*Edited by Olga Petrucci*

This book is an overview of the complex and multifaceted topic of natural disasters impact. Several possible approaches can be undertaken to assess economic, psychological, societal or environmental damage caused by natural disasters, aiming to reduce the effects of future events on the whole of these sectors. This book proposes a range of studies realized in different continents, showing various aspects from which natural disasters can be view, thus giving a measure of the complexity and multidisciplinary of the topic. It starts with a paper presenting a possible strategy to either avoid or reduce the vulnerability of concrete buildings during floods. Then, it continues with an insight into the communication during post-disaster emergency phase and with two chapters concerning the assessment of two different kinds of impact on people everyday life. The book ends with an analysis of the role of stakeholder participation in post-disaster reconstruction.

ISBN 978-953-51-1190-0

Natural Disasters - Multifaceted Aspects in Management and Impact Assessment

Photo by vchal / iStock


*4.2.2 The HSE plan*

*Risk Management in Construction Projects*

guidance.

department.

relevant contents through risk management activities.

contents, facilitating the education on the HSE guidance.

*<IP_ADDRESS> Compilation and application of the HSE guidance*

Except for the "patrol inspection and main contents," all the rest are readily available. Incorporate them into the HSE guidance after modifications are made to

The revised position-specific HSE guidance (version II) mainly contains the basic requirements that employees should meet. Unlike version I, the contents on the management of conventional risks relating to the discipline in version II were incorporated into position-specific operating procedures and other relevant

In addition, we also recommend the use of "bowtie" model and other effective methods to reinforce the prevention of significant risks. Significant risks generally fall into the category of conventional risks. In addition to the normal prevention means such as operating procedures, we recommend using the "bowtie" model (**Figure 3**) to strengthen the prevention of significant risks. Depending on the circumstances, the "key tasks" and "key facilities" generated by the "bowtie" model should be allocated to relevant positions and included in the position-specific HSE

The HSE guidance should be compiled considering the nature of grassroots organizations. For grassroots organizations of the same type, a consistent HSE guidance could be compiled since their disciplines and position settings are the same. The discipline-specific HSE guidance should be compiled usually by the enterprise or its subsidiaries. When compiling the discipline-specific HSE guidance, attention should be focused on the discipline and related activities and potential abnormalities and emergencies in the entire process of the project, followed by hazard identification, risk assessment, and development of appropriate risk control measures. The HSE guidance shall be reviewed and approved by the competent

Since the HSE risks arising from discipline-related conventional operations are relatively stable, risk prevention measures may stay the same as long as no change occurred to the process, technology, equipment, facilities, etc. Hence the HSE guidance is a kind of relatively stable document. It can be used as a working guide for relevant employees in their day-to-day work and can also be used as a resource for self-study. More importantly, grassroots organizations should regard the education on the HSE guidance as a management action that should be persisted for a long time, so as to enhance the staff's professional quality and risk prevention capability.

**24**

**Figure 3.**

*Bowtie model for preventing significant risks.*


**3.2 Model solution**

Effective diffusion coefficient of each component directly affects the time to reach the balance for the whole system during the calculation procedure. There is no absolutely accurate general calculation equation to calculate the diffusion coefficient of i-component in oil phase and gas phase, except using the empirical equation which is a relatively accurate method. The diffusion factor of i-component in oil phase usually is usually calculated by Will— Chang(1955) and that in gas phase by Chapman-Enskog empirical formula (1972). The initial K value of each component is calculated by Wilson function, and corrected by fugacity coefficient in every time step, while fugacity coefficient is calculated by PR-EOS. Compared with the computation model proposed for single component, the model is much closer to the actual simulation, since it has taken interaction among the components into consideration.


**5. Translating science to therapies in hemodialysis vascular access dysfunction: from the bench to bedside**

There are currently few if any effective therapies to treat hemodialysis vascular access stenosis and neointimal hyperplasia. However, the knowledge obtained in recent years regarding the pathology and pathogenesis of vascular access access dysfunction has provided a framework for development of therapies that target neointimal hyperplasia and vascular stenosis. The purpose of the next section is to (1) describe current therapies for AVF and AVG stenosis and (2) novel therapies using localized delivery systems for AVF and AVG.

### **5.1 Systemic therapies**

Systemic therapies, such as dipyridamole, angiotensin-converting enzyme inhibitors, aspirin, and fish oil, from small clinical trials and observational studies have been shown to have the potential to block smooth muscle cell proliferation and migration and to prevent thrombosis in AVFs and AVGs 166-170. Most recently, two large randomized controlled trials, sponsored by the National Institutes of Health, evaluating anti-platelet agents in AVG and AVF to prevent neointimal hyperplasia were published 16,171. In the AVG study, dipyridamole and aspirin, modestly reduced the risk of stenosis and improved primary unassisted patency 171. In the AVF study clopidogrel reduced frequency of early thrombosis but did not improve AVF suitability defined as cannulation with two needles, minimum dialysis blood flow of 300ml/min, successful use 8/12 dialysis sessions, and use after 120 days from creation 16. While these two studies have shown some promising results, the clinical significance of these drugs used as standard treatment for hemodialysis access stenosis remains questionable.

Fish oil has been shown to prevent AVG stenosis and thrombosis in one randomized, controlled trial 172. Currently, another study evaluating fish oil and AVG stenosis and thrombosis is ongoing 173. Other systemic agents, though not tested in randomized clinical trials, which have shown potential anti-proliferative effects targeting neointimal hyperplasia in CVD or PVD models, include peroxisome proliferation-activated receptor agonist 174-176, sirolimus 177, and imatinib mesylate 176,178,179.

### **5.2 Radiation therapy**

372 Progress in Hemodialysis – From Emergent Biotechnology to Clinical Practice

sensitivity patterns that are grown at the dialysis center. Due to the high prevalence of methicillin-resistant *Staph Aureus* (MRSA), empiric therapy should include coverage for MRSA. When the specific organism and antibiotic sensitivities are identified, it is important to narrow the antibiotic therapy to prevent the development of drug resistant organisms. While the exact duration of antibiotic treatment for catheter-related bacteremia is uncertain, the Infectious Disease society of America recommends a 2 week course of antibiotics 153, while the K/DOQI guidelines recommends a 3 week course of antibiotics 19. Other therapies, which have been used in conjunction with systemic antibiotics, to treat catheterrelated bacteremia are antibiotic catheter locks. A number of studies have shown that antibiotic locks (which may treat the biofilm layer) used in conjunction with systemic antibiotics, in tunneled dialysis catheters, have documented a 70% cure rate 30,145,154-156. Recent studies have evaluated pharmacologic therapies to prevent catheter-related bacteremia. Routine application of topical antibiotic ointments at the CVC exit such as mupirocin, povidine-iodine, and polysporin triple ointment has been associated with a 73- 93% reduction in the risk of catheter-related bacteremia 7,151,157-159. Prophylactic antibiotic catheter locks have also recently been evaluated. A marked reduction in catheter-related bacteremia has been reported, ranging from 51-99%, with use of a prophylactic antibiotic catheter locking solution 7,160-164. However, of concern, a recent study has shown emergence of gentamicin-resistant organisms after 6 months when using a gentamicin-heparin

The above strategies for treatment of catheter-related bacteremia apply to patients who are clinically stable. However, catheter removal, in addition to antibiotic therapy, should be the treatment of choice when patients: (1) are clinically unstable, (2) have persistent fever for 48 hours, (3) have evidence of tunnel infection, or (4) develop metastatic infectious

There are currently few if any effective therapies to treat hemodialysis vascular access stenosis and neointimal hyperplasia. However, the knowledge obtained in recent years regarding the pathology and pathogenesis of vascular access access dysfunction has provided a framework for development of therapies that target neointimal hyperplasia and vascular stenosis. The purpose of the next section is to (1) describe current therapies for AVF and AVG stenosis and (2) novel therapies using localized delivery systems for AVF and

Systemic therapies, such as dipyridamole, angiotensin-converting enzyme inhibitors, aspirin, and fish oil, from small clinical trials and observational studies have been shown to have the potential to block smooth muscle cell proliferation and migration and to prevent thrombosis in AVFs and AVGs 166-170. Most recently, two large randomized controlled trials, sponsored by the National Institutes of Health, evaluating anti-platelet agents in AVG and AVF to prevent neointimal hyperplasia were published 16,171. In the AVG study, dipyridamole and aspirin, modestly reduced the risk of stenosis and improved primary unassisted patency 171. In the AVF study clopidogrel reduced frequency of early thrombosis but did not improve AVF suitability defined as cannulation with two needles, minimum

**5. Translating science to therapies in hemodialysis vascular access**

prophylactic catheter lock 165.

**dysfunction: from the bench to bedside**

complications 7.

AVG.

**5.1 Systemic therapies**

Radiation therapy has been hypothesized to be a potential therapy to treat vascular stenosis due to its antiproliferative effects and potential beneficial effects of vascular remodeling180- 183. In experimental models, both external beam and endovascular radiation therapy has proven effective to reduce neointimal hyperplasia in AVF and AVG 184,185. However, in clinical studies, a recent randomized-controlled trial of in AVGs 25 patients showed that 42% of the radiated AVGs achieved the target lesion primary patency end point at 6 months as compared to 0% of the control group (p = 0.015), but this did not translate into an improvement in secondary patency at either 6 or 12 months 186.

### **5.3 Far infrared therapy**

Infrared radiation is an invisible electromagnetic wave with a longer wavelength than that of visible light. In experimental models, far infrared therapy has been shown to improve skin blood flow and endothelial function in cardiovascular disease 187-189. The rationale for far infrared therapy to treat dialysis vascular access stenosis is that the dialysis vascular access in patients are located at a superficial site and improving access flow may improve vascular access performance. In the lone clinical study of far infrared in dialysis access in AVFs, patients who received far infrared therapy had improved access flows and longer unassisted patencies 190.

### **5.4 Local drug delivery systems for hemodialysis access**

The rationale behind local delivery of drugs treat hemodialysis vascular access stenosis is that (1) AVFs and AVGs could be the ideal clinical model for the use of perivascular therapies since these can be easily applied at the time of surgery, (2) perivascular therapies preferentially target the "active" adventitia, (3) studies have demonstrated that lipophilic molecules when placed over the adventitia rapidly diffuse through all the layers of the vessel wall, and (4) small amounts of otherwise toxic drugs can be safely delivered to the site of stenosis using the perivascular approach resulting in high local concentrations with minimal systemic toxicity 4. The subsequent section will discuss local therapies to treat hemodialysis vascular access stenosis from experimental models and clinical studies.

