\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\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:"5761",leadTitle:null,fullTitle:"Quality of Life and Quality of Working Life",title:"Quality of Life and Quality of Working Life",subtitle:null,reviewType:"peer-reviewed",abstract:'In this book, we can read about the well-being, quality of life, and quality of working life. The authors come from different countries, and their ideas, studies, findings, and experiences offer beneficial contributions to enhance our knowledge in the field of well-being and quality of life, as well as quality of working life. The book is divided into two sections, and their respective chapters refer to two major areas. The first section covers "Different Perspectives of Quality of Life," considering the antecedents of happiness, quality of life and sports, quality of life indexes for the United States, well-being in the context of family policies in European countries, cultural well-being and income in Italy, and the right to life in South Africa. The second section deals with "Well-Being and Quality of Working Life," emphasizing these topics for university professors in Brazil, as well as work-related well-being, psychological well-being of individuals as employees, physical and psychical well-being and stress, human work in organizations considering the discomfort perspective, and professional pride and dignity among social workers. Thus, we consider this book will be of interest for readers with a diverse group of audience in different areas of specialty such as psychology, industrial and social psychology, management, medicine, education, law, and sociology.',isbn:"978-953-51-3446-6",printIsbn:"978-953-51-3445-9",pdfIsbn:"978-953-51-4705-3",doi:"10.5772/65198",price:139,priceEur:155,priceUsd:179,slug:"quality-of-life-and-quality-of-working-life",numberOfPages:312,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"f6000bc0eeed7fcf0277a2f8d75907d9",bookSignature:"Ana Alice Vilas Boas",publishedDate:"August 23rd 2017",coverURL:"https://cdn.intechopen.com/books/images_new/5761.jpg",numberOfDownloads:23592,numberOfWosCitations:18,numberOfCrossrefCitations:15,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:36,numberOfDimensionsCitationsByBook:2,hasAltmetrics:1,numberOfTotalCitations:69,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 20th 2016",dateEndSecondStepPublish:"October 11th 2016",dateEndThirdStepPublish:"January 7th 2017",dateEndFourthStepPublish:"April 7th 2017",dateEndFifthStepPublish:"June 6th 2017",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"175373",title:"Dr.",name:"Ana Alice",middleName:null,surname:"Vilas Boas",slug:"ana-alice-vilas-boas",fullName:"Ana Alice Vilas Boas",profilePictureURL:"https://mts.intechopen.com/storage/users/175373/images/5450_n.jpg",biography:"Ana Alice Vilas Boas is a post-doctor by HEC-Montreal. She attended her PhD at the University of Reading – UK. She holds a Master in Management by the Federal University of Lavras. From 1993 up to 2008 she worked at the Federal University of Rio de Janeiro and then she moved back to Lavras – Minas Gerais – Brazil where she is Associated Professor in the Department of Management and Economics of the Federal University of Lavras - UFLA. She is an expert in Human Resources Management and related areas such as business strategy, entrepreneurship, quality of working life and distance learning. She supervised many Master dissertations and some PhD thesis. Author of papers, chapters and books published in Brazil and worldwide. Her main topics of interest nowadays are Quality of Working Life and Organizational Behavior.",institutionString:"Federal University of Lavras",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Federal University of Lavras",institutionURL:null,country:{name:"Brazil"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1338",title:"Family Studies",slug:"social-psychology-family-studies"}],chapters:[{id:"54570",title:"Exploring the Antecedents of Happiness: Reconceptualization of Human Needs with Glasser's Choice Theory",doi:"10.5772/68022",slug:"exploring-the-antecedents-of-happiness-reconceptualization-of-human-needs-with-glasser-s-choice-theo",totalDownloads:1647,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"This chapter aims to present a review about the antecedents of happiness by using human needs perspective. The chapter briefly includes the definition of happiness as a scientific matter, definition of the need theories approach for explaining the antecedents of happiness, definitions and discussions about the major need theories and reconceptualization of human needs with Glasser’s Choice Theory, and also empirical studies that investigate the relationship between basic needs satisfaction and happiness. It is also thought that the conclusion obtained from this chapter will encourage researchers to investigate the antecedents of happiness with Glasser’s conceptual framework and also invite researchers to study in a new research area with a new conceptual perspective.",signatures:"Turgut Turkdogan",downloadPdfUrl:"/chapter/pdf-download/54570",previewPdfUrl:"/chapter/pdf-preview/54570",authors:[{id:"197018",title:"Ph.D.",name:"Turgut",surname:"Turkdogan",slug:"turgut-turkdogan",fullName:"Turgut Turkdogan"}],corrections:null},{id:"55323",title:"Positive Psychology: The Use of the Framework of Achievement Bests to Facilitate Personal Flourishing",doi:"10.5772/intechopen.68873",slug:"positive-psychology-the-use-of-the-framework-of-achievement-bests-to-facilitate-personal-flourishing",totalDownloads:1749,totalCrossrefCites:3,totalDimensionsCites:9,hasAltmetrics:0,abstract:"The Framework of Achievement Bests, which was recently published in Educational Psychology Review, makes a theoretical contribution to the study of positive psychology. The Framework of Achievement Bests provides an explanatory account of a person’s optimal best practice from his/her actual best. Another aspect emphasizes on the saliency of the psychological process of optimization, which is central to our understanding of person’s optimal functioning in a subject matter. Achieving an exceptional level of best practice (e.g. achieving excellent grades in mathematics) does not exist in isolation, but rather depends on the potent impact of optimization. This chapter, theoretical in nature, focuses on an in‐depth examination of the expansion of the Framework of Achievement Bests. Our discussion of the Framework of Achievement Bests, reflecting a methodical conceptualization, is benchmarked against another notable theory for understanding, namely: Martin Seligman’s PERMA theory. For example, for consideration, one aspect that we examine entails the extent to which the Framework of Achievement Bests could explain the optimization of each of the five components of PERMA (e.g. how does the Framework of Achievement Bests explain the optimization of engagement?).",signatures:"Huy P. Phan and Bing H. Ngu",downloadPdfUrl:"/chapter/pdf-download/55323",previewPdfUrl:"/chapter/pdf-preview/55323",authors:[{id:"196435",title:"Prof.",name:"Huy",surname:"Phan",slug:"huy-phan",fullName:"Huy Phan"}],corrections:null},{id:"54807",title:"Understanding the Concept of Life Quality within the Framework of Social Service Provision: Theoretical Analysis and a Case Study",doi:"10.5772/intechopen.68200",slug:"understanding-the-concept-of-life-quality-within-the-framework-of-social-service-provision-theoretic",totalDownloads:1422,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The study discusses the quality of life concept and its relation to the right to lead an independent life as a social service recipient. The combination of these concepts can be found in various strategic documents at the national and international level. The study articulates the thesis that the concept of capabilities is the basic concept for both the definition of quality of life and the definition of the right to independent living, as the level of freedom and capability (capabilities) provides information on real opportunities and possibilities of individuals to make free decisions as well as allows to identify disparities caused by the social structure that disadvantages, marginalises or discriminates certain groups. The aims of the study are to provide a clear definition of the right to lead an independent life and to explicate the link between the concepts of quality of life, self‐determination, autonomy, competence in the context of the rights of disabled people to the integration and social inclusion. Reflecting on the experience from the Slovak Republic, the study suggests that the social service transformation process does not always imply an improvement in the life quality of the disabled. Instead, an ill‐prepared deinstitutionalisation of the social services might dissolve the available system without providing an adequate replacement.",signatures:"Zuzana Palovičová",downloadPdfUrl:"/chapter/pdf-download/54807",previewPdfUrl:"/chapter/pdf-preview/54807",authors:[{id:"196861",title:"Associate Prof.",name:"Zuzana",surname:"Palovicova",slug:"zuzana-palovicova",fullName:"Zuzana Palovicova"}],corrections:null},{id:"55530",title:"Quality of Life and Physical Activity: Their Relationship with Physical and Psychological Well-Being",doi:"10.5772/intechopen.69151",slug:"quality-of-life-and-physical-activity-their-relationship-with-physical-and-psychological-well-being",totalDownloads:1978,totalCrossrefCites:3,totalDimensionsCites:3,hasAltmetrics:1,abstract:"Many studies have been focused on the analysis of different factors that relate to the quality of life. And those studies have found a clear relationship between the quality of life, psychological well-being, and health. It is important to know those relationships and to know factors that can improve these three aspects simultaneously. And one of the most important factors is the realization of physical activity on a regular basis. This study analyzes the effect of physical activity on improving the quality of life (physical health and well-being) and its relationship with psychological well-being through two studies. One was a randomized clinical trial involving 98 low-risk incident cases of acute coronary syndrome, who were randomly assigned to an unsupervised walking program or a cycle ergometer exercise program. The other study is an expost-facto investigation with a total of 841 healthy subjects. We apply them questionnaires to measure subjective well-being, satisfaction with life, positive and negative affect, Short Form-36 Health Survey (SF-36), and the specific Velasco-del Barrio questionnaire for post-myocardial infarction. This study concludes physical activity and exercise are key factors in an individual’s perception for their quality of life, both in the area of physical and psychological health.",signatures:"Arantzazu Rodríguez-Fernández, Ana Zuazagoitia-Rey-Baltar and\nEstibaliz Ramos-Díaz",downloadPdfUrl:"/chapter/pdf-download/55530",previewPdfUrl:"/chapter/pdf-preview/55530",authors:[{id:"90485",title:"Dr.",name:"Arantzazu",surname:"Rodriguez-Fernández",slug:"arantzazu-rodriguez-fernandez",fullName:"Arantzazu Rodriguez-Fernández"},{id:"205182",title:"Dr.",name:"Ana",surname:"Zuazagoitia-Rey-Baltar",slug:"ana-zuazagoitia-rey-baltar",fullName:"Ana