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These books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\\n\\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\\n\\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
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IntechOpen and Knowledge Unlatched formed a partnership to support researchers working in engineering sciences by enabling an easier approach to publishing Open Access content. Using the Knowledge Unlatched crowdfunding model to raise the publishing costs through libraries around the world, Open Access Publishing Fee (OAPF) was not required from the authors.
\n\nInitially, the partnership supported engineering research, but it soon grew to include physical and life sciences, attracting more researchers to the advantages of Open Access publishing.
\n\n\n\nThese books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\n\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\n\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
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\r\n\tPlasma is the most widespread form of the fourth state of matter, comprising more than 99% of the universe. Plasma is used to disinfect clothing and sterilize surgical equipment due to its antibacterial properties. This book is proposed to provide an advanced understanding of plasma physics and its importance in science and engineering. The book aims to be useful for everyone interested in the current development of plasma theory. The book will contain invited chapters from the experts, who are working on plasma waves, terahertz waves, solitons, higher-order harmonic generation, and dusty plasmas. The microplasma technology can be applied to generate and detect THz sources. The laser-induced microplasma is used to produce terahertz radiation with a wide frequency spectrum. The electric propulsion system is also based on the discharge of plasma which is used to produce high exhaust velocity. This book will serve as a reference source for plasma physics researchers. The reader is expected to have had experience with basic electrodynamics, including Maxwell’s equations and the propagation of plane waves in space.
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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"65765",title:"Physical Exercise Improves Quality of Life in Patients with Connective Tissue Disease",doi:"10.5772/intechopen.83388",slug:"physical-exercise-improves-quality-of-life-in-patients-with-connective-tissue-disease",body:'Therapeutic with regular controlled exercise has been widely employed in a range of disease treatments that involves a broad range of causes and various effects on the human body. Studies show that physical activity and regular exercise in association with specific medications provide greater longevity and improve the quality in the treatment and prevention of disease when compared to groups that do not integrate exercise into their daily lifestyle. The case of CTD is no distinct. The aggressive effects of autoimmune and degenerative diseases on the connective tissue of the locomotive apparatus directly reflect on patients’ ability to perform physical exercise. The physical capacity of these patients is lower when compared to sedentary individuals who do not have any type of disease. This is due to the functional limitations caused by the deformities, fixed or not, and mainly by the pain that the movements impose on the patients. Patients with their connective tissue, affected by degenerative or autoimmune diseases, are subject to periods of acute crisis that make simple movements painful and more elaborate movements impossible. Consequently, it makes the physical activity practice a challenge [1, 2, 3].
Another important aspect to be highlighted is fatigue in these patients. This group tires more quickly, especially when they are compared to sedentary individuals without systemic diseases or other physical limitations. The more sedentary the patients with connective tissue diseases are, the less they can tolerate effort, and sooner they get fatigued. It is important to emphasize that sometimes these diseases have a differential diagnosis for pain syndromes observed in elite competitive athletes. In other words, patients are mistakenly diagnosed as having sports injuries. This error can lead to a higher period away from the practice of sport since initial treatment is not compatible with the underlying and neglected disease [2, 3].
In this sense, this chapter aims to show not only the benefits that regular exercise can have for this group of patients in terms of connective tissue but also what type of exercise should be performed and at what intensity, duration and weekly frequency. It also encourages the assisting physician to prescribe regular physical activities, which complements treating diseases of the connective tissue, being a powerful ally of essential pharmaceutical treatment. Controlled physical activity minimizes the effects of these diseases in acute crises as well as in terms of controlling the signs and symptoms involved in the chronic progression of the disease. Exercise is also a preventive method to delay the onset of connective tissue degeneration as well as to interspace acute crises, becoming less frequent [3, 4].
A medical evaluation to identify limitations and correct deformities (whether fixed or not) is fundamental and should be performed by the assisting physician, who will prescribe the restrictions to the practice of physical activity and exercises. This step is crucial to avoid training mistakes and further progress of diseases. Once the underlying disease (autoimmune or degenerative) is determined, questions that provide information about the level of physical activity in the patient’s daily life are important in order to understand how sedentary he or she is as well as the number of steps the patient takes each day. During this initial contact, the patient should state which of the joint (or joints) is (are) more affected and more painful and whether the pain is related to work, leisure activities or both. In addition, notes of the approximate interval between acute disease crises will serve as feedback for treatment involving exercise. With exercises, these crises will tend to become farther apart, and this type of information is important for patients to adhere to treatment [5].
Identifying the story of sports and exercises practised so far will help to prescribe the best type of motion to the patient. The memory of movement will make the difference in selecting the future route to be followed. For instance, prescribing aquatic exercises is an alternative for those patients, who have never been in a pool or who are likely to abandon treatment.
During the physical examination, the physician might have an accurate idea of how much balance and coordination the patient has even its standing and sitting posture. This can be confirmed by the axial skeleton, potential lateral and anteroposterior deviations of the spinal column, anterior and posterior scales of the scapula and pelvic ring beyond the alignment of the arms and legs, all resulting from mechanical causes (agonist and antagonist muscle imbalances). The range of motion in affected and unaffected joints should be recorded, mainly in the lower limbs. Whether it is possible, deformities must be treated prior to or alongside therapy, in order to address pain or functional limitations [5]. The arm, forearm, thigh and leg circumference measures should be taken, and an evaluation of the secondary stability that muscular strength can offer to the joints will be useful as a parameter to measure changes in physical capacity.
Observing the gait of patients during short displacement and their ability to sit down and stand up contributes to a better understanding of essential physical needs in the routine life of patients. In relation to the subsidiary exams, which are directly relevant to an efficient orientation of the best activity to be performed, we highlight the treadmill or cycle ergometer test. The maximum effort achieved allows better determination of the heart rate interval for the practice of aerobic exercise that will be prescribed.
Clinically speaking, the evaluation of cardiovascular function in stress tests may also cause cardiac function alterations and diseases that eventually exacerbate during more intense efforts, which had been performed before. The exercise prescription will be more accurate when the values for oxygen consumption, aerobic and anaerobic thresholds and maximum consumption are obtained over the appointment with a physician.
In addition, body composition measurements are very useful for identifying the loss of muscle mass (sarcopenia), which can be expected from diseases that develop chronically. Similarly, body composition is an extremely important examination since it evaluates the quantity of stored body fat (particularly the amount of visceral fat), a measurement of the excess of weight, which directly affects joints in the legs and worsens degenerative conditions [4, 5].
The type of physical activities and exercises practised can be classified according to how the energy is produced by the muscle responsible for this movement. The aerobic energy production system is the main responsible for long-duration work involving strong resistance. The anaerobic system of energy production, on the other hand, is mainly responsible for power, strength and speed, offering short bursts of energy during movement. In general, a combination of both systems of energy production is used to execute various tasks and always depends on the stimulation offered.
Here we will differentiate the types of movement and their application as an adjuvant in treating autoimmune and degenerative diseases of the connective tissue.
Overall, the physical capacity should receive more attention from physicians and patients because of the increased benefits it provides to the sedentary and sick people, and it should be no different in patients with connective tissue diseases. This factor will require the most attention in any regular physical training programme, especially for younger and older adults. With this physical work, we seek improvement in the endothelial dysfunction caused by atherosclerosis, which is generally more significant in autoimmune diseases and degenerative arthritis than in the sedentary population. Atherosclerosis is also responsible for the increase in blood pressure, insulin intolerance and diabetes type II, and all can be aggravated by obesity, which in turn becomes more accentuated with a sedentary lifestyle [4].
Patients with connective tissue diseases have less physical capacity than sedentary individuals who do not practice regular exercise. The consequently reduced mobility aggravates their capacity to carry out tasks, even the simplest daily routines. The greater sensation of fatigue, common in patients with early onset connective tissue diseases, decreases in trained individuals when compared to the population in general [6].
In addition, the rise in aerobic capacity has also a fundamental role in diminishing the variation in heart rate. This occurs in trained individuals and requires less effort by the cardiovascular system, with lower energy costs in carrying out the same task. The number of mitochondria in cardiac muscle fibers can be up to five times greater than those contained in the skeletal muscle, and training will yield additional benefits for cardiac function.
After determining the maximum oxygen consumption capacity in this population, the start of training can be planned as well as its evolution, which should be slow and progressive. More intense stimuli for expanding energy gains (and greater benefits) should always be offered when the body reaches a state of balance at a new level. Increasing loads also interest patients who wish to participate in sports and competitions. In controlling disease, these loads are sometimes eliminated as soon as the autonomy of movement and disease control is shown to be effective [6].
Alongside the improved physical capacity obtained with regular exercise, the pain, so far, presented in the life of these patients will diminish. Joint swelling and sensitivity in the affected regions also decrease as a result of improved venous return and better peripheral circulation. The direct impact on better quality of life is remarkable. Mood variations that come from improved self-esteem and better quality of sleep (which is more relaxing and restorative) can also be perceived in patients who practice regular exercise. These encourage patients to adhere to exercise and sports [7].
