Osmotic properties of aqueous solutions of NaCl and KCl [11, 40].
\r\n\tThis book aims to provide a comprehensive overview for the robotic interaction including dynamic modeling and control aspects in order to provide a guide for designers of robotic controllers. Furthermore, it helps the roboticists to select the right model, control architecture and accordingly design the appropriate control algorithm for robotic interactive task with respect to the implemented robotic technology.
",isbn:null,printIsbn:null,pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,hash:"9531ee9c84fd27d3e5f84caf963632b3",bookSignature:"Dr. Ali Leylavi Shoushtari and Prof. Andon Venelinov Topalov",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/8359.jpg",keywords:"Robotic physical interaction, Human - robot interaction, Kinematics, Dynamics, Interactive tasks, Motion planning, Anthropomorphic manipulators, Compliant joint, Back-drivability, Control approaches, Safety in robotic interaction, Soft robotics",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"July 9th 2018",dateEndSecondStepPublish:"July 30th 2018",dateEndThirdStepPublish:"September 28th 2018",dateEndFourthStepPublish:"December 17th 2018",dateEndFifthStepPublish:"February 15th 2019",remainingDaysToSecondStep:"4 years",secondStepPassed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"266351",title:"Dr.",name:"Ali",middleName:null,surname:"Leylavi Shoushtari",slug:"ali-leylavi-shoushtari",fullName:"Ali Leylavi Shoushtari",profilePictureURL:"https://mts.intechopen.com/storage/users/266351/images/system/266351.png",biography:"He received his PhD in Biorobotics from Scuola Superiore Sant\\'Anna, Pisa and MSc in Mechatronics from South Tehran Branch, Azad University. During his PhD he designed and developed Bio-inspired inverse kinematic algorithm for anthropomorphic robotic manipulators, and designed and developed a unified motion planning and compliance control framework for upper-arm Neuro-rehabilitation robotic task. Persued research on design, fabrication and modeling or soft origami actuators in Center for Micro-BioRobotics (CMBR), IIT as a postdoctoral researcher. In 2019, the Farm Tech Group joined Wageningen University & Research and is currently working on soft adhesive grippers for delicate crop handling. The project is in collaboration with the Department of Experimental Zoology, WUR to take inspiration from adhesive properties of tree frog fingertip and Department of Physical Chemistry and Soft Matter in order to develop fabrication methods for soft actuators and sensor.",institutionString:"Wageningen University & Research",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Wageningen University & Research",institutionURL:null,country:{name:"Netherlands"}}}],coeditorOne:{id:"147800",title:"Prof.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",profilePictureURL:"https://mts.intechopen.com/storage/users/147800/images/system/147800.jpeg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. He has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:"Technical University of Sofia, branch in Plovdiv",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"22",title:"Robotics",slug:"physical-sciences-engineering-and-technology-robotics"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"247041",firstName:"Dolores",lastName:"Kuzelj",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/247041/images/7108_n.jpg",email:"dolores@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"117",title:"Artificial Neural Networks",subtitle:"Methodological Advances and Biomedical Applications",isOpenForSubmission:!1,hash:null,slug:"artificial-neural-networks-methodological-advances-and-biomedical-applications",bookSignature:"Kenji Suzuki",coverURL:"https://cdn.intechopen.com/books/images_new/117.jpg",editedByType:"Edited by",editors:[{id:"3095",title:"Prof.",name:"Kenji",surname:"Suzuki",slug:"kenji-suzuki",fullName:"Kenji Suzuki"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3828",title:"Application of Nanotechnology in Drug Delivery",subtitle:null,isOpenForSubmission:!1,hash:"51a27e7adbfafcfedb6e9683f209cba4",slug:"application-of-nanotechnology-in-drug-delivery",bookSignature:"Ali Demir Sezer",coverURL:"https://cdn.intechopen.com/books/images_new/3828.jpg",editedByType:"Edited by",editors:[{id:"62389",title:"PhD.",name:"Ali Demir",surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"872",title:"Organic Pollutants Ten Years After the Stockholm Convention",subtitle:"Environmental and Analytical Update",isOpenForSubmission:!1,hash:"f01dc7077e1d23f3d8f5454985cafa0a",slug:"organic-pollutants-ten-years-after-the-stockholm-convention-environmental-and-analytical-update",bookSignature:"Tomasz Puzyn and Aleksandra Mostrag-Szlichtyng",coverURL:"https://cdn.intechopen.com/books/images_new/872.jpg",editedByType:"Edited by",editors:[{id:"84887",title:"Dr.",name:"Tomasz",surname:"Puzyn",slug:"tomasz-puzyn",fullName:"Tomasz Puzyn"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3569",title:"Biodegradation",subtitle:"Life of Science",isOpenForSubmission:!1,hash:"bb737eb528a53e5106c7e218d5f12ec6",slug:"biodegradation-life-of-science",bookSignature:"Rolando Chamy and Francisca Rosenkranz",coverURL:"https://cdn.intechopen.com/books/images_new/3569.jpg",editedByType:"Edited by",editors:[{id:"165784",title:"Dr.",name:"Rolando",surname:"Chamy",slug:"rolando-chamy",fullName:"Rolando Chamy"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"58198",title:"Nonideal Solution Behavior in Forward Osmosis Processes Using Magnetic Nanoparticles",doi:"10.5772/intechopen.72474",slug:"nonideal-solution-behavior-in-forward-osmosis-processes-using-magnetic-nanoparticles",body:'\nForward osmosis (FO) exploits the natural osmotic pressure gradient between two fluids separated by a semi-permeable membrane to induce the net transport of solvent from a solution of lower osmotic pressure to that of higher osmotic pressure. The FO process appears to provide a low-energy, low-cost alternative to more conventional membrane-based separation methods and offers a myriad of potential applications in industries as diverse as desalination, oil and gas, and food processing [1, 2]. Despite advances made in FO during the past decade, several challenges must still be overcome before more widespread relevance of the technology can be realized [3]. Recently, Shaffer et al. [4] provided a thermodynamic argument showing that FO-reverse osmosis (RO) desalination schemes cannot provide energy savings when compared to standalone RO. Although FO technology has been applied to a variety of water treatment strategies, draw solute inadequacies restrict its wider application [5, 6]. Mitigation of these inadequacies requires identification of draw solutions that achieve high osmotic pressure while minimizing reverse solute flux and also providing ease of recovery; the need for osmotic agents that allow for facile, inexpensive recovery remains paramount [7].
