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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\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:"1319",leadTitle:null,fullTitle:"Embryonic Stem Cells - Differentiation and Pluripotent Alternatives",title:"Embryonic Stem Cells",subtitle:"Differentiation and Pluripotent Alternatives",reviewType:"peer-reviewed",abstract:"The ultimate clinical implementation of embryonic stem cells will require methods and protocols to turn these unspecialized cells into the fully functioning cell types found in a wide variety of tissues and organs. 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\r\n\tSince the introduction of the first sub-picosecond lasers in the 1990s, the interest in femtosecond optics has grown rapidly. A femtosecond pulse is an electromagnetic pulse with a time duration of one femtosecond (10-15 seconds) or less. Understanding the behavior of the ultrashort light pulses makes it possible to develop ultra-fast lasers with a wide range of applications in such areas as micro-machining, chemical analysis, material processing, spectroscopy, and medical imaging.
\r\n\r\n\tThis book will be a compilation of works presenting recent advances and progress in femtosecond optics. It aims to focus on developing femtosecond laser systems, the study of the interaction of femtosecond light pulses with the matter, application of ultrafast nonlinear optics, and manipulation of ultrashort pulses to fill the need for a thorough and detailed account of femtosecond optics. We hope this book will be useful for engineers and managers, for professors and students, and for those who are interested in laser science and technologies. The rise of robotic technology continues in the new century, taking firm steps towards becoming a part of humanity day by day. Robots have become a part of both industrial production and human life, increasingly taking their place in factories, hospitals, schools, the military system, streets, and homes. As a result of this rapid involvement of robotic structures in modern life, scientists are accelerating both theoretical and applied studies on robotic manipulators. This book focuses on the latest developments in kinematics, dynamics, control, simulation tools, optimization, and structural design of serial, parallel, and hybrid robot manipulators. I would like to thank all the authors who will contribute to the book with their novel ideas in advance. During the last years, there was intense research on Ankylosing Spondylitis (AS) and related disorders, which were found to have a strong association with the HLA-B27 allele. Further studies showed that 92% of the population variance is due to genetic factors, and only a fraction of AS genetics can be explained by the influence of HLA-B27. Updated information on the genomic and auto-immune knowledge on AS is an important component of this book, calling attention to markers of disease activity, possible pathways, and the interaction with the gut microbiome, which are a step forward in the knowledge of the pathophysiology of AS, providing markers which are targets for the more recent biologic therapies.
\r\n\r\n\tAn update on clinical manifestations, their assessment, monitoring, and imagiology, including peripheral arthritis, enthesopathy, and extra-articular findings, and, the differential diagnosis with other diseases which evolves with axial and peripheral calcifications will be provided.
\r\n\tAn important component of this book must be dedicated to the more recent treatments namely with biologic therapies but focusing also on new small molecule inhibitors and experimental therapies.
Psychoanalytic and psychiatric practices have often got me in touch with people displaying a disproportionate fear of infectious diseases. They wastes their life among washing and cleaning rituals, but can get back no sense of safeness. The patient’s partner or relatives – at length even the patient himself – get to realize his anxiety about infectious risk is clearly unrealistic and that he is wasting all of his existential energy. So, in the end a professional help is sought, and a psychiatric diagnosis is formulated, which generally includes phobic neurosis or hypochondriasis.
Anxiety about inter-human contact has a long story and no doubt antedates our modern understanding of the etiology of infectious diseases. In primitive or archaic societies contact with certain members of the community was associated with the violation of severe religious prohibitions. The anthropological literature speaks of
In Europe the culturally accepted representation of pollution had gone through several stages over time. Medieval Christianity focused on improperly polluted sexual contacts. The water of Greek-Roman ritual purifications gave so way to the sacrament of Penance, which included magical components and often featured a compulsive quality.
In modern societies the danger associated with inter-human contact has often been equated with an infectious threat. So the feared contagion diffused by supposed plague spreaders has repeatedly replaced sexuality as a paradigm of pollution. In his masterpiece,
Nowadays, humanity is confronted again after decades with an infectious disease characterized by significant morbidity and mortality rates, particularly so in older people. And fear grows more and more. Epidemiologists, the government, the media, and the public opinion are racing in the pledge for more and more restrictive measures which put severe limits to individual freedom.
Hostility among citizens is increasing by the day. Older retired women use to blame the rare pedestrians when they fail to properly wear their face masks; fierce checkout girls spell detailed hygienic regulation to fearful consumers; zealous citizens report to the police their neighbour for any supposed violation of lock-down measures; young people with substantial internet skills expose innocent runners or reckless children to mediatic shame.
No doubt: the SARS COVID-19 Coronavirus had yielded a deep and dramatic cultural change. The epidemic mitigation measures have called for an interpersonal distancing which is unprecedented in western history. Social and economic problems which have been tripping European governments over the last decades have been suddenly put aside, while public wealth has been wasted without reserve in the unfortunately useless attempt to stop the spread of the disease.
In a recent book [4], the well-known philosopher Gorgio Agamben formulated the coronavirus epidemic within the framework of German theory of the state as a
Fear has gained a core position in current socially shared representation of human reality. The politicians, the media and the public opinion have unanimously agreed that all the social structure and the economic organization should be rapidly reformulated according to illness prevention needs.
Just as in primitive or early modern societies, contagion, contact and fear occupy the centre stage. Hypochondriac anxieties have begun to spill out of the corner where modern thought and the advancements of medicine had confined them. The phobic parts of personality have taken control of contemporary culture.
So, in XXI century advanced societies, hypochondriasis becomes the official, or rather the single accepted thought, and severe opponents of critical thinking call for a strict censorship of any dissent.
The dissidents have been the victim of a savage mediatic campaign which associates them explicitly to neo-Nazi’s intellectuals. Just as the latter strive to negate the width of Hitler instigated butchery of Jews during World War II, the opponents of the health related state of exception would be negationsists,
Against such a background several eminent psychoanalyst have taken sides. They have openly blamed dissidents. They have suggested psychoanalysis gives up its traditional option for neutrality and enlists beside traditional institutional powers in the repression of dissent.
Over the last years a greater integration of psychoanalysis within the healthcare system has been authoritatively advocated [7]. Now Austin Ratner [8], an advisor to the American Psychoanalytic Association advocacy, public information, messaging, and branding task force, stated that psychoanalysis should contribute to fostering the citizens’ widest consensus to contagion preventing measures.
In Italy, many mediatically prominent psychoanalysts are sharply critical of the opponents of the government. Massimo Recalcati (“I paradossi della tirannia sanitaria”
In an interview to the TV network
Lingiardi and Giovanardi have no doubts: any opposition to infection prevention measures “increases the number of cases and deaths due to coronavirus infections” and is dependent on a primitive mental functioning, where denial is a basic defense mechanism. Psychoanalysis should therefore leave her century old withdrawal from the political arena and become “a force for social change” merging within public health institutions with the aim to reeducate and free from their own neuroses the scanty army of the dissidents.
Sarantis Thanopolus, current President of the Italian Psychoanalytic Society, in an article for the
How could this deep change be brought about? How could psychoanalysis turn into a compliant device for the management of public opinion? In order to answer this question we will now cast a look at the history of the relations between professionals and praxes of mental health, on one side, and control of socially improper behaviors, on the other.
Our review will begin with the late Middle Ages. In the year 1321, authorities close to the King of France began to spread (obviously forged) evidence that a dangerous international plot was underway ([9], p 5–28). The plot would have been supported by Islamic powers along the Mediterranean coasts and maybe by international Jewish elites.
The plot was aiming to overthrow legitimate Christian sovereigns and establish a new rule. The inquirers had no doubt about the main agents in the conspiracy: people living at the margins and all the more dangerous as suffering from an infectious disease. The Pope couldn’t but yield to the overwhelming evidence and authorized the civil servants to take appropriate action.
The lepers’ slaughter began in June, 1321, in several cities. The outraged populace took active part in the repression of the rascals, enthusiastically welcomed the authorities’ recommendations and, should these prove late, initiated the rampage without waiting for “a judge or a bailiff”.
As could be expected, such a wide slaughter could not be completed. The surviving lepers were therefore permanently confined within
Official psychiatric narratives celebrates Philippe Pinel as the man who gave back freedom to lunatics, in 1795. Actually Pinel released lunatics from workhouses where their behavior had been controlled and their vices punished, but their psychiatric condition had never been treated. However, in the state hospital which succeeded to workhouses as a place for the specialized treatment of mental disorders, behavioral control rapidly reemerged as a basic institutional goal. In Italy, it took to Franco Basaglia decades of political fight to obtain a law who banned psychiatric hospitals, in 1978.
