Marijuana use among adolescents and young adults.
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"6132",leadTitle:null,fullTitle:"Advanced Casting Technologies",title:"Advanced Casting Technologies",subtitle:null,reviewType:"peer-reviewed",abstract:"Major casting processing advancements have been made in experimental and simulation areas. Newly developed advanced casting technologies allow foundry researchers to explore detailed phenomena associated with new casting process parameters helping to produce defect-free castings with good quality. Moreover, increased computational power allows foundry technologists to simulate advanced casting processes to reduce casting defects. In view of rapid expansion of knowledge and capability in the exciting field of casting technology, it is possible to develop new casting techniques. This book is intended to discuss many casting processing technologies. It is devoted to advanced casting processing technologies like ductile casting production and thermal analysis, casting of metal matrix composites by vortex stir casting technique, aluminum DC casting, evaporative casting process, and so on. This book entitled Advanced Casting Technologies has been organized into seven chapters and categorized into four sections. Section 1 discusses the production of ductile iron casting and thermal analysis. Section 2 depicts aluminum casting. Section 3 describes the casting manufacturing aspects of functionally graded materials and evaporative casting process. Section 4 explains about the vortex stir casting technique to process metal matrix composite castings. All the chapters discussed in detail the processing steps, process parameters involved in the individual casting technique, and also its applications. The goal of the book is to provide details on the recent casting technologies.",isbn:"978-1-78923-033-8",printIsbn:"978-1-78923-032-1",pdfIsbn:"978-1-83881-297-3",doi:"10.5772/intechopen.68254",price:119,priceEur:129,priceUsd:155,slug:"advanced-casting-technologies",numberOfPages:136,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"f2da423c1b74b321e5302adaaf888495",bookSignature:"T.R. Vijayaram",publishedDate:"May 2nd 2018",coverURL:"https://cdn.intechopen.com/books/images_new/6132.jpg",numberOfDownloads:9788,numberOfWosCitations:31,numberOfCrossrefCitations:34,numberOfCrossrefCitationsByBook:1,numberOfDimensionsCitations:53,numberOfDimensionsCitationsByBook:1,hasAltmetrics:1,numberOfTotalCitations:118,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 28th 2017",dateEndSecondStepPublish:"April 18th 2017",dateEndThirdStepPublish:"November 19th 2017",dateEndFourthStepPublish:"December 19th 2017",dateEndFifthStepPublish:"February 19th 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"139338",title:"Prof.",name:"Thoguluva",middleName:"Raghavan",surname:"Vijayaram",slug:"thoguluva-vijayaram",fullName:"Thoguluva Vijayaram",profilePictureURL:"https://mts.intechopen.com/storage/users/139338/images/system/139338.jpg",biography:"Dr. T. R. Vijayaram is a senior professor in the Department of Mechanical Engineering, School of Mechanical Engineering, Bharath Institute of Higher Education and Research (BIHER), India. He is an expert in the field of materials and metallurgical, manufacturing, and mechanical engineering. He received his BE in Mechanical Engineering from Madurai Kamaraj University, India, followed by an ME in Industrial Metallurgy from PSG College of Technology, Bharathiyar University, India. He obtained his Ph.D. in Mechanical Engineering from Universiti Putra Malaysia. Later, he worked as a rector researcher in metallurgy at the Department of Chemistry and Industrial Chemistry (DCCI), Genoa University, Italy. His passion for academics, research, and education led him to obtain an MBA in Educational Management and an MA in Sociology from the University of Madras, India. He is also a Chartered Engineer (India) and a member of several professional and scientific bodies in India and abroad, including the Indian Society for Technical Education (ISTE), Institution of Engineers (IEI), Institute of Indian Foundryman (IIF), and Society of Automotive Engineers (SAE). He is also a fellow of IEI. Dr. Vijayaram received the Distinguished Scientist Award in Metallurgical and Materials Engineering for his outstanding contribution to metallurgy. He has published more than 210 papers in international and national journals, conferences, broadsheets, and magazines. His areas of research include materials engineering, metallurgical engineering, manufacturing engineering, and mechanical engineering.",institutionString:"Bharath University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"1",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"944",title:"Metallurgy",slug:"metals-and-nonmetals-metallurgy"}],chapters:[{id:"57999",title:"Thin Wall Ductile Iron Castings",doi:"10.5772/intechopen.72117",slug:"thin-wall-ductile-iron-castings",totalDownloads:1021,totalCrossrefCites:2,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The use of austempered ductile iron (ADI) as an alternative material has increased, and it is predicted that it will reach 300,000 tons by the year of 2020 due to