\nDuring the past decade, researchers have primarily focused their efforts in two areas, FO membrane production and draw solute identification. While considerable progress has been made toward the development of inexpensive and more robust membranes [8, 9], few commercially viable osmotic agents have been identified [10]. Desirable properties of the ideal osmotic agent are that it be nontoxic, inexpensive, stable, and highly water-soluble. In addition, the agent should have limited reverse draw solute flux, reduce internal concentration polarization (ICP), and be easily recoverable. Some osmotic agents and recovery schemes investigated to date include using inorganic salts with recovery by RO [11]; using poly(sodium acrylate) with recovery by ultrafiltration (UF) [12]; using thermoresponsive chitosan derivatives with recovery by aggregation at elevated temperature [13]; using ammonia-carbon dioxide with recovery by thermal separation [14]; using poly(N-isopropylacrylamide-co-acrylic acid) with recovery by heating and centrifugation [15]; using surfactants with recovery by UF [16]; and, using polyelectrolyte-based hydrogels with recovery by elevated temperature and pressure [17]. A critical review of what the authors term non-responsive and responsive draw solutes was recently provided by Cai and Hu [7].
\nBecause they meet several of the aforementioned criteria, low reverse draw flux and easy recovery in particular, functionalized magnetic nanoparticles (MNPs) have garnered much attention as potential osmotic agents [18]. These MNPs typically incorporate a superparamagnetic core of Fe3O4, with a magnetization value of 75.0 emu g−1 [19], onto which organic content is coated. Among the grafting agents that have been affixed to MNPs and investigated in FO processes are 2-pyrrolidine, triethylene glycol, and poly(acrylic acid) [20]; dextran [21]; poly(ethylene glycol) diacid [22]; poly(sodium acrylate) [23, 24, 25]; poly(sodium styrene-4-sulfonate) and poly(N–isopropylacrylamide) [26]; citrate [27]; hyperbranched polyglycerol [28]; and, citric acid and oxalic acid [19]. A primary advantage of using MNPs is their ease of recyclability through magnetic separation, although particle aggregation has been shown to diminish FO water flux values after multiple regeneration cycles [10]. Another benefit of derivatized MNPs is that they have been shown to provide higher osmotic pressures when compared to solutions of the organic grafting agents alone [20], an enhancement attributable to increased solution nonideality.
\nA solution behaves ideally when: (1) solute/solute, solvent/solvent, and solvent/solute interactions are identical and (2) all solute and solvent molecules occupy the same volume. Real solutions deviate from ideality due to an energetic nonequivalence in one or more of these interactions and/or volume occupancies are not identical. In aqueous solution, water molecules exhibit particularly strong hydrogen bonding with various organic functional groups, carboxylate moieties in particular [29]. Factors such as hydration, ion-pairing, and dimerization can be significant contributors to thermodynamic nonideality [30] and can dramatically impact the osmotic performance of FO draw solutions.
\nA variety of models have been developed to explain the interesting osmotic behavior of concentrated solutions of proteins and other biological molecules [31, 32, 33, 34]. The nonideal solution behavior of large biological molecules can lead to extreme changes in osmotic pressure. As an example, at a fixed protein concentration, the osmotic pressures of bovine serum albumin (BSA) solutions display greater than fivefold changes in the range 3 < pH < 8 [32]. Such nonideality is generally attributable to variations in solvent-accessible surface area and polymeric segmental motion [35]. Models that adequately describe nonideal behavior in BSA and other polymer solutions provide a basis for explaining the unique osmotic properties of MNPs used in FO.
\nIn order to function effectively as a draw agent in FO, the osmotic pressure of the draw solution must far exceed that of the feed solution. In terms of desalination, the draw must have an osmotic pressure significantly in excess of 7.7 atm in the case of a brackish feed, and in excess of 27 atm in the case of a seawater feed [4]. Because of their abilities to achieve high osmotic pressures while maintaining low solution viscosities, simple inorganic salts remain the most widely used draw agents. In addition, small ions tend to have greater diffusivity values thus moderating the effect of concentrative ICP. The strong affinity of small inorganic ions for water is revealed in their highly exothermic enthalpies of hydration [36]. This strong affiliation serves to significantly lower the chemical potential of water in draw solutions. Strong solvent/solute interactions provide high solution osmotic pressures while paradoxically making the regeneration of draw solute more difficult. Resolving this paradox has spurn interest in the development of easily removable draw agents that allow for regeneration through exploitation of solute size, thermal sensitivity, or magnetic properties. Of course, to be effective in FO processes these solutes must still provide appreciable osmotic pressure. Interestingly, structural features of various macromolecular species and molecular aggregates that allow for easy removal from aqueous solution can also serve to enhance osmotic pressure through nonideal solvent/solute interactions.
\nThe effects of osmotic pressure, solution viscosity, and molecular/ionic diffusivity on water flux (\n
where \n
Consider an FO process using a polymer solution as the osmotic agent. If a polymer solution is separated from pure water by a semipermeable membrane the movement of water through the barrier is explained in terms of the chemical potential of the water, \n
where \n
Osmotic behavior of an aqueous polymer solution.
As Eq. (2) implies, it is reasonable to differentiate \n
The definitions of Gibbs free energy and chemical potential are given by Eqs. (4) and (5), respectively,
\nwhere \n
Eq. (6) reveals that under conditions of constant temperature and solution composition, the derivative of Gibbs free energy with respect to pressure is given by Eq. (7).
\nBy differentiating Eq. (5) with respect to pressure, while holding other variables constant, Eq. (8) is obtained.
\nSimilarly, by differentiating Eq. (7) with respect to amount of water Eq. (9) is obtained, in which \n
Because of the symmetry of second derivatives, meaning the order of differentiation is inconsequential, the partial molar volume of water is also given by Eq. (10).
\nNext, differentiation of an analogous form of Eq. (2) with respect to \n
Because \n
If there is no net flow of water in an apparatus like that depicted in Figure 1, \n
Substituting Eqs. (10) and (12) into Eq. (13) and then integrating provides Eq. (14).
\nAssuming the solution is incompressible (meaning that partial molar volume is independent of pressure) allows for simple integration providing Eq. (15).
\nFor dilute solutions (\n
which upon substitution into Eq. (15) provides the familiar van’t Hoff equation, Eq. (18).
