Psychosocial factors impacting sexuality.
\r\n\tThis book intends to provide the reader information about various dynamic analysis methods and evaluated structures with this methods. This book also presents an overview and a state-of-the art compilation of time integration methods for solving problems of dynamics, with a particular focus on developments that have occurred during the past years.
",isbn:null,printIsbn:"979-953-307-X-X",pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"6282bc749f4a87573e21c325adaced45",bookSignature:"Dr. Hakan Yalciner, Dr. Atila Kumbasaroglu and Mr. Alper Celik",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/9296.jpg",keywords:"Numerical Methods, Finite Element Methods, Algorithms, Time History Analysis, Earthquake Engineering, Structural Behavior, Performance Based Design, Crane Loads, RC Design, Retrofitting, Fiber Reinforced Polymer",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 29th 2019",dateEndSecondStepPublish:"June 19th 2019",dateEndThirdStepPublish:"August 18th 2019",dateEndFourthStepPublish:"November 6th 2019",dateEndFifthStepPublish:"January 5th 2020",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 years",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"72283",title:"Associate Prof.",name:"Dr. Hakan",middleName:null,surname:"Yalçıner",slug:"dr.-hakan-yalciner",fullName:"Dr. Hakan Yalçıner",profilePictureURL:"https://mts.intechopen.com/storage/users/72283/images/system/72283.jpeg",biography:"Associate Professor Dr. Hakan Yalçıner is an earthquake and structure engineer in Erzincan Binali Yıldırım University and chair in the Department of Civil Engineering. Dr. Hakan Yalçıner received his PhD from Eastern Mediterranean University. He is a voting member of ACI Committees 546-00 (Repair of Concrete) and 546-0E (Corrosion Studies). His research interests include performance analysis of structures under extreme conditions and loads, such as corrosion, seismic events, and blast. Dr. Yalçıner developed different empirical models for the prediction of the structural behavior of corroded reinforced concrete members. He is currently director of the 13th March of Structural Mechanics Laboratory in Erzincan Binali Yıldırım University. 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The applications of the optics increased significantly after the first demonstration of the light guiding phenomenon based on total internal reflection in the 1840s, which was the precursor for the development of modern optical fibres. In modern life, optical fibres found their niche in telecommunications and, more recently, as sensors.
The sensing of chemical compounds is very important for monitoring outdoor and indoor environments (air and soil pollutions and sick building syndrome) [1], diseases (allergy and cancer) [2], and dangerous substances (drugs, hidden bombs, and landmines) [3]. Sensitive, reliable and cheap sensors for application in different areas of human activities are still sought.
Optical fibre-based measurement techniques have attracted a great deal of attention in a variety of analytical areas such as chemical and biological sensing, environmental monitoring and medical diagnosis. The variety of different designs and measurement schemes that may be employed using optical fibres provides the potential to create very sensitive and selective measurement techniques in real environments.
Different approaches exist for creation of fibre-optic sensors (FOS), which generally can be classified into two groups depending on the sensing mechanism: intrinsic and extrinsic fibre-optic sensors [4]. Interferometric sensors can be made that respond to an external stimulus by a change in the optical path length and thus a phase difference in the interferometer. Traditional interferometers such as Michelson, Mach Zehnder [5, 6, 7], Fizeau, Sagnac [8] and Fabry Perot [9, 10, 11] used for measuring of both chemical and physical parameters can be constructed utilizing optical fibres.
Fibre-optic sensors based on the evanescent wave absorption effect are an example of simple, cost effective yet very efficient type of intrinsic fibre-optic sensor [12]. As light travels along the core of the optical fibre, a small portion of energy penetrates the cladding in the form of an
This allows the direct analysis of the spectroscopy of an analyte in contact with the surface of the optical fibre. Alternatively an indirect measurement approach can be employed, whereby a chemically sensitive functional coating, which changes its optical properties when it comes into contact with the analyte, can be deposited onto the surface of the optical fibre. Analysis of the transmission spectrum can provide quantitative and qualitative information on the chemical species under examination. The use of chemically sensitive coatings means that the operating wavelength of the sensor is defined by the coating properties, rather than the absorption spectrum of the analyte, which can be advantageous. Fibre optic sensors based on the intrinsic evanescent wave offer the prospect for the development of cheap and compact devices, due to combination of low cost light emitting diodes (LED) and photodetectors. The sensitivity of the device is dependent on the length of the sensing area and for efficient operation coating materials with the strong absorption features should be selected. Generally, the simplest implementation of the fibre optic evanescent wave spectroscopy is application of the multimode optical fibre with the silica core and plastic cladding. The plastic cladding can easily be removed to allow the access to the evanescent wave and replaced with the functional coating providing sensor with its sensitivity and selectivity. In the case of the singlemode fibres with silica core and silica cladding polishing, etching or tapering is employed in order to get an access to the evanescent wave.
Intrinsic FOS allows to implement different measurements designs within an optical fibre based on the gratings (Bragg Gratings, FBG and long period gratings, LPG) written into the fibre core in which the changes in the reflected light due to changes in the grating period is measured to detect the effect caused by an external stimulus [13, 14]. Refractometers and chemical sensors based on optical fibre gratings, both FBGs and LPGs, have been extensively employed for refractive index measurements and monitoring associate chemical processes since they offer wavelength-encoded information, which overcomes the referencing issues associated with intensity based approaches.
Among the optical waveguide devices that have been investigated, tapered optical fibre sensors are able to measure environmental parameters (refractive index, chemical concentration, etc.) with high sensitivity owing to the large proportion of the energy of the propagating mode extending into the surrounding environment in the form of an evanescent field [15, 16, 17]. The tapered area of the optical fibre facilitates evanescent wave spectroscopy, in which the absorption spectrum of the surrounding medium is measured. Alternatively, the influence of the surrounding medium on the properties of the optical modes of the tapered waveguide can be explained as a change in the refractive index, i.e. it will operate as a refractometer.
Various deposition techniques, such as dip- and spin-coatings, layer-by-layer deposition (LbL) electrostatic self-assembly, Langmuir-Blodgett deposition, and chemical and physical vapour deposition have been employed for the functional coating of optical fibres. Among these techniques, the LbL technique, which is based on the alternate adsorption of polycations and polyanions onto the surface, has been used as a powerful surface modification method. This alternate adsorption technique is still expanding its potential because of its versatility and convenience for the fabrication of nano-assembled thin films employing various organic and inorganic materials.
In this chapter we will describe recent approaches to the development of fibre-optic chemical sensors utilising different measurement designs based on evanescent wave, tapered and long period gratings functionalized with nanoassembled thin films. Advantages and characteristic features of each measurement design will be discussed and examples of the sensitive and selective detection of various chemical analytes will be demonstrated. In addition, the potential of fibre-optic chemical sensors for future sensor technology will be discussed.
To fabricate the evanescent wave fibre-optic sensor (EWFOS), a short section of the plastic cladding of a multimode optical fibre (HCS silica core/plastic cladding with 200 μm core diameter, Ocean Optics) was replaced with a functional coating of alternate poly(diallyldimethylammonium chloride) (PDDA, Mw: 200000–350000, 20 wt% in H2O) and tetrakis-(4-sulfophenyl)porphine (TSPP,
(a) Schematic illustration of the layer-by-layer adsorption of TSPP and PDDA on a multimode optical fibre and (b) deposition cell used for optical fibre coating [
The measurement principle of the device is based on the analyte-induced optical change in the transmission spectrum of the coated optical fibre.
The penetration depth (
where λ is the wavelength of light in free space,
Structural models of the polycation (PDDA) and porphyrin (TSPP) compounds used for sensor fabrication [
Porphyrin compounds can be used as a sensitive element for optical sensors because their optical properties (absorbance and fluorescence features) depends on the environmental conditions in which molecule is present [20]. Porphyrins are tetrapyrrolic pigments that widely occur in nature and play an important role in many biological systems [21]. The optical spectrum of the solid state porphyrin is modified as compared to that of porphyrin in solution, due to the presence of strong π−π interactions [22]. Interactions with other chemical species can produce further optical spectral changes, thus creating the possibility that they can be applied to optical sensor systems. The high extinction coefficient (> 200,000 cm-1/M) makes porphyrin especially attractive for the creation of optical sensors.
A tapered optical fibre may be fabricated by simultaneously heating and stretching a short section of a single mode optical fibre. This creates a region of fibre with reduced and uniform diameter (the waist) that is bounded by conical sections where the diameter of the fibre changes to merge the tapered section with the unperturbed surrounding single mode fibre. The optical properties of the tapered fibre waveguide are influenced by the profile of the conical tapering sections, by the diameter of the taper waist and by the optical thickness of the surrounding medium. The proportion of the power in the evanescent field, and thus the interaction with the surrounding medium, increases with decreasing diameter of the taper waist [23, 24]. In the tapering section, the guided mode of the single mode fibre is converted into a mode of the waist, Figure 2. In adiabatic tapers this is achieved without coupling to higher order modes. In non-adiabatic tapers the taper profile is such that a proportion of the light is coupled into higher order modes of the tapered section, which interfere to produce the channeled spectra reported for tapers of diameter of order 5 µm [23, 25].
