Permissible limit of heavy metal ions in water [21].
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"5376",leadTitle:null,fullTitle:"Applications of Laser Ablation - Thin Film Deposition, Nanomaterial Synthesis and Surface Modification",title:"Applications of Laser Ablation",subtitle:"Thin Film Deposition, Nanomaterial Synthesis and Surface Modification",reviewType:"peer-reviewed",abstract:"Laser ablation refers to the phenomenon in which a low wavelength and short pulse (ns-fs) duration of laser beam irradiates the surface of a target to induce instant local vaporization of the target material generating a plasma plume consisting of photons, electrons, ions, atoms, molecules, clusters, and liquid or solid particles. This book covers various aspects of using laser ablation phenomenon for material processing including laser ablation applied for the deposition of thin films, for the synthesis of nanomaterials, and for the chemical compositional analysis and surface modification of materials. Through the 18 chapters written by experts from international scientific community, the reader will have access to the most recent research and development findings on laser ablation through original research studies and literature reviews.",isbn:"978-953-51-2812-0",printIsbn:"978-953-51-2811-3",pdfIsbn:"978-953-51-4129-7",doi:"10.5772/62615",price:139,priceEur:155,priceUsd:179,slug:"applications-of-laser-ablation-thin-film-deposition-nanomaterial-synthesis-and-surface-modification",numberOfPages:428,isOpenForSubmission:!1,isInWos:1,isInBkci:!0,hash:"7ea5104a7037f15e68fcc05be277fa37",bookSignature:"Dongfang Yang",publishedDate:"December 21st 2016",coverURL:"https://cdn.intechopen.com/books/images_new/5376.jpg",numberOfDownloads:34194,numberOfWosCitations:64,numberOfCrossrefCitations:40,numberOfCrossrefCitationsByBook:2,numberOfDimensionsCitations:79,numberOfDimensionsCitationsByBook:3,hasAltmetrics:1,numberOfTotalCitations:183,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 15th 2016",dateEndSecondStepPublish:"April 5th 2016",dateEndThirdStepPublish:"July 10th 2016",dateEndFourthStepPublish:"October 8th 2016",dateEndFifthStepPublish:"November 7th 2016",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7,8",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"177814",title:"Dr.",name:"Dongfang",middleName:null,surname:"Yang",slug:"dongfang-yang",fullName:"Dongfang Yang",profilePictureURL:"https://mts.intechopen.com/storage/users/177814/images/system/177814.jpg",biography:"Dongfang Yang received his Ph.D. in Physical Chemistry from the University of Guelph in 1995. He joined the National Research Council Canada in London Ontario in 2001 and is now a Senior Research Officer. His current research interests include laser materials processing; pulsed laser, sputtering and e-beam deposition of thin films; new materials development for energy storage devices; chemical and optical sensors development; and electrochemical studies of organic adsorption and self-assembly monolayer. He is currently serving as an editor or editorial board member for ten scientific journals and was listed among the top 2% most-cited scientists according to a Stanford study in 2020. He also holds an adjunct professorship at Western University, Ontario, Canada.",institutionString:"National Research Council Canada",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"National Research Council Canada",institutionURL:null,country:{name:"Canada"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1226",title:"Optoelectronics",slug:"optics-and-lasers-optoelectronics"}],chapters:[{id:"52399",title:"Laser Ablation Applied for Synthesis of Thin Films: Insights into Laser Deposition Methods",doi:"10.5772/65124",slug:"laser-ablation-applied-for-synthesis-of-thin-films-insights-into-laser-deposition-methods",totalDownloads:2272,totalCrossrefCites:1,totalDimensionsCites:5,hasAltmetrics:1,abstract:"This chapter will focus on laser ablation applied for thin film deposition. The first thin films deposition method based upon laser ablation was pulsed laser deposition (PLD), that could produce thin films out of metals, ceramics and even temperature resistant organics. The need of depositing increasingly complex and delicate materials, lead to radical modifications of PLD and allowed other laser ablation methods to develop. If complex libraries are to be synthesized two or more plasmas will be mixed and the thin films will have a variable composition over surface. This technique is called Combinatorial PLD (CPLD).",signatures:"Camelia Popescu, Gabriela Dorcioman and Andrei C. Popescu",downloadPdfUrl:"/chapter/pdf-download/52399",previewPdfUrl:"/chapter/pdf-preview/52399",authors:[{id:"23532",title:"Dr.",name:"Andrei",surname:"Popescu",slug:"andrei-popescu",fullName:"Andrei Popescu"},{id:"188228",title:"Dr.",name:"Camelia",surname:"Popescu",slug:"camelia-popescu",fullName:"Camelia Popescu"},{id:"188229",title:"Dr.",name:"Gabriela",surname:"Dorcioman",slug:"gabriela-dorcioman",fullName:"Gabriela Dorcioman"}],corrections:null},{id:"52231",title:"Influence of Alkali Metal Ions on Luminescence Behaviour of Ca0.5R1-x(MoO4)2:xLn3+ (R = Y, La), (Ln = Eu, Tb, Dy) Pulsed Laser Deposited Thin Phosphor Films",doi:"10.5772/65006",slug:"influence-of-alkali-metal-ions-on-luminescence-behaviour-of-ca0-5r1-x-moo4-2-xln3-r-y-la-ln-eu-tb-dy",totalDownloads:1762,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Thin phosphor films of Ca0.5R1-x(MoO4)2:xLn3+, M+ (R3+ = La, Y), (Ln3+ = Eu, Tb, Dy) (M+ = Li+, K+ and Na+) were deposited on quartz substrates by pulsed laser deposition (PLD) technique by ablation of a stoichiometric monocrystal target. The deposition was carried out using an Nd‐YAG laser (λ = 1064 nm) in an ultra‐high vacuum (UHV) with an oxygen back pressure of 300 mTorr at 600°C substrate temperatures. The laser‐ablated films are optically active, as verified by the photoluminescence (PL) spectra, and the films exhibit smooth Stark levels. The photoluminescence of the Ca0.5R1-x(MoO4)2:xLn3+, M+ phosphors properties reveals characteristic visible emissions. Further, the co‐doping of alkali metal chlorides MCl (M = Na, K, Li) into the Ca0.5R1-x(MoO4)2:xLn3+, M+ phosphor greatly improves the luminescence intensity, which can be explained by charge compensation effect. The fluorescence lifetime and photometric coordinates are discussed in detail.",signatures:"Jagannathan Thirumalai, Venkatakrishnan Mahalingam and\nRajagopalan Krishnan",downloadPdfUrl:"/chapter/pdf-download/52231",previewPdfUrl:"/chapter/pdf-preview/52231",authors:[{id:"99242",title:"Prof.",name:"Jagannathan",surname:"Thirumalai",slug:"jagannathan-thirumalai",fullName:"Jagannathan Thirumalai"}],corrections:null},{id:"52917",title:"Thermoelectric and Topological Insulator Bismuth Chalcogenide Thin Films Grown Using Pulsed Laser Deposition",doi:"10.5772/65898",slug:"thermoelectric-and-topological-insulator-bismuth-chalcogenide-thin-films-grown-using-pulsed-laser-de",totalDownloads:1906,totalCrossrefCites:3,totalDimensionsCites:6,hasAltmetrics:1,abstract:"Bismuth chalcogenides have been intensively studied for their high-performance thermoelectric properties and their novel topological surface states, which could significantly benefit novel applications in fields such as TE devices, spintronics, and quantum computing. This chapter reports recent advances in pulsed laser deposition (PLD) for the growth of bismuth chalcogenide (e.g., Bi2Te3, Bi2Se3, and Bi3Se2Te) thin films and their novel properties. It covers a wide range of fields such as thin film growth using PLD for fabricating polycrystalline and epitaxial films with different thermoelectric, nanomechanical, and magnetotransport properties as a function of the PLD processing conditions. Moreover, the proximity-induced superconductivities in Bi inclusions/bismuth chalcogenide thin films are also reported and discussed in detail.",signatures:"Phuoc Huu Le and Chih Wei Luo",downloadPdfUrl:"/chapter/pdf-download/52917",previewPdfUrl:"/chapter/pdf-preview/52917",authors:[{id:"52371",title:"Prof.",name:"Chih Wei",surname:"Luo",slug:"chih-wei-luo",fullName:"Chih Wei Luo"},{id:"187013",title:"Dr.",name:"Phuoc",surname:"Huu Le",slug:"phuoc-huu-le",fullName:"Phuoc Huu Le"}],corrections:null},{id:"52845",title:"Pulsed Laser Deposition of ITO: From Films to Nanostructures",doi:"10.5772/65897",slug:"pulsed-laser-deposition-of-ito-from-films-to-nanostructures",totalDownloads:2298,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Indium-tin oxide (ITO) films have been deposited by pulsed laser deposition (PLD) to achieve low resistivity and high transmittance in visible region. Important parameters governing the growth of ITO films, which include laser wavelength, substrate temperature, and the background gas pressure, are discussed. By utilizing the energetic plasma in laser ablation of an ITO target, relatively low substrate temperature growth has been demonstrated. Room temperature deposition enables ITO films to be deposited on the polymer substrate. In addition, deposition in different background gases promotes the catalyst-free growth of nanostructured ITO films. In particular, deposition in Ar or He at optimized pressures enables the growth of highly crystalline ITO nanostructures, which include nanorods and nanowires due to the self-catalyzed growth from the plasma plume. The conditions which allow the pulsed laser deposition of ITO thin films and the growth of nanostructured ITO are reviewed and discussed.",signatures:"Seong Shan Yap, Thian Khok Yong, Chen Hon Nee and Teck Yong\nTou",downloadPdfUrl:"/chapter/pdf-download/52845",previewPdfUrl:"/chapter/pdf-preview/52845",authors:[{id:"187806",title:"Dr.",name:"Seong Shan",surname:"Yap",slug:"seong-shan-yap",fullName:"Seong Shan Yap"},{id:"195467",title:"Dr.",name:"Thian Khok",surname:"Yong",slug:"thian-khok-yong",fullName:"Thian Khok Yong"},{id:"195468",title:"MSc.",name:"Chen Hon",surname:"Nee",slug:"chen-hon-nee",fullName:"Chen Hon Nee"},{id:"195469",title:"Dr.",name:"Teck Yong",surname:"Tou",slug:"teck-yong-tou",fullName:"Teck Yong Tou"}],corrections:null},{id:"52347",title:"Laser Ablation of Biomaterials",doi:"10.5772/65197",slug:"laser-ablation-of-biomaterials",totalDownloads:1956,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Biomaterials, defined by high biocompatibility and biodegradability, are intensively used in medical applications, mainly to replace partial or total, damaged or destroyed hard or soft tissues. Most of them are used not only as coatings for implant coverage but also as parts for some medical devices. In the last decades, researchers sought to find the optimum processing methods and parameters to modify or deposit the biomaterial of interest. An important family of techniques, used to process a biomaterial, is represented by laser techniques, based upon laser ablation phenomenon. Laser ablation of biomaterials ensures the transference or modification with good precision and without or with minimal disruptions generated. To obtain thin coatings from biomaterials, one can use deposition techniques: pulsed laser deposition (PLD) or matrix-assisted pulsed laser evaporation (MAPLE). These techniques are chosen according to the selected biomaterial and desired performances of the obtained coating. Therefore, some sensitive biomaterials can be transferred only by MAPLE. Some results in the field of calcium phosphates deposited by PLD or MAPLE are presented, proving the usefulness of these biomaterials for medical applications.",signatures:"Gianina-Florentina Popescu-Pelin, Carmen Ristoscu and Ion N.\nMihailescu",downloadPdfUrl:"/chapter/pdf-download/52347",previewPdfUrl:"/chapter/pdf-preview/52347",authors:[{id:"17636",title:"Prof.",name:"Ion N.",surname:"Mihailescu",slug:"ion-n.-mihailescu",fullName:"Ion N. Mihailescu"}],corrections:null},{id:"51899",title:"Concurrent Multi-Target Laser Ablation for Making Nano-Composite Films",doi:"10.5772/64816",slug:"concurrent-multi-target-laser-ablation-for-making-nano-composite-films",totalDownloads:1455,totalCrossrefCites:4,totalDimensionsCites:7,hasAltmetrics:0,abstract:"New method of using laser ablation for film deposition that can be called as concurrent multi-beam multi-target matrix-assisted pulsed laser evaporation and pulsed laser deposition (MBMT-MAPLE/PLD) is described. Practical MBMT-MAPLE/PLD system built at Dillard University has three separate laser beams, three targets and the remotely controlled plume overlapping mechanism that provides even mixing of the target materials during their deposition on the substrate. The system accommodates MAPLE targets in the form of polymer solutions frozen with flowing liquid nitrogen. The feasibility of the method was demonstrated when it was used for making polymer nano-composite films with two inorganic additives: upconversion fluorescent phosphor NaYF4:Yb3+, Er3+ and aluminum-doped ZnO (AZO). Three laser beams, an infrared 1064-nm beam for the MAPLE and two 532-nm beams for the PLD targets, were concurrently used in the process. The fabricated nano-composite films were characterized using X-ray diffraction, scanning electron microscopy (SEM), optical fluorescent spectroscopy, and the measurement of the quantum efficiency (QE) of the upconversion fluorescence. The size of the inorganic nanoparticles varied in the range 10–200 nm. The AZO additive increased QE by 1.6 times. The conclusion was made on the feasibility of MBMT-MAPLE/PLD method for making multi-component nano-composite films for various applications.",signatures:"Abdalla M. Darwish, Sergey S. Sarkisov and Darayas N. Patel",downloadPdfUrl:"/chapter/pdf-download/51899",previewPdfUrl:"/chapter/pdf-preview/51899",authors:[{id:"186782",title:"Dr.",name:"Sergey",surname:"Sarkisov",slug:"sergey-sarkisov",fullName:"Sergey Sarkisov"},{id:"186848",title:"Prof.",name:"Abdalla",surname:"Darwish",slug:"abdalla-darwish",fullName:"Abdalla Darwish"}],corrections:null},{id:"52063",title:"Pulsed Laser Deposition of Large‐Area Thin Films and Coatings",doi:"10.5772/64978",slug:"pulsed-laser-deposition-of-large-area-thin-films-and-coatings",totalDownloads:2007,totalCrossrefCites:5,totalDimensionsCites:6,hasAltmetrics:0,abstract:"Simple and inexpensive methods of obtaining large‐area uniform in thickness and composition thin films on rotating substrates and moving ribbons through pulsed laser deposition have been proposed. Thin films of different compositions were prepared using these methods. The thickness uniformity of obtained films was preserved within the limits of ±3% on up to 300 mm diameter substrates. Also, a method of creating a laser spot with a certain configuration on the target is proposed allowing almost full utilization of the target material.",signatures:"Armen S. Kuzanyan and Astghik A. Kuzanyan",downloadPdfUrl:"/chapter/pdf-download/52063",previewPdfUrl:"/chapter/pdf-preview/52063",authors:[{id:"187158",title:"Dr.",name:"Armen",surname:"Kuzanyan",slug:"armen-kuzanyan",fullName:"Armen Kuzanyan"},{id:"187159",title:"MSc.",name:"Astghik",surname:"Kuzanyan",slug:"astghik-kuzanyan",fullName:"Astghik Kuzanyan"}],corrections:null},{id:"52337",title:"Laser Ablation in Different Environments and Generation of Nanoparticles",doi:"10.5772/65241",slug:"laser-ablation-in-different-environments-and-generation-of-nanoparticles",totalDownloads:2152,totalCrossrefCites:11,totalDimensionsCites:19,hasAltmetrics:0,abstract:"In the last two decades, pulsed-laser ablation has received attention from researchers in micro- and nanotechnology. During the development of laser ablation in materials processing, several media, such as vacuum, air, gases and liquids, have been used to improve the quality and quantity of laser machining and production of nanoparticles. The laser-ablation environment is important in order to control the average size and chemical compositions of nanoparticles. Conducting the laser-ablation process in liquid environments has become of increasing relevance for the production of precise and pure micromachining and nanomaterials. In addition, deionised water has been found to be the optimal environment to produce nanoparticles for bioapplications.",signatures:"Abubaker Hassan Hamad, Khawla Salah Khashan and Aseel\nAbdulkreem Hadi",downloadPdfUrl:"/chapter/pdf-download/52337",previewPdfUrl:"/chapter/pdf-preview/52337",authors:[{id:"183494",title:"Dr.",name:"Abubaker",surname:"Hamad",slug:"abubaker-hamad",fullName:"Abubaker Hamad"}],corrections:null},{id:"53207",title:"Laser Ablation in Liquid: An Unconventional, Fast, Clean and Straightforward Technique for Material Preparation",doi:"10.5772/66245",slug:"laser-ablation-in-liquid-an-unconventional-fast-clean-and-straightforward-technique-for-material-pre",totalDownloads:1751,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:1,abstract:"The laser ablation in liquid environment (LALE) technique is a straightforward experimental technique with few controllable parameters, capable to provide extreme pressure and temperature conditions during target ablation without the need for dedicated systems to provide those variables. Additionally, we can state that LALE can be considered a low-cost experimental technique, with few steps and a clean synthesis method, by which a wide variety of materials can be synthesized with high yield. The majority of studies published in the literature using this technique seem to be limited only to the synthesis of metal nanoparticles, metal oxides, nitrates and semiconducting. However, in order to extend the synthesis potential of this technique, in this chapter we are going to demonstrate that with the appropriate choice of reactants, solvent, target materials and the solid-liquid interface interactions we will be able to prepare more complex molecules such as carbonate compound Pb3(CO3)2(OH)2, metal-organic frameworks (MOFs), luminescent metal-organic frameworks (LMOFs), highly dispersed CdS quantum dots and magnetic materials. Also for each material synthesized, we are going to propose a mechanism to explain its preparation using the LALE technique.",signatures:"Walter Mendes de Azevedo, Sérgio de Lemos Campello, Diego\nLeite da Cunha, Leonardo Tadeu Boaes de Mendonça and Ohanna\nMaria Menezes Madeiro da Costa",downloadPdfUrl:"/chapter/pdf-download/53207",previewPdfUrl:"/chapter/pdf-preview/53207",authors:[{id:"20979",title:"Dr.",name:"Walter",surname:"mendes de Azevedo",slug:"walter-mendes-de-azevedo",fullName:"Walter mendes de Azevedo"},{id:"188106",title:"Dr.",name:"Sérgio",surname:"Campello",slug:"sergio-campello",fullName:"Sérgio Campello"},{id:"188597",title:"MSc.",name:"Diego",surname:"Leite