Classification and the criteria of ototoxic substances based on occupational exposure limits.
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"6938",leadTitle:null,fullTitle:"Elections - A Global Perspective",title:"Elections",subtitle:"A Global Perspective",reviewType:"peer-reviewed",abstract:"Among the most prized and revered democratic institutions are elections. Few other actions typify what it means to participate in the democratic process in the same way that turning up, casting a ballot, and then having that ballot be part of determining who will control power has. Indeed, elections are at the center of what we view as democracy and much ink has been spilled in attempting to explain just how essential the electoral action is to democracy. In this volume our authors explore elections both from an understanding of the systems that govern elections across both the developed and developing world, and from the perspective of the individual voter who participates in that system. Taken together these analyses provide an intriguing look into this core aspect of democracy.",isbn:"978-1-78985-026-0",printIsbn:"978-1-78985-025-3",pdfIsbn:"978-1-83962-003-4",doi:"10.5772/intechopen.73469",price:119,priceEur:129,priceUsd:155,slug:"elections-a-global-perspective",numberOfPages:158,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"4a122ebf3b961d2c46bbfc8def2916fe",bookSignature:"Ryan M. Yonk",publishedDate:"February 6th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/6938.jpg",numberOfDownloads:9828,numberOfWosCitations:1,numberOfCrossrefCitations:1,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:3,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:5,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 17th 2018",dateEndSecondStepPublish:"May 8th 2018",dateEndThirdStepPublish:"July 7th 2018",dateEndFourthStepPublish:"September 25th 2018",dateEndFifthStepPublish:"November 24th 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"196259",title:"Dr.",name:"Ryan Merlin",middleName:null,surname:"Yonk",slug:"ryan-merlin-yonk",fullName:"Ryan Merlin Yonk",profilePictureURL:"https://mts.intechopen.com/storage/users/196259/images/system/196259.jpg",biography:"Ryan M. Yonk is a senior faculty fellow at the American Institute for Economic Research, Massachusetts. He holds a Ph.D. from Georgia State University and an MS and BS from Utah State University. He has held academic positions at North Dakota State University, Utah State University, and Southern Utah University, and was one of the founders of the Strata Policy. He is the author or editor of numerous books including Politics and Quality of Life: The Role of Well-Being in Political Outcomes, Green V. Green, and Nature Unbound: Bureaucracy vs. the Environment. He has also (co) authored numerous articles in academic journals including Public Choice, Applied Research in Quality of Life, and the Journal of Private Enterprise. His research explores how policy can be better crafted to achieve greater individual autonomy and prosperity.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"5",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"American Institute for Economic Research",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"277",title:"Social Policy",slug:"social-policy"}],chapters:[{id:"64192",title:"Who Does Not Vote and Why? Implication for New Democracies",doi:"10.5772/intechopen.80988",slug:"who-does-not-vote-and-why-implication-for-new-democracies",totalDownloads:961,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"With the attention of scholars already drawn to the decline in voter turnout in new democracies after the first wave of open/competitive elections, by relying on aggregate data studies have provided explanations for cross-national variations in turnout. Yet, the reliance on aggregate data makes it hard to establish what had lead individuals to abstain from the political process. Thus, in this chapter, by using individual-level analysis from the European Social Survey and the Afrobarometer we re-interrogate the determinants of non-voting in two new democracies of post-Communist Europe and sub-Saharan Africa. Having tested the various explanations for non-voting, first, our results show some consistency across the two regions, suggesting non-voters are those who lack any form of psychological engagement with politics, who are isolated from the recruitment networks and live in urban areas. Second, our result tends to be contradictory, in which while in post-Communist Europe non-voters are men and those with lower level of education in sub-Saharan Africa they are women and those with higher level of education. Third, pertaining to country level indicators, apart from the fact non-voters in both regions are those who have no trust in elections and who lived in countries with disproportional electoral systems, the results tend to be varied.",signatures:"Elvis Bisong Tambe",downloadPdfUrl:"/chapter/pdf-download/64192",previewPdfUrl:"/chapter/pdf-preview/64192",authors:[{id:"255692",title:"Dr.",name:"Elvis Bisong",surname:"Tambe",slug:"elvis-bisong-tambe",fullName:"Elvis Bisong Tambe"}],corrections:null},{id:"63923",title:"The Electoral Cycle and Grassroots Realities in Cameroon: The Omnipresent, Overbearing and Contested Political Elite",doi:"10.5772/intechopen.80966",slug:"the-electoral-cycle-and-grassroots-realities-in-cameroon-the-omnipresent-overbearing-and-contested-p",totalDownloads:996,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:1,abstract:"Electoral periods in Cameroon involve an impressive mobilisation of human, material and financial resources. Campaigning is marked by rallies, speeches, door-to-door solicitations, as well as vote buying, intimidation, ballot box stuffing etc. Electoral manipulation involves selective voter registration, tampering with the electoral roll and other administrative manoeuvres. At the centre of these activities is a group of people known locally as the political elite. These elites notably the head of state Paul Biya, key cabinet members, government officials etc. have been at the helm of the state since independence in the 1960s. At the receiving end are grassroots populations, who over the years witnessed the political elite appear on the eve of elections and disappear immediately thereafter. On occasion, the grassroots are able to see through the mirage, which often leaves some members of the political elite staring into the abyss. This chapter is based on events around the 2013 municipal and legislative elections in Mbankomo in the Centre Region of Cameroon. I employed participant observation, document and archival analysis, interviews among others to unearth and document the complex relationship between grassroots populations, party officials and other high-ranking members of the governing CPDM party during election periods in Cameroon.",signatures:"Numvi Gwaibi",downloadPdfUrl:"/chapter/pdf-download/63923",previewPdfUrl:"/chapter/pdf-preview/63923",authors:[{id:"256697",title:"Dr.",name:"Wallace",surname:"Numvi Gwaibi",slug:"wallace-numvi-gwaibi",fullName:"Wallace Numvi Gwaibi"}],corrections:null},{id:"63851",title:"Electoral Behavior and Politics of Stomach Infrastructure in Ekiti State (Nigeria)",doi:"10.5772/intechopen.81387",slug:"electoral-behavior-and-politics-of-stomach-infrastructure-in-ekiti-state-nigeria-",totalDownloads:1133,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Ekiti State is one of the most literate communities in Nigeria and adjudged to be a politically sophisticated entity within the federation. Expectedly, its politics becomes a research interest for political observers, policymakers and scholars alike. However, the 2014 governorship poll and 2015 general elections in the state present some socio-political paradoxes, contradictions and nuances that need an analytical examination. What could have propelled a state rich in human capital to prefer the choice of “stomach infrastructure” over sustainable development? What could have precipitated the rejection of a manifesto-driven candidature in preference for “I will put smile on your faces” sloganeering? This study interrogates the philosophical and socio-political underpinnings that may have shaped the political behavior of Ekiti people within the context of its larger Yoruba nation in particular and Nigeria in general. It also examines the nexus between performance in government—as a political investment—and electoral rewards by the voters. It employs the concept of prebendalism to further examine the interplay between politics of the belly and voting behavior in an electoral contest.",signatures:"Mike Omilusi",downloadPdfUrl:"/chapter/pdf-download/63851",previewPdfUrl:"/chapter/pdf-preview/63851",authors:[{id:"256067",title:"Dr.",name:"Mike",surname:"Omilusi",slug:"mike-omilusi",fullName:"Mike Omilusi"}],corrections:null},{id:"63563",title:"Electoral Legitimacy, Preventive Representation, and Regularization of Authoritarian Democracy in Bangladesh",doi:"10.5772/intechopen.80929",slug:"electoral-legitimacy-preventive-representation-and-regularization-of-authoritarian-democracy-in-bang",totalDownloads:1029,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Despite variations in its forms, contents, and qualities, arguably regular election is the only tool that upholds the “democratic” label of a government. Election works as the only legitimizing factor and, over the past several decades, it has become a popular means for authoritarian political leaders or dominant political parties in young or transitional democracies to consolidate their powerbase. Hence, elections have apparently lost their representative value and have, increasingly, been turned into a democratic means to legitimize and institutionalize undemocratic regimes. This has been the most obvious trend in Bangladesh electoral politics over the past decade. Both national and local level elections are engineered in such ways through manipulating electoral laws, the election commission, and the legal system that effectively developed an intended mechanism of preventive representation. A field of electoral competition emerged from such a mechanism where the opposition parties are formally and informally prevented from entering competition in the first place. Technically, this is shown as deliberate nonparticipation by the opposition parties but, in effect, nonparticipation is deliberately orchestrated by the ruling party. An eventual outcome is a government that is free from the parliamentary or legislative opposition, which helps to regularize an authoritarian democracy in the country.",signatures:"Moniruzzaman M.",downloadPdfUrl:"/chapter/pdf-download/63563",previewPdfUrl:"/chapter/pdf-preview/63563",authors:[{id:"256037",title:"Associate Prof.",name:"Moniruzzaman",surname:"M.",slug:"moniruzzaman-m.",fullName:"Moniruzzaman M."}],corrections:null},{id:"63783",title:"Estimating the Effect of Voters’ Media Awareness on the 2016 US Presidential Election",doi:"10.5772/intechopen.80964",slug:"estimating-the-effect-of-voters-media-awareness-on-the-2016-us-presidential-election",totalDownloads:3219,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"We examine whether voter media awareness of the 2016 US Presidential election campaign influenced the election using a logit model to estimate the probability that a voter with certain characteristics votes for one of the two candidates. Our results indicate that the more active voters were on social media, the more likely they were to vote for Trump, and the more aware they were of the electoral campaign (watching TV, listening to the radio, reading newspapers, etc.) and the more interested they were in the news/politics, the less likely they were to vote for Trump. The impact of these variables was not as important as their sociodemographic characteristics.",signatures:"Lauren Dique and Maria Gallego",downloadPdfUrl:"/chapter/pdf-download/63783",previewPdfUrl:"/chapter/pdf-preview/63783",authors:[{id:"258400",title:"Prof.",name:"Maria",surname:"Gallego",slug:"maria-gallego",fullName:"Maria Gallego"},{id:"262143",title:"Ms.",name:"Lauren",surname:"Dique",slug:"lauren-dique",fullName:"Lauren Dique"}],corrections:null},{id:"64134",title:"How Italian Female Local and National Politicians Perceive and Cope with Obstacles in a Gatekeeping Political Culture",doi:"10.5772/intechopen.81728",slug:"how-italian-female-local-and-national-politicians-perceive-and-cope-with-obstacles-in-a-gatekeeping-",totalDownloads:839,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In spite of decades of women’s political battles, there is a persistent underrepresentation of women in legislative bodies, with only 23.8% in 2018. In this chapter, we discuss theories and empirical studies that have explored what kind of obstacles female politicians are more likely to meet and how they cope with them, when they face more hurdles, and why we need more women elected to political office. Furthermore, we report the results of several studies, which have involved 233 Italian national politicians (46% females), 425 local politicians (56% females), 626 political activists (44% females), and 3249 ordinary citizens (49% females). Results of these studies show that female politicians face mainly external obstacles as the gatekeeping theory maintains. Women find obstacles all along their political career supporting labyrinth hypotheses. Females at all levels of political involvement scored higher in self-transcendence values that emphasize concern for the welfare of others, partially confirming the politics of presence theory. Female politicians were also more open to change and less conservation oriented than their male colleagues. Our findings in general support ethical struggles for a more balanced gender representation.",signatures:"Donata Francescato and Minou Ella Mebane",downloadPdfUrl:"/chapter/pdf-download/64134",previewPdfUrl:"/chapter/pdf-preview/64134",authors:[{id:"149375",title:"Prof.",name:"Donata",surname:"Francescato",slug:"donata-francescato",fullName:"Donata Francescato"},{id:"261445",title:"Prof.",name:"Minou