Regarding the intensity of aerobic exercise, the World Health Organization recommends that aerobic training should be performed at moderate intensity, with heart rate oscillating between the aerobic and anaerobic thresholds (roughly represents around 60 and 80% of the aerobic exercise intensity maximal heart rate), which has direct relation to maximal oxygen consumption (VO2max). The physiological objective of this type of training is not only to raise maximum oxygen consumption (VO2max) levels (increasing maximum work capacity) but also to expand the thresholds and consequently promote greater efficiency during the aerobic resistance exercise. Consequently, it will be reflected in the improvement in health as a whole and, in particular, for connective tissue disease in particular. For patients with a low aerobic capacity due to years of inactivity and sedentary lifestyles, who have been affected by disease symptoms, beginning a programme of regular physical activity may seem impossible. These patients often prefer not to leave their homes and become dependent on their relatives or friends, requiring assistance in all activities [8, 9].
These patients must take on the challenges of their day to day as the beginning of their recovery for independence. Simple tasks such as leaving the house on foot to purchase groceries, taking the stairs to the next floor and walking greater distances to access transport (even slowly and even if this means walking to the patient’s own car in a parking area) trigger initial effects and can help stimulate the practice of exercise in the near future.
In some cases, patients may require constant monitoring by specialized staff and daily stimuli to maintain minimal levels of activity. Even if this is done remotely, through messages or phone calls, regular exercise should be encouraged; and the patient will feel obliged to carry out the assigned task. Although they may be less frequent, acute crises may occur. At these times, the intensity of training should be reduced. Movements should be adapted temporarily, and equipment may even be changed (replacing running with bicycling, for example) in order to stop the patient from becoming sedentary once again [9].
Once the intensity and cardiac frequency range for the patient’s training has been determined, the type of resistance should be chosen. In other words, the type of equipment that will be used should be established. Walking and/or running (either outdoors or on the treadmill), cycling on a stationary or traditional bicycle, swimming and rowing are the most frequent methods chosen for aerobic resistance training.
Since the different movements and specificity (which are important in sports) are not the objective of the training, varying the type of movement is interesting because it moves different muscle groups, making exercise less routine. This may occur when swimming is replaced with running, for instance. For some types of exercises, the memory of movement is essential. These exercises require more advanced coordination and balance than others. It is often difficult for an adult to learn to ride a bicycle, even if it is stationary, which makes prescribing this exercise unfeasible. This is even more difficult when swimming is chosen as the exercise [9].
The easiest and most natural exercise for all patients is walking and/or running. The limitations of this mode are excess body weight and the conditions of the cartilage in the leg joints bearing this burden as well as the ability to work the muscle groups in these limbs which may be weakened from disuse. The natural alternative for overweight patients (or even those who are not) and joints that cannot support them is cycling. A stationary bicycle is better because it allows us to efficiently control the speed that will be constant (approximately 30 km/h or 70 revolutions per minute) and a load that is compatible with the desired proportional heart rate and oxygen consumption.
Cycling provides the best gateway to starting a regular aerobic physical activity when there is a need to compensate the reduced muscle resistance in supporting and carrying body weight (and frequently, excessive body weight). The benefits will be felt quickly. Like all equipment, bicycle requires some care in its use. The height of the saddle must be correctly positioned between the perineal region and the ground, avoiding unnecessary stress (particularly on the knees). Handlebars should be correctly positioned with the patient sitting comfortably in the saddle and should allow the rider to gaze towards the horizon. This arrangement will not lead to unwanted stress on lordosis and kyphosis when the line of the axial skeleton is abnormally positioned [10].
If for any reason, the patient cannot cycle, walk or run regularly, walking in the water can be an option. The greater density of water makes the body lighter, while offers resistance to achieve the desired training. The only requirement is to control heart rate and to use floats in order to allow the patient to reproduce the natural movement practised over an entire lifetime. It is always necessary to be careful with fatigue, which appears more quickly in this group of arthritic patients. The lower muscle mass of the arm muscles (in comparison with the legs) yields less efficiency in training for aerobic resistance. This makes this alternative an exception.
When incapacitating mechanical alterations make arm exercises the only option, rowing seems to be the best alternative to exercising. This modality requires specific coordination but is easier to perform than swimming, for instance. This can be done traditionally on the water or on equipment that simulates this activity and allows the intensity of the exercise to be controlled. Because it combines leg and arm movements, swimming is a good alternative; nonetheless, specific conditions are required for this to be part of efficient training. Because of the horizontal position of the patient and the fact that water is denser than air, the maximum heart rate achieved in water is lower than in tests performed on the ground. For sedentary patients, you must deduct 13 beats per minute from the values obtained during these tests or from the VO2max determined mathematically [7, 8].
Swimming requires knowledge (movement memory), and this style of exercise may be chosen as a function of biomechanical limitations that may be present in the arms as well as the legs. It may be necessary for the exercise sessions to take place in a location where immediate assistance can be provided and where the staff is trained to work with a population that has limitations imposed by disease in order to prevent accidents. The monitoring of progress during training is more difficult, particularly in terms of exercise intensity. This applies equally to the patient and to those supervising the patient. Remember that this group fatigues earlier than the population in general and that supervision should be attentive and constant.
Because of the adversities involved in the exercises mentioned up to this point, the natural choice is walking or running, since it is more practical and easier to implement and monitor and does not require special or sophisticated equipment. It is universal and can be done indoors or outdoors, and it is the most commonly practised individual sport around the world. It is important to mention that all aerobic work should be done individually. Groups that form around the activity should be social in nature. The intensity of work will always be obtained and applied individually.
Calculations of heart rate, at the beginning of the training (for patients who were sedentary or who had clinical complications interrupt the practice of exercise), should establish a heart rate for oxygen consumption of approximately 50% of maximum capacity (VO2max), which is a lower level than the levels to sedentary people without degenerative diseases. It is explained by the fact that these patients fatigue earlier [9, 10].
In order to maintain the ideal weekly volume of training and considering a lower and more comfortable intensity to the exercises, the session length can be increased, or more sessions can be added per week. The time for each session can be divided and carried out over the space of the same day. As clinical conditions permit and conditioning increases tolerance to fatigue, higher levels of oxygen consumption (higher VO2max percentages) will be offered as a stimulus, always remaining in the moderate activity range between the anaerobic and aerobic thresholds obtained directly or via mathematical calculations. Outdoor exercise makes this activity more playful and should be encouraged, especially when the weather conditions are favorable. Training should begin on soft and flat terrain with few curves. Participants should change direction regularly.
The heart rate controls the pace of intensity during the activity. This may be reflected in a speed that only allows walking during the entire course.
As the patient improves, walking will gradually alternate with small periods of jogging and running, until the patient jogs or runs the entire trajectory. These characteristics make outdoor exercise more individualized. Groups can gather at the beginning and the end of training during warm-up and cool-down activities, but not during the workout. Competitive practices may be indicated for those patients who need individual limits to surpass. It is important that they always be aware of their limitations and tendency towards earlier fatigue [8, 9, 10].
In order to obtain the weekly volume of exercise to be practised by the patient, the intensity of the aerobic resistance training should be added to the time it is performed per session and the number of sessions that will be repeated over the space of a week. It is essential that the pace of each workout be reached gradually and slowly until the desired heart rate is reached (warm-up). At this intensity, start marking time without worrying about the distance traveled. The World Health Organization and the American College of Sports Medicine suggest practising moderate aerobic exercise for an average of 150 minutes per week. These same organizations suggest reducing this time for the week by 50% if the exercise is vigorous. This more intense training should be avoided, especially during periods of connective tissue disease crisis. For more advanced patients, however, this might be an alternative.
The distribution per session must include periods of recovery that integrate the benefits of physical activity and tissue renewal. With this in mind, we suggest dividing the 150 minutes into up to 6 sessions per week and the 75 minutes into up to 5 sessions per week for the determined intensities. For beginners, we suggest training on alternate days and at moderate intensity. We must account for earlier fatigue and muscular hypotrophy, which may require adaptations. Alternating between light and moderate effort can be an interesting option.
If the patient continues to have problems on tolerating exercise, dividing the session into morning and evening activities on the same day can be an interesting alternative (30 minutes broken down into two 15-minute periods, for example). Warm-up and cool-down periods are required for each one of these training periods [10].
Muscle loss does not seem to be directly correlated with degenerative and autoimmune diseases, nonetheless, with the progressive inactivity developed over years of disease crisis and its impact on joint function, in addition to disabling pain. To better monitor physical development in patients performing localized exercises and test the efficiency of their training, it is important to quantify the amount of muscle tissue. The results of body composition calculations are often shocking.