### **5.4.1 Drug eluting paclitaxel perivascular wraps**

Experimental studies have previously demonstrated the efficacy of paclitaxel eluting wraps in AVG stenosis likely due to anti-proliferative effects 191-193. In 2007, a large multi-center randomized-controlled study, evaluating the use of paclitaxel-eluting mesh wraps, Vascular

of bare metal stents after angioplasty compared to angioplasty 201 alone has been shown to improve primary patency 202,203. However, bare-metal stents have yielded poor results due to aggressive development of in-stent restenosis. In experimental models of dialysis access in AVGs, drug-eluting stents have shown to reduce neointimal hyperplasia and improve luminal stenosis compared to bare-metal stents 204. However, there are no clinical studies

Stent grafts (covered stents constructed from the same material of AVGs) have received recent attention as a therapy for prevention of restenosis due to its ability to prevent elastic recoil and inability of the neointimal cells to penetrate the covered barrier. A recently published multicenter, randomized controlled, clinical trial showed stent grafts (Bard Peripheral Vascular, Tempe, AZ), placed after angioplasty, to treat venous stenosis had better primary unassisted patency compared to angioplasty alone 205. This is the only treatment to date that has shown to be effective to treat vascular access stenosis in a large,

Hemodynamic sheer stresses play a significant role in development of neointimal hyperplasia 87,112,206,207. Therefore, altering the sheer stress pattern to prevent turbulent, lowflow, and low-sheer stresses could reduce the development of neointimal hyperplasia. Previous clinical data to date to support such an intervention comes from several studies evaluating cuffed AVG grafts ("Venaflo"; Bard Vascular, Tempe Arizona) 208-210. In a recent randomized control trial evaluating cuffed vs non-cuffed AVG, cuffed AVGs showed better primary patency and cumulative survival 211. Finally, results from a newly developed anastomotic implant device, "OptiflowTM" (Bioconnect Systems; Ambler, PA), to connect the artery and vein in AVFs and improve hemodynamics by providing a symmetric flow pattern, have shown a primary patency of 83% at 90 days 212. This primary patency rate was

In the last decade our knowledge of vascular access dysfunction has significantly evolved. We now understand that the most common pathologic lesion seen in AVF and AVG dysfunction is aggressive venous neointimal hyperplasia, and biofilms and fibrin sheaths play a major role in CVC infection and dysfunction. In order to advance the field further, we need to further our current understanding of both the clinical and experimental pathways that result in venous neointimal hyperplasia and mechanisms that lead to biofilm and fibrin sheath production in CVCs by using the advanced technologies and tools in cellular and molecular biology, bioengineering, genomics, proteomics, and vascular imaging (ultrasound, computed tomography, and magnetic resonance imaging) 65,124,214. Finally, small and large animal models of AVF and AVG, which a number of investigators in this field have already developed 61,93,207,215-217, will play an essential role in "translating" our knowledge of pathophysiologic

The magnitude and costs of dialysis access dysfunction is clearly evident, and will only become magnified in the coming years as the prevalent dialysis population continues to

evaluating drug-eluting stents in dialysis access to date.

higher compared to other similarly published studies 213.

**6. Future perspectives: new frontiers in research**

mechanisms in vascular access dysfunction to novel therapies for patients.

randomized, clinical trial.

**7. Conclusion**

**5.6 Improving hemodynamics**

WrapTM, (Angiotech Pharmaceuticals, Inc.; Vancouver, British Columbia, Canada), was initiated to study the effectiveness and safety of this therapy on primary AVG patency compared to a standard AVG. However, this study was recently suspended in 2009 following a data safety monitoring review, due to an imbalance in the incidence of infections in one of the arms (either control or treatment). An alternative approach is the use of sirolimus eluting COLL-R® wraps (Covalon Technologies Ltd: Mississauga, Ontario, Canada). An initial Phase II study demonstrated primary unassisted AVG patency of 75% and 38% at 1 and 2 years respectively with these wraps 194.


*3.3. Cropping Practices*

Two main cropping systems were used for maize production: single-cropping in rotation with other crops (cotton, cowpea, cassava, soybean, and groundnut) and intercropping with cassava, groundnut, cowpea, and sorghum. Overall, single-cropping was the most common cropping system (67.6%) (Table 5). More than half of the farmers applied mineral fertilizers to the maize plants, on average 134.6 kg/ha of NPK (Nitrogen, Phosphorus, and Potassium) and 75.4 kg/ha of urea.

**Table 5.** Farmers' cropping practices.

Traditional varieties refer to local varieties cultivated by farmers over generations while modern varieties refer to improved varieties developed by research centers. About 58.7% of the farmers grew traditional varieties of maize (Table 5). Farmers who grew modern varieties of maize used more mineral fertilizers and intercropping. In addition, farmers who grew traditional varieties of maize used fewer mineral fertilizers and practised more single-cropping in rotation with other crops.

#### *3.4. Damage Caused by S. frugiperda*

The results showed that around 97.1% of farmers su ffered from *S. frugiperda* attacks in 2018. It confirms the presence of *S. frugiperda* throughout Benin, despite the geo-climatic contrasts (Table 1). About 93.9% of the maize fields were infested. The incidence of damaged maize plants per field was estimated to 58.9%, and the incidence of damaged maize ears was estimated at 50.4%. The estimated yield losses by farmers averaged 797.2 kg/ha of maize in 2018 (Table 6). The farmers revealed that before the invasion of *S. frugiperda*, they obtained an average maize yield of 1626 kg/ha. Thus, the yield losses caused by *S. frugiperda* represented 49% of the average maize yield that farmers obtained before the invasion of *S. frugiperda*.

**Table 6.** Indicators of damage caused by *S. frugiperda* according to farmers.

The analysis of the severity of *S. frugiperda* attacks was carried out by distinguishing the different parts of the attacked maize plants, in particular the leaves and ears. The majority of farmers reported that *S. frugiperda* attacks were moderately severe on the leaves and ears (Table 6). At the time of the attack, they found large elongated perforations on the leaves, whorl attack and damage ranging from 15 to 25% of maize grains.

Chi-square tests showed that there was a relationship between the severity of *S. frugiperda* attack and the types of grown maize varieties. The severity of *S. frugiperda* attack on the leaves and ears was significantly associated with types of grown maize varieties (*p* = 0.001). *S. frugiperda* attacks were more severe for modern varieties of maize. There was no significant relationship between the cropping systems, application of mineral fertilizers, and attack severity (Table 7).

**Table 7.** Chi-square test analysis of the relationship between cropping practices and the severity of *S. frugiperda* damage.

DF: Degree of Freedom; χ2: Chi-square value; *p*: Probability; \*\*: *p* < 0.01, ns: not significant.

#### *3.5. Knowledge of Natural Enemies, Host and Repellent Plants of S. frugiperda*

About 16% of farmers stated knowing insects and birds that feed on *S. frugiperda* larvae. They identified the francolin (*Francolinus bicalcaratus*), the village weaver (*Ploceus cucullatus*), and the common wasp (*Vespula vulgaris*) as natural enemies of *S. frugiperda*. For 14% of farmers, *S. frugiperda* could destroy other crops besides maize. They said the pest could damage sorghum, cotton, cowpea, and tomato crops.

In addition, about 5% of farmers stated knowing plants that repel *S. frugiperda*. They identified yellow nutsedge (*Cyperus esculentus*), chan (*Hyptis suaveolens*), shea tree (*Vitellaria paradoxa*), neem (*Azadirachta indica*), tamarind (*Tamarindus indica*), and soybean (*Glycine max*) as repellent plants of *S. frugiperda*.

#### *3.6. Farmers' Management Practices*

About 38% of the farmers surveyed used at least one control practice. The most common management method used by farmers was synthetic pesticides. Among farmers using at least one management method, 91.4% used synthetic pesticides, 1.9% used botanical pesticides, and 6.6% used other management practices. The wide range of synthetic pesticides used by farmers included Thalis 112 EC (emamectin benzoate and acetamiprid), Pyro FTE 472 (cypermethrin and chlorpyriphos-ethyl), Pacha 25 EC (lambda-cyhalothrin and acetamiprid), Lambda super 2.5 EC (lambda-cyhalothrin), and Emacot 019 EC (emamectin benzoate) (Table 8).

**Table 8.** Management practices used by farmers.

The average e ffectiveness score for all of these synthetic pesticides is 5 out of 7. Thus, farmers believed that synthetic pesticides were relatively e ffective against *S. frugiperda*. Among the synthetic pesticides, Emacot 019 EC is the one for which the average e ffectiveness score is 6 followed by Thalis 112 EC whose score is 5 (Table 8).

The botanical pesticides used by farmers against *S. frugiperda* were usually made from neem leaves or seeds (*Azadirachta indica*), vernonia leaves (*Vernonia amygdalina*), pepper (*Capsicum annuum*), and ashes. Some farmers also added other raw materials such as soap, detergents, or petroleum to botanical pesticides. The average e ffectiveness score for all botanical pesticides is 6 and indicates that the botanical pesticides were e ffective against *S. frugiperda*.

Moreover, some farmers used other practices to manage *S. frugiperda* (7%). These included early planting, handpicking larvae, and the application of ash to the whorls of maize. The average effectiveness score for these practices is 3 and indicates that they were relatively ine ffective against *S. frugiperda*.

Chi-square tests showed that there was a relationship between knowledge of the pest and the use of management practices (*p* = 0.001) and between knowledge of the pest and the types of management practices used (*p* = 0.002) (Table 9). This result confirms that the implementation of management strategies by farmers was associated with their knowledge of the pest. The Chi-square tests also showed that the use of management practices by farmers and the type of management practices used were significantly associated with membership in a farmer organization and contact with research or extension services (Table 9).

**Table 9.** Chi-square test analysis of the relationships between farmers' management practices, knowledge, perceptions, and socio-economic characteristics.

DF: Degree of Freedom; χ2: Chi-square coefficient; *p*: Probability; \*: *p* < 0.05, \*\*: *p* < 0.01, ns: not significant.


