Coating parameters of tested tubes used in present study.
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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:"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"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"},{slug:"intechopen-identified-as-one-of-the-most-significant-contributor-to-oa-book-growth-in-doab-20210809",title:"IntechOpen Identified as One of the Most Significant Contributors to OA Book Growth in DOAB"}]},book:{item:{type:"book",id:"6601",leadTitle:null,fullTitle:"Disinfection",title:"Disinfection",subtitle:null,reviewType:"peer-reviewed",abstract:"Disinfection is a method used to destroy most microbial forms, especially vegetative pathogens, by using physical and chemical procedures such as chlorination, UV radiation, boiling, vapor, etc. Biotic surfaces such as skin and abiotic surfaces such as contaminated medical devices and kitchen equipment exposed to cross contamination must be disinfected. Especially, inadequate disinfection of water can be fatal and cause life-threatening outbreaks. For this reason, water must be disinfected adequately by appropriate methods. There are several factors that affect the efficacy of disinfection against pathogens, such as capacity of biofilm and spore formation, having antibiotic resistance, etc. It is hard to destroy bacterial biofilms, bacterial spores, and resistant microorganisms. Some bacterial spores and resistant microorganisms can withstand disinfectants, so adequate disinfection must be done by appropriate methods. The aim of this book is to summarize disinfection, disinfection methods, and chemical analysis of by-products by providing up-to-date topics.",isbn:"978-1-78984-475-7",printIsbn:"978-1-78984-474-0",pdfIsbn:"978-1-83881-582-0",doi:"10.5772/intechopen.71513",price:100,priceEur:109,priceUsd:129,slug:"disinfection",numberOfPages:86,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:"ea121cf9b26d006bc6d7c7f92195852d",bookSignature:"Sahra Kırmusaoğlu",publishedDate:"November 14th 2018",coverURL:"https://cdn.intechopen.com/books/images_new/6601.jpg",numberOfDownloads:4576,numberOfWosCitations:1,numberOfCrossrefCitations:2,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:3,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:6,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 22nd 2017",dateEndSecondStepPublish:"December 13th 2017",dateEndThirdStepPublish:"February 11th 2018",dateEndFourthStepPublish:"May 2nd 2018",dateEndFifthStepPublish:"July 1st 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"179460",title:"Associate Prof.",name:"Sahra",middleName:null,surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu",profilePictureURL:"https://mts.intechopen.com/storage/users/179460/images/system/179460.jpeg",biography:"Dr. Kırmusaoğlu, PhD, is an assistant professor of Microbiology\nat the Department of Molecular Biology and Genetics, T.C. Haliç\nUniversity. She specialized in Microbiology at Abant Izzet Baysal\nUniversity (Biology Department), Turkey. Her previous experience\nincludes laboratory manager at microbiology laboratories in several\nresearch and private hospitals. Throughout her career, she collaborated\nwith academicians/researchers from Abant Izzate Baysal University (AIBU), Middle East Technical University (METU), and Istanbul\nUniversity Cerrahpaşa Faculty of Medicine, and has participated in various research projects.\nDr. Kırmusaoğlu’s research interests include medical microbiology, pathogenic bacteria, bacterial biofilms, antibiofilm and antibacterial activity, bacterial drug resistance, pathogen–host interactions, pathogenesis, molecular microbiology, and microbiota. She has published several international research articles, books, book chapters, and congress proceedings.\nShe is also the editor of Disinfection, Bacterial Pathogenesis and Antibacterial Control,\nand Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods\npublished by IntechOpen. In addition to these, she wrote the book Genel Biyoloji Laboratuvar\nKılavuzu (General Biology Laboratory Manual) published by Hipokrat Publisher.\nShe has contributed to a chapter translation of the book Sherris Medical Microbiology\nby Ryan et al. as one of the translation authors of Sherris Tıbbi Mikrobiyoloji, which is a\nTurkish translated book edited by Prof. Dr. Dürdal Us and Prof. Dr. Ahmet Başustaoğlu.",institutionString:"Haliç University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"5",institution:{name:"Haliç University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1135",title:"Preventive Healthcare",slug:"preventive-healthcare"}],chapters:[{id:"64076",title:"Introductory Chapter: Overview of Disinfection",doi:"10.5772/intechopen.81051",slug:"introductory-chapter-overview-of-disinfection",totalDownloads:1203,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Sahra Kırmusaoğlu",downloadPdfUrl:"/chapter/pdf-download/64076",previewPdfUrl:"/chapter/pdf-preview/64076",authors:[{id:"179460",title:"Associate Prof.",name:"Sahra",surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"}],corrections:null},{id:"61103",title:"Disinfection of Water Used for Human and Animal Consumption",doi:"10.5772/intechopen.76430",slug:"disinfection-of-water-used-for-human-and-animal-consumption",totalDownloads:992,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter deals with disinfection of water used for human and animal consumption. Water is the most abundant chemical component of the Earth and is very extensively used by mankind. Anthropogenic pressure on the environment leads to decrease in water quality. The quality of water is determined using the most important range of parameters (physical, chemical, and microbiological). This chapter discusses major pollutants of water, protection of water sources, micro-organisms causing the main waterborne diseases and methods of treatment, and disinfection of water. Different methods are used to disinfect drinking water. One of the most frequently used methods is disinfection with active chlorine, which is the only method providing continuous protection against microbial regrowth. However, this method has also some disadvantages (e.g., formation of trihalomethane and haloacetic acid precursors) linked to increased risk of cancer. It is important to remember that none of the products used to disinfect water is capable of ensuring complete safety of treated water if the water comes from unsuitable sources.",signatures:"Tatiana Hrušková, Naďa Sasáková, Gabriela Gregová, Ingrid\nPapajová and Zuzana Bujdošová",downloadPdfUrl:"/chapter/pdf-download/61103",previewPdfUrl:"/chapter/pdf-preview/61103",authors:[null],corrections:null},{id:"60956",title:"Carrier and Liquid Heat Inactivation of Poliovirus and Adenovirus",doi:"10.5772/intechopen.76340",slug:"carrier-and-liquid-heat-inactivation-of-poliovirus-and-adenovirus",totalDownloads:1207,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:1,abstract:"Viral inactivation is typically studied using virus suspended in liquid (liquid inactivation) or virus deposited on surfaces (carrier inactivation). Carrier inactivation more closely mimics disinfection of virus contaminating a surface, while liquid inactivation mimics virus inactivation in process solutions. The prevailing opinion has been that viruses are more susceptible to heat inactivation when suspended in liquid than when deposited on surfaces. In part, this reflects a paucity of comparative studies performed in a side-by-side manner. In the present study, we investigated the relative susceptibilities of the enteroviruses poliovirus-1 and adenovirus type 5 to heat inactivation in liquid versus carrier studies. The results of our side-by-side studies suggest that these two viruses are more readily inactivated when heat is applied to virus deposited on carriers. Decimal reduction values (i.e., the amount of time required to reduce the virus titer by one log10) measured at 46°C displayed the greatest difference between carrier and liquid inactivation approaches, with values ranging from 14.0 to 15.2 min (carrier) and from 47.4 to 64.1 min (liquid) for poliovirus. The corresponding values for adenovirus 5 were 18.2–29.2 min (carrier) and 20.8–38.3 min (liquid). At 65°C, the decimal reduction values were more similar (from 4 to 6 min) for the various inactivation approaches.",signatures:"S. Steve Zhou, Cameron Wilde, Zheng Chen, Tanya Kapes, Jennifer\nPurgill, Raymond Nims and Donna Suchmann",downloadPdfUrl:"/chapter/pdf-download/60956",previewPdfUrl:"/chapter/pdf-preview/60956",authors:[null],corrections:null},{id:"62656",title:"New Trends in Chemical Analysis of Disinfection By-Products",doi:"10.5772/intechopen.77254",slug:"new-trends-in-chemical-analysis-of-disinfection-by-products",totalDownloads:1174,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The disinfection by-products are special category of emergent pollutants, and their formation is widely known when the organic matter present in the catchment water reaches the disinfection agent in the water treatment plants. These kinds of compounds are close to more than 500 molecules classified in the following main families: halomethanes, haloacetic acids, haloacetonitriles and haloketones. Their adverse effects in the health are widely recognized for international health organisms and normally are in trace levels that promote the development of smart strategies for their analysis in aquatic environments where these compounds are generally not alone. In this way, the microextraction techniques for analysis of emergent contaminants in the environment which are in trace amounts have gained a lot of space because they comply fully with the objectives established in the sample preparation field: reduction in the number of steps, adaptability to field sampling, automation and reduction or total elimination of solvents required for extraction by meeting in one step the main tasks of any sample preparation technique: extraction, clean up and enrichment. There are a lot of possibilities in this field: solid phase microextraction (SPME), liquid phase microextraction (LPME), stir bar sorptive extraction (SBSE) and rotating disk sorptive extraction (RDSE).",signatures:"Milton Rosero-Moreano",downloadPdfUrl:"/chapter/pdf-download/62656",previewPdfUrl:"/chapter/pdf-preview/62656",authors:[null],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"8427",title:"Antimicrobials, Antibiotic Resistance, Antibiofilm Strategies and Activity Methods",subtitle:null,isOpenForSubmission:!1,hash:"0fdedc9bf6c23241235a0ae011c0304c",slug:"antimicrobials-antibiotic-resistance-antibiofilm-strategies-and-activity-methods",bookSignature:"Sahra Kırmusaoğlu",coverURL:"https://cdn.intechopen.com/books/images_new/8427.jpg",editedByType:"Edited by",editors:[{id:"179460",title:"Associate Prof.",name:"Sahra",surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6148",title:"Bacterial Pathogenesis and Antibacterial