\r\n\tSolar radiation is the radiant energy that originated from the sun in the form of electromagnetic radiation at various wavelengths. Solar radiation is the source of renewable energy and can be captured and converted into various forms of energy (e.g. electricity and heat) using different technologies. \r\n\tA very vast amount of solar energy reaches the atmosphere and surface of the earth and solar energy has been used for heating purposes for a very long-time and after solar cells’ invention in 1954, solar cells have also been used widely for electricity generation. Solar cells convert the sunlight into electricity by the creation of voltage and electric current through the so-called photovoltaic effect. \r\n\tPhotovoltaic (PV) solar energy has attracted significant attention in the recent decade as a reliable source for power generation due to various merits such as the free source of energy, abundant materials resources, environmentally friendly and noise-free, longtime service life, requiring low maintenance, technological advancements, market potential, and very importantly, low cost. The growth of using photovoltaic (PV) solar energy as a promising renewable energy technology, is being increased more and more worldwide. Therefore, much further research is needed for possible future developments in the field of solar photovoltaic energy. \r\n\tThe aim of this book is to provide detailed information about solar radiation as the source of photovoltaic (PV) solar energy for a broad range of readership including undergraduate and postgraduate students, young or experienced researchers and engineers. \r\n\tThis should be accomplished by addressing the various technical and practical aspects of solar radiation fundamentals, modeling and the measurement for photovoltaic (PV) solar energy applications. \r\n\tThe majority of this book should describe the basic, modern, and contemporary knowledge and technology of extraterrestrial and terrestrial solar irradiance for photovoltaic (PV) solar energy. \r\n\tThe book covers the most recent developments, innovation and applications concerning the following topics:
\r\n
\r\n\t• Fundamental of solar radiation and photovoltaic solar energy \r\n\t• Solar radiation and photovoltaic solar energy potential \r\n\t• Solar irradiance measurement: techniques, instrumentation and uncertainty analysis \r\n\t• Solar radiation modeling for photovoltaic solar energy applications \r\n\t• Solar monitoring and data quality assessment \r\n\t• Solar resource assessment and photovoltaic system performance \r\n\t• Solar energy and photovoltaic power forecasting
\r\n
\r\n\tThese are accompanied with other useful research topics and material.
",isbn:"978-1-83968-859-1",printIsbn:"978-1-83968-858-4",pdfIsbn:"978-1-83968-860-7",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"4c3d1319d7286e81bfb15c1f4b20460a",bookSignature:"Dr. Mohammadreza Aghaei",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/9862.jpg",keywords:"Solar Radiation Modeling, Solar Data Assessment, Solar Monitoring, Solar Radiation Forecasting, Solar Irradiance Measurements, Solar Instruments, Solar Spectral Distributions, Uncertainty Analysis, Solar Cell Technologies, Photovoltaics (PV), Solar Resource Assessment, Photovoltaics Power Forecasting",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 17th 2020",dateEndSecondStepPublish:"October 15th 2020",dateEndThirdStepPublish:"December 14th 2020",dateEndFourthStepPublish:"March 4th 2021",dateEndFifthStepPublish:"May 3rd 2021",remainingDaysToSecondStep:"3 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"A senior researcher in the field of photovoltaic solar energy, a postdoctoral scientist at Eindhoven University of Technology (TU/e), Chair of the WG2: reliability and durability of PV in EU COST PEARL PV.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"317230",title:"Dr.",name:"Mohammadreza",middleName:null,surname:"Aghaei",slug:"mohammadreza-aghaei",fullName:"Mohammadreza Aghaei",profilePictureURL:"https://mts.intechopen.com/storage/users/317230/images/system/317230.jpg",biography:"Mohammadreza Aghaei is a senior researcher in the field of photovoltaic solar energy, Eindhoven University of Technology (TU/e), The Netherlands. He is chair of the Working Group 2: reliability and durability of PV in European Cooperation in Science and Technology, COST Action PEARL PV.\nHe received the M.S. degree in electrical engineering from the Universiti Tenaga Nasional (UNITEN), Selangor, Malaysia, in 2013, and the Ph.D. degree in electrical engineering from the Politecnico di Milano, Milan, Italy, in 2016.\nHe was a Postdoctoral Scientist with Fraunhofer ISE and Helmholtz-Zentrum Berlin (HZB)-PVcomB, Germany, in 2017 and 2018, respectively. He is a Guest Scientist with the Department of Microsystems Engineering (IMTEK), Solar Energy Engineering, University of Freiburg since 2017. He is currently a Postdoctoral Scientist with the Design of Sustainable Energy Systems Group, Eindhoven University of Technology (TU/e), The Netherlands. He has authored numerous publications in international refereed journals, book chapters, and conference proceedings. The main his research interests include Solar Energy, Photovoltaic systems, PV monitoring, LSC PV, solar cells, machine learning, and UAVs.\nDr. Aghaei is a member of the International Energy Agency, PVPS program-Task 13 and International Solar Energy Society, and also an MC member in EU COST Action PEARL PV.",institutionString:"Eindhoven University of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Eindhoven University of Technology",institutionURL:null,country:{name:"Netherlands"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"10",title:"Earth and Planetary Sciences",slug:"earth-and-planetary-sciences"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"247865",firstName:"Jasna",lastName:"Bozic",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/247865/images/7225_n.jpg",email:"jasna.b@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"43934",title:"Trends in Amputation",doi:"10.5772/52175",slug:"trends-in-amputation",body:'
1. Introduction
Representatives of government health departments and patients’ organisations from all European countries met with diabetes experts under the aegis of WHO Regional Offices for Europe and the International Diabetes Federation (IDF), European region, in St Vincent, Italy on 10–12 October 1989. Within this declaration of the five-year targets was to reduce by one half the rates of limb amputations for diabetic gangrene.
There is an ongoing discussion whether this target could be achieved. In the recent years some data were published presenting promising numbers of decreasing amputation rates.
2. United States
Rowe et al. analysed data from a Nationwide Inpatient Sample (NIS) from 1996-2005 in the United States (Rowe et al. 2009). The NIS included 74 millions discharge records and was used as source data regarding treatment patterns for patients with PAD. Since 1988, the NIS has constructed a dataset comprising approximately 20% of the hospital discharges within the United States. In order to develop a sample that most accurately represents the total universe of domestic hospitalizations, hospitals are sampled according to specific characteristics (strata), including geographic region, hospital ownership, urban/rural location, and teaching status. Each discharge in the NIS dataset, therefore represents approximately five domestic discharges. This 5:1 ratio is not constant across the NIS sample, however. Certain combinations of strata may be under-sampled or over-sampled due to pragmatic considerations of sampling design. When this occurs, the importance (weight) assigned to a specific hospitalization may be greater or less than five. Unless specifically stated, all data and analyses in this study are reported using the weighting scheme included with the NIS.
Average annual admissions receiving major amputation in the years 1996 to 2005 were 41,275. 53.2% were females. Individuals undergoing major amputation were older (72.2 years) than those that had open or endovascular procedures performed. The number of major amputations fell significantly between 1996 and 2005, by an estimated 6.4% per year (P <0.05) (Fig 1). Rates of decrease were more dramatic in the above 75 age group than in the younger age groups.
Figure 1.
