Marijuana use among adolescents and young adults.
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These books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\\n\\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\\n\\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
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IntechOpen and Knowledge Unlatched formed a partnership to support researchers working in engineering sciences by enabling an easier approach to publishing Open Access content. Using the Knowledge Unlatched crowdfunding model to raise the publishing costs through libraries around the world, Open Access Publishing Fee (OAPF) was not required from the authors.
\n\nInitially, the partnership supported engineering research, but it soon grew to include physical and life sciences, attracting more researchers to the advantages of Open Access publishing.
\n\n\n\nThese books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\n\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\n\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
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The advances in characterization techniques and their application have improved our understanding of the catalytic processes and mechanisms occurring in both homogeneous and heterogeneous catalysis.\r\nThe aim of this volume, although not exhaustive, is to provide a general overview of new progress of the hydrogenation reactions.\r\nThis volume comprises a series of various contributions, as reviews or original articles, treating heterogeneously and homogeneously catalyzed hydrogenation reactions. It is composed of three parts: hydrogenation reactions in fine organic chemistry, hydrogenation reactions in environmental chemistry and renewable energy, and special topics in hydrogenation.",isbn:null,printIsbn:"978-953-51-0785-9",pdfIsbn:"978-953-51-4272-0",doi:"10.5772/3208",price:139,priceEur:155,priceUsd:179,slug:"hydrogenation",numberOfPages:340,isOpenForSubmission:!1,isInWos:1,isInBkci:!0,hash:"737b7439c2b3372d6c4b34ce28a37fe4",bookSignature:"Iyad Karamé",publishedDate:"October 10th 2012",coverURL:"https://cdn.intechopen.com/books/images_new/2874.jpg",numberOfDownloads:75464,numberOfWosCitations:224,numberOfCrossrefCitations:73,numberOfCrossrefCitationsByBook:11,numberOfDimensionsCitations:193,numberOfDimensionsCitationsByBook:13,hasAltmetrics:1,numberOfTotalCitations:490,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 29th 2011",dateEndSecondStepPublish:"December 20th 2011",dateEndThirdStepPublish:"March 25th 2012",dateEndFourthStepPublish:"June 23rd 2012",dateEndFifthStepPublish:"July 23rd 2012",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7,8",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"145512",title:"Prof.",name:"Iyad",middleName:null,surname:"Karamé",slug:"iyad-karame",fullName:"Iyad Karamé",profilePictureURL:"https://mts.intechopen.com/storage/users/145512/images/3352_n.jpg",biography:"Iyad Karamé, PhD.\nHe is a professor at the Faculty of sciences in the Lebanese University in Beirut. 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Possible causes include iatrogenic surgical injury (cardiac, thoracic, neck), neoplasm (e.g. thyroid, esophagus, lung) or neurological disease. Injury to the RLN results in vocal cord paresis or paralysis. Poor or absent movement of one or both vocal folds causes difficulties with voice, swallowing or breathing. This can have a substantial negative effect on quality of life due to poor vocal function, aspiration, and upper airway obstruction in the rare event of bilateral RLN injury.
Injury to the RLN can occur at any point along the course of the nerve, which spans the neck and thorax. The RLN is a branch of the vagus nerve, and has an extensive and complex anatomical course, beginning at the brainstem, coursing through the skull base, within the carotid sheath in the neck, into the thorax, looping around the aortic arch (left RLN), around the subclavian artery (right RLN), within the tracheoesophageal groove, posteromedial to the thyroid gland, and enters the larynx at the posteroinferior border of the cricoid cartilage. The RLN provides motor supply to the thyroarytenoid muscle, posterior cricoarytenoid muscle, lateral cricoarytenoid muscle, and interarytenoid muscles. It also provides sensory supply to the glottis and infraglottic larynx.
Standard options for management of unilateral vocal cord paralysis include observation, voice and swallowing therapy, and surgery.
Patients sometimes exhibit variable clinical improvement with expectant management. This can be due to (i) spontaneous nerve regeneration, or (ii) natural compensation for glottic insufficiency by strengthening of the contralateral vocal cord.
A referral to an experienced speech language pathologist is commonly employed in cases of severe functional deficit where patients are reluctant or unfit to pursue surgery. Voice and swallowing rehabilitation has been shown to be effective, especially in motivated patients.
Medialization of the paralyzed vocal cord aims to close the glottic gap, resulting in improvement in voice and aspiration. Specific procedures can be classified into endolaryngeal and extralaryngeal. Endolaryngeal procedures include injection laryngoplasty, whereby a ‘filler’ substance is injected into the paraglottic space, either percutaneously or endoscopically. Percutaneous approaches are performed in the clinic as an office-based procedure, and can be done safely under endoscopic guidance with local anaesthesia transorally, through the thyrohyoid membrane, through the thyroid cartilage, or most commonly, through the cricothyroid membrane. “Filler” substances commonly employed include calcium hydroxyapatite, collagen, and autologous fat. Extralaryngeal procedures include medialization laryngoplasty (thyroplasty), arytenoid adduction, and cricothyroid subluxation with adduction arytenopexy. The most commonly performed extralaryngeal procedure is the medialization thyroplasty. This is done in the operating room with IV sedation. The laryngeal framework is approached transcervically, and an alloplastic implant (such as Gortex™ or silastic) is inserted into the paraglottic space after drilling a window through the thyroid cartilage. This operation can be safely performed as an outpatient in selected patients (Zhao et al., 2010). Although implants can be hand-carved, contemporary thyroplasty systems include fully or partially pre-fabricated implants with gender-specific sizers and templates, for improved technical precision.
Although current therapies have been shown to be clinically effective, they represent static solutions to a dynamic problem. Physiologic vocal cord function is not actually restored. The ability to restore physiologic vocal cord movement depends upon developing strategies to maintain survival of injured or vulnerable neurons and to stimulate axonal regeneration to appropriate laryngeal muscles (Hogikyan et al. 2001, Rubin et al. 2003).
Spontaneous natural nerve recovery can occur, but axon regrowth may fail to reach the laryngeal muscles, or fail to reinnervate the correct muscles (Crumley et al. 2000). Non-selective reinnervation of adductor and abductor laryngeal muscles results in synkinesis, which explains the variable clinical outcomes observed with expectant management.