Ella",surname:"Mebane",slug:"minou-ella-mebane",fullName:"Minou Ella Mebane"}],corrections:null},{id:"64200",title:"Presidential Elections of 1934 in Colombia and Mexico",doi:"10.5772/intechopen.81232",slug:"presidential-elections-of-1934-in-colombia-and-mexico",totalDownloads:787,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter reflects upon the 1934 electoral processes of Colombia and Mexico, after which presidents Alfonso López Pumarejo and Lázaro Cárdenas, respectively, were elected. They both designed social government programs, with the aim of improving the living conditions of the population. From the electoral history, a historiographical and documental review was carried out, which allowed for a better understanding of the political dynamics of the two candidates in distinct settings, but both with political projects oriented toward aiding the most vulnerable. This allowed a view of how their government programs were perceived during the electoral campaigns and what brought about the favorable results which made Alfonso López the president of Colombia and Lázaro Cárdenas the president of Mexico.",signatures:"Olga Yanet Acuña Rodriguez",downloadPdfUrl:"/chapter/pdf-download/64200",previewPdfUrl:"/chapter/pdf-preview/64200",authors:[{id:"258008",title:"Ph.D.",name:"Olga Yanet",surname:"Acuña Rodriguez",slug:"olga-yanet-acuna-rodriguez",fullName:"Olga Yanet Acuña Rodriguez"}],corrections:null},{id:"63499",title:"Judicialization and Citizens: Elites and Election Practices—Chile, 1860–1920",doi:"10.5772/intechopen.80931",slug:"judicialization-and-citizens-elites-and-election-practices-chile-1860-1920",totalDownloads:865,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This paper examines the judicialization and election practices and their impact on Chilean citizens in the nineteenth century. It is established that the formation and maintenance of an archaic political-electoral system served for many decades the interests of an elite that kept the middle and lower classes excluded from political participation. The political culture of the elite, which was tied to fraud, corruption, bribery, and intimidation against the voters, was not transformed by the decorative political and electoral reforms. In that context, these forms of behavior were supported by the existence of a pseudo-democratic government that ruled with a complete indifference of the legal and constitutional standards and whose main victims were poor people and farmers frequently treated despotically. The lack of a “human rights culture,” meaning, the idea that all individuals have rights, as well as the absence of a genuine competition between parties to regulate the political power through equal and effective vote, showed, until around 1920, the fragile state of a political-electoral system controlled by the infights between important families that alternated their position in ruling.",signatures:"Juan Cáceres Muñoz",downloadPdfUrl:"/chapter/pdf-download/63499",previewPdfUrl:"/chapter/pdf-preview/63499",authors:[{id:"255301",title:"Ph.D.",name:"Juan",surname:"Cáceres",slug:"juan-caceres",fullName:"Juan Cáceres"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"9030",title:"Perspectives on Economic Development",subtitle:"Public Policy, Culture, and Economic Development",isOpenForSubmission:!1,hash:"8167ab72010ab459c0fc080da946ae8c",slug:"perspectives-on-economic-development-public-policy-culture-and-economic-development",bookSignature:"Ryan Merlin Yonk and Vito Bobek",coverURL:"https://cdn.intechopen.com/books/images_new/9030.jpg",editedByType:"Edited by",editors:[{id:"196259",title:"Dr.",name:"Ryan Merlin",surname:"Yonk",slug:"ryan-merlin-yonk",fullName:"Ryan Merlin Yonk"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7781",title:"Improving Quality of Life",subtitle:"Exploring Standard of Living, Wellbeing, and Community Development",isOpenForSubmission:!1,hash:"8130b1bca2a4feb7f313f127d302dcdd",slug:"improving-quality-of-life-exploring-standard-of-living-wellbeing-and-community-development",bookSignature:"Ryan Merlin Yonk",coverURL:"https://cdn.intechopen.com/books/images_new/7781.jpg",editedByType:"Edited by",editors:[{id:"196259",title:"Dr.",name:"Ryan Merlin",surname:"Yonk",slug:"ryan-merlin-yonk",fullName:"Ryan Merlin Yonk"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9537",title:"Human Rights in the Contemporary World",subtitle:null,isOpenForSubmission:!1,hash:"54f05b93812fd434f3962956d6413a6b",slug:"human-rights-in-the-contemporary-world",bookSignature:"Trudy Corrigan",coverURL:"https://cdn.intechopen.com/books/images_new/9537.jpg",editedByType:"Edited by",editors:[{id:"197557",title:"Dr.",name:"Trudy",surname:"Corrigan",slug:"trudy-corrigan",fullName:"Trudy Corrigan"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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\r\n\tThe word “research” comes from the French word “recherche” which means an intensive force to search. Medical research is designed to provide recent information on health or disease. There are three areas of research, i.e. basic medical research, clinical research and epidemiological research. This book aims to be a comprehensive guide for medical research, and will discuss the topics on ethics, statistics, study designs, resources, recent advances and grants for medical research.
\r\n\r\n\tThe book "Medical Research” will bring together the worldwide contributions and experiences of renowned medical researchers from several parts of the world the clinical applications from different academic medical research institutions. Each chapter will be structured and designed for those with a basic knowledge of research. This book will be very useful and informative to fellows in medical research, residents in internal medicine. The authors will concentrate on advances in modern medical research useful in daily clinical practice.
",isbn:null,printIsbn:"979-953-307-X-X",pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"f054553b4f0531b051d2fa79a63374e6",bookSignature:"Prof. Sharan Badiger and Prof. Prema T. Akkasaligar",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/9513.jpg",keywords:"Ethical Review, Good Clinical Practice, Conflict of Interest, Medical Statistics, Statistical Analysis, Study Sample Calculation, Clinical Trials, Human Resource, Animal Resource, Stem cell research, Cancer research, Funding Agencies",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 13th 2019",dateEndSecondStepPublish:"December 4th 2019",dateEndThirdStepPublish:"February 2nd 2020",dateEndFourthStepPublish:"April 22nd 2020",dateEndFifthStepPublish:"June 21st 2020",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 years",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"168832",title:"Prof.",name:"Sharan",middleName:null,surname:"Badiger",slug:"sharan-badiger",fullName:"Sharan Badiger",profilePictureURL:"https://mts.intechopen.com/storage/users/168832/images/system/168832.jpg",biography:"Dr. Sharan Badiger was born in 1968. He completed his MD in Internal Medicine, Gulbarga University, Gulbarga, Karnataka, India in 1994 and MBBS, Gulbarga University, Gulbarga, Karnataka, India in 1989. He is presently working as Professor and Head in the Department of Medicine, Sri. B. M. Patil Medical College, Vijayapur, Karnataka, India affiliated to BLDE University Vijayapur, Karnataka, India. He's recently been awarded Senior Scientist award – 2019 in 7th convocation 2019. \r\n\r\nHis main research interests are in Internal Medicine, Echocardiography and Imaging in Medicine. He has 60 publications in International/National Journals and Proceedings of the conferences. He is a Life Member of Association of Physicians of India (API) since 1996, Research Society for the Study of Diabetes in India (RSSDI) since 2005, Indian Society of Cardiology (ISC) since 2006, Indian Society of Electro-cardiology (ISE) since 2010, Indian Academy of Geriatrics (IAG) since 2010, International Association of Computer Science and Information Technology (IACSIT), Singapore since 2010. He is an Associate Member of American College of Cardiology; he is serving as editor-in-chief, editorial board member, the peer reviewer and advisory board member of various journals of national and international repute.",institutionString:"Shri B. M. Patil Medical College",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Shri BM Patil Medical College",institutionURL:null,country:{name:"India"}}}],coeditorOne:{id:"168831",title:"Prof.",name:"Prema T.",middleName:null,surname:"Akkasaligar",slug:"prema-t.-akkasaligar",fullName:"Prema T. Akkasaligar",profilePictureURL:"https://mts.intechopen.com/storage/users/168831/images/10715_n.jpg",biography:"Dr. Prema T. Akkasaligar is working as a Professor and PG coordinator at the Department of Computer Science and Engineering of BLDEA's V P Dr. PG Halakatti College of Engineering & Technology, Vijayapur, Karnataka, India. She has completed her Ph.D. from Gulbarga University, Gulbarga in 2013, ME (CSE) from Gulbarga University, Kalaburagi in 1999. \r\n\r\nShe has published 8 book chapters, 24 articles in international journals, 17 international conference papers and 3 national conference papers. She was selected for National Level AICTE – UKIERI Technical Leadership Development Programme for the year 2019-2020. She has been awarded for highest research publications for the year 2018. Appreciation certificate by the LEAD program of Deshpande foundation on account of International Women’s Day 2019. BEST Publisher of the Department for the Year 2017-2018. She is guiding several research scholars\r\nunder VTU, Belagavi. She is a life member of the Computer Society of India (CSI), Indian Society for Technical Education (ISTE), The Institution of Engineers, India (IEI) and International Association of Computer Science and Information Technology (IACSIT), Singapore. She has been a resource person in several workshops and FDPs. She has completed several research projects sanctioned by KBITS Incubation center Karnataka, VTU- FOSS Belagavi. Her areas of interest are Medical image processing and Computer vision.",institutionString:"BLDEA's V. P. Dr. P. 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Up to 25% of workers are exposed to workplace noise above 85 dB(A) (weighted decibel relative to human ear) [1]. Noise-induced hearing loss (NIHL) is the second most common cause of hearing loss after age-related hearing loss (ARHL) and 16% of adult hearing loss is estimated to be caused by workplace noise [2]. In addition, one-third of workers exposed to noise showed audiometric evidence of NIHL, with 16% experiencing material hearing loss [3, 4].
The prevalence of NIHL is increasing worldwide. Prevalence in Korea is also increasing, especially over the past 20 years. Cases of accepted compensation for NIHL are more rapidly rising from 2016 than the cases for audiometric diagnosis (Figure 1).
Prevalence of noise-induced hearing loss (D1) and compensated cases in Korea by year (1991 to 2018). Prevalence of noise-induced hearing loss (D1) (in blue bars) and cases for compensation (in red line) have increased from 1991 to 2018. Diagnostic criteria of NIHL in Korea requires hearing loss more than 30 dB on average threshold across 0.5 kHz, 1 kHz, and 2 kHz and more than 50 dB at 4 kHz. If the average threshold exceeds 40 dB, decision for compensation could be made. The compensated cases for NIHL were increasing more sharply since 2016, whereas the diagnosed cases were increasing more steadily.
Hearing loss is associated with cognitive decline and depression, and now accepted as a risk factor for dementia [5]. Noise from by daily life (subways, electric tools) or hobby (music concerts, sports viewing, hunting, etc.) can also contribute to hearing loss.
There are jobs where hearing is very important due to the nature of work itself or safety concerns. Hearing loss reduces speech recognition ability in the noisy environment and hearing protection devices (HPDs) also hampers speech recognition in noise. When hearing impaired workers wear a HDPs, their difficulty increases in hearing warning signals. There was association between the severity of hearing loss and the risk of work-related injury requiring hospitalization [6]. Even in the workplace where hearing is less important, hearing loss is a major cause of stress-related sick leave [7]. Economic impact of NIHL on social burden includes lost productivity, absenteeism, reduced income and tax revenues, welfare payment and compensation, special education, vocational rehabilitation programs, and health care [8].
The purpose of this review is to have a comprehensive overview of NIHL including pathophysiology, diagnosis, prevention, and to understand the recently emerging topics on noise-induced cochlear synaptopathy.
Noise-induced hearing loss is a complex disease caused by the interaction of genetic and environmental factors. It is usually caused by chronic loud noise exposure but also could be caused by transient or repetitive acoustic trauma of very high intensity, resulting in greater damage [9]. The total energy level of noise causing NIHL is determined by the intensity of the noise and the total exposure time. The noise at the same total energy level will cause the same amount of cochlear damage [10].
The inner ear damage caused by noise is divided into temporary threshold shift (TTS) and permanent threshold shift (PTS) depending on the duration of the hearing loss. Hearing loss recovers within 24–48 hours in TTS, while it is irreversible in PTS. Mechanisms of TTS and PTS are considered to be different. Animal study showed that TTS in early life can accelerates age-related hearing loss (ARHL) [11]. However, long-term impact of TTS in human ear is lacking. Pathology of noise induced damage is the loss of outer hair cells leading to threshold elevations and poorer frequency discrimination. Main threshold shift occurs at an half octave higher than the frequency of loud noise, with the largest damage at 4 kHz and the smallest at 0.5 kHz [12]. Susceptibility around 4 kHz is associated with the mechanical properties of the middle ear and resonance frequency of external auditory canal [13].
