Summary of some environments caused by SCC on different alloys.
\r\n\tIn sum, the book presents a reflective analysis of the pedagogical hubs for a changing world, considering the most fundamental areas of the current contingencies in education.
",isbn:"978-1-83968-793-8",printIsbn:"978-1-83968-792-1",pdfIsbn:"978-1-83968-794-5",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"b01f9136149277b7e4cbc1e52bce78ec",bookSignature:"Dr. María Jose Hernandez-Serrano",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10229.jpg",keywords:"Teacher Digital Competences, Flipped Learning, Online Resources Design, Neuroscientific Literacy (Myths), Emotions and Learning, Multisensory Stimulation, Citizen Skills, Violence Prevention, Moral Development, Universal Design for Learning, Sensitizing on Diversity, Supportive Strategies",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 14th 2020",dateEndSecondStepPublish:"October 12th 2020",dateEndThirdStepPublish:"December 11th 2020",dateEndFourthStepPublish:"March 1st 2021",dateEndFifthStepPublish:"April 30th 2021",remainingDaysToSecondStep:"3 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Phil. Maria Jose Hernandez Serrano is a tenured lecturer in the Department of Theory and History of Education at the University of Salamanca, where she currently teaches on Teacher Education. She graduated in Social Education (2000) and Psycho-Pedagogy (2003) at the University of Salamanca. Then, she obtained her European Ph.D. in Education and Training in Virtual Environments by research with the University of Manchester, UK (2009).",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"187893",title:"Dr.",name:"María Jose",middleName:null,surname:"Hernandez-Serrano",slug:"maria-jose-hernandez-serrano",fullName:"María Jose Hernandez-Serrano",profilePictureURL:"https://mts.intechopen.com/storage/users/187893/images/system/187893.jpg",biography:"DPhil Maria Jose Hernandez Serrano is a tenured Lecturer in the Department of Theory and History of Education at the University of Salamanca (Spain), where she currently teaches on Teacher Education. She graduated in Social Education (2000) and Psycho-Pedagogy (2003) at the University of Salamanca. Then, she obtained her European Ph.D. on Education and Training in Virtual Environments by research with the University of Manchester, UK (2009). She obtained a Visiting Scholar Postdoctoral Grant (of the British Academy, UK) at the Oxford Internet Institute of the University of Oxford (2011) and was granted with a postdoctoral research (in 2021) at London Birbeck University.\n \nShe is author of more than 20 research papers, and more than 35 book chapters (H Index 10). She is interested in the study of the educational process and the analysis of cognitive and affective processes in the context of neuroeducation and neurotechnologies, along with the study of social contingencies affecting the educational institutions and requiring new skills for educators.\n\nHer publications are mainly of the educational process mediated by technologies and digital competences. Currently, her new research interests are: the transdisciplinary application of the brain-based research to the educational context and virtual environments, and the neuropedagogical implications of the technologies on the development of the brain in younger students. Also, she is interested in the promotion of creative and critical uses of digital technologies, the emerging uses of social media and transmedia, and the informal learning through technologies.\n\nShe is a member of several research Networks and Scientific Committees in international journals on Educational Technologies and Educommunication, and collaborates as a reviewer in several prestigious journals (see public profile in Publons).\n\nUntil March 2010 she was in charge of the Adult University of Salamanca, by coordinating teaching activities of more than a thousand adult students. She currently is, since 2014, the Secretary of the Department of Theory and History of Education. Since 2015 she collaborates with the Council Educational Program by training teachers and families in the translation of advances from educational neuroscience.",institutionString:"University of Salamanca",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Salamanca",institutionURL:null,country:{name:"Spain"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"23",title:"Social Sciences",slug:"social-sciences"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"301331",firstName:"Mia",lastName:"Vulovic",middleName:null,title:"Mrs.",imageUrl:"https://mts.intechopen.com/storage/users/301331/images/8498_n.jpg",email:"mia.v@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"6942",title:"Global Social Work",subtitle:"Cutting Edge Issues and Critical Reflections",isOpenForSubmission:!1,hash:"222c8a66edfc7a4a6537af7565bcb3de",slug:"global-social-work-cutting-edge-issues-and-critical-reflections",bookSignature:"Bala Raju Nikku",coverURL:"https://cdn.intechopen.com/books/images_new/6942.jpg",editedByType:"Edited by",editors:[{id:"263576",title:"Dr.",name:"Bala",surname:"Nikku",slug:"bala-nikku",fullName:"Bala Nikku"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophanides",surname:"Theophile",slug:"theophanides-theophile",fullName:"Theophanides Theophile"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"50733",title:"Genital Human Papillomavirus (HPV) Infections in Men as a Factor for the Development of Cervical Cancer",doi:"10.5772/62954",slug:"genital-human-papillomavirus-hpv-infections-in-men-as-a-factor-for-the-development-of-cervical-cance",body:'\nNumerous infectious, inflammatory, and neoplastic diseases arise in male sexual organs. Infection of the genitalia with human papillomavirus (HPV) is worldwide and is currently the most frequent sexually transmitted infection [1]. For unknown reasons, clinical changes are absent in most infected individuals as the virus remains in a latent phase until spontaneous elimination occurs by unknown mechanisms. On the other hand, immunosuppressed individuals frequently present with the clinical changes caused by HPV. Their clinical course is more severe, and their therapy is impeded since the immune system is compromised. Furthermore, genital HPV infections in women and subclinical changes of various degrees of cervical intraepithelial neoplasia (CIN 1–3) that can pave the way for the development of cervical cancer are relatively well understood. However, little is known about the subclinical infections in men that cause penile intraepithelial neoplasia (PIN). The significance of PIN is clear, since men who are carriers of HPV can be frequently undiscovered sources of infection for their female sexual partners [2, 3].