Depending on the degree of muscular involvement (when sarcopenia is diagnosed), physical rehabilitation through localized resistance exercises and muscle strength may need to precede the initiation of a broader programme of regular physical activity, such as the aerobic training proposed in the previous item, for example. This step requires the supervision of a professional in the area of rehabilitation.
Independent work boosts localized muscular strength and endurance while it completes aerobic exercise in an attempt to provide a better quality of life for these patients. The anti-gravitational muscle groups are the focus since they involve large amounts of muscle tissue and are secondary joint stabilizers that keep the body in an orthostatic position. To do so, the gluteal, ischiotibial (“hamstrings”), quadriceps and triceps surae muscles should be assessed and prepared to sustain body weight during essential movement activities, whether these are walking, running, swimming or cycling [11].
Starting the programme with isometric muscle exercises can provide benefits in terms of gains in strength and endurance, with lower overload in the joint affected by connective tissue diseases. As strength and muscle resistance are worked, gains can even be seen in balance and coordination for movement and tasks in everyday life. And as the patient gains autonomy and strength, localized muscular resistance exercises will replace isometric ones.
Regardless of the modality, resistance exercises must be performed in a closed kinetic chain, allowing greater control and coordination of the patient over the movement, which is to be performed. Because of the limitations of the disease itself, each series will contain more repetitions, and less weight will be used for resistance in comparison with programmes that are recommended for beginners without chronic diseases. Encouraging regular exercise of arms, paravertebral muscles and abdominal cavities help in daily tasks and posture during work and leisure [12].
When exercises are performed three times per week, they complement the localized exercise programme. These exercises allow the increase on mobility in a range of joints, not only those affected by connective tissue diseases. Because of the adverse clinical conditions, the movements should provide increased joint range, however, without forcing, in a steady manner. Instead of repetitions, the patient will hold the position for 15 seconds. There is no need to repeat each exercise more than five times for each position because this yields no significant gain.
The improved flexibility benefits the load distribution on the joint cartilage, while the increased range of motion encourages nutrition of the cartilage, an effect that occurs mainly in the synovial joints because of improved circulation and distribution of the synovial fluid. This increased mobility brings patients’ independence in their daily lives and can inspire other activities such as dance, yoga and tai chi, for example [11, 12].
Although it is fundamental to health, coordination is not addressed in specific programmes, except in situations in which the disease worsens and rehabilitation requires it. The patient will have more strength and flexibility to coordinate movements, which previously was difficult and was abandoned or even avoided. Skill and specific coordination can be trained simultaneously with more complex exercises to train strength and flexibility, for example. Exercises that involve balance, coordination and proprioception prevent falls, which can be disastrous in this group of patients [13].
In general, in the treatment of degenerative diseases with exercises, the speed that movements and activities are executed will emerge as a direct consequence of advances in the physical capacity for exercise.
The sequence of exercises presented below was designed and used to treat degenerative arthritis of the knee after trauma with impairment of the articular cartilage, which required surgical treatment. After the postoperative period was complete and physical therapy was administered for rehabilitation (while pain and functional disability were still present), patients have begun to be part of the study group for this research [14, 15].
To all patients, pain decreased with the use of hyaluronic acid in an intra-articular infusion. Assessment by a doctor of sports medicine has determined the appropriate thresholds for intensity, duration, frequency and type of exercise. In the following example, the patient was able to perform all of the suggested activities in the weekly volume presented.
The aerobic training involved walks four times per week in 30-minute sessions at an intensity determined by stress tests by the ability to chat or hum or by the heart rate determined by the attending physician through mathematical formulas, always corresponding to 50% of VO2max. The walks were to always take place on flat terrain with only a few gentle curves. The direction of walking was to be reversed (clockwise to counterclockwise and vice versa) every 10 minutes.
Once the patient was warmed up (through aerobic activity or independently), the exercises described below were performed three times per week, with at least 1 day between sessions for better recovery and utilization.
With one leg bent and the other extended, place a strap on the foot and lift the leg, keeping the knee extended and the ankle at 90°. Hold the position still for 15 seconds (without forcing), and return to the resting position for 5 seconds. Next, repeat the same motion with the other leg. Perform five repetitions for each leg, at intervals of 15 seconds of exercise and 5 seconds of recovery (Figure 1).
Stretching back muscles.
Bend one of your knees, and keep the other extended. Holding the ankle and leg with the knee bent, count 15 seconds and then relax, returning to the rest position (Figure 2). In some cases, the joint may not permit full flexion; use a strap to maintain a lesser degree of knee flexion while the position is maintained (Figure 3). Perform five repetitions for each leg, at intervals of 15 seconds of exercise and 5 seconds of recovery.
Stretching previous muscles.
Strengthening of anterior muscles.
Bend one leg at the knee, and support the foot. The other leg should be extended with a soft support under the other knee (a rolled towel or foam pad). Force this extended knee down, pressing against the ground, holding for 20 seconds in isometric contraction. Then, relax for 5 seconds. Repeat 10 times for each leg in two sets totalling 20 repetitions (Figure 4).
Isometric contraction for thigh.
Bend one leg at the knee, and extend the other leg. The same support used in the previous exercise will be placed under the heel of the extended leg, maintaining pressure against the ground for 20 seconds in isometric contraction. Relax for 5 seconds and repeat the movement with the other leg (Figure 5).
Isometric contraction for leg.
Supported and knees flexed at 90° and feet fully supported by the ground or on a support. In this position, flex your muscles as if it was to move the chair forwards (without actually moving the chair forwards), and hold this position for 20 seconds; then relax for 5 seconds. Next, move your muscles as if it was to move the chair backwards (again, without actually moving the chair), and hold this position for 20 seconds, again followed by a rest period of 5 seconds. Perform 10 repetitions for the combined “chair movements” (Figure 6).
Abdomen strengthening.
Try to balance yourself on only one leg; stay close to a wall or some means of support, in case you lose your balance. Flex and extend your hips, knees and ankles to a small extent without losing the position, and keep your eyes fixed on the horizon. This exercise should be performed for a full minute, one leg each minute (Figure 7). When you feel safe with regard to balance and executing the movements described above, repeat for another minute, but this time throw a ball against the wall or support, always maintaining your posture and your gaze at the horizon (Figure 8).
Exercise for simple body balance.
Exercise for advanced body balance.
We live in an era in which sedentarism has become one of the leading causes of morbidity and mortality. For patients with CDH, such as RA, PM, DM, and SS, phobia due to the pain associated with these diseases may lead to greater immobility, more pain, greater body weight (obesity) leading to more immobility and so on. Entering this vicious circle, patients with CTD will have their activities compromised, such as getting up from a chair, going up and down stairs, shorter walks and difficulty in doing housework. Once the limitations that go beyond the underlying disease are established, patients are dependent on family members or specialized professionals, which makes their lives totally dependent [16].
Regular aerobic exercises and muscle strengthening exercises mainly in the affected joints may interrupt the pain cycle in patients with RA. The review promoted by Hurkmans [9, 17] showed that this association can improve the pain and functional capacity of the locomotor system. It has also been shown that the adaptations occur rapidly and that there is no additional damage to the joints and other tissues affected by the CTD [17]. The review shows that there is sufficient evidence in the literature to state that the medium in which the exercises are performed does not interfere with the beneficial result obtained. Thus, practising the solo or aquatic exercises did not show differences that justify the choice of one of the two for the patients with CTD [17]. Regular exercises of strength and localized muscular resistance and aerobic exercises have been shown to be ancillary to muscular diseases such as PM and DM when practised in moderate intensity, although they do not present sufficient evidence to support clinical observations. It can be affirmed, however, that the practice occurs totally free of physical damages to the practising patients, the fact that counts on evidence that allows reaching that conclusion [18].
Strength training and aerobic resistance training should include proprioception exercises (balance) alone or not. There is evidence in the literature to conclude about its efficiency in patients with CTD, especially in RA and OA knees, contrary to what was demonstrated. Clinical experience points in the direction that the practice of balance exercises should be part of regular training programmes. Takacs et al. have demonstrated that after training for 10 weeks there is an improvement in pain, function and especially the loss of fear of movement when balancing exercises are performed in isolation. However, the lack of further studies still leaves evidence of its benefits not very well-defined [19, 20, 21].
The benefits of regular physical activity and the harm of sedentary lifestyle and its consequences are well demonstrated in the review by Pinto et al. on autoimmune diseases. The advice to sit less and move more (sit less and move more) is also applied to CTA patients. The review definitely shows the benefits that regular physical activity brings to people with autoimmune rheumatic diseases. As to the intensity of the work performed, it was noted that it need not necessarily be intense. Mild exercises can also help these patients. Most of the studies cited, however, advocate on even increasing intensities for those who demonstrate adaptation to the stimulus offered [22].
