Antidotes included in the private part of the Network.
\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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\r\n\tWhen the diverse types of wear reported in the different industrial segments are studied it is observed that, approximately, 50% of them are related to the action of “abrasive wear” and/or “micro-abrasive wear”, being occasioned, in many circumstances, by natural abrasives. In contrast, the same abrasive materials that cause tribologic damage and financial loss in machines and equipment used in mechanical, metallurgical, materials, mining industries and agricultural sector, are applied on the analysis of dental materials, biomaterials adopted in the manufacturing of orthopaedic implants and complements, as well as industrial processes of manufacturing: conventional machining processes, special machining processes, lapidation and polishing. Consequently, the researches focused on wear analysis occasioned during work become important, as well as the scientific researches with the purpose of to study and to develop materials for the benefit of the human, like materials used in dental and orthopaedic areas. Thereby, this book aims to focus on the topics mentioned above, beyond general aspects related to natural abrasives.
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The Infrastructure Tracker was responsible for collecting data from the real world, sending them to the Processing Unit, which mixed the virtual content with the real content and sent the result to the Video Out module of the Visual Unit. Some designs used a Video In, to acquire required data for the Infrastructure Tracker Unit. The Visual Unit can be classified in two types of system, depending on the followed visualization technology:
Video see-through: It uses a Head-Mounted Display (HMD) that employs a video-mixing and displays the merged images on a closed-view HMD.
Optical see-through: It uses a HMD that employs optical combiners to merge the images within an open-view HMD
Augmented Reality Systems (ARS) standard design.
HMDs are currently the dominant display technology in the AR field. [5]. However they lack in several aspects, such as ergonomics, high prices and relatively low mobility due to their sizes and connectivity features. An additional problem involving HMD is the interaction with the real environment, which places virtual interactive zones to the user, making the collision with these zones hard due to the difficulty to interact with multiple points in different depths.
Alternative approachs to develop ARS involve the use of monitors and tablets. Monitors are used as an option for indirect view, since the user does not look directly into the mixed world. Tablets are used in direct view, since the user points the camera to the scene and looks directly into the mixed world. Both approaches still have difficulties in getting collision.
To make easy the collision actions, we developed series of artifacts, which help the user activity in the active zones, or int the active points by overlapping physical objects with virtual objects. The AR collision is implemented even if the user is not looking directly into the mixed world, but only into the artifact, providing another cognitive possibility as the user can use the tactile to collide. The cognitive function associated to the artifact empowered with augmented reality is based on an Augmented Reality Cognitive Artifact (ARCA).
This chapter presents the concepts and the technology involved with, emphasizing aspects of authoring and interaction on augmented reality applications based on multiple markers and multiple points. Moreover, the discusses augmented reality applications in the education and rehabilitation areas, which use artifacts aiming to overcome the main interaction problems. Finally, the last section concludes the chapter and presents future work.
Virtual reality was the first three-dimensional interface option, allowing natural interaction using hands with virtual environment rendered on monitors, projections or through VR HMD. To interact with the virtual elements, it is necessary to have multimodal devices, such as VR gloves (with sensors and tracking capabilities), force-feedback devices, 3D mice, stereoscope glasses, etc.
Representative definitions of virtual reality are: "virtual reality is an advanced computer interface that has real-time simulation and interactions through multi-sensor channels" [6] and "virtual reality is a computer interface that allows the user to interact, in real time, in a computer generated three-dimensional world, using his senses through special devices" [19]. In virtual reality environments, the user sees the virtual world, through a window rendered on monitor screens or projection screens; or the user is inserted into the virtual world through HMD or projection rooms, called caves. When the user is totally inserted into the virtual world, through HMD, caves and multi-sensed devices, the virtual reality is called Immersive (Figure 2a). When the user is partially inserted into the virtual world, through monitor or equivalent, the virtual reality is called Non-Immersive (Figure 2b).
The AR definition has evolved with the technologic evolution. In early definitions, the real world augmentation was obtained only through visual elements [16]; however, with the development of audio and haptic interactions associated with spatial position in real-time, the AR concept has been extended.
Virtual reality examples. (a) Immersive VR environment; (b) Non-Immersive VR environment.
Azuma [2] [1] defines augmented reality as a system that allows the user to see the real world, with virtual objects superimposed upon or composed with the real world. That system has the following three characteristics: it combines real and virtual elements; it is interactive in real time; and it is registered in a three-dimensional (3D) way. Figure 3 shows some results of a real world augmentation with virtual elements.
Augmented reality examples. (a) Virtual objects are misplaced; (b) Virtual objects are correctly placed.
In addition, the development of audio and haptic interactions associated with spatial position in real-time, the AR concept has been expanded. In this context, a wider AR definition involves the real world empowered with virtual objects that consider several aspects, such as: visualization, audio, haptic, etc.
According to an updated definition "Augmented Reality is an interface based on computer generated information combination (static and dynamic images, spatial sounds and haptic sensations) with the real user environment, provided by technological devices and using natural interaction in the real world" [19].
Away to bring virtual information to the physical user environment is using a webcam, which captures a live stream of the real world, and tracks some features, allowing the computer to add virtual information to the real world. The result can be seen, heard and felt by monitors, projections, helmets and haptic devices, depending on the interaction devices that take part of the system.