its characteristics especially design flexibility. When the reduction in weight is considered as a parameter for energy saving, ADI is presented as thin wall austempered ductile iron (TWADI). To produce a good quality TWADI, a good quality thin wall ductile iron (TWDI) must be used as a raw material. Good quality TWDI is produced by casting design. This chapter discusses the production of thin wall ductile iron, including its characterisation and defect. The discussion includes the background of thin wall casting (TWC) and TWDI, applying TWC in general casting, the problems in producing TWDI, characterisation of the TWDI and specific defects.",signatures:"Rianti Dewi Sulamet-Ariobimo, Johny Wahyuadi Soedarsono and\nTresna Priyana Soemardi",downloadPdfUrl:"/chapter/pdf-download/57999",previewPdfUrl:"/chapter/pdf-preview/57999",authors:[{id:"208291",title:"Dr.",name:"Rianti",surname:"Sulamet-Ariobimo",slug:"rianti-sulamet-ariobimo",fullName:"Rianti Sulamet-Ariobimo"}],corrections:null},{id:"57825",title:"Thermal Analysis of Ductile Iron Casting",doi:"10.5772/intechopen.72030",slug:"thermal-analysis-of-ductile-iron-casting",totalDownloads:1560,totalCrossrefCites:3,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Pure metals solidify with a solidification front that is very well defined and a clearly delineated solid-liquid interface. Ductile cast iron solidification is characterised by a very thin solidified skin and appearance of different phases. The outer skin is formed being very thin in ductile iron; the expansion occurs due to graphite nucleation into the casting forces to the mould walls. With proper care taken while designing and during melt processing stage, quality ductile iron castings can be produced with minimal risering. With recent developments in sensing and storing instruments, it is now possible to see and measure structural transformations within the solidification in ductile iron castings very precisely. The shape of a cooling curve measured by a thermocouple mounted on a thermal analysis sample cup reflects the solidification process of the melted cast alloy for the given solidification conditions. By analysing particular cooling curve, the solidification start, eutectic arrests, recalescence, amount of undercooling and end of freezing temperature temperatures are generated. The thermal analysis data so generated will be used to study composition, soundness, chill and microstructure by analysis of cooling curve. The cooling rates measured in degrees per second at different stages of solidification sequence will be analysed and correlated with the properties of the castings to be produced from the same melt.",signatures:"Vasudev D. Shinde",downloadPdfUrl:"/chapter/pdf-download/57825",previewPdfUrl:"/chapter/pdf-preview/57825",authors:[{id:"208778",title:"Prof.",name:"Vasudev",surname:"Shinde",slug:"vasudev-shinde",fullName:"Vasudev Shinde"}],corrections:null},{id:"57796",title:"Depicting Aluminium DC Casting by Means of Dimensionless Numbers",doi:"10.5772/intechopen.71893",slug:"depicting-aluminium-dc-casting-by-means-of-dimensionless-numbers",totalDownloads:1137,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"DC casting of aluminium and its alloys is a controlled heat removal solidification process. The rate of heat extraction has strong effects on the microstructure and mechanical properties of the solidified alloy ingots. In view of this strict temperature, control over the ingot as it solidifies should be implemented in order to achieve metal with the best possible properties. In situ direct temperature measurements are complicated; so in this report, the use of dimensionless analysis to predict temperature distributions on the ingots as they are casted is proposed. It is reported that the dimensionless groups that better represent the impact of process variables on the solidification of aluminium and its alloys are the Péclet (Pe) and Biot (Bi) numbers.",signatures:"José C. Méndez, Ricardo R. Ambriz, David Jaramillo and Gabriel\nPlascencia",downloadPdfUrl:"/chapter/pdf-download/57796",previewPdfUrl:"/chapter/pdf-preview/57796",authors:[{id:"46960",title:"Prof.",name:"Gabriel",surname:"Plascencia",slug:"gabriel-plascencia",fullName:"Gabriel Plascencia"},{id:"85573",title:"Dr.",name:"Ricardo Rafael",surname:"Ambriz",slug:"ricardo-rafael-ambriz",fullName:"Ricardo Rafael Ambriz"},{id:"170247",title:"Dr.",name:"David",surname:"Jaramillo",slug:"david-jaramillo",fullName:"David Jaramillo"},{id:"208155",title:"Prof.",name:"Claudio",surname:"Méndez",slug:"claudio-mendez",fullName:"Claudio Méndez"}],corrections:null},{id:"58487",title:"Castability and Characteristics of High Cerium Aluminum Alloys",doi:"10.5772/intechopen.72830",slug:"castability-and-characteristics-of-high-cerium-aluminum-alloys",totalDownloads:1009,totalCrossrefCites:6,totalDimensionsCites:13,hasAltmetrics:0,abstract:"This chapter describes the development and the castability of near eutectic aluminum-cerium (Al-Ce) alloy systems. These alloys have good mechanical properties at high temperatures and are very castable. The castability of the binary systems is as good or better than the aluminum-silicon system with some deterioration