Brief overview of the STAXI-2 scales and subscales.
\\n\\n
These books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\\n\\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\\n\\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
\\n\\n\\n\\n\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
IntechOpen and Knowledge Unlatched formed a partnership to support researchers working in engineering sciences by enabling an easier approach to publishing Open Access content. Using the Knowledge Unlatched crowdfunding model to raise the publishing costs through libraries around the world, Open Access Publishing Fee (OAPF) was not required from the authors.
\n\nInitially, the partnership supported engineering research, but it soon grew to include physical and life sciences, attracting more researchers to the advantages of Open Access publishing.
\n\n\n\nThese books synthesize perspectives of renowned scientists from the world’s most prestigious institutions - from Fukushima Renewable Energy Institute in Japan to Stanford University in the United States, including Columbia University (US), University of Sidney (AU), University of Miami (USA), Cardiff University (UK), and many others.
\n\nThis collaboration embodied the true essence of Open Access by simplifying the approach to OA publishing for Academic editors and authors who contributed their research and allowed the new research to be made available free and open to anyone anywhere in the world.
\n\nTo celebrate the 50 books published, we have gathered them at one location - just one click away, so that you can easily browse the subjects of your interest, download the content directly, share it or read online.
\n\n\n\n\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:"10323",leadTitle:null,fullTitle:"Osteoporosis - Recent Advances, New Perspectives and Applications",title:"Osteoporosis",subtitle:"Recent Advances, New Perspectives and Applications",reviewType:"peer-reviewed",abstract:"Osteoporosis is a significant social health problem, not only in terms of pain and disability but also in terms of mortality rate. Osteoporosis affects approximately 200 million people worldwide, with nearly 9 million fractures occurring annually.This book provides an overview of osteoporosis, addressing different aspects of the disease and related conditions. It includes five chapters that cover such topics as glucocorticoid-induced osteoporosis, the relationship between osteoporosis and diet, osteoporosis in the dento-maxillofacial complex, and more.",isbn:"978-1-83969-237-6",printIsbn:"978-1-83969-236-9",pdfIsbn:"978-1-83969-238-3",doi:"10.5772/intechopen.91509",price:100,priceEur:109,priceUsd:129,slug:"osteoporosis-recent-advances-new-perspectives-and-applications",numberOfPages:98,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"08e07eb8b6c4997a39a2d04b99ac2ffc",bookSignature:"Luis Rodrigo",publishedDate:"June 30th 2021",coverURL:"https://cdn.intechopen.com/books/images_new/10323.jpg",numberOfDownloads:1225,numberOfWosCitations:0,numberOfCrossrefCitations:1,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:1,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:2,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 29th 2020",dateEndSecondStepPublish:"November 26th 2020",dateEndThirdStepPublish:"January 25th 2021",dateEndFourthStepPublish:"April 15th 2021",dateEndFifthStepPublish:"June 14th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"73208",title:"Prof.",name:"Luis",middleName:null,surname:"Rodrigo",slug:"luis-rodrigo",fullName:"Luis Rodrigo",profilePictureURL:"https://mts.intechopen.com/storage/users/73208/images/system/73208.jpg",biography:"Dr. Luis Rodrigo, MD, is a Professor Emeritus of Medicine, at the University of Oviedo, Spain. He has been Chief of Gastroenterology Service at HUCA Hospital, Oviedo, for more than forty years. He obtained a Ph.D. in 1975 and has developed a long teaching and research career. Dr. Rodrigo has published 716 scientific papers, 435 written in English and the rest in Spanish. He has participated as the main investigator in forty-five clinical trials and has directed forty doctoral theses. He has contributed actively to the formation of around 100 specialists in gastroenterology working in his hospital and other hospitals in Spain and abroad. He has written around thirty-five book chapters and edited twenty-six books in his specialty and related diseases.",institutionString:"University of Oviedo",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"5",totalChapterViews:"0",totalEditedBooks:"17",institution:{name:"University of Oviedo",institutionURL:null,country:{name:"Spain"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1414",title:"Osteology",slug:"osteology"}],chapters:[{id:"76677",title:"Introductory Chapter: Osteoporosis Overview",doi:"10.5772/intechopen.97760",slug:"introductory-chapter-osteoporosis-overview",totalDownloads:176,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Luis Rodrigo",downloadPdfUrl:"/chapter/pdf-download/76677",previewPdfUrl:"/chapter/pdf-preview/76677",authors:[{id:"73208",title:"Prof.",name:"Luis",surname:"Rodrigo",slug:"luis-rodrigo",fullName:"Luis Rodrigo"}],corrections:null},{id:"76351",title:"Glucocorticoid-Induced Osteoporosis",doi:"10.5772/intechopen.97416",slug:"glucocorticoid-induced-osteoporosis",totalDownloads:254,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The use of glucocorticoids (GC) in the medium and long term, causes several considerable side effects, being one of the main ones the reduction of bone mineral density (BMD). Prolonged corticosteroid therapy reduces BMD by up to 20% in trabecular bone and approximately 2–3% in cortical bone in the first year of use. This loss rate declines and stabilizes at approximately 2% in subsequent years. Therefore, there is a considerable increase in the incidence of pathological fractures, whether clinically symptomatic or asymptomatic (detected as a radiological finding), which varies between 30 and 50% of patients who use GC for more than three months. In view of the above, it is essential to prevent fractures and treat osteoporosis in patients using glucocorticoids for long periods (in particular, greater than or equal to 3 months), which may or may not be associated with clinical risk factors or previous fractures. The guidelines for the treatment and prevention of this comorbidity are well established for postmenopausal women and men over 50 years of age. However, for patients below this range, studies are still lacking.",signatures:"José Renan Vieira da Costa Júnior and Sérgio Luchini Batista",downloadPdfUrl:"/chapter/pdf-download/76351",previewPdfUrl:"/chapter/pdf-preview/76351",authors:[{id:"164388",title:"Prof.",name:"Sergio",surname:"Luchini Batista",slug:"sergio-luchini-batista",fullName:"Sergio Luchini Batista"},{id:"354032",title:"Dr.",name:"José Renan",surname:"Vieira Da Costa Júnior",slug:"jose-renan-vieira-da-costa-junior",fullName:"José Renan Vieira Da Costa Júnior"}],corrections:null},{id:"75742",title:"Osteoporosis and Dietary Inflammatory Index",doi:"10.5772/intechopen.96772",slug:"osteoporosis-and-dietary-inflammatory-index",totalDownloads:235,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Healthy bones are constantly being renewed and proper nutrition is an important factor in this process. Anti-inflammatory diet is designed to improve health and prevent the occurrence and development of chronic diseases associated with inadequate diet. Proper nutrition is based on the anti-inflammatory pyramid and changes in poor eating habits are the long-term strategy for preventing inflammation and chronic diseases. Inflammatory factors from food may play a role in the development of osteoporosis and an anti-inflammatory diet may be a way to control and reduce long-term inflammation and prevent bone loss. Pro-inflammatory cytokines from the fat tissue, through activation of the RANKL/RANK/OPG system could intervene with bone metabolism in a way of increased bone loss. Therefore the special attention need to be given to obese patients due to twofold risk, one related to pro-inflammatory cytokines release and the other related to the deprivation of the vitamin D in the fat tissue.",signatures:"Olga Cvijanović Peloza, Sandra Pavičić Žeželj, Gordana Kenđel Jovanović, Ivana Pavičić, Ana Terezija Jerbić Radetić, Sanja Zoričić Cvek, Jasna Lulić Drenjak, Gordana Starčević Klasan, Ariana Fužinac Smojver and Juraj Arbanas",downloadPdfUrl:"/chapter/pdf-download/75742",previewPdfUrl:"/chapter/pdf-preview/75742",authors:[{id:"339281",title:"Associate Prof.",name:"Olga",surname:"Cvijanović Peloza",slug:"olga-cvijanovic-peloza",fullName:"Olga Cvijanović Peloza"},{id:"346420",title:"Prof.",name:"Sandra",surname:"Pavičić Žeželj",slug:"sandra-pavicic-zezelj",fullName:"Sandra Pavičić Žeželj"},{id:"346421",title:"BSc.",name:"Ivana",surname:"Pavičić",slug:"ivana-pavicic",fullName:"Ivana Pavičić"},{id:"346423",title:"Prof.",name:"Ana Terezija",surname:"Jerbić Radetić",slug:"ana-terezija-jerbic-radetic",fullName:"Ana Terezija Jerbić Radetić"},{id:"346424",title:"Prof.",name:"Sanja",surname:"Zoričić Cvek",slug:"sanja-zoricic-cvek",fullName:"Sanja Zoričić Cvek"},{id:"346426",title:"MSc.",name:"Jasna",surname:"Lulić Drenjak",slug:"jasna-lulic-drenjak",fullName:"Jasna Lulić Drenjak"},{id:"346427",title:"Prof.",name:"Gordana",surname:"Starčević Klasan",slug:"gordana-starcevic-klasan",fullName:"Gordana Starčević Klasan"},{id:"346428",title:"MSc.",name:"Ariana",surname:"Fužinac Smojver",slug:"ariana-fuzinac-smojver",fullName:"Ariana Fužinac Smojver"},{id:"346429",title:"Prof.",name:"Juraj",surname:"Arbanas",slug:"juraj-arbanas",fullName:"Juraj Arbanas"},{id:"350011",title:"Dr.",name:"Gordana",surname:"Kenđel Jovanović",slug:"gordana-kendjel-jovanovic",fullName:"Gordana Kenđel Jovanović"}],corrections:null},{id:"76507",title:"Osteoporosis: A Multifactorial Disease",doi:"10.5772/intechopen.97549",slug:"osteoporosis-a-multifactorial-disease",totalDownloads:209,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"A great achievement of modern medicine is the increased lifespan of the human population. Unfortunately, the comorbidities of aging have created a large economic and health burden on society. Osteoporosis is the most prevalent age-related disease. It is characterized by uncoupled bone resorption that leads to low bone mass, compromised microarchitecture and structural deterioration that increases the likelihood of fracture with minimal trauma, known as fragility fractures. These fractures lead to disproportionally high mortality rate and a drastic decline in quality of life for those affected. While estrogen loss