\nHPV is known for its characteristic heterogeneity, and the viral infection can run its course asymptomatically, subclinically, or symptomatically. Thanks to the polymerase chain reaction (PCR), over 200 types of HPV have been identified and subsequently classified according to changes induced, that is high risk (e.g., types 16, 18, 31, and 33) and low risk (e.g., 6 and 11) [2, 4]. Infection with HPV types 16 and 18 carries a large risk of precancerous and cancerous changes, while the appearance of genital warts caused by HPV types 6 and 11 is accompanied by a small risk of cancer development. Evaluation of risk and detection of HPV infection when clinical symptoms are absent is possible with a number of investigations, which include peniscopy, hybrid capture II (HC2), and PCR. The results of tested specimens, however, are variable and largely depend on anatomic sampling site and method of investigation [5, 6]. For instance, HPV DNA was found around the glans penis and external prepuce in 24% of individuals studied, while in 44% it was found on the inner (mucosal) prepuce where low-risk HPV types predominated. When material was collected using a brush, 70–92% of obtained samples were positive and 33% of which were high-risk types [6]. Furthermore, the results of a peniscopy only suggest the probability of HPV infection, since the presence of HPV DNA was not confirmed in 57% of positive peniscopy results [5, 7]. Nonetheless, peniscopy is necessary for gross identification of lesions, and the biopsy allows for histopathologic assessment of character to differentiate inflammatory changes (e.g., lichen sclerosus) from neoplastic changes of low- and high-grade PIN. PCR and HC2 examinations together with peniscopy allow for evaluation of the infection and defining its risk group. Also, positive findings upon acetowhitening, PCR, and HC2 are sufficient to establish diagnosis [7].
\nHPV DNA is detected in approximately 5–11% of sexually active and healthy men aged 16–35 years [8]. The HPV types responsible for the development of genital warts (mainly types 6 and 11) are the predominant cause of infection. Other viral types are strongly associated with cancer of the cervix and are therefore termed “high-risk” types, and they include 16, 18, 31, 33, 39, 42, and 51–54 [9]. HPV viruses 16 and 18 are diagnosed most often in infections running subclinical courses in genital cancer patients. The risk of infecting sexual partners is estimated at 60%. However, although the peak of infection detection is in the age of 18–25 years, peak incidence of cervical cancer occurs around the fifth decade of life. Thus, the process of tumor progression is slow, and additional factors, so-called cocarcinogens, are necessary for the development of the cancer [10, 11].
\nWarts are most often multifocal. The following are three main types affecting the genital region:\n
genital warts (condyloma acuminata) are the most infectious lesions; they are pedunculated with a cauliflower-like appearance; depending on location and degree of irritation, they can be flesh-colored or various shades of red; and in uncircumcised men, they are localized on the inner (mucosal) prepuce, but can also be found on the glans penis, coronal sulcus, frenulum, external prepuce, shaft of penis, and scrotum [12].
papular, flesh-colored warts, and
flat warts—flattened papules of various colors such as red, pink on red, and brown [8, 13].
Warts may also occur at the urethral meatus or navicular fossa, where they are diagnosed in approximately 28% of patients [8]. In men who use condoms, warts are often localized in the suprapubic area. Interestingly, apart from prevention, condoms may accelerate the regression of flat warts on the penis [14]. In addition, they prevent reinfection and formation of new growths on the penis, but only when the same type of HPV occurs in partners. When different HPV types are present in the female partner, condoms do not protect against infection [15]. Condoms minimize the risk of so-called neoplasm transmission because they block the transmission of oncogenic HPV [16]. By minimizing the risk of penile cancer formation, the risk of cervical cancer is significantly limited. Moreover, with circumcision, the risk of penile cancer is decreased from 19.6 to 5.5% and subsequently the risk of cervical cancer formation in female sexual partners is also decreased [17, 18].
\nIn a study of a large number of patients and a group of healthy controls, HPV DNA was found in 25% of men whose female partners had been diagnosed with CIN. HPV DNA was found in 6% of healthy women, but there was often discord with the results in their partners. Consequently, it has been proposed that no investigations are required in the absence of clinical changes in the partner of a woman with diagnosed CIN. It is also emphasized that HPV DNA results be assessed diligently because HPV DNA was not found in 25% of positive acetowhitening and 57% of those diagnosed with peniscopy [19]. In addition, up to 30% of warts have been found to regress spontaneously over the course of 3 months owing to immune system functions dominated by a cell-mediated response [10].