Control",subtitle:null,isOpenForSubmission:!1,hash:"92128a5094670f6b0c9321640f60d3a3",slug:"bacterial-pathogenesis-and-antibacterial-control",bookSignature:"Sahra",coverURL:"https://cdn.intechopen.com/books/images_new/6148.jpg",editedByType:"Edited by",editors:[{id:"179460",title:"Associate Prof.",name:"Sahra",surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8133",title:"Pathogenic Bacteria",subtitle:null,isOpenForSubmission:!1,hash:"b26e69f94525a38ead8ac88e3c68631a",slug:"pathogenic-bacteria",bookSignature:"Sahra Kırmusaoğlu and Sonia Bhonchal Bhardwaj",coverURL:"https://cdn.intechopen.com/books/images_new/8133.jpg",editedByType:"Edited by",editors:[{id:"179460",title:"Associate Prof.",name:"Sahra",surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8032",title:"Staphylococcus and Streptococcus",subtitle:null,isOpenForSubmission:!1,hash:"b9ddbf132ac8ea9d2a7613836e5a27ca",slug:"staphylococcus-and-streptococcus",bookSignature:"Sahra Kırmusaoğlu",coverURL:"https://cdn.intechopen.com/books/images_new/8032.jpg",editedByType:"Edited by",editors:[{id:"179460",title:"Associate Prof.",name:"Sahra",surname:"Kırmusaoğlu",slug:"sahra-kirmusaoglu",fullName:"Sahra Kırmusaoğlu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1811",title:"Public Health",subtitle:"Social and Behavioral Health",isOpenForSubmission:!1,hash:"93597bfaec819d81d8764fde5784fc02",slug:"public-health-social-and-behavioral-health",bookSignature:"Jay Maddock",coverURL:"https://cdn.intechopen.com/books/images_new/1811.jpg",editedByType:"Edited by",editors:[{id:"67153",title:"Prof.",name:"Jay",surname:"Maddock",slug:"jay-maddock",fullName:"Jay Maddock"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2289",title:"Public Health",subtitle:"Methodology, Environmental and Systems Issues",isOpenForSubmission:!1,hash:"c23d3d6a58e69be8a876d9772022a52d",slug:"public-health-methodology-environmental-and-systems-issues",bookSignature:"Jay Maddock",coverURL:"https://cdn.intechopen.com/books/images_new/2289.jpg",editedByType:"Edited by",editors:[{id:"67153",title:"Prof.",name:"Jay",surname:"Maddock",slug:"jay-maddock",fullName:"Jay Maddock"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3453",title:"Infection Control",subtitle:null,isOpenForSubmission:!1,hash:"b85a2fb3c8ea8c11034e436a8389bd3c",slug:"infection-control",bookSignature:"Silpi Basak",coverURL:"https://cdn.intechopen.com/books/images_new/3453.jpg",editedByType:"Edited by",editors:[{id:"101476",title:"Dr.",name:"Silpi",surname:"Basak",slug:"silpi-basak",fullName:"Silpi Basak"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6268",title:"Vignettes in Patient Safety",subtitle:"Volume 2",isOpenForSubmission:!1,hash:"0d2a1e477127a80d432276b11e6806d0",slug:"vignettes-in-patient-safety-volume-2",bookSignature:"Michael S. 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\r\n\tThis book covers recent advances in the field, applications, and future trends in biosensors. The goal of the book is to give the reader an overview of a field related to biosensor technologies, biosensors applications, and nanostructure-based biosensors. This book aims to provide information about the biosensing mechanism, detection limit, stability, reproducibility, rapid response, flexibility, sensitivity, and selectivity of biosensors. The book will be written by authors in the field of experimental methods and critical reviews from multidisciplinary sciences such as chemistry, environmental chemistry, pharmacy, physics, biochemistry, medicine, electronics, and materials science. The book will provide an outlook on future applications for building effective nonenzymatic biosensors, enzymatic biosensors, biosensing nanomaterials, smart biosensors and sensing techniques.
\r\n\r\n\tAmong others, topics covered will be: Optical biosensor, Fluorescent Biosensors, Graphene-based biosensors, Plasmonic biosensors, Plasmonic multicolorimetric chemo-/biosensors, Voltammetric biosensors, Microbial biosensors, Polyphenol oxidase-based electrochemical biosensors, Peptide-based electrochemical biosensors, Magnetic nanobead-based biosensors, Nanoparticles-based biosensors, Screen-printed carbon-based biosensors, Artificial intelligence biosensors and Biosensor platforms for the detection of COVID-19.
",isbn:null,printIsbn:"979-953-307-X-X",pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,hash:"f51b810bed7d06e2f972b1727ecb39a6",bookSignature:"Dr. Selcan Karakuş",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11157.jpg",keywords:"Detection, Sensitivity, Analyte, Bioreceptor, Transducer, Electrochemical Biosensors, Biosensors Applications, Diagnostic Biosensors, Nonenzymatic Biosensors, Enzymatic Biosensors, Biosensing Nanomaterials, Smart Biosensors",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 28th 2021",dateEndSecondStepPublish:"December 8th 2021",dateEndThirdStepPublish:"February 6th 2022",dateEndFourthStepPublish:"April 27th 2022",dateEndFifthStepPublish:"June 26th 2022",remainingDaysToSecondStep:"5 months",secondStepPassed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:"Multidisciplinary Nanoscience Technology Research Group Leader from Istanbul University (Cerrahpasa) and holder of three registered patents. Assoc. Prof. Selcan Karakuş has research experience in nanoparticles, nanocomposites, nanoemulsions, metal oxide nanostructures, and sensors.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"206110",title:"Dr.",name:"Selcan",middleName:null,surname:"Karakuş",slug:"selcan-karakus",fullName:"Selcan Karakuş",profilePictureURL:"https://mts.intechopen.com/storage/users/206110/images/system/206110.jpeg",biography:"Assoc. Prof. Selcan Karakuş is currently working at the Department of Chemistry, Istanbul University - Cerrahpasa, Turkey. She obtained her Master of Science degree in Physical Chemistry from Istanbul University (IU) in 2006. She obtained her Doctor of Philosophy degree in Physical Chemistry from IU in 2011. She has worked as a visiting researcher at the University of Massachusetts, Department of Polymer Science and Engineering. She has research experience in nanoparticles, nanocomposites, nanoemulsions, metal oxide nanostructures, and sensors. She has worked on different projects funded by Istanbul University - Cerrahpasa and has published several research articles and book chapters in her area of interest.",institutionString:"Istanbul University Cerrahpaşa",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"Istanbul University Cerrahpaşa",institutionURL:null,country:{name:"Turkey"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"11",title:"Engineering",slug:"engineering"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"418965",firstName:"Nera",lastName:"Butigan",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/418965/images/16899_n.jpg",email:"nera@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors.\nFrom 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.\nI assist authors in preparing their full chapter submissions and track important deadlines to 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:"6519",title:"Science and Technology Behind Nanoemulsions",subtitle:null,isOpenForSubmission:!1,hash:"f4dd10764e9841064827609a62952748",slug:"science-and-technology-behind-nanoemulsions",bookSignature:"Selcan Karakuş",coverURL:"https://cdn.intechopen.com/books/images_new/6519.jpg",editedByType:"Edited by",editors:[{id:"206110",title:"Dr.",name:"Selcan",surname:"Karakuş",slug:"selcan-karakus",fullName:"Selcan Karakuş"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6694",title:"New Trends in Ion Exchange Studies",subtitle:null,isOpenForSubmission:!1,hash:"3de8c8b090fd8faa7c11ec5b387c486a",slug:"new-trends-in-ion-exchange-studies",bookSignature:"Selcan Karakuş",coverURL:"https://cdn.intechopen.com/books/images_new/6694.jpg",editedByType:"Edited by",editors:[{id:"206110",title:"Dr.",name:"Selcan",surname:"Karakuş",slug:"selcan-karakus",fullName:"Selcan Karakuş"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7604",title:"Colloid Science in Pharmaceutical Nanotechnology",subtitle:null,isOpenForSubmission:!1,hash:"f3940914be015381c3928eae31c2457e",slug:"colloid-science-in-pharmaceutical-nanotechnology",bookSignature:"Selcan Karakuş",coverURL:"https://cdn.intechopen.com/books/images_new/7604.jpg",editedByType:"Edited by",editors:[{id:"206110",title:"Dr.",name:"Selcan",surname:"Karakuş",slug:"selcan-karakus",fullName:"Selcan Karakuş"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9199",title:"Sonochemical Reactions",subtitle:null,isOpenForSubmission:!1,hash:"72f3010437d022fd2a932421ff4a9200",slug:"sonochemical-reactions",bookSignature:"Selcan Karakuş",coverURL:"https://cdn.intechopen.com/books/images_new/9199.jpg",editedByType:"Edited by",editors:[{id:"206110",title:"Dr.",name:"Selcan",surname:"Karakuş",slug:"selcan-karakus",fullName:"Selcan Karakuş"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10198",title:"Response Surface Methodology in Engineering Science",subtitle:null,isOpenForSubmission:!1,hash:"1942bec30d40572f519327ca7a6d7aae",slug:"response-surface-methodology-in-engineering-science",bookSignature:"Palanikumar Kayaroganam",coverURL:"https://cdn.intechopen.com/books/images_new/10198.jpg",editedByType:"Edited by",editors:[{id:"321730",title:"Prof.",name:"Palanikumar",surname:"Kayaroganam",slug:"palanikumar-kayaroganam",fullName:"Palanikumar Kayaroganam"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"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:"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:"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:"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"}}]},chapter:{item:{type:"chapter",id:"64222",title:"Nucleate Pool Boiling Heat Transfer of Refrigerants Using Coated Surfaces",doi:"10.5772/intechopen.81864",slug:"nucleate-pool-boiling-heat-transfer-of-refrigerants-using-coated-surfaces",body:'\nPool boiling characteristic has immense heat transfer applications because of the ability to remove enormous quantities of heat from heating surface with maintaining the lower temperature difference. This gives a reduced size of heat exchanger by enhancing the performance of equipments used in many industries such as refrigeration and air-conditioning industries, thermal power plants, process industries, and many other allied industries. In refrigeration and air-conditioning field, flooded evaporator is widely used as heat exchanger surface. The energy Industry demands for more enhancing surface and economic incentives as well, have spurred the development of methods to increase the heat transfer coefficients. The various types of surface modification are used to improve the performance of equipments. Among the various available surface coating methods, metallic coating is one of the appropriate coating material for use in pool boiling of refrigerants. This is considered for the basis on the overall consideration of enhanced performance, durability, the ease of manufacturing and application. Hence, a flame spraying technique was used to prepare the coated surfaces. The copper powder was used as a coating material applied over the surface of copper tube.