Da Cunha",slug:"diego-leite-da-cunha",fullName:"Diego Leite Da Cunha"},{id:"188598",title:"MSc.",name:"Leonardo",surname:"Tadeu Boaes De Mendonça",slug:"leonardo-tadeu-boaes-de-mendonca",fullName:"Leonardo Tadeu Boaes De Mendonça"},{id:"188599",title:"BSc.",name:"Ohanna",surname:"Maria Menezes Madeiro Da Costa",slug:"ohanna-maria-menezes-madeiro-da-costa",fullName:"Ohanna Maria Menezes Madeiro Da Costa"}],corrections:null},{id:"52700",title:"Pulsed Laser Ablation in High-Pressure Gases, Pressurized Liquids and Supercritical Fluids: Generation, Fundamental Characteristics and Applications",doi:"10.5772/65455",slug:"pulsed-laser-ablation-in-high-pressure-gases-pressurized-liquids-and-supercritical-fluids-generation",totalDownloads:1870,totalCrossrefCites:3,totalDimensionsCites:7,hasAltmetrics:1,abstract:"Pulsed laser ablation (PLA) in high-density media—high-pressure gases, liquids, and supercritical fluids—has shown to be promising for nanomaterials fabrication and as an analysis technique in extreme environments, for example, the exploration of deep ocean levels and planetary atmospheres and surfaces. Despite the high potential of this technique, it is still not very widely used. The objective of the present chapter is to present the reader with an overview of recent advances in the use of pulsed laser ablation in pressurized media, the fundamental characteristics, especially the dynamics of cavitation bubbles and the optical emission, and the applications to the fabrication of metallic and semiconductor nanoparticles, and diamond molecules, the so-called diamondoids. Finally, a short overview of the use of pulsed laser ablation in pressurized media as a promising tool for the analysis of extreme environments is presented.",signatures:"Sven Stauss, Keiichiro Urabe, Hitoshi Muneoka and Kazuo\nTerashima",downloadPdfUrl:"/chapter/pdf-download/52700",previewPdfUrl:"/chapter/pdf-preview/52700",authors:[{id:"187878",title:"Ph.D.",name:"Sven",surname:"Stauss",slug:"sven-stauss",fullName:"Sven Stauss"},{id:"188197",title:"Dr.",name:"Hitoshi",surname:"Muneoka",slug:"hitoshi-muneoka",fullName:"Hitoshi Muneoka"},{id:"188198",title:"Dr.",name:"Keiichiro",surname:"Urabe",slug:"keiichiro-urabe",fullName:"Keiichiro Urabe"},{id:"188199",title:"Prof.",name:"Kazuo",surname:"Terashima",slug:"kazuo-terashima",fullName:"Kazuo Terashima"}],corrections:null},{id:"52559",title:"Metal Oxide Nanoparticle Preparation by Pulsed Laser Ablation of Metallic Targets in Liquid",doi:"10.5772/65430",slug:"metal-oxide-nanoparticle-preparation-by-pulsed-laser-ablation-of-metallic-targets-in-liquid",totalDownloads:1940,totalCrossrefCites:7,totalDimensionsCites:14,hasAltmetrics:0,abstract:"The basic mechanisms of pulsed laser ablation in liquids (PLAL) as a method for the synthesis of nanoparticles (NPs) were considered. Physical and chemical processes occurring during the PLAL that determine the formation, composition and structure of the nanoparticles obtained are described. The influence of the composition and properties of the target material, the solvent and the characteristics of the laser irradiation on the efficiency of the synthesis of nanoparticles is discussed. Separately, an influence of the absorption and scattering (including nonlinear) of laser radiation in the dispersion of nanoparticles on the primary synthetic processes and secondary transformations inside the colloidal solution is examined. The specificity of the characterization of the colloidal solutions of oxide particles produced by PLAL is highlighted. The most promising practical applications of nanomaterials obtained are identified and the examples of their successful use in catalytic research and biomedicine are provided.",signatures:"Valery A. Svetlichnyi, Anastasiia V. Shabalina, Ivan N. Lapin and\nDaria A. Goncharova",downloadPdfUrl:"/chapter/pdf-download/52559",previewPdfUrl:"/chapter/pdf-preview/52559",authors:[{id:"186499",title:"Dr.",name:"Anastasiia",surname:"Shabalina",slug:"anastasiia-shabalina",fullName:"Anastasiia Shabalina"},{id:"186502",title:"Dr.",name:"Valery",surname:"Svetlichnyi",slug:"valery-svetlichnyi",fullName:"Valery Svetlichnyi"},{id:"186503",title:"MSc.",name:"Ivan",surname:"Lapin",slug:"ivan-lapin",fullName:"Ivan Lapin"},{id:"186504",title:"BSc.",name:"Daria",surname:"Goncharova",slug:"daria-goncharova",fullName:"Daria Goncharova"}],corrections:null},{id:"52241",title:"Application of Liquid Laser Ablation: Organic Nanoparticle Formation and Hydrogen Gas Generation",doi:"10.5772/64939",slug:"application-of-liquid-laser-ablation-organic-nanoparticle-formation-and-hydrogen-gas-generation",totalDownloads:1969,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Laser ablation is induced by a heating process of materials through the absorption of laser light and results in an explosive expansion of materials. For materials located in liquid, in contrast to those in vacuum, laser ablation proceeds under rather mild conditions via a cycle of heating and cooling by mediated solvent; therefore, it is applicable for organic solids to fragment into nanoparticles. Alternatively, for effective light absorbers, the irradiated site becomes the reaction centre of a photochemical reaction even in liquids, resulting in hydrogen gas generation. In this chapter, two topics of laser ablation in the liquid phase are presented: nanoparticle formation of organic materials and hydrogen gas generation from solid carbon in water. Thereby, the extended abilities of liquid laser ablation to transform ordinary materials into functional ones are introduced.",signatures:"Ikuko Akimoto and Nobuhiko Ozaki",downloadPdfUrl:"/chapter/pdf-download/52241",previewPdfUrl:"/chapter/pdf-preview/52241",authors:[{id:"187905",title:"Dr.",name:"Ikuko",surname:"Akimoto",slug:"ikuko-akimoto",fullName:"Ikuko Akimoto"}],corrections:null},{id:"52517",title:"High-Quality Carbon Nanomaterials Synthesized by Excimer Laser Ablation",doi:"10.5772/65309",slug:"high-quality-carbon-nanomaterials-synthesized-by-excimer-laser-ablation",totalDownloads:1811,totalCrossrefCites:1,totalDimensionsCites:5,hasAltmetrics:0,abstract:"Due to their special physical and chemical properties and potential applications from hydrogen storage to medical implantation, the carbon-based nanomaterials are in the frame of attention for many research groups all over the world. As synthesis techniques, we highlight arc discharge, chemical vapor deposition (CVD) and laser ablation. Even an expensive technique, laser ablation is suitable for single-wall carbon nanotubes (SWCNTs) synthesis, providing the highest yield of over 70%, while arc discharge yield is about 30% and CVD is about 42%. The most common investigation methods for carbon nanomaterials are micro-Raman spectroscopy, thermo-gravimetric analysis (TGA) and morphological and topographic studies done by atomic force microscopy (AFM), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and high-resolution transmission electron microscopy (HR-TEM). We also emphasize in this work that by involving a home-designed reactor, we successfully synthesized SWCNTs, carbon nano-onions (CNOs) as well as graphene in the same reactor. Tuning the experimental parameters, we switch the end type of nanomaterials. We have done comprehensive studies regarding the carbon nanomaterials synthesis.",signatures:"Calin-Constantin Moise and Marius Enachescu",downloadPdfUrl:"/chapter/pdf-download/52517",previewPdfUrl:"/chapter/pdf-preview/52517",authors:[{id:"102690",title:"Prof.",name:"Marius",surname:"Enachescu",slug:"marius-enachescu",fullName:"Marius Enachescu"},{id:"188154",title:"MSc.",name:"Calin",surname:"Moise",slug:"calin-moise",fullName:"Calin Moise"}],corrections:null},{id:"52487",title:"Femtosecond Laser-Induced Surface Modification and its Application",doi:"10.5772/65428",slug:"femtosecond-laser-induced-surface-modification-and-its-application",totalDownloads:2016,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"In this chapter, we present femtosecond laser micromachining to fiber optics, focusing on surface qualities. Some techniques applied in the field are introduced to date and a review of some of the current applications for this type of technology. Section 2 describes laser-induced periodic surface structures (LIPSSs), which are induced in low- and high-fluence regime. Section 3 describes the influences of laser-induced structures for the fabrication of fiber-optic sensors, with experimental techniques and results in our research group. These sections explore ultrashort laser pulses applications, roughly going from lower to higher energy (power, intensity) ones.",signatures:"Kenji Goya, Masahiko Shiraishi, Yusuke Fuchiwaki, Kazuhiro\nWatanabe and Toshihiko Ooie",downloadPdfUrl:"/chapter/pdf-download/52487",previewPdfUrl:"/chapter/pdf-preview/52487",authors:[{id:"7143",title:"Dr.",name:"Yusuke",surname:"Fuchiwaki",slug:"yusuke-fuchiwaki",fullName:"Yusuke Fuchiwaki"},{id:"187343",title:"Dr.",name:"Kenji",surname:"Goya",slug:"kenji-goya",fullName:"Kenji Goya"},{id:"187354",title:"Dr.",name:"Toshihiko",surname:"Ooie",slug:"toshihiko-ooie",fullName:"Toshihiko Ooie"},{id:"187355",title:"MSc.",name:"Masahiko",surname:"Shiraishi",slug:"masahiko-shiraishi",fullName:"Masahiko Shiraishi"},{id:"187356",title:"Prof.",name:"Kazuhiro",surname:"Watanabe",slug:"kazuhiro-watanabe",fullName:"Kazuhiro Watanabe"}],corrections:null},{id:"52832",title:"Laser Ablation of Polymethylmethacrylate (PMMA) by Phase- Controlled Femtosecond Two-Color Synthesized Waveforms",doi:"10.5772/65637",slug:"laser-ablation-of-polymethylmethacrylate-pmma-by-phase-controlled-femtosecond-two-color-synthesized-",totalDownloads:1324,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Single-shot laser ablation of polymethylmethacrylate (PMMA) was studied using dual-color waveform synthesis of the fundamental (ω) and its second harmonic (2ω) of a femtosecond Ti: Sapphire laser. Changing the relative phase of the fundamental (ω) and second-harmonic (2ω) outputs of the exciting laser resulted in clear modulation of the ablated area. The modulation as well as the dependence of the ablation threshold on the relative phase between the ω and 2ω beams correlated closely with the theoretical model of laser breakdown (ablation) of transparent materials through photoionization in the intermediate regime (Keldysh parameter γ ≈ 1.5). Our study illustrates the potential applications of using phase-controlled synthesized waveform for laser processing of materials.",signatures:"Ci-Ling Pan, Chih-Hsuan Lin, Chan-Shan Yang and Alexey Zaytsev",downloadPdfUrl:"/chapter/pdf-download/52832",previewPdfUrl:"/chapter/pdf-preview/52832",authors:[{id:"3341",title:"Prof.",name:"Ci-Ling",surname:"Pan",slug:"ci-ling-pan",fullName:"Ci-Ling Pan"}],corrections:null},{id:"53235",title:"Surface Modification of Polymer Materials Induced by Laser Irradiation",doi:"10.5772/66377",slug:"surface-modification-of-polymer-materials-induced-by-laser-irradiation",totalDownloads:1609,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"We report on the surface modification effects using allyl‐diglycol CR39 polymer induced by laser irradiation at 157 nm F2 laser (VUV) and 248 nm KrF laser. The motivation is to investigate the ablation effects on this polymer in optical waveguides application the ablation effects on this polymer in optical waveguides. Fabrication of waveguides has been observed using continuous wave (CW) at 244 nm argon ion laser. Ablation effects on the surface of this polymer have been characterized including ablation threshold at different wavelengths from the assorted depth of craters formed from UV pulsed laser. Application of this polymer in optical waveguide application is corroborated by the refractive index value on the CR39 channels that varied as fluences changed when using the continuous wave UV irradiation. A limit for upper fluence at the point where laser ablation originates on this polymer has also been determined.",signatures:"Rozalina Zakaria",downloadPdfUrl:"/chapter/pdf-download/53235",previewPdfUrl:"/chapter/pdf-preview/53235",authors:[{id:"187435",title:"Dr.",name:"Rozalina",surname:"Zakaria",slug:"rozalina-zakaria",fullName:"Rozalina Zakaria"}],corrections:null},{id:"52260",title:"Laser Ablation Applications in Ablation-Resistance Characterization of Materials",doi:"10.5772/65108",slug:"laser-ablation-applications-in-ablation-resistance-characterization-of-materials",totalDownloads:2121,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Owing to the rapid heating and large power intensity, the laser beams were successfully used to characterize the ablation-resistant performance of materials, which provided us more knowledge about the usability of materials in the ablation environment and developing protection against laser irradiation. In this chapter, we comparatively introduced some experimental methods for ablation-resistance characterization of materials. The fundamentals of laser-material interactions were discussed from the physical and chemical aspects to help understand the laser ablation mechanism. Finally, we presented some practical applications of laser ablation in ablation-resistance characterization of ultra-high-temperature ceramics (UHTCs) and ceramic matrix composites and discussed the laser ablation behavior and mechanism.",signatures:"Yonggang Tong, Xiubing Liang, Shuxin Bai and Qing H. Qin",downloadPdfUrl:"/chapter/pdf-download/52260",previewPdfUrl:"/chapter/pdf-preview/52260",authors:[{id:"186785",title:"Dr.",name:"Yonggang",surname:"Tong",slug:"yonggang-tong",fullName:"Yonggang Tong"},{id:"187185",title:"Prof.",name:"Xiubing",surname:"Liang",slug:"xiubing-liang",fullName:"Xiubing Liang"},{id:"187186",title:"Prof.",name:"Shuxin",surname:"Bai",slug:"shuxin-bai",fullName:"Shuxin Bai"},{id:"187187",title:"Prof.",name:"Qing H",surname:"Qin",slug:"qing-h-qin",fullName:"Qing H Qin"}],corrections:null},{id:"51807",title:"Standardization and Normalization of Data from Laser Ablation Inductively Coupled Plasma Mass Spectrometry",doi:"10.5772/64769",slug:"standardization-and-normalization-of-data-from-laser-ablation-inductively-coupled-plasma-mass-spectr",totalDownloads:1977,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Laser ablation inductively coupled plasma mass spectrometry is a useful technique for the precise determination of major, minor and trace element distributions or isotope ratios in solid samples and biological tissue sections. However, measured ion intensities of selected mass-to-charge ratios, may vary considerably from run to run and might also underlie non-linear drift within a run. Therefore, beside the calibration of the measurement, normalization of ion intensities to a reference such as an internal standard is necessary. Other strategies use an endogenous reference element of which a homogenous distribution in the sample is assumed, or derive a more complex reference parameter from a given dataset. Generally, normalization methods depend on the experimental setup and sample material and are usually based on one or few isotopes or the total ion current. This chapter reports different normalization methods that either used a separate reference value for each data point – constituting a pixel in the isotope image – or used a constant normalization factor per measurement run. In conclusion, normalization is essential to minimize deviations of element concentrations due to measurement-related fluctuations. Normalization and definition of an area of interest are powerful tools to obtain high-contrast isotope images with absolute element concentrations.",signatures:"Ricarda Uerlings, Andreas Matusch and Ralf Weiskirchen",downloadPdfUrl:"/chapter/pdf-download/51807",previewPdfUrl:"/chapter/pdf-preview/51807",authors:[{id:"186526",title:"Prof.",name:"Ralf",surname:"Weiskirchen",slug:"ralf-weiskirchen",fullName:"Ralf Weiskirchen"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"6426",title:"Titanium Dioxide",subtitle:"Material for a Sustainable Environment",isOpenForSubmission:!1,hash:"5626c0fe0b53330717e73094946cfd86",slug:"titanium-dioxide-material-for-a-sustainable-environment",bookSignature:"Dongfang Yang",coverURL:"https://cdn.intechopen.com/books/images_new/6426.jpg",editedByType:"Edited by",editors:[{id:"177814",title:"Dr.",name:"Dongfang",surname:"Yang",slug:"dongfang-yang",fullName:"Dongfang Yang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5168",title:"Alkali-ion Batteries",subtitle:null,isOpenForSubmission:!1,hash:"2ffb06f3e5dbad9167428c4c443e3a5e",slug:"alkali-ion-batteries",bookSignature:"Dongfang Yang",coverURL:"https://cdn.intechopen.com/books/images_new/5168.jpg",editedByType:"Edited by",editors:[{id:"177814",title:"Dr.",name:"Dongfang",surname:"Yang",slug:"dongfang-yang",fullName:"Dongfang Yang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10481",title:"Practical Applications of Laser Ablation",subtitle:null,isOpenForSubmission:!1,hash:"e9f235e98a88813c08a9dba80525b195",slug:"practical-applications-of-laser-ablation",bookSignature:"Dongfang Yang",coverURL:"https://cdn.intechopen.com/books/images_new/10481.jpg",editedByType:"Edited by",editors:[{id:"177814",title:"Dr.",name:"Dongfang",surname:"Yang",slug:"dongfang-yang",fullName:"Dongfang Yang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1505",title:"Scanning Electron Microscopy",subtitle:null,isOpenForSubmission:!1,hash:"3305b759b0efc22e8ed16e9048818817",slug:"scanning-electron-microscopy",bookSignature:"Viacheslav Kazmiruk",coverURL:"https://cdn.intechopen.com/books/images_new/1505.jpg",editedByType:"Edited by",editors:[{id:"100815",title:"Dr.",name:"Viacheslav",surname:"Kazmiruk",slug:"viacheslav-kazmiruk",fullName:"Viacheslav Kazmiruk"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2397",title:"Advanced Aspects of Spectroscopy",subtitle:null,isOpenForSubmission:!1,hash:"bcc83fcd6b4bbfdaa677b37d94bdbdb6",slug:"advanced-aspects-of-spectroscopy",bookSignature:"Muhammad Akhyar Farrukh",coverURL:"https://cdn.intechopen.com/books/images_new/2397.jpg",editedByType:"Edited by",editors:[{id:"63182",title:"Dr.",name:"Muhammad Akhyar",surname:"Farrukh",slug:"muhammad-akhyar-farrukh",fullName:"Muhammad Akhyar Farrukh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2018",title:"Recent Progress in Optical Fiber Research",subtitle:null,isOpenForSubmission:!1,hash:"c9f4716122beee57c42cff13c357a2cb",slug:"recent-progress-in-optical-fiber-research",bookSignature:"Moh. 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Toxicity, Human Health and Environment",slug:"nanomaterials-toxicity-human-health-and-environment",publishedDate:"February 19th 2020",bookSignature:"Simona Clichici, Adriana Filip and Gustavo M. do Nascimento",coverURL:"https://cdn.intechopen.com/books/images_new/8137.