is one known trigger of osteoporosis, a number of recent studies have shown that osteoporosis is a multifactorial condition in both humans and rodent models. The presence or absence of certain factors are likely to determine which subset of the population develop osteoporosis. In this chapter, we review the factors that contribute to osteoporosis with an emphasis on its multifactorial nature and the therapeutic consequences.",signatures:"Di Wu, Anna Cline-Smith, Elena Shashkova and Rajeev Aurora",downloadPdfUrl:"/chapter/pdf-download/76507",previewPdfUrl:"/chapter/pdf-preview/76507",authors:[{id:"339667",title:"Associate Prof.",name:"Rajeev",surname:"Aurora",slug:"rajeev-aurora",fullName:"Rajeev Aurora"},{id:"347366",title:"Mr.",name:"Di",surname:"Wu",slug:"di-wu",fullName:"Di Wu"},{id:"347367",title:"Ms.",name:"Anna",surname:"Cline-Smith",slug:"anna-cline-smith",fullName:"Anna Cline-Smith"},{id:"347579",title:"Dr.",name:"Elena",surname:"Shashkova",slug:"elena-shashkova",fullName:"Elena Shashkova"}],corrections:null},{id:"75660",title:"Bone Quality of the Dento-Maxillofacial Complex and Osteoporosis. Opportunistic Radiographic Interpretation",doi:"10.5772/intechopen.96487",slug:"bone-quality-of-the-dento-maxillofacial-complex-and-osteoporosis-opportunistic-radiographic-interpre",totalDownloads:351,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Research suggests the use of different indexes on panoramic radiography as a way to assess BMD and to be able to detect changes in bone metabolism before fractures occur. Therefore, the objective of this chapter is to describe the use of these parameters as an auxiliary mechanism in the detection of low bone mineral density, as well as to characterize the radiographic findings of patients with osteoporosis.",signatures:"Plauto Christopher Aranha Watanabe, Giovani Antonio Rodrigues, Marcelo Rodrigues Azenha, Michel Campos Ribeiro, Enéas de Almeida Souza Filho, Rafael Angelo Soares Vieira and Fabio Santos Bottacin",downloadPdfUrl:"/chapter/pdf-download/75660",previewPdfUrl:"/chapter/pdf-preview/75660",authors:[{id:"76171",title:"Prof.",name:"Plauto C. A.",surname:"Watanabe",slug:"plauto-c.-a.-watanabe",fullName:"Plauto C. A. 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\r\n\tThe study of global biogeochemical cycles of biogenic elements is necessary to describe the surrounding world, as well as to understand the trajectory of biosphere evolution and to realize the threats with which the humanity will have to face in the nearest and remote future. The book is devoted to the global biogeochemical cycles of biogenic elements: carbon, nitrogen, oxygen, sulfur, phosphorus and hydrogen. The participation of these elements in the synthesis of "living" matter on the Earth says by itself that biogeochemical cycles of biogenic elements are somehow linked and interdependent. To find out these links and to establish the key reactions of the cycles and coupling points are the most important tasks of researchers in order to get a precise and complete picture of the world. Recently obtained findings require generalization and comprehension and set the tasks of elucidating the interaction between the cycles, establishing the role and participation of the photosynthesis in the interaction, determining driving forces and building physic chemical models. This is pushed by deteriorating environmental conditions, global climate change and warming, ice melting and other problems.
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Stress contributes to many disease processes. Exposures to chronic stress are considered the most deleterious as it leads to everlasting distortion in the emotional, physiological, and behavioral reverberation that accelerates susceptibility to and course of disease like essential hypertension. It is now well established that the total variability in the aetiology of HTN cannot be solely explained by physiological, genetic, and lifestyle factors. Several physiological and behavioural mechanisms are suggested to explain the link between psychological stress, hypertension, and cardiovascular diseases (CVD). The hypothalamus–pituitary–adrenal axis and the sympathetic nervous system are activated by psychological stress, due to which hemodynamic and hormonal responses are generated [1]. Mimicking chronic stress by experimentally elevating glucocorticoids within the brain produces enhanced adrenocorticotropic hormone (ACTH) responses [2]. It increases both baseline arterial blood pressure [3] and blood pressure and heart responses to an acute novel stressor [4], as seen in many animal studies. There is a vast body of documentation to support the role of psychosocial factors as the primary risk for HTN [5, 6, 7]. As a result, national HTN guidelines recommend psychosocial intervention as a means to prevent or delay the onset of HTN [8, 9, 10].
Hypertension (HTN) is a rapidly pervasive condition observed in different parts of the world. It brings about a variety of chronic conditions in the human body [11] without apparently noticeable symptoms and hence is often called a silent killer [12]. It affects the overall body functioning and human life in various ways. Untreated patients with HTN have an average life expectancy between 50 and 60 years, compared with 71 years for the population at large.
What causes essential hypertension is still unknown. The intensity and duration of exposure to chronic stressors are presumed to be important determinants of risk. Effects of acute stressors on blood pressure (BP) have been demonstrated, but ongoing exposure to stress may be more plausibly linked to sustained BP elevations and hypertension incidence [5]. The effects of chronic stress in several domains are being investigated, including work-related stress, relationship stress, low socioeconomic status (SES). The adrenal gland is a major site that coordinates the stress response via the hypothalamic-pituitary–adrenal axis and the sympathetic-adrenal system. There is a fight or flight response to the stress stimulus. Due to which catecholamines are released from the adrenal medulla, they function in the neurohormonal regulation of blood pressure and have a well-established link to hypertension.
The psychological status of an individual greatly affects his physical condition. Hypertension is among the seven psychosomatic diseases for which mental aetiologies were proposed in the 1950s [13]. Studies conducted during the last decade have reported significant relationships between HT and psychological factors such as anger, anxiety, and depression. Usually, as individuals experience stress, they activate the sympathetic nervous system and the hypothalamic-pituitary–adrenal–cortical axis system. As a result of this activation, catecholamines (e.g., epinephrine and norepinephrine) and glucocorticoids (e.g., cortisol) are released, contributing to increases in blood pressure and heart rate [14]. Although the exact mechanism that explains the relationship between cardiovascular reactivity (CVR) and high blood pressure (and the subsequent development of coronary artery disease) is still under debate, research has focused on releasing catecholamines and glucocorticoids [15]. Early research in this field investigated trait anger and whether it was related to overall increased physiological reactivity [14]. These researchers assumed physiological reactivity was a person-based trait associated with a constellation of emotional, cognitive, and behavioural anger reactions. Anger could contribute to the elevation of BP directly through the psychophysiological activation and indirectly by facilitating the emergence of a coping style that contributes to the maintenance of elevated BP [16, 17, 18].
Also, anger and hostility are associated with adverse lifestyle behaviour, such as excess alcohol consumption and smoking, higher BMI values, and increased total energy intake [19], which are recognized as critical behavioural risk factors for HT and cardiovascular diseases.
Positive family history is commonly found in hypertensive patients, with the heritability varying between 35% and 50% in most studies [17, 23]. Family history of hypertension doubles the risk of developing hypertension [24] independent of other risk factors, such as weight, age, and smoking status.
Gender is also a critical social determinant of Health to which global forums have increasingly drawn attention. Gender encompasses various practices, beliefs, roles, opportunities, and constraints, shaping men\'s and women\'s Health differently. In both men and women, the subjective experience of psychophysiological wellbeing significantly correlates with cardiovascular risk factors [25]. It seems that men must defend their status more often than women. The effects of job strain on BP tend to be stronger among men than women [26].
Excess alcohol consumption and smoking, higher BMI values, and increased total energy intake [19] are recognized as critical behavioural risk factors for HT.
Epidemiologic studies consistently demonstrate graded associations between SES and risk of hypertension, cardiovascular disease, and mortality [27, 28, 29]. Low SES is associated with hypertension-related BP patterns, including reduced nocturnal BP dipping [24] and delayed BP recovery following laboratory stress [30].
Employed men are healthier than their unemployed counterparts even after adjusting for low income and low educational attainment [31]. The same holds for women [32], although employment does not affect all women in the same way [33].
Psychosocial stress was defined under four domains: social, work, financial, and environment. Women and young adults reported higher psychological stress levels, particularly at work, which raised age-and sex-related job strain issues with high demand and low control (Figure 1) [34, 35].
Karasek job strain model.
Modifying effect of suppressed anger on the relationship between job stress and hypertension were studied by Cottington et al. [36], and they found that high blood pressure was markedly associated with self-reporting of ambiguous job future, disappointment with colleagues, and advancements in ranks among employees who suppress their anger. These findings advocate that anger expression, a coping mechanism, maybe an important factor that can modify the relation between occupational stress and essential hypertension.
Anger is the most basic emotion varying from mild irritation to intense fury in response to feeling threatened or hurt.
It has three components:
Physical – fight or flight response.
Cognitive – angry thoughts.
Behavioural – anger expressed verbally, physically, or just withdrawal.