Mechanism of cochlear pathology can be categorized into mechanical and metabolic [12]. Metabolic damage is a major mechanism of NIHL from chronic exposure to noise. Characteristic finding is loss of hair cells as a result of increased free radicals such as reactive oxygen species (ROS) and reactive nitrogen species within cochlear hair cells [14]. Damage starts in outer hair cells in row 2 and 3 of most vulnerable area to noise, possibly as a result of necrosis [15]. Noise releases ROS from mitochondria into cytoplasm of hair cells via release of Ca2+. Cytoplasmic ROS leads to production of pro-inflammatory cytokines and pro-apoptotic factors, finally to apoptosis of hair cells. Free radicals can persist for 7–10 days after cessation of noise exposure, which could induce progressive cochlear damage [16]. Noise-induced ischemia and reperfusion also increase the generation of ROS [14]. Lipid peroxidation induced by ROS acts as a toxic substance, causing apoptosis [15].
When the noise is extremely loud over 130 dB SPL, mechanical damage could occur via excessive vibrations of the delicate cochlear structures. Breaking or fusion of stererocilia of hair cells are most specific morphopathology. Noise could damage other cochlear structures; damage to cochlear vasculature, loss of fibrocytes, rupture of attachments of stereocilia tips to the tectorial membrane, distension or rupture of tip links, damage to pillar cells, and rupture of dendrites [14]. Noise could crumple pillar cell, decreasing length of the OHC, and detaching stereocilia from tectorial membrane in reversible way, which is understood as a mechanism of TTS [17].
Recent hot topic on noise-induced damage on auditory system is cochlear synaptopathy. Until recently, noise that does not cause threshold shift was considered safe. However, recent animal experiments have shown that noise exposure that does not cause hair cell loss may damage ribbon synapse between inner hair cell and spiral ganglion neuron [11]. Cochlear inner hair cells (IHCs) are important as mechano-electrical transducer of auditory information. Receptor potential generated by IHCs releases the neurotransmitter at the synaptic end, while outer hair cells work as cochlear amplifier via process of electromotility which increases the vibration of basilar membrane. Synaptic ribbon is specialized electron-dense structure, which is anchored to pre-synaptic membrane only nanometers apart. It contains large pool of “readily releasable” vesicles to finely vary synaptic output continuously in sensory organ of hearing and vision [18]. Thus, damage of ribbon synapse between IHCs and spiral neurons results in improper conveyance of neural information to auditory nerve fiber. Noise causes damage of presynaptic ribbons and postsynaptic nerve terminals showing various degree of swelling. The mechanism of damage for postsynaptic terminal is glutamate-mediated excitotoxicity, while mechanism of ribbon loss is unclear [19]. In cochlear synaptopathy, hearing threshold is normal because OHC is undamaged, but the amplitude of auditory nerve activity decreases as a result of silenced auditory nerve fibers [20].
Auditory nerve fibers (ANFs) could be functionally categorized by their spontaneous rate (SR). High-SR ANFs respond to sound at threshold level, whereas low-SR ANFs react to loud sound, follow rapid amplitude changes of acoustic signal, and are considered to have an important role in the hearing in noisy environment due to their larger dynamic range. Low-SR ANF appears to be damaged selectively after noise exposure [20]. Because it causes functional hearing loss without threshold change, it is also called “noise-induced hidden hearing loss”. Cochlear synaptopathy could be permanent and lead to a degenerative death of the spiral ganglion neuron [21]. The results of human studies on cochlear synaptopathy are controversial. If the cochlear synaptopathy is confirmed in human subjects, the conventional belief that noise would be safe if it does not cause a threshold shift should be changed [19].
Severity of cochlear damage after noise exposure varies among individuals. Genetic factors would account for the different susceptibility up to 50% [22]. In animal study, genetic deficits leading to ARHL predispose the inner ear to NIHL [23]. Single Nucleotide Polymorphism (SNP) is the most common site of genomic mutations. It is estimated that the SNP of K+ recycling gene and heat shock protein (HSP) gene in the inner ear is associated with the sensitivity of NIHL [24, 25].
ISO 1999:2013 model assesses the risk of NIHL with age, gender in addition to intensity of exposed noise and exposure time in years [26]. The prevalence of NIHL is higher in male than in female and racial difference exists with lower prevalence in darker pigmentation [27]. Increasing age, smoking, poor diet, lack of exercise, comorbidity such as diabetes, cardiovascular disease may increase risk of NIHL [28]. Sufficient nutrition helps to preserve high frequency hearing [29].
The prevalence of hearing loss among noise-exposed workers is various across industries and occupations. Noise exposure is common in industries of mining, construction, manufacturing, forestry, utilities, repair and maintenance, and transportation sectors [2]. Sixty-one percent of the mining workers, 51% of the construction workers, and 47% of the manufacturing workers are exposed to noise [1]. Among workers of the above industry sectors, 20 ~ 25% have a material hearing impairment [30]. In Korea, NIHL was most common in the workers of manufacturing sector, followed by construction sector (Figure 2).
Prevalence of noise-induced hearing loss (D1) according to Korean standard industrial classification. A total of 12,822 cases were diagnosed as NIHL in 2018 in Korea. Among them, NIHL was most commonly reported in manufacturing sector with 9,455 cases, followed by construction, mining, transportation, and business facility management and business support services sectors.
Audiometric evidence of NIHL is characteristic notch or bulge between 3 kHz and 6 kHz, mostly worst at 4 kHz, with preserved hearing at 8 kHz and lower frequencies [31]. Notch deepens and widens with continued noise exposure, eventually involving lower frequencies. Hearing aggravates in the first 10–15 years of noise exposure, and then process slows down [17]. The maximum hearing loss from NIHL has been accepted not to exceed 75 dB at higher frequencies and 40 dB at lower frequencies [32]. However, it could reach 80 dB or worse in 2.6% of construction industry engineers [33]. Notch could be observed in 19.9% of persons without history of loud noise exposure, so audiometric notch does not necessarily mean NIHL [3].
Unlike NIHL, the ARHL accelerates over time. Hearing loss in ARHL starts at 8 kHz or higher frequencies and expands to lower frequencies. When NIHL and ARHL coexist, the notch widens and looks like a bulge [34]. As the combined ARHL progresses with advanced age, noise notch may be rarely observed [35]. Sometimes medicolegal opinion is sought about which factor contributes more on the etiology of hearing loss between noise and age. It is impossible to distinguish the allocation of each factor in aged persons.
Hearing in noise may be compromised probably due to cochlear synaptopathy. To quantify damage from noise exposure, speech recognition in quiet and noise is also recommended [21]. Otoacoustic emission (OAE) can be used as an earlier test before PTA deficit is evident [36]. But recent studies showed that OAE was not more sensitive than PTA in assessing hearing loss caused by long-term exposure to noise [37]. Possibility of middle ear acoustic reflex as a diagnosis of cochlear synaptopathy was also suggested [38].
Noise-induced hearing loss is typically bilateral because noise affects both ears symmetrically. However, it could be asymmetric. Prevalence of asymmetric hearing gap larger than 15 dB in general population is 1% while those of NIHL were reported as 4.7–36% [35]. Left ear was more affected, especially in male [39, 40]. Lateral difference was most prominent in 3–6 kHz [41]. The firefighters and public safety workers may no longer be able to carry their duties because asymmetric hearing disturbs to distinguish sound direction and causes work-related risk [42].
There are two theories about mechanism of lateral asymmetry. One is head shadowing effect that makes noise level affecting each ear unequal [43]. Another is that left ear is more susceptible to noise damage for physiological reasons. It involves a less sensitive acoustic reflex in left side and a stronger protective auditory efferent system of the right olivocochlear bundle [44, 45].
MRI scan should be performed to rule out vestibular schwannoma in asymmetric hearing loss. Medicolegal decision of asymmetric NIHL is quite unconvincing. According to Robinson’s criteria, if there is no evidence of NIHL in the better ear, patients can be declined compensation [45]. Whereas, Fernandes et al. insisted that comment should be made on the causation as being noise-induced, if there is no other cause to explain the asymmetry [46].
The prevalence of tinnitus among noise-exposed workers is 24%, which is much higher than that of the general population [47]. Tinnitus is bilateral in majority of workers exposed to noise, however, some of them complains of unilateral symptom, more commonly in left ear [48]. Tinnitus degrades quality of life in workers and distracts military personnel during military operation [49]. Although association of noise and hyperacusis have rarely been studied, pop and rock musicians were at high risk for the development of hyperacusis [50].
Besides hearing loss, noise can induce vestibular dysfunction through the damage to sacculocolic reflex pathway or damage to vestibular hair cell [51, 52]. The relationship between NIHL and abnormal vestibular evoked myogenic potentials (VEMPs) was reported in human study [53]. Noise exposure reduced the stereocilia bundle density of the vestibular end organ and reduces the firing rate of the anterior semicircular canal (ASCC) without significant change of the vestibular-ocular reflex, suggesting possibility of “hidden vestibular loss” [52]. Abnormal electronystagmography (ENoG) was more common in the asymmetrical NIHL group than in symmetrical NIHL [54].
Noise regulation is the best option to prevent NIHL. Current noise regulations are based on the intensity of chronic continuous noise rather than impulsive acoustic trauma. Degree of exposure is calculated as registered in individual reporting or hearing protection programs [30]. Noise of intensity below 80 dB (A) (weighted decibel relative to human ear) reduces the risk of NIHL [55]. Daily permissible exposure limit (PEL) and exchange rate should be set to run hearing conservation program. Many countries legislate PEL at 85 dB(A) for an 8-hour workday. Some countries loosely permit up to 90 dB(A). Exchange rate defines the 3–5 dB increase in noise intensity with which exposure time should be halved to protect hearing. Exchange rate of 5 dB appears to be more accurate than 3 dB [56]. For example, 4 hours of exposure to 90 dB(A) is as hazardous as 8 hours of exposure to 85 dB(A). Number of workplaces of which noise exceeds PEL of 85 dB(A) for an 8-hour workday has been decreasing in Korea. It reduced from 20.2% of total workplaces in 2014 to 15.3% in 2018 (Figure 3). For impulse noise, 140 dB is generally set as the upper limit [57].
Korean workplaces of which noise exceeded permissible exposure limit (2014 to 2018). Percentage of Korean workplaces of which noise exceeded permissible exposure limit was 21% until 2010 but is gradually decreasing. In the second half of 2018, it was 15.3% showing the lowest rate for the past 5 years.
Hearing protection devices (HPDs), including earmuffs and earplug, are secondary level personal protection. Most workplace noise can be attenuated to a safe level by reducing noise by 5–10 dB, and this goal can be achieved when if HPDs are worn properly and continuously [30]. However, many workers do not wear HPDs for enough time and the effect is cut in half if workers remove HPDs for only 30 minutes of an 8-hour workday [58]. Therefore, it is efficient, when selecting HPDs, to focus on consistency of use than noise reduction rate of HPDs [59]. Individual fit-test system for earplugs is more feasible for field use and could effectively prevent hearing deterioration [60]. Earmuffs can reduce noise more consistently than earplug, and 3D print earmuffs made from light materials such as acrylonitrile butadiene styrene/clay nanocomposites was helpful in reducing weight of earmuffs and would probably increase comfort [61]. Hearing conservation program in elementary school are potentially effective way to know the risks of noise exposure early in life, leading to behavioral changes such as noise reduction and HPDs [62].
It is important to reduce the “know-do” gap between knowledge accumulated to prevent NIHL and actual implementation at workplace. This requires frequent communication meetings for noise control, assigning staff to provide daily program support, noise hazard identification, selection of HPDs, and providing inexpensive sound level meters or sound measuring apps [30].