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"64160",title:"Prof.",name:"Simona",middleName:null,surname:"Clichici",slug:"simona-clichici",fullName:"Simona Clichici"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"251730",title:"Dr.",name:"Guilherme",middleName:"Fredeico Bernardo",surname:"Lenz E Silva",fullName:"Guilherme Lenz E Silva",slug:"guilherme-lenz-e-silva",email:"guilhermelenz@usp.br",position:null,institution:null},{id:"286148",title:"Dr.",name:"Camila",middleName:null,surname:"Viana",fullName:"Camila Viana",slug:"camila-viana",email:"camilaoviana@gmail.com",position:null,institution:{name:"Centro de Desenvolvimento da Tecnologia Nuclear",institutionURL:null,country:{name:"Brazil"}}},{id:"286149",title:"Dr.",name:"Fernanda",middleName:null,surname:"Vieira",fullName:"Fernanda Vieira",slug:"fernanda-vieira",email:"fevieira2001@gmail.com",position:null,institution:{name:"Centro de Desenvolvimento da Tecnologia Nuclear",institutionURL:null,country:{name:"Brazil"}}},{id:"286151",title:"M.Sc.",name:"Danieli",middleName:"Silva",surname:"Domingues",fullName:"Danieli Domingues",slug:"danieli-domingues",email:"danielisilva@ymail.com",position:null,institution:{name:"Centro de Desenvolvimento da Tecnologia Nuclear",institutionURL:null,country:{name:"Brazil"}}}]}},chapter:{id:"66689",slug:"risk-assessment-and-health-safety-and-environmental-management-of-carbon-nanomaterials",signatures:"Guilherme Lenz e Silva, Camila Viana, Danieli Domingues and Fernanda Vieira",dateSubmitted:null,dateReviewed:"February 26th 2019",datePrePublished:"April 11th 2019",datePublished:"February 19th 2020",book:{id:"8137",title:"Nanomaterials",subtitle:"Toxicity, Human Health and Environment",fullTitle:"Nanomaterials - 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Blood transfusion medicine has become a sophisticated and specialized field of medicine. Some aspects will be discussed in this book. The book has been divided into three sections. The first section includes chapters describing the immunological and coagulation-assisting functions of red blood cells and methods to measure their life span. The second section discusses the role of platelets in inflammatory processes. The third section reviews functional dose of RBC transfusions and transfusion practice in various clinical settings.",isbn:"978-953-51-3320-9",printIsbn:"978-953-51-3319-3",pdfIsbn:"978-953-51-4759-6",doi:"10.5772/66265",price:119,priceEur:129,priceUsd:155,slug:"transfusion-medicine-and-scientific-developments",numberOfPages:128,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"b5a95b51b34becb58f940bdc6cc2c26e",bookSignature:"A.W.M.M. Koopman-van Gemert",publishedDate:"July 5th 2017",coverURL:"https://cdn.intechopen.com/books/images_new/5965.jpg",keywords:null,numberOfDownloads:11230,numberOfWosCitations:5,numberOfCrossrefCitations:6,numberOfDimensionsCitations:9,numberOfTotalCitations:20,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 8th 2016",dateEndSecondStepPublish:"November 29th 2016",dateEndThirdStepPublish:"February 25th 2017",dateEndFourthStepPublish:"May 26th 2017",dateEndFifthStepPublish:"July 25th 2017",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"6 years",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:"Edited by",kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"105746",title:"Dr.",name:"A.W.M.M.",middleName:null,surname:"Koopman-van Gemert",slug:"a.w.m.m.-koopman-van-gemert",fullName:"A.W.M.M. Koopman-van Gemert",profilePictureURL:"https://mts.intechopen.com/storage/users/105746/images/5803_n.jpg",biography:"Dr. Anna Wilhelmina Margaretha Maria Koopman-van Gemert MD, PhD, became anaesthesiologist-intensivist from the Radboud University Nijmegen (the Netherlands) in 1987. She worked for a couple of years also as a blood bank director in Nijmegen and introduced in the Netherlands the Cell Saver and blood transfusion alternatives. She performed research in perioperative autotransfusion and obtained the degree of PhD in 1993 publishing Peri-operative autotransfusion by means of a blood cell separator.\nBlood transfusion had her special interest being the president of the Haemovigilance Chamber TRIP and performing several tasks in local and national blood bank and anticoagulant-blood transfusion guidelines committees. Currently, she is working as an associate professor and up till recently was the dean at the Albert Schweitzer Hospital Dordrecht. She performed (inter)national tasks as vice-president of the Concilium Anaesthesia and related committees. \nShe performed research in several fields, with over 100 publications in (inter)national journals and numerous papers on scientific conferences. \nShe received several awards and is a member of Honour of the Dutch Society of Anaesthesia.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Albert Schweitzer Hospital",institutionURL:null,country:{name:"Gabon"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1030",title:"Immunohaematology",slug:"immunohaematology"}],chapters:[{id:"55513",title:"A Double In Vivo Biotinylation Technique to Assess Erythrocyte Turnover in Blood Circulation",slug:"a-double-in-vivo-biotinylation-technique-to-assess-erythrocyte-turnover-in-blood-circulation",totalDownloads:1575,totalCrossrefCites:0,authors:[{id:"202626",title:"Prof.",name:"Rajiv",surname:"Saxena",slug:"rajiv-saxena",fullName:"Rajiv Saxena"}]},{id:"55207",title:"Immunocamouflaged RBC for Alloimmunized Patients",slug:"immunocamouflaged-rbc-for-alloimmunized-patients",totalDownloads:1545,totalCrossrefCites:1,authors:[{id:"202243",title:"Dr.",name:"Mark",surname:"Scott",slug:"mark-scott",fullName:"Mark Scott"},{id:"205640",title:"BSc.",name:"Wendy",surname:"Toyofuku",slug:"wendy-toyofuku",fullName:"Wendy Toyofuku"},{id:"205641",title:"BSc.",name:"Xining",surname:"Yang",slug:"xining-yang",fullName:"Xining Yang"},{id:"205642",title:"Dr.",name:"Meera",surname:"Raj",slug:"meera-raj",fullName:"Meera Raj"},{id:"205643",title:"Dr.",name:"Ning",surname:"Kang",slug:"ning-kang",fullName:"Ning Kang"}]},{id:"55954",title:"Red Blood Cells and Relation to Thrombosis",slug:"red-blood-cells-and-relation-to-thrombosis",totalDownloads:2067,totalCrossrefCites:4,authors:[{id:"202814",title:"Associate Prof.",name:"Anil",surname:"Tombak",slug:"anil-tombak",fullName:"Anil Tombak"}]},{id:"55635",title:"Platelet and Immunity in Transfusion Medicine",slug:"platelet-and-immunity-in-transfusion-medicine",totalDownloads:1464,totalCrossrefCites:1,authors:[{id:"200979",title:"Prof.",name:"Xingbin",surname:"Hu",slug:"xingbin-hu",fullName:"Xingbin Hu"},{id:"206182",title:"Ms.",name:"Jinmei",surname:"Xu",slug:"jinmei-xu",fullName:"Jinmei Xu"}]},{id:"55343",title:"Red Blood Cell Transfusion and Functional Dose",slug:"red-blood-cell-transfusion-and-functional-dose",totalDownloads:1289,totalCrossrefCites:0,authors:[{id:"202960",title:"Prof.",name:"Deqing",surname:"Wang",slug:"deqing-wang",fullName:"Deqing Wang"},{id:"202995",title:"Dr.",name:"Leiying",surname:"Zhang",slug:"leiying-zhang",fullName:"Leiying Zhang"}]},{id:"55676",title:"Transfusion in Transplantation",slug:"transfusion-in-transplantation",totalDownloads:1878,totalCrossrefCites:0,authors:[{id:"94230",title:"Prof.",name:"Guray",surname:"Saydam",slug:"guray-saydam",fullName:"Guray Saydam"},{id:"94231",title:"Prof.",name:"Fahri",surname:"Sahin",slug:"fahri-sahin",fullName:"Fahri Sahin"},{id:"202813",title:"M.D.",name:"Eren",surname:"Arslan Davulcu",slug:"eren-arslan-davulcu",fullName:"Eren Arslan Davulcu"}]},{id:"55256",title:"Red Blood Cell Transfusion Strategy for Upper Gastrointestinal Bleeding",slug:"red-blood-cell-transfusion-strategy-for-upper-gastrointestinal-bleeding",totalDownloads:1413,totalCrossrefCites:0,authors:[{id:"197501",title:"Dr.",name:"Xingshun",surname:"Qi",slug:"xingshun-qi",fullName:"Xingshun Qi"},{id:"205228",title:"Prof.",name:"Fernando",surname:"Romeiro",slug:"fernando-romeiro",fullName:"Fernando Romeiro"},{id:"207599",title:"Prof.",name:"Yiling",surname:"Li",slug:"yiling-li",fullName:"Yiling Li"}]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"177731",firstName:"Dajana",lastName:"Pemac",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/177731/images/4726_n.jpg",email:"dajana@intechopen.com",biography:"As a Commissioning Editor at IntechOpen, I work closely with our collaborators in the selection of book topics for the yearly publishing plan and in preparing new book catalogues for each season. 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Clinical organ transplantation has been recognized as one of the most gripping medical advances of the century as it provides a way of giving the gift of life to patients with terminal failure of vital organs, which requires the participation of other fellow human beings and of society by donating organs from deceased or living individuals [Ehtuish et al 2006 & Hariharan et al 2000]. The gap between the demand for organ transplantation and the supply of donor organs is growing [The economist 2008].The waiting list of the United Network for Organ Sharing has grown from 21,975 names in 2000 to 32,722 in 2008 Fig. (1).
The gap between the demand for organ transplantation and the supply of donor organs (UNOS) publications
The scarcity of organs has dire consequences. And an average of 19 people dies each day waiting for a transplant that never comes [United Network for Organ Sharing (UNOS) 1999]. The World Health Organization WHO global observatory showed that in 2009 about 100,900 people receive a lifesaving organ transplant, representing only less than 10% of the global needs Fig. (2). the entire issue has raised serious ethical concerns and the debate over
Number of Transplants done worldwide WHO publication
them rages unabated. As further advances are made in such areas as cloning [Savules et al 1999], the ethical debate should grow more intense. The increasing incidence of vital organ failure and the inadequate supply of organs, especially from cadavers, have created a wide gap between organ supply and organ demand, which has resulted in very long waiting times to receive an organ as well as an increasing number of deaths while waiting. These events have raised many ethical, moral and societ al issues regarding supply, the methods of organ allocation, and the use of living donors including minors. It has also led to the practice of organ sale by entrepreneurs for financial gains in some parts of the world through exploitation of the poor, for the benefit of the wealthy the ethical questions are complicated by an outgoing debate over the definitions of certain key terms such as life, death, human, and body. One example is the definition of brain death [Delmonico et al 1973]. People have been confused over the issue because of the highly public cases of people recovering from comas even after many years. The distinction between the idea of brain death and coma becomes a matter that must be clearly defined. A family that is asked to donate body organs from dead relative on the basis of brain death must be confident that there is no hope of recovering. Other ethical issues of organ donation are considered bioethical an important one is the idea of cloning. The technology that would allow the cloning of genetically matched clones for the purpose of body harvesting another issue is known as xenotransplantation which involves the harvesting of certain compatible animal organs for use in humans. A whole new plethora of ethical issues surround this idea due to fear from animals and the diseases might transmitted form them, or to protect them, even animal rights groups have joined in these debates. There is no question that body donation and organ donation will remain a hot topic for many years to come. Organ transplantation in general, and kidney transplants in particular, are fraught with ethical issues and dilemmas worldwide, about which there is ongoing debate, especially because of the shortage of organs The ethical questions associated with transplantation are many [Abouna 2008]. Is the human body a commodity? How should decisions be made about who should receive scarce organs? Who should pay for transplants? Should someone who has received one organ transplant be given a second transplant? Or should people who have not had a transplant be given priority over those who have already had one? Should one person receive several organs or should several people each receive one? Should one person have a second transplant when the first one fail or should a different person be given a first chance at new organ? Should people who have young children be given an organ transplant over a single person? Should young people be given an organ transplant over an elderly person? Should age and whether or not a person has children even matter? Should organs be given to people who have abused their bodies (smoking and drinking etc, ) or only to people whose organs are damaged by disease? Should hands or other appendages, which are not essential to life, be transplanted? Who can “donate” the organs of people who cannot give informed consent to the process? Should money now spent on transplantation be put to other uses? Is it possible to prevent the coercion of some donors? Should suicidal individuals be given an organ transplant? What if they attempted suicide in the past but are not currently contemplating suicide? Should people who can’t afford expensive anti-rejection drugs be passed over for a transplant? Should people who don’t have Insurance and can’t pay for a transplant be allowed to go on the National waiting list? Should condemned prisoners receive organ transplants? What if they are serving a life sentence without parole? Should country lawmakers be involved in transplantation? When should courts be involved in these questions?
The questions go on and on; the answers are never simple. Knowing that there are more people who need organs than there are organs available, how would you answer these questions? Are your answers based on a belief of equal access or maximum benefit distribution?
An organ transplant is a surgical operation involves removing of an organ from one person (donor) and transferring it to another (recipient), keeping the native organs like Kidneys or removing them like Livers and Hearts. The need to obtain informed consent from both persons (and their surrogate decision-makers) is compulsory. This is in keeping with the ethical principle of respect for persons and is expressed in many ethical guidelines today.
1950 – 1954 The first successful kidney transplant. A kidney is taken from one identical brother and transplanted in another, where it worked for 8 years.
1960 - 1962 The first successful cadaveric transplant used deceased donor kidney. The kidney worked for almost 2 years.
1966 First successful liver transplant. The liver worked for over one year.
1967 First successful heart transplant. The heart worked for 2 1/2 weeks.
1980 – 1981 First successful heart-lung transplant. The organs worked for 5 years.
1982 First artificial heart transplant.
1983 Cyclosporine, an immunosuppressant drug, was approved by the FDA.
1986 A baboon heart was transplanted into Baby Faye and worked for 20days.
1989 The first successful living-related liver transplant.
1990 – 1996 The first “split liver” transplant was performed where one cadaveric liver was split into several pieces to transplant into more than one person.
2000 First culture of human embryonic stem cells.
The sources of organs for transplantation, i.e., living donor (related and nonrelated), cadaveric donor, and brain-dead patients. In countries where transplantation is well established, organs are sourced from living and cadaveric donors using different strategies, i.e., an opt-in (explicit consent), opt-out (presumed consent), and donation after brain death, donation after controlled cardiac death, and extended criteria for deceased donors.
Four categories of donation by living persons can be distinguished: Living Related Organ Donation “blood or emotional”: directed donation to a loved one; Altruistic Organ Donation: non-directed donation, in which the donor gives an organ to the general pool to be transplanted into the recipient at the top of the waiting list; Living Non-Related Organ Donation: directed donation to a stranger, whereby donors choose to give to a specific person with whom they have no prior emotional connection; and Cross donation where a living donor wants to donate to his blood or emotional relative an organ but blood groups does not match, there is a complete mismatch or cross matching is positive. Two families or more can cross donate if matches exist. Each type of donation prompts distinct ethical concerns. Living Related Organ Donation is presumed to be the most ethical form of organ donation [Spittal A 1997]. One can argue that the psychological and non-specific benefits to the donor are real, particularly when a close relative is returned to normal health. There can, however, be no doubt that the physical consequences of living donation are entirely detrimental to the donor. Motives behind the 1st degree living renal donation are understandable and one may assume that the living donation between relatives carries the same altruistic motives. In related organ donation, the donor saves the life and attains the wellbeing of its immediate relative by accepting a physical injury and debilitation to itself. While many related donors fall neatly into this altruistic categorization, unfortunately, there are many examples where the related donors have attained physical, emotional or financial toll from the recipient. With directed donation to loved ones or friends, worries arise about the intense pressure that can be put on people to donate, leading those who are reluctant to do so to feel coerced. In these cases, transplantation programs are typically willing to identify a plausible medical excuse, so that the person can bow out gracefully. Equally important, however, are situations in which people feel compelled to donate regardless of the consequences to themselves. In cases like these, simply obtaining the informed consent of the relative is insufficient; physicians are obligated to prevent people from making potentially life-threatening sacrifices unless the chance of success is proportionately large. Non directed donation raises different ethical concerns. The radical altruism that motivates a person to make a potentially life threatening sacrifice for a stranger calls for careful scrutiny [Garwood et al 2007].