as additional alloying elements are added. In alloy systems that use cerium in combination with common aluminum alloying elements such as silicon, magnesium, and/or copper, the casting characteristics are generally better than the aluminum-copper system. Alloying with magnesium increases room temperature strength considerably.",signatures:"David Weiss",downloadPdfUrl:"/chapter/pdf-download/58487",previewPdfUrl:"/chapter/pdf-preview/58487",authors:[{id:"206168",title:"Mr.",name:"David",surname:"Weiss",slug:"david-weiss",fullName:"David Weiss"}],corrections:null},{id:"57524",title:"Casting and Applications of Functionally Graded Metal Matrix Composites",doi:"10.5772/intechopen.71225",slug:"casting-and-applications-of-functionally-graded-metal-matrix-composites",totalDownloads:1501,totalCrossrefCites:3,totalDimensionsCites:6,hasAltmetrics:0,abstract:"This chapter discusses the concepts, casting techniques and applications of functionally graded materials metal matrix composites (FGMMCs). Considerations were given to bulk functionally graded aluminium matrix composites (FGAACs) production processes. Liquid-metal forging processes of FGAACs fabrication, such as infiltration process, squeeze casting, friction casting or compocasting, stir, and centrifugal casting were discussed. The chapter provides basic concepts of the processes and overview of their processing parameters, such as mould rotational speed; reinforcement particles size and volume; degassing method; melting and pouring temperatures; pressure; and stirrer. The study notes that functionally graded materials (FGMs) are commonly used in automotive, aircraft, aviation, chemical, medical, engineering, renewable energy, nuclear energy, and optics electronics industries.",signatures:"Williams S. Ebhota and Tien-Chen Jen",downloadPdfUrl:"/chapter/pdf-download/57524",previewPdfUrl:"/chapter/pdf-preview/57524",authors:[{id:"206268",title:"Dr.",name:"Williams",surname:"Ebhota",slug:"williams-ebhota",fullName:"Williams Ebhota"},{id:"214786",title:"Prof.",name:"Tien-Chien",surname:"Jen",slug:"tien-chien-jen",fullName:"Tien-Chien Jen"}],corrections:null},{id:"59140",title:"Evaporative Pattern Casting (EPC) Process",doi:"10.5772/intechopen.73526",slug:"evaporative-pattern-casting-epc-process",totalDownloads:1234,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The chapter provides details of operations and activities in evaporative pattern casting (EPC) Process. The process was developed in the year 1956 to tackle some of the inadequacies of the traditional sand casting processes but has in itself some challenges that should be taken care of if sound castings would be obtained. The challenges come mainly from the evaporative pattern employed as pattern material in the process. The material makes the process to be sensitive to process variables such that proper and adequate control should be ensured to have castings of sound integrity. Some of the known process variables are pouring temperature, refractory coating, vibration and pattern and molding materials. In the whole the EPC is known to have edge over the traditional sand casting methods.",signatures:"Babatunde Victor Omidiji",downloadPdfUrl:"/chapter/pdf-download/59140",previewPdfUrl:"/chapter/pdf-preview/59140",authors:[{id:"228410",title:"Dr.",name:"Victor",surname:"Omidiji",slug:"victor-omidiji",fullName:"Victor Omidiji"}],corrections:null},{id:"58816",title:"Fabrication of Aluminum Matrix Composites by Stir Casting Technique and Stirring Process Parameters Optimization",doi:"10.5772/intechopen.73485",slug:"fabrication-of-aluminum-matrix-composites-by-stir-casting-technique-and-stirring-process-parameters-",totalDownloads:2326,totalCrossrefCites:20,totalDimensionsCites:30,hasAltmetrics:1,abstract:"Aluminum matrix composites (AMCs) and hybrid aluminum matrix composites (HAMCs) becomes choice for automobile and aerospace industries due to its tunable mechanical properties such as very high strength to weight ratio, superior wear resistance, greater stiffness, better fatigue resistance, controlled co-efficient of thermal expansion and good stability at elevated temperature. Stir casting is an appropriate method for composite fabrication and widely used industrial fabrication of AMCs and HAMCs due to flexibility, cost-effectiveness and best suitable for mass production. Distribution of the reinforcement particles in the final prepared composite regulates the anticipated properties of AMCs and HAMCs. However, distribution of reinforcements is governed by stirring process parameters. The study of effect of stirring parameters in the particle distribution and optimal selection of these is still a challenge for the ever-growing industries and research. In this chapter accurate and precise attempts were taken to explore the effect of stirring parameters in stir casting process rigorously. Further, Optimal values of stirring parameters were suggested which may be helpful for the researchers for the development of AMCs and HAMCs. This chapter may also provide a better vision towards the selection of stirring parameters for industrial production of AMCs and HAMCs comprising superior mechanical properties.",signatures:"Mohit