Additional benefits can be realized in patients with CTD. In their experiment, Stavropoulos-Kalinoglou et al. demonstrated that aerobic and localized muscular endurance exercises reduce the risk of cardiovascular diseases in patients with RA besides increasing their physical work capacity. It also showed that when the prescriptions are individualized, works at lower intensities produce a protective effect as well as those of greater intensity in those who had restrictions for such [23].
Regular physical activity yields countless benefits to patients with degenerative diseases of the connective tissue, both in terms of prevention and in association with a treatment regimen.
The intensity, duration, frequency and type of exercises should be determined by each clinical condition of the patient, and it should be studied on a case-by-case basis for individualized recommendations.
Beyond doubts, Seawater desalination is commonly considered as a significant method towards producing and supplying potable water across the globe, especially in areas like the Middle East and North Africa (MENA) region characterized by a dry climate, low precipitation, and insufficiency of surface water. Despite the availability of various desalination technologies, membrane technology presented by Reverse Osmosis (RO) witnessed significant growth dominating about 60% of the desalination industry worldwide. The newly developed RO membranes characterized by high rejection and high flow membranes were allowed to operate at high pressures (up to 80–90 bar), thereby making conversions to 55–60% economically feasible. Such advancements towards simplifying RO processes from a two-stage treatment change to a single-stage array which in turn reduced capital and operational costs [1, 2, 3].
The high demand and global climate change have contributed to water scarcity in a significant way. As such, 71% of the world’s population live under conditions of moderate to extreme water shortage, and about 66% (4.0 billion people) live in severe water deficiency. This well-felt scarcity could be a binding limitation on the socio-economic development of many countries according to Goal #6 [SDG6] of the Sustainable Development Goals cover all aspects of managing water for fair access, sustainability, and environmental protection. Having said so, seawater desalination is reliably seen compared to other sources, especially with the long-term satisfaction tends to be achieved fully or partially for the demand in areas around the globe where water scarcity is felt, such as Australia, Southern Carolina, the Middle East, and Northern Africa [4].
Seawater desalination technology by RO is proven to be an extreme energy-efficient compared to other conventional thermal distillation methods and therefore is economically feasible. Membrane technologies application in the desalination industry has witnessed some rapid development and growth over the past 20 years. However, SWRO membranes are highly sensitive to the feedwater characteristics and to the concentration of certain organic compounds that potentially lead to membrane fouling phenomena [1, 5, 6, 7].
Pretreatment is crucial to SWRO, as it influences membrane efficiency and life expectancy by fouling reduction. Practically, it is essential to enhance the raw water quality before passing through RO vessels to promote high and effective performance. Yet, Membrane fouling and scaling remain challenging even though the perfect design and operating conditions can be significantly helpful. Both source and quality of feed water influence the pretreatment choice towards better fouling control. Technically, the silt density index (SDI) and turbidity are the two main parameters determining pretreatment performance [8, 9, 10]. In addition, microbial foulants characterization can be found in [11]. Pretreatment techniques are designed to eliminate the microbial loads on high-pressure membranes but may scavenge nutrients and potentially provide a suitable environment for microbial growth. A comparison of the bacterial community composition can, therefore, answer whether pretreatment compartments serve as inoculum for high-pressure membranes. Physical and chemical water treatment processing feed water in desalination industry is referred to usually as pretreatment, as shown in Figure 1, usually proceed by a series of methods: coagulation and flocculation, followed by granular media filtration (e.g., anthracite coal, silica sand, or garnet) and cartridge filtration. Biocides such as chlorine and Peracetic acid, in addition to ozone or ultraviolet (UV), can be used when biofouling is a problem [2, 11].
Stages of an RO membrane system.
Furthermore, membrane biofouling cannot be removed by conventional pretreatment methods such as coagulation, flocculation, ultrafiltration, and cartridge filters (CF), as they are unable to remove all passing microorganisms tending to colonize the membrane. Sand filtration combined with chemical disinfection is more efficient in reducing microbial contaminants, including viruses, to acceptable levels meeting drinking water standards. Technically, the pressure-driven process presented by membrane filtration can provide high-quality drinking water. However, it could be faced with vital challenges including system demanding, relatively high cost, clogging, scale formation, and biofouling. Moreover, membranes have a limited lifetime regardless of how good they are and so they may not reject all pollutants of concern for drinking water after a certain time of operation even if microorganisms are successfully removed. One consideration in large-scale applications is that membrane filtration systems produce considerable amounts of more concentrated wastewater per unit of purified water. Having said so, membrane selection must take into consideration the nature of the contaminants associated or extracted [10, 12, 13].
Microbial colonization at the membrane surface is traditionally overcome by overall applying disinfection to the feed water. Ideally, any disinfectant should not be expensive or hazardous. However, it must be highly toxic to microbes with zero effect on the desalination plant productivity. Traditionally, there are many disinfection processes applied in water treatment including but not limited to chlorination, ozonation, and UV radiation. Although ozonation is found to be an effective disinfection technique using oxidative effects in removing microorganisms, it is a bit costly and unstable in addition to producing carcinogenic bromates as by-products in the treated water occasionally. Chlorine on the other hand is the most commonly used disinfectant characterized by easiness use and low cost. During the chlorination process, the biomass on the RO membrane is effectively destroyed. Besides and due to molecular analysis, some bacterial groups appear to tolerate this biocide. Well-known bacterial classes potentially resisting chlorination, such as Bacillus and Clostridia due to their ability to sporulate, are very much identified on fouled membranes [2, 14].
For many reasons, biofouling is challengingly difficult to manage in RO systems. Some membranes like polyamide-based membranes tend to be sensitive to oxidizing agents such as chlorine leading to significant limitations for such use. Generally, Commercial plants are not observably in sterile environments. Therefore, any microorganism that enters the system can rapidly multiply. Surprisingly, it takes only 30 minutes for some bacteria to duplicate their population, showing exponential growth. The free chlorine presented during the chlorination process may potentially lead to membrane damage and salt rejection deterioration. Another downside of applying chlorine as a disinfectant is its capacity of breaking down the organic and humic material to Assimilable organic carbon (AOC), resulting in the rapid growth of biofilm which in-turn leads to accelerated incremental of feed channel pressure drop. In some treatment plants, Mono-chloramine is usually applied to achieve biofouling control. Nevertheless, mono-chloramine can be used to produce N-Nitrosodimethylamine (NDMA), which is a human carcinogenic material that can result in public health issues. Furthermore, contaminated water with mono-chloramine may potentially result in the damage of membrane in the iron and manganese presentation [8, 12, 15].
Surprisingly, various bacterial types and groups were found to be succeeding and thriving when membranes are cleaned intermittently with various cleaning agents. One thing to think of is the inclusion of citric acid leading to several community compositions compared to when chlorine was used alone.
Membrane fouling is practically seen as a chronic drawback hindering the development and operation of SWRO desalination processes. Fouling results in overall membrane performance deterioration with operational pressure drop and more frequent cleaning leading to operational costs increase and eventually full loss of membrane. From hydrodynamics perspectives, fouling development mainly in space-filled channels of the membrane is influenced by water quality, operational conditions, and spacer and membrane design. Technically, membrane fouling issues vary from organic and inorganic fouling to colloidal and biofouling contributing to increase cost of operation as well as affecting the quality of water produced. Amongst, biofouling seems to be way too complicated and hard to be controlled due to the excessively increase of biofilm formation on the surface of membrane surface, consequently leading to deteriorated performance. Additionally, the capability of lived bacteria inside biofilms in terms of high tolerance to antibiotics and other antimicrobials than planktonic cultures is problematic. As such, various techniques including pretreatment, membrane surface alteration or modification, disinfecting of feed water via chlorination, and cleaning are developed to overcome and/or control biofouling simply by treating biofilm formation on membrane surfaces [2, 17, 18].
Presently, several foulants considered or categorized as microbial ones including various microorganisms and organic compounds, known also to be aquatic, such as polysaccharides, proteins, and lipids, called extracellular polymeric substances (EPS). Identically, the biofouling process involves in adhesion of organisms that are aquatic along with their metabolic products presented on membrane surface or feed spacers. As shown in Figure 2, strong biofilm growth can be observed and found on the feed spacer strands. More than 45% of all membrane fouling is biofouling originated mainly by unicellular or multicellular microorganisms and therefore seen as one of the major issues of concern to reverse osmosis membrane filtration processes. Although membrane biofilm majority is formed by bacteria, other organisms such as fungi, algae, and protozoa may potentially be attracted by the membrane surface and add up to the formation of biofilm in a significant manner. Various studies confirm that
Biofouling in RO sample (left: top view, right: cross-section) [
Membrane biofouling takes place gradually in sequential steps, as shown in Figure 3. Firstly, the microbial cells get to membrane surface attachment, causing the forming of the biofilm as layer, involving communities of different microorganisms’ types (e.g., bacteria, algae, protozoa, and fungi). Initially and acting as mediator for the attachment of microbial substances, electrokinetic and hydrophobic interaction, the growth and multiplication of cell usually follows at the expenses of nutrients being soluble in water feed or membrane surface adsorbing organics. The roughness and charge of the membrane surface are considered as key factors contributing to the enhancement of the microorganisms attached to the membrane surface [9].