Rates of major amputation for peripheral arterial disease by age in the United States from 1996 to 2005. Overall incidence rate reflects population-adjusted incidence rate among individuals aged 18years and older in the United States (adjusted to 1996 population). (Rowe et al., 2009)
The authors also analyzed population-based rates of major amputation by diagnosis (PAD, non-atheroslerotic PVD, infection, malignancy, trauma, and other/unspecified). The vast majority of the reduction in population-based rates of major lower extremity amputations is due to decreases in amputation rates for PAD (Fig. 2).
A more recent publication from Li et al. based on the same population analysed the period from 1988 to 2008. The age-adjusted nontraumatic lower-extremity amputation per 1,000 persons among those diagnosed with diabetes and aged ≥40 years decreased from 11.2 in 1996 to 3.9 in 2008 (absolute percent -8.6%; P < 0.01), while rates among persons without diagnosed diabetes changed little. (Li et al., 2012)
In 2009 Goodney et al. published data based on the Medicare population (Goodney et al., 2009). The Medicare population included all people 65 years and older and regardless of age, every citizen with a recognized disability and each citizen with acute renal failure, which makes long-term dialysis or a kidney transplant needed. All Medicare claims from the Centers for Medicare and Medicaid Services between 1996 and 2006, using the Medicare Physician/Supplier Procedure Summary Master File were included. This is a 100% sample of all Part B claims from all insurance carriers. Codes including a 250 modifier represented a procedure done on both sides of the body; therefore, any code with this modifier was multiplied by two in order to account for each limb. The absolute size of the Medicare population remained was rather stable over the study period, (31.7 million beneficiaries in 1996, 31.9 million beneficiaries in 2006). Presented were only unadjusted data reported per 100,000 beneficiaries. Rates of major amputations, defined as above-knee or below-knee amputation, coded according to current procedural terminology were examined over the study period. Given that lesser amputations at the metatarsal or single toe level are not generally considered failures of limb salvage, amputations at lesser levels were not included in this analysis. To allow for comparison over time, annual rates were again normalized to reflect incidence rates per 100,000 Medicare beneficiaries, and RRs were calculated similarly as above. The author assumed that the proportion of major lower extremity amputation due to peripheral vascular disease remained constant over the study period, as prior analyses have demonstrated that fewer than 15% of major lower extremity amputations are traumatic in nature, and little change has occurred in the incidence of traumatic amputation in recent years.
Figure 2.
Rates of major amputation by indication in the United States from 1996 to 2005. Incidence rates are population-adjusted to 1996. (Rowe et al., 2009)
A distinct decline in the population based rates of major lower extremity amputation occurred between 1996 and 2006 (Fig. 3)). Overall, the rate of below and above-knee amputation decreased from 263 to 188 amputations per 100,000 Medicare beneficiaries, a 29% decline (RR 0.71, 95% CI 0.6-0.8). This decline began in 2000, and remains progressive throughout the next 6 years. Results were not different if above-knee amputations were studied distinctly from below-knee amputations as both decreased in similar magnitude.
Figure 3.
Trends in endovascular interventions, major amputation, and lower extremity bypass surgery, 1996-2006. RR,Risk ratio; CI, confidence interval. (Goodney et al., 2009)
3. Australia
In contrast to the data from the United States the number of diabetes-related hospitalisations for major lower limb amputation did not show a significant trend in Far North Queensland, Australia. (O’Rouke et al. 2012). There was a discrepancy of 6 (3.7%) in 161 cases over 10 years from 1998-99 to 2007-08. The number of diabetes-related hospitalisations for major lower limb amputation did not show a significant trend during this period, with an annual percentage change of -0.32% (P=0.915). Thus, there was a modest reduction in the hospitalisation rate for major lower limb amputation over the 10-year period only, demonstrating the need for improvements in the organisation of care.
4. United Kingdom
Recent data from the United Kingdom are in line with the findings from Australia. Vamos et al identified all patients aged >16 years who underwent any nontraumatic amputation in England between 2004 and 2008 using national hospital activity data from all National Health Service hospitals. During the study period the incidence of diabetes-related amputations decreased by 9.1%, from 27.5 to 25.0 per 10,000 people with diabetes (p>0.2) (Fig. 4). The incidence of minor and major amputations did not significantly change (15.7-14.9 and 11.8-10.2 per 10,000 people with diabetes; p=0.66 and p=0.29, respectively). Poisson regression analysis showed no statistically significant change in diabetes-related amputation incidence over time (0.98 decrease per year [95% CI 0.93-1.02]; p=0.12) (Vamos et a. 2010).
Figure 4.
Changes in minor and major amputation incidence rates in (A) individuals with diabetes expressed per 10,000 people with diabetes and (B) individuals without diabetes expressed per 100,000 people without diabetes.(Vamos et al. 2010)
Incidence of lower extremity amputations was significantly higher among men than among women with diabetes (P < 0.001). However, changes in overall lower extremity amputations rates did not significantly differ between men and women (19.9 to 18.3 vs. 7.6 to 6.7 per 10,000 people with diabetes; P = 0.81). When stratified by age, the incidence was the highest among individuals aged ≥65 years in both men and women. Poisson regression analysis showed no significant decrease in incidence of amputations after adjustment for age, sex, year, and level of amputation (0.98 decrease per year [95% CI 0.93–1.02]; P = 0.12).
The number of people without diabetes who underwent a lower extremity amputations decreased during the study period. Although the percentage of men undergoing minor amputations increased significantly, male predominance was not evident among minor amputees. Amputation incidence (minor and major combined) decreased from 13.6 per 100,000 people without diabetes in 2004 to 11.9 per 100,000 people without diabetes in 2008.
Incidence of minor lower extremity amputations decreased significantly from 5.9 to 5.0 per 100,000 people without diabetes (P < 0.01). There was a nonsignificant reduction in the incidence of major lower extremity amputations among individuals without diabetes, from 7.7 to 6.9 per 100,000 people (P = 0.39) (Fig. 1).
The fall in lower extremity amputations rates was achieved between 2004 and 2006, and incidence rates remained constant afterward for both minor and major procedures. Incidence of lower extremity amputations declined among both men and women.
Poisson regression analysis showed that the decline in nondiabetes-related lower extremity amputations was marginally significant after adjustment for age, sex, level of amputation, and year (0.97 decrease by year [95% CI 0.93–1.00], P= 0.059).
5. Spain
A Spanish analysis did not report a decrease in the incidence of lower limb amputation in Andalusia from 1998 to 2006 in the population with and without diabetes (Almaraz et al., 2012). Andalusia, one of the 17th Spanish Autonomous Communities in Spain, had a total population of 7,975,672 inhabitants in 2006. The Andalusian Health Service, guarantees health care to almost 100% of the population (free, universal care). The information system is the same for the whole of Andalusia and all main diagnosis from people admitted to hospital are recorded in the CMBD (Conjunto Mı´nimo Ba´ sico de Datos, a basic set of data), at patient discharge. This data collection (CMBD) is mandatory and this collection of data with a standardized methodology was introduced in Spain in 1982. These data are registered in accordance with the ICD-9-CM, and then send them to the Andalusian Health Service Central Services.