We suggest that hearing conservation program should include administrative or engineering controls to reduce sound levels. Workplace noise should be monitored using either a wearable sound level meter or a dosimeter to determine if noise exposure level is at or above 85 dB(A). If the workplace noise exceeds an 85 dB(A) for an 8-hour workday, exposed employees should be enrolled in a hearing conservation program (HCP) and audiometric test should be conducted annually by audiologist to check if the standard threshold shift occurs. Employees enrolled in HCP should be offered HPDs and take mandatory training program annually about effects of noise on hearing, purpose and value of HPDs and hearing test. Managers or supervisors must attend training sessions and should keep the record of all hearing tests, noise surveys, and training records.
There is no practical medication to prevent NIHL from chronic noise exposure. Most drugs have been studied either on an experimental level or on an animal study basis.
The noise exposure increases the immune and inflammatory factors in the cochlea. Steroids are the only approved medicine in treating sudden hearing loss. Animal study showed that steroids before and after the exposure to acoustic trauma were effective through control of the inflammatory response [63, 64]. It is estimated that intratympanic steroid injection would be effective in protecting outer hair cell efferent terminal synapse, and intraperitoneal steroid injection would be effective in protecting organ of Corti and stria vascularis [65]. In human studies, combined systemic & intratympanic steroid administration was more effective than systemic steroid only [66]. Long-term administration of steroid is inadequate due to its possible side effects.
Free oxygen radicals and oxidant stress are important pathological mechanisms of NIHL. N-acetylcysteine (NAC) is an antioxidant and is known to reduce noise-induced ototoxicity in animal study. There was no significant differences of overall hearing loss in military population between NAC group and placebo group [67].
Neurotropin-3 (NT3) and Brain derived neurotrophic factor (BDNF) are known to be important factors in the generation and maintenance of cochlear hair cell ribbon synapse [68, 69]. Animal study demonstrated a reduction in synaptopathy and a restoration of hearing immediately after strong noise exposure [70] but human data is lacking.
Noise-induced hearing loss is drawing more attention than ever before. Besides hearing loss, noise can also compromise the vestibular function. Recently, evidence on noise-induced cochlear synaptopathy is accumulating. Exposure to noise in short duration or less intense noise may result in functional hearing loss without threshold change on audiogram. So far, prevention is the best option, but we expect that continuous research on NIHL will open up the possibility for treating drug ototoxicity and ARHL as well.
Chemicals such as organic solvents, metals and asphyxiants are known for their neurotoxic effects on both the central and peripheral nervous systems. These agents could injure the sensory cells and peripheral nerve endings of the cochlea [71].
Over the past 3 decades, several studies investigated the relationship between occupational exposure to chemical substances and hearing loss for humans [72]. According to the score combining human and animal data, lead (and its inorganic salts) as an only inorganic substance and the organic chemicals including toluene, styrene, and trichloroethylene were ranked as “ototoxic”. Other candidate substances classified as “possibly ototoxic” are nitriles (acrylonitrile, 3-butenenitrile), carbohydrates (n-hexane, p-xylene, and ethylbenzene), hydrogen cyanide, carbon monoxide, carbon disulfide, and mercury, germanium, and tin. Recently, a classification criteria on ototoxic substances was delivered by the Nordic Expert Group (NEG). The NEG chose a quantitative approach, meticulously comparing the “no observed” or “lowest observed” effect levels with occupational exposure limits from various countries. This information can be useful for the management of toxic substances and prevention of hearing loss (Table 1) [73].
Classification | Criteria | Ototoxic substances |
---|---|---|
Category 1 | Human data indicate auditory effects below or near the existing OELs. There are also robust animal data supporting an effect on hearing resulting from exposure | toluene, styrene, carbon monoxide, carbon disulfide, lead and mercury |
Category 2 | Human data are lacking, whereas animal data indicate an auditory effect below or near the existing OELs. | p-xylene, ethylbenzene, and hydrogen cyanide |
Category 3 | Human data are poor or lacking. Animal data indicate an auditory effect well above the existing OELs. | Other substance |
Classification and the criteria of ototoxic substances based on occupational exposure limits.
OEL: occupational exposure limits.
Until now, regarding regulatory problem, the interaction with noise has not been investigated in a satisfactory way. Although it is very difficult to combine all of the data to arrive at solid conclusions, this does not exclude the possibility of other chemical substances can worsen hearing losses due to noise.
In workplace, one of the most common kinds of exposure is solvents mixture. The most prevalent exposures seem to happen in industries where workers have contacts with paints, thinners, lacquers and printing inks [74]. In Korea, organic solvents have the second highest excess rate among harmful factors in workplaces. The exceeded rate of the occupational exposure limit maintained a similar level of 0.4 to 0.7% for the last five years from 2014 to 2018 (Figure 4). Although the ototoxic effects of organic solvents have been widely studied, there is no consensus about the correlation between the solvents exposure level and the resultant hearing loss.
Korean workplaces of which organic solvents exceeded permissible exposure limit (2014 to 2018).
In occupational condition, the ototoxicity of organic solvents is more difficult to prove. Because the workplace concentration of chemicals is much lower than that used in animal studies, and the workers are usually exposed to a mixture of solvents with widely varying compositions and concentrations, it is difficult to assess the effect of a single substance. Furthermore, in industrial settings, exposure to chemicals often coexists with an elevated level of noise, which makes it difficult to distinguish the solvent effect from the noise-induced hearing loss [22].
Recently, Hormozi et al. reported dose–response relationship between organic solvents mixture exposure and risk of hearing loss from a meta-analysis [72]. The results showed a statistically significant dose–response relationship between the occupational exposure level (Exposure Index, EI), duration of exposure or number of solvents and the risk of developing hearing loss (Table 2).
Variable | Reports (n) | OR (95% CI)† | p |
---|---|---|---|
Duration of exposure | 0.001 | ||
< 5 years | 4 | 1.01 (0.92–1.10) | |
5–10 years | 3 | 1.57 (1.27–1.93) | |
> 10 years | 7 | 3.36 (2.36–4.79) | |
Exposure index (EI)‡ | 0.049 | ||
< 0.5 | 3 | 1.37 (0.75–2.48) | |
0.5–0.99 | 3 | 3.25 (1.88–5.62) | |
≥ 1 | 7 | 4.51 (3.46–5.90) | |
Solvents | 0.045 | ||
2–5 | 7 | 1.62 (1.07–2.44) | |
6–8 | 4 | 4.22 (2.72–6.56) |
Dose–response relationship between organic solvents mixture exposure and risk of hearing loss*.
Hearing loss: average hearing threshold greater than 25 dB in at least one ear (250–8000 Hz).
Reference group: not exposed to either noise or solvents mixture.
EI: the sum of the mean time-weighted exposures to each solvent was divided by its occupational exposure limit (American Conference of Governmental Industrial Hygienists threshold limit value, ACGIH TLV).
Cited from THE RISK OF HEARING LOSS ASSOCIATED WITH OCCUPATIONAL EXPOSURE TO ORGANIC SOLVENTS MIXTURE WITH AND WITHOUT CONCURRENT NOISE EXPOSURE: A SYSTEMATIC REVIEW AND META-ANALYSIS. International Journal of Occupational Medicine and Environmental Health 2017;30(4):521–535 https://doi.org/10.13075/ijomeh.1896.01024.
Long-term exposure to organic solvents has been shown to cause irreversible hearing impairment damaging the cochlear hair cells as the first target [75]. The mechanism of acute injury would be the direct action of solvents on the cells of the organ of Corti, resulting in disorganization of their membranous structures, whereas chronic ototoxic effects may be explained by the formation of chemically and biologically reactive intermediates [76].
The ototoxicity mechanisms with strong evidence were described in Table 3. These solvents adversely affect both peripheral and central auditory system. For example, toluene may enhance inhibitory synaptic responses as CNS depressants, also can inhibit the middle-ear acoustic reflex (cholinergic efferent system). This would make inner ear more susceptible to co-exposure even to a noise intensity below permissible limit value [77].
Chemicals | Targets and impacts | Mechanism | Points to consider |
---|---|---|---|
Aromatic solvents | Target: Central nervous system, cochlear hair cell Impact: Enhancement in inhibitory synaptic responses, affecting middle-ear acoustic reflex. | In case of acute effect, direct action on the cells of the organ of Corti. In case of chronic effect, formation of intermediates such as reactive oxygen species. Cause K+ flow dysfunction. Outer hair cell toxicity due to K+ massive efflux and tunnel accumulation. | Prolonged exposure causes irreversible hearing impairment. Affect the middle-ear acoustic reflex, which partially explain the synergistic effects of co-exposure to noise and aromatic solvents. |
Nitriles | Target: cochlear hair cell, spiral ganglion cells Impact: Reduces high-frequency hearing sensitivity and enhances noise-induced hearing impairment. | Induce loss of inner ear hair cells and spiral ganglion cells. In the case of acrylonitrile, the risk of oxidative damage to the inner ear is increased due to damage to the cellular antioxidant defense mechanisms. | Permanent hearing damage may occur due to combined exposure with noise. |
Halogenated hydrocarbons | Target: Outer hair cell | In the case of polychlorinated biphenyls (PCB), it is assumed to have a direct effect on outer hair cells. | Presumed to be a sequelae of thyroid disease caused by halogenated hydrocarbons. |
Trichloroethylene | Target: Cochlear sensory hair cell, spiral ganglion cells, auditory nerve pathways | Unknown, but dose dependent hearing loss | Hearing loss tends to occur only at high level of exposure. |
Summary for impacts and mechanisms of ototoxic chemicals in workplace exposure.
Śliwinska-Kowalska (2007) summarized a risk/odds ratio of organic solvent-induced hearing loss, compared to non-exposed population, as followings. 1) No excess risk was found for workers exposed to solvent mixture when: the exposure history was short (up to 4 years), or the exposure level was very low (current exposure ranged from few to 18 ppm for toluene, to few ppm for xylene and other solvents, and the exposure index was <1). 2) Excess risk was found for workers exposed to solvent mixture when: the exposure level was moderate (toluene exposure ranged from 25 to 70 ppm, xylene exposure 25–40 ppm, and exposure index from 0.3–1.53), or the workers were exposed to high solvent concentrations and noise (the mean lifetime exposure to xylene was 696 ppm, to toluene 203 ppm, and the mean exposure index was 6.3) [72]. Risk/odds ratios of hearing loss due to exposure to organic solvent mixture were ranged 1.4 to 5.0, while the ratio of populations co-exposed to noise and solvents were 1.7 to 8.25 [78].
Previous experiments on ototraumatic substances in animals have confirmed the synergistic adverse effects of combined exposure to noise and solvents on hearing [79, 80]. In the case of combined exposure to noise and organic solvents, depending on the parameters and characteristics associated to the noise (such as intensity and impulsiveness) and solvent (such as concentration), they might interactively affect each other.
From the animal studies, the increase in auditory brainstem response (ABR) latencies after exposure by inhalation of more than two solvents observed an additive effect rather than a synergistic or antagonistic interaction. Results of these studies imply that the mechanism of ototoxicity for these solvents may be similar. However, rats simultaneously exposed to both toluene and noise induced a more severe hearing loss than the summated hearing loss obtained from an equivalent exposure level to each agent alone [77].
From the human studies, exposure to a mixture of solvents may damage the inner ear to a much greater extent than noise exposure. The relative risk for hearing loss in workers exposed to solvents was greater (RR = 9.6) in comparison to workers exposed only to noise (RR = 4.2). Hearing loss associated with styrene significantly increased in high frequency (8–16 kHz) and mid-audiometric frequency of 2 kHz [22]. Sliwinska-Kowalska et al. (2003) found a positive linear relationship between average working life exposure to styrene concentrations and hearing thresholds at 6 and 8 kHz. The possible synergism of combined exposure to solvents and noise on hearing has not been consistently identified in human studies. Some researchers have failed to find a synergistic effect between these agents on hearing [22].