It is known that neurotrophic and neuroprotective growth factors can prevent nerve degeneration following injury. Administration of these growth factors through the central nervous system (CNS) is an appealing strategy. However, technical access to these neurons is challenging, and direct injection is ineffective, since trophic factors diffuse poorly, and can cause injury to adjacent neuronal structures. A novel and innovative approach that is minimally invasive and avoids systemic side effects is remote delivery utilizing a viral vector, and forms the fundamental basis of the emerging evidence from investigations into the potential role of gene therapy for treatment of recurrent laryngeal nerve injury.
The remote delivery of genes encoding therapeutic growth factors to the CNS is an attractive management strategy, because it avoids the potential pitfalls of direct CNS injection (into the brainstem or spinal cord) and systemic administration. In this approach, viral vectors can be injected into the peripheral nervous system and be transported in a retrograde fashion to the CNS (Boulis et al. 1999, Rubin et al. 2001). Several viral vectors have been described for in vivo gene transfer in the nervous system, including herpes simplex virus, retroviruses, adenovirus, and adeno-associated virus (AAV). Contemporary bench techniques can impact virus attenuation, thereby preventing the negative consequences of local proliferation, and allow the addition of potentially therapeutic genes.
Previous research by our group has shown that an AAV vector, remotely injected into the RLN, travels in a retrograde fashion to the rat brainstem (Rubin et al. 2001) and that injection of an adenoviral vector into a crushed RLN added no additional injury compared with crush alone (Shiotani et al. 1999).
An experimental model of RLN injury for the study of viral gene therapy has been previously described (Fung et al., 2008, Figure 1). In this model, a standardized crush injury was induced to the RLN. Immediately following crush, there was a dramatic, measurable decrease in nerve–endplate contact percentage, and spontaneous recovery was observed by three weeks post-injury. Recovery was confirmed both endoscopically as well as histologically by determining a high nerve-endplate contact percentage. Nerve-endplate contact was quantified by a rigorous method of evaluation of immunohistochemically stained rat larynges for neurofilament and motor endplates. We showed that this method reliably quantified the anatomical integrity of neuromuscular connections in laryngeal muscle.
There are promising results from a study (Sabowski et al., 2009) investigating the effects of remote administration of an engineered zinc-finger protein transcription factor, Ad-32Ep65-Flag (Ad-p65). This factor has been found to induce expression of vascular endothelial growth factor (VEGF; also called VEGF-A). VEGF has well known neuroprotective effects. Subsequent work demonstrated that remote injection of Ad-p65 after RLN crush accelerated the return of vocal fold mobility and the percentage of nerve-endplate contacts in the thyroarytenoid muscle. Similar results have been described with adenoviral GDNF gene transfer (Araki et al., 2006). This study observed faster motor nerve conduction velocity of the RLN and quicker recovery rate of vocal fold movement following gene transfer.
reproduced from
A) Dennervation, as evidenced by low neuron-motor endplate contact percentage, following crush injury. (B) Reinnervation, as evidence by high neuron-motor endplate contact percentage, following 3 weeks of recovery. Reproduced from
Gene therapy is a promising methodology that may enhance our ability to minimize nerve injury while maximizing functional outcome. Research using this model to investigate the potential therapeutic role of viral gene therapy for the treatment of recurrent laryngeal nerve injury is ongoing.
In 2014 recreational, adult-use of cannabis (interchangeably referred to as marijuana) was established in the state of Colorado. At this time the Colorado Department of Public Health and Environment (CDPHE) was given statutory responsibility in Colorado Revised Statute (C.R.S.) 25-1.5-110, to; “monitor changes … in the emerging science and medical information relevant to the health effects associated with marijuana use.” and “appoint a panel of health care professionals with expertise in, but not limited to, neuroscience, epidemiology, toxicology, cannabis physiology, and cannabis quality control to further direct policy.” Based on this charge, CDPHE appointed a 14-member committee titled the Retail Marijuana Public Health Advisory Committee (RMPHAC) to review scientific literature on the health effects of marijuana.
Under the same statute mentioned previously, the RMPHAC is directed to “…establish criteria for studies to be reviewed, reviewing studies and other data, and making recommendations, as appropriate, for policies intended to protect consumers of marijuana or marijuana products and the general public.” To implement this charge, the RMPHAC meets four or five times a year to review the scientific literature currently available on health effects of marijuana use, evaluate findings without bias, openly discuss the science and apply expert opinion, come to consensus on the science, translate the science into public health messages, make policy-related recommendations, recommend surveillance activities, and identify and address gaps in the science important to public health. All this information is compiled and detailed in a report every two years for the Colorado State Board of Health, the Colorado Department of Revenue, and the Colorado General Assembly, titled “Monitoring Health Concerns Related to Marijuana in Colorado” [1].
Since 2014, and prior to this publication, the RMPHAC has come together on a quarterly basis, held discussions concerning hundreds of articles, and developed over one hundred evidence statements within eleven health topics. As more scientific evidence regarding cannabis health effects are published, this committee continues to build upon existing evidence statements or will construct new statements when appropriate. This chapter will detail the review methods used by the RMPHAC to develop evidence statements about the health effects associated with marijuana use, describe the findings from all eleven health topics, and report the public health statements, recommendations, and research gaps used to inform public health policy in the State of Colorado.
The first step in the process of investigating the health effects from marijuana use was to develop and implement an unbiased, transparent, and complete process for evaluating scientific literature and data on marijuana use and health outcomes. To ensure this, the RMPHAC and CDPHE technical staff developed a twelve step review process guided by the established preferred reporting items for systematic reviews and meta-analyses (PRISMA) framework [2]. These twelve steps are followed for each review and are as follows:
Conduct a broad search of current peer-reviewed publications quarterly. Relevant articles cited in reviews or other primary studies are also included.
Review relevant full-text articles identified in the search.
Rate the findings: each finding in the articles is rated as a high-, medium-, or low-quality finding based on strengths and limitations of the methods. Evaluation of the strengths and limitations was based on criteria in the grading of recommendations assessment, development and evaluation (GRADE) system, a well-accepted method for evaluating the quality of scientific evidence [3].