Zuazagoitia-Rey-Baltar"},{id:"205183",title:"Dr.",name:"Estibaliz",surname:"Ramos-Díaz",slug:"estibaliz-ramos-diaz",fullName:"Estibaliz Ramos-Díaz"}],corrections:null},{id:"54577",title:"Building a Quality of Life Index",doi:"10.5772/67821",slug:"building-a-quality-of-life-index",totalDownloads:1769,totalCrossrefCites:0,totalDimensionsCites:3,hasAltmetrics:1,abstract:"This chapter outlines how an index measuring quality of life should be developed and then applies that work at the county level in the United States. The index we create is a unique and data‐driven approach to calculating quality of life. In the chapter, we explain the process that leads us to selecting our five indicators: public safety, health, economic development, infrastructure, and education. Each indicator breaks apart into subindicators. This chapter theoretically and statistically verifies our chosen indicators. First, we develop theoretical arguments explaining the connections between quality of life and our indicators. Then, we perform confirmatory factor analyses on our index to empirically verify our theoretical arguments for why each component should be included in the index. Further, we finally verify our theory and index using survey results. We use only publicly available data to facilitate replication by others. The results of our confirmatory factor analysis provide statistical evidence for our choice of indicators in measuring quality of life. Our findings indicate that those measuring quality of life must account for the roles of: public safety, health, economic development, infrastructure, and education. Most importantly, our results indicate that our index is a valid measure of quality of life.",signatures:"Ryan M. Yonk, Josh T. Smith and Arthur R. Wardle",downloadPdfUrl:"/chapter/pdf-download/54577",previewPdfUrl:"/chapter/pdf-preview/54577",authors:[{id:"196259",title:"Dr.",name:"Ryan Merlin",surname:"Yonk",slug:"ryan-merlin-yonk",fullName:"Ryan Merlin Yonk"},{id:"197814",title:"Mr.",name:"Joshua",surname:"Smith",slug:"joshua-smith",fullName:"Joshua Smith"}],corrections:null},{id:"55349",title:"The Development of a Human Well-Being Index for the United States",doi:"10.5772/intechopen.68596",slug:"the-development-of-a-human-well-being-index-for-the-united-states",totalDownloads:2050,totalCrossrefCites:3,totalDimensionsCites:9,hasAltmetrics:1,abstract:"The US Environmental Protection Agency (EPA) has developed a human well-being index (HWBI) that assesses the over-all well-being of its population at the county level. The HWBI contains eight domains representing social, economic and environmental well-being. These domains include 25 indicators comprised of 80 metrics and 22 social, economic and environmental services. The application of the HWBI has been made for the nation as a whole at the county level and two alternative applications have been made to represent key populations within the overall US population—Native Americans and children. A number of advances have been made to estimate the values of metrics for counties where no data is available and one such estimator—MERLIN—is discussed. Finally, efforts to make the index into an interactive web site are described.",signatures:"J. Kevin Summers, Lisa M. Smith, Linda C. Harwell and Kyle D. Buck",downloadPdfUrl:"/chapter/pdf-download/55349",previewPdfUrl:"/chapter/pdf-preview/55349",authors:[{id:"197485",title:"Dr.",name:"J. Kevin",surname:"Summers",slug:"j.-kevin-summers",fullName:"J. Kevin Summers"},{id:"197486",title:"Ms.",name:"Lisa",surname:"Smith",slug:"lisa-smith",fullName:"Lisa Smith"},{id:"197487",title:"Ms.",name:"Linda",surname:"Harwell",slug:"linda-harwell",fullName:"Linda Harwell"},{id:"197488",title:"Dr.",name:"Kyle",surname:"Buck",slug:"kyle-buck",fullName:"Kyle Buck"}],corrections:null},{id:"54653",title:"Quality of Life, Well-Being and Social Policies in European Countries1",doi:"10.5772/68003",slug:"quality-of-life-well-being-and-social-policies-in-european-countries1",totalDownloads:1372,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"European Public Policies have traditionally focused on material welfare conditions and indicators, but recent studies demand the inclusion of other subjective indicators. This work deals with the need to go beyond welfare to well‐being and aims a critical review of the scientific literature on subjective well‐being and quality of life in social policies, and of the indicators usually managed for its operationalization. A comparative study of different variables used by the OECD Better Life Index (BLI, 2014) has been carried out to analyze the relationship between social and economic indicators and the other indicators traditionally linked to life satisfaction and subjective perception of life satisfaction. As the main result, this research remarks the need to include social policies in analyses of well‐being as a key element in people's satisfaction, recognizing the perception of subjective well‐being and quality of life as a political and public issue.",signatures:"Ángel Carrasco‐Campos, Almudena Moreno and Luis‐Carlos\nMartínez",downloadPdfUrl:"/chapter/pdf-download/54653",previewPdfUrl:"/chapter/pdf-preview/54653",authors:[{id:"196212",title:"Prof.",name:"Almudena",surname:"Moreno Minguez",slug:"almudena-moreno-minguez",fullName:"Almudena Moreno Minguez"},{id:"196411",title:"Dr.",name:"Angel",surname:"Carrasco Campos",slug:"angel-carrasco-campos",fullName:"Angel Carrasco Campos"},{id:"196412",title:"Dr.",name:"Luis Carlos",surname:"Martínez Fernández",slug:"luis-carlos-martinez-fernandez",fullName:"Luis Carlos Martínez Fernández"}],corrections:null},{id:"54311",title:"Cultural Well-Being and GDP Per Capita in Italy: Empirical Evidence",doi:"10.5772/67613",slug:"cultural-well-being-and-gdp-per-capita-in-italy-empirical-evidence",totalDownloads:1188,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Social and cultural participation has always been a means to promote high economic growth and the development of the individual in a given society. Public and private institutions often try to make available efforts and resources to promote the usability of free time and social participation. This paper uses data from the multipurpose survey on Italian households, conducted by the Italian Institute of Statistics, and it analyses the relationship between cultural capability and the income and economic means of Italian households through the construction of a composite indicator of cultural well‐being. The analysis of the individual indicators of education and cultural participation makes it possible to study issues related to the development of social capital in the northern and southern areas, thus highlighting the gap and enabling the decision‐maker to apply possible corrections.",signatures:"Enrico Ivaldi and Marta Santagata",downloadPdfUrl:"/chapter/pdf-download/54311",previewPdfUrl:"/chapter/pdf-preview/54311",authors:[{id:"197113",title:"Prof.",name:"Enrico",surname:"Ivaldi",slug:"enrico-ivaldi",fullName:"Enrico Ivaldi"},{id:"203495",title:"Dr.",name:"Marta",surname:"Santagata",slug:"marta-santagata",fullName:"Marta Santagata"}],corrections:null},{id:"55015",title:"The Mammoth Task of Realising the Right to Life: A South African Perspective",doi:"10.5772/67632",slug:"the-mammoth-task-of-realising-the-right-to-life-a-south-african-perspective",totalDownloads:1574,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Concentrating on South Africa, this chapter critically scrutinises the realisation of everyone's right to life as guaranteed in section 11 of the Constitution of the Republic of South Africa. Although the right to life is explored within the ambit of an international legal framework, realising the right to life in South Africa, with its history of demeaning the value of the life of the majority of its inhabitants in the past, forms the main pivot of discussion. It is argued that, despite the 1996 Constitution's promise to heal these past divisions and improve the quality of life of all citizens and free each person's potential, the State has been ambivalent about realising everyone's right to life. As part of post‐apartheid transformation, the State has, on the one hand, made substantial progresses in creating a supporting and legal environment for the attainment of a better life for some of its inhabitants. On the other hand, reality still reflects poignantly flaws in freeing everyone's potential, thus highlighting the mammoth task that lies ahead.",signatures:"Erika M. Serfontein",downloadPdfUrl:"/chapter/pdf-download/55015",previewPdfUrl:"/chapter/pdf-preview/55015",authors:[{id:"196203",title:"Prof.",name:"Erika",surname:"Serfontein",slug:"erika-serfontein",fullName:"Erika Serfontein"}],corrections:null},{id:"56529",title:"Well-being and Quality of Working Life of University Professors in Brazil",doi:"10.5772/intechopen.70237",slug:"well-being-and-quality-of-working-life-of-university-professors-in-brazil",totalDownloads:1684,totalCrossrefCites:2,totalDimensionsCites:6,hasAltmetrics:0,abstract:"This chapter presents a study about the perceptions on quality of working life (QWL) regarding factors and indicator in two public universities in Brazil. It aimed also to analyze their perceptions about university working conditions. This exploratory study is based on quantitative and qualitative analyses. A sample of 715 university professors participated on the research. Data collection was carried out in two steps: online survey and focus groups. There is a moderate negative correlation between psychological well-being and work-related stress. Emotional charge also presents a moderate positive correlation with work-related stress, as well as physical charge and psychological distress. Work-life balance is negatively correlated with physical charge, emotional charge, work-related stress, psychological distress, and burnout. We observed also that 43.6% of the professors reported high levels of work-related stress in their everyday work. The precariousness of university teaching is associated with three main elements, which we defined as the tripod of the precarization of university teaching work. It consists of academic productivism, excess of administrative work and bureaucratic activities, and inadequate working conditions. The operating dynamics of this tripod effect professors’ well-being, their QWL, and even the quality of the work they develop in public universities.",signatures:"Alessandro Vinicius de Paula and Ana Alice Vilas Boas",downloadPdfUrl:"/chapter/pdf-download/56529",previewPdfUrl:"/chapter/pdf-preview/56529",authors:[{id:"175373",title:"Dr.",name:"Ana Alice",surname:"Vilas Boas",slug:"ana-alice-vilas-boas",fullName:"Ana Alice Vilas Boas"},{id:"196534",title:"Dr.",name:"Alessandro Vinicius",surname:"De Paula",slug:"alessandro-vinicius-de-paula",fullName:"Alessandro Vinicius De Paula"}],corrections:null},{id:"54223",title:"Work-Related Well-Being: From Qualitative Job Insecurity to Cognitive Reappraisal",doi:"10.5772/67507",slug:"work-related-well-being-from-qualitative-job-insecurity-to-cognitive-reappraisal",totalDownloads:1085,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"This study contributes to the understanding of the moderating effect of cognitive reappraisal, as a personal resource, for the relationship between qualitative job insecurity (QJI) and