Psychiatrists in clinical practice know all too well that to the general public madness has always amounted to a frightful ghost, a gloomy, lurking danger which needs to be put under control at all costs. I will not discuss here the upsetting condition of contemporary psychiatric care in Italy or elsewhere, but none will deny that the control of improper behavior still stays a core concern of psychiatric services.
Today, against the background of epidemic emergencies, from psychiatric and psychoanalytic institutions something more is required than the sole enforcement of social norms. Nowadays, mental health professionals are called to substantially contribute to the establishment of an unrestricted compliance with institutionally proposed beliefs and ethical values.
This more ambitious social goal is however no complete novelty either. The reader may consider the role psychiatric services played in Soviet Russia as a device for the repression of political dissent [11]. In Soviet society the control of dissent relied on two concurrent and cooperating paradigms: the criminal justice and the mental health services. The Art. 70 in Soviet Criminal Code of 1958 included the crime of “Disorders and anti-Soviet propaganda”. In addition, the “Dissemination of fabrications known to be false, which defame the Soviet political and social system” was the focus of the Art. 190–1, introduced in 1967.
The harsh juridical procedures were integrated by mental health interventions. A large number of dissidents were classified as suffering with mental disorders and relegated into psychiatric institutions. On a descriptive perspective, heterodox political ideas were interpreted in terms of delusion of reform, while the diagnostic category of latent schizophrenia was the most relied upon in order to justify compulsory admissions.
In the most perfect society the world over, opposition to government was obviously evidence of madness. As Khrushchev wrote on the
The parallel between Khrushchev’s thoughts and Galimberti’s unsympathetic devaluation of lock-down opponents is obvious and dismaying. In Soviet Russia political violence and repression were everyday means to enforce consensus. We do hope they will not soon infiltrate the democratic West, too.
Propaganda, no less than advertisement, thrives on a skillful distortion of language. Psychoanalytic theory and practice, on the other hand, requires extreme accuracy in word selection and use. Before we develop further our review of the role of psychoanalysis with reference to health related negationism vs. conformism, we need discuss briefly some words which are relevant to the issue.
Denial may refer to both internal and external reality. This may create substantial confusion. So, in order to be more accurate, we’d better rely on the original German terms. The
The concept of
We may mention here
Let us finally come to the historical
From a psychoanalytic point of view, Shoah Denial amounts to a sadistic interpersonal strategy. It aims to elicit the maximum possible emotional pain in the political enemies, through the downplaying and pollution of their most intimate and traumatic collective memories. It should not be misunderstood as a defense mechanism.
How can we then realistically describe social movements opposing pandemia mitigating measures? Which words could be the most appropriate? The core issue with preventive measure oppositions is no doubt the
Over the course of history, the citizens have ranged again and again along opposite poles: Catholic and Lutherans, fascists and antifascists, patriots and reactionary clericals, supporters of Stalinist Communism and democratic activists, and, nowadays, supporters of political freedom and advocates of sanitary ideology. Such ideology and identity polarization can be understood from a psychoanalytic point of view as a function of the defense mechanisms of splitting and projection into the adversary of one’s own anxieties.
As for the opponents to the government policies and to prevailing social organization, a masochistic identification may play a significant role. This is particularly obvious whenever opposition implies facing overwhelming threats, like was the case for Christian undergoing martyrdom, for various national heroes wasting their life for the good of their community, to Solzhenitsyn in the Gulag or Cato the Younger choosing freedom over life.
In the next section we will try to formulate a more articulated model which could help us better understand the splitting which has recently appeared within contemporary society and the harshness displayed by the two opposing sides.
What happened to contemporary man? How could a whole society get ill with fear? Can psychoanalysis contribute to the understanding of the changes which the Coronavirus pandemic has yielded in our society and of the amazing consensus which the ideology of social distancing has won the world over?
Wilfred Bion clinical and theoretical work during and after World War II cast an original light on regressive phenomena in groups [15]. Whenever a group experiences distress and helplessness, it regresses to primitive functioning patterns where emotional exchange and the search for the truth are replaced by Super-ego imperatives and prejudice.
Bion termed such patterns
At the core of contemporary society an enigmatic and ominous threat is lurking, then. What frightens contemporary man? Why do as much or even more dangerous social threats – you may think of terrorism, nuclear war, climate change or cancer – exert a much milder impact on our emotional social life than an infectious disease? Which gloomy resonance can a respiratory virus elicit in Western cultural space?
In order to answer such questions we must firstly remember that modernity relies on a specific epistemological option: our society and our culture have explicitly opted for a strict and rigid materialistic reductionism. This has brought about an inevitable devaluation of emotional experiences and an underestimation of their role in the society and in the individuals’ lives. Under this perspective, the pain associated with experiences of separation has been the object of a particularly fierce denial.
The life cycle brings about an inevitable amount of emotional pain (
Against such experiences, contemporary culture has tried to put up an impassable wall, through the activation of massive defensive mechanisms. It has isolated and sterilized death within the hospital container. Has hidden corpses in far-flung crematoria.
We all know the impact such cultural structures have had on the elaboration of the response to Coronavirus epidemic. Besides, the distancing between generations, but also within the sexual couple, which is so obvious in contemporary society, dates back to some decades before virologists have agitated the threat of intrafamilial contagion.
The ever increasing and now undisputed success of the paradigm of the nuclear family and the concurrent spread of permanent celibacy give evidence of a widely shared fear and uneasiness with close interpersonal relationships and amount to an exasperated response to the issue of interpersonal and couple conflicts.
No human interaction, though, can be immune from a meaningful exchange of emotions: happy, but more often sad ones. Any contact within the couple or the family conveys not only viruses but also an unavoidable burden of anxiety, pain, conflicts and fears. This is the very contagion which frightens contemporary men: the emotions which arise in interpersonal interactions.
No safety measure, though, no surgical or FPP3 mask can spare us this emotional contagion. From the toil of interpersonal relationships can only the most extreme autism free us. Or death.
We will now report a psychoanalytic case, which may offer some further insight in the phenomenon of pandemic related anxiety and the use of social distancing as a way to regulate emotional distance in relationship.
COVID pandemic stroke during the third year in Nedda’s second analytic experience with me. Nedda – then about 50 years old - had been referred to me for a depressive state some years earlier. Her first treatment segment had been focused on her interpersonal patterns. The analytic work had revealed a severely dependent oral structure with inability to handle separation from mother and sisters within a large family.
Since the first consultation, Nedda’s imposing appearance had given further evidence of a severe dysfunction in her oral libidinal organization. Her severe obesity seemed to have stripped her body from the most obvious female shape markers. Her dressing style, her attitude and her behavior all concurred in reassuring the interviewer that she represented no sexual challenge or opportunity. In fact, she was compliant with every social norm or widespread ethical ideal, and made every effort to let the interviewer feel at ease and in control. She never questioned treatment rules and conventions.
In the first treatment segment the interpersonal sources of depressive symptoms had been a major concern and interpretative interventions had been limited to the more superficial components of transference. Nearly two years elapsed before Nedda sought again my help.
In the second treatment segment, the question of weight control took the foreground in sessions for a while. Due to her obesity, she experienced severe abdominal problems, which required surgical treatment. For a few weeks, she attended self-help meetings for eating disorders. However, at the time of the onset of COVID-19 epidemic in Italy, the issue of weight control had already slipped back in the background or, rather, it had even been forgotten.
Nedda was now completely focused on her unique marital relationship. Consistently with her developmental pattern, the relation was very close, nearly suffocating, and the spouses’ social interactions outside the couple were limited to immediate relatives. A single medication supported intercourse, on the wedding night, had been extremely dissatisfying, and was followed by no other attempt over 15 years. Nedda and her husband used to spend all of their free time in their apartment, but their relationship was strained, with chronic hostility and coldness, and occasional rage outbursts.
Nedda seemed absolutely unaware of her contribution to the permanent sexual inhibition in the couple. Her husband’s poor availability to undergo treatment for a possibly somatically based impotence was to her the undisputable evidence of his guilty indifference. While never considering the option of becoming a mother through artificial insemination, she laid on him all the blame for her having missed the experience of motherhood.
She consumed sessions after sessions in complaining of her husband’s insensitivity. If her house was usually in a mess and the furniture had never been completed this was due only to her husband’s insufficient motivation and general fear of responsibility. Consistently, Nedda believed her consistent devaluation and coldness had no impact on the chronic depression he had been suffering for years. This highly ambivalent but obviously symbiotic lifestyle was bound to get even more strained due to the impact of COVID 19, as we will soon see.
