Potential mechanisms of hypertension related cerebral dysfunction.
\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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It is a major cause of premature death worldwide and is the risk factor with greatest impact on the global burden of disease. It is the leading modifiable risk factor for cardiovascular disease and all-cause mortality [1, 2].
Worldwide, an estimated 1.38 billion individuals (31.1% of the adult population) have hypertension, defined as systolic blood pressure (BP) ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg, and/or current use of antihypertensive medication. The age-standardized prevalence of hypertension is marginally higher in men (31.9%) than in women (30.1%) and is lower in high-income countries (HICs), as compared to low and middle-income countries (LMICs) (28.5% vs. 31.5%) [3]. According to global estimates in 2010, only 45.6% of individuals with hypertension were aware of the disease, only 36.9% were receiving treatment and only 13.8% had achieved adequate BP control (defined as systolic BP < 140 mm Hg and diastolic BP < 90 mm Hg). Also, the proportion of hypertension awareness and treatment was nearly twice and the proportion of hypertension control was four times in HICs as compared to LMICs. In the last 2 decades, HICs have shown substantial increases in the proportions of hypertension awareness, treatment and control. However, during the same period, awareness and treatment have increased only modestly in LMICs and the proportion of hypertensive patients having adequately controlled BP has decreased slightly [3].
The global prevalence of hypertension is increasing steadily as a result of aging of the population and increase in lifestyle risk factors like unhealthy diets (high sodium, low potassium intake, high intake of saturated and trans-fats and low intake of fruits and vegetables), physical inactivity, increased consumption of alcohol and tobacco, and being overweight or obese. However, the changes in the prevalence of hypertension have not been uniform worldwide. In the last two decades, a modest decline has been noted in hypertension prevalence in HICs, whereas LMICs have experienced significant increases. These trends can impose a greater burden of hypertension and related cardiovascular disorders on the fragile health-care systems of LMICs, many of which are also facing a substantial burden of infectious diseases [4].
Hypertension is often called a “silent killer”, as most hypertensives are unaware of the problem due to lack of warning symptoms or signs. Hypertension can cause sub-clinical target organ damage for years, before any symptoms or signs develop. It is the leading modifiable risk factor implicated in the causation of coronary heart disease (CHD), cerebrovascular disease, renal dysfunction, peripheral arterial disease (PAD), heart failure and atrial fibrillation. The brain is a major target for hypertension related end-organ damage and hypertension is a prominent risk factor for two major categories of brain diseases: stroke and dementia. In the following sections, we discuss the role of hypertension in causation of these diseases, along with prevention and treatment strategies.
Human brain, in general, is highly vulnerable to the harmful effects of elevated BP and it represents the classic target organ of hypertension-induced damage. Arterial hypertension, besides being responsible for its well-known effect in causing clinical stroke, is also associated with the development of asymptomatic, subclinical brain damage, such as cerebral small vessel disease with resultant cognitive impairment, memory loss and dementia. Also, sudden and marked elevations of blood pressure can lead to the development of hypertensive encephalopathy, characterized by severe headache, seizures and other neurological symptoms like cerebral edema.
Globally, stroke ranks second among the causes of mortality and third among the causes of disability. In recent decades a trend towards reduction in the incidence, prevalence and mortality of stroke has been noted, but the overall disease burden continues to rise in terms of total number of patients affected [5].
Stroke is usually categorized into ischemic and hemorrhagic forms. Ischemic stroke has further subtypes including large vessel occlusive disease, lacunar infarctions due to small vessel disease, cerebral embolism including cardioembolic stroke, non-atherogenic stroke and cryptogenic stroke. Various subtypes of hemorrhagic stroke include intra-parenchymal hemorrhage, subarachnoid hemorrhage and intraventricular hemorrhage.
Hypertension is the most prevalent risk factor for stroke and has been reported in nearly two-thirds of stroke patients [6]. In LMICs, the reported prevalence of risk factors among patients with stroke is lower, however the in-hospital mortality rates have been higher, probably related to delays in presentation, differences in healthcare system responses and acute management of stroke [7].
There is robust evidence from observational and interventional studies, implicating hypertension as a strong risk factor for all types of strokes. The Framingham heart study in 1970 showed a significant association between the risk of stroke and blood pressure ≥ 160/95 mm Hg at all ages and in both sexes [8]. Persons with a normal BP (<120/80 mm Hg) had been reported approximately half the lifetime risk of stroke compared to those with high BP (≥140/90 mm Hg) [9].
Large epidemiological studies have consistently shown the relationship between the level of BP and risk of stroke to be consistent, continuous, and independent of other risk factors. Older epidemiological studies gave more importance to the diastolic BP as a determinant of stroke risk, and consistently showed a higher risk of stroke with increasing levels of diastolic BP [10, 11]. MacMahon et al., in their meta-analysis of nine observational studies conducted between 1958 and 1990, showed that as the level of BP decreased so did the risk of stroke. A decrease in diastolic BP of 5, 7.5, and 10 mm Hg was associated with a lowering of stroke risk by 34, 46, and 56%, respectively [11]. Similarly, The Eastern Stroke and Coronary Heart Disease Collaborative Research project, showed that for every 5 mm Hg fall in the diastolic BP resulted in nearly 50% reduction in the risk of ischemic (odds ratio (OR) 0.61; 95% confidence interval 0.57–0.66) and hemorrhagic stroke (odds ratio 0.54, 95% confidence interval 0.50–0.58) [12]. Systolic BP attracted greater attention in 1990s after the results from many epidemiological studies suggested that it could have more robust association with stroke as compared to diastolic BP. Systolic BP also showed a stronger correlation with 12 year stroke mortality than the diastolic BP in Framingham heart study [13]. Similarly, the prospective population-based Copenhagen city heart study demonstrated systolic BP to be a better predictor of stroke than the diastolic BP [14]. The Asia Pacific Cohort Studies Collaboration (APCSC), an extension of the Eastern Stroke and Coronary Heart Disease Collaborative project, which analyzed 37 cohort studies of 425,325 patients in the Asia Pacific region, demonstrated a continuous, log-linear association between systolic BP and risk of stroke down to the levels of 115 mm Hg of systolic BP. In the age groups of <60, 60–69, and >70 years, a 10 mm Hg lower systolic BP was associated with 54%, 36% and 25% lower risk of stroke respectively [15]. In a meta-analysis of 61 prospective studies by the Prospective Study Collaboration (PSC), it was demonstrated that there was more than a twofold decrease in stroke mortality with each 20 mm Hg of decrease in systolic BP for patients aged 40–69 years; and throughout middle and old age, usual BP is directly and strongly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115 mm Hg of systolic BP and 75 mm Hg of diastolic BP [16].