Kumar Sahu and Raj Kumar Sahu",downloadPdfUrl:"/chapter/pdf-download/58816",previewPdfUrl:"/chapter/pdf-preview/58816",authors:[{id:"200118",title:"Dr.",name:"Raj",surname:"Sahu",slug:"raj-sahu",fullName:"Raj Sahu"},{id:"225730",title:"Mr.",name:"Mohit",surname:"Sahu",slug:"mohit-sahu",fullName:"Mohit Sahu"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"3817",title:"Developments in Corrosion Protection",subtitle:null,isOpenForSubmission:!1,hash:"8ff86fac7ac8bce142fdc3c0e5a79f30",slug:"developments-in-corrosion-protection",bookSignature:"M. Aliofkhazraei",coverURL:"https://cdn.intechopen.com/books/images_new/3817.jpg",editedByType:"Edited by",editors:[{id:"155413",title:"Dr.",name:"Mahmood",surname:"Aliofkhazraei",slug:"mahmood-aliofkhazraei",fullName:"Mahmood Aliofkhazraei"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"27",title:"Magnesium Alloys",subtitle:"Design, Processing and Properties",isOpenForSubmission:!1,hash:null,slug:"magnesium-alloys-design-processing-and-properties",bookSignature:"Frank Czerwinski",coverURL:"https://cdn.intechopen.com/books/images_new/27.jpg",editedByType:"Edited by",editors:[{id:"16295",title:"Dr.",name:"Frank",surname:"Czerwinski",slug:"frank-czerwinski",fullName:"Frank Czerwinski"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3494",title:"Titanium Alloys",subtitle:"Advances in Properties Control",isOpenForSubmission:!1,hash:"83dc0b49b280c4df33cb4cac06fc3660",slug:"titanium-alloys-advances-in-properties-control",bookSignature:"Jan Sieniawski and Waldemar Ziaja",coverURL:"https://cdn.intechopen.com/books/images_new/3494.jpg",editedByType:"Edited by",editors:[{id:"109232",title:"Prof.",name:"Jan",surname:"Sieniawski",slug:"jan-sieniawski",fullName:"Jan Sieniawski"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3844",title:"Light Metal Alloys Applications",subtitle:null,isOpenForSubmission:!1,hash:"6ddeae36c90447289dd3320146d31861",slug:"light-metal-alloys-applications",bookSignature:"Waldemar A. 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Segovia",authors:[{id:"35353",title:"Dr.",name:"Jose",middleName:"C",surname:"Segovia",fullName:"Jose Segovia",slug:"jose-segovia"},{id:"59062",title:"Dr.",name:"Susana",middleName:null,surname:"Navarro",fullName:"Susana Navarro",slug:"susana-navarro"},{id:"158068",title:"Ph.D. Student",name:"María",middleName:null,surname:"García-Gómez",fullName:"María García-Gómez",slug:"maria-garcia-gomez"},{id:"158069",title:"Dr.",name:"Oscar",middleName:null,surname:"Quintana-Bustamante",fullName:"Oscar Quintana-Bustamante",slug:"oscar-quintana-bustamante"},{id:"158742",title:"Dr.",name:"Maria",middleName:null,surname:"Garcia-Bravo",fullName:"Maria Garcia-Bravo",slug:"maria-garcia-bravo"},{id:"158743",title:"Dr.",name:"Zita",middleName:null,surname:"Garate",fullName:"Zita Garate",slug:"zita-garate"}]},{id:"43285",title:"Targeting the Lung: Challenges in Gene Therapy for Cystic Fibrosis",slug:"targeting-the-lung-challenges-in-gene-therapy-for-cystic-fibrosis",signatures:"George Kotzamanis, Athanassios Kotsinas, Apostolos Papalois and Vassilis G. Gorgoulis",authors:[{id:"34121",title:"Dr.",name:"George",middleName:null,surname:"Kotzamanis",fullName:"George Kotzamanis",slug:"george-kotzamanis"},{id:"45037",title:"Dr.",name:"Athanassios",middleName:null,surname:"Kotsinas",fullName:"Athanassios Kotsinas",slug:"athanassios-kotsinas"},{id:"45038",title:"Dr.",name:"Vassilis",middleName:null,surname:"Gorgoulis",fullName:"Vassilis Gorgoulis",slug:"vassilis-gorgoulis"},{id:"166017",title:"Dr.",name:"Apostolos",middleName:null,surname:"Papalois",fullName:"Apostolos Papalois",slug:"apostolos-papalois"}]},{id:"41748",title:"Gene Therapy for the COL7A1 Gene",slug:"gene-therapy-for-the-col7a1-gene",signatures:"E. Mayr, U. Koller and J.W. Bauer",authors:[{id:"55760",title:"Dr.",name:"Ulrich",middleName:null,surname:"Koller",fullName:"Ulrich Koller",slug:"ulrich-koller"},{id:"55761",title:"Mr.",name:"Johann W",middleName:null,surname:"Bauer",fullName:"Johann W Bauer",slug:"johann-w-bauer"},{id:"158243",title:"Dr.",name:"Elisabeth",middleName:null,surname:"Mayr",fullName:"Elisabeth Mayr",slug:"elisabeth-mayr"}]},{id:"43283",title:"Molecular Therapy for Lysosomal Storage Diseases",slug:"molecular-therapy-for-lysosomal-storage-diseases",signatures:"Daisuke Tsuji and Kohji Itoh",authors:[{id:"155727",title:"Prof.",name:"Kohji",middleName:null,surname:"Itoh",fullName:"Kohji Itoh",slug:"kohji-itoh"}]},{id:"43290",title:"Gene Therapy Perspectives Against Diseases of the Respiratory System",slug:"gene-therapy-perspectives-against-diseases-of-the-respiratory-system",signatures:"Dimosthenis Lykouras, Kiriakos Karkoulias, Christos Tourmousoglou, Efstratios Koletsis, Kostas Spiropoulos and Dimitrios Dougenis",authors:[{id:"37122",title:"Prof.",name:"Dimitrios",middleName:null,surname:"Dougenis",fullName:"Dimitrios Dougenis",slug:"dimitrios-dougenis"},{id:"46526",title:"Dr.",name:"Dimosthenis",middleName:null,surname:"Lykouras",fullName:"Dimosthenis Lykouras",slug:"dimosthenis-lykouras"},{id:"158368",title:"Prof.",name:"Kostas",middleName:null,surname:"Spiropoulos",fullName:"Kostas Spiropoulos",slug:"kostas-spiropoulos"},{id:"158369",title:"Prof.",name:"Kiriakos",middleName:null,surname:"Karkoulias",fullName:"Kiriakos