**1. Epidemiology of osteonecrosis of the femoral head**

Femoral head necrosis (FHN) is a painful disorder of the hip joint [1, 2]. Without treatment, more than 70% of clinically diagnosed cases of FHN proceed to collapse of the femoral head, requiring prosthetic joint replacement within 3–4 years after diagnosis [3, 4]. FHN typically occurs in adults, 30–40 years old, and is more prevalent in males than females, with evidence of bilater‐ al involvement identified in 75% of cases [2]. The exact pathomechanism of FHN is not well understood. However, obstruction of blood supply caused by steroid use, alcoholism, sickle cell anemia, and femoral neck fracture are predisposing factors due to loss of osteogenic cells in the greater trochanteric region [1, 2].

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

In the natural history of FHN, 59% of cases progress to symptomatic disease and collapse of the femoral head [5]. The prognosis is different depending on the etiology. FHN resulting from sickle cell disease has the highest risk for progressing to collapse (73%), while 47% of cases due to excessive alcohol consumption are at risk of collapse and 46% of cases resulting from renal failure. The risk for collapse associated with corticosteroid use (26%) and for idiopathic FHN (38%) is comparable to the overall prevalence of collapse (38%). Cases of FHN associated with human immunodeficiency virus infection (15%) or systemic lupus erythematosus (7%) have a relatively lower risk for collapse, compared to the overall prevalence [5]. Therefore, under‐ standing the etiologic factor of FHN is important for treatment planning.

Nonoperative treatment of FHN has been shown to have limited success in preventing disease progression [2]. Consequently, the use of joint preserving procedures has decreased in the United States, from being the treatment of choice in 25% of cases of FHN in 1992 compared to 12% of cases in 2008. Over the same period, total hip replacement for the management of FHN has increased from 75% in 1992 to 88% in 2008 [6].


**5. Conclusions**

This review reveals the international effort to supply 67Cu, a promising theranostic radionuclide. The increasing availability of intense particle accelerators and the optimization of the associated technologies (targetry and radiochemical processing) are making 67Cu closer to the clinics. The positron emitter counter-parts of 67Cu, i.e., 60Cu, 61Cu, and 64Cu, can be produced in cyclotrons. In particular, 64Cu is now widely available for clinical use, promoting the development of innovative Cu-labeled radiopharmaceuticals. The improved availability of 67Cu would speed up further radiopharmaceutical applications for therapy. Should 67Cu be produced in sufficient quantities and quality, its clinical use would spread worldwide. Therefore, in addition to a detailed analysis of the possible nuclear reactions to produce 67Cu, the radiochemical procedures to extract and purify Cu from the bulk material were also described in this work. Recent developments in the photoproduction of 67Cu, and in the possibility of having accelerators providing intense 70 MeV proton beams and/or intense 30 MeV deuteron beams, are grounds for a future reliable supply of 67Cu.

In most of the nuclear reactions leading to 67Cu, the 64Cu is produced in various radioactivity ratios. What is the impact of this impurity on a patient's dosimetry? Further studies on the possible use of 67/64Cu labeled-radiopharmaceuticals are encouraged, to find out the possible therapeutic benefits for the patient exploiting, at the same time, the β −

radiation emitted by 67Cu and 64Cu decay and the shorter range Auger-electrons emitted by 64Cu. Encouraging technological achievements, namely working out methods to isolate the small amount of 67Cu from the large mass of zinc in the target and to recover the target material in the accelerator-based production, show that, soon, 67Cu will be available daily in the United States and in Europe for research purposes. The relatively long half-life of 67Cu makes production in large facilities and the shipping of the purified product to clinical centers possible.

**Author Contributions:** Conceptualization, L.M., G.P., P.M., I.C. and R.M.; formal analysis, L.M. and G.P.; writing—original draft preparation, L.M., G.P., P.M., I.C. and R.M.; writing—review and editing, L.M., G.P., P.M., I.C., C.S.C. and R.M. All authors have read and agreed to the published version of the manuscript.

**Funding:** This work was partially supported by the IAEA/CRP code F22053; the Polish Ministry of Science and Higher Education, grant no. 3639/FAO/IAEA/16/2017/0; the CERAD project, financed under the Smart Growth Operational Programme 2014–2020, Priority IV, Measure 4.2. POIR.04.02.00– 14-A001/16; COME project INFN-CSN3; LARAMED and TERABIO premium projects funded by the Italian Ministry for University and Research (MIUR).

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** Not applicable.

**Acknowledgments:** We would like to acknowledge PRISMAP, the European medical radionuclide programme, for the production of high purity radionuclides (radioactive isotopes) by mass separation. This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no. 101008571.

**Conflicts of Interest:** The authors declare no conflict of interest.


**12. Antibiotics in rivers and sea**

*Emerging Contaminants*

otic treatment.

than expected.

persistence in soil.

**11. Antibiotics in crops plants**

antibiotics [44], and veterinary antibiotics [78].

**10. Antibiotics in soil**

the use of antibiotics and having led to only a few antibiotics being licensed for use in aquaculture and preventing the high proportions of antibiotic-resistant bacteria which still persist in sediments and farm surroundings and suggesting the implementation of rearing practices that reduce the level of stress from fish larvae to adult, which could reduce the likelihood of infections requiring antibi-

Probably one of the main concerns about antibiotic contamination is their accumulation in soil, by the effect on resistant bacteria and direct consequence in human and animal health. Likely the easier indirect antibiotic detection is to calculate the concentration in crops [73, 74], as was mentioned by Christou et al. [25] reporting antibiotics in tomatoes from the soil. This work elaborated during three years shows that the accumulation of DCF, SMX, and TMP in the soil detected by MeOH-NaOH solution and Chromatography MS/MS, The results show an imminent physical translocation as we shown in **Figure 1**, and show great variability in the accumulation of the three antibiotics during those 3 years, with increases or decreases depending on the irrigation using wastewater and depending on the duration of irrigation and the origin of the wastewater applied. Other authors monitoring sulfonamides and tetracyclines over 18 years from an agricultural field site in Lower Saxony, Germany [75]. SAs and TCs are largely fixed in the upper soil layer. The analysis showed a strong decrease below the sampling depth of 30 cm which is the depth of the plow and below other antibiotics such as SG and SMZ were detected up to 90 cm, TC was shown to persist >100 μg/kg in topsoil, however this antibiotic no leachate in deeper soil segments or groundwater. They conclude that some SAs disappeared, but other veterinary antibiotics are even more persistent

In Kenia, Africa Yang et al. [76] analyzed four soils in the suburban area of Narok. Over 12 antibiotics analyzed they found that SMX, SMZ, OTC, and ENR were the major antibiotics that polluted those soils among 12 antibiotics monitored and the highest average value was for Narok 43,64 μg/kg dry weight, and the other three average values were Mai Mahiu 26.70 μg/kg dry weight, Juja 24.41 μg/kg dry weight, and Mount Suswa Conservancy 12,21 μg/kg dry weight. They advise more attention to reduce the misuse of SAs. Pan and Chu [27], investigated TC, NOR, SM2, CAP, Erythromycin (EM), antibiotics in agricultural soils, and was probably the first study. The Persistence and environmental risk profile of the five antibiotics were TC > NOR>EM > CAP>SM2, but "the study suggests that the adsorption of antibiotics in soil depends on the physicochemical properties of both antibiotics and soil". Probably this study was the first to develop a model for predict antibiotic

Antibiotics for plants were used since the 1950s to control certain bacterial diseases the most common used are oxytetracycline and streptomycin. In the United State antibiotics for plants represent 0,5% of total antibiotics used in this country. However, the emergence of antibiotic resistance of *Xanthomonas campestris*, *Erwinia amylovora*, and *Pseudomonas* spp., and has blocked the control of their diseases [77]. Then plants could pick up three kinds of antibiotics: antibiotics plants, human

**174**

Finally, we arrive at the climax where all the antibiotics will finally be deposited if their degradation does not occur or if the increase of antibiotics continues its course as if such substances do not represent a risk for all the species in nature that has learned to fight diseases with evolution as antibiotic resistance [81]. Rivers and the sea are the final deposits of antibiotics and or following studies and many others that we cannot all cite shown that biodegradation, degradation, and bioaccumulation can once again put the health of the planet at risk.

The previous data show that antibiotics degradation is not totally in agreement with antibiotics in soils, farms, and WWTPs. We know today the antibiotic loads in pristine rivers as Amazona, Niger, Congo, Zambezi, Lena, Amour, and Yenisei carrying low concentrations of antibiotics, but the remaining rivers of the worldwide receive greater loads of antibiotics [41, 73, 82]. We could again make the list of antibiotics and see that they follow the same comparison of antibiotics and all effluents from WWTPs [81], the main technical solution will be the degradation of antibiotics before reach the river stream. About this concern, some researchers begin to develop this challenge [48, 83, 84].

As Zang et al., [85], mentioned," the ocean is an important sink of land-based pollutants", and exactly as crop plants allow detection of antibiotics, marine food will be the best way to follows the study of bioaccumulation of antibiotics [86, 87]. Liu et al. [86], found 9 SAs, TMP, 5 FQ, and 4 ML, which were in gill, muscle, kidney, and liver tissues of seven wild fish species collected from Laizhou Bay, North China. As previous famous works with mercury accumulation of marine fish, now there are antibiotics reports in tissue fish in higher concentrations than aquaculture fish.

Alga will be another antibiotic "*bio-accumulator*" to detect antibiotics in rivers and sea. Seoane et al. [88] developed an experimental evaluation of chloramphenicol (CHL), florfenicol (FLO), and oxytetracycline (OTC) in marine microalga *Tetraselmis suecica*, showing that three antibiotics inhibited the growth after 96 h with IC50. Finally, we think that in the future it will be necessary to look for antibiotics in river and sea sediments. But these first works are already beginning to fill the research data worldwide and to conclude without doubts that antibiotics are the "new emergent pollutants of Earth". Pioneer work from Fernandes et al., [89] in Portugal found azithromycin in Leça river at 2819 ng/g in water but in sediments at 43,2 ng/g.