Sessions with Nedda used to develop along one of two possible patterns. In the first pattern, which we might term
The object of blame might vary: the boss, a colleague, a sister or a sister in law. Usually, the husband seemed to carry most of the guilt. When a session unfolded according to this
Generally, the misdeeds of the guilty character were described in detail and took most of the session. I had only the option to listen in silence or ask for some additional information. Whenever I could finally have a chance to offer an interpretative intervention, Nedda would immediately got overcome by emotionality and tears.
In the subsequent session or sessions, Nedda would typically appear quiet and satisfied. She would waste the session in trivial chatter, which offered no meaningful material for my interventions. I will term this second associative pattern a
At the time COVID-19 epidemic reached our country, I was dissatisfied with Nedda’s treatment. I could envisage no clear goal or therapeutic pathway. I began to believe Nedda was unable to sustain any interpretative work. She apparently came to the sessions to the only aim of checking my continuing availability and keeping at bay any interpretative effort by me.
COVID pandemic unavoidably had a substantial impact on the therapeutic relation. As a physician spending some hours a week in an inpatient psychiatric facility, located within a general hospital, I expectedly got ill with Coronavirus syndrome early, even days before the epidemic had been officially recognized in Italy by local health authorities. I could personally inform Nedda of my condition, which kept me from meeting her in session for some time. Nedda had no difficulty in getting back to analytic work as soon as I had recovered.
While back in my office, I felt clearly relived by my somewhat easy recovery. Although I needed no hospital treatment, the experience of a potentially lethal condition is bound to bring about a closer awareness of the reality of death. In the first session after the interruption, I often realized my interventions included a measure of basically improper optimism about the epidemic, which gave evidence of the activation of manic defenses.
Nedda’s behavior in session showed a clear compliance with what she guessed were my unconscious expectations. Neither then nor later she showed any hesitation in attending sessions with me, and the treatment was suspended only over a short time period, when a general ban on outpatient health services was enforced by authorities for epidemiological reasons.
However, in her life outside the analytic situation, Nedda stuck to the opposite attitude with reference to contagion prevention. As time went by and the morbidity and lethality associated with the COVID 19 disease came to be more and more apparent, Nedda’s social isolation got absolute.
She worked only on a remote working basis. She left her house only to purchase food. She meticulously disinfected each shopping bag. She ceased meeting any relatives of her, including her old mother.
At the time the illness was ravaging in Italy, her life choices were far from exceptional within the general population. However, as the months elapsed, most citizens kept to the restrictions suggested by official health institutions and avoided any further preventive procedures.
Nedda, on the other hand, continued to lead an extremely secluded life. At length she got back to office every now and then, but met her mother and sisters only in a couple of instances (two funerals) over an entire year. She had no other human contact beside her husband. However, oddly enough, particularly as the media were emphasizing the epidemiological risk associated with healthcare professionals, Nedda never questioned meeting me regularly in sessions. Nedda used to enter the room with some hesitation, as if she feared the contact with me might be actually the cause of an infection, but once inside she seemed to lose any inhibition, and even occasionally dropped her face mask as a matter of course.
I will now report a sequence of sessions which yielded novel insights into Nedda’s specific transference patterns and into the anxieties elicited in her by the COVID pandemic. Nedda began a session by reporting how the COVID pandemic had painfully affected her own life. She particularly missed very much a chance to meet again her mother physically. I pointed out to her that the COVID-19 epidemic had led her to a nearly complete withdrawal from social and even family life, but that she apparently didn’t fear meeting with a physician in occasional clinical contact with COVID patients.
Nedda felt the need to justify herself. She had not forgot her mother. She got in touch with her daily on the phone. Beside, the choice for a definitive physical distancing from her had not been completely her own, and had actually been forced on her by her youngest sister. Nedda had always described the latter as aggressive and authoritarian. Against her will, no one in the family, and particularly Nedda, dared to act.
I told Nedda that the COVID-19 pandemic had dramatically changed her own life. She had lost the relationships which had meant so much, which had even meant all to her till some months earlier. I acknowledged her view that her sister’s pressure had been a meaningful factor but formulated the hypothesis that she was less in need of contact with her relatives than before.
The patient acknowledged only that she felt some annoyance towards her sister. She had felt rejected in a couple of episodes. She did not appeared particularly moved or interested by my comments.
Some sessions elapsed and Nedda entered my office in a state of deep distress. After some unsubstantial interpersonal memories, she focused on her husband. She was fed up with him. She reported that he had been withdrawn and depressed for a couple of weeks. She was not willing to put up with him any longer, and in fact she had been more explicitly aggressive and devaluing towards him than ever.
Nedda went on reporting that during a quarrel her husband had even put his hands at her neck, and could only with difficulty control the drive to chock her. I, too, found some difficulty in controlling my countertransferential response to the patient’s communication.
I felt the patient was in some way provoking me no less than her husband. She was apparently precipitating an explosive couple conflict which could prove dramatically dangerous. After years of analysis, she was still turning more to acting out than to associations in the analytic room as a communication device. I could exteriorly control my helplessness feelings and shared with the patient my concern for her health and even life. Nedda spent most of the last part of the session in tears but did not express any manifest comment on my intervention.
In the following session things were different. Nedda was outraged and flooded the room with savage blaming. The focus was no more the husband, though, rather myself. In a way disregarding my manifest comment on the dangers she was exposed to, she relied on an intuitive insight into my countertransferential feelings. To her I was implicitly siding with her husband, a violent, murderous man. I wasn’t defending her from him, even when her own life was at stake.
At the time, Nedda’s transference was obviously dominated by an oedipal unconscious fantasy where a heroic knight was bound to rescue her from the hand of an impotent but murderous father. Nedda’s fantasy may also have included a dawning awareness that her enormous body would never allow her to compete with mother’s beauty and erotic power.
Nedda talked in a loud voice and vomited her blames on me one after the other. For several minutes I was unable to stop her complaint. I felt both hurt by her authoritarian projective blames and helpless. Finally, I commented that she was realizing psychoanalysis, particularly psychoanalysis with myself, was different from what she expected and maybe even from what she could actually need.
She was looking for someone to encourage, support and praise her, someone who could show agreement with all she made and said. I admitted a relation like that – which we can here characterize as regressive and narcissistic – could temporarily ease her emotional pain, but made clear that psychoanalysis was something different.
It amounted to an interaction with a professional who has his own identity, and just because of that can offer novel views and open new doors. This was the only way genuine interpersonal change might be brought about.
The intervention proved able to loose tension in the session. The patient told me she didn’t need now to interrupt the treatment as she had decided before entering the office.
To me the session had been extremely informative and had offered the elements I was badly in need to properly formulate Nedda’s transference. I was now in the position to answer some questions: Why had Neddda exceeded authorities’ recommendations and turned to a phobic avoidance of most human interactions? Why did she meet her analyst with no apparent anxiety and even occasionally and deliberately pull off her face mask?
In fact, Nedda feared nothing more than an object, an interpersonal object. After weaning she had never accepted her mother could no more directly answer her oral emotional needs. And had turned to concrete, material nourishment in order to sustain the fantasy of an omnipotent mother which was indefinitely available to her oral wishes.
Her regressive oral inner world was at ease with self-object and only with self-objects. A male sexualized object did not frighten her because of his valuable gifts or his ability to elicit libidinal forces within her body. Rather, she deeply feared the emotional exchange which any interaction with an external object is bound to yield. An object has his own wishes, fears and memories. An object hosts his own fantasies within his own inner world. An object can receive projections, can react empathically, but may also be withdrawn, hurt or enraged.
In the transference, she was often unable to resist her own oral greed. She felt forced to close distance to the analyst, to meet at last a human being, to find a listener to her pain. Such transference wish brought about
However, this very transference communication and exchange was bound to enhance her deep fears. Her need to be fully in control in any interpersonal relationship was severely threatened. She felt helpless, exposed, dependent on the transference object for her emotional well-being. To her, human interactions included then a virus, an emotional contagion. In the
In Nedda’s case, exaggerated illness prevention measures amounted to a strategy to control interpersonal interactions and keep at bay her unlimited interpersonal greed. The severe social and interpersonal withdrawal Nedda had gone through in the third analytic year was not based on health related concerns. It was Nedda’s strategy to shelter herself from the threats implied by close interpersonal relationships and particularly by the transference relationship.
Nedda’s case teaches us that the primitive part of personality may be continuously concerned with the emotion elicited by interpersonal relationships. The resulting persistent conflict between the unlimited longing for close interactions with significant others and the concomitant fear of being flooded with projections by the interpersonal objects has played a significant role all through human history. We have mentioned above how widely shared cultural representations and institutions offer evidence that inter-human contact is dangerous. Contemporary society enhanced concern with the threat of infectious diseases, a concern which dates back much earlier than coronavirus epidemic, is very likely to thrive on this very unconscious threat.