Cross-reality involves a ubiquitous mixed reality environment that comes from the fusion of a network of sensors and actuators (which collects and sends data related to the real world) with shared virtual worlds, using an augmented reality interface, where the exchange of information is bidirectional between the real and the virtual world. [34] [17]
Cross-reality can be classified in two types: Non Overlapped and Overlapped.
Non Overlapped Cross-Reality (NonOVER-CR). It is an AR environment with virtual elements, which are not overlapped with the real elements, using a network of sensors and actuators to acquire bidirectional communication between virtual and real objects. An example of this type of CR is a Seconf Life application that communicates with the real world [35].
Overlapped Cross-Reality (OVER-CR). It is an AR environment with virtual elements overlapped with the real elements, using a network of sensors and actuators to acquire bidirectional communication between virtual and real objects. This type of CR was discussed by [27], who explained the concept of augmented space, overlaying layers of data over the physical space using technology. Keiichi Matsuda, in his thesis [29], describes some examples of physical space overlaid with dynamically changing multimedia information, localized for each user.
Figure 4 shows an example of NonOVER-CR and OVER-CR, developed with the basAR authoring tool (Section 4.2), where there are two buttons (one virtual and one real) and an overlapped lamp (LED and virtual light beam). The buttons are not overlapped, witch characterizes a NonOVER-CR example; additionally, the illumination characterizes an OVER-CR example. The interaction with the real or the virtual button activates or deactivates the overlapped lamp, showing the LED on and the virtual beam or the LED off without the virtual beam.
Cross-Reality example.
Figure 5 shows a CR representation obtained from the fusion of the augmented reality area (overlapping real and virtual environments) with ubiquitous computing, involving a network of real and virtual sensors and actuators. In this situation, interactions in the real environment reflect into the virtual environment and vice-versa. When the virtual and real sensors are overlapped, the interactions in the two worlds are concomitant. These results of this property could be useful in several types of applications, involving telepresence, collaborative and remote work in physical installations empowered by virtual elements, etc. Cross-Reality makes possible to interact with remote equipments, as well as with complex experiments which are hard to simulate.
Cross-Reality, virtual and real interfaces.
Humans actuating in the physical world frequently use artifacts as extension of their own knowledge and reasoning systems to support the remembering and processing of information [3] [32]. Classical examples are a shopping list and a string tied around a finger. In this way, artifacts that are used in cognitive applications, are named cognitive artifacts.
The term cognitive artifact was coined by Norman [31] and has different definitions, depending on the available technology and the type of application. An up-to-date definition, a cognitive artifact is a physical object or software application used to aid, enhance or improve thinking and reasoning.
Artifacts, including the cognitive ones, have significant potential to be implemented with augmented reality based on computer vision, once the prototype can present low cost and be easily distributed to interested users. Several interactive artifacts for rehabilitation are being developed, however most of them are applied in motor rehabilitation. There are few examples related to cognitive rehabilitation [4] [37] [12].
Artifacts based on Augmented Reality technology may fulfill the following requirements: [21]
The artifact, for cogntive application have to involve muti-sensory perception, memory, attention, logic and motor control, in order to allow the preparation of cognitive exercises;
The physical parts of the artifact has to be built with ordinary materials, involving a simple process, presenting availability and low cost;
For this, it could be adopted materials such as Styrofoam, cardboard or wood, to implement the physical structure, tied with glue, always followed by instructions and templates;
The logical parts of the artifact have to use augmented reality technology based on computer vision software. Authoring tools for rapid prototyping, using augmented reality can make easy the development of applications. A further section will present three possible authoring tools for these purposes;
The user interactive actions on the artifact must be tangible and easy. This property, due to the coincident physical and virtual points, allows force feedback interactions, because when the user touches the interacting device (pointer) on the artifact, he feels the contact and the virtual action point is enabled. This characteristic is important because it gives more comfort to the user. When the points are placed into the 3D space, without physical association, they demand more ability and concentration from the user to collide the pointer with the virtual points.
Augmented Reality Artifacts Applications can be visualized with a projector or a HMD; however, using a computer monitor is cheaper, available and easy to operate. The artifact allows direct interaction with sound feedback, but the visualization will be indirect, when a monitor is used.
In the last years, series of AR authoring tools were released to help users to develop spatial applications mediated by computer. Authoring augmented reality tools can be classified, according to their characteristics of programming and content design, in low and high level, considering the concepts abstraction and interface complexity incorporated in the tool.
Programming tools are based on basic or advanced libraries (basic or advanced ones), involving computer vision, registration, three-dimensional rendering, sounds, input/output and other functions. ARToolKit [16], MR [42], MX [11] and FLARToolKit are examples of low level programming tools. The development of applications, based on programming tools can be complex. Futhermore, authoring tools, templates and interfaces cover the development complexity and ease the steps to achieve the application abstraction, as illustrated in Figure 6.
Complexity versus Abstraction in AR Applications Development.
ARToolKit is one of the first augmented reality programming tools that use marker registration and computer vision. In this tool, the developers need C/C++ programming skills to author the applications. A more recent tool, FLARToolKit is a wrapper from ARToolKit, developed with Action Script 3, the language from Adobe Flash environments. FLARToolKit has a distinguishing feature, which is to enable the creation of web-based augmented reality applications.
Content design tools are independent of a specific programming language, replacing it by the description of the virtual objects and their relationship with the real environment. IN this context, APRIL [24] is a low level example of this type of tool, which uses XML descriptions. IN the other had, high level content design tools use graphical user interfaces to represent the descriptions and interactions, as it occurs in DART [26], AMIRE [13], ECT [15], ComposAR [39] and ARSFG [43].