Age is an important cofactor in the relationship between hypertension and stroke. The direct relation between elevated BP and stroke risk is weaker in older aged populations than in middle-aged individuals. The APCSC observed a lower percentage reduction in stroke risk with similar reduction in systolic BP with increasing age [15]. A similar trend was observed in the PSC study [16]. Although there is a less robust association between hypertension and stroke risk in older populations, lowering BP in this population is still beneficial owing to the higher incidence of stroke and higher morbidity/mortality rates in this population [17].
Racial and ethnic disparities in the relationship between elevated BP and stroke have been reported from several observational studies from the United States. The Baltimore-Washington Cooperative Young Stroke Study, demonstrated a positive relationship between hypertension and the risk of ischemic stroke in whites and blacks for both sexes. In this study, age-adjusted odds ratios and 95% confidence interval for ischemic stroke with a history of hypertension in white males, white females, black males, and black females were 1.6 (0.7–3.2), 2.5 (1.1–5.9), 3.8 (1.8–7.9), and 4.2 (2.4–7.5), respectively [18]. Similarly, the Northern Manhattan Stroke Study showed higher odds ratios for hypertension and ischemic stroke in blacks as compared to whites and hispanics (OR 2.0 vs. 1.8, 1.2 respectively) [19]. A similar increase in systolic BP is associated with a nearly three times higher risk of stroke risk in blacks as compared to whites [20].
Although arterial hypertension is a major risk factor for both stroke and myocardial infarction, stroke is much more closely related to elevated levels of BP per se. It has been suggested that a sustained reduction in systolic blood pressure of 10 mm Hg would reduce stroke risk by 56%, but reduce the risk of myocardial infarction by only 37% [11]. This difference is largely attributed to the possibility that elevated levels of blood pressure are directly responsible for strokes occurring due to small vessel disease, but is only indirectly related to the development of atherosclerotic changes. Atherosclerosis in the arterial tree is usually focal and is usually seen at the branching points of the arteries or where arteries take a bend. It is likely that the effects of hypertension on atherosclerosis are not per se due to pressure energy, but are more likely related to the transmission of kinetic energy to the arterial wall at sites of flow disturbance, thus leading to the formation of atherosclerotic plaques at the areas of low shear stress [21].
Strokes due to small vessel disease, in contrast, are directly caused by elevated blood pressure. For this reason, these tend to occur in a particular distribution at the base of the brain, where short, straight arteries with limited branches result in direct transmission of high blood pressure directly from the large arteries to the smaller resistance vessels, with resultant damage to the walls of the arterioles. This results in the pathological changes of hyaline degeneration and fibrinoid necrosis, with consequent lacunar infarctions where the arterioles occlude and hypertensive intracerebral hemorrhages where they rupture. These pathophysiological changes account for the fact that true lacunar infarctions and intracerebral hemorrhages are particularly distributed in the areas of basal ganglia, internal capsule, thalamus, cerebellum, and brainstem [22].
Hypertension can indirectly contribute to the development of stroke as it is an important etiological factor for atrial fibrillation and for acute myocardial infarction and left ventricular clot formation; with attendant risk of cardioembolic stroke.
There are many theories related to the pathophysiological mechanisms of hypertension related brain dysfunction. Central to these theories are the mechanisms related to impaired cerebrovascular auto-regulation in hypertension and the chronic maladaptive changes in the structure of the cerebral vasculature in hypertensive patients.
Cerebrovascular autoregulation is the process by which cerebral vasculature regulates intracranial blood flow, so that a steady perfusion is maintained to meet the metabolic needs of the brain tissue across a range of systemic blood pressures. This control is achieved by the ability of the cerebral arterioles to compensate for a decrease in cerebral perfusion pressure by vasodilatation, and also, to protect the brain against increased perfusion pressure by vasoconstriction, thus keeping the cerebral blood flow constant. This complex process is regulated by interplay between sympathetic nervous system, brain carbon dioxide and other metabolites, and neurovascular coupling. In normotensive individuals, this response occurs over a range of approximately 60–160 mm Hg systolic BP; but, in patients with hypertension, this range may be shifted to higher pressures [23, 24]. This upward shift in the limits of pressure autoregulation, make hypertensive patients especially susceptible to episodes of hypotension, which plays a role in the development of white matter changes. Also, elderly hypertensive patients often have impaired cerebrovascular autoregulation which contributes to the development of stroke, cognitive dysfunction and vascular dementia. Impaired autoregulation increases the transmission of elevated pressures to cerebral capillaries resulting in increased permeability of blood brain barrier (BBB), parenchymal edema, inflammation neuronal degeneration that is commonly seen in patients with vascular cognitive dysfunction [25]. Chronic hypertension has been reported to promote arteriolar and capillary rarefaction, especially in the deep hemispherical white matter and basal ganglia [26]. This is associated with infiltration of perivascular macrophages, endothelial dysfunction, increased oxidative stress, and impaired functional hyperemia [27]. These changes promote the development of lacunar infarcts, white matter hyper-intensities, microinfarcts, and microbleeds [28].
Chronic elevation of intraluminal pressure stimulates the growth of smooth muscle cells and increases media thickness in resistance arteries, resulting in hypertrophic remodeling, thus causing an elevated vascular resistance. There may also be eutrophic remodeling, characterized by inward remodeling with rearrangement of the vessel wall components that leads to a reduction in lumen diameter and elevated vascular resistance. Hypertension may also result in narrowing of the intermediate and small vessels due to lipo-hyalinosis and micro-atherosclerosis. Also, chronically elevated BP promotes hyaline degeneration, fibrinoid degeneration and formation of microaneurysms in small vessels of the cerebral vasculature. These small vessel alterations predispose these patients to the development of ischemic and hemorrhagic complications [29].
Hypertension promotes atherosclerosis in large extracranial and intracranial arteries, which predispose to the development of atherothrombotic infarctions. The most frequent sites of atherosclerosis are common carotid artery bifurcation, origin and intra-cavernous part of internal carotid artery, first segment of middle cerebral artery, origin and distal part of vertebral artery, and middle portion of basilar artery [29]. These atherosclerotic plaques are usually progressive and lead to ischemic strokes by thrombotic occlusion of the narrowed lumen or, more often, by their acute rupture, which causes atheroembolism resulting in occlusion of distal intracranial vessels [29]. Major mechanisms of hypertension related cerebral dysfunction are summarized in Table 1.
