Summary of summation folds of the athletes.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"10236",leadTitle:null,fullTitle:"Plasmodium Species and Drug Resistance",title:"Plasmodium Species and Drug Resistance",subtitle:null,reviewType:"peer-reviewed",abstract:"As teachers of parasite biology, we are becoming increasingly aware of the lack of detailed information and experimental approaches about drugs and drug resistance in many medical schools and undergraduate courses. Therefore, this book discusses parasite biology, antimalarial drugs and their mechanism of action, and the dynamic situation of evolving drug resistance of parasites, which has become a pressing issue. It provides insight into the plasmodium species, the role of cytokines in activating immune response during malaria infection, the importance of antimalarials as a therapeutic option, issues of drug resistance and co-resistance, and validation of evolved resistance in humanized mouse models. It is a timely addition to the existing literature on malaria parasite biology and a useful resource for students, researchers, and those working in the field of parasite biology, drugs, drug resistance of infectious diseases in general, and human malaria parasites in particular and beyond.",isbn:"978-1-83969-256-7",printIsbn:"978-1-83969-255-0",pdfIsbn:"978-1-83969-257-4",doi:"10.5772/intechopen.91077",price:119,priceEur:129,priceUsd:155,slug:"plasmodium-species-and-drug-resistance",numberOfPages:286,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"964a389525d1147af3e527c056ac1a73",bookSignature:"Rajeev K. Tyagi",publishedDate:"November 10th 2021",coverURL:"https://cdn.intechopen.com/books/images_new/10236.jpg",numberOfDownloads:2518,numberOfWosCitations:0,numberOfCrossrefCitations:3,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:4,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:7,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"November 23rd 2020",dateEndSecondStepPublish:"December 21st 2020",dateEndThirdStepPublish:"February 19th 2021",dateEndFourthStepPublish:"May 10th 2021",dateEndFifthStepPublish:"July 9th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"269120",title:"Dr.",name:"Rajeev",middleName:"K.",surname:"Tyagi",slug:"rajeev-tyagi",fullName:"Rajeev Tyagi",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRaBqQAK/Profile_Picture_1644331884726",biography:'Dr. Rajeev K. Tyagi earned Ph.D. degree at Biomedical Parasitology Unit, Institute Pasteur, Paris, France in June 2011 on a very challenging and interesting topic of malaria immunology/parasitology. He developed a long lasting, stable and straightforward laboratory animal model (humanized mouse model: a versatile mouse model) to study biology and immunology of infectious diseases and beyond. Dr. Tyagi worked as postdoc fellow in the laboratory of Dr. John Adams, University of South Florida, USA and received training to explore the potential of the developed “humanized mouse” to characterize attenuated asexual blood stage falciparum parasite to understand the innate immune response of the attenuated parasite (growth mutant). Also, he developed small laboratory human liver chimeric mice by transplanting the human hepatocytes in transgenic/immunodeficient mice (TK/NOG) at USF to study the least known liver stage infection of P. falciparum. Later on, he discovered novel dendritic like cell population called “pathogen differentiated dendritic cells (PDDCs)” when incubated with P. gingivalis and tracking of monocyte derived dendritic cells (MoDcs) in a reconstituted immunodeficient NOD.PrkdcscidIl2rg-/- (NSG) mice was carried out at Augusta University, USA to understand the host-pathogen interaction. Dr. Tyagi at the Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition Vanderbilt University Medical Centre (VUMC), USA deployed his efforts to understand the role of IL-23R in the modulation of functioning of regulatory T cells and its role in the pathogenesis of colitis in an experimental humanized mouse. Currently, Dr. Tyagi has been leading a group at CSIR-Institute of Microbial Technology, Chandigarh, India and his lab is focused to:\r\n 1. Developing human-liver chimeric mice for huHep transplantation to study liver stage infection of P. falciparum and transition to asexual blood stage infection to test antimalarial drugs and vaccine candidates in one host. \r\n2. Study of drug resistance against Plasmodium falciparum\r\n3. Dendritic cells as "therapeutic vaccines" playing a crucial role in translational biomedical research.\r\n4. Formulation and characterization of nanoscale drug carriers to deliver methotrexate (MTX) and aceclofenac to address Rheumatoid Arthritis, cancer and other inflammatory diseases as well as candidate vaccines.',institutionString:"CSIR - Institute of Microbial Technology, India",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"2",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1195",title:"Drug Discovery",slug:"pharmacology-toxicology-and-pharmaceutical-science-pharmacology-drug-discovery"}],chapters:[{id:"76981",title:"Finding Novel Strategies to Overcome the Impact of Malaria Vector Resistance in Limited-Resources Settings. The Case of Cameroon as a Basis for Reflection",doi:"10.5772/intechopen.98318",slug:"finding-novel-strategies-to-overcome-the-impact-of-malaria-vector-resistance-in-limited-resources-se",totalDownloads:118,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Malaria remains one of the most important and deadliest diseases in many countries in Africa, in the Americas, in South-East Asia, in the Eastern Mediterranean and in the Western Pacific regions, with high morbidity and mortality, despite important successes for the control of this disease borne by the vector Anopheles mosquitoes. Malaria elimination relies on different strategies including early diagnosis, improved drug therapies and better health infrastructure, and mainly the use of long-lasting insecticidal nets (LLINs) and indoor residual sprayings (IRS) of insecticide. In Cameroon, a country composed of several ethnic groups, malaria transmission is endemic in some regions, while it is seasonal in others; children and pregnant women are most vulnerable. Progress has been made towards malaria control, considering these specificities, and led to a reduction in both morbidity and mortality, but these accomplishments are under threat, mainly due to the development of resistance to insecticides among mosquitoes, targeting the 4 commonly used insecticide classes. To continue our route towards malaria control and elimination, it is urgent to have more knowledge about resistance mechanisms, in the objective of elaborating new strategies with the involvement of the community; these strategies should take into consideration socio-ecological factors such as the young age of the population, low literacy rate especially among women, population’s beliefs, traditions, and customs. Forest ecosystems with abundant rains, humidity and hot temperature, lower access to water for populations living in rural areas, and poverty level are other factors to consider when elaborating malaria control approaches.",signatures:"Benjamin Jr Fouda Abougou",downloadPdfUrl:"/chapter/pdf-download/76981",previewPdfUrl:"/chapter/pdf-preview/76981",authors:[{id:"342228",title:"M.D.",name:"Benjamin Jr",surname:"Fouda Abougou",slug:"benjamin-jr-fouda-abougou",fullName:"Benjamin Jr Fouda Abougou"}],corrections:null},{id:"77286",title:"Plasmodium Species and Drug Resistance",doi:"10.5772/intechopen.98344",slug:"plasmodium-species-and-drug-resistance",totalDownloads:187,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Malaria is a leading public health problem in tropical and subtropical countries of the world. In 2019, there were an estimated 229 million malaria cases and 409, 000 deaths due malaria in the world. The objective of this chapter is to discuss about the different Plasmodium parasites that cause human malaria. In addition, the chapter discusses about antimalarial drugs resistance. Human malaria is caused by five Plasmodium species, namely P. falciparum, P. malariae, P. vivax, P. ovale and P. knowlesi. In addition to these parasites, malaria in humans may also arise from zoonotic malaria parasites, which includes P. inui and P. cynomolgi. The plasmodium life cycle involves vertebrate host and a mosquito vector. The malaria parasites differ in their epidemiology, virulence and drug resistance pattern. P. falciparum is the deadliest malaria parasite that causes human malaria. P. falciparum accounted for nearly all malarial deaths in 2018. One of the major challenges to control malaria is the emergence and spread of antimalarial drug-resistant Plasmodium parasites. The P. vivax and P. falciparum have already developed resistance against convectional antimalarial drugs such as chloroquine, sulfadoxine-pyrimethamine, and atovaquone. Chloroquine-resistance is connected with mutations in pfcr. Resistance to Sulfadoxine and pyrimethamine is associated with multiple mutations in pfdhps and pfdhfr genes. In response to the evolution of drug resistance Plasmodium parasites, artemisinin-based combination therapies (ACTs) have been used for the treatment of uncomplicated falciparum malaria since the beginning of 21th century. However, artemisinin resistant P. falciparum