Group related findings: each finding is categorized based on population, exposure, and outcome (health effect), to answer specific questions.
Weigh the evidence: draft evidence statements that summarize the quantity and quality of evidence answering a specific question.
Translate the evidence: draft public health statement that translate the evidence statement into language at an 11th grade reading level.
Synthesize the evidence: draft public health recommendations (e.g., for education or monitoring) based on important information identified through the review process.
Identify research gaps: draft statements to articulate the research gaps identified during the review process.
Present to committee: findings, evidence statements, public health statements, public health recommendations, and research gaps are publicly presented to the RMPHAC for review and revision during open public meetings.
Public comment: during the open public meetings, interested stakeholders and members of the public are invited to provide comments relevant to the topics presented.
Reach consensus: committee members come to consensus on findings, evidence statement, public health statement, public health recommendations, and research gaps.
Adopt summary statements: committee votes to officially accept findings, evidence statements, public health statements, public health recommendations, and research gaps.
All review methods were approved by the RMPHAC, including the terms used to conduct the ongoing broad search of peer-reviewed publications for relevant literature. Medline is the priority research database used to obtain articles for review. Embase, the biomedical database, and gray literature were secondarily reviewed when references in included articles were not included in Medline searches. Studies of marijuana use in humans were the primary focus of the review, with animal studies included for only specific topics with limited human research. All identified peer-reviewed literature on a given topic was reviewed, regardless of positive or negative findings or quality of the methods utilized. For the ongoing broad Medline search, medical subject heading (MeSH) terms were used and is as follows; “Cannabis”[Mesh] OR Marijuana “Smoking”[Mesh] OR “Marijuana Abuse”[Mesh] OR cannabis OR marijuana OR marihuana OR hash oil OR hashish. In 2014, when this review was established, specific searches were conducted using the appropriate MeSH terms for each topic area.
Once relevant literature is obtained, each finding is rated high, medium, or low quality based on the strengths and limitations of the methods which is determined by criteria in the GRADE system. The GRADE system is a well-established method for systematic literature review and has been used by the Cochrane Collaboration, British Medical Journal, American College of Physicians, World Health Organization, and many others [3]. Findings rated high quality are defined as “We are very confident that the true effect lies close to that of the estimate of the effect outlined in the study.” These are well-designed and well-controlled studies with few limitations. Due to the fact that most studies included in our review are observational epidemiology studies, receiving a high quality rating does not necessarily imply causation. It simply implies that an observed association persists between an exposure and effect in an appropriately-sized study population after adjusting for appropriate confounders. Medium quality findings are defined as “we are moderately confident in the effect estimate outlined in the study. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.” For observational epidemiology studies this implies the finding of an observed association may be limited by a small study population or insufficient adjustment for important confounders. Low quality findings are defined as “our confidence in the effect estimate outlined in the study is limited. The true effect may be substantially different from the estimate of the effect.” For observational epidemiology studies this implies the finding of an observed association with an interpretation that is significantly restricted by study limitations.
Findings from relevant literature are usually grouped based on outcome or the health effect in question. However, in some situations findings are further subdivided based on factors such as: age range of the exposed population, special subject circumstances such as pregnancy or breastfeeding, level or method of marijuana use, time period since last use of marijuana, amount of marijuana used, and THC concentration. Standardized definitions of level of marijuana use (daily, weekly, etc.) and age groups (child, adolescent, young adult, etc.) were established to help facilitate grouping of findings. Once findings are grouped appropriately, the evidence is drafted into evidence statements that summarize the quality and quantity of scientific evidence supporting an association between marijuana use and a health outcome.
In order to make our review findings easily interpretable we used a standardized rating system to classify evidence statements. These statements are also constructed to accurately portray the quality and quantity of all findings used to support the particular health outcome. Evidence statements all use standardized language from one of the following six classifications:
Substantial evidence—indicates robust scientific findings that support an association between marijuana use and the outcome.
Moderate evidence—indicates scientific findings that support an association, but these findings have some limitations.
Limited evidence—indicates modest scientific findings that support an association, but these findings have significant limitations.
Mixed evidence—indicates both supporting and opposing scientific findings for an association, with neither direction dominating.
Insufficient evidence—indicates the outcome has not been sufficiently studied to conclude whether or not there is an association between marijuana use and the outcome.
Body of research failing to show an association—indicates the topic has been researched without evidence of an association; is further classified as a limited, moderate, or substantial body of research.
In the following sections evidence statements will be discussed according to health topic and statements with enough findings to receive a substantial or moderate rating are displayed in tables. All statements, regardless of evidence level, are drafted by CDPHE technical staff, revised based on committee review and feedback from technical advisors and public stakeholders. Statements in their final form are approved by a vote of the committee.
The RMPHAC has reviewed the relationships between adolescent and young adult marijuana use on various areas of concern; including cognitive abilities, academic performance, mental health, and future substance use, displayed in Table 1. Specifically regarding cognitive and academic abilities, weekly marijuana use by adolescents is associated with deficits for at least twenty-eight days after last use. Weekly use among adolescents is also associated with failure to graduate from high school or complete a college degree. Information on how marijuana use affects short-term and long-term IQ is currently insufficient and limited, respectively. As with many of our statements that reflect long-term marijuana use, the paucity of long-term studies is a research gap that will hopefully improve due to the changing legal landscape of cannabis throughout the United States.