\nThe treatment of warts includes the use of podofilox in 0.5% gel or solution, dichloroacetic acid or trichloroacetic acid, 5% imiquimod cream, cryotherapy with liquid nitrogen, destruction of tissue with electrofulguration, and laser ablation [20].
\nLarge warts resembling tumors were first described in 1925 by Buschke and Lowenstein—the Buschke and Lowenstein tumor [21]. This rare wart variant is associated with HPV infection types 6 and 11 and is characterized by deep rooting into the stroma that results in damage to deep-lying tissues. Its aggressive growth produces tumors of large dimensions. Histopathologically, typically mild warts are found alternating in coexistence with foci of atypical epithelial cells or cells of highly differentiated squamous cell carcinoma. Patient history is positive for inflammation or ulceration and phimosis of the glans penis. The warts may ulcerate or cause fistulation. Diagnosis of this tumor may require multiple biopsies or imaging studies that include computed tomography (CT) and magnetic resonance imaging (MRI) [22].
\nIntraepithelial neoplasia may involve both male and female genitalia—penile intraepithelial neoplasia (PIN), cervical intraepithelial neoplasia (CIN), vulvar intraepithelial neoplasia (VIN), and vaginal intraepithelial neoplasia (VaIN), respectively. Additionally, the anus may be involved in either gender—anal intraepithelial neoplasia (AIN). The changes can have a character of bowenoid papulosis or Bowen’s disease. Moreover, female sexual partners of men with diagnosed PIN can have changes corresponding to CIN, VIN, or VaIN in various degrees of advancement. They require long-term observation over several months because these changes often resolve spontaneously. Fortunately, neoplastic transformation of PIN is very rare [23]. Although the infection status of female partners of men with subclinical infection of the penis is not determined, it has been accepted that subclinical changes and latent infections do not require treatment, which would be ineffective in such cases.
\nBowenoid papulosis (BP), also described as Bowen’s atypia, is an advanced phase of intraepithelial changes with features of PIN. These warts are generally numerous and tend to form clusters on the penile shaft and scrotum [22]. In young men, BP resolves spontaneously, but in the elderly it can maintain itself for years with a tendency to progression. Progression to squamous cell carcinoma is marked. BP characterizes itself with the occurrence of flat warts (papulae) of skin color, but they may also be pink or sometimes brown. In men, it mainly occurs on the glans, while in women on the labia, groin, and around the anus. It is evoked by HPV 16, but other types (e.g., 18 and 31) may be culprits. The threat to infected women is the development of cervical cancer; for men, it is that they can infect their female partners and in doing so predispose them to cervical cancer [24]. Since the presence of BP is entwined with great risk of cancer development, treatment is considered crucial; excision of the change is most effective. Cryoablation with liquid nitrogen or laser ablation is also used. Recurrence should be taken into consideration since it has been estimated as high as 33% [20].
\nErythroplasia of the glans penis is a form of carcinoma in situ occurring in uncircumcised men. Macroscopically, the change is erythematous, well demarcated, and slightly raised above the level of the skin on the glans penis or on the internal (mucosal) prepuce.
\nHistologically, it resembles Bowen’s disease; it occurs on mucosal surfaces. The changes are singular or multiple and painless. Their surface tends to be smooth, scaly, or verrucous. The most frequent patient complaints are itching and bleeding with difficulties in retracting the prepuce. Diagnosis is made on the basis of biopsy specimen evaluation. Transformation of erythroplasia into penile squamous cell carcinoma occurs in 10–33% of patients [25]. Treatment of choice is surgical excision of the lesions.
\nBowen’s disease is most often observed as a solitary focus that is demarcated, flat, and reddish in color. Histopathological assessment reveals a squamous cell carcinoma in situ (corresponding to changes of PIN 3 and VIN 3). The disease is mainly caused by HPV 16 and 18, but sometimes also by HPV 31, 33, 45, and other oncogenic types. It occurs less often in women, growing slowly over years though it does not resolve spontaneously. The possibility of progression to invasive cancer should be considered when induration of the base, ulceration, or bleeding occurs, or the lesions increase in size. Changes on the vulva classified as intraepithelial neoplasia VIN 1–3 occur particularly in young women. The possible risk of progression of VIN3 to invasive cancer should be considered during therapy [22, 26]. In men who are partners of women with CIN 1–3 or VIN 1–3, changes consistent with PIN 1–3 are relatively frequent (up to 40%) in comparison with partners of women with genital warts (approximately 5%) [22]. Advanced changes corresponding to PIN 3 are diagnosed more often in older men in comparison with PIN 1–2. Clinical observations show that BP occurs more often than Bowen’s disease in younger men [22].