work engagement. Data was collected from 190 employees (53% men) who work in a multinational company in Romania. Hypotheses were tested using a hierarchical regression analysis, with work engagement as the dependent variable. The results support the moderation hypothesis: a cognitive reappraisal, as an efficient type of emotion regulation strategy, moderates the relationship between qualitative job insecurity and work engagement. Practical implications of the present findings suggest that trainings aimed at improving emotion regulation skills can help to increase work engagement for employees that experiment job insecurity based on deteriorating work conditions, specific to the qualitative job insecurity.",signatures:"Delia Vîrgă",downloadPdfUrl:"/chapter/pdf-download/54223",previewPdfUrl:"/chapter/pdf-preview/54223",authors:[{id:"196953",title:"Ph.D.",name:"Delia",surname:"Virga",slug:"delia-virga",fullName:"Delia Virga"}],corrections:null},{id:"55004",title:"Psychological Well-Being of Individuals as Employees and a Paradigm in the Future Economy and Society",doi:"10.5772/67927",slug:"psychological-well-being-of-individuals-as-employees-and-a-paradigm-in-the-future-economy-and-societ",totalDownloads:1614,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"We report about a new non-technological innovation aimed to manage socioeconomic crises. Economic theory cannot manage them: it is too one-sided. The model suggests solving the crises with requisite holism (RH), social responsibility (SR), human personal requisite holism (HPRH), and well-being (WB). Qualitative analysis using RH, SR, HPRH, WB, and dialectical systems theory (DST) was applied in this research. Field research covered Slovene midsize enterprises. Findings include the following: The global and local political and economic decision-makers poorly know and use systemic behavior; they are therefore one-sided rather than requisitely holistic and caused the current global socioeconomic and environmental crisis. RH/SR would make decision-makers more/requisitely holistic, honest, and reliable. RH/SR supports holism better, if upgraded with increasing WB, not welfare alone. Both RH/SR and WB support HPRH. Their innovative synergy WB&RH/SR leads to the solution of crises. DST backs WB&RH/SR methodologically. Research was qualitative analysis in desk and previous field research. Its practical implications show that the RH/SR/WB/DST/HPRH approach to managing socioeconomic crises helps practitioners essentially to avoid oversights and failures. Available literature offers no similar concept.",signatures:"Simona Šarotar Žižek and Matjaž Mulej",downloadPdfUrl:"/chapter/pdf-download/55004",previewPdfUrl:"/chapter/pdf-preview/55004",authors:[{id:"192730",title:"Associate Prof.",name:"Simona",surname:"Šarotar Žižek",slug:"simona-sarotar-zizek",fullName:"Simona Šarotar Žižek"},{id:"197979",title:"Dr.",name:"Matjaž",surname:"Mulej",slug:"matjaz-mulej",fullName:"Matjaž Mulej"}],corrections:null},{id:"54549",title:"Physical and Psychical Well-Being and Stress: The Perspectives of Leaders and Employees",doi:"10.5772/67889",slug:"physical-and-psychical-well-being-and-stress-the-perspectives-of-leaders-and-employees",totalDownloads:1489,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Stress among employees is a significant issue in each organization and society because of its costs on individual, organizational, and society levels. Addressing and reducing stress is thus an important goal, which leads humans to well-being. The main role of managing stress at work belongs to leaders. Their leadership can have effects on the level of stress of employees as well as for themselves. They also decide about their systemic approaches for overcoming stress within organizations. We therefore conducted a stress (qualitative and quantitative) research of employees and leaders within organizations with the main goal to find out the differences between their stresses. The main purpose of this article was to research stress among leaders and employees and to compare their perceived physical and psychical well-being (and stress). For this purpose, we used descriptive statistics and Mann-Whitney U-test. We confirmed that (1) leaders report a higher frequency of some kinds of the daily work stress than employees, (2) on average, leaders were more frequently under pressure than employees, (3) on average, leaders had more frequently satisfying sleep than employees, and (4) on average, employees could use their strong points at work less frequently than leaders.",signatures:"Simona Šarotar Žižek and Vesna Čančer",downloadPdfUrl:"/chapter/pdf-download/54549",previewPdfUrl:"/chapter/pdf-preview/54549",authors:[{id:"192730",title:"Associate Prof.",name:"Simona",surname:"Šarotar Žižek",slug:"simona-sarotar-zizek",fullName:"Simona Šarotar Žižek"},{id:"197783",title:"Dr.",name:"Vesna",surname:"Čančer",slug:"vesna-cancer",fullName:"Vesna Čančer"}],corrections:null},{id:"54386",title:"Human Work and its Discontents",doi:"10.5772/67611",slug:"human-work-and-its-discontents",totalDownloads:1426,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"The objective of the proposed chapter is to discuss the evolution of research on meanings and quality of life at work, highlighting gaps and emphasizing the way the approach that articulates “work” and “human suffering” can contribute to advance in contemporary studies in this field [1]. Given its centrality in people's life and in society development, work has been analyzed from different perspectives and methodological‐theoretical‐conceptual approaches [2–5]. Notwithstanding the plurality of views on the theme, it is generally possible to define it as an activity that has an objective and is aimed at producing some personal or collective result that is objectively and/or subjectively useful. It can also be carried out within the space of employment, employment being understood as the set of remunerated activities performed within a system that is economically organized and marked by institutionalized exchange relations.",signatures:"Anderson de Souza Sant'Anna, Zélia Miranda Kilimnik and Daniela\nMartins Diniz",downloadPdfUrl:"/chapter/pdf-download/54386",previewPdfUrl:"/chapter/pdf-preview/54386",authors:[{id:"197768",title:"Prof.",name:"Daniela",surname:"Diniz",slug:"daniela-diniz",fullName:"Daniela Diniz"},{id:"197896",title:"Dr.",name:"Anderson",surname:"Sant\\'Anna",slug:"anderson-sant'anna",fullName:"Anderson Sant\\'Anna"},{id:"197897",title:"Prof.",name:"Zélia",surname:"Kilimnik",slug:"zelia-kilimnik",fullName:"Zélia Kilimnik"}],corrections:null},{id:"54833",title:"Professional Pride and Dignity? 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The results of the study generated a theoretical model that illustrates how the phenomenon of “work satisfaction” can be understood and reached through a process of balancing, maintaining, and recreating professional pride and dignity in the field of social work. 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Ataolah Sadr",authors:[{id:"25086",title:"Dr.",name:"Mohammad Reza",middleName:null,surname:"Hedayati",fullName:"Mohammad Reza Hedayati",slug:"mohammad-reza-hedayati"},{id:"135758",title:"Dr.",name:"Ali Asghar",middleName:null,surname:"Amidian",fullName:"Ali Asghar Amidian",slug:"ali-asghar-amidian"},{id:"135759",title:"Prof.",name:"Ataolah",middleName:null,surname:"Sadr",fullName:"Ataolah Sadr",slug:"ataolah-sadr"}]},{id:"21265",title:"Conceptual Model Development for a Knowledge Base of PID Controllers Tuning in Open Loop",slug:"conceptual-model-development-for-a-knowledge-base-of-pid-controllers-tuning-in-open-loop",signatures:"José Luis Calvo-Rolle, Ramón Ferreiro García, Antonio Couce Casanova, Héctor Quintián-Pardo and Héctor Alaiz-Moreton",authors:[{id:"9942",title:"Dr.",name:"Ramon",middleName:"Garcia",surname:"Ferreiro",fullName:"Ramon Ferreiro",slug:"ramon-ferreiro"},{id:"12579",title:"Dr.",name:"Jose Luis",middleName:null,surname:"Calvo-Rolle",fullName:"Jose Luis Calvo-Rolle",slug:"jose-luis-calvo-rolle"},{id:"26462",title:"Dr.",name:"Antonio",middleName:null,surname:"Couce-Casanova",fullName:"Antonio Couce-Casanova",slug:"antonio-couce-casanova"},{id:"26463",title:"Dr.",name:"Hector",middleName:null,surname:"Quintian-Pardo",fullName:"Hector Quintian-Pardo",slug:"hector-quintian-pardo"},{id:"26940",title:"Dr.",name:"Hector",middleName:null,surname:"Alaiz-Moreton",fullName:"Hector Alaiz-Moreton",slug:"hector-alaiz-moreton"}]},{id:"21266",title:"Hybrid System for Ship-Aided Design Automation",slug:"hybrid-system-for-ship-aided-design-automation",signatures:"Maria Meler-Kapcia",authors:[{id:"28416",title:"Dr.",name:"Maria",middleName:null,surname:"Meler-Kapcia",fullName:"Maria Meler-Kapcia",slug:"maria-meler-kapcia"}]},{id:"21267",title:"An Expert System Structured in Paraconsistent Annotated Logic for Analysis and Monitoring of the Level of Sea Water Pollutants",slug:"an-expert-system-structured-in-paraconsistent-annotated-logic-for-analysis-and-monitoring-of-the-lev",signatures:"João Inácio Da Silva Filho, Maurício C. Mário, Camilo D. Seabra Pereira, Ana Carolina Angari, Luis Fernando P. Ferrara, Odair Pitoli Jr.\nand Dorotéa Vilanova Garcia",authors:[{id:"28847",title:"Dr.",name:"João Inácio",middleName:null,surname:"Da Silva Filho",fullName:"João Inácio Da Silva Filho",slug:"joao-inacio-da-silva-filho"},{id:"37116",title:"Dr.",name:"Maurício",middleName:null,surname:"Conceição Mário",fullName:"Maurício Conceição Mário",slug:"mauricio-conceicao-mario"},{id:"37117",title:"Dr.",name:"Camilo",middleName:null,surname:"Seabra Pereira",fullName:"Camilo Seabra Pereira",slug:"camilo-seabra-pereira"},{id:"37118",title:"MSc.",name:"Ana Carolina",middleName:null,surname:"Agari",fullName:"Ana Carolina Agari",slug:"ana-carolina-agari"},{id:"37119",title:"Dr.",name:"Dorotéa",middleName:null,surname:"Vilanova Garcia",fullName:"Dorotéa Vilanova Garcia",slug:"dorotea-vilanova-garcia"},{id:"80929",title:"BSc.",name:"Odair",middleName:null,surname:"Pitoli Jr",fullName:"Odair Pitoli Jr",slug:"odair-pitoli-jr"},{id:"80930",title:"MSc.",name:"Luís Fernando Pompeu",middleName:null,surname:"Ferrara",fullName:"Luís Fernando Pompeu Ferrara",slug:"luis-fernando-pompeu-ferrara"}]},{id:"21268",title:"Expert System Based Network Testing",slug:"expert-system-based-network-testing",signatures:"Vlatko Lipovac",authors:[{id:"39491",title:"Dr.",name:"Vlatko",middleName:null,surname:"Lipovac",fullName:"Vlatko Lipovac",slug:"vlatko-lipovac"}]},{id:"21287",title:"An Expert System Based Approach for Diagnosis of Occurrences in Power Generating Units",slug:"an-expert-system-based-approach-for-diagnosis-of-occurrences-in-power-generating-units",signatures:"Jacqueline G. Rolim and Miguel Moreto",authors:[{id:"30718",title:"Dr.",name:null,middleName:null,surname:"Rolim",fullName:"Rolim",slug:"rolim"},{id:"38897",title:"Mr.",name:"Miguel",middleName:null,surname:"Moreto",fullName:"Miguel Moreto",slug:"miguel-moreto"}]},{id:"21293",title:"Fuzzy Based Flow Management of Real-Time Traffic for Quality of Service in WLANs",slug:"fuzzy-based-flow-management-of-real-time-traffic-for-quality-of-service-in-wlans",signatures:"Tapio Frantti and Mikko Majanen",authors:[{id:"34193",title:"Prof.",name:"Tapio",middleName:null,surname:"Frantti",fullName:"Tapio