Impairment of cerebral autoregulation |
Increased permeability of blood brain barrier |
Endothelial dysfunction, oxidative stress, impaired functional hyperemia |
Small vessel changes: remodeling, increased vascular resistance, lipo-hyalinosis, micro-atherosclerosis, micro aneurysms, lacunar infarcts |
Large vessel changes: atherosclerosis with atherothrombotic, atheroembolic infarctions |
Potential mechanisms of hypertension related cerebral dysfunction.
The relation between BP and stroke risk is direct, strong, linear, and etiologically predictive. Thus, within the usual BP ranges, including non-hypertensive ones, the higher levels of BP are associated with increased risk of stroke [16]. Non-hypertensive individuals with slight elevations of BP (prehypertension, defined as systolic BP of 120–139 mm Hg and/or diastolic BP of 80–89 mm Hg) derive benefit from lifestyle changes with or without pharmacological therapies. A meta-analysis with 70,664 prehypertensive individuals from 16 trials demonstrated a robust 22% reduction in the stroke risk in individuals randomized to pharmacological therapy arm as compared to the placebo arm. In hypertensive patients, lifestyle approaches combined with adequate BP treatment and control produced a 35–40% decrease in the stroke risk [30, 31].
Practical strategies for hypertension management for primary stroke prevention, on the basis of recommendations made by the American Heart Association (AHA)/American Stroke Association (ASA) [32, 33], and European Society of Cardiology (ESC)/European Society of Hypertension (ESH) [34] include:
Regular screening for hypertension and management of raised BP using lifestyle modifications and pharmacological therapies are recommended.
According to European guidelines the target BP in those with hypertension should be <140/90 mm Hg, whereas, the recent American guidelines recommend a BP goal to lower levels of <130/80 mm Hg, even in very elderly.
Successful attainment of BP goal is emphasized over the administration of a particular anti-hypertensive agent.
Individualized BP treatment is recommended, based on particular patient characteristics and tolerance to medications.
Self-monitoring of BP is recommended to help in adequate BP control.
Management of elevated BP in acute ischemic stroke (AIS) has been a matter of considerable debate. AIS is usually associated with islands of infarcted tissue with surrounding areas of potentially salvageable tissue, referred to as ischemic penumbra. Moreover, the infarcted tissue is characterized by loss of autoregulation with increased vessel permeability [35]. Hence an over aggressive approach of lowering BP can result in extension of infarction and worsening of neurological dysfunction. On the other hand, if the elevated BP is not lowered sufficiently, there is risk of excessive cerebral edema and hemorrhagic transformation of the infarcted tissue. Furthermore, as the cerebrovascular auto regulatory response is set at a higher level in chronic hypertensive patients, these individuals are at risk of impaired cerebral perfusion if BP is lowered very aggressively.
Practical strategies for management of hypertension in AIS, based on recommendations of AHA/ASA [36], and European stroke organization (ESO) [37] include:
In patients with AIS who are not eligible for systemic thrombolysis or mechanical thrombectomy and who have a BP > 220/120 mm Hg, guarded BP reduction (<15% systolic BP reduction over 24 h) is reasonable and is likely to be safe. No recommendations are made regarding the use of a specific anti-hypertensive agent to achieve this goal.
In hospitalized patients with AIS and blood pressure < 220/110 mm Hg not treated with intravenous thrombolysis or mechanical thrombectomy, there is suggestion against the routine use of blood pressure lowering agents at least in first 24 h following symptom onset, unless this is necessary for specific comorbid conditions like acute aortic dissection, acute myocardial infarction, pulmonary edema, hypertensive encephalopathy and acute renal failure.
In patients with AIS undergoing treatment with intravenous thrombolysis (with or without mechanical thrombectomy) it is suggested that BP is maintained below 185/110 mm Hg before bolus and below 180/105 mm Hg after bolus, and for 24 h after alteplase infusion.
In patients with AIS undergoing treatment with intravenous thrombolysis (with or without mechanical thrombectomy), there is suggestion against lowering systolic blood pressure to a target of 130–140 mm Hg compared to <180 mm Hg during the first 72 h following of symptom onset.
Initiating or continuing anti-hypertensive agents during hospitalization for AIS, if BP > 140/90 mm Hg: BP lowering is generally safe in AIS if patient is medically and neurologically stable, and there are no contraindications for BP lowering. The time window for administration of such therapies is usually 2–3 days after the symptom onset.
Drug options to treat hypertension in patients with AIS who are planned for emergency reperfusion therapy are shown in Table 2.
Labetalol: 10–20 mg intra-venous over 1–2 min, may be repeated once; or |
Nicardipine: 5 mg/h intra-venous, dose may be up-titrated by 2.5 mg/h in every 5–15 min to a maximum of 15 mg/h; when desired BP levels is obtained, adjust the dose to maintain proper BP levels; or |
Clevidipine: 1–2 mg/h intra-venous, up-titrate by doubling the dose in every 2–5 min until desired BP level is obtained; maximum dose 21 mg/h |
Other agents like enalaprilat, hydralazine may also be useful |
If BP is not controlled or diastolic BP > 140 mm Hg, consider intravenous nitroprusside (may increase intracranial pressure). |
Observational studies have suggested that BP is often markedly elevated in the acute phase of hemorrhagic stroke, significantly higher than that seen after AIS [38]. High levels of BP in acute hemorrhagic stroke are often associated with hematoma expansion and poor clinical outcomes [39]. Simultaneously, there have been suggestions that high BP may be necessary to maintain adequate cerebral perfusion after intracranial hemorrhage, and that aggressively lowering it may be deleterious. These concerns are however, opposed by the evidence suggesting that adequate cerebral perfusion is maintained after acute BP reduction in patients with hemorrhagic stroke [40, 41]. However, results of the two largest randomized clinical trials (INTERACT2, ATACH-2) of intensive BP lowering early after intracranial hemorrhage have renewed this uncertainty [42, 43]. Meta-analyses of these trials and many other smaller studies have shown that early intensive BP reduction after hemorrhagic stroke is safe, but without mortality benefit or significant functional improvement [44, 45, 46, 47]. In contrast, a recent meta-analysis of the two largest trials demonstrated a direct linear relation between the level of systolic BP achieved during the first 24 h of hemorrhagic stroke and the functional status. The improvements in the functional status were noted for systolic BP levels of as low as 120–130 mm Hg [48]. These studies however excluded patients with severe, large hematomas and hence caution is warranted in too aggressive lowering of BP in such patients as it might predispose to harmful consequences [49].