The detailed description of the fibre tapering procedure can be found elsewhere [23]. Briefly, a single mode silica optical fibre was tapered using the heat and pull technique. Firstly, the polymer buffer coating was removed from a 50 mm long section in the middle of a ~1 m length of the single mode optical fibre using a mechanical stripper. The stripped section of the optical fibre was then fixed on a 3-axis flexure stage (NanoMaxTM, Thorlabs) and exposed to the flame produced by a gas burner (max temperature 1800oC) for approximately 60 sec while the ends of the fibre were pulled in opposite directions using translation stages. Nonadiabatic optical fibre tapers of diameters 9, 10 and 12 µm, all having a taper waist of length 20 mm, were fabricated. The dimensions of the tapers were determined using a digital optical microscope, DZ3 Union Optical Co., Ltd., Japan.
The LbL method described above has been used to deposit a multilayer porphyrin film over the tapered region of a single mode optical fibre with the aim of demonstrating a gas sensor, Figure 2a. The effect of the polycation on the optical properties and structure of the multilayer porphyrin film was studied thoroughly. It is suggested that, by using poly(allylamine hydrochloride) (PAH,
(a) Schematic illustration of the layer-by-layer adsorption of TSPP and PAH on a tapered optical fibre and (b) optical images of the tapered region of the optical fibres with different waist diameter.
LPGs promote coupling between the propagating core mode and co-propagating cladding modes, i.e. work as transmission gratings. The high attenuation of the cladding modes results in the transmission spectrum of the fibre containing a series of resonance bands centred at discrete wavelengths, each resonance band corresponding to coupling to a different cladding mode, as shown in Figure 3 [26].
The refractive index sensitivity of LPGs arises from the dependence of the phase matching condition upon the effective refractive index of the cladding modes, which is governed by Equation 2 [26]:
where
(a) Schematic illustration of the LPG structure and (b) transmission spectra of LPGs with different grating periods fabricated in an optical fibre of cut-off wavelength 670 nm (Fibrecore SM750): (i) 80 µm, (ii) 100 µm, and (iii) 400 µm [
The effective indices of the cladding modes are dependent upon the difference between the refractive index of the cladding and that of the medium surrounding the cladding. The highest sensitivity is shown for surrounding refractive indices close to that of the cladding of the optical fibre, provided that the cladding has the higher refractive index [28]. For surrounding refractive indices higher than that of the cladding, the centre wavelengths of the resonance bands show a considerably reduced sensitivity [29].
A detailed description and reference to the optical properties of LPGs can be found elsewhere [27, 30, 31]. In this work, an LPG of length 30 mm with a period of 100 µm was fabricated in a single mode optical fibre (Fibercore SM750) with a cut-off wavelength of 670 nm using point-by-point UV writing process. The photosensitivity of the fibre was enhanced by pressurizing it in hydrogen for a period of 2 weeks at 150 bar at room temperature.
The coated LPG was used for the detection of ammonia in the gas phase and in solution. For the detection of ammonia in solution, the LPG was coated with mesoporous PDDA/SiO2 nanoparticles (NPs) (SNOWTEX 20L (40–50 nm), Nissan Chemical) film using the LbL process and infused with functional compound, TSPP, as illustrated in Figure 4a. As the LPG transmission spectrum is known to be sensitive to bending, for the film deposition process and ammonia detection experiments the optical fibre containing LPG was fixed within a special holder, as shown in Figure 4b, such that the section of the fibre containing the LPG was taut and straight throughout the experiments [30]. The detailed procedure of the deposition of the SiO2 NPs onto the LPG and infusion of the TSPP compound has been reported previously [27]. Briefly, the section of the optical fibre containing LPG, with its surface treated such that it was terminated with OH groups, was alternately immersed into a 0.5 wt% solution containing a positively charged polymer, PDDA, and, after washing, into a 1 wt% solution containing the negatively charged SiO2 NPs solution, each for 20 min. This process was repeated until the required coating thickness was achieved. When the required film thickness had been achieved (i.e. when the development of the second resonance band was observed with the fibre immersed into water), ca. after 10 deposition cycles, the coated fibre was immersed in a solution of TSPP as functional compound for 2 h, which was infused into the porous coating and provided the sensor with its specificity. Due to the electronegative sulfonic groups present in the TSPP compound, an electrostatic interaction occurs between TSPP and positively charged PDDA in the PDDA/SiO2 film. After immersion into the TSPP solution, the fibre was rinsed in distilled water, in order to remove physically adsorbed compounds, and dried by flushing with N2 gas. The compounds remaining in the porous silica structure were bound to the surface of the polymer layer that coated each nanosphere. This effectively increased the available surface area for the compounds to bond to. The presence of functional chemical compounds increased the RI of the porous coating and resulted in a significant change in the LPG’s transmission spectrum, consistent with previous observations for increasing the coating thickness [32]. All experiments have been conducted at 25oC and 50% of rH.
(a) Schematic illustration of the electrostatic self-assembly deposition process and (b) deposition cell with a fixed LPG fibre.
For the ammonia detection in gas phase the LPG was designed to operate at the phase match turning point. In coated LPGs, for coupling to a particular cladding mode, the phase matching turning point occurs at a specific combination of grating-period and optical thickness of the coating. Near the phase matching turning point conditions, it is possible to couple to the cladding mode at two different wavelengths, with the corresponding resonance band wavelengths showing opposite sensitivity to perturbations to the properties of the coating [33]. LPGs show there highest sensitivity to environmental perturbations when operating in this regime [33]. The LPG was coated with an alternate thin film composed of poly(acrylic acid) (PAA,
(a) Schemetic illustration of an LPG and its surface modification using PDDA and PAA [
Ammonia is one of the major metabolic compounds and the importance of its detection has been recently emphasized because of its correlation with specific diseases [36,37]. At normal physiological conditions ammonia can be expelled from the slightly alkaline blood and emanated through the skin or exhaled with the breath. Dysfunction in the kidneys or liver that converts ammonia to urea can result in an increase of the ammonia concentration in breath or urine. Consequently, the detection of the ammonia gas present in the breath or urine can be used for the early diagnostics of liver or stomach diseases [36].
Ammonia-induced changes in the transmission spectrum of the (PDDA/TSPP)5 film are shown in Figure 6. As ammonia concentration increased from 0 to 20 ppm, a concomitant intensity change is observed at several wavelengths; at 706 nm the intensity increases, whereas at 350 and 470 nm it decreases. Upon exposure of the (PDDA/TSPP)5 film to ammonia, the largest intensity change was observed at 706 nm. The interaction between ammonia and TSPP molecules leads to the deprotonation from the pyrolle ring and hence affects the interaction between TSPP molecules. Similarly, the largest change in absorbance is observed at 706 nm (Q band), which is attributed to the aggregation structure of TSPP [38]. The difference spectra were obtained by subtracting a spectrum measured in ammonia atmosphere from a spectrum measured in air.
Optical transmission difference spectra of the optical fibre coated with a five-cycle PDDA/TSPP alternate film on exposure to ammonia concentrations ranging from 0–20 ppm.
The dynamic response of the (PDDA/TSPP)5 coated fibre to exposure to ammonia was monitored at 350, 470 and 706 nm (Figure 7a). As can be seen from the result, the sensor response is fully reversible for low ammonia concentrations (up to 1 ppm). However, at higher concentrations the sensor takes a longer time to return to the base line. The base line may be recovered by flushing with air for sufficient time, as shown in Figure 7a. Alternatively, the sensor response can be regenerated by rinsing for a few seconds in distilled water [39]. The calibration curve at each wavelength was plotted from the recorded spectra at given ammonia concentrations. The sensor shows linear responses at all wavelengths for a wide concentration range from 0.1 to 20 ppm and the highest sensitivity was observed at 706 nm (Figure 7b).
(a) Dynamic response of the optical fibre coated with a five-cycle PDDA/TSPP alternate film for ammonia concentrations ranging from 0–20 ppm at 350, 470, and 706 nm. (b) Calibration curves at 350 nm (squares), 470 nm (rhombuses), and 706 nm (circles). Lines show the linear fitting and are used only as guidance to an eye.
The response and recovery times (
where σ ≈ 0.31 is the standard deviation, and
The results suggest that it will be possible to create a low-cost fibre optic sensor by selecting a LED and a photodiode with parameters that coincide with the wavelength at which the largest ammonia-induced changes were observed (706 nm).
The optical fibre acts as a platform that may be exploited to facilitate the detection of different chemicals by coating the fibre with appropriate functional materials. In order to demonstrate its capability, it was employed for the detection of the gaseous compounds excreted from the human body. Gaseous compounds excreted from the human body are believed to reflect certain metabolic conditions of the organism as well as the blood gaseous content [41]. A lot of information about human skin excretion is present in the literature. In gas chromatography (GC) based experiments, variety of compounds were found to be emitted by human skin, such as acetone [42], ammonia [43], hydrocarbons [44] and aromatics [45], and the quantity of some of these compounds was correlated to blood content. Ammonia gas has been known to emanate through the skin from serum and its level depends on the humans health conditions [37]. Studies have demonstrated the possibility of identifying human subjects through the examinations of their volatile organic compound (VOC) odour patterns, formulating the idea of personal “smellprint” as an analogue of the fingerprint [46]. Applicability of electronic nose techniques was shown for the classification of bacteria related to human diseases [47,48], urinary tract infections [49] and further progress to metabolic disorders such as diabetes [50] or renal dysfunction [51]. The detection of renal failure in rats [52] and of lung cancer in people [53] was achieved using the breath sniffing method by arrays consisting of appropriately modified chemiresistors. Analysis of gases emitted from skin, however, is mainly being performed with the use of GC, which in spite of its high sensitivity and selectivity is expensive and time-consuming and requires a well- trained operator. Development of miniaturized sensing devices is expected to overcome the drawbacks of conventional approaches.