To a psychoanalytic eye, the general public representations of compliance vs. nonadherence to prevention measures are massively infiltrated by socially shared unconscious phantasies based on the dangers of interpersonal contact. As both clinically active and theoretically informed psychoanalysts, we are consistently called to understand the unconscious roots of these very phenomena.
Sigmund Freud developed psychoanalysis as an antidote against the hypocrite moralism of Victorian Europe. Freud believed that the freedom with which he had been able to explore human sexuality was the most important source of the opposition psychoanalysis met in the to him contemporary culture.
Psychoanalysis still remains a theory and a practice which allow those who have been silenced to open their mouth at last, which lend to the repressed unconscious contents an unexpected freedom of speech. Psychoanalysis is a subversive discipline.
Psychoanalysis has always been unwelcomed in totalitarian regimes. In Soviet Russia it was banned altogether [17]. In Nazi Germany it underwent a process of
Within the framework of the dramatic reality we are currently experiencing, psychoanalysts, no less than other citizens, can agree with various different preventive strategies and support various political forces. They must always remember, however, that the psychoanalytic endeavor implies a position of strict neutrality vis-a-vis political and social issues.
In
Freud believed psychoanalysis thrived on the search for truth ([20], p 94), but psychoanalytic truth is never an external, objective truth. It’s always a subjective truth, better a dyadic truth, which is piecemeal constructed within any specific patient-analyst couple.
In order to effectively reach such subjective truth, the psychoanalyst is required to keep to a position of strict neutrality with reference to the object of his investigation. There’s no doubt: a psychoanalyst will never be able to enroll his or her professional skill in the service of any ideology or social model, however valuable to the society at large it might be, without permanently infringing his or her professional ethic.
Progress in semiconductor technology has led to the development of substantially miniaturised Micro Active Implantable Medical Devices (also called M-AIMD) that are significantly smaller in size and are implanted in difficult to reach interstitial spaces within the human body, thereby permitting direct interaction with organ systems. This reduction in size facilitates the use of delivery systems (e.g., via catheter or hypodermic needle) that significantly reduce procedure time and burden of care for patients [1, 2, 3, 4]. M-AIMDs are either battery-less or have small batteries necessitating the need for efficient charging and powering solutions [5, 6, 7, 8]. The most common method is power transferred from an on-body transmitter to an in-body AIMD equipped with a receiver using near-field magnetic induction [9]. This is very challenging as it requires carefully balancing multiple design parameters such as size, depth of implant, orientation of implant (and associated misalignment), and regulatory limits for emission and tissue safety [10]. The need to efficiently deliver power to a small target volume (<1 cc) inside the body requires careful design of the transmit coil system and the receive coil system [11].
There is a lot of work in the literature identifying various parameters that need to be optimised to maximise power delivered to a load (therapy delivering M-AIMD) [12, 13, 14, 15]. For example, Fu et al. [16] studied the SIMO (single input multiple output) resonant inductive system and derived an expression for the optimal load and efficiency. Monti et al. [17] concentrated on deriving the solution for the SIMO system that is not necessarily a resonant inductive system. The authors approached the problem of maximising efficiency as a generalised eigenvalue problem. Zargham and Gulak [18] focused their attention on SISO (single input single output) systems. They focused on power transfer through CMOS substrates and lossy biological tissue. Minnaert and Stevens [19] described the three optimisation approaches (efficiency, delivered power and conjugate matching) for SISO systems. Their derivation was based on a generalised 2-port system and was not specific to an inductive resonant system. They suggested that the efficiency of power transmission is a monotonic function of an “extended kQ product, α” which was first introduced by the works of Ohira [20, 21]. Cho et al. [22] studied specific coil designs for wireless power transmission and compared the performance of the designed coils by using a figure of merit defined by Shinohara et al. [23]. In [24], Sharma derived the formulas for efficiency and the figure of merit of a two-coil resonant system. While there are many more relevant articles in the literature, to the best of our knowledge, none of the articles provides metrics to efficiently design the transmitter and receiver coils independently, taking into account the most important regulatory limits for designing these coils for delivering wireless power to medical implants. This is one of the two novel contributions of this article.
This article also focuses on the design of efficient transmit and receive coils where the coil segments are separated by lumped capacitors. These coils are called segmented coils. Segmentation of coils using lumped or distributed capacitors is not new and has been heavily used in Magnetic Resonance Imaging (MRI), for reducing Specific Absorption Rate (SAR) (for transmit coils) [25] and improving coil sensitivity (for receive coils) [26]. Mirbozorgi et al. [27] mentioned that segmentation helps achieve homogeneous power transfer efficiency. Tang et al. [28, 29] stated that the segmentation can significantly reduce the power loss (including the dielectric loss) and required voltage. Stoecklin et al. [30] concluded that capacitive coil segmentation can effectively suppress dielectric losses and non-uniform current distribution. Mark et al. [31] demonstrated that the segmentation results in decrease of the electric field above the transmit coil thereby reducing SAR in the nearby tissue and permitting higher power transfer efficiency. Pokharel et al. [32] use lumped capacitors to segment printed coils and subsequently develop a stacked metamaterial inspired wireless power transfer (WPT) system for efficient and robust power delivery to M-AIMDs. Most of the literature have discussed the positive outcomes of segmentation of coils, but to the best of our knowledge, no one has provided a detailed analytical and numerical (full wave) explanation, as to why segmented coils have lower dielectric losses and significant reduction in SAR when they are near (<1 cm) lossy body tissue. In this article, we address those gaps in knowledge and define our figures of merit (FoMs) to highlight the positive impact of segmenting the transmitter and receiver coils separately. To further validate our novel FoMs, we build and test the transmitter and receiver coils and compare our calculations with measurement results. This is the second novel contribution of this article.
This article is organised into the following sections:
First, we present a brief overview of the pertinent regulations (exposure and radiation) that limit the performance of WPT systems for medical implants. For a chosen design frequency, we identify the critical parameters that bound the maximum currents that can be carried by a transmit coil and a receive coil. These maximum currents dictate the maximum power that can be delivered by a WPT system.
Second, for a two-coil system, we derive, using circuit analysis, the optimal load resistance needed to maximise (a) delivered power and (b) efficiency. For both cases, we find the receive coil current, delivered power and efficiency.
Third, we derive an optimisation metric we term,
Fourth, we identify two mechanisms that cause proximity of lossy dielectric tissue to impact the impedance of a transmit coil. We identify the first mechanism to be associated with the interaction of the coil current with the tissue and the second mechanism to be associated with the interaction of the charges accumulated in the coil with the tissue.
Fifth, we study the effects of introducing lumped capacitors in series with coil wiring to break the coil turns into segments. We study the effect of segmentation on the resistance and reactance of coils. We investigate the impact that segmentation capacitors have on the transmit and receive figure of merit of the coil.
Finally, we validate our circuit models and associated transmit and receive figures of merit with measurements and full wave simulations in HFSS. We perform measurements and full wave simulations of the electrical properties of transmit coil design to demonstrate that the introduction of the segmentation capacitors improves the figure of merit of the transmit coil when it is both unloaded (in air) and loaded with lossy tissue.
Figure 1 diagrammatically illustrates that the regulations associated with wireless power transmission to an implant from an external transmitter can be divided into two groups: radiation (EMC) and exposure. We note that in this article we have examined the regulatory limits for USA and Europe only.
Diagrammatic representation of the pertinent FCC and EU regulations.
Ensuring the safety of the human body during exposure to electromagnetic waves is an indisputable fact. SAR is a measuring factor for electromagnetic wave absorption. SAR is calculated as
where
The FCC rules and regulations are presented in Title 47 of the Code of Federal Regulations (CFR). Part 15 [35] covers the radio frequency devices. Part 18 [36] covers the Industrial, Scientific and Medical Equipment (ISM). Part 15 and Part 18 limit the radiated electric field at 3 m or 30 m depending on frequency.
EN 300330 [37] covers Short Range Devices (SRD) in the frequency range 9 kHz to 25 MHz and inductive loop systems in the frequency range 9 kHz to 30 MHz. It is a harmonised standard covering the essential requirements of article 3.2 of Directive 2014/53/EU. The standard limits the magnetic field at 10 m from the device. The most generous H-field limits are in three frequency bands containing 6.78 MHz, 13.56 MHz, 27.12 MHz.
EN 303417 [38] covers the wireless power transmission systems, using technologies other than radio frequency beam in the 19–21 kHz, 59–61 kHz, 79–90 kHz, 100–300 kHz, 6765–6795 kHz ranges. It is harmonised standard covering the essential requirements of article 3.2 of Directive 2014/53/EU.