Steps of the biofilm [
Several environmental factors raising bacterial growth such as nutrients amount and types which strongly affect the microbial composition and biofilms density. Also, membrane characteristics such as type, roughness, charge, and hydrophobic/hydrophilic characters very much influence the biofouling microbial film establishment. Producing RO membranes highly resistant to biofouling as well as other fouling types remains challenging. Typically and from operational point of view, biofouling poses itself as a challenge, especially for saline waters having natural organics at high levels. Seasonally, biofouling tends to be problematic during extreme algal blooms or in time of having accident entrance to the open intake of the plant in rainy season with highly organic water [2, 11].
Commonly, biofouling attributes to the increased probability of bacteria producing polysaccharides and natural adhesives. It occurs at all open-ocean desalination plants such as the Jeddah SWRO desalination station in KSA. Mature biofilms exhibit anti-bactericidal properties and are also resistant to detachment. Biofilm formation results in biofouling when exacerbated in desalination systems by water production efficiency deterioration of membrane degradation, leading to a significant increase in operational costs associated with cleaning regiment and shortened membrane lifespan [23, 24].
Generally, the saline feed water biofouling potential is influenced by several interrelated factors including microorganisms’ concentration; content of readily biodegradable compounds; nutrients concentration and composition in the source water; temperature; the salinity of the feed water as well as operating parameters such as cross-flow velocity [11, 25, 26].
The study of [25] elucidated Algal organic matter (AOM) impact on biofouling affecting various membranes modules (capillary and spiral wound) by algal blooms. They found that measuring Adhesion force illustrate that AOM has the propensities towards adhering to a membrane surface and would need massive force to be removed from the membrane. Also, the seawater capacity supporting bacterial growth illustrated a correlated positive linear with AOM concentration levels in the water. It was linked to the tending of AOM, especially, transparent exopolymer particles (TEP), to nutrients concentration absorption from the feed water feeding attached bacteria. Also, fastened experiments of biofouling made with spiral wound and capillary membranes evidently show that when biodegradable nutrients presented in the feed water unlimitedly, a high level of AOM concentration in water feeds or as membrane attachment may significantly speedup biofouling. Further observation is that lower biofouling rates occurred once membranes are exposed to feed spikes with AOM or nutrients [25].
The bacteria can tolerate a wide range of pH (0.5–13) and temperature (−12–110 °C) while being able to colonize on all membrane surfaces in RO plants under different conditions. Various studies were carried out to investigate frequently observed microorganisms on membranes in RO plants. As concluded by [28] some bacterial groups are presented with some potential finger print significantly related to biofouling. Their study mostly opened some future window towards focusing on having already-cleaned membranes treated prior to installation. Also, paying more attention to primarily target troubling colonizers, or developing pre-treatment designs considering biofouling measures through the bacterial load minimization attempting to access membrane unit feed. While, a pilot-scale study of [29] was implemented to compare bacterial populations (membrane biofilm) in seawater, CF, and from Carlsbad plant at California, USA.
Observably, population of biofilm for seawater and membrane tend to have some similarity, but the CF harbored other biofilm community type. It was a relatively firm study because it concluded the findings of different communities of biofilm in five fouled SWRO membranes than those of other found around the globe. Apparently, such unique occurrence was due to differences observed in operational conditions and sampling across the year. Various mutually and dominantly existence of bacterial group could be observed in all samples. As such, strong suggestion was made about certain group being conformed to the membrane surfaces growing under chemolithoheterotrophic conditions oligotrophically [27, 28, 29].
Similarly, [30] results found that members of the
A review of [14] found that the most commonly detected bacteria on fouled membranes are
In the experiment of [34], a lab-bench cross-flow RO system was used to explore the impact of chlorine disinfection on reverse osmosis membrane biofouling. No significant distinctively chlorine-resistant bacteria were detected in the sample without chlorine dosage and with 1 mg-Cl2/L chlorine dosage. However, in the samples with 5 and 15 mg-Cl2/L chlorine, kinds of significantly distinctive chlorine-resistant bacteria were presented included
The research of [28] analyzed the biochemical properties by selecting a good-model bacteria include
A biofilm has a high content of water and organic matter (70–95%), high numbers of colony-forming units and cells, high contents of carbohydrates and proteins, high content of ATP, and low content of inorganic matter. Indicating biofouling potential can be proposed by multiple parameters as ATP, AOC, and biodegradable dissolved organic carbon (BDOC). Generally, the previously mentioned parameters are generally applicable for fresh waters and yet to be extended to be applied for desalination plants [25, 36]. Meanwhile, the study of [37] suggested some testing sets to allow for the determination of the water samples capacity of microbial support. In addition to using fluorescence intensity microplate analysis to determine biofouling potential on RO membranes [35, 37, 38].
Measurement of RO feed water biofouling tendency is not an easy task. To do so, several in-practice parameters are indicatively considered like: Silt density index SDI, turbidity, and total suspended solids (TSS). Having said so, biologically-based data is yet to be obtainable supporting such measurements. The RO feed water microbial support capacity (MSC) is practically determined by factors associated with the algal activity, such as TOC, the ratio of TOC:TN: TP, the increase in RO train DP, Chlorophyll a, TEP, bacterial activity (e.g., ATP), total bacterial count, microscopic observation, and nutrients concentration (Total N, Total P). Biological-based factors such as AOC and BDOC are used in waters with no salinity. Also, many consistent monitoring systems like monitoring of biofilm and the MFS had been developed to determine formation rate of biofilm. These monitoring systems cannot predict the feed water potentiality for biofouling but simulate overall plant operation [11, 19].
The concentration of TOC is widely applied to indicate the potentiality of saline water to biofouling whereas the rate of DP increase is indicatively used for the rate of biofouling. From operational point of view, potentiality to biofouling tends to be significantly increased when TOC concentration raises to 2 mg L−1. Practically, the weekly measurements made for ratio of TOC:TN: TP to indicate biofouling increasing. Consequently, ratios above 20% of 1:1:1 indicates an elevation requires bacterial EPS generation leading to have the bacteria encouraged to cause membrane fouling [11, 39].
The concentration of Chlorophyll
In SWRO systems, biofouling has many adverse effects, as increases in differential driving pressure and feed channel pressure drop. These are required to maintain the same production rate due to biofilm resistance. In addition to increased energy consumption associated with high pressure to achieve the biofilm resistance and flux decline. Biofouling eventually leads to the biodegradation of cellulose acetate membranes caused by acidic by-products concentrated at the membrane surface. Also, it leads to reducing the active membrane area, and therefore decreased flux of permeate due to the formation of a low-permeability biofilm on the membrane surface. Other main consequences of biofouling decreased membrane permeability, increased the frequency of chemical cleaning, and the possible increase in replacement frequency of membrane [9, 19, 24, 40].
Research conducted by [41] investigated the biofouling effect on the sequentially declining in reverse osmosis membranes in terms of membrane operational parameters like membrane permeability, pressure drop in feed, salt rejection. Also, the consumption of temporal organic carbon (DOC) is being measured. It could be illustrated that all indicators were influenced by biofouling formation. Observed increase in the pressure drop in the feed channel (FCP) affected permeability and decline salt rejection, consequently leading to prove the FCP sensitivity to biofouling. Besides, [35] found that biofouling can accelerate the formation of scaling, and the mixed foulants can block the membrane pores, leading to a significant flux drop [35, 41]. In brief, biofouling has a potential effect on the following: differential driving pressure, feed channel pressure, energy consumption, the flux of permeate, membrane area, membrane permeability, the frequency of chemical cleaning, and salt rejection.
The control of biofilm formation is a complicated and controversial process involving the reduction of microorganisms within the RO water, monitoring strategies, and controlling factors such as nutrient concentrations and physicochemical interactions between microorganisms and membrane surface. Gulf Sea at the Saudi Arabia is known to be having biofouling major challenge uneasy to be controlled. It still the main challenge in membrane filtration installations. Curative or preventive measures are not always efficient. Flocculants provide a suitable habitat for microbial growth, whereas conditioning agents are potential sources of microorganisms and nutrients for the biofilm. Another source of microbial contamination is the piping, storage tanks, and treatment systems before RO, such as ion exchangers and active carbon filters. Biofilm can grow in very low-nutrient habitats with TOC levels as low as 5–100 μg/L. In practice, several methods for biofouling control have been investigated, such as the application of the pretreatment before SWRO to remove bacteria and biodegradable organic matter, dosing of biocides, and limiting essential nutrients such as carbon and phosphate [9, 40, 42, 43, 44].