\nThe impacts of Refrigeration and air conditioning system on environment are majorly supposed to release ozone-depleting refrigerants. The increase in emission of halogenated refrigerant used in refrigeration systems increases the concentration of greenhouse gases in the environment. As a result, adverse climatic changes being observed recently and contribute significantly to global warming. A reduction in GHG emissions can only be achieved by using alternative refrigerants. Thus to protect the earth surface from direct infrared radiation and to find solutions to socioeconomic favor for the mankind, further study in this area is indispensable.
\nIn order to fill the gap caused by the phase out of CFCs, researches have been carried out extensively to find alternative refrigerants whose ozone depletion potential (ODP) is zero. Nowadays, design engineers have put remarkable efforts in designing efficient and compact systems thus reducing ODP. Therefore, R-134a can be better alternative refrigerant for CFCs because of its good thermodynamic properties as well as eco-friendly features. The refrigerant mixture R-410A is also a long-term alternative refrigerant with zero ODP for time being in developing countries. Due to the low temperature efficiency and lower discharge temperatures, favorable physical and transport properties, R410A are widely preferred in refrigeration and air conditioning applications. In present study, the refrigerants R-134a and R-410A were used as alternative refrigerants. A very few research works on pool boiling of refrigerants on coated surfaces are reported in the literatures.
\nNowadays, many researches have focused on enhanced boiling heat transfer surface which fulfill the requirements of advance developments in energy generating equipments. Thome [1]; Webb [2]; and Bergles [3] were discussed the different enhancement techniques for fabricating the heating surfaces. Active, passive and compound were considered as enhancement techniques. A passive technique does not require any external power source and also its fabrication process of heating surface is easy and economical. The metallic coated surface is prepared by the passive techniques for enhancing the boiling heat transfer. The boiling of new refrigerants on metallic coated surfaces has been studied by very few researchers [4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18]. However, the experimental work on metallic coated surfaces and their impact on boiling heat transfer are still indispensable. The boiling heat transfer of refrigerants on these surfaces generates more active nucleation sites and it depends on the properties of refrigerants and surface geometry. The main objective of the present study is to conduct the pool boiling experiments of refrigerants R-134a and R-410A in metallic coated surfaces. This study provides the data to the refrigeration industry for the design of efficient heating surface. In addition, parametric study on the boiling characteristics is analyzed which determines the probability of flooding the reentrant cavities and the amount of superheat required for bubble growth.
\nFigure 1 represents the experimental setup for the boiling of refrigerants on coated surfaces. This setup consists of boiling vessel, power supply arrangement, condensing loop and test section. The sealed cylindrical boiling vessel was fabricated with a 490 mm long stainless steel pipe of 150 mm internal diameter. It is closed at both ends with flange of same material. The bottom cover of boiling vessel contains fitting to mount a pipe with a valve to charge or drain out refrigerant from the vessel as and when required. This bottom cover has also fitting for preheater to control the saturation pressure of the system. Two inspection windows were welded at diametrically opposite side position of the boiling vessel body for visual observation of bubble dynamics on and near the tube surface. The boiling vessel was well insulated with glass wool to ensure adiabatic condition. A powder flame spraying method is applied to fabricate heating surface where copper powder used as coating material. The details of the test section along with the cartridge heater shown in Figure 2. The test sections were heated by cartridge heaters. Each cartridge heater having 16.5 mm diameter and actual heated length of 116 mm, and was inserted into the copper tube. K-type chromel-alumel thermocouples were embedded in the circumferential position of the tube to measure the wall temperatures. Four holes at top, two sides and bottom positions were made circumferentially in the wall thickness of test tube. Four thermocouple probes were embedded to measure the temperature at each hole and the average of these temperatures indicates the wall temperatures. Two thermocouple probes were also inserted through the top cover of the boiling vessel at suitable positions to measure the liquid pool temperature on opposite sides of heating tube.
\nSchematic diagram of experimental set up.
Test section along with the heating arrangement.
The refrigerant vapor produced in the boiling vessel get condensed in an internal water cooled condenser and returned to the vessel. The internal condenser was mounted vertically below the top cover of the vessel to ensure return of the condensate by gravity to liquid pool. An external chiller with an accurate temperature controller was used to condense to maintain the pool temperature to 10°C. The heat transfer experiments were conducted for boiling of three refrigerants R-134a, and R-410A on plain and coated tubes at saturation temperature of 10°C. The following procedure was adopted for pool boiling of given refrigerants on coated surfaces:
Before each test, the boiling vessel and fabricated test surfaces were cleaned with acetone, chlorinol and water.
A pressure and vacuum gauges were used to check the leakage inside the boiling setup maintaining a pressure of 2.0 MPa and a vacuum of 60 cm of Hg for 24 hours. When the system is ensured from leakage then refrigerant was filled into boiling vessel as vapor form to the level of 35 mm above the boiling surface.
To remove the non-condensable gases and air from the boiling vessel through purging valve, the refrigerant was heated at 50 kWm−2 for 1 hour. When the complete removal of air from the boiling vessel was ensured, the chiller was started 3 hours prior to beginning of the experiments.
The cartridge heater was used to supply the power to test surface in the range of 5–50 kWm−2 for both increasing and decreasing heat flux levels. This was done for the purpose of avoiding a boiling hysteresis. The saturation temperature of the refrigerant was maintained at 10°C within 0.2°C temperature fluctuation.
Data were acquired under steady state within the variation of the wall temperature of 0.1°C in 5 minutes. For each power input, the condenser mass flow rate of liquid was adjusted to maintain the constant pressure. An 8 channel data acquisition module (ADAM-4019) was used to collect the experimental data. The above procedure was repeated for each test surface.
In current study, the thermal spraying coating surface was prepared at Metallizing Equipment Co. Pvt. Ltd. (MEC) Jodhpur, India. The oxy- acetylene flame was used to melt copper powder by a spraying gun. For atomization and acceleration of the particles onto heating surface, high pressure air is passed over the molten material to solidify and forming a coating. For supplying the oxygen and acetylene gases, two stage precision regulators were used in this spray system. The spray distance for the coating surfaces is 18 cm. This spray conditions depend on the pressures and flow rates of oxygen and acetylene gases. Oxygen as the oxidizing gas at a pressure of 0.25 MPa and a flow rate of 1.27 m3/hour with acetylene gas pressure of 0.11 MPa and a flow rate of 1.56 m3/hour were maintained. The specifications of prepared coated surfaces were as given in Table 1. Scanning electron microscope (SEM) images of test surfaces were analyzed using ‘Image J’ offered by Research Services Branch (RSB) of the National Institute of Mental Health (NIMH). The SEM images of one coated tube of 42 μm thick and plain tube is shown in Figure 3. The image analysis procedure is well described by Dewangan et al. [18]. This analyze is done to obtain coating parameters of the coated surfaces. As a result, the coating parameters are obtained and as shown in Table 1.
\nTest tubes | \nCoating thickness, tc (μm) | \nPorosity, \n | \nMean pore diameter, dmp (μm) | \n
---|---|---|---|
C-1 | \n42 | \n11.03 | \n2.58 | \n
C-2 | \n95 | \n13.1 | \n2.52 | \n
C-3 | \n151 | \n8.5 | \n1.75 | \n
C-4 | \n271 | \n13.8 | \n2.39 | \n
C-5 | \n395 | \n10.4 | \n2.45 | \n
C-6 | \n423 | \n11.9 | \n2.51 | \n
Coating parameters of tested tubes used in present study.
SEM images of plain and coated surfaces.
In order to establish the integrity of the experimental set-up and verify the temperature measurement in the present test arrangement, preliminary tests have been conducted with R-134a, and R-410A. The heat transfer results of the pool boiling of refrigerants over a horizontal tube are compared with conventional correlations of Stephan and Abdelsalam [19]; Cooper [20]; Cornwell and Houston [21]; Gorenflo [22]; and Jung et al. [23] correlations. The comparisons of the experimental results have been depicted in Figures 4 and 5. These figures show the discrepancy between the current experimental data and the predicted results incurred with the same operating condition for different refrigerants. This shows that, the experimental results on pool boiling using the test apparatus and measurement system are reliable. The straight line in each plot signifies that, no discrepancy between the experimental and correlated data.