Here, a preliminary study of an optical fibre based skin gas sensor is discussed.The measurement setup for the skin gas analysis is shown in Figure 8. One end of the optical fibre was connected to a deuterium/halogen tungsten light source (DH-2000-BAL, Micropack) and other end was connected to an optical spectrometer (S1024DW, Ocean Optics) via fibre-optic connectors. The fabricated optical sensor was located inside a small acryl sensing cell (cylinder shape with radius
For skin gas measurements, the top of the acryl cell was completely covered by palm surface. The optical measurement of palm skin emanations inside the chamber was done for 5-30min while the optical output spectrum and optical changes at selected wavelengths were recorded every second using an Ocean Optics software (OOIBase32).
To test the influence of the humidity, the acryl sensing chamber was additionally connected to a humidified air generating system through the additional inlet and outlet of the measuring cell, as shown in Figure 8. Dry compressed air was divided into two flows by the use of flow controllers (FC1 and FC2) and one of the flows passed through a bubbling bottle with deionized water to humidify the air. Recombination of the flows of dry and wet air was used to obtain the different levels of relative humidity.
Experimental setup containing light source LS, optical spectrophotometer OS, data acquisition DA and humidified air generating system [
Sensor response to changes in relative humidity was measured every second by recording the transmission spectrum of the optical fibre coated with a thin film. To explore the reproducibility of the measurements, the response of the fibre optic sensor was recorded twice at three different levels of humidity and flushed with dry air between each measurement.
The sensor response to palm skin gas was assessed by recording the changes of the optical properties of a (PAH/TSPP)10 film deposited on the optical fibre. Optical spectral changes induced by the presence of the skin gases emitted from two different people (R and S) are shown in Figure 9a (spectral change) and Figure 9b (dynamic intensity change at selected wavelengths). Measurements were conducted on the same day at similar conditions: the both participants were healthy, and hands were washed before the experiment with filtrated water. A slightly different response for two different people was observed. It should be noted that relative humidity level measured using a humidity logger, reached equilibrium at a maximum value of 95% within 1 min (data not shown). In general, relative humidity is an important factor that can influence sensor response. The sensor response to the skin gas emanations, however, is much slower as compared to the changes induced by relative humidity.
(a) Spectral changes induced by the skin gas emanations and (b) dynamic sensor response measured at selected wavelengths (black line 305 nm, red line 455 nm, blue line 629 nm, green line 733 nm) for different people (R-closed circles, S-open triangles).
This difference in the senor response for two different participants suggests that some additional volatile compounds are exhaled by the human skin surface along increasing humidity. Interaction of compounds present in the skin gas with the PAH/TSPP film would contribute to the additional change observed in the output spectra.
(a) Principal component analysis performed using the data measured at 25 wavelengths. Results measured at relative humidity change (black, with an arrow indicating increase of relative humidity values); Sensor response induced by skin gas emanations from participant R (blue, arrow indicating increase of sampling time of human skin gas emanation; i.e. attachment of the palm to the chamber containing the sensor, green point indicate the response one day after alcohol consumption); and from participant S (red, arrow indicating increase of sampling time of human skin gas emanation, magenta points show the response one day after alcohol consumption ). (b) PCA loadings.
From the complex sensor response observed over the wide spectral range, it is not a trivial task to discriminate the influences of humidity and skin gases. For the purpose of qualitative data description, the measured results were analyzed using principal component analysis (PCA, Statistical EXCEL add-in, V. 5.05 by Esumi Co. Ltd.) in order to reduce the multi-dimensionality of the obtained data. The 25 wavelengths at which the biggest intensity changes were observed were manually chosen from the difference spectra. Such selection was sufficient to obtain good separation between qualitatively different samples. The PCA results are shown in Figure 10, with a 96.5% cumulative proportion of PC1 and PC2. General observations are as follows: humidity points are grouped along the positive side of PC1 while most points representing responses to skin gas are located in the negative PC1 region. Additionally, PC2 can possibly be used for the separation of participants who have different physiological conditions and different skin exhaling properties. The bigger distance between points in the S sample is probably related to the more intensive VOCs emanation. In addition, skin gasses were measured the day after alcohol consumption, and these points are added to the PCA plot. Those measurements were repeated several times and skin gas sampling was done for 5 min. From the PCA plot, we can see that for the participant R, the points after consuming alcohol lie very close to those of the normal physiological conditions. For participant S, the points after consuming alcohol are located on the opposite side of the both principal component axes, which might be a result of a considerable change in the skin gas content after consuming alcohol. The obtained results further illustrate that the proposed sensor, combined with PCA data analysis, could recognize human samples and humidified air. However, based on the data gathered from only two persons, it is not possible to make a generalization on the behaviour of the sensor and on its ability to distinguish physiological conditions. We can speculate, however, that due to the normal physiological differences (for example in metabolic processes and related products excretion through the skin) between two people, the characteristics of the optical sensor response, such as response time and intensity change at different wavelengths, would be expected to be different. As shown in GC-MS and HPLC studies, variety of compounds can be found from human skin at normal conditions, such as ammonia [43], carbon monoxide [55], acetaldehyde [56], and acetone [42]. These compounds and many other emanations that are constituents of body odor are believed to contribute into the optical spectra of the EW sensor. Measurements using wider group of participants should be conducted, and the physiological condition of the various individuals tested should be considered to clarify the sensor response in more detail. Additionally, the response of the sensor to exposure to particular VOCs should be charcaterised to enable qualitative and quantitative analysis of skin gases.
A purpose-designed measurement chamber was used in order to characterise the tapered optical fibre sensor performance. The tapered section of the optical fibre, coated with the functional film, was inserted into the chamber. The desired gas concentrations were produced using a two-arm flow system described elsewhere [18]. The dry compressed air that was used as the carrier gas and ammonia gas of 100 ppm concentration were passed separately through two flowmeters. The two flows were combined to produce the desired ammonia concentration in the measurement chamber. The concentration could be controlled by adjusting the flow rates of the ammonia and of the air.
The transmission spectrum was recorded with a 1 Hz update rate as the device was exposed to a given ammonia concentration and subsequently flushed with dry air. The difference spectrum was plotted by subtracting a spectrum measured at a given ammonia concentration from the spectrum recorded in the presence of dry air. The baseline spectrum and sensor response of each experiment were recorded by passing dry air through the measurement chamber until the signal measured at a wavelength of 700 nm reached equilibrium.
The results are shown in Figure 11a–11d. As the ammonia concentration increased from 10 ppm up to 100 ppm, the intensity measured at 700 nm increased for the 10 µm and 12 µm diameter optical fibre tapers (Figure 11b). Interaction of the ammonia molecule with TSPP leads to the deprotonation of the pyrolle ring of TSPP and hence influences the electrostatic interaction between the TSPP moieties in the PAH/TSPP film [18, 39]. Consequently, the biggest change in absorbance is observed at 700 nm (Q band), which may be closely related to the aggregation state of the TSPP molecules [20].
Interestingly, when measurements were conducted using the tapered fibres with 10 and 12 µm waist diameters, the channeled spectra did not exhibit a wavelength shift in response to exposure to ammonia, suggesting that ammonia–induced RI change cannot be measured with tapers of these diameters, possibly because the modes are tightly bound and the influence of the modes’ evanescent field interaction with the coatings do not induce significant differential changes in the propagation constants (Figure 11b). When the 9 µm diameter tapered fibre coated with the (PAH/TSPP)5 film was exposed to ammonia, a red–shift of the spectral features at 1000 and 1040 nm was observed that saturates with the increase of the concentration (Figure 11c). We can assume that the wavelength red–shift of the spectral features is caused by the ammonia–induced change in the RI of the PAH/TSPP film. It should be noted that this change is not continuous and saturation occurs between 0 and 50 ppm (Figure 11c). The 9 µm diameter tapered fibre possesses higher sensitivity to RI change as compared to 10 and 12 µm diameter tapered fibres. The absence of the intensity change at 700 nm can be explained by considering the transmission spectrum of the 9 µm diameter tapered fibre obtained after deposition of the 5th bilayer of the PAH/TSPP film (data not shown); the optical power at 700 nm transmitted to the spectrometer is very low, complicating the measurement of the small ammonia–induced intensity change. We can conclude from these results that the wavelength shift near 1000 µm observed in the transmission spectrum of the 9 µm diameter tapered fibre is sensitive to ammonia-induced RI changes of the coating and the change in transmitted power near 700 nm of the 10 and 12 µm tapered fibres can be used to monitor ammonia gas concentration.