High level content design should be more intuitive and suitable for non-programmers. These tools can support scripting and visual interfaces, new functionalities added by user and real time interpretation.
Our research is different from other AR authoring tools, since it considers the following characteristics.
A level of abstraction that covers the framework (ARToolKit or FLARToolkit);
Authoring AR applications depends on editing configuration files and tangible operations;
There are different authoring levels, depending on the skills of the developer;
Authoring can use tangible operations, editing configuration files and mouse and keyboard support; however the end users can interact with the AR application using only one or two markers.
Authoring AR application basically depends on: structure of the AR environment; data structure and folders that support the tool; authoring interface; configuration tasks, action commands, system commands, and utilization procedures that support the end-user to navigate and interact with the augmented environment.
To make easy the development of AR applications with those elements, we developed the authoring tool ARAS-NP (Augmented Real Authoring System for Non-Programmers). It includes authoring and utilization characteristics, besides additional features related to a shared remote use, which enables user collaboration.
ARToolKit is the core of ARAS-NP and additional functionalities were programmed with C/C++. The software, user manual and applications of ARAS-NP are freely distributed by the authors [18].
Augmented reality involves more than superimpose virtual objects and annotations over the real world. Thus, the augmented world (Figure 7 ), as considered in this work, presents real and virtual objects, such as: interactive objects, which can change in certain situations; animated objects, which can be activated; visible or invisible objects, which vanish or appear in certain cases; visible or invisible points, which can be activated or deactivated; etc.
Moreover, the augmented reality environment can be modified after the initial authoring, for example, by adding, changing and deleting points and virtual objects.
Augmented World.
The data structure of the augmented reality environment to be authored comprises reference markers, which have associated virtual boards, and their respective elements (points, virtual objects and sounds) that appear on the board, according to Figure 8. These elements must be placed in folders that the developer needs to manipulate in order to create the augmented reality environment.
ARAS-NP Data Structure.
The basAR (Behavioral Authoring System for Augmented Reality) is an evolution of the ARAS-NP, once it uses the same AR framework ARToolKit as its core. Its configuration is based on description files and it follows the same approach of using action points, differently of other authoring tools that create behavior and interactivity based on marker position, orientation and proximity. The software, user manual and applications of basAR are freely distributed by the authors [8].
The basAR data structure is organized according to Figure 9.
basAR Data Structure.
The basAR tool involves a multi-layer approach, with the following features:
Infrastructure: It defines the correlation between the real and virtual worlds, such as markers and their properties;
Structure: It defines the virtual points layer and where they are located;
Content: It defines the models, sounds, etc. that are used to create the application abstraction;
Behavior: It defines how the augmented layer handles the feedbacks from the user interaction. The basAR behavior is structured by commands that describe dynamically the application; those commands are grouped on a language called basAR-AL (basAR Authoring Language) [8];
Acting: It defines how the user interacts with the structure layer;
Cross-Reality: It defines the keywords used by the behavior layer to communicate with the hardware.
FLARAS (Flash Augmented Reality Authoring System) is an augmented reality authoring tool based in the same action point approach of ARAS-NP; futhermore, it represents an evolution, mainly due to the graphic interface and because it allows to develop application to be hosted on the Internet and played on any computer that has Adobe Flash Player. This is an important advance, since most technologies are going forward the Web applications and the cloud computing. The software, user manual and applications of FLARAS are freely distributed by the authors [41].
The FLARAS data structure is organized according to Figure 10.
FLARAS Data Structure.
The main advantages to use ARS for educational purposes are: [7]
Students are more motivated, because they live an experience proposed by the application and the use of a new technology;
AR can illustrate processes and characteristics that are not usually viewed by the user;
AR allows detailed visualization and objects animation;
AR allows micro and macro visualizations that cannot be seen with naked eyes, as well as proposes different view angles to understand the subject;
AR allows interactive virtual learning using virtual experiments;
AR allows the students to recreate the experiments out of the school environment;
The students become more active due to the interactive application characteristics;
AR encourages creativity, improving the experience;
AR provides equal opportunities to different cultural students;
AR helps to teach computational and peripheral skills.
AR technology has an strong appeal to the constructivism, where the students control their own learning [10]. AR environments allow the students to explore objects, perform tasks, learn concepts and develop skills. Using AR educational applications, each student can look for its own interests, in its own speed and need, which better suits to its individual characteristics. For example, in a historical place, using an AR application, each student can define its own discovery way [14].
This section shows some educational examples developed with different authoring tools, such as:
ARAS-NP: AR books, Spatial Tutor, Q&A Applications, Perspective learning;
basAR: Geometry teach and learning application;
FLARToolKit: Electromagnetism teach and learning application.
The AR books comprise applications that have been much disseminated in the last years [14]. When a person looks to an AR books, it seems as any other book. However, when the user puts the books in front of a computer with a webcam, 3D objects, sounds, animation, extra explanations and several interactive elements seem to jump from the pages. These resources are added to the book to motivate the student to explore the presented theme, supporting the learning process.
Some examples of AR Books are the GeoAR [36] and the SpaceAR [33].
The GeoAR is an AR book to teach geometry subjects related to the main geometric shapes. Figure 11a presents the page of the square in the GeoAR, showing the marker, and some explanations and formulas. Figures 11b and 11c shows the book with the AR layer of the sphere and cube square pages.