#### **13. Strategies to change all previous practices, challenges, and hopes**

**Table 2** is not a summary of this review of all articles. It is a simple exercise to verify that perhaps no antibiotic has disappeared from industrial production and it generates a contradictory taste associated with the fact that pharmaceutical companies are discouraged from manufacturing new antibiotics, but the sale and

**177**

**Type** **In agricultural practices in farms**

Azoles Macrolides Sulfonamides Diaminopyrimidines

Tetracyclines Cephalosporins (second generation)

β-lactams Amphenicols Lincosamides

Quinolones Aminoglycosides

Peptides Ionophores Peptidomimetics

Diaminopyrimidines

Cephalosporins

**Hospital**

β-lactams Sulfonamides Tetracyclines Aminoglycosides

Fluoroquinolones

Cephalosporins

Cephamycin

(second-generation)

Azoles Macrolides Diaminopyrimidines

Cephalosporins (second generation)

streptomycin

ciprofloxacin;

cefotaxime;

cefoxitin

metronidazole

erythromycin

trimethoprim

cefuroxime

cefuroxime

chloramphenicol

lincomycin

ofloxacin, pefloxacin, ciprofloxacin, enrofloxacin, difloxacin, marbofloxacin

Streptomycin, apramycin, kanamycin, spectinomycin

virginiamycin

monensin

bacitracin

trimethoprim

ceftiofur, cefquinom

ampicillin amoxicillin

streptomycin; sulfamethoxazole

tetracycline, oxytetracycline chlortetracycline and doxycycline

[39]

[44]

trimethoprim tetracycline, oxytetracycline, chlortetracycline, doxycycline

ampicillin, amoxicillin, benzylpenicillin, cloxacilin, dicloxacillin, oxacillin

metronidazole erythromycin¸ norfloxacin, tylosin, spiramycin

sulfamethoxazole, Sulfadiazine: sulfamethazine, sulfamethoxazol sulphathiazole sulfaguanidine, sulfanilamide, sulfamonomethoxine, sulfamerazine, sulfachlorpyridazine, sulphadimethoxine, sulphadimidine, sulfapyridine

**Antibiotic**

**References**

[25] [44] [49–54] [60] [78]

*Pharmaceutical Antibiotics at a Significant Level in Nature: From Hospitals, Livestock…*

*DOI: http://dx.doi.org/10.5772/intechopen.95368*

*Pharmaceutical Antibiotics at a Significant Level in Nature: From Hospitals, Livestock… DOI: http://dx.doi.org/10.5772/intechopen.95368*

*Emerging Contaminants*

**References**

[27]

[57]

[74]

[76]

[79]

[58]

[70]

[72]

**176**

**Type** **Agricultural soil**

Tetracyclines Fluoroquinolones

Sulfonamides

Macrolides Amphenicols **Aquaculture**

Sulfonamides Tetracyclines Fluoroquinolones

Macrolides Amphenicols Aminoglycosides

Combination of trimethoprim and

sulfamethoxazole

Sulfonamide/Diaminopyridine

**Crops**

Tetracyclines Sulfonamides Diaminopyrimidines

Macrolides

Azoles Cephalosporins

β-lactams Fluoroquinolones

Aminoglycosides

antibiotics of fungal origin

sulfadimethoxine/ormetoprim

Tetracycline, oxytetracycline, chlortetracycline, doxycycline

sulfamethoxazole

trimethoprim

erythromycin

metronidazole

Cefuroxime, second generation

ampicillin, amoxicillin

ciprofloxacin (CIP); norfloxacin (NOR)

blasticidin S, validamycin

strobilurin, odemansins.

[28]

[58]

[74]

[79]

[80]

erythromycin

chloramphenicol

sulfamethoxazole, sulfaquinoxaline

oxytetracycline

*erythromycin-H*

*O*2 chloramphenicol, florphenicol,

streptomycin

cotrimoxazole

norfloxacin, ofloxacin, ciprofloxacin, enrofloxacin, pefloxacin

**Antibiotic** tetracycline, doxycycline, oxytetracycline

ofloxacin, ciprofloxacin, norfloxacin, enrofloxacin

sulfadimethoxine, sulfamethazine, sulfamethizole, sulfamerazine, sulfamethoxazole, sulfadiazine

**179**

**Type** **Wastewater treatment plants (WWTPs)**

Quinolones Sulfonamides Diaminopyrimidines

Tetracyclines

β-lactams Cephalosporins (second generation)

Macrolides

Azoles **Veterinary and human antibiotics**

Β-lactams Macrolides Aminoglycosides

Fluoroquinolones

Tetracyclines Streptogramins

Glycopeptide

Phenicol Cephalosporins

Polypeptides Pleuromultilin

**Foods**

Fluoroquinolones

β-lactams Macrolides

**Table 2.**

*Some selected antibiotics in the practices were reviewed*

ofloxacin, ciprofloxacin

sulfamethoxazol

trimethoprim tetracycline, oxytetracycline, chlortetracycline, doxycycline

ampicillin, amoxicillin

cefuroxime

erythromycin

metronidazole

emoxycilin tylosin, azithromycin

neomycin, gentamycin

enrofloxacin, ciprofloxacin, levofloxacin, ofloxacin

oxytetracycline, chlortetracycline

virginiamycin

avoparcin

florphenicol

cephalexin

enramycin

tiamulin

Enrofloxacin,

penicillin

Erythromycin, tilmicosin

*the last years and the discouragement to discover new antibiotics are not in a relationship with production.*

*This table is not a summary of the articles reviewed, and the goal was compared to all human practices with antibiotics used, which it is clear that antibiotics production and release in nature was risen in*

[46]

[92]

**Antibiotic**

**References**

[25] [44] [47]

*Pharmaceutical Antibiotics at a Significant Level in Nature: From Hospitals, Livestock…*

[58]

*DOI: http://dx.doi.org/10.5772/intechopen.95368*

#### *Pharmaceutical Antibiotics at a Significant Level in Nature: From Hospitals, Livestock… DOI: http://dx.doi.org/10.5772/intechopen.95368*

*the last years and the discouragement to discover new antibiotics are not in a relationship with production.*


*2.2. Design*

This study was approved by the by the Uniting *C*are Health Human Research Ethics Committee (#2013.03.74). The study utilized a cross-sectional design. Voluntary informed consent was obtained from each participant.


*3.2.2. In vitro bioassays*

In vitro bioassays are based on the ability of patients serum to stimulate adenylate cyclase and produce cAMP from cultured hamster ovary cells transfected with human TSHR (CHO-R),23 or rat thyroid cell strain (FRTL-5)24 or human thyroid follicular cells 25 are used as a source for functional TSHR. CHO-R system is slightly more sensitive, and requires an easier culture condition than other systems. Advantages of bioassays are that it gives information about the functional property of TSHR-Ab, but bioassays are more expensive, not widely available, having poor precision and sensitivity of more than 90%. These problems have been solved in newer bioassays.


**Meet the editor**

Assosiate Professor, Dr. Sundaresan received his M. Phil. in Biochemistry in 1999 from Annamalai University and his Ph.D. in Biochemistry in 2003 from Annamalai University as well. He currently teaches research methodology at SRM MCH and RC. Dr. Sundaresan is Ph.D guide in Medical and Health sciences, and is also incharge for the Central Research Laboratory. He

is a Journal editorial board member and reviewer for many national and international publications. He is a member of the Association of Clinical Biochemists of India (ACBI), member of the Society of Biological Chemists –MSBC and member of Indian Inborn Errors of Metabolism society IB.

Contents

**Preface VII**

Alhabeel

**Patients 51**

**Oral Cancer 83**

Chapter 1 **Introductory Chapter: Head and Neck Cancer 1**

Chapter 2 **Laser Dental Treatment Techniques 17**

Nihat Akbulut and Ahmet Altan

Chapter 5 **Management Strategies for Oral Cancer Subsites 69**

Masakatsu Fukuda and Hideaki Sakashita

**Treat Oral Cancer 33** Abdul Hameed Khan

Sivapatham Sundaresan and Paliarasu Rajapriya

Chapter 3 **The Impact of Sequencing Human Genome on Drug Design to**

Chapter 4 **Early Detection and Multidisciplinary Approach to Oral Cancer**

Neeti Kapre Gupta, Monica Mahajan and Apeksha Hore

Chapter 6 **The Mechanisms of Proliferation and Energy Metabolism in**

Zahra Jassim Mohammed Al Timimi and Mohammed Saleem Ismail


5.1.5. Protective Gas

The influence of inert gas on spatter is due to two factors: the primary component of the gas (Ar, He, N2, 50% Ar–50% He mixture) and the secondary component of the gas (O). The inert gas' protective effect is due to its major component. Helium, which has a positive influence on spatter suppression, has a high thermal conductivity (ten times that of Argon). As a result of this high thermal conductivity, the temperature of the melt pool is lower and the back punch is smaller, resulting in less spatter generated. However, the rarity of Helium is the reason for its high price, in the range of about 3 to 6 times per cylinder compared to argon, so, taking this into account, there is more use of argon gas for production. Oxygen, being a tiny component of the inert gas, can cause spatter to increase and oxidize; therefore, lowering the oxygen level in the inert gas helps to suppress spatter generation.

• **Primary components of inert gases:** Pauzon et al. [125] studied the effect of protective gas on L-PBF of Ti-6Al-4V powder in three different conditions: pure argon, pure helium, and a helium and argon mix (oxygen content was controlled at 100 ppm). In comparison to the common use of argon, studies have indicated that using pure helium or a mixture of helium and argon can reduce hot spatter by at least 60% and ~30%, respectively, as shown in Figure 25. No influence of different protective gases on the number of cold spatters was detected. The study also found that adding helium to the gas can help cool spatter more quickly, which is important for limiting powder-bed degradation throughout L-PBF. *Micromachines* **2022**, *13*, x FOR PEER REVIEW 31 of 42

**Figure 25.** The interaction of the laser–powder bed with (a) Helium and (b) Argon in the L-PBF protective gas. (Reprinted with permission from Ref. [125]. Copyright 2021 CIRP.). **Figure 25.** The interaction of the laser–powder bed with (**a**) Helium and (**b**) Argon in the L-PBF protective gas. (Reprinted with permission from Ref. [125]. Copyright 2021 CIRP).