\nComparison of experimental data of R-134a with correlations.
Comparison of experimental data of R-410A with correlations.
Dashed lines are appended to show the deviation of calculated values from the experimental data. The experimental result shows ±15% errors for R-134a with mean deviation (MD) ranging from −8.91% to 15.21% and a mean absolute deviation (MAD) of 7.91 to 15.21% for R-134a and ± 19% errors for R-410A with a MD of −19.19 to 18.98% and MAD of 5.85 to 18.98% for R-410A. Among them, the deviations are smallest by using Cornwell-Houston correlation for R-134a. Cooper correlation also shows the minimum deviation the smallest deviation between the experimental and the calculated values for R-134a and R-410A. The variation of imposed heat flux with wall superheat for the boiling of all three refrigerants on a plain heating tube surface at saturation temperature of 10°C. From this observation salient features can be inferred:
At a given saturation temperature, the wall superheat increases with increase in imposed heat flux and the variation between two by power law, \n
Heat flux in nucleate boiling of R-134a and R-410A are proportional to the wall superheat raised to a power of 3.86, and 4.22 respectively.
The main reason can also be seen from the physical properties of the tested refrigerants as in Table 2.
\nProperties | \nR-134a | \nR-410A | \n
---|---|---|
10 | \n10 | \n|
0.415 | \n1.09 | \n|
1261 | \n1128.4 | \n|
20.23 | \n41.917 | \n|
0.088 | \n0.0974 | \n|
0.012 | \n0.0132 | \n|
0.0019 | \n0.0013 | \n|
0.0055 | \n0.0030 | \n|
0.0101 | \n0.0075 | \n|
102.03 | \n72.6 | \n|
1.37 | \n1.58 | \n|
190.74 | \n208.5 | \n
Properties of tested refrigerants at 10°C [24].
Figure 6 depicts the variation of heat transfer coefficients of a plain surface for saturated boiling of all three refrigerants at saturation temperature of 10°C with heat flux as a parameter. From this figure, the heat transfer coefficient as a function of superheat for the surface tested and the variation between two can be represented by a power law, \n
Variation of heat transfer coefficient with wall superheat.
These features can be explained as follows: Wall superheat increases with increase in imposed heat flux on heating tube and therefore variation of the local heat transfer coefficient is found at the top, two sides of the middle and bottom of heating plain tube. This, in turn, increases the wall superheat and thereby value of minimum radius of nucleation sites at which bubble can originate decreases. This can be substantiated by following Eq. (1):
\nThe high heat flux condition enhances the number of nucleation sites and thereby the population of vapor bubbles form on heating surface. The bubbles grow and detach from the heating surface to travel in the pool of refrigerant, which increases the intensity of turbulence near the heating surface and increases heat removal rate. As a result, heat transfer coefficients are obtained to be higher at high heat flux condition. The magnitude of heat transfer coefficient at given circumferential position on plain surface is found to differ from liquid to liquid. This is due to variation in thermo-physical properties of liquids under consideration. Similar features have also been observed during pool boiling of R-134a and R-410A refrigerants at saturation temperature of 10°C as shown in Figure 7 which shows that the local heat transfer coefficients increases with increase in imposed heat flux and shown as \n
Variation of heat transfer coefficient with heat flux.
Figures 8 and 9 contain the graphs drawn for heat transfer coefficients versus wall superheat as well as imposed heat flux for seven types of surface. The experimental data points lies in the nucleate pool boiling region as the wall superheat \n
Variation of heat transfer coefficients for R-134a.
Variation of heat transfer coefficients for R-410A.
As a result, the recirculation of liquid in the inner portion of the coated surfaces increases and it enhances turbulence behavior of bubbles near the heating surface and heat removal rate. The effect of increase in coating thickness reveals two opposing characteristics [25] follows as: heat removal rate increases or decreases as a result of vapor bubble agglomerates and capillary action respectively. Coating thickness and applied heat flux are the main parameters to contribute of each effect. During initial stages of coating, the effect of capillary action is more pronounced than other coating surfaces for enhancing the boiling performance. Therefore, the boiling heat transfer coefficient is found to be more on a 42 μm thick coated surface than plain surface.
\nFor an increase in coating thickness from 42 to 95 μm, the above characteristics are observed. However, the nucleation site density is the key parameter to observe the effect of heat removal rate from the heating surface as compared to capillary action. For a given applied heat flux, lower heat transfer coefficient is observed on a 95 μm thick coated tube than 42 μm thick tube due to the combined effect of above characteristics. Further increase in coating thickness from 95 to 151 μm, heat removal rate is more significant than other effects. The reason behind this phenomena is that the rise in recirculation intensity (liquid from bulk rushes to inner layer of the structure with greater intensity). Therefore boiling heat transfer coefficients on 151 μm is found to be greater than that on the 95 μm coated tube. Again increase in thickness of coating from 151 to 271 μm, the effect of heat removal rate is not to be significant than other effects. Thus for increase in coating thickness from 151 to 423 μm, heat removal rate and heat transfer coefficient decreases. For 395 μm coating surface, the intensity of recirculation of liquid play a dominating role than other effects which enhances the heat transfer rate. Due to this phenomenon, higher heat transfer coefficient is achieved on 395 μm coating surface than that on the 271 μm thick coated surface. As can be observed from Figure 8, at low heat flux value \n
The evolution of new refrigerants in the market makes the scientist to work for developing a nucleate pool boiling correlation based on a consistent database. Especially, many of the R-22 alternatives azeotropic refrigerant blends and to predict heat transfer coefficients of near azeotropic mixtures, a precise nucleate boiling correlation for pure refrigerants is required immediately. Therefore, a new correlation is developed based upon the present data of three refrigerants following Rudemiller and Lindsay approach [26]. Nucleate pool boiling heat transfer is affected by imposed heat flux, surface specifications, wall superheat, density of liquid and vapor, latent heat of evaporation, characteristic length, other thermophysical properties and their relationship may be summarized in Eq. (2) as described by Incropera [27].
\nThe non-dimensional groups can be formed by using the above properties. The major dimensionless groups according to Rudemiller and Lindsay are the Reynolds number
In this work, the values of constant and exponents depends upon the thermophysical properties of refrigerants R-134a, R-410A and measured experimental data and their values are:
\nHence, the relationship can be generated in the generalized form.
\nFigure 10 shows the comparison between the present experimental data with a correlation proposed in this study. The mean deviation was found to be within a maximum error of ±13 percent for all refrigerants tested.
\nDeviation of present correlation against experimental data.
In this study, nucleate pool boiling heat transfer coefficients (HTCs) of two refrigerants of R-134a, and R-410A were observed at saturation temperature of 10°C on heating surfaces. Data were collected for the heat flux range from 5 to 50 kW m−2 in the interval of 5 kWm−2. As per the experimental results, following conclusions is made:
For refrigerant R-134a, the experimental data were predicted by Stephan and Abdelsalam [19], Cooper [20], Cornwell and Houston [21] and Jung et al. [23] correlations within an error band of\n
At a given saturation temperature and corresponding pressures for all three refrigerants, heat transfer coefficients increase with increase in heat flux. For the same heat flux range, the boiling heat transfer coefficients of R-134a and R-410A are 1.86 and 1.92 times higher than those of plain surfaces respectively.
Experimental data for pool boiling of R-134a, and R-410A on copper coated surfaces with different coating thicknesses of copper have been generated for various values of heat flux at saturation temperature of 10°C. Analysis has shown that the heat transfer coefficients increase with increase in imposed heat flux as in the form of \n
The coated surface of 151 μm thick (C-3) shows the highest enhancement factor of 1.92 among all coated surfaces. In addition, the experimental data for all coated surfaces were correlated in terms of the major dimensionless groups of Nusselt number (Nu), the Rayleigh number (Ra), the geometric scale factor (tc/dp) and the constant heat flux number. The mean deviation was found to be within a maximum error of ±13 percent for all refrigerants tested.
\n surface area of tube [m2] specific heat of liquid [Jkg−1 K−1] tube diameter [mm] pressure function diameter [μm] grash of number, \n boiling heat transfer coefficient [Wm−2 K−1] latent heat of vaporization current [amp] thermal conductivity [Wm−1 K−1] effective thermal conductivity… molecular weight [gmol−1] Nusselt number, \n pressure [MPa] reduced pressure, \n Prandtl number [−] heat transfer rate [W] constant heat flux number, \n heat flux [Wm−2] Rayleigh number, \n Reynolds number, \n surface roughness [μm] coating thickness [μm] temperature [K] temperature difference [K] voltage [volt] density [kgm−3] kinematic viscosity [m2s−1] surface tension [Nm−1] porosity [%] coating constant heat flux critical experimental liquid mean pore predicted scale saturation vapor wall
Posttraumatic stress disorder (PTSD) is an often debilitating mental disorder that may occur following trauma exposure [1]. PTSD is characterized by four diagnostic clusters—(1) the re-experiencing the traumatic event (e.g., recurrent memories, dreams, or flashbacks); (2) symptoms of avoidance (e.g., efforts to evade trauma reminders); (3) arousal (e.g., hypervigilance, sleep disruptions); and (4) negative cognitions and mood (e.g., self-blame) [1]. Substance use disorder (SUD) is another psychiatric disorder characterized by 11 possible symptoms which involve negative consequences arising from one’s substance use and inability to control one’s substance use [1]. In the last version of the
PTSD often co-occurs with SUD. Research has documented high rates of comorbidity between PTSD and alcohol use disorder (AUD) [2], cannabis use disorder (CUD) [3, 4], and other SUDs [5]. The prognosis of comorbid PTSD-SUD is worse than either disorder alone [6] with comorbid PTSD-SUD leading to greater functional impairment in comparison to those with only PTSD or a SUD [7].