\nDeviations of solution osmotic pressure data from Eq. (18) are generally attributable to nonideal solvent-solute and solute-solute interactions. One way of expressing the extent to which a solution deviates from ideality is through the osmotic coefficient, \n
The osmotic coefficient is analogous to the activity coefficient and can be defined in terms of other concentration units. It is often used in conjunction with \n
Alternatively, and in particularly for polymer solutions, solution osmotic pressure is often expressed as a power series expansion in \n
where \n
An empirical, semi-empirical, or theoretical methodology can then be used to relate \n
In terms of solute molality (\n
where \n
Wilson and Stewart [38] have provided a good discussion of how solution osmotic pressure is affected by the hydration of simple ionic compounds. The short range interactions between electron pairs in water molecules and cations lead to \n
Compound | \nMolarity | \n\n\n | \n\n\n | \n\n\n | \n\n\n | \n\n\n | \n
---|---|---|---|---|---|---|
NaCl | \n0.869 | \n3.9 | \n1.84 | \n0.968 | \n44 | \n3.38 × 10−6 | \n
KCl | \n0.943 | \n1.7 | \n1.85 | \n0.968 | \n44 | \n3.74 × 10−6 | \n
In terms of osmotic pressure and corresponding FO performance there are diminishing returns on using ever-higher concentrations of ionic compounds, especially when increased solution viscosity is also considered. While hydration numbers tend to increase with increasing cation charge density, they decrease with increasing concentration, owing in part to increased ion-pairing, effectively reducing \n
In their studies of BSA, Kanal et al. [32] observed that osmotic pressure decreases as solution pH increases from 3 to approximately 4.6 and then increases with pH. Increases in osmotic pressure on either side of the minimum are attributed to increased electrostatic repulsive interactions. At pH values below the isoelectric point (pIBSA = 5.4), the protein adopts a net positive charge along its surface. At pH values above pIBSA, it is net negative. Electrostatic repulsion leads to a less compact protein conformation, greater segmental motion, more effective hydration, and higher osmotic pressures. Near the isoelectric point, the net-neutral protein strands adopt a more compact configuration, are less hydrated, and even tend to aggregate due to reduced intermolecular repulsion. The osmotic nonideality of BSA solutions is generally attributable to two sources: (1) large solvent/solute interactions that effectively increase polymer hydration (\n
The hydration of PEG of molecular weight 2000 Da (PEG2000), both unattached and attached to distearoyl phosphoethanolamine liposomes ((DSEP)-PEG2000), was investigated by Tirosh et al. [43]. Using differential scanning calorimetry, PEG2000 was found to bind 136 ± 4 water molecules, while (DSEP)-PEG2000 binds 210 ± 6 water molecules. In terms of hydration number per monomeric unit (approximately 46 units in 2000 Da PEG), these binding values correspond to hydration numbers of 3.0 and 4.6 for PEG2000 and (DSEP)-PEG2000, respectively. The increase in water molecule binding is attributed to conformational changes, a coil configuration in PEG2000 and a brush configuration in (DSEP)-PEG2000. When grafted to the liposome surface, the close proximity of the polymeric strands causes them to repel each other and to adopt a more extended, easily hydrated, form. Such behavior has been exploited in the development of draw agents that incorporate superparamagnetic magnetite (Fe3O4) onto which polymers were grafted [19, 20, 21, 22, 23, 24, 25, 26, 27, 28].
\nA summary of some recent applications of derivatized MNPs as draw agents in FO processes is provided in Table 2, which includes approximate concentrations of the repeating (monomeric) units used as capping agents on the MNPs. Other researchers have demonstrated that the osmotic properties of aqueous polymer solutions are perhaps best interpreted in terms of monomer concentration [31, 45].
\nCoating agent | \nSize (nm) | \n[Monomer] (M) | \n\n\n | \n\n\n | \nRef. | \n
---|---|---|---|---|---|
2-Pyrrolidine TREG PAA1800 | \n28 24 21 | \n0.15 0.20 1.0 | \n4.6 5.8 7.6 | \n17 23 36 | \n[20] | \n
Dextran | \n10 | \n11 | \n8.9 | \nN/A | \n[21] | \n
PEG250-(COOH)2 PEG600-(COOH)2 PEG4000-(COOH)2 | \n11.7 13.5 17.5 | \n0.37 0.88 5.9 | \nN/A 9.1 N/A | \n73 66 55 | \n[22] | \n
PAA1800 | \n5 | \n1.5 | \n11.2 | \n70 | \n[46] | \n
PAA1800 PNaAA1800 PCaAA1800 | \n20 20 20 | \nN/A N/A N/A | \nN/A 2.1 1.8 | \n18 32 27 | \n[23] | \n
PNaSS-PNIPAM | \n5 9 | \n2.3 2.5 | \n14.9 9.9 | \n55.0 40.8 | \n[26] | \n
Citrate | \n3–8 | \n0.015 | \n16 | \nN/A | \n[27] | \n
HPG | \n20.9 | \n2.1 | \n6.7 | \n15 | \n[28] | \n
PNaAA2100 | \n9 | \n0.0083 | \n5.3 | \n11.4 | \n[24] | \n
Citric acid Oxalic acid | \n40 35 | \n0.52 0.84 | \n12.7 10.3 | \n64 47 | \n[19] | \n
PNaAA | \n160 | \n12.4 | \nN/A | \n19.5 | \n[25] | \n
Si-COOH Si-PEG530 | \n12.7 13.6 | \n0.046 0.43 | \n1.7 2.0 | \n6.3 7.6 | \n[47] | \n
Summary of MNP-based draw agents used in FO processes.
Abbreviations: TREG: triethylene glycol; PAA: poly(acrylic acid); PEG-(COOH)2: poly(ethylene glycol) diacid; PNaAA: poly(sodium acrylate); PCaAA: poly(calcium acrylate); PNaSS-PNIPAM: poly(sodium styrene-4-sulfonate) and poly(N-isopropylacrylamide) [15% PNaSS, 85% PNIPAM]; HPG: hyperbranched polyglycerol; Si-COOH: N-(trinethoxysilylpropyl)ethylenediamine triacetic acid; Si-PEG: 2-[methoxy- (polyethyleneoxy)propyl]trimethoxysilane. Superscripts represent the average molecular weights of polymeric stands.
Some investigators have studied the FO properties of osmotic agents that are both alone in aqueous solution and grafted onto MNPs [20, 24]. Ling et al. [20] compared 2-pyrrolidine, TREG, and PAA as draw solutes. When grafted onto MNPs, 2-pyrrolidine exhibited a near sixfold increase in osmolality when compared to the ungrafted solute. TREG and PAA exhibited approximately threefold and thirtyfold increases in osmolalities, respectively, at similar concentrations when grafted onto MNPs. Dey and Izake [24] found that 3.5 wt.% PNaAA provided a FO-water flux value of 1.72 LMH while only 0.078 wt.% PNaAA grafted onto MNPs provided a flux value of 5.32 LMH. These results indicate that anchoring polymers onto nanoparticles serves to significantly improve their osmotic performance.
\nThe tremendous enhancement to osmotic pressure and water flux values associated with polymeric solutes anchored to MNPs can be attributed to improved hydration of the polymeric strands. The dense packing of polymer chains around MNPs leads to a more extended, brush-like, conformation due to excluded volume interactions [48, 49]. In addition, Ling et al. [20] ascribe a reduced interaction between PAA-MNPs and the FO-membrane surface as also contributing to the improved performance; carboxyl groups interacting with ester moieties on the membrane surface are not interacting with water and thereby reducing its chemical potential.