Although it is difficult to derive a dose–response relationship between the solvent concentration and the hearing outcome, the risk of hearing loss increase with the longer duration of employment and accompanying noise in workers exposed to organic solvent [72].
Although there is no consensus on the lowest OELs for solvents in relation to their effect on the auditory organ, the current standards for solvent-exposed populations seem to be inadequate. Since organic solvents have detrimental effects both on the peripheral and central parts of the auditory pathway, pure-tone audiogram might be insufficient to monitor their ototoxicity [78].
From previous studies, researchers have found some useful tests for the evidence of adverse effects on the central auditory system in workers exposed to mixture of solvents: 1) dichotic listening: useful tool in the assessment of solvent-exposed workers, particularly in those who have had intermediate levels of exposure; 2) electrophysiological techniques (ABR): increase of the absolute latencies and inter-peak latencies (IPL) between waves of the ABR (I-III IPL; I-V IPL; III-V IPL) or prolonged P300 (a long latency auditory evoked potential); 3) otoacoustic emissions (OAEs): gradual deterioration of hearing threshold before audiometric change; 4) comprehensive battery of behavioral central auditory function assessment procedures: solvent-exposed participants presented with poorer results adjusted for age and hearing thresholds in comparison to non-exposed subjects [77]. These tests can be conjugated to evaluate possible adverse effects of solvents on the auditory system.
So far, the robust evidence confirms that the effects of ototoxic substances on auditory function can be aggravated by noise, which is supported by data from epidemiologic studies on human workers.
In real world, the exposure to solvent mixtures is various in terms of levels and composition. Numerous study groups reported an association between low to moderate exposure to solvent mixtures and hearing disorders. However, occupational legislation does not take environmental chemicals hazardous to hearing into consideration. Thus, there may be numerous workers with unmet needs concerning hearing conservation.
Here we are going to make some necessary suggestions for occupational health professionals and the workforce. Health care provider should be aware of the risks related to ototoxic substances. Employers and workers should be advised accordingly. Risk management measures aimed at reducing exposure to noise and ototoxic substances, especially co-existence of them, should be encouraged. In occupational health-screening activities, ototoxicity should be included. Appropriate diagnostic tools should be developed for early detections of chemically induced hearing impairment. Suitable scientific investigations into ototoxic properties of substance and combined effects with noise should be encouraged by well-designed studies.
Occupational noise exposure has been well-known as the most deleterious factor to hearing loss, however, the impact of chemical-induced hearing loss on workers should not be underestimated [81]. Industry-based initiatives should include the identification of populations at risk and the delivery of tailored hearing conservation program accordingly to noise and chemical-exposed workers regarding their exposure levels.
The authors declare no conflict of interest.
I would like to thank the members of the Department of Occupational and Environmental Medicine, Ulsan University Hospital. A Ram Kim, Daeyun Kim, Sunghee Lee, Jisoo Kim, and Hanjoon Kim, also Jinhee Bang, member of Environmental health center have contributed directly or indirectly to this chapter. We have shared information and ideas. Moreover, they have made suggestions and comments.
The Mediterranean diet was first described scientifically by Ancel Keys in the 1960s as a result of “The Seven Countries Study”, in which the dietary habits of individuals in the Mediterranean basin were studied [1, 2]. With its nutritional dimension, the Mediterranean diet reflects the common dietary characteristics of Mediterranean countries. It is mainly characterized by high consumption of olive oil, olives, fruit, vegetables, cereals (mostly whole grains), legumes, and oilseeds; a moderate-to-high consumption of fish, moderate consumption of eggs, poultry, and dairy products; and low consumption of meat and meat products [3, 4, 5]. In this diet, moderate wine consumption is acceptable unless it is contrary to religious and social norms [5, 6].
The Mediterranean diet gained popularity at the beginning of the 1990s with the creation of the Mediterranean pyramid, which is a nutrition guide and categorizes nutrients graphically into daily, weekly, or less frequent consumption [7]. The scientific world has continued to work on the Mediterranean diet to update this pyramid, considering the changing lifestyles of the societies in the Mediterranean region over time, the dietary and health status of new generations, and environmental and cultural factors [4]. At the international conference titled “The Mediterranean Diet as a Sustainable Diet Model” held in Italy in 2009, the Mediterranean diet was defined as a sustainable diet model because of its nutritional, environmental, economic, and socio-cultural dimensions [8]. At the international scientific symposium held in 2010 on “Biodiversity and Sustainable Diets”, it was emphasized that sustainable diets are diets offering healthy living for the present and future generations. The thousands-year-old heritage of the Mediterranean countries, the Mediterranean diet was accepted as the “Intangible Cultural Heritage of Humanity” by UNESCO in 2010. As a result of the international scientific consensus, a new Mediterranean diet pyramid developed in accordance with today’s lifestyles was published in the same year, and it was proposed that individuals should organize their daily nutrition plans according to this pyramid. The latest Mediterranean pyramid is shown in Figure 1 [4, 7]. The beneficial health effects of nourishment suited to the Mediterranean diet pyramid are mostly correlated with reduced risks of cardiovascular diseases, Type 2 diabetes, obesity, some neurodegenerative diseases, and cancer [9, 10, 11]. Rich fiber content, a high proportion of unsaturated fatty acids and antioxidant components, and low energy content might account for these positive effects of this diet on health [5]. The findings of the studies that examined the effects of the Mediterranean diet on health are presented in the following headings.
The Mediterranean diet pyramid.
Today, cardiovascular diseases are the most important health problem in industrialized societies. Mortality and morbidity rates from cardiovascular diseases are of particular importance [12]. It is acknowledged that the Mediterranean diet has a protective role in reducing these rates and supporting the cardiovascular system [13]. For instance, a study found that coronary heart patients on a Mediterranean diet had a 70% reduced risk of a second heart attack [14]. Another study revealed that adherence to the Mediterranean diet also protected against the development of coronary heart disease in patients with metabolic syndrome, hypercholesterolemia, and hypertension [15].
A population-based study examining the relationship between the survival status of 1302 Greek men and women diagnosed with coronary heart disease and eating a traditional Mediterranean diet suggested a significant decline in mortality rates from coronary heart diseases. This situation has been affiliated with adherence to the traditional Mediterranean diet [16]. Great adherence to the Mediterranean diet has also been associated with a significant decrease in mortality from cardiovascular diseases in the Mediterranean and non-Mediterranean populations [17].
Studies have also shown the beneficial effects of the Mediterranean diet with low rates of saturated fatty acids on primary and secondary prevention of cardiovascular diseases [18, 19]. In one study, in addition to adapting the daily dietary plan to the Mediterranean diet, tomato products were also included in the diet. Lycopene in tomatoes was observed to improve endothelial function in patients with dysfunctional cardiovascular disease. This has explained the beneficial effects of lycopene, a component of the Mediterranean diet, on the vascular system. It has also strengthened the evidence that a healthy diet is needed to increase endothelial function in populations at risk despite medical treatments. However, the researchers have also noted that further interventional studies are needed to determine whether lycopene supplementation might alter outcomes in preventing cardiovascular diseases in populations at risk [20].
The Mediterranean diet contributes to the intake of antioxidant compounds, such as polyphenols, vitamins, and carotenoids. It has been stated that supplementing these compounds in the diet together with compliance with the Mediterranean diet might be beneficial in the prevention of cardiovascular diseases. It has been confirmed that carotenoids have antioxidant biological properties due to their chemical structure and interactions with biological membranes. It has been stated that Mediterranean diet components might have positive effects on cardiovascular risk factors, including antioxidant and anti-inflammatory activities, inflammation markers, hyperlipidemia, hypertension, insulin resistance, and obesity. It has further been determined that the diet might contribute indirectly to the subsequent improvements in blood pressure baseline levels, reduction of inflammation, correction of dyslipidemias, and improvement of cardiovascular health [21].
Diabetes is a disease that develops when the pancreas does not produce enough insulin hormone, or the insulin hormone it produces cannot be used effectively [22]. Diabetes is constantly increasing in parallel with obesity and is estimated to affect 340 million people worldwide. Proper diet, physical activity, and education have a significant contribution, especially in reducing the course of Type 2 diabetes. The Mediterranean diet is recommended as an effective way to reduce obesity, considered a major public health problem. In addition, the traditional Mediterranean diet is shown as the best diet form to maintain a healthy weight [3, 23]. Weight loss is the first step in the treatment of overweight diabetic patients. It was determined that certain foods had a protective effect on Type 2 diabetes or reduced its course [24]. Based on the consumption of whole-grain products, fruit and vegetables, fish, and olive oil, the Mediterranean cuisine, rich in traditional fiber, has the feature of meeting the nutrients required for diabetic patients. The Mediterranean diet might also improve blood, glucose, and lipid profiles [25]. Most foods in the Mediterranean diet have a low glycemic index [23].
A study among participants with Type 2 diabetes revealed that adherence to a Mediterranean diet with high olive oil content might delay the use of glucose-lowering drugs at the onset of the disease. It has been determined that this diet form also significantly reduces the need for insulin [26]. At the University of Spain, 13,380 non-diabetic people were followed up for 4.4 years. The study findings revealed that the participants who followed the Mediterranean diet exactly had an 83% lower risk of diabetes compared to the patients with the lowest adherence score to this diet [27]. Another study conducted on 944 Italian patients with type 2 diabetes evaluated the relationship between peripheral artery disease risk and adherence to a Mediterranean diet. The results emphasized that the course of the disease decreased, and the Mediterranean diet was effective in this positive change [28]. Adherence to the Mediterranean diet is now known to provide sustained protection against Type 2 diabetes and other insulin resistance conditions. It was asserted that the interactions between exercise and nutrition and their synergistic effects might fully optimize metabolic health in people prone to diabetes and other metabolic diseases. It was further stated that changing the diet forms of individuals would improve their quality of life [29].
The growth of obesity in developed countries has revealed the importance of diet models that diminish the incidence of obesity. The Mediterranean diet is considered an effective dietary model recommended to people searching for a healthy model rather than diets high in saturated fatty acids [30]. The Mediterranean diet has proven to be the most effective nutritional model among diets for preventing obesity-related diseases [3]. Research findings demonstrated that the diet was effective in the treatment of various metabolic disorders and related obesity [31]. High adherence to the Mediterranean diet was found to have a 33% effect on the prevention of obesity [32]. Adherence to the Mediterranean diet provided many advantages in preventing and treating obesity in several observational studies describing the highly satiating effect of meals prepared with olive oil [30, 31]. The Mediterranean diet was also claimed to be an effective way to prevent childhood obesity, considered an important public health problem with short- and long-term effects [17].
It has also been established that especially young people in Mediterranean countries avoid the Mediterranean dietary plan despite its association with numerous health benefits and preventive effects against many pathologies including obesity. Guiding people’s adherence to the principles of the Mediterranean diet should therefore be among the goals of governments in their health policies [33]. This approach could help combat the obesity epidemic, especially in childhood. Well-designed, carefully executed, and supported public health communication programs might contribute to shaping the dietary behaviors of individuals by increasing their awareness and knowledge because the institutions responsible for the development of health policies have the capacity to elicit the change in the lifestyles of their citizens through the activities they might carry out [34].
Although hypertension is acknowledged as an adult disease, its incidence is gradually increasing in childhood and adolescence. Specifically, adherence to the Mediterranean diet, the quality of diet, and nutrient adequacy were shown to be protective against hypertension [35].
Although the Mediterranean diet model has been proven and published to have both hypertension-preventing and health-promoting qualities, researchers are discussing whether it is a diet that will sustain in the future. There is a tendency for the younger generations to abandon their traditional dietary habits throughout the Mediterranean basin. Studies have suggested that adherence to the Mediterranean diet begins to decline dramatically among young people, while it remains a pronounced choice for the elderly. Recent reports have shown that young people’s diets lack key features of the traditional Mediterranean diet. It has been noted that the rates of hypertension, obesity and high cholesterol among young people are increasing in Greece, Spain, and Italy, similar to the United States [36, 37, 38].