GeoAR examples. (a) Example page, (b) Sphere page and (c) Square page.
Another example of AR Book is the SpaceAR. It has information about the Solar System, and its pages guide the user into new discoveries of the objects that orbit the Sun. Figures 12a, 12b and 12c illustrate the use of the book, with the Sun and its information and a rotating animation.
SpaceAR examples. (a) How to use the book, (b) Sun information page and (c) Sun animation.
The AR Spatial Tutor aims at creating interaction with panels and mockups using AR, to expose 3D objects, annotations, sounds and animations.
This tutor is based on the ARAS-NP tool and includes two physical artifacts to show the tutor use. The first version is based on a Photographic Panel representing the Itaipú Hoover, in Brazil (Figure 13a). It has some action points located on the panel, which, when are clicked with the interaction artifact, they show annotations (Figure 13b), sounds and explanations. Those points can have multiple information elements that allow the expansion of contents or the fulfilling of different types of users.
AR Spatial Tutor - Multimedia. (a) Photographic Panel and (b) AR annotations.
The second version of the AR Spatial Tutor is based on a mockup of the same Itaipú Hoover, made from Styrofoam. An AR layer paints the Styrofoam and place the action points. Asimple look at the mockup shows a static artifact, without interaction, which could be no attractive to students or users. However, when the AR layer is placed, the mockup is empowered with dynamic content, motivating its use. Figure 14a shows the mockup without the AR layer and Figure 14b shows the AR layer added.
AR Spatial Tutor - Multimedia. (a) Mockup without AR layer and (b) with AR layer.
The Q&A-AR educational spatial game is a multiplayer car racing game based on questions and answers, which works in an augmented reality environment [20].
The game Q&A-AR fulfills the following requirements:
The game must have educational potential involving several themes of study using texts, illustrations and sounds;
The physical parts of the game must be made with ordinary materials and process in order to have availability and low cost;
The logical parts of the game must use augmented reality technology based on computer vision;
The interactive actions to be executed on the game must be tangible and easy;
The information related to the game (questions, answers, instructions) must be easily customized by teachers;
The user interface of the game must consider usability factors, such as easy to understand, easy to learn and easy to use.
The game uses a series of artifacts, including nonmoving artifacts, and moving parts. The nonmoving artifact contains two perpendicular planes in order to present the game information to the user. The vertical plane contains the reference marker, which is used to superimpose the virtual information on the artifact. The horizontal plane presents the race path with ten cells, and a textual area for questions and answers.
The moving parts are composed by the player cars, the dices and an interaction pointer with a marker.
The virtual structure is composed of virtual buttons that overlap the printed buttons, the virtual cell buttons. To perform the interaction, the player only needs to touch the physical pointer on the printed button or on the top of the cars placed on the path cells.
Figures 15a, 15b, 15c and 15d present the nonmoving parts, the moving parts, the activation of a question and the answer elements, and the augmented reality environment of the game, respectively.
Q&A-AR Game. (a),(b),(c) and (d) present the nonmoving parts, the moving parts, the activation of a question and the answer elements, and the augmented reality environment of the game, respectively.
The goal of the game is to reach the end of the path first. The cars run over the path on the horizontal plane driven by moving information, involving dice, forward and backward movement indicated by buttons or by result of the player performance, and answering to the questions presented by the activation of the virtual path cell buttons.
To see and describe real and imaginary three-dimensional scenes from the observer’s viewpoint is an intuitive activity for non-impaired people; However, it is difficult and even impossible for congenitally blind people, once it involves abstract concepts for them, such as: perspective, depth planes, occlusion, etc. This project, supported by an augmented reality tool, helps blind people to understand, describe and convert three-dimensional scenes in two-dimensional embossed representations, like painting. To understand how the blind people can acquire those concepts, we developed an augmented reality application, working as an audio spatial tutor to make the perspective learning process easy [23] [38].
Figure 16 presents some developed ARCAs for perspective learning application.
a),(b),(c) and (d) are ARCAs used in this Perspective Learning, respectively.
The development of spatial skills involves a critical understanding, when students start learning three-dimensional objects. In order to help this achievement, the teachers usually employ woodcraft artifacts and several orthographic and axonometric projections inside books [28]. A way to improve the learning of three-dimensional shapes is content based on AR. This application is used to teach polygon extrusion and revolution math concepts, using the authoring tool basAR to create the interactive application, where the student chooses the type of polygon and then apply the movement. Figure 17a shows the three possible polygons (circle, cube and triangle). When a polygon is chosen, it shows the two possibilities (extrusion or revolution), according to the Figure 17b. Figures 17c and 17b show the extrusion and revolution results of a circle.
This application can be found on the Internet [9].
a) Polygons choices; (b) user selected the circle; (c) extrusion result; (d) revolution result.
Some concepts of electromagnetism, as they are relatively abstract, require more effort from the students to be understood. With the intention to offer an alternative way, that would be more interactive and dynamic, the MiniLabElectroMag-AR (Mini Laboratory of Electromagnetism with Augmented Reality) was developed. The purpose of this application is to work as a simple laboratory for experiments about electromagnetism, allowing, for example, that students explore in a practical way some basic concepts, such as electric currents, electric circuits, that inducted magnetic field generated by the flow of electric current on a straight wire, and also the simulation of the Oersted’s experiment.