Membrane cleaning as a method of biofouling control typically done when there a significant decrease in differential pressure drop or permeability. Principally, cleaning process involves removing and/or destroying of the biomass accumulating on membrane surface to reserve membrane permeability. Cleaning process can be applied physically or chemically. Physical cleaning was usually performed before chemical cleaning, involving flushing of air and water. It requires applying pressure mechanically, attributing to the removal of all non-adhesive fouling-based. Membrane manufacturers suggest different chemical agents’ forms for cleaning purposes (e.g. alkaline, acids, biocides, enzymes, and detergents). Such process is efficiently eliminating or deactivating non-accumulating microorganisms. Therefore, the residual inactive biomass can be consumed as food by survived bacteria leading to bacteria regrowth acceleration. Base/acid cleaning removes organic foulants on membranes and destroys the microbial cell walls. Metal chelating agents and surfactants were used to disintegrate EPS layers by removal of divalent cations and solubilization of macromolecules, respectively. The efficiency of cleaning agents to remove biofouling is limited because the EPS layer is recalcitrant against cleaning agents. Improvement of cleaning efficiency difficult, particularly for aged biofilms. Membrane cleaning frequently removes only part of the fouling layer and cleaned membranes, therefore, provide a suitable environment for swift microbial colonization. Thus, cleaning processes (physically and chemically based) may partially result in biofouling reduction on the short run without sustainably controlling biofouling on the long run [8, 45, 46, 47].
Control of bacterial growth by chemical disinfectants depends on many factors, such as chemical concentration, its mode of action, contact time, the density of organisms, and TSS of feed water. These factors make it extremely difficult to attain absolute disinfection. Besides, chemical disinfectants like chlorine and its derivatives may be hazardous to health. Chlorine is known to oxidize and degrade the humic substances in seawater, thus, resulting in smaller molecules, which are AOC. The AOC is a good nutrient source for marine bacteria, and under such status could also lead to rapid biofilm formation in SWRO plants. Chlorination may foster the formation of trihalomethanes and other chlorinated by-products, which are carcinogenic [48].
Many researchers have concluded that biofouling is inevitable and tend to be difficult to prevent with having the focus shifted towards control strategies aiming to achieve: biofilm formation delay, biofilm accumulation impact reduction or delay on performance, and finally removing biofilm via advanced strategies of cleaning. For many reasons, biofouling control tends to be challenging. As such, various methods were developed towards treating biofilm formation on membrane surface and/or mitigating biofouling effect in general. Instantly, some strategies were applied including: membrane flushing or cleaning, application of chemical additives to target bacterial cell or extra-cellular matrices, membrane surface modification, limiting nutrient content, and the quenching of quorum. All previously mentioned methods have limitations and may result in unwanted membrane degradation [14, 18, 21, 49, 50]. As part of chemical treatments with biocides in addition to anti-microbes were applied mutually as part of industry practices. Chemically-based cleaning are known to be affecting exclusively the topper biofilm layers by colonizers. The effect of nutrient levels and possible manners to control membrane biofouling poses another potential solution for many membrane installations and should be further investigated. Biofouling impact on membrane efficiency is potentially minimized through a combination of strategies involving early identification, preventive cleaning, substrate limitation for delaying biofouling built-up, and cleaning procedures optimization towards effective biofilm removal [14, 41, 50].
Based on the current knowledge, membrane surface modifications tend to be incompatible for control biofilm formation in full-scale membrane operations because of the drag force that transfers bacteria and nutrients to the membrane surface. As various components are moved to the membrane surface by the drag force, they are easily covered, and membrane surface modifications are rendered less efficient. By applying comprehensive pretreatment, therefore, biofouling can be limited but not eliminated. Practically, membrane biofouling prevention tends to be fully or partially achievable by better pretreatment in new desalination systems. Yet, it might be essential to have old, insurgent biofilms and prolonged membrane operating plants dispersed sufficiently. Most existing techniques in efficiently use an enormous spectrum of biocides and chemicals attacking bacteria to maturely disperse biofilms [14, 26, 28].
Practices presented as clean-in-place (CIP) tend to be less efficient and that successful. This is related probably to various reasons including: wrong selection of chemical, improper pH control, temperature, time of contact, unsuitable recirculating flow rates, and partial biomass removing. The repetitive biocides usage potentially lead to bacterial resistance inducing via bacterial cell modification on membrane surface, permeability deterioration of biocide, and biocides degradation by enzymes development, or gaining more resistance for biocide genes [28].
Strategies for Biofilm control applying enzymes towards degrading of EPS matrix including glycosidases, proteases, and deoxyribonucleases. However, these enzymes targeting specific strains, and their sufficiency in complex multi-species biofilms is yet to be established. Also, enzymes are costly and may not be so practical when applied for membrane treatment or flushing. On the other hand, a bad need for more efficient and cost-effective methods to eliminate biofilms and alleviate biofouling in SWRO processes do exist. As such, it is highly recommended to conduct researches investigating novel chemical cleaning agents which may positively contribute to overcome or mitigate biofouling [26, 28].
A study of [18] investigated the
The application of bacteriophage in synergetic way combined with some other traditional methods, such as cleaning proven to be mitigating
In [51] research, the isolation of lytic bacteriophages was used to hinder
In [26] study, biofilm amount and characterization were analyzed concerning membrane performance applying acid/base cleaning. Generally, cell and tissue of the bacteria deactivate chemical agents used in cleaning process to remove mainly the biomass related to biofouling. Chemical-based reactions like dispersing, chelating, solubilization, suspension, peptisation, sequestration, and hydrolyzing are observed during cleaning process. Cleaning by Alkaline-based solutions like Sodium hydroxide was also applied in this study for three types of biofilm to explore biofilm removal efficiency as well as illustrating EPS matrix role. They concluded that with minimum biomass amount at low substrate concentration cleaning was not as efficient as with high substrate concentration, with same observed phenomena for membrane performance restore [26].
While [43] describes the biofouling monitoring technology of the “Megaton Water System” project and verifies the technology in the pilot and real plants in Al Jubail, Saudi Arabia. Biofouling monitoring technology refers to the community of bacteria composition change by chemical usage of the Membrane Biofilm Formation Rate (MBFR) was applied to this project was a positive indication of a reliably system design and operation. Such monitoring technology could be applied to achieve plant operational and reliability improvement throughout the overcome of biofouling issue. It could also assist in environmental impact reduction and lower plant production costs through chemical-free injection [43].
According to [52] study, they developed a simple method where a combination of bubbling and cleaning-based on frequent addition of hydrogen peroxide (H2O2) at lower concentration level at feed water. The same approach was also explored with the use of CuO or PP spacers. The dosage of 0.3% (w/w) H2O2 being applied periodically at 12 h intervals resulting in having no increase in FCP in the tested system, also an indication referring to the tangible biofouling lacking with intermittent H2O2 dosing. For tested fouled membranes fouled over a period of eleven days, a single dose of 0.3% (w/w) H2O2 applied and successfully eliminated almost all spacers and membranes accumulated biofilm in few minutes demonstratively by a FCP of 69% (CuO spacer) and 54% (PP spacer). The biofouling reduction was primarily due to the high shear created by the generated oxygen bubbles in the system, combined with the disinfection effect of H2O2. The reasonably low cost of $0.009/m3 from intermittent H2O2 dosage was not more than 0.8% of overall assumed cost and 6.5% out of pre-treatment cost, allowing for economical accepted approach to overcome biofouling [52].
It seems that dechlorination water, activated carbon, cartridge filtration, UV irradiation, ozone treatment, hydrogen peroxide, detergents, alkaline, sodium bisulfite, and hot water sanitization are effective techniques and limitations to control biofouling.
Biofouling in SWRO membranes continues to be problematic for operation and maintenance quality. It plays an essential role in the fouling of the membrane parts in full-scale and pilot-scale plants, and it’s significant to reduce its occurrence by prediction and prevention. The study demonstrates the RO membrane biofouling mechanisms and the effective fouling control strategies within seawater desalination, where biofouling is a critical drawback. The study aims to evaluate microbial fouling (biofouling) to understand its effect on RO membrane performance. The study highlighted the composition of the microbial community and the functional potential of the RO membrane biofilm. In general, biofouling has affected all performance indicators. The selection of pretreatment seems to be a factor affecting the microbial community composition and functional potential. Analysis of the biofilm bacterial community has shown that seasonal changes in water quality influenced the biofouling bacteria.
The results showed that the accumulation of biofilms on membrane surfaces remains the key obstacle for high-pressure membrane filtration. For future research, it is significant to describe the cleaning agent and cleaning frequency. Also, measuring feedwater temperature, determine the location of the membrane element, and the sampling location at the membrane. These comprehensive researches will use to establish an integrated strategy to control biofouling. Biofouling control should concentrate on improving low fouling feed spacers, and the hydrodynamic conditions reduce the effect of biomass accumulation.