Unfortunately, anger is also poorly understood in current diagnostic practices. For example, in DSM V, there are no Axis I disorders that directly address the emotion of anger, unlike anxiety and mood disorders.
Anger as such is a natural emotion, but if it increases, it can cause devastating effects upon the body and most conspicuously upon the heart [37]. It is observed that healthy persons may also occasionally have a conspicuous boost in their blood pressure occasionally when they are angry [38, 39] explain that anger is an arousing state with feelings varying from slight irritation to intense fury or rage. It is reported that anger-arousing situations also become an important contributing factor for increased blood pressure [17]. Historically, its roots back to 1939, when Alexander identified the suppression of anger as a major cause of HTN and further investigated its lethal outcomes in the human body. The reactivity hypothesis describes that individuals prone to HTN react to environmental stress with intense anger [23]. In an earlier study on people with HTN [24] reports that blood pressure rises remarkably during anger states. The association of anger with HTN has been confirmed by many researchers [40, 41], and is a well-established risk factor for CHD [40, 42] further augmenting the association between HTN and cardiovascular diseases.
Proposed biological and behavioral pathways linking psychological factors to an increased risk of incident essential hypertension [
Anger is an important variable in essential hypertension. Cardiovascular reactivity to stress in which a recurrent pattern of exaggerated sympathetic nervous system activity is proposed to up-regulate basal blood pressure levels over time.
The neurohormonal model shows that psychological characteristics may predispose to CVR and hypertension development by altering the central nervous system control of baroreceptor function, opioid activity, and neurotransmitter levels. Unresolvable anger causes prolonged sympathetic nervous system over-activity. Anxiety and guilt of consequences of expressing anger results in suppression of anger. In vulnerable individuals, neural mediation of repetitive high BP episodes causes structural adjustments in arterioles culminating in sustained hypertension. Anger could be contributing to the elevation of BP directly through psychophysiological activation via the HPA axis and indirectly by facilitating the emergence of a coping style that contributes to the maintenance of elevated BP (Figure 2).
According to Addotta [43] anger comes from the reptilian part of our body, known as the amygdala, an almond-shaped structure located just above the hypothalamus, one on each side. They consist of several nerves connected to various parts of the brain, such as the neocortex and the visual cortex. Amygdala is an excellent indicator of threats. Its primary purpose is emotional and social processing. One can react to a threat before the prefrontal cortex, responsible for the brain\'s thoughts and judgments, can assess the rationality of the reaction. The amygdala is responsible for the brain to react to a threat or fear before the prefrontal cortex can consider the consequences. Resilient people can make rapid recoveries from stress, with their prefrontal cortex working to calm the amygdala. However, the brain cannot release itself out of an emotional rut; and, the body is flooded with the cascade of cortisol or stress hormones ("Effects of Anger,", para. 18).
Before one feels anger, a primary emotion is felt. It can be a feeling of fear, offense, disrespect, force, entrapment, or pressure. When the primary emotions become too intense, the secondary emotion of anger is experienced.
In some cases, minor irritation can trigger full-blown anger within a shorter period. According to Dr. Sietse d Boer of the University of Groningen, "serotonin deficiency appears to be related to pathological, violent forms of aggressiveness, but not to the normal aggressive behaviour that animals and humans use to adapt to everyday survival" (as cited in Society for Neuroscience, 2007, para. 19).
Anger can assemble psychological resources for corrective action. Uncontrolled anger can negatively affect personal and social wellbeing. Many philosophers and writers have cautioned against the spontaneous, wild fits of rage, but they disagree on anger\'s intrinsic value. Coping with anger has been addressed in the writings of the earliest philosophers up to modern times. Most notable being Bhagvad Geeta in its Chapter 2, Verse 63, says:
क्रोधाद्भवति सम्मोह: सम्मोहात्स्मृतिविभ्रम: |स्मृतिभ्रंशाद् बुद्धिनाशो बुद्धिनाशात्प्रणश्यति || Meaning: Anger distorts thought & perception leading to errors in reasoning which results in damage & destruction [44].
Modern psychologists and psychiatrists have also pointed out the harmful effects of suppressing anger.
Anger is a predominant feeling expressed behaviorally, cognitively, and physiologically when a person consciously chooses to stop the threatening behaviour of another outside force immediately [45].
Anger is a universal emotion. It has long been recognized as a significant constituent of human life since long. Individuals face many problems in their daily lives and solve them [46]. While solving these problems, they exhibit different emotional and behavioral reactions, and anger is one of them. Anger is one of the basic emotions felt by almost everyone at times. Simultaneously, it can be suggested that it is one of the most interesting and least understood feelings [47].
Kassinove and Tafrate [48] asserted that anger is often a learned emotion. They believe that anger is partly an inborn quality but mostly modeled from family and the surrounding environment. However, people learn from the social environment about what and when they will get angry and the kind of behaviors they will exhibit [49, 50, 51, 52].
Anger is a multidimensional construct that consists of physiological (general sympathetic arousal, hormone/neurotransmitter function), cognitive (irrational beliefs, automatic thoughts, inflammatory imagery), phenomenological (subjective awareness and labeling of angry feelings), and behavioral (facial expressions, verbal/behavioral anger expression strategies) variables [53, 54, 55]
Spielberger et al. [56] stated that the expression of anger must be distinguished conceptually and empirically from the experience of anger as an emotional state (S-anger) and individual differences in anger as a personality trait (T-anger).
Anger-In (AX-In): mean anger held in or suppression of angry feelings.
Anger-Out (AX-O): this is defined as the frequency at which angry feelings are expressed in verbally or physically aggressive behavior.
Anger Control (AX-Con): this refers to attempts to control and suppress or mitigate anger expression.
Homeopathy is an over 226-year-old system of complementary and alternative medicine (CAM) developed by the German physician Samuel Hahnemann, MD. This mode of healing is based on distinct principles, comprehensive case history-based clinical findings], noteworthy patient contentment, and an expanding contemporary research database. It deals with the patient holistically and looks at the patient\'s ailment as a multicausative phenomenon. Dynamic forces that derail need dynamic intervention, and homeopathy provides a solution. It focuses on the patient with hypertension rather than on hypertension itself.
Potentially therapeutic substances must be tested carefully in healthy subjects in order to document their ‘pure’, direct effects on physical as well as mental sphere; this is the basis of the medical matter.
The remedy capable of causing a similar state in a healthy subject causes a counter-reaction in a patient that is stronger than the pathological stimulus of the disease itself.
The disease must be studied as a whole (and not only in terms of its main symptom or pathology but also the state of mind it causes in an individual) in order to ensure that it and the drug interact in a global manner; the choice of the remedy must be based on the complex of individual symptoms rather than on the name of the disease and the organ or system affected.
The dose must be the minimal effective dose and therefore adjusted on the basis of individual sensitivity.
The original method of preparing homeopathic medicines comprises trituration in lactose and/or serial dilution in ethanol–water solutions and succession (vigorous replicated cycles of pounding by hand or standardized mechanical arm pounding on a hard surface) in glass vials containing ethanol–water solutions [37]. This generates "top–down" nanoparticles of the source material. Nanoparticles range in size from 1 nanometer (nm) on a side up to 1000 nm or more. Thus, insoluble substances were converted into effective remedial agents for the first time in the history of western medicine. He also observed that as these potentization methods ascend the scale, the capacity of the drug to produce mental symptoms increased. By potentization, the drug energy is released in a form best suited to restoring the lost harmony through the use of a similar force. The physico-chemical effects of the remedy cease, and it acts at the dynamic level where it follows the rules applicable to the field of dynamics.
Nanoparticle model for homeopathic remedy action: hormesis, allostatic cross-adaptation, and time-dependent sensitization of the nonlinear stress response mediator network. Global and local healing occur across the person as a self-organized complex adaptive system in response to the individualized remedy serving as personalized hermetic stressor, i.e., holistic nanomedicine: an exogenous nanoparticle stimulating self-amplified, bidirectional adaptive change (see text).
The action of homoeopathic remedy on a living organism (Figure 3) [57]
Fundamental research in basic science indicates that authentically-prepared homeopathic medicines:
contain calculable source nanoparticles (NPs) and/or silica nanoparticles with adsorbed original materials [57, 58, 59, 60], which are compositely dispersed in colloidal solution;
act by regulating the biological function of the allostatic stress response network [61, 62], including cytokines, oxidative stress, and heat shock proteins [63, 64], as well as immune, endocrine, metabolic, autonomic, and central nervous system functions [65, 66];
evoke biphasic actions on the adaptive plasticity of living systems [67, 68, 69, 70, 71] via organism-dependent, endogenously amplified, rather than agent-dependent pharmacological effects [72]. The effects of homeopathic remedy nanoparticles involve state- and time-dependent adaptive changes [63, 64, 73, 74, 75, 76] within the complex adaptive organism [75, 76, 77, 78]. The main clinical outcome is
improvement in intrinsic resilience to future environmental stressors and recovery back to normal healthy homeostatic operating [80]. The disease resolves as an indirect result of changing the system dynamics that had supported its initial development [77, 78], rather than as a downright consequence of suppressing end-organ symptoms.
The action of homoeopathic medicines can be explained with the help of the biopsychosocial model. The biopsychosocial model reflects the development of illness through the complex interaction of biological factors (genetic, infections, trauma, nutrition, etc.), psychological factors (mood, personality, emotional turmoil, negative thinking, etc.), and social factors (cultural, socioeconomic, technological, etc.) [81]. According to the biopsychosocial model, individuals as per their present state and personal history, respond differently to one and the same substance. Homeopathy is the pioneer of personalized medicine where the patient\'s complete data of health issues is considered for a precisely aimed therapy. The homoeopath considers the case a disease phenomenon that is a modification in the whole individual from his original state of health. It is the totality of alterations that comprises all the patient\'s mental, physical, and psychological changes.