Frantti",slug:"tapio-frantti"},{id:"38583",title:"Mr.",name:"Mikko",middleName:null,surname:"Majanen",fullName:"Mikko Majanen",slug:"mikko-majanen"},{id:"38584",title:"Mrs.",name:"Mirjami",middleName:null,surname:"Jutila",fullName:"Mirjami Jutila",slug:"mirjami-jutila"}]},{id:"21294",title:"Expert System for Automatic Analysis of Results of Network Simulation",slug:"expert-system-for-automatic-analysis-of-results-of-network-simulation",signatures:"Joze Mohorko, Sasa Klampfer, Matjaz Fras and Zarko Cucej",authors:[{id:"17781",title:"Prof.",name:"Zarko",middleName:null,surname:"Cucej",fullName:"Zarko Cucej",slug:"zarko-cucej"},{id:"17782",title:"Dr.",name:"Joze",middleName:null,surname:"Mohorko",fullName:"Joze Mohorko",slug:"joze-mohorko"},{id:"34544",title:"MSc.",name:"Sasa",middleName:null,surname:"Klampfer",fullName:"Sasa Klampfer",slug:"sasa-klampfer"},{id:"34545",title:"Dr.",name:"Matjaz",middleName:null,surname:"Fras",fullName:"Matjaz Fras",slug:"matjaz-fras"}]}]}],publishedBooks:[{type:"book",id:"173",title:"Expert Systems for Human, Materials and Automation",subtitle:null,isOpenForSubmission:!1,hash:"d00cfbf1f4ec20211e33264642361190",slug:"expert-systems-for-human-materials-and-automation",bookSignature:"Petrică Vizureanu",coverURL:"https://cdn.intechopen.com/books/images_new/173.jpg",editedByType:"Edited by",editors:[{id:"12354",title:"Prof.",name:"Petrică",surname:"Vizureanu",slug:"petrica-vizureanu",fullName:"Petrică Vizureanu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3779",title:"Autonomous Agents",subtitle:null,isOpenForSubmission:!1,hash:"2de8f35c0784b403c61442c900cf2e93",slug:"autonomous-agents",bookSignature:"Vedran Kordic",coverURL:"https://cdn.intechopen.com/books/images_new/3779.jpg",editedByType:"Edited by",editors:[{id:"396",title:"Dr.",name:"Vedran",surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3794",title:"Swarm Intelligence",subtitle:"Focus on Ant and Particle Swarm Optimization",isOpenForSubmission:!1,hash:"5332a71035a274ecbf1c308df633a8ed",slug:"swarm_intelligence_focus_on_ant_and_particle_swarm_optimization",bookSignature:"Felix T.S. 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Paediatric administrated doses are considered, firstly.
Too high administrated activities increased radiation dose without adding diagnostic information but too low activities may not permit an adequate examination. The optimal activity amount gives the desired diagnostic information with the minimum patient radiation exposure.
The next session of this chapter refers to the rules and procedures that are established for the evaluation of quantities as absorbed dose, effective dose or Paediatric Dose Reference Levels (PDRL).
In general, patient-specific dosimetry for a child examination in nuclear medicine differs from that of an adult due to different biodistribution and kinetics and variability of body size. It requires the knowledge of many factors like age, weight, biological and molecular background of the pathology and of the developmental process of the child, shape, mass, volume, anatomy, physiological indices.
Different values of instrumental parameters will be used for personalized dosimetric measurements in planar, SPECT, PET, or hybrid (SPECT/CT, PET/CT) examinations in children’s studies.
Single Photon Emission Computed Tomography (SPECT) is a nuclear medicine imaging modality that generates 3-dimensional pictures of the examined body.
Positron Emission Tomography (PET) investigates areas of abnormal activity by revealing relative glucose metabolic activity in tissues and organs.
SPECT and PET can be combined with Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) producing the so-called “hybrid” imaging.
Nuclear medicine imaging examinations are performed in paediatric patients for diagnosis of diseases or injuries. The necessity of these examinations by radiopharmaceuticals must be ensured and then should be performed securely.
The International Atomic Energy Agency (IAEA) helps medical professionals to improve quality and safety by providing standards and guidelines, training and information resources. Radiation Protection of Patients (RPOP) is also the leading resource for patients and the public on the safe and effective use of radiation in medicine (IAEA, Radiation Protection of Patients).
World Health Organization (WHO) has edited leaflets and posters titled: ‘Nuclear medicine exams in children: what do we need to know?’, for patients and families with many simple advices on what do they need to know about nuclear medicine examinations in children.
The performance of a nuclear examination should be based upon the ‘justification’ radioprotection rule as well as the ‘optimization’ rule. Both are part of responsible and ethical medical practice.
Paediatric applications of nuclear medicine provide invaluable information in the diagnosis and follow-up of many pathological disorders as well as in therapy.
In North America, the ‘Image Gently’ Campaign encouraged the formation of an expert group to overcome the lack of paediatric guidelines and to look into the possibility of developing paediatric harmonized guidelines. These guidelines were approved by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the Society for Pediatric Radiology (SPR) and the American College of Radiology (ACR).
Although the North American and European Association of Nuclear Medicine (EANM) guidelines use different models, both have concluded in the development of a set of international guidelines, also referred to as “
A modified version of the EANM dosage card incorporating the suggested changes is available online. Data on the biokinetics and dosimetry of commonly used radiopharmaceuticals in paediatric nuclear medicine is missing; an appreciable increase, in obtaining more and better data on image quality and biokinetics, focuses on dosimetry as a basis for further improving the recommended administered activities.
Application of the guidelines will allow many paediatric nuclear medicine patients to receive radiopharmaceutical doses lower than those that are traditionally given, resulting in an overall reduction of radiation exposure in these patients.
Paediatric patients are a particular challenge, as body size and the spatial relationships of individual organs can be very different compared to those of a typical adult.
Effective dose is a useful method for assessing the potential radiationally induced effects as a result from various practices within a population group, or more specifically to children within a similar age group, but attention should be paid used when comparing the radiation risks between the groups considering that the organ-weighting factors are averaged over both age and gender [2].
The International Commission on Radiological Protection (ICRP) has published numerous reports addressing the issue of radiation dose with respect to administrated activities in diagnostic nuclear medicine procedures. ICRP Publication 17, published in 1971 and updated in ICRP Publications 53, 80 and 106, address the absorbed dose for various used radiopharmaceuticals. In more details, these reports represent a collection of available data that may be used to estimate radiation dose, expressed as radiation dose to specified target organs, as well as the effective dose, to a population of patients to whom a specific radiopharmaceutical has been administered. They provide conversion factors for the administered activity to effective dose (in mSv/MBq) based on models of patients of different ages, such as 1, 5, 10 and 15 years-old, as well as adults).
Efforts of standardizing and optimising administered activities of radiopharmaceuticals in paediatric nuclear medicine produced fruitful results. Two major guidelines providing administered activities recommended for children, have been developed: one in Europe and the other one in North America.
The European Association of Nuclear Medicine (EANM) issued guidelines for administered activities in children that included a dosage card which provides recommended administered activities for a variety of diagnostic nuclear medicine procedures and radioisotopes correspondingly. EANM’s dosage card aim is to secure similar radiation dose levels for all patients undergoing a particular type of nuclear medicine procedure. Therefore, for each radiopharmaceutical, recommended administered activities were calculated (Figure 1) so that patients in various age groups receive similar estimated effective doses.
EANM dosage card- Radiopharmaceutical activities are calculated for administration to paediatric patients by weight coefficient in all age groups. Effective doses are estimated for various diagnostic examinations.
Effective Doses in paediatric PET examinations are included in the following (Figure 2), per age group in mSv/MBq.
Effective doses in paediatric PET examinations by common PET radiopharmaceuticals for age groups 5-, 10-, and 15- (ICRP publications).
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) of North America, the American College of Radiology (ACR), the Society of Pediatric Radiology (SPR) and the Image Gently campaign developed also guidelines for dose optimization by identifying best practices [3]. The North American harmonic so-called guidelines are strictly weight-based for 10 out of the 12 procedures included in the guideline, with recommended administered activities corrected for patient size (expressed as mCi/kg or MBq/kg). Consequently, for each nuclear medicine procedure, these guidelines tend to result in similar levels of image noise and thus image quality, for patients of all sizes.
European and North American guidelines differ due to the different models used to develop them. In addition, for some radiopharmaceuticals, there are considerable variances between the two guidelines in the reference adult administered activities, which are used in order to calculate children’s activities.
Differences in the effective doses resulting between the two ‘schools’ were more pronounced in younger patients. For ages 1 year or 5-year olds, the EANM’s administered activities result in an estimated effective dose at least 20% greater than that provided by the North American guidelines.
The critical organ is independent of the administered activity of radiopharmaceuticals. The most common critical organ is the urinary bladder. At the administered activities recommended by the two guidelines, the highest radiation absorbed doses to other critical organs are those produced by Tc99m-MDP to bone and I123-MIBG to the liver. Normal renal function is assumed when dose estimates are calculated. Age-specific or disease-specific alteration in organ function can change the biokinetics of a radiopharmaceutical and thus change radiation exposure.
The ICRP allows an adjustment for abnormal renal function or for unilateral ureteral blockage when calculating the absorbed radiation dose from renal imaging agents. For example, infants with biliary atresia have an underdeveloped or absent gallbladder, so the gallbladder is unlikely to be the critical organ during a performance of hepatobiliary scintigraphy in these children.
The Image Gently Alliance was formed to help change practice and increase awareness about radiation exposure to children by medical imaging. The effort of Image Gently Alliance was supported by SNMMI, the SPR and the ACR.