Reducing the oxygen content in the build chamber is an efficient approach to prevent spatters from generating. Through multiple gas circulations, the equipment can decrease the oxygen level in the build chamber as much as feasible. Furthermore, keeping the build

Most modern L-PBF equipment using gas flow removes process by-products from the process zone to enable an undisturbed process. Ladewig et al. [87] examined the influence of the protective gas flow uniformity and rate on single-laser tracks and the hatching process during the building procedure of bulk material. The efficiency of spatter removal decreased as the velocity of the protective gas flow reduced. Chien et al. [134] proposed to optimize and calibrate the inert purge airflow in an L-PBF build chamber using simulation framework methods such as coupled computational fluid dynamics (CFD) and the discrete element method (DEM). Wang et al. [126] created a full-scale geometric model to explore the interaction between the protective gas flow and the laser-induced spatter particles. The flow field was found to be steady up to a height of 30 mm above the surface of the powder bed. It was discovered that printing in this region could improve the final quality due to the consistent high-velocity flow of the protective airflow in the center of

In addition to regulating process parameters, research on L-PBF equipment and materials has become a major focus for mitigating the effect of spatter. These two research areas will also contribute to the future commercialization of L-PBF technology. A sum-

mary of the research on L-PBF equipment and materials is shown in Table 10.

outside the equipment and, at the same time, the flowing inert gas can eliminate the gen-

the powder bed, which removed by-products such as spatter.

*5.2. Equipment and Materials for L-PBF*

erated spatter.

5.1.6. Gas Flow Strategies

• **Secondary component of the inert gas:** According to Wu et al. [124], the oxygen concentration in the protective environment increased considerably, resulting in the generation of spatter and an increase in the oxygen content of spatter during flight. By decreasing the oxygen level of the build chamber, the spatter generation can be reduced.

Reducing the oxygen content in the build chamber is an efficient approach to prevent spatters from generating. Through multiple gas circulations, the equipment can decrease the oxygen level in the build chamber as much as feasible. Furthermore, keeping the build chamber at slightly above the atmospheric pressure can prevent the entry of oxygen from outside the equipment and, at the same time, the flowing inert gas can eliminate the generated spatter.


**5.1. Procedure**

Following appropriate counseling of the patient and obtaining informed consent for the procedure, the patient is put in lithotomy position with the cervix exposed using a bivalve speculum. A soft cotton is used to remove any mucous material from the external cervical Os, while taking care not to contact the cervix, a tenaculum is used to grasp the anterior lip of the cervix.The collecting device which could be a spatula is introduced into the internal Os and rotated in 3600 degree once. The samples collected are smeared on already labeled slide and fixed in 95% alcohol. A four quadrant pap smear of the vaginal walls is advised in patients with history of exposure to diethylstibesterol who are at risk of developing adenosquamous vaginal cancer (Sarina et al 2004)

#### **5.2. Interpretation of results of PAP smear after analysis**

The specimen can be categorized as satisfactory or non-satisfactory according to the Bethesda system of reporting of adequacy of smears collected. A satisfactory PAP specimen is that in which the sample collected has a adequate number of squamous epithelial cell, endocervical and representative amount of the transformation zone cell components while an unsatisfactory smear has paucity of epithelial cells poorly preserved or cellular or inflammatory cell that obscure the film.Epithelial cell abnormalities can be classified as:

Atypical squamous cells of undermined significance, low grade squamous intraepithelial lesions (CIN1) and high grade intra epithelial lesions which include carcinoma in-situ, CIN2

**Figure 1.** Taking a sample of cells

ogy.It is advisable for evidence of cervicitis /vaginitis be treated if present and intercourse should be avoided with 24-48hours of the procedure in addition to avoidance of vaginal douching or application of vaginal tampons and creams which may introduce artifacts on the slides examined. Clinical information on the last menstrual period, use of hormonal contra‐ ception, intrauterine contraceptive devices, any form of immunosuppression and previous history of abnormal smears are important to the pathologist in accurate interpretation of

A pathologist and trained personnel in the collection of the specimen is an important ingredient in conducting the investigation. Other items needed are 95% alcohol for fixing of slides, and a

Over the years various sampling items have been introduced. The traditional wooden Ayrles spatula was initially used but has some limitations as the failure of accessing the endocervix, which is the point of origin of 20% of adenocarcinomas of the cervix. Specimen collections devices include the broom and the endocervical bush (cytobrush) with both having the ability to access the endocervix more than the traditional spatula. The plastic spatula is preferable to the wooden variety because the collected samples are more adherent to the wooden spatula

Following appropriate counseling of the patient and obtaining informed consent for the procedure, the patient is put in lithotomy position with the cervix exposed using a bivalve speculum. A soft cotton is used to remove any mucous material from the external cervical Os, while taking care not to contact the cervix, a tenaculum is used to grasp the anterior lip of the cervix.The collecting device which could be a spatula is introduced into the internal Os and

fixed in 95% alcohol. A four quadrant pap smear of the vaginal walls is advised in patients with history of exposure to diethylstibesterol who are at risk of developing adenosquamous

The specimen can be categorized as satisfactory or non-satisfactory according to the Bethesda system of reporting of adequacy of smears collected. A satisfactory PAP specimen is that in which the sample collected has a adequate number of squamous epithelial cell, endocervical and representative amount of the transformation zone cell components while an unsatisfactory smear has paucity of epithelial cells poorly preserved or cellular or inflammatory cell that

Atypical squamous cells of undermined significance, low grade squamous intraepithelial lesions (CIN1) and high grade intra epithelial lesions which include carcinoma in-situ, CIN2

degree once. The samples collected are smeared on already labeled slide and

and may be discarded with the spatula after use (Goodman, Hutchinson, 1996.)

smears.

**5. Material needed**

130 Contemporary Gynecologic Practice

jar to contain the specimen.

**5.1. Procedure**

rotated in 3600

vaginal cancer (Sarina et al 2004)

**5.2. Interpretation of results of PAP smear after analysis**

obscure the film.Epithelial cell abnormalities can be classified as:

and CIN3.Other abnormalities include squamous cell abnormalities and glandular cell abnormalities. (Solomom D et al, 2001)

#### **5.3. Limitations of PAP smear**

The impact of this screening method has being felt over the years and had contributed to reducing cervical cancer related morbidities, however limitations exist which has affected its utilization. The primary need for a trained pathologist has hampered its utilization especially in the third world with scarcity of trained personnel. Even in the presence of trained personnel the interpretation of morphological alterations in the histological pattern of cervical dysplasia is highly subjective and in the presence of large pool of samples likely to be subject to observer fatigue.The sensitivity of the screening method to identify cervical intraepithelial neoplasia is 51% with a specificity of 98% with increase of sensitivity if interval of screening is made 1-3 years


**4. Photovoltaic effect in inorganic–organic perovskite solar cells**

Solar power is the one of the world's most abundant energy resource and daily input of this energy to the earth's surface is enough to cover our energy needs, but efficient and costeffective ways of converting it to electricity, have remained as one of the scientist's challenges. Photovoltaic cells are the most promising device for directly converting the photons to electricity and it has been extensively studied in the past 50 years using various combinations of inorganic semiconductors or organic sensitizers. For photovoltaic energy to become competitive with fossil fuels and to capture a worthy place at energy markets, it is necessary to reduce the total cost of solar energy conversion by increasing their power conversion efficiencies or by reducing the cost of photovoltaic cells.

Today there is a lot of material used in photovoltaic structure and installed around the world. The photovoltaic market is currently dominated by crystalline Si solar cells with efficiencies close to 20% that known as First Generation of Solar Cells. This generation that have more than 150 micrometer thick, have the highest efficiency in all type of Solar cells that manufactured, but take a lot of energy to produce and therefore the cost of manufacturing is too high.

As cost-effective devices, thin film solar cell those containing a few micrometers of inorganic materials that known as second generation can be introduced. With a thin photovoltaic film, optical management is an important key for harvesting light while ensuring high efficiency. Thin film solar cell often limit light-harvesting ability because of their materials low absorption coefficients and narrow absorption bands. At least, these flexible cells have lower material costs, but they are also less efficient.

Alternative "third generation" technologies such as dye sensitized solar cells, organic photo‐ voltaics and quantum dot solar cells in both electrochemical and solid-state structures, assure low cost solar power because of low cost fabrication methods based on solution-processing techniques such as blade coating, screen printing and spraying, but high bandgap light absorption by these types has not allowed high performance in quantum conversion and photovoltaic generation.

The first observation of photocurrents in oxide perovskite material can date back to 1956 [1] that have been widely studied. David B. Mitzi in 1990 used organometal halide perovskites in LED [2] and thin-film field-effect transistors [3] and demonstrated its high efficiency as light emitters. Given that we know the good light emitter is a good light absorber, perovskites materials because of their light absorption efficiently over a broad spectrum is convenient option as photovoltaic materials.

Also, because perovskite can directly deposited from solution, manufacturing costs is lower than another type of solar cells. But it should be noted that manufacturing cost could rise due to encapsulation process. Therefore, perovskites could resolve the solar cell industry by matching the output of silicon cells at a lower price than that of thin film, because of their lowcost materials and manufacturing process.

For first time in 2009, perovskites were used as solar cell [4]. As show in Figure 15 this device are built upon the architectural basis for DSSCs and achieved 3.8% efficiencies in a liquid electrolyte configuration where the absorber was regarded as a QDs deposited on tio2. The efficiency was further improved to 6.5% but the enormous drawback to this types, regardless of their low efficiency, were had dissolution of liquid electrolyte away the perovskite that cause short stability for device.

Liquid electrolyte

Electron Selective

Electron Selective

Contact

Perovskite

Glass

*Figure 15. Schematic of first perovskites solar cell* **Figure 15.** Schematic of first perovskites solar cell Introducing of Solid Hole Transporting Layer (HTL) by Nam-Gyu Park and Gratzel [49], and

Hybrid Perovskite

Hybrid

TiO2

Photovoltaic cells are the most promising device for directly converting the photons to electricity and it has been extensively studied in the past 50 years using various combinations of inorganic semiconductors or organic sensitizers. For photovoltaic energy to become competitive with fossil fuels and to capture a worthy place at energy markets, it is necessary to reduce the total cost of solar energy conversion by increasing their power conversion

Today there is a lot of material used in photovoltaic structure and installed around the world. The photovoltaic market is currently dominated by crystalline Si solar cells with efficiencies close to 20% that known as First Generation of Solar Cells. This generation that have more than 150 micrometer thick, have the highest efficiency in all type of Solar cells that manufactured, but take a lot of energy to produce and therefore the cost of manufacturing is too high.