The change in the lifestyles of individuals, leading a life away from families, and divergence from the habit of preparing food at home have indicated the need to present the Mediterranean diet commercially to individuals. For that reason, the dissemination of commercial businesses that carry the characteristics of the Mediterranean diet and their consideration as a gastronomic element is important for reaching people who want to live a healthy life.
Cancer is one of the most common diseases of our age. It is a type of tumor defined as a physiological disorder as a result of the uncontrolled proliferation of some cells in the organism. During this time, some cells disappear, or their normal biochemical functions change. They are divided into two benign and malignant [39]. Alcohol and tobacco use, environmental pollution, occupational types, geophysical factors, various infections, drugs, genetic predisposition, and dietary habits are among the causes of cancer.
It is stated that there is an important relationship between cancer and diet, and the formation of cancer can greatly be prevented with the Mediterranean diet. The Mediterranean diet is claimed to prevent the risk of prostate, pancreatic, uterine cancer by up to 10%, the risk of breast cancer by 15%, and the risk of colon cancer by 25% in individuals on a Mediterranean diet. The Mediterranean diet is therefore acknowledged as an important cultural model for delaying and preventing the onset of cancer [40]. One study presented evidence for the beneficial role of the Mediterranean diet on the risk of endometrial cancer, suggesting that the combination of foods rich in antioxidants, fibers, phytochemicals, and unsaturated fatty acids had a positive effect in protecting against cancer [41].
Lung cancer is one of the most common types of cancer, and smoking is known to be an important risk factor. However, there are findings suggesting that a diet rich in fruit and vegetables, such as the Mediterranean diet, might be protective against lung cancer. Antioxidant vitamins and phytochemicals have been shown as the main factor in this relationship [42]. In studies that examined the compliance of the daily diet of lung and bladder cancer patients on a Mediterranean diet, it was determined that these people were deficient in beta carotene. It was stated that malnutrition from beta carotene might also account for the formation of these cancers. Vitamin C found in fruit and vegetables is known to be protective against esophageal and stomach cancers. Foods such as nuts and olive oil containing Vitamin E were also proven to have beneficial effects on protecting against digestive tract cancers [42]. It was reported that oleic acid, one of the important components of olive oil, blocks the growth of breast cancer cells. It was noted that the rich polyphenol compounds in olive oil also reduced DNA damage with their antioxidant power [43].
It was determined that adherence to the Mediterranean diet had a lowering effect on the risk of prostate cancer, especially in men [40]. Although its mechanism was not fully explained, it was revealed that consumption of whole meal and fiber foods could also prevent intestinal cancer cases at a high rate [42]. 25,623 people (10,582 men, 15,041 women), participated in the Greek EPIC cohort study. The study examined the relationship between the traditional Mediterranean diet and the incidence of cancer. The results indicated a correlation between high adherence to the Mediterranean diet and a decrease in the incidences of cancer [44].
It was asserted that the global proliferation of particularly olive oil consumption might contribute to reducing the onset of cancer in the world population. The consumption of olive oil was also shown as a protective factor to slow down the development of various types of cancer by preventing DNA damage. However, it was emphasized that prospective studies should be increased by considering various external variables, including geographical areas, lifestyles, hereditary factors, and the origin of foods [40].
Alzheimer’s is a disease characterized by a decrease in daily living activities and deterioration in cognitive abilities, accompanied by neuropsychiatric symptoms and behavioral changes. Alzheimer’s is the most common type of dementia in developed countries due to the increase in the elderly population. It gradually increases in parallel with the aging of the population [45, 46]. The most common neurodegenerative disorder, Alzheimer’s manifests itself with memory loss that develops after cell loss in neural structures. Many risk factors including medical, social, psychological, environmental, lifestyles, dietary habits, and genetic factors are involved in the onset and progression of the disease [45]. In addition to genetic factors, other causes are also emphasized. Both human and animal experiments have shown that high intake of saturated fatty acids, low intake of polyunsaturated fatty acids, high level of low-density lipoprotein cholesterol (LDL), and the use of refined sugar are effective factors in the formation of Alzheimer’s. The results of epidemiological studies have indicated a relationship between Alzheimer’s disease and the use of oils containing saturated fatty acids and sugar consumption. Various studies have also shown that people who take less unsaturated fatty acids, and especially omega-3 fatty acids, have a higher risk of Alzheimer’s.
The possible relationship between the Mediterranean diet and Alzheimer’s disease was first demonstrated in 2006 as a result of a four-year follow-up study of 2258 people without dementia. The risk of Alzheimer’s disease was observed to be high in those with a low score for adherence to the Mediterranean diet. 262 of the participants in the study were diagnosed with Alzheimer’s disease at the end of the fourth year. The risk of developing Alzheimer’s disease was reported to be 40% less in the group with the highest adherence to the diet. These results were confirmed by other studies conducted with the same group. Another study determined that the highest adherence to the Mediterranean diet reduced the risk of Alzheimer’s by 68% [47]. A different study demonstrated that the positive relationship between adherence to the Mediterranean diet and memory performance might mediate the maintenance of brain volume in the medial temporal lobes. The Mediterranean diet was also shown to be inversely associated with pathological biomarkers, such as amyloidosis and tauopathy. A healthier diet is thought to reduce brain atrophy, and the Mediterranean diet is considered to contribute to preserving brain structure [48].
Positive relationships between the Mediterranean diet and brain morphology and the Mediterranean diet and memory performance define the relationship between the Mediterranean diet and Alzheimer’s. The Mediterranean diet is thought to be a protective lifestyle against the neurodegeneration and memory impairment associated with Alzheimer’s disease. Alzheimer’s disease might be delayed with dietary interventions [48, 49]. It was shown that changes in dietary habits might prevent Alzheimer’s disease and slow the progression of the disease. It is noted that olive oil is contained in the diet, vitamins contained in vegetables and fruit (beta-carotene, Vitamin C and E, as well as folate), and flavonoids exert this effect. Due to its omega-3 fatty acid content, fish consumption might also affect the onset and progression of Alzheimer’s disease [47, 50]. In addition, the Mediterranean diet can protect against dementia, thanks to its positive effects on cardiovascular risk factors such as obesity, insulin resistance, hypercholesterolemia, and hypertension [51, 52]. To further explain the extent to which the Mediterranean diet is responsible for preventing dementia risk, it is emphasized that the data on long-term adherence to the Mediterranean diet should also be evaluated before dementia is diagnosed [49].
Dental caries is a multifactorial infectious disease that represents a significant health problem worldwide. Besides cariogenic bacteria and poor oral hygiene, the cariogenic diet is the main risk factor for dental caries. It has been stated that the Mediterranean diet can be a good example of adequate and balanced nutrition, that this diet can provide a healthier diet worldwide, and in connection with this, a healthier dental structure can be achieved. There was an inverse correlation between dental caries in children aged 3–9 years with low adherence to the Mediterranean diet, and diet quality was directly related to dental caries [53]. In a study, a lower Body Mass Index (BMI) was determined in adults with high adherence to the Mediterranean diet, which was associated with higher chewing performance. Also, dental treatment and the rehabilitation of missing teeth were claimed to be beneficial in improving diet quality. In addition, impaired oral and dental health might cause deficiencies in dietary intake [54, 55]. A study conducted with elderly individuals with low adherence to the Mediterranean diet (73.9 ± 8.5) found higher BMI, more drug use, and lower chewing performance [54]. Another study evaluating the relationship between the Mediterranean diet and Sjögren’s syndrome characterized by dry mouth (xerostomia) associated higher adherence to the Mediterranean diet with a lower probability of Sjögren’s syndrome [56].
Wine is an important element of the Mediterranean diet, and it is recommended to consume one glass of wine every day. Studies have emphasized that wine might also affect the oral cavity positively due to its acidity and alcohol content [57]. However, the amount of consumption is also important in wine consumption. It was stated that frequent consumption of white wine might lead to serious dental erosion. In addition, it was shown that white wine had a higher abrasive potential on tooth enamel than red wine, and the amount of consumption was an important factor [58].
The role of the Mediterranean diet on the risk of the oral cavity and pharyngeal cancer was also investigated, and it was reported that adherence to a high Mediterranean diet was protective against pharyngeal cancer [59]. The main source of monounsaturated fatty acids in Mediterranean countries, olive oil is consumed at high rates. It was determined that olive oil had a positive effect on various neoplasms, including oral and pharyngeal cancers, due to its antioxidant properties rich in both oleic acid and Vitamin E [60]. It was further asserted that the favorable effect of the Mediterranean diet on oral and dental health was apparently stronger in young, highly educated ex-smokers or nonsmokers [59].
Adequate and balanced nutrition is to maintain a healthy life. Just as a healthy digestive system is needed to ensure this, a healthy diet within a healthy digestive system is of great importance. The digestive system is one of our important systems in which solid and liquid foods are broken down into small building blocks that can be absorbed and passed into the blood circulation, along with water, vitamins, and minerals, as well as proteins, carbohydrates, and fats during their progression through the digestive tract. Digestive system diseases caused by infectious agents and stress factors added to an unbalanced diet are frequently encountered today [61]. The Mediterranean diet positively affects the digestive system due to its rich olive oil content. It is suggested that olive oil can also prevent the formation of gallstones due to the fact that it increases bile production and provides monounsaturated and polyunsaturated fatty acids in a balanced way. It was found that the formation of gallstones is lower in areas with high consumption of olive oil [25].
As can be seen from the studies conducted, compliance with the Mediterranean diet is an important dietary model both for the protection of general health and the prevention of many diseases. For that reason, it is important for individuals to acquire the right dietary habits from a young age. Individuals should be made conscious of the protection of public health, sustainability, and the transformation of the Mediterranean diet into a lifestyle.
Dietary patterns and culinary culture exhibit regional differences. Despite the similarity of the diet in the regions with a coast to the Mediterranean to the Mediterranean diet, marked variations might be observed in other regions. The results of the studies discussed in this chapter have suggested that the Mediterranean diet is a diet that should be applied as a lifestyle. It might be observed that this dietary form, however, has not been adopted adequately or attached significance throughout the world. Emerged as a result of globalization and technological developments, fast-food diet causes societies to move away from their traditional dietary habits. Although the climatic conditions and geographical structure of countries are considered as an obstacle for individuals to adopt the Mediterranean diet, the development of trade networks and transportation conditions today might enable us to eliminate this obstacle. The important point is that individuals demand other nutrients, especially olive oil, recommended to be consumed in this diet. The fact that individuals have this awareness might create an important solution to the Mediterranean diet in reducing the risk of obesity and other chronic diseases viewed as the main public health problem in many countries. The nutrition of the family, the smallest unit of society, is the prerequisite for a healthy society. Adequate, balanced, and healthy nutrition of individuals is the basic requirement for maintaining health and preventing diseases for individuals of all age groups. It is crucial to acquire the right nutritional knowledge and habits from childhood to increase life quality and experience a quality aging process. Current information reveals that the Mediterranean diet has the potency to do this. The current situation might be revealed by conducting interdisciplinary scientific studies based on long-term observations with broad participation, considering the dietary styles of societies. Individuals might be made aware of the Mediterranean diet, both through social media and through written and visual communication tools. This can thus contribute to the increase in the quality of life of individuals and lead a healthy life.