Karkoulias",slug:"kiriakos-karkoulias"},{id:"162954",title:"Dr.",name:"Christos",middleName:null,surname:"Tourmousoglou",fullName:"Christos Tourmousoglou",slug:"christos-tourmousoglou"},{id:"167156",title:"Prof.",name:"Efstratios",middleName:null,surname:"Koletsis",fullName:"Efstratios Koletsis",slug:"efstratios-koletsis"}]},{id:"43291",title:"Gene Therapy in Critical Care Medicine",slug:"gene-therapy-in-critical-care-medicine",signatures:"Gabriel J. Moreno-González and Angel Zarain-Herzberg",authors:[{id:"28335",title:"Dr.",name:"Angel",middleName:null,surname:"Zarain-Herzberg",fullName:"Angel Zarain-Herzberg",slug:"angel-zarain-herzberg"},{id:"161820",title:"Dr.",name:"Gabriel",middleName:null,surname:"Moreno-González",fullName:"Gabriel Moreno-González",slug:"gabriel-moreno-gonzalez"}]},{id:"43292",title:"Clinical and Translational Challenges in Gene Therapy of Cardiovascular Diseases",slug:"clinical-and-translational-challenges-in-gene-therapy-of-cardiovascular-diseases",signatures:"Divya Pankajakshan and Devendra K. Agrawal",authors:[{id:"156595",title:"Prof.",name:"Devendra",middleName:null,surname:"Agrawal",fullName:"Devendra Agrawal",slug:"devendra-agrawal"},{id:"360675",title:"Dr.",name:"Divya",middleName:null,surname:"Pankajakshan",fullName:"Divya Pankajakshan",slug:"divya-pankajakshan"}]},{id:"43104",title:"Gene Therapy for Chronic Pain Management",slug:"gene-therapy-for-chronic-pain-management",signatures:"Isaura Tavares and Isabel Martins",authors:[{id:"156578",title:"Prof.",name:"Isaura",middleName:null,surname:"Tavares",fullName:"Isaura Tavares",slug:"isaura-tavares"},{id:"360537",title:"Dr.",name:"Isabel",middleName:null,surname:"Martins",fullName:"Isabel Martins",slug:"isabel-martins"}]},{id:"40434",title:"Insulin Trafficking in a Glucose Responsive Engineered Human Liver Cell Line is Regulated by the Interaction of ATP-Sensitive Potassium Channels and Voltage-Gated Calcium Channels",slug:"insulin-trafficking-in-a-glucose-responsive-engineered-human-liver-cell-line-is-regulated-by-the-int",signatures:"Ann M. Simpson, M. Anne Swan, Guo Jun Liu, Chang Tao, Bronwyn A O’Brien, Edwin Ch’ng, Leticia M. Castro, Julia Ting, Zehra Elgundi, Tony An, Mark Lutherborrow, Fraser Torpy, Donald K. Martin, Bernard E. Tuch and Graham M. Nicholson",authors:[{id:"157918",title:"Prof.",name:"Ann M.",middleName:null,surname:"Simpson",fullName:"Ann M. Simpson",slug:"ann-m.-simpson"},{id:"186950",title:"Dr.",name:"Fraser",middleName:null,surname:"Torpy",fullName:"Fraser Torpy",slug:"fraser-torpy"},{id:"364218",title:"Dr.",name:"M. Anne",middleName:null,surname:"Swan",fullName:"M. Anne Swan",slug:"m.-anne-swan"},{id:"364219",title:"Dr.",name:"Guo Jun",middleName:null,surname:"Liu",fullName:"Guo Jun Liu",slug:"guo-jun-liu"},{id:"364220",title:"Dr.",name:"Chang",middleName:null,surname:"Tao",fullName:"Chang Tao",slug:"chang-tao"},{id:"364221",title:"Dr.",name:"Bronwyn A",middleName:null,surname:"O’Brien",fullName:"Bronwyn A O’Brien",slug:"bronwyn-a-o'brien"},{id:"364222",title:"Dr.",name:"Edwin",middleName:null,surname:"Ch’ng",fullName:"Edwin Ch’ng",slug:"edwin-ch'ng"},{id:"364223",title:"Dr.",name:"Leticia M.",middleName:null,surname:"Castro",fullName:"Leticia M. Castro",slug:"leticia-m.-castro"},{id:"364224",title:"Dr.",name:"Julia",middleName:null,surname:"Ting",fullName:"Julia Ting",slug:"julia-ting"},{id:"364225",title:"Dr.",name:"Zehra",middleName:null,surname:"Elgundi",fullName:"Zehra Elgundi",slug:"zehra-elgundi"},{id:"364226",title:"Dr.",name:"Tony",middleName:null,surname:"An",fullName:"Tony An",slug:"tony-an"},{id:"364227",title:"Dr.",name:"Mark",middleName:null,surname:"Lutherborrow",fullName:"Mark Lutherborrow",slug:"mark-lutherborrow"},{id:"364228",title:"Dr.",name:"Donald K.",middleName:null,surname:"Martin",fullName:"Donald K. Martin",slug:"donald-k.-martin"},{id:"364229",title:"Dr.",name:"Bernard E.",middleName:null,surname:"Tuch",fullName:"Bernard E. Tuch",slug:"bernard-e.-tuch"},{id:"364230",title:"Dr.",name:"Graham M.",middleName:null,surname:"Nicholson",fullName:"Graham M. Nicholson",slug:"graham-m.-nicholson"}]},{id:"43101",title:"Feasibility of Gene Therapy for Tooth Regeneration by Stimulation of a Third Dentition",slug:"feasibility-of-gene-therapy-for-tooth-regeneration-by-stimulation-of-a-third-dentition",signatures:"Katsu Takahashi, Honoka Kiso, Kazuyuki Saito, Yumiko Togo, Hiroko Tsukamoto, Boyen Huang and Kazuhisa Bessho",authors:[{id:"53779",title:"Prof.",name:"Kazuhisa",middleName:null,surname:"Bessho",fullName:"Kazuhisa Bessho",slug:"kazuhisa-bessho"},{id:"172983",title:"Dr.",name:"Katsu",middleName:null,surname:"Takahashi",fullName:"Katsu Takahashi",slug:"katsu-takahashi"},{id:"360532",title:"Dr.",name:"Honoka",middleName:null,surname:"Kiso",fullName:"Honoka Kiso",slug:"honoka-kiso"},{id:"360533",title:"Dr.",name:"Kazuyuki",middleName:null,surname:"Saito",fullName:"Kazuyuki Saito",slug:"kazuyuki-saito"},{id:"360534",title:"Dr.",name:"Yumiko",middleName:null,surname:"Togo",fullName:"Yumiko Togo",slug:"yumiko-togo"},{id:"360535",title:"Dr.",name:"Hiroko",middleName:null,surname:"Tsukamoto",fullName:"Hiroko