Figure 18a shows the artifact with the lamp, battery and switch elements draw. The Figure 18b shows the same artifact with the AR layer, with the virtual elements superimposed.
Figure 18c shows compass deflection due to the magnetic induction of the wire. Figure 18d shows two students collaboratively exploring the experience.
a) Artifact with drawn elements; (b) Artifact with AR layer; (c) and (d) Oersted’s experiments.
This application can be found on the Internet [40].
Nowadays, with the technological evolution, cognitive rehabilitation is using interactive artifacts, such as software applications (based on multimedia and virtual reality) and physical objects controlled by computer (PDAs, tablets, cellular phones, specific devices with GPS, accelerometers and other technological resources, etc.). Those artifacts are part of technology for cognitive rehabilitation and can help disabled people presenting traumatic brain injury, stroke, learning disabilities and multiple sclerosis. Besides, they have some potential to aid people with dementia, autism spectrum disorders and mental retardation [30].
The cognitive artifacts used for retraining and development of cognitive skills explores the following aspects: temporal and spatial orientation; attention, concentration and calculation; language understanding and speaking; understanding of social cues; judgment and abstraction; immediate recall, recent and remote memory; organization; planning and problem solving; mental processing speed; multi-sensory processing (visual, auditory and motor); self-control and self-confidence.
With recent technological trends, rehabilitation patients are getting access to advanced interactive devices with interesting features, such as highly technological, highly interactive and multi-sensory ones. Nevertheless, those devices present some disadvantages, such as: complex using, difficulty to convert the rehabilitation training to real-life benefits, low or medium availability, medium or high cost, medium or high dexterity demanding, etc. To overcome such problems, it is important to use assistive devices, presenting simplicity as their main feature [25].
We discuss next the development of interactive cognitive artifacts and their applications for retraining and improvement of cognitive skills, aiming at satisfying the main characteristics desired in a modern cognitive device, such as: low cost, easy customization, user-friendly interface, multi-sensory input/output, low dexterity demanding, etc.
The rehabilitation examples, presented next, are:
ARAS-NP: Artifact-AR
basAR: dGames-VI Memory Game and dGames-inclusive AR Pong
The Artifact-AR was implemented as a 3D structure built with three perpendicular planes, so that each one contains nine cells that can be virtually colored or has spatial colored virtual "coins" activated (Fig. 19). Besides, on the upper side, there is a plane extension used to accommodate the application marker and control buttons and to receive visual information like pictures and texts. The user interacts with the physical artifact, hears the auditory information from computer loudspeaker and visualizes effects (video of the physical artifact expanded with virtual information) on a monitor placed in front of him/her.
The visualization can also be obtained by a projector or an augmented reality HMD, although using a computer monitor is cheap, available and easy to operate. The artifact allows direct interaction with sound feedback; on the other hand, if a monitor or a projector is utilized, the visualization will be indirect, and, if a HMD is utilized, the visualization will be direct. We initially developed two cognitive applications exploring identification, memorization, comparison and association of pictures, patterns and sounds. An application considers pre-built patterns whereas the other one allows the assembly of patterns through the interaction with each cell individually. Figure 19a presents examples where the user can select a picture on the right side and/or a pattern composed of virtual embossed "coins" on the perpendicular planes, comparing or associating pictures and patterns. Figure 19b presents an example of picture containing one plane pattern to serve as reference to be replicated by the user through the activation of cells on a plane.
a) Comparison and association of pictures and/or patterns; (b) Replication of patterns.
Although that application was implemented originally with ARAS-NP, it is being converted with FLARAS to work on the Internet. The final project using FLARAS will be available on the Internet [22]
This project presents a solution to exercise cognitive skills, as association and memory, based on a classic memory card game, using a simple artifact, enhanced with AR. In this application, a therapist can setup several maps, with different characteristics and levels.
This artifact (Figure 20a) was developed using blended tactile and audition sense allowing its use for visual-impaired people. However, as it can also show images (Figure 20b), it can be used by non-visual impaired people as a memory game, or in classes activities, to teach word association, languages, scene associations, etc.
a) Artifact design; (b) Artifact with AR layer.
An example of this artifact, applied as an inclusive memory card game, is given as follows (Figure 21):
The therapist builds several maps, with different characteristics, levels, etc.;
The therapist setups the environment with the artifact and the webcam/computer, adopting the AR required software;
The system creates the first option, asking to start the activity. The user chooses the next option. The system issues a start sound and shows the covered map.
The user chooses a first card (hole). The system issues the card sound and shows its image;
The user chooses a second card. The system issues the card sound and its image. If the pair of sounds (and/or images) related to the two cards matches, the system verifies if the amout of pairs on the map is completed. If it is completed, the system issues a game over sound and releases the next map, retrieving to step 3; otherwise it continues. If the pair does not match, it issues a mistaken sound, closing both selected cards and enabling the user to go to step 4.
dGames-VI Memory Game Diagram.
This project presents a solution to exercise spatial association of a 3D audio stimulus with its corresponding motor feedback. It was inspired on the Ping-Pong game, using a low cost and easily built Artifact enhanced with an AR layer provided by the basAR authoring tool. In this application, a blind people can play against the computer or against other player who is not necessarily blind as well. The game can has a therapeutic and, in this last case, the therapist can set exercises sequences to evaluate the patient.
