Approved/cleared anti-obesity medical devices in the USA ranked by approval date.
\\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:"9873",leadTitle:null,fullTitle:"Strategies of Sustainable Solid Waste Management",title:"Strategies of Sustainable Solid Waste Management",subtitle:null,reviewType:"peer-reviewed",abstract:"The world is currently experiencing increased environmental contamination with solid waste, which is one of the greatest environmental threats today. Although solid waste is harmful, proper management and profitable recycling can make it beneficial to the environment. In this regard, estimation of the true quantities of solid wastes generated annually in developed and developing countries is important for evaluating suitable strategies for economic and sustainable procedures of waste management. This book presents an interesting review of the economics of solid waste management in various developing and developed countries. It examines several economic applications of solid waste, such as innovative methods to generate bioelectricity from organic waste using microbial fuel cells and using solid waste as an alternative fuel in cement kilns.",isbn:"978-1-83962-560-2",printIsbn:"978-1-83962-559-6",pdfIsbn:"978-1-83962-561-9",doi:"10.5772/intechopen.87682",price:119,priceEur:129,priceUsd:155,slug:"strategies-of-sustainable-solid-waste-management",numberOfPages:170,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"59b5ceeeedaf7449a30629923569388c",bookSignature:"Hosam M. Saleh",publishedDate:"April 21st 2021",coverURL:"https://cdn.intechopen.com/books/images_new/9873.jpg",numberOfDownloads:6742,numberOfWosCitations:5,numberOfCrossrefCitations:10,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:28,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:43,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"June 12th 2020",dateEndSecondStepPublish:"July 3rd 2020",dateEndThirdStepPublish:"September 1st 2020",dateEndFourthStepPublish:"November 20th 2020",dateEndFifthStepPublish:"January 19th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"144691",title:"Prof.",name:"Hosam M.",middleName:null,surname:"Saleh",slug:"hosam-m.-saleh",fullName:"Hosam M. Saleh",profilePictureURL:"https://mts.intechopen.com/storage/users/144691/images/system/144691.png",biography:"Hosam M. Saleh is a Professor of Radioactive Waste Management in the Radioisotope Department, Atomic Energy Authority, Egypt. He obtained an MSc and Ph.D. in Physical Chemistry from Cairo University, Egypt. He has more than 25 years of experience in hazardous waste management with an emphasis on treatment and developing new matrixes for the immobilization of these wastes. He is also interested in studying innovative economic and environmentally friendly techniques for the management of hazardous and radioactive wastes. He has authored many peer-reviewed scientific papers and chapters and served as an editor of several books. He was selected among the top 2% of scientists in the world according to the Stanford University report for 2020 and 2021.",institutionString:"Egyptian Atomic Energy Authority",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"15",totalChapterViews:"0",totalEditedBooks:"14",institution:{name:"Egyptian Atomic Energy Authority",institutionURL:null,country:{name:"Egypt"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"891",title:"Solid Waste",slug:"solid-waste"}],chapters:[{id:"74478",title:"Introductory Chapter: Solid Waste",doi:"10.5772/intechopen.95327",slug:"introductory-chapter-solid-waste",totalDownloads:359,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Hosam M. Saleh and Amal I. Hassan",downloadPdfUrl:"/chapter/pdf-download/74478",previewPdfUrl:"/chapter/pdf-preview/74478",authors:[{id:"144691",title:"Prof.",name:"Hosam M.",surname:"Saleh",slug:"hosam-m.-saleh",fullName:"Hosam M. Saleh"},{id:"218811",title:"Prof.",name:"Amal I.",surname:"Hassan",slug:"amal-i.-hassan",fullName:"Amal I. Hassan"}],corrections:null},{id:"73477",title:"Reflections on the Influence of Family Demographics on Food Waste Generation among the City of Tshwane Households, Republic of South Africa",doi:"10.5772/intechopen.93755",slug:"reflections-on-the-influence-of-family-demographics-on-food-waste-generation-among-the-city-of-tshwa",totalDownloads:338,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"This chapter presents the influence of households’ demographics on food waste generation. A mixed method research approach consisting of meta-analysis, survey (structured interviews), and experimental were used to collect opinions and weigh the amount of waste generated in each household. Although not all demographic variables were investigated, the influence of: (1) family size, (2) household monthly income, (3) employment status, (4) educational level, and (5) age of respondents on food waste generation were analyzed. The results of the study confirmed that age and family size are positive factors that influence the amount of food waste generated in households of the City of Tshwane, as opposed to the level of education, employment status, and monthly income levels. It should be noted, however, that this study does not conclusively exclude the other factors as not having an influence in food waste generations. However, their influence in the current food waste generation quantities was not conclusive. Further studies with larger sample size are thus recommended.",signatures:"Machate Machate",downloadPdfUrl:"/chapter/pdf-download/73477",previewPdfUrl:"/chapter/pdf-preview/73477",authors:[{id:"326045",title:"Prof.",name:"Machate",surname:"Machate",slug:"machate-machate",fullName:"Machate Machate"}],corrections:null},{id:"74039",title:"Sustainable Pathway for Closing Solid Waste Data Gaps: Implications for Modernization Strategies and Resilient Cities in Developing Countries",doi:"10.5772/intechopen.94384",slug:"sustainable-pathway-for-closing-solid-waste-data-gaps-implications-for-modernization-strategies-and-",totalDownloads:405,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"This chapter addresses three peculiar challenges in the solid waste management system of developing countries, namely: the chronic lack of reliable data for planning purposes, the absence of participatory engagement strategies in data gathering for wider ownership and usage, and the lack of monitoring of the climate change burden of existing waste disposal practices. A team of researchers has collaborated with system managers and a responsible philanthropic organization to engage key stakeholders to address these gaps in a sustainable manner. The strategy deployed has been to work in a participatory and evidenced-based frame to solicit support, enhance capacities, empower each other to understand the problems and find for ourselves the practical routes by which solid waste data gaps can be closed in the greater Accra region of Ghana. Stakeholders have participated in a comprehensive waste audit and landfill emission monitoring exercise to develop a baseline, and have used local resources and ideas to recommend steps to sustain reliable data flows and the development of a climate action plan for purposes of modernization. The methodological processes and research outcomes suggest that structural collaboration between researchers and system stakeholders is necessary to break the vicious circle of chronic data gaps and substitute virtuous circles of reliable data for planning purposes.",signatures:"Kwaku Oduro-Appiah and Abraham Afful",downloadPdfUrl:"/chapter/pdf-download/74039",previewPdfUrl:"/chapter/pdf-preview/74039",authors:[{id:"324899",title:"Dr.",name:"Kwaku",surname:"Oduro-Appiah",slug:"kwaku-oduro-appiah",fullName:"Kwaku Oduro-Appiah"},{id:"330032",title:"Mr.",name:"Abraham",surname:"Afful",slug:"abraham-afful",fullName:"Abraham Afful"}],corrections:null},{id:"73972",title:"Guide for Organising a Community Clean-up Campaign",doi:"10.5772/intechopen.94515",slug:"guide-for-organising-a-community-clean-up-campaign",totalDownloads:890,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"While it is the government’s and municipality’s mandate to ensure that its citizens stay in a clean and safe environment, it is of concern that waste management remains a big challenge in urban areas especially in developing countries. Increased economic development, rapid population growth and improvement of living standards are among the factors attributed to increased quantity and complexity of solid waste being generated. On the other hand, while people generate wastes, they continue to be looked at as passive recipients of municipality services. Ultimately, citizens fail to recognise their role in waste management and become unwilling to either pay for service delivery or participate in clean-up campaigns. Waste dumps are prime breeding sites for communicable disease vectors such as rodents, mosquitoes and houseflies, which can exacerbate the prevalence of water, food and waterborne diseases such as cholera and typhoid. This chapter thus describes the methodology of successfully conducting a community-led cleanup campaign. It is based on experience gained during implementation of an urban water, sanitation and hygiene (WASH) project. Ward level clean-up campaigns were organised and conducted by community members and local leaders. Besides clearing illegal dumpsites, the activity was also used to raise awareness on the consequence of waste dumping. The experience showed that organising a clean-up campaign only requires careful timeous planning. Overall, it was concluded that not only does the activity serve the practical purpose of cleaning, but it also creates a greater sense of unity and friendship among community members. Additionally, the power of beautification in a clean-up campaign wold naturally motivate residents to believe that their problems could be solved, resulting in a shared responsibility for sustainable management of waste and commons at local level.",signatures:"Innocent Rangeti and Bloodless Dzwairo",downloadPdfUrl:"/chapter/pdf-download/73972",previewPdfUrl:"/chapter/pdf-preview/73972",authors:[{id:"171647",title:"Mr.",name:"Innocent",surname:"Rangeti",slug:"innocent-rangeti",fullName:"Innocent Rangeti"},{id:"327929",title:"Dr.",name:"Bloodless",surname:"Dzwairo",slug:"bloodless-dzwairo",fullName:"Bloodless Dzwairo"}],corrections:null},{id:"74647",title:"Economics of Solid Waste Management: A Review",doi:"10.5772/intechopen.95343",slug:"economics-of-solid-waste-management-a-review",totalDownloads:822,totalCrossrefCites:0,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Solid Waste Management is one of the importance environmental issues at many developing countries. There is a lack of studies on economic analysis of solid waste management in the many cities at the national and international level. Most of the Municipal Corporation or city management is the major responsibility for better waste management. However, the local governments has been allocated budget for solid waste management without analysing cost and benefit of solid waste. Although, waste management budget is focusing on collected waste but, uncollected waste has been creating a number of socio, economic and health issues. Therefore, this chapter has presents a details review on economics of solid waste management at the various developing and developed countries. The main policy implication of the paper is to emphasis on better understanding of economic importance of solid waste management to the local policy makers.",signatures:"Muniyandi Balasubramanian",downloadPdfUrl:"/chapter/pdf-download/74647",previewPdfUrl:"/chapter/pdf-preview/74647",authors:[{id:"275432",title:"Dr.",name:"Muniyandi",surname:"Balasubramanian",slug:"muniyandi-balasubramanian",fullName:"Muniyandi Balasubramanian"}],corrections:null},{id:"73967",title:"Sustainable Solid Waste Management in Morocco: Co-Incineration of RDF as an Alternative Fuel in Cement Kilns",doi:"10.5772/intechopen.93936",slug:"sustainable-solid-waste-management-in-morocco-co-incineration-of-rdf-as-an-alternative-fuel-in-cemen",totalDownloads:346,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The management of municipal solid waste (MSW) is a major obstacle for the majority of municipalities in developing countries because of the impacts related to the landfilling of waste. Garbage is an energy-rich material. As a result, energy recovery is considered to be a sustainable waste management method. In Morocco, 7.4 million tons are produced annually; most of the waste is landfilled without any recovery despite the impacts related to this method of disposal. The objective of this chapter is to characterize combustible fractions (RDF) from household waste in Morocco and to study the economic and environmental benefits of their use as alternative fuels in cement kilns. The results of this research show that the combustible fractions contained in household waste in Morocco constitute a potential sustainable energy source with a high lower calorific value (4454 kcal/kg). The study of the advantages of co-incineration shows that the substitution of pet coke by 15% RDF reduces the pollution linked to gaseous emissions. In addition, the cement plant can make financial savings 389 USD/h by minimizing the use of fossil fuels.",signatures:"Aziz Hasib, Abdellah Ouigmane, Otmane Boudouch, Reda Elkacmi, Mustapha Bouzaid and Mohamed Berkani",downloadPdfUrl:"/chapter/pdf-download/73967",previewPdfUrl:"/chapter/pdf-preview/73967",authors:[{id:"166445",title:"Prof.",name:"Aziz",surname:"Hasib",slug:"aziz-hasib",fullName:"Aziz Hasib"},{id:"237725",title:"Prof.",name:"Reda",surname:"Elkacmi",slug:"reda-elkacmi",fullName:"Reda Elkacmi"},{id:"325462",title:"Dr.",name:"Abdellah",surname:"Ouigmane",slug:"abdellah-ouigmane",fullName:"Abdellah Ouigmane"},{id:"325463",title:"Prof.",name:"Otmane",surname:"Boudouch",slug:"otmane-boudouch",fullName:"Otmane Boudouch"},{id:"325528",title:"Prof.",name:"Mustapha",surname:"Bouzaid",slug:"mustapha-bouzaid",fullName:"Mustapha Bouzaid"},{id:"325529",title:"Prof.",name:"Mohammed",surname:"Berkani",slug:"mohammed-berkani",fullName:"Mohammed Berkani"}],corrections:[{id:"74392",title:"Corrigendum to: Sustainable Solid Waste Management in Morocco: Co-Incineration of RDF as an Alternative Fuel in Cement Kilns",doi:null,slug:"corrigendum-to-sustainable-solid-waste-management-in-morocco-co-incineration-of-rdf-as-an-alternativ",totalDownloads:null,totalCrossrefCites:null,correctionPdfUrl:null}]},{id:"74238",title:"Effectiveness of Anaerobic Technologies in the Treatment of Landfill Leachate",doi:"10.5772/intechopen.94741",slug:"effectiveness-of-anaerobic-technologies-in-the-treatment-of-landfill-leachate",totalDownloads:602,totalCrossrefCites:2,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Improper Solid Waste Management leads to the generation of landfill leachate at the landfills. To reduce the negative impacts of highly toxic and recalcitrant leachate on the environment, several techniques have been used. A lot of research is conducted to find suitable methods for the treatment of landfill leachate such as biological processes, chemical oxidation processes, coagulation, flocculation, chemical precipitation, and