\nWhile \n
where \n
where \n
Figure 2 depicts the application of Eq. (25) to data for TREG [20, 31, 52] both alone in solution and grafted to MNPs. The ungrafted TREG molecules display little deviation from ideality, with a relatively small \n
Nonideality analyses for TREG, using data from [
The application of Eq. (25) to data for which 2-[methoxy-(polyethyleneoxy)6–9propyl] trimethoxysilane (MW: 459–591 g mol−1) was used as the grafting agent [47] is provided in Figure 3. When compared to TREG data, the greater number of monomers per polymeric strand results in a smaller \n
Nonideality analyses for TREG and Si-PEG530, using data from [
In Figure 4, data for MNPs coated with PAA [20] and HPG [28] are depicted. These results again demonstrate the significant nonideal solution behavior of derivatized MNPs. The large \n
Nonideality analyses for HPG and PAA1800, using data from [
Osmotic agent | \n\n\n | \n\n\n | \nRef. | \n
---|---|---|---|
TREG–alone | \n0.37 | \n153 | \n[20, 31, 52] | \n
TREG–MNP | \n19.3 | \n56.1 | \n[20] | \n
Si-PEG530–MNP | \n5.8 | \n101 | \n[47] | \n
PAA1800–MNP | \n4.2 | \n111 | \n[46] | \n
HPG–MNP | \n2.2 | \n433 | \n[28] | \n
Summary of \n
Another significant contributing factor to the osmotic potential of draw solutions incorporating polyelectrolytes is counterion binding. Oosawa was among the first to introduce the concept of counterion condensation around a polyion [53]. His model considers a fraction of counterions that is
Using this model, bound counterions would not contribute to osmotic pressure while unbound ions would. Polymeric structural features that influence the magnitude of \n
Data also indicate that MNP particle size influences their osmotic performance because smaller particles have a larger surface area per volume, thus allowing for more effective grafting-agent coverage and increased nonideality. Ling et al. [20] demonstrated the inverse relationship between nanoparticle size and osmolality using PAA-MNPs. However, Kim et al. [56] found that particles smaller than 11 nm were difficult to separate from solution even with the application of a strong magnetic field, while the removal of particles larger than about 20 nm from the magnetic separator column was problematic. Additionally, the larger the mass percentage of coating material on a Fe3O4 core, the lower the saturated magnetization value on a per gram of particle basis. More coating material likely imparts greater osmotic pressure, but it reduces the efficacy of separation. Another significant challenge associated with MNP draw agents is particle aggregation following magnetic separation.
\nGe et al. [22] observed a flux decline to approximately 80% of its original value after 9 recycles; this flux decline was accompanied by a particle size increase to 141% of the original value. That study used MNPs with an initial diameter <20 nm. Mino et al. [25] used much larger particles, with diameters of approximately 160 nm, and observed no aggregation even after 10 recycles, though the larger particles achieved only modest osmotic pressures. Park et al. [47] demonstrated that Si-PEG530-MNPs (diameterinitial = 13.6 nm) showed no significant aggregation or FO performance decline after 8 recycles, while Si-COOH-MNPs displayed considerable aggregation after only 5 recycles. Aggregation of the Si-COOH-MNPs was attributed to strong hydrogen bonding between carboxylate groups on adjacent particles when brought into close proximity during magnetic separation and subsequent drying. The oxalic acid- and citric acid-coated MNPs studied by Ge et al. [19] showed no significant particle agglomeration during regeneration, likely the result of strong electrostatic repulsion between particles. Zhao et al. [26] also observed only a slight decline in water flux (<10%) following recycles of their negatively charged PNaSS-PNIPAM-coated particles. In addition, Na et al. [27] demonstrated that small MNPs (3–8 nm) penetrate pores within the FO-membrane support layer (10–40 nm) and become lodged leading to a decline in flux values with time.
\nWhile it is now generally accepted that FO processes do not offer an overall energy cost savings when compared to RO for seawater desalination, the prospects of niche applications for FO where RO is unsuitable are numerous. A major challenge for the wider use of FO technology is the development of draw agents that provide high water flux, low reverse solute flux, and facile recovery. Organic-coated superparamagnetic nanoparticles provide properties that address these requirements. The FO performance of MNPs is a function of coating material, particle size, and concentration; with mitigation of particle aggregation during recovery being an essential consideration. The osmotic performance of organic compounds improves significantly when grafted onto MNPs, likely resulting from increased solvent-accessible surface area and enhanced hydration. Application of a simple semiempirical model provides assessments of the nonideality associated with MNPs through calculation of a solvent/solute interaction parameter (\n
Support for this work was provided by the Qatar Foundation and was made possible in part by a grant from the Qatar National Research Fund under its Undergraduate Research Experience Program award no. UREP13-018-1-001. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Qatar National Research Fund.
\nPolycystic ovarian syndrome (PCOS) is characterized by endocrine and ovarian disorders that affect quality of life in women of reproductive age. In 1935, PCOS was first described by Stein and Leventhal with a description of seven women suffering from amenorrhea, hirsutism, and enlarged ovaries with multiple cysts [1, 2]. Some different criteria about the National Institute of Health (NIH), Rotterdam criteria, Androgen Excess Society and Polycystic Ovary Syndrome Society guidelines (AE-PCOS) are shown in \nTable 1\n [3, 4, 5, 6, 7, 8].
\nTitle | \nNIH 1992 | \nRotterdam 2003 | \nAE-PCOS 2006 | \nNIH 2012 extension of Rotterdam 2003 | \n
---|---|---|---|---|
Criteria | \n• Clinical or biochemical androgen excess • Rare ovulations | \n• Clinical or biochemical androgen excess • Oligo- or anovulation Polycystic ovaries | \n• Clinical or biochemical androgen excess • Ovarian dysfunction and/or polycystic ovaries | \n• Clinical or biochemical androgen excess • Oligo- or anovulation Polycystic ovaries | \n
Restriction | \nNeed both criteria | \nNeed two of three criteria | \nNeed both criteria | \n• Need two of three criteria • Specifically identifying the four sub-phenotype: | \n
Exclusion | \nExclusion of other androgen excess and other similar etiology | \n
Diagnostic criteria for PCOS.
Globally, PCOS affects 5–20% of women of reproductive age [9]. One report summarized the incidence of PCOS as 6–13% in Hispanic women, 3–9% in African American women, and 2–9% in Asian women [10]. The prevalence of PCOS in different geographical regions ranges from 5 to 10% according to the NIH 1990 criteria, from 10 to 15% according to the AE-PCOS 2006 criteria, and from 6 to 21% when the Rotterdam criteria are applied [7]. East Asian subjects (Korean, Chinese, and Thai) appear to have a lower prevalence of PCOS (about 5%) compared to Caucasian women (11–20%) [11].