Transplantation teams have an obligation to assess potential donors in all these dimensions and prohibit donations that arouse serious concern. Directed donation to stranger raises similar ethical questions with a few additional wrinkles. This type of donation usually occurs when a patient advertises for an organ publicly, on television or billboards or over the Internet. Such advertising is not illegal, but it has been strongly discouraged by the transplantation community. Two central objections are that the practice is unfair and that it threatens the view that an organ is a “gift of life,” not a commodity to be bought and sold. Some argue that just as we have a right to donate to the charities of our choice, so should we be able to choose to whom to give our organs. In practice, however, this means that those who have the most compelling stories and the means to advertise their plight tend to be the ones who get the organs — rather than those most in need. This strikes some ethicists as unfair. Unlike monetary gifts, they argue, organ transplantation requires the involvement of social structures and institutions, such as transplantation teams and hospitals. Hence, the argument goes, these donations are legitimately subject to societ al requirements of fairness, and transplantation centers should refuse to permit the allocation of organs on the basis of anything but morally relevant criteria [Hull et al 1997].
The most ethically problematic cases are those in which the recipient is chosen on the basis of race, religion, or ethnic group [Epstein 2007]. A person with organ damage or organ failure may look for a living donor to donate an organ, allowing the patient to bypass the national waiting pool to receive a cadaveric organ.
Currently there is some debate whether altruistic donation should be anonymous or the donor should choose the recipient that he wishes to donate the organ to [Epstein et al 2009]. Donation could be criticized ethically that it unfairly favors some potential recipients by allowing them to jump to the top of
the waiting list; however, many transplant surgeons and ethicists believe that this is a very special kind of advantage when a good Samaritan donates one of his organs to a friend or colleague who is on the waiting list. For this not only helps the recipient, but actually also helps those who are on the waiting list who will move up the ladder and will have a better chance of having a cadaveric organ.
The operation can be pre-arranged so, the hot and cold ischemia will be minimized which will have a good impact on the transplantation outcome.
There are often better matches between donors and recipients with living donation, because many donors are genetically related to the recipient.
Psychological benefits for both the donors and recipients.
Not everyone encourages the practice of living donation for all people.
Health consequences: Pain, discomfort, infection, bleeding and potential future health complications.
Psychological consequences: Family pressure, guilt or resentment.
Pressure: Family members may feel pressured to donate when they have a sick family member or loved one.
No donor advocate: While the patients have advocates, like the transplant surgeon or medical team (who are there to advise the patient and work in favor of his or her best interests) donors do not have such an advocate and can be faced with an overwhelming and complicated process with no one to turn to for guidance or advice.
A few medical and ethical professionals argue that living donation is inappropriate under any circumstances and should not only be discouraged but abandoned all together because of the risk and dangers associated with donating organs.
WHO publications
Other critics seek to discourage living donation because they think extending life through costly and physically taxing medical procedures is not the purpose of health systems. Although there are some who object to the practice of living donation, this potential source of organs is currently a major focus as a way to reduce the shortage of organs. Increasing the number of living donors could occur through a variety of strategies from education and civic duty promotion to the sale and purchase of organs Fig. (4).
International Registry of Organ Donation
Living related donation, emotional related or altruistic are very justifiable on humanistic grounds and they are ethically and medically acceptable, providing that donor evaluation both medical and psychological is carried out in accordance with accepted protocols and that a fully informed consent is given by the donor. Also, the rate of donor complications after kidney donation is extremely small. The reported mortality rate after kidney donation is 1 in 10,000 [Delmonico et al 2008].
On the side of the donor, there are many psychological and spiritual benefits, and most donors express an increased sense of pride and satisfaction and the joy of giving a gift of life to a relative, a friend or to another fellow human being. Another justification is that the success rate of living donor kidney transplantation is considerably higher than that of cadavers [Hunsicker 1999]. The expected patient survival rate and graft function at 5 years in 2007 is 99 and 96%, respectively, with living donors and 96 and 91% with cadaver donors, which is much better than 1998 statistics and that is most probably due to the recent introduction of more effective immunosuppression medications Fig. (5 & 6).
In living donor transplantation it must be shown that the benefits to both donor and recipient outweigh the risks associated with donation and transplantation.
Patient & Graft survival (UNOS Published Reports)
Patient & Graft survival (WHO Published Reports)
Many decisions to be living donors will be made within a family context - whether blood relations or less commonly, spouses, or in-laws - and involve the needs of specific members of that family. Very often, in living donation, there will be a host of pressures and family complexities to take into account. These may affect the extent to which a decision to donate or not to donate is genuinely free. Understanding some of these complexities and family dynamics can assist greatly in reaching a decision that is genuinely voluntary. It is important to distinguish between different kinds of pressure that a person faced with the decision about living donation may feel Avoidable pressures or Unavoidable pressures [Spital A 1996]. The decision to be a living donor should be based on adequate information and understanding, an informed decision is one based on information relevant to the making of that decision. Of course, in assisting a potential donor to make his or her decision about donation, doctors have an ethical and legal duty to warn about material risks in a treatment [Danovitch 2007]. Material risks are those that most people would want to know and also those that would be significant for a particular individual. It follows that a donor, before deciding about donation, should ask the appropriate medical practitioner to disclose the risks of the intended procedure and of its short and long term effects.
This includes information and understanding about possible emotional and psychological consequences of making a decision one way or the other, for the potential recipient, the potential donor, the relationship between these two people, and for other family members. These questions can only be answered within the context of understanding a particular family and/or the particular individuals involved whatever the outcome, certain issues may take some time to resolve.
Tissue typing and other medical checks may identify only one suitable donor in a family, which can lead to great pressure being put on that person. There may be more than one suitable donor and in these cases there can be complex pressures again as a choice is made between these people. As examples of such pressures, focus may fall on one of the suitable people for various reasons, perhaps without sufficient thought. In other cases there may be one person who is extremely eager to donate and so perhaps too willing to overlook possible difficulties that may be encountered. Often, such very willing people may need even more careful counseling to ensure that their decision is sound.
Living donation offers the recipient immediate hope. Because the results are generally favorable, the mood of the recipient, family and donor are usually optimistic. Against this background, other issues need to be considered [Jarvis 1995]:
Chances of survival of recipient:
It is argued by some that it is preferable to donate to recipients who are not critically ill, because choosing recipients with higher chances of survival better balances the risk to the donor. In addition, when such recipients are chosen, there is less need to make a decision under pressure and the additional time allows thorough medical and psychological evaluation of the proposed donor.
Changes in donor/recipient relationship:
The exceptional nature of what has happened and what both the donor and recipient have shared may be mutually enhancing. After a donation, there is often increased contact between a donor and the recipient where they are known to each other. Our experience suggests that reaction to being identified as a donor is very positive [Mathieson 1999].
Feeling if the transplant fails:
If the donation does fail, the donor may have feelings of guilt or inadequacy or feelings of anger, sadness, or that the donated organs or tissues have been wasted, and that the discomforts he or she has suffered have been made for nothing.
Feelings of ‘ownership’ towards the recipient:
Living donors can feel closer to recipients and have expressed attitudes of ownership about the state of health and activities of the recipient. They may feel that they have a right to ensure that the recipient is taking good care of his or her health and therefore of the donated organ or tissue. Conversely, the recipient may identify with the donor and feel that part of the donor is living in them. Ultimately such feelings may not be in the best interest of either party.
Recipient feelings of guilt if the donation has harmful effects on the donor:
A recipient may feel guilty and responsible if the donor suffers from his or her donation.
Consequences of not donating:
A decision not to donate can have a major impact on relationships within a family. The recipient’s illness is often life-threatening and death may occur before or after transplantation. It is therefore important that the family, including prospective donors, do not have unrealistic expectations for the recipient nor underestimate the difficulties for the donor. A decision not to donate might be entirely appropriate for the individual, but still have profound effects on family relationships if the proposed recipient dies. It is very important to consider whether such factors amount to undue pressure on a potential donor
Organs for transplantation which obtained from living donors unfortunately, have so far been unable to keep up with demand. As a result, there are a large and steadily increasing number of potential recipients awaiting transplantation, some of whom will die before an organ can be found. This scarcity of organs for transplantation can only be met from the cadavers Fig. (7). Cadaveric source is beneficial in another way that it provides multi-organ donation. To utilize cadaveric organs effectively, it needs legal formalities and most of the countries have passed cadaveric law [Alashek, Ehtuish et al 2009].
International Registry of Organ Donation WHO Publications
a. Education
Educational efforts focus on increasing the number of people who consent to be an organ donor before they die. And educating families when they are considering giving consent for their deceased loved one’s organs. Social responsibility and the idea of “the gift of life” should be popularized
b. Mandated choice
Under this strategy, every individual would have to indicate his wishes regarding organ transplantation, perhaps on driver’s licenses. When a person dies, the hospital must comply with their written wishes regardless of what their family may want. The positive aspect of this strategy is that it strongly enforces the concept of individual autonomy of the organ donor. A mandated choice policy would require an enormous level of trust in the medical system. People must be able to trust their health care providers to care for them no matter what their organ donation wishes
c. Presumed consent
This method of procuring organs is in fact the policy of many European nations. In countries with presumed consent, their citizens’ organs are taken after they die, unless a person specifically requests to not donate while still living. Advocates of a presumed consent approach might say that it is every person’s civic duty to donate their organs once they no longer need them (i.e. after death) to those who do. People against presumed consent would argue that to implement this policy, the general public would have to be educated and well-informed about organ donation, which would be difficult to adequately achieve. Doubters of the presumed consent approach might also argue that requiring people to opt out of donating their organs requires them to take action and this might unfairly burden some people. The countries having presumed consent principles like Spain and Canada shows higher donation rate 40-50 per million population [Miranda et al 1998 & Rithalia et al 2009].
d. Incentives
Incentives take many forms [Beier et al 2008]. Some of the most frequently debated incentive strategies are:
Give assistance to families of a donor with funeral costs
Donate to a charity in the deceased person’s name if organs are donated
Offer recognition and gratitude incentives like a plaque or memorial
Provide financial or payment incentives
One of the most highly debated incentives would give donating families assistance with burial or funeral costs for their loved one this could be an attractive incentive for many families.
Proponents say that since the person will be dead and unable to receive the recognition, that this would not be a coercive action. Some ethicists believe that many of the incentives above, while not attached directly to cash money, are still coercive and unfair. They believe that some people will be swayed to donate, in spite of their better judgment, if an incentive is attractive enough. They further argue that a gesture may seem small and a mere token to one person, but others might interpret it quite differently. A final anti-incentives argument offered by some ethicists discourages the practice of incentivizing organ donation [Jasper et al 1999]. They believe that society should instead re-culture its thinking to embrace a communitarian spirit of giving and altruism where people actively want to donate their organs
In order to maximize the donation from deceased donors it is important to consider the following:
Legal and organizational framework
Coordinating authority over health system
Citizen\'s understanding: donation in school curriculum
Ongoing reality and momentum in media
Adaptation of relevant models (Spain) in emerging countries
It is another issue that needs considerate discussion. Living donors provide the best outcome for children undergoing renal transplantation. Most of these donors are parents. When parents are unable to donate, siblings are often considered. But what if the siblings are also children? Should they be permitted to donate? They are below 18 years of age and not able to consent and they might be pushed or convinced to donate. And what about those who are mentally subnormal and their families wants to use them as donors?
Sometimes there are reports that children have been kidnapped, only to re- appear later lacking one kidney, or that they simply disappear and are subsequently killed to have all their transplantable organs removed for profit. However, the issue is covered in a broader sense by more general provisions. There are endless rumors surrounding this area. Members of various organizations who travel in the suspected countries say that the trafficking in children who are sold for transplantation is well known, but it is too difficult and very dangerous to catch the people involved [Spital A 1997],
Several authors and ethicists have recently commented on the current practice in some countries of the use of organs from executed prisoners. While all societies strongly condemn the arbitrary use of taking organs from executed prisoners, which is a common practice in some countries, where organs are taken and given to various institutions for transplantation or even sold to other countries. It is suggested that it will be ethically permissible to allow a prisoner on death row to donate an organ to a relative or a friend. [Miller 1999].
One argument in favor of taking organs from prisoners, who are put to death, is that it is the execution that is ethically unsound and not the organ removal. Indeed, in light of the severe organ shortage, some ethicists could make the argument that to not use the organs for transplantation is wasteful. Some ethicist, put forth the argument that obtaining organs from condemned prisoners is allowable if the prisoner or their next of kin consents to donation, as long as organ donation is not the means by which the prisoner is killed because that violates the principle that a cadaveric donor be dead prior to donation. Some could argue that organ retrieval from executed prisoners is morally justifiable only if a “presumed consent” donation practice was in place. Many, if not most, bioethicists consider taking organs from condemned prisoners a morally objectionable practice. And immoral [Cameron et al 1999].
Some potential non-traditional sources of organs are:
Animals are a potential source of donated organs. Experiments with baboon hearts and pig liver transplants have received extensive media attention in the past. One cautionary argument in opposition to the use of animal organs concerns the possibility of transferring animal bacteria and viruses to humans. Some argue that xenotransplantation is the only potential way of addressing this shortage. As immunological barriers to xenotransplantation are better understood, those hurdles are being addressed through genetic engineering of donor animals and the development of new drugs therapies [Starzl et al 1964 & Grant et al 2001]. The focus of ethical attention has changed from the moral correctness of using animals for research/therapy to an increasingly appreciated danger of the establishment and spread of xenozoonses in recipients, their contacts and the general public. There are a number of reasons for not using subhuman primates for xenotransplantation, including their closeness to humans, the likelihood of passing on infections, their availability (gorillas, chimpanzees), their slow breeding and the expense of breeding them under specified pathogen free conditions. The pig, although domesticated and familiar, is too distant to evoke the same feeling as we have for primates, has the correct size organs, is probably less likely to pass infections, breeds rapidly and is not endangered; moreover, millions of them are eaten every year. Although drawing ethical conclusions is difficult at the stage of knowledge and debate, it seems acceptable to manipulate pigs genetically and to proceed to using their organs for xenotransplantation trials when infection control measures and the scientific base justify it [Bukler et al 1999 & Sim et al 1999]. The use of pigs in Muslim countries would be more controversial and disruptive although it is acceptable by Islamic religion in case of a real need and when there is no alternative [Rahman 1998]. In this case the question of informed consent is likely to be ambiguous and awkward. It might end up more of a binding legal contract than consent, as we understand it now. Xenotransplantation is also unlikely to cost less than or significantly alleviate the shortage of cadaveric organs in the short term. The international dimension of the risk of infection is becoming obvious, but there has so far been no effort to convene an international forum to agree on universally acceptable guidelines However, before xenotransplantation can be fully implemented, both the scientific/medical communities and the general public must seriously consider and attempt to resolve many complex ethical, social and economic issues that it presents [Platt 1999].
Artificial organs are yet another potential option.
The ethical issues involved in artificial organs often revert to questions about the cost and effectiveness of artificial organs. People who receive artificial organ transplants might require further transplanting if there is a problem with the device.
The ethics of using tissues and organs from fetuses have been a matter of enormous discussion. Aborted fetuses are a proposed source of organs. Debates address whether it is morally appropriate to use organs from a fetus aborted late in a pregnancy for transplantation that could save the life of another infant. Many people believe that this practice would encourage late-term abortions, which some individuals and groups find morally objectionable. Another objection comes from people who fear that encouraging the use of aborted fet al organs would encourage “organ farming,” or the practice of conceiving a child with the intention of aborting it for its organs[Golmakani et al 2005]., but the use of spontaneously aborted fetus or anencephalic newborn could be encouraged. Although there is ethical debate concerning the possible use of organs of anencephalic babies for transplant. Some have argued that because of the absence of neocortex these are ‘nonpersons ‘and are ‘brain-dead’ and thus, such infants should be available for organ donation if this is the wish of the parents. However, as brain stem function is present in these infants, the ‘whole of the brain’ or ‘brain stem’ requirement for certification of brain death precludes removal of organs until cardiorespiratory death occurs.
Stem cells are cells that can specialize into many different cells found in the human body. Researchers have great hopes that stem cells can one day be used to grow entire organs, or at least groups of specialized cells [Bartholomew et al 2001 & Eradini 2002]. Some of the very recent developments in transplantation over the past decade have been the use of stem cells from bone marrow, cord blood, and from fet al and adult tissue, including somatic cells and neural cells. These cells have the great potential for differentiation and proliferation into other types of body cells including neuronal, hepatic, hemopoietic and muscular and thus help many patients with organ failure after their transplantation into the patients. These stem cells have also been shown to induce immunological tolerance and chimerism when they are transplanted into recipients of vital organ grafts and their rejection of a transplanted organ such as bone marrow, kidney, heart, liver, is prevented [Fandrich 2002]. A new hope is emerging now with the possibility of preserving the architecture of an organ i.e. preserving capsule, vascular structures and draining system and removing the destroyed or fibrosed cells and replace them with new cell mass produced by stem cells like removing all non-functioning Hepatocytes and replacing them with a new Hepatocyte cell mass, The ethical objections concerning stem cells have focused primarily on their source. While stem cells can be found in the adult human body, the seemingly most potent stem cells come from the first few cells of a human embryo. When the stem cells are removed, the embryo is destroyed. Some people find this practice morally objectionable and would like to put a stop to research and medical procedures that destroy human embryos in the process.