Figure 22a shows the Styrofoam artifact, with the AR layer, from the camera view (Figure 22b). Figure 22c shows a therapeutic setup, where, in the right artifact (Therapist Artifact), the therapist can set the sequences and the speed in the top three spaces on his artifact grid.
a) Artifact design; (b) Artifact with AR layer; (c) Application setup.
The AR software layer provides a 3D audio placement, as Figure 23a, the horizontal placement is performed by the stereo balance; the vertical placement is performed by the frequency modulation, in which a higher pitch indicates a higher height and a lower pitch indicates a lower height; the deep placement is associated with the volume, in which higher volumes indicate that the object is near of the user. Figure 23b shows how to control the ball speed. Five stages, with four time intervals control the ball speed, that is, with high time intervals the speed is decreased, and to get fast speed the time intervals are decreased.
a) Sound placement into a 3D space; (b) Adjusting the time intervals to control ball speed.
The inclusion of 3D placement in the artifact, enables the augmented reality properties. In this sense, each artifact cell has a deep placement (Figure 24a), to create each cell ball movement. The vertical and horizontal placements are interlaced, to create nine possible combinations of pan and possible pitch (Figure 24b) so that the user can find the correct cell by its sound.
a) Deep placement; (b) Sound behavior.
In this chapter, we presented the concepts and technology related to augmented reality applications, as well as authoring tools and developed applications in the areas of education and cognitive rehabilitation.
When using augmented reality systems based on multiple points instead of on multiple markers, we notice that the collision of the interaction device with the virtual points was hard to accomplish, due to the spatial positioning. To solve this problem, an augmented reality artifact was created, to place the virtual points over real points in a physical structure. The augmented reality artifacts solved the problem with the spatial collision in multiple depths. This allowed the development of several augmented reality applications for educational and cognitive rehabilitation purposes, once the artifact empowered with smart augmented reality reactions would provide significant support to students and patients, at low cost.
The fast prototyping of the application solutions with Styrofoam, cardboards, and easily found materials allows the creation of artifacts enriched with the augmented reality layer, which can be easily distributed and used. Even with the artifact weaknesses, it seems to be a very interesting option to be applied. Evaluation tests confirmed important strengths of using the artifacts, such as low cost, availability, user-friendly interfaces, multi-sensory, tangible interaction, non-demanding dexterity, etc.
The proposed authoring tools have distinct characteristics with respect to other approaches which are based on marker relation behavior, as we use action point interactions. This option allows the use of a minimum amount of marker, instead of a pack of markers to drive an application.
The authors believe that augmented reality artifacts have high potential to be applied in educational and cognitive rehabilitation applications, due to the specific potentiality provided by the augmented reality and the three-dimensional artifact features.
As future work, we are evolving the authoring tools, aiming at generating more powerful and easy-friendly versions and exploring the integration of web applications with online augmented reality applications implemented with the FLARAS authoring tool. Besides, we are developing cognitive and motor rehabilitation games, using the basAR authoring tool, and studying the use of cross-reality in innovative applications that could effectively contribute to the educational and rehabilitation areas.
This research was partially funded by Brazilian Agencies CNPq (Grants #558842/2009-7 and #559912/2010-2) and FAPEMIG (Grant #APQ-03643-10).
Poisoning is the second leading cause of injury-related morbidity and mortality in the United States, with more than 2.4 million toxic exposures reported each year [1].
Antidotes, remedies or agents counteracting or neutralizing the action of poisons (MeSH and Emtree definitions, from Dorland’s Medical Dictionary, 32nd edition), apply their useful impacts through an assortment of components, including the development of an inactive complex with the venom, the speeding up of venom detoxification, the decrease of venom transformation rate to a progressively dangerous compound, rivalry with venom for fundamental receptor locales, blockage of basic receptors through which lethal impacts are intervened, and avoidance of venom impact. There are explicit antidotes for few toxins, and a couple of counteractants are routinely utilized in clinical practice. These are acetylcysteine, naloxone and flumazenil.
Antidotal therapy is a critical aspect of the poisoning management in emergency setting: prompt availability and sufficient amount are essential, particularly when these molecules represent life-saving therapy for the acute poisoned patient.
Pharmacists can help reduce morbidity and mortality due to poisonings and overdoses by recognizing the signs exposure, guiding emergency room staff on the appropriate use of antidotes and supportive therapies, helping to ensure appropriate monitoring of patients for antidote response and adverse effects and managing the procurement and stocking of antidotes to ensure their timely availability [2].
Antidotes are essential medicines for the management of some of the emergencies attended in the hospital environment, and the speed of administration can be a key element for the survival of the patient. The Hospital Pharmacy Services are responsible for guaranteeing its availability [3, 4, 5, 6].
However, it can be affected by several causes:
Frequency of presentation of an intoxication in a geographical area
Urgency in administration
Difficulties of acquisition
Cost
Period of validity
Therefore, it is necessary to create a tool that facilitates the exchange of antidotes between hospitals and ensures their availability.