\nOne systematic review and meta-analysis showed the incidence of PCOS phenotypes using the 2012 NIH criteria was 50% for phenotype A, 13% for phenotype B, 14% for phenotype C, and 17% for phenotype D [12].
\nPatients with PCOS often have comorbidities such as obesity, insulin resistance/type II diabetes mellitus (Type II DM), dyslipidemia, hypertension/cardiovascular disease, infertility/subfertility, or cancer. One systematic review and meta-analysis demonstrated that women with PCOS had a pooled prevalence of 61% for overweight [body mass index (BMI) > 25], 49% for obesity (BMI > 30), and 54% for central obesity [13]. Insulin resistance (IR) is present in 50–80% of these women, which is associated with obesity [14, 15]. Both lean (30%) and obese women (70%) with PCOS show decreased insulin sensitivity [16].
\nAround 27% of premenopausal women with PCOS have type II DM [17]. Dyslipidemia may be up to 70% in women with PCOS [18, 19]. In a large study of European and American women with PCOS, the total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels increased significantly, up to 29 and 16 mg/dl, respectively, in non-Hispanic white, obese women with PCOS compared to obese women without PCOS [19]. This study also noted that the total cholesterol and LDL-C levels were elevated significantly, up to 32 and 32 mg/dl, respectively, in nonobese women with PCOS compared to nonobese women without PCOS [19]. Another worldwide systematic review and meta-analysis demonstrated that triglycerides (TG) and LDL-C levels were 26 and 12 mg/dl higher, and high-density lipoprotein cholesterol (HDL-cholesterol) concentration was 6 mg/dl lower than that of controls [20].
\nOne clinical study demonstrated that nearly 26% of women with PCOS have hypertension [21]. The metabolic imbalances in patients with PCOS cause chronic low-grade inflammation and cardiovascular disturbances, which increase the risk of cardiovascular disease [22]. One systematic review and meta-analysis showed a 2-fold increased risk of coronary heart disease (CHD) and stroke for women with PCOS compared to those without PCOS [23].
\nWomen with PCOS account for around 80% of women with anovulatory infertility [24, 25]. A recently systematic review and meta-analysis showed that women of all ages with PCOS were at a significantly increased risk [odds ratio (OR) up to 2.79] for endometrial cancer [26]. Moreover, this study also revealed that when women over 54 years of age were excluded from the analysis, the risk for women with PCOS increased more (OR up to 4.05) for endometrial cancer and for ovarian cancer (OR up to 2.52), but stable for breast cancer [26].
\nThe etiology of PCOS is still not clear. A systematic review suggested that post-natal exposure to androgens results in reprogramming of the hypothalamic-pituitary-ovarian-axis [27]. Recently, some clinical studies have confirmed that human fetal androgen excess promotes PCOS development after birth by checking infant blood levels at term [28]. The circulating androgen levels of the human female fetus in the second trimester can increase into the male range and mid-gestational amniotic testosterone levels in female fetuses of PCOS mothers may be higher than those in normal mothers, which might influence fetal development [28]. Another review article mentioned that the fetal ovary is more likely to produce an excess of androgens in response to maternal human chorionic gonadotropin (hCG) in subjects genetically predisposed to PCOS [29]. Furthermore, some genetic variations are associated with PCOS. For example, DENND1A is found in the cytoplasm and nuclei of ovarian theca cells. Over expression of DENND1A variant 2 results in a PCOS-like phenotype, and knock-down of DENND1A variant 2 in PCOS theca cells reversed this phenotype [30]. In addition, a recent review showed that genome-wide association studies (GWAS) have identified some loci containing genes with clear roles in reproductive (LHCGR, FSHR, and FSHB) and metabolic (INSR and HMGA2) dysfunction in PCOS [31].
\nThere are several diagnostic criteria for PCOS such as NIH 1990/2012, ESHRE/ASRM 2003 (Rotterdam), or AE-PCOS 2006. Diagnosis of PCOS should take into consideration the history, clinical manifestations, ultrasound imaging results, and serum examination results.
\nMenstrual abnormality such as oligo-anovulation (OA) is usually noted [32]. According to the Rotterdam criteria, OA is defined as less than eight episodes of menses a year or cycle lengths of more than 35 days [5]. A stricter definition, such as less than eight menstruations and/or two cycles of less than 22 or more than 42 days per year, the prevalence of OA drops to 14% and OA becomes highly predictive of PCOS [33, 34]. Although 30% of women with PCOS will have normal menses [2, 35], 85–90% of women with OA have PCOS, while 30–40% of women with amenorrhea have PCOS [2, 36]. After the age of 40, women with PCOS often have more regular menstrual cycles while women over 30 who develop OA are less likely to have PCOS [32].
\nWeight gain and central obesity are common presentations in PCOS and usually come before the onset of anovulatory cycles [14]. In the United States, the prevalence of obesity in girls aged 12–19 years in 2007–2008 was 17%, compared with 50–80% among adolescent girls with PCOS [13, 37, 38, 39, 40].
\nClinical manifestations are acne, hirsutism, and androgenic alopecia . Some patients appear with only one or two manifestations, while a few patients have all the three [2]. Sixty percent of patients with PCOS have hirsutism and 15–25% patients have acne [6].
\nThe BMI, blood pressure, waist circumference (WC), and hip circumference should be measured at the initial visit. Fasting lipid profile, sugar and glycohemoglobin, or a 2-hour oral glucose tolerance test (OGTT) should be performed if PCOS is suspected at the initial visit. Trans-vaginal ultrasound is indicated rather than trans-abdominal ultrasound if the patient has one of either irregular menstruation or HA. The Rotterdam PCOM criteria, considered to have sufficient specificity and sensitivity to define PCOM, requires the presence of ≥12 follicles measuring 2–9 mm in diameter and/or increased ovarian volume (>10 cm3) in a single ovary or both ovaries [32, 41, 42]. In 2014, the AE-PCOS guidelines suggested using follicle number per ovary (FNPO) ≥25 for the definition of PCOM when using newer technology that allows maximal resolution of ovarian follicles (such as a transducer frequency of more than 8 MHz) [41, 43].
\nSerum hormone examination, such as serum androgens, should be performed on women with clinical appearance of PCOS. In addition, anti-Müllerian hormone (AMH) in women is generated by granulosa cells, and preantral and antral follicles, and its major function seems to be limited to inhibit the development of the initial stage of follicular maturation [44]. Serum AMH in women with PCOS is higher than in healthy women, which probably reflects the number of small follicles observed on the ultrasounds of polycystic ovaries [45]. Studies have reported that 97% of women with AMH >10 ng/mL had PCOS and this correlated positively with LH, total testosterone, and DHEA [45, 46]. Besides, serum AMH revealed high predictive ability for the presence of OA or amenorrhea [45, 46]. Recently, serum AMH is proving to be a better tool to understand ovarian function and follicular count; however, the clinical use of serum assays for AMH still poses some technical problems [33, 44].