EN 300220–2 [39] covers SRDs operating in the frequency range 25–1000 MHz. for non-specific radio equipment. The most generous H-field limits are in two frequency bands containing 27.12 MHz, 40.68 MHz.
EN 2013/572/EU [40] covers SRDs too. The emphasised frequency bands having higher limits are centred at 6.78 MHz, 13.56 MHz, 27.12 MHz, 40.68 MHz.
EN 55014–1 (“CISPR 14”) [41] covers household appliances, electric tools and similar apparatus. This regulation is very restrictive (3 dBμA/m at 3 m in 4–30 MHz range) when applied to the inductive loops and WPT devices.
EN 55011 (“CISPR 11”) [42] covers ISM equipment. The devices are sorted into two groups (Non-ISM and ISM equipment) and two classes (non-residential environment and residential environment).
Most commonly, WPT circuits use electromagnetic coupling between coils. These WPT circuits use capacitors to reduce reactive power. Figure 2 is a commonly chosen series–series capacitor representation which has been widely used because the capacitances can be chosen independent of the load and coupling conditions.
Schematic of the WPT system.
At resonance,
where
From Eq. (2) we can see that there is a 90-degree phase shift between the transmit and receive currents. The
If we ignore the phase shift and redefine
Additionally, the delivered power is:
The power loss in the receive coil is:
The power loss in the transmit coil is:
The efficiency is:
We assume that the current in the transmit coil is fixed at its maximum value of
(a) Maximising the delivered power.
We differentiate the delivered power with respect to
where the receive current is limited by
(b) Maximising the efficiency.
We differentiate the efficiency, equate it to zero and obtain the optimal current in the receive coil:
where
which we call a mutual quality factor.
We use the optimal receive current to obtain the expressions for the optimal delivered power
If the current limits are high (infinite), then both cases can be elaborated further:
Maximising the delivered power, with high current limits.
Optimal current is:
Optimal load resistance is:
Delivered power is:
Efficiency is:
Maximising the efficiency, with high current limits.
Optimal current is:
Optimal load resistance is:
Delivered power is:
Efficiency is:
From the above formulas we see that
For some WPT systems the magnetic field of the transmit coil is not changing significantly in the region of space that contains the receive coil. This happens if the receive coil is much smaller than the transmit coil and/or it is located far enough from the transmit coil. The induced voltage of the receive coil is
The expression for the mutual quality factor can be expressed as follows:
We observe that the values of the transmit and receive coil can be separated. We can define the figures of merit for the transmit coil
where
The expression for the receive figure of merit
we get:
From Eq. (19) we get the expression for the mutual inductance as:
Increase in any of these two figures of merit (
The expressions for the transmit figures of merit defined as
Transmit figure of merit
Receive figure of merit
It is worth mentioning that the
The expression for the delivered power Eq. (22) can be modified as follows:
The delivered power is proportional to the square of the receive figure of merit
The magnetic field that we are able to generate at the location of the receive coil cannot be arbitrarily high: the current in the coil is limited by exposure and radiation limits. SAR limit is one of these limits. One can define a SAR figure of merit as a ratio of the magnetic field of the transmit coil to the square root of SAR:
By defining the SAR figure of merit using Eq. (26) the maximum achievable magnetic field would be calculated as
It is worth saying that the
This figure of merit can also be used to compare the competing designs of the transmit coils. The transmit coil with higher
Apart from SAR, there are other regulations that limit the transmit coil current and the transmit coil magnetic field. For each one of them one can establish the corresponding figure of merit in the following way:
Volumetric current
Electric field at the certain distance from the coil (
Magnetic field at the certain distance from the coil (
Figure 3 provides a visual representation of the development of figures of merit from the WPT formulas and the regulations.
Figures of merit diagram.
The electric field of the transmit coil can be separated into two parts: the “current” electric field and the “charge” electric field:
where
Electric field of the coil.
The
Induced current in the tissue.
The effect of the current flow in the tissue may be crudely approximated by a shorted inductance. The Kirchhoff’s laws are:
where
Solving this for impedance
The presence of the
where the definitions of
It can be observed that the tissue loading the coil leads to induced (eddy) currents in the tissue which causes power loss. This power loss in the tissue exhibits itself as an increased resistance and a decreased reactance of the transmit coil.
When we excite the transmit coil with voltage, there are electric charges that accumulate on the wiring near the coil terminals. When the coil is in close proximity to lossy tissue it can be modelled as a lossy dielectric between the plates of a parallel plate capacitor, as shown in Figure 6.
Approaching tissue to the coil.
The Ampere’s law is:
where
where
The normal component of the vector
Electric field inside the capacitor.
The electric fields inside the capacitor and outside of the tissue are related as follows:
where
We denote the thickness of the tissue as
The electrical field in empty space between capacitor plates is:
where
We note that the capacitance has an imaginary component. The impedance associated with this capacitance is calculated as:
This can be elaborated as:
where
As we see from these formulas, the presence of the tissue between the capacitor plates leads to an increase of the effective capacitance
To determine the resistance and reactance of a coil in close proximity to lossy tissue we develop an equivalent circuit shown in Figure 8. The impedance of the circuit in Figure 8 is:
Coil model with shunt capacitor and resistor.
We assume that the capacitive reactance
We assume that the capacitive reactance
With the aforementioned assumptions, the impedance of the coil simplifies to:
From the above equation it can be observed that the proximity of lossy dielectric tissue results in an increase of the parasitic capacitance
Segmentation is a process of inserting additional capacitors in between the coil windings (see Figure 9). The capacitor placement is roughly equidistant throughout the windings of the coil. The purpose of the segmentation capacitors is to decrease the voltages between the terminals of the coil and between the turns of the coil.
Schematic of non-segmented and segmented loaded coils.
The values of the segmentation capacitors are chosen to significantly decrease the visible inductance of the coil. There is no exact formula for the values of the segmentation capacitors, but our recommendation is as follows:
where
Figure 10 shows the equivalent circuit of a non-segmented and segmented coil when the coil is loaded by body tissue. The segmentation affects the coil impedance by reducing the electric charges on the wiring of the coil. Mathematically, the effect of segmentation capacitors can be introduced by modifying Eq. (46) as follows:
Non-segmented and segmented loaded coils.
The SRF
We will now study the effect of tissue loading on both the non-segmented and the segmented coils. For the non-segmented coil, the expression
For the tuned non-segmented coil, the unloaded and loaded impedances are:
The difference between these values is:
For the segmented coil, the expression
For the tuned segmented coil, the unloaded and loaded impedances are:
The difference between these values is:
Comparing Eqs. (52) and (55) we observe that for a segmented coil: (a) the resistance increase due to proximity of lossy tissue is lower than that for unsegmented coil, (b) the reactance increase due to the proximity of lossy tissue is lower than that for unsegmented coil. This is clearly due to the
Figure 11 shows the equivalent circuit for non-segmented and segmented loaded transmit coils.
Non-segmented and segmented loaded transmit coils.
The input current splits into two branches: current
These two currents are related as follows:
where we neglected the resistances
In the transmit figure of merit (
The power needed to generate the current
The figure of merit is then:
We observe that segmentation leads to an increase in the transmit figure of merit of a coil. This is because for the segmented coil, the voltage
Figure 12 shows the equivalent circuit for non-segmented and segmented loaded receive coils. In the figure,
Non-segmented and segmented loaded receive coils.
For the non-segmented coil, the optimal loaded resistance is:
Currents through the voltage source
The delivered power is:
Again, we observe that the receive figure of merit
To verify the theory presented in the previous sections, a PCB spiral coil is modelled in Ansys HFSS, as shown in Figure 13. A trace on the bottom layer is used to connect the inner terminal of the coil through a via, to form a closed loop. The locations of the segmentation capacitors are indicated for different segmentation numbers. The dimensions of the coil are listed in Table 1. The substrate is a 1.5 mm FR-4 with 1 oz. copper.
Top (left) and bottom (right) view of the spiral coil. (
The coil is firstly simulated without any capacitors. The inductance of the coil can be obtained as:
where
The values of the segmentation capacitors are calculated using Eq. (47). In practice, the values of the segmentation capacitors would be a little higher due to the parasitic capacitance of the coil itself.
Once the coil is tuned to resonate at the desired frequency, either with or without segmentation, the resistance can be obtained as:
To evaluate the effect of the segmentation on the resistance, three cases are compared by simulation and verified with measurement: (a) coil without segmentation with one series capacitor to resonate the coil; (b) coil with one segmentation capacitor splitting the coil wiring into two equal segments; (c) coil with three segmentation capacitors splitting the coil wiring into four equal segments.