Practical strategies for BP control in patients with acute hemorrhagic stroke based on recent AHA/ASA [50], and ESO [37] guidelines include:
If initial systolic BP is >220 mm Hg, it is reasonable to administer continuous intravenous BP lowering therapy to achieve an initial reduction of about 15%. Choice of drugs is similar to that used in AIS (Table 2).
In patients with initial systolic BP of 150–220 mm Hg, American guidelines suggest a target goal of 140–150 mm Hg of systolic BP [50], however, the recent ESO guidelines [37] recommend even more aggressive lowering of systolic BP to less than 140 mm Hg (but to keep it above 110 mm Hg) to reduce hepatoma expansion.
Control of blood pressure variability may be helpful in improving the outcomes [51].
After hemorrhagic stroke, the optimal timing for initiation of antihypertensive therapies for secondary stroke prevention has not been well established. It may be reasonable to start such treatment when the patient is medically and neurologically stable. The target BP goal for secondary stroke prevention is <130/80 mm Hg [50].
About a quarter of strokes are recurrent, the annual risk of recurrence is nearly 4% and the mortality rate after a recurrent stroke is 41% [33, 34]. A large proportion of strokes can be prevented by adequate BP control, regular physical activity, healthy dietary habits and cessation of smoking. In fact, the INTERSTROKE study demonstrated that these 5 factors—hypertension, imbalanced diet, lack of adequate physical activity, abdominal obesity and smoking—were responsible for 82% and 90% of the population attributable risk (PAR) for ischemic and hemorrhagic stroke respectively [6]. Also, the Global Burden of Disease Study suggested that nearly 90% of the global stroke burden was attributable to the modifiable risk factors [52]. A modeling study has shown that targeting multiple modifiable risk factors of stroke has additive benefits in secondary prevention of stroke. According to this study, aspirin, anti-hypertensive therapies and statins, along with dietary modification and adequate exercise, can lead to an 80% cumulative risk reduction in the incidence of recurrent vascular events [53].
Practical strategies for BP control for secondary recent AHA/ASA guidelines [54] include:
In hypertensive patients who suffer a stroke or transient ischemic attack (TIA), an office BP goal of <130/80 mm Hg is recommended for most patients to reduce the risk of recurrent stroke and vascular events.
In individuals with no history of hypertension who experience a stroke or TIA and have an average office BP of ≥130/80 mm Hg, antihypertensive drug treatment can be beneficial to decrease the risk of recurrent stroke, intracranial hemorrhage, and other vascular events.
A thiazide diuretic, angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) may be useful, however, other classes of BP lowering therapy can be used to achieve the target BP goals (e.g., calcium channel blocker, newer generation beta blocker).
Individualized drug treatments that take into account patient comorbidities, pharmacological class of the drug, and patient preferences are recommended to maximize the drug efficacy.
Dementia is characterized by a progressive and often irreversible decline of cognitive function which is most commonly seen in older adults. It is one of the most common neurological diseases, nearly affecting 30–40 million people worldwide. The number of people with dementia is estimated to triple by 2050, largely driven by the aging of the population, demographic shifts, and lack of disease-modifying therapies [55]. Alzheimer disease (AD) and cerebrovascular diseases are the major causes of cognitive dysfunction, accounting for nearly 80% of the cases and often have a mixture of both the pathologies [55]. Although the majority of dementias including AD are primarily considered as neuro-degenerative diseases of unknown cause, recent studies have shown that cerebrovascular disease and microscopic vascular lesions are often found in patients affected by these conditions [56].
The term vascular cognitive impairment (VCI) refers to the entire spectrum of cognitive abnormalities caused by vascular etiologies, whereas the term vascular dementia is used for cases with more profound vascular cognitive deficits which negatively affect the daily functioning of an individual [57].
Among the various vascular risk factors, systemic hypertension is a major factor contributing to cognitive impairment [57]. It has been been associated with decreased abstract reasoning, reduced mental processing speed, and, less commonly, memory deficits [58]. Although dementia due to AD and vascular dementia have classically been considered as separate entities, recent evidence indicates that the two conditions are frequently coexistent [59, 60]. In nearly 40–50% of cases with a clinical diagnosis of AD, the pathological hallmarks of AD (amyloid plaques and the neurofibrillary tangles), are associated with micro-cerebrovascular and macro-cerebrovascular lesions [61]. Moreover, ischemic lesions markedly elevate the effect of AD pathology on cognitive function [62, 63]. Also, traditional cardiovascular risk factors have been suggested to have a role in the development of AD [64], and some estimates suggest that risk factor modification, especially the treatment of hypertension, could decrease the incidence of clinically diagnosed AD by up-to 30% [65].
Hypertension-related cognitive dysfunction occurs as a result of complex interplay between functional alterations and structural changes seen in the brain parenchyma and the cerebral vasculature, many of which have been discussed previously in Section 2.1.2. Briefly, these changes include increased cerebrovascular resistance, reduced vasomotor reactivity, decreased cerebral blood flow, vascular remodeling, lacunar infarcts, white matter lesions, micro bleeds, enlarged perivascular spaces and cerebral atrophy [66]. These overlapping pathophysiological changes might account for the correlation between hypertension and stroke or vascular dementia. This relation may also hold true for other forms of dementia; like, for example the link between chronic hypertension and the AD has been documented, as hypertension is often associated with formation of neurofibrillary tangles and senile plaques, the presence of which was seen in brains of hypertensive patients even in the absence of clinical features of dementia [67].
Hypertension is a major modifiable risk factor for cognitive dysfunction, VCI and AD. Robust clinical evidence has demonstrated that antihypertensive therapies, besides preventing major cerebrovascular events [57], also reduce the incidence and/or delay the progression of cognitive dysfunction [68, 69]. The Syst-Eur randomized clinical trial showed that, on treating 1000 hypertensive individuals with anti-hypertension therapies for 5 years, 19 cases of dementia could be prevented [70]. Similarly, the PROGRESS trial observed that therapy with a perindopril (a long-acting ACE inhibitor), and indapamide (a thiazide-like diuretic), was associated with reduced risks of cognitive dysfunction and dementia on a mean follow-up of 3.9 years [71]. Also, various clinical and experimental studies have suggested that antihypertensive drugs, including ACE inhibitors, angiotensin receptor blockers (ARBs) and diuretics, might cause an improvement in the biomarkers of AD, and decrease the incidence of AD and/or delay its progression [72].