membrane procedures. The biological process is still being used widely for the treatment of leachate. The current system of leachate treatment consists of various unit processes which require larger area, energy and cost. In addition, the current aerobic treatment is not able to treat entirely the pollutants which require further treatment of the leachate. Anaerobic wastewater treatment has gained considerable attention among researchers and sanitary engineers primarily due to its economic advantages over conventional aerobic methods. The major advantages of anaerobic wastewater treatment in comparison to aerobic methods are: (a) the lack of aeration, which decreases costs and energy requirements; and (b) simple maintenance and control, which eliminates the need for skilled operators and manufacturers. Several anaerobic processes have been used for leachate treatment such as up-flow anaerobic sludge blanket (UASB) reactor, anaerobic filter, hybrid bed reactor, anaerobic sequencing batch reactor and Anaerobic baffled reactor. The following chapter provides an insight to the solid waste management at the landfills, generation of leachate and details of some of the highly efficient anaerobic treatment systems that are used for the overall treatment of landfill leachate.",signatures:"Imran Ahmad, Norhayati Abdullah, Shreeshivadasan Chelliapan, Ali Yuzir, Iwamoto Koji, Anas Al-Dailami and Thilagavathi Arumugham",downloadPdfUrl:"/chapter/pdf-download/74238",previewPdfUrl:"/chapter/pdf-preview/74238",authors:[{id:"237449",title:"Dr.",name:"Shreeshivadasan",surname:"Chelliapan",slug:"shreeshivadasan-chelliapan",fullName:"Shreeshivadasan Chelliapan"},{id:"324168",title:"Ph.D. Student",name:"Imran",surname:"Ahmad",slug:"imran-ahmad",fullName:"Imran Ahmad"},{id:"332462",title:"Dr.",name:"Norhayati",surname:"Abdullah",slug:"norhayati-abdullah",fullName:"Norhayati Abdullah"},{id:"338893",title:"Dr.",name:"Ali",surname:"Yuzur",slug:"ali-yuzur",fullName:"Ali Yuzur"},{id:"338894",title:"Dr.",name:"Iwamoto",surname:"Koji",slug:"iwamoto-koji",fullName:"Iwamoto Koji"},{id:"338895",title:"Dr.",name:"Anas",surname:"Al-Dailami",slug:"anas-al-dailami",fullName:"Anas Al-Dailami"},{id:"343758",title:"Dr.",name:"Thilagavathi",surname:"Arumugham",slug:"thilagavathi-arumugham",fullName:"Thilagavathi Arumugham"}],corrections:null},{id:"74004",title:"Hydrometallurgical Recovery of Gold from Mining Wastes",doi:"10.5772/intechopen.94597",slug:"hydrometallurgical-recovery-of-gold-from-mining-wastes",totalDownloads:743,totalCrossrefCites:0,totalDimensionsCites:3,hasAltmetrics:1,abstract:"Gold is a highly required material for a wide range of personal and industrial applications. The high demand for gold, together with the shortage of natural resources and high pollution potential of wastes generated during mining and ore processing activities led to search for alternative sources of gold. A possible source is represented by mine wastes resulting from the processing of polymetallic or sulfidic ores. The reprocessing of wastes and old tailings with moderate to low content of gold offers not only a business opportunity, but also enhances the quality of the surrounding environment, changes the land use and offers a wide range of socio-economic benefits. Cyanidation, the most widespread Au leaching option, is progressively abandoned due to the high risk associated with its use and to the low public acceptance. Therefore, alternative methods such as thiocyanate, thiourea, thiosulphate and halide leaching gained more and more interest. This chapter presents the most important features of some Au leaching methods, emphasizing their advantages, limitations and potential applications.",signatures:"Emilia Neag, Eniko Kovacs, Zamfira Dinca, Anamaria Iulia Török, Cerasel Varaticeanu and Erika Andrea Levei",downloadPdfUrl:"/chapter/pdf-download/74004",previewPdfUrl:"/chapter/pdf-preview/74004",authors:[{id:"324453",title:"Dr.",name:"Erika Andrea",surname:"Levei",slug:"erika-andrea-levei",fullName:"Erika Andrea Levei"},{id:"335075",title:"Dr.",name:"Emilia",surname:"Neag",slug:"emilia-neag",fullName:"Emilia Neag"},{id:"335077",title:"MSc.",name:"Eniko",surname:"Kovacs",slug:"eniko-kovacs",fullName:"Eniko Kovacs"},{id:"335078",title:"Dr.",name:"Zamfira",surname:"Dinca",slug:"zamfira-dinca",fullName:"Zamfira Dinca"},{id:"335080",title:"Dr.",name:"Anamaria Iulia",surname:"Török",slug:"anamaria-iulia-torok",fullName:"Anamaria Iulia Török"},{id:"335081",title:"BSc.",name:"Cerasel",surname:"Varaticeanu",slug:"cerasel-varaticeanu",fullName:"Cerasel Varaticeanu"}],corrections:null},{id:"74827",title:"Bioelectricity from Organic Solid Waste",doi:"10.5772/intechopen.95297",slug:"bioelectricity-from-organic-solid-waste",totalDownloads:465,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Resource recovery and recycling of organic waste is a great challenge in the world. The unmanaged organic waste causes a great damage to the environment and the public health both in the developing countries and industrial parts of the world. In this research, an innovative method was adopted to generate bioelectricity from the organic waste by using the Microbial Fuel Cell (MFC). Various types of organic wastes such as livestock waste, food waste, fruit waste were used as the substrates of the microbial fuel cell. All the experiments were carried out in the same sized one chamber microbial fuel cell and the similar electrode materials. It was observed that all the organic wastes can be used to generate bioelectricity through microbial fuel cell. The generated electricity can be used in several environmental monitoring sensors and can be used as an alternate power source in the developing countries. The by-products of the bioelectricity generation can be used as soil conditioner in the organic depleted soil and agricultural fields.",signatures:"M. Azizul Moqsud",downloadPdfUrl:"/chapter/pdf-download/74827",previewPdfUrl:"/chapter/pdf-preview/74827",authors:[{id:"7199",title:"Dr.",name:"Md.Azizul",surname:"Moqsud",slug:"md.azizul-moqsud",fullName:"Md.Azizul Moqsud"}],corrections:null},{id:"73517",title:"Agricultural Solid Wastes: Causes, Effects, and Effective Management",doi:"10.5772/intechopen.93601",slug:"agricultural-solid-wastes-causes-effects-and-effective-management",totalDownloads:1772,totalCrossrefCites:6,totalDimensionsCites:16,hasAltmetrics:1,abstract:"The role of the agricultural sector in human development and economic development cannot be overemphasized. Awareness for increased agricultural production is on the increase, arising from the need to feed the ever-increasing human population. Interestingly, almost all agricultural activities generate wastes, which are generated in large quantities in many countries. However, these wastes may constitute a serious threat to human health through environmental pollution and handling them may result in huge economic loss. Unfortunately, in many developing countries where large quantities of these wastes are generated, they are not properly managed because little is known about their potential risks and benefits if properly managed. There are studies that address some of the challenges of agricultural solid wastes as well as suggestions on how they can be properly managed. In this chapter, we intend to explore the major sources of agricultural solid wastes, their potential risks, and how they can be properly managed.",signatures:"Isaac Oluseun Adejumo and Olufemi Adebukola Adebiyi",downloadPdfUrl:"/chapter/pdf-download/73517",previewPdfUrl:"/chapter/pdf-preview/73517",authors:[{id:"276527",title:"Dr.",name:"Isaac Oluseun",surname:"Adejumo",slug:"isaac-oluseun-adejumo",fullName:"Isaac Oluseun Adejumo"},{id:"328699",title:"Dr.",name:"O.A.",surname:"Adebiyi",slug:"o.a.-adebiyi",fullName:"O.A. Adebiyi"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"8580",title:"Municipal Solid Waste Management",subtitle:null,isOpenForSubmission:!1,hash:"e3554c02569fe3ac8afa79cb02daae97",slug:"municipal-solid-waste-management",bookSignature:"Hosam El-Din Mostafa Saleh",coverURL:"https://cdn.intechopen.com/books/images_new/8580.jpg",editedByType:"Edited by",editors:[{id:"144691",title:"Prof.",name:"Hosam M.",surname:"Saleh",slug:"hosam-m.-saleh",fullName:"Hosam M. Saleh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6534",title:"Heavy Metals",subtitle:null,isOpenForSubmission:!1,hash:"a7573426a162c18f39acc575c1e69f67",slug:"heavy-metals",bookSignature:"Hosam El-Din M. Saleh and Refaat F. 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In some Asian countries (e.g., Japan), the threshold to define obesity is lower (25 kg/m2). Obesity is a major health problem worldwide associated with increased morbidity/mortality and high cost for the society. The prevalence of obesity has doubled in more than 70 countries since 1980. The number of adult subjects with obesity is around 700 million worldwide. Nearly 4 million subjects die each year from the consequences of obesity. The annual cost of obesity is more than $2 trillion [1, 2, 3].
Management of obesity requires multidisciplinary approaches including diet, food supplement, exercise, behavior change, drug, medical device, gut microbiome manipulation, and surgery [1, 4, 5, 6, 7, 8, 9]. The annual obesity treatment market is around $6 billion. In the USA, among subjects with obesity, only 2% receive drug therapy and less than 1% who are eligible for bariatric surgery benefits from it. The reasons for these undertreatment rates are mainly related to adverse effects/complications and cost of drugs and bariatric surgery.
Medical devices available 100 years ago were limited to stethoscope, original medical X-ray imaging device, and electrocardiograph [10]. Over the past several decades, the number of medical devices has increased exponentially. Anti-obesity medical devices are positioned to bridge the gap between more conservative treatments (e.g., lifestyle) and more aggressive interventions (e.g., bariatric surgery). Compared to bariatric surgery, they have the advantage of being less invasive, easier to perform, and reversible. Anti-obesity medical devices are available upon prescription or as over-the-counter products.
Anti-obesity medical devices represent a heterogeneous family of devices in terms of presentation, usage/administration, mechanism of action, effectiveness, safety, regulation, availability, and cost [8, 11, 12, 13, 14]. The devices can be as different as an intragastric balloon, a stomach aspiration system, or particles administered orally in capsule.
Unlike anti-obesity drugs that act chemically through specific receptors, anti-obesity medical devices act rather mechanically. They do not have systemic absorption, specific metabolism, or receptors. Their research and development pattern follow specific models. The terminology used for medical devices differs slightly from that used for drugs (e.g., sham instead of placebo, effectiveness instead of efficacy). With some medical devices, it is not possible to use a sham for ethical and/or technical reasons. Compared to drugs, medical devices have different effectiveness dynamics. Unlike drugs, for some anti-obesity medical devices, there is no compliance issue with the device use since the device is placed in the body for several months and there is no need for repeated administration that might be affected by the subject’s discipline. Because there is no systemic absorption, there are no side effects related to the impact of medical devices on different organs through the bloodstream. The regulatory systems ruling anti-obesity medical devices are based on short product life cycles. The marketing and sales of anti-obesity medical devices are based on different models as compared to drugs.
Anti-obesity medical devices can cause weight loss through different mechanisms by acting at different levels.
Although the primary impact of the anti-obesity medical devices is mechanical, the final effect may be achieved through changes in several factors controlling appetite and food intake, especially the gastrointestinal hormones (e.g., decrease in ghrelin, increase in glucagon-like peptide-1).
An anti-obesity medical device can decrease the food intake by limiting the bite size in the oral cavity.
An anti-obesity medical device can decrease the food intake by reducing the available stomach volume.
Other levels of impact to achieve food intake reduction are possible and have been or will be investigated.
An anti-obesity medical device can decrease the amount of available nutrient by removing part of the gastric contents.
An anti-obesity medical device can decrease the absorbed nutrient by bypassing part of the intestine.
The main challenges in the development of anti-obesity medical devices are due to lack of unique regulatory guidance and disparities in time and cost of approval processes in different countries.
The regulation of anti-obesity medical devices varies by countries or group of countries. There are important differences in the regulatory processes, cost, and time to approval between the USA and Europe [15].
Over-the-counter anti-obesity medical devices may or may not need regulation and approval/clearance depending on the devices and countries.
In the USA, the regulation of medical devices is centralized since 1976 through the FDA. This centralized process allows a better coordination and enforcement of rules. The CDRH is in charge of approval/clearance of anti-obesity medical devices. There are three regulatory classes of medical devices: Class I (low risk), Class II (moderate risk), and Class III (high risk). Based on the expected weight loss, two categories of anti-obesity medical devices have been defined: weight-loss devices (“more” weight loss) and weight-management devices (“less” weight loss). The approval/clearance is through premarket notification process [510(k)] or premarket approval (PMA) process and is based on safety and effectiveness.
A new guidance using benefit-risk approaches is in preparation by the CDRH taking into account the weight loss (extent and duration), the rate of responders (≥ 5% weight loss), the reduction of comorbidities (e.g., hypertension, dyslipidemia, type 2 diabetes), and the safety [rate and severity of adverse events (AEs)].
Since its formation in 1993, the European Union (EU), currently a group of 27 countries (after the recent removal of the United Kingdom), has established rules for the approval of medical devices. Anti-obesity medical devices are regulated under directive 93/42/EC. There are four regulatory classes of medical devices: Class I (low risk), Class IIa (low-moderate risk), Class IIb (moderate-high risk), and Class III (high risk). Each member country has a regulatory entity called Competent Authority (CA). The CA certifies/notifies entities called Notified Bodies (NBs) in each country. The NBs are private, for-profit companies responsible for conformity assessment and CE (Conformité Européenne) mark. There are over 50 NBs in the EU. The NBs contract with the manufacturers to supply the CE mark and the approval is based on safety and performance. Clinical effectiveness is not a requirement. An anti-obesity medical device with a CE mark can be marketed in any EU member country.