strains have been recently observed in different parts of the world, which indicates the possibility of the spread of artemisinin resistance to all over the world. Therefore, novel antimalarial drugs have to be searched so as to replace the ACTs if Plasmodium parasites develop resistance to ACTs in the future.",signatures:"Sintayehu Tsegaye Tseha",downloadPdfUrl:"/chapter/pdf-download/77286",previewPdfUrl:"/chapter/pdf-preview/77286",authors:[{id:"344290",title:"M.Sc.",name:"Sintayehu",surname:"Tsegaye Tseha",slug:"sintayehu-tsegaye-tseha",fullName:"Sintayehu Tsegaye Tseha"}],corrections:null},{id:"76582",title:"Recent Advances in Antimalarial Drug Discovery: Challenges and Opportunities",doi:"10.5772/intechopen.97401",slug:"recent-advances-in-antimalarial-drug-discovery-challenges-and-opportunities-1",totalDownloads:211,totalCrossrefCites:1,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Malaria is a global health problem that needs attention from drug discovery scientists to investigate novel compounds with high drug efficacy, safety and low cost to encounter the malaria parasites that are resistant to existing drug molecules. Antimalarial drug development follows several approaches, ranging from modifications of existing agents to the design of novel agents that act against novel targets. Most of market and clinical drugs act on blood schizonticide are in current therapy for malaria reduction. This chapter will intend to highlight the currently available drugs including various novel agents. In addition, emphasis has been given on the prospective pharmacophores that are likely to emerge as effective clinical candidates in the treatment of malaria. Besides all aspects, some alternative approaches will also be highlight.",signatures:"Imrat, Ajeet Kumar Verma and Pooja Rani Mina",downloadPdfUrl:"/chapter/pdf-download/76582",previewPdfUrl:"/chapter/pdf-preview/76582",authors:[{id:"320004",title:"Dr.",name:"Pooja",surname:"Mina",slug:"pooja-mina",fullName:"Pooja Mina"},{id:"414260",title:"Dr.",name:"Imrat",surname:null,slug:"imrat",fullName:"Imrat null"},{id:"414261",title:"Dr.",name:"Ajeet",surname:"Kumar Verma",slug:"ajeet-kumar-verma",fullName:"Ajeet Kumar Verma"}],corrections:null},{id:"77047",title:"Adaptive Drug Resistance in Malaria Parasite: A Threat to Malaria Elimination Agenda?",doi:"10.5772/intechopen.98323",slug:"adaptive-drug-resistance-in-malaria-parasite-a-threat-to-malaria-elimination-agenda-",totalDownloads:167,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Malaria is a global disease of importance, especially in the sub-Saharan African region, where malaria accounts for great losses economically and to life. Fight to eliminate this disease has resulted in reduced disease burden in many places where the diseases is endemic. Elimination strategies in most places is focus on the use of treated nets and drug application. Exposure of malaria parasites to anti-malaria drugs have led to the evolution of drug resistance in both parasites and host. Development of drug resistance vary but, studies on adaptive drug resistance has implications and consequences. Our knowledge of this consequences are limited but important for the pursuit of an uninterrupted malaria elimination agenda. This chapter draws our attention to this risks and recommends interventions.",signatures:"Moses Okpeku",downloadPdfUrl:"/chapter/pdf-download/77047",previewPdfUrl:"/chapter/pdf-preview/77047",authors:[{id:"344467",title:"Assistant Prof.",name:"Moses",surname:"Okpeku",slug:"moses-okpeku",fullName:"Moses Okpeku"}],corrections:null},{id:"77119",title:"Treatment of Malaria Infection and Drug Resistance",doi:"10.5772/intechopen.98373",slug:"treatment-of-malaria-infection-and-drug-resistance",totalDownloads:186,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Malaria is a public health challenge that requires prompt treatment for those infected to make a full recovery. Treatment of malaria infection is to be started as soon as a diagnosis is confirmed. Antimalarial medications are administered to prevent and also to treat malaria. The type of medication used and the duration of therapy is dependent on the type of malaria-causing plasmodium species, the severity of the symptoms, geographical area where malaria infection occurred and the medication used to prevent malaria and whether there is pregnancy. Treatment of malaria from public health perspective is to reduce transmission of the infection to others, by reducing the infectious reservoir and to prevent the emergence and spread of resistance to antimalarial medicines. Medications used in the treatment of malaria infection come from the following five groups of chemical compounds: quinolines and aryl amino alcohols, antifolate, artemisinin derivatives, hydroxynaphthoquinones and antibacterial agents. The treatment of malaria is not initiated until the diagnosis has been established through laboratory testing. Artemisinin-based Combination Therapy (ACTs) has been used for the treatment of uncomplicated malaria. ACTs are also to enhance treatment and protect against the development of drug resistance. IV artesunate is used in the treatment of severe malaria, regardless of infecting species.",signatures:"Bernard Kofi Turkson, Alfred Ofori Agyemang, Desmond Nkrumah, Reinhard Isaac Nketia, Michael Frimpong Baidoo and Merlin Lincoln Kwao Mensah",downloadPdfUrl:"/chapter/pdf-download/77119",previewPdfUrl:"/chapter/pdf-preview/77119",authors:[{id:"342313",title:"Dr.",name:"Bernard Kofi",surname:"Turkson",slug:"bernard-kofi-turkson",fullName:"Bernard Kofi Turkson"},{id:"344502",title:"Mr.",name:"Michael",surname:"Frimpong Baidoo",slug:"michael-frimpong-baidoo",fullName:"Michael Frimpong Baidoo"},{id:"344503",title:"Mr.",name:"Alred",surname:"Ofori Agyemang",slug:"alred-ofori-agyemang",fullName:"Alred Ofori Agyemang"},{id:"344504",title:"Mr.",name:"Desmond",surname:"Nkrumah",slug:"desmond-nkrumah",fullName:"Desmond Nkrumah"},{id:"344505",title:"Mr.",name:"Reinhard Isaac",surname:"Nketia",slug:"reinhard-isaac-nketia",fullName:"Reinhard Isaac Nketia"},{id:"344507",title:"Prof.",name:"Merlin Lincoln Kwao",surname:"Mensah",slug:"merlin-lincoln-kwao-mensah",fullName:"Merlin Lincoln Kwao Mensah"}],corrections:null},{id:"77461",title:"P. falciparum and Its Molecular Markers of Resistance to Antimalarial Drugs",doi:"10.5772/intechopen.98372",slug:"-em-p-falciparum-em-and-its-molecular-markers-of-resistance-to-antimalarial-drugs",totalDownloads:193,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The use of molecular markers of resistance to monitor the emergence, and the spread of parasite resistance to antimalarial drugs is a very effective way of monitoring antimalarial drug resistance. The identification and validation of molecular markers have boosted our confidence in using these tools to monitor resistance. For example, P. falciparum chloroquine resistance transporter (PfCRT), P. falciparum multidrug resistance protein 1 (PfMDR1), P. falciparum multidrug kelch 13 (pfk13), have been identified as molecular markers of resistance to chloroquine, lumefantrine, and artemisinin respectively. The mechanism of resistance to antimalarial drugs is mostly by; (1) undergoing mutations in the parasite genome, leading to expelling the drug from the digestive vacuole, or (2) loss of binding affinity between the drug and its target. Increased copy number in the pfmdr1 gene also leads to resistance to antimalarial drugs. The major cause of the widespread chloroquine and sulfadoxine-pyrimethamine resistance globally is the spread of parasites resistant to these drugs from Southeast Asia to Africa, the Pacific, and South America. Only a few mutations in the parasite genome lead to resistance to chloroquine and sulfadoxine-pyrimethamine arising from indigenous parasites in Africa, Pacific, and South America.",signatures:"Peter Hodoameda",downloadPdfUrl:"/chapter/pdf-download/77461",previewPdfUrl:"/chapter/pdf-preview/77461",authors:[{id:"344545",title:"M.Sc.",name:"Peter",surname:"Hodoameda",slug:"peter-hodoameda",fullName:"Peter Hodoameda"}],corrections:null},{id:"78631",title:"A Double Line of Defense: Heat Shock Proteins and Polyamines Act as Contributing Factors to Drug Resistance of some Plasmodium Parasites",doi:"10.5772/intechopen.98852",slug:"a-double-line-of-defense-heat-shock-proteins-and-polyamines-act-as-contributing-factors-to-drug-resi",totalDownloads:104,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Malaria remains a threat to human life worldwide with children under the age of 5 being the most vulnerable. Plasmodium falciparum, known as the causative agent of the deadliest malaria, survives both in the mosquito vector and human host. The sudden temperature change seems to not affect the parasite’s cellular system. Heat shock proteins and polyamines are the major house-keepers of the parasite’s cellular system to remain viable, despite the temperature changes that the parasite gets exposed to. While heat shock proteins protect newly synthesized proteins until they are properly folded polyamines are needed for cell differentiation, proliferation, and cell growth. In plants for example, polyamines have been reported to act as molecular chaperones when cells are exposed to unfavorable conditions that could be detrimental to cells. In this review, the role of heat