Tsukamoto",slug:"hiroko-tsukamoto"},{id:"360536",title:"Dr.",name:"Boyen",middleName:null,surname:"Huang",fullName:"Boyen Huang",slug:"boyen-huang"}]}]}],publishedBooks:[{type:"book",id:"364",title:"Gene Duplication",subtitle:null,isOpenForSubmission:!1,hash:"79e1de88c46f703c92c157b80d886221",slug:"gene-duplication",bookSignature:"Felix Friedberg",coverURL:"https://cdn.intechopen.com/books/images_new/364.jpg",editedByType:"Edited by",editors:[{id:"62782",title:"Prof.",name:"Felix",surname:"Friedberg",slug:"felix-friedberg",fullName:"Felix Friedberg"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1446",title:"Senescence",subtitle:null,isOpenForSubmission:!1,hash:"7aa2772cf0b5653b6c599dba90f4c709",slug:"senescence",bookSignature:"Tetsuji Nagata",coverURL:"https://cdn.intechopen.com/books/images_new/1446.jpg",editedByType:"Edited by",editors:[{id:"93967",title:"Dr.",name:"Tetsuji",surname:"Nagata",slug:"tetsuji-nagata",fullName:"Tetsuji Nagata"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3428",title:"Meiosis",subtitle:null,isOpenForSubmission:!1,hash:"5be852a0afc01de31a5dd7164bcd025e",slug:"meiosis",bookSignature:"Carol Bernstein and Harris Bernstein",coverURL:"https://cdn.intechopen.com/books/images_new/3428.jpg",editedByType:"Edited by",editors:[{id:"61946",title:"Dr.",name:"Carol",surname:"Bernstein",slug:"carol-bernstein",fullName:"Carol Bernstein"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3429",title:"Senescence and Senescence-Related Disorders",subtitle:null,isOpenForSubmission:!1,hash:"2dc962eff773b82b389299073279b4c8",slug:"senescence-and-senescence-related-disorders",bookSignature:"Zhiwei Wang and Hiroyuki Inuzuka",coverURL:"https://cdn.intechopen.com/books/images_new/3429.jpg",editedByType:"Edited by",editors:[{id:"164282",title:"Dr.",name:"Wang",surname:"Zhiwei",slug:"wang-zhiwei",fullName:"Wang Zhiwei"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3509",title:"Gene Therapy",subtitle:"Tools and Potential Applications",isOpenForSubmission:!1,hash:"0fd8b4898c201b4a9f8e597cbcf4d968",slug:"gene-therapy-tools-and-potential-applications",bookSignature:"Francisco Martin Molina",coverURL:"https://cdn.intechopen.com/books/images_new/3509.jpg",editedByType:"Edited by",editors:[{id:"32294",title:"Dr.",name:"Francisco",surname:"Martín-Molina",slug:"francisco-martin-molina",fullName:"Francisco Martín-Molina"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],publishedBooksByAuthor:[{type:"book",id:"1446",title:"Senescence",subtitle:null,isOpenForSubmission:!1,hash:"7aa2772cf0b5653b6c599dba90f4c709",slug:"senescence",bookSignature:"Tetsuji Nagata",coverURL:"https://cdn.intechopen.com/books/images_new/1446.jpg",editedByType:"Edited by",editors:[{id:"93967",title:"Dr.",name:"Tetsuji",surname:"Nagata",slug:"tetsuji-nagata",fullName:"Tetsuji Nagata"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},onlineFirst:{chapter:{type:"chapter",id:"82942",title:"Evidence of Health Effects Associated with Marijuana Use: A Comprehensive Public Health Review",doi:"10.5772/intechopen.106250",slug:"evidence-of-health-effects-associated-with-marijuana-use-a-comprehensive-public-health-review",body:'
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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Along this line, we have proposed clinically optimized plan comparison protocols and indicated further directions of such studies.",book:{id:"4604",slug:"evolution-of-ionizing-radiation-research",title:"Evolution of Ionizing Radiation Research",fullTitle:"Evolution of Ionizing Radiation Research"},signatures:"Suk Lee, Yuan Jie Cao and Chul Yong Kim",authors:[{id:"96630",title:"Prof.",name:"Suk",middleName:null,surname:"Lee",slug:"suk-lee",fullName:"Suk Lee"},{id:"175104",title:"Prof.",name:"Chul Yong",middleName:null,surname:"Kim",slug:"chul-yong-kim",fullName:"Chul Yong Kim"},{id:"175234",title:"Dr.",name:"Yuan Jie",middleName:null,surname:"Cao",slug:"yuan-jie-cao",fullName:"Yuan Jie Cao"}]},{id:"48894",doi:"10.5772/60435",title:"Gamma Radiation as a Recycling Tool for Waste Materials Used in Concrete",slug:"gamma-radiation-as-a-recycling-tool-for-waste-materials-used-in-concrete",totalDownloads:2330,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"Over the course of the last 50 years, a large number of major technological advances have contributed to the development of higher-strength, high-performance materials that provide excellent benefits. Nevertheless, in most cases, after a very short useful life, these products become waste material and contribute to environmental degradation. This situation has created an environmental crisis that has reached global proportions. In efforts to combat this issue and to promote sustainable development and reduce environmental pollution, some investigations have focused on recycling using innovative and clean technologies, such as gamma radiation, as an alternative to conventional mechanical and chemical recycling procedures. In this context, the reuse and recycling of waste materials and the use of gamma radiation are useful tools for improving the mechanical properties of concrete; for example, the compressive strength and modulus of elasticity are improved by the addition of waste particles and application