It has been suggested that PTSD and SUD are likely functionally related to one another [8] in comorbid individuals. While the precise underlying mechanisms are not well understood, there are several learning theories that may help explain the high rates of substance misuse in people with trauma histories and help us understand the high comorbidity of PTSD with SUD. The first is the two-factor learning theory which was originally developed by Mowrer to explain the acquisition and maintenance of phobias [9] and which has more recently been applied by Stasiewicz [10] to the acquisition and maintenance of SUDs. Two-factor learning theory applies a combination of classical conditioning and operant conditioning mechanisms to the development and maintenance phases of these disorders, respectively. Applying this theory to the co-occurrence of PTSD and SUDs in traumatized individuals, trauma-relevant cues that were paired with the original traumatic experience (e.g., loud noises of gunfire paired with witnessing a comrade fatally injured in wartime) are thought to come to elicit negative affect through the process of classical conditioning [10]. Future exposures to the trauma cue alone (e.g., loud noises alone) motivate avoidance/escape behavior, including substance misuse, to reduce the associated negative affect and thereby experience relief [10]. Avoidance/escape behaviors like substance misuse are thus negatively reinforced in individuals with trauma histories/PTSD as they remove the aversive experience of negative affect. Therefore, substance misuse is maintained as a self-medication type of coping response through operant conditioning processes where behavior is repeated when it is followed by desirable consequences, in this case, relief from negative affect.
Another theory that is relevant to understanding the links of trauma/PTSD with SUD involves the role of classical conditioning in the development of conditioned craving—a strong urge to use the substance in response to exposure to the conditioned cues. It has long been known that drug-related stimuli that are frequently paired with drug-taking can come to elicit a conditioned craving response through the process of classical conditioning [11]. For example, a needle and other drug use paraphernalia that are frequently paired with heroin use can come to elicit craving when presented alone, for an injection drug user. Similarly, for a substance user with a trauma history/PTSD, the frequent pairing of trauma cues (e.g., intrusive memories of the trauma, exposure to external trauma reminders) with substance use, as explained by the two-factor learning theory above [10], can come to create strong associations between trauma cues and substance use [12]. The result is that such trauma cues can become conditioned stimuli that elicit a conditioned craving response when presented on their own [13]. For example, if a young woman with sexual assault-related PTSD drinks alcohol each time she has an intrusive memory about her sexual assault, such trauma cues can come to elicit a strong craving for a drink, which may motivate her alcohol seeking and maintain her alcohol use.
The study of the above putative mechanisms under controlled, laboratory conditions is crucial for a better understanding of the intertwined relationships between trauma/PTSD and substance misuse. Specifically, the use of cue-reactivity paradigms allows researchers to examine how substance-related and trauma cues may come to elicit craving and/or negative affective responses through the conditioning processes described above.
The cue-reactivity paradigm is broadly defined as a lab-based method in which participants are exposed to a set of stimuli meant to elicit a “reactivity” response—that is, a change from baseline in response to the stimulus [14]. In the context of addictions research, stimuli may be substance-related cues, such as a syringe or other drug-related paraphernalia for an injection drug user [15]; these stimuli serve as analogs for real-life stimuli which may evoke a craving response outside of the lab. Indeed, research in this area has shown that relevant drug-related cues presented in the lab can elicit a heightened craving response among substance users [16, 17]. More recently, cue-reactivity paradigms have been used to study conditioned craving as a possible mechanism underlying the relationship between trauma/PTSD and SUD [18, 19]. Indeed, extant research has shown that in-lab exposure to cues representing trauma reminders (e.g., a video of a violent crime) activates both substance-related craving responses as well as increased negative affect [20].
Craving has been measured in a number of ways in substance- and trauma-related cue-reactivity research, including with subjective self-report measures, such as the Desire for Drug Questionnaire [21], and measures specific to the substances used, such as the Alcohol Urge Questionnaire [22] and the Marijuana Craving Questionnaire [23]. Craving has also been measured more objectively in cue-reactivity studies, albeit less commonly than via self-report. Specifically, physiological measures, such as salivary flow and heart rate monitoring, are often used as a more objective proxy measure of craving [24]. Craving has also been further differentiated into reward-related craving (i.e., a desire for reward or stimulation from a substance) and relief-related craving (i.e., a desire for a reduction in tension or negative affect from using a substance) using certain self-report measures [23].
While cue exposure paradigms are homogenous in their goal to elicit some form of reactivity (e.g., change from baseline in craving or emotional state in response to the stimulus), the types of cues and paradigms used in this area of research have varied widely. For example, cues may be standardized across participants in the study or may be personalized to the individual’s own trauma history details; cues may be presented through the use of script-driven imagery (i.e., audio recordings, such as a retelling of a traumatic event) or
Indeed, it is evident that cue-reactivity paradigms vary widely in design, are used in an expansive variety of contexts and with a wide range of populations, with many different outcomes used to capture cue-reactivity effects. Thus, in this chapter, we intend to scope the extant cue-reactivity literature in the context of PTSD-SUD comorbidity research to identify patterns and variations in methodology, measures, and outcomes used in this growing field.
Our first aim was to examine how cue-reactivity paradigms have been used in samples of substance users with trauma histories. Specifically, we were interested in how these studies lead to a further understanding of the mechanisms underlying comorbid PTSD-SUD. Second, we intended to examine the different types of cues used within the cue-reactivity paradigm as well as the specific effects, strengths, and weaknesses of variations in paradigm design. Specifically, we compared the merit of personalized vs. non-personalized cues, as well as other cue variations, in PTSD-SUD cue-reactivity research (e.g.,
The present scoping review followed preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines appropriate for a scoping review. Specifically, we used the PRISMA Scoping Review checklist [25].
Studies were included if they used an experimental design if they utilized a cue-reactivity paradigm and if self-reported craving was assessed following the cue-reactivity paradigm. Furthermore, the population of interest had to include individuals who had experienced a traumatic event consistent with Criterion A of a DSM-5 PTSD diagnosis [1]. Alternatively, PTSD symptoms must have been assessed for each participant. Additionally, it was required that participants report on their substance use.
We excluded studies that were not written in English, or if humans were not the research participants. We did not exclude gray literature. Specifically, we included theses and dissertations to gather the full scope of research in this area and to reduce publication bias.
The databases PsycInfo, PubMed, and PTSDPubs were searched to identify studies of interest. Each search was conducted using a Boolean search logic and relevant keywords: (“PTSD” OR “post traumatic stress disorder” OR “posttraumatic stress disorder” OR “post-traumatic stress disorder” OR “trauma”) AND (“cue” OR “cue exposure” OR “cue-reactivity” OR “conditioned response” OR “stimuli”) AND (“substance” OR “substances” OR “alcohol” OR “drug” OR “drugs” OR “cocaine” OR “cannabis” OR “marijuana” OR “opioids” OR “opiates” OR “tobacco” OR “nicotine”) AND (“craving” OR “urge”). There were no search restrictions based on year of publication or language.1
One hundred fifty-eight studies were initially imported into Covidence, a literature screening software. After duplicates were removed by Covidence, 128 studies remained. Abstracts of all studies were screened by two independent raters (SDG and CS) who removed all irrelevant studies; a moderate rate of agreement of 74% was achieved [26]. A third screener (PRS) aided in resolving any conflicts between the two raters. A total of 28 studies met our final inclusion criteria (Figure 1).
PRISMA flowchart of literature search and screening.
The data were extracted into a spreadsheet, including information on the study sample, sample characteristics, outcome measures, cue-reactivity methodology, hypotheses/aims, outcomes of interest, and general findings. A quality assessment and risk of bias assessment were not conducted, as these are not typical in scoping reviews [27]. The extracted data were then synthesized into common categories by the first author to further examine themes in the scoped research.
Script-driven imagery cues were the most common cue paradigm used in the present sample of studies (n = 20). These were often paired with a substance-related
All studies used subjective self-report measures of craving as a measure of reactivity (n = 28); this was an inclusion criterion for this scoping review. However, many did include objective craving measures in addition to subjective measures (i.e., salivation, heart rate; n = 9). Other reactivity measures assessed included affect (n = 14), subjective stress (n = 6), objective stress (i.e., cortisol; n = 3), attentional/memory tasks (n = 3), and neural activation (n = 3).
Types of substances used/misused by participants in the study were alcohol (n = 17), cocaine (n = 6), nicotine (n = 3), heroin (n = 1), opioids (n = 1), and any substance (n = 4). It is important to note that some studies (n = 4) allowed for combinations of specific drugs (i.e., individuals who use alcohol and/or cocaine were recruited for one study).
Studies identified in the present scoping review employed the use of several types of cues. Specifically, neutral cues (n = 24; e.g., brushing your teeth), trauma cues (n = 23; e.g., a physical assault), substance cues (n = 14; i.e., cannabis paraphernalia), stress cues (n = 5; a presentation at work), and social cues (n = 1; speaking with a friend; [33]) were used. The average number of cue types used per study was 2.36 (SD = .731).
The majority of studies utilized pre-cue baseline as a comparator for their measures of reactivity (n = 22); a minority only compared reactivity data across cue types (i.e., comparing neutral vs. trauma responses; n = 6). However, many studies used a combination of comparators by comparing to baseline data and across cue types as well (n = 12).
While we have summarized the key components of included studies here, a full summary of each study across the coded variables of interest is available in Appendix A.