In the EU, the approval process is more flexible, faster, and less expensive in comparison to the USA.
Other countries have different regulatory procedures. The approval process has varying degrees of sophistication and challenges. In Japan for example, the application is processed by the Pharmaceutical and Medical Device Agency (PMDA). Although the Japanese market is very attractive for foreign manufacturers, the approval process is complicated, long, and expensive due to multiple factors (e.g., lack of translated documents from Japanese, need to perform specific and costly studies in the Japanese population).
Several countries accept the FDA approval/clearance or the CE mark.
Several anti-obesity medical devices have been approved/cleared in the USA, in the EU, and in other countries. Some devices have been approved first in the EU before being approved several years later in the USA. This section focuses on anti-obesity medical devices regulated in the USA.
Below are the anti-obesity medical devices approved/cleared in the USA (Table 1). Their use should always be in conjunction with lifestyle recommendations on diet and exercise.
Lap-Band® (BioEnterics Corporation) is an adjustable silicone band placed laparoscopically around the proximal stomach immediately below the gastro-esophageal junction and attached to a subcutaneous reservoir (Figure 1). The level of pressure is adjusted by varying the amount of fluid that is inserted into the band. The technique is reversible, has low procedural risk, and can be performed in an outpatient setting. Lap-Band® can be revised and/or replaced as needed. The pressure imposed to the proximal stomach causes early satiety and a decrease in food intake with subsequent weight loss [8].
Lap-Band® (BioEnterics Corporation—Picture downloaded from the internet).
In the pivotal study, 292 subjects (247 females, 45 males, mean BMI = 47.4 kg/m2) were implanted with Lap-Band® and had follow-up evaluations for 36 months. The primary effectiveness endpoint, assessed in the per protocol population at Month 36, was the excess weight loss. Safety analysis also included an additional seven subjects who previously received a similar device. At Month 36, the excess weight loss was 36.2%, relatively stable over the previous 18 months (the weight loss was 18.0%). AEs were observed in 266 subjects (89.0%). Most AEs were of gastrointestinal origin (mainly nausea/vomiting, gastroesophageal reflux, and abdominal pain, mild in the majority of cases). Serious AEs (SAEs) were observed in 16 subjects (5.4%), mainly port leakage and 2 deaths (unrelated to device).
Overall, Lap-Band® is relatively safe and has a strong effectiveness. The device was approved by the FDA in June 2001. It is indicated for weight loss in severe obesity with BMI ≥ 40 kg/m2 or obesity with BMI ≥ 35 kg/m2 in the presence of one or more severe comorbidities, in conjunction with lifestyle recommendations, in subjects who failed to respond to diet, exercise, and behavior change. It is contraindicated in several conditions including pregnancy, non-adult subjects, inflammatory diseases of the gastrointestinal tract, upper gastrointestinal bleeding conditions, portal hypertension, and severe cardiopulmonary diseases (non-exhaustive list). Complications include proximal gastric enlargement, erosion or migration of the band, and leaks of the band system (non-exhaustive list).
Orbera™ Intragastric Balloon System (Apollo Endosurgery, Inc.) is a balloon made of silicone placed endoscopically in the stomach (Figure 2). The balloon is filled with saline mixed with methylene blue (450–700 mL). The methylene blue is a marker for balloon dysfunction. In case of balloon rupture, the methylene blue will be systematically absorbed and change the color of urine to blue. The procedure is minimally invasive and can be performed in an outpatient setting. The balloon is removed endoscopically after 6 months. By occupying gastric volume, Orbera™ Intragastric Balloon System causes early satiety and a decrease in food intake with subsequent weight loss [8, 11, 13, 14].
Orbera™ Intragastric Balloon System (Apollo Endosurgery, Inc.—Picture downloaded from the internet).
In the pivotal study, 255 subjects (229 females, 26 males, mean BMI = 35.3 kg/m2) were randomized into Orbera™ Intragastric Balloon System (n = 125) or control (no intragastric intervention, n = 130) arms for 6 months and 6 months follow-up after Orbera™ Intragastric Balloon System removal. Safety analysis also included an additional 35 run-in, non-randomized subjects who received Orbera™ Intragastric Balloon System. All subjects were given lifestyle recommendations. The co-primary effectiveness endpoints, assessed in the modified intention-to-treat (mITT) population at Month 9, were the excess weight loss in Orbera™ Intragastric Balloon System arm and a significantly greater weight loss in Orbera™ Intragastric Balloon System arm compared to control arm. At Month 9, the excess weight loss was 26.5% in Orbera™ Intragastric Balloon System arm, and the weight losses were 9.1 and 3.4% in Orbera™ Intragastric Balloon System and control arms, respectively. The study did not meet the first co-primary effectiveness endpoint but met the second co-primary effectiveness endpoint. At Month 6, the weight losses were 10.2 and 3.3% in Orbera™ Intragastric Balloon System and control arms, respectively. A total of 810 device-related AEs was observed (mainly nausea/vomiting, gastroesophageal reflux, and abdominal pain, mild or moderate in the majority of cases). Fourteen device- or procedure-related SAEs were observed, mainly device intolerance but no death.
Overall, Orbera™ Intragastric Balloon System is relatively safe and has a strong effectiveness. The device was approved by the FDA in August 2015. It is indicated for weight loss in obesity with BMI between 30 and 40 kg/m2, in conjunction with lifestyle recommendations, in subjects who failed to respond to diet, exercise, and behavior change. It is contraindicated in several conditions including pregnancy, non-adult subjects, prior bariatric surgery, inflammatory diseases of the gastrointestinal tract, upper gastrointestinal bleeding conditions, and liver deficiency (non-exhaustive list). Complications include balloon migration, intestinal obstruction, gastric ulcer, and gastric perforation (non-exhaustive list).
Obalon Balloon System (Obalon Therapeutics, Inc.) is a swallowable balloon made of nylon and polyethylene contained within a gelatin capsule (attached to a thin inflation catheter) that is taken orally. The correct position of the capsule is confirmed with fluoroscopy. The capsule disintegrates in the stomach and releases the balloon. The balloon is filled with air (250 cc of nitrogen and sulfur hexafluoride gas mixture). Up to three balloons can be placed in the same session or sequentially over a 6-month period (Figure 3). The procedure is minimally invasive and can be performed in an outpatient setting without endoscopy. The balloon is removed endoscopically after 6 months. By occupying gastric volume, Obalon Balloon System causes early satiety and a decrease in food intake with subsequent weight loss [8, 13, 14].
Obalon Balloon System (Obalon Therapeutics, Inc.—Picture downloaded from the internet).
In the pivotal study, 387 subjects (341 females, 46 males, mean BMI = 35.2 kg/m2) were randomized into Obalon Balloon System (n = 198) or control (sham capsule, n = 189) arms for 6 months. At Month 6, the eligible control arm subjects were permitted to crossover and receive Obalon Balloon System for 6 months. All subjects were given lifestyle recommendations. The co-primary effectiveness endpoints, assessed in the mITT population at Month 6, were a significantly greater weight loss in Obalon Balloon System arm compared to control arm (super-superiority) and the responder rate at 5% weight loss in Obalon Balloon System arm. Device-related safety analysis also included 138 subjects who switched at Month 6 from control to Obalon Balloon System. At Month 6, the weight losses were 6.6 and 3.4% in Obalon Balloon System and control arms, respectively, and the responder rate at 5% weight loss in Obalon Balloon System arm was 62.1%. The study met both co-primary effectiveness endpoints. Most device-related AEs were of gastrointestinal origin (mainly abdominal pain and nausea/vomiting, mild in the majority of cases), observed in 300 subjects (89.3%). Device- or procedure-related SAEs were observed in one subject (0.3%), a case of peptic ulcer disease.
Overall, Obalon Balloon System is relatively safe and has a modest effectiveness. The device was approved by the FDA in September 2016. It is indicated for weight loss in obesity with BMI between 30 and 40 kg/m2, in conjunction with lifestyle recommendations, in subjects who failed to respond to diet, exercise, and behavior change. It is contraindicated in several conditions including pregnancy, non-adult subjects, prior bariatric surgery, inflammatory diseases of the gastrointestinal tract, gastric diseases, and eating disorders (non-exhaustive list). Complications include balloon migration, intestinal obstruction, gastric ulcer, and gastric perforation (non-exhaustive list).
TransPyloric Shuttle (BAROnova, Inc.) is a device placed endoscopically in the stomach (Figure 4). It is not strictly a balloon but functions like a balloon. It has two asymmetrical bulbs made of silicone connected by a flexible catheter. The procedure is minimally invasive and can be performed in an outpatient setting. The shuttle is removed endoscopically after 12 months. By creating intermittent obstruction to gastric outflow that delays gastric emptying, TransPyloric Shuttle causes early satiety and a decrease in food intake with subsequent weight loss [8, 13].
TransPyloric Shuttle (BAROnova, Inc.—Picture downloaded from the internet).
In the pivotal study, 270 subjects (252 females, 18 males, mean BMI = 36.6 kg/m2) were randomized into TransPyloric Shuttle (n = 181) or control (sham endoscopic procedure, n = 89) arms for 12 months. The TransPyloric Shuttle was successfully placed in 171 subjects. The study also included an additional 32 open-label subjects who received TransPyloric Shuttle. All subjects were given lifestyle recommendations. The co-primary effectiveness endpoints, assessed in the per protocol population at Month 12, were a significantly greater weight loss in TransPyloric Shuttle arm compared to control arm and the responder rate at 5% weight loss in TransPyloric Shuttle arm. At Month 12, the weight losses were 9.5 and 2.8% in TransPyloric Shuttle and control arms, respectively, and the responder rate at 5% weight loss in TransPyloric Shuttle arm was 66.8%. The study met both co-primary effectiveness endpoints. Most device-related AEs were of gastrointestinal origin (mainly nausea/vomiting, abdominal pain, and dyspepsia, mild or moderate in the majority of cases), observed in 200 subjects (98.5%). Device- or procedure-related SAEs were observed in six subjects (3.0%), mainly device impaction but no death.
Overall, TransPyloric Shuttle is relatively safe and has a strong effectiveness. The device was approved by the FDA in April 2019. It is indicated for weight loss in obesity with BMI between 35 and 40 kg/m2 or obesity with BMI between 30 and < 35 kg/m2 in the presence of one or more comorbidities, in conjunction with lifestyle recommendations, in subjects who failed to respond to diet, exercise, and behavior change. It is contraindicated in several conditions including pregnancy, non-adult subjects, prior bariatric surgery, inflammatory diseases of the gastrointestinal tract, gastric diseases, and eating disorders (non-exhaustive list). Complications include device impaction and gastric ulcer (non-exhaustive list).
AspireAssist® (Aspire Bariatrics, Inc.) is a device attached to a percutaneous endoscopic gastrostomy tube implanted endoscopically (Figure 5). It allows the aspiration of gastric contents 20–30 minutes after each major meal (a meal containing more than 200 calories). Thorough chewing of food is required to facilitate aspiration with the 6-mm-diameter tube. The procedure is minimally invasive and can be performed in an outpatient setting. The device is removed when the desired body weight is reached. By allowing the removal of approximately 30% of ingested calories over 5–10 minutes, AspireAssist® causes decreased absorption of gastrointestinal nutrients with subsequent weight loss [8, 11, 12, 13, 14].
AspireAssist® (Aspire Bariatrics, Inc.—Picture downloaded from the internet).
In the pivotal study, 171 subjects (149 females, 22 males, mean BMI = 41.6 kg/m2) were randomized into AspireAssist® (n = 111) or control (no intragastric intervention, n = 60) arms for 12 months. All subjects were given lifestyle recommendations. The co-primary effectiveness endpoints, assessed in the mITT population at Month 12, were a significantly greater excess weight loss in AspireAssist® arm compared to control arm (super-superiority) and the responder rate at 25% excess weight loss in AspireAssist® arm. At Month 12, the excess weight losses were 31.5 and 9.8% in AspireAssist® and control arms, respectively, and the responder rate at 25% excess weight loss in AspireAssist® arm was 56.8%. The study met the first co-primary effectiveness endpoint but not the second co-primary effectiveness endpoint. At Month 12, the weight losses were 12.1 and 3.6% in AspireAssist® and control arms, respectively. Device- or procedure-related AEs were observed in 93 subjects (83.8%, mainly peristomal granulation tissue, abdominal pain, and nausea/vomiting, mild in the majority of cases). Device- or procedure-related SAEs were observed in four subjects (3.6%), including peritonitis but no death.
Overall, AspireAssist® is relatively safe and has a strong effectiveness. The device was approved by the FDA in June 2016. It is indicated for weight loss in obesity with BMI between 35 and 55 kg/m2, in conjunction with lifestyle recommendations, in subjects who failed to respond to non-surgical weight-loss therapy. It is contraindicated in several conditions including pregnancy, non-adult subjects, upper gastrointestinal bleeding conditions, chronic abdominal pain, severe cardiopulmonary diseases, and eating disorders (non-exhaustive list). Complications include skin irritation, infection, and electrolyte abnormalities (non-exhaustive list).