During the study period 1998–2006 a total of 16,210 lower limb amputations were performed in people aged ≥30 years old in Andalusia. Of these, 11,770 (72.6%) were in patients with diabetes mellitus and 4440 (27.4%) in individuals without diabetes mellitus. The average age of patients who underwent lower limb amputations was (mean ± SD): 70.6 ± 11.6 years; patients with diabetes mellitus were aged 70.3 ± 10.7 years and patients without diabetes mellitus were 71.3 ± 13.7 years old ( p <0.05). In the population with diabetes the standardized incidence of all lower limb amputation was found to be 34.0 per 10,000 (95% CI, 31.5-37.2) in 2004-2006. There was an estimated incidence increase for all lower limb amputation by 14% and for minor lower limb amputation by 13.6% in 2004-2006. In people with diabetes the RR increased by 31.6% as compared to the first period (Fig. 5).
Figure 5.
Changes in total, major and minor LLA incidence rates in patients with diabetes mellitus (A) and without diabetes mellitus (B) expressed per 100,000 inhabitants. *p < 0.05 (Poisson regression analysis).(Almaraz et al. 2012)
6. Germany
In 2011 Moysidis et al published data from Germany based on the national statistics (DRG statistics) provided from the Federal Statistical Office. The DRG-statistics include data from all hospitals in Germany that use the DRG system, which are more than 99 %. These hospitals are legally obliged to deliver extensive data on hospital treatment, including demographic data, diagnoses, co-morbidities, complications, and procedures to the “Institute for the Hospital Remuneration System” which uses the data for a yearly adaptation of the German DRG system and transmits them to the Federal Statistical Office.
\n\t\t
\n\t\t
\n\t\t
\n\t\t
\n\t\t
\n\t\t
\n\t\t
\n\t\t
\n\t\t\t
\n\t\t\t\tMajor amputation\n\t\t\t
\n\t\t
\n\t\t
\n\t\t\t
\n\t\t\t
total
\n\t\t\t
< 50
\n\t\t\t
50-60
\n\t\t\t
60-70
\n\t\t\t
70-80
\n\t\t\t
"/>80
\n
\n
\n\t
all
\n\t
\n\t
\n\t
\n\t
\n\t
\n\t
\n
\n
\n\t
2005
\n\t
23.3
\n\t
1
\n\t
14
\n\t
43
\n\t
94
\n\t
181
\n
\n
\n\t
2006
\n\t
22.6
\n\t
1
\n\t
14
\n\t
41
\n\t
87
\n\t
173
\n
\n
\n\t
2007
\n\t
21.8
\n\t
1
\n\t
14
\n\t
37
\n\t
85
\n\t
161
\n
\n
\n\t
2008
\n\t
21.0
\n\t
1
\n\t
13
\n\t
36
\n\t
79
\n\t
153
\n
\n
\n\t
Males
\n\t
\n\t
\n\t
\n\t
\n\t
\n\t
\n
\n
\n\t
2005
\n\t
27.0
\n\t
1
\n\t
22
\n\t
67
\n\t
135
\n\t
216
\n
\n
\n\t
2006
\n\t
26.6
\n\t
1
\n\t
23
\n\t
65
\n\t
125
\n\t
208
\n
\n
\n\t
2007
\n\t
25.6
\n\t
2
\n\t
22
\n\t
59
\n\t
124
\n\t
180
\n
\n
\n\t
2008
\n\t
25.1
\n\t
1
\n\t
21
\n\t
58
\n\t
116
\n\t
178
\n
\n
\n\t
Females
\n\t
\n\t
\n\t
\n\t
\n\t
\n\t
\n
\n
\n\t
2005
\n\t
19.7
\n\t
1
\n\t
5
\n\t
20
\n\t
63
\n\t
168
\n
\n
\n\t
2006
\n\t
18.7
\n\t
1
\n\t
6
\n\t
18
\n\t
57
\n\t
158
\n
\n
\n\t
2007
\n\t
18.2
\n\t
1
\n\t
6
\n\t
16
\n\t
54
\n\t
152
\n
\n
\n\t
2008
\n\t
17.1
\n\t
1
\n\t
5
\n\t
16
\n\t
49
\n\t
142
\n
\n
\n\t
\n\t\tMinor amputation\n\t
\n
\n
\n\t
\n\t
total
\n\t
< 50
\n\t
50-60
\n\t
60-70
\n\t
70-80
\n\t
"/>80
\n
\n
\n\t
all
\n\t
\n\t
\n\t
\n\t
\n\t
\n\t
\n
\n
\n\t
2005
\n\t
35.0
\n\t
3
\n\t
31
\n\t
79
\n\t
144
\n\t
183
\n
\n
\n\t
2006
\n\t
36.1
\n\t
3
\n\t
33
\n\t
81
\n\t
147
\n\t
180
\n
\n
\n\t
2007
\n\t
36.6
\n\t
3
\n\t
33
\n\t
78
\n\t
148
\n\t
180
\n
\n
\n\t
2008
\n\t
38.1
\n\t
3
\n\t
33
\n\t
80
\n\t
148
\n\t
192
\n
\n
\n\t
Males
\n\t
\n\t
\n\t
\n\t
\n\t
\n\t
\n
\n
\n\t
2005
\n\t
47.4
\n\t
4
\n\t
51
\n\t
129
\n\t
224
\n\t
266
\n
\n
\n\t
2006
\n\t
49.5
\n\t
4
\n\t
54
\n\t
133
\n\t
230
\n\t
259
\n
\n
\n\t
2007
\n\t
50.6
\n\t
4
\n\t
54
\n\t
129
\n\t
234
\n\t
261
\n
\n
\n\t
2008
\n\t
53.7
\n\t
4
\n\t
55
\n\t
134
\n\t
240
\n\t
285
\n
\n
\n\t
Females
\n\t
\n\t
\n\t
\n\t
\n\t
\n\t
\n
\n
\n\t
2005
\n\t
23.1
\n\t
2
\n\t
12
\n\t
31
\n\t
83
\n\t
150
\n
\n
\n\t
2006
\n\t
23.1
\n\t
1
\n\t
11
\n\t
32
\n\t
82
\n\t
148
\n
\n
\n\t
2007
\n\t
23.1
\n\t
2
\n\t
12
\n\t
29
\n\t
80
\n\t
146
\n
\n
\n\t
2008
\n\t
23.2
\n\t
2
\n\t
11
\n\t
29
\n\t
76
\n\t
151
\n
\n
Table 1.
Age-adjusted incidence of major (OPS 5 – 864) and minor (OPS 5 – 865) amputations per 100.000 inhabitants in Germany from 2005 to 2008 excluding those patients amputated for injury and toxicity, musculoskeletal disorder, diseases of skin and subcutaneous tissue and malignant neoplasm. (Moysidis et al. 2011)
The total number of patients hospitalised with the principal diagnosis peripheral arterial disease and neurovascular disease increased from 163,520 in 2005 to 178,086 in 2008. Within the same time period the total number of major amputations decreased from 25,315 in 2005 to 23,009 in 2008 whilst the number of minor amputations increased form 37,690 in 2005 to 40,276 in 2008. After age adjustment major amputation rates still decreased for both genders (Tab. 1) Overall minor amputation rates do not show such a decrease but increased in males and remained unchanged in females.