\nPenile cancer is not analogous to cervical cancer. While the detection of HPV DNA approaches 100% in cervical cancer cases, it is found in approximately 40% of penile cancer cases. Differences in frequency of finding HPV DNA (50–70%) exist and it depends on the type of cancer. HPV DNA is diagnosed most often in early premalignant changes corresponding to PIN 3, and in warts undergoing malignant transformation. For female sexual partners, infectivity is greater in cases with PIN 2 and 3 than in those with invasive cancers. The risk of infecting male partners of women with invasive cancer is not greater than when compared to women with CIN 2 [27].
\nPenile cancer is a rarely diagnosed neoplasm (<1% of neoplasms in men) occurring mainly in older individuals. In recent years, however, this cancer is being diagnosed in younger men. It predominantly arises on preexisting PIN 3, but, in addition to infection with high-risk oncogenic HPV types, other factors play a significant role: tobacco smoking, poor hygiene, phimosis, and changes consistent with lichen sclerosus [28, 29]. When PIN lesions are sustained, circumcision should be performed for its protective effect.
\nChronic infection with oncogenic HPV types, specifically 16 and 18, is the most significant factor favoring penile cancer. Depending on the method used, HPV DNA is found in up to 90% of penile cancer in such cases. The risk of developing cervical cancer is increased in female partners of men having penile cancer [30]. As in women, an association between lichen sclerosus and cancer of genital organs has also been described in men [29, 31]. In one study, it was shown that neoplastic changes of the penis occur in approximately 8% of men with lichen sclerosus localized there for 10–23 years [32]. In subsequent studies, it was concluded that lesions consistent with lichen sclerosus coexisted or preceded penile squamous cell carcinoma in eight of 20 cases [33]. The etiopathogenesis of lichen sclerosus is unknown, but genetic, immunologic, infectious (bacteria such as Borrelia), or environmental factors may be possible. The disease is chronic in character. An association between lichen sclerosus and squamous cell carcinoma, which is diagnosed in 6% of patients with lesions on the labia, exists in women. Lichen sclerosus is an inflammatory disease in which involved tissues are affected by atrophic changes and indurations. Secondary phimosis or induration of the urethral meatus may be observed in men [31, 33]. In a study of 86 uncircumcised men affected by lichen sclerosus (the disease most often concerns the uncircumcision of middle age), malignant changes occurred in five (6%) [32]. The presence of HPV 16 was found in PCR studies while another study found histologic features of lichen sclerosus in 10 of 20 patients with diagnosed penile squamous cell carcinoma [33]. A significant role is attributed to genital HPV types. Men affected by lichen sclerosus report to physicians due to itching and burning sensations, they have painful erections and difficulties retracting the prepuce, and also they complain of voiding symptoms. If lichenification involves the glans penis, there is often bleeding, ulceration, and fistulas, and hemorrhagic bullae may also occur. Progression of changes often expands to involve the glans penis and prepuce, as well as the frenulum. An indurated white ring around the rim of the prepuce is a significant finding. It can present with strangulation of the prepuce (paraphimosis) or phimosis [34, 35]. Genital HPV types are regarded as dominating in the development of cancer on preexisting lichen sclerosus [36]. It is possible that the long-term inflammation favors proliferation of epidermal cells and causes activation of the HPV life cycle. Another favoring factor is local immunosuppression caused by use of preparations containing potent corticosteroids [36]. Due to the risk of phimosis, especially in young men, circumcision is most often performed following diagnosis of lichen sclerosis.
\nSince HPV is a proliferating virus, it should be remembered that it multiplies only in proliferating cells. Therefore, an underlying inflammatory state or irritation in the genital region increases the proliferation of epidermis, which in this way supports infection and multiplication of the virus. Significantly more often, infections with genital HPV types occur in immunosuppressed patients, such as those undergoing treatment with cytostatic agents, those after organ transplant, and also women during pregnancy [37–39]. The clinical course of HPV infection in patients infected with HIV is very aggressive [40]. The changes caused by HPV are more extensive in such cases. The risk of progression of preneoplastic lesions into invasive cancer increases, and the changes occur rapidly. The risk of neoplasm development increases fivefold in patients after organ transplant [41, 42]. This is linked to HPV infection and impairment of T lymphocyte and natural killer (NK) cell function by the immunosuppressive preparations. T lymphocytes and NK cells are responsible for elimination of neoplastic cells in early oncogenesis [43].
\nMost men infected with HPV are naive, either because they have no signs and symptoms or because the signs and symptoms are so mild that they persist unrecognized or ignored. Men with HPV infection are a frequent source of infection for their female sexual partners who are at great risk of death resulting from the development of cervical cancer. Identification of infected men may reduce transmission and subsequent preneoplastic and neoplastic changes; however, numerous factors reduce the plausibility of testing men. Unlike the consistent sampling site in women (the cervix), the sampling site in men varies from anus and perianal area to the scrotum up to the urethral meatus and into the navicular fossa. Incomplete anogenital sampling is a major factor contributing to the variability in HPV prevalence estimates [44]. This variability together with spontaneous elimination of the virus will pose difficulties for recommendations regarding duration of abstinence and frequency of follow-up. It has been suggested that for optimal detection, scrotal, perianal, or anal samples should be included together with the minimum protocol of penile shaft, glans penis, and coronal sulcus [44].