With the development of mechanical ventilators, new drugs, and other forms of treatment, it became possible to artificially maintain circulatory and respiratory functions, even after the brain had stopped functioning. In the past four decades many countries amended their death statutes to include a definition of death by the complete and irreversible cessation of all brain functions. Since that time almost all cadaveric organs have been recovered from patients who have been declared "brain dead." Veatch has never been comfortable with the term "brain death," preferring instead "brain-oriented definition of death." Since the 1970s he has argued that the entire brain does not have to be dead for the individual as a whole to be dead. Instead, he advocates a "‘higher-brain-oriented definition’ of death—in other words, one is dead when there is irreversible loss of all ‘higher’ brain functions" he further proposes creating a new definition of death law that incorporates the notion that one need only have an irreversible loss of consciousness as opposed to an irreversible loss of all brain functions [Veatch 2008]. Veatch’s proposal is clearly controversial. It suggests a violation of an ethical boundary most clinicians are currently unwilling to cross. Perhaps he is correct that such a change is inevitable and that the "definition of death at the conceptual level is a religious/philosophical/social policy choice rather than a question of medical science".There was clear leadership from individuals such as pioneering transplant surgeon, Dr. David Hume; Dr. Hume wrote “there is only one definition of death, irreversible brain damage. Cessation of heart beat does not constitute death unless it has caused irreversible brain damage there must be no spontaneous respirations” [Delmonico 2010]. These observations were later corroborated by Dr. William Sweet published in the New England of Medicine when he wrote “it is clear that a person is not dead unless his brain is dead [Sweet 1978]. The time-honored criteria of stoppage of heart beat in circulation are long enough for the brain to die”. Dr. Sam Shemie has clarified the paradigm for donation and death by emphasizing on the “required absence of circulation” and by underscoring the vital functions of the brain as an essential criterion of life [Shemie 2007]. “Where the extracorporeal machines of transplantation can support or replace the function of organs such as the heart, lung, liver or kidney, the brain is the only organ that cannot be supported by medical technology”. On the other hand Byrne and others have rejected brain death as constituting death of the person contending the “cessation of the entire brain function, whether irreversible or not, is not necessarily linked to total destruction of the brain or the death of the person”. Byrne, apparently, bases his opinion regarding death as philosophically constituting a separation of the soul from the body [Byrne 1979]. However, applying that personal philosophy to the diagnosis of death defies a legal and medical standard, and an ethical and practical sensibility. No one knows when the soul may separate from the body at the time of death. However, the legal and medical definition of death is clear in terms of neurological and circulatory function. It becomes unethical to impose futile clinical treatments to a comatose individual, if the function of the entire brain is irreversibly lost. What would opponents of the brain death determination do with a patient on a ventilator with such a clinical condition have them maintained indefinitely in such a state? To propose the brain death criteria as constituting death was the central issue that confronted the Harvard Committee in 1967 [Ad Hoc 1968]. No one knows when the soul separates from the body, but a precise time of death must be specified for obvious legal, medical and social reasons, so that futile treatment can be concluded (without further obligation or responsibility to provide resuscitative or supportive technologies) and proper disposition of the body with burial and estate and property transfer, etc can be exercised. For many years, Truog has also objected to the determination of death by neurologic evaluation and by circulatory function. He wrote in the New England Journal of Medicine that “arguments about why these patients should be considered dead have never been fully convincing [Truog 1997]. The definition of brain death requires a complete absence of all functions of the entire brain yet many of these patients retaining essential neurologic function, such as regulated secretion of hypothalamic hormones”. The rebuttal to this assertion has been given by Shemie [Shemie et al 2006] who claimed that “the release of antidiuretic hormone (ADH) from the hypothalamus is not considered to be essential neurologic function. Brain death is determined by an absence of consciousness, receptivity and responsiveness, spontaneous movement, spontaneous breathing and absence of brainstem reflexes”. Brain death does not require every brain cell to be nonviable but the criteria require an irreversible loss of neurologic function of a patient interminably supported by a mechanical respirator. For Truog and others however, these patients are not considered dead because they indeed can be supported indefinitely beyond the acute phase of their illness. It is well known however that despite the irreversible loss of brain function the remainder of the body can be maintained by mechanical support; for example, even by patients who become brain-dead during pregnancy yet successfully have their fetuses brought to term. The clinical condition still constitutes the death of the mother and a viable fetus buys continued mechanical support until birth. Again in the New England Journal of Medicine. Truog and Veatch [Veatch 2008 & Truog et al 2008 & Life 9 November 1962] have asserted the donation after cardiac death (DCD) is not acceptable; that is, the recovery of organs after the determination of death by circulatory and respiratory criteria. Troug suggests that recovery of the heart following DCD is “paradoxical” because the hearts of patients who have been declared dead on the basis of the irreversible loss of cardiac function have in fact been transplanted and successfully functioned in the chest of another”. Veatch is similarly not convinced that the donor is dead and stated that “if someone is pronounced dead on the basis of irreversible loss of heart function, after all. It would not be possible for heart function to be restored in another body. Both Veatch and Truog misinterpret the uniform declaration of death act UDDA which precisely stated that it applies to an individual who had sustained irreversible cessation of circulatory and respiratory functions. It is not a matter of the cessation of heartbeat or cardiac function per se but an irreversible cessation of circulation in the donor. The consequence of the absence of circulation is upon the function of the brain results in an irreversible loss or neurologic function – the UDDA definition of death [Ad Hoc committee 1968 & President Commission 1981 & Delmonico et al 1999].
Bernat has written that circulation – not heartbeat – is the critical function that must be lost using circulatory-respiratory tests to determine death [Bernat 2008]. For example, we do not declare patients dead who are on heart lung machines during cardiac surgery, on ECMO awaiting heart transplantation (even if they never receive a heart), or carrying artificial hearts because, despite absence of heartbeat, their circulation remains continuously maintained. That is why the death standard requires absence of circulation. “Whether the asystolic heart is subsequently left alone, removed and not restarted or removed and restarted in another patient is irrelevant to the circulatory status of the just-declared dead patient [Norton 1992]. Removing and restarting the heart elsewhere simply has no impact on the previous death determination because that patient remains permanently without circulation in exactly the same way as if the non-beating had been left in place”. And as an everyday example after slaughtering the rooster it jumps higher and stronger as never than done in its life, this movement doesn’t indicate that he is still alive and it continues bleeding strongly indicating that the heart is still functioning, and on the opposite side the heart beating may stop spontaneously, known as cardiac arrest and attempts of rescue continue, in many cases the restitution succeed. The heart start beating again and life gets back to its normal state, moreover doctors can stop the heart for hours during the operation of the open heart, however the blood circulation does not stop, not even for seconds, therefore the heart beating does not mean life and the stoppage of heart beating does not necessarily mean death. Irreversible loss of consciousness may be due to partial or total brain injury [Shewmon 1998]. For the determination of brain death, irreversible coma must be due to injury to the brain so severe as to cause loss of brain functions
Death is when blood stop reaching the brain causing a permanent harm to the brain and leading to a permanent loss of all its functions including the brainstem functions and to diagnose death it is necessary to prove the cessation of the functions of the brain, and then brain commences disintegration and its known that many cells from a dead person remain alive after the declaration of his death. Therefore we find that the muscular cells responds to electrical stimulations and some cells within the liver continue transforming the glucose to glycogen, so cells do not die all at once, however they differ in their timing of death and perish after death of the person. We can extend the life of these cells if they are put in saline solution, especially with the flow by means of a pump hence allowing the use of organs and cell of the dead person for another patient needing them, the death is a process and not an event.
Brain death can be defined as follows: When the brain is damaged, and its activities completely cease, brain death is present, even if it is possible for the patient to be kept breathing and his heart is beating with artificial respiration and medications; even if the heart and liver are functioning that is not live it is just artificial. The consideration of legality of brain death as “true death” was first considered in the early 1960’s; with the 1968 Harvard report becoming the “standard” definition of brain death. the majority of countries and international professional associations have accepted it.
The majority of Muslim jurisprudents consider organ transplantation to be permissible on the basis of principles that needs of the living outweigh those of the dead. Saving a life is of paramount value in Islam as the following verse from the Quran illustrates “And if any one sustains life, it would be as if he sustained the life of all mankind” [Ebrahim 1995 & Ebrahim 1998 & Van Bommel 1999 & Al Faqih 1991]. The Islamic jurisprudence Assembly Council in its meeting in Saudi Arabia on Feb 6-11, 1988 ratified resolution number 26.1.41 declared the following fatwa the permissibility of proxy consent: “Transplantation of an organ of the dead to a living human being whose life or essential function of the body would rely on the donated organ is allowed, provided that the dead (before his death) or his heirs permit it. Shiite scholars have made similar rulings. The majority of Shiite jurisprudents confirm organ transplantation especially when human life is at stake.[Moqaddam 2000 & Ghods et al 2006 & Zargooshi 2008].
Ordinarily, the dead have a right in Islam to the sanctity and wholeness of their body, but as we have already noted, the need to save a life overrides this injunction as it has a prima facie importance in the mundane affairs of mankind. While saving a life is of paramount importance in Islam, the family of the deceased must consent and there are in no way obliged to consent to organ donation even if it involves the death of another person who is alive but gravely ill. It has been reasoned that the “ownership” of organs, like that of property, is relative and subjective because God is the ultimate “owner” of the universe having created it. Therefore, it would be permissible to donate them because God had placed great value on saving a life.
In the address of pope John Paul II to the Transplantation Congress in Rome in 2000, regarding the determination of death, he said …”it is helpful to recall that the death of the person is a single event, consisting in the total disintegration of the unitary and integrated whole that is the personal self”. And that “it is a well-known fact that for some time certain scientific approaches to ascertaining death have shifted the emphasis from the traditional cardio respiratory signs to the so-called neurological criterion. Specifically, this consists in establishing, according to clearly determined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem). This is then considered the sign that the individual organism has lost its integrative capacity” [Abouna 1984 & Pope John Paul II 2000].
Patients who fulfill the brain function criterion for death are commonly said to be ‘brain dead’. This term, unfortunately, suggests that there are two ways of being dead, being ‘brain dead’ and being ‘really dead’. The term ‘brain death’ is also used, incorrectly, in other contexts to describe much lesser degrees of neurological dysfunction than it strictly implies. This misuse of the term is to be found in the medical and related professions as much as in the general public. It has lead to confusion surrounding the idea of a brain function criterion and its relation to ‘brain death’. It may be that it is too late to reclaim the term for its legitimate use. Whenever it is used, it is important that it is sufficiently qualified to ensure that its meaning is clear, and professional medical bodies may have a role to play in encouraging correct application of the term.
Even apart from confusion over the use of the term ‘brain death’ it can be very difficult for families to fully understand the reality of death based on a brain function criterion. To casual observation, patients fulfilling the brain function criterion for death appear to be sleeping rather than dead. The skin is warm. The chest rises and falls with mechanical ventilation. The heart and the kidneys continue to function. There are even reports that pregnancy may be maintained in patients fulfilling the brain function criterion for death. This ambiguity is reflected in the way medical and paramedical staff relates to the beating-heart cadaver in the period before organ donation. Nurses will often talk to such a cadaver as they carry out their nursing care as if the body retained the ability to hear. Acceptance of death by the brain function criterion in the context of organ donation asks much more of a family than does the same diagnosis with a view to cessation of treatment. Community education programs might go part way in helping families understand the issues involved. Detailed explanations with appropriate written material should be provided. Practitioners dealing with families should be trained in the process of explaining the brain function criterion and in grief counseling in general. Families should be provided with the opportunity to ask relevant questions and to have their questions answered in a genuinely sympathetic environment. Sufficient time should be provided to ensure that families really understand the brain function criterion before the issue of organ donation is broached. Families should then be allowed whatever time and assistance are necessary to make a decision concerning organ donation and then to deal with the particular grieving problems over the ensuing days and weeks. They should be offered the opportunity to view the body after the retrieval process has occurred when it has the appearance of being dead [Shemie et al 2006 & Delmonico et al 1999 & Norton 1992].
The main reason why people may consider donating organs is because of the very great benefit that this can bring to others. Organ transplantation may be a lifesaving treatment for patients with liver or heart disease, and it may be the only hope of treatment there is. For kidney patients, having a transplant can mean being able to cease, and this can bring a great improvement in health and lifestyle. For instance, it may enable a kidney patient to return to the workforce, or to work longer hours, and it can even mean that a woman can now have a baby. The transplantation of a cornea can give someone back his or her sight [Ehtuish et al 2006 & Abouna 1998 & Hunsicker 1999 & Alashek et al 2009 & Cohen et al 1995]. Transplantation is generally a very successful procedure. The success rates of transplantations vary, but in all cases these have increased considerably since transplantation first began (Fig. 4b). It can be difficult in medical science to predict which procedures will become more successful and eventually routine. However, kidney transplantation is now considered to be accepted medical treatment and this is likely to happen in other areas of transplantation. Some people decide not to donate organs because they are not confident that donation would be in accordance with their dead relative’s wishes. Some people think that transplantation is a very costly procedure from which relatively few people benefit. If you believe that your family may gain some comfort from donation, this may be a reason to consider it for yourself. On the other hand, if you feel that your family may be upset about donation, you may decide against it. This shows the importance of discussing donation with your family. You need also to bear in mind that the people who donate organs are mostly those who have died suddenly and unexpectedly and they are often quite young. For the families of these patients, death may be especially traumatic. When deciding about donation for yourself before death, you may begin by thinking of how you would feel if you were in the position of needing lifesaving organ or tissue transplantation. In making your decision, you also may feel, for instance, that you no longer need your body, and would like to feel that you had done something to help others. Or you may feel that it is important that your body remains intact for burial or cremation. If you belong to a religious faith, you may want to consider how organ donation and transplantation is understood from that religious point of view. Indeed you may wish to consult a religious advisor on the appropriateness of organ donation in your particular circumstances.
Deciding about organ donation on behalf of a loved relative who has just died may be a very difficult decision to make. Often the relative’s death will have been the result of a traumatic event such as a car accident or a head injury. This makes the death an especially sad one for family and friends, means that people are asked to make a serious decision at a difficult, stressful and emotional time. You may feel shocked, bewildered, angry, and numb [Norton 1992]. But, for practical reasons, if organ donation is to occur, it must take place within a certain time period: so there will be only a limited time in which to make this decision. The difficult circumstances in which the decision has to be made make it all the more important that you are well-informed and that you feel confident that you have considered the matter as fully as you wish. Families are greatly assisted in their decision-making at a time of crisis if they have previously discussed organ and tissue donation and the wishes of individuals are known. There are three scenarios that need to be considered: (1) Your relative dies having made known his or her wish to donate organs after death: in this case the family is consulted in order to clarify what the person’s wishes were in relation to organ donation and to see whether the family has any objections to the deceased’s wishes being acted on. Donation will not proceed in the face of objection from families. If you know that your relative wished to donate his or her organs and/or tissues, this may provide you with a substantial reason for you to consent to the request for donation. Islamic religion respect the intestate and wishes of the person before he died and the relatives are obliged to implement the intestate that is clear in many verses in Quran. (2) Your relative dies having made known to you his or her wish not to donate organs: in this case, made this known to hospital staff and organ donation will not be discussed further. (3) Your relative dies and either had no views about organ donation (as in the case of a young child) or had not made his or her views known to you: in this case the hospital authorities will consult the family to find out whether anything is known about the deceased person’s wishes and/or to find out whether the family will consent to donation on behalf of their deceased relative. One thing that you may like to do in this situation is to make a judgment based on your knowledge of that person. What was his or her attitude to transplantation: had he or she ever shown any sign of being in favor or against it? What were his or her beliefs and feelings about the body and about how it should be treated after death? Was he or she the kind of person who would want to help others? Would he or she have been likely to have discussed organ donation with someone outside the family? It is professional practice not to pressure people in any way. The decision that you have to make is not a purely rational or ‘head’ decision but also an emotional or ‘heart’ decision. You may need time to come to terms a little more with the emotional significance of events, may be to accept that your relative really is dead. You may wish for time to imagine how you may feel afterwards, whatever decision you make; and how others in your family may feel. You may feel you need time alone, or time with just your family [Evans 1993 & Courtney et al 2009].
Do I think that donating organs and/or tissues for transplantation (or other purposes) is a worthwhile cause? How would I feel if I needed a transplanted organ? How does organ donation fit with my religious, spiritual and moral beliefs? How would I feel if a friend or relative needed an organ? What do my other family members think about organ donation? Have I made my wishes about organ donation known to my family? If I decide I want to donate organs, how will this affect my family? Am I satisfied that I understand the concept of ‘brain death’ as a way of determining death? Do I feel that I could trust the medical staff involved if I were ever in a situation to be a potential organ donor? How do I think of my body after death? Are there some organs I would like to donate, and not others? Will my family try to carry out my wishes? Will counseling be available for my family if they need it? Am I satisfied that respect will be shown to my body? Are there other people I would like to consult? [Miranda et al 1998 & Jasper et al 1999 & Cameron et al 1999 & Cohen et al 1995]
Decision-making becomes necessary at two stages of the process of organ and tissue allocation. The first stage deals with those considerations which should be taken into account in deciding on the identity of the individual patients to whom offers of transplants are to be made. Decisions of this type, by reason of the technical details involved, will remain a responsibility of medical personnel. Entry to, and exclusion from, a transplantation program both raise ethical issues.
Entry to a program is offered following assessment of patients by the program personnel. Exclusion criteria include age restrictions, abnormalities in other organ systems, previous history of malignant disease and other medical considerations. In making decisions about which patients are to be admitted to a program, there is merit in more than one medical practitioner being involved.
The second stage of decision-making relates to whether an individual chooses to become a transplant recipient. This is a decision to be made by the patients in the light of advice received from their medical attendants and consultation with their families. Acceptance of the offer requires an informed decision on the part of a patient and/or their family. Prior to this decision, a patient should receive a full description of what is entailed in being in the program, what procedures can be expected and their possible risks and benefits. On the other hand, if a patient is excluded from a transplantation program, he or she is entitled to know why? [Turcotte et al 1989].
In an attempt to ensure that transplanted kidneys have the best outcome possible for individual patients, concurrent medical conditions that introduce a potential risk following transplantation should be managed before acceptance on to the waiting list, If a pre-existing condition is likely to be affected adversely by the ongoing immunosuppression required after transplantation (for example, immunosuppression increases the risk of recurrence of cancer and of persistence of chronic infection) a patient may be excluded from transplantation in his or her own interest. Though some may think it is unfair to deny a patient the opportunity to receive a transplanted kidney because of renal disease which could recur in the graft, others might consider it unreasonable to inflict repeated transplantation when there is a high risk of rejection. In rare circumstances, the kidney allocation system may be suspended to provide an organ for transplantation to a critically ill patient. To ensure fairness in allocation, the selection criteria and weighting of different criteria are subject to repeated review by personnel from all institutions involved in renal transplantation.