7. Discussion
All in all there is a great variation in the incidence of lower extremity amputations, even within one country. In England the incidences of amputations in adults determined from hospital episode statistics over 3 years to 31 March 2010 showed large variation between 151 Primary Care Trusts. Incidence varied eightfold across Primary Care Trusts in people both with diabetes (range 0.64-5.25 per 1,000 person-years) and without (0.03-0.24 per 1,000 person-years). Amputations in people with diabetes varied tenfold-both major (range 0.22-2.20 per 1,000 person-years) and minor (range 0.30-3.25 per 1,000 person-years). (Holman et al. 2012).
Moxey et al. performed an electronic search using the EMBASE and MEDLINE databases from 1989 until 2010 for incidence of lower extremity amputation. There reviewed showed significant global variation exists in the incidence of lower extremity amputation. Incidence of all forms of lower extremity amputation ranges from 46.1 to 9600 per 100.000 in the population with diabetes compared with 5.8-31 per 100.000 in the total population. Major amputation ranges from 5.6 to 600 per 100.000 in the population with diabetes and from 3.6 to 68.4 per 100.000 in the total population (Moxey et al., 2011). The authors mad the following conclusions:
Significant reductions in incidence of lower extremity amputation have been shown in specific at-risk populations after the introduction of specialist diabetic foot clinics.
Ethnicity and social deprivation play a significant role but it is the role of diabetes and its complications that is most profound.
Lower extremity amputation reporting methods demonstrate significant variation with no single standard upon which to benchmark care.
Thus, all data and the specific conclusion drawn from these data, respectively, have to be handled with care as there are no lower extremity amputation reporting standards used that would allow benchmark (Moxey et al., 2011). Especially data regarding minor amputation rates can be assumed to underestimate the truth. An unknown but probably high number of patients suffering from foot lesion is effectively treated in outdoor settings and do not appear in the analysed data basis. In light of the rising prevalence of diabetes mellitus minor amputations might mirror the burden of the problem more accurately, whereas major amputation rates might give an insight in effectiveness of treatment strategies. Minor amputation rates that do not decrease or even increase show that prevention of foot lesions is not effectively achieved. Decreasing major amputations rates show, that if patients will get optimal treatment this treatment is able to prevent deterioration of the lesion in some patients.
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Klinik Angiologi & Kardiologi "Waringin Medika", Jakarta, Indonesia
Department of Angiology, HELIOS Klinikum Krefeld, Germany
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Vitin",authors:[{id:"46555",title:"Dr.",name:"Alexander",middleName:null,surname:"Vitin",fullName:"Alexander Vitin",slug:"alexander-vitin"}]}]}]},onlineFirst:{chapter:{type:"chapter",id:"66160",title:"A Cooperative Game Using the P300 EEG-Based Brain-Computer Interface",doi:"10.5772/intechopen.84621",slug:"a-cooperative-game-using-the-p300-eeg-based-brain-computer-interface",body:'
1. Introduction
A brain-computer interface (BCI) offers a noninvasive means of enabling a human to send messages and commands directly from his or her brain to a computer without moving, by wearing a simple scalp probe (a set of electrodes or sensors) [1, 2, 3, 4]. This noninvasive technology differs from invasive, surgical approaches that can cause irreversible damage to brain tissue.
In this paper, we present a BCI-based cooperative game, Brainio Bros 300. The BCI uses the P300 brain wave [5, 6, 7, 8, 9], a typical electrophysiological response to internal and external event-related potential (ERP) stimuli, measured using an EEG. The P300 wave has proven relatively easy to use for a variety of control-signaling purposes in much recent practical research.
When a human experiences interest in any kind of target, there is a measurable brain activity response. It is known that when a subject recognizes a specified photograph among a series of randomly presented photographs (i.e., the “ah!” response), P300 can be measured around the top of the head. Regardless of the type of stimulus (visual, tactile, auditory, olfactory, gustatory, etc.), P300 appears around 300 ms after the stimulus, which makes it a very useful brain feature that can be used by healthy or handicapped people for controlling an external device or communicating with the environment in real time. Notable applications of a P300 BCI include previous engineering studies in which a locomotive robot [10] and wheelchair [11] were controlled. Some neuroscientific experimental studies have also been conducted using “brain painting” [12, 13] for patient rehabilitation. A P300 BCI has also been used with virtual reality spaces [14] and as an interface for Twitter and Second Life [15].
Simple BCI games can also be useful for helping a user to control his or her brain activity. Games controlled using EEG signals have been designed to improve the power and duration of concentration, increase the speed and accuracy of brain waves, and improve cognitive function [16]. BCI-based games appear in both medical- and entertainment-focused varieties. Medical applications include games that use a steady-state visual evoked potential (SSVEP) to improve the concentration power necessary to control a BCI [17]. Here, SSVEPs refer to the brain signals induced by using a pattern reversal stimulus (i.e., the use of a checkerboard pattern to stimulate vision) or a flash stimulus (i.e., the use of a flickering light source such as an LED to stimulate vision). Medical games to promote the speedy generation of BCI commands, thus improving the user experience, have also been developed [18]. In the entertainment realm, games have been developed using a number of signals, including P300, to play popular games such as Pong and Tetris and to control a dancing robot [19, 20, 21, 22]. Most such games depend on the player’s degree of concentration [22].
In this research, we developed Brainio Bros 300 as a game controlled cooperatively by two people using P300-generating color discrimination. The two users advance together through the game, one as the “player” and the other as the “supporter” providing assistance. The player controls the game character by using a keyboard’s arrow keys to navigate through a series of colored blocks, while the supporter removes blocks obstructing the player’s path by thinking of the appropriate color via the P300 BCI. By cooperating, the participants can reach the end of the game. We assumed that players would be able-bodied, while supporters could include people with severe disabilities.
2. Brainio Bros 300 cooperative game
This section describes the Brainio Bros 300 game, with the discussion divided into two parts: the P300 BCI used and the components and design of the cooperative game.
2.1 P300-based brain-computer interface
We used a new, portable wireless EEG cap called g.Unicorn EEG (g.tec medical engineering, Austria), as shown in Figure 1, for recording brain activity in real time. For our experimental paradigm, we adapted the P300 speller idea to our problem by using MATLAB/Simulink to develop the game-based BCI. Ten dry electrodes were used to record EEG signals at a sampling frequency of 256 Hz. The electrodes were placed according to the international 10–20 system, using the Fz (forehead), Cz (crown), P3, Pz, P4, PO7, Oz, and PO8 (all at the back of the head) locations, with references placed at A2 (earlobe) and Fz (forehead), as shown in Figure 2.
Figure 1.
Calibration of the EEG experiment using the g.Unicorn EEG cap for a P300-based BCI.
Figure 2.
Electrode positions of the eight channels.
Before the cooperative game begins, the first user (designated as the “supporter”) had to put on the EEG cap and perform calibration for sending color commands. We developed a program enabling the user to calibrate six colors: red, blue, green, yellow, purple, and white. The six colors were randomly arranged into two rows of three, with each box flickering 30 times between a photograph of a human face and a color. The subject choses a color and counted in their head how many times that color was displayed. Because research results have indicated that flickering photographs of famous people increases calibration accuracy by increasing the amplitude of the P300 wave, we used images of widely recognizable people, such as Albert Einstein and President Donald Trump. The procedures of the calibration and game phases are detailed below:
Calibration phase
Select the colors to be used in calibration, as illustrated in Figure 3. For example, red, blue, green, and yellow can be displayed in order, as shown in the figure under “Item selections.”
Begin calibration.