Substantial evidence | Moderate evidence | |
---|---|---|
Benefits of quitting | Treatment for cannabis use disorder can reduce use and dependence [4, 5, 6, 7, 8, 9, 10] | Quitting or decreasing marijuana use lowers the risk of adverse mental health outcomes [11, 12, 13, 14] |
Cognitive and academic effects | Weekly, or more frequent, use is associated with a lower rate of graduating high school [15, 16, 17, 18, 19, 20, 21, 22, 23] | Weekly, or more frequent, use is associated with a lower rate of attaining a college degree (among those who start a degree program) [19, 24, 25, 26, 27, 28, 29] |
Weekly, or more frequent, use is associated with ongoing cognitive and academic impairment for at least 28 days after last use [30, 31, 32, 33, 34, 35] | ||
Mental health | Daily or near daily use is associated with future psychotic disorders like schizophrenia [36, 37, 38, 39, 40, 41, 42, 43] | Marijuana use is associated with suicidal thoughts or attempting suicide [22, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63] |
Use is associated with future psychotic symptoms (likelihood increases with more frequent use) [14, 40, 42, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80] | ||
Substance use, abuse, and addiction | Those who use marijuana can develop cannabis use disorder (addiction) [81, 82, 83, 84, 85, 86, 87] | Marijuana use is associated with future use and use disorder for alcohol [15, 20, 88, 89, 90, 91, 92] |
Marijuana use is associated with future use and use disorder for marijuana, tobacco and other drugs [13, 15, 20, 22, 25, 28, 79, 84, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105] | ||
High THC (%) concentration | Using marijuana with higher THC concentration (>10% THC) is associated with continued use [38, 106, 107, 108] | |
Use of marijuana with higher THC concentration (>10% THC) is associated with future mental health symptoms and disorders [38, 78, 107] |
Marijuana use among adolescents and young adults.
Adolescents and young adults who use marijuana are more likely to experience psychotic symptoms in adulthood (such as hallucinations, paranoia, and delusional beliefs), future psychotic disorders (such as schizophrenia), and suicidal thoughts or attempting suicide, when compared to adolescents and young adults who do not use marijuana. Additionally, those using marijuana with higher tetrahydrocannabinol (THC) concentration (>10% THC) are more likely than non-users to continue using and to develop future mental health symptoms and disorders. How marijuana use during adolescence affects symptoms or a diagnosis of anxiety in adulthood currently stands at a mixed evidence level, with fourteen articles contributing to this rating. Only one of which received a high quality rating and also reported mixed findings relevant to this evidence statement on anxiety [64]. Results from their main analysis did show an association with adolescent cannabis use and adulthood anxiety, however, results from a monozygotic-only co-twin control analysis reported no association [64].
Evidence shows that adolescents who use marijuana can develop cannabis use disorder, along with marijuana use being associated with developing use disorder for tobacco, alcohol, and other drugs. On a more positive note, evidence shows that adolescents who receive treatment for cannabis use disorder can decrease their use and dependence. Additionally, those who quit using marijuana have lower risks of adverse cognitive and mental health outcomes than those who continue to use.
To assess how marijuana use may or may not be associated with cancer, the RMPHAC reviewed health effects of the chemicals released in marijuana smoke and vapor and evaluated how different rates of marijuana use relate to cancer. Strong evidence shows marijuana smoke contains many of the same cancer-causing chemicals found in tobacco smoke [109]. There is also substantial evidence that daily or near-daily marijuana smoking is associated with pre-malignant lesions in the airway. However, there is conflicting research for whether or not marijuana smoking is associated with lung cancer. As shown by the moderate evidence statement in Table 2, the body of research reviewed has failed to show an association between smoking less than the equivalent of one joint per day for 10 years and lung cancer.
Substantial evidence | Moderate evidence | |
---|---|---|
Cancer and precancerous lesions | Daily or near daily use is associated with pre-cancerous lesions in airway [110, 111, 112] | Smoking less than the equivalent of one joint per day for 10 years is not associated with lung cancer [113, 114, 115, 116, 117, 118] |
Chemicals in MJ smoke or vapor | Marijuana smoke contains many of the same cancer causing chemicals as tobacco smoke [109, 119, 120, 121, 122] | |
Genitourinary Cancer | Use among adult males is associated with increased risk of nonseminoma testicular cancer [123, 124, 125, 126, 127] |
Marijuana use and cancer.
Apart from the respiratory system, most of our statements are not in Table 2 due to the limited evidence available concerning cancers of the bladder, prostate, head and neck. These limited statements all suggest these forms of cancer might not have any association with marijuana use. However, there is evidence that marijuana use among adult males may be associated with nonseminoma testicular cancer. High quality research on non-respiratory tract cancers related to marijuana use remains a research gap identified by the RMPHAC.
Related to cardiovascular health effects, how marijuana use associates with myocardial infarction, stroke, and death from cardiovascular causes were reviewed. Evidence shows that marijuana use or consumption in those under the age of fifty-five years are at an increased risk of ischemic stoke, as shown in Table 3. However, currently there is only limited scientific evidence to support our statements on myocardial infarction and death related to a cardiovascular event.
An important metric to understand is how THC blood levels compare from various marijuana methods of use and the numerous concentrations of THC in available products on the retail marijuana market. For example, there is substantial evidence that smoking more than 10 mg THC (or 10–20% of a 1 g marijuana joint) produces a blood THC level near or above 5 ng/mL within 10 min. As we see the THC concentration of marijuana products increase, we can expect this association to remain strong. One important finding in Table 4 is that it can take up to four hours after consuming an edible marijuana product to reach the peak THC blood concentration and feel the full effects. Another method of use, vaporized THC, shows moderate evidence of producing a similar blood THC level to smoking the same amount.
Substantial evidence | Moderate evidence | |
---|---|---|
THC blood levels resulting from different exposures | It takes up to four hours after ingesting marijuana (edible products) to reach peak blood THC levels [146, 147, 148, 149, 150, 151] | Ingesting (edible products) more than 15 mg THC may produce a blood THC level above 5 ng/mL [148, 152, 153, 154] |
Smoking more than 10 mg THC produces a blood THC level near or above 5 ng/mL within 10 min [152, 155, 156, 157, 158, 159] | Inhaling vaporized THC produces a blood THC level similar to smoking the same dose [149, 159, 160] | |
Secondhand exposure | Typical secondhand marijuana smoke exposure is unlikely to cause a positive drug screen by urine or blood [161, 162, 163, 164, 165, 166, 167, 168, 169] |
Marijuana dose and drug interactions.