We conclude that to maintain plant productivity and membrane recovery it is necessary to increase the membrane cleaning frequency. In the CF and RO membrane, the microbial regrowth rate is a significant factor that impacts the biofouling rate. We recommend further searches of the strategy of balancing the nutrient levels as a solution for several membrane installations to control membrane biofouling. To measure biofouling, it needs for real tool, sensitive pressure drop data, and systematic methodology. Therefore further studies related to avoiding adverse biofouling processes will be valuable to investigate specific microbial members in more detail using biofilm monitoring and control strategies. Finally, additional SWRO research and development are critical for the efficiency of this growing industry.
AHL | N-acyl-homoserine lactone |
AOC | Assimilable organic carbon |
ATP | Adenosine Triphosphate |
BDOC | Biodegradable Dissolved Organic Carbon |
CF | Cartridge Filters |
CIP | Current Clean-In-Place |
DOC | Temporal Organic Carbon |
DP | Differential Pressure |
EPS | Extracellular Polymeric Substances |
FCP | Feed Channel Pressure |
H2O2 | Hydrogen Peroxide |
MENA | Middle East and North Africa |
MFS | Membrane-Fouling Simulator |
μg L−1 | Micrograms Per Liter |
mg L−1 | Milligrams Per Liter |
MSC | Microbial Support Capacity |
NDMA | Nitrosodimethylamine |
PQS | Pseudomonas Quinolone Signal |
PX | Pressure Exchangers |
QS | Quorum Sensing |
RO | Reverse Osmosis |
SDI | Silt Density Index |
SWRO | Seawater Reverse Osmosis |
TEP | Transparent Exopolymer Particles |
TOC | Total Organic Carbon |
TSS | Total Suspended Solids |
UF | Ultrafiltration |
UV | Ultraviolet |
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Some systems are highly affected by a small fraction of influential nodes. Number of fast and efficient spreaders in a network is much less compared to the number of ordinary members. Information about the influential spreaders is significant in the planning for the control of propagation of critical pieces of information in a social or information network. Identifying important members who act as the fastest and efficient spreaders is the focal theme of a large number of research papers. Researchers have identified approximately 10 different methods for this purpose. Degree centrality, closeness centrality, betweenness centrality, k‐core decomposition, mixed degree decomposition, improved k‐shell decomposition, etc., are some of these methods. In this expository article, we review all previous works done in the field of identifying potential spreaders in a network.",book:{id:"5842",slug:"graph-theory-advanced-algorithms-and-applications",title:"Graph Theory",fullTitle:"Graph Theory - Advanced Algorithms and Applications"},signatures:"Reji Kumar Karunakaran, Shibu Manuel and Edamana Narayanan\nSatheesh",authors:[{id:"200190",title:"Dr.",name:"Reji Kumar",middleName:null,surname:"Karunakaran",slug:"reji-kumar-karunakaran",fullName:"Reji Kumar Karunakaran"},{id:"200193",title:"Mr.",name:"Manuel",middleName:null,surname:"Shibu",slug:"manuel-shibu",fullName:"Manuel Shibu"},{id:"200194",title:"Dr.",name:"E N",middleName:null,surname:"Satheesh",slug:"e-n-satheesh",fullName:"E N Satheesh"}]},{id:"55541",doi:"10.5772/intechopen.68703",title:"Modeling Rooted in‐Trees by Finite p‐Groups",slug:"modeling-rooted-in-trees-by-finite-p-groups",totalDownloads:1138,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Graph theoretic foundations for a kind of infinite rooted in-trees T(R)=(V,E) with root R, weighted vertices v ∈ V, and weighted directed edges e∈E⊂V×V are described. Vertex degrees deg(v) are always finite but the trees contain infinite paths (vi)i≥0. A concrete group theoretic model of the rooted in-trees T(R) is introduced by representing vertices by isomorphism classes of finite p-groups G, for a fixed prime p, and directed edges by epimorphisms π: G → πG of finite p-groups with characteristic kernels ker(π). The weight of a vertex G is realized by its nuclear rank n(G) and the weight of a directed edge π is realized by its step size s(π)=logp(#ker(π)). These invariants are essential for understanding the phenomenon of multifurcation. Pattern recognition methods are used for finding finite subgraphs which repeat indefinitely. Several periodicities admit the reduction of the complete infinite graph to finite patterns. The proof is based on infinite limit groups and successive group extensions. It is underpinned by several explicit algorithms. As a final application, it is shown that fork topologies, arising from repeated multifurcations, provide a convenient description of complex navigation paths through the trees, which are of the greatest importance for recent progress in determining p-class field towers of algebraic number fields.",book:{id:"5842",slug:"graph-theory-advanced-algorithms-and-applications",title:"Graph Theory",fullTitle:"Graph Theory - Advanced Algorithms and Applications"},signatures:"Daniel C. Mayer",authors:[{id:"198580",title:"Dr.",name:"Daniel C.",middleName:null,surname:"Mayer",slug:"daniel-c.-mayer",fullName:"Daniel C. Mayer"}]},{id:"57771",doi:"10.5772/intechopen.71774",title:"Governance Modeling: Dimensionality and Conjugacy",slug:"governance-modeling-dimensionality-and-conjugacy",totalDownloads:1324,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"The Q-analysis governance approach and the use of simplicial complexes—type of hypergraph—allow to introduce the formal concepts of dimension and conjugacy between the network of entities involved in governance (typically organizations) and the networks of those attributes taken into account (e.g. their competences), which offer a specific angle of analysis. The different sources of existing data (e.g. textual corpora) to feed the analysis of governance—environmental in particular—are mentioned, their reliability is briefly discussed and the required pre-processing steps are identified in the perspective of evidence-based analyses. Various indices are constructed and evaluated to characterize the context of governance as a whole, at mesoscale, or locally, i.e. at the level of each of the entities and each of the attributes considered. The analysis of ideal-type stylizing boundary cases provides useful references to the analysis of concrete systems of governance and to the interpretation of their empirically observed properties. The use of this governance modeling approach is illustrated by the analysis of a health-environment governance system in Southeast Asia, in the context of a One Health approach.",book:{id:"5842",slug:"graph-theory-advanced-algorithms-and-applications",title:"Graph Theory",fullTitle:"Graph Theory - Advanced Algorithms and Applications"},signatures:"Pierre Mazzega, Claire Lajaunie and Etienne Fieux",authors:[{id:"220099",title:"Dr.",name:"Pierre",middleName:null,surname:"Mazzega",slug:"pierre-mazzega",fullName:"Pierre Mazzega"},{id:"220102",title:"Dr.",name:"Claire",middleName:null,surname:"Lajaunie",slug:"claire-lajaunie",fullName:"Claire Lajaunie"},{id:"220103",title:"Prof.",name:"Etienne",middleName:null,surname:"Fieux",slug:"etienne-fieux",fullName:"Etienne Fieux"}]},{id:"57940",doi:"10.5772/intechopen.72145",title:"Graph-Based Decision Making in Industry",slug:"graph-based-decision-making-in-industry",totalDownloads:1693,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Decision-making in industry can be focused on different types of problems. Classification and prediction of decision problems can be solved with the use of a decision tree, which is a graph-based method of machine learning. In the presented approach, attribute-value system and quality function deployment (QFD) were used for decision problem analysis and training dataset preparation. A decision tree was applied for generating decision rules.",book:{id:"5842",slug:"graph-theory-advanced-algorithms-and-applications",title:"Graph Theory",fullTitle:"Graph Theory - Advanced Algorithms and Applications"},signatures:"Izabela Kutschenreiter-Praszkiewicz",authors:[{id:"218951",title:"Associate Prof.",name:"Izabela",middleName:null,surname:"Kutschenreiter-Praszkiewicz",slug:"izabela-kutschenreiter-praszkiewicz",fullName:"Izabela Kutschenreiter-Praszkiewicz"}]},{id:"72140",doi:"10.5772/intechopen.91972",title:"Comparative Study of Algorithms Metaheuristics Based Applied to the Solution of the Capacitated Vehicle Routing Problem",slug:"comparative-study-of-algorithms-metaheuristics-based-applied-to-the-solution-of-the-capacitated-vehi",totalDownloads:653,totalCrossrefCites:0,totalDimensionsCites:2,abstract:"This chapter presents the best-known heuristics and metaheuristics that are applied to solve the capacitated vehicle routing problem (CVRP), which is the generalization of the TSP, in which the nodes are visited by more than one route. To find out which algorithm obtains better results, there are 30 test instances used, which are grouped into 3 sets of problems according to the position of the nodes. The study begins with an economic impact analysis of the transportation sector in