The system directs the user to look at “red.”
The colors randomly flicker. The user mentally adds to the count every time he or she sees the color red. After red has flickered 30 times, the system is configured to stop.
The system records the speed of the response every time the color red was flashed and the EEG information.
This process continues three–five more times for all the other colors. Each color takes 20 s, for a total of around 2 min.
Game phase
As colors are randomly flashed on the screen, the user looks at the color he or she wants to select and mentally counts its flashes. We used 20 flashes for a balance between selection accuracy and enjoyability of the game.
The system guesses which color the user selected according to how the EEG changes. The EEG readings at these moments are measured, and the instants at which the low-frequency stimuli are displayed are averaged as the trigger.
Figure 3.
Calibration screen for our P300 experimental paradigm.
The information on the selected color was sent by a UDP broadcast on port 1000 and received by a Unity application. As seen in Figure 3, the selected colors were also shown under “Written text,” but this was not actually used in the game.
2.2 Brainio Bros 300 design
The Brainio Bros 300 cooperative game was developed in Unity 2018 and runs on the Windows 10 operating system. It is a game in the style of Nintendo’s Super Mario Bros., in which the player maneuvers a character through various obstacles to reach a goal flag and complete the stage. Along the way, the player encounters blocks that are too high to clear and points where it is impossible to pass, but the player and supporter work together to complete the game.
The game contains blocks of five colors: red, blue, green, yellow, and purple. Figure 4 illustrates a green block obstructing the player, preventing him or her from advancing. In such situation, the player communicates an instruction to the supporter (e.g., “green’s in the way” or “destroy green”), and the supporter then thinks of the color green. By doing so, the green block in the game can be destroyed, as shown in Figure 5. The game was designed so that it cannot be completed without the player and supporter cooperating.
Figure 4.
Obstructed by the green block.
Figure 5.
After destroying the green block.
Because the game would not be enjoyable with only one obstruction, multiple blocks of different colors are placed in one spot, as shown in Figure 4, requiring the player to consider which color to destroy. The game was also designed to offer multiple courses, allowing the player to choose his or her own course. For example, Figure 6 shows a case of two paths. If the red block is destroyed, the player can advance via the blue block, whereas if the blue block is destroyed, the player can jump onto the red block and continue onward.
Figure 6.
Start screen with two ways of advancing.
The game was designed to destroy (i.e., hide) only the one color currently recognized by the BCI, so that only one color could be destroyed at a time. For example, if a red block is first destroyed and then a green block, the game displays the destroyed red block again. Figure 7 shows a case of the player unable to advance with only a blue block displayed, while Figure 8 shows the result with the blue block destroyed, causing the red blocks to reappear. The game was designed as indicated by these images, so that, even though there are no blocks beyond the blue block, destroying the blue block causes the red blocks to reappear, allowing the player to advance.
Figure 7.
Unable to reach the blue block.
Figure 8.
Blue block destroyed, causing red blocks to reappear.
This system, with the combined limitations of using only five colors and allowing only one color to be destroyed at a time, gives the player manual control over which blocks are destroyed. Because an unintended color can be destroyed, it is possible to destroy the player character’s foothold. When the character falls, however, it returns to the start point, from where the player can continue the game.
The game also features obstacles in which blocks move horizontally or vertically. Such blocks were programmed in advance to behave as such in the game in advance. We included such features to prevent the game from becoming a monotonous experience for the users. A flag is beyond all the obstacles. When the character touches the flag, the game is completed.
3. Game experiment
For experiments using an EEG capable of measuring the P300 brain wave, it is extremely difficult at present to prepare an environment supporting easy calibration for many subjects. For example, even preparing only one EEG device capable of measuring P300 requires a considerable cost, and it takes time to perform the calibration. Therefore, this paper considers the possibilities of games for use with such a BCI by focusing on evaluating the Brainio Bros 300 game.
Specifically, we evaluated Brainio Bros 300 in terms of the user’s impression of the game and its usefulness. For our methodology, we used the Wizard of Oz (WOZ) approach. A WOZ system involves a user interacting with a person acting as a computer system (i.e., the “wizard”), allowing for effective simulation of a real system [23].
For Brainio Bros 300, although the supporter wore the EEG device, the game was actually controlled with a keyboard. We thus conducted an evaluation experiment with the supporter as a reference.
The experiment was conducted with 25 students at Future University Hakodate: 19 men and 6 women. Of these students, 12 were designated as supporters and 13 as players. The supporters consisted of 8 men and 4 women, while the players consisted of 11 men and 2 women. The average age of the whole group was 20.76 years, with average ages of 20.75 and 20.77 years for the supporter and player groups, respectively.
To use the WOZ approach, we created an experimental system using keyboard input to destroy blocks as a substitute for the P300 BCI component of Super Brainio Bros 300. In this system, pressing the “R,” “G,” “B,” “Y,” or “C” keys caused the red, green, blue, yellow, or purple blocks, respectively, to be destroyed. For the ease of distinguishing which key corresponded to which color, we applied a sticker of each color to its corresponding key.
We also created a post-experiment questionnaire to evaluate the users’ impressions and opinions of the usefulness of Super Brainio Bros 300. Table 1 lists the details of the questionnaire, which included questions using the semantic differential (SD) method, a five-point scale method, and free responses. For the five-point scale, the responses consisted of “strongly agree,” “agree,” “neither,” “disagree,” and “strongly disagree.” The questions are listed with abbreviated forms in the table.
Table 1.
Questionnaire details.
Table 2 lists the details of each condition for the SD method and the reasons for its selection. Each condition showing a positive impression is filled in gray. On the questionnaire form, the positive and negative responses were distributed between the left and right sides as a counterbalancing measure. The SD method used a seven-stage evaluation, with responses consisting of “extremely” (positive or negative), “very” (positive or negative), “a little” (positive or negative), and “neither.”
Table 2.
Details of the conditions used for the SD method, together with the reasons for their use.
We also used a keyboard, display, notebook PC, desk, chair, and EEG headset as experimental materials, arranged as shown in Figure 9.
Figure 9.
Arrangement of the experimental materials.
We next describe the experimental procedure. The total experiment time was around 30 minutes. The first step was to gather all the subjects in a room and form them into pairs. The participants were instructed to pair with someone they did not know, where possible. As there was an odd number of participants, resulting in one excess player, a researcher acted as the supporter for that player and did not fill out a questionnaire. After pairing the participants, we explained the experiment to the whole group. This included explanations of the following: (1) an overview of the game (a game controlled by brain waves, requiring the player and supporter to cooperate to reach the goal), (2) the role of the player (to control the character by using the keyboard), (3) the role of the supporter (to assist the player by using brain waves), (4) the control method, and (5) an image of the game screen. The players were then taken into separate rooms containing the experimental materials. Each player was seated in the chair indicated by “Player’s chair” in Figure 9 and asked to wait until the supporter arrived.
After the players had been moved, we explained to the supporters that this experiment used the WOZ approach, that brain waves were not actually used, and that they would advance through the game by using the keyboard. The supporters were asked to wear the EEG headset and appear to the player as if they were controlling the game through brain waves. The supporters were then taken to the separate rooms in which the players were waiting, and each was seated in the “Supporter’s chair” shown in Figure 9. As soon as we had confirmed that the player and supporter were both seated, a brief explanation was once again provided to both of them. At this time, the participants were instructed to communicate regarding the color of the block when the player wanted a certain block cleared, when the supporter was trying to clear a block, and so on.