Within this topic the RMPHAC reviewed effects of secondhand marijuana smoke, drug-drug interactions involving marijuana, and relationships between marijuana and opioid use. There is credible evidence of clinically important drug-drug interactions between marijuana and multiple medications, including some anti-seizure medications and a common blood-thinner, warfarin. Data about potential interactions are lacking for many drugs at this time and are likely to evolve substantially in the coming years. Other than our statement about secondhand marijuana smoke exposure being unlikely to cause a positive drug screen, our statements in this topic area are all based on limited evidence. Health effects resulting from secondhand marijuana smoke exposure is an area lacking in research. There is also conflicting evidence for whether or not marijuana use is associated with a decrease in opioid use among chronic pain patients or individuals with a history of problem drug use.
As with any psychoactive substance it is imperative to know how marijuana affects a person’s ability to drive and the crash risks associated with use. To fully comprehend how marijuana causes driving impairment we must also understand the pharmacokinetics of THC in the human body to know how long these affects will persist after last use. Table 5 displays all driving related statements that have evidence to provide a substantial or moderate rated statement. Current research shows substantial evidence that recent marijuana use by a driver increases the risk of a motor vehicle crash. In addition, using alcohol and marijuana together increases impairment and the risk of a motor vehicle crash more than using either substance alone.
Substantial evidence | Moderate evidence | |
---|---|---|
Combined marijuana and alcohol use | Combined use of marijuana and alcohol increases crash risk more than either substance alone [170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181] | |
Impairment and crash risk | Recent marijuana use/consumption by a driver increases the risk of a motor vehicle crash [170, 171, 172, 174, 182, 183, 184, 185, 186, 187, 188] | Higher THC blood level increases the risk of a motor vehicle crash [173, 178, 180, 189] |
Smoking more than 10 mg THC can lead to driving impairment [147, 155, 157, 177, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200] | Blood THC levels of impaired drivers are higher now than they were in the past [201] | |
Orally ingesting more than 10 mg THC can lead driving impairment [146, 147, 153, 155] | ||
Increased risk of driving impairment at blood THC as low as 2–5 ng/mL [155, 185, 190, 202, 203, 204, 205, 206] | ||
Time to wait before driving | Waiting at least 6 after smoking less than 18 mg allows driving impairment to resolve or nearly resolve [155, 190, 207] | Waiting at least 6 h after smoking about 35 mg allows driving impairment to resolve or nearly resolve [157, 192, 196] |
Waiting at least 8 h after orally ingesting less than 18 mg allows driving impairment to resolve or nearly resolve [147, 153, 155, 208] |
Marijuana use and driving.
The RMPHAC also set out to determine how various patterns of marijuana use affect driving. People that consume marijuana less-than-weekly are likely to experience impaired driving after using marijuana containing ten milligrams or more of THC. This statement holds true for smoking or consuming edible marijuana products. Research on driving impairment for those that consume more frequently than weekly is currently lacking in scientific literature. Due to this our evidence statement on crash risk for different levels of use (less-than-weekly compared to more frequent use) has received an insufficient rating at this time.
Articles measuring THC blood levels were also assessed to evaluate for any correlation to driving impairment, crash risk, and to develop statements informing consumers the amount of time to wait prior to driving. There is substantial evidence, including a randomized clinical trial [202], which has displayed meaningful driving impairment with a whole blood THC of 2–5 ng/mL. Additionally, moderate evidence points to a positive relationship between THC blood level and motor vehicle crash risk. In order for marijuana consumers to allow impairment to resolve, less-than-weekly consumers should wait at least six hours after smoking or eight hours after eating or drinking marijuana products. When consuming larger amounts of THC or for people that consume more frequently, evidence is currently insufficient to determine the safe amount of time for impairment to wear off. Evidence is also showing that blood THC levels of marijuana-impaired drivers are higher now than in the past, likely resulting from the increasing THC concentration of available marijuana products.
The RMPHAC reviewed how marijuana use may affect gastrointestinal disease, particularly cyclic vomiting, and infertility or abnormal reproductive function. Displayed in Table 6, evidence shows that long-time, daily or near daily marijuana use is associated with cyclic vomiting, also called cannabinoid hyperemesis syndrome (CHS). A majority of evidence supporting this statement is from case reports or case series of identified CHS patients, however, many review articles detail diagnostic criteria, treatment options, and the physiology behind marijuana use and CHS presentation [220]. Regarding reproductive function, there is limited research showing marijuana use is associated with male infertility or abnormal function, however, the research is conflicting for women.
The RMPHAC reviewed workplace, recreational and other non-driving injuries, burns from hash-oil extraction or failed electronic smoking devices, and physical dating violence. Evidence shows mixed results for marijuana use affecting the risk of workplace injury, recreational injury, and other types of non-driving-related injury. There have been many reports of severe burns resulting from home-extraction of butane hash oil leading to explosions, and cases of electronic smoking devices exploding, leading to trauma and burns.
Concerning dating violence, Table 7 shows our only statement reaching moderate or substantial levels of evidence is that young adult women who use marijuana are unlikely to perpetrate physical dating violence against their dating partners. Otherwise, evidence does show that young adults who use marijuana are unlikely to commit or be victims of physical dating violence, however evidence is limited at this time. Evidence for adolescent boys that use marijuana has mixed findings for physical dating violence perpetration and limited evidence for victimization, with evidence for adolescent girls being the opposite (Table 7).
Similar to statements in our adolescent and young adult section, it is imperative to understand how marijuana could impact neurological, cognitive, and mental health in adult marijuana consumers. This section also explores how marijuana consumption relates to marijuana abuse and addiction among adult consumers. While our review on cognitive effects includes decision making, executive function, memory impairment, and lasting cognitive effects, strong evidence has been found only for memory impairment, as shown in Table 8. We have found substantial evidence that daily or near daily adult marijuana consumers are more likely than non-users to have memory impairments for at least seven days after last use. Evidence is mixed for whether or not these memory impairments or other cognitive effects last for at least twenty-eight days after last use, among the same population of adult consumers.