\nSurely, we may infer that the knowledge of the presence of HPV infection in the man may reduce the incidence of cervical cancer in woman by reducing transmission resulting from proper condom use or sexual abstinence until the virus is eradicated. However, how can the man be inspired to do comply with such recommendations and what findings can be used to determine when the man is HPV free and allowed to resume unrestricted coitus? For what duration and frequency should the man be tested to determine the continued presence of HPV after the initial positive result? When and for how long should he be tested after changing partners? This can be considered a serious issue since HPV can be deadly for the woman who contracts HPV from the unsuspecting man and develops cervical cancer as a result. Yearly PAP testing for women is already a standard of care in many countries, but what can be done in developing and underdeveloped countries? How can illiterate populations be educated about the risks of HPV infection and consequences, and also how they can avoid it? What solutions can we implement in poor communities, whose women may not visit their gynecologists yearly, or ever? HPV is currently the leading sexually transmitted infection. In countries where resources are limited or women must travel hours or days by foot to visit their physician, the implications of late diagnosis may be deadly.
\nIn summary, it must be stated that chronic immunosuppression favors HPV infection, allows for its self-preservation, and also favors activation of the viral life cycle, which is a primary factor triggering proliferative changes on genital organs. The therapeutic options for HPV-related changes are numerous (superficial preparations, cryotherapy, laser therapy, surgical excision) but are unfortunately burdened with recurrence and complications to a large degree. The changes caused by genital HPV types in the region of the sexual organs demand elimination of coexisting inflammatory states and treatment of sexual partners when indicated. It also appears that using a polyvalent HPV vaccine may prove effective in preventing benign and malignant changes, especially in groups of patients at increased risk [45]. Vaccination strategies, however, may be met with difficulties given geographic (e.g., access to facilities), cultural (e.g., core beliefs), and socio-demographic limitations (e.g., access to information) [46].
\nStress corrosion cracking (SCC) in chemical, petrochemical, and power plant industries is an insidious form of corrosion, which causes a lot of financial losses and human damages [1, 2, 3, 4, 5]. This phenomenon is associated with a combination of tensile stress, environment, and some metallurgical conditions as described in Figure 1.
The essential requirements for SCC.
During stress corrosion cracking, the metal or alloy is virtually unattacked over most of its surface, while fine and branch cracks progress through the bulk of material [6]. It is shown in Figure 2. This cracking phenomenon has serious consequences since it can occur under stresses much lower than design stresses and lead the equipment and structures to premature failures [7, 8, 9, 10, 11].
Crack development in carbon steel exposed to nitrate solution.
Stress corrosion cracking starts from corrosion sites at the material surfaces and progresses into a brittle manner. The process of cracking is not strictly a mechanical process, as the corrosivity of the environment strongly affects the fracture mode. Both intergranular and transgranular stress corrosion cracking are observed. Intergranular cracking proceeds along grain boundaries, while transgranular cracking advances without apparent preference for boundaries [12]. An example of stress corrosion cracking in which the crack has progressed in both intergranular and transgranular paths is shown in Figure 3. The development mode of cracking depends on the composition and microstructure of the material and environment.
Intergranular and transgranular stress corrosion cracking of the AISI 316L stainless steel at polythionic acid environment [8].
In this chapter, the conditions for the occurrence of SCC are first introduced. Then, the stress corrosion cracking mechanism for various materials in conditions that are susceptible is discussed in detail. The design of industrial structures and components is usually based on tensile properties, which have many disadvantages. So, the science of fracture mechanics applies in the situations prone to SCC because of the inevitability of manufacturing and service defects in materials and for considering the role of such imperfections. Methods of prevention based on corrosion science and empirical data are presented. Finally, practical examples are given to better understand the issue.
Not all metal-environment combinations are susceptible to cracking. In other words, the environment for occurrences of SCC for each metal or alloys is specific. Also, the resources of stress for each case of failure may be different.
Austenitic stainless steels suffer from SCC in chlorides, caustic, and polythionic acid. When austenitic stainless steels with sufficient carbon content (more than 0.03 wt.%) are heated in the range of 415–850°C, their microstructure becomes susceptible to precipitation of chromium carbides (M23C6) along grain boundaries known as sensitization [9, 12, 13]. Formation of Cr-rich carbides along grain boundaries may drastically deplete free chromium content in the area adjacent to the grain boundaries and render them susceptible to rapid preferential dissolution. Sensitized steels are most susceptible; the stress corrosion cracking of nonsensitized steels is also observed [14, 15]. Dissolution of grain boundaries in some corrosive environments aside from tensile stress led these types of materials to SCC.