SmartByte Device (Scientific Intake) is an oral device occupying space on the upper palate. It includes a temperature-recording sensor to monitor usage (Figure 6). It is worn in mouth during meal consumption. The device is renewed every 12 months. By creating limited bite size and slower eating, SmartByte Device causes a decrease in food intake with subsequent weight loss [16].
SmartByte Device (Scientific Intake—Picture downloaded from the internet).
In the pivotal study, 173 subjects (BMI between 26 and 36 kg/m2) were randomized into SmartByte Device (n = 102) or control (no oral intervention, n = 71) arms for 4 months. All subjects were given lifestyle recommendations. The primary effectiveness endpoint, assessed in the ITT population at Month 4, was a greater responder rate at 5% weight loss in SmartByte Device arm compared to control arm. At Month 4, the responder rates at 5% weight loss were 20.6 and 5.6% in SmartByte Device and control arms, respectively. The study did not meet the primary effectiveness endpoint. At Month 4, the weight losses were 1.7 and 0.4% in SmartByte Device and control arms, respectively. Device-related AEs were observed in five subjects (4.9%, including two episodes of transient choking on food). No device-related SAEs were observed.
Overall, SmartByte Device is safe and has a weak effectiveness. The device was cleared by the FDA in May 2017. It is indicated to aid in weight management in overweight and obesity with BMI between 27 and 35 kg/m2, in conjunction with lifestyle recommendations. It is contraindicated in pregnancy and eating disorders. Complications include choking on food and mouth soreness (non-exhaustive list).
Plenity™ (Gelesis, Inc.) is a superabsorbent hydrogel (cellulose and citric acid, forming a three-dimensional matrix) administered orally in capsules with 500 mL of water (three capsules, 20–30 minutes before lunch and dinner). The hydrogel particles hydrate up to 100 times their initial weight in the stomach and intestine (Figure 7). The particles mix with ingested food and create a larger volume with higher elasticity and viscosity. The particles degrade in the colon and are eliminated in the feces. By creating a larger volume with higher elasticity in the stomach and intestine, Plenity™ causes early satiety and a decrease in food intake with subsequent weight loss [17].
Plenity™ (Gelesis, Inc.—Picture downloaded from the internet).
In the pivotal study, 436 subjects (245 females, 191 males, mean BMI = 33.8 kg/m2) were randomized into Plenity™ (n = 223) or control (sham capsule, n = 213) arms for 6 months. All subjects were given lifestyle recommendations. The co-primary effectiveness endpoints, assessed in the ITT population (multiple imputation) at Month 6, were a significantly greater weight loss in Plenity™ arm compared to control arm (super-superiority) and the responder rate at 5% weight loss in Plenity™ arm. At Month 6, the weight losses were 6.4 and 4.4% in Plenity™ and control arms, respectively, and the responder rate at 5% weight loss in Plenity™ arm was 58.6%. The study did not meet the first co-primary effectiveness endpoint but met the second co-primary effectiveness endpoint. Most device-related AEs were of gastrointestinal origin (mainly abdominal distension, diarrhea, infrequent bowel movements, and flatulence, mild in the majority of cases), observed in 84 subjects (37.7%). No device-related SAEs were observed.
Overall, Plenity™ is safe and has a modest effectiveness. The device was cleared by the FDA in April 2019. It is indicated to aid in weight management in overweight and obesity with BMI between 25 and 40 kg/m2, in conjunction with lifestyle recommendations. It is contraindicated in pregnancy, non-adult subjects, and history of allergic reaction to the components of Plenity™ capsule. No relevant complications have been reported.
Comparative effectiveness of the above anti-obesity medical devices is reported in Table 2.
Medical device | Approval date | Indication |
---|---|---|
Lap-Band® | June 5, 2001 | Weight-loss device (BMI ≥ 35 kg/m2) |
Orbera™ Intragastric Balloon System | August 5, 2015 | Weight-loss device (BMI 30–40 kg/m2) |
AspireAssist® | June 14, 2016 | Weight-loss device (BMI 35–55 kg/m2) |
Obalon Balloon System | September 8, 2016 | Weight-loss device (BMI 30–40 kg/m2) |
SmartByte Device | May 18, 2017 | Weight-management device (BMI 27–35 kg/m2) |
Plenity™ | April 12, 2019 | Weight-management device (BMI 25–40 kg/m2) |
TransPyloric Shuttle | April 16, 2019 | Weight-loss device (BMI 30–40 kg/m2) |
Approved/cleared anti-obesity medical devices in the USA ranked by approval date.
Medical device | Treatment duration | Total body weight loss |
---|---|---|
Lap-Band® | 36 months | 18.0% |
AspireAssist® | 12 months | 12.1% |
Orbera™ Intragastric Balloon System | 6 months | 10.2% |
TransPyloric Shuttle | 12 months | 9.5% |
Obalon Balloon System | 6 months | 6.6% |
Plenity™ | 6 months | 6.4% |
SmartByte Device | 4 months | 1.7% |
Approved/cleared anti-obesity medical devices in the USA ranked by extent of total body weight loss in pivotal studies.
Relevant complications (non-exhaustive list), some being very rare, of the above anti-obesity medical devices are reported in Table 3.
Medical device | Treatment duration | Relevant complication |
---|---|---|
Lap-Band® | 36 months | Proximal gastric enlargement, band erosion or migration, system leaks |
AspireAssist® | 12 months | Skin irritation, infection, electrolyte abnormalities |
Orbera™ Intragastric Balloon System | 6 months | Balloon migration, intestinal obstruction, gastric ulcer, gastric perforation |
TransPyloric Shuttle | 12 months | Device impaction, gastric ulcer |
Obalon Balloon System | 6 months | Balloon migration, intestinal obstruction, gastric ulcer, gastric perforation |
Plenity™ | 6 months | None |
SmartByte Device | 4 months | Choking on food, mouth soreness |
Relevant complications of the approved/cleared anti-obesity medical devices in the USA in pivotal studies.
Cost of the above anti-obesity medical devices is reported in Table 4.
Medical device | Average cost (Range) |
---|---|
Lap-Band® | $15,000 ($10,000–$30,000) |
AspireAssist® | $10,000 ($7,000–$13,000) |
Orbera™ Intragastric Balloon System | $6,000 ($3,000–$9,000) |
TransPyloric Shuttle | To be determined |
Obalon Balloon System | $8,000 ($6,000–$9,000) |
Plenity™ | $100/month |
SmartByte Device | $500 |
Cost of the approved/cleared anti-obesity medical devices in the USA.
Several anti-obesity medical devices have been withdrawn by the manufacturers from the market in the USA after approval by the FDA (e.g., Maestro Rechargeable System, Realize Adjustable Gastric Band, ReShape Integrated Dual Balloon System, Garren Gastric Bubble).
Several anti-obesity medical devices are currently in development in different countries (e.g., Epitomee Device [18]).
EndoBarrier® has obtained a CE mark in the EU but its approval in the USA has been challenged for safety reasons [8, 11, 12, 13, 14].
A variety of anti-obesity medical devices are available as over-the-counter products (e.g., NozNoz, slow control fork, slipper genie).
Anti-obesity medical devices represent a heterogenous family of devices in terms of presentation, usage/administration, mechanism of action, effectiveness, safety, regulation, availability, and cost. They offer an attractive approach in managing obesity. Anti-obesity medical devices are positioned to bridge the gap between more conservative treatments (e.g., lifestyle) and more aggressive interventions (e.g., bariatric surgery). Their use should always be combined with lifestyle changes.
Considering the large market size of obesity treatment and the small percentage of subjects treated with drugs or bariatric surgery, anti-obesity medical devices can play a major role in the management of obesity.
The author received honorarium for consultancy from Gelesis, Inc.
The co-variability of paleomagnetic and paleoclimate time series has been found in many sedimentary records, e.g. [1] and references therein. Most of the reversals of geomagnetic field polarity and magnetic poles’ excursions seem to appear in periods of cold climate [1, 2]. Other authors, however, announced that climatic cooling fairly well corresponds to episodes with a stronger geomagnetic field [3, 4, 5]. This controversy, together with objective difficulties for disentangling paleomagnetic from paleoclimate data – due to the high variability and climate dependence of marine sedimentation rates – determines the skepticism of the greater part of the scientific community regarding possible links between geomagnetic filed and climate.
On the other hand, time series based on contemporary instrumental measurements do not contain the ambiguity of paleo-data records. Based on the magnetic and climate measurements collected from the beginning of 1900 up to 2010, this chapter provides not only more evidence for existing coupling between geomagnetic field and climate system, but also offers a physically rational explanation and results supporting its validity.
The Earth’s magnetic field interacts with all planetary shells – the core, mantle, and crust of the solid Earth, as well as with the atmosphere, hydrosphere, and biosphere. It comprises information about both the state of near-earth space and the internal structure of our planet. The Earth’s magnetic field is continuously changing in space and time. The sources of its variations are located inside and outside of the planet. The amplitude and periodicity of geomagnetic variations are very different, which affects the methods used for data acquisition.
The longest periods of reoccurrence have geomagnetic
The palaeomagnetic records reveals also the existence of shorter periods (with a duration of several thousand years) when the field has departed from its near-axial configuration. Such short-term events are called geomagnetic
In the first approximation, the magnetic field is interpolated as the field of a magnetic dipole. However, the empirical models (incorporating all available measurements of field intensity), as well as satellite measurements, reveal the existence of a non-dipolar component in the real geomagnetic field. The irregularities in the spatial distribution of geomagnetic field intensity are well visible in Figure 1, based on the 13th generation of the International Geomagnetic References Field model (IGRF) [8]. The two-wave distribution of field intensity in the Northern Hemisphere and a single-wave in the Southern Hemisphere are well visible in Figure 1.
Spatial structure of the modulus of the total vector of the geomagnetic field intensity, calculated for 2021 by the IGRF-13 model. (
Moreover, the temporal evolution of geomagnetic field also differs in different regions over the world. The greatest amplitude of changes is observed in the Western Hemisphere, in the regions of the Canadian (Figure 2a) and South Atlantic (Figure 2c) world anomalies. In the Eastern Hemisphere amplitudes of these changes are smaller (Figure 2b and d). The spatial structure of these irregularities is well visible in the maps of geomagnetic secular variations (Figure 3), which are calculated by the formula:
Geomagnetic field changes in the regions of world geomagnetic anomalies: (a) Canadian, (b) Siberian, (c) South Atlantic and (d) Geomagnetic pole in the southern hemisphere.
Secular variations of the first two decades of twenty-first century, based on the IGRF-13 model. (
Figure 3 illustrates fairly well that focuses of the strongest secular variations evolve with time, in their strength and position over the globe. All the features of the spatio-temporal structure of the geomagnetic field, the problems of its observations and modeling, are described in great details in [9].
Short-term changes in geomagnetic field (from seconds to days) are caused by the external sources – i.e. the current systems in the magnetosphere and ionosphere. In the absence of solar-terrestrial disturbances, the Earth’s magnetic field shows regular daily variations with small amplitude (∼tens of nT), which are primarily composed of 24, 12, 8, and 6-hour spectral components [10, 11, 12]. These variations are known as solar quiet (Sq) variations. Today it is well understood that Sq variations are induced by the electric currents existing in the ionospheric dynamo region (between 90 and 150 km), where the neutral wind drives an electromotive force – through the ionospheric wind dynamo mechanism [13, 14]. The Sq variations are sensitive to the sunspot numbers [10]. For example, the midlatitude Sq currents’ intensity is approximately twice higher in solar maximum than in solar minimum conditions [15, 16].
In addition, the geomagnetic perturbations at the planetary surface also have
The maximum amplitude of quiet Sq and lunar variations has a maximum during the daytime hours, and when the moon is in opposition. These are smooth periodic variations with intensities reaching 200nT, increasing from the equator to the poles [20].
The quiet conditions, however, are frequently disturbed by active processes on the Sun (e.g. solar flares, coronal mass ejection, coronal holes, etc.). The ejected solar mass and magnetic fields propagate in the interplanetary magnetic field (IMF) as a shock wave, which distorts significantly geomagnetic field when it splashes on the Earth. Only ∼1% of energy carried by the solar wind is transferred to the Earth’s magnetic field because the reconnection between interplanetary and geomagnetic fields depends on their directions. It is well established that the southward direction of the interplanetary magnetic field favors its reconnection with the Earth’s magnetic field. The energy transferred to the magnetosphere in such periods abrupt dramatically by one-two orders of magnitude, reaching power of ≥1011 W [21]. These periods are known as
The dominant interplanetary phenomena causing
Magnetic clouds are large-scale interplanetary formations, caused by coronal mass ejection on the Sun, in which the magnetic field strength, propagating speed, and plasma concentration are higher than in the surrounding flows [23]. The vertical Bz component of IMF slowly changes from negative to positive sign in SN clouds, and vice versa in NS clouds. The interaction of the Earth’s magnetosphere with magnetic clouds, as a rule, is accompanied by intense geomagnetic disturbances [24, 25]. According to some estimates, the geoeffectiveness of magnetic clouds to disturb Earth’s magnetic field is 77% [25, 26].
During solar minimum, high-speed streams from coronal holes dominate the interplanetary medium activity. The high-density, low-speed streams (associated with the heliospheric current sheet plasma) impinging upon the Earth’s magnetosphere cause positive Dst values in the initial phase of the storm. In the absence of shocks, sudden impulses are infrequent in periods of low solar activity. The interaction between fast stream (emanated from coronal holes) and the slow heliospheric current sheet plasma leads to the formation of a compression region with a high magnetic gradient, called
For certain classes of magnetic storms, the interaction of CIR with the Earth’s magnetosphere is more efficient than CME [27]. On the other hand, comparisons of the geoeffectiveness of various interplanetary structures, such as shock waves, magnetic clouds, IMF sectors boundaries, and CIR, showed that 33% of CIR are accompanied by moderate or intense storms. This means that every third phenomenon of the observed CIR at the Earth is geoeffective [28].