The prescription of a homoeopath is based on the totality of the symptoms, which includes patient\'s life span, counting past illnesses, family history, constitution and temperament, and peculiar symptoms of the present illnesses. A patient\'s portrait is created on this base, and this disease partite is correlated with a remedy picture. When these two portraits match, a homeopathic response is established, and the body shall make efforts to cure the illness. It is called the similia principle. The fundamental law of homoeopathy is based on nature\'s law of "Like cures like," also known as the "Law of similars." According to this law, the prescribed homeopathic medicine faces very little resistance as the patient exhibits an enhanced susceptibility to it (Figure 4).
Application of the law of similia in homeopathy.
Modern anti-hypertensive drugs are not always well-tolerated due to their many harmful side effects [82]. They have the inconvenience of drug treatment despite its unchallenged efficacy [83, 84]; side effects [85] and difficulties with drug compliance occur in up to 70% of the patients [86]. They have no impact on depression, general psychopathology, and quality of life scores compared to those who use only a dietary program [87]. Such drugs do not have any effect on reducing the anger of hypertensive patients. Homeopathic medicines do not have unwanted side effects [88].
This research studies the relationship between essential hypertension (EHT), higher levels of negative emotion such as high trait anger and perceived stress, and their homeopathic treatment. This anger research has mainly explored the experience and expression of anger. The purpose of this study is to ascertain the efficacy of a homeopathic similimum in treating anger and thereby controlling EHT. Homeopathic treatment is much more cost-effective, has no adverse effects, and improves the quality of life, making it more readily accepted.
This trial was randomized, placebo-controlled, comparative, and open-label conducted at an urban and a rural charitable homoeopathic hospital and a plastic factory. About 1187 adults were screened for hypertension. They were asked about the history of hypertension as well. We found 303 patients with either history of hypertension or were detected with hypertension during screening on BP measurements. The screening was carried out at a rural and an urban charitable hospital and a plastic factory. Secondary hypertension was ruled out among these 303 hypertensive patients by checking routine blood biochemistry, Ultrasonography (USG), electrocardiogram (ECG), and x-ray chest. However, eight patients were found to have secondary causes like renal artery stenosis, Conn\'s syndrome, coarctation of the aorta; these patients were excluded from moving into the study. One-hundred and seventy-two patients (108 males and 64 females) between 18 and 65 years who gave their informed, voluntary consent were enrolled in the study as per the approval from the ethics committee of Dr. M.L. Dhawale Memorial Homoeopathic Institute\'s approval. By simple randomization, they were allocated their respective groups, i.e., placebo and intervention groups. More than 50% of patients in both groups were on Antihypertensives prescribed by the physician at the beginning of the study.
All the patients were given necessary lifestyle management advice, also suggested a dietary approach to stop hypertension (DASH diet) [89] and regular exercises. Thorough homeopathic case-taking was done, and the STAXI-2 scale was applied at the beginning and after a 6-months study period to measure the change in anger for all the patients. Every 2 weeks, these patients were followed up for subjective criteria like anger, anger episodes, fights, and moods. Also, objective criteria were assessed like BP, pulse rate, physical complaints. Regular follow-up was done every 2 weeks to check all the patients\' subjective and objective parameters.
Data were entered in MS Excel and then transferred to SPSS SW V. 21 for analysis. The quantitative data were represented as mean ± SD & compared using Student\'s
Spielberger’s State-Trait Anger Expression Inventory-2 (STAXI-2) is a measure of anger experience and expression used to assess aggression and violence, given the close association between anger dysregulation and aggressive and violent behavior. The STAXI-2 is one of the most widely used measures in clinical and research settings (Table 1) [56].
STAXI-2 scale/subscale | Description of scale/subscale | |
---|---|---|
Measures the intensity of angry feelings and the extent to which a person feels like expressing anger at a particular time | ||
A | Feeling angry ( | Measures the intensity of the angry feelings the person is currently experiencing |
B | Feel like expressing anger verbally ( | Measures the intensity of current feelings related to the verbal expression of anger |
C | Feel like expressing anger physically ( | Measures the intensity of current feelings related to the physical expression of anger |
Measures how often angry feelings are experienced over time | ||
A | Angry temperament ( | Measures the disposition to experience anger without specific provocation |
B | Angry reaction ( | Measures the frequency that angry feelings are experienced in situations that involve frustration and/or negative evaluations |
Measures how often angry feelings are expressed in verbally or physically aggressive behaviour | ||
Measures how often angry feelings are experienced but not expressed (suppressed) | ||
Measures how often a person controls the outward expression of angry feelings | ||
Measures how often a person attempts to control angry feelings by calming down or cooling off | ||
Provides a general index of anger expression based on responses to the |
Brief overview of the STAXI-2 scales and subscales.
It calculates the experience and expression of anger and is a 57-item self-report questionnaire. It consists of six scales and an anger expression index. It is a widely used scale for assessment, with the following dimensions:
State anger (S-Ang): the intensity of angry feelings at the time of completion;
Trait anger (T-Ang): a disposition to experience anger;
Anger Expression-Out (Ax-O): the expression of angry feelings out;
Anger Expression-In (AX-I): the suppression of angry feelings;
Anger Control-Out (AC-O): the prevention of anger expression toward other people or objects;
Anger Control-In (AC-I): the control of suppressed anger and
Anger Expression Index (AX-index): an overall index of the frequency of anger expression, regardless of direction.
The maximum number of patients was 36–50 years. Seventy-eight out of 171 (46%) patients belonged to this age group in this study.
It has been noticed that hypertensive men reported more anger than hypertensive women. It is a randomized trial, and a separate analysis of anger between men and women has not been attempted. However, these findings were observed.
Sixty-four participants (28 females and 36 males) out of 171 had a positive family history of hypertension. Furthermore, it was observed that people with a family history of hypertension were more likely to suppress their anger.
This table shows the analysis of different variables done at the end of the study period—6 months. As seen in this table depicting the intervention arm—except state anger & its subgroups, all other anger variables & systolic and diastolic BP have a statistically significant reduction with the p-value <0.001 with a 95% confidence interval (Table 2).
Group | Mean | Std. deviation | Std. error mean | Mean difference | 95% confidence interval of the difference | |||
---|---|---|---|---|---|---|---|---|
Lower | Upper | |||||||
S_ang_diff | T | 4.72 | 9.505 | 1.025 | 2.062 | −0.414 | 4.539 | 0.102 |
C | 2.66 | 6.629 | 0.719 | |||||
S_ang_F_diff | T | 3.77 | 12.669 | 1.366 | 2.756 | −0.835 | 6.346 | 0.132 |
C | 1.01 | 11.048 | 1.198 | |||||
S_Ang_V_diff | T | 3.81 | 9.444 | 1.018 | 1.202 | −1.419 | 3.824 | 0.367 |
C | 2.61 | 7.838 | 0.850 | |||||
S_ang_P_diff | T | 4.00 | 10.993 | 1.185 | 2.188 | −0.551 | 4.927 | 0.117 |
C | 1.81 | 6.580 | 0.714 | |||||
T_Ang_diff | T | 13.63 | 8.609 | 0.928 | 8.993 | 6.473 | 11.512 | |
C | 4.64 | 8.066 | 0.875 | |||||
T_Ang_T_diff | T | 11.16 | 9.483 | 1.023 | 7.563 | 4.937 | 10.189 | |
C | 3.60 | 7.824 | 0.849 | |||||
diff_T_Ang_R | T | 16.00 | 9.239 | 0.996 | 9.106 | 6.362 | 11.85 | |
C | 6.89 | 8.931 | 0.969 | |||||
Diff_AX_O | T | 11.84 | 11.699 | 1.262 | 7.72 | 4.492 | 10.947 | |
C | 4.12 | 9.559 | 1.037 | |||||
Diff_AX_I | T | 11.72 | 10.125 | 1.092 | 8.262 | 5.598 | 10.926 | |
C | 3.46 | 7.273 | 0.789 | |||||
Diff_AC_O | T | 9.05 | 12.362 | 1.333 | −7.988 | −11.125 | −4.851 | |
C | 1.06 | 7.908 | 0.858 | |||||
Diff_AC_I | T | 13.91 | 12.043 | 1.299 | 10.754 | 7.664 | 13.845 | |
C | 3.15 | 8.002 | 0.868 | |||||
Diff_AX_Index | T | 13.91 | 12.043 | 1.299 | 10.754 | 7.664 | 13.845 | |
C | 3.15 | 8.002 | 0.868 | |||||
Diff_SBP | T | 31.20 | 14.839 | 1.609 | 20.474 | 16.299 | 24.648 | |
C | 10.73 | 12.538 | 1.368 | |||||
Diff_DBP | T | 18.12 | 16.151 | 1.742 | 12.81 | 8.352 | 17.269 | |
C | 5.31 | 13.220 | 1.434 |
Change in variables in both groups w.r.t. anger after 6-months study period (Test used: unpaired
This slide shows the values in both arms at the end of the study period. The values in the intervention arm show a much greater reduction in the values of all the variables compared to the control arm.
In both arms, the patients who were on standard antihypertensive treatment (AHT), in the control arm, 98% of patients continued with the same dose of their medicines at the end of the study period. However, standard AHT was stopped completely in the intervention group in 33% of patients. And in 28% of patients, the dose of AHT was reduced.