The patient sickness.
The patient most likely to benefit based on medical or other criteria.
The length of the patient on the waiting list.
All patients on the waiting list should have an equal chance.
The patient’s importance for the well-being of others, for example previous organ donors.
The patients who have previously had one or more transplants.
Capacity of the patient to pay.
The allocation of kidneys occurs under circumstances not paralleled in the case of other organs because candidates for transplantation are drawn exclusively from patients already within a dialysis program. This introduces the difficulty that, whereas selection to receive a kidney is determined by clearly defined and promulgated criteria that are uniformly applicable nationally, selection to enter dialysis programs is affected by a variety of sets of guidelines. In some cases uniform criteria for entry to dialysis are being formulated. However, in other instances, individual clinics have their own guidelines, not all of which are readily available. This lack of transparency precludes ethical assessment of the procedures employed and this should occasion concern: it is an ethical issue in itself. As kidneys can be preserved safely by simple cold storage for at least twenty-four hours, the results of a blood T-cell cross match and tissue matching can be available before transplantation is undertaken. Because of the length of waiting lists, several potential recipients are commonly equally well matched with each presenting donor. Allocation of kidneys should be organized on a national basis so that recipients with the closest tissue matching with the donor are selected to receive the organs. This provides the best chance of success. Currently, kidneys are raised by allocation of transplant resources allocated to potential recipients according to the best available tissue match. If there are no suitably matched potential recipients on the national waiting list, the length of time on dialysis usually determines the recipient. Factors such as recipient age, period on dialysis, pre-sensitization to tissue antigens, presence of diabetes mellitus and the previous receipt of a transplant are likely to be taken into account.
The concept of distributive justice – how to fairly divide resources – arises around organ transplantation. Distributive justice theory states that there is not one “right” way to distribute organs, but rather many ways a person could justify giving an organ to one
Particular individual over someone else. Equal access criteria include [UNOS 2001]:
Length of time waiting (i.e. first come, first served)
Age (i.e. younger to younger, older to older or youngest to oldest)
Organ type, blood type and organ size
Distance from the donor to the patient
Level of medical urgency
Equal access supporters believe that organ transplantation is a valuable medical procedure and worth offering to those who need it. They also argue that because the procedure is worthy, everyone should be able to access it equally.
Successful transplants are measured by the number of life years gained. Life years are the number of years that a person will live with a successful organ transplant that they would not have lived otherwise. This philosophy allows organ procurement organizations to take into account several things when distributing organs that the equal access philosophy does not – like giving a second organ transplant to someone who’s already had one or factoring in the probability of a successful medical outcome.
Three primary arguments oppose using the maximum benefit distribution criteria. First, predicting medical success is difficult because a successful outcome can vary. Is success the number of years a patient lives after a transplant? Or is success the number of years a transplanted organ functions? Is success the level of rehabilitation and quality of life the patient experiences afterward? These questions pose challenges to those attempting to allocate organs using medical success prediction criteria. The second argument against maximum benefit distribution is that distributing organs in this way could leave the door open for bias, lying, favoritism and other unfair practices more so than other forms of distribution due to the subjective nature of these criteria. Third, some ethicists argue against using age and maximizing life years as criteria for distributing organs because it devalues the remaining life of an older person awaiting a transplant. Regardless of how old someone is, if that person does not receive a transplant they will still be losing “the rest of his or her life,” which is valuable to everyone.
Organs trading
The transfer, traveling, hosting, receiving living or deceased persons, or their organs, through threat, by force or any other forms of oppression or kidnapping or fraud, or deceit, or misuse of power or position, mis-receipt by a third party of money or subsidies submitted to oppress the contingent donor and use him as an organ donor.
Commercialization of organs
It is the policy or conduct by which the organ is dealt with as if it is a trade goods, including their purchase, sale or use for material gain.
Travel for organs transplantation
It is the travel of organs, donors, recipients or professionals of organs transplantation over the international borders for purpose of organs transplantation.
The donor, recipient and surgeon may be of the same country. The agreement may be done before they get to the surgeon. The donor and recipient may travel to the country of the surgeon. The patient may travel to the donor country and vice-versa. The donor may be from one country, the patient from another country and the surgeon from third country, and all may travel to a fourth country to perform the transplantation
[Bramstedt 2007] Fig (8 & 9). This needs organizers and coordinators, until the matter arrived to the existence of organized gangs aiming for benefit and do not care of the donor or the patient. They are standing on extortion principle and earning profits on the account of poor people and those in need. The matter arrived to even stealing organs, yet to kidnap children and women and even men in order to get their organs for selling them to whom pays more [Fasting et al 1998].
The patient may travel to the donor country and vice-versa
The travel of donors, recipients and surgeons for Transplantation
Paying people to donate their kidneys is one of the most contentious ethical issues being debated at the moment. The most common arguments against this practice include:
Donor safety
Unfair appeal of financial incentives to the economically disadvantaged
Turning the body into a money-making tool “commodity’
Wealthy people would be able to access more readily
The idea of nonfinancial incentives may be rising in popularity as a way to entice people to donate their organs. Financial incentives aimed at encouraging living donation have received much attention from bioethicists lately. Most experts argue that buying and selling human organs is an immoral and disrespectful practice [Daar 1998]. The moral objection raised most is that selling organs will appeal to the socioeconomically disadvantaged (poor, uneducated people) and these groups will be unfairly pressured to sell their organs by the promise of money. This pressure could also cause people to overlook the possible drawbacks in favor of cash incentives. On the other hand, wealthy people would have unfair access to organs due to their financial situations. It has been noticed that almost all of the people sold their kidneys to pay off debts and those will still had debt some time later but they will have a deterioration in their health status after donation and most of them would not recommend to others that they sell kidneys. Arguments that favor the buying and selling of human organs are scarce, but a few do exist. One of them is that payments aren’t necessarily a bad idea if they work to increase the number of donated organs. The position contends that donating an organ is a relatively small burden compared to the enormous benefit reaped by recipients. Some argues that buying and selling organs is not morally objectionable, but that the system as it exists is inadequate to provide appropriate safeguards. This critique extends not only to the medical system, but also to legal and religious safeguarding organizations as well. It is an important ethical issue in organ transplantation. Whatever the perceptions of this practice in developed countries, it is widespread across the world. There are regional variations in its acceptance and practice. In France it is crime to get involved in paid organ donation. Most of the international organizations and forums have called fora moratorium against the sale of organs [Budiani-Saberi et al 2008] but the debate is not yet over. Recently the existing arguments against paid organ donation have been re-examined and found to be unconvincing. It is argued that the real reason why organ sale is generally thought to be wrong is that (a) bodily integrity is highly valued and (b) the removal of healthy organs constitutes a violation of this integrity [Wilkinson et al 1996]. Both sale and (free) donation involve a violation of bodily integrity. In case of free donation the violation of bodily integrity is typically outweighed by the presence of other goods: mainly, the extreme altruism involved in free donation. There is usually no such outweighing feature in the case of paid donation. Given this, the idea that we value bodily integrity can help to account for the perceived moral difference between sale and free donation. International trade in human organs, particularly in the developing countries of the world where cadaveric organs are not easily available and where there is marked disparity in wealth. As a consequence, a deplorable type of medical practice has emerged, where human kidneys are bought from the poor for transplantation into the wealthy clientele with soaring profits for brokers, private hospitals and physicians [Danovitch 2008]. It is estimated that since 1980, over 2,000 kidneys are sold annually in India, Iraq, Philippines, Iran and elsewhere. to wealthy recipients from the Middle East, the Far East and Europe. Human organ (“Kidneys”) trade which has shifted from India to Pakistan [Noorani 2008 & Naqvi et al 2007 & Delmonico 2007]. Media, in particular had gone to the extent of labeling it as shifting of “Kidney Bazar”, “Bombay Bazar” from India to Karachi, Lahore and Islamabad [Naqvi et al 2008 & Sajjad et al 2008 & Beasley et al 2000 & Amerling 2001]. Fig (10).
Kidney bazar
The drawback is that physical harm comes to one person for the benefit of another. However, this is considered an acceptable side effect because of the rule of choosing between the lesser of two maladies, i.e. one person dies and one lives, or, two people live, both with physical deformities. It is not surprising, therefore, that this practice of trading in human organs has alarmed the medical profession, the public and many governments and it has rightly been condemned by all major religions, and by most transplant societies. Organ sale has serious negative impact on all aspects and on everyone involved in the process of transplantation, including the donor, the recipient, the local transplant program, the medical profession and the moral and ethical values of the society. Most ethicists believe that organ sale is an affront not only to altruism, but also to basic human dignity as opposed to a utilitarian approach to the important issue of transplantation for the following main reasons: (a) Organ sale promotes coercion and exploitation of the poor. (b) It promotes poor quality of care to the donor and particularly to the recipient as a result of poor standards of donor selection and inadequate screening for transmissible disease. (c) It benefits ruthless entrepreneurs, greedy doctors who care for their egos and financial gain. It is also against the patient’s right for autonomy. It is contrary to accepted moral and ethical beliefs of most societies, including the major religions of Islam, Christianity, and Judaism. It diminishes the current benefit of altruistic donation by living donors and the families of cadaveric donors. It makes human organs a commodity for profit and sale thus inviting corruption and an unjust and unfair system of organ access and distribution and it predisposes to criminal tendencies of selling, kidnapping or killing children and women for organ sale, which has been reported [Spital 1997 & Danovitch et al 2006]. Some proponents of organ sale claim that well-controlled organ purchase does have several major advantages: by making more organs available it can reduce the waiting time for organs, reduce the number of deaths among waiting list patients as well as reduce the overall cost of treatment of patients with end-stage kidney disease. Some professionals in the transplant community believe that it will be much more productive as well as protective from sale of organs by vendors, at least in the developing countries where cadaver organs are not available, if the practice of organ sale is regulated by an independent organization. They argue that the feeling of repugnance of organ sale for the rich and the healthy should not justify removing the only hope for the destitute and dying. Cameron and Hoffenberg [Cameron et al 1999 & Ghods et al 2006 & Friedman 2006 & Laurance 2008] have recommended that organs be paid for through nationally established organ sharing networks to ensure the quality of care received by donors and to promote the equity of distribution which will involve the ethical and medical problems that exist with organ sale. Radcliffe-Richards et al. [Radcliffe et al 1998] have emphasized that current exploitation of donors and lack of informed consent through organ purchase are due to poverty and lack of education, which do not justify banning organ sale. They suggest that a national organization be established to regulate the sale of organs or provide educational and appropriate consultation to patients to enable them to have informed consent and even a ‘guardian’ for the donor. Also this organization will regulate and control organ vending, proper selection, payment of fees and provision of necessary care which will prevent the current exploitation, the risk of removing organs, both for the donor and the recipient, and provide screening and counseling, together with reliable payment and financial incentives [Friedman E 2006 & Friedman Al 2006 & Surman et al 2008]. They believe that this will not affect cadaveric donation, since payment can also be made to the family of the deceased. Some have proposed a market for organ donation or sale. The proponents of this model propose a legitimate governmental or nonprofit nongovernmental organization to take charge for the responsibility of compensating the donor, without any direct contact between donors and recipients. This would eliminate profit-seeking middlemen and organ brokers. While in certain instances, this practice has led to elimination of the waiting list [Matas 2008], evidence for negative impact of kidney donation for the donors have been reported. The best is to avoid people and their organs of being a commodity in the market weather it is an open black market or an organized and controlled market. In addition to direct payment, various other forms of compensation such as life and health insurance, medal of honor, reimbursement for travel expenses, compensation for time out of work, or a tax credit have been proposed. The potential problem with this model is that if it is not well organized, it will open the door to an organ market, where the organs are sold to the highest bidder, benefiting the rich and disadvantaging the poor [Chapman 2008 & Godlee 2008 & Thomas 2000]. Concern has also been raised that this will reduce altruistic kidney donation and discourage deceased multi-organ donation. However, some believe that it does not preclude increased donation, and others have shown that it has not inhibited the establishment of deceased donor transplantation programs. Opponents to any form of compensation and an organ market cite the concern that the poor will be viewed as mere providers of spare parts and will live with fewer organs, adding to this their list of disadvantages. According to this viewpoint, the market will be driven by poverty and the poor will be a disadvantage compared to the ealthier, feeling a disproportionately higher pressure to sell their organs Fig (11). On a global scale this could translate into people from rich nations travelling to poor countries to buy organs. There is the concern that the market could potentially lead to demeaning bodies to “articles of trade”. Degrading human relationships, and particularly damaging the altruistic bond. There is also the concern about the occasional coercion of a spouse by an addicted spouse into selling an organ to pay for the addiction.
Major destination host countries WHO publications
With related donor transplantation, altruism is the expected driving force; however, regarding unrelated donors, several valid question have been raised. Why should the unrelated donors not be at least partially rewarded for their donation? Why should they be expected to undergo the surgery and live with one less organ for the rest of their lives? Are the other parties involved (physicians, surgeons, nurses, etc,) providing their services only altruistically? Why should the only individuals sacrificing their bodies not be appropriately acknowledged? Although current laws in most countries and guidelines by WHO and professional societies prohibit the sales of organs, it has been debated that provision of financial incentive seems not only fair, but may also encourage donation and subsequently benefit the patients on the waiting list [Novelli et al 2007 & Satel et al 2008 & Kranenburg et al 2008]. The main opponents of providing financial incentives have voiced concern over “devaluing” the body to a mere commodity and the potential for commercialization. Some would argue that the body is a property and, in fact, the most valuable commodity that an individual possesses. They would contend that the owner of this property has a right to sell part of it for his/her better good.
There is little doubt that commercialization of organ donation is fraught with drawbacks, dangers and potential immoral consequences. On the other hand, it is clear that efforts to increase the rate of organ donation through education have failed and sole moral incentives have not worked [Delmonico et al 2008 & Colakgin et al 1998 & Prasad et al 2006]. Organs are currently limited by supply, and in the hope of expanding the available organs, it seems prudent to provide incentives not only to encourage donation, but also in order to express appreciation. In the process, we should be cognizant of the fact that we might be sacrificing some good for the sake of other potentially more meritorious goods, weighing the ethical and morals risks of one against the other. The obligation of society is to establish safeguards to protect all parties involved, as well as the humane inter-relationship between donor and recipient. In this regard, the method of acknowledging the good deeds of donors is of paramount importance.
It is clear that we need to look for feasible, ethical alternatives to the current model. This is not limited to whether or not donors should be compensated. Now that living unrelated transplant (LURT) has become an ever increasing reality Fig (12). Society and the transplant community should devise safeguards to scrutinize the process [Matas 2007 & Chapman 2008 & Godlee 2008 & Novelli et al 2007 & Satel et al 2008 & Kranenburg et al 2008 & Leung 2006].
Trends in living related and living unrelated donors UNOS publications
The antimarket campaign could change things. To be able to do so, however, it needs to embrace a strategy combining new discursive and practical elements.
The campaign against transplant commercialism could be coherent and possibly successful only if it explained that the suffering-preventing capacity of a kidney disease-free and poverty-free world is considerably greater than that of any regulated market in organs [Danovitch et al 2008 & Turner 2008].
WHO has condemned the commercialization of organs in several occasions, starting from the decision of the General assembly No. 40.13 in year 1987 and No. 42.5 in year 1989, and requested the countries to consolidate efforts to implement the decision, then the decision No. 44.25 for the year 1991 which has adopted the first draft of the WHO guiding principles regarding the human cells, tissues and organs transplantation, and which has contoured the methodological and ethical standard framework.
Among the most important recommendations issued by the general assembly, are those issued in its fifty-seventh session (decision 57.18) in may 2004, where the organization has required from the member countries the necessity of existence of an actual supervision on the organ transplantation, and promotion of both living and deceased donation, and to take the necessary measures to protect the poorest and exposed to the organs transplantation tourism. In year 2008, the guiding principles of the WHO have been updated regarding the human cells, tissues and organs transplantation [WHO 2008]. They were adopted by the executive council in its session held in November 2008 these guidelines are.
Consent for deceased donation
No conflict between physicians determining death
Deceased but also live consenting donors
Minors and incompetent persons be protected
No sale or purchase
Promotion of donation no advertising nor brokering
Physician responsibility on origin of transplant
Justifiable professional fees
Allocation rules
Quality safety efficacy of procedures and transplants
Transparency and anonymity
A group of meetings were held by the WHO joined number of scientists and international and national organizations in order study the challenges facing human cells, tissues and organ transplantation. Open consultations were done in Karachi, Geneva and Madrid, different experts were invited The purpose of all such consultations is to determine the problem about such a matter and also to extract preparatory ideas in order to make them implemented and to encourage countries to have national or regional strategies for self sufficiency by promoting both living and deceased donation and to cooperate towards organ trafficking free world. They urge the need for an international binding treaty to regulate transplantation and to combat organ trafficking [Carmi 1996]. Fig (13)
Kidney and transplant surgeons met in Amsterdam. The Netherland, from April 1-4, 2004 for the international forum on the care of the live kidney donor. Forum participants included over 100 experts and leaders in Transplantation representing more than 40 countries from around the world. The Forum analyzed the sentinel events associated with live kidney donation; the data emphasized the extremely low Operative mortality rates and the long-term safety of this procedure. Forum participants affirmed the necessity for live donors to receive complete medical and psychosocial evaluation prior to donation. A great detail of discussion focused on prevention of transmissible infectious diseases through live kidney transplantation [Delmonico et al 2007].
An international conference about the care of the kidney transplantation recipients, held in Lisbon, Portugal, February 2nd-4th 2006, with the cooperation between the WHO and different international and national societies of organs transplantation. The conference has joined more than 100 experts and leaders in organ transplantation. It represents more than 40 countries from all over the world. The conference aimed to determine the main issues and to set recommendations to improve the outcome of kidney transplantation all over the world [The Consensus Statement of the Amsterdam Forum 2004].
A meeting was held in Taipei – January 2008, About the immoral and unfair practices related to the organs transplantation in Asia by local citizens and by others from other areas. The recommendation of the Asian campaign stressed the importance of collective measures against organ trafficking [Bagheri 2005].