A Nuclear Medicine Working Group has assisted to
The Nuclear Medicine Global Initiative project (NMGI) was formed in 2012 by 13 international organizations to promote human health by advancing the field of nuclear medicine and molecular imaging. The first project focused on the standardization of administered activities in paediatric nuclear medicine and resulted in two articles [4, 5].
Guidelines have a positive effect on the practice of many nuclear medicine departments dealing with children. Resources useful for radiation dose estimation of paediatric nuclear medicine examinations can be obtained in
Paediatric model-derived pharmacokinetics to compare absorbed dose and effective dose estimates for F18−FDG in paediatric patients, using S values generated from two different geometries of computational phantoms; Cristy-Eckerman stylized phantoms (C−E) and University of Florida/National Cancer Institute (UF/NCI) hybrid computational phantoms.
Time−integrated activity coefficients of F18−FDG in brain, lungs, heart wall, kidneys and liver, retrospectively, were calculated. The absorbed dose calculation was performed in accordance with the Medical Internal Radiation Dose (MIRD) method using S values generated from the UF/NCI hybrid phantoms. The effective dose was computed using tissue−weighting factors from ICRP publication 60 and 103 for the C−E and UF/NCI, respectively.
Differences in anatomical modelling features among computational phantoms used to perform Monte Carlo−based photon and electron transport simulations for F18, effect internal organ dosimetry computations for paediatric nuclear medicine studies.
Paediatric pharmacokinetic data are collected for diagnostic imaging agents, relevant to paediatric studies and the field conversions from older stylized phantoms to more detailed computation hybrid phantoms were created. The effective doses, computed by the UF/NCI hybrid phantom S values, were different than those seen using the C−E stylized phantoms for newborns, 1-year-old and 5 years old, Figures 3 and 4 [6].
Three-D visualization of Cristy-Eckerman (C-E) stylized phantoms [
Three-D visualization of University of Florida/National Cancer Institute (UF/NCI) hybrid computational phantoms for various age groups [
Since hermaphrodite
In contrast, the University of Florida hybrid phantoms are gender-specific and these tissues are specifically modelled age-wise. The dose estimates for breast and ovaries obtained by the University of Florida F/NCI hybrid phantom were higher for newborn, 1-year-old and 5-year-old ages. The effective dose coefficient computed by OLINDA/EXM version 1.0 uses an effective dose coefficient that is based on radiation and tissue weighting factors specified in ICRP Publication 60 (1991). Later publication 103 (2007), readjusted the tissue weighting factor for breast from 0.05 to 0.12 and for gonads from 0.20 to 0.08.
The understanding of transitioning from the older phantoms and tissue−weighting factors to the most recently updated phantoms that are now being adopted by ICRP is essential (OLINDA/EXM version 2.0).
The OLINDA/EXM has standardized dose calculations for diagnostic and therapeutic radiopharmaceuticals. The previous generation of anthropomorphic phantoms based on the Oak Ridge models, employed geometrical shapes in order to define the body and its organs.
Nowadays, these models have been replaced with realistic, Non-Uniform Rational B-Spline (NURBS) type models based on the recent standardized masses defined by the ICRP in its Publication 89. NURBS is a mathematical model using B-splines that is commonly used in computer graphics for representing curves and surfaces.
These and other new models have been implemented in a new version of the OLINDA/EXM 2 code. The new generation of models is now available in the OLINDA/EXM code and represents a significant improvement in standardized dose calculations. OLINDA/EXM version 2.0 employs realistic NURBS-style phantoms [7].
ICRP in Publication 143, Paediatric Computational Reference Phantoms, 2020, has adopted a set of reference phantoms that were derived from the University of Florida phantoms. ICRP phantoms will be used to calculate ICRP dose coefficients. The publication is supported by a series of annexes. The last annex gives a description of the electronic files available for download and use of each of the 10 paediatric reference computational phantoms.
A reference set of phantoms and dose coefficients for external exposures and intakes of radionuclides will promote consistency in the assessment of doses.
Based on the OLINDA/EXM version 2.0 software and on 2007 recommendations of the ICRP, a new generation of voxel-based, realistic human computational phantoms was developed by the RADAR committee of the SNMMI.
It was used to develop the dose estimates as well as the most recent biokinetic models. These estimates will be made available in electronic form and can be modified and updated, as models are changed and new radiopharmaceuticals are added, MIRD Pamphlet No. 21 [8].
RADAR Dose Estimates Report in 2018 based on OLINDA/EXM Version 2.0 for Radiopharmaceutical Dose Estimates [9].
The MIRD method uses the term A˜ (cumulated activity) for the time–activity integral and presents the dose factor by the S factor.
RADAR uses the terms N (number of disintegrations) and dose factor, respectively.
The ICRP has a method for internal dose calculations, originally described in ICRP Publication 30. This schema has been repeated, with modifications, several times, the latest being in ICRP Publication 130.
In many ICRP documents, slightly different names are given to some terms, but all the concepts are identical [8, 9].
OLINDA/EXM 2.0 used biokinetic models for 100 radioisotopes and adult and paediatric phantoms in order to develop dose estimate tables. Data within the ICRP task group on radiopharmaceutical dosimetry was considered. Tables for males and females were generated for 1-y olds, 5-y olds, 10-y olds, 15-y olds and adults.
The dose estimate tables give male and female dose values for approximately 25 target organs, as well as sex-averaged values for the five phantom-ages considered (1-y olds, 5-y olds, 10-y olds, 15-y old and adults). In these estimations, individual organ doses are given in units of equivalent dose (e.g., mSv) and not of absorbed dose (e.g., mGy), as quality factors applied may be non-unity for some emitters. For example, OLINDA/EXM 2.0 uses:
for emissions a default radiation weighting factor.
variable radiation weighting factors adjusted by the user.
effective doses that are expressed in the same units as equivalent doses, by applying individual tissue weighting factors.
a bone model that is the same as that used in OLINDA/EXM versions 1.0 and 1.1.
unlike the Cristy-Eckerman phantoms, no breast tissue that was assigned in children 10 years old or younger.
several new organs that have been defined in the RADAR phantoms.
Biokinetic models for nearly 100 radiopharmaceuticals can be used with the OLINDA/EXM 2.0 paediatric phantoms to develop dose estimate tables. Male and female tables for 1-year-olds, 5-year-olds, 10-year-olds, 15-year-olds can be generated.
In ICRP Publication 103, a sex-averaged rule is described for the development of relative data.
Individual organ doses are given in units of equivalent dose (mSv) and not in units of absorbed dose (mGy).
The International Commission on Radiological Protection (ICRP) Publication 73 was first to introduce the term ‘Diagnostic Reference Level’ (DRL) in 1996, a concept that was further developed further. The DRL has been proven to be an effective tool towards the optimisation of protection in the medical exposure of patients in diagnostic procedures.
For planar nuclear medicine imaging, DRLs have been set either by administered activity (MBq) or by administered activity per body weight (MBq/kg).
For SPECT imaging procedures, DRL values should be used in the same way as for planar nuclear medicine procedures. DRL values for SPECT studies are usually slightly higher than for the same radiopharmaceuticals used for planar imaging.
Specific radiopharmaceuticals are used for PET imaging, depending on the scope of the study. F18-fluorodeoxyglucose (F18-FDG) is used for diagnosing, staging and assessing therapeutical schemes in cancer, inflammation, viable myocardium and brain diseases by revealing relative glucose metabolic activity in tissues and organs. N13-ammonia or Rb82-chloride assesses myocardial perfusion. Ga68-DOTATATE and DOTATOC in neuroendocrine tumours reflecting the status of somatostatin receptors. As the physical half-lives of radionuclides and biological half-times of radiopharmaceuticals are different, DRL values have to be set for each one.
European guidelines provide a calculation system according to body weight, image acquisition method (two-, or three-dimensional), scan speed (minutes per table position) and table overlap during the following PET acquisitions.
PET and SPECT have been combined with the modality of CT generating the so-called hybrid systems of PET-CT and SPECT-CT accordingly. Nowadays, they have been combined with the Magnetic Resonance Imaging (MRI) modality too, as these combinations increase diagnostic accuracy by providing both functional and anatomical images of the body.
The acquisition of accurately co-registered anatomical and functional images is a major strength of combined modality (hybrid imaging) devices. The patient dose from a PET-CT or SPECT-CT examination is the combination of the radiation exposures caused by the radiopharmaceutical and by the CT study via the exposure to ionising radiation.
The MRI component of PET/MRI or SPECT/MRI does not increase the patient dose considering that it uses non-ionising radiation, so from a radiation protection point of view, this hybrid imaging is preferable in paediatric examinations.
In the framework of a PET/CT or SPECT/CT, the CT portion of the examination consists of a localiser radiograph and the helical CT scan. If a CT is solely performed for attenuation correction and co-localisation, the acquisition parameters (tube current, voltage, slice thickness, rotation time, and pitch) should be selected in order to minimise the patient’s radiation exposure. A low-dose CT used in hybrid imaging is sufficient for attenuation correction and anatomic localisation and proper for paediatric examinations.
Establishing Dose Reference Level values for children is more challenging than for adults, due to the broad range of sizes of paediatric patients. Weight in children can vary by a factor of more than 100 from a premature infant to an obese adolescent. The amounts of radiation used for examinations of children can vary extremely due to the great difference in children’s size and weight.
Patient age groups have been used in the past in order to establish Paediatric DRL values. However, it has been recognized that age alone is not a representative parameter. Weight categories have to be included and should be used whenever possible. The difference in patient dose due to patient weight is expected and therefore weight ranges are recommended for establishing Paediatric DRL values.
Age groups around the ages of 0, 1, 5, 10 and 15 years can be used if age is the only available quantity. For examinations including the head, age grouping is recommended for establishing PDRL values. In paediatric imaging, sufficient data is an issue and therefore it has been suggested that the DRL quantity could be a function of patient’s weight.
For nuclear medicine imaging, the DRL quantities and DRL values are set as administered activity per body weight (MBq/kg) as a practical and simple approach.
Activities for administration should be adjusted based on size or weight associated factors.
When regional or national DRL values, relevant for paediatrics, are not available, the local practice may be compared with appropriate available published data.
For CT used in a hybrid system SPECT/CT or PET/CT, the DRL quantities are Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP), based on calibration with a 32-cm-diameter phantom for body examinations and a 16-cm-diameter phantom for head examinations.
The CTDIvol and the DLP are common methods to estimate a patient’s radiation exposure from a CT procedure. The exposures are the same regardless of patient size, but the size of the patients is a factor in the overall patient’s absorbed dose.