At the end of the study period, in both the arms, the patients who were not on standard AHT, in the control arm, 16% patients had to be prescribed standard AHT. Whereas in the intervention arm, the BP of all patients was maintained on the indicated homoeopathic medicine.
No statistical difference was found in rural and urban participants in both control and intervention arms with respect to anger and blood pressure variables (Tables 3 and 4).
Group statistics—Control group | |||||||||
---|---|---|---|---|---|---|---|---|---|
Residence | Mean | Std. deviation | Std. error mean | Sig. (2-tailed) | 95% confidence interval of the difference | ||||
Lower | Upper | ||||||||
S_ang_diff | U | 44 | 2.00 | 5.104 | 0.769 | −0.949 | 0.346 | −4.229 | 1.498 |
R | 41 | 3.37 | 7.955 | 1.242 | |||||
S_ang_F_diff | U | 44 | 0.55 | 10.498 | 1.583 | −0.401 | 0.689 | −5.761 | 3.827 |
R | 41 | 1.51 | 11.720 | 1.830 | |||||
S_Ang_V_diff | U | 44 | 1.68 | 5.960 | 0.899 | −1.135 | 0.260 | −5.306 | 1.450 |
R | 41 | 3.61 | 9.426 | 1.472 | |||||
S_ang_P_diff | U | 44 | 0.64 | 3.629 | 0.547 | −1.726 | 0.088 | −5.245 | 0.371 |
R | 41 | 3.07 | 8.580 | 1.340 | |||||
T_Ang_diff | U | 44 | 4.00 | 8.286 | 1.249 | −0.750 | 0.455 | −4.809 | 2.175 |
R | 41 | 5.32 | 7.869 | 1.229 | |||||
T_Ang_T_diff | U | 44 | 3.14 | 7.899 | 1.191 | −0.564 | 0.575 | −4.353 | 2.431 |
R | 41 | 4.10 | 7.810 | 1.220 | |||||
diff_T_Ang_R | U | 44 | 5.95 | 8.291 | 1.250 | −1.005 | 0.318 | −5.803 | 1.908 |
R | 41 | 7.90 | 9.570 | 1.495 | |||||
Diff_AX_O | U | 44 | 3.09 | 8.610 | 1.298 | −1.026 | 0.308 | −6.254 | 1.997 |
R | 41 | 5.22 | 10.477 | 1.636 | |||||
Diff_AX_I | U | 44 | 3.36 | 5.879 | 0.886 | −0.124 | 0.901 | −3.356 | 2.961 |
R | 41 | 3.56 | 8.597 | 1.343 | |||||
Diff_AC_O | U | 44 | −0.77 | 7.090 | 1.069 | 0.344 | 0.732 | −2.839 | 4.025 |
R | 41 | −1.37 | 8.780 | 1.371 | |||||
Diff_AC_I | U | 44 | 2.77 | 6.971 | 1.051 | −0.452 | 0.653 | −4.260 | 2.683 |
R | 41 | 3.56 | 9.050 | 1.413 | |||||
Diff_AX_Index | U | 44 | 2.77 | 6.971 | 1.051 | −0.452 | 0.653 | −4.260 | 2.683 |
R | 41 | 3.56 | 9.050 | 1.413 | |||||
Diff_sys_BP | U | 44 | 10.91 | 10.465 | 1.578 | 0.139 | 0.889 | −5.098 | 5.866 |
R | 40 | 10.53 | 14.620 | 2.312 | |||||
Diff_dia_BP | U | 44 | 6.16 | 8.271 | 1.247 | 0.614 | 0.541 | −3.960 | 7.498 |
R | 41 | 4.39 | 17.082 | 2.668 |
To check if there is a significant difference in anger variables in the control group based on residence (rural/urban) of participants.
Residence | Mean | Std. deviation | Std. error mean | Sig. (2-tailed) | Mean difference | 95% confidence interval of the difference | ||||
---|---|---|---|---|---|---|---|---|---|---|
Lower | Upper | |||||||||
S_ang_diff | U | 48 | 4.46 | 10.057 | 1.452 | −0.286 | 0.775 | −0.594 | −4.721 | 3.532 |
R | 38 | 5.05 | 8.880 | 1.441 | ||||||
S_ang_F_diff | U | 48 | 2.08 | 14.510 | 2.094 | −1.393 | 0.167 | −3.811 | −9.252 | 1.629 |
R | 38 | 5.89 | 9.642 | 1.564 | ||||||
S_Ang_V_diff | U | 48 | 3.67 | 10.134 | 1.463 | −0.162 | 0.872 | −0.333 | −4.435 | 3.768 |
R | 38 | 4.00 | 8.624 | 1.399 | ||||||
S_ang_P_diff | U | 48 | 4.21 | 12.129 | 1.751 | 0.196 | 0.845 | 0.471 | −4.302 | 5.245 |
R | 38 | 3.74 | 9.520 | 1.544 | ||||||
T_Ang_diff | U | 48 | 13.79 | 9.455 | 1.365 | 0.197 | 0.844 | 0.371 | −3.368 | 4.109 |
R | 38 | 13.42 | 7.525 | 1.221 | ||||||
T_Ang_T_diff | U | 48 | 11.92 | 10.388 | 1.499 | 0.827 | 0.411 | 1.706 | −2.396 | 5.809 |
R | 38 | 10.21 | 8.237 | 1.336 | ||||||
diff_T_Ang_R | U | 48 | 15.17 | 10.188 | 1.471 | −0.939 | 0.350 | −1.886 | −5.878 | 2.106 |
R | 38 | 17.05 | 7.888 | 1.280 | ||||||
Diff_AX_O | U | 48 | 11.46 | 11.417 | 1.648 | −0.336 | 0.738 | −0.857 | −5.936 | 4.221 |
R | 38 | 12.32 | 12.184 | 1.976 | ||||||
Diff_AX_I | U | 48 | 11.71 | 10.462 | 1.510 | −0.013 | 0.990 | −0.029 | −4.426 | 4.369 |
R | 38 | 11.74 | 9.822 | 1.593 | ||||||
Diff_AC_O | U | 48 | −7.75 | 13.096 | 1.890 | 1.094 | 0.277 | 2.934 | −2.398 | 8.266 |
R | 38 | −10.68 | 11.326 | 1.837 | ||||||
Diff_AC_I | U | 48 | 12.42 | 12.836 | 1.853 | −1.295 | 0.199 | −3.373 | −8.552 | 1.807 |
R | 38 | 15.79 | 10.833 | 1.757 | ||||||
Diff_AX_Index | U | 48 | 12.42 | 12.836 | 1.853 | −1.295 | 0.199 | −3.373 | −8.552 | 1.807 |
R | 38 | 15.79 | 10.833 | 1.757 | ||||||
Diff_sys_BP | U | 47 | 33.43 | 14.764 | 2.154 | 1.551 | 0.125 | 4.978 | −1.407 | 11.364 |
R | 38 | 28.45 | 14.656 | 2.377 | ||||||
Diff_dia_BP | U | 48 | 18.60 | 18.252 | 2.634 | 0.313 | 0.755 | 1.104 | −5.907 | 8.116 |
R | 38 | 17.50 | 13.244 | 2.148 |
To check if there is a significant difference in anger variables in the treatment group based on residence (rural/urban) of participants.
The family history of hypertension was analyzed in female participants of the study, as shown in the above table, and it has been correlated with various anger components (Table 5).
F/H of HT | Mean | Standard deviation | Standard error mean | Sig. (2-tailed) | Mean difference | 95% confidence interval of the difference | |||
---|---|---|---|---|---|---|---|---|---|
Lower | Upper | ||||||||
S_ang_diff | 0.00 | 4.91 | 9.053 | 1.530 | −0.193 | 0.848 | −0.493 | −5.604 | 4.617 |
1.00 | 5.41 | 11.064 | 2.129 | ||||||
S_ang_F_diff | 0.00 | 1.03 | 17.049 | 2.882 | −1.282 | 0.205 | −4.749 | −12.157 | 2.658 |
1.00 | 5.78 | 10.112 | 1.946 | ||||||
S_Ang_V_diff | 0.00 | 4.23 | 10.138 | 1.714 | 0.058 | 0.954 | 0.154 | −5.171 | 5.48 |
1.00 | 4.07 | 10.720 | 2.063 | ||||||
S_ang_P_diff | 0.00 | 2.91 | 8.936 | 1.510 | −0.927 | 0.358 | −2.715 | −8.576 | 3.146 |
1.00 | 5.63 | 14.055 | 2.705 | ||||||
T_Ang_diff | 0.00 | 7.14 | 7.945 | 1.343 | −10.982 | −1.251 | |||
1.00 | 13.26 | 11.206 | 2.157 | ||||||
T_Ang_T_diff | 0.00 | 5.89 | 7.955 | 1.345 | −10.869 | −1.359 | |||
1.00 | 12.00 | 10.770 | 2.073 | ||||||
diff_T_Ang_R | 0.00 | 9.60 | 7.997 | 1.352 | −1.938 | 0.057 | −4.993 | −10.146 | 0.16 |
1.00 | 14.59 | 12.239 | 2.355 | ||||||
Diff_AX_O | 0.00 | 5.31 | 10.220 | 1.728 | −1.711 | 0.092 | −4.315 | −9.36 | 0.729 |
1.00 | 9.63 | 9.332 | 1.796 | ||||||
Diff_AX_I | 0.00 | 4.57 | 7.770 | 1.313 | −10.067 | −0.346 | |||
1.00 | 9.78 | 11.345 | 2.183 | ||||||
Diff_AC_O | 0.00 | −1.83 | 9.790 | 1.655 | 2.725 | 13.173 | |||
1.00 | −9.78 | 10.703 | 2.060 | ||||||
Diff_AC_I | 0.00 | 4.69 | 11.029 | 1.864 | −13.916 | −2.935 | |||
1.00 | 13.11 | 10.293 | 1.981 | ||||||
Diff_AX_Index | 0.00 | 4.69 | 11.029 | 1.864 | −13.916 | −2.935 | |||
1.00 | 13.11 | 10.293 | 1.981 |
Comparison of positive and negative F/H of HT in control and treatment groups: (females).