(a) Transmission difference spectra obtained by subtracting a spectrum measured in the 100 ppm ammonia atmosphere from the spectrum measured in air with the tapered fibres of 9, 10, and 12 µm diameter modified with a (PAH/TSPP)5 film, (b) transmission difference spectra of the 10 µm tapered fibre measured at given ammonia concentrations from 10 to 100 ppm, (c) transmission spectra of the 9 µm tapered fibre measured before and after 50 and 100 ppm ammonia exposures, and (d) dynamic responses of the 10 and 12 µm diameter tapered fibres to the varying ammonia concentration (from 100 ppm to 10 ppm) recorded at 706 nm, where arrows indicate the admission time of ammonia and air into the measurement chamber. The inset of
Dynamic ammonia–induced changes of the tapered fibres with 10 and 12 µm waist diameters coated with the (PAH/TSPP)5 film were monitored at 700 nm, as shown in Figure 11d. The measurement principle for these waist diameters is based on evanescent wave spectroscopy. The response time and recovery time (
(a) Transmission spectra of the 10 µm diameter tapered fibre modified with a 5-cycle PAH/TSPP film measured before and after change of the relative humidity and (b) dynamic responses of the 10 µm diameter tapered fibre to the varying RH from 70 to 10 % and backwards recorded at 706 nm, where lines indicate the admission time of dry air into the measurement chamber; line 1, sensor response; and line 2, RH change measured using humidity logger.
The fabricated device was exposed to varying relative humidity to study its effect on the sensor response. When rH was reduced from 70 % to 10% and increased back to 70%, no significant change in the transmission spectra was observed (Figures 12a and 12b) revealing selectivity of the sensor to ammonia over rH. The immunity of the sensor to rH change is very important for real-world practical applications where humidity is one of the major interfering parameters. For example, ammonia detection in breath is highly important non-invasive diagnostic tool in medicine [37], but highly challenging due to the high humidity present in breath. To-date, to the best of our knowledge, there is no sensor with satisfactory sensitivity and selectivity for the detection of ammonia in breath. In our future study of the use of this sensor for ammonia breath measurement, the cross-sensitivity to other gases will be investigated.
The sensitivity to ammonia in water of an LPG coated with a (PDDA/SiO2)10 film that was infused with TSPP was characterized by sequential immersion of the coated LPG into ammonia solutions with different concentrations (0.1, 1, 5 and 10 ppm). The lower ammonia concentrations were prepared by dilution of the stock solution of 28 wt%. In order to assess the stability of the base line, the coated LPG was immersed several times into 150 µL of pure water. The decrease of attenuation of the second resonance band, LP021, at 800 nm, indicates the partial removal of the adsorbed TSPP molecules. The equilibrium state was achieved after several exposures into water. For the ammonia detection, the LPG fibre was exposed into a 150 µL ammonia solution of 0.1 ppm, followed by drying and immersion into ammonia solutions of 1, 5 and 10 ppm.
(a) Transmission spectra of the LPG coated with a TSPP infused (PDDA/SiO2)10 film due to immersion into water and into ammonia solutions of different concentrations: “H2O”, LPG exposed into water; “air”, LPG in air after drying with N2 gas; “NH3 x ppm”, LPG exposed into a x ppm ammonia solution, where x = 0.1, 1, 5 and 10. (b) Dynamic response to water and ammonia solutions (0.1, 1, 5 and 10 ppm) recorded at 800 nm; LP020 and LP021 are labelling the linear polarized 020 and 021 modes, respectively.
The response of the transmission spectrum to varying concentration of ammonia is shown in Figure 13a. The dynamic response of the sensor was assessed by monitoring the transmission at the centre of the LP021 resonance band at 800 nm. The response is shown in Figure 13b, where “air” region and “H2O” and “NH3” regions correspond to the transmission recorded at 800 nm after drying the LPG and immersing the device into water and ammonium solutions, respectively. After repeating the process of immersion in water and drying 4 times, the recorded spectrum was stable, demonstrating the robustness and stability of the employed molecules in aqueous environments (H2O regions indicated in Figure 13). On immersion in 1 ppm and 5 ppm ammonia solutions, the transmission measured at 800 nm increases. The transmission when the coated LPG was immersed in a 10 ppm ammonia solution exhibits a further increase, reaching a steady state within 100 s, as shown in Figure 13b. The resonance feature corresponding to coupling to the LP020 cladding mode exhibits additional small red shifts of 0.5 and 1.5 nm when subsequently immersed in solutions of 1 ppm and 10 ppm ammonia concentration, respectively, along with decreases in amplitude, as shown in Figure 13a. The limit of detection (LOD) for the 100 µm period LPG coated with a (PDDA/SiO2)10 film that was infused with TSPP was 0.14 ppm and 2.5 ppm when transmission and wavelength shift were measured respectively. The LOD was derived from the calibration curve and the using equation 3 [40].
Response of the sensor to ammonia gas was measured with ammonia vapor of different concentrations generated from aqueous ammonia solutions in proximity to the modified LPG sensor. Ammonia gas was generated by placing 100 μl of aqueous ammonia solution with different concentrations into the measurement chamber. Concentrations of ammonia in the gas phase were measured using ammonia detection gas tubes (GasTec, Japan) and compared with the values of the corresponding solutions. The sensor response was recorded with a resolution of 1 Hz.
The transmission spectrum was recorded with each analyte solution present in the chamber before and after its removal. To regenerate the sensor response the optical fibre was washed with water and flashed using nitrogen gas.
A linear increase in the separation of the 1st and 2nd bands in the TS was observed at the exposure of the LPG coated with the PDDA/PAA to the increasing ammonia gas concentration, Figures 15a and 15b. The sensitivity of the sensor was estimated to be 0.35 and 0.31 nm/ppm for the 1st and 2nd resonance bands, respectively (Figure 15b). The limit of detection (LOD) for both resonance bands was estimated to be 1.6 and 2.3 ppm (3σ = 0.47 nm), respectively. The sensor response was fast and almost saturated within 5 min. Along with the wavelength shift, both the extinction of both of the resonance bands also decreased in proportion to the increase of the ammonia gas concentration. Moreover, the sensor response could be easily regenerated by washing the LPG sensor with water (data not shown).
To confirm the selectivity of the sensor, different analyte gases of amine and non-amine compounds were tested (see Figure 15c). The sensor demonstrated higher sensitivity towards amine compounds. It appears that the superior binding of the sensor to amine compounds is assigned to the acid-base reaction between the functional moieties of PAA and the amine compounds. Other parameters of the analytes such as molecular size, solubility to the film, and equilibrium constant (p
TS changes of the LPG fibre after deposition of PAA.
(a) TS changes of the 2nd resonance band of the LPG fibre with a 7-cycle PDDA/PAA film at the exposure to different concentrations of ammonia gas. (b) Ammonia concentration dependence of the 7-cycle PDDA/PAA film coated LPG fibre on wavelength shifts at 654 and 848 nm. (c) TS changes of the LPG fibre modified with a 7-cycle PDDA/PAA film at the exposure to 100 ppm ammonia gas (estimated from the calibration curve of
In order to demonstrate the capabilities and versatility of the coated optical fibre LPG in chemical sensing, a PAH/SiO2 film was deposited onto the surface for the detection of the organic compounds, namely aromatic carboxylic acids (ACAs, see Scheme 2). The LbL procedure described above was employed for coating the LPG.
After deposition of the PAH/SiO2 film onto the LPG it was exposed to aqueous solutions of ACAs in the range of 0.001–1000 µM of individual ACAs or their mixtures. All experiments were conducted using the same sensor transducer. After exposure and measurement, the substrate was washed in 0.1 wt% of aqueous ammonia in order to remove adsorbed analytes from the PAH/SiO2 film.
Structures of ACAs used for binding test and cationic polymer (PAH) used for film assembly.
For the detection of the chemical binding the LPG coated with the (PAH/SiO2)10 film was exposed to different ACAs of concentration 10 µM in water, which lead to a significant change in the TS, Figure 17a. The magnitude of the TS change at 825 nm differed according to the number of carboxylic acid groups in the molecule, the molecular weights and the pKa values of the ACAs. The largest change was observed when the coated LPG was exposed to mellitic acid (MA), as shown in Figures 16a and 16b. As MA has the biggest molecular weight and the highest number of the functional group, suggesting the efficient binding to the amino functional groups of PAH. The response of phthalic acid (PA) is higher than that of BA. These results suggest that the sensitivity of the sensor depends additionally on the number of the functional group and increases in the order of MA >> PA > BA (Figures 16a and 16b). It should be noted that, when MA binds to the PAH, the sensor response cannot be regenerated simply by water washing (see “H2O” after MA exposure in Figure 17b). The sensor response can be perfectly recovered, however, using 0.1 wt% NH3 aqueous solution for 10 min (see areas marked with “*” in Figures 16b and 16c).