The unit of CTDIvol is the gray (Gy) and it can be used in conjunction with patient size to estimate the absorbed dose. The CTDIvol and absorbed dose may differ by more than a factor of two for small patients such as children. On the other hand, DLP measured in mGy.cm is a measure of CT tube’s radiation output/exposure. It is related to volume CT Dose Index (CTDIvol). CTDIvol represents the dose through a slice of an appropriate phantom and DLP accounts for the length of radiation output along the long axis of the patient. DLP = (CTDIvol) [
The effective dose depends on factors including patient size and the region of the body being scanned. Values for these quantities should be obtained from patient examinations. Most CT scanners permit the determination of effective diameter or patient equivalent thickness. This is an additional improvement for setting Paediatric DRL values.
Size Specific Dose Estimate (SSDE) measured in mGy, is a method of estimating CT radiation dose that takes a patient’s size into account. SSDE may be used in addition to the recommended DRL quantities as an extra source of information for the evaluation of the absorbed dose value.
Results from the largest international dose survey in paediatric computed tomography (CT) in 32 countries are included in ICRP Publication 135 where international DRL for Paediatric computed tomography were established [10]. Patient data were recorded among four age groups: <1 year, 1–5 years, <5–10 years and <10–15 years.
The risk of harmful radiation effects is greater in children than in adults and optimisation of paediatric imaging is of particular importance because they have a longer life expectancy during which these effects may appear.
The amount of radiation used for examinations of children can vary greatly due to the excessive difference in patient size and weight from neonates to adult-sized adolescents.
Variation in patient radiation dose for two paediatric patients with the same size, same exposed area of anatomy should be the minimum. If not, this could be due to poor technique, or failure to adapt imaging protocols to account for both paediatric diseases and paediatric patient sizes. Weight or size-adjusted paediatric DRL values are therefore particularly important in optimization.
A number of factors need to be considered when communicating the development of DRL values for children. Some parameters are the same for adults and children. These include the choice of DRL quantities, the percentile of the distribution of the DRL quantity and whether to collect data from patient examinations or from measurements with phantoms.
DRL values for children, there cannot be as a single standard patient due to the large size range of paediatric patients [11].
Weight in children can vary by a factor of more than 100, from that of a premature infant.
Within the first 6 months of life, a typical baby’s body weight doubles, and during the first year, it increases 3-fold. Ideally, five or more size ranges should be established between premature to infants (newborn, >1, >5, >10 and >15 years) [12].
It is preferable creation of groups based on paediatric patient body size and that body size be determined for individual patients before performing diagnostic imaging procedures by radiation sources.
In 1999, the European Commission issued Radiation Protection 109 (RP 109) with the title: ‘Guidance on diagnostic reference levels (DRLs) for medical exposure’. This document indicates the critical need of establishing DRLs for high-dose medical examinations of patients sensitive to radiation, such as children. This work used average-sized adult phantom or standard size phantoms.
However, the same approach has not been considered appropriate for children due to the wide variation in body habitus.
DRL values for paediatric patients are only available for some common radiological examinations and there is a need to generate appropriately more.
The European Commission recognized this need and approved the 27-month tender project, European Diagnostic Reference Levels for Paediatric Imaging (PDRL) on the establishment of European DRLs for paediatric patients in December 2013. PDRL is coordinated by the European Society of Radiology (ESR,
The calculated PDRLs may help in the standardization of the appropriate activity in paediatric nuclear medicine [
The Japanese Society of Nuclear Medicine (JSNM) in 2014 has published the consensus guidelines for paediatric nuclear medicine. JSNM proposes dose optimization in paediatric nuclear medicine studies and widely discusses imaging techniques for the appropriate conduct of paediatric nuclear medicine procedures, considering the features of children imaging in order to produce harmonic PDRL [13].
Scientists in nuclear medicine departments must be familiar with
the increased radiosensitivity of children,
the risks of low dose radiation,
the patterns of dedicated clinical results when radiation activities in paediatric patients are minimized.
Regarding the reduction of radiation exposure to paediatric patients, continuous education and thoughtful application of techniques for radiation dose management may lead to the improvement of risk-benefit ratios when performing diagnostic imaging in children by radiopharmaceuticals.
Technology provides options such as new software and new hardware (collimators, computer components, etc.) for reducing radiation exposure while maintaining image quality driving to a minimum variation in PDRL values, globally.
Paediatric patients are referred to nuclear medicine from nearly all paediatric specialities including urology, oncology, cardiology, gastroenterology or orthopaedics. Radiation exposure is associated with a potential small risk of inducing cancer in the patient, later in life; this danger is higher in younger patients.
In the field of
In 2021, the EANM published a position paper on the role of radiobiology in nuclear medicine [14]. For that paper, a group of EANM radiobiology, physics and dosimetry experts summarized the main issues concerning radiobiology in nuclear medicine. The position of the EANM is that radiobiology will contribute to the
There is a need to generate and apply more radiobiologic knowledge specific to nuclear medicine diagnostic and therapeutic procedures, as DNA damage induction and repair strongly because of the comparatively low dose rates varying over time with physical decay and kinetic clearance.
While the role of radiobiology for diagnostics remains to be clarified, its role in the benefits of radiopharmaceuticals in therapy is clear.
It is expected that a better understanding of radiobiological parameters can contribute to fully exploiting the abilities of new and existing nuclear medicine applications; how can be effective and safe for each individual patient, child or adult. Radiobiology plays an important role in supporting
A better understanding of radiobiologic parameters will enhance the capabilities of new and existing nuclear medicine applications in adults and paediatric patients. There is a need to better define the dose-effect relationships of radiopharmaceutical radiation in tumours and normal tissue. To reach this target, the EANM recommends a strong link between all scientists involved (Radiobiologists, radiochemists, radiopharmacists, medical physicists, and physicians). So, an improved understanding of the biological processes, with special regard to the effects of ionizing radiation to normal tissues and tumours, for any living matter, will be gained.
When ionizing radiation interrupts living matter, it deposits energy along its path leading to atomic ionization, thereby damaging biological molecular structures (Figure 6).
Interaction of ionizing radiation with cellular matter- DNA and others. DNA and other cell elements are potential targets for ionizing radiation damage. Ionizing radiation also influences cell signalling pathways like oxidative stress, cell death and survival pathways, premature ageing and inflammation [
DNA damage induced by radiation is considered critical. DNA, as well as proteins, lipids and metabolites can potentially be modified by ionizing radiation. As first action, absorption of ionizing radiation will occur at the site of the atoms of the cellular molecules. Following ionization events may cause the breakage of chemical bonds. It may also convert atoms and molecules into free radicals with very sensitive unpaired electrons that can further interact with close molecules, after which a damaging sequence may occur.
Molecular imaging provides detailed images at the molecular and cellular levels. Molecular imaging indicates how the body is functioning and gives the prospect to measure its chemical and biological processes. It offers exclusive insights into the human body that patients can obtain
When disease occurs, the biochemical activity of cells begins to change. Cancer cells may multiply at a much faster rate and are more energetic than normal cells. As the disease progresses, this abnormal cellular activity begins to affect body tissue and structures, causing anatomical changes; Cancer cells may form a mass or tumour. Molecular imaging detects cellular changes early in the course of the disease. A variety of imaging agents are used to visualize cellular activity, such as the chemical processes involved in metabolism, oxygen use or blood flow. The imaging agent in the body accumulates in a target organ or attaches to specific cells. The distribution pattern of the agent helps to distinguish how well organs and tissues are functioning.
Children are more radiosensitive as the organs and cells in children are undergoing constant self-renewal, therefore are more sensitive to radiation. Measurement of DNA synthesis by PET Radiopharmaceuticals that identify increased DNA synthesis can be used to identify increased cellular proliferation in tumours.
Children, due to increased mitotic activity and longer life expectancy, are more radiosensitive than middle-aged adult by a factor of up to 10 and girls are considered more radiosensitive than boys [12].
Radiosensitivity decreases with age, exhibiting lifetime attributable cancer mortality risks per unit dose as a function of age at a single acute exposure. This was estimated by the Committee on the Biological Effects of Ionizing Radiations (BEIR) [15, 16] and the International Commission on Radiological Protection (ICRP) [17].
Children are two to three times more susceptible to radiation for the development of leukaemia. Adults exposed to radiation during childhood have an increased likelihood of emerging breast or thyroid cancer.
The National Academy of Sciences BEIR V committee and the ICRP report 60 have estimated the lifetime cancer mortality risks per unit dose at a single acute exposure as a function of age. They have shown a rapid increase in lifetime risk with decreasing age at exposure (Figure 7).
The above risk estimate is an average for a population comprised of all ages. It is apparent that the risk varies dramatically with age (from Eric J. Hall, 2002), [
This indicates that radiosensitivity decreases with age. Neonates are more radiosensitive than infants, infants are more radiosensitive than children and children are more radiosensitive than adolescents.
Radiation-induced cancers tend to appear at the same age as spontaneous cancers of the same type. So, it takes half a century or more to judge the impact of radiation exposure, especially when children are included in the exposed individuals.
Exposed to radiation individuals in their first decade of life, the risk is approximately 15% per Sv, while for adults in their late middle age, the risk drops to 1 or 2%/Sv. There is also a clear gender difference, especially at early ages, with girls being more radiosensitive than boys (Figure 7).
Paediatric Dose Reference Levels (PDRLs) must be established, especially in a national level and then effective dose estimations from images data can be obtained. The calculated PDRLs may help in the standardization of the appropriate activity in paediatric nuclear medicine.
Individualized dosimetry and iterative algorithms may reduce further the administered dose resulting in safer children’s examinations.
To limit radiation exposure to children from diagnostic nuclear medicine procedures to the lowest levels consistent with quality imaging, a study has been established [18] to correlate administered activity/weight- to an effective dose in paediatric nuclear medicine imaging.
In radiopharmaceutical schedules for children, fractions of adult administered amounts and formulae based on the child’s body parameters are used. Recommended activities could also be obtained by EANM dosage-card or North American Guidelines.
The paediatric administered activities are determined by the formula that reduces adult administered activity as:
Paediatric dosage [MBq] = (Child Weight [Kg] x Adult Reference Activity [MBq])/70.