Populations of interest were largely adults who were assessed for PTSD symptoms/diagnoses and/or trauma history, and substance use. Participants across studies were more often male (
All studies included participants with either PTSD (n = 14) or those who had been exposed to a lifetime trauma (n = 10), or both with PTSD and/or trauma histories assessed continuously (n = 4). PTSD was assessed but not required for some studies, with others requiring trauma exposure but not a PTSD diagnosis (see [44, 45]). To assess for PTSD, most studies used some form of a validated structured interview (n = 25), such as the MINI [46], the SCID-5-RV [47], and the Clinician-Administered PTSD Scale [48]. Those studies examining trauma-exposed individuals typically administered a questionnaire to assess trauma history (n = 3), such as the Trauma History Questionnaire [49] or the Life Events Checklist [50], as well as continuous measures of PTSD symptoms, such as the PTSD Checklist for DSM-5 [51].
Substance use among the study populations was similarly measured. Specifically, the majority of studies (n = 18) required an SUD as inclusion criteria [18, 52], with some using inpatients receiving treatment for PTSD, SUD, or both (n = 12; [32, 53]). Fewer studies required less extreme forms of substance use, such as occasional drinking (n = 6) (see [13, 54]) and other cut-off points for use of various substances (n = 3; [55]). To assess for the presence of a SUD, most studies (n = 18) used structured interviews, such as the C-DIS IV [56] or the SCID-5-RV [47], but others used shorter self-report measures, such as the Alcohol Use Disorders Identification Test (AUDIT; n = 10) [57].
Many of the studies employed personalized cues within their cue-reactivity paradigms, either through interviews where they obtained information about a participant’s worst traumatic experience and transcribed the interview into an imagery-based cue [58] or utilized the participants’ preferred substance as part of an
Studies that utilized photographic cues as part of task-based cue paradigms found to support that their paradigms functioned as effective cue-reactivity paradigms, even though craving was not the primary outcome of interest. For example, Garland and colleagues [28] showed participants trauma-related images and asked them to either simply view the photos or reappraise the photos by reinterpreting the photo’s meaning to regulate their emotions in reaction to the photo. Following this task, relief craving increased; this increase was associated with the number of adverse childhood experiences to which participants reported having been exposed. Similarly, Beckham et al. [30] utilized a Stroop color-naming attentional [31] task with trauma-related words with a veteran sample of cigarette smokers. Results demonstrated trauma words, relative to neutral words, led to greater cigarette craving as well as more withdrawal symptoms.
One of our inclusion criteria was the measurement of craving following a cue-reactivity paradigm. Accordingly, all studies included a measure of craving, with all studies including a measure of subjective craving. Many studies measured craving using a Visual Analog Scale (VAS) or various Likert-type rating scales. Among those who examined craving changes from baseline by cue type, subjective craving responses were highest following trauma-related cues compared to substance, stress, and/or neutral cues (n = 9). Studies that did not use trauma cues found substance-related cues elicited greater craving compared to neutral cues (n = 3). In those studies that used trauma cues, substance cues, and neutral cues (n = 9), typically trauma cues elicited the greatest craving, followed by substance cues, and then neutral cues. Interestingly, studies, where trauma imagery cues were paired with
While our inclusion criteria did not specifically require an objective assessment of craving, the frequent use of salivation, heart rate, and other measures of physiological reactivity warrants a brief summary of this work. Most studies that included physiological/objective craving measures did so by measuring salivary flow (n = 5). Coffey et al. [18] found a significant increase in salivation following trauma and alcohol cues relative to neutral cues. Nosen et al. [59] found an increase in salivation following alcohol
Seven studies examined outcomes of pharmacological or psychotherapeutic treatment in clinical populations, utilizing cue reactivity as a secondary outcome measure or adjunct to symptom measures. Two studies examined the effectiveness of pharmaceuticals as a treatment for comorbid PTSD-SUD. Specifically, in a pre-clinical lab-based study, Stauffer et al. [35] examined the use of intranasal oxytocin (20 IU and 40 IU) vs. placebo in males with comorbid PTSD-AUD. Each participant took part in each condition across three counterbalanced sessions. Following drug or placebo administration, participants were exposed to
Five studies examined the effects of several psychotherapeutic interventions on cue-elicited craving as well as distress, PTSD symptoms, and resilience. Coffey and colleagues [18] examined the effects of trauma-based imaginal exposure vs. relaxation using a cue-reactivity paradigm to assess trauma cue-reactivity (i.e., craving), showing a decrease in craving to the trauma-alcohol cue combination only among those enrolled in prolonged exposure (PE) therapy but not among those in the relaxation condition. However, craving following the trauma-only cue decreased relative to baseline among both intervention groups. Similarly, two studies ([53, 61]) assessed the merits of PE therapy in comparison to a health/lifestyle therapy using a craving to a cue-reactivity paradigm as an outcome measure; one study [53] found both healthy lifestyle (control) and trauma cue-exposure treatments led to a decrease in craving responses to trauma imagery and
Three studies combined fMRI and a cue-reactivity paradigm. One study [34] examined neural activation during the presentation of stress, neutral, and substance-related cues among cocaine-dependent individuals with and without childhood maltreatment histories. The degree of craving to the stress cues predicted activation of the rostral anterior cingulate cortex to a lesser extent in the participants with maltreatment histories. The authors interpreted this to suggest that childhood maltreatment interferes with a key mechanism for resolving conflict and responding adaptively to stress [34]. Conversely, the degree of craving to the substance-related cues was associated with activation of the supplemental motor area and the visual cortex to a greater extent in those with maltreatment histories. The authors interpreted this latter finding to suggest that childhood maltreatment enhances the anticipatory reward response to substance cue exposure [34]. Further, during substance cue presentation, another study [35] found childhood trauma histories among substance users were significantly associated with increased activation of the frontal striatal circuit and the amygdala. However, a third study [32] did not find any psychological correlates of neural activation during the presentation of substance-related vs. neutral stimuli in a sample of adults with comorbid PTSD-AUD. It is difficult to know if this failure to observe an effect of cue exposure on neural activation was due to an ineffective manipulation since craving responses were not measured.
Fourteen studies included a measure of effect as part of their evaluation of cue-reactivity. Eleven of such studies examined both positive and negative affect, and three examined negative affects only. The Positive and Negative Affect Schedule or PANAS [63] was overwhelmingly used as the standardized measure of this variable (n = 10), although other measures were used as well, such as the Affect Grid [64] (n = 2). Among the majority of studies (n = 9), negative affect increased following stress and trauma-related cues [38]. In those studies which also examined positive affect, positive affect tended to decrease following stress and trauma-related cues [42, 33] but this was not always consistent. For example, Coffey et al. [39] did not find any statistically significant differences in positive affect across cue types. Interestingly, one study reported that substance-related cue exposure increased both positive and negative affect, and this ambivalent response was associated with the strongest substance cravings [55].
The primary aim of this scoping review was to map the use of cue-reactivity paradigms in PTSD-SUD research among substance users with trauma histories and/or PTSD. Specifically, we sought to summarize the characteristics of the samples, examine outcomes measured followed the cue-reactivity paradigm (e.g., subjective/objective craving, negative affect), and map how such paradigms vary across the literature on several dimensions (e.g., cue type, personalization/standardization, cue presentation). Furthermore, we aimed to assess the consequences of methodological differences in cue-reactivity research. While prior literature has summarized cue-reactivity methodology in substance use research [65] and one group has briefly summarized cue-reactivity research in a comorbid PTSD-AUD population as part of a broader review of mechanisms involved in this form of comorbidity [66], we aimed to map the use of cue-reactivity paradigms in a way which could lead to further understanding of conditioned craving as a mechanism in the maintenance of comorbid PTSD-SUD. Specifically, our systematic scoping of the literature identified 28 studies that assessed craving following a cue-reactivity paradigm in a population of substance users with trauma histories and/or PTSD.
Our scoping review revealed wide variations in methodologies used to examine cue-induced craving. Specifically, characteristics of study samples, the methodological details of the cue-reactivity paradigm, and the types of outcomes assessed, all varied broadly. We have identified four themes in the studies through our scoping of the literature that may help elucidate commonalities and important distinctions across the identified studies—(1) increases in craving following trauma cue presentation; (2) the use of methodological subtypes of cue-reactivity paradigms; (3) affect as an outcome and possible mediator of craving in cue-reactivity research; and (4) the cue-reactivity paradigm as an adjunct outcome measure in intervention research.
From the above literature review, it is evident that craving has been repeatedly shown to increase following exposure to certain cues in substance users with trauma histories and/or PTSD. In particular, trauma cues tend to elicit the greatest increase from baseline in craving responses when compared to substance-related and neutral cues. This was true across studies using both personalized [43] and standardized cues [54]. However, this effect was typically magnified when a combination of trauma-related imagery and
Second, the cue-reactivity methodologies used in the studies identified through our scoping review tended to vary widely. While the majority of studies utilized imagery-based audio cues to elicit cue-reactivity craving responses, some used combinations of imagery-based trauma and substance-related
Third, while we did not systematically aim to include effect as an outcome in the present scoping review, we decided to cover this outcome as many of the studies included in the review (50%) did include a measure of effect as an additional outcome alongside craving. Our findings elucidated the importance of effect in helping explain the relationship between trauma cue-reactivity and craving. To elaborate, negative affect has quite consistently been shown to increase following trauma cue exposure [44, 59]. This is consistent with suggestions that conditioned
Finally, it is important to note that seven studies utilized cue-reactivity paradigms as an additional outcome in trauma and/or substance-related therapeutic interventions. Notably, neither of the two pharmacological studies found an effect of the respective medications (oxytocin and neurokinin-1 receptor antagonist aprepitant) relative to placebo as a means of reducing either PTSD symptoms or stress cue- or substance cue-induced craving (see [32, 35]). Conversely, all studies examining the efficacy of PE therapy for PTSD or PTSD-SUD found that trauma cue-induced craving, as well as other forms of cue-reactivity (e.g., salivation, distress), decreased over time in those who received PE when compared to patients who received a control intervention [36, 37, 39, 53, 61]. Indeed, behavioral interventions seem to be more efficacious than pharmacological interventions in reducing reactivity to both trauma and substance-related cues among trauma-exposed substance users, at least for the few pharmacotherapies that have been investigated with this paradigm thus far, and at least in comparison to PE therapy. Furthermore, the use of cue-reactivity paradigms as a secondary outcome in randomized controlled trials of therapeutic interventions speaks to the multifaceted functionality of the cue-reactivity paradigm in the PTSD/trauma-exposed population, offering a mechanism-based outcome that informs beyond the decrease of symptoms.