(a) Evolution of the transmission spectra due to the exposure of the optical fibre LPG coated with a (PAH/SiO2)10 film to 10 µM of different ACAs and (b) time-dependence of the transmission measured at 825 nm; “air” arrow indicates signal measured in air, corresponding to spectra 1 in
The adsorption of the ACAs in the PAH/SiO2 film can be described using a Langmuir adsorption curve. The calculated binding constant of BA to the PAH/SiO2 film is estimated to be 1.36 ± 0.01×106 M-1. The lowest measurable concentration was 1 nM when MA was used, with a binding constant of 5.6 ± 0.01×108 M-1
In summary, in this chapter fibre-optic sensors based on different measurement principles were coated with the nano-assembled thin films for the detection of various chemical compounds. When of the different fibre optic sensor designs were characterised for their response to ammonia gas, the highest sensitivity was observed when EWFOS was coated with the porphyrin based film, showing an LOD of 0.9 ppm. The coated LPG had an LOD of 1.6 ppm and the tapered fibre has an LOD of 2 ppm. The high sensitivity of the EWFOS makes it a promising device for medical applications where there is a requirement of measure low concentrations of specific chemical compounds. The possibility of employing EWFOS for medical diagnosis was explored in the example of skin emanation measurements. In solution, the LOD of LPG sensor was as low as 0.14 ppm for ammonia and the lowest measurable concentration for mellitic acid was 1 nM. From a practical point of view, the EWFOS are limited to the materials with the strong absorption features, while tapered and LPGs fibres can be modified with the wider class of materials, including transparent materials. In addition, tapered and LPGs fibres offer wavelength-encoded information, which overcomes the referencing issues associated with intensity based approaches. Moreover, LPGs owing to the multiplexing capabilities enable sensor design for multi-analyte detection using a single optical fibre. Our future work will focus on the creation of multi-analyte detection systems in which the number of individual gratings with the characteristic grating period inscribed in the single optical fibre will be chemically modified for sensitive detection of targeted analytes.
This work was supported by the Regional Innovation Cluster Program of the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan. The authors from Cranfield are grateful to the Engineering and Physical Sciences Research Council, EPSRC, UK for funding under grants EP/D506654/1 and GR/T09149/01.
Sexuality and disability is a comparatively new issue of concern with pertinent research on the topic originating in the 1970s [1]. It was during this era that we witnessed increased focus on principles of normalization as a basis for service delivery for people with disabilities [2]. It was also during the 70s that the
Best professional practices dictate that healthcare providers refrain from coercing clients to discuss sexuality needs or concerns. However, questions pertaining to this significant aspect of human functioning are basic to holistic assessment and treatment. Clients should feel as if the door to discussing these matters is open throughout the tenure of care or service and that sexuality is a natural topic for discussion. Conscientious providers are aware of their limitations and promptly refer out when a sexual concern extends beyond their scope of practice. According to Nosek [5], “disability is a complex phenomenon, but psychosocial and social factors make all the difference in the outcomes” (p. 121). In the following section we will explore psychosocial factors that should be considered when sexuality and disability present as a rehabilitation concern.
The goal of the conscientious provider is to increase protective psychosocial factors and to decrease or eliminate psychosocial factors that foster risk or harm. These factors can be addressed by a single provider or an interprofessional team [6]. According to Mah and Binik [7], sexuality involves more than physical performance or physical factors. Positive attention to psychosocial factors tend to correlate more with healthy sexuality. Table 1 depicts psychosocial factors impacting sexuality.
Protective factors | Risk factors |
---|---|
Healthy, functional, supportive family-of- origin | Dysfunctional family-of-origin |
High level of self-confidence, self-esteem | Low self-confidence, poor self-esteem |
Appropriate sex education (e.g., age level, cognitive level, etc.) | No formal sex education |
Body image acceptance (rejection of dominant, ableist, heteronormative notions about beauty, sex) | Poor body acceptance (internalization of dominant, ableist, heteronormative notions about beauty, sex) |
Positive social network | No (or insufficient) social network |
Healthy, positive coping ability | Poor coping ability |
Internal locus of control | External locus of control |
No history of sexual abuse, exploitation | History of sexual abuse, exploitation |
Acceptance or positive adaptation to disability | Low acceptance or poor adaptation to disability |
General sense of optimism | General sense of pessimistic |
Service agency or provider adheres to a social-environmental model of care | Service agency or provider adheres to a medical model of care |
A holistic assessment tool should capture information or invite discussion in all of the areas above. This information can easily be converted into a needs assessment. Agencies adhering to the medical model of disability versus the social-environmental model of disability may not see the value of assessing for protective and risk factors that impact sexual functioning.
Myths about disability and sexuality are pervasive in our society. According to Esmail et al. [8], stigmas and negative attitudes often result in the internalization of concepts that can adversely influence self-esteem and sexual confidence. The researchers underscored how public attitudes and perceptions are driven by education and knowledge. Personal biases and beliefs can also limit providers’ ability to engage comfortably with clients while discussing sexuality or sexual health. The ethical expectation is to do no harm; yet harm can occur when providers fail to embrace the notion that sexuality is a critical quality of life determinant. It is important that healthcare professionals be mindful of the roles they play in propagating myths and negative attitudes about sex and disability. Obtaining accurate knowledge and relaying this knowledge is the only way to eradicate broadly held destructive beliefs [10]. According to Haboubi and Lincoln [11], 90% of multi-disciplinary health professionals agreed that sexuality should be part of holistic care (
Sexuality has longed been a taboo subject because of societal, religious, and cultural norms and expectations. It is the forbiddingness of the topic that has erected barriers to addressing sexuality in healthcare settings. This taboo is associated with a lack of knowledge, inadequacies in training, and low levels of comfortability. Sexuality is a private and sensitive subject and must be approached professionally to avoid any confusion of emotions and feelings between the healthcare professional and client. Therefore, adequate knowledge of and training on how to approach and address this topic is vital to overcoming barriers and ensuring successful interventions.
Common myths are outlined below [3, 10, 13, 14]. Rehabilitation professionals, in particular, have an obligation to do what they can to debunk these myths.
People with disabilities are asexual, having no sexual desires or interests
No able-bodied person would find someone with a disability desirable
Sexual intimacy is not possible for people with disabilities
People with disabilities are not suitable marriage or sexual partners
Preventive medical procedures such as pap smears are not necessary for women with disabilities, especially those with spinal cord injuries
Sex education is not necessary for people with disabilities
It is easier for people with disabilities to adapt to sexual losses and changes
Large aggregate care institutions serving people with disabilities were closed in most western European and North American countries in the 1970s and 1980s and today, large numbers of people with disabilities are living independently. They hire personal assistants who are their employees, not their overseers. They have been empowered by the disability rights movement to demand access, support, and respect. As part of their increased independence, many are unapologetically exploring their sexuality. They are finding partners, engaging in romantic relationships and refusing to be told that a disability automatically disqualifies them from having an erotic life [15]. There is a delicate balance between the legal and ethical requirements to protect people with disabilities from harm, including sexual exploitation and abuse, while at the same time protecting their rights to express sexuality in a healthy way [16]. Honest, accurate information about sexuality changes lives, especially for individuals with disabilities. It dismantles stereotypes and assumptions, builds self-acceptance and self-esteem, fosters healthy relationships, improves decision-making, and has the potential to save lives. However, because the topic of sexuality and disability is often surrounded by controversy and stigma, it is important for healthcare providers to remain ethical and professional when dealing with such issues.
There is a delicate balance between the legal and ethical requirements to protect people with disabilities from harm, while at the same time protecting their rights to sexual expression. Traditionally, parents, professionals, and the law have erred on the side of protection from harm, consequently limiting sexual expression of people with disabilities, e.g., the same laws that were designed to protect people with disabilities from harm prevented them from engaging in normal sexual activities [16]. What appears to be concern for the welfare of people with disabilities therefore could, in reality, be masking an anti-sexual bias. Since the law protects the rights for sexual activity for and between individuals with disabilities, service providers cannot have policies prohibiting it [17]. Instead, agencies should have policies that help people with disabilities learn about and express their sexuality in healthy ways within the confines of the law and ethical principles [16, 18, 19].
Among the many barriers to healthy sexual expression for people with physical and developmental disabilities is lack of privacy [20]. Individuals have the right to privacy and to consensual sexual relations. These rights are restricted, obviously, for children, and also for those individuals who are determined to be incapable of consenting to sexual activities. However, the right to privacy is often restricted in the case of an individual who engages in severe self-injurious behavior and/or property destruction. In these cases, the individual’s service or behavior plan frequently requires ‘line-of-sight’ supervision, which challenges the individual’s right to private sexual expression. This is not a simple matter, as it exemplifies the conflict between concern for wellbeing and upholding of the rights of the individual.
Capacity to consent can vary over time. This means capacity to consent is a state rather than a trait. Sexuality education can enhance the capacity of people previously deemed incapable of making informed decisions. Thus, repeating an assessment for capacity to consent may yield different findings across time and may indicate that even individuals with intellectual or developmental disabilities who were previously deemed incapable, have developed the capacity to consent to sexual interactions. Additionally, the requirements of consent can vary based on the nature of the sexual interaction. Thus, to best help people with disabilities make informed choices, good quality ongoing sexuality education is necessary [21].