For example, in other countries like in the USA, to appropriately prepare for bioterrorism response, the governmental Agency that optimally provides the surveillance and planning guidance is the Centers for Disease Control and Prevention (CDC). Pharmacists can play a key role in reducing poisoning and overdose injuries and deaths by assisting in the early recognition of toxic exposures and guiding emergency personnel on the proper storage, selection, and use of antidotal therapies. The clinical pharmacist for a hospital is creating a protocol for the pharmacy department in the event of a biological disaster. Five elements that are critical to the protocol follow the National Preparedness Goal (NPG) created to prepare the United States for threats that pose risks to the nation, including acts of terrorism. The five mission areas that were identified in order to achieve the NPG are: Prevention, protection, mitigation, response, and recovery. The pharmacy department of a given hospital stores a Strategic National Stockpile (SNS) cache for use in a disaster. The person that authorizes deployment of the stockpile is the State governor’s office, and thereafter, Pharmacy director and Hospital Incident Command System (HICS).
Inadequate stock or insufficient number of antidotes is a common and diffused problem in the Emergency Departments in many countries. In Italy, based on this consideration, from 2003 to 2012 two National surveys has been conducted from Pavia Poison Control Centre (Pavia-PCC) with the grant of the Italian Ministry of Health. The aim of these surveys was to evaluate antidotes availability in the Emergency Services (PCCs, EDs, intensive care units) and Hospital Pharmacies of the National Health System (NHS) throughout the Italian country. As a result of this initiative, since 2006, the collected data were organized in a specific “National data-base of antidotes” (BAnDA), available online (
Regarding Spain, in July 2015, the Xarxa d’Antídots de Catalunya was created to interconnect public and private hospitals throughout the community. It includes the provision, in these centers, of 18 antidotes for which there may be problems of availability due to the aforementioned factors.
The experience of the first few years has been very positive, both in terms of the number of hospitals adhered to and the toxicological consultations received, and loans made. For this reason, and with the intention of extending this project throughout the country, the Antidote Network was created. The Balearic Islands has been the first community to join and it is planned to expand with more regions in the near future.
To describe and to make a revision of Antidotes and their importance as an essential drug for management of acute intoxications.
To give several evidences that the availability problems about stocking of antidotes in hospitals are an important concern, due to the lack of a National Regulation.
To show the importance and responsibility that Pharmacy Departments are for warranting an optimal qualitative and quantitative stock of these drugs.
In this context, the main objective is to propose a detailed review of the Antidotes Network that has been created in the Spanish territory.
Within the framework of the Catalan Society of Clinical Pharmacy, a working group formed by pharmacists and doctors with experience in the field of Clinical Toxicology was created to develop the network. First, the group prepared a document with recommendations on the storage of antidotes according to the complexity and location of the hospital. An online application was then intended to be utilized as a specialized instrument between centers.
The application collects information on 15 antidotes, selected according to criteria of availability, urgency, frequency of use or cost (fragments of digoxin antibodies, methylene blue, deferoxamine, dimercaprol, calcium sodium edate, ethanol, physostigmine, fomepizole, glucagon, hydroxocobalamin, pyridoxine, pralidoxime, silibinin, botulinum antitoxin and snake venom antiserum). This tool provides information on the stock of each center (including the expiration date) and facilitates the loan of antidotes between hospitals.
The online application “Red de Antidotos” was propelled in July 2015. It has an open region with data about the task and offers the probability of non-dire toxicological discussions to the specialists of the gathering, and a private zone available with username and secret key for the focuses that have joined the network. So far 34 Catalan clinics offering crisis care have been fused. In each inside there is a drug specialist and a specialist from the Emergency Department in charge of the network. These figures are designated “farmatox” and “urgetox”. The “farmatox” is responsible for the support of the stocks, refreshes the developments of medications and arranges and loan antidotes between emergency clinics. The “urgetox” builds up the elements of toxicology referent of the Emergency Department.
The network of antidotes is a really intuitive and helpful device. The private region is separated into four segments. The Antidote segment contains data on antidotes, which can be counseled on the web. It is a powerful list, kept up by the individuals from the gathering, which gathers information on toxicological signs, measurements with the best agreement for the two grown-ups and kids, accessible definitions, perceptions on organization, strength, unfriendly responses and different contemplations to be considered, just as the prescribed amounts to be put away relying upon the multifaceted nature of every medical clinic.
The Antidote Stock Management segment gathers the accessible measure of antitoxins in the network put away in every emergency clinic. The application permits the “farmatox” to enter any section and leave development. Every passage must include: medicine, number of units, bunch, lapse date and sort of development. For the last mentioned, two sorts of passage developments have been characterized (buy of drugs and return of the advance to another medical clinic), and three kinds of leave developments (claim use, termination and credit).
All developments for stock refreshing (credit developments just as for possess use) must be done physically by the drug specialist mindful in every emergency clinic. To encourage this stock upkeep, the application enables you to print a record with the units entered for each clump and the lapse date for each group. Lapsed units are featured in red.
The application enables you to scan for antidotes by drug or by medical clinic, in the area of the guide that demonstrates the data of the considerable number of emergency clinics incorporated into the network. At the point when the inquiry is done by clinic, the accompanying information can be counseled on the guide: name of the “farmatox” and the “urgetox”, address, phone, email, fax and opening times of the Pharmacy, Department and phone of the Emergency Unit. It likewise demonstrates every one of the antidotes accessible in the inside, with their number of units and the following expiry date. At the point when the antitoxin search is played out, all clinics in which the cure is accessible will be shown, just as the quantity of accessible units and the following termination date.
The network was first implemented in Catalonia and now the project is being extended to other Spanish regions (currently it has been implemented in three out of 17 regions, Figure 1), with the aim to continue improving communication between professionals involved in intoxication management, sharing knowledge and improving the care we offer to our patients.
Centers of the Antidotes Network in Spain.