The fabricated coils with and without segmentation are shown in Figure 14. All the coils are tuned to resonate at 27.12 MHz. A comparison of the simulated and the measured resistance with and without segmentation is shown in Table 2. Excellent agreement is found between the simulations and the measurements. The values of the capacitors needed to resonate the coil at 27.12 MHz are higher than the values calculated using Eq. (64). The measured resistances of the Printed Circuit Board (PCB) coils are higher than the simulated ones because of the extra capacitance and loss from the testing cable and connector which is not included in the simulations. What is clear from both simulation and measurement is that the addition of segmentation capacitors significantly reduces the coil resistance and the associated power loss in the coil.
Fabricated coils with and without segmentation capacitors.
Radius | Trace width | Inter-trace distance | No. of turns |
---|---|---|---|
35 | 3 | 2 | 4 |
Coil dimensions.
Coil | Simulated/Measured | Capacitor values (pF) | Resistance (Ω) |
---|---|---|---|
Coil non-segmented | Simulated | C1 = 30 | 0.69 |
Measured | C1 = 35 | 0.86 | |
Coil with 2 segments | Simulated | C1 = C2 = 64 | 0.50 |
Measured | C1 = C2 = 68 | 0.53 | |
Coil with 4 segments | Simulated | C1 = C2 = C3 = C4 = 134 | 0.39 |
Measured | C1 = C2 = C3 = C4 = 139 | 0.42 |
Simulated and measured resistance for segmented and non-segmented coils.
The electromagnetic (EM) fields generated from the coils can be simulated in HFSS. The FoM
Segmentation can increase the magnetic field strength without changing the field distribution generated by the coil. So, the designer can start with the non-segmented coil to optimise the field coverage first.
Segmentation can suppress the electric field in the direction perpendicular to the coil surface (moving away from the coil).
Segmentation can significantly alter the electric field distribution near the coil surface with localised maxima close to the capacitors.
FoM Ft and normalised electric field plots along Z, X, and Y directions. The plots for X and Y directions are at z = 4 mm height.
Figure 16 plots the heat map of the magnitude of the electric field in the PCB substrate indicating that, as the electric fields are concentrated around the segmentation capacitors, the dielectric loss in the substrate is reduced.
Electric field in the substrate. (left: no segment; middle: 2 segments; right: 4 segments).
In this section, the effect of the segmentation on the power transfer efficiency is evaluated in both simulations and measurements. The receive coil shares the same HFSS model as the transmit coil, only with different dimensions and number of turns. The parameters of the receive coil that is simulated is shown in Table 3. The substrate is 0.8 mm FR-4 with 1 oz. copper.
Radius | Trace width | Inter-trace distance | No. of turns |
---|---|---|---|
4.88 | 0.24 | 0.26 | 5 |
Geometry of the receive coil.
The receive coil is placed 10 mm above the transmit coil with its center aligned with the center of the transmit coil, as shown in Figure 17. To investigate the loading effect of the human body, a hand is placed close to the coil. To measure the transfer efficiency, we perform the following steps:
Measurement setup for the transfer efficiency (left: top view; middle: side view; right: a hand is close to the coils).
Calibrate two ports of network analyser at the frequency of interest.
Tune the transmit coil with series capacitor, connect it to the network analyser and measure its resistance. Repeat for the receive coil.
Place the two coils in proximity of each other and connect them to the network analyser.
Measure and save the S-matrix of the system (2 × 2 matrix).
Convert S-matrix to Z-matrix using:
where
Calculate mutual inductance using:
Calculate the mutual quality factor using Eq. (10).
Calculate the efficiency using Eqs. (14) or (18), depending on if we choose to maximise delivered power or transfer efficiency.
While designing a WPT system for medical implants, care must be taken to understand the various use cases and user interactions and its implications on power delivery. An important decision that needs be made is whether a design is maximised for delivered power to an implant or efficiency of the WPT link. On one hand, if it is challenging for the receive coil inside of the implant to harvest the needed amount of power, then maximising the delivered power is preferential. On the other hand, most body worn charging systems are battery-powered and have a limited amount of available power to deliver to the implant. So, maximising the efficiency directly results in longer duration before the battery runs out on the charger and needs to be recharged by the patient or the caregiver.
As an example for this article, we chose to calculate the transfer efficiency using Eq. (18) for the coils with and without segmentation. The transfer efficiency is also simulated in HFSS for comparison. Furthermore, a 200 mm × 200 mm 3-layered tissue stack model is placed 2 mm above the transmit coil and the receive coil is embedded in the fat layer with the same 10 mm distance to the transmit coil in HFSS, as shown in Figure 18. The thickness of the skin, fat and muscle is 2 mm, 23 mm and 20 mm, respectively.
Transfer efficiency simulation with tissue stack.
The simulated and measured transfer efficiencies are summarised in Table 4. We observe that the transfer efficiency both in air and in tissue can be improved with segmentation. Although we have done the calibration to minimise the effect of the cables and connectors, the measured efficiency is still a little lower than the simulated one, which is not surprising. However, with segmentation, we can see that the measured efficiency is much closer to the simulated one. It implies that the segmentation can reduce the loading effect of the environment (e.g. cables). The measured efficiency of a coil without segmentation in the presence of body tissue (hand) shows a significant drop from 61.9% to 46.2%, while the measured efficiency of a coil with two and four segmentations shows only a drop from 65.0% to 62.3% and 67.2% to 66.5%, respectively. This clearly indicates that the segmented coils are more robust to the presence of lossy tissue. In case of the simulated coils, the tissue of Figure 18 has a much larger effect on the coil, because there is large drop in efficiency when the tissue is nearby for non-segmented and segmented coils.
Segmentation | no segments | 2 segments | 4 segments |
---|---|---|---|
Simulated in air | 67.4 | 68.6 | 70.7 |
Simulated with tissue stack | 36.3 | 41.6 | 42.8 |
Measured in air | 61.9 | 65.0 | 67.2 |
Measured with a hand nearby | 46.2 | 62.3 | 66.5 |
Transfer Efficiency (%).
The SAR value in tissue is simulated in HFSS using the same tissue model as in the previous section. For a fair comparison, the SAR is also normalised by the input power as:
Figure 19 compares the distribution of the peak average SAR where the SAR value has been normalised to the peak SAR value for each of the three coil designs presented. The IEC/IEEE 62704-4 method is used to calculate the peak average 1 g SAR. Without segmentation, the regions of high SAR value occur at the overlapping area between the trace on the top and bottom layers of the PCB. This is because there is high stored electric field between the layers resulting in high parasitic capacitance. For the coil with two segments, the regions of high SAR value are between the segmentation capacitor and the areas of overlap between the top and the bottom layers of the PCB. Both these regions have high parasitic capacitance. For the coil with four segments, the 3 segmentation capacitors are lined close to each other resulting in a region of high stored electric field. This results in the coil with four segments having higher peak average SAR compared to the coil with two segments, but still lower than the coil with no segmentation capacitors. The results also clearly indicate that the locations of the segmentation capacitors play a critical role in reducing the peak average SAR.
The SAR maps in the tissue. (top: coil with no segments; middle: coil with two segments; bottom: coil with four segments).
Another important advantage of introducing segmentation capacitors in the wiring of the coils (or along the coil traces) is that the distribution of the averaged SAR and its maximum value can be significantly altered by optimising the locations of the segmentation capacitors along the coil. For example, the 4-segment coil (in Figure 14) has the three segmentation capacitors in close proximity, all in the same sector of the circular coil. For the same coil Figure 20 shows a significantly different SAR distribution and reduced maximum SAR value when the three segmentation capacitors are spread along the coil with 90-degree separation. The heat map shows that the regions of high SAR value are shaped like a circle and the peak value of the SAR is reduced by 40%. It should be noted that the tuning capacitor is not shown in this plot because it is placed at the far end of the coil input.
SAR map of the coil with spread segmentation capacitors.
With the normalised SAR and the coil resistance, the maximum allowed current within FCC limit can be calculated as
where
Table 5 summarises the coil impedance, SAR,
Coil | Non-segmented | Segmented with 2 segments | Segmented with 4 segments | Segmented with 4 segments, spread |
---|---|---|---|---|
0.69 + j1.27 | 0.50 + j0.94 | 0.39 + j4.69 | 0.42 + j4.28 | |
1.88 + j9.65 | 1.13 + j2.17 | 0.97 + j5.51 | 0.94 + j4.40 | |
13.93 | 7.26 | 10.13 | 6.00 | |
0.0938 | 0.1015 | 0.1089 | 0.1070 | |
0.0251 | 0.0377 | 0.0342 | 0.0437 | |
Max allowed current within FCC 1.6 W/kg limit (mA) | 349.6 | 624.6 | 570.7 | 753.2 |
Comparison of coil impedance, SAR,
When we compare the “
The figure of merit
Let us now compare the change in resistance
Coil | Non-segmented | Segmented with 2 segments | Segmented with 4 segments | Segmented with 4 segments, spread |
---|---|---|---|---|
1.19 | 0.63 (−47%) | 0.58 (−51%) | 0.52 (−56%) |
Change in resistance.