shock proteins and polyamines in plasmodium parasite drug resistance and their role in parasite survival are discussed. The current drugs against malaria as well as the alternative future approach towards malarial drug development are reviewed.",signatures:"Xolani Henry Makhoba",downloadPdfUrl:"/chapter/pdf-download/78631",previewPdfUrl:"/chapter/pdf-preview/78631",authors:[{id:"342340",title:"Dr.",name:"Xolani Henry",surname:"Makhoba",slug:"xolani-henry-makhoba",fullName:"Xolani Henry Makhoba"}],corrections:null},{id:"77697",title:"Molecular Approaches for Malaria Therapy",doi:"10.5772/intechopen.98396",slug:"molecular-approaches-for-malaria-therapy",totalDownloads:190,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Malaria is a potentially fatal blood disease spread by mosquitos. Malaria is preventable, but it is more prevalent in developing countries where prevention is difficult and prophylaxis is often inaccessible. Malaria remains one of the world’s most serious public health problems, according to the World Health Organisation (WHO). The development of resistance is a current problem that poses a danger to the environment. Resistance is a current problem that could jeopardise the use of well-established and cost-effective antimalarials. The World Health Organisation recommends an artemisinin-based drug combination (ACT) to avoid or postpone the development of resistance. This book’s chapter discusses current medicines as well as potential and rational possibilities for finding new drugs to treat malady. There were also WHO recommendations for both complicated and non-complicated malaria. Other preventive measures such as ITN and IPT are listed in the manuscript in addition to routine care. While a brief overview of the vaccine tested so far has been included, there is currently no vaccine available to treat malaria.",signatures:"Mitali Mishra, Vikash Kumar Mishra, Varsha Kashaw and Sushil Kumar Kashaw",downloadPdfUrl:"/chapter/pdf-download/77697",previewPdfUrl:"/chapter/pdf-preview/77697",authors:[{id:"345127",title:"Dr.",name:"Sushil",surname:"Kashaw",slug:"sushil-kashaw",fullName:"Sushil Kashaw"},{id:"350673",title:"Dr.",name:"Vikash",surname:"Mishra",slug:"vikash-mishra",fullName:"Vikash Mishra"},{id:"350674",title:"Mrs.",name:"Mitali",surname:"Mishra",slug:"mitali-mishra",fullName:"Mitali Mishra"},{id:"350757",title:"Dr.",name:"Varsha",surname:"Kashaw",slug:"varsha-kashaw",fullName:"Varsha Kashaw"}],corrections:null},{id:"75927",title:"Regulation of T-reg/Th-17 Balance: One Step Closer Towards Immunotherapy Against Malaria Infection",doi:"10.5772/intechopen.97045",slug:"regulation-of-t-reg-th-17-balance-one-step-closer-towards-immunotherapy-against-malaria-infection",totalDownloads:135,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"According to World Malaria Report 2020, the rate of decline in malaria case incidence and deaths caused by malaria has ceased in latter half of the past decade. Though Artemisinin Combination Therapy (ACT) is still the major therapeutic approach globally to treat malaria patients, increased resistance of Plasmodium sp. to artemisinin can be looked upon as a major factor responsible for the rate of decline. In the present world, immunotherapeutic approaches are in the limelight to treat several infections, autoimmune disorders, cancers but application of such therapeutic measures in case of malaria are yet not available. Among different immune cells, T-regulatory cells (T-reg) and Th-17 cells and the balance between them, helps in determining the outcome of the immune response in host during both lethal and non-lethal malaria. TGFβ and IL-6 are two major cytokines that play important role in fine tuning the Treg/Th-17 balance by modulating dendritic cell responses, specially by regulating the ratio between myeloid DC and plasmacytoid DC (mDC/pDC). Studies in rodent malaria models have revealed that neutralization of IL-6 by using anti IL-6 monoclonal antibodies in-vivo has been found effective in declining the parasitemia, malaria induced deaths and also in reverting back the altered T-reg/Th-17 balance to normal levels. Apart from these, autophagy is one of the major factors which also contributes to regulate the T-reg/Th-17 balance. In malaria infected mice, autophagy induction has been found to normalise the dysregulated T-reg/Th-17 ratio and promote anti-inflammatory Th-2 pathway by supressing pro-inflammatory Th-1 pathway. So, Treg/Th-17 balance and its associated regulators can be important immunotherapeutic targets for malaria prevention in near future.",signatures:"Saikat Mukherjee, Soubhik Ghosh and Arindam Bhattacharyya",downloadPdfUrl:"/chapter/pdf-download/75927",previewPdfUrl:"/chapter/pdf-preview/75927",authors:[{id:"343432",title:"Prof.",name:"Arindam",surname:"Bhattacharyya",slug:"arindam-bhattacharyya",fullName:"Arindam Bhattacharyya"},{id:"343434",title:"Mr.",name:"Soubhik",surname:"Ghosh",slug:"soubhik-ghosh",fullName:"Soubhik Ghosh"},{id:"343435",title:"Mr.",name:"Saikat",surname:"Mukherjee",slug:"saikat-mukherjee",fullName:"Saikat Mukherjee"}],corrections:null},{id:"76204",title:"A Comprehensive Review of 4(1H)-Quinolones and 4(1H)-Pyridones for the Development of an Effective Antimalarial",doi:"10.5772/intechopen.97084",slug:"a-comprehensive-review-of-4-1-em-h-em-quinolones-and-4-1-em-h-em-pyridones-for-the-development-of-an",totalDownloads:215,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Malaria is a global public health issue. Despite the efforts in malaria prevention, nearly half the world’s population is at risk of infection. Until present-day, researchers are struggling to design and discover an efficacious antimalarial. In comparison to most common antimalarial chemotypes that eliminate erythrocytic stages of P. falciparum, 4(1H)-quinolones and 4(1H)-pyridones exhibit antimalarial activity against multiple stages of the parasite. They have potential to treat blood stages of multidrug resistant P. falciparum malaria, eradicate dormant exoerythro stages of relapsing malaria species (P. vivax), and prevent transmission of infectious gametocytes to mosquitoes. However, thus far, the advancement of these chemotypes towards pre-clinical and clinical development has been impeded due to poor physicochemical properties, poor oral bioavailability, and poor dose-proportionality limiting preclinical safety and toxicity studies. Despite all these challenges, 4(1H)-quinolones and 4(1H)-pyridones continue to be at the forefront for the development of the next-generation antimalarials as they would have tremendous global public health impact and could significantly enhance current malaria elimination efforts.",signatures:"Ami H. Asakawa and Roman Manetsch",downloadPdfUrl:"/chapter/pdf-download/76204",previewPdfUrl:"/chapter/pdf-preview/76204",authors:[{id:"334739",title:"Associate Prof.",name:"Roman",surname:"Manetsch",slug:"roman-manetsch",fullName:"Roman Manetsch"},{id:"345559",title:"Dr.",name:"Ami H.",surname:"Asakawa",slug:"ami-h.-asakawa",fullName:"Ami H. Asakawa"}],corrections:null},{id:"78959",title:"Stable Artesunate Resistance in A Humanized Mouse Model of Plasmodium falciparum",doi:"10.5772/intechopen.100381",slug:"stable-artesunate-resistance-in-a-humanized-mouse-model-of-em-plasmodium-falciparum-em-",totalDownloads:101,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Plasmodium falciparum, the most devastating human malaria parasite, confers higher morbidity and mortality. Although efforts have been made to develop an effective malaria vaccine, stage- and species-specific short-lived immunity crippled these efforts. Hence, antimalarial drug treatment becomes a mainstay for the treatment of malaria infection in the wake of the unavailability of an effective vaccine. Further, there has been a wide array of antimalarial drugs effective against various developmental stages of P. falciparum due to their different structures, modes of action, and pharmacodynamics as well as pharmacokinetics. The development of resistance against almost all frontline drugs by P. falciparum indicates the need for combination therapy (artemisinin-based combination therapy; ACT) to treat patients with P. falciparum. A higher pool of parasitemia under discontinuous in vivo artemisinin drug pressure in a developed humanized mouse allows the selection of artesunate resistant (ART-R) P. falciparum. Intravenously administered artesunate, using either single flash doses or a 2-day regimen, to the P. falciparum-infected human blood chimeric NOD/SCID.IL-2Rγ−/− immunocompromised (NSG) mice, with progressive dose increments upon parasite recovery, was the strategy deployed to select resistant parasites. Parasite susceptibility to artemisinins and other antimalarial compounds was characterized in vitro and in vivo. P. falciparum has shown to evolve extreme artemisinin resistance as well as co-resistance to antimalarial drugs. Overall, the present information shall be very useful in devising newer therapeutic strategies to treat human malaria infection.",signatures:"Sheetal Saini, Rajinder Kumar and Rajeev K. Tyagi",downloadPdfUrl:"/chapter/pdf-download/78959",previewPdfUrl:"/chapter/pdf-preview/78959",authors:[{id:"269120",title:"Dr.",name:"Rajeev",surname:"Tyagi",slug:"rajeev-tyagi",fullName:"Rajeev