Seasonal cracking of brass in the rainy season in an ammoniacal environment is another classical example of SCC. This was first identified on the brass cartridge used by the British Army in India. Since it is usually identified during the rainy season, it is also called seasonal cracking [12]. Alpha brass is an alloy of Cu-Zn. It can crack either intergranularly or transgranularly in nontarnishing ammonia solutions, depending on its zinc content [16, 17, 18]. Transgranular stress corrosion cracking, TGSCC, is observed in alloys with 20 or 30% Zn but not in alloys with 0.5 or 10% Zn [19, 20]. Stress corrosion cracking of Cu-Zn and Cu-A1 alloys in cuprous ammonia solutions can only occur when the parting limits for dealloying are exceeded. The parting limits are about 14 and 18 a/o for Cu-A1 and Cu-Zn, respectively [21]. Cu-A1 and Cu-Ga alloys have shown similar behaviors [19, 22].
Aluminum and all its alloys can fail by cracking along grain boundaries when simultaneously exposed to specific environments and stresses of sufficient magnitude [23, 24]. Of eight series of aluminum alloys, 2xxx, 5xxx, and 7xxx aluminum alloys are susceptible to SCC. Among them, 7xxx series aluminum alloys have a specific application in aerospace, military, and structural industries due to superior mechanical properties. In these high-strength 7xxx aluminum alloys, SCC plays a vital factor of consideration, as these failures are catastrophic during the service [25].
Carbon and low alloy steels have shown SCC in a wide range of environments that tend to form a protective passive or oxide film [26, 27, 28, 29, 30]. The environments that would passivate carbon steels have been found to cause SCC, including strong caustic solutions, phosphates, nitrates, carbonates, ethanol, and high-temperature water. The problems are important for both economic and safety reasons, due to the extensive use of carbon steels [31]. For example, nitrate cracking in an ammonium nitrate plant caused by catastrophic failures and a lot of financial losses. Caustic cracking of steam-generating boilers made of low alloy steels was a serious problem, which led an ammonia plant to repeated emergency shutdowns.
Stress corrosion cracking may be a problem whenever certain high-strength titanium alloys are exposed to aqueous and certain solvent environments [32, 33, 34, 35, 36]. For the first time, SCC of titanium was reported by Kiefer and Harple who describe the cracking phenomena with commercially pure titanium in red fuming nitric acid [37]. Hot salt cracking of titanium alloys was reported in turbine blades that operate at high temperature in the mid-1950s. The subject became very active in the early 1960s because of the SCC problem connected to these alloys in a transportation program [38].The first known report of stress corrosion cracking of titanium alloys in room temperature aqueous environments was that of Brown. He found that titanium alloys, 8% aluminum–1% molybdenum–1% vanadium alloy (Ti, 8–1–1), were susceptible to SCC in seawater [38].
Another requirement for SCC to occur is a corrosive environment. The environments for SCC are specific because not all environments promote SCC. For those alloys that develop a protective film, an aggressive ion is required to promote SCC. The aggressive media to passive layer of stainless steels are chlorides, caustic, and polythionic acid. The austenitic stainless steel series 300 is more susceptible in an environment containing chlorides. Chlorides will not cause SCC unless an aqueous phase is present. It appears that stress corrosion cracking in austenitic stainless steels in the presence of chlorides proceeds transgranularly and usually occurs at temperature above 70°C
Metal | Environment |
---|---|
Al alloys | NaCl-H2O2 solutions |
NaCl solutions | |
Seawater | |
Copper alloys | Ammonia vapor and solutions |
Amines | |
Water or water vapor | |
Gold alloys | FeCl3 solutions |
Acetic acid-salt solutions | |
Inconel | Caustic soda solutions |
Lead | Lead acetate solutions |
Magnesium alloys | NaCl-Na2CrO4 solutions |
Rural and coastal atmospheres | |
Seawater | |
Distilled water | |
Nickel | Fused caustic soda |
Steels | NaOH solutions |
NaOH-Na2SiO4 solutions | |
Calcium, ammonium, and sodium nitrite solutions | |
Mixed acids (H2SO4-HNO3) | |
Acidic H2S solutions | |
Seawater | |
Carbonate-bicarbonate solutions | |
Stainless steels | Acidic chloride solutions |
NaCl-H2O2 solutions | |
Seawater | |
H2S | |
NaOH-H2S solutions | |
Condensing steam from chloride waters | |
Titanium alloys | Red fuming nitric acid |
Seawater | |
Methanol-HCl |
The stress in the form of tensile (not compressive) plays a key role in the SCC fracture processes. In fact, SCC would never have occurred in the absence of stress. The required tensile stresses may be in the form of directly applied stresses, thermal, in the form of residual stresses, or a combination of all [8, 50]:
For SCC to occur alone by applied stress, it must have a very high magnitude. The welding and mechanical residual stresses are the main sources of stress attributed to the stress corrosion cracking. The welding residual stress is produced as a result of nonuniform temperature changes during welding operation and can be calculated from thermal strain vectors.