of gamma radiation. In this chapter, we propose the use of gamma radiation as a method for modifying waste materials; for instance, polyethylene terephthalate plastic bottles, automotive tire rubber, and the cellulose in Tetra Pak containers, and their reuse to enhance the properties of concrete.",book:{id:"4604",slug:"evolution-of-ionizing-radiation-research",title:"Evolution of Ionizing Radiation Research",fullTitle:"Evolution of Ionizing Radiation Research"},signatures:"Gonzalo Martínez-Barrera, Liliana Ivette Ávila-Córdoba, Miguel\nMartínez-López, Eduardo Sadot Herrera-Sosa, Enrique Vigueras-\nSantiago, Carlos Eduardo Barrera-Díaz, Fernando Ureña-Nuñez and\nNelly González-Rivas",authors:[{id:"102080",title:"Dr.",name:"Gonzalo",middleName:null,surname:"Martínez-Barrera",slug:"gonzalo-martinez-barrera",fullName:"Gonzalo Martínez-Barrera"},{id:"110214",title:"Dr.",name:"Fernando",middleName:null,surname:"Ureña-Nuñez",slug:"fernando-urena-nunez",fullName:"Fernando Ureña-Nuñez"},{id:"177864",title:"Dr.",name:"Liliana Ivette",middleName:null,surname:"Ávila-Córdoba",slug:"liliana-ivette-avila-cordoba",fullName:"Liliana Ivette Ávila-Córdoba"},{id:"177865",title:"Dr.",name:"Miguel",middleName:null,surname:"Martínez-López",slug:"miguel-martinez-lopez",fullName:"Miguel Martínez-López"},{id:"177866",title:"Dr.",name:"Eduardo",middleName:null,surname:"Sadot Herrera-Sosa",slug:"eduardo-sadot-herrera-sosa",fullName:"Eduardo Sadot Herrera-Sosa"},{id:"177867",title:"Dr.",name:"Enrique",middleName:null,surname:"Vigueras-Santiago",slug:"enrique-vigueras-santiago",fullName:"Enrique Vigueras-Santiago"},{id:"177868",title:"Dr.",name:"Carlos Eduardo",middleName:null,surname:"Barrera-Díaz",slug:"carlos-eduardo-barrera-diaz",fullName:"Carlos Eduardo Barrera-Díaz"},{id:"177869",title:"Dr.",name:"Nelly",middleName:null,surname:"González-Rivas",slug:"nelly-gonzalez-rivas",fullName:"Nelly González-Rivas"}]}],mostDownloadedChaptersLast30Days:[{id:"48796",title:"Ionizing Radiation Detectors",slug:"ionizing-radiation-detectors",totalDownloads:3943,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Ionizing radiation has always been present in the natural environment. However, this radiation is not easily detected and since it also possesses high ionizing power and penetration strength, it constitutes a risk to human health when it is found outside of its acceptable limits. The adverse effects of ionizing radiation on human health need to be systematically monitored in order to prevent damage, overexposure, or even death. The detection of the radiation depends on its particular interaction with a sensitive material, and different types of detectors, in different physical states (solid, liquid or gas), are used to measure selective types of ionizing radiation. New materials such as organic semiconductors, for instance, are being targeted for research and as potential candidates for new perspectives on ionizing radiation sensing.",book:{id:"4604",slug:"evolution-of-ionizing-radiation-research",title:"Evolution of Ionizing Radiation Research",fullTitle:"Evolution of Ionizing Radiation Research"},signatures:"Marcia Dutra R. Silva",authors:[{id:"173533",title:"Dr.",name:"Marcia",middleName:"Dutra",surname:"Silva",slug:"marcia-silva",fullName:"Marcia Silva"}]},{id:"73661",title:"Localization Mechanisms of Radiopharmaceuticals",slug:"localization-mechanisms-of-radiopharmaceuticals",totalDownloads:1046,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Scintigraphic techniques have opened a new era of developments in the localization of infectious and cancerous foci. Diseases area targeting mechanisms of radiopharmaceuticals encompasses visualization, characterization, and measurement of physiological and biological functioning at targeted sites in addition to measure the area and density of the disease. The accumulation of a radiopharmaceutical at specific organ is based upon numerous processes such as enzymatic interactions, receptor binding site, transport of chemical species and elimination of damaged cells from circulation by a normal metabolic process. PET and SPECT are developing scanning techniques that provides effective diagnostic tool to identify pathophysiology of diseased cells. In this chapter, we are exploring and explaining different mechanisms of radiopharmaceutical localization for imaging and therapeutic processes. The knowledge of these mechanisms will help to develop target based new radiopharmaceuticals using variety of medically used radioisotopes either for imaging or therapy of diseased cells.",book:{id:"7769",slug:"medical-isotopes",title:"Medical Isotopes",fullTitle:"Medical Isotopes"},signatures:"Sana Komal, Sana Nadeem, Zahra Faheem, Arouma Raza, Komal Sarwer, Hijab Umer, Samina Roohi and Syed Ali Raza Naqvi",authors:null},{id:"49039",title:"Physical and Radiobiological Evaluation of Radiotherapy Treatment Plan",slug:"physical-and-radiobiological-evaluation-of-radiotherapy-treatment-plan",totalDownloads:4477,totalCrossrefCites:6,totalDimensionsCites:9,abstract:"Radiation treatment planning plays an important role in modern radiation therapy; it could simulate to plan the geometric, radiobiological, and dosimetric aspects of