From the Table 7 we observe that there is a decrease in the change in reactance
Coil | Non-segmented | Segmented with 2 segments | Segmented with 4 segments | Segmented with 4 segments, spread |
---|---|---|---|---|
8.38 | 1.23 (−85%) | 0.82 (−90%) | 0.12 (−98.6%) | |
1 | 6.8 | 10.2 | 69.8 | |
1 | 4 | 16 | 16 |
Comparing the change in reactance with the predicted one.
In this work, we introduced and derived unique optimisation metrics for designing efficient transmit and receive coils for magnetics based WPT solutions for medical implants. We reviewed the regulations imposed on WPT systems for medical implants in the US and EU regions and determined the most limiting parameters that place a bound on the maximum current that can be driven into a coil. We derived the expressions for delivered power and efficiency considering the identified regulatory limits for the transmit and the receive coil currents. We demonstrated that, under certain conditions, the system figure of merit can be “split” into transmit figure of merit and receive figure of merit permitting independent evaluation of transmit and receive coils.
We studied the effect of lossy tissue on the performance of transmit coils from a circuit theory perspective. We showed that the resistance of the transmit coil increases in the presence of tissue because of two types of electromagnetic phenomena: (i) increase in parasitic capacitance between the opposite charges accumulating in the surfaces of the coil (charge contribution); (ii) the eddy currents in the tissue (current distribution). We showed that the change in reactance of the coil due to the presence of lossy tissue is dependent on which contribution (charge or current) is more significant.
With this improved understanding of the effect of lossy tissue on coils we introduced the concept of segmented on-body transmit coils. We hypothesised that the resistance and reactance of a transmit coil with segmentation capacitors is less sensitive to the presence of lossy tissue. We derived the impact of segmentation on the transmit figure of merit and the receive figure of merit of a coil using circuit theory. We showed analytically that segmented coils have the potential to significantly improve both (transmit and receive) figures of merit, thereby positively affecting the efficiency of a WPT system.
To validate our hypothesis and assertions we built PCB coil prototypes at 27.12 MHz with and without segmentation. We performed full wave simulations using HFSS models of the same coils. We showed through simulations and measurements that the resistance of the transmit coil reduces substantially (as much as 50%) when we went from no segmentation to up to four segments (with three segmentation capacitors). We also confirmed that the proximity of lossy tissue has a significantly smaller effect on segmented transmit coil. We noted that, on the specific coils we built, we measured that the change in reactance of a coil between air and close proximity of tissue reduced from 4.2% (for non-segmented coil) to 0.06% (for segmented coil with capacitors uniformly spread). We also confirmed that the transmit figures of merit (
We are grateful to Mark Norris, Richard Davies, Matthew Armean-Jones, and Olympia Karadima for their useful feedback that helped in writing this chapter.
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As the science gets more advanced and the information about these two points becomes clearer, the view of this information might modify our understanding to these processes. Then, some topics might be dropped, and others might be raised or become more obvious. However, the feeding of halophyte forages as per se has several drawbacks and therefore, they have to be fed in mixed rations, fortifying these rations with energy supplements.",book:{id:"5978",slug:"new-perspectives-in-forage-crops",title:"New Perspectives in Forage Crops",fullTitle:"New Perspectives in Forage Crops"},signatures:"Salah A. 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CW has been successfully applied as an adsorbent for removing pollutants from wastewater and gas, a precursor for obtaining activated carbon, and a feedstock for producing energy and valuable products using mono-process extraction and biorefinery.",book:{id:"8952",slug:"coffee-production-and-research",title:"Coffee",fullTitle:"Coffee - Production and Research"},signatures:"Felipe J. Cerino-Córdova, Nancy E. Dávila-Guzmán, Azucena M. García León, Jacob J. Salazar-Rabago and Eduardo Soto-Regalado",authors:null},{id:"56029",doi:"10.5772/intechopen.69614",title:"Production of Spineless Cactus in Brazilian Semiarid",slug:"production-of-spineless-cactus-in-brazilian-semiarid",totalDownloads:1901,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"The term “spineless cactus” is used in Brazil to designate cultivars of Opuntia ficus indica Mill and Nopalea cochenillifera Salm Dyck. The spineless cactus was consolidated in Brazilian semiarid as a strategic fundamental food resource in several production livestock systems, constituting a plant with enormous productive potential. Thus, the spineless cactus has been widely cultivated and used for several decades, by enabling the animal feeding in critical periods of year because of its characteristics, morpho‐anatomical and physiological (CAM), which makes it tolerant to long droughts, being a crop that presents high productivity in droughts conditions, when compared to other forages. Nevertheless, the spineless cactus is a crop relatively picky about soil and climate characteristics of region, presenting greater growth in fertile soils, as well as in regions where nighttime temperatures are cool and the air humidity is relatively high. Although the crop be adapted to long droughts periods, many times it’s necessary to perform irrigation in its production system, mainly in regions of low rainfall, for to supply its water needs, thus ensuring productivity and survival of crop. Therefore, the knowledge of characteristics of plant, as well as of appropriate management techniques to crop, is essential for the good performance of spineless cactus.",book:{id:"5978",slug:"new-perspectives-in-forage-crops",title:"New Perspectives in Forage Crops",fullTitle:"New Perspectives in Forage Crops"},signatures:"Wilma Cristina Cavalcante dos Santos Sá, Edson Mauro Santos,\nJuliana Silva de Oliveira and Alexandre Fernandes Perazzo",authors:[{id:"139631",title:"Dr.",name:"Edson Mauro",middleName:null,surname:"Santos",slug:"edson-mauro-santos",fullName:"Edson Mauro Santos"},{id:"180036",title:"Dr.",name:"Juliana",middleName:null,surname:"Oliveira",slug:"juliana-oliveira",fullName:"Juliana Oliveira"},{id:"203022",title:"MSc.",name:"Wilma",middleName:null,surname:"Sá",slug:"wilma-sa",fullName:"Wilma Sá"},{id:"207265",title:"Dr.",name:"Alexandre",middleName:null,surname:"Perazzo",slug:"alexandre-perazzo",fullName:"Alexandre Perazzo"}]},{id:"70151",doi:"10.5772/intechopen.89224",title:"The Harvest and Post-Harvest Management Practices’ Impact on Coffee Quality",slug:"the-harvest-and-post-harvest-management-practices-impact-on-coffee-quality",totalDownloads:1858,totalCrossrefCites:3,totalDimensionsCites:7,abstract:"Coffee is one of the most important agricultural commodities in the world. The coffee quality is associated with pre-harvest and post-harvest management activities. Each step starting from selecting the best coffee variety for plantation until the final coffee drink preparation determines the cupping quality. The overall coffee quality influenced by the factors which involve in changes the physicochemical properties and sensorial attributes, including the post-harvest operations. The post-harvest processing activities contribute about 60% of the quality of green coffee beans. The post-harvest operations include pulping, processing, drying, hulling, cleaning, sorting, grading, storage, roasting, grinding, and cupping. This chapter comprises the harvest and post-harvest operations of coffee and their impacts on coffee quality.",book:{id:"8952",slug:"coffee-production-and-research",title:"Coffee",fullTitle:"Coffee - Production and Research"},signatures:"Mesfin Haile and Won Hee Kang",authors:null},{id:"69900",doi:"10.5772/intechopen.89508",title:"Coffee By-Products: Nowadays and Perspectives",slug:"coffee-by-products-nowadays-and-perspectives",totalDownloads:1160,totalCrossrefCites:3,totalDimensionsCites:6,abstract:"Coffee is one of the most consumed products around the world; 2.25 billions of coffee cup are consumed everyday in the world. For coffee crop production, different by-products are produced, such as coffee peel, coffee husk, parchment, and spent coffee grounds. These by-products have several problems associated at the final disposition. In this book chapter, we study the main coffee varieties produced in the world, the by-products produced, and its composition and finally assess the potential of supramolecular solvents (SUPRAS) and water as green solvents for high-added-value compound extractions. Bioactive compounds were extracted from fresh and dried coffee peel in an acceptable rate for industrial applications. SUPRAS offer advantages in terms of rapidity (5 min) and simplicity (stirring and centrifugation at room temperature), thus avoiding costly processes based on high pressure and temperature. Extractions carried out using water as solvent is another technique of extraction mixing temperature (above 60°C) and time (4.5 min) obtained a beverage or solution with presence a bioactive compounds how caffeine, chlorogenic acid and polyphenols.",book:{id:"8952",slug:"coffee-production-and-research",title:"Coffee",fullTitle:"Coffee - Production and Research"},signatures:"Laura Sofía Torres-Valenzuela, Johanna Andrea Serna-Jiménez