First, it is important to note that no formal examination of the study quality of the included literature was completed, as this step is not typical for scoping reviews [27]. It should also be noted that our choice to include unpublished theses and dissertations in the present review may have led to the inclusion of some studies with poor methodological quality, although it does help ensure that our conclusions are not hampered by publication bias.
To further assess the studies included in the present scoping review, we recommend a formal analysis of methodological quality be completed in the future to better understand how methodological variations in cue-reactivity may influence relevant outcomes. Additionally, the use of cue-reactivity paradigms as secondary outcomes in the context of behavioral and pharmacological intervention trials is an interesting research direction that should be studied further, as this may lead to important implications for understanding the breadth of response to the use of psychotherapeutic or pharmacological interventions in this population, and may point to potential mechanisms of action. We also recommend that a formal systematic review and meta-analysis be conducted to quantify the magnitude of trauma cue-induced craving responses in this population, and to identify significant moderators of this response in terms of sample characteristics (e.g., percentage of the sample with PTSD), and methodological variables (e.g., personalized vs. standardized cues). Providing that relevant data could be obtained from published papers or authors, novel techniques, such as two-step meta-analytic structural equation modeling (TS-MASEM; [68]) could also be employed to examine theorized mediational pathways (e.g., that trauma cue exposure leads to activation of negative affect which in turn activates craving). Finally, meta-analyses could also quantify the degree of reduction in trauma cue-induced craving that is achieved with various forms of treatment for PTSD, SUD, and their comorbidity, and its relations to treatment efficacy (i.e., symptom reduction).
Our scoping review maps the use of cue-reactivity paradigms across the trauma-exposed, substance-using population with and without PTSD, and summarizes methodological variations in cue-reactivity paradigms across this body of literature, as well as the results of identified studies. Cue-reactivity paradigms have proven efficacious in eliciting cue-induced craving responses in populations of trauma-exposed individuals who use substances. Cue-reactivity research may help increase understanding of the learning processes that are involved in the development, maintenance, or exacerbation of a SUD among trauma-exposed individuals with and without PTSD who use substances. Furthermore, cue-reactivity paradigms may be used as an important means of assessing whether behavioral and/or pharmacological treatments for PTSD and/or SUD have had an impact on the ability of trauma cues to elicit a conditioned craving response in this population.
First author (year) | Sample characteristics and context | Cue reactivity paradigm and method | Outcome(s) of interest | Craving measure | Relevant findings |
---|---|---|---|---|---|
Elton et al. [34] | 38 cocaine-dependent males with (n = 20) and without (n = 18) childhood maltreatment histories. | Script-driven imagery. All participants listened to a personalized neutral, stress, and cocaine-related audio cue whilst in an fMRI scanner. | Brain region activation, anxiety, and subjective craving response. | Cue-induced cocaine craving was measured using the visual analog scale (VAS) from 0 to 10. | Stress-Neutral: The interaction between maltreatment severity and craving responses was associated with activation of the left premotor cortex and right cerebellum. Substance-Neutral: The interaction between maltreatment severity and craving responses was associated with activation of the bilateral occipital cortex, caudal pre-supplementary motor area [SMA], and cuneus. Findings suggest that childhood maltreatment alters neural correlates of cue-induced substance craving. |
Dutton [33] | 46 hazardous drinkers who met DSM-5 criterion A (trauma exposure) of a PTSD diagnosis | Script-driven imagery. Participants listened to a personalized neutral cue followed by either a neutral-social (n = 24) or a social conflict cue (n = 22). Each cue was 1 minute long followed by a 30 second visualization period. | State PTSD symptoms, subjective craving response, affect, and alcohol approach bias. | Cue-induced alcohol craving was measured using a VAS from 0 to 100. | Following the social conflict cue but not the neutral social cue, state PTSD symptoms increased. There were no differences in alcohol approach bias, affect, or craving between cues. |
Trautmann et al. [54] | 95 healthy occasional drinkers who had experienced childhood trauma. | Standardized video. Participants watched either a 15-minute trauma film (n = 47) or a 15-minute neutral film (n = 48). | Subjective craving response, anxiety, and physiological reactivity (i.e., skin conductance, heart rate, and saliva cortisol levels) | Cue-induced alcohol craving was measured using the Alcohol Craving Questionnaire-Short Form [69]. | In females, the trauma film elicited greater craving responses compared to the neutral film. In males, the number of childhood traumas positively moderated the relationship between film condition and craving responses. In males, childhood trauma was associated with increases in skin conductance, heart rate, and cortisol levels; only skin conductance was related to craving responses. |
Stauffer et al. [35]* | 47 males with comorbid PTSD-AUD and 37 healthy control males. | Effects of oxytocin as a treatment for comorbid PTSD-AUD, subjective craving responses, and heart rate variability. | Cue-induced alcohol craving was measured using a VAS from 0 to 100. | Craving responses and heart rate were higher following the alcohol cues compared to neutral cues. No effects of oxytocin compared to placebo on cue-induced craving or heart rate. | |
Ralevski et al. [38]* | 25 veterans with comorbid PTSD-AUD. | Script-driven imagery. All participants listened to personalized trauma, stress, and neutral audio cues. | Subjective craving responses, blood pressure, heart rate, negative affect, and salivary cortisol. | Cue-induced alcohol craving was measured using the Alcohol Craving Questionnaire-Short Form [69] and a VAS. | Craving responses, cardiovascular reactivity, and negative affect were highest following the trauma cue but were also high following the stress cue, both compared to the neutral cue. |
Winokur [60] | 95 individuals with (n = 31) and without (n = 39) trauma histories who were heroin (n = 25) or nicotine (n = 70) dependent. | Standardized video. Participants watched standardized video cues related to either heroin or nicotine use, and a neutral video cue. | Subjective craving responses. | Cue-induced heroin or nicotine craving was measured using a Within Sessions Rating Scale (0–9). | Post substance cue-craving responses increased among both the opiate and nicotine-dependent groups, but were highest in the opiate-dependent group, and only among those with trauma histories. |
Coffey et al. [39]* | 43 SUD inpatients with comorbid PTSD-AUD. 75% of participants who completed at least one clinical session were randomly assigned to receive six sessions of either imaginal exposure therapy (n = 12) or relaxation (control) condition (n = 12). However, only 17 participants completed the study. | Script-driven imagery and Trial 1: All participants listened to personalized neutral and trauma cues. Trial 2: All participants listened to a personalized trauma cue followed by the presentation of either alcohol or water. | Subjective craving responses, affect, and emotional distress. | Cue-induced alcohol craving was measured using a VAS from 0 to 10. | Craving responses decreased from pre- to post-treatment among those in the imaginal exposure condition following the trauma-alcohol cue (trial 2) and did not change in the relaxation condition. Craving responses also decreased in both groups following the trauma cue (trial 1). Negative affect was highest in trial 2. |
Read et al. [13] | 232 undergraduate students with PTSD (n = 28), with trauma exposure but no PTSD (n = 113), or no trauma history (n = 91) taking part in a clinical trial. | Script-driven imagery. Participants listened to either a personalized trauma (n = 111) or neutral cue (n = 121). Participants wrote about the event while continuing to imagine the scene. | Subjective craving, affect, and performance on a Stroop attentional task with trauma and alcohol-specific stimuli. | Cue-induced alcohol craving was measured using a 10-point Likert scale rating urge to drink. | Participants with PTSD in the trauma cue condition showed a slowed response in the Stroop task. This effect was associated with an urge to drink only among those with PTSD in the trauma cue condition. |
Kaag et al. [29] | 117 adults, half cocaine users (n = 59) and half healthy controls (n = 58) | Event-related cue-reactivity paradigm. All participants viewed substance-related photos, neutral photos, and photos of animals. They were instructed to press a button when photos of animals were presented. | Subjective craving and neural activation. | Cue-induced cocaine craving was measured using the Desire for Drug Questionnaire [21] at baseline and following the cue-reactivity paradigm. | Only among substance users, the presentation of cocaine cues led to neural activation in the frontal striatal circuit and the amygdala. Amygdala-striatal connectivity was associated with childhood trauma among substance users. |
Coffey et al. [58] | 75 individuals receiving SUD treatment with PTSD who were cocaine (n = 30) or alcohol-dependent (n = 45) | Script-driven imagery and | Subjective craving. | Cue-induced craving was measured using the Cocaine Craving Questionnaire-Now (CCQ-Now) [70] and Alcohol Craving Questionnaire-Now (ACQ-Now) [71] | Both alcohol-dependent and cocaine-dependent participants evidenced greater cravings following the trauma- and substance-related cues compared to the neutral cues. |
McHugh et al. [44] | 194 individuals with PTSD receiving treatment for a comorbid SUD. | Script-driven imagery. All participants listened to a personalized trauma and neutral cue, counterbalanced across two sessions, followed by a 1-minute visualization period. | Subjective craving and affect. | Cue-induced substance craving was measured on an 11-point scale. Ratings ranged from 0 (no cravings) to 11 (very strong cravings). | Craving and negative emotional reactivity were greater following the trauma cue compared to the neutral cue. Anxiety sensitivity was associated with greater emotional reactivity following the trauma cue, but there was no association between anxiety sensitivity and craving response. |
