on self-care, productivity, and leisure time activities. Since the life skills includes a wide range of abilities that enable a person to perform personal care and more complicated tasks such as traveling, shopping, community participation etc., occupational therapists provide life skills training programs to meet the needs of the clients. This chapter aims to contribute to the current understanding and practices of life skills from an occupational therapy perspective. The chapter starts with a brief discussion of the importance of life skills in occupational therapy. After this introduction, the first part takes a look at the definition of life skills and identifies core components of life skills. The second part describes assessment and interventions of life skills. The third one gives an overview about school life skills programs for children and adolescents. Finally, the last part explains some life skills programs in people with disadvantages.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Hatice Abaoğlu, Özge Buket Cesim, Sinem Kars and Zeynep Çelik",authors:[{id:"197551",title:"Dr.",name:"Hatice",middleName:null,surname:"Abaoğlu",slug:"hatice-abaoglu",fullName:"Hatice Abaoğlu"},{id:"205199",title:"Dr.",name:"Sinem",middleName:null,surname:"Kars",slug:"sinem-kars",fullName:"Sinem Kars"},{id:"205200",title:"Dr.",name:"Zeynep",middleName:null,surname:"Celik",slug:"zeynep-celik",fullName:"Zeynep Celik"},{id:"205203",title:"Ms.",name:"Özge Buket",middleName:null,surname:"Cesim",slug:"ozge-buket-cesim",fullName:"Özge Buket Cesim"}]},{id:"62493",title:"Occupational Therapy in Forensic Settings",slug:"occupational-therapy-in-forensic-settings",totalDownloads:2543,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"It is necessary for a person to comply with the expectations of society and the rules of law to which these expectations are secured. Offenders turn back to the community after the penalty was executed by isolating from society and some occupations. An occupational imbalance is seen in the individuals, during this penalty period and afterward, because of limited occupational participation. As an occupational being, this affects their physical, mental and psychological well-being. Imprisonment is an important practice in criminal law to punish criminals. This may be necessary for the protection of society from criminals, but successful integration into a community after exiting the prison is the most important factor in preventing recidivism. Occupational therapy focuses on health and well-being by using meaningful and purposeful occupations. Occupation involves any activity that people perform or participate in, such as giving care to themselves or others, working, learning, playing games, and interacting with others. From this perspective, the role of occupational therapists in forensic settings is to determine the abilities of these individuals to congregate their deprived freedoms and use them to train them for an independent and autonomous life; to provide a professional orientation, career counseling, and self-esteem; to gain some habits for physical, spiritual and moral life and to reinforce.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Esma Ozkan, Sümeyye Belhan, Mahmut Yaran and Meral Zarif",authors:null},{id:"70122",title:"Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives",slug:"parkinson-s-disease-rehabilitation-effectiveness-approaches-and-new-perspectives",totalDownloads:2083,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"Parkinson’s disease has been considered one of the most important and common neurodegenerative diseases in the world. Its motor and nonmotor signs determine a huge functional loss, leading the individuals to lose their independence. Although the treatment requires a pharmacological approach, physical therapy has confirmed its importance in this process. Today, neurorehabilitation is indispensable to increase many of the cardinal signs of the disease. Using traditional or technological approaches, physical therapy has reached good results in improving motor and nonmotor functions, as well as the quality of life of Parkinsonians. However, it is important to develop and to fortify the physical therapy approach so that we can provide stronger evidence about our practice.",book:{id:"7543",slug:"physical-therapy-effectiveness",title:"Physical Therapy Effectiveness",fullTitle:"Physical Therapy Effectiveness"},signatures:"Luciana Auxiliadora de Paula Vasconcelos",authors:[{id:"98546",title:"Dr.",name:"Luciana Auxiliadora",middleName:null,surname:"De Paula Vasconcelos",slug:"luciana-auxiliadora-de-paula-vasconcelos",fullName:"Luciana Auxiliadora De Paula Vasconcelos"}]},{id:"62210",title:"Occupational Therapy’s Role in the Treatment of Children with Autism Spectrum Disorders",slug:"occupational-therapy-s-role-in-the-treatment-of-children-with-autism-spectrum-disorders",totalDownloads:2756,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Occupational therapists (OT) offer a wide range of therapies for individuals with ASD on the basis of specific deficits and difficulties. This chapter explores the role that OT plays, and the expertise, in relation to the interdisciplinary team. In addition, it discusses and presents empirical support for several therapeutic approaches commonly used by OTs working with individuals with ASD.