and Katherine Martínez",authors:null}],mostDownloadedChaptersLast30Days:[{id:"71528",title:"A Detail Chemistry of Coffee and Its Analysis",slug:"a-detail-chemistry-of-coffee-and-its-analysis",totalDownloads:2410,totalCrossrefCites:5,totalDimensionsCites:6,abstract:"This review article highlights the detailed chemistry of coffee including its components; chemical constituents like carbohydrates, proteins, lipids, and caffeine; aromatic principles; oil and waxes; and minerals and acids. The high extent of caffeine can be found in the coffee plants; hence, in the second part of the study, various analytical methods are designed for the proper identification, separation, optimization, purification, and determination of caffeine present in coffee, tea, and marketed coffee. These analytical methods are appropriated for the separation and quantification of caffeine. The various analytical methods include spectroscopy methods like UV, IR, and NMR spectroscopy; chromatographic methods like paper, TLC, column, HPLC, and gas chromatography; and hyphenated techniques like LC–MS, GC–MS, and GC–MS/MS. This article compares and contrasts the amount of caffeine by various analytical methods.",book:{id:"8952",slug:"coffee-production-and-research",title:"Coffee",fullTitle:"Coffee - Production and Research"},signatures:"Hemraj Sharma",authors:null},{id:"70151",title:"The Harvest and Post-Harvest Management Practices’ Impact on Coffee Quality",slug:"the-harvest-and-post-harvest-management-practices-impact-on-coffee-quality",totalDownloads:1866,totalCrossrefCites:3,totalDimensionsCites:7,abstract:"Coffee is one of the most important agricultural commodities in the world. The coffee quality is associated with pre-harvest and post-harvest management activities. Each step starting from selecting the best coffee variety for plantation until the final coffee drink preparation determines the cupping quality. The overall coffee quality influenced by the factors which involve in changes the physicochemical properties and sensorial attributes, including the post-harvest operations. The post-harvest processing activities contribute about 60% of the quality of green coffee beans. The post-harvest operations include pulping, processing, drying, hulling, cleaning, sorting, grading, storage, roasting, grinding, and cupping. This chapter comprises the harvest and post-harvest operations of coffee and their impacts on coffee quality.",book:{id:"8952",slug:"coffee-production-and-research",title:"Coffee",fullTitle:"Coffee - Production and Research"},signatures:"Mesfin Haile and Won Hee Kang",authors:null},{id:"72400",title:"Factors Affecting Efficiency of Vegetable Production in Nigeria: A Review",slug:"factors-affecting-efficiency-of-vegetable-production-in-nigeria-a-review",totalDownloads:819,totalCrossrefCites:0,totalDimensionsCites:2,abstract:"Vegetables are important for maintenance of good health; their production and marketing are veritable sources of employment and livelihood. To promote vegetables’ contribution to the above, there is a need for sustainable and efficient production process. The paper reviewed production, socioeconomic factors, and constraint affecting efficiency of production of three important vegetables (tomato, pepper, and onion). The review showed that socioeconomic factors found to increase technical efficiency in vegetable production were educational level, extension contact, and household size. Influence of farmer age on technical efficiency was inconclusive due to varied opinions. Increase in farm size, quantity of seed, amount of fertilizer, and agrochemical were found to have positive influence on output. Majority of the literature reviewed opined that increase in quantity of labour raises productivity; however, it must be utilized efficiently. The mean technical efficiency of the vegetables varied from the southern to the northern part of the country. The cross cutting constraints in vegetables production are pest and diseases, inadequate storage facilities, and high cost of improved inputs. The study recommends increase awareness and sensitization on optimum levels of resource use for increased productivity and appropriate intervention to constraints in the value chain.",book:{id:"10142",slug:"agricultural-economics",title:"Agricultural Economics",fullTitle:"Agricultural Economics"},signatures:"Iyabo Bosede Adeoye",authors:[{id:"317695",title:"Dr.",name:"Iyabo Bosede",middleName:null,surname:"Adeoye",slug:"iyabo-bosede-adeoye",fullName:"Iyabo Bosede Adeoye"}]},{id:"65591",title:"Insect Pest Management in Organic Farming System",slug:"insect-pest-management-in-organic-farming-system",totalDownloads:2660,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Due to the regulations of organic farming, few options remain for organic farmers to manage pests and diseases in their crops compared to conventional farming. However, major pests could still be managed through manipulation of the agroecosystem processes in advantage of the crops and disadvantage of pests. The limited number of active plant protection substances authorized for use in organic farming can provide support to natural and biological control agents in suppression of pests and diseases. This chapter highlights the principles and strategies of crop protection in organic farming, the cultural practices adopted, the active substances allowed for use to suppress pests, and the impacts on faunal and floral biodiversity. A case study of organic date palm cultivation is discussed.",book:{id:"6988",slug:"multifunctionality-and-impacts-of-organic-and-conventional-agriculture",title:"Multifunctionality and Impacts of Organic and Conventional Agriculture",fullTitle:"Multifunctionality and Impacts of Organic and Conventional Agriculture"},signatures:"Hamadttu Abdel Farag El-Shafie",authors:[{id:"192142",title:"Dr.",name:"Hamadttu",middleName:null,surname:"Abdel Farag El-Shafie",slug:"hamadttu-abdel-farag-el-shafie",fullName:"Hamadttu Abdel Farag El-Shafie"}]},{id:"69412",title:"Soil Management and Water-Use Efficiency in Brazilian Coffee Crops",slug:"soil-management-and-water-use-efficiency-in-brazilian-coffee-crops",totalDownloads:817,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Brazil is a world leader in coffee production. However, currently, it coexists with recurrent and severe droughts, accompanied by intense heat, strong insolation and low relative humidity. As the cultivation is carried out primarily in the rainy season, these world climate variations have affected crops yields and fruits quality, requiring innovative actions that promote efficient use of water stored in the soil. Among several soil management practices that promote a more rational use of water, deep tillage combined with liming, gypsum and fertilizer amendments lead to an increase in effective depth of coffee roots, therefore reducing water stress. Moreover, intercropping with Urochloa sp. is highly efficient in enhancing soil structure, water infiltration and plant available water capacity. Additionally, other innovative techniques and practices are also introduced in this chapter.",book:{id:"8952",slug:"coffee-production-and-research",title:"Coffee",fullTitle:"Coffee - Production and Research"},signatures:"Bruno Montoani Silva, Geraldo César de Oliveira, Milson Evaldo Serafim, Carla Eloize Carducci, Érika Andressa da Silva, Samara Martins Barbosa, Laura Beatriz Batista de Melo, Walbert Junior Reis dos Santos, Thiago Henrique Pereira Reis, César Henrique Caputo de Oliveira and Paulo Tácito Gontijo Guimarães",authors:null}],onlineFirstChaptersFilter:{topicId:"27",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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",coverUrl:"https://cdn.intechopen.com/series/covers/23.jpg",latestPublicationDate:"August 1st, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:0,editor:{id:"280770",title:"Dr.",name:"Katherine K.M.",middleName:null,surname:"Stavropoulos",slug:"katherine-k.m.-stavropoulos",fullName:"Katherine K.M. Stavropoulos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRdFuQAK/Profile_Picture_2022-05-24T09:03:48.jpg",biography:"Katherine Stavropoulos received her BA in Psychology from Trinity College, in Connecticut, USA and her Ph.D. in Experimental Psychology from the University of California, San Diego. She completed her postdoctoral work at the Yale Child Study Center with Dr. James McPartland. Dr. Stavropoulos’ doctoral dissertation explored neural correlates of reward anticipation to social versus nonsocial stimuli in children with and without autism spectrum disorders (ASD). She has been a faculty member at the University of California, Riverside in the School of Education since 2016. Her research focuses on translational studies to explore the reward system in ASD, as well as how anxiety contributes to social challenges in ASD. She also investigates how behavioral interventions affect neural activity, behavior, and school performance in children with ASD. She is also involved in the diagnosis of children with ASD and is a licensed clinical psychologist in California. 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He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. 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. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. Gonzalez-Sanchez",slug:"juan-a.-gonzalez-sanchez",fullName:"Juan A. Gonzalez-Sanchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico System",country:{name:"United States of America"}}},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}}]}},subseries:{item:{id:"3",type:"subseries",title:"Bacterial Infectious Diseases",keywords:"Antibiotics, Biofilm, Antibiotic Resistance, Host-microbiota Relationship, Treatment, Diagnostic Tools",scope:"