Tyagi"},{id:"426960",title:"Dr.",name:"Sheetal",surname:"Saini",slug:"sheetal-saini",fullName:"Sheetal Saini"},{id:"426961",title:"Mr.",name:"Rajinder",surname:"Kumar",slug:"rajinder-kumar",fullName:"Rajinder Kumar"}],corrections:null},{id:"77444",title:"Drug Design for Malaria with Artificial Intelligence (AI)",doi:"10.5772/intechopen.98695",slug:"drug-design-for-malaria-with-artificial-intelligence-ai-",totalDownloads:200,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Malaria is a deadly disease caused by the plasmodium parasites. Approximately 210 million people get affected by malaria every year resulting in half a million deaths. Among several species of the parasite, Plasmodium falciparum is the primary cause of severe infection and death. Several drugs are available for malaria treatment in the market but plasmodium parasites have successfully developed resistance against many drugs over the years. This poses a serious threat to efficacy of the treatments and continuing discovery of new drug is necessary to tackle the situation, especially due to failure in designing an effective vaccine. People are now trying to design new drugs for malaria using AI technologies which can substantially reduce the time and cost required in classical drug discovery programs. In this chapter, we provide a comprehensive overview of a road map for several AI based computational techniques which can be implemented in a malaria drugs discovery program. Classical computers has limiting computing power. So, researchers are also trying to harness quantum machine learning to speed up the drug discovery processes.",signatures:"Bhaswar Ghosh and Soham Choudhuri",downloadPdfUrl:"/chapter/pdf-download/77444",previewPdfUrl:"/chapter/pdf-preview/77444",authors:[{id:"343436",title:"Dr.",name:"Soham",surname:"Choudhri",slug:"soham-choudhri",fullName:"Soham Choudhri"},{id:"346210",title:"Dr.",name:"Bhaswar",surname:"Ghosh",slug:"bhaswar-ghosh",fullName:"Bhaswar Ghosh"}],corrections:null},{id:"76742",title:"Plasmodium vivax and Drug Resistance",doi:"10.5772/intechopen.97320",slug:"-em-plasmodium-vivax-em-and-drug-resistance",totalDownloads:213,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Resistance to antimalarial drugs is a threat to global efforts to eliminate malaria by 2030. Currently, treatment for vivax malaria uses chloroquine or ACT for uncomplicated P. vivax whereas primaquine is given to eliminate latent liver stage infections (a method known as radical cure). Studies on P. vivax resistance to antimalarials and the molecular basis of resistance lags far behind the P. falciparum as in vitro cultivation of the P. vivax has not yet been established. Therefore, data on the P. vivax resistance to any antimalarial drugs are generated through in vivo studies or through monitoring of antimalarial treatments in mixed species infection. Indirect evidence through drug selective pressure on the parasites genome, as evidenced by the presence of the molecular marker(s) for drug resistance in areas where P. falciparum and P. vivax are distributed in sympatry may reflect, although require validation, the status of P. vivax resistance. This review focuses on the currently available data that may represent the state-of-the art of the P. vivax resistance status to antimalarial to anticipate the challenge for malaria elimination by 2030.",signatures:"Puji Budi Setia Asih and Din Syafruddin",downloadPdfUrl:"/chapter/pdf-download/76742",previewPdfUrl:"/chapter/pdf-preview/76742",authors:[{id:"216332",title:"Dr.",name:"Puji",surname:"Budi Setia Asih",slug:"puji-budi-setia-asih",fullName:"Puji Budi Setia Asih"},{id:"239838",title:"Prof.",name:"Din",surname:"Syafruddin",slug:"din-syafruddin",fullName:"Din Syafruddin"}],corrections:null},{id:"77452",title:"rRNA Platform Technology for Drug Discovery Methods for Identifying Ligands That Target Plasmodium RNA Structural Motifs",doi:"10.5772/intechopen.98776",slug:"rrna-platform-technology-for-drug-discovery-methods-for-identifying-ligands-that-target-plasmodium-r",totalDownloads:107,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Determining the structure of the P. falciparum40s leads to better understanding of the structural basis for its protein-synthesizing roles in the cell. This enables researchers in the field of drug development to run in silico ligand screening experiments using the solved P. falciparum 40S structure as a target against a library of potential anti-malarial compounds. Drug leads identified through this method can lead to further biochemical and In vitro binding studies with the ultimate goal of developing new class of anti-malarial drugs. The use of structure prediction and modeling technologies in this study dramatically reduces the time it takes from target identification to drug lead determination. Furthermore, very many compounds that were previously incapable of being experimentally tested can now be tested in silico against the generated structure. Owing to the increasing utility of bioinformatics and three dimensional structural modeling software, one can accurately build physical models solely from sequence data by unwrapping the information therein on probable motif sites capable of being anchored onto available compounds or aptamers.",signatures:"Harrison Ndung’u Mwangi and Francis Jackim Mulaa",downloadPdfUrl:"/chapter/pdf-download/77452",previewPdfUrl:"/chapter/pdf-preview/77452",authors:[{id:"343043",title:"Prof.",name:"Francis",surname:"Jackim Mulaa",slug:"francis-jackim-mulaa",fullName:"Francis Jackim Mulaa"},{id:"343049",title:"Dr.",name:"Harrison",surname:"Ndung’u Mwangi",slug:"harrison-ndung'u-mwangi",fullName:"Harrison Ndung’u Mwangi"}],corrections:null},{id:"77404",title:"Malaria: Introductory Concepts, Resistance Issues and Current Medicines",doi:"10.5772/intechopen.98725",slug:"malaria-introductory-concepts-resistance-issues-and-current-medicines",totalDownloads:193,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Malaria continues to be the main community health problem in numerous nations. Six species of Plasmodium are documented as the cause of human malaria infection. Among others, Plasmodium falciparum and Plasmodium vivax parasites produce an immense challenge in the public health. Anopheles funestus and Anopheles gambiae are the major transimmiter of the disease (malaria) from one person to another. The disease parasite has a complicated cycle of life that occurs in human and mosquitoes. In general, malaria diagnosis is divided into parasitological and clinical diagnosis. Internationally, the death rate of malaria becomes reduced although few records from Ethiopia describe the presence of raised prevalence of malaria in certain areas. Apart from reduction in incidence and prevalence, transmission of malaria is continued throughout the globe. Hence, its control needs a combined approach comprising treatment with effective antimalarial agents. A lot of novel compounds are under pre-clinical and clinical studies that are triggered by the occurrence of resistance among commonly used antimalarial drugs. In addition to the already known new compounds and targets for drug discovery, scientists from all corner of the world are in search of novel targets and chemical entities.",signatures:"Dejen Nureye",downloadPdfUrl:"/chapter/pdf-download/77404",previewPdfUrl:"/chapter/pdf-preview/77404",authors:[{id:"343470",title:"Mr.",name:"Dejen",surname:"Nureye",slug:"dejen-nureye",fullName:"Dejen Nureye"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"7663",title:"Role of Novel Drug Delivery Vehicles in Nanobiomedicine",subtitle:null,isOpenForSubmission:!1,hash:"e3fc1c64277dcc5702828fc74a423eea",slug:"role-of-novel-drug-delivery-vehicles-in-nanobiomedicine",bookSignature:"Rajeev K. 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Analysis",doi:null,correctionPDFUrl:"https://cdn.intechopen.com/pdfs/66300.pdf",downloadPdfUrl:"/chapter/pdf-download/66300",previewPdfUrl:"/chapter/pdf-preview/66300",totalDownloads:null,totalCrossrefCites:null,bibtexUrl:"/chapter/bibtex/66300",risUrl:"/chapter/ris/66300",chapter:{id:"65375",slug:"recovery-intervention-to-promote-social-connectedness-through-social-recreational-programs-for-perso",signatures:"Winnie Sun, Shelby-Lynne Clarke, Hanaan Madahey and Ping Zou",dateSubmitted:"November 12th 2018",dateReviewed:"December 22nd 2018",datePrePublished:"January 28th 2019",datePublished:"April 10th 2019",book:{id:"8268",title:"Advances in Dementia Research",subtitle:null,fullTitle:"Advances in Dementia Research",slug:"advances-in-dementia-research",publishedDate:"April 10th 2019",bookSignature:"Ghulam Md. 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\r\n\r\n\tThis book will shed light on various methods for the preparation and characterization of liposomes and their engineered versions. Technological advancements have enabled us to develop newer methods of formulating liposomes. Over time, liposomes have been modified to a larger extent and engineered to meet our growing needs for sustained and controlled delivery for developing therapeutic interventions vaccines. Further, this book will throw light on the various methods of preparation and characterization of liposomes, and discuss several biochemical and indirect methods to understand the biological and physicochemical mechanisms of action of liposomes that decide their efficiency in vivo.