Radiopharmaceutical dosages for five diagnostic radiopharmaceuticals (Tc99m-DMSA, Tc99m-DTPA, Tc99m-MAG3, Tc99m-MDP & I123-MIBG) were calculated for 100 paediatric imaging procedures and administered in terms of activity/kg.
Knowledge of physical and biological parameters is required for the calculation of the absorbed dose.
Absorbed dose is the average deposition of energy in the tissue from the administered radiopharmaceutical.
The radioactive elements, used in the diagnosis, are distributed to the human body following the rules of pharmacokinetics & pathophysiology (Figure 8).
The absorbed dose depends on: The administered activity. The active time of its stay in an organ. The parameters fixed in time, that is: radioisotope characteristics, shape and size of the radiating organ (source), the irradiated organ (target) and the distance and mass of the target) [
The RADAR dosimetry program was used by Plousi et al [18] in order to estimate the effective dose per child per weight/age for various radioisotopes, with reduced reference adult activity being incorporated, Figure 9.
The absorbed dose in neonates is extremely higher (because the activity is distributed over smaller volumes). Significant differences -about a factor of two and sometimes three in activity and effective dose were measured between underweight, average weight and corpulent children of the same age [
Weighting Factor of administered activities per weight (kg) were varied from (0.1–0.86%) for 3Kg weight of a neonate to 40Kg weight of an adult.
For neonates and infants’ cases, a minimum administered activity is applied considering that the use of a fraction of the administered activity of adults would result in an uncompleted study. Planar whole-body and SPECT imaging studies were performed on a γ-camera equipped with a high-resolution collimator.
Regarding I123-MIBG, the lower limit [30 MBq for neonatal] and upper limit [110 MBq] was established to give the least effective dose with the best quality imaging.
For newborn cases, it is necessary to apply a minimum activity, as the activity calculated according to weight is less than the recommended minimum activity. When the suggested weight-based administered activities are used, the resulting effective doses range in ages 1–10 years old are, Figure 10.
Effective doses for ages between 1 and 10 years old.
Activities for Tc99m-DMSA for planar and 3D imaging are lowering as filtering and iterative reconstruction methods were used. In dynamic studies of paediatric patients, the SNMMI/EANM Guidelines for Diuresis Renography in infants and children were followed [19]. The lowest burden is estimated for Tc99m-MAG3.
Optimal protocols, with improved image reconstruction methods and advanced instrumentation, facilitate the dosage reduction and provide the maximum image quality at a minimum of effective dose [20].
A graphic relation of Administered Activity versus weight of all patient groups, from neonates to adolescents, is presented in Figure 11A.
(A) Administered Activity (MBq) to patient. Weight in Kg/from neonates to adolescents. (B) Positive relation of the effective dose (mSv) with patients’ age (0–26 years). No differences were observed between boys and girls of the same age [
In Figure 11B, a positive correlation of the effective dose (mSv) with patient ages (0–26years) is shown. No differences were observed between boys and girls of the same age [18].
Dose reduction in PET/CT and SPECT/CT studies with children can be achieved by optimized CT parameters and the administered activity of the radiopharmaceutical, without compromising the diagnostic information needed for high-quality examination. Effective doses to the paediatric patient examined by PET/CT or SPECT/CT depend on the CT protocol of the accompanying CT scan. The co-registered CT scan can be optimized to meet the patient’s diagnostic needs and may be performed either as a diagnostic-type CT scan or as an attenuation-correction only [21].
The hybrid molecular imaging examination by PET or SPECT and the CT should be acquired without child-patient movement. Attention to the respiratory phase during the CT imaging for PET/CT is also of a semantic point.
High-quality biokinetic data must be known for the calculation of dose estimates of new PET radiopharmaceuticals. Then, standardized dosimetry codes as OLINDA/EXM can provide information of doses to organs and effective doses [22].
In addition to the molecular imaging agents 18F-FDG (PET) and 123I-MIBG (SPECT) that are frequently used in children, other PET and SPECT imaging agents may have promise for molecular imaging in children.
C-11-methionine by PET has been shown in several studies to better depict paediatric brain tumours when compared to FDG.
SPECT/CT may be used to localize sites of abnormal I-131 uptake in thyroid cancer patients who are post-thyroidectomy or
Tc-99m-HMPAO-labeled white blood cells may be used with SPECT/CT to localize areas of inflammation [21].
PET/MRI use in children with systemic malignancies may benefit from the reduced radiation exposure offered by PET/MRI. The effective dose of a PET/MRI scan is only about 20% that of the equivalent PET/CT examination. Simultaneous acquisition of PET and MRI data combines the advantages of the two previously separate modalities. One disadvantage of PET/MRI is that in order to have an effect, a significantly longer examination time is needed than with PET/CT. PET/MRI has turned out to be a stable hybrid imaging modality, which generates paediatric safe diagnostic studies [23].
Doses are provided for “early pregnancy” (dose to the nongravid uterus in the RADAR reference adult female model) and doses to the foetus at 3, 6, and 9 months of gestation (OLINDA/EXM 2.0 software).
Uncertainties in using these estimates for a specific subject are noteworthy, both in the physiology of the radiopharmaceutical kinetics and in the assumed geometry of the maternal and foetal organs [23].
Foetal whole-body doses from common nuclear medicine examinations in early pregnancy as well as at terms have been calculated by Russell and Stabin using ICRP 53 and ICRP 80.
For Example:
A pregnant woman at 4 months’ gestation is administered 370 MBq of 18FDG. The estimated foetal dose at 3 months is 4.8 mGy and at 6 months is 3.1mGy. An estimate of 5 mGy is reasonable and conservative [24].
Foetal thyroid doses are much higher than foetal whole-body doses, 5–15 mGy/MBq for 123I and 0.5–1.1 Gy/MBq for 131I (Figure 12).
Foetal thyroid doses for 30MBq 123I or 0.55 MBq 131I in early pregnancy and at 9 months.
The radiation burden in nuclear medicine depends principally on the administered radiopharmaceutical properties and the biological parameters-pharmacokinetics properties of the radiopharmaceutical within the patient. So,
Activity determination is one of the fundamental bases in nuclear medicine dosimetry.
The calculation of effective dose in a paediatric patient varies also due to anatomical differences.
The basic schema for dosimetry calculations involved in the MIRD formalism for radiopharmaceutical dosimetry.
The ICRP models underlying the application of dosimetry.
Imaging value in dosimetry is the best conversion of image data to absolute values of uptake.
To limit radiation exposure to children from diagnostic nuclear medicine procedures to the lowest levels with reliable qualitative imaging, a correlation of administered activity with weight-effective dose in radiopharmaceutical imaging is valued.
Administered activities in paediatric subjects are distributed over smaller volumes generating higher absorbed doses. In diagnostic examinations, fractions of adult administered amounts and formulae based on child’s body parameters are used. Recommended activities could be obtained by EANM dosage-card or North American Guidelines—Paediatric dosage card.
Cumulated activity calculation from the time-activity curve will lead to a total number of disintegrations. Absorbed dose algorithms and image processing determine the radiation transport, energy deposition and the radiation burden of the subject; Advanced approaches such as Monte-Carlo modelling in nuclear medicine for imaging and dosimetry are successfully used.
For newborn subjects, it is necessary to apply the minimum dose, because the activity calculated according to newborn weight is less than the recommended minimum activity, resulting to worsen diagnostic imaging quality.
Optimization in medical imaging is the balancing of the amount of ionizing radiation and image quality. The minimum radiation dose for the paediatric patient must assure that the image quality provides satisfactory information to meet the clinical requirement. Optimization involves both the imaging systems as testing and quality control as well as imaging body parameters and administered activity [25].
Optimal protocols, with improved image reconstruction methods and advanced instrumentation, facilitate the dosage reduction and provide the maximum image quality at a minimum effective dose. Optimization of imaging protocols and establishment of diagnostic reference levels achieve the goals of good quality images at reduced radiation doses. Standardized methods for performing dose calculations for radiopharmaceuticals by various steps in the process and models for calculating time–activity integrals as urinary bladder or intestines can be used [26].
In hybrid imaging PET/CT or SPECT/CT, deep learning-based reconstruction (DLR) may facilitate CT radiation dose reduction in children. Lower-dose DLR images were compared with standard-dose iterative reconstruction images. DLR use at 80-kVp results in substantial dose reduction with preserved or even improved image quality. So, the use of DLR allows greater dose reduction for paediatric CT than current image reconstruction techniques [27].
Clinical dosimetry in targeted radionuclide therapy in children supports the treatment decisions and should be a strong indication that treatment results are dependent on the absorbed dose delivered to the treated organ as well as to the critical organs.
D.A. Verganelakis gratefully acknowledges all support provided by the ‘ELPIDA’ Association of Friends of Children with Cancer and the Oncology Clinic “Marianna V. Vardinoyiannis” at Children’s hospital “Aghia Sophia” in Athens.