00, negative family history; 1.00, positive family history.
The result suggests that women with a positive family history of hypertension scored higher on trait anger and angry temperament. Still, they tended to suppress their outward expression of anger than participants with negative F/H of HT. It correlates with higher blood pressure values. In expressing anger, cultural standards define what is appropriate and appear to determine such expressions\' physiological consequences.
In the group analysis of male participants in the study, as shown in the above table, the results suggest that even men with a positive family history of hypertension have higher trait anger and anger temperament. Still, they tend to suppress their outward expression of anger compared to participants with negative F/H of HT. Besides, they try to resolve their anger by calming down or cooling off (Table 6).
fam_hist | Mean | Standard deviation | Standard error mean | Sig. (2-tailed) | Mean difference | Std. error difference | 95% confidence interval of the difference | ||
---|---|---|---|---|---|---|---|---|---|
Lower | Upper | ||||||||
S_ang_diff | 0.00 | 2.03 | 5.990 | 0.737 | 0.110 | −2.262 | 1.405 | −5.048 | 0.523 |
1.00 | 4.29 | 8.527 | 1.332 | ||||||
S_ang_F_diff | 0.00 | 1.06 | 7.510 | 0.924 | 0.262 | −2.305 | 2.043 | −6.356 | 1.746 |
1.00 | 3.37 | 13.619 | 2.127 | ||||||
S_Ang/V_diff | 0.00 | 2.03 | 6.762 | 0.832 | 0.233 | −1.823 | 1.520 | −4.837 | 1.191 |
1.00 | 3.85 | 8.893 | 1.389 | ||||||
S_ang_P_diff | 0.00 | 1.67 | 6.587 | 0.811 | 0.287 | −1.602 | 1.495 | −4.567 | 1.364 |
1.00 | 3.27 | 8.829 | 1.379 | ||||||
T_Ang_diff | 0.00 | 7.03 | 9.628 | 1.185 | |||||
1.00 | 11.66 | 8.111 | 1.267 | ||||||
T_Ang_T_diff | 0.00 | 4.94 | 8.891 | 1.094 | |||||
1.00 | 9.61 | 9.542 | 1.490 | ||||||
diff_T_Ang/R | 0.00 | 9.88 | 10.864 | 1.337 | 0.081 | −3.536 | 2.006 | −7.513 | 0.441 |
1.00 | 13.41 | 8.675 | 1.355 | ||||||
Diff_AX_O | 0.00 | 6.82 | 13.070 | 1.609 | 0.093 | −4.060 | 2.395 | −8.809 | 0.689 |
1.00 | 10.88 | 10.159 | 1.587 | ||||||
Diff_AX_I | 0.00 | 6.85 | 10.366 | 1.276 | 0.130 | −2.956 | 1.935 | −6.793 | 0.880 |
1.00 | 9.80 | 8.600 | 1.343 | ||||||
Diff_AC_O | 0.00 | −3.27 | 10.885 | 1.340 | 0.055 | 4.337 | 2.234 | −0.093 | 8.767 |
1.00 | −7.61 | 11.783 | 1.840 | ||||||
Diff_AC_I | 0.00 | 6.55 | 11.707 | 1.441 | |||||
1.00 | 11.85 | 11.139 | 1.740 | ||||||
Diff_AX_Index | 0.00 | 6.55 | 11.707 | 1.441 | |||||
1.00 | 11.85 | 11.139 | 1.740 |
Comparison of positive and negative F/H of HT in control and treatment groups: (males).
Table of associated illnesses these participants suffered from (Table 7):
Number | Associated illness | No. of patients | Total % |
---|---|---|---|
1 | Alcoholism | 4 | 2.34 |
2 | Allergic dermatitis | 6 | 3.51 |
3 | Allergic rhinitis | 4 | 2.34 |
4 | Acid-peptic disorder | 34 | 19.88 |
5 | Benign paroxysmal postural vertigo | 1 | 0.6 |
6 | Cholelithiasis | 2 | 1.17 |
7 | Chronic obstructive pulmonary disease | 6 | 3.51 |
8 | Chronic suppurative otitis media | 1 | 0.6 |
9 | Climacteric complaints | 6 | 3.51 |
10 | Dysthymia | 4 | 2.34 |
11 | Diabetes mellitus | 36 | 21.05 |
12 | Dyslipidaemia | 6 | 3.51 |
13 | Epilepsy | 2 | 1.17 |
14 | Fibromyalgia | 12 | 7.02 |
15 | Frozen shoulder | 4 | 2.34 |
16 | Generalised anxiety disorder | 8 | 4.68 |
17 | Hypothyroidism | 12 | 7.02 |
18 | Hyperthyroidism | 1 | 0.6 |
19 | Hyperuricaemia | 8 | 4.68 |
20 | Irritable bowel syndrome | 2 | 1.17 |
21 | Malnutrition | 4 | 2.34 |
22 | Menstrual irregularities | 12 | 7.02 |
23 | Migraine | 2 | 1.17 |
24 | Obesity | 4 | 2.34 |
25 | Osteo-arthritis knees | 8 | 4.68 |
26 | Psoriasis | 2 | 1.17 |
27 | Rheumatoid arthritis | 4 | 2.34 |
28 | Urolithiasis | 6 | 3.51 |
29 | Urinary tract infection—recurrent | 2 | 1.17 |
30 | Vitiligo | 2 | 1.17 |
Associated illnesses seen in patients along with essential hypertension.
It shows the list of associated ailments these patients had along with EHT.
At the end of the study period:
About 89% of patients had relief in the symptoms of their comorbidities in the treatment group with the curative effect of the similimum, but 73% of patients\' symptoms of associated illnesses were status quo in the control arm.
A Pearson\'s correlation test was done to determine whether there is a linear correlation between anger variables and systolic and diastolic BP. Unfortunately, in this study (like many others in the past), we could not find a significant correlation (Table 8).
Post-test correlations between variables in TREATMENT group.
Correlation of variables in each group.
The predictive importance of stress resulting in anger was seen only in the subgroup of participants with high genetic susceptibility to hypertension, defined as having one or more hypertensive parents. It is also important to emphasize that although a family history of hypertension was an important predictor of alterations in BP status on its own, high trait anger greatly potentiated this increased risk of developing elevated BP.
High-stress responsivity itself may have a possible genetic basis. In addition, there is a possible lack of generalizability to older persons because the sample was restricted to 18–65 years. It indicates that any adverse effects of increased life stress or decreased stress buffers would be most evident among those who are both high-stress responders and have a genetic susceptibility to hypertension and heart disease.
This study was conducted at charitable hospitals and in a plastics factory, where patients belonged to the low-income group. Hence, only 18% of patients had middle or high SES. Although employment itself does not seem to be a risk factor, there is some evidence that the combination of jobs and a family may increase hypertension and CHD incidence in women. In two studies, the Framingham study [90, 91] and the Minnesota Heart Survey, [92] working women reported greater levels of stress than working men or homemakers. A similar observation was found in the female participants in the present study. Many study participants were rotational factory shift workers, including working days, afternoon, and night shifts. Blood pressure elevation effects appear to be mainly mediated by maladaptive or unhealthy coping behaviors such as excessive consumption (food, cigarettes or bidis, gutka, and alcohol) and physical inactivity. These inconclusive results may have resulted partly from lifestyle differences in the study populations and have been strongly influenced by different perceptions of overwork and stress. It was found that psychological stress was associated with age, sex, and socioeconomic status. In addition, higher stress levels at work were found but lower levels of financial stress among persons with high versus low levels of income or education in both men and women. It was observed that blood pressure was explicitly related to job control (lower control linked to higher pressure) and perceived stress on the job. Participants with higher socioeconomic status and women were more stressed by low job control than men and people with lower socioeconomic status (SES). Women and young adults reported higher psychological stress levels, particularly at work, which raised age-and sex-related job strain issues with high demand and low control at work [34, 35].
A correlation between anger and hypertension (Table 8) was examined. The finding that none of the anger measures was associated with resting BP in this study is consistent with literature reviews on anger and hypertension [93, 94, 95]. In addition, previous reviews have found only low and inconsistent associations between trait anger and HT [96, 97, 98].
All homeopathic medicines alter the state of mind and disposition in their peculiar way [99]. Therefore, the changes in the patient\'s state of mind and disposition must be considered and matched with the particular homeopathic remedy that can produce a similar state in a healthy human being. As a result, permanent relief from the disease can occur. Furthermore, this ability to make distinctions among patients and superficially similar disease processes – that is, to "individualize" every case – is the natural result of the concern for the whole person, which lies at the core of homeopathic practice."