Substantial evidence | Moderate evidence | |
---|---|---|
Cognitive effects | Daily or near daily use is associated with impaired memory for at least 7 days [30, 227, 228, 229, 230, 231, 232, 233, 234, 235] | |
Mental health effects | Use is associated with acute psychotic symptoms during intoxication, which are worse with higher doses [236, 237, 238, 239, 240, 241, 242, 243] | |
Daily or near daily use is associated with future psychotic disorders like schizophrenia [38, 42, 107, 244, 245, 246] | Use of marijuana with THC concentration > 10% is associated with future psychotic disorders like schizophrenia [38, 107, 247] | |
Substance use, abuse and addiction | Those who use marijuana can develop cannabis use disorder (addiction) [82, 85, 86, 93, 248, 249, 250, 251, 252] | |
Treatment for cannabis use disorder can reduce use and dependence [4, 6, 8, 9, 253, 254, 255, 256, 257] | ||
Those using daily or near daily can experience withdrawal symptoms when abstaining [11, 258, 259, 260, 261, 262, 263, 264, 265, 266, 267, 268, 269, 270] |
Marijuana use and neurological, cognitive, mental health effects.
As with all psychoactive substances, mental health effects in adult marijuana consumers must be examined. An important acute effect of THC with substantial evidence is psychotic symptoms, such as hallucinations, paranoia, and delusional beliefs during intoxication, and these symptoms are worse with higher doses. Additionally, daily or near daily marijuana use is associated with developing a psychotic disorder such as schizophrenia. As detailed in our report focusing on the increasing concentration of THC in products available, there is increased public health concern as these products may lead to higher potential for adverse health effects in consumers [1]. This concern is substantiated by available research enabling us to provide a moderate rated statement showing association between higher concentration THC products and future psychotic disorders in adult marijuana consumers.
Finally, evidence shows marijuana consumers can experience withdrawal symptoms when abstaining and become addicted to marijuana or develop cannabis use disorder. However, as with adolescents, treatment for cannabis use disorder can reduce use and dependence in adult consumers. Many associations within this section lack high quality evidence or research currently exhibits mixed findings, such as marijuana use being associated with anxiety, depression, or bipolar disorder (Table 8).
Table 9 details our evidence concerning marijuana use during pregnancy and breastfeeding. Biological evidence shows THC passes through the placenta to the fetus and is present in the breast milk of women who use marijuana. Scientific evidence shows the fetus absorbs and metabolizes THC passed through the placenta and THC metabolites are found in the meconium or first stool passed by the newborn after birth. Additionally, infants who drink breast milk containing THC absorb and metabolize the THC. These statements show how important it is to understand how marijuana use during pregnancy and/or breastfeeding can affect the offspring or impact delivery of the offspring.
Substantial evidence | Moderate evidence | |
---|---|---|
Effects on exposed offspring | Prenatal marijuana exposure is associated with reduced cognitive function, academic ability, and IQ scores in childhood [271, 272, 273, 274, 275, 276, 277, 278, 279, 280] | |
Prenatal marijuana exposure is associated with attention problems in childhood [273, 281, 282, 283, 284, 285] | ||
Birth defects | Prenatal marijuana use is not associated with birth defects [286, 287, 288, 289, 290, 291, 292] | |
Preterm delivery or abnormal birth weight | Maternal use during pregnancy is associated with infants being born small for gestational age (birth weight less than 10th percentile for gestational age) [286, 287, 289, 292, 293, 294, 295, 296, 297, 298, 299, 300, 301, 302, 303, 304, 305] | |
THC is passed through the placenta of women who use marijuana, the fetus absorbs and metabolizes the THC, and THC metabolites are found in the meconium [306, 307, 308, 309, 310]. | ||
THC is present in the breast milk of women who use marijuana. Infants who drink breast milk containing THC absorb and metabolize the THC [311, 312, 313, 314, 315, 316]. |
Marijuana use during pregnancy and/or breastfeeding.
Specifically regarding exposed offspring, the RMPHAC reviews potential effects starting at birth and later in childhood or adolescence. Marijuana use during pregnancy has shown to not be associated with birth defects in general, but limited evidence of an association with an increased risk of heart defects, stillbirth, and decreased growth in offspring. Stronger evidence was found for effects that are seen in offspring years after birth if a child’s mother used marijuana while pregnant. These include impaired cognitive function and academic ability, lower IQ scores, and attention problems in childhood.
While consumers have a variety of marijuana products to choose from, smoking marijuana flower remains the most common method of use and thus respiratory effects must be evaluated [317]. The RMPHAC reviews respiratory diseases such as chronic obstructive pulmonary disorder (COPD), chronic bronchitis and asthma, respiratory infections, lung function relative to smoked marijuana. The committee has also reviewed potential health effects of vaporized marijuana as those products have emerged on the legal market. Displayed in Table 10, strong evidence shows an association between daily or near-daily marijuana use and chronic bronchitis, including chronic cough, sputum production, and wheezing. Weaker evidence shows daily or near-daily marijuana use may be associated with bullous lung disease leading to pneumothorax in individuals younger than forty years of age. Additionally, limited evidence does show frequent smokers who switch from marijuana smoking to marijuana vaporizing may have fewer respiratory symptoms and improved pulmonary function. Finally, a notable effect of acute marijuana smoking is a short-term improvement in lung airflow, though evidence contributing to this statement is dated (Table 10).
Substantial evidence | Moderate evidence | |
---|---|---|
Smoked marijuana | Use is associated with chronic bronchitis with cough, wheezing and mucus [318, 319, 320, 321, 322, 323, 324, 325, 326, 327] | |
Acute use is associated with short-term lung airflow improvement [328, 329, 330] |
Marijuana use and respiratory effects.
As marijuana becomes more accessible to the public, we must consider unintentional exposures in homes with children and how packaging can affect these. Strong evidence was found, shown in Table 11, that more unintentional exposures of children occur in states with increased legal access to marijuana, and exposures can lead to significant clinical effects requiring medical attention and even hospitalization. However, evidence does show that child-resistant packaging reduces unintentional pediatric marijuana poisonings (Table 11).
Substantial evidence | Moderate evidence | |
---|---|---|
Legal marijuana access increases unintentional marijuana exposures in children [331, 332, 333, 334, 335, 336, 337, 338, 339, 340, 341] | Child-resistant packaging reduces unintentional pediatric poisonings [342, 343, 344] |
Unintentional marijuana exposure in children.