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Hypertension-induced structural remodeling is associated with an increased risk of life-threatening arrhythmias and heart failure in both humans and experimental animals. Recent studies suggest that abnormal distribution and/or downregulation of Cx43 accompanied with altered protein kinase C (PKC)ε signaling in spontaneously hypertensive rats were linked with increased propensity to ventricular fibrillation compared to normotensive rats. By contrast, the long-term treatment of hypertensive rats with cardioprotective compounds such as melatonin, omega-3 fatty acids, or red palm oil resulted in protection from lethal arrhythmia. Their antiarrhythmic effect was attributed to the attenuation of abnormal Cx43 topology and modulation of Cx43 mRNA as well as protein expression and its functional phosphorylated forms. The latter might be attributed to upregulation of PKCε. It appears that maladaptive consequences of hypertension resulting in abnormal myocardial distribution of Cx43 and its downregulation can contribute to arrhythmogenesis and occurrence of malignant arrhythmias. On the other hand, the attenuation of myocardial Cx43 abnormalities by treatment with melatonin, omega-3 fatty acids, or red palm oil confers arrhythmia protection in rodent model of essential hypertension. Findings uncover novel mechanisms of cardioprotective effects of melatonin, omega-3 fatty acids, and red palm oil. Well-designed clinical trials are needed to explore antiarrhythmic potential of these compounds in human essential hypertension.",book:{id:"5216",slug:"update-on-essential-hypertension",title:"Update on Essential Hypertension",fullTitle:"Update on Essential Hypertension"},signatures:"Tamara Egan Benova, Barbara Szeiffova Bacova, Csilla Viczenczova,\nMiroslav Barancik and Narcis Tribulova",authors:[{id:"181938",title:"D.Sc.",name:"Narcisa",middleName:null,surname:"Tribulova",slug:"narcisa-tribulova",fullName:"Narcisa Tribulova"},{id:"185905",title:"Dr.",name:"Tamara",middleName:null,surname:"Egan Benova",slug:"tamara-egan-benova",fullName:"Tamara Egan Benova"},{id:"185907",title:"Dr.",name:"Barbara",middleName:null,surname:"Szeiffova Bacova",slug:"barbara-szeiffova-bacova",fullName:"Barbara Szeiffova Bacova"},{id:"185908",title:"Dr.",name:"Csilla",middleName:null,surname:"Viczenczova",slug:"csilla-viczenczova",fullName:"Csilla Viczenczova"}]},{id:"48384",doi:"10.5772/60418",title:"A Review on Amiodarone as an Antiarrhythmic Drug",slug:"a-review-on-amiodarone-as-an-antiarrhythmic-drug",totalDownloads:2774,totalCrossrefCites:4,totalDimensionsCites:6,abstract:"Antiarrhythmic drugs are used to suppress abnormal heart rhythms by different mechanisms. Amiodarone as an iodinated benzofuran derivative is a potent antiarrhythmic drug that is being used for the treatment of a wide variety of cardiac arrhythmias. Amiodarone has been reported to cause frequent and potentially serious toxicity. It was estimated that the prevalence of side effects was 15 % in the first year and increased to 50% with long-term therapy. Thyroid, lung, liver, ophthalmologic and neurologic systems can be affected by Amiodarone. Most of the adverse effects of the drug are related to its dosage and duration of administration. Therefore the effectiveness of Amiodarone in long-term treatment of patients with heart arrhythmia is limited because of the development of its adverse side effects.",book:{id:"4584",slug:"abnormal-heart-rhythms",title:"Abnormal Heart Rhythms",fullTitle:"Abnormal Heart Rhythms"},signatures:"Fereshteh Mehraein",authors:[{id:"173324",title:"Associate Prof.",name:"Fereshteh",middleName:null,surname:"Mehraein",slug:"fereshteh-mehraein",fullName:"Fereshteh Mehraein"}]},{id:"34335",doi:"10.5772/25800",title:"Ryanodine Receptor Channelopathies: The New Kid in the Arrhythmia Neighborhood",slug:"ryanodine-receptor-channelopathies-the-new-kid-in-the-arrhythmia-neighborhood",totalDownloads:2259,totalCrossrefCites:4,totalDimensionsCites:6,abstract:null,book:{id:"997",slug:"tachycardia",title:"Tachycardia",fullTitle:"Tachycardia"},signatures:"María Fernández-Velasco, Ana María Gómez, Jean-Pierre Benitah and Patricia Neco",authors:[{id:"64594",title:"Dr.",name:"Ana",middleName:null,surname:"Gomez",slug:"ana-gomez",fullName:"Ana Gomez"},{id:"71604",title:"Dr.",name:"Maria",middleName:null,surname:"Fernandez-Velasco",slug:"maria-fernandez-velasco",fullName:"Maria Fernandez-Velasco"},{id:"71606",title:"Dr.",name:"Jean-Pierre",middleName:null,surname:"Benitah",slug:"jean-pierre-benitah",fullName:"Jean-Pierre Benitah"},{id:"71607",title:"Dr.",name:"Patricia",middleName:null,surname:"Neco",slug:"patricia-neco",fullName:"Patricia Neco"}]},{id:"41776",doi:"10.5772/52512",title:"Principles of External Defibrillators",slug:"principles-of-external-defibrillators",totalDownloads:3718,totalCrossrefCites:2,totalDimensionsCites:5,abstract:null,book:{id:"3289",slug:"cardiac-defibrillation",title:"Cardiac Defibrillation",fullTitle:"Cardiac Defibrillation"},signatures:"Hugo Delgado, Jorge Toquero, Cristina Mitroi, Victor Castro and Ignacio Fernández Lozano",authors:[{id:"38793",title:"Dr.",name:"Jorge",middleName:null,surname:"Toquero",slug:"jorge-toquero",fullName:"Jorge Toquero"}]}],mostDownloadedChaptersLast30Days:[{id:"41776",title:"Principles of External Defibrillators",slug:"principles-of-external-defibrillators",totalDownloads:3710,totalCrossrefCites:2,totalDimensionsCites:5,abstract:null,book:{id:"3289",slug:"cardiac-defibrillation",title:"Cardiac Defibrillation",fullTitle:"Cardiac Defibrillation"},signatures:"Hugo Delgado, Jorge Toquero, Cristina Mitroi, Victor Castro and Ignacio Fernández Lozano",authors:[{id:"38793",title:"Dr.",name:"Jorge",middleName:null,surname:"Toquero",slug:"jorge-toquero",fullName:"Jorge Toquero"}]},{id:"46160",title:"Basic Mechanisms of Cardiac Arrhythmias",slug:"basic-mechanisms-of-cardiac-arrhythmias",totalDownloads:4464,totalCrossrefCites:1,totalDimensionsCites:1,abstract:null,book:{id:"3815",slug:"cardiac-arrhythmias-mechanisms-pathophysiology-and-treatment",title:"Cardiac Arrhythmias",fullTitle:"Cardiac Arrhythmias - Mechanisms, Pathophysiology, and Treatment"},signatures:"Andrey Moskalenko",authors:[{id:"63235",title:"Dr.",name:"Andrey",middleName:"V.",surname:"Moskalenko",slug:"andrey-moskalenko",fullName:"Andrey Moskalenko"}]},{id:"48384",title:"A Review on Amiodarone as an Antiarrhythmic Drug",slug:"a-review-on-amiodarone-as-an-antiarrhythmic-drug",totalDownloads:2769,totalCrossrefCites:4,totalDimensionsCites:5,abstract:"Antiarrhythmic drugs are used to suppress abnormal heart rhythms by different mechanisms. Amiodarone as an iodinated benzofuran derivative is a potent antiarrhythmic drug that is being used for the treatment of a wide variety of cardiac arrhythmias. Amiodarone has been reported to cause frequent and potentially serious toxicity. It was estimated that the prevalence of side effects was 15 % in the first year and increased to 50% with long-term therapy. Thyroid, lung, liver, ophthalmologic and neurologic systems can be affected by Amiodarone. Most of the adverse effects of the drug are related to its dosage and duration of administration. Therefore the effectiveness of Amiodarone in long-term treatment of patients with heart arrhythmia is limited because of the development of its adverse side effects.",book:{id:"4584",slug:"abnormal-heart-rhythms",title:"Abnormal Heart Rhythms",fullTitle:"Abnormal Heart Rhythms"},signatures:"Fereshteh Mehraein",authors:[{id:"173324",title:"Associate Prof.",name:"Fereshteh",middleName:null,surname:"Mehraein",slug:"fereshteh-mehraein",fullName:"Fereshteh Mehraein"}]},{id:"61466",title:"Idiopathic Ventricular Arrhythmias",slug:"idiopathic-ventricular-arrhythmias",totalDownloads:1529,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Idiopathic ventricular arrhythmias (VAs) occur with a mechanism that is unrelated to myocardial scar. Idiopathic VAs most commonly occur in patients without structural heart disease, but can occur in those with structural heart disease. Idiopathic VAs present as a sustained or a non-sustained ventricular tachycardia or premature ventricular contractions. Imaging examinations such as echocardiography, nuclear tests, and cardiac magnetic resonance imaging are helpful for excluding any association of an idiopathic VA occurrence with myocardial scar. For the past two decades, the sites of idiopathic VA origins, commonly endocardial but sometimes epicardial, have been increasingly recognized. Idiopathic VAs usually originate from specific anatomical structures and exhibit characteristic electrocardiograms based on their anatomical background. Idiopathic VAs are basically benign, but they require medical treatment or catheter ablation when idiopathic VAs are symptomatic, frequent, or cause tachycardia-induced cardiomyopathy. This book chapter describes the up-to-date information on the prevalence of idiopathic VA origins relevant to the anatomy, diagnosis, and treatment of idiopathic VAs.",book:{id:"6536",slug:"cardiac-arrhythmias",title:"Cardiac Arrhythmias",fullTitle:"Cardiac Arrhythmias"},signatures:"Takumi Yamada",authors:[{id:"68148",title:"Prof.",name:"Takumi",middleName:null,surname:"Yamada",slug:"takumi-yamada",fullName:"Takumi Yamada"}]},{id:"59994",title:"Atrial Flutter: Diagnosis and Management strategies",slug:"atrial-flutter-diagnosis-and-management-strategies",totalDownloads:1501,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Atrial flutter (AFL) is a regular, macro reentrant arrhythmia traditionally defined as a supraventricular tachycardia with an atrial rate of 240–320 beats per minute (bpm). Pathophysiology of atrial flutter and atrial fibrillation (AF) is closely related to the similar risk of stroke and they coexist clinically. Atrial flutter is classified to cavotricuspid isthmus (CTI) dependent (or typical) and non-isthmus dependent (atypical). Isthmus is a distinct structure in the right atrium (RA) through which atrial flutter passes and makes a good target for ablation therapy. Ablation is the primary therapy in atrial flutter, particularly in CTI dependent group, with regard to its safety profile and high success rate of approximately 90%. Three-dimensional electroanatomic mapping is progressively being used to ablate atypical forms of atrial flutter.",book:{id:"6536",slug:"cardiac-arrhythmias",title:"Cardiac Arrhythmias",fullTitle:"Cardiac Arrhythmias"},signatures:"Hamid Reza Bonakdar",authors:[{id:"227955",title:"Dr.",name:"Hamid Reza",middleName:null,surname:"Bonakdar",slug:"hamid-reza-bonakdar",fullName:"Hamid Reza Bonakdar"}]}],onlineFirstChaptersFilter:{topicId:"986",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:141,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:123,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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Editor-in-chief of the journal in the field of aesthetic medicine and dermatology - Aesthetica.",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},{id:"8",title:"Bioinspired Technology and Biomechanics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",isOpenForSubmission:!0,editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",slug:"adriano-andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",biography:"Dr. Adriano de Oliveira Andrade graduated in Electrical Engineering at the Federal University of Goiás (Brazil) in 1997. He received his MSc and PhD in Biomedical Engineering respectively from the Federal University of Uberlândia (UFU, Brazil) in 2000 and from the University of Reading (UK) in 2005. He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). 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