The crucial components of capacity to consent are knowledge, rationality, and voluntariness [22]. Sexual knowledge starts with the ability to label body parts, identify sexual behaviors, and understand where and when it is appropriate to engage in sexual behaviors and where and when it is not appropriate to do so. Sexual knowledge encompasses being able to state the consequences of sexual behavior, specifically pregnancy and sexually transmitted infections, and how to prevent them. Knowledge also means the person can demonstrate how to obtain and use contraception [22]. Voluntariness means the person can decide without coercion, that, and with whom he or she wants to have sex. This also means he or she is able to take necessary self-protective measures against abuse, exploitation, and other unwanted advances. Voluntariness also means that the person has the ability to say, “No,” either vocally or non-vocally, and to remove him or herself from a situation and indicate a desire to discontinue an interaction [22, 23, 24]. Rationality means the ability to evaluate and weigh the pros and cons of a sexual situation and make a rational decision. When considering someone’s ability to be rational, any neurological conditions that can impair decision-making need to be considered. Determining rationality comprises the individual’s awareness of person, place and time; his or her ability to accurately report events; and to discriminate between fantasies, lies, and truth. The individual should be able to describe the process for deciding to engage, or not, in a partnered sexual interaction, to demonstrate an understanding of mutual consent, and chose socially appropriate times and places to engage in sexual behaviors. Finally, he or she should be able to perceive and respond to the vocal and non-vocal signals of the feelings of his or her partner, specifically the desire to continue or discontinue the sexual interaction [22].
Sexuality is defined as a multidimensional construct in which the individual expresses feelings, thoughts, and cognition, such as the demonstration of intimacy, affection, love, touch, hugging, including sexual contact itself [25]. This asserts that sexuality includes many aspects of a person’s life and while it encompasses the concept of intercourse, sexuality exceeds the idea of physical sex. The ability to fully experience sexuality does not have to be hindered by a person’s or couple’s disability status. Sexuality and being sexually healthy is an important part of life. According to the World Health Organization (WHO), sexual health is defined as “a state of physical, mental and social well-being in relation to sexuality”, which “requires a positive and respectful approach to sexuality and sexual relationships, as well as pleasurable and safe sexual experiences, free of coercion, discrimination and violence” [4]. This definition indicates that sexual health is not just about physical intercourse but also about the mental and social connections involved with intimacy. People with disabilities have the right to experience this connectivity just as people without disabilities. Societal attitudes, beliefs and perceptions guide how individuals with disabilities are regarded. These attitudes, beliefs, and perceptions are also evident in healthcare settings. If an individual without a disability experiences a lack of sexual desire, he or she is diagnosed as having hypoactive or inhibited sexual desire disorder [26]. Similarly, if this person is unable to experience an orgasm, he or she is diagnosed as having an orgasmic disorder. The rendering of a diagnosis makes it possible to qualify for medical treatment and to receive assistance in achieving sexual satisfaction [26]. These disparities in medical perspectives can ultimately impact the quality of life for people with disabilities. Very often these individuals are expected to simply adjust to their disability status with no consideration or discussion about appropriate or possible interventions.
More than 15% of the world’s population have disabilities. These disabilities can be categorized as physical and sensory; developmental and intellectual; and psychosocial [27]. Society has long disregarded the sexuality and reproductive concerns, aspirations, and human rights of this sector of our population [27]. People with disabilities are often not educated related to concepts about sexuality, relationships, and intimacy. People with disabilities are often viewed as infantilized and held to be asexual (or in some cases, hypersexual). Furthermore, they are often viewed as incapable of reproduction and unsuitable as sexual or marriage partners or parents [27]. While not all disabilities impact sexuality, many of them disabilities do. The following sections discuss how physical disabilities, cognitive/intellectual disabilities, mental disabilities, and disabilities related to aging impact sexuality and levels of intimacy.
Physical disabilities are disabilities that impact the mobility of a person. Physical disabilities directly affect muscles and limbs. Physical disabilities include but are not limited to the following types of conditions: lupus, cerebral palsy, absent or reduction in limb functions, and muscular dystrophy.
Lupus
Lupus is a chronic autoimmune disease where one’s own immune system attacks many different systems within the body.
Cerebral palsy
Cerebral palsy is a group of disorders that affect a person’s ability to move and maintain both balance and posture. This disorder is characterized by stiff muscles, uncontrollable movements, and poor balance and coordination [28].
Absent limbs or reduction in limb functions
This group is related to the loss of limbs through amputation or injury in addition to the absence of limbs since birth. Additionally, this group includes individuals who lose functioning or control of their limbs over time, limiting their mobility and their ability to complete tasks
Muscular dystrophy
Physical disabilities impact sexuality in a variety of ways. The impact is based on the person, their specific condition, and the severity of their condition.
Lupus
Individuals with lupus are impacted physically and emotionally by their symptoms. Sexual dysfunctions are the result of both the physical and psychological problems [30]. The physical limitations affect individual’s ability to be intimate but psychologically their motivation and desire to engage in intimacy is impacted. Those diagnosed with lupus often experience pain during sexual activity [30]. Pain can be a significant barrier to a healthy sexual experience. With lupus, this pain can occur even with gentle movement. Pain during intercourse, vaginal dryness, and the development of ulcers in the mouth and genitals areas are manifestations of with lupus [30]. Additional side effects of lupus that such as fatigue and weight gain may also impact sexuality.
Cerebral palsy
Individuals with cerebral palsy frequently are not able to reach an orgasm and report infrequent experiences with intimacy. Individuals with cerebral palsy are limited by personal and functional characteristics that are specific to their type of cerebral palsy. Additionally, they may struggle with issues related to energy, fatigue, body image concerns, and lack of sexual confidence.
Absent limbs or reduction in limb functions
While sexual functioning is rarely structurally diminished by absent limbs or reduction in limb functions; many individuals with these disabilities experience sexual challenges [31]. They may struggle with internalized views of their sexual self or with the external views of others. Reductions in sexual interest, frequency, arousal, and difficulties pertaining to orgasm and sexual drive have specifically been reported in this group of disabilities [31].
Muscular dystrophy
Individuals with muscular dystrophy report difficulties with kissing and oral sex [32]. Both of these activities require significant muscle movement and coordination. Individuals with muscular dystrophy also report difficulties with bodily positions during sexual activities and having a negative body image in general [32]. Individuals with muscular dystrophy also report difficulty communicating with their partners about their functional limitations [32]. Some of their limitations are related to hugging and being able to caress [32]. Other manifestations may include pain during intimacy, fatigue, and erectile dysfunction [32].
Cognitive/developmental/intellectual disabilities are disabilities that impact the thinking process, adaptive development, and ability to socially connect with others. These conditions have a variety of social characteristics: impulsivity, limited attention span, difficulty understanding social ques, and perceptual limitations related to other behaviors. This group of disabilities are characterized by diagnoses such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, and down syndrome.
Attention deficit hyperactivity disorder
ADHD is a neurodevelopmental disorder, which many recognize as a childhood disorder [33]. However, a review of the literature as well as longitudinal studies of individuals with ADHD reveals that symptoms of ADHD can persist into adulthood [34]. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5), ADHD is characterized by impulsivity, hyperactivity and inattention [35]. Overall, it is a developmental disorder that impacts social interaction and behavior patterns.
Autism spectrum disorder
According to the DSM 5, autism spectrum disorder is a neurodevelopmental disorder characterized by (1) persistent deficits in social communication and social interaction across multiple contexts and (2) restricted, repetitive patterns of behavior, interests, or activities [35]. Autism spectrum disorder may impact individuals’ ability to interact socially and make connections with others.
Intellectual disability
This is a disorder where an individual may present with limited understanding along a spectrum. These individuals may present with cognitive impairments (mild, moderate, severe or profound).
Down syndrome
Down syndrome is a genetic disorder that results in an extra chromosome 21, either partially or fully. Down syndrome symptoms exist on a spectrum from mild to severe. Individuals with Down syndrome often present with both physical and intellectual challenges.
Autism spectrum disorder and ADHD
Social connection, a large component of sexual health, is often a major obstacle for individuals diagnosed with autism spectrum disorder [4]. Individuals with autism spectrum disorder often have social deficits that influence their ability to connect with others. Sexuality is associated with an emotional and social skillset that may directly influence appropriate sexual behaviors and how human beings connect with others [4]. Similarly, to autism spectrum disorder, ADHD presents social obstacles. These social obstacles impact intimacy, experiences with connectivity, and sexual decisions.
Intellectual disability and down syndrome
Studies indicate that people with intellectual disabilities and Down syndrome face various personal and socioenvironmental barriers in their sexual lives [36]. Many of these are related to their inability to understand the dynamics of intimacy and sexual situations. Some of the barriers that negatively impact individuals with intellectual disabilities and Down syndrome include limited sexual knowledge, poor education, negative attitudes related to sex, lack of access to healthcare, lack of sexual experiences, and social isolation [36]. Each of these factors impede the development of healthy sexual behavior practices. Overall, the lack of knowledge about sexuality coupled with limited sexual experiences, language difficulties, communication problems, fear, embarrassment, low self-esteem, and poor negotiating skills can increase exposure to unsafe situations for both men and women with intellectual difficulties and/or Down syndrome [36].
There are many mental health disorders that impact sexual functioning. Some categories identified in the DSM 5 are mood disorders, anxiety disorder, psychotic disorders, and eating disorders. The prevalence of sexual dysfunctions is higher in persons with mental disorders, particularly those treated with psychotropic medications [37].