Once evidence statements have been drafted and approved by the RMPHAC, the next step (number 6 from our systematic review process) is to translate the evidence into public health statements. These are designed to accurately reflect the evidence statements using language the public can understand. The committee also wanted to ensure these statements conveyed the volume and quality of research related to the outcome and allowed the statement to stand on its own without context. Similar to our evidence statements, these use standardized language to represent the strength of relationship and use the phrase “associated with” to represent epidemiologic associations that do not imply causation. As of the date of this book’s publication CDPHE has seventy-four public health statements corresponding to all our evidence statements rated moderate or substantial.
In a similar manner, public health statements are subsequently drafted into public health recommendations. These are synthesized in order to inform the development of evidence-based prevention and education campaigns performed by CDPHE. Furthermore, recommendations are separated by data quality issues, surveillance, and education. Our recommendations share common themes to those put forth by the National Academies of Sciences, Engineering, and Medicine’s review of health effects associated with cannabis and cannabinoids [345].
Data quality issues are defined as recommendations to improve current data collection deficiencies at the clinical or governmental level that prevent full analysis of public health outcomes related to marijuana use. It is especially important to improve data quality by systematically collecting information on the frequency, amount, THC content, and method of marijuana use in both public health surveillance and medical care settings. Clinicians should routinely screen for marijuana use during hospitalizations, especially among pregnant or adolescent patients.
Public health surveillance recommendations are based on improving capacity to detect an acute public health danger (e.g., real time emergency department surveillance to detect poisonings from contaminated product); the ability to characterize chronic public health dangers to support policy and other intervention decisions; or the ability to generate epidemiologic data to contribute to planning and evaluating population level interventions. Questions regarding marijuana use should be continued on population-based surveys such as the Behavioral Risk Factor Surveillance System, the Healthy Kids Colorado Survey, and Pregnancy Risk Assessment Monitoring System. Additionally, methods should be expanded to collect more detailed information, such as quantity and methods of use, THC content of products used, and adverse effects experienced.
Education recommendations are included to ensure evidence-based information on potential health effects of marijuana use is provided to the appropriate target audiences. Public education is especially important related to the effects of use during pregnancy, adolescent use, driving after use, increasing THC concentration of products, and unsafe storage around children. Education for health care providers should also be emphasized on the need for marijuana use screening, the known health effects of use, and encouraging more open dialog between providers and patients.
In addition to public health recommendations, important research gaps related to the population-based health effects of marijuana use were identified during the literature review process. These research gaps are based on common limitations of existing research or issues important to public education or policymaking. Research gaps particularly important to public health and safety include the need for: (1) research on the effects of marijuana use on pregnant women and their offspring, including while breastfeeding; (2) research on marijuana and marijuana products that contain THC concentrations consistent with products currently available in legalized markets; (3) research on health effects among individuals who have used marijuana frequently for a long period of time; (4) research on driving impairment among people who use marijuana more than weekly and may have developed tolerance; (5) research to better characterize the pharmacokinetics/pharmacodynamics, potential drug interactions, health effects, and impairment related to non-smoking methods of marijuana use such as edible products and vaporizing; and (6) research to better describe the risk of adverse health effects due to contamination of the marijuana product by fungi, mold, solvents, additives, heavy metals, and pesticides.
Other research gaps identify areas that need improvement in new research moving forward. Such as studies using better and more standardized indicators of marijuana use, including frequency, THC content, and route of exposure, including populations that use marijuana daily or near daily, and stratifying groups by age and gender. Finally one step to provide strong evidence would be research data on a community based cohort to study both beneficial and adverse health effects of marijuana consumption. Identifying these research gaps provides researchers and funding sources with an important framework to prioritize areas of research related to marijuana use and public health.
Since 2014, when CDPHE was designated to monitor the emerging science and medical information relevant to the health effects associated with marijuana use, the RMPHAC and CDPHE technical staff have conducted an ongoing systematic review of scientific literature to establish over one hundred evidence statements with eleven health topics. Our mission is to translate the science into meaningful public health statements and recommendations to inform and educate the general public, healthcare providers, and everyone in-between on the health effects associated with marijuana use.
First, the committee established a strict process to ensure a thorough and unbiased review, set up quarterly meetings to enable open discussions on a continuous basis, and come to consensus on the science and how to present this information to the public. After establishing our process, evidence from scientific research is constantly reviewed and added when appropriate to form a comprehensive review of marijuana health effects across eleven health topic. Strong evidence statements from all health topics were displayed in tables and key findings were detailed in subsections to provide an overview of effects associated with marijuana use across many different populations and health topics. Additional details were described on how these evidence statements are used to inform public health policy in the State of Colorado through public health recommendations and research gaps.
Elyse Contreras, DeLayna Goulding, Daniel I. Vigil, Katelyn E. Hall, Michael Van Dyke, Shireen Banerji, Russell Bowler, Ashley Brooks-Russell, Christopher Domen, Heather Krug, David J Kroll, Sharon Langendoerfer, Andrew Monte, Kenneth Novoa, Judith Shlay, Elizabeth Stuyt, George Sam Wang, Bernadette Albanese, Lisa Barker, Laura Borgelt, Alvin C. Bronstein, Todd Carlson, Rowena Crow, Teresa Foo, Ken Gershman, Tista Ghosh, Heath Harmon, Rebecca Helfand, Renee M. Johnson, Bruce Mendelson, Madeline Morris, Kristina T. Phillips, Allison Rosenthal, Kim Siegal, Scott Simpson, Christian Thurstone.
“The authors declare no conflict of interest.”