companies, which represents up to 20% of the final cost of the product. This case study focuses on the CVRP for its acronym capacitated vehicle routing problem, analyzing the best-known heuristics such as Clarke & Wright and sweep, and the algorithms GRASP and simulated annealing metaheuristics based.",book:{id:"8241",slug:"novel-trends-in-the-traveling-salesman-problem",title:"Novel Trends in the Traveling Salesman Problem",fullTitle:"Novel Trends in the Traveling Salesman Problem"},signatures:"Fernando Francisco Sandoya Sánchez, Carmen Andrea Letamendi Lazo and Fanny Yamel Sanabria Quiñónez",authors:[{id:"155426",title:"Ph.D.",name:"Fernando",middleName:"Francisco",surname:"Sandoya",slug:"fernando-sandoya",fullName:"Fernando Sandoya"},{id:"313162",title:"M.Sc.",name:"Carmen",middleName:null,surname:"Letamendi",slug:"carmen-letamendi",fullName:"Carmen Letamendi"},{id:"319376",title:"Dr.",name:"Fanny",middleName:null,surname:"Sanabria",slug:"fanny-sanabria",fullName:"Fanny Sanabria"}]}],mostDownloadedChaptersLast30Days:[{id:"71899",title:"Moments of Catalan Triangle Numbers",slug:"moments-of-catalan-triangle-numbers",totalDownloads:542,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"In this chapter, we consider the Catalan numbers, \n\n\nC\nn\n\n=\n\n1\n\nn\n+\n1\n\n\n\n\n\n\n2\nn\n\n\n\n\nn\n\n\n\n\n\n, and two of their generalizations, Catalan triangle numbers, \n\n\nB\n\nn\n,\nk\n\n\n\n and \n\n\nA\n\nn\n,\nk\n\n\n\n, for \n\nn\n,\nk\n∈\nN\n\n. They are combinatorial numbers and present interesting properties as recursive formulae, generating functions and combinatorial interpretations. We treat the moments of these Catalan triangle numbers, i.e., with the following sums: \n\n\n∑\n\nk\n=\n1\n\nn\n\n\nk\nm\n\n\nB\n\nn\n,\nk\n\nj\n\n,\n\n∑\n\nk\n=\n1\n\n\nn\n+\n1\n\n\n\n\n\n2\nk\n−\n1\n\n\nm\n\n\nA\n\nn\n,\nk\n\nj\n\n,\n\n for \n\nj\n,\nn\n∈\nN\n\n and \n\nm\n∈\nN\n∪\n\n0\n\n\n. We present their closed expressions for some values of \n\nm\n\n and \n\nj\n\n. Alternating sums are also considered for particular powers. Other famous integer sequences are studied in Section 3, and its connection with Catalan triangle numbers are given in Section 4. Finally we conjecture some properties of divisibility of moments and alternating sums of powers in the last section.",book:{id:"8142",slug:"number-theory-and-its-applications",title:"Number Theory and Its Applications",fullTitle:"Number Theory and Its Applications"},signatures:"Pedro J. Miana and Natalia Romero",authors:null},{id:"55642",title:"Monophonic Distance in Graphs",slug:"monophonic-distance-in-graphs",totalDownloads:1534,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"For any two vertices u and v in a connected graph G, a u − v path is a monophonic path if it contains no chords, and the monophonic distance dm(u, v) is the length of a longest u − v monophonic path in G. For any vertex v in G, the monophonic eccentricity of v is em(v) = max {dm(u, v) : u ∈ V}. The subgraph induced by the vertices of G having minimum monophonic eccentricity is the monophonic center of G, and it is proved that every graph is the monophonic center of some graph. Also it is proved that the monophonic center of every connected graph G lies in some block of G. With regard to convexity, this monophonic distance is the basis of some detour monophonic parameters such as detour monophonic number, upper detour monophonic number, forcing detour monophonic number, etc. The concept of detour monophonic sets and detour monophonic numbers by fixing a vertex of a graph would be introduced and discussed. Various interesting results based on these parameters are also discussed in this chapter.",book:{id:"5842",slug:"graph-theory-advanced-algorithms-and-applications",title:"Graph Theory",fullTitle:"Graph Theory - Advanced Algorithms and Applications"},signatures:"P. Titus and A.P. Santhakumaran",authors:[{id:"198301",title:"Dr.",name:"P.",middleName:null,surname:"Titus",slug:"p.-titus",fullName:"P. Titus"},{id:"199035",title:"Prof.",name:"A. P.",middleName:null,surname:"Santhakumaran",slug:"a.-p.-santhakumaran",fullName:"A. P. Santhakumaran"}]},{id:"71501",title:"Accelerating DNA Computing via PLP-qPCR Answer Read out to Solve Traveling Salesman Problems",slug:"accelerating-dna-computing-via-plp-qpcr-answer-read-out-to-solve-traveling-salesman-problems",totalDownloads:783,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"An asymmetric, fully-connected 8-city traveling salesman problem (TSP) was solved by DNA computing using the ordered node pair abundance (ONPA) approach through the use of pair ligation probe quantitative real time polymerase chain reaction (PLP-qPCR). The validity of using ONPA to derive the optimal answer was confirmed by in silico computing using a reverse-engineering method to reconstruct the complete tours in the feasible answer set from the measured ONPA. The high specificity of the sequence-tagged hybridization, and ligation that results from the use of PLPs significantly increased the accuracy of answer determination in DNA computing. When combined with the high throughput efficiency of qPCR, the time required to identify the optimal answer to the TSP was reduced from days to 25 min.",book:{id:"8241",slug:"novel-trends-in-the-traveling-salesman-problem",title:"Novel Trends in the Traveling Salesman Problem",fullTitle:"Novel Trends in the Traveling Salesman Problem"},signatures:"Fusheng Xiong, Michael Kuby and Wayne D. Frasch",authors:[{id:"14757",title:"Prof.",name:"Wayne",middleName:null,surname:"Frasch",slug:"wayne-frasch",fullName:"Wayne Frasch"},{id:"317054",title:"Prof.",name:"Michael",middleName:null,surname:"Kuby",slug:"michael-kuby",fullName:"Michael Kuby"},{id:"317055",title:"Dr.",name:"Fusheng",middleName:null,surname:"Xiong",slug:"fusheng-xiong",fullName:"Fusheng Xiong"}]},{id:"72027",title:"Identification of Eigen-Frequencies and Mode-Shapes of Beams with Continuous Distribution of Mass and Elasticity and for Various Conditions at Supports",slug:"identification-of-eigen-frequencies-and-mode-shapes-of-beams-with-continuous-distribution-of-mass-an",totalDownloads:904,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"In the present article, an equivalent three degrees of freedom (DoF) system of two different cases of inverted pendulums is presented for each separated case. The first case of inverted pendulum refers to an amphi-hinge pendulum that possesses distributed mass and stiffness along its height, while the second case of inverted pendulum refers to an inverted pendulum with distributed mass and stiffness along its height. These vertical pendulums have infinity number of degree of freedoms. Based on the free vibration of the above-mentioned pendulums according to partial differential equation, a mathematically equivalent three-degree of freedom system is given for each case, where its equivalent mass matrix is analytically formulated with reference on specific mass locations along the pendulum height. Using the three DoF model, the first three fundamental frequencies of the real pendulum can be identified with very good accuracy. Furthermore, taking account the 3 × 3 mass matrix, it is possible to estimate the possible pendulum damages using a known technique of identification mode-shapes via records of response accelerations. Moreover, the way of instrumentation with a local network by three accelerometers is given via the above-mentioned three degrees of freedom.",book:{id:"8142",slug:"number-theory-and-its-applications",title:"Number Theory and Its Applications",fullTitle:"Number Theory and Its Applications"},signatures:"Triantafyllos K. Makarios",authors:[{id:"69418",title:"Prof.",name:"Triantafyllos",middleName:"Konstantinos",surname:"Makarios",slug:"triantafyllos-makarios",fullName:"Triantafyllos Makarios"}]},{id:"57940",title:"Graph-Based Decision Making in Industry",slug:"graph-based-decision-making-in-industry",totalDownloads:1693,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Decision-making in industry can be focused on different types of problems. Classification and prediction of decision problems can be solved with the use of a decision tree, which is a graph-based method of machine learning. In the presented approach, attribute-value system and quality function deployment (QFD) were used for decision problem analysis and training dataset preparation. A decision tree was applied for generating decision rules.",book:{id:"5842",slug:"graph-theory-advanced-algorithms-and-applications",title:"Graph Theory",fullTitle:"Graph Theory - Advanced Algorithms and Applications"},signatures:"Izabela Kutschenreiter-Praszkiewicz",authors:[{id:"218951",title:"Associate Prof.",name:"Izabela",middleName:null,surname:"Kutschenreiter-Praszkiewicz",slug:"izabela-kutschenreiter-praszkiewicz",fullName:"Izabela Kutschenreiter-Praszkiewicz"}]}],onlineFirstChaptersFilter:{topicId:"1399",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[],lsSeriesList:[],hsSeriesList:[],sshSeriesList:[],testimonialsList:[]},series:{item:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:null,scope:"