It is statistically confirmed that geoeffective disturbances can be caused by a whole spectrum of various phenomena on the Sun:
The influence of geomagnetic storms on the lower atmospheric variables is studied by many authors. The storm imprint on the near-surface pressure and temperature has been reported by [33, 34], on circulation by [35, 36, 37, 38, 39, 40], on total ozone density by [41], etc. The latter authors have compared geomagnetic storm manifestation in upper, middle, and lower atmosphere, emphasizing on differences in the atmospheric response to geomagnetic storms. Their main conclusions are summarized as follow: (i) unlike the prevailing latitudinal dependence of storm impact on the upper-middle atmosphere, the tropospheric effects manifest itself with a well pronounced
All these effects are due to the short-term geomagnetic disturbances, initiated by the external influence – i.e. solar variability and inhomogeneity of interplanetary medium. Although important, these fluctuations of Earth’s magnetic field are short-lasting and their impact on the climate system is negligible. Oppositely, this publication is focused on the long-term variations of geomagnetic field on interdecadal and multidecadal time scales (initiated at the core-mantle boundary) and their relation to climate variability with its regional specifics.
Important structures in Earth’s magnetosphere are its radiation belts, which consist of relativistic electron and proton populations, trapped in the Earth’s magnetic field. The Earth has two such belts and some others may be temporarily created. The
An electrons population is found also in the outer edge of the
The
Particles trapped within the geomagnetic field are urged by the Lorentz force (1) to move along the magnetic field lines on spiral trajectories (the result of a combined
where: B(r,t) is external magnetic field – function of the spatial dimensions and time, r and v are respectively particle’s radius vector and velocity; “m” is particle’s mass and “q” – its charge.
Besides the helical movement of particles along geomagnetic field lines, they also perform the additional movement in a direction perpendicular to the magnetic field lines – known as
where B is the magnetic vector, ρ – the radius of the geomagnetic lines curvature,
Formula (2) shows also that particles’ drift across the magnetic field lines depends on their charge q, and consequently leads to a charge separation, which in turn generates electric field E along the drift direction. The combined effect of E and B fields induces an E×B/B2 drift of particles, which displaces positive ions and negative electrons in the same direction – perpendicular simultaneously to B and to E. These charged particles are then “lost” in the ambient atmosphere, where they release their energy, producing showers of secondary particles.
In a dipolar geomagnetic field (with its cross-latitudinal magnetic gradient) the protons are drifting westward, while electrons – eastward. The real geomagnetic field has, however, a non-dipole component creating additionally a cross-longitudinal gradient. In this case, the protons (entering the denser atmosphere from the west) are shifted sought-westward in regions with a positive cross-longitudinal gradient and sought-eastward – in regions with a negative gradient (refer to Eq. (1)). Consequently, the overall westward drift (forced by the magnetic curvature and cross-latitudinal gradient) is reduced by the eastward component – exerted in regions with a negative azimuthal magnetic gradient. Furthermore, the electric field (induced by the charge separation of impending particles) is significantly reduced in these regions. Finally, the number of particles expelled outside the magnetic trap (due to the (E × B)/B2 electric drift) is much less. More precisely, only a few of them have a “chance” to be lost in the atmosphere in said regions.
Oppositely, in regions with positive azimuthal geomagnetic gradients, the southward drift component changes slightly in the direction, but not the amplitude of the westward drift, impelled by the magnetic curvature and latitudinal gradient. Consequently, in these regions, the induced electric field – resulted from the charge separation of arriving particles – is much stronger. It will intensively expel the charged particles outside the magnetic trap through the imposed (E × B)/B2 drift. Furthermore, these particles interact with the atmospheric molecules creating secondary electrons, ions, and nuclear products, giving rise to the ionization of the lower atmosphere.
The confinement of any particle in the gradient magnetic field B depends on the ratio between the maximum field strength Bmax in the polar regions (where the backward reflection of trapped particles occurs) and the equatorial magnetic field strength B0, i.e.
where the angle
Orientation of the particle’s velocity vector, with respect to the equatorial magnetic field B0, and changing particles pitch angle α (from α0 at the equator, to 90 degrees at magnetic mirror point).
Any particle is assumed trapped by the magnetic field, when the angle
The geomagnetic field near the poles is stronger in the Southern Hemisphere, compared to those in the Northern Hemisphere. Consequently, in the case of isotropic particles’ flux arriving at magnetopause – almost every third particle will be confined in the Southern Hemisphere, while in the Northern Hemisphere less than ¼ of all arriving particles are trapped, because of its larger loss cone [51]. This means that some of particles confined in the Southern Hemisphere could not be held by the weaker geomagnetic field in the Northern Hemisphere. The expected result is – more particles precipitating in the Northern Hemisphere.
Energetic particles penetrating deeper in the atmosphere create showers of secondary particles, produced from their interaction with atmospheric molecules – the deeper the penetration is, the wider the showers are. In the lower stratosphere, the number of secondary products dramatically increases, becoming maximal at a certain level. This level is known as a Regener-Pfotzer maximum. Beneath it, the concentration of secondary ions and electrons decreases again.
The longitudinal geomagnetic gradient and hemispherical asymmetry of geomagnetic field determine the uneven distribution of geomagnetically trapped particles’ precipitation over the globe (refer to Subsections 3.2 and 3.3). Existence of such an effect is illustrated in [52].
For almost a century –since the creation of the theory about ozone production in the upper atmosphere by Sydney Chapman [53] – the single source of stratospheric ozone is believed to be the photo-dissociation of molecular oxygen by solar ultraviolet radiation. Recently it has been shown that in the dry lowermost stratosphere the lower-energy electrons in the Regener-Pfotzer maximum initiate ion-molecular reactions producing ozone [54].
The mean energy of electrons in the Regener-Pfotzer max (∼35 eV [55]) is not sufficient to break the molecular bounds of the major atmospheric constituents. It is, however enough to ionize the molecular oxygen (Reaction (5)). The oxygen cation interacts furthermore with neutral oxygen molecule, producing a tetra-oxygen ion
Being very unstable, this oxygen complex rapidly dissociates into two different channels [57]. The first channel (7) produces
As a result, the dissociation of one
At middle and high latitudes, the Regener-Pfotzer maximum is placed well above the tropopause [60], which provides the necessary conditions for activation of the autocatalytic cycle of ozone production – i.e. a dry atmosphere and plenty of low energy electrons. As discussed in Sections 3.2 and 3.3, and shown in [52], the ionization in the Regener-Pfotzer maximum is unevenly distributed over the globe. Remind that an increased particles’ flux is expected in regions of geomagnetic field strengthening. Consequently, if the autocatalytic production of ozone is significant, the longitudinal variations of the Regener-Pfotzer maximum ionization should be projected on the ozone profile.
Figure 5 presents a comparison between ozone profiles in regions with increasing and decreasing geomagnetic field, during solar minimum in 2009. Note that the O3 values beneath the peak ozone density are higher in regions with increasing geomagnetic field (i.e. the longitudinal sector 90–50°W in the Western Hemisphere and 120–140°E – in the Eastern one), relative to corresponding O3 values in regions with a geomagnetic field weakening in the sectors: 140–110°W and 30–50°E.
Difference between ozone profiles in regions with positive (red curves) and negative (black curves) cross-longitudinal magnetic gradients; (a) for the Eastern hemisphere, and (b) for the Western one.
The longitudinal variations in atmospheric ozone have been noticed long ago [61, 62]. The authors have suggested that this variability could be related to the planetary wave structure. However, the maximal amplitude of the stationary planetary waves is found at ∼300 hPa [61], while the highest amplitude of O3 longitudinal variations in ERA Interim reanalysis is placed near 150–70 hPa [51]. These and some other problems, e.g. [63, 64] suggest that other factor(s) (e.g. energetic particles) may have an important influence on the spatial and interannual variability of the extra-tropical near tropopause O3.
In order to assess quantitatively the coupling between energetic particles precipitating in Earth’s atmosphere and lower stratospheric ozone, as well as its spatial distribution, we have performed a cross-correlation analysis in a grid with 10° increments in latitude and longitude. Ground-based measurement of galactic cosmic rays (GCR) by neutron monitors, has been used as an indication of energetic particles flux. The Moscow record of GCR has been expanded backward in time by the paleore constructed GCR intensity [65]. The 11-year periodicity of GCR has been removed by moving averaging procedure with 22-year running window. The winter values of ozone at 70 hPa have been taken from ERA twentieth century reanalysis, covering the period 1900–2010. Data have been preliminarily smoothed by 11-year running window.
The map of ozone-GCR correlation is presented in Figure 6 (colored shading). It is important to note that the map has been created from correlation coefficients, being preliminary weighted by the autocorrelation function of GCR with time lag corresponding to the delay of O3 response to the GCR forcing. This procedure, which reduces correlation coefficients with longer time lags, allows a comparison of correlations with different time lags. The introduction of weighs for the lagged correlation coefficients is justified by the assumption that the effect of the applied forcing in a given moment of time decreases with moving away from this moment [66].
Lag-corrected correlation map of GCR and O3 at 70 hPa (shading), compared with modeled effective vertical cut-of rigidity of geomagnetic field (courtesy to Boschini MJ, Della Torre S, Gervasi M., Grandi D, Rancoita PG: Http://
Figure 6 shows that the ozone responds differently to particles’ impact at different regions over the world – not only by amplitude but even by sign. Thus, at high latitudes and in the Indo-Pacific region, ozone varies synchronously with GCR. On the other hand, at the Northern Hemisphere extratropics and near the southernmost edge of Latin America, both variables covariate in antiphase – meaning that in these regions ozone increases with time.
Such heterogeneity in ozone response to particles’ forcing could be attributed to the different origins of impacting particles. For example, the polar regions are vulnerable to the particles from interplanetary space, propagating along the open geomagnetic field lines. The long-term variations of these particles are modulated mainly by the interplanetary magnetic field in the heliosphere. The latitudes shielded by the closed geomagnetic field lines (i.e. the tropics and mid-latitudes) are accessible to very highly energetic particles (which are very few), and to the radiation trapped in the Van Allen radiation belts. The latter are subject to geomagnetic lensing (in the lowest part of their helical trajectories along the magnetic field lines) and asymmetrical precipitation in both hemispheres, due to the asymmetry of geomagnetic field (refer to Sections 3.2 and 3.3).
Figure 6 shows in addition the effective vertical cut-off rigidity of geomagnetic field (contours), with the values greater than 12 GV being colored in red. Note that the strongest GCR-O3 correlation over the equatorial Indo-Pacific region fairly well coincides with the higher geomagnetic cut-off rigidity. Having in mind the centennial negative trend in GCR, the positive correlation coefficients indicate ozone depletion during the examined period (1900–2010). Consequently, the reduced ozone density could be attributed to the weaker particles’ fluxes accessing the said region.
On the other side, the negative GCR-ozone correlation in extratropics suggests enhancement of ozone density near 70 hPa. This result indicates that particles confined in the outer radiation belt are involved in ozone production in the lower stratosphere. Powered by the solar wind, the population of this radiation belt is highly variable [45], reflecting the changes in solar activity. The examined period is characterized by enhanced solar activity, which appears to be projected on the extratropical latitudes as enhanced ozone density at 70 hPa – due to the enhanced particles’ population in the outer radiation belt.
The positive GCR-O3 correlation at polar latitudes suggests a centennial ozone depletion, which corresponds to the decreased flux of GCR, modulated itself by the stronger interplanetary magnetic field in the heliosphere during the twentieth century [51].
The centennial changes in ozone mixing ratio at 70 hPa, between the first decades of twenty-first and twentieth centuries, is presented in Figure 7. Note that ozone changes deduced from the correlation map in Figure 6 fairly well corresponds to the observed changes of ozone at 70 hPa.
Spatial distribution of centennial ozone changes between the first decades of twenty-first and twentieth centuries.
The sensitivity of atmospheric temperature profiles and climate to the ozone density (particularly near the tropopause) has been noticed long ago [67, 68, 69, 70, 71], etc. The detected synchronization between the spatial and temporal variability of particles’ flux reaching the ground, and the lower stratospheric ozone, is a hint that ozone could serve as a mediator of the geomagnetic field-energetic particles’ influence on climatic variables (i.e. temperature, pressure, etc.) [72]. The following section throws some more light on this problem.
The potential synchronization between ozone at 70 hPa and near-surface temperature variability, within the period 1900–2010, is examined by the use of lagged cross-correlation analysis. The leading role of winter ozone in the ozone-temperature correlation, have been analyzed in a spatial grid with 10° steps in latitude and longitude. The time series of both variables are taken from the monthly values provided by the ERA twentieth century reanalysis. The correlation map presented in Figure 8 is created from the preliminary weighted correlation coefficients by the autocorrelation function of ozone, with lag corresponding to the time delay of temperature response – to account for the reduced weigh of covariances being away from the moment of applied forcing.
(top) correlation map of winter ozone at 70 hPa and air surface temperature, calculated over the period 1900–2010; (bottom) time lag in years of temperature response following ozone changes.