the therapy using radiation transport simulations and optimization. In this chapter, we have reviewed several quantitative methods used for evaluating radiation treatment plans and discussed some important considering points. For the purpose of quantitative plan evaluation, we reviewed dosimetrical indexes like PITV, CI, TCI, HI, MHI, CN, COSI, and QF. Furthermore, radiobiological indexes like Niemierko’s EUD-based TCP and NTCP were included for the purpose of radiobiological outcome modeling. Additionally, we have reviewed dose tolerance for critical organs including RTOG clinical trial results, QUENTEC data, Emami data, and Milano clinical trial results. For the purpose of clinical evaluation of radiation-induced organ toxicity, we have reviewed RTOG and EORTC toxicity criteria. Several programs could help for the easy calculation and analysis of dosimetrical plan indexes and biological results. We have reviewed the recent trend in this field and proposed further clinical use of such programs. Along this line, we have proposed clinically optimized plan comparison protocols and indicated further directions of such studies.",book:{id:"4604",slug:"evolution-of-ionizing-radiation-research",title:"Evolution of Ionizing Radiation Research",fullTitle:"Evolution of Ionizing Radiation Research"},signatures:"Suk Lee, Yuan Jie Cao and Chul Yong Kim",authors:[{id:"96630",title:"Prof.",name:"Suk",middleName:null,surname:"Lee",slug:"suk-lee",fullName:"Suk Lee"},{id:"175104",title:"Prof.",name:"Chul Yong",middleName:null,surname:"Kim",slug:"chul-yong-kim",fullName:"Chul Yong Kim"},{id:"175234",title:"Dr.",name:"Yuan Jie",middleName:null,surname:"Cao",slug:"yuan-jie-cao",fullName:"Yuan Jie Cao"}]},{id:"70286",title:"Parathyroid Scintigraphy",slug:"parathyroid-scintigraphy",totalDownloads:659,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The visualization of abnormal parathyroid glands is difficult due to their variations in number and localization. Noninvasive parathyroid imaging studies include 99mTc-sestamibi scintigraphy, ultrasonography, computed tomography scanning, magnetic resonance imaging, and positron emission tomography. There is a general consensus that the most sensitive and specific imaging modality, especially when it is combined with single-photon emission CT is the scintigraphy with 99mTc-sestamibi or 99mTc-tetrofosmin. 99mTc-sestamibi scintigraphy significantly increases the role of preoperative scintigraphy in patients with hyperparathyroidism and allows unilateral surgical approach with minimally invasive parathyroidectomy to be used. Generally, three protocols with the use of two radiopharmaceuticals, 99mTc-sestamibi or 99mTc-tetrofosmin, are most widely applied: single-phase dual-isotope subtraction, dual-phase single-isotope and combination of both. Each one of them has specific advantages and disadvantages. While single parathyroid adenomas are localized with greater precision, hyperfunctioning parathyroid hyperplastic cells represent a real challenge to the imaging modalities. Several factors can influence the radionuclide uptake in pathologically changed parathyroid cells, like the size, the level of their functional activity, the quantity of oxyphilic cells, mitochondria, P glycoprotein and other MDR gene products.",book:{id:"7769",slug:"medical-isotopes",title:"Medical Isotopes",fullTitle:"Medical Isotopes"},signatures:"Albena Dimitrova Botushanova and Nikolay Petrov Botushanov",authors:null},{id:"70578",title:"Gallium-68: Radiolabeling of Radiopharmaceuticals for PET Imaging - A Lot to Consider",slug:"gallium-68-radiolabeling-of-radiopharmaceuticals-for-pet-imaging-a-lot-to-consider",totalDownloads:1741,totalCrossrefCites:4,totalDimensionsCites:6,abstract:"Gallium-68 was applied for positron emission tomography (PET) imaging already in the early beginnings of PET imaging. Today, with the introduction of PSMA-targeting tracers (e.g. PSMA-11, PSMA-617, and PSMA-I&T), the number of clinical applications of 68Ga-radiopharmaceuticals for diagnostic imaging has grown considerably. This development was initiated and supported already in the mid-2000s by the commercial availability of 68Ge/68Ga generators designed for clinical usage. This progression was accompanied by the development of several purification methods to generator eluate as well as sophisticated 68Ga-radiopharmaceuticals. Due to the 68Ga-rush, the need for implementation of gallium-68 (depending on production route) and its certain tracers into the pharmacopeia increased. Based on the specifications given by the pharmacopeia, interest focused on the development of automated synthesis systems, 99mTc-analog kits with regard to patient as well as operator safety.",book:{id:"7769",slug:"medical-isotopes",title:"Medical Isotopes",fullTitle:"Medical Isotopes"},signatures:"Michael Meisenheimer, Yury Saenko and Elisabeth Eppard",authors:null}],onlineFirstChaptersFilter:{topicId:"1213",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},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:"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"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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