Interestingly, antihypertensive drug therapies might have class specific effects on cognitive function. Both ACE inhibitors and calcium channel blockers have been reported to delay the development of cognitive dysfunction [72]. However, results from the Canadian Study of Health and Aging suggested that hypertensive individuals aged ≥65 years who received treatment with calcium channel blockers had a more marked cognitive decline than those receiving other antihypertensive drugs at follow-up of 5 years [73]. These findings lend support to the hypothesis that the systemic and local renin-angiotensin systems may respond differently to different antihypertensive drugs [74]. Furthermore, calcium channel blockers may potentially cause an impairment of myogenic autoregulatory protective responses in the cerebral vasculature. Taking these factors into account, it might be suggested that ACE inhibitors and ARBs might be preferable to calcium channel antagonists for dementia prevention in hypertensive patients [75].
The subject of optimum BP targets for the prevention of dementia has generated considerable debate and controversy. In the SPRINT MIND trial, it was seen that in ambulatory hypertensive individuals, a more intensive BP control strategy (target systolic BP of <120 mm Hg as compared to a target of <140 mm Hg) was not associated with any significant cognitive benefits [76]. An important point to be considered here is that due to the adaptive rightward shift of the cerebrovascular autoregulatory curve in hypertension, too aggressive lowering of BP may result in cerebral hypoperfusion and consequential negative impact on the brain. These U-shaped associations between BP and cognitive function in the elderly individuals have been reported in many studies [77, 78]. These findings stress the importance of individualized blood pressure management strategies for prevention of cognitive dysfunction.
Hypertension is also a major contributor to the risk of stroke, which nearly doubles the risk of developing dementia. It is estimated that about one-third cases of dementia can be prevented by preventing the development of stroke [79]. Clinical studies have shown that prevention of stroke by using anticoagulation in atrial fibrillation and BP-lowering therapies in hypertensive patients can significantly decrease the risk of dementia [80]. Based on these results, the World Stroke Organization came out with a manifesto stressing the need for a joint strategy for prevention of stroke and dementia [79].
Hypertension is a major global public health problem and is the major cause of premature death worldwide. Human brain is highly vulnerable to the deleterious effects of elevated blood pressures. Hypertension related cerebrovascular diseases include stroke, cognitive dysfunction and dementia. Elevated blood pressure levels are strongly, directly and linearly related to the incidence and prevalence of these diseases. Adequate management of hypertension can go a long way in mitigating the global burden of these cerebrovascular diseases.
Elevated systemic blood pressures are associated with increased risk of cerebrovascular diseases including stroke and dementia. Good blood pressure control, which can be achieved easily in majority of the patients, is necessary for prevention of these cerebrovascular diseases.
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Naser",authors:[{id:"50322",title:"Dr.",name:"Humood",middleName:null,surname:"Naser",slug:"humood-naser",fullName:"Humood Naser"}]},{id:"46375",doi:"10.5772/58231",title:"Arbuscular Mycorrhizal Fungi and their Value for Ecosystem Management",slug:"arbuscular-mycorrhizal-fungi-and-their-value-for-ecosystem-management",totalDownloads:3460,totalCrossrefCites:15,totalDimensionsCites:42,abstract:null,book:{id:"3821",slug:"biodiversity-the-dynamic-balance-of-the-planet",title:"Biodiversity",fullTitle:"Biodiversity - The Dynamic Balance of the Planet"},signatures:"Andrea Berruti, Roberto Borriello, Alberto Orgiazzi, Antonio C.\nBarbera, Erica Lumini and Valeria Bianciotto",authors:[{id:"169266",title:"Dr.",name:"Andrea",middleName:null,surname:"Berruti",slug:"andrea-berruti",fullName:"Andrea Berruti"},{id:"170685",title:"Dr.",name:"Roberto",middleName:null,surname:"Borriello",slug:"roberto-borriello",fullName:"Roberto Borriello"},{id:"170686",title:"Dr.",name:"Alberto",middleName:null,surname:"Orgiazzi",slug:"alberto-orgiazzi",fullName:"Alberto Orgiazzi"},{id:"170687",title:"Dr.",name:"Antonio Carlo",middleName:null,surname:"Barbera",slug:"antonio-carlo-barbera",fullName:"Antonio Carlo Barbera"},{id:"170688",title:"Dr.",name:"Erica",middleName:null,surname:"Lumini",slug:"erica-lumini",fullName:"Erica Lumini"},{id:"170689",title:"Dr.",name:"Valeria",middleName:null,surname:"Bianciotto",slug:"valeria-bianciotto",fullName:"Valeria Bianciotto"}]},{id:"23585",doi:"10.5772/24540",title:"Fishes of the Atlantic Rain Forest Streams: Ecological Patterns and Conservation",slug:"fishes-of-the-atlantic-rain-forest-streams-ecological-patterns-and-conservation",totalDownloads:3179,totalCrossrefCites:9,totalDimensionsCites:36,abstract:null,book:{id:"1369",slug:"changing-diversity-in-changing-environment",title:"Changing Diversity in Changing Environment",fullTitle:"Changing Diversity in Changing Environment"},signatures:"Vinícius Abilhoa, Raul R. Braga, Hugo Bornatowski and Jean R. S. Vitule",authors:[{id:"58022",title:"Dr.",name:"Jean Ricardo Simões",middleName:null,surname:"Vitule",slug:"jean-ricardo-simoes-vitule",fullName:"Jean Ricardo Simões Vitule"},{id:"61834",title:"Dr.",name:"Vinicius",middleName:null,surname:"Abilhoa",slug:"vinicius-abilhoa",fullName:"Vinicius Abilhoa"},{id:"123966",title:"Dr.",name:"Hugo",middleName:null,surname:"Bornatowski",slug:"hugo-bornatowski",fullName:"Hugo Bornatowski"},{id:"123968",title:"BSc.",name:"Raul",middleName:"Rennó",surname:"Braga",slug:"raul-braga",fullName:"Raul Braga"}]},{id:"38670",doi:"10.5772/48351",title:"Efforts to Combat Wild Animals Trafficking in Brazil",slug:"efforts-to-combat-wild-animals-trafficking-in-brazil",totalDownloads:4697,totalCrossrefCites:9,totalDimensionsCites:33,abstract:null,book:{id:"2719",slug:"biodiversity-enrichment-in-a-diverse-world",title:"Biodiversity Enrichment in a Diverse World",fullTitle:"Biodiversity Enrichment in a Diverse World"},signatures:"Guilherme Fernando Gomes Destro, Tatiana Lucena Pimentel, Raquel Monti Sabaini, Roberto Cabral Borges and Raquel Barreto",authors:[{id:"142735",title:"M.Sc.",name:"Guilherme Fernando",middleName:null,surname:"Gomes Destro",slug:"guilherme-fernando-gomes-destro",fullName:"Guilherme Fernando Gomes Destro"},{id:"148026",title:"Ms.",name:"Raquel",middleName:null,surname:"Monti Sabaini",slug:"raquel-monti-sabaini",fullName:"Raquel Monti Sabaini"},{id:"148027",title:"MSc.",name:"Roberto",middleName:null,surname:"Cabral