After this instruction, the participants began playing the game. After they had completed it, they returned to the room where the initial explanation had been provided, and they filled out the questionnaires. Once they had completed the questionnaires, the experiment was over. At this point, they were instructed not to reveal the details of the experiment.
Finally, we explain our analysis methods for the experimental data. For the SD method in which pairs of words were displayed side by side (e.g., easy vs. difficult) to assess the impression of the participants, they were asked to assign a score in the range of −3 and 3, with 0 representing “neither”, −3 representing “extremely leaning to the left word”, and 3 representing “extremely leaning to the right word”. We then compiled descriptive statistics and plotted a semantic profile.
Next, the five-point scale was tallied with “strongly agree” as 5 points, “agree” as 4 points, “neither” as 3 points, “disagree” as 2 points, and “strongly disagree” as 1 point. After compiling descriptive statistics for this data, we performed a chi-square test.
Finally, for the free responses, we counted experiences and keywords shared among participants and collected them into overall viewpoints. We also collected strongly held minority opinions as necessary.
4. Results
Table 3 and Figure 10 give the results of the SD method. Table 3 lists the average for each question for each participant role, as well as the difference between the groups. The fields shown in gray indicate a response that implies a positive impression. The left/right distribution of the response fields is the same as on the questionnaire sheet provided to the participants. Averages and average differences with an absolute value greater than 1 are also shown in gray. We also conducted semantic profiling based on the results, as shown in Figure 10.
Table 3.
SD method results.
Figure 10.
Semantic profile of the SD method.
From the group differences indicated by this table and graph, we observed no great differences between the impressions of the supporters and players. The average values in gray show that “substantial,” “cooperative,” “enjoyable,” “happy,” “cute,” “friendly,” and “lively” were evaluated highly by both players and supporters, with “cooperative” evaluated particularly highly. Moreover, the players highly evaluated “satisfying” and “new.”
Because all the data fell within one standard deviation, we could conclude that it was a good set of low-variance data. In the grayed averages, we also see that both supporters and players rated “Was it interesting?” and “Interacting with a child” highly. Players alone rated “Game design” and “Would recommend” highly.
Table 4 and Figure 11 show the five-point scale responses, organized by the participants’ roles, in terms of averages and standard deviations (Table 4) and percentages (Figure 11). Table 4 shows averages greater than 4 in gray. In addition, Table 5 lists the sums of the percentages of “strongly agree” and “agree” responses to each question, as well as the results of the chi-square test. The percentages in gray indicate values above 80%, while the statistical significances in gray indicate a significant statistic at the 5% significance level. The analysis shows that “Would you recommend it?” had a significant result at the 5% level, while the results of the remaining six questions were significant at a significance level of 10%.
Table 4.
Averages and standard deviations for the five-point scale method.
Figure 11.
Percentage results for the five-point scale method.
Table 5.
Percentage sums of the players’ “strongly agree” and “agree” responses and chi-square test results.
Finally, we will discuss the participants’ free responses, including particularly common responses and useful minority opinions. First, out of the people who responded that “it was interesting”, 9 out of the 12 supporters and 8 out of the 13 players gave “cooperative play” as a reason.
For “Other future uses,” 6 out of 12 supporters offered “use as an icebreaker” as a response, as did 4 out of 13 players. In addition, notable minority opinions included “use in brain training,” “communication with foreigners,” and “prevention of dementia in the elderly.”
As for “Points for improvement,” 2 out of 12 supporters mentioned the addition of more complex features and the ability to actually play using brain waves. Of the 13 players, 2 mentioned the ability to use items and the appearance of enemies in the game as points for improvement. Additionally, one minority opinion suggested the capability of the player, too, to use brain waves to control the game.
Finally, for “Any other opinions or feelings,” many supporters and players mentioned that the game was interesting and fun.
5. Discussion
We conducted an impression evaluation of the Brainio Bros 300 cooperative game and its usefulness. First, the results of the SD method showed that the players evaluated the game as “full,” “cooperative,” “enjoyable,” “happy,” “cute,” “friendly,” “lively,” “satisfying,” and “new,” with “cooperative” evaluated particularly highly. On the five-point scale, the game was evaluated highly in terms of both the players’ average values and the combined percentages of “strongly agree” and “agree” for the questions of “Interesting,” “Communicating with a child,” “Game design,” and “Would recommend,” with “Would recommend” showing a particularly strong correlation. Finally, the opinion that the cooperative aspect of play was interesting was particularly widely expressed in the free responses.
One of the biggest advantages of Brainio Bros 300 is the capability for the player, who does not have to wear an EEG cap, to play together with the supporter, who does wear an EEG cap. We believe that playing cooperative games using a P300 BCI could be of significant benefit to people with major disabilities such as amyotrophic lateral sclerosis (ALS), enabling them to play with able-bodied children, family members, and friends, thus deepening connections and communication.
The use of a P300 BCI is an easy-to-measure, noninvasive method. It can also be controlled with a high degree of accuracy without the need for detailed user training in advance. Training the P300 BCI command categories does not take a great deal of time. Most patients, including almost all able-bodied people and even people with severe paralysis, can use a P300 BCI. It also offers a goal-oriented control signal that is particularly suited to situations that do not require a continuous control signal.
On the other hand, one of the game’s limitations is as follows. The P300 BCI is one of the fastest of the currently usable BCIs, but it is still very slow compared to normal input devices such as mice and game controllers. In the current Brainio Bros 300 system, the player must wait for the colors to flash before having the supporter select a color.
With the development of a decoding algorithm that could detect the P300 brain wave to a high degree of accuracy after only one attempt, a command could be sent to the game every second. The results could then be adjusted according to feedback following categorization. For example, in the event of a mistaken command, the response time could be minimized by testing the supporter again. This should also allow the result to be checked once per second. Although Brainio Bros P300 is a game in which players and supporters cooperate, it takes time for a supporter to erase blocks by using P300 control as compared to standard games. Moreover, as it is a game in which two people cooperate, it differs from a competitive game based on speed. For this reason, a player and a supporter must play together and possibly become friends.
We believe that, in the future, if it is possible to reduce the number of flashes while maintaining the current level of accuracy and to increase the number of commands (controllable dimensions), this type of game would be usable in the real world and present an extremely promising interface.
Some problems with using a P300 BCI are that real-time P300 detection can sometimes be inaccurate, as it is easily affected by a number of human sensory phenomena such as attentional blinking, repetition blindness, and change blindness [24, 25, 26, 27, 28]. It is also possible for motivation to impact BCI performance [29], causing the EEG signal pattern to change according to the attention level, fatigue, state of mind, learning, and unsteadiness [1]. A P300 BCI might also not be an effective method for people who cannot control their line of sight [30]. It is thus important to work carefully, given the potential impacts of participants’ state of mind and attention to the problem.
6. Conclusion
In this BCI-based game research, we developed a real-time game, Brainio Bros 300, a cooperative game using a P300 BCI to facilitate two users (a player, who controls the character in the game and does not wear an EEG cap, and a supporter, who uses his or her brain activity to communicate) working together to achieve one goal. We evaluated participants’ impressions of the game and its usefulness and considered the viability of the P300 BCI interface.