As cost-effective devices, thin film solar cell those containing a few micrometers of inorganic materials that known as second generation can be introduced. With a thin photovoltaic film, optical management is an important key for harvesting light while ensuring high efficiency. Thin film solar cell often limit light-harvesting ability because of their materials low absorption coefficients and narrow absorption bands. At least, these flexible cells have lower material

Alternative "third generation" technologies such as dye sensitized solar cells, organic photo‐ voltaics and quantum dot solar cells in both electrochemical and solid-state structures, assure low cost solar power because of low cost fabrication methods based on solution-processing techniques such as blade coating, screen printing and spraying, but high bandgap light absorption by these types has not allowed high performance in quantum conversion and

The first observation of photocurrents in oxide perovskite material can date back to 1956 [1] that have been widely studied. David B. Mitzi in 1990 used organometal halide perovskites in LED [2] and thin-film field-effect transistors [3] and demonstrated its high efficiency as light emitters. Given that we know the good light emitter is a good light absorber, perovskites materials because of their light absorption efficiently over a broad spectrum is convenient

Also, because perovskite can directly deposited from solution, manufacturing costs is lower than another type of solar cells. But it should be noted that manufacturing cost could rise due to encapsulation process. Therefore, perovskites could resolve the solar cell industry by matching the output of silicon cells at a lower price than that of thin film, because of their low-

For first time in 2009, perovskites were used as solar cell [4]. As show in Figure 15 this device are built upon the architectural basis for DSSCs and achieved 3.8% efficiencies in a liquid electrolyte configuration where the absorber was regarded as a QDs deposited on tio2. The efficiency was further improved to 6.5% but the enormous drawback to this types, regardless of their low efficiency, were had dissolution of liquid electrolyte away the perovskite that cause

efficiencies or by reducing the cost of photovoltaic cells.

costs, but they are also less efficient.

238 Solar Cells - New Approaches and Reviews

photovoltaic generation.

option as photovoltaic materials.

short stability for device.

cost materials and manufacturing process.

Introducing of Solid Hole Transporting Layer (HTL) by Nam-Gyu Park and Gratzel [49], and replace liquid electrolyte by it, solve this problem in 2012 and rose the efficiency to 9%. (Figure 16) Introducing of Solid Hole Transporting Layer (HTL) by Nam-Gyu Park and Gratzel [5], and replace liquid electrolyte by it, solve this problem in 2012 and rose the efficiency to 9%. (Figure 16) *Figure 15. Schematic of first perovskites solar cell* Introducing of Solid Hole Transporting Layer (HTL) by Nam-Gyu Park and Gratzel [49], and replace liquid electrolyte by it, solve this problem in 2012 and rose the efficiency to 9%. (Figure 16) replace liquid electrolyte by it, solve this problem in 2012 and rose the efficiency to 9%. (Figure 16) Electron Selective

Metal Contact

Glass

Glass

 In the late 2012s, research topics towards to materials engineering and switch structure by *Figure 16. Nam-Gyu Park and Gratzel perovskites solar cell* **Figure 16.** Nam-Gyu Park and Gratzel perovskites solar cell

manufacturing methods to increase the Efficiency of these type of solar cells. Henry Snaith [50] in Oxford University Switched TiO2 to an insulating Aluminum oxide scaffold in Gratzel perovskites solar cell that show in Figure 17. This switch, surprisingly increase efficiency to 10.9%. Hybrid TiO2 Hybrid Al2O3 In the late 2012s, research topics towards to materials engineering and switch structure by manufacturing methods to increase the Efficiency of these type of solar cells. Henry Snaith [50] in Oxford University Switched TiO2 to an insulating Aluminum oxide scaffold in Gratzel perovskites solar cell that show in Figure 17. This switch, surprisingly increase efficiency to 10.9%. In the late 2012s, research topics towards to materials engineering and switch structure by manufacturing methods to increase the Efficiency of these type of solar cells. Henry Snaith [6] in Oxford University Switched TiO2 to an insulating Aluminum oxide scaffold in Gratzel perovskites solar cell that show in Figure 17. This switch, surprisingly increase efficiency to 10.9%. *Figure 16. Nam-Gyu Park and Gratzel perovskites solar cell* In the late 2012s, research topics towards to materials engineering and switch structure by manufacturing methods to increase the Efficiency of these type of solar cells. Henry Snaith [50] in Oxford University Switched TiO2 to an insulating Aluminum oxide scaffold in Gratzel perovskites solar cell that show in Figure 17. This switch, surprisingly increase efficiency to 10.9%.

TiO2

15

On the other hand, Snaith and coworkers [17] demonstrated efficient planar solar cells of CH3NH3PbI3-xClx formed by dual source evaporation of PbCl2 and CH3NH3I. The film was evaporated on a compact TiO2 layer (as an electron transport layer) and then a Spiro-OMeTAD layer (as a hole transport layer) was spin coated over it (Figure 18). The evaporated films containing crystalline structures on the length scale of hundreds of nanometers are enormously uniform [32].

15

15

(as a hole transport layer) was spin coated over it (Figure 18). The evaporated films containing crystalline structures on the length scale of hundreds of nanometers are enormously uniform [32].

(as a hole transport layer) was spin coated over it (Figure 18). The evaporated films containing crystalline structures on the length scale of hundreds of nanometers are enormously uniform [32]. CH3NH3PbI3-xClx formed by dual source evaporation of PbCl2 and CH3NH3I. The film was evaporated on a compact TiO2 layer (as an electron transport layer) and then a Spiro-OMeTAD layer *Figure 17. Switching TiO2 to an Al2O3 in Gratzel perovskites solar cell* **Figure 17.** Switching TiO2 to an Al2O3 in Gratzel perovskites solar cell

Perovskite

Al2O3

On the other hand, Snaith and coworkers [17] demonstrated efficient planar solar cells of CH3NH3PbI3-xClx formed by dual source evaporation of PbCl2 and CH3NH3I. The film was evaporated on a compact TiO2 layer (as an electron transport layer) and then a Spiro-OMeTAD layer (as a hole transport layer) was spin coated over it (Figure 18). The evaporated films containing crystalline structures on the length scale of hundreds of nanometers are enormously uniform [32].

*Figure 18. Schematic of Snaith hybrid perovskite solar cell* **Figure 18.** Schematic of Snaith hybrid perovskite solar cell

and coworkers, that report 12.1 % efficiency for their device.

TiO2

Finally they reported 15.4% efficiency for their device and another research in this area, reported the difference efficiency by using different material for example Pbl2 that Graetzel and Bolink [51] used (device efficiency was 12.04 %) or difference evaporation method for example as show in Figure 19 employs both solution based deposition and vapor phase transformation by Graetzel [21] and coworkers, that report 12.1 % efficiency for their device. Finally they reported 15.4% efficiency for their device and another research in this area, reported the difference efficiency by using different material for example Pbl2 that Graetzel and Bolink [7] used (device efficiency was 12.04 %) or difference evaporation method for example as show in Figure 19 employs both solution based deposition and vapor phase transformation by Graetzel [21] and coworkers, that report 12.1 % efficiency for their device. *Figure 18. Schematic of Snaith hybrid perovskite solar cell* Finally they reported 15.4% efficiency for their device and another research in this area, reported the difference efficiency by using different material for example Pbl2 that Graetzel and Bolink [51] used (device efficiency was 12.04 %) or difference evaporation method for example as show in Figure 19 employs both solution based deposition and vapor phase transformation by Graetzel [21]

*Figure 19. Gratzel sticks with the TiO2 structure and tinkered with the deposition step.* **Figure 19.** Gratzel sticks with the TiO2 structure and tinkered with the deposition step.

Inorganic

Inorganic

Substrate film

Substrate film

These deposition techniques had two important drawbacks: first challenging for large-scale industrial production and second is that the all-solution process results in decreased film quality, and the vacuum process requires expensive equipment and uses a great deal of energy. Yang Yang [16] from UCLA university present new method named "Vapor-assisted solution process" that organic material infiltrates the inorganic matter and forms a compact perovskite film. These films is significantly more uniform than the films produced by the wet technique (Figure 20). Organic vapor *Figure 19. Gratzel sticks with the TiO2 structure and tinkered with the deposition step.* These deposition techniques had two important drawbacks: first challenging for large-scale industrial production and second is that the all-solution process results in decreased film quality, and the vacuum process requires expensive equipment and uses a great deal of energy. Yang Yang [16] from UCLA university present new method named "Vapor-assisted solution process" that organic material infiltrates the inorganic matter and forms a compact perovskite film. These films is significantly more uniform than the films produced by the wet technique (Figure 20). These deposition techniques had two important drawbacks: first challenging for large-scale industrial production and second is that the all-solution process results in decreased film quality, and the vacuum process requires expensive equipment and uses a great deal of energy. Yang Yang [16] from UCLA university present new method named "Vapor-assisted solution process" that organic material infiltrates the inorganic matter and forms a compact perovskite film. These films is significantly more uniform than the films produced by the wet technique (Figure 20).

16

16

*Figure 20. Vapor-assisted solution process*

Organic vapor

*Figure 20. Vapor-assisted solution process*

Perovskite

Perovskite

significantly more uniform than the films produced by the wet technique (Figure 20).

*Figure 19. Gratzel sticks with the TiO2 structure and tinkered with the deposition step.*

These deposition techniques had two important drawbacks: first challenging for large-scale industrial production and second is that the all-solution process results in decreased film quality, and the vacuum process requires expensive equipment and uses a great deal of energy. Yang Yang [16]

*Figure 18. Schematic of Snaith hybrid perovskite solar cell*

Glass

and coworkers, that report 12.1 % efficiency for their device.