Mood disorders
This is a group of mental health conditions that is characterized by the disturbance of one’s mood contributing to feelings of dysthymia, dysphoria, euthymia and/or euphoria. Very often in this group, a person’s mood is unstable and requires medical treatment.
Anxiety disorder
This is a group of mental health conditions that are known to cause excessive and consistent fear and worry. Some individuals may experience panic attacks or have severe forms of anxiety that not only impact their perceptions and experiences socially and intimately, but also affect their physical mobility.
Psychotic disorders
This is a group of mental health conditions where perceptions and experiences are impacted by external stimuli and thoughts that may not be based on reality. Psychotic disorders are regularly treated with antipsychotic medications whose common mechanisms impact sexual experiences as well [37]. Symptoms associated with psychotic disorders may also impact the ability to meaningfully connect with others, socially and intimately.
Eating disorders
This is a group of mental health conditions relate to eating habits. Eating disorders are manifested by eating and purging, binge eating, and extreme caloric restriction. Very often individuals are ashamed of their behaviors and engage in these activities in secret. Eating Disorders can influence individuals’ ability to connect socially and intimately with others.
The rate of sexual disorders in people experiencing mental disabilities is significantly high. The use of psychotropic medications and subsequent side effects often exacerbate sexual dysfunction [37].
Mood disorders
Major depression is a common mood disorder. Decreased libido commonly accompanies an episode of major depression [37]. Depressed persons may also experience diminished ability to maintain sexual arousal or achieve orgasm. In males with severe depression, the rate of erectile dysfunction is as high as 90% [37].
Anxiety disorder
There are several types of anxiety disorders and each has symptoms that impact a person’s ability to emotionally connect with others due to stress and worry. Additionally, a loss of libido occurs frequently in people with high levels of anxiety.
Psychotic disorders
Patients suffering from psychotic disorders are prone to experience sexual dysfunction as a part of the nature of the disease [37]. Negative symptoms of the disorder, such as anhedonia, avolition, and blunted affect significantly diminishes the ability to enjoy sexual and intimate activities [37]. In addition, these individuals face difficulties in establishing relationships due to recurrent psychotic episodes, obesity, and low self-esteem [37].
Eating disorders
Clinicians have often reported that anorexia nervosa patients suffer from sexual dysfunction and immaturity, evident by low sexual interest, inhibited sexual behavior, disgust towards sex, and fear of intimacy [37].
Aging and neurological disabilities are disabilities that impact the brain and spinal cord. These disorders may also be more prominent in individuals who are older.
Alzheimer’s disease and dementia
Dementia is a disorder that encompasses conditions that affect memory, focus, communication, judgement, and perceptions. They vary in degree of severity and influence the way individuals are able to interact with and experience others. Alzheimer’s disease is a specific and common type of dementia.
Parkinson’s disease
Traumatic brain injuries
Traumatic brain injury is harm to the brain due to trauma. This can result from a forceful strike to the head or from something penetrating the head. Both injuries can result in both physical and emotional symptoms.
Spinal cord injuries
Spinal cord injuries are debilitating conditions that result from a sudden, traumatic impact on the spine that fractures or dislocates the vertebrae [39]. The severity of the injury and the location of the injury dictates the level of functional limitation. Spinal cord injuries can result in paraplegia, or tetraplegia [39]. Paraplegia is defined as the impairment of sensory or motor function of the lower extremities while tetraplegia is defined as a partial or total loss of sensory or motor function in all four limbs [39].
Alzheimer’s and dementia
Individuals diagnosed with dementia or Alzheimer’s endure mental health symptoms such as depression and anxiety that impact their motivation and ability to participate intimately with others. Physically they may experience erectile dysfunction and reduced strength and mobility due to impairment of the motor systems.
Parkinson’s
Adults with Parkinson’s report significant adverse effects on quality of life due to their symptoms [38]. They report concerns with both depression and anxiety [38]. These symptoms influence how they view themselves and how they believe others view them. They also report issues with urinary disturbances and erectile dysfunction as well as issues with pain, and sensory issues related to the reduced blood flow to and from sexual organs [38].
Traumatic brain injury
Individuals who experience traumatic brain injury report coping with changes in their sexual desires. Some report that they have decreased sexual desires and a loss in sexual interest while others report increased in sexual desires and difficulty controlling sexual desires [40]. Individuals with traumatic brain injuries report decreased sexual arousal even when they are interested in intimacy [40]. Men may experience erection difficulty, while women may present with difficulties with vaginal lubrication. Both men and women with traumatic brain injuries report trouble reaching a climax and in general they report lacking satisfaction after intimacy [40].
Spinal cord injuries
The type of injury to the spinal cord dictates the degree of sexual difficulty [41]. Sexuality concerns vary widely. There are reports of limitations with erections and ejaculatory difficulties in men [41]. In women there are reports of decreased lubrication [41]. In general, the frequency of sexual activity and intercourse appears to decline after a spinal cord injury [41]. Individuals with spasticity in the hips and thighs also experience challenges as they relate to sexual intimacy [41].
This final section of the chapter will identify how occupational therapy (OT), physical therapy (PT), and rehabilitation counseling approach the topic of sexuality with clients. All three disciplines emphasize the importance of (1) acknowledging sexuality and disability, (2) early initiation of discussions by the healthcare professionals, (3) self-awareness of the healthcare professionals’ attitudes towards sexuality and disability and as their own sexuality, and (4) counseling education.
The topic of sexuality has previously been unrecognized or disregarded by many healthcare professionals when addressing clients’ care, holistically [12, 42, 43]. Discussions concerning sex and disability have been particularly arduous. However, over the course of years, the emergence of the identification and acknowledgement that sexuality is important to all human beings has contributed to a positive shift towards acceptance. Consequently, sexuality is slowly becoming a more acceptable topic to discuss and approach in the clinical setting.
Sexuality in healthcare should be approached from an interprofessional perspective. Sexuality is a core aspect of an individual’s overall health that “encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction” ([44] , p. 5). Disciplines within the healthcare realm address these core sexuality aspects in manners specific to their disciplines. Healthcare professionals from various disciplines acknowledge that individuals with disabilities are sexual beings, and that addressing sexuality in practice is integral in providing holistic care. According to Haesler et al. [45], given the strong connection between sexuality and quality of life it is important to understand factors that influence its recognition by health professionals. Despite differences in addressing sexuality, some methods amongst providers are comparable. Furthermore, the practitioners’ “interactions should be directed toward creating an environment that promotes the client’s self-esteem, positive and appropriate sexuality, and adjustment to disability” ([46], p. 214).
Personal bias and comfortability are important elements to consider when creating an environment where sexual issues can be addressed or explored. Healthcare practitioners must be able to express empathy and understanding while maintaining appropriate personal and professional boundaries [9]. Such attributes allow practitioners to establish a therapeutic relationship in which they can build trust and confidence necessary to approach this intimate subject. Practitioners must look inward and conduct a self-assessment of their personal attitudes and beliefs, even before initiating the discussion of sexuality with their clients. Being aware of one’s own sexuality and level of comfort is an essential component when conversing about sexuality [12]. Healthcare personnel should not demand that their clients discuss concerns related to sexuality, but rather create opportunities by obtaining permission to discuss sexuality [47].
To counsel effectively, one must first feel comfortable with one\'s own sexuality and then progress to achieving comfort in discussing sexuality with others” ([48], p. 543). Addressing sexuality and disability requires a multifaceted skill-set; one that necessitates factual knowledge, awareness, and interpersonal skills. Health-care professionals’ roles can vary when providing sexuality counseling for people with disabilities [47]. Sexuality training implemented by healthcare practitioners may comprise sex health education and information on related topics and issues such as the physical and psychosocial effects of disability on sexuality, anatomy and development of sexuality, anatomical and systems-related dysfunction, sexual adaptation to functional issues, and appropriate sexual behavior [46, 47, 48]. Due to the sensitive nature of the topic of sexuality, healthcare practitioners have been encouraged to utilize the PLISSIT Model when approaching this topic with their clients.
OT is a profession in healthcare that involves “the therapeutic use of everyday life occupations with persons, groups, or populations (e.g., the client) for the purpose of enhancing or enabling participation” (c, 2020, p. 1). Occupations are identified as an aspect within the domain of practice for OT and are defined as “everyday activities that people do as individuals, in families, and with communities to occupy time and bring meaning and purpose to life” ([49], p. 7), and the therapeutic use of self is defined as the process “in which OT practitioners develop and manage their therapeutic relationship with clients by using professional reasoning, empathy, and a client-centered, collaborative approach to service delivery” ([49], p. 20). Occupations, along with the therapeutic use of self are cornerstones for this profession.