The most impressive of the results shown in Figure 8 is the asymmetry of the temperature response to ozone variations. The positive O3 –T2m correlation coefficients – over Eurasia and the extratropical Pacific Ocean, unlike the overall negative correlation, require their explanation. In addition, the analysis of the long-term variations of ozone and temperature at 60°N latitude, and at longitudinal zones, 140 and 70°W (corresponding to the regions with positive and negative GCR-ozone correlation) are presented in Figure 9. It is important to note that the short-term variations are preliminarily filtered by data smoothing through 11-year running average procedure.
(left) Time series of winter ozone at 70 hPa and 60°N latitude, obtained at Eastern (140°E longitude) and Western (70°W) longitude; (right) air surface temperature at the same latitude and longitudes.
Figure 9 clarifies that the lower temperature trend of Eastern Asia corresponds to the higher ozone density at 70 hPa. Oppositely, the stronger warming in south-eastern Canada corresponds to a lower ozone density at 70 hPa, with a negative centennial trend. Examination of the global picture of twentieth century warming (presented in Figure 10) reveals that the “hot spots” of contemporary global warming (i.e. north-eastern Canada and Greenland, and the Southern Ocean – southward of Africa) correspond to the regions of negatively correlated ozone and temperature (refer to Figure 8). In opposite, the regions with in-phase co-varying ozone and temperature are characterized by weaker warming.
Centennial changes of the air surface temperature between the first decades of twenty-first and twentieth centuries, derived from the ERA twentieth century reanalysis.
Conclusively, the above results indicate that the strongest warming during the twentieth century is observed in regions with reduced density of the lower stratospheric ozone.
Climate variability is not homogeneous in space and is usually described as a combination of some “preferred” spatial regimes, called
Although the spatial-temporal variations of climatic modes are extensively studied, the reasons for their occurrence and variability over time are not fully understood. Internal variations of the climate system are usually associated with the processes of energy exchange and redistribution between the planetary atmosphere and ocean. The huge heat capacity of the ocean is the reason for its inertia in response to short-time fluctuations of atmospheric variables, which transforms them into long-period variations of the ocean surface temperature. This understanding does explain the phase alteration, but it is not able to explain neither the various manifestations of climatic modes [75] nor their long-term changes.
Analysis of the spatial-temporal variability of GCR and ozone at 70 hPa reveals the important role of the latter in the formation of regional specificity of air surface temperature variability (refer to Subsection 4.1.1, or to [76]). Examination of the temporal synchronization between two of the most important
Figure 11 illustrates the projection of the long-term variations of ozone at 70 hPa on the NAO index (which describes the variability of the surface pressure between Azores and Iceland). The coupling between both variables has been estimated by the use of the lagged cross-correlation analysis between annual values of NAO index (smoothed by 5 points averaging) and winter ozone values at 70 hPa (smoothed by 11 points moving window). The stronger smoothing of ozone is due to its higher temporal variability. The leading factor (i.e. the “forcing”) in calculated ozone-NAO variability is ozone. As in the previous case, the correlation coefficients have been preliminarily weighted (according to different delay of NAO response) with the ozone’s autocorrelation function. The physical reasoning behind this weighting is that the memory of the climate system for the applied impact weakens with time. This suggests that the high correlation coefficients with a large delay are more or less random.
(top) Cross-correlation maps of the winter lower stratospheric ozone and NAO index, calculated for the period 1900–2010; (bottom) time lag of NAO response in years.
Figure 11 shows that the ozone’s impact on the NAO climatic pattern fairly well coincides with both centers of action (Azores and Iceland) determining the phase of NAO mode. Unlike the previous results (stressing the leading role of the northern [78] or the southern part of NAO spatial structure [79]), Figure 11 indicates that the variations of lower stratospheric ozone density can impact each center of action (Azores or Icelandic), or simultaneously both of them – altering in such a way the phase of NAO mode [76].
Analysis of the time delay of NAO response to ozone changes shows that surface temperature near the Icelandic Low respond with a delay of 1–2 years. In the subtropical center of action, however, the atmospheric response is delayed approximately by a decade (see the bottom panel in Figure 11).
Direct ozone influence on the surface temperature is quite small due to the mutually exclusive effect of stratospheric and tropospheric ozone in the planetary radiation balance [70]. Ozone’s ability to absorb the incoming solar radiation (and to a lesser extent the longwave radiation emitted from the Earth), makes it a radiatively active gaz. The covariance between the near tropopause ozone and temperature has been noticed long ago [80, 81]. However, the tropopause temperature determines the moist adiabatic lapse rate and accordingly the static stability of the upper troposphere [82, 83], which in turn alters the humidity near the tropopause [51]. For example, ozone depletion cools the near tropopause region making the upper troposphere more unstable [82, 83]. The upward propagation of the more humid air masses from the lower atmospheric levels moistens the upper troposphere, and strengthens the greenhouse warming of the planet. The satellite measurements show that water vapor at these levels ensures 90% of the greenhouse warming of the total atmospheric humidity [84]. Consequently, ozone variability in the lower stratosphere is projected on the planetary surface through the modulation of the strength of greenhouse warming.
Figure 12, which compares the lag-corrected correlation maps of ozone mixing ratio at 70 hPa with: (i) GCR, and (ii) humidity at 150 hPa, is a good illustration of our hypothesis validity. Note that the latitudinal band of antiphase correlation between GCRs and ozone (dark shading), and in phase correlation between ozone and water vapor (red contours), coincide impressively well. In the Northern Hemisphere, this coincidence persists round the year, although being slightly reduced in summer season (compare panels (a) and (b) in Figure 12). In the winter Southern Hemisphere, the area of synchronous variations of GCR, ozone, and humidity is narrower and practically disappears in summer (Figure 12d). The results presented in Figure 12 are a good indication that ozone–humidity variations, which are projected down to Earth’s surface by the strengthening or weakening of the greenhouse effect, are actually related to GCR variability.
Comparison of correlation maps of ozone at 70 hPa with GCRs (dark shading) and water vapor at 150 hPa (contours), for winter (a) and (c), and summer (b) and (d) panels.
Historical and contemporary changes in climate system put a lot of questions, the answers to which are difficult. This motivates scientists from different branches to look for various factors with a potential influence on the climate system. Geomagnetic field is one of the proposed factors, due to the rendered multiple evidence for spatially or temporary co-varying geomagnetic field and climate, at different time scales. In this chapter, we clarify that hypothesized geomagnetic influence on climate could be reasonably explained through the mediation of energetic particles, propagating in Earth’s atmosphere, and their influence on the ozone density in the lower stratosphere.
More specifically, the non-dipolar part of geomagnetic field creates irregularities in the spatial distribution of lower atmospheric ionization in the Regener-Pfotzer maximum [51]. The bulk of low-energy electrons and dry lower stratosphere favors activation of autocatalytic ozone production at these altitudes. Thus geomagnetic irregularities are projected on the ozone density near the tropopause. Being a radiatively active gas, the ozone itself affects the temperature and humidity in the tropopause region, altering in such a way the greenhouse effect and consequently – the near-surface temperature.
This chapter provides evidence for the validity of this chain of sequences, which gives an adequate explanation of hemispherical and longitudinal asymmetry of the lower stratospheric ozone distribution, regionality of climate change, formation of regional climate patterns, known as climatic modes, etc.
The authors are grateful to the project teams of ERA 20C and ERA Interim reanalyses, providing gridded data for ozone temperature and pressure, as well as to the Climatic research unit of University of East Anglia – for the data of NAO index. We are thankful to the National Centre for Environmental Information (NOAA) for providing IGRF model.
This research was funded by National Science Fund of Bulgaria, Contracts KP-06-N34/1/30-09-2020, and DN 14/1 from 11.12.2017.
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\n'}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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Activity",isOpenForSubmission:!1,hash:"0f6de90c02282919494d6254e473defe",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",bookSignature:"Meral Huri",coverURL:"https://cdn.intechopen.com/books/images_new/6772.jpg",editedByType:"Edited by",editors:[{id:"171525",title:"Dr.",name:"Meral",middleName:null,surname:"Huri",slug:"meral-huri",fullName:"Meral Huri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5711",title:"Occupational Therapy",subtitle:"Occupation Focused Holistic Practice in Rehabilitation",isOpenForSubmission:!1,hash:"38180e287b6cb09b8002b7ab485de2c2",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",bookSignature:"Meral Huri",coverURL:"https://cdn.intechopen.com/books/images_new/5711.jpg",editedByType:"Edited by",editors:[{id:"171525",title:"Dr.",name:"Meral",middleName:null,surname:"Huri",slug:"meral-huri",fullName:"Meral Huri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:2,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"55163",doi:"10.5772/intechopen.68799",title:"Virtual Reality and Occupational Therapy",slug:"virtual-reality-and-occupational-therapy",totalDownloads:2642,totalCrossrefCites:4,totalDimensionsCites:6,abstract:"Virtual reality is three dimensional, interactive and fun way in rehabilitation. Its first known use in rehabilitation published by Max North named as “Virtual Environments and Psychological Disorders” (1994). Virtual reality uses special programmed computers, visual devices and artificial environments for the clients’ rehabilitation. Throughout technological improvements, virtual reality devices changed from therapeutic gloves to augmented reality environments. Virtual reality was being used in different rehabilitation professions such as occupational therapy, physical therapy, psychology and so on. In spite of common virtual reality approach of different professions, each profession aims different outcomes in rehabilitation. Virtual reality in occupational therapy generally focuses on hand and upper extremity functioning, cognitive rehabilitation, mental disorders, etc. Positive effects of virtual reality were mentioned in different studies, which are higher motivation than non‐simulated environments, active participation of the participants, supporting motor learning, fun environment and risk‐free environment. Additionally, virtual reality was told to be used as assessment. This chapter will focus on usage of virtual reality in occupational therapy, history and recent developments, types of virtual reality technologic equipment, pros and cons, usage for pediatric, adult and geriatric people and recent research and articles.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Orkun Tahir Aran, Sedef Şahin, Berkan Torpil, Tarık Demirok and\nHülya Kayıhan",authors:[{id:"172938",title:"Prof.",name:"Hulya",middleName:null,surname:"Kayihan",slug:"hulya-kayihan",fullName:"Hulya Kayihan"},{id:"183079",title:"Ph.D.",name:"Sedef",middleName:null,surname:"Şahin",slug:"sedef-sahin",fullName:"Sedef Şahin"},{id:"196848",title:"M.Sc.",name:"Orkun Tahir",middleName:null,surname:"Aran",slug:"orkun-tahir-aran",fullName:"Orkun Tahir Aran"},{id:"197159",title:"Mr.",name:"Tarık",middleName:null,surname:"Demirok",slug:"tarik-demirok",fullName:"Tarık Demirok"},{id:"197312",title:"M.Sc.",name:"Berkan",middleName:null,surname:"Torpil",slug:"berkan-torpil",fullName:"Berkan Torpil"}]},{id:"61806",doi:"10.5772/intechopen.78312",title:"Executive Functions and Neurology in Children and Adolescents",slug:"executive-functions-and-neurology-in-children-and-adolescents",totalDownloads:1756,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"This chapter discusses the theoretical and methodological issues of creating a developmental perspective on executive function (EF) in childhood and adolescence. Focusing on school periods, this section outlines the development of the basic components of EF—inhibition, working memory, and attention. Cognitive and neurophysiological evaluations show that despite the emergence of EF in the first few years of life, it continues to grow significantly in childhood and adolescence. The components vary slightly according to their developmental sequence. The chapter links findings to long-standing developmental issues (i.e. developmental sequences and processes) and suggests the necessary research to establish a developmental framework covering early childhood throughout adolescence.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Gokcen Akyurek",authors:[{id:"197265",title:"Dr.",name:"Gokcen",middleName:null,surname:"Akyurek",slug:"gokcen-akyurek",fullName:"Gokcen Akyurek"}]},{id:"56049",doi:"10.5772/intechopen.69101",title:"Measurement of Participation: The Role Checklist Version 3: Satisfaction and Performance",slug:"measurement-of-participation-the-role-checklist-version-3-satisfaction-and-performance",totalDownloads:2820,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Participation in society is an area of interest to both clinicians and population researchers. Measurement of participation is therefore important, yet differences in definition, in terms of both content and scope, have made general agreement on one instrument tool elusive. What is recognized is the need for a theoretically based tool that captures both the insider and the outsider perspective. The outsider perspective, inclusive of the generally held views of a society, supports the utility for aggregating population data, whereas the insider perspective provides the internally held views of an individual needed for client-centered treatment planning. The Role Checklist Version 3 modifies one of the most commonly used assessment tools in occupational therapy practice, has good preliminary psychometric properties, and is theoretically consistent with both the ICF and the Model of Human Occupation. The Model of Human Occupation is the most widely used theoretical model in occupational therapy. This chapter provides an overview of the theoretical development, empirical testing, and implications for use of this participation measure by occupational therapists along with implications for population researchers.