\nManagement of PCOS is limited to improve clinical manifestations, since the real etiology of the disorder is unclear [47]. While multiple cardiovascular risk factors such as obesity, dyslipidemia, hypertension, and DM are prevalent in PCOS, current therapeutic management of PCOS usually focuses firstly on the treatment of metabolic disturbances (anovulation, menstrual irregularity, and hirsutism) and secondly on the control of reproductive hormones or insulin levels [48]. Lifestyle modifications including increased exercise, dietary changes, and weight loss are appropriate first-line interventions for many women with PCOS [49]. Diet therapy for patients with PCOS includes the design of low-calorie diets to achieve weight loss or preserve a healthy weight, restrict the intake of simple sugars, and increase the consumption of foods with a low glycemic index and refined carbohydrates, a decrease in the consumption of trans and saturated fatty acids, and awareness of possible deficiencies such as omega-3, vitamin D, and chromium [50]. One systematic review and meta-analysis demonstrated that moderate physical activity mostly 12 or 24 weeks would improve ovulation, decreased IR (9–30%), and weight loss (4.5–10%) [51]. The AE-PCOS guidelines suggested a target of caloric, diet, and body weight control in PCOS women with more restrictions if dyslipidemia occurred [52, 53, 54]. The detailed information is listed in \nTable 2\n [52, 53, 54].
\n\n | \n\n | \n
---|---|
Limitation of calories | \nDecrease current diet 500–1000 kcal/day | \n
Reduction of fat | \nDecrease total fat (less than 30% total caloric intake) and saturated fat (less than 10% total caloric intake) | \n
Favor foods intake | \nIncrease fiber, vegetables, fruit, cereals, wholegrain breads, monounsaturated and polyunsaturated fat intake | \n
\n | \n\n | \n
Reduce body weight by 7–10% | \n5–8% | \n
Decrease saturated fat to 7% total energy | \n8–10% | \n
Decrease dietary cholesterol to <200 mg daily | \n3–5% | \n
Decrease transfat to 1% total energy | \n2% | \n
Increase 2 g of plant stanols daily | \n6-–0% | \n
Add 5–10 g viscous fiber daily | \n3–5% | \n
Nutritional recommendations for PCOS women from the AE-PCOS society.
Unfortunately, lifestyle interventions are associated with low adherence and sustainability, and engagement, compliance, and sustainability remain challenging [55]. Medical treatment of PCOS is indicated if lifestyle modifications are a failure or unsuitable. Medical treatments include clomiphene citrate, metformin, oral contraceptives (OCPs), anti-androgen, steroids, and statins. One-year randomized clinical trial (RCT) showed that combined oral contraceptives plus spironolactone can decrease hirsutism score, androgens, and DHEA levels with fewer menstrual dysfunction [56]. Another randomized, controlled crossover study demonstrated that both metformin and myoinositol significantly reduced the insulin response to OGTT and improved insulin sensitivity [57]. Metformin could reduce body weight, improve menstrual pattern, and decrease LH, oestradiol levels, androgens, and AMH levels [57]. \nTable 3\n lists the medical treatment agents and limitations for PCOS [58, 59, 60, 61, 62, 63, 64, 65, 66, 67].
\nMedical agents | \nIndication and effect | \nLimitations | \n
---|---|---|
Clomiphene citrate | \n*As an ovary-stimulating drug in subfertile/infertile women *Nonsteroidal synthetic hormone consisting of a racemic mixture of two stereoisomers (40% enclomiphene [EnC] and 60% zuclomiphene [ZuC]), with anti-estrogenic properties | \n*Possible fetal malformations, mainly neural tube defects and hypospadias *Increased risk of endometrial cancer, especially at doses greater than 2000 mg and high (more than 7) number of cycles | \n
Metformin | \n*Usually used in young girls and adolescents with PCOS as first-line monotherapy or in combination with anti-androgen medications and OCPs *Improve hyperandrogenemia and symptoms of androgen excess *Recovery ovary function with normal menses *Assist in weight reduction *Reduce in metabolic parameters of insulin resistance | \n*Promoting ovulation is still controversial *Maybe increase IR after a 2-year period of intervention | \n
Oral conceptions | \n*Contain estrogen (almost exclusively ethinylestradiol) and a progestin *Decrease androgens and block the effect of androgens by inhibiting of ovarian androgen production and by increasing SHBG *Advantageously combined with an anti-androgen to attain a better effect when treating hirsutism and alopecia | \n*Progestins, such as chlormadinone and drospirenone, may increase venous thrombosis events and may be contraindicated in severe obesity patients. *Little effect in blocking mild to moderate hirsutism or alopecia with OCPs only | \n
Anti-androgens | \n*Competitive antagonism of the androgen receptor (spironolactone (SPA), cyproterone acetate, flutamide) or suppression of 5α-reductase (5αR, such as finasteride) to prevent the conversion of 5α-dihydrotestosterone into free testosterone *Suppress the effects of androgen in the hair follicle or in the pilosebaceous unit | \n*SPA may induce hyperkalemia, breast discomfort, dry skin, gastritis, headaches and dizziness *Intermenstrual spotting may occur if the women taking SPA as monotherapy *SPA has the potential for teratogenicity | \n
Steroids | \n*Physiologic doses of prednisolone or dexamethasone can reduce androgen output directly | \n*Less effective for the treatment of hirsutism | \n
Statins | \n*Lipid-lowering agents with multiple actions to improve dyslipidemia *Combined with an OCP can improve hirsutism | \n*Statins alone do not improve hirsutism, menstruation, or BMI | \n
Current medical agents and limitations for PCOS.
Bariatric surgery is used for weight reduction in patients with morbid obesity. One systematic review showed that bariatric surgery can improve postoperative conception rates, hirsutism, menstrual irregularities, and hormonal abnormalities in women with PCOS [68]. Another systematic review and meta-analysis about bariatric surgery demonstrated that the incidence of PCOS preoperatively was 45.6%, which significantly decreased to 6.8 and 7.1% at the 1 year follow-up and study endpoint, respectively [69]. Moreover, it also demonstrated nearly a 50% improvement in menstrual irregularity and a 30% improvement in hirsutism [69]. There is still a lack of evidence for the improvement in fertility after bariatric surgery [68, 69]. One report revealed the tendency of increasing infant mortality in the bariatric group and bariatric surgery may have its own unique risk-benefit ratio with regards to pregnancy results [70].