\r\n\tDespite their limitations such as encapsulation efficiency, liposomes are a well-established choice for a number of unconventional and conventional biological applications. The versatility of these lipid-based vesicles presents the importance of these nanoparticles in the future applications of nanotechnology besides targeted drug delivery. Overall, this book provides the necessary and relevant information about various aspects of liposomes and their use in nanomedicine.
\r\n\t
Nutrition is strongly linked to health, especially when sports are concerned, due to the increase in energy and nutrient demands. It is necessary to know the physiology of the exercise in order to know the different metabolic pathways that coexist during sports practice. In this way, you can predict the changes that occur in the organism during physical effort, in order to achieve some dietary recommendations.
\nThe nutritional practices of athletes are multifactorial and depend on the habits, culture, or nutritional knowledge of the athlete. So the work of a sports nutritionist is to advise the athlete and his environment to make the necessary changes in his intake and thereby improve sports performance (SP).
\nNutrition is determinant in achieving an adequate SP, which is defined by three variables: training, rest, and feeding. However, the main objective of sports nutrition must be preserving the health of the athlete, which can be achieved with an adequate intake adapted to the type of training performed. Optimal nutrition provides the energy necessary to perform physical exercise while reducing injury rate, a factor that together makes the SP increase by itself.
\nTwo of the aspects that can limit the SP are the state of hydration and the energy contribution. Hypohydration states produce alterations in homeostasis, decreased blood volume, increased heart rate, lower rate of sweating, increased organism temperature, and greater perception of effort which translates into SP deterioration. Likewise, a low energy consumption accentuates fatigue, immunosuppression, and predisposition for injuries, which can interfere in the development of SP.
\nNowadays, an exponential increase in the population that performs physical activity has been reported. In the USA, the total number of runners endorsed in marathon events is 541,000 in 2013, which represents 27% more participants than observed in 2008 in the same trend observed in many countries. For example, in Spain the number of participants increased from 28,000 (2008) to 57,931 (2013), which represented an increase of 101%. These increases far from ceasing have continued growing in the last 5 years. Specifically, marathons of Sevilla and Valencia have reached 14,500 and 20,000 runners in 2018, which contrast with the previous participation observed in 2013 (5963 and 9653 participants, respectively).
\nUnfortunately, sports nutrition is often referenced to sports supplements or “magical” strange diets. In fact 40–70% of athletes use sports supplements without even analyzing if their use is really necessary.
\nThe body composition (BC) of the athletes is related to the SP, as it can be modified throughout the season. There is no single BC for each group of athletes; however, it can serve as a guide for athletes and coaches [1].
\nThe season of the athlete will be divided into different phases throughout the competitive period. Competitive season can be divided in preseason, competitive period, transition period, and in the worst case injury period. Due to different intensities, timing, and types of training, the BC is normally different in the competitive season. Therefore, it is vital to know the BC of the athletes in order to determine the adequacy of the current season stage [2].
\nApart from a higher body mass index (BMI), there are several methods for the evaluation of BC [2]. Dual-energy X-ray absorptiometry (DEXA) is considered the gold standard for the assessment of body fat, mainly due to its high reproducibility and accuracy. However, DEXA has high economic cost, is not portable, and also emits a small radiation, so its use is not very common [3].
\nAmong the most used methods are bioelectrical impedance analysis (BIA) and anthropometry. Impedance is defined as the opposition shown by biological materials to the passage of an electric flow. Tissues with high impedance offer greater resistance (adipose tissue, bone, air in the lungs) and contain less amount of water [4]. The greater the amount of water, the better this electrical flow, will pass through. Therefore, the hydration sate of the individual is the determinant for the BC measurement by BIA. In addition, in order to standardize previous conditions and dismiss errors, certain protocols must be followed prior to the measurement of BC by BIA. That fact makes BIA a rather imprecise method [5].
\nAnthropometry allows the evaluation of different body dimensions and the overall composition of the body. It consists of the measurement of skinfolds, perimeters of the muscles, and bone diameters. This technique must be carried out by experts qualified by the International Society for the Advancement of Kinanthropometry (ISAK) [4]. It is the most widely used method in the sports field, from which the percentages of fat, muscle mass, and bone mass can be obtained by means of mathematic formulas [5]. The most effective way to monitor an athlete using this technique is performing a sum of six bodyfolds (triceps, subscapular, supraspinal, abdominal, thigh, and medial leg) that gives an absolute value [6]. In summary mode, the values for said summation of folds are estimated in physically active people (75 mm men and 100 mm in women), footballers (<50 mm men and <65 mm women), and endurance athletes (<35 mm men and 50 mm women). The minimum values seen in the healthy sports population were 25 mm for men and 42 mm for women (Table 1).
\nPopulation | \nMen (∑six skinfolds) | \nWomen (∑six skinfolds) | \n
---|---|---|
Physically active people | \n75 | \n10 | \n
Footballers | \n<50 | \n<65 | \n
Runners | \n<35 | \n50 | \n
Minimum value | \n25 | \n42 | \n
Summary of summation folds of the athletes.
However, it must be taken into account that BC is not the only thing that will measure sports performance, but it is one more parameter of the measurements that must be made in the athlete.
\nPrior to establishing requirements regarding quantity and timing of macronutrients, a brief approach about different metabolic pathways that provides energy during exercise is necessary. The energy systems are integrated by a set of metabolic pathways that come into operation during exercise, depending on the intensity and duration. In summary, they can be divided into non-oxidative pathways (phosphogenic and glycolytic pathways) and aerobic pathways (nutrient oxidation) [1].
\nBoth pathways aim to generate ATP that will be consumed during the exercise. The non-oxidative pathways occur in the cellular cytosol, do not require oxygen, and are activated during short-time periods (seconds). Phosphagen route uses ATP and phosphocreatine, lasting between 1 and 10 s, and is a route that does not need oxygen and does not generate lactate. Glycolytic pathways metabolize glucose, muscle, and liver glycogen through glycolysis and occur in high-intensity exercises up to 3 min. These glycolytic pathways generate lactate and hydrogen bonds, generating an acidity in the muscle cell—this acidity being one of its limitations [7].
\nThe aerobic pathway occurs inside the mitochondria, so it requires the presence of oxygen to metabolize fuels. It is typical of resistance exercises with medium-low intensity and long duration. It includes the oxidation of CHOs, fats, and to a lesser extent proteins. This route generates much more ATP than the anaerobic path but more slowly, speed being the limitation of this path [7].
\nThe key to success for any athlete will be to adapt energy intake to energy expenditure, which allows the correct functioning of the organism while improving BC [1]. However, it can be complicated due to multiple changes in periodization of training and competitions.