An international summit was held in Istanbul on May 2nd 2008, joining more than 150 representatives for medical professional, governmental and non governmental organizations, and transplant societies from 78 countries and 20 international organizations, The meeting was organized by The Transplantation Society (TTS) and the International Society of Nephrology (ISN). The recommendations of Istanbul Declaration have added very important dimensions to the international standards of organ transplantation and emphasized the encouragement of living and deceased donation and stressed on the living donors care and to view their act as a championship as they are sharing in the Gift of life and the necessity to evaluate the donors medically and psychologically before and after donation [Steering Committee of the Istanbul Summit 2008]. The declaration was centered on Organ commercialism, which targets vulnerable populations (such as illiterate and impoverished persons, undocumented immigrants, prisoners, and political or economic refugees) in resource-poor countries, has been condemned by international bodies such as the World Health Organization for decades. Yet in recent years, as a consequence of the increasing ease of Internet communication and the willingness of patients in rich countries to travel and purchase organs, organ trafficking and transplant tourism have grown into global problems.
The Istanbul Declaration proclaims that the poor who sell their organs are being exploited, whether by richer people within their own countries or by transplant tourists from abroad. Moreover, transplant tourists risk physical harm by unregulated and illegal transplantation. Participants in the Istanbul Summit concluded that transplant commercialism, which targets the vulnerable, transplant tourism, and organ trafficking should be prohibited. And they also urged their fellow transplant professionals, individually and through their organizations, to put an end to these unethical activities and foster safe, accountable practices that meet the needs of transplant recipients while protecting donors.
Countries from which transplant tourists originate, as well as those to which they travel to obtain transplants, are just beginning to address their respective responsibilities to protect their people from exploitation and to develop national self-sufficiency in organ donation. The Declaration should reinforce the resolve of governments and international organizations to develop laws and guidelines to bring an end to wrongful practices. “The legacy of transplantation is threatened by organ trafficking and transplant tourism. The Declaration of Istanbul aims to combat these activities and to preserve the nobility of organ donation. The success of transplantation as a life-saving treatment does not require—nor justify—victimizing the world\'s poor as the source of organs for the rich” [Epstein 2008]
A conference was held in Madrid. It has concentrated about the self-sufficiency of organs for each country or region. The conference has recommended the necessity to set national plans and strategies to promote the donation of organs from deceased and living persons, arriving to the self-sufficiency and to fight, struggle and limit organ trafficking and transplant tourism.
During the period May 10th-13th, 2010, the global leadership symposium on organs donation was held in California. It was attended by a lot of workers in the promotion of organs donation and a number of the international experts in the organs donation and transplantation and ethicists from several countries to more support the organs donation and fight organ trafficking.
Expeditious expansion and industrial development near the rivers have led to more stress on the river, and with increased stress, the water becomes polluted, and worsening environmental health is observed [1]. The water-soil interface and the water-atmosphere interface are the medium through which the heavy metals travel [2, 3]. Both anthropogenic activities and geochemical processes are responsible for heavy metal contamination in ecosystems [4]. Elements that have high density and are less noxious are known as heavy metals. Examples of heavy metals are lead, iron, mercury, cadmium, zinc, arsenic, copper, and chromium and the actual volume of these heavy metals is more than 6 g/m3 [5]. Heavy metals have the property of environmental persistence and bioaccumulation, and these heavy metals enter the aquatic system through various routes. These heavy metals not only impair the quality of the aquatic ecosystem but also human health [6, 7]. These heavy metals can be found on the layer of earth in their regular form. These heavy metals are so dangerous that they cannot be degraded or decomposed and they have the arability to bioaccumulate [8]. These heavy metals once get into the ecosystem through the air, via drinkable water, or multiple chemicals and products that are manmade. The route of administration of these heavy metals is via inhalation, ingestion, and skin absorption. These heavy metals get into the biosphere via human activities, which include industrial production, mining, agriculture, and transportation [9]. Some methods are fossil fuel burning, smelting of different, waste from the municipality, fertilizers, pesticides, and sewage these all are considered to be the primary sources of metal pollution [10, 11, 12, 13]. The toxicity of these heavy metals in the human body reduces energy levels; disrupts brain functioning; disturbs the functioning of various other organs such as the brain, lungs, liver, and kidney; and also hinders blood composition. If the contact with heavy metals continues, then it can hinder the physical, neurological, and muscular functioning. And due to these diseases like multiple sclerosis, Parkinson’s disease and muscular dystrophy, and Alzheimer’s disease. Chronic exposure to some of the heavy metals and their compounds may even cause cancer [14]. Pollution of these heavy metals into the river may cause distressing effects on the ecological balance of the aquatic environment, and with the extent of contamination, the diversity of aquatic organisms becomes limited [15]. The fish in the aquatic ecosystem can be used for examining the well-being of biota. Due to pollutants in the food chain of organisms, harmful effects can be seen and the aquaculture can become dead [16]. These heavy metals are neurotoxins for the fish living in the aquatic environment. When these heavy metals enter the fish body, they interact with them to generate biochemical reaction inside the fish, which makes it difficult for fish to communicate with their surroundings [17]. The presence of these heavy metals leads to diseases like Minamata, which is organic mercury poisoning. When these heavy metals get bioaccumulated, they become a threat to both the human population and animals who uses that water [18]. Modeling of risk assessment is divided into four stages, i.e., exposure assessment, toxicity (dose-response) assessment, hazard identification, and risk characterization. There are three pathways through which humans get exposed to traced metals, which include directly ingesting, inhaling through the mouth or nose, and via skin absorption when it gets exposed. From the water, the heavy metals usually enter through ingestion and dermal absorption. To assess exposure, the average daily dose is measured for pollutants through different identified paths. In a dose-response assessment for no carcinogens, reference doses (RfD) are calculated, and for carcinogens, slope factors (SF) are obtained by the United States Environment Protection Agency (USEPA) Integrated Risk Information System (IRIS) database. With the help of the facts which are discussed above, there was a study done with an aim to evaluate the water quality of the Subarnarekha River relating to metals, their temporal classification, source of identification, and assessment of human health risk when that water was ingested or the contaminate when absorbed through the skin. Through this, it is possible to know the contamination level and accordingly, the strategies were planned (Table 1) [19, 20].
Heavy metal ions | WHO’s permissible limit (mg L−1) |
---|---|
Se | 0.02 |
Hg | 0.001 |
Mn | 0.02 |
Ag | 0.1 |
Cd | 0.05 |
Cr | 0.003 |
Pb | 0.01 |
Zn | 3.00 |
Fe | 0.30 |
Cu | 0.02 |
As | 0.01 |
Permissible limit of heavy metal ions in water [21].
The presence of these heavy metals on the surface of the water can be due to natural or anthropogenic activities. In natural activities, weathering of rocks that contain metals, an eruption from volcanos, fires in the forest, and naturally occurring processes of weathering can be included. From these activities, metal enters the different sections of the environment. Heavy metals can be found in the forms of sulfates, hydroxides, oxides, sulfides, phosphates, and silicates [12, 22]. A huge amount of accumulation of heavy metals into the water is mainly due to anthropogenic and natural activities. Some more examples of natural source through which heavy metals contaminates water are, wet and dry deposition of atmospheric salts, water-rock interaction, or water interaction with the soil. While the sudden increase in urbanization and industrialization are an example of anthropogenic sources through which water get contaminated (Table 2; Figure 1) [23].
Heavy metal ion | Common sources |
---|---|
Copper (Cu) | Fertilizers, tanning, and photovoltaic cells |
Zinc (Zn) | Soldering, cosmetics, and pigments |
Silver (Ag) | Refining of copper, gold, nickel, zinc, jewelry, and electroplating industries |
Chromium (Cr) | Leather industry, tanning, and chrome plating industries |
Arsenic (As) | Wooden electricity poles that are treated with arsenic-based preservatives, pesticides, fertilizers, the release of untreated effluents, oxidation of pyrite (FeS) and arsenopyrite (FeAsS) |
Mercury (Hg) | Combustion of coal, municipal solid waste incineration, and volcanic emissions |
Cadmium (Cd) | Paints, pigments, electroplated parts, batteries, plastics, synthetic rubber, photographic and engraving process, photoconductors, and photovoltaic cells |
Lead (Pb) | PVC pipes in sanitation, agriculture, recycled PVC lead paints, jewelry, lead batteries, lunch boxes, etc. |
Major sources of some heavy metal ions in water [24].
Contamination of water through different sources.
Trace metals are found in excess levels in the environment, they are formed by geographical processes such as volcanic eruptions, weathering of rocks, and leaching into rivers, lakes, and oceans due to the action of water [25]. The presence of heavy metals in water depends on the local geology, hydrogeology, and geochemical characteristics of the aquifer [26]. One of the main sources of pollution is weathering. The weathering of the sedimentary rocks such as limestone or dolomite or shale makes the water contaminated or polluted. When there is an interaction of water with rock element, it also leads addition of these elements into the water; thus, contamination occurs. Examples of such elements are granite, syenite, basalt, gabbro, nepheline, and andesite. Due to the particular ore or the minerals, the element level increases. Elements examples are magnetite, hematite, goethite, siderite, calcite, cuprite, malachite, azurite, chromite, kaolinite, montmorillonite, arsenic trioxide, orpiment, arsenopyrite, calamine, smithsonite, pyrolusite, and rhodochrosite [27, 28, 29, 30]. The sulfide deposition also increases as it is associated with the mineralization of the gold and hydrous iron oxide ores [31].
Anthropogenic events, in which human settlement replaced the natural forest and agricultural activities have increased the environmental impacts. Such activities have contaminated the aquatic ecosystems, which include spring waters from the river like the Amala and Nyangores, tributaries of Mara River, Indonesia in Mau Complex. The maximum of forest land is converted into human settlement and agriculture. People who live near the Mara River Basin use that spring water for the purpose of animal and agricultural purposes [21]. The water carrying capacity has decreased with the rapid increase in industrialization and urbanization. Hg concentration in water has increased with agriculture activities and human activities. Activities like domestic sewage into the water, solid waste burning, coal and oil combustions, and pyrometallurgical processes and mining are the main reason for this. Water, by either snow or rain, brings the contaminated soil with Hg into the adjacent water areas [32, 33]. The source of Ni is the corroded metal pipes and containers [34]. The major source of lead in water majorly comes from additives of paints and petrol and aerosol precipitation, which is formed due to the high temperature used in industrial processes for the purpose of coal combustion, smelting, and cement production [35], and chloralkali, batteries, fluorescent lamps, thermometers, and electronic switches production. Chemical industries are some industrial activities through which Hg pollutes the water system and these activities are the largest contributor to Hg contamination in the environment [36].
Huge amount of untreated sewage from domestic is thrown into the river. This untreated waste from domestic has the presence of toxins. These toxins are due to the presence of solid waste or from the litter of plastic, or the contamination of bacteria due to the presence of these the water can get polluted. Domestic untreated water is thrown directly into the water resource and this majorly causes pollution inside the water and harms the ecosystem [37]. These pollutants majorly depend upon what kind of industry has thrown those pollutants. When these toxic metals get inside the water, they decrease the quality of the water [38]. Around 25% of pollution inside the water is caused only by these industries [39]. When the water gets contaminated, the water gets enriched by the nitrogen and phosphorous elements. With the presence of these nutrients, the growth rate of algae gets multiplied, and then it competed with the surrounding aquatic biota for the dissolved oxygen in water [40]. The presence of nitrite and nitrate anions leads to a major threat to the exposed organisms; examples of such threats are methemoglobinemia. It is more common in small children, and the symptoms caused by this are cyanotic color in the skin due to blood alterations [41]. Water sources that get deposited by this sewage also become anions rich, due to the presence of chlorine in urine, and NaCl is used in the human diet. On the side of the sea, there is the presence of chloride in high concentrations due to the leakage of salt into the sewerage system. It also may be increased by industrial processes [42].
Contamination of heavy metals in the aquatic environment is very harmful since these elements cannot be degraded and they get accumulated inside the living organisms [43]. Residue from the industry is the major source through which these heavy metals get into the aquatic ecosystems, and their accumulation in water varies with the type of wastewater treatment used [44]. Effects known as deleterious can be observed when the metal particles are introduced into the water system [45, 46]. Different metals from the Amazon River (Brazil) and the Yukon River (Alaska) were analyzed in the solid-state only. Plants have the presence of these metals in water. In tissue, the concentration of several metals is slow, and their concentration should be kept in less range only as more concentration can be harmful to the biological development of the pant [47]. Through the food chain, fish contaminants can reach man [48]. Effluent from industries, water tank leakages, dumping beside marines, and due to radioactive waste and atmospheric deposition, are some sources of water contamination. Disposed of heavy metals and waste from industries they get accumulated in rivers and lakes thus causing harmful impacts on animals and humans. For suppression of the immune, reproductive failure and acute poisoning toxins are responsible [49]. Then there is direct damage to plant or animal nutrition at that time human health is affected. The pollutants that are polluting the water are killing marine organisms such as mollusks, marine birds, fishes, and other organisms that live in the sea [50].
With an increase in the population has created many issues and one of the issues is the pollution of water [38]. An increase in the population leads automatically leads to more generations of solid waste [51]. Both solid waste and liquid waste are deposited into the water without any treatment. Human excreta also contaminate the water. Thus, contaminated water leads to a generation of a large number of bacteria, which is a threat to human well-being [39]. Government is unable to supply vital requirements to the People because of the increase in the number of people. Facility for sanitization is more in urban areas as compared to rural areas. Plastic bag and waste are a major contribution to pollution. People throw the waste in plastic bags into water sources [24]. From the research, it was found that around three crore people of the population defecate in the open, while 77% population use flush and around 8% use the pit latrines. Urbanization can cause many infectious diseases. Overpopulation, unhealthy conditions, and dangerous drinkable water are these major health problems in urban areas. One-third of urban people are vulnerable to disease [37].
The population in rural areas is less but the use of fertilizers, pesticides, and eroded soil contaminates the water. When it rains the water from the surface runoff and that rainwater enters the nearby water resource and thus pollutes the existing water [52]. Agricultural runoff cases freshwater bodies’ eutrophication. Half of the lakes in the US are eutrophic. Phosphate has one of the major contributions to eutrophication. And the high concentration of phosphates promotes cyanobacteria and algae growth, which leads to the excessive use of the biologically dissolved oxygen inside the water [53]. Fertilizers that are too enriched with nitrogen decrease the dissolved oxygen in rivers and coastal zones thus bringing hazardous effects to the biota. Since 2006, the nitrogen in fertilizers is being controlled in America and Northwest Europe [54]. Like pesticides, which are used as pest control, these pesticides leach into groundwater, thus polluting groundwater. The pesticides that are water-soluble leach more and the sandy soil favors the process of leaching [55].
Small pollutants particles which are present in the air, get into the water stream through the rain, when it rains these particles come down and then with the flow of water enters into the sea, thus polluting the water there. These pollutants that are present in the air usually get from the burning of fossil fuels e.g. is CO2, which combines with water and produces sulfuric acid. Sulfur dioxide, which is formed via volcanic eruption and from industries, also gets attached to a water molecule to form the sulfuric acid. When coal is combusted then also sulfuric dioxide is produced and it is also produced from petroleum products. Just like this nitrogen dioxide also combines with the water and forms the nitric acid. And with the help of rainwater, they enter the water resources (Figure 2) [52, 56, 57, 58, 59].
Circulation of contaminants between environmental sources under the effect of atmospheric sources.
Heavy metals are present on the earth and thus they can enter the water system through various pathways and one of them is through mining sources. When it rains or through flowing water, it leaches heavy metals out from their geological formation. These processes get disturbed when manmade economic activities such as mining are done. Through these processes, the area that is already mined out gets exposed to water and air and this leads to the acid mine drainage (AMD). The low pH conditions associated with AMD mobilize heavy metals, including radionuclides where these are present [60].
Soil gets polluted with the presence of heavy metal on surface and underground water and the pollution rises when mined ores are discarded on the ground surface for manual dressing [61]. Due to the dumping over the surface, the metals get exposed to air and rain thereby generating huge AMD. If soil is polluted at that time, it gets into the plant tissue and gets accumulated there. And when those plants are grazed by animals and water is used for the drink from polluted waters, through there these heavy metals enter the body. Also, marine lives, which reproduce in contaminated water, also have the presence of heavy metals inside their body tissues, if they are lactating then inside their milk. As an overview, all organisms within a given ecosystem are contaminated via these pollutants through their food chains [62]. When nutrition from these contaminated vegetables is taken, the presence of heavy metals in those vegetables can lead to different chronic diseases. Toxic effects due to these heavy metals usually depend on the amount of concentration and the oxidative state of the particular heavy metals [63]. Heavy metals have a very dangerous impact as they are non-biodegradable in nature, have long biological half-lives, and have the potential to accumulate inside the body. Also, there are some heavy metals that are extremely toxic only because of their solubility. Fewer concentrations of heavy metals inside the food chain also show severe effects as there is no particular procedure through which these heavy metals pollutants can be extracted from the body of an organism. Nowadays presence of these toxic heavy metals is everywhere because of their extreme use in industries. In case of the wastewater, it contains a huge concentration of heavy metals, which create various health-related problems [64, 65].