The thermal strain vector,
in which
The operational thermal stress can also be calculated from Eq. 2. Mechanical workings such as cold deformation and forming, machining, and grinding are the other sources, which introduce residual stresses [8, 51].
Extensive investigations have been devoted to find mechanisms of SCC for different materials and environments. An SCC failure illustrates the combined effects of mechanical, physical, and chemical/electrochemical factors causing the separation of metal bonds at the crack tip, thereby advancing the crack. Three mechanisms for SCC have been proposed through the investigations [52]:
This model supposes that there are pre-existing paths in an alloy that is susceptible to anodic dissolution. Because of precipitation or solute segregation of impurities like sulfur, phosphorus, and chromium carbides, the electrochemical properties of the matrix and segregates are changed. The area adjacent to the grain boundaries is depleted from one or more alloying elements, and so under such conditions, localized galvanic cells are created (Figure 4). Since precipitation or segregation is generally anodic to the matrix of the grains, dissolution under an anodic reaction occurs and provides active path for localized corrosions [53]. Also, the removal of the protective film at the pre-existing crack tips by plastic deformation would facilitate the onset of localized corrosion.
Galvanic cell mechanism [52].
This mechanism has been extensively studied in stress corrosion cracking of alpha brass in ammoniacal environment and also proposed for caustic cracking of boiler steel. The model is based on the idea of a strain-induced rupture of the protective film, and so plastic strains play a main role in failure processes [52, 55]. The theory assumes the existence of a passivation film on a metal surface. The passivation film protects the underlying metal against corrosive agents. The passivation film is ruptured by plastic strain due to mechanical workings. After the film is ruptured, the bare metal is exposed to the corrosive environment. The processes of disruptive strain (disruption of protective film) and film formation (due to repassivation) have occurred and alternate with each other. The crack propagates when the rate of rupture of oxide film is higher than the rate of repassivation of the film [52]. The mechanism is shown in Figure 5.
Strain-generated active path mechanisms. (A) Film rupture model and (B) slip-step dissolution model [52].
This model is based on the effects of environmental species on interatomic bond strength. The theoretical fracture stress required to separate two layers of atoms of spacing b is given by [56].
where E is the Young modulus, γ is the surface energy, and b is the spacing between atoms.
This theory implies that if surface energy is reduced, then
The design of steel structure and component based on tensile properties has many disadvantages that do not take into account the role of imperfections. Fracture mechanic introduces another material characteristic, namely, fracture toughness, KIC, which considered the role of cracks and imperfection in the form of cracks in designs. In its simplest form [57].
where
According to this equation, fracture occurs when stress intensity factor,
Effects of corrosive environment on fracture toughness [12].
Since the exact mechanism of SCC has not been completely understood, prevention methods are either general or empirical in nature. Appropriate strategy should be done in order to minimize this problem to ensure not only the safety of human life but also the safety of cost. The following general methods are recommended to overcome the SCC problems [12, 52, 58, 59]:
Lowering the tensile stress in the welded component using post weld heat treatment. The post weld heat treatment reduced or eliminated residual stress on surface and through the bulk of material. Plan and low alloy steels may be a stress relief at 1100–1200°F. The range of residual stress relief temperature for austenitic stainless steels is from 1500 to 1700°F. Reduction of tensile stresses by shot peening is also recommended. Shot peening introduces surface compressive stresses.
Eliminating aggressive agents from the environment by, for example, degasification, demineralization, or distillation.
Changing the alloy is one possible solution if neither the environment nor stress can be changed. For example, it is a common practice to use Inconel (raising the nickel content) when typ. 304 stainless steel is not satisfactory.
Applying cathodic protection: impressed current cathodic protection system has been successfully used to prevent SCC of steels.
Adding inhibitors to the system if feasible: high concentrations of phosphate have been successfully used.
Coatings are sometimes used, and they depend on keeping the environment away from the metal.
After only 3 years’ service of a circulation water heater (heat exchanger), it has been shown to sever leakage and has led a methanol plant to emergency shutdown. An on-site investigation revealed extensive cracking initiated at weld area and through the tube sheet holes as it is shown in Figure 7.
Failed area (a) cracks extending in the weld joint of tube sheet to plugs and (b) branched cracks in the surface of the tube sheet and through the holes [8].
The circulation water heater is a vertical U-type heat exchanger made of austenitic stainless steels. The equipment used to decline reforms gas temperature in a methanol plant. The hot reformed gas at approximately 385°C entered the tubes and is cooled down to 168°C by exchanging the heat with processed water in the shell. The gases that flow through the tubes are mainly CO2, CO, H2, CH4, and N2 and at a pressure of 3.9 MPa. At the shell cooling process, water flows with about 6 MPa pressure.