Metal Contact

HTL

TiO2 mesoporous Hole transporting layer

Finally they reported 15.4% efficiency for their device and another research in this area, reported the difference efficiency by using different material for example Pbl2 that Graetzel and Bolink [51] used (device efficiency was 12.04 %) or difference evaporation method for example as show in Figure 19 employs both solution based deposition and vapor phase transformation by Graetzel [21]

Hybrid perovskite

Metal Contact

Electron Selective Contact

PbI2 CH3NH3I

*Figure 20. Vapor-assisted solution process* **Figure 20.** Vapor-assisted solution process

On the other hand, Snaith and coworkers [17] demonstrated efficient planar solar cells of CH3NH3PbI3-xClx formed by dual source evaporation of PbCl2 and CH3NH3I. The film was evaporated on a compact TiO2 layer (as an electron transport layer) and then a Spiro-OMeTAD layer (as a hole transport layer) was spin coated over it (Figure 18). The evaporated films containing crystalline structures on the length scale of hundreds of nanometers are enormously

Glass

Glass

*Figure 18. Schematic of Snaith hybrid perovskite solar cell*

Finally they reported 15.4% efficiency for their device and another research in this area, reported the difference efficiency by using different material for example Pbl2 that Graetzel and Bolink [7] used (device efficiency was 12.04 %) or difference evaporation method for example as show in Figure 19 employs both solution based deposition and vapor phase transformation by Graetzel [21] and coworkers, that report 12.1 % efficiency for their device.

*Figure 18. Schematic of Snaith hybrid perovskite solar cell*

*Figure 19. Gratzel sticks with the TiO2 structure and tinkered with the deposition step.*

*Figure 19. Gratzel sticks with the TiO2 structure and tinkered with the deposition step.*

These deposition techniques had two important drawbacks: first challenging for large-scale industrial production and second is that the all-solution process results in decreased film quality, and the vacuum process requires expensive equipment and uses a great deal of energy. Yang Yang [16] from UCLA university present new method named "Vapor-assisted solution process" that organic material infiltrates the inorganic matter and forms a compact perovskite film. These films is significantly more uniform than the films produced by the wet technique

significantly more uniform than the films produced by the wet technique (Figure 20).

significantly more uniform than the films produced by the wet technique (Figure 20).

Inorganic

**Figure 19.** Gratzel sticks with the TiO2 structure and tinkered with the deposition step.

Inorganic

These deposition techniques had two important drawbacks: first challenging for large-scale industrial production and second is that the all-solution process results in decreased film quality, and the vacuum process requires expensive equipment and uses a great deal of energy. Yang Yang [16] from UCLA university present new method named "Vapor-assisted solution process" that organic material infiltrates the inorganic matter and forms a compact perovskite film. These films is

These deposition techniques had two important drawbacks: first challenging for large-scale industrial production and second is that the all-solution process results in decreased film quality, and the vacuum process requires expensive equipment and uses a great deal of energy. Yang Yang [16] from UCLA university present new method named "Vapor-assisted solution process" that organic material infiltrates the inorganic matter and forms a compact perovskite film. These films is

Organic vapor

Organic vapor

and coworkers, that report 12.1 % efficiency for their device.

and coworkers, that report 12.1 % efficiency for their device.

Metal Contact

Metal Contact

Substrate film

Substrate film

Hole transporting layer

Hole transporting layer

**Figure 18.** Schematic of Snaith hybrid perovskite solar cell

Finally they reported 15.4% efficiency for their device and another research in this area, reported the difference efficiency by using different material for example Pbl2 that Graetzel and Bolink [51] used (device efficiency was 12.04 %) or difference evaporation method for example as show in Figure 19 employs both solution based deposition and vapor phase transformation by Graetzel [21]

Finally they reported 15.4% efficiency for their device and another research in this area, reported the difference efficiency by using different material for example Pbl2 that Graetzel and Bolink [51] used (device efficiency was 12.04 %) or difference evaporation method for example as show in Figure 19 employs both solution based deposition and vapor phase transformation by Graetzel [21]

Hybrid perovskite

Hybrid perovskite

Metal Contact

Metal Contact

Electron Selective Contact

Electron Selective Contact

PbI2 CH3NH3I

PbI2 CH3NH3I

Perovskite

Perovskite

16

16

*Figure 20. Vapor-assisted solution process*

*Figure 20. Vapor-assisted solution process*

uniform [32].

240 Solar Cells - New Approaches and Reviews

HTL

HTL

(Figure 20).

TiO2 mesoporous

TiO2 mesoporous

In conjunction with these exciting device-centric advancements, fundamental studies into the photoexcited species and their photogeneration and recombination dynamics in perovskites also began in earnest. In conjunction with these exciting device-centric advancements, fundamental studies into the photoexcited species and their photogeneration and recombination dynamics in perovskites also

16 At least one of the remaining question is "Is the Solar Cell Excitonic?" Perovskite solar cell had similar diffusion lengths for electron and hole that average is about 100 to 300 nm [8] that put these cells in conventional solar cell class. On other hand either indicate similar mobilities for both holes and electrons [9] and this classify these cells in excitonic solar cell group (Figure 21). began in earnest. At least one of the remaining question is "Is the Solar Cell Excitonic?" Perovskite solar cell had similar diffusion lengths for electron and hole that average is about 100 to 300 nm [52] that put these cells in conventional solar cell class. On other hand either indicate similar mobilities for both holes and electrons [53] and this classify these cells in excitonic solar cell group (Figure 21).

Conventional Solar Cell

Excitonic Solar Cell

*Figure 21. Schematic of conventional and excitonic solar cell* **Figure 21.** Schematic of conventional and excitonic solar cell

Chemical Physics 1963; 38 2042–2043.

wells. Solid State Communications 1994; 92 295–301.

Accordingly, due to the common properties of these types of solar cells, between Conventional and excitonic solar cell, researchers cannot exactly determine whether the photoexcited species are excitons or free charges. Accordingly, due to the common properties of these types of solar cells, between Conventional and excitonic solar cell, researchers cannot exactly determine whether the photoexcited species are excitons or free charges.

#### In this section we have presented the synthesis and characterization of organic-inorganic hybrid **5. Conclusion**

**5) Conclusion**

guarantee improved optical and electronic properties by combining organic and inorganic components together. The unusual features and versatile characteristics of hybrid organic-inorganic perovskites open up promising applications in many fields such as electronics, optics, optoelectronics, mechanics, environment, medicine and biology. The application of these materials in the solar cells as a novel class of low-cost materials for high efficiency hybrid semiconductor photovoltaic cells has been explained in more detail. **6) References**  [1]. Agranovich V, Gartstein Y N, Litinskaya M. Hybrid Resonant Organic-Inorganic Nanostructures In this section we have presented the synthesis and characterization of organic-inorganic hybrid perovskite. Hybrid organic-inorganic materials represent an alternative to present materials as they guarantee improved optical and electronic properties by combining organic and inorganic components together. The unusual features and versatile characteristics of hybrid organic-inorganic perovskites open up promising applications in many fields such as electronics, optics, optoelectronics, mechanics, environment, medicine and biology. The application of these materials in the solar cells as a novel class of low-cost materials for high efficiency hybrid semiconductor photovoltaic cells has been explained in more detail.

[2]. Pope M, Kalmann H, Magnante P. Electroluminescence in Organic Crystals The Journal of

[3]. Agranovich V, Atanasov R, Bassani F. Hybrid interface excitons in organic-inorganic quantum

[4]. Agranovich V, La Rocca G C, Bassani F. Efficient electronic energy transfer from a

semiconductor quantum well to an organic material. JETP Letters 1997; 66 748–751.

for Optoelectronic Applications. Chemical Reviews 2011; 111 5179–5214.

perovskite. Hybrid organic-inorganic materials represent an alternative to present materials as they


**3. Mechanisms of zinc metalloenzyme**

In several studies have shown either the metal zinc, or ions zinc, or zinc transporters, or zinc signals, it has acted in different cellular functions and function of immune cells for both innate immune responses and adaptive immune responses [34–37]. This chapter explains the mechanisms of zinc metalloenzyme being necessary for regulating zinc homeostasis in the body. The angiotensinconverting enzyme 2 (ACE2), contains a zinc metalloenzyme [17], in addition to the angiotensin-converting enzyme 2 (ACE2) protein contains protease and amino acid [17], which means that both a protease and a zinc metalloenzyme in the angiotensin-converting enzyme 2 (ACE2) are often used to generate an electric current from spontaneous redox reactions like as electrical battery, has two different metalloenzymes connected by a salt bridge (amino acid) externally completing an angiotensin-converting enzyme 2 (ACE2). An angiotensin-converting enzyme 2 (ACE2) is using this electric current seemingly as signals.

*The Link between Electrical Properties of COVID-19 and Electromagnetic Radiation DOI: http://dx.doi.org/10.5772/intechopen.96815*

To understand an (ACE2) is extensions of spontaneous redox reactions, in this redox reaction, zinc metalloenzyme or metal is oxidized to ions (Zn2+) and ions other electrode is reduced to metalloenzyme or metal such as two electrodes (a cathode and an anode). When electrons are transferred directly from Zn to ions another electrode, is allowing the chemical energy interconversion to electrical energy. In the zinc metalloenzyme such as (half-cell), which is inside the (ACE2), the zinc dissolves via oxidation into the oxidation ions (Zn2+), other words releasing electrons. Results the zinc ion concentration increased to recompense via amino acid, which is inside the (ACE2), the zinc ions leave, and anions enter the zinc. In the other electrode such as (another half-cell), the ions onto this electrode reduce, taking up electrons that are leaving the zinc.

#### **4. Vaccine strategy**

To optimize vaccine design, it seems relevant to investigate the relationship between the electrophysiology properties for COVID-19, which can include the COVID-19 's journey to and electrochemical interactions with the host cells, and the regulate zinc homeostasis on an intracellular level which includes (the mechanisms of zinc metalloenzyme inside the angiotensin-converting enzyme 2 (ACE2), zinc transporters, and zinc signals) through the physical processes. In several studies have shown the zinc is an essential supplement that serves to regulate different physiological mechanisms, it has antiviral properties [34–37]. It is well known that zinc homeostasis or the zinc metalloenzyme homeostasis is crucial for a single cell or even inside cell level, protects the cell against oxidative damages, and supports on functions of the immune system [34].