\nThe energy demands of athletes differ widely depending on the type of sport, duration, intensity, competitive level, and individual variability of each athlete. The more demanding the competitive levels of the athlete are, the greatest increase in the intensity of both training and competition occurs, which will result in a significant reduction energy reserves that must be replaced by an adequate diet [8].
\nThe objectives of the athletes’ diet are the following: provide the necessary energy for exercise, regulate body metabolism, and provide nutrients to maintain and repair tissues [9]. Due to variation among athletes, different available food options, and individual food patterns, there is no single feeding pattern for athletes, so there are a large number of strategies and options to assess [2].
\nCaloric intakes below the basal metabolic rate (BMR) are not recommended because it can compromise organism functions. Depending on the type of training energy requirement, the following recommendations for athletes can be approached: moderate training 1.7 × BMR, intense training 2.1 × BMR, extreme training 3 × BMR, and with the maximum recommended limit being 4 × BMR.
\nAthletes should bear in mind that it is not enough to pay attention to food only on the day of competition, but daily. Appropriate nutritional guidelines will optimize SP, improve recovery, and reduce the risk of injury and illness [2]. For example, in women daily intake below 30 kcal/kg body mass/day can induce damage to metabolic and hormonal functions that affect SP, growth, and health [10].
\nA varied diet is recommended, covering energetic requirements, and is based on foods as fruits, vegetables, legumes, cereals, dairy products, eggs, fish, and lean meat, in order to provide vitamins and minerals. A poor choice of foods cannot be compensated by the use of supplements [2].
\nIn order to establish recommendations for macronutrients, it is preferable taking into account the body weight (BW) of the athlete, instead of giving the typical percentages based on the total caloric intake of the diet [2]. For this purpose the recommendations will be provided by grams of nutrient/kg of BW.
\nMain energy substrates used for physical exercise are carbohydrates (CHO) and lipids, while proteins as energy substrate are reserved for extreme conditions. The use of energy substrate varies depending on the intensity and duration of the exercise, level of training of the athlete, and the state of pre-workout CHO stores. The use of CHO as energy substrate is produced mainly during high-intensity and short-duration exercises. Meanwhile, less intense and long-term exercises use fats’ main energy substrate [11]. However the use of CHO will also have a great impact on exercises of less intensity and longer duration such as resistance test, showing that depletion of CHO together with dehydration is a major limitation of the SP [12].
\nOne of the big differences between CHO and lipids is their storage in the body. While CHOs have a limited reserve which leads to around 1600–2000 kcal, fats suppose a practically unlimited energy reserve close to 70,000 kcal (depending on fat mass) [7, 11].
\nCurrently, there are a large number of myths related to nutrition, which causes great confusion in general population. One of the most widespread errors is the demonization suffered by the CHO, which has generated some carbophobia in society, including the athlete population [13]. This is a mistake, due to the importance of CHO as energy substrate for the brain and central nervous system. Moreover, they can also be used at different intensities both by anaerobic and aerobic pathways [1].
\nCHO are an energy fuel that provides 4 kcal/g of dry weight. They are stores in liver and muscle in the form of glycogen. Although, these deposits are limited to around 400-500 g, providing 1600- 2000 kcal, they can be depleted if the diet does not contain enough CHO. Glycogen stores in the organism are divided into 350–400 g in the muscle, 75–100 g in the liver, and around 5 g in the plasma [14]. In addition to size differences, the liver is really a store of glycogen, responsible for maintaining blood glucose. Meanwhile, the muscle can be considered a “false” store since it only uses glucose for its own needs. In other words, the liver can contribute to the replacement of muscle glycogen in the event of depletion, something that does not happen in reverse, which can lead to hypoglycemia and considerably affect SP due to fatigue [15].
\nIt is vitally important to maintain high levels of glycogen so as not to compromise the physical demands of physical activity, since low availability can be associated with loss of abilities and impaired decision-making and increases risk of injury and decreases SP. Therefore, it is essential to provide CHO before exercise, as well as during, in order to improve the SP and delay the onset of fatigue [14, 16].
\nA good strategy in order to optimize increased glycogen reserves for a competition is the “CHO overload” in the hours or even days before. In athletes with good training status, it is not necessary to deplete these deposits previously, as was believed decades ago. In fact an intake or around 10 g CHO/kg/day during the previous 36–48 h would be enough [17]. Athletes are advised to test how many CHOs are able to inatek without gastric problems. On the other hand, it is also advisable not to try new things on competition days [14].
\nIn general, the CHO recommendations based on the intensity and duration of physical activity can be summarized as follows [1, 18]:
3–5 g/kg/d of low-intensity training such as recovery days or tactical skills
5–7 g/kg/d for moderate intensity training of 1 h duration
6–10 g/kg/d for moderate–high intensity exercises between 1 and 3 h
8–12 g/kg/d for workouts of more than 4–5 h of moderate-high intensity
During competition as well as during high-intensity training, a high intake of CHO between 3 and 4 h before the beginning of the exercise is convenient, in order to complete glycogen levels [14]. In case of CHO overload, the recommendation ranges from 200 g CHO to 300 g CHO of moderate glycemic index. The intake should be light, easily digestible, and low in fat, protein, and fiber, in order not to decrease glycemia. Also, an intake of 1–4 g/kg of CHO between the previous 1 and 4 h would be recommended. However, some athletes should be careful with the intake of simple CHOs in the hour before the competition, which can cause a reactive hypoglycemia that affects the SP [18].
\nThe type of exercise, length, and provisioning are determinant factors for the physical exercise. Depending on all the variables, the nutritional strategies will be adapted to the athlete as personalized as possible. To summarize, the recommendations of CHO during the exercise are [19, 20]:
In an exercise of less than 30 min, CHO intake is not necessary.
In exercise lasting 45–75 min, it seems that the intake of CHOs is not necessary and it would be enough to perform mouth rinses. However, ingesting this liquid can promote hydration.
In exercises lasting 1–2 h, the intake of 30 g/h seems to be sufficient, increasing CHO intake up to 60 g/h in case of more delayed sports.
In exercises lasting more than 2.5 h, the intake of CHO should be 90 g/h. High CHO amounts can cause digestive problems; therefore, a previous intestine training is determinant to tolerate such CHO intake.
The rate of glucose oxidation is estimated at 60 g/h. Therefore, the CHO composition must be formed by a combination of CHOs that use different transporters and increase the oxidation rate, such as maltodextrin or sucrose, among others [20]. Consuming 90 g CHOs/h can cause gastrointestinal problems in sports such as continuous running. These gastrointestinal problems may be due to the redistribution of blood flow to the muscles during exercise. Therefore, strategies for bowel training have been proposed to increase the rate of gastric emptying as well as reduce possible discomfort [21]. When it is proposed to reach recommendations, it seems beneficial to alternate different types of drinks, gels, or bars, so that the taste is not monotonous.
\nThe reposition of CHO is determinant in approaching the following training or competitive sessions. After the completion of physical activity, it is vitally important to replenish CHO stores after the training and competition sessions. These replacements of CHO levels can be approached by different methods, depending on the closeness and intensity of the next sporting event. It will be necessary to rehydrate and to ensure glycogen recovery as well as muscle tissue. The optimum approach is a recovery of 150% of BW lost and a CHO intake between 1 and 2 g/kg/h during the following 6 h after exercise. Moreover, it is advisable to take advantage of the first 2 h afterward where the glycogen resynthesis rate is maximum [14, 22].
\nThe contribution of 1 g/kg BW of CHO after the first hour post-exercise has anticatabolic effect, increases insulin secretion, and increases muscle protein synthesis. Moreover, the addition of protein may also increase the glycogen resynthesis, so a less aggressive pattern can be reached by combining a consumption of 0.8 g kg BW/h of CHO together with protein intake of 0.2–0.4 g/kg BW/h [19].
\nThe appropriate intake of CHO before, during and, after exercise ensures a satisfactory energy intake to face both training and competitions. Most CHOs are found in cereals, fruits, legumes, and vegetables and can be found in smaller quantities in dairy products, unless they could have added sugars. Given the importance of CHO, it is considered essential that athletes ingest enough CHO complexes during the course of the day, leaving simple CHOs during and after exercise [2].