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Patricia J. Scott, Kelsey McKinney, Jeff Perron, Emily Ruff and Jessica\nSmiley",authors:[{id:"195495",title:"Dr.",name:"Patricia J",middleName:null,surname:"Scott",slug:"patricia-j-scott",fullName:"Patricia J Scott"},{id:"208801",title:"Dr.",name:"Kelsey G.",middleName:null,surname:"McKinney",slug:"kelsey-g.-mckinney",fullName:"Kelsey G. McKinney"},{id:"208802",title:"Mr.",name:"Jeffrey M.",middleName:null,surname:"Perron",slug:"jeffrey-m.-perron",fullName:"Jeffrey M. Perron"},{id:"208803",title:"Dr.",name:"Emily G.",middleName:null,surname:"Ruff",slug:"emily-g.-ruff",fullName:"Emily G. Ruff"},{id:"208804",title:"Dr.",name:"Jessica L.",middleName:null,surname:"Smiley",slug:"jessica-l.-smiley",fullName:"Jessica L. Smiley"}]},{id:"55024",doi:"10.5772/intechopen.68463",title:"Occupational Therapy in Oncology and Palliative Care",slug:"occupational-therapy-in-oncology-and-palliative-care",totalDownloads:2694,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Cancer is a chronic disease that may occur in both children and adults. Occupational therapy focuses on the activity limitations and participation problems in their life. Oncology rehabilitation involves in helping an individual with cancer to regain maximum physical, psychological, cognitive, social, and vocational functioning with the limits up to disease and its treatments in an interdisciplinary team concept. These treatment options are associated with the risk of some side effects, including fatigue, pain, cognitive problems, decrease in bone density and muscle endurance, weight loss, and stress- or anxiety-related psychosocial problems. Occupational therapy approaches are a holistic view in a client center and use training in activities of daily living, assistive technology, education of energy conservation techniques, and management of treatment-related problems, such as pain, fatigue, and nausea. In palliative and hospice care, occupational therapists support clients with cancer by minimizing the secondary symptoms related to cancer and its treatments. At the end of life, occupational therapy offers to identify the roles and activities that are meaningful and purposeful to the client with cancer and try to determine the barriers that limit their performance. Clients with cancer who have childhood cancer or adult cancer can face problems about body structure and functions, activity, and participation, which may limit their participation to their daily life.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Sedef Şahin, Semin Akel and Meral Zarif",authors:[{id:"183079",title:"Ph.D.",name:"Sedef",middleName:null,surname:"Şahin",slug:"sedef-sahin",fullName:"Sedef Şahin"},{id:"183078",title:"Dr.",name:"Burcu Semin",middleName:null,surname:"Akel",slug:"burcu-semin-akel",fullName:"Burcu Semin Akel"},{id:"198859",title:"Dr.",name:"Meral",middleName:null,surname:"Zarif",slug:"meral-zarif",fullName:"Meral Zarif"}]},{id:"55018",doi:"10.5772/intechopen.68315",title:"Psychomotor Therapy for Patients with Severe Mental Health Disorders",slug:"psychomotor-therapy-for-patients-with-severe-mental-health-disorders",totalDownloads:2267,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"Psychomotor therapy is defined as a method of treatment based on a holistic view of the human being that is derived from the unity of body and mind. Assessments (observation and/or evaluation) are essential to achieving concrete psychosocial objectives methodically. Psychomotor therapy uses movement, body awareness and a wide range of movement activities to optimize movement behaviour as well as the cognitive, affective and relational aspects of psychomotor functioning (i.e. the relationships between physical movements and cognitive and social-affective aspects). Consequently, the approach to this type of therapy integrates the physical, cognitive and emotional aspects of functioning in relation to the capacity of being and acting in a psychosocial context in order to achieve clearly defined goals in consultation with the patients. Psychomotor therapy framework consists of three different approaches: a health-related approach, a psychosocial approach and a psychotherapeutic approach, which can be embedded in several psychotherapeutic approaches. Through the implementation of both systematically planned evaluations and individually targeted interventions in group, the psychomotor therapist strives to broaden the general action competences and specific skills and to stimulate a positive self-image and personal well-being in balanced social relationships. Today, there is sufficient evidence that psychomotor therapy has a major contribution to both well-being and mental health of patients with severe psychiatric problems. In Flemish psychiatric hospitals, psychomotor therapy is imbedded in different treatment programmes. In this chapter, the theory behind this approach and some practical examples will be provided.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Michel Probst",authors:[{id:"196227",title:"Prof.",name:"Michel",middleName:null,surname:"Probst",slug:"michel-probst",fullName:"Michel Probst"}]}],mostDownloadedChaptersLast30Days:[{id:"55080",title:"Life Skills in Occupational Therapy",slug:"life-skills-in-occupational-therapy",totalDownloads:6076,totalCrossrefCites:4,totalDimensionsCites:1,abstract:"Occupational therapy is a health profession that uses the purposeful activities to achieve multiple and complex rehabilitation aims. The main goals of the occupational therapy are to support the reintegration of individuals in daily living skills as well as to increase their independence and autonomy. Interventions of occupational therapists have primarily focused on self-care, productivity, and leisure time activities. Since the life skills includes a wide range of abilities that enable a person to perform personal care and more complicated tasks such as traveling, shopping, community participation etc., occupational therapists provide life skills training programs to meet the needs of the clients. This chapter aims to contribute to the current understanding and practices of life skills from an occupational therapy perspective. The chapter starts with a brief discussion of the importance of life skills in occupational therapy. After this introduction, the first part takes a look at the definition of life skills and identifies core components of life skills. The second part describes assessment and interventions of life skills. The third one gives an overview about school life skills programs for children and adolescents. Finally, the last part explains some life skills programs in people with disadvantages.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Hatice Abaoğlu, Özge Buket Cesim, Sinem Kars and Zeynep Çelik",authors:[{id:"197551",title:"Dr.",name:"Hatice",middleName:null,surname:"Abaoğlu",slug:"hatice-abaoglu",fullName:"Hatice Abaoğlu"},{id:"205199",title:"Dr.",name:"Sinem",middleName:null,surname:"Kars",slug:"sinem-kars",fullName:"Sinem Kars"},{id:"205200",title:"Dr.",name:"Zeynep",middleName:null,surname:"Celik",slug:"zeynep-celik",fullName:"Zeynep Celik"},{id:"205203",title:"Ms.",name:"Özge Buket",middleName:null,surname:"Cesim",slug:"ozge-buket-cesim",fullName:"Özge Buket Cesim"}]},{id:"62493",title:"Occupational Therapy in Forensic Settings",slug:"occupational-therapy-in-forensic-settings",totalDownloads:2544,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"It is necessary for a person to comply with the expectations of society and the rules of law to which these expectations are secured. Offenders turn back to the community after the penalty was executed by isolating from society and some occupations. An occupational imbalance is seen in the individuals, during this penalty period and afterward, because of limited occupational participation. As an occupational being, this affects their physical, mental and psychological well-being. Imprisonment is an important practice in criminal law to punish criminals. This may be necessary for the protection of society from criminals, but successful integration into a community after exiting the prison is the most important factor in preventing recidivism. Occupational therapy focuses on health and well-being by using meaningful and purposeful occupations. Occupation involves any activity that people perform or participate in, such as giving care to themselves or others, working, learning, playing games, and interacting with others. From this perspective, the role of occupational therapists in forensic settings is to determine the abilities of these individuals to congregate their deprived freedoms and use them to train them for an independent and autonomous life; to provide a professional orientation, career counseling, and self-esteem; to gain some habits for physical, spiritual and moral life and to reinforce.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Esma Ozkan, Sümeyye Belhan, Mahmut Yaran and Meral Zarif",authors:null},{id:"62210",title:"Occupational Therapy’s Role in the Treatment of Children with Autism Spectrum Disorders",slug:"occupational-therapy-s-role-in-the-treatment-of-children-with-autism-spectrum-disorders",totalDownloads:2757,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Occupational therapists (OT) offer a wide range of therapies for individuals with ASD on the basis of specific deficits and difficulties. This chapter explores the role that OT plays, and the expertise, in relation to the interdisciplinary team. In addition, it discusses and presents empirical support for several therapeutic approaches commonly used by OTs working with individuals with ASD.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Bryan M. Gee, Amy Nwora and Theodore W. Peterson",authors:null},{id:"55049",title:"Community Participation in People with Disabilities",slug:"community-participation-in-people-with-disabilities",totalDownloads:2436,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Despite the fact that participation is an important building and a valuable target, the conceptualization, identification and measurement methods vary widely. This chapter tried to gain an insider’s perspective from the obstacles that summarize what meaning participation means, how to characterize it, and what prevents and supports participation. Participation is seen as a right and a responsibility attributed to and attributed to both the person and the community. Participation does not take place in a vacuum; the environment dynamically influences participation. The effects of this conceptual framework are discussed for change at the level of evaluation, research and systems to support the participation of the people with disability.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Gokcen Akyurek and Gonca Bumin",authors:[{id:"32431",title:"Prof.",name:"Gonca",middleName:null,surname:"Bumin",slug:"gonca-bumin",fullName:"Gonca Bumin"},{id:"197265",title:"Dr.",name:"Gokcen",middleName:null,surname:"Akyurek",slug:"gokcen-akyurek",fullName:"Gokcen Akyurek"}]},{id:"56049",title:"Measurement of Participation: The Role Checklist Version 3: Satisfaction and Performance",slug:"measurement-of-participation-the-role-checklist-version-3-satisfaction-and-performance",totalDownloads:2822,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Participation in society is an area of interest to both clinicians and population researchers. Measurement of participation is therefore important, yet differences in definition, in terms of both content and scope, have made general agreement on one instrument tool elusive. What is recognized is the need for a theoretically based tool that captures both the insider and the outsider perspective. The outsider perspective, inclusive of the generally held views of a society, supports the utility for aggregating population data, whereas the insider perspective provides the internally held views of an individual needed for client-centered treatment planning. The Role Checklist Version 3 modifies one of the most commonly used assessment tools in occupational therapy practice, has good preliminary psychometric properties, and is theoretically consistent with both the ICF and the Model of Human Occupation. The Model of Human Occupation is the most widely used theoretical model in occupational therapy. 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(2002), and Ph.D. (2008) degrees in Veterinary Medicine, Animal Pathology and Veterinary Microbiology from College of Veterinary Medicine, Addis Ababa University, Ethiopia; College of Veterinary Medicine, Utrecht University, the Netherlands and Western College of Veterinary Medicine, University of Saskatchewan, Canada respectively. He did his Postdoctoral training in microbial pathogenesis (2009 - 2015) in the Department of Animal Science, the University of Tennessee, Institute of Agriculture, Knoxville, Tennessee. Dr. Kerro Dego’s research focuses on the prevention and control of infectious diseases of farm animals, particularly mastitis, improving dairy food safety, and mitigation of antimicrobial resistance. Dr. Kerro Dego has extensive experience in studying the pathogenesis of bacterial infections, identification of virulence factors, and vaccine development and efficacy testing against major bacterial mastitis pathogens. Dr. Kerro Dego conducted numerous controlled experimental and field vaccine efficacy studies, vaccination, and evaluation of immunological responses in several species of animals, including rodents (mice) and large animals (bovine and ovine).",institutionString:"University of Tennessee at Knoxville",institution:{name:"University of Tennessee at Knoxville",country:{name:"United States of America"}}},{id:"251314",title:"Dr.",name:"Juan Carlos",middleName:null,surname:"Gardón Poggi",slug:"juan-carlos-gardon-poggi",fullName:"Juan Carlos Gardón Poggi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/251314/images/system/251314.jpeg",biography:"Juan Carlos Gardón Poggi received University degree from the Faculty of Agrarian Science in Argentina, in 1983. Also he received Masters Degree and PhD from Córdoba University, Spain. He is currently a Professor at the Catholic University of Valencia San Vicente Mártir, at the Department of Medicine and Animal Surgery. He teaches diverse courses in the field of Animal Reproduction and he is the Director of the Veterinary Farm. He also participates in academic postgraduate activities at the Veterinary Faculty of Murcia University, Spain. His research areas include animal physiology, physiology and biotechnology of reproduction either in males or females, the study of gametes under in vitro conditions and the use of ultrasound as a complement to physiological studies and development of applied biotechnologies. Routinely, he supervises students preparing their doctoral, master thesis or final degree projects.",institutionString:null,institution:{name:"Valencia Catholic University Saint Vincent Martyr",country:{name:"Spain"}}},{id:"309529",title:"Dr.",name:"Albert",middleName:null,surname:"Rizvanov",slug:"albert-rizvanov",fullName:"Albert Rizvanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/309529/images/9189_n.jpg",biography:'Albert A. Rizvanov is a Professor and Director of the Center for Precision and Regenerative Medicine at the Institute of Fundamental Medicine and Biology, Kazan Federal University (KFU), Russia. He is the Head of the Center of Excellence “Regenerative Medicine” and Vice-Director of Strategic Academic Unit \\"Translational 7P Medicine\\". Albert completed his Ph.D. at the University of Nevada, Reno, USA and Dr.Sci. at KFU. He is a corresponding member of the Tatarstan Academy of Sciences, Russian Federation. Albert is an author of more than 300 peer-reviewed journal articles and 22 patents. He has supervised 11 Ph.D. and 2 Dr.Sci. dissertations. Albert is the Head of the Dissertation Committee on Biochemistry, Microbiology, and Genetics at KFU.