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Saleh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"1074",title:"Bone Oncology",slug:"bone-oncology",parent:{id:"190",title:"Oncology",slug:"medicine-oncology"},numberOfBooks:2,numberOfSeries:0,numberOfAuthorsAndEditors:57,numberOfWosCitations:14,numberOfCrossrefCitations:13,numberOfDimensionsCitations:26,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicId:"1074",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"7187",title:"Osteosarcoma",subtitle:"Diagnosis, Mechanisms, and Translational Developments",isOpenForSubmission:!1,hash:"89096359b754beb806eca4c6d8aacaba",slug:"osteosarcoma-diagnosis-mechanisms-and-translational-developments",bookSignature:"Matthew Gregory Cable and Robert Lawrence Randall",coverURL:"https://cdn.intechopen.com/books/images_new/7187.jpg",editedByType:"Edited by",editors:[{id:"265693",title:"Dr.",name:"Matthew Gregory",middleName:null,surname:"Cable",slug:"matthew-gregory-cable",fullName:"Matthew Gregory Cable"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5399",title:"Osteosarcoma",subtitle:"Biology, Behavior and Mechanisms",isOpenForSubmission:!1,hash:"9f1855e3cb1ca5be058bb788243fda7c",slug:"osteosarcoma-biology-behavior-and-mechanisms",bookSignature:"Kanya Honoki and Kurt Richard Weiss",coverURL:"https://cdn.intechopen.com/books/images_new/5399.jpg",editedByType:"Edited by",editors:[{id:"28035",title:"Associate Prof.",name:"Kanya",middleName:null,surname:"Honoki",slug:"kanya-honoki",fullName:"Kanya Honoki"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:2,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"54598",doi:"10.5772/67564",title:"Osteosarcoma of the Jaw: Classification, Diagnosis and Treatment",slug:"osteosarcoma-of-the-jaw-classification-diagnosis-and-treatment",totalDownloads:3152,totalCrossrefCites:4,totalDimensionsCites:6,abstract:"Osteosarcomas are rare, highly malignant, bone tumors defined by the presence of malignant mesenchymal cells producing osteoid or immature bone. Osteosarcomas of the jaws are extremely rare, representing about 7% of all osteosarcomas and 1% of all head and neck malignancies. An accurate diagnosis, usually facilitated by chemotherapy (CT), MRI and biopsy, is required in order to define the stage of the disease and plane the adequate treatment. Aggressive surgical resection and advanced technique reconstruction are the mainstay of treatment, as the single most important factor for cure is radical resection. Clinical outcomes can be improved by a multimodal strategy combining surgery with neo-adjuvant and adjuvant chemotherapy in selected cases, and adjuvant radiotherapy in the absence of clear margins.",book:{id:"5399",slug:"osteosarcoma-biology-behavior-and-mechanisms",title:"Osteosarcoma",fullTitle:"Osteosarcoma - Biology, Behavior and Mechanisms"},signatures:"Daris Ferrari, Laura Moneghini, Fabiana Allevi, Gaetano Bulfamante\nand Federico Biglioli",authors:[{id:"188372",title:"Dr.",name:"Daris",middleName:null,surname:"Ferrari",slug:"daris-ferrari",fullName:"Daris Ferrari"},{id:"188884",title:"Dr.",name:"Laura",middleName:null,surname:"Moneghini",slug:"laura-moneghini",fullName:"Laura Moneghini"},{id:"188885",title:"Prof.",name:"Federico",middleName:null,surname:"Biglioli",slug:"federico-biglioli",fullName:"Federico Biglioli"},{id:"194643",title:"Dr.",name:"Fabiana",middleName:null,surname:"Allevi",slug:"fabiana-allevi",fullName:"Fabiana Allevi"},{id:"194645",title:"Prof.",name:"Gaetano",middleName:null,surname:"Bulfamante",slug:"gaetano-bulfamante",fullName:"Gaetano Bulfamante"}]},{id:"54117",doi:"10.5772/67448",title:"Immune Environment and Osteosarcoma",slug:"immune-environment-and-osteosarcoma",totalDownloads:1548,totalCrossrefCites:1,totalDimensionsCites:5,abstract:"Immune niche with its huge cell diversity including more specifically tumour infiltrating lymphocytes (TILs), tumour-associated macrophages (TAMs) regulate osteosarcoma (OS) microenvironment. TAMs exert differential activities in the tumour development according to their polarisation. Indeed, in oncology, M1-polarised macrophages are considered as anti-tumour effectors, and M2-polarised macrophages are defined as pro-tumour modulators by increasing the neoangiogenic process. TAM density is correlated with tumour cell proliferation, invasion, metastasis and poor prognosis in various epithelial and haematological cancers and in bone metastasis. Similarly, tumour infiltrating lymphocytes play a key role in tumour development by inducing a local tolerant environment favourable for the tumour growth. The present chapter will describe the main roles of the immune system in the pathogenesis of osteosarcoma and the most recent therapeutic development based on its regulation.",book:{id:"5399",slug:"osteosarcoma-biology-behavior-and-mechanisms",title:"Osteosarcoma",fullTitle:"Osteosarcoma - Biology, Behavior and Mechanisms"},signatures:"Marie-Françoise Heymann and Dominique Heymann",authors:[{id:"188133",title:"Dr.",name:"Marie-Francoise",middleName:null,surname:"Heymann",slug:"marie-francoise-heymann",fullName:"Marie-Francoise Heymann"},{id:"202635",title:"Prof.",name:"Dominique",middleName:null,surname:"Heymann",slug:"dominique-heymann",fullName:"Dominique Heymann"}]},{id:"53766",doi:"10.5772/67068",title:"Microenvironment Signals and Mechanisms in the Regulation of Osteosarcoma",slug:"microenvironment-signals-and-mechanisms-in-the-regulation-of-osteosarcoma",totalDownloads:1754,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Osteosarcoma (OS) is the most common malignant primary bone tumor in children and adolescents and features rapid development, strong metastatic ability, and poor prognosis. It has been well established that diverse genetic aberrations and metabolic alterations confer the tumorigenesis and development of OS. The intricate metabolism and vascularization that contributes to the nutrient and structural support for tumor progression should be thoroughly clarified to help us gain novel insights into OS and its clinical diagnoses and treatments. With regard to the complex bone extracellular matrix (ECM) and local cell populations, we intend to illustrate the interrelationship between various microenvironmental signals and the different stages of OS evolution. Solid evidence has noted two crucial factors of the OS microenvironment in the acquisition of stem cell phenotypes - transforming growth factor-β1 (TGF-β1) signaling and hypoxia. Different cell subtypes in the local environment might also serve as unique contributors that interact with each other and communicate with distant cells, thus participating in local invasion and metastasis. Proper models have been established and improved to reveal the evolutionary footsteps of how normal cells transform into a neoplastic state and progress toward malignancy.",book:{id:"5399",slug:"osteosarcoma-biology-behavior-and-mechanisms",title:"Osteosarcoma",fullTitle:"Osteosarcoma - Biology, Behavior and Mechanisms"},signatures:"Yu Zhang, Qing Mai, Xiaowen Zhang, Chunyuan Xie and Yan Zhang",authors:[{id:"151260",title:"Prof.",name:"Zhang",middleName:null,surname:"Yan",slug:"zhang-yan",fullName:"Zhang Yan"},{id:"194516",title:"Ms.",name:"Yu",middleName:null,surname:"Zhang",slug:"yu-zhang",fullName:"Yu Zhang"},{id:"194517",title:"Ms.",name:"Qing",middleName:null,surname:"Mai",slug:"qing-mai",fullName:"Qing Mai"},{id:"199302",title:"Dr.",name:"Xiaowen",middleName:null,surname:"Zhang",slug:"xiaowen-zhang",fullName:"Xiaowen Zhang"},{id:"199303",title:"Dr.",name:"Chunyuan",middleName:null,surname:"Xie",slug:"chunyuan-xie",fullName:"Chunyuan Xie"}]},{id:"67824",doi:"10.5772/intechopen.85190",title:"Differential Diagnosis of Osteogenic Tumors in the Context of Osteosarcoma",slug:"differential-diagnosis-of-osteogenic-tumors-in-the-context-of-osteosarcoma",totalDownloads:1410,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Primary bone tumors are rare, but osteosarcoma (OS) is the fourth commonest non-hematological primary neoplasm of the bone in the adolescence, and the other three commonest neoplasms, in descending order, are leukemia, brain tumors, and lymphoma. The commonest presenting complaints are swelling and aches. These tumors cannot be diagnosed without the help of radiology. There is a wide age range of these neoplasms commonly appearing in the second and third decade of life with a peak incidence in early teens. Males are affected more than females. The exact cause of osteosarcoma is unknown. However, a number of risk factors, like genetic predisposition, some existing bone diseases, environmental risk factors, and radiations, have been identified. If the bone tumors are viewed by clinical, radiological, and histopathological perspectives, the correct diagnosis can be made easily. Chemotherapy combined with surgery is the standard treatment modality with better 5-year survival rates. Elevated AKP is an important prognostic factor in this malignancy.",book:{id:"7187",slug:"osteosarcoma-diagnosis-mechanisms-and-translational-developments",title:"Osteosarcoma",fullTitle:"Osteosarcoma – Diagnosis, Mechanisms, and Translational Developments"},signatures:"Mulazim Hussain Bukhari, Samina Qamar and Farwa Batool",authors:[{id:"266124",title:"Prof.",name:"Mulazim",middleName:"Hussain",surname:"Bukhari",slug:"mulazim-bukhari",fullName:"Mulazim Bukhari"},{id:"272788",title:"Dr.",name:"Farwa",middleName:null,surname:"Batool",slug:"farwa-batool",fullName:"Farwa Batool"},{id:"272790",title:"Dr.",name:"Samina",middleName:null,surname:"Qamar",slug:"samina-qamar",fullName:"Samina Qamar"},{id:"288567",title:"Dr.",name:"Mandeep",middleName:null,surname:"Bedi",slug:"mandeep-bedi",fullName:"Mandeep Bedi"}]},{id:"54108",doi:"10.5772/67371",title:"Osteosarcoma: From Molecular Biology to Mesenchymal Stem Cells",slug:"osteosarcoma-from-molecular-biology-to-mesenchymal-stem-cells",totalDownloads:1494,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"Osteosarcoma is the most common primary malignant tumour of bone. Currently, despite treatment with multi-agent chemotherapy and limb salvage surgery, the five-year survival rate for osteosarcoma remains at 70%. The pathogenesis of osteosarcoma is complex and involves alterations in cellular apoptosis, adhesion, migration, invasion and molecular signalling. Research most recently has focused on the molecular basis of the disease with the goal of identifying novel therapeutic targets. To this end, mesenchymal stem cells (MSCs) have been identified to play a role in sarcomagenesis. MSC transformation may give rise to tumours, whereas interactions of MSCs with osteosarcoma cells in the tumour microenvironment may cause increased cell proliferation. This is in stark contrast to the role of MSCs as a promising source for tissue repair and regeneration. In order to utilize MSCs for biological reconstruction in the setting of osteosarcoma, further research is necessary to delineate the role of MSCs in osteosarcoma transformation and progression.",book:{id:"5399",slug:"osteosarcoma-biology-behavior-and-mechanisms",title:"Osteosarcoma",fullTitle:"Osteosarcoma - Biology, Behavior and Mechanisms"},signatures:"Matthew L. Broadhead, Saumiyar Sivaji, Zsolt Balogh and Peter F.M.\nChoong",authors:[{id:"26682",title:"Prof.",name:"Zsolt",middleName:null,surname:"Balogh",slug:"zsolt-balogh",fullName:"Zsolt Balogh"},{id:"188241",title:"Dr.",name:"Matthew",middleName:null,surname:"Broadhead",slug:"matthew-broadhead",fullName:"Matthew Broadhead"},{id:"189162",title:"Dr.",name:"Saumiyar",middleName:null,surname:"Sivaji",slug:"saumiyar-sivaji",fullName:"Saumiyar Sivaji"},{id:"189163",title:"Prof.",name:"Peter",middleName:null,surname:"Choong",slug:"peter-choong",fullName:"Peter Choong"}]}],mostDownloadedChaptersLast30Days:[{id:"53932",title:"A Dog in the Cancer Fight: Comparative Oncology in Osteosarcoma",slug:"a-dog-in-the-cancer-fight-comparative-oncology-in-osteosarcoma",totalDownloads:4635,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Since the great Rudolf Virchow advised, “Between animal and human medicine there is no dividing line, nor should there be,” limited attention has been paid to cancer in animals. This is finally changing thanks to a renewed focus on studying pet dogs with cancer. Unlike the laboratory mice who have been the mainstay of animal models of disease, pet dogs share an environment with their human owners, have an intact immune system, and often develop diseases spontaneously in ways that mimic their human counterparts. Osteosarcoma (OSA) – while uncommon in humans - is a common malignancy in dogs. This comparatively high incidence alone renders pet dogs an ideal “model” to conduct translational and clinical research into OSA. Indeed, there are many similarities between the two species with respect to this disease. However, owing to the shorter life span and accelerated disease progression, treatment effects can be assessed much more rapidly in canines than in humans. Overall, dogs represent a unique model to study OSA; this chapter aims to discuss the ways that comparative oncology between dogs and humans are being used from basic science research, to genetics and mechanisms of disease, to tumor biology and finally to developing novel treatments.",book:{id:"5399",slug:"osteosarcoma-biology-behavior-and-mechanisms",title:"Osteosarcoma",fullTitle:"Osteosarcoma - Biology, Behavior and Mechanisms"},signatures:"Alexander L. Lazarides, Allison B. Putterman, William C. Eward and\nCindy Eward",authors:[{id:"189065",title:"Dr.",name:"Alexander",middleName:"Leandros",surname:"Lazarides",slug:"alexander-lazarides",fullName:"Alexander Lazarides"},{id:"189071",title:"Dr.",name:"William",middleName:null,surname:"Eward",slug:"william-eward",fullName:"William Eward"},{id:"189072",title:"Dr.",name:"Allison",middleName:"Brooke",surname:"Putterman",slug:"allison-putterman",fullName:"Allison Putterman"},{id:"196706",title:"Dr.",name:"Cindy A.",middleName:null,surname:"Eward",slug:"cindy-a.