In the future, we would like to use noninvasive measurement to investigate more deeply the brain mechanism during a cooperative video game.
Acknowledgments
This research was a first place winner, IEEE Brain Winner, and BR41N.IO SfN Winner at the IEEE SMC2018 BCI Hackathon. On receipt of these awards, we would like to express our gratitude to g.tec and to all the organizers, as well as all the students, who assisted with our experiment.
\n',keywords:"P300, brain computer interface, EEG, cooperative game, game for people with major disabilities, game design",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/66160.pdf",chapterXML:"https://mts.intechopen.com/source/xml/66160.xml",downloadPdfUrl:"/chapter/pdf-download/66160",previewPdfUrl:"/chapter/pdf-preview/66160",totalDownloads:479,totalViews:0,totalCrossrefCites:3,dateSubmitted:"October 16th 2018",dateReviewed:"January 22nd 2019",datePrePublished:"April 18th 2019",datePublished:"December 4th 2019",dateFinished:null,readingETA:"0",abstract:"In this paper, we present a cooperative game, Brainio Bros 300, using a brain-computer interface (BCI). The game is cooperatively controlled by two people using P300-generating color discrimination. The two users advance through the game together, one as the “player” and the other as the “supporter” providing assistance. We assumed that players would be able-bodied, while supporters would include people with severe disabilities. Through experiments using human subjects, we evaluated the subjects’ impressions of the game and its usefulness. The results of the impression evaluation showed that the subjects generally had good impressions, and there were many opinions that such cooperative games are interesting. We also discuss the possibilities of using the P300 BCI.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/66160",risUrl:"/chapter/ris/66160",signatures:"Kaoru Sumi, Keigo Yabuki, Thomas James Tiam-Lee, Abdelkader Nasreddine Belkacem, Quentin Ferre, Shogo Hirai and Teruto Endo",book:{id:"7701",title:"Assistive and Rehabilitation Engineering",subtitle:null,fullTitle:"Assistive and Rehabilitation Engineering",slug:"assistive-and-rehabilitation-engineering",publishedDate:"December 4th 2019",bookSignature:"Yves Rybarczyk",coverURL:"https://cdn.intechopen.com/books/images_new/7701.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"72920",title:"Prof.",name:"Yves",middleName:"Philippe",surname:"Rybarczyk",slug:"yves-rybarczyk",fullName:"Yves Rybarczyk"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"281030",title:"Prof.",name:"Kaoru",middleName:null,surname:"Sumi",fullName:"Kaoru Sumi",slug:"kaoru-sumi",email:"kaoru.sumi@acm.org",position:null,institution:null},{id:"290439",title:"Mr.",name:"Keigo",middleName:null,surname:"Yabuki",fullName:"Keigo Yabuki",slug:"keigo-yabuki",email:"g2117050@fun.ac.jp",position:null,institution:null},{id:"290440",title:"Mr.",name:"Thomas James",middleName:null,surname:"Tiam-Lee",fullName:"Thomas James Tiam-Lee",slug:"thomas-james-tiam-lee",email:"g3117002@fun.ac.jp",position:null,institution:null},{id:"290441",title:"Dr.",name:"Abdelkader Nasreddine",middleName:null,surname:"Belkacem",fullName:"Abdelkader Nasreddine Belkacem",slug:"abdelkader-nasreddine-belkacem",email:"belkacem011@hotmail.com",position:null,institution:null},{id:"290442",title:"Mr.",name:"Quentin",middleName:null,surname:"Ferre",fullName:"Quentin Ferre",slug:"quentin-ferre",email:"quentin.ferre@outlook.fr",position:null,institution:null},{id:"290443",title:"Mr.",name:"Shogo",middleName:null,surname:"Hirai",fullName:"Shogo Hirai",slug:"shogo-hirai",email:"g2117041@fun.ac.jp",position:null,institution:null},{id:"290444",title:"Mr.",name:"Teruto",middleName:null,surname:"Endo",fullName:"Teruto Endo",slug:"teruto-endo",email:"s1612216@st.tohtech.ac.jp",position:null,institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Brainio Bros 300 cooperative game",level:"1"},{id:"sec_2_2",title:"2.1 P300-based brain-computer interface",level:"2"},{id:"sec_3_2",title:"2.2 Brainio Bros 300 design",level:"2"},{id:"sec_5",title:"3. Game experiment",level:"1"},{id:"sec_6",title:"4. Results",level:"1"},{id:"sec_7",title:"5. Discussion",level:"1"},{id:"sec_8",title:"6. Conclusion",level:"1"},{id:"sec_9",title:"Acknowledgments",level:"1"}],chapterReferences:[{id:"B1",body:'Wolpaw J, Birbaumer N, McFarland D, Pfurtscheller G, Vaughan T. Brain-computer interfaces for communication and control. Clinical Neurophysiology. 2002;113:767-791'},{id:"B2",body:'Krucoff MO, Rahimpour S, Slutzky MW, Edgerton VR, Turner DA. Enhancing nervous system recovery through neurobiologics, neural interface training, and neurorehabilitation. Neuroprosthetics. 2016;10:584. DOI: 10.3389/fnins.2016.00584. PMC 5186786. PMID 28082858'},{id:"B3",body:'Vidal JJ. 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Biomedical Engineering. 2010;55:203-210'},{id:"B28",body:'Townsend G, Lapallo B, Boulay C, Krusienski D, Frye G, Hauser C, et al. A novel P300-based brain-computer interface stimulus presentation paradigm: Moving beyond rows and columns. Clinical Neurophysiology. 2010;121:1109-1120'},{id:"B29",body:'Kleih S, Kaufmann T, Zickler C, Halder S, Leotta F, Cincotti F, et al. Out of the frying pan into the fire—The P300 based BCI faces real world challenges. Progress in Brain Research. 2012;194:27-46'},{id:"B30",body:'Brunner P, Joshi S, Briskin S, Wolpaw J, Bischof H, Schalk G. Does the ‘P300’ speller depend on eye gaze? Journal of Neural Engineering. 2010;7:056013'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Kaoru Sumi",address:"kaoru.sumi@acm.org",affiliation:'
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IntechOpen is the first native scientific publisher of Open Access books, with more than 116,000 authors worldwide, ranging from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery. Established in Europe with the new headquarters based in London, and with plans for international growth, IntechOpen is the leading publisher of Open Access scientific books. The values of our business are based on the same ones that any scientist applies to their research -- we have created a culture of respect, collegiality and collaboration within an atmosphere that’s relaxed, friendly and progressive.
",metaTitle:"Social Media Community Manager and Marketing Assistant",metaDescription:"We are looking to add further talent to our team in The Shard office in London with a full-time Marketing and Communications Specialist position. The candidate will bring with them a creative and enthusiastic mindset, high level problem-solving skills, the latest marketing and social media platforms skills and strong involvement in community-best practices to engage with researchers and scholars online. The ideal candidate will be a dynamic, forward thinking, approachable team player, able to communicate with all in the global, growing company, with an ability to understand and build a rapport within the research community.",metaKeywords:null,canonicalURL:null,contentRaw:'[{"type":"htmlEditorComponent","content":"
We are looking to add further talent to our team in The Shard office in London with a full-time Social Media Community Manager and Marketing Assistant position. The candidate will bring with them a creative and enthusiastic mindset, high level problem-solving skills, the latest marketing and social media platforms skills and strong involvement in community-best practices to engage with researchers and scholars online. The ideal candidate wll be a dynamic, forward thinking, approachable team player, able to communicate with all in the global, growing company, with an ability to understand and build a rapport within the research community.