Deposits had formed on top of the tube sheet due to shutdown errors. AISI 316L materials overheated in service because of the insulation role of the deposits. Material sensitization occurs since overheating. The presence of sulfur in the process gas aside from moisture formed polythionic acid during shutdowns. Residual stress produced by heavy machining and welding aside from operational thermal stress provided tensile stress, which is needed for SCC. Stress corrosion cracking is induced by polythionic acid. Concentrated water with other aggressive agents such as caustic and chlorides leaked through the cracks aid the failures.
Cleaning of the shell by demineralized water after each shut down in order to prevent the forming of insulating deposits above the tube sheet
Reduction of sulfur in feeding gas
Reduction of caustic and chlorides in processed water
Carryover of caustic soda (NaOH) in the steam path caused catastrophic failure of superheater stainless steel tubes in a gas-fired heater and led to an unexpected shutdown after just 5 months of continuous service following the start of production. The failure areas are shown in Figure 8. Three types of cracks are identified in various regions of the tube: circumferential cracks adjacent to the seam weld, circumferential cracks at the ribbon of the seam weld, and longitudinal cracks on the U-bend. The path of cracks was complex on the surface or in the bulk metal; all had nucleated from inside the tubes. A visual inspection revealed a white deposit, high in sodium, around the cracks on the surface of the tubes.
(a and b) Circumferential cracks adjacent to the seam weld, (c and d) circumferential cracks at the ribbon of seam weld, and (e) longitudinal cracks on the U-bend [9].
The superheater tube material was made of AISI 304H austenitic stainless steel material.
The gas-fired steam heater (FH) generates high-pressure (HP) steam for turbines for the processing of methanol. Demineralized water for the boiler and subsequent steam path is prepared in the water treatment unit. Caustic soda is injected to demineralized water for pH control. The water is transferred to the preheat exchangers, is converted to saturated high-pressure steam at 325°C and 119 MPa, and is sent to the FH. Through the FH tubes, saturated steam converted to supersaturate steam at a temperature of 505°C and pressure of 119 MPa.
The main cause of crack initiation was the increase of pH due to the rise of caustic concentration in condensed drops. Sensitized austenite grains caused by chromium carbide depletion adjacent to the grain boundaries were attacked by concentrated caustic in the HAZ metal and U-bend area and led the heater to the caustic SCC failure.
Using A335 Grade P9, a low alloy steel tube shows higher resistance to SCC than AISI 304H stainless steel
Proper discharge of the tubes during shutdowns to prevent the formation of the concentrated deposits of caustic through the tubes
After a general overhaul of a thermal power plant in Serbia in November 2014, failure of hundreds of brass condenser tubes occurred during the hydrostatic test. Also, it was noted that some backing plates had fallen off from the tubes before this test. Fracture is observed only in condenser tubes of brass, as can be seen in Figure 9.
Failure of brass condenser tubes near joining location with backing plate.
The failed tube material of the condenser was made of brass CuZn28Sn1 (admiralty brass). The cooling water (roughly filtered river water) flows through the tubes, while the hot steam flows around the tubes.
Analysis of fracture surfaces using scanning electron microscopy (SEM) has shown the brittle transgranular fracture due to the occurrence of SCC. The condenser tubes are made of brass CuZn28Sn1. Ammonia and other nitrogen compounds in the cooling water through the tubes were found. These compounds are specific agents that cause stress corrosion cracking (SCC) in brass. In the joining region of condenser tubes to backing plates, there are residual tensile stresses. During the floods in May 2014, there was an increase in the concentration of ammonia and other nitrogen compounds in the river cooling water flowing through the condenser tubes. Failure of brass condenser tubes occurred due to SCC, because the necessary conditions for the SCC occurrence were fulfilled.
The risk of SCC in brass condenser tubes can be reduced if specific substances responsible for SCC occurrence are removed, as much as possible. This can be achieved by cleaning and drying the tubes immediately after the operation delay of the power plant.
Another way to reduce the risk of SCC occurrence in condenser tubes is the replacement of existing tubes (made of brass CuZn28Sn1, very susceptible to SCC) with tubes made of alloys of greater resistance to SCC, such as copper-nickel alloys or Bi-brass alloys [61].
Stress corrosion cracking is one of the main causes of unforeseen and dangerous destruction of industrial plants. The sensitized material, certain environments, and stress are three factors necessary for the occurrence of these types of failures. The environment prone to the cracking for each metal or alloy is specific because not all environments promote the SCC. Austenitic stainless steels suffer from SCC in chlorides, caustic, and polythionic acid. Copper alloys corrode in ammonia-containing environments. Well-known specific environments for the stress corrosion cracking in Al alloys include water vapor, aqueous solutions, organic liquids, and liquid metals. The SCC of Ti alloys in aqueous chloride and methanolic chloride environments has been widely reported. The tensile stress plays a key role in the stress corrosion cracking phenomenon. The required tensile stresses may be in the form of directly applied stresses, thermal, in the form of residual stresses, or a combination of all.
If one of these three components does not exist, this type of corrosion will not occur. Therefore, the solving methods should be based on the elimination of one of these three factors. Corrosive environment modification, the stress in the form of compression, and using proper material are three general proposed methods of prevention.
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