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We report on the level of student engagement and the extent to which learning outcomes were met through the introduction of such an activity.",book:{id:"11552",title:"Gamification - Analysis, Design and Development",coverURL:"https://cdn.intechopen.com/books/images_new/11552.jpg"},signatures:"Mike Mavromihales and Violeta Holmes"}],onlineFirstChaptersTotal:109},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403",scope:"Artificial Intelligence (AI) is a rapidly developing multidisciplinary research area that aims to solve increasingly complex problems. In today's highly integrated world, AI promises to become a robust and powerful means for obtaining solutions to previously unsolvable problems. This Series is intended for researchers and students alike interested in this fascinating field and its many applications.",coverUrl:"https://cdn.intechopen.com/series/covers/14.jpg",latestPublicationDate:"July 5th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:9,editor:{id:"218714",title:"Prof.",name:"Andries",middleName:null,surname:"Engelbrecht",slug:"andries-engelbrecht",fullName:"Andries Engelbrecht",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNR8QAO/Profile_Picture_1622640468300",biography:"Andries Engelbrecht received the Masters and PhD degrees in Computer Science from the University of Stellenbosch, South Africa, in 1994 and 1999 respectively. He is currently appointed as the Voigt Chair in Data Science in the Department of Industrial Engineering, with a joint appointment as Professor in the Computer Science Division, Stellenbosch University. Prior to his appointment at Stellenbosch University, he has been at the University of Pretoria, Department of Computer Science (1998-2018), where he was appointed as South Africa Research Chair in Artifical Intelligence (2007-2018), the head of the Department of Computer Science (2008-2017), and Director of the Institute for Big Data and Data Science (2017-2018). 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He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"23",title:"Computational Neuroscience",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",isOpenForSubmission:!0,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null},{id:"24",title:"Computer Vision",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",isOpenForSubmission:!0,editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",slug:"george-papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",biography:"George A. Papakostas has received a diploma in Electrical and Computer Engineering in 1999 and the M.Sc. and Ph.D. degrees in Electrical and Computer Engineering in 2002 and 2007, respectively, from the Democritus University of Thrace (DUTH), Greece. Dr. Papakostas serves as a Tenured Full Professor at the Department of Computer Science, International Hellenic University, Greece. Dr. Papakostas has 10 years of experience in large-scale systems design as a senior software engineer and technical manager, and 20 years of research experience in the field of Artificial Intelligence. Currently, he is the Head of the “Visual Computing” division of HUman-MAchines INteraction Laboratory (HUMAIN-Lab) and the Director of the MPhil program “Advanced Technologies in Informatics and Computers” hosted by the Department of Computer Science, International Hellenic University. He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. Dr Ventura also holds the positions of Affiliated Professor at Virginia Commonwealth University (Richmond, USA) and Distinguished Adjunct Professor at King Abdulaziz University (Jeddah, Saudi Arabia). Additionally, he is deputy director of the Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI) and heads the Knowledge Discovery and Intelligent Systems Research Laboratory. He has published more than ten books and over 300 articles in journals and scientific conferences. Currently, his work has received over 18,000 citations according to Google Scholar, including more than 2200 citations in 2020. In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. He is a Senior Member of the IEEE Computer, the IEEE Computational Intelligence, and the IEEE Systems, Man, and Cybernetics Societies, and the Association of Computing Machinery (ACM). Finally, his main research interests include data science, computational intelligence, and their applications.",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"26",title:"Machine Learning and Data Mining",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",isOpenForSubmission:!0,editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. His research interests include intelligent and embedded systems.",institutionString:"Universidad Autonoma de Queretaro",institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null},{id:"27",title:"Multi-Agent Systems",coverUrl:"https://cdn.intechopen.com/series_topics/covers/27.jpg",isOpenForSubmission:!0,editor:{id:"148497",title:"Dr.",name:"Mehmet",middleName:"Emin",surname:"Aydin",slug:"mehmet-aydin",fullName:"Mehmet Aydin",profilePictureURL:"https://mts.intechopen.com/storage/users/148497/images/system/148497.jpg",biography:"Dr. Mehmet Emin Aydin is a Senior Lecturer with the Department of Computer Science and Creative Technology, the University of the West of England, Bristol, UK. His research interests include swarm intelligence, parallel and distributed metaheuristics, machine learning, intelligent agents and multi-agent systems, resource planning, scheduling and optimization, combinatorial optimization. Dr. Aydin is currently a Fellow of Higher Education Academy, UK, a member of EPSRC College, a senior member of IEEE and a senior member of ACM. In addition to being a member of advisory committees of many international conferences, he is an Editorial Board Member of various peer-reviewed international journals. He has served as guest editor for a number of special issues of peer-reviewed international journals.",institutionString:null,institution:{name:"University of the West of England",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:20,paginationItems:[{id:"82526",title:"Deep Multiagent Reinforcement Learning Methods Addressing the Scalability Challenge",doi:"10.5772/intechopen.105627",signatures:"Theocharis Kravaris and George A. 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(Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. His research interests include intelligent and embedded systems.",institutionString:"Universidad Autonoma de Queretaro",institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}}]},{type:"book",id:"7726",title:"Swarm Intelligence",subtitle:"Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/7726.jpg",slug:"swarm-intelligence-recent-advances-new-perspectives-and-applications",publishedDate:"December 4th 2019",editedByType:"Edited by",bookSignature:"Javier Del Ser, Esther Villar and Eneko Osaba",hash:"e7ea7e74ce7a7a8e5359629e07c68d31",volumeInSeries:2,fullTitle:"Swarm Intelligence - Recent Advances, New Perspectives and Applications",editors:[{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",institutionURL:null,country:{name:"Spain"}}}]},{type:"book",id:"7656",title:"Fuzzy Logic",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7656.jpg",slug:"fuzzy-logic",publishedDate:"February 5th 2020",editedByType:"Edited by",bookSignature:"Constantin Volosencu",hash:"54f092d4ffe0abf5e4172a80025019bc",volumeInSeries:3,fullTitle:"Fuzzy Logic",editors:[{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. 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He worked as a Executive Research & Development @ Cadila Pharmaceuticals Ltd, Ahmedabad. He received DBT-postdoc fellow @ Molecular Biophysics Unit, Indian Institute of Science, Bangalore under the supervision of Prof. P. Balaram, later he moved to NIH-postdoc researcher at Drexel University College of Medicine, Philadelphia, USA, after his return from postdoc joined NITK-Surthakal as a Adhoc faculty at department of chemistry. Since from August 2013 working as a Associate Professor, and in 2016 promoted to Profeesor in the School of Basic Sciences: Department of Chemistry and having 20 years of teaching and research experiences.",institutionString:null,institution:{name:"Rani Channamma University, Belagavi",country:{name:"India"}}},{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. 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He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. 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He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. 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In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. 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He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. 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She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. 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This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. This topic will closely deal with all emerging trends in this discipline.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11411,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. 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