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The Social Media Community Manager and Marketing Assistant will report to the Senior Marketing Manager. They will work alongside the Marketing and Corporate Communications team, supporting the preparation of all marketing programs, assisting in the development of scientific marketing and communication deliverables, and creating content for social media outlets, as well as managing international social communities.
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Responsibilities:
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Assist in developing creative ideas and implementing materials to support marketing campaigns and events. Deliver projects as part of overall company marketing programme
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Play a key part in workshops for current and new programme ideas, collate ideas and recommendations for tactical programme elements
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Support marketing program preparation and wrap up (e.g., agendas, meeting notes, topics for discussion, background research, setting up campaigns, preparing lists)
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Preparation and content building for online and print material.
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Support relationships with external partners from across the scholarly communications and research, including overall research and support of the academic and institutional liaison program
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Social and Community moderation and monitoring to ensure high quality of answers provided via digital communities (e.g. research communities, LinkedIn, forums)
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Identify and implement effective social media coverage and monitoring tools. ie. Social listening
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Create content for different social media platforms (e.g. LinkedIn, Twitter, Facebook, blogs)
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Influencer and community outreach content
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Contribute creative ideas for using social media in existing programmes
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2-3 years of experience supporting marketing programme, including social and community experience with an understanding of how digital communication fits into the overall communications and marketing programmes
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Excellent communications skills -- able to write in a clear, explanatory and customer-focused manner, with a demonstrated strong command over the English language.
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Strong copywriting skills -- will be called upon to write online including hard copy content.
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Experience of engaging customers using social media technologies, platforms, listening programs and tracking/analytics. Evidence will be required.
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Experience of leveraging influencer communities and managing content strategies to maximise customer engagement. Examples will be required.
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Superb organisational skills - ability to take ownership and manage time effectively, as well as manage multiple priorities while maintaining a high level of accuracy within an environment of continuous change
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Self-starter able to work to deadlines with minimal supervision
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Team player with a learning and forward-thinking mindset who fosters a strong working environment with flexibility and willingness to work on a variety of different programs
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Experience in supporting programs with external partners, including global companies
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Previous experience of working with research, academia or scholarly communications
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Knowledge of open science, open research or open access
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What makes IntechOpen a great place to work?
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IntechOpen is a global, dynamic and fast-growing company offering excellent opportunities to develop. We are a young and vibrant company where great people do great work. We offer a creative, dedicated, committed, passionate, and above all, fun environment where you can work, travel, meet world-renowned researchers and grow your career and experience.
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Competitive salary
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Interactions with all areas of our business in all offices, which can lead to opportunities for career advancement
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Collaboration with scientists and publishing experts worldwide
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Insight into book editorial and production processes
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To apply, please email a copy of your CV and covering letter to hogan@intechopen.com stating your salary expectations.
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*IntechOpen is an Equal Opportunities Employer consistent with its obligations under the law and does not discriminate against any employee or applicant on the basis of disability, gender, age, colour, national origin, race, religion, sexual orientation, war veteran status, or any classification protected by state, or local law.
We are looking to add further talent to our team in The Shard office in London with a full-time Social Media Community Manager and Marketing Assistant position. The candidate will bring with them a creative and enthusiastic mindset, high level problem-solving skills, the latest marketing and social media platforms skills and strong involvement in community-best practices to engage with researchers and scholars online. The ideal candidate wll be a dynamic, forward thinking, approachable team player, able to communicate with all in the global, growing company, with an ability to understand and build a rapport within the research community.
\n\n
The Social Media Community Manager and Marketing Assistant will report to the Senior Marketing Manager. They will work alongside the Marketing and Corporate Communications team, supporting the preparation of all marketing programs, assisting in the development of scientific marketing and communication deliverables, and creating content for social media outlets, as well as managing international social communities.
\n\n
Responsibilities:
\n\n
\n\t
Assist in developing creative ideas and implementing materials to support marketing campaigns and events. Deliver projects as part of overall company marketing programme
\n\t
Play a key part in workshops for current and new programme ideas, collate ideas and recommendations for tactical programme elements
\n\t
Support marketing program preparation and wrap up (e.g., agendas, meeting notes, topics for discussion, background research, setting up campaigns, preparing lists)
\n\t
Preparation and content building for online and print material.
\n\t
Support relationships with external partners from across the scholarly communications and research, including overall research and support of the academic and institutional liaison program
\n\t
Social and Community moderation and monitoring to ensure high quality of answers provided via digital communities (e.g. research communities, LinkedIn, forums)
\n\t
Identify and implement effective social media coverage and monitoring tools. ie. Social listening
\n\t
Create content for different social media platforms (e.g. LinkedIn, Twitter, Facebook, blogs)
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Influencer and community outreach content
\n\t
Contribute creative ideas for using social media in existing programmes
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Essential Skills:
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2-3 years of experience supporting marketing programme, including social and community experience with an understanding of how digital communication fits into the overall communications and marketing programmes
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Excellent communications skills -- able to write in a clear, explanatory and customer-focused manner, with a demonstrated strong command over the English language.
\n\t
Strong copywriting skills -- will be called upon to write online including hard copy content.
\n\t
Experience of engaging customers using social media technologies, platforms, listening programs and tracking/analytics. Evidence will be required.
\n\t
Experience of leveraging influencer communities and managing content strategies to maximise customer engagement. Examples will be required.
\n\t
Superb organisational skills - ability to take ownership and manage time effectively, as well as manage multiple priorities while maintaining a high level of accuracy within an environment of continuous change
\n\t
Self-starter able to work to deadlines with minimal supervision
\n\t
Team player with a learning and forward-thinking mindset who fosters a strong working environment with flexibility and willingness to work on a variety of different programs
\n
\n\n
Desired Skills:
\n\n
\n\t
Experience in supporting programs with external partners, including global companies
\n\t
Previous experience of working with research, academia or scholarly communications
\n\t
Knowledge of open science, open research or open access
\n
\n\n
What makes IntechOpen a great place to work?
\n\n
IntechOpen is a global, dynamic and fast-growing company offering excellent opportunities to develop. We are a young and vibrant company where great people do great work. We offer a creative, dedicated, committed, passionate, and above all, fun environment where you can work, travel, meet world-renowned researchers and grow your career and experience.
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\n\t
Competitive salary
\n\t
Interactions with all areas of our business in all offices, which can lead to opportunities for career advancement
\n\t
Collaboration with scientists and publishing experts worldwide
\n\t
Insight into book editorial and production processes
\n
\n\n
To apply, please email a copy of your CV and covering letter to hogan@intechopen.com stating your salary expectations.
\n\n
Note: This full-time position will have an immediate start. In your cover letter, please indicate when you might be available for a block of two hours. As part of the interview process, all candidates that make it to the second phase will participate in a writing exercise.
\n\n
*IntechOpen is an Equal Opportunities Employer consistent with its obligations under the law and does not discriminate against any employee or applicant on the basis of disability, gender, age, colour, national origin, race, religion, sexual orientation, war veteran status, or any classification protected by state, or local law.
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