The study results also showed a reduction in anger in the control group, which was statistically significant but not as much as the reduction of anger variables in the treatment group, suggesting rapport building, up-front collaborative agenda-setting, and acknowledging social and emotional concerns as done during homeopathic case taking may help improve quality of care and efficiency. The consultation process\'s therapeutic benefits on health outcomes in conventional medicine and CAM have been depicted in various studies [78, 79]. These contextual effects include not the treatment\'s active components but are inherent within the whole treatment package such as the doctor–patient relationship, rapport-building and relationship maintenance, empathic response to social and emotional cues and mindfulness [100, 101, 102, 103, 104, 105]). Research into homeopathic consultation has identified contextual factors such as empathy and empowerment [106], which may mediate the homeopathic therapeutic effect. Homeopathy consultations involve a complete exploration of the patient\'s emotional, spiritual, and physical wellbeing to enable the whole person\'s treatment, not just the illness.
Our consultation process was standardized in that specific topics were covered (e.g., detailed clinical history, current symptoms and medication, assessment of emotional and mental states, etc.) to identify the relevant information to prescribe. The consultations\' content varied between patients and between consultations; homeopathic intervention was individualized and patient-centered and led by the patient\'s narratives.
The findings confirm previous work demonstrating that therapeutic benefits arise from inquiries within the homeopathic interview which includes communication skills, empathy, hopefulness, enablement, and narrative competence [82, 83, 84]. Homeopathic consultation necessitates a detailed understanding of the patient and is a unique and personalized approach. Therefore, the placebo effects of the homeopathic consultation may be specific to this therapy, possibly dependent on the process of the collaborative and highly individualized consultation imperative to find a homeopathic remedy and the associated symbolic meaning response for that patient [102].
During regular follow-ups every 2 weeks, there was no adverse reaction reported to homeopathic medicine in any study participants in the intervention group, proving the safety of the individualized medicine prescribed to the patients.
The results suggest the usefulness of the individualized homoeopathic treatment in the management of anger and the EHT in the population.
During regular follow-ups every 2 weeks, no adverse reaction to the homoeopathic medicine was found in any intervention group study participants, proving the safety of the individualized medicine prescribed to the patients.
STAXI-2 instrument was successfully used to measure the various anger variables in the study participants.
It was found that all the variables in both the groups were statistically not significantly different except the trait anger (T-Ang), angry temperament (T-Ang/T), and angry reaction (T-Ang/R), which were higher in the treatment group in comparison with the control group.
Convincing evidence did not emerge for the existence of strong linear relationships between anger and blood pressure.
A significant correlation between high blood pressure and suppressed anger was found in male and female participants with a positive family history of HTN.
The study results also showed a reduction of anger in the control group, which was statistically significant but not as much as the reduction of the anger variables in the treatment group, suggesting rapport building, up-front collaborative agenda-setting, and acknowledging social and emotional concerns as done during homoeopathic case taking might help improve quality of care and efficiency.
Study needs replication with a larger sample size over a longer duration.
Presence of "Social desirability bias" – cannot be denied in a self-reporting scale-like STAXI-2.
Ambulatory BP monitoring is not used, so there can be misdiagnosed cases of white-coat hypertension or cases of masked HT that could have been missed.
Lack of generalizability to population older than 65 years of age.
Anger variables were not analysed separately for man and women as this being a randomized controlled trial, the number of male and female participants was unequal.
A double-blind, randomized controlled trial without using conventional anti-hypertensives is highly recommended.
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Hunter",authors:[{id:"176855",title:"Dr.",name:"Wayne",middleName:null,surname:"Hunter",slug:"wayne-hunter",fullName:"Wayne Hunter"},{id:"177693",title:"Dr.",name:"Eduardo",middleName:null,surname:"Andrade",slug:"eduardo-andrade",fullName:"Eduardo Andrade"}]},{id:"43162",doi:"10.5772/52704",title:"Non-Viral Delivery Systems in Gene Therapy",slug:"non-viral-delivery-systems-in-gene-therapy",totalDownloads:4253,totalCrossrefCites:13,totalDimensionsCites:35,abstract:null,book:{id:"3509",slug:"gene-therapy-tools-and-potential-applications",title:"Gene Therapy",fullTitle:"Gene Therapy - Tools and Potential Applications"},signatures:"Alicia Rodríguez Gascón, Ana del Pozo-Rodríguez and María Ángeles Solinís",authors:[{id:"156696",title:"Dr.",name:"Alicia",middleName:null,surname:"Rodríguez Gascón",slug:"alicia-rodriguez-gascon",fullName:"Alicia Rodríguez Gascón"}]},{id:"30029",doi:"10.5772/34438",title:"The Legume Root Nodule: From Symbiotic Nitrogen Fixation to Senescence",slug:"the-legume-root-nodule-from-symbiotic-nitrogen-fixation-to-senescence",totalDownloads:4710,totalCrossrefCites:18,totalDimensionsCites:32,abstract:null,book:{id:"1446",slug:"senescence",title:"Senescence",fullTitle:"Senescence"},signatures:"Laurence Dupont, Geneviève Alloing, Olivier Pierre, Sarra El Msehli, Julie Hopkins, Didier Hérouart and Pierre Frendo",authors:[{id:"100143",title:"Dr.",name:"Pierre",middleName:null,surname:"Frendo",slug:"pierre-frendo",fullName:"Pierre Frendo"},{id:"100842",title:"Dr.",name:"Laurence",middleName:null,surname:"Dupont",slug:"laurence-dupont",fullName:"Laurence Dupont"},{id:"100848",title:"Dr.",name:"Geneviève",middleName:null,surname:"Alloing",slug:"genevieve-alloing",fullName:"Geneviève Alloing"},{id:"100852",title:"MSc.",name:"Sarra",middleName:null,surname:"El Msehli",slug:"sarra-el-msehli",fullName:"Sarra El Msehli"},{id:"100854",title:"MSc.",name:"Olivier",middleName:null,surname:"Pierre",slug:"olivier-pierre",fullName:"Olivier Pierre"},{id:"100859",title:"BSc.",name:"Julie",middleName:null,surname:"Hopkins",slug:"julie-hopkins",fullName:"Julie Hopkins"},{id:"100860",title:"Prof.",name:"Didier",middleName:null,surname:"Hérouart",slug:"didier-herouart",fullName:"Didier Hérouart"}]},{id:"49590",doi:"10.5772/61807",title:"Management of Insect Pest by RNAi — A New Tool for Crop Protection",slug:"management-of-insect-pest-by-rnai-a-new-tool-for-crop-protection",totalDownloads:3769,totalCrossrefCites:17,totalDimensionsCites:29,abstract:"The fast-growing human population requires the development of new agricultural technologies to meet consumers´ demand, while minimizing environmental impacts. Insect pests are one of the main causes for losses in agriculture production, and current control technologies based on pesticide application or the use of transgenic crops expressing Bacillus thuringiensis toxin proteins are facing efficacy challenges. Novel approaches to control pests are urgently necessary. RNA interference (RNAi) is a gene silencing mechanism triggered by providing double-stranded RNA (dsRNA), that when ingested into insects can lead to death or affect the viability of the target pest. Transgenic plants expressing dsRNA version of insect specific target genes are the new generation of resistant plants. However, the RNAi mechanism is not conserved among insect orders, and its elucidation is the key to develop commercial RNAi crops. In this chapter, we review the core RNAi pathway in insects and the dsRNA uptake, amplification, and spread of systemic silencing signals in some key insect species. We also highlight some of the experimental steps before developing an insect-pest-resistant “RNAi plant”. Lastly, we review some of the most recent development studies to control agricultural insect pests by RNAi transgenic plants.",book:{id:"5090",slug:"rna-interference",title:"RNA Interference",fullTitle:"RNA Interference"},signatures:"Thais Barros Rodrigues and Antonio Figueira",authors:[{id:"176770",title:"Dr.",name:"Thais B.",middleName:null,surname:"Rodrigues",slug:"thais-b.-rodrigues",fullName:"Thais B. Rodrigues"},{id:"176820",title:"Dr.",name:"Antonio",middleName:null,surname:"Figueira",slug:"antonio-figueira",fullName:"Antonio Figueira"}]}],mostDownloadedChaptersLast30Days:[{id:"50471",title:"Molecular Mechanisms of Skin Aging and Rejuvenation",slug:"molecular-mechanisms-of-skin-aging-and-rejuvenation",totalDownloads:5174,totalCrossrefCites:6,totalDimensionsCites:13,abstract:"The aging process in the skin is complex and influenced by more intrinsic and extrinsic factors than any other body organ. The effects of these two types of factors overlap for the most part. The combined effects of these two aging processes also affect dermal matrix alterations. The main clinical signs of skin aging include wrinkling and irregular pigmentation, which are influenced by a combination of intrinsic and extrinsic (e.g., UV radiation, heat, smoking, and pollutants) factors. Histologically, collagen decreases, and the dermis is replaced by abnormal elastic fibers as a cause of wrinkle formation through the loss of skin elasticity. There have been numerous studies of skin aging performed to elucidate the underlying molecular mechanisms and to develop various antiaging therapeutics and preventive strategies. We summarized the molecular mechanisms and treatments of skin aging. Mainly UV radiation induces ROS formation and DNA damage, leading to increased production of MMPs and decreased production of collagen in keratinocytes and fibroblasts, which reflect the central aspects of skin aging. Besides UV radiation exposure, extrinsic factors including tobacco smoking, exposure to environmental pollutants, infrared radiation, and heat contribute to premature skin aging. Like UV radiation, these factors cause ROS formation and increase expression of MMPs, thus accelerating skin aging by inducing extracellular matrix (ECM) degradation. Accumulated collagen fibrils inhibit the new collagen synthesis and account for the further degradation of the ECM through this positive feedback loop. Accumulating evidence for molecular mechanisms of skin aging should provide clinicians with an expanding spectrum of therapeutic targets in the treatment of skin aging.",book:{id:"5258",slug:"molecular-mechanisms-of-the-aging-process-and-rejuvenation",title:"Molecular Mechanisms of the Aging Process and Rejuvenation",fullTitle:"Molecular Mechanisms of the Aging Process and Rejuvenation"},signatures:"Miri Kim and Hyun Jeong Park",authors:[{id:"47695",title:"Prof.",name:"Hyun Jeong",middleName:null,surname:"Park",slug:"hyun-jeong-park",fullName:"Hyun Jeong Park"},{id:"185767",title:"Prof.",name:"Miri",middleName:null,surname:"Kim",slug:"miri-kim",fullName:"Miri Kim"}]},{id:"49637",title:"RNA Interference Technology — Applications and Limitations",slug:"rna-interference-technology-applications-and-limitations",totalDownloads:4097,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"RNA interference (RNAi), an evolutionarily conserved mechanism triggered by double-stranded RNA (dsRNA), causes gene silencing in a sequence-specific manner. RNAi evolved naturally to mediate protection from both endogenous and exogenous pathogenic nucleic acids and to modulate gene expression. Multiple technological advancements and precision in gene targeting have allowed a plethora of potential applications, ranging from targeting infections in crop plants to improving health in human patients, which have been reviewed in this chapter.",book:{id:"5090",slug:"rna-interference",title:"RNA Interference",fullTitle:"RNA Interference"},signatures:"Devi Singh, Sarika Chaudhary, Rajendra Kumar, Preeti Sirohi,\nKamiya Mehla, Anil Sirohi, Shashi Kumar, Pooran Chand and Pankaj\nKumar Singh",authors:[{id:"176625",title:"Prof.",name:"Devi",middleName:null,surname:"Singh",slug:"devi-singh",fullName:"Devi Singh"},{id:"176744",title:"Ms.",name:"Preeti",middleName:null,surname:"Sirohi",slug:"preeti-sirohi",fullName:"Preeti Sirohi"},{id:"176745",title:"Dr.",name:"Rajendra",middleName:null,surname:"Kumar",slug:"rajendra-kumar",fullName:"Rajendra Kumar"},{id:"176746",title:"Mrs.",name:"Sarika",middleName:null,surname:"Chaudhary",slug:"sarika-chaudhary",fullName:"Sarika Chaudhary"},{id:"176747",title:"Dr.",name:"Kamiya",middleName:null,surname:"Mehla",slug:"kamiya-mehla",fullName:"Kamiya Mehla"},{id:"176748",title:"Dr.",name:"Pankaj Kumar",middleName:null,surname:"Singh",slug:"pankaj-kumar-singh",fullName:"Pankaj Kumar Singh"},{id:"176749",title:"Dr.",name:"Shashi",middleName:null,surname:"Kumar",slug:"shashi-kumar",fullName:"Shashi Kumar"},{id:"176809",title:"Dr.",name:"Pooran",middleName:null,surname:"Chand",slug:"pooran-chand",fullName:"Pooran Chand"}]},{id:"43280",title:"Gene Therapy for Diabetic Retinopathy – Targeting the Renin-Angiotensin System",slug:"gene-therapy-for-diabetic-retinopathy-targeting-the-renin-angiotensin-system",totalDownloads:2458,totalCrossrefCites:2,totalDimensionsCites:2,abstract:null,book:{id:"3509",slug:"gene-therapy-tools-and-potential-applications",title:"Gene Therapy",fullTitle:"Gene Therapy - Tools and Potential Applications"},signatures:"Qiuhong Li, Amrisha Verma, Ping Zhu, Bo Lei, Yiguo Qiu, Takahiko Nakagawa, Mohan K Raizada and William W Hauswirth",authors:[{id:"155578",title:"Dr.",name:"Qiuhong",middleName:null,surname:"Li",slug:"qiuhong-li",fullName:"Qiuhong Li"}]},{id:"49416",title:"Microinjection-Based RNA Interference Method in the Water Flea, Daphnia pulex and Daphnia magna",slug:"microinjection-based-rna-interference-method-in-the-water-flea-daphnia-pulex-and-daphnia-magna",totalDownloads:2186,totalCrossrefCites:5,totalDimensionsCites:7,abstract:"It is well known that most daphnid species have several attractive life history characteristics such as cyclical parthenogenesis, environmental sex determination, and predator-induced defense formation. Recent advances in high-throughput omics technologies make it easy to obtain a huge number of potential candidate factors involved in environmental stimuli-triggered phenotypic alterations. Furthermore, our group has developed a microinjection system to introduce foreign materials such as nucleotides and chemicals into the early-stage (one-cell stage) egg of Daphnia pulex and Daphnia magna. Consequently, we established a microinjection-based RNAi system that allows arbitrary gene functions to be investigated. However, this microinjection system does not seem to have pervaded in the daphnid research community due to its low throughput and high level of skills required. In this chapter, we review the microinjection method and its RNAi system in water fleas, D. pulex and D. magna, providing some technical tips and making challenging proposals for the development of novel high-throughput RNAi methods. Finally, we provide an overview of recently developed gene functional analysis methods such as overexpression and genome-editing systems.",book:{id:"5090",slug:"rna-interference",title:"RNA Interference",fullTitle:"RNA Interference"},signatures:"Kenji Toyota, Shinichi Miyagawa, Yukiko Ogino and Taisen Iguchi",authors:[{id:"92826",title:"Dr.",name:"Taisen",middleName:null,surname:"Iguchi",slug:"taisen-iguchi",fullName:"Taisen Iguchi"},{id:"176835",title:"Dr.",name:"Kenji",middleName:null,surname:"Toyota",slug:"kenji-toyota",fullName:"Kenji Toyota"}]},{id:"55603",title:"RNA‐seq: Applications and Best Practices",slug:"rna-seq-applications-and-best-practices",totalDownloads:3743,totalCrossrefCites:7,totalDimensionsCites:8,abstract:"RNA‐sequencing (RNA‐seq) is the state‐of‐the‐art technique for transcriptome analysis that takes advantage of high‐throughput next‐generation sequencing. Although being a powerful approach, RNA‐seq imposes major challenges throughout its steps with numerous caveats. There are currently many experimental options available, and a complete comprehension of each step is critical to make right decisions and avoid getting into inconclusive results. A complete workflow consists of: (1) experimental design; (2) sample and library preparation; (3) sequencing; and (4) data analysis. RNA‐seq enables a wide range of applications such as the discovery of novel genes, gene/transcript quantification, and differential expression and functional analysis. This chapter will encompass the main aspects from sample preparation to downstream data analysis. It will be discussed how to obtain high‐quality samples, replicates amount, library preparation, sequencing platforms and coverage, focusing on best recommended practices based on specialized literature. Basic techniques and well‐known algorithms are presented and discussed, guiding both beginners and experienced users in the implementation of reliable experiments.",book:{id:"5944",slug:"applications-of-rna-seq-and-omics-strategies-from-microorganisms-to-human-health",title:"Applications of RNA-Seq and Omics Strategies",fullTitle:"Applications of RNA-Seq and Omics Strategies - From Microorganisms to Human Health"},signatures:"Michele Araújo Pereira, Eddie Luidy Imada and Rafael Lucas Muniz\nGuedes",authors:[{id:"202103",title:"Ph.D. Student",name:"Michele",middleName:"Araújo",surname:"Pereira",slug:"michele-pereira",fullName:"Michele Pereira"},{id:"202456",title:"MSc.",name:"Eddie Luidy",middleName:null,surname:"Imada",slug:"eddie-luidy-imada",fullName:"Eddie Luidy Imada"},{id:"202460",title:"Dr.",name:"Rafael",middleName:null,surname:"Guedes",slug:"rafael-guedes",fullName:"Rafael Guedes"}]}],onlineFirstChaptersFilter:{topicId:"419",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:31,numberOfPublishedChapters:314,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:105,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:18,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:14,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403",scope:"Artificial Intelligence (AI) is a rapidly developing multidisciplinary research area that aims to solve increasingly complex problems. In today's highly integrated world, AI promises to become a robust and powerful means for obtaining solutions to previously unsolvable problems. 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Prior to his appointment at Stellenbosch University, he has been at the University of Pretoria, Department of Computer Science (1998-2018), where he was appointed as South Africa Research Chair in Artifical Intelligence (2007-2018), the head of the Department of Computer Science (2008-2017), and Director of the Institute for Big Data and Data Science (2017-2018). 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He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"23",title:"Computational Neuroscience",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",isOpenForSubmission:!0,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null},{id:"24",title:"Computer Vision",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",isOpenForSubmission:!0,editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",slug:"george-papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",biography:"George A. 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He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. Dr Ventura also holds the positions of Affiliated Professor at Virginia Commonwealth University (Richmond, USA) and Distinguished Adjunct Professor at King Abdulaziz University (Jeddah, Saudi Arabia). Additionally, he is deputy director of the Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI) and heads the Knowledge Discovery and Intelligent Systems Research Laboratory. He has published more than ten books and over 300 articles in journals and scientific conferences. Currently, his work has received over 18,000 citations according to Google Scholar, including more than 2200 citations in 2020. In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. He is a Senior Member of the IEEE Computer, the IEEE Computational Intelligence, and the IEEE Systems, Man, and Cybernetics Societies, and the Association of Computing Machinery (ACM). Finally, his main research interests include data science, computational intelligence, and their applications.",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"26",title:"Machine Learning and Data Mining",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",isOpenForSubmission:!0,editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. 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