Borges",slug:"roberto-cabral-borges",fullName:"Roberto Cabral Borges"},{id:"148028",title:"MSc.",name:"Raquel",middleName:null,surname:"Barreto",slug:"raquel-barreto",fullName:"Raquel Barreto"},{id:"154825",title:"MSc.",name:"Tatiana Lucena",middleName:null,surname:"Pimentel",slug:"tatiana-lucena-pimentel",fullName:"Tatiana Lucena Pimentel"}]}],mostDownloadedChaptersLast30Days:[{id:"56873",title:"Impacts of Climate Change and Climate Variability on Wildlife Resources in Southern Africa: Experience from Selected Protected Areas in Zimbabwe",slug:"impacts-of-climate-change-and-climate-variability-on-wildlife-resources-in-southern-africa-experienc",totalDownloads:3368,totalCrossrefCites:7,totalDimensionsCites:14,abstract:"Climate change and variability pose a threat to wildlife resources in semi-arid savannahs. With examples from selected protected areas in Southern Africa, this chapter highlights studies on detected climate changes particularly rainfall and temperature, outlines the predicted and observed impacts of climate change and variability on wildlife resources in savannah ecosystems and highlights the adaptation and mitigation strategies and implications for conservation. Literature indicates that Southern Africa is characterised by highly variable, erratic and unpredictable rainfall and increasing temperature coupled with an increasing trend in climate-related extreme events such as frequent droughts, cyclones and heat waves. Drought, in particular, has led to death in several wildlife species. This has implications on long-term survival of the species. Changes in rainfall and temperature patterns influence habitat quality and consequently abundance of distribution of wildlife species. Large herbivores such as elephants and hippopotamus in particular are vulnerable to climate change due to their ecology, whereas other species are less vulnerable. Climate-related extreme events, coupled with other anthropogenic stressors, interact to influence changes in abundance and distribution of wildlife resources. Understanding the influence of these climatic factors on wildlife resources is vital for adaptive management and protection of biodiversity.",book:{id:"5934",slug:"selected-studies-in-biodiversity",title:"Selected Studies in Biodiversity",fullTitle:"Selected Studies in Biodiversity"},signatures:"Olga L. Kupika, Edson Gandiwa, Shakkie Kativu and Godwell\nNhamo",authors:[{id:"202318",title:"Ms.",name:"Olga Laiza",middleName:null,surname:"Kupika",slug:"olga-laiza-kupika",fullName:"Olga Laiza Kupika"},{id:"202328",title:"Prof.",name:"Edson",middleName:null,surname:"Gandiwa",slug:"edson-gandiwa",fullName:"Edson Gandiwa"},{id:"202330",title:"Prof.",name:"Shakkie",middleName:null,surname:"Kativu",slug:"shakkie-kativu",fullName:"Shakkie Kativu"},{id:"202334",title:"Prof.",name:"Godwell",middleName:null,surname:"Nhamo",slug:"godwell-nhamo",fullName:"Godwell Nhamo"}]},{id:"57718",title:"Methods for Biodiversity Assessment: Case Study in an Area of Atlantic Forest in Southern Brazil",slug:"methods-for-biodiversity-assessment-case-study-in-an-area-of-atlantic-forest-in-southern-brazil",totalDownloads:2825,totalCrossrefCites:2,totalDimensionsCites:8,abstract:"Populations and species are disappearing due to disturbances in the environment caused by human activities. Given, the obvious risk of loss of diversity, it is increasingly necessary to take actions concerning preservation, in which safety features are necessary for measuring the variation of diversity in space and time. The aim of this study was to evaluate the structure and diversity in the arboreal component and natural regeneration in an area of Araucaria Forest in Southern Brazil. The vegetation sampling was performed by analyzing 180 subunits of 10 × 10 m, where all the arboreal individuals and natural regeneration were inventoried. Different alpha and beta indexes of diversity were calculated. The Margalef, Shannon, and the Beta indexes were underestimated, possibly influenced by the size of sample unit. Index Menhinick represented the diversity in a very real form, even in small sampling units. The indexes of Simpson and MacIntosh denote low dominance and the equity indexes showed high uniformity in species.",book:{id:"5934",slug:"selected-studies-in-biodiversity",title:"Selected Studies in Biodiversity",fullTitle:"Selected Studies in Biodiversity"},signatures:"Maria Raquel Kanieski, Solon Jonas Longhi and Philipe Ricardo\nCasemiro Soares",authors:[{id:"219216",title:"Dr.",name:"Maria Raquel",middleName:null,surname:"Kanieski",slug:"maria-raquel-kanieski",fullName:"Maria Raquel Kanieski"},{id:"220250",title:"Dr.",name:"Solon Jonas",middleName:null,surname:"Longhi",slug:"solon-jonas-longhi",fullName:"Solon Jonas Longhi"},{id:"220251",title:"Dr.",name:"Philipe Ricardo",middleName:null,surname:"Casemiro Soares",slug:"philipe-ricardo-casemiro-soares",fullName:"Philipe Ricardo Casemiro Soares"}]},{id:"46541",title:"Ecosystem Biodiversity of India",slug:"ecosystem-biodiversity-of-india",totalDownloads:3492,totalCrossrefCites:1,totalDimensionsCites:4,abstract:null,book:{id:"3821",slug:"biodiversity-the-dynamic-balance-of-the-planet",title:"Biodiversity",fullTitle:"Biodiversity - The Dynamic Balance of the Planet"},signatures:"Vivek Khandekar and Anita Srivastava",authors:[{id:"51372",title:"Dr.",name:"Anita",middleName:null,surname:"Srivastava",slug:"anita-srivastava",fullName:"Anita Srivastava"},{id:"170148",title:"Dr.",name:"Vivek",middleName:null,surname:"Khandekar",slug:"vivek-khandekar",fullName:"Vivek Khandekar"}]},{id:"38697",title:"Floral and Avifaunal Diversity of Thol Lake Wildlife (Bird) Sanctuary of Gujarat State, India",slug:"floral-and-avifaunal-diversity-of-thol-lake-wildlife-bird-sanctuary-of-gujarat-state-india",totalDownloads:4012,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"2719",slug:"biodiversity-enrichment-in-a-diverse-world",title:"Biodiversity Enrichment in a Diverse World",fullTitle:"Biodiversity Enrichment in a Diverse World"},signatures:"Jessica P. Karia",authors:[{id:"142623",title:"Dr.",name:"Jessica",middleName:null,surname:"Karia",slug:"jessica-karia",fullName:"Jessica Karia"}]},{id:"38612",title:"Soil Fauna Diversity - Function, Soil Degradation, Biological Indices, Soil Restoration",slug:"soil-fauna-diversity-function-soil-degradation-biological-indices-soil-restoration",totalDownloads:7791,totalCrossrefCites:27,totalDimensionsCites:59,abstract:null,book:{id:"3007",slug:"biodiversity-conservation-and-utilization-in-a-diverse-world",title:"Biodiversity Conservation and Utilization in a Diverse World",fullTitle:"Biodiversity Conservation and Utilization in a Diverse World"},signatures:"Cristina Menta",authors:[{id:"145410",title:"PhD.",name:"Cristina",middleName:null,surname:"Menta",slug:"cristina-menta",fullName:"Cristina