\nHowever, in some circumstances in which physiological adaptations to training are the target, different strategies can be handled to those previously mentioned. For example, training with low availability of glycogen induces mitochondrial biogenesis (increase in the number of mitochondria) and thereby enhances lipid oxidation [23]. This strategy can make the athlete more profitable metabolically, allowing a saving of glycogen reserves during exercise and thereby delaying the onset of fatigue. Another purpose of this strategy can be to accustom the athlete to know the feeling of emptiness that can have at the end of a competition and know in advance how to deal with it [24].
\nBecause a reduction in the availability of CHO will affect the quality of the training, these strategies should be carried out with extreme caution and under the supervision of nutritionist and coach. The performance of training under low availability of CHO will be done during low-intensity sessions due to the perception of effort is greater, the immune system can be affected, and the athlete is at greater risk of injury [24].
\nThe proteins are composed of amino acid (AA) chains. There are 20 types of AA, divide into nonessential AAs (can be synthetized by the organism) and essential AAs (must be contributed by the diet) [2]. Within the essential AAs, there are three types of AAs called branched (leucine, valine, and isoleucine). Among them, leucine stands out as a stimulator of the mammalian target of rapamycin (mTOR) pathway, which is related to protein synthesis and hypertrophy [25].
\nAlthough proteins can contribute between 5 and 10% to the total energy used during physical activity, they are not considered as energy source. Proteins constitute the base of muscle tissue and of the immune system and are the major component of muscle enzymes and play a large role in SP [14].
\nRegarding sedentary population, the estimated consumption rate is 0.8 g/kg BW/day. In the athlete population, these requirements are increased to repair muscle damage caused by exercise, enhance metabolic adaptations to training, and avoid possible muscle catabolism [2]. The focus of protein consumption is on estimating an adequate protein intake for each given moment [1].
\nThe current recommendations for athlete population range between 1.2 and 2.0 g/kg BW/day depending on the type of sports performed [1]. Moreover, higher amounts may be reached at exceptional times such as injurious period, high-intensity training, or weight loss plans with caloric restriction. The purpose of this increase is to maintain maximum muscle mass integrity [26].
\nAlthough the most important factor in terms of protein consumption is the overall consumption throughout the day, it may be advisable to divide the protein intake into several intakes. For example, four doses of 0.4 g/kg BW ensuring a total of 1.6 g/kg BW a day [25]. Likewise, it is recommended to ensure a contribution of 3 g of leucine every meal [27]. The optimal timing seems to adjust the intake depending on the moment, type of training, as well as availability of the rest of nutrients and energy. It is important to have an adequate energy and CHO consumption, so that dietary amino acid are used for protein synthesis and not oxidized to obtain energy [28].
\nProtein-rich diets are associated with increased risk of dehydration due to elimination of nitrogenous waste products, an increased cardiovascular disease risk due to the association of fat with protein products, or a shift of CHO [2]. However, even at high doses, no negative effects on renal function have been reported in healthy subjects.
\nRegarding timing of protein intake along with exercise, it seems that the most optimal time is the period after exercise. Better doses ranged between 0.25 and 0.3 g/protein/kg BW (approximately 15–25 g protein) [1]. However, high protein intake is discouraged close to physical exercise, due to possible digestive problems as a result of its long time of gastric emptying. However, in very long duration exercise, there is not such limitation.
\nIn order to stimulate muscle protein synthesis, the intake of 30–40 g of casein is beneficial prior to going to bed, promoting nocturnal recovery due to its slow digestion [29].
\nTo choose protein sources, it is important that animal proteins may be of greater interest. In fact, animal proteins are considered as a complete protein due to the presence of all essential AAs [30].
\nThe main protein sources are lean meat products, fish, eggs, dairy products, and legumes that provide vegetable protein and reduce animal consumption.
\nThe use of protein supplements does not seem to be necessary because protein requirements are usually reached with diet in Western population. However, population that may find it difficult to reach such recommendations should be monitored. These groups includes: vegetarian athletes, young athletes in the growth phase, and athletes who restrict their diet due to religious or cultural reason. can be included [2]. If protein supplementation is chosen, the best option is whey protein for its high content on AAs and leucine content.
\nAlong with the CHO, lipids are major energy substrates during exercise [27]. The difference is that fats are not as profitable per unit of time as CHO and high fat consumption is not associated with improvements in SP [31].
\nLipid consumption is important for both energy intake and essential nutrients such as fat-soluble vitamins A, D, E, and K. Both quantity and quality of fats are determinant in the diet. The quality is often referred by its content on inflammatory fatty acids [2].
\nThe recommendation regarding fat consumption in athletes is similar to that of the general population. It is advisable not to make restrictive consumption of fat, as it can lead to deficit of nutrients such as fat-soluble vitamins and omega-3 fatty acids [1].
\nFatty acid requirements, according to the American College of Sports Medicine (ACSM), are 20–35% of the total kcal of the diet, where 7–10% should correspond to saturated fatty acids, 10% to polyunsaturated fatty acids, and 10–15% to monounsaturated fatty acids [32].
\nAdequate intake of omega-3 fatty acids should be ensured due to its anti-inflammatory effects, improvements in the organism’s coagulation, or increase in omega-3/omega-6 ratio [33].
\nIn particular, food as avocado or olive oil is recommended, due to their high content on monounsaturated fatty acids, which have less susceptible to oxidation.
\nIt is recommended to reduce the consumption of fatty meats, substituting them for lean meats, fish, and legumes. It is also advisable to eliminate the consumption of processed products such as sausages [2].
\nAn excess of polyunsaturated fatty acids carries a risk of lipid peroxidation, so a joint intake with vitamin E is recommend. Moreover, the ratio omega-3/omega-6 series should be greater as possible, because of the greater pro-inflammatory character of omega-6. The recommendations regarding the omega-6/omega-3 range oscillate between 2 and 4/1 in favor of the omega-6, something that is far from the inflammatory level that this entails [33]. In order to reduce the omega-6/omega-3 ratio, it is advisable to reduce consumption of meats and increase consumption of blue fish such as sardines, salmon, tuna, anchovy, and mackerel.
\nDuring exercise, increments of energy requirements are associated to larger production of metabolic heat [34]. Human organism dissipates that extra heat mainly by the mechanism of evaporation, which ultimately induces dehydration [35, 36].
\nOne of the greatest limitations of SP is dehydration. It is estimated that each kg of BW lost during exercise corresponds to 1 L of sweat [35]. The sensitivity to dehydration is personal, but generally no losses greater than 2% of the BW are recommended in order not to compromise the SP [37]. In fact, 1% of BW lost leads to SP decrease by 10%. Some authors have raised the possibility of training dehydration, but there is some controversy about it [38, 39].
\nThe consumption of water is the only method to prevent dehydration and will be essential before, during, and after exercise. However, a large number of athletes usually begin the exercise in a state of hypohydration [40]. Therefore, it is necessary to instruct the athlete to acquire correct hydration habits according to the type of sports, so that the SP is affected as little as possible [12].
\nLosses of electrolytes, especially sodium, occur along with water losses. It has been seen that well-trained athletes “sweat more but swear better,” that is, they sweat more water, but the loss of electrolytes is lower [41]. Recent studies have compared both the rate of sweating and the concentration of sodium in tattooed people versus non-tattooed people, concluding that the most tattooed skin presented lower sweating rate and higher sodium concentration [42].
\nIt seems interesting to perform a sweat test to athletes, in order to know their rate of sweating (liters/hour). To accomplish it, weighing the athlete before and after the exercise session is enough. This data reveals the amount of sweat that is lost at the time, so it can serve to adjust the athlete’s water intake (Figure 1). [43]. In general, the rate of sweating is usually greater than that of gastric emptying. However athletes can be trained to increase gastric emptying during workouts and thereby reduce dehydration as possible [21]. In conditions of higher temperature and humidity, this rate of sweating will rise higher. Another simpler way to determine the state of hydration in athletes is controlling the color of urine (darker colors are associated with enhanced dehydration states) [2].
\nHow to calculate sweat rate? [
Wherein some cases, athletes must acclimatize to different temperatures they accustomed. It has been reported that among all factors, the most important factor is the previous state of hydration.
\nIn healthy non-athlete population, the sensation of thirst is an ancestral mechanism that informs of the need to ingest liquid. However, in children, elderly people, and athletes, this mechanism is altered and liquid should be ingested before presenting thirst sensation. In the case of athletes, thirst appears when there is a deficit of 2% dehydration [27]. However, special care should be taken to amateur athletes, who increase their water intake above their needs, which can suffer dilutional hyponatremia “leading to serious problems and even lead to death” [44].