\nORCID https://orcid.org/0000-0002-9427-5739\nWebsite https://kpfu.ru/Albert.Rizvanov?p_lang=2',institutionString:"Kazan Federal University",institution:{name:"Kazan Federal University",country:{name:"Russia"}}},{id:"210551",title:"Dr.",name:"Arbab",middleName:null,surname:"Sikandar",slug:"arbab-sikandar",fullName:"Arbab Sikandar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210551/images/system/210551.jpg",biography:"Dr. Arbab Sikandar, PhD, M. Phil, DVM was born on April 05, 1981. He is currently working at the College of Veterinary & Animal Sciences as an Assistant Professor. He previously worked as a lecturer at the same University. \nHe is a Member/Secretory of Ethics committee (No. CVAS-9377 dated 18-04-18), Member of the QEC committee CVAS, Jhang (Regr/Gen/69/873, dated 26-10-2017), Member, Board of studies of Department of Basic Sciences (No. CVAS. 2851 Dated. 12-04-13, and No. CVAS, 9024 dated 20/11/17), Member of Academic Committee, CVAS, Jhang (No. CVAS/2004, Dated, 25-08-12), Member of the technical committee (No. CVAS/ 4085, dated 20,03, 2010 till 2016).\n\nDr. Arbab Sikandar contributed in five days hands-on-training on Histopathology at the Department of Pathology, UVAS from 12-16 June 2017. He received a Certificate of appreciation for contributions for Popularization of Science and Technology in the Society on 17-11-15. He was the resource person in the lecture series- ‘scientific writing’ at the Department of Anatomy and Histology, UVAS, Lahore on 29th October 2015. He won a full fellowship as a principal candidate for the year 2015 in the field of Agriculture, EICA, Egypt with ref. to the Notification No. 12(11) ACS/Egypt/2014 from 10 July 2015 to 25th September 2015.; he received a grant of Rs. 55000/- as research incentives from Director, Advanced Studies and Research, UVAS, Lahore upon publications of research papers in IF Journals (DR/215, dated 19-5-2014.. He obtained his PhD by winning a HEC Pakistan indigenous Scholarship, ‘Ph.D. fellowship for 5000 scholars – Phase II’ (2av1-147), 17-6/HEC/HRD/IS-II/12, November 15, 2012. \n\nDr. Sikandar is a member of numerous societies: Registered Veterinary Medical Practitioner (life member) and Registered Veterinary Medical Faculty of Pakistan Veterinary Medical Council. The Registration code of PVMC is RVMP/4298 and RVMF/ 0102.; Life member of the University of Veterinary and Animal Sciences, Lahore, Alumni Association with S# 664, dated: 6-4-12. ; Member 'Vets Care Organization Pakistan” with Reference No. VCO-605-149, dated 05-04-06. :Member 'Vet Crescent” (Society of Animal Health and Production), UVAS, Lahore.",institutionString:"University of Veterinary & Animal Science",institution:{name:"University of Veterinary and Animal Sciences",country:{name:"Pakistan"}}},{id:"311663",title:"Dr.",name:"Prasanna",middleName:null,surname:"Pal",slug:"prasanna-pal",fullName:"Prasanna Pal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311663/images/13261_n.jpg",biography:null,institutionString:null,institution:{name:"National Dairy Research Institute",country:{name:"India"}}},{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. Dr. Rutland has also written popular science books for the public. https://orcid.org/0000-0002-2009-4898. www.nottingham.ac.uk/vet/people/catrin.rutland",institutionString:null,institution:{name:"University of Nottingham",country:{name:"United Kingdom"}}},{id:"283315",title:"Prof.",name:"Samir",middleName:null,surname:"El-Gendy",slug:"samir-el-gendy",fullName:"Samir El-Gendy",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRduYQAS/Profile_Picture_1606215849748",biography:"Samir El-Gendy is a Professor of anatomy and embryology at the faculty of veterinary medicine, Alexandria University, Egypt. Samir obtained his PhD in veterinary science in 2007 from the faculty of veterinary medicine, Alexandria University and has been a professor since 2017. Samir is an author on 24 articles at Scopus and 12 articles within local journals and 2 books/book chapters. His research focuses on applied anatomy, imaging techniques and computed tomography. Samir worked as a member of different local projects on E-learning and he is a board member of the African Association of Veterinary Anatomists and of anatomy societies and as an associated author at local and international journals. Orcid: https://orcid.org/0000-0002-6180-389X",institutionString:null,institution:{name:"Alexandria University",country:{name:"Egypt"}}},{id:"246149",title:"Dr.",name:"Valentina",middleName:null,surname:"Kubale",slug:"valentina-kubale",fullName:"Valentina Kubale",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246149/images/system/246149.jpg",biography:"Valentina Kubale is Associate Professor of Veterinary Medicine at the Veterinary Faculty, University of Ljubljana, Slovenia. Since graduating from the Veterinary faculty she obtained her PhD in 2007, performed collaboration with the Department of Pharmacology, University of Copenhagen, Denmark. She continued as a post-doctoral fellow at the University of Copenhagen with a Lundbeck foundation fellowship. She is the editor of three books and author/coauthor of 23 articles in peer-reviewed scientific journals, 16 book chapters, and 68 communications at scientific congresses. Since 2008 she has been the Editor Assistant for the Slovenian Veterinary Research journal. She is a member of Slovenian Biochemical Society, The Endocrine Society, European Association of Veterinary Anatomists and Society for Laboratory Animals, where she is board member.",institutionString:"University of Ljubljana",institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"258334",title:"Dr.",name:"Carlos Eduardo",middleName:null,surname:"Fonseca-Alves",slug:"carlos-eduardo-fonseca-alves",fullName:"Carlos Eduardo Fonseca-Alves",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/258334/images/system/258334.jpg",biography:"Dr. Fonseca-Alves earned his DVM from Federal University of Goias – UFG in 2008. He completed an internship in small animal internal medicine at UPIS university in 2011, earned his MSc in 2013 and PhD in 2015 both in Veterinary Medicine at Sao Paulo State University – UNESP. Dr. Fonseca-Alves currently serves as an Assistant Professor at Paulista University – UNIP teaching small animal internal medicine.",institutionString:null,institution:{name:"Universidade Paulista",country:{name:"Brazil"}}},{id:"245306",title:"Dr.",name:"María Luz",middleName:null,surname:"Garcia Pardo",slug:"maria-luz-garcia-pardo",fullName:"María Luz Garcia Pardo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/245306/images/system/245306.png",biography:"María de la Luz García Pardo is an agricultural engineer from Universitat Politècnica de València, Spain. She has a Ph.D. in Animal Genetics. Currently, she is a lecturer at the Agrofood Technology Department of Miguel Hernández University, Spain. Her research is focused on genetics and reproduction in rabbits. The major goal of her research is the genetics of litter size through novel methods such as selection by the environmental sensibility of litter size, with forays into the field of animal welfare by analysing the impact on the susceptibility to diseases and stress of the does. Details of her publications can be found at https://orcid.org/0000-0001-9504-8290.",institutionString:null,institution:{name:"Miguel Hernandez University",country:{name:"Spain"}}},{id:"350704",title:"M.Sc.",name:"Camila",middleName:"Silva Costa",surname:"Ferreira",slug:"camila-ferreira",fullName:"Camila Ferreira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/350704/images/17280_n.jpg",biography:"Graduated in Veterinary Medicine at the Fluminense Federal University, specialist in Equine Reproduction at the Brazilian Veterinary Institute (IBVET) and Master in Clinical Veterinary Medicine and Animal Reproduction at the Fluminense Federal University. She has experience in analyzing zootechnical indices in dairy cattle and organizing events related to Veterinary Medicine through extension grants. I have experience in the field of diagnostic imaging and animal reproduction in veterinary medicine through monitoring and scientific initiation scholarships. I worked at the Equus Central Reproduction Equine located in Santo Antônio de Jesus – BA in the 2016/2017 breeding season. I am currently a doctoral student with a scholarship from CAPES of the Postgraduate Program in Veterinary Medicine (Pathology and Clinical Sciences) at the Federal Rural University of Rio de Janeiro (UFRRJ) with a research project with an emphasis on equine endometritis.",institutionString:null,institution:null},{id:"41319",title:"Prof.",name:"Lung-Kwang",middleName:null,surname:"Pan",slug:"lung-kwang-pan",fullName:"Lung-Kwang Pan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41319/images/84_n.jpg",biography:null,institutionString:null,institution:null},{id:"125292",title:"Dr.",name:"Katy",middleName:null,surname:"Satué Ambrojo",slug:"katy-satue-ambrojo",fullName:"Katy Satué Ambrojo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/125292/images/system/125292.jpeg",biography:"Katy Satué Ambrojo received her Veterinary Medicine degree, Master degree in Equine Technology and doctorate in Veterinary Medicine from the Faculty of Veterinary, CEU-Cardenal Herrera University in Valencia, Spain.Dr. Satué is accredited as a Private University Doctor Professor, Doctor Assistant, and Contracted Doctor by AVAP (Agència Valenciana d'Avaluació i Prospectiva) and currently, as a full professor by ANECA (since January 2022). To date, Katy has taught 22 years in the Department of Animal Medicine and Surgery at the CEU-Cardenal Herrera University in undergraduate courses in Veterinary Medicine (General Pathology, integrated into the Applied Basis of Veterinary Medicine module of the 2nd year, Clinical Equine I of 3rd year, and Equine Clinic II of 4th year). Dr. Satué research activity is in the field of Endocrinology, Hematology, Biochemistry, and Immunology in the Spanish Purebred mare. She has directed 5 Doctoral Theses and 5 Diplomas of Advanced Studies, and participated in 11 research projects as a collaborating researcher. She has written 2 books and 14 book chapters in international publishers related to the area, and 68 scientific publications in international journals. Dr. Satué has attended 63 congresses, participating with 132 communications in international congresses and 19 in national congresses related to the area. Dr. Satué is a scientific reviewer for various prestigious international journals such as Animals, American Journal of Obstetrics and Gynecology, Veterinary Clinical Pathology, Journal of Equine Veterinary Science, Reproduction in Domestic Animals, Research Veterinary Science, Brazilian Journal of Medical and Biological Research, Livestock Production Science and Theriogenology, among others. Since 2014 she has been responsible for the Clinical Analysis Laboratory of the CEU-Cardenal Herrera University Veterinary Clinical Hospital.",institutionString:null,institution:null},{id:"201721",title:"Dr.",name:"Beatrice",middleName:null,surname:"Funiciello",slug:"beatrice-funiciello",fullName:"Beatrice Funiciello",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/201721/images/11089_n.jpg",biography:"Graduated from the University of Milan in 2011, my post-graduate education included CertAVP modules mainly on equines (dermatology and internal medicine) and a few on small animal (dermatology and anaesthesia) at the University of Liverpool. After a general CertAVP (2015) I gained the designated Certificate in Veterinary Dermatology (2017) after taking the synoptic examination and then applied for the RCVS ADvanced Practitioner status. After that, I completed the Postgraduate Diploma in Veterinary Professional Studies at the University of Liverpool (2018). My main area of work is cross-species veterinary dermatology.",institutionString:null,institution:null},{id:"291226",title:"Dr.",name:"Monica",middleName:null,surname:"Cassel",slug:"monica-cassel",fullName:"Monica Cassel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/291226/images/8232_n.jpg",biography:'Degree in Biological Sciences at the Federal University of Mato Grosso with scholarship for Scientific Initiation by FAPEMAT (2008/1) and CNPq (2008/2-2009/2): Project \\"Histological evidence of reproductive activity in lizards of the Manso region, Chapada dos Guimarães, Mato Grosso, Brazil\\". Master\\\'s degree in Ecology and Biodiversity Conservation at Federal University of Mato Grosso with a scholarship by CAPES/REUNI program: Project \\"Reproductive biology of Melanorivulus punctatus\\". PhD\\\'s degree in Science (Cell and Tissue Biology Area) \n at University of Sao Paulo with scholarship granted by FAPESP; Project \\"Development of morphofunctional changes in ovary of Astyanax altiparanae Garutti & Britski, 2000 (Teleostei, Characidae)\\". She has experience in Reproduction of vertebrates and Morphology, with emphasis in Cellular Biology and Histology. She is currently a teacher in the medium / technical level courses at IFMT-Alta Floresta, as well as in the Bachelor\\\'s degree in Animal Science and in the Bachelor\\\'s degree in Business.',institutionString:null,institution:null},{id:"442807",title:"Dr.",name:"Busani",middleName:null,surname:"Moyo",slug:"busani-moyo",fullName:"Busani Moyo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Gwanda State University",country:{name:"Zimbabwe"}}},{id:"439435",title:"Dr.",name:"Feda S.",middleName:null,surname:"Aljaser",slug:"feda-s.-aljaser",fullName:"Feda S. Aljaser",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"423023",title:"Dr.",name:"Yosra",middleName:null,surname:"Soltan",slug:"yosra-soltan",fullName:"Yosra Soltan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Alexandria University",country:{name:"Egypt"}}},{id:"349788",title:"Dr.",name:"Florencia Nery",middleName:null,surname:"Sompie",slug:"florencia-nery-sompie",fullName:"Florencia Nery Sompie",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Sam Ratulangi University",country:{name:"Indonesia"}}},{id:"428600",title:"MSc.",name:"Adriana",middleName:null,surname:"García-Alarcón",slug:"adriana-garcia-alarcon",fullName:"Adriana García-Alarcón",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"428599",title:"MSc.",name:"Gabino",middleName:null,surname:"De La Rosa-Cruz",slug:"gabino-de-la-rosa-cruz",fullName:"Gabino De La Rosa-Cruz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"428601",title:"MSc.",name:"Juan Carlos",middleName:null,surname:"Campuzano-Caballero",slug:"juan-carlos-campuzano-caballero",fullName:"Juan Carlos Campuzano-Caballero",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}}]}},subseries:{item:{id:"7",type:"subseries",title:"Bioinformatics and Medical Informatics",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine",scope:"Bioinformatics aims to help understand the functioning of the mechanisms of living organisms through the construction and use of quantitative tools. The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11403,editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",slug:"slawomir-wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",biography:"Professor Sławomir Wilczyński, Head of the Chair of Department of Basic Biomedical Sciences, Faculty of Pharmaceutical Sciences, Medical University of Silesia in Katowice, Poland. 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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,series:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343"},editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",slug:"alexandros-tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",slug:"lulu-wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",slug:"reda-r.-gharieb",fullName:"Reda R. 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Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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