Menta"}]}],onlineFirstChaptersFilter:{topicId:"841",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82587",title:"Introductory Chapter: Factors That Affect Biodiversity and Species Richness of Ecosystems - A Review",slug:"introductory-chapter-factors-that-affect-biodiversity-and-species-richness-of-ecosystems-a-review",totalDownloads:16,totalDimensionsCites:0,doi:"10.5772/intechopen.105890",abstract:null,book:{id:"10763",title:"Biodiversity of Ecosystems",coverURL:"https://cdn.intechopen.com/books/images_new/10763.jpg"},signatures:"Levente Hufnagel and Ferenc Mics"},{id:"81863",title:"Exploiting the Attributes of Biocontrol Agent (Neochetina bruchi) as a Potential Ecosystem Engineer’s",slug:"exploiting-the-attributes-of-biocontrol-agent-neochetina-bruchi-as-a-potential-ecosystem-engineer-s",totalDownloads:8,totalDimensionsCites:0,doi:"10.5772/intechopen.104775",abstract:"The biodiversity of lakes is continuously declining and diverse communities are being substituted by monoculture of invasive Eichhornia crassipes, resulting in a slew of environmental cascade effects. The ability of the Neochetina bruchi to self-perpetuate is a desirable aspect of biological control since it decreases the population to a reasonable level, making the approach more sustainable. N. bruchi is often referred to as “ecological engineers” because of the number of services it provides to the environment and enables herbicide application to be substantially reduced. Despite the presence of highly effective weevils against this weed, its effect on water hyacinth in association with the nutrients present in sites, is likely to vary with levels of disturbance caused by natural and anthropogenic factors. Understanding the aspects that determine the performance of these eco-engineers as valuable management tools will help to guide future endeavors. Our objective is to better comprehend their utility and limitations, along with critical knowledge gaps, to further enhance future applications.",book:{id:"10763",title:"Biodiversity of Ecosystems",coverURL:"https://cdn.intechopen.com/books/images_new/10763.jpg"},signatures:"Prerna Gupta and Sadhna Tamot"},{id:"80833",title:"Comparison of the Effectiveness of Different Tags in the Sea Urchin Paracentrotus lividus (Lamarck, 1816)",slug:"comparison-of-the-effectiveness-of-different-tags-in-the-sea-urchin-paracentrotus-lividus-lamarck-18",totalDownloads:58,totalDimensionsCites:0,doi:"10.5772/intechopen.102594",abstract:"The marking of sea urchins was implemented with the main objective of being able to individually identify the urchins in the natural environment once released. In addition, it’s very useful to monitor individuals in studies of growth, movements, development, population dynamics, etc., that develop in the natural environment. Numerous different marking methodologies have been tested for sea urchins, either by physical marking (external and internal labels) or by using chemical marking methods consisting of the use of fluorochromes, which adhere to the calcified structures of the urchin. In this work, 5 different physical marks were used to mark 400 urchins of the Paracentrotus lividus species, which were kept for a month at the ECIMAT facilities in Toralla island. The efficacy of the methods used in each case was analyzed, comparing the survival rate and the tag retention rate of the tagged urchins obtained with each tagging methodology.",book:{id:"10763",title:"Biodiversity of Ecosystems",coverURL:"https://cdn.intechopen.com/books/images_new/10763.jpg"},signatures:"Noelia Tourón, Estefanía Paredes and Damián Costas"},{id:"79769",title:"Elucidation of Some Ecological Traits of Carabids (Coleoptera: Carabidae) Inhabiting Kakuma Campus Grassland, Kanazawa City, Japan",slug:"elucidation-of-some-ecological-traits-of-carabids-coleoptera-carabidae-inhabiting-kakuma-campus-gras",totalDownloads:46,totalDimensionsCites:0,doi:"10.5772/intechopen.101658",abstract:"Although adult feeding habits and food requirements are currently and reasonably well known for many coleopteran species, still some carabid species are with peculiar feeding guilds. Although many studies have shown a relationship between morphology of mandibles and feeding behavior in different taxal group, still many aspects concerning the feeding behavior of carabids are promising. An assemblage of carabid species was collected from Kakuma Campus grassland in Kanazawa City, Japan. These species were represented by five subfamilies and nine tribes where the highest number of tribes (3 tribes) was confined to subfamily Harpalinae. The collected carabid assemblage was subjected to mandibular analysis and being categorized into two main groups; carnivorous and omnivorous species. Homologies among mandibular characteristics and functional adaptations of the mandible were also proposed to explore how the interaction network of carabids can affect their behavior in different habitats.",book:{id:"10763",title:"Biodiversity of Ecosystems",coverURL:"https://cdn.intechopen.com/books/images_new/10763.jpg"},signatures:"Shahenda Abu ElEla Ali Abu ElEla, Wael Mahmoud ElSayed and Nakamura Koji"},{id:"79313",title:"The Diversity of Endophytic Aspergillus",slug:"the-diversity-of-endophytic-aspergillus",totalDownloads:131,totalDimensionsCites:0,doi:"10.5772/intechopen.99717",abstract:"In plants, endophytic fungi and plant are closely related, endophytic fungi can use substances in plants as nutrients to survive. In return, they bring many benefits to the plant, playing an important role in protecting the host plant against the harmful effects of insects, harmful microorganisms or environmental disadvantages. Recently, secondary fungi metabolites, especially endophytic fungi, are gaining interest because they can produce many bioactive metabolites with antibacterial, anticancer and antioxidant properties. Some endophytic fungi are noted as Aspergillus, Penicllium, Fusarium due to the production of many metabolites for biological effects such as antibacterial, antiviral, anticancer, etc. in which Aspergillus species product many compounds have properties antibacterial such as terrequinon A, terrefuranon, Na-acetyl aszonalemin, etc.",book:{id:"10763",title:"Biodiversity of Ecosystems",coverURL:"https://cdn.intechopen.com/books/images_new/10763.jpg"},signatures:"Vo Thi Ngoc My and Nguyen Van Thanh"},{id:"79203",title:"Soil Biodiversity and Root Pathogens in Agroecosystems",slug:"soil-biodiversity-and-root-pathogens-in-agroecosystems",totalDownloads:157,totalDimensionsCites:0,doi:"10.5772/intechopen.99317",abstract:"Soil ecosystem is a living and dynamic environment, habitat of thousands of microbial species, animal organisms and plant roots, integrated all of them in the food webs, and performing vital functions like organic matter decomposition and nutrient cycling; soil is also where plant roots productivity represent the main and first trophic level (producers), the