Consequently, by investigating from this relationship, the findings that are the regulated zinc homeostasis on the intracellular level is targeted to inhibit or prevent COVID-19 before infection or even infection has already occurred. Zinc-regulation plays a critical and essential role in maintaining immune cell numbers and activities. The surprising efficiency of the influence on influenza virus, HCV, SARS-CoV-2, treatment of COVID-19, suggest a novel strategy for the vaccine design of COVID-19. Continuous monitor every period of the zinc homeostasis in the body, and correct zinc homeostasis if there is a defect in zinc homeostasis. This strategy can enhance antiviral immunity and innate immunity functions, it holds promise as an effective vaccine design strategy that should be further explored.

### **5. The nature of electromagnetic radiation (EM radiation)**

To exploitation of biophysics, electrochemical, and physical processes for combat infectious diseases by blocking or disrupting their electrostatic discharge (ESD) properties link with electromagnetic radiation (EM) interactions something in a skillful manner. Here, electromagnetic radiation is imagined as a flow of tones produce via the vibrating strings with free ends, whereas tones produce via the vibrating strings with fixed ends in the darkness. In nature the electromagnetic radiation, more studies have suggested that the electromagnetic radiation has behaved either a wave or a particle, and some of the studies have suggested, it behaves as a wave and a particle at the same time. In this chapter, we will raise the conjecture (the purport of which will hereafter be called the "Principle of Diplopia and String"), to the status of a postulate, and introduce another postulate, which is only apparently irreconcilable with the former, namely, that the introduction of a "gravitational wave" will prove to be necessary since the view here to be developed

will require a unification of electromagnetic radiation and gravitational waves. Those two postulates suffice for the attainment of a simple and consistent theory of electromagnetic radiation. Thus, those two principles contribute as key to solve the mystery of the wave-particle duality for objects, the darkness, the dark energy.

#### **5.1 Vibrating strings with free ends**

To describe the electromagnetic radiation based on the principle of diplopia and string. We must imagine the electron, which that is a closed vibrating string loop or an opened vibrating string. To render our presentation more precise and to distinguish this electron verbally from others which will be introduced hereafter, we call it the "electronString" and the free electronString. Thus, that is an electronString, which is the quotient of a combination between energy, and its mass (− 9.11 x 10–31 kg) [38].

If the electromagnetic radiation is imagined as a flow of tones, these tones we will call the "photonTone" with each photonTone carrying a separated packet of energy. To prove these tones means sound waves, and sound waves are part of the electromagnetic. First, according to several studies of electromagnetic radiation, which is a vibration of electric and magnetic fields at right angles. Accordingly, the tones or a sound wave are a disturbance that travels through a medium, this medium is a vibration of electric and magnetic fields, where here the tones, which is a vibration of electric and magnetic fields.

Let us apply the pair production [39, 40], based on the principle of diplopia and string when photonTone at extreme energy (gamma ray) can create two electron-Strings. Here, the gamma ray or high photonTone, makes an electronString and its anti electronString, where the anti electronString is positively charged with the same mass as the electronString. By several studies have shown the sound waves carrying mass [41], and because the photonTone is a flow of tones carrying by a tones separated packet of energy, which means these photonTones carrying mass. Because we used a photonTone at extreme energy, this means the tones (sound wave) could carry much of mass to produces an electronString and its anti electronString. These two electronStrings can recombine with each other and create the photonTones. Thus, with the help of certain imaginary physical experiments we have settled what is to be understood by:

$$(\mathbf{es} - ) + \mathbf{es} \rightarrow \mathbf{pht} + \mathbf{pht} \tag{1}$$

where,

(es−): an electronString = −9.11 x 10–31 kg + pht (its energy), es: a positronString = 9.11 x 10–31 kg + pht (its energy), and pht: an emitted photonString.

$$(-9.11 \ge 10^{-31} \text{kg}) \star \text{pht} \star 9.11 \ge 10^{-31} \text{kg} \star \text{pht} \cdot -- \dots > \text{pht} \star \text{pht} \tag{2}$$

Thus, when a number or amount (9.11 x 10<sup>−</sup>31 kg) is subtracted from itself, the results is zero.

$$\text{phiht} + \text{pht} \rightarrow \text{pht} + \text{pht} \tag{3}$$

When applying the photoelectric effect as shown in **Figure 1** based on the principle of diplopia and string, when a photonTone incident on an atom transfers all its energy to this electronString, while the electronString containing the energy of the photonTone leaves the orbit of the atom.

*The Link between Electrical Properties of COVID-19 and Electromagnetic Radiation DOI: http://dx.doi.org/10.5772/intechopen.96815*

**Figure 1.** *Here, a photon incident on a hydrogen atom transfers its energy to an electronString, which leaves the orbit and is detected.*

Each electronString has a certain amount of binding energy, which is the minimum energy that is required to remove an electronString from an atom, this electronString is held in place by the electrostatic pull of the positively charged nucleus. For example, when an electronString absorbs a photonTone incident, this electronString becomes the move to a higher energy shell or become a free electron-String, when this electronString drops back down to a lower-energy shell. Thus, this electronString will release energy represent a photonTone. Now, the electromagnetic radiation can be pictured as a vibrating photonTone by oscillating electric and magnetic fields that move in a straight line at a constant velocity.

#### **5.2 Vibrating strings with fixed ends**

If darkness is imagined as a flow of tones, these tones are producing via the vibrating strings with fixed ends by the gravitational wave, thus can generate standing waves. Where the gravitational waves squeeze and stretch strings in their path as they pass by to vibrate the string produce their tones, these tones represent energy. The tones are standing wave modes that arise from the combination of reflection and interference such that the reflected waves interfere constructively with the incident waves.

In the musical instrument, the vibrating strings are squeeze and stretch the string in their path as they pass by to vibrate the string produce their tones [42], as in the darkness is created from two waves with equal frequency, amplitude, and wavelength traveling in opposite directions by applying superposition. Where occur the destructive or constructive interference of counter-propagating waves one form of energy decreases and the other increases such that the total energy remains constant, we will call this a pair of the superposition of standing waves "diplopia waves".

#### **6. Conclusion**

Effectiveness of vaccine against several types of viruses such as COVID-19 is mainly realized through investigating the relationship between the electrophysiology properties for a virus, and the regulate zinc homeostasis on intracellular level through the physical processes such as viral binding, membrane fusion,

and infection. The regulated zinc homeostasis serves to stabilize the membrane potential which could play a role in preventing the virus of COVID-19 entry into the host cell. In additionally, the regulated zinc homeostasis serves to inhibit viral replication by protecting the deoxyribonucleic acid (DNA) from damage via an emitted ionizing radiation or mutagens as discussed under step III, protect the cells from exposure to oxidizing agents because the Zn2+ concentrations are directly belonging to the intracellular redox state. Interestingly, all this evidence used in this chapter supports the essential role for regulating zinc homeostasis to inhibit the physiological consequences as discussed under step III by this new vaccine strategy. This vaccine strategy is based on the properties of COVID-19, the voltage-viral charges channel activity required to inhibit the physiological consequences via dampening specific electrochemical functions associated with COVID-19's journey to and interaction with the host cells and to strengthen immune system develop protection against COVID-19 and new strains.


*6.2.2 Image segmentation*

The task of image segmentation is to map an input image into a segmented output image. The encoder-decoder networks have been developed dramatically in recent years and achieve a significant impact on computer vision. Specifically, there are mainly two types of tasks including semantic segmentation and instance segmentation. In 2015, Long et al. [20] firstly showed that an end-to-end fully CNN can achieve state-of-art in image segmentation tasks. Similar work has also been introduced in [6] in 2015, in which a U-Net architecture is proposed for medical image segmentation, and the main advance in this architecture is that the shortcut connection method is also used between the encoder and decoder network. Since then, a series of papers based on these two methods have been published. In particular nowadays the U-Net based architectures are widely used for the medical image diagnosis.


*2.2.2 Placement*

• First, a purse suture with 2–0 polypropylene suture and rubber sleeve is used at the insertion point, and then mean arterial pressure is maintained at 100 mmHg (1 mmHg = 0.133 kPa) by medical management. The aorta wall is

**259**

*Management of Ascending Aorta Calcification in Coronary Artery Bypass Grafting*

then the sleeve is tightened to limit the bleeding.

tion perpendicular to the metal rod of the lower jaw.

aortic wall and then exhaust and knot (**Figure 2**).

**2.3 Key points of Enclose using technique**

punctured at the central position of the purse suture with the puncture needle

• The lower jaw of Enclose is inserted into the aorta through the above-mentioned puncture point and placed at the pre-selected anastomotic position, and

• Unscrew the membrane at the end of the lower jaw with the self-contained

• Adjust the knob of the upper jaw to move the upper arm vertically downward and then attach the aortic adventitia and tighten the fixator. When no blood flows out of the suction tube of the lower arm, a blood-free environment is formed between the intima and the arterial wall. Behind the suction tube, a 50 ml syringe can be connected to absorb a small amount of blood oozing from

• Use a circular knife to cut the aortic wall at the preselected anastomosis posi-

• Use Enclose' s own perforator to drill through the aortic incision. The perforator shall be close to the metal rod of the lower jaw to ensure full layer

Anastomosis of saphenous vein (A) to ascending aorta (B) is performed with 6–0 polypropylene suture. The local bleeding that affects the suture field can be removed by suction. At the same time, maintain systolic blood pressure of systemic circulation at 90–100 mmHg level to reduce bleeding and ensure full layer suture of

Close membrane after anastomosis and then release and remove Enclose. Knot the purse suture and use 2–0 polypropylene suture with felt pad to mattress suture

A considerable proportion of patients with coronary disease has ascending atherosclerosis. Many soft atherosclerotic plaques similar to "toothpastes" exist in the middle layer of ascending aorta, whereas obvious calcification can be identified by finger touch on the surface of aorta. Therefore, the plaques are prone to break and fall off after the application of side wall clamp and lead to organ embolism along with blood flow. In addition, except for the requirement of healthy aortic tissue at the puncture insertion point and anastomotic site, healthy tissue should also be selected between the two points as much as possible to avoid excessive bleeding due to atherosclerosis or calcification of the arterial wall between the two points, or plaque falling off due to extrusion.

*DOI: http://dx.doi.org/10.5772/intechopen.91909*

provided by Enclose.

rotary rod of Enclose.

the anastomosis area.

drilling (**Figure 1**).

*2.2.3 Anastomosis*

*2.2.4 Remove*

for reinforcement.

*2.3.1 Position selection*

punctured at the central position of the purse suture with the puncture needle provided by Enclose.