Studies have shown that “sexuality is important to clients and that occupational therapists believe that addressing clients’ sexual issues is a legitimate domain of practice that should be included in order to provide holistic treatment” ([43], p. 53). In OT, occupations are further categorized in eight broad categories within the OT practice domain: activities of daily living, instrumental activities of daily living, health management, rest and sleep, education, work, play, leisure, and social participation. It is from these broad occupations that occupational therapists approach the topic of sexuality with their clients. OT practitioners recognize sexuality as an important aspect of an individual’s activities of daily living, health management, and social participation, and acknowledge how sexuality directly impacts an individual’s self-esteem and quality of life. In fact, sexual activity, “engaging in the broad possibilities for sexual expression and experiences with self or others (e.g., hugging, kissing, foreplay, masturbation, oral sex, intercourse)” ([49], p. 30), is specifically identified as an ADL in the Occupational Therapy Practice Framework-IV (OTPF-IV). Along with an individual’s occupation, OT practitioners also recognize an individual’s sexuality as it relates to their roles and routines. Despite the inclusion of sexual activity as an occupation in the OTPF-IV and the acknowledgement of sexuality as a legitimate domain of practice, studies show OT practitioners “do not adequately address sexual activity in their clinical work” [43].
OT practitioners also address sexuality with their clients with disabilities by providing management of physical problems that may contribute to sexual dysfunction through rehabilitation of physical impairments and adaptive modifications. Some areas of physical impairment addressed by OTs include, tone, endurance, mobility, pain, sensation, anxiety, skin care, and hygiene. Occupational therapists provide education and training in the use of adaptive aids, equipment, and positioning for clients who may require special or alternative support to engage in sexual activity. Psychosocial and emotional problems related to self-esteem, body image, and perception are also addressed.
PT is a healthcare profession that works to “improve quality of life through prescribed exercise, hands-on care, and client education” [50]. PT practitioners also view the client from all aspects of health, thus including sexuality as an integral component to holistic care of their clients [42]. Physical therapists approach sexuality with their clients by addressing “basic sexual function and anatomy, as well as information regarding male and female disorders of sexual function, including the effects of psychological and social factors” [51]. Some areas of physical impairment addressed by physical therapists include muscle strength, tone, mobility, pain, sensation, and reflexes.
Along with client education, one specific area in which physical therapists address sexuality in practice is through pelvic floor physical therapy (PFPT). This type of therapy comprises various manual therapies such as neuromuscular reeducation and behavioral modifications. PFPT has been successful in treating many sexual disorders [52]. This functional retraining therapy promotes pelvic floor muscle strength, endurance, power, and relaxation in patients with pelvic floor dysfunction [53]. This treatment explores neuromusculoskeletal causes of pelvic floor disorders and how they affect sexual dysfunction. As with other PT treatments, emphasis is placed on the muscles, ligaments, and nerves to improve sexual function. PT practitioners identify that sexual dysfunction is related to disorders of the pelvic floor, whether the cause is over activity or inactivity [52]. PFPT provides an effective basis for addressing sexuality with clients using therapeutic interventions such as strengthening and stretching; trigger point and myofascial release; connective tissue manipulation; electrical nerve stimulation; cold laser therapy; and heat and cold therapy.
Rehabilitation counseling is an allied health profession in which the counseling process is used to assist individuals with disabilities in achieving personal, career, and life goals. The counseling process involves communication, goal setting, and beneficial growth or change through self-advocacy, psychological, vocational, social, and behavioral interventions [54]. Rehabilitation counselors have been identified as the health professional clients with disabilities are more likely to discuss personal issues with ([12], p. 16). Rehabilitation counselors often serve as the bridge between the individual with a disability and a self-sufficient, fully integrated life. Certified rehabilitation counselors (CRCs) are equipped to address the topic of sexuality and disability and provide counseling and education with their clients. The impact of disability on sexuality is listed as one of the core content areas for rehabilitation counseling programs ([55], 5H.2j, Section).
Typically, rehabilitation counselors adhere to two professional Codes of Ethics: The American Counseling Association (ACA) Code of Ethics and the CRC Code of Professional Ethics. However, when dealing with the issue of disability and sexuality, neither code offers specific guidelines on the topic. To remain ethical when dealing with issues of sexuality and disability, Rehabilitation Counselors should consider becoming a member of The American Association of Sexuality Educators, Counselors and Therapists (AASECT) [56]. It is also important to become acquainted with certified sexual education resources offered through programs such as Planned Parenthood and Our Whole Lives (OWL). Certified sexuality educators are trained in and adhere to specific ethical guidelines, including issues such as restrictions on genital touching and may therefore have more specific information and resources available regarding sexuality and disability [57].
A counselor’s response to a client’s sexuality concerns can have lasting effects [47]. Given their specialized training in counseling and education, CRCs guide their clients in achieving personal goals related to their sexual health. Rehabilitation counselors can be especially helpful to their clients if they use their disability-related knowledge and rehabilitation counseling skills in conjunction with PLISSIT (Permission, Limited Information, Specific Suggestion, and Intensive Therapy). This is a basic behavioral model of sexuality counseling useful with individuals with disabilities [58, 59]. PLISSIT provides a basis for exploring sexual expression and receiving relevant information on how disability may affect sexuality. The therapy also fosters specific suggestions on how to deal with the effects of disability on sexuality. Through intensive therapy, a client is assisted in coping with issues related to sexuality [58, 59].
Individuals with disabilities have the natural biological desires to express and fulfill their sexual desires. As a result, it is imperative that healthcare professionals address sexuality as a part of their intervention in the clinical settings. Although healthcare professionals from various disciplines acknowledge the need to address this intimate topic, there continues to be a disparity between acknowledgement and sexual health intervention as a part of routine care. According to Sengupta and Sakellariou [42], “inclusion of sexuality in education of health care professionals can contribute to integrating this important issue as a routine aspect of practice” (p. 101). Improving the knowledge, training, attitudes, and level of comfortability of the healthcare professional is key in tackling the taboo of sexuality and ensuring clients that it is appropriate to talk about the topic freely. Those who are committed to providing holistic care for people with disabilities will take the necessary actions to stay abreast of issues pertaining to sexuality and disability. There are a number of psychosocial factors that influence the sexuality of individuals with disabilities. In order to determine risk factors and promote protective factors conversations between people with disabilities and counselors and healthcare providers must take place. Moreover, providers have to develop relevant competences, become knowledgeable about sexuality trainings and resources, and be mindful of ethical guidelines. It is also importants for care providers to be cognizant of how certain disabilities and chronic illnesses impact sexuality.
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Other positions she has held at the university include Vice-Dean of Master Programs, Vice-Dean of the Degree in Biology and Vice-Dean for Mobility and Enterprise and Engagement at the Faculty of Science (University of Alicante). She received her Bachelor in Biology in 1998 (University of Alicante) and her PhD in 2003 (Biochemistry, University of Alicante). She undertook post-doctoral research at the University of East Anglia (Norwich, U.K. 2004-2005; 2007-2008).\nHer multidisciplinary research focuses on investigating archaea and their potential applications in biotechnology. She has an H-index of 21. She has authored one patent and has published more than 70 indexed papers and around 60 book chapters.\nShe has contributed to more than 150 national and international meetings during the last 15 years. Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. 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Dr. Şentürk currently works as an professor of Biochemistry in the Department of Basic Pharmacy Sciences, Faculty of Pharmacy, Ağri Ibrahim Cecen University, Turkey. \nDr. Şentürk published over 120 scientific papers, reviews, and book chapters and presented several conferences to scientists. \nHis research interests span enzyme inhibitor or activator, protein expression, purification and characterization, drug design and synthesis, toxicology, and pharmacology. \nHis research work has focused on neurodegenerative diseases and cancer treatment. 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He then worked as an Assistant Professor at the Faculty of Science of the same University until 1984. In 1985, Prof. Iadarola became Associate Professor at the Department of Biology and Biotechnologies of the University of Pavia and retired in October 2017. Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. He is a Consultant Reviewer for several journals, including the Journal of Chromatography A, Journal of Chromatography B, Plos ONE, Proteomes, International Journal of Molecular Science, Biotech, Electrophoresis, and others. 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She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. She is an author of about 90 publications (According to Scopus: H-Index: 23; According to WOS: H-Index: 20) on peer-reviewed journals, a member of the “Società Italiana di Biochimica e Biologia Molecolare,“ and a Consultant Reviewer for International Journal of Molecular Science, Journal of Chromatography A, COPD, Plos ONE and Nutritional Neuroscience.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,series:{id:"11",title:"Biochemistry"}}},seriesLanding:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. 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Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. 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In recent years, the application of chemistry to biological molecules has gained significant interest in medicinal and pharmacological studies. This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. 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Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. 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Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. The Proteomics topic aims to attract contributions on all aspects of MS-based proteomics that, by pushing the boundaries of MS capabilities, may address biological problems that have not been resolved yet.",annualVolume:11414,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,editorialBoard:[{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",institutionString:null,institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},{id:"40928",title:"Dr.",name:"Cesar",middleName:null,surname:"Lopez-Camarillo",fullName:"Cesar Lopez-Camarillo",profilePictureURL:"https://mts.intechopen.com/storage/users/40928/images/3884_n.png",institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",institutionURL:null,country:{name:"Mexico"}}},{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",fullName:"Shymaa Enany",profilePictureURL:"https://mts.intechopen.com/storage/users/81926/images/system/81926.png",institutionString:"Suez Canal University",institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/45020",hash:"",query:{},params:{id:"45020"},fullPath:"/chapters/45020",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()