beginning of the soil food web and of thousands of biological interactions. Agroecosystems are modified ecosystems by man in which plant, animal and microorganisms biodiversity has been altered, and sometimes decreased to a minimum number of species. Plant diseases, including root diseases caused by soil-borne plant pathogens are important threats to crop yield and they causes relevant economic losses. Soil-borne plant pathogens and the diseases they produce can cause huge losses and even social and environmental changes, for instance the Irish famine caused by Phytophthora infestans (1845–1853), or the harmful ecological alterations in the jarrah forests of Western Australia affected by Phytophthora cinnamomi in the last 100 years. How can a root pathogen species increase its populations densities at epidemic levels? In wild ecosystems usually we expect the soil biodiversity (microbiome, nematodes, mycorrhiza, protozoa, worms, etc.) through the trophic webs and different interactions between soil species, are going to regulate each other and the pathogens populations, avoiding disease outbreaks. In agroecosystems where plant diseases and epidemics are frequent and destructive, soil-borne plant pathogens has been managed applying different strategies: chemical, cultural, biological agents and others; however so far, there is not enough knowledge about how important is soil biodiversity, mainly microbiome diversity and soil food webs structure and function in the management of root pathogens, in root and plant health, in healthy food production, and maybe more relevant in the conservation of soil as a natural resource and derived from it, the ecosystem services important for life in our planet.",book:{id:"10763",title:"Biodiversity of Ecosystems",coverURL:"https://cdn.intechopen.com/books/images_new/10763.jpg"},signatures:"María del Pilar Rodríguez Guzmán"}],onlineFirstChaptersTotal:12},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:140,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:123,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"3",title:"Bacterial Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",isOpenForSubmission:!0,editor:{id:"205604",title:"Dr.",name:"Tomas",middleName:null,surname:"Jarzembowski",slug:"tomas-jarzembowski",fullName:"Tomas Jarzembowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKriQAG/Profile_Picture_2022-06-16T11:01:31.jpg",biography:"Tomasz Jarzembowski was born in 1968 in Gdansk, Poland. He obtained his Ph.D. degree in 2000 from the Medical University of Gdańsk (UG). After specialization in clinical microbiology in 2003, he started studying biofilm formation and antibiotic resistance at the single-cell level. In 2015, he obtained his D.Sc. degree. His later study in cooperation with experts in nephrology and immunology resulted in the designation of the new diagnostic method of UTI, patented in 2017. He is currently working at the Department of Microbiology, Medical University of Gdańsk (GUMed), Poland. Since many years, he is a member of steering committee of Gdańsk branch of Polish Society of Microbiologists, a member of ESCMID. 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He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"117248",title:"Dr.",name:"Andrew",middleName:null,surname:"Macnab",slug:"andrew-macnab",fullName:"Andrew Macnab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. Gonzalez-Sanchez",slug:"juan-a.-gonzalez-sanchez",fullName:"Juan A. Gonzalez-Sanchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico System",country:{name:"United States of America"}}},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}}]}},subseries:{item:{id:"4",type:"subseries",title:"Fungal Infectious Diseases",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment",scope:"Fungi are ubiquitous and there are almost no non-pathogenic fungi. Fungal infectious illness prevalence and prognosis are determined by the exposure between fungi and host, host immunological state, fungal virulence, and early and accurate diagnosis and treatment. \r\nPatients with both congenital and acquired immunodeficiency are more likely to be infected with opportunistic mycosis. Fungal infectious disease outbreaks are common during the post- disaster rebuilding era, which is characterised by high population density, migration, and poor health and medical conditions.\r\nSystemic or local fungal infection is mainly associated with the fungi directly inhaled or inoculated in the environment during the disaster. The most common fungal infection pathways are human to human (anthropophilic), animal to human (zoophilic), and environment to human (soilophile). Diseases are common as a result of widespread exposure to pathogenic fungus dispersed into the environment. \r\nFungi that are both common and emerging are intertwined. In Southeast Asia, for example, Talaromyces marneffei is an important pathogenic thermally dimorphic fungus that causes systemic mycosis. Widespread fungal infections with complicated and variable clinical manifestations, such as Candida auris infection resistant to several antifungal medicines, Covid-19 associated with Trichoderma, and terbinafine resistant dermatophytosis in India, are among the most serious disorders. \r\nInappropriate local or systemic use of glucocorticoids, as well as their immunosuppressive effects, may lead to changes in fungal infection spectrum and clinical characteristics. Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",hasOnlineFirst:!0,hasPublishedBooks:!1,annualVolume:11400,editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. Completed the Course Medical Mycology, the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Netherlands (2006). International Union of Microbiological Societies (IUMS) Fellow, and International Emerging Infectious Diseases (IEID) Fellow, Centers for Diseases Control and Prevention (CDC), Atlanta, USA. Diploma of Dermatological Scientist, Japanese Society for Investigative Dermatology. Ph.D. of Juntendo University, Japan. Bachelor’s and Master’s degree, Medicine, West China University of Medical Sciences. Chair of Sichuan Medical Association Dermatology Committee. General Secretary of The 19th Annual Meeting of Chinese Society of Dermatology and the Asia Pacific Society for Medical Mycology (2013). In charge of the Annual Medical Mycology Course over 20-years authorized by National Continue Medical Education Committee of China. Member of the board of directors of the Asia-Pacific Society for Medical Mycology (APSMM). Associate editor of Mycopathologia. Vice-chief of the editorial board of Chinses Journal of Mycology, China. 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Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. 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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