\nTraditional Chinese medicine formulas and herbs have been used to manage the health problems of women for hundreds of years. Classically, Chinese medicine prescription is composed of many herbs to treat a specific disease. According to the principles of TCM syndrome patterns for PCOS, one study showed that Shen deficiency with blood-stasis syndrome was the most frequent pattern noted in these patients, followed by Pi-deficiency with phlegm-dampness syndrome, Pi-Shenyang-deficiency syndrome, and Shen-yin deficiency syndrome [71]. Another study demonstrated that TCM syndrome patterns presented in patients with PCOS were mostly amalgamative, of which Shen deficiency and Gan stagnancy are the basic syndromes [72]. One earlier study revealed that elevated levels of testosterone correlated more with the TCM syndrome pattern of Shen-Yi deficiency compared to other patterns [73]. Interestingly, there is one study that describes the correlation between TCM syndrome patterns of PCOS and ovulation induction effects [74]. The effects of clomiphene on patients with phlegm-dampness accumulation syndrome and Shen-yin deficiency syndrome were poorer than in patients with Shen-yang deficiency syndrome and Gan-stagnancy transformed heat syndrome, which suggested the degree of reproduction endocrine dysfunction or the metabolism disturbance of the former two syndrome patterns were more severe than the latter two syndrome patterns [74].
\nJia-Wei-Xiao-Yao-San, also called Dan-Zhi-Xiao-Yao-San, consists of Moutan Radicis Cortex, Radix Paeoniae Rubra, Bupleuri Radix, Angelicae Sinensis Radix, Poria, Glycyrrhizae Radix, Atractylodes Ovatae Rhizoma, Zingiberis Rhizoma Recens, and Menthae Herba. According to the principles of TCM, Jia-Wei-Xiao-Yao-San disperses stagnated liver qi for relief of qi stagnation and suppresses heat and nourishes the blood. One study showed that a danzhi xiaoyao pill could improve ovulation rates and pregnancy rates in anovulation infertility patients with PCOS complicated by IR [75]. It was also reported as the most frequently prescribed formula for patients with PCOS in north Taiwan [76].
\nWen-Jing-Tang consists of
Cang-Fu-Dao-Tan-Wan consists of
\n
\n
\n
As with TCM formulas and single Chinese herbal therapy, acupuncture and moxibustion have also been used to treat clinical manifestations of PCOS for hundreds of years. Traditionally, acupuncture and moxibustion were performed by inserting needles into or burning moxa sticks upon specific points (acupoints) on the meridians of the body surface. Acupuncture and moxibustion work by regulating energy flow, also called Qi in Chinese, over the meridians. Newer therapeutic methods include electro-acupuncture (EA), laser-acupuncture, burning moxa granules on the top of the needle, points pasting, and far-infrared moxibustion.
\nClinical effects of acupuncture are mediated by activation of somatic afferent nerves innervating the skin and muscle, which, via modulation of the activity in the somatic and autonomic nervous system, may regulate metabolic and endocrine functions in patients with PCOS [89]. One analysis showed that the acupoints of Sanyinjiao (SP 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zhongji (CV 3), and Qihai (CV 6) are most frequently used in the clinical management of acupuncture for patients with PCOS [90]. This report also demonstrated the meridians of the main acupoints are the conception vessel, stomach meridian of the foot-yangming, and the spleen meridian of foot-taiyin. The main acupoints are distributed in the lower limbs, lower abdomen, and back [90]. In the special points, usage of front-mu points, five-shu points, and back-shu points are more frequently used and the prescription is usually an average of five to seven acupoints [90].
\nOne prospective clinical study investigated responses to 5 weeks of EA in overweight-obese women with PCOS [91]. The results showed that HbA1c levels and circulating and adipose tissue androgens were significantly decreased, together with modulation of vagal activity and adipose tissue sympathetic activity [91]. A systematic review and meta-analysis demonstrated that manual acupuncture (MA) or EA can improve clinical pregnancy rates and ongoing pregnancy rates, and lower the risk of ovarian hyperstimulation syndrome (OHSS) in women with PCOS undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) [92]. Another RCT revealed that serum androgens decreased and menstrual frequency increased after 16 weeks of EA intervention, while the acne improved after the 16-week follow-up in the EA group compared to the exercise group [93]. The other RCT showed that serum levels of AMH were significantly decreased in the EA group compare with the change in the exercise group after 16 weeks of intervention, but there was no difference in the exercise group and the no intervention group at 32 weeks follow-up [94]. An earlier RCT found that abdominal acupuncture for obese patients with PCOS can reduce BMI and WHR and increase menstrual frequency more effectively, and with fewer adverse effects, than metformin after a 6-month trial [95].
\nTrue (EA group) and sham (Park sham device group) acupuncture (EA V.S. Park sham device) may have similar effects on mean ovulation rates and reproductive endocrine changes, but the true acupuncture group could show lower fasting insulin and free testosterone levels after 8 weeks of intervention [96]. Another RCT showed that the utilization of acupuncture with or without clomiphene, compared with control acupuncture and placebo, did not increase live births in patients with PCOS [97]. A recent systematic review and meta-analysis demonstrated that acupuncture may be more likely to improve ovulation rates and menstruation frequency than no acupuncture in patients with PCOS [98]. This report also noted that acupuncture could be as an adjunct to medication with regard to LH, LH/FSH ratio, testosterone, fasting insulin, and pregnancy rates [98]. Another study revealed that there were very few RCTs have been reported and there was deficient evidence to support the use of acupuncture for management of ovulation problems in patients with PCOS [99].
\nTraditional Chinese medicine formulas or single herbs have been shown to be effective in many clinical or animal studies to restore regular menstruation, relieve symptoms, and improve ovulation dysfunction in patients with PCOS. Acupuncture, both EA and MA, have the potential to change the local ovarian hyperandrogenic environment and improve reproductive and endocrine metabolic disorders in PCOS. Thus, better outcomes can be achieved through complementary therapy with TCM for PCOS, expediting and boosting treatment efficacy, and ultimately leading to decreased medical costs. However, more clear, effective, and safe evidence for the use of TCM management for PCOS is needed in the future.
\n"Open access contributes to scientific excellence and integrity. It opens up research results to wider analysis. It allows research results to be reused for new discoveries. And it enables the multi-disciplinary research that is needed to solve global 21st century problems. Open access connects science with society. It allows the public to engage with research. To go behind the headlines. And look at the scientific evidence. And it enables policy makers to draw on innovative solutions to societal challenges".
\n\nCarlos Moedas, the European Commissioner for Research Science and Innovation at the STM Annual Frankfurt Conference, October 2016.