-eward",fullName:"Cindy A. Eward"}]},{id:"54268",title:"Biological Reconstruction Using Liquid Nitrogen-Treated Tumor Bearing Bone",slug:"biological-reconstruction-using-liquid-nitrogen-treated-tumor-bearing-bone",totalDownloads:1614,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"In general, a tumor prosthesis is used for reconstruction after removal of osteosarcoma. However, the durability of artificial materials becomes a problem in the long term, and many patients inevitably undergo revision due to loose or damaged prostheses. Moreover, preservation of articular surface is the key to maintain better limb function for long duration. Reconstruction of affected limbs using biological materials has been sought to overcome the aforementioned problems. In some countries, it is significantly difficult to obtain allograft as a biological reconstruction material because of socio-religious or cost problem. Thus, a biological reconstruction method has been developed in which the patient’s affected bone is treated and used for reconstruction. Especially in recycling treatment for affected autologous bone, liquid nitrogen treatment has several favorable characteristics. There is optimal morphological fit because the treated bone itself is one’s own, and bone strength is maintained after treatment. Satisfactory bone union and bone regeneration are expected to be achieved due to good osteoconduction and osteoinduction because proteins and enzymes are preserved in the bone.",book:{id:"5399",slug:"osteosarcoma-biology-behavior-and-mechanisms",title:"Osteosarcoma",fullTitle:"Osteosarcoma - Biology, Behavior and Mechanisms"},signatures:"Norio Yamamoto and Hiroyuki Tsuchiya",authors:[{id:"189049",title:"Prof.",name:"Norio",middleName:null,surname:"Yamamoto",slug:"norio-yamamoto",fullName:"Norio Yamamoto"},{id:"202742",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Tsuchiya",slug:"hiroyuki-tsuchiya",fullName:"Hiroyuki Tsuchiya"}]},{id:"54598",title:"Osteosarcoma of the Jaw: Classification, Diagnosis and Treatment",slug:"osteosarcoma-of-the-jaw-classification-diagnosis-and-treatment",totalDownloads:3152,totalCrossrefCites:4,totalDimensionsCites:6,abstract:"Osteosarcomas are rare, highly malignant, bone tumors defined by the presence of malignant mesenchymal cells producing osteoid or immature bone. Osteosarcomas of the jaws are extremely rare, representing about 7% of all osteosarcomas and 1% of all head and neck malignancies. An accurate diagnosis, usually facilitated by chemotherapy (CT), MRI and biopsy, is required in order to define the stage of the disease and plane the adequate treatment. Aggressive surgical resection and advanced technique reconstruction are the mainstay of treatment, as the single most important factor for cure is radical resection. Clinical outcomes can be improved by a multimodal strategy combining surgery with neo-adjuvant and adjuvant chemotherapy in selected cases, and adjuvant radiotherapy in the absence of clear margins.",book:{id:"5399",slug:"osteosarcoma-biology-behavior-and-mechanisms",title:"Osteosarcoma",fullTitle:"Osteosarcoma - Biology, Behavior and Mechanisms"},signatures:"Daris Ferrari, Laura Moneghini, Fabiana Allevi, Gaetano Bulfamante\nand Federico Biglioli",authors:[{id:"188372",title:"Dr.",name:"Daris",middleName:null,surname:"Ferrari",slug:"daris-ferrari",fullName:"Daris Ferrari"},{id:"188884",title:"Dr.",name:"Laura",middleName:null,surname:"Moneghini",slug:"laura-moneghini",fullName:"Laura Moneghini"},{id:"188885",title:"Prof.",name:"Federico",middleName:null,surname:"Biglioli",slug:"federico-biglioli",fullName:"Federico Biglioli"},{id:"194643",title:"Dr.",name:"Fabiana",middleName:null,surname:"Allevi",slug:"fabiana-allevi",fullName:"Fabiana Allevi"},{id:"194645",title:"Prof.",name:"Gaetano",middleName:null,surname:"Bulfamante",slug:"gaetano-bulfamante",fullName:"Gaetano Bulfamante"}]},{id:"53758",title:"Osteosarcomagenesis: Biology, Development, Metastasis, and Mechanisms of Pain",slug:"osteosarcomagenesis-biology-development-metastasis-and-mechanisms-of-pain",totalDownloads:1573,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Osteosarcoma is the most common primary cancer of the bone and third most common cancer in children and adolescents with approximately 900 new cases annually in the United States. A major facet of osteosarcoma is its high level of genomic instability, in particular chromosomal instability, which is the result of increased or decreased chromosome number in a cell. Furthermore, pain is the most common symptomatic feature of osteosarcoma that lacks effective therapy. Pain in osteosarcoma is relatively more complicated than many other painful conditions requiring a more thorough understanding of its etiology, pathobiology, and neurobiology to allow the development of better therapies for reducing pain in osteosarcoma patients. Studies are underway to define the diverse modalities of presentation, growth, development, metastases, and nociception in osteosarcoma. New data from human studies in combination with data from studies incorporating transgenic mouse models of osteosarcoma are providing valuable insights into the mechanisms underlying the development of both the tumor and the tumor-induced pain. These new data will undoubtedly lead to improved prognoses, as well as the development of novel therapeutics that will significantly decrease bone cancer pain.",book:{id:"5399",slug:"osteosarcoma-biology-behavior-and-mechanisms",title:"Osteosarcoma",fullTitle:"Osteosarcoma - Biology, Behavior and Mechanisms"},signatures:"Branden A. Smeester, Branden S. Moriarity and Alvin J. Beitz",authors:[{id:"187313",title:"Prof.",name:"Alvin J",middleName:null,surname:"Beitz",slug:"alvin-j-beitz",fullName:"Alvin J Beitz"},{id:"187983",title:"Ph.D. Student",name:"Branden",middleName:null,surname:"Smeester",slug:"branden-smeester",fullName:"Branden Smeester"},{id:"194521",title:"Prof.",name:"Branden",middleName:null,surname:"Moriarity",slug:"branden-moriarity",fullName:"Branden Moriarity"}]},{id:"67824",title:"Differential Diagnosis of Osteogenic Tumors in the Context of Osteosarcoma",slug:"differential-diagnosis-of-osteogenic-tumors-in-the-context-of-osteosarcoma",totalDownloads:1410,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Primary bone tumors are rare, but osteosarcoma (OS) is the fourth commonest non-hematological primary neoplasm of the bone in the adolescence, and the other three commonest neoplasms, in descending order, are leukemia, brain tumors, and lymphoma. The commonest presenting complaints are swelling and aches. These tumors cannot be diagnosed without the help of radiology. There is a wide age range of these neoplasms commonly appearing in the second and third decade of life with a peak incidence in early teens. Males are affected more than females. The exact cause of osteosarcoma is unknown. However, a number of risk factors, like genetic predisposition, some existing bone diseases, environmental risk factors, and radiations, have been identified. If the bone tumors are viewed by clinical, radiological, and histopathological perspectives, the correct diagnosis can be made easily. Chemotherapy combined with surgery is the standard treatment modality with better 5-year survival rates. 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Ribeiro-Barros",profilePictureURL:"https://mts.intechopen.com/storage/users/171036/images/system/171036.jpg",institutionString:"University of Lisbon",institution:{name:"University of Lisbon",institutionURL:null,country:{name:"Portugal"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Sustainable Economy and Fair Society",value:91,count:1}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:1}],authors:{paginationCount:189,paginationItems:[{id:"221831",title:"Prof.",name:"Niansheng",middleName:null,surname:"Tang",slug:"niansheng-tang",fullName:"Niansheng Tang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221831/images/system/221831.jpeg",biography:"Niansheng Tang is a Professor of Statistics and Dean of the School of Mathematics and Statistics, Yunnan University, China. He was elected a Yangtze River Scholars Distinguished Professor in 2013, a member of the International Statistical Institute (ISI) in 2016, a member of the board of the International Chinese Statistical Association (ICSA) in 2018, and a fellow of the Institute of Mathematical Statistics (IMS) in 2021. He received the ICSA Outstanding Service Award in 2018 and the National Science Foundation for Distinguished Young Scholars of China in 2012. He serves as a member of the editorial board of Statistics and Its Interface and Journal of Systems Science and Complexity. He is also a field editor for Communications in Mathematics and Statistics. His research interests include biostatistics, empirical likelihood, missing data analysis, variable selection, high-dimensional data analysis, Bayesian statistics, and data science. He has published more than 190 research papers and authored five books.",institutionString:"Yunnan University",institution:{name:"Yunnan University",country:{name:"China"}}},{id:"1177",title:"Prof.",name:"António",middleName:"J. R.",surname:"José Ribeiro Neves",slug:"antonio-jose-ribeiro-neves",fullName:"António José Ribeiro Neves",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1177/images/system/1177.jpg",biography:"Prof. António J. R. Neves received a Ph.D. in Electrical Engineering from the University of Aveiro, Portugal, in 2007. Since 2002, he has been a researcher at the Institute of Electronics and Informatics Engineering of Aveiro. Since 2007, he has been an assistant professor in the Department of Electronics, Telecommunications, and Informatics, University of Aveiro. He is the director of the undergraduate course on Electrical and Computers Engineering and the vice-director of the master’s degree in Electronics and Telecommunications Engineering. He is an IEEE Senior Member and a member of several other research organizations worldwide. His main research interests are computer vision, intelligent systems, robotics, and image and video processing. He has participated in or coordinated several research projects and received more than thirty-five awards. He has 161 publications to his credit, including books, book chapters, journal articles, and conference papers. He has vast experience as a reviewer of several journals and conferences. As a professor, Dr. Neves has supervised several Ph.D. and master’s students and was involved in more than twenty-five different courses.",institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"11317",title:"Dr.",name:"Francisco",middleName:null,surname:"Javier Gallegos-Funes",slug:"francisco-javier-gallegos-funes",fullName:"Francisco Javier Gallegos-Funes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/11317/images/system/11317.png",biography:"Francisco J. Gallegos-Funes received his Ph.D. in Communications and Electronics from the Instituto Politécnico Nacional de México (National Polytechnic Institute of Mexico) in 2003. He is currently an associate professor in the Escuela Superior de Ingeniería Mecánica y Eléctrica (Mechanical and Electrical Engineering Higher School) at the same institute. His areas of scientific interest are signal and image processing, filtering, steganography, segmentation, pattern recognition, biomedical signal processing, sensors, and real-time applications.",institutionString:"Instituto Politécnico Nacional",institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"428449",title:"Dr.",name:"Ronaldo",middleName:null,surname:"Ferreira",slug:"ronaldo-ferreira",fullName:"Ronaldo Ferreira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428449/images/21449_n.png",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). 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