\nRegarding the drink to be used for sports, it is advisable to use replacement drinks instead of water, due to the CHO and sodium content. Both salts and CHO improve intestinal transport, which facilitates the arrival of fluid in the blood. Prepositional beverages should present an isotonic composition, with the following characteristics [12]:
80–35 kcal
At least 75% of the kcal should be high glycemic index CHO
No more than 90 g CHO/liter
460–1150 mg sodium/liter
Osmolality 200–330 mOsm/kg of water
As commented before, it is advisable to use drink with different CHOs as glucose, sucrose, and maltodextrinas, in order to facilitate the absorption of liquid due to the use of different intestinal transporters. Moreover, the fructose content should not be very high, due to quantities between 20 and 30% can cause intestinal problems [22].
\nThe hydration guidelines indicated for performing physical exercise are [12, 14]:
Ingest between 400 and 600 ml of water along the 4 h before the start of the exercise.
Just at the beginning of the activity, ingest 200–400 ml of water with CHO (5–8%).
During the exercise, ingest 100–200 ml of water every 15–20 min.
After physical activity consume 150% of the BW lost in the 6 h after.
In low-intensity training and short-duration, the intake of water alone is sufficient
The ideal temperature of drinks oscillates between 15 and 21°C
The taste should be pleasant to the palate of the athlete.
In a situation where the environment is very hot and has high humidity, the recommendations of intake of liquid and sodium will be higher [22]. A good strategy can be to make salted snacks in the hours before the exercise or add more salt content to the meals before and after the exercise. Such increase of sodium has a double purpose, on the one hand to increase the intake of liquid through thirst and on the other to favor the retention of that liquid in the organism.
\nFinally, alcohol consumption is discouraged in both athletes and non-athletes. However, there seems to be a high consumption of this substance in team sports and greater consumption in men than women [45]. Among the harmful effects of alcohol consumption, the following can be highlighted: reduction of SP due to decrease in strength, power, speed, and resistance; diuretic effect that affects hydration [46]; diminution of sleep quality, mood, and immune system [47]; elevation of cortisol concentration; and reduction of muscle synthesis up to 24% even when consumed right at the end of the exercise [48].
\nFirst, the effect of exercise between insulin-dependent (type 1) and insulin-dependent (type 2) diabetes should be differentiated. In type 2, you do the exercise to improve insulin resistance, while in type 1, you should adjust and modify the amount of insulin administered, along with the CHO intake.
\nPhysical exercise is one of the most difficult activities to adapt to diabetes, due to the increase in the frequency of hypoglycemia. People with diabetes who perform physical activity on a regular basis have less need for insulin, but this does not ensure adequate glycemic control. The blood glucose value is of multifactorial origin, and one should take into account the CHO intake and type of sports performed as well as adjust the dose of insulin used [49].
\nIn order to avoid hypoglycemia, during the exercise the dose of insulin will be reduced but in no case will be completely eliminated, because the lack of insulin prevents the entry of a sufficient amount of glucose into the cells for obtaining energy. A greater use of fats as fuel can generate an accumulation of ketone bodies and cause ketoacidosis. In the presence of glucose values (>250 mg/dL), ketone levels should be checked, and if elevated (>0.5 mmol/l), postpone the activity [49].
\nThe type of exercise performed by the athlete should be taken into account, since aerobic exercise increases the risk of hypoglycemia during and after exercise, while anaerobes cause hyperglycemia due to counterregulatory hormones (glucagon, cortisol, and catecholamines) [49].
\nPhysical exercise has some ability to introduce glucose into the muscle cell without the need for insulin action. This effect can occur during the 48 h after exercise, so there is a certain risk of suffering hypoglycemia in that period depending on the sports performed. This is due to the fact that during the physical exercise, the reserves of the muscle and liver glycogen have been emptied. Once the exercise is finished and after the intake of CHO, the glucose will be destined to replace the glycogen reserves instead of the blood, which can cause hypoglycemia, so that the high blood glucose value after a type of anaerobic exercise can be deceptive. Therefore, higher consumption of CHO or decreased insulin dose can prevent such hypoglycemia [49].
\nAn ergonomic aid is a product that contains a nutrient or a group of nutrients that improve the SP without taking into account the harmful effects in athletes, while a supplement is a nutritional aid to complete the diet associated with the practice of physical exercise [50].
\nWhen an athlete seeks to improve in the SP, his ability to tolerate intense workouts and hard competitions is crucial to avoid falling into injury or chronic fatigue. To achieve this purpose, an adequate supply of nutrients is essential. However, many times this does not happen, and the use of dietary supplements is resorted to [50].
\nThese supplements must be prescribed individually according to the needs of each person (sex, age, fitness, intensity and duration of the exercise, season, etc.), in order to maintain both the state of health and the improvement of the SP. Dietary supplements must offer maximum possible safety and have a degree of scientific evidence to support their effect [50].
\nCurrently between 40 and 70% of athletes make use of supplements without previously analyzing if necessary. In addition, a large number of sports supplements have not shown empirical evidence to improve SP. Likewise, there is a certain legal vacuum with the labeling of these substances, where 80% of these products do not contain the quantities declared on the label. In addition, 10–15% of these contain prohibited substances, and this can generate a high risk of committing an offense involuntarily by the athlete [51].
\nAccording to the Australian Institute of Sport, supplements are classified into four groups, based on effectiveness and safety [52]:
Group A: based on the evidence. Recommended for athletes.
Useful and timely source of energy or nutrients in the diet of athlete
Scientifically proven their evidence for the improvement of the SP, when they are used with a protocol and specific situation
In this group we can find:
Food for athletes (gels, bars, electrolytes, isotonic drinks, maltodextrins, whey protein)
Medical supplements (vitamin D, probiotics, iron/calcium supplements)
Substances to improve SP (creatine monohydrate, caffeine, beta-alanine, bicarbonate, beet juice)
Group B: more research deserved and advised under research or monitoring protocol.
Some benefit in non-athlete population or have data that suggest possible benefit of SP.
Of particular interest to athletes and coaches.
In this group we can find (quercetin, HMB, glutamine, BCCA, CLA, carnitine).
Group C: few tests of beneficial effect are not provided to athletes.
Not proven improvement RD despite its widespread use.
Very little or no benefit, and sometimes they even affect the RD in a negative way.
In this group supplements of group A and B may be included when used without an individualized protocol and without a basis in scientific evidence.
Group D: should not be used by athletes.
Are prohibited or have risk of contamination with doping or positive substance by drug
In this group we can find glycerol, ephedrine, sibutramine, and tribulus terrestris.
\nDespite all this information, many athletes believe that supplements are the basis of the athlete’s diet and believe that without that supplement, they will not reach their maximum level. This belief is one of the biggest mistakes in the world of sports nutrition, where the basic diet that is the true pillar on which sports nutrition is based is neglected.
\nThe basis of sports nutrition is a varied diet and individually tailored to the requirements and appetency of each athlete. The athlete should be instructed about the importance of diet, called “invisible training,” which is not only important on competition day. Prior to establishing nutritional guidelines, it is necessary to know and adapt the BC of the athlete in the different periods of the season and make revisions through the sum of six skinfolds.
\nIt is necessary to know some physiology to know the different metabolic pathways that interact during the exercise. In this way depending on the type of sports performed, duration and intensity adapt dietary intake at expense. Macronutrient requirements will be established based on g/kg/BW. With respect to CHOs, recommendations vary between 3 and 12 g/kg/BW to avoid compromising the SP, and protein consumption can vary between 1.2 and 2.0 g/kg/BW, with the total daily intake being more important than the number of intakes. Regarding to fatty acids, quality will prevail, improving the inflammatory profile with an increase in the consumption of omega-3 compared to omega-6.
\nIt is essential to maintain a state of hydration before, during, and after exercise to avoid compromising SP, so it is necessary to instruct the athlete with proper hydration guidelines. It is advisable to train the digestive system during workouts, both for hydration and testing different CHOs doses. It is important not to try new patterns on the day of competition.
\n\n sports performance body composition body mass index dual-energy X-ray absorptiometry bioelectrical impedance analysis International Society for the Advancement of Kinanthropometry carbohydrates basal metabolic rate body weight amino acid mammalian target of rapamycin American College of Sports Medicine
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He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). 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:null},{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:"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: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. 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