McGuire et al. [36] | 29 veterans receiving treatment for comorbid PTSD-SUD. | Interview. All participants provided a detailed verbal description of their most traumatic lifetime event. | Subjective craving, resilience, and PTSD symptoms. | Cue-induced craving for alcohol and/or other substances was measured using the Alcohol Craving Questionnaire Short Form-Revised [71] | Posttreatment, participants evidenced a decrease in cue-induced craving and fewer PTSD symptoms, as well as increased resiliency, relative to pre-treatment baseline. |
Saladin et al. [45] | 124 individuals with trauma histories receiving SUD treatment who were alcohol- (n = 70) or cocaine-dependent (n = 54). | Script-driven imagery and | Subjective craving. | Cue-induced substance craving was measured using a 21-point VAS. | Craving was greater following the trauma- and substance-related cues in comparison to the neutral cues. PTSD symptom severity predicted greater craving responses, but only following the trauma + substance cue pairing. |
Coffey et al. [18] | 40 individuals with comorbid PTSD-AUD receiving inpatient SUD treatment. | Script-driven imagery and | Subjective and objective craving responses; emotional distress. | Cue-induced craving was measured using a VAS from 0 to 10 and salivary flow. | Subjective craving responses, distress, and salivary flow were greater following substance and trauma cues compared to the neutral cue. |
Vujanovic et al. [43] | 58 low-income inner-city adults. | Script-driven imagery. All participants listened to personalized trauma, substance, and neutral audio cues. | Subjective craving responses. | Cue-induced craving was measured using a VAS from 0 to 100. | Lower distress tolerance was a significant predictor of higher craving responses following the trauma cue. |
Rodriguez et al. [40] | 305 undergraduate students with no trauma (n = 127), trauma exposure (n = 106), and PTSD (n = 72). | Script-driven imagery. Participants were instructed to close their eyes and imagine their most traumatic event as if it was happening to them. Participants then wrote about the scene while continuing to imagine the scene. | Subjective craving responses and affect. | Cue-induced craving was measured using the Urge to Drink Questionnaire [22], on a scale from 1 to 10. | Emotional responses to the trauma cue mediated the relationship between trauma exposure and the urge to drink. |
Bing-Canar et al. [41] | 184 young adults with trauma histories | Script-driven imagery and | Subjective and objective craving responses. | Cue-induced craving was measured using a three-item Alcohol Craving Scale [72] and salivation levels. | Depressive symptoms did not have any effect or interaction with the cue-reactivity paradigm to predict increased craving or salivation. |
Zambrano-Vazquez et al. [61] | 85 individuals with comorbid PTSD-SUD and current alcohol dependence receiving SUD treatment. Only 66 participants who completed 8 or more prolonged exposure treatment sessions were included in the analyses. | Script-driven imagery and | Subjective and objective (salivation) craving, subjective distress, and domains of functioning. | Cue-induced craving was measured using the Alcohol Craving Questionnaire-Now [69] and salivation levels. | Severity in all domains of functional impairment (Negative Valence, Arousal, and Cognitive) decreased from pre to post-treatment, and this change was associated with a decrease from pre-treatment baseline in self-reported craving and salivation post-treatment following alcohol and trauma cue exposure. |
Garland et al. [28]* | 36 opioid-treated chronic pain patients at risk for opioid use disorder, with adverse childhood experiences (ACEs). | Emotional Regulation Task. Participants were shown trauma-related images and were asked to both views or reappraise the images (dependent on the trial block) to regulate the emotions elicited by the image. | Subjective craving, heart rate variability, and negative affect. | Cue-induced opioid craving was measured using a 5-point scale, with 1 indicating no craving and 5 indicating very strong cravings. | Following the emotional regulation task, craving increased from the pre-task baseline. This change was related to the number of ACE exposures. ACEs and duration of opioid use also predicted a blunted heart rate variability when regulating negative emotions. |
Zaso et al. [42] | 611 college students with PTSD (n = 50), with trauma exposure but no PTSD (n = 325), and no trauma (n = 236) who drink alcohol | Script-driven imagery. Participants were randomized to listen to either a personalized trauma or neutral cue followed by a 2-minute writing period relating to the cues. | Subjective craving response and affect. | Cue-induced craving was measured using a 10-point scale, with 1 indicating no urge to drink and 10 indicating a very strong urge to drink. | Following the trauma cue, but not the neutral cue, participants reported greater cravings and negative affect relative to baseline, which was associated with coping drinking motives. |
Kwako et al. [32]* | 53 individuals with comorbid PTSD-AUD receiving inpatient SUD treatment. Participants received either aprepitant (n = 26) or a placebo (n = 27) prior to cue exposure. | Script-driven imagery, | Subjective craving, blood cortisol, and neural activation. | Cue-induced alcohol craving was measured using the Alcohol Urge Questionnaire [22] | Alcohol and stress cues induced more cravings compared to neutral cues. There was no significant neural activation following the substance-related relative to the neutral stimuli. |
Nosen et al. [59] | 108 adults with comorbid PTSD-AUD who were receiving residential treatment for SUD. | Script-driven imagery and | Subjective and objective (salivation) craving and affect. | Cue-induced alcohol craving was measured using a three-item alcohol craving scale [72] and salivation levels. | Trauma and substance cue pairings elicited the greatest subjective craving responses, negative affect, and salivation vs. all other cue combinations. Ambivalent affective responses predicted the strongest craving. |
Tull et al. [19] | 60 cocaine-dependent individuals with (n = 30) and without PTSD (n = 30) in treatment for a SUD | Script-driven imagery. Across two sessions, all participants listened to a personalized cue (trauma or neutral; 1 min) followed by a visualization period (1 min). | Subjective craving response and affect. | Cue-induced cocaine craving was measured using an 11-point scale, with 0 indicating no cravings and 10 indicating very strong cravings. | PTSD was associated with greater craving and negative affect following the trauma cue, but not the neutral cue. Among men, this relationship was mediated by self-conscious emotions. |
Nosen et al. [53] | 120 individuals with comorbid PTSD-AUD in treatment for a SUD. Participants were assigned to receive exposure therapy (n = 52) or health and lifestyle treatment (n = 35); only those who completed treatment (n = 87) were included in analyses. | Script-driven imagery and | Subjective and objective (salivation) craving response, distress, and affect. | Cue-induced craving was measured using a three-item alcohol craving scale [72] and salivation levels. | Pre-treatment, the trauma + substance cue-elicited the strongest craving responses, negative affect, and distress. Post-treatment, trauma cues no longer elicited greater craving compared to substance cues alone. Both treatments led to a decrease in salivation and subjective craving following cue exposure. |
Badour et al. [37]* | 54 veterans with comorbid PTSD-SUD taking part in a COPE RCT. | Participants were presented with personalized | Subjective craving and distress. | Cue-induced craving for participants’ preferred substance was measured using a VAS (0–100). | Between-session reduction of substance cue-induced craving and distress responses were associated with a decrease in PTSD symptom severity. |
Tull et al. [52] | 133 individuals with trauma histories in treatment for a SUD. | Script-driven imagery. Participants listened to a personalized trauma cue (1 min) followed by a visualization period (1 min). | Subjective craving, emotional regulation, negative affect, and salivary cortisol. | Cue-induced craving for participants’ preferred substance was measured using an 11-point scale, with 0 indicating no cravings and 11 indicating very strong cravings. | Following the trauma cue, craving increased relative to the pre-cue baseline. This change was associated with greater PTSD symptom severity. PTSD symptom severity was related to both adaptive and maladaptive emotional regulation strategies. |
Beckham et al. [55] | 129 smokers with (n = 82) and without PTSD (n = 47) were randomly assigned to either a nicotine or a non-nicotine smoking condition. | Script-driven imagery. Participants listened to either a personalized trauma, neutral, or stress cue (30 sec) followed by a visualization period (30 sec) both before and after smoking a nicotine or denicotinized cigarette. | Subjective craving and affect. | Cue-induced craving to smoke was measured using the Questionnaire on Smoking Urges [73]. | Trauma-related cues produced greater cravings and negative affect compared to stress scripts and neutral scripts. This effect was most pronounced among those with PTSD. Smoking either the nicotine or non-nicotine cigarettes reduced craving, negative affect, and PTSD symptoms following the trauma and stress script relative to the neutral script. |
Beckham et al. [30] | 25 veterans receiving PTSD treatment who smoke cigarettes. | Stroop task with combat/trauma-related words. Participants named the ink color of three blocks of trauma-related and three blocks of neutral words. | Subjective craving, affect somatic symptoms, and alertness. | Cue-induced craving to smoke was measured using a modified Smoking Withdrawal Questionnaire Short Form-Revised [71] | Craving, negative affect, somatic symptoms, and lack of alertness were all greater following the presentation of trauma-related words compared to neutral words. |
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The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. 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Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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