Water from estuaries and freshwater is not polluted till now to some extent, but that water is also at threat of being polluted in the long term due to metal deposition because of human past activities [66]. The water in the river and lakes can be highly polluted depending on the volume of flow and proximity to the point sources. Due to the human civilization, the element content in water is raised. Such elements are cadmium, lead, mercury, zinc, and chromium. Unlike organic chemicals, there are some metals that cannot be converted into compounds with lesser toxicity, and one of its characteristics is the loss of biodegradability. Once the heavy metals enter the water system it gets redistributed throughout the column and gets accumulated in the sediments [67]. The sediments constitute a partial contribution to polluting the natural phenomena due to their activity and metal remobilization processes. Metal residues that are present in the contaminated surroundings have the flexibility to get bioaccumulated into the aquatic environment [68]. Growth in fish larvae and juveniles is rapid. But when these heavy metals enter they might inhibit the growth rate. The fish grows in length and bulk when given the right conditions, such as a specific temperature and an acceptable amount of food. Fish growth, on the other hand, may be impeded in water contaminated with toxicants, such as heavy metals. One of the most noticeable signs of metal toxicity in fish larvae is growth inhibition. As a result, the length and bulk of fish are indications of environmental conditions [69]. Heavy metals are introduced in liquid form and surface water constituents (carbonate, sulfate, organic substances humic, fulvic, and amino acids) cause the formation of non-soluble salts or complexes. Aquatic species are not expected to be harmed by these salts and compounds. Some of them sink and collect in the sediments at the bottom. A decrease in pH of water either due to acid rain or any other acidic incidents, due to the heavy metal’s deposition into the water column, causes aquatic biota to become poisonous. Low levels of heavy metals can also make chronic stress, through fish might not get dead but can cause them to lose weight and become smaller, reducing their capacity to compete for food and habitat [70]. Pollution poses a hazard to both freshwater and marine habitats. Heavy metal poisoning of water is a significant environmental hazard that has detrimental consequences for organisms who are exposed to it be that plant-animal or humans. Fish from freshwater are majorly exposed to various heavy metals, which are added into the water bodies through the different-different sources. Contamination of these heavy metals into aquaculture has intensified global issues because it shows a risk to fish and has harmful impacts on fish buyers [71]. There are three different modes through which heavy metals enter the fish. These methods are either through the gills of fish, by the body of the fish, or by the digestive tract of the fish. Heavy metals immediately enter the fish body through the gills, while the body surface takes time for uptaking of these heavy metals through this mode [72]. Mostly the metals get accumulated in the liver, kidney, and gills. In fishes, the muscles have most of the metals present there as compared to the other body parts of the fish. Too much accumulation of these heavy metals inside the fish organ can cause lesions and operative disturbances [73]. These heavy metals also interfered with the embryo’s shape and the metabolic processes of the fishes. Structural and functional defects throughout the development of the embryo resulted in fewer larvae hatching. Several freshly born larvae die shortly after hatching owing to lead and copper absorption [74, 75]. Heavy metals get into the fish through three routes: the first is via the fish gills, the second is through the digestive tract of the fish and the last one is through the body of the fish. The gills of fish are the area that is known for the primary metal intake from the contaminated water. On the fish gills, zinc accumulates. It suggests a depressing influence on tissue respiration, which leads to hypoxia and mortality. Zinc pollution also causes alterations in the structure of the lungs and heart [76]. Humans and fish are both affected by mercury. Brain damage, with postnatal and fetal problems, leads to abortions, congenital deformity, and development differences in young fry due to Monomethyl. Minamata illness and Hg poisoning (via methyl Hg) both showed considerable neurotoxicity [77]. Nickel is necessary for tiny amounts for the formation of RBC, but when its concentration gets increased, at that time, it becomes harmful or poisonous. Cd has been linked to an increase in blood pressure and cardiac illness in fish. Blood vessels damage, hemorrhages, and depletion of blood cell count of a fish are induced by Hg, from previous research. Anemia, eosinophilia, lymphocytosis, bronchial, and renal injuries can affect chromium levels in the blood [18]. Malformations in fish are caused by cadmium, nickel, mercury, chromium, lead, and arsenic. The accumulation of these heavy metals in excessive amounts causes a variety of physiological effects. Fin loss, gill underdevelopment, liver dysfunction, and fin function in fingerlings were all prevalent findings in the studies [78]. The harmful effects of heavy metals have the greatest impact on the death rate, reproduction, individual development rates, and physiological capacity of fish. There have been effects on physical functioning and chemical parameters in the tissues and blood of fish living in water that is polluted via metals. It has been reported that fish exposed to metals developed immune system defects, making them more susceptible to infectious infections and increasing their chances of dying (Figure 3) [79].
Harmful effects on the aquatic environment.
For the growth of plants, few HMs like As, Cd, Hg, Pb, and Se are not important as they do not perform any known physiological function in them. Others, such as Co, Cu, Fe, Mn, Mo, Ni, and Zn, are key elements that are required for regular plant development and metabolism, but their amounts can quickly exceed the appropriate levels, resulting in poisoning [80, 81]. Heavy metal concentrations in plants vary by plant species, and the efficiency with which various plants absorb metals is measured by plant absorption or metal transfer factors from soil to plant. An increased amount of Pb in agricultural soil decreases the productivity rate of the soil, and a less lead amount may hinder some important processes of plant, dark green leaves, withering of older leaves, stunted foliage, and brown short roots are poisonous indicators of photosynthesis, mitosis, and water absorption [82]. Heavy metals are poisonous and phytotoxic to plants, resulting in diseases such as chlorosis, poor plant development, and yield depression, as well as decreased nutrient absorption, plant metabolic problems, and a reduced capacity to fix molecular nitrogen in leguminous plants. Seed germination was gradually reduced in the presence of increasing levels of lead, it may be due to exposure to lead for a longer duration, some methods, such as leaching, chelation, metal binding, or microbe accumulation, have resulted in the neutralization of lead’s harmful effects [83]. Heavy metals such as Cd, Pb, and Ni even their small concentration in plants can be hazardous to them. Poisoning due to this heavy metal will result in the complex interplay between the primary unpleasant ions and additional necessary or non-essential ions. Metals affect the activity of enzymes by swapping metal ions from metal enzymes, as well as preventing plant growth [84]. Some exceptional metals are vital for plants, as they reveal their roles in the catabolism of plants and biosynthesis, together as cofactors for enzymes and as metabolic yields. For example, Zn, Fe, Cu, Cr, and Co are the important nutrients but when their amounts are increased, they become toxic. Comparatively, Pb and Cd have no effect, which is favorable to the plant and is solely lethal [85]. The most abundant hazardous elements in the soil are lead. Pb poisoning in the soil is caused by municipal sewage sludge discharge, mining and smelting operations, Pb-containing paints, paper and pulp, gasoline, and explosives. They do not have any role in the shape of the plant or their growth and photosynthetic process of the plant. Pb poisoning also inhibits enzyme action, creates an imbalance of the water, alters membrane permeability, and disrupts mineral feeding [86].
One of the main sources of contamination of the water is heavy metals, as it overwhelms the important species indirectly through biological chains or directly via chemical modifications in water. Three potential ways are there, through which heavy metals get into the fish body: though fish gills, through the body of the fish, and through the fish digestive tract. Gills are responsible for the immediate absorption of metals from the water, whereas the body surface is thought to have a smaller role in the intake of these elements in fish [87]. By altering the normal activities of numerous enzymes and metabolites, the accumulation of these heavy metals in the tissues causes significant biochemical, physiological, and histological changes in fish and other freshwater fauna. Fish are one of the most widely dispersed creatures in the aquatic ecosystem, and their susceptibility to metal poisoning may indicate the extent of metal pollution’s biological impact [88]. Heavy metals, such as As, Cd, Cu, Cr, Fe, Pb, Mn, Hg, Ni, Zn, and tin (Sn), are major contaminants that cause serious toxicity in fish. Due to the heavy metals, the physiological and biochemical functions both in tissues and in blood Carpi can be altered. The compounds of As and inorganic As, Cd, Ni, silica in its crystal form, beryllium, and its compounds are considered to be chemical carcinogens, which results in the development of cancer inside the fishes. The drop in hematological parameters indicated that the exposed fishes had become anemic as a result of Cr exposure. This dangerous heavy metal was released into the aquatic ecosystem via trash, causing severe anemia and changes in hematological parameters in the
Water pollution is a global problem, and the world’s population is suffering the consequences of tainted water. Living organisms are also affected by the polluted water very much and it is very harmful to the environment. Acute and choric illnesses are caused by heavy metal concentrations in drinking water that exceed the permissible limits set by several national and international organizations. These can range from nonfatal, such as muscle and physical weakness, to fatal, such as brain, nervous system, and even cancer. Water quality testing is necessary for the protection of human health and the environment.
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",metaTitle:"Copyright Policy",metaDescription:"Copyright is the term used to describe the rights related to the publication and distribution of original works. Most importantly from a publisher's perspective, copyright governs how authors, publishers and the general public can use, publish and distribute publications.",metaKeywords:null,canonicalURL:"/page/copyright-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"Copyright is the term used to describe the rights related to the publication and distribution of original Works. Most importantly from a publisher's perspective, copyright governs how Authors, publishers and the general public can use, publish, and distribute publications.
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\\n"}]'},components:[{type:"htmlEditorComponent",content:'Copyright is the term used to describe the rights related to the publication and distribution of original Works. Most importantly from a publisher's perspective, copyright governs how Authors, publishers and the general public can use, publish, and distribute publications.
\n\nIntechOpen only publishes manuscripts for which it has publishing rights. This is governed by a publication agreement between the Author and IntechOpen. This agreement is accepted by the Author when the manuscript is submitted and deals with both the rights of the publisher and Author, as well as any obligations concerning a particular manuscript. However, in accepting this agreement, Authors continue to retain significant rights to use and share their publications.
\n\nHOW COPYRIGHT WORKS WITH OPEN ACCESS LICENSES?
\n\nAgreement samples are listed here for the convenience of prospective Authors:
\n\nDEFINITIONS
\n\nThe following definitions apply in this Copyright Policy:
\n\nAuthor - in order to be identified as an Author, three criteria must be met: (i) Substantial contribution to the conception or design of the Work, or the acquisition, analysis, or interpretation of data for the Work; (ii) Participation in drafting or revising the Work; (iii) Approval of the final version of the Work to be published.
\n\nWork - a Chapter, including Conference Papers, a Scientific Article and any and all text, graphics, images and/or other materials forming part of or accompanying the Chapter/Conference Paper.
\n\nMonograph/Compacts - a full manuscript usually written by a single Author, including any and all text, graphics, images and/or other materials.
\n\nCompilation - a collection of Works distributed in a Book that IntechOpen has selected, and for which the coordination of the preparation, arrangement and publication has been the responsibility of IntechOpen. Any Work included is accepted in its entirety in unmodified form and is published with one or more other contributions, each constituting a separate and independent Work, but which together are assembled into a collective whole.
\n\nScientific Journal – Periodical publication intended to further the progress of science.
\n\nJournal Article/Scientific Article – Publication based on empirical evidence. It can support a hypothesis with original research, describe existing research or comment on current trends in a specific field.
\n\nIntechOpen - Registered publisher with office at 5 Princes Gate Court, London, SW7 2QJ - UNITED KINGDOM
\n\nIntechOpen platform - IntechOpen website www.intechopen.com whose main purpose is to host Monographs in the format of Book Chapters, Long Form Monographs, Compacts, Conference Proceedings, Scientific Journals and Videos.
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\n\t\t\t Creative Commons Attribution 3.0 Unported (CC BY 3.0) \n\t\t\t | \n\t\t\t5 October 2011 (2011-10-05) | \n\t\t\tCurrently | \n\t\t
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The CC BY 3.0 and CC BY 4.0 license permits Works to be freely shared in any medium or format, as well as the reuse and adaptation of the original contents of Works (e.g. figures and tables created by the Authors), as long as the source Work is cited and its Authors are acknowledged in the following manner:
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Programs",slug:"quality-management-systems-for-laboratories-and-external-quality-assurance-programs",totalDownloads:4659,totalCrossrefCites:2,totalDimensionsCites:5,abstract:"A quality management system (QMS) plans, controls, and improves the elements that impact on the achievement of the desired results by the laboratory and on the satisfaction of the users. There are different standards that establish requirements for the implementation of a quality management system for laboratories, and a cross comparison between them is shown. Additionally, external quality assurance or assessment (EQA) programs offer multiple benefits to laboratories: method validation, comparing of results with other laboratories, testing problem identification, accreditation requirement compliance, and credibility. In order to control the quality of the procedures, these programs are a tool to keep the laboratory procedures and every variable involved in (staff, equipment, and method) well controlled. In the frame of a quality management system, benefits from external quality assurance programs are discussed, and different available designs are reviewed. On the other hand, previous benefits will be real only if reported results for each program are analyzed in detail. Because additional advantages are achieved when the EQA results are integrated in the quality management system of the laboratory, a procedure is proposed. In addition, results from external quality assurance programs corroborate the usefulness of internal controls implemented by the laboratory as part of its quality management system.",book:{id:"6325",slug:"quality-control-in-laboratory",title:"Quality Control in Laboratory",fullTitle:"Quality Control in Laboratory"},signatures:"Verónica Valdivieso-Gómez and Rocío Aguilar-Quesada",authors:[{id:"217457",title:"Ph.D.",name:"Rocio",middleName:null,surname:"Aguilar-Quesada",slug:"rocio-aguilar-quesada",fullName:"Rocio Aguilar-Quesada"},{id:"217467",title:"Ms.",name:"Veronica",middleName:null,surname:"Valdivieso-Gomez",slug:"veronica-valdivieso-gomez",fullName:"Veronica Valdivieso-Gomez"}]},{id:"41063",title:"Cosmetics’ Quality Control",slug:"cosmetics-quality-control",totalDownloads:12708,totalCrossrefCites:2,totalDimensionsCites:12,abstract:null,book:{id:"3276",slug:"latest-research-into-quality-control",title:"Latest Research into Quality Control",fullTitle:"Latest Research into Quality Control"},signatures:"Bruna Galdorfini Chiari, Maria Gabriela José de Almeida, Marcos Antonio Corrêa and Vera Lucia Borges Isaac",authors:[{id:"35801",title:"Dr.",name:"Vera",middleName:null,surname:"Isaac",slug:"vera-isaac",fullName:"Vera Isaac"},{id:"56070",title:"MSc.",name:"Bruna",middleName:null,surname:"Chiari",slug:"bruna-chiari",fullName:"Bruna Chiari"},{id:"56072",title:"Dr.",name:"Marcos Antonio",middleName:null,surname:"Corręa",slug:"marcos-antonio-correa",fullName:"Marcos Antonio Corręa"},{id:"154324",title:"BSc.",name:"Maria Gabriela José De",middleName:null,surname:"Almeida",slug:"maria-gabriela-jose-de-almeida",fullName:"Maria Gabriela José De Almeida"}]},{id:"58071",title:"Systematic Error Detection in Laboratory Medicine",slug:"systematic-error-detection-in-laboratory-medicine",totalDownloads:1792,totalCrossrefCites:4,totalDimensionsCites:4,abstract:"Measurements in laboratory medicine have a degree of uncertainty; this uncertainty is often called “error” and refers to imprecisions and inaccuracies in measurement. This measurement error refers to the difference between the true value of the measured sample and the measured value. One of the types of error is systematic error, also called bias, because these errors errors are reproducible and skew the results consistently in the same direction. A common approach to identify systematic error is to use control samples with a method comparison approach. An alternative is use of statistical methods that analyze actual patient values either as an “Average of Normals” or a “Moving Patient Averages.” Fundamental questions should be decided before a quality control method is used: how are weights assigned to the results? Is preference given to more recent samples or to the older samples? How sensitive should the model be? In this chapter, we will expand the fundamental notion of systematic error and explain why it is difficult to identify and measure and current statistical methods that are used to detect systematic error or bias.",book:{id:"6325",slug:"quality-control-in-laboratory",title:"Quality Control in Laboratory",fullTitle:"Quality Control in Laboratory"},signatures:"Amir Momeni-Boroujeni and Matthew R. 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In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. 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His later study in cooperation with experts in nephrology and immunology resulted in the designation of the new diagnostic method of UTI, patented in 2017. He is currently working at the Department of Microbiology, Medical University of Gdańsk (GUMed), Poland. Since many years, he is a member of steering committee of Gdańsk branch of Polish Society of Microbiologists, a member of ESCMID. He is also a reviewer and a member of editorial boards of a number of international journals.",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorTwo:{id:"484980",title:"Dr.",name:"Katarzyna",middleName:null,surname:"Garbacz",slug:"katarzyna-garbacz",fullName:"Katarzyna Garbacz",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003St8TAQAZ/Profile_Picture_2022-07-07T09:45:16.jpg",biography:"Katarzyna Maria Garbacz, MD, is an Associate Professor at the Medical University of Gdańsk, Poland and she is head of the Department of Oral Microbiology of the Medical University of Gdańsk. She has published more than 50 scientific publications in peer-reviewed journals. She has been a project leader funded by the National Science Centre of Poland. Prof. Garbacz is a microbiologist working on applied and fundamental questions in microbial epidemiology and pathogenesis. Her research interest is in antibiotic resistance, host-pathogen interaction, and therapeutics development for staphylococcal pathogens, mainly Staphylococcus aureus, which causes hospital-acquired infections. Currently, her research is mostly focused on the study of oral pathogens, particularly Staphylococcus spp.",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorThree:null,editorialBoard:[{id:"190041",title:"Dr.",name:"Jose",middleName:null,surname:"Gutierrez Fernandez",slug:"jose-gutierrez-fernandez",fullName:"Jose Gutierrez Fernandez",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:null,institution:{name:"University of Granada",institutionURL:null,country:{name:"Spain"}}},{id:"156556",title:"Prof.",name:"Maria Teresa",middleName:null,surname:"Mascellino",slug:"maria-teresa-mascellino",fullName:"Maria Teresa Mascellino",profilePictureURL:"https://mts.intechopen.com/storage/users/156556/images/system/156556.jpg",institutionString:"Sapienza University",institution:{name:"Sapienza University of Rome",institutionURL:null,country:{name:"Italy"}}},{id:"164933",title:"Prof.",name:"Mónica Alexandra",middleName:null,surname:"Sousa Oleastro",slug:"monica-alexandra-sousa-oleastro",fullName:"Mónica Alexandra Sousa Oleastro",profilePictureURL:"https://mts.intechopen.com/storage/users/164933/images/system/164933.jpeg",institutionString:"National Institute of Health Dr Ricardo Jorge",institution:{name:"National Institute of Health Dr. Ricardo Jorge",institutionURL:null,country:{name:"Portugal"}}}]},{id:"4",title:"Fungal Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. 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He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. 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