There are presently 63 Spanish emergency clinics incorporated into the Antidotes Network. It has been utilized multiple times to find a remedy that was vital and to apply for an advance between focuses. Up until this point, 13 counteractants have been engaged with these developments. The most requested drugs are represented in the image below (Figure 2). Likewise, proposals on stock accessibility and utilization of antidotes as indicated by the multifaceted nature of the medical clinic were distributed and are accessible in the Emergencias Journal.
Most request drugs. Source: Aguilar-Salmerón et al [7].
As a result of this project, “the Antidotes Guide” was published, that includes recommendations for the availability of 38 antidotes depending on the level of complexity of the hospitals and information on toxicological indications, posology and other observations of interest.
In the private part of the Antidotes Network, the stocks of the adhered hospitals are available for those antidotes in which availability problems may occur. Currently there are 18 antidotes included in the private part of the Network (Table 1).
Antidotes | Commercial presentations | Initial dosing |
---|---|---|
Antidigoxin antibodies | Digifab® 40 mg vial Refrigerator. Foreigner | IV 40 mg per 0.5 mg digoxin. If unknown digoxin quantity 400 mg (10 vials). To reconstitute with 4 mL of water + 250 mL PS 30 minutes inf. It may be necessary to repeat doses |
Dantrolene | Dantrolen® 20 mg vial | IV 2.5 mg/kg (each vial in 3 min) preferably via central. Maximum doses reached 10 mg/kg |
Deferoxamine | Desferin® vial 500 mg | IM 2 g in 10 mL Water or IV 15 mg/Kg/h (max. 80 mg/Kg/24 h) |
Defibrotide | Defibrotide® 200 mg/2.5 mL vial | IV 6.25 mg/kg/h in 2 h |
Dimercaprol (bal, British anti-lewisite) | Dimercaprol® amp. 200 mg c/12 amp 2 mL. Foreigner | IM 3 mg/Kg/4 h for 2 days |
Calcium edetate sodium (EDTA) | Calcium Edetate sodium® amp.500 mg/10 mL c/10 amp. Foreigner | IV 1000 mg in 250 mL SF 6 hours infusion. Repeat every 12 h for 5 days |
Ethanol (absolute ethanol) | Absolute ethanol® amp 10 mL Pharmaceutical Compounding | IV. 1 mL/Kg in D 5% 50 mL in 1 h. Continue with 0.1 mL/Kg/h. If alcoholic, double dose. Requires analytical control e/6h |
Physostigmine | Anticholium® 2 mg/5 mL amp | IV 1–2 mg in 2 min. Repeat each bolus every 10–30 min. Alternatively: 2 mg/h up to a maximum of 8 mg/h |
Fomepizole | Fomepizol® vial 100 mg | IV Loading dose of 15 mg/kg in 100–250 mg of NaCl 0.9% or D 5% and administered in 30–45 min |
Glucagon | Glucagon Gen Hypokit® 1 mg syringe | IV 5 mg in 1 min. Repeat, if needed, in 10 min |
Glucarpidase | Voraxazane® 1000 U vial | IV 50 U/kg in 5 min injection |
Hydroxocobalamin | Cyanokit® 5 g vial | IV 5 g in 10 min (2.5 g if <35 Kg). If cardiac arrest 10 g in 10 min. If after 1 h there is no change, 5 more grams in 15 min |
Idarucizumab | Praxbind® 2.5 g injectable solution | IV 5 g (2 vials) in two consecutive infusions or in one infusion |
Pralidoxime (pam) | Contrathion® vial 200 mg/10 mL c/10 vials-amp. Foreigner | IV 1 g in 100 mL G 5 % 1 h infusion. If necessary, continue with the same dose every 6 h for 2–3 days. |
Silibinin | Legalon® vial 350 mg | IV 5 mg/kg in 500 mL NaCl 0.9% or D 5% in 2 h. Repeat each 6 h (3–4 days) |
Antibotulinum serum | Botulism Antitoxin Heptavalent A, B, C, D, E, F, G (BAT) 50 mL injectable solution | IV dilute 1 vial 1:10 and administer at 0.5 mL/min during 30 min. Maximum rate of 2 mL/min |
Antiophidic serum | Snake venom antiserum (Bulbio®) vial 100 UI (5 mL). Foreigner | One dose corresponds to 100 IU (1 vial). First dose given via SC at the site of the sting, second dose via IM in the buttock. Further doses may be necessary at a later time as clinically determined. |
Uridine triacetate | Vistonuridine® 10 g sachet | PO 10 g each 6 h, 20 doses |
Antidotes included in the private part of the Network.
Note also that the list of antidotes included in the network will change according to the needs of its hospitals, any epidemiological changes in poisoning, the launch of new antidotes, and problems for supply of others.
The consultations section is a tool very useful that the Antidote Network offers to any Health Professional the possibility of carrying out various types of toxicological consultations, as: (i) intoxications in which an antidote could be used, (ii) antidotes that could be used in some types of poisonings, (iii) agents used for digestive, cutaneous or ocular decontamination (iv) recommendations on qualitative and quantitative availability of antidotes.
Also, this section offers the possibility that the answer to some of these questions can be found by the reader in the Antidote Guide that can be found in this website.
For urgent medical consultations due to poisonings and toxicological emergencies, it is possible to contact by telephone the Toxicological Information Service of the National Institute of Toxicology and Forensic