",metaTitle:"About Open Access",metaDescription:"Open access contributes to scientific excellence and integrity. It opens up research results to wider analysis. It allows research results to be reused for new discoveries. And it enables the multi-disciplinary research that is needed to solve global 21st century problems. Open access connects science with society. It allows the public to engage with research. To go behind the headlines. And look at the scientific evidence. And it enables policy makers to draw on innovative solutions to societal challenges.\n\nCarlos Moedas, the European Commissioner for Research Science and Innovation at the STM Annual Frankfurt Conference, October 2016.",metaKeywords:null,canonicalURL:"about-open-access",contentRaw:'[{"type":"htmlEditorComponent","content":"The Open Access publishing movement started in the early 2000s when academic leaders from around the world participated in the formation of the Budapest Initiative. They developed recommendations for an Open Access publishing process, “which has worked for the past decade to provide the public with unrestricted, free access to scholarly research—much of which is publicly funded. Making the research publicly available to everyone—free of charge and without most copyright and licensing restrictions—will accelerate scientific research efforts and allow authors to reach a larger number of readers” (reference: http://www.budapestopenaccessinitiative.org)
\\n\\nIntechOpen’s co-founders, both scientists themselves, created the company while undertaking research in robotics at Vienna University. Their goal was to spread research freely “for scientists, by scientists’ to the rest of the world via the Open Access publishing model. The company soon became a signatory of the Budapest Initiative, which currently has more than 1000 supporting organizations worldwide, ranging from universities to funders.
\\n\\nAt IntechOpen today, we are still as committed to working with organizations and people who care about scientific discovery, to putting the academic needs of the scientific community first, and to providing an Open Access environment where scientists can maximize their contribution to scientific advancement. By opening up access to the world’s scientific research articles and book chapters, we aim to facilitate greater opportunity for collaboration, scientific discovery and progress. We subscribe wholeheartedly to the Open Access definition:
\\n\\n“By “open access” to [peer-reviewed research literature], we mean its free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited” (reference: http://www.budapestopenaccessinitiative.org)
\\n\\nOAI-PMH
\\n\\nAs a firm believer in the wider dissemination of knowledge, IntechOpen supports the Open Access Initiative Protocol for Metadata Harvesting (OAI-PMH Version 2.0). Read more
\\n\\nLicense
\\n\\nBook chapters published in edited volumes are distributed under the Creative Commons Attribution 3.0 Unported License (CC BY 3.0). IntechOpen upholds a very flexible Copyright Policy. There is no copyright transfer to the publisher and Authors retain exclusive copyright to their work. All Monographs/Compacts are distributed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Read more
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\\n\\nAll scientific works are Peer Reviewed prior to publishing. Read more
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\\n\\nThe Open Access publishing model employed by IntechOpen eliminates subscription charges and pay-per-view fees, enabling readers to access research at no cost. In order to sustain operations and keep our publications freely accessible we levy an Open Access Publishing Fee for manuscripts, which helps us cover the costs of editorial work and the production of books. Read more
\\n\\nDigital Archiving Policy
\\n\\nIntechOpen is committed to ensuring the long-term preservation and the availability of all scholarly research we publish. We employ a variety of means to enable us to deliver on our commitments to the scientific community. Apart from preservation by the Croatian National Library (for publications prior to April 18, 2018) and the British Library (for publications after April 18, 2018), our entire catalogue is preserved in the CLOCKSS archive.
\\n\\nOpen Science is transparent and accessible knowledge that is shared and developed through collaborative networks.
\\n\\nOpen Science is about increased rigour, accountability, and reproducibility for research. It is based on the principles of inclusion, fairness, equity, and sharing, and ultimately seeks to change the way research is done, who is involved and how it is valued. It aims to make research more open to participation, review/refutation, improvement and (re)use for the world to benefit.
\\n\\nOpen Science refers to doing traditional science with more transparency involved at various stages, for example by openly sharing code and data. It implies a growing set of practices - within different disciplines - aiming at:
\\n\\nWe aim at improving the quality and availability of scholarly communication by promoting and practicing:
\\n\\n\\n"}]'},components:[{type:"htmlEditorComponent",content:'
The Open Access publishing movement started in the early 2000s when academic leaders from around the world participated in the formation of the Budapest Initiative. They developed recommendations for an Open Access publishing process, “which has worked for the past decade to provide the public with unrestricted, free access to scholarly research—much of which is publicly funded. Making the research publicly available to everyone—free of charge and without most copyright and licensing restrictions—will accelerate scientific research efforts and allow authors to reach a larger number of readers” (reference: http://www.budapestopenaccessinitiative.org)
\n\nIntechOpen’s co-founders, both scientists themselves, created the company while undertaking research in robotics at Vienna University. Their goal was to spread research freely “for scientists, by scientists’ to the rest of the world via the Open Access publishing model. The company soon became a signatory of the Budapest Initiative, which currently has more than 1000 supporting organizations worldwide, ranging from universities to funders.
\n\nAt IntechOpen today, we are still as committed to working with organizations and people who care about scientific discovery, to putting the academic needs of the scientific community first, and to providing an Open Access environment where scientists can maximize their contribution to scientific advancement. By opening up access to the world’s scientific research articles and book chapters, we aim to facilitate greater opportunity for collaboration, scientific discovery and progress. We subscribe wholeheartedly to the Open Access definition:
\n\n“By “open access” to [peer-reviewed research literature], we mean its free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited” (reference: http://www.budapestopenaccessinitiative.org)
\n\nOAI-PMH
\n\nAs a firm believer in the wider dissemination of knowledge, IntechOpen supports the Open Access Initiative Protocol for Metadata Harvesting (OAI-PMH Version 2.0). Read more
\n\nLicense
\n\nBook chapters published in edited volumes are distributed under the Creative Commons Attribution 3.0 Unported License (CC BY 3.0). IntechOpen upholds a very flexible Copyright Policy. There is no copyright transfer to the publisher and Authors retain exclusive copyright to their work. All Monographs/Compacts are distributed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Read more
\n\nPeer Review Policies
\n\nAll scientific works are Peer Reviewed prior to publishing. Read more
\n\nOA Publishing Fees
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\n\nIntechOpen is committed to ensuring the long-term preservation and the availability of all scholarly research we publish. We employ a variety of means to enable us to deliver on our commitments to the scientific community. Apart from preservation by the Croatian National Library (for publications prior to April 18, 2018) and the British Library (for publications after April 18, 2018), our entire catalogue is preserved in the CLOCKSS archive.
\n\nOpen Science is transparent and accessible knowledge that is shared and developed through collaborative networks.
\n\nOpen Science is about increased rigour, accountability, and reproducibility for research. It is based on the principles of inclusion, fairness, equity, and sharing, and ultimately seeks to change the way research is done, who is involved and how it is valued. It aims to make research more open to participation, review/refutation, improvement and (re)use for the world to benefit.
\n\nOpen Science refers to doing traditional science with more transparency involved at various stages, for example by openly sharing code and data. It implies a growing set of practices - within different disciplines - aiming at:
\n\nWe aim at improving the quality and availability of scholarly communication by promoting and practicing:
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