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Bryan M. Gee, Amy Nwora and Theodore W. Peterson",authors:null},{id:"55049",title:"Community Participation in People with Disabilities",slug:"community-participation-in-people-with-disabilities",totalDownloads:2436,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Despite the fact that participation is an important building and a valuable target, the conceptualization, identification and measurement methods vary widely. This chapter tried to gain an insider’s perspective from the obstacles that summarize what meaning participation means, how to characterize it, and what prevents and supports participation. Participation is seen as a right and a responsibility attributed to and attributed to both the person and the community. Participation does not take place in a vacuum; the environment dynamically influences participation. 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Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{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://mts.intechopen.com/storage/users/219081/images/system/219081.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. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",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:"329248",title:"Dr.",name:"Md. Faheem",middleName:null,surname:"Haider",slug:"md.-faheem-haider",fullName:"Md. Faheem Haider",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329248/images/system/329248.jpg",biography:"Dr. Md. Faheem Haider completed his BPharm in 2012 at Integral University, Lucknow, India. In 2014, he completed his MPharm with specialization in Pharmaceutics at Babasaheb Bhimrao Ambedkar University, Lucknow, India. He received his Ph.D. degree from Jamia Hamdard University, New Delhi, India, in 2018. He was selected for the GPAT six times and his best All India Rank was 34. Currently, he is an assistant professor at Integral University. Previously he was an assistant professor at IIMT University, Meerut, India. He has experience teaching DPharm, Pharm.D, BPharm, and MPharm students. He has more than five publications in reputed journals to his credit. Dr. Faheem’s research area is the development and characterization of nanoformulation for the delivery of drugs to various organs.",institutionString:"Integral University",institution:{name:"Integral University",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/system/329795.png",biography:"Dr. Mohd Aftab Siddiqui is an assistant professor in the Faculty of Pharmacy, Integral University, Lucknow, India, where he obtained a Ph.D. in Pharmacology in 2020. He also obtained a BPharm and MPharm from the same university in 2013 and 2015, respectively. His area of research is the pharmacological screening of herbal drugs/natural products in liver cancer and cardiac diseases. He is a member of many professional bodies and has guided many MPharm and PharmD research projects. Dr. Siddiqui has many national and international publications and one German patent to his credit.",institutionString:"Integral University",institution:null}]}},subseries:{item:{id:"1",type:"subseries",title:"Oral Health",keywords:"Oral Health, Dental Care, Diagnosis, Diagnostic Imaging, Early Diagnosis, Oral Cancer, Conservative Treatment, Epidemiology, Comprehensive Dental Care, Complementary Therapies, Holistic Health",scope:"
\r\n\tThis topic aims to provide a comprehensive overview of the latest trends in Oral Health based on recent scientific evidence. Subjects will include an overview of oral diseases and infections, systemic diseases affecting the oral cavity, prevention, diagnosis, treatment, epidemiology, as well as current clinical recommendations for the management of oral, dental, and periodontal diseases.
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Her qualifications are: a specialist in Dental Imaging and Radiology, Master in Dentistry (Periodontics) from the University of São Paulo (FORP-USP, Ribeirão Preto, SP), and Doctor (Ph.D.) in Dentistry (Stomatology Clinic) from Hospital São Lucas of the Pontifical Catholic University of Rio Grande do Sul (HSL-PUCRS, Porto Alegre, RS). She held a postdoctoral internship at the Federal University from Jequitinhonha and Mucuri Valleys (UFVJM, Diamantina, MG). She is currently a member of the Brazilian Society for Dental Research (SBPqO) and the Brazilian Society of Stomatology and Pathology (SOBEP). Dr. Marinho's experience in Dentistry mainly covers the following subjects: oral diagnosis, oral radiology; oral medicine; lesions and oral infections; oral pathology, laser therapy and epidemiological studies.",institutionString:null,institution:{name:"State University of Paraíba",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,series:{id:"3",title:"Dentistry",doi:"10.5772/intechopen.71199",issn:"2631-6218"},editorialBoard:[{id:"267724",title:"Prof.",name:"Febronia",middleName:null,surname:"Kahabuka",slug:"febronia-kahabuka",fullName:"Febronia Kahabuka",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRZpJQAW/Profile_Picture_2022-06-27T12:00:42.JPG",institutionString:"Muhimbili University of Health and Allied Sciences, Tanzania",institution:{name:"Muhimbili University of Health and Allied Sciences",institutionURL:null,country:{name:"Tanzania"}}},{id:"70530",title:"Dr.",name:"Márcio",middleName:"Campos",surname:"Oliveira",slug:"marcio-oliveira",fullName:"Márcio Oliveira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRm0AQAS/Profile_Picture_2022-08-01T12:34:46.jpg",institutionString:null,institution:{name:"State University of Feira de Santana",institutionURL:null,country:{name:"Brazil"}}}]},onlineFirstChapters:{paginationCount:25,paginationItems:[{id:"82654",title:"Atraumatic Restorative Treatment: More than a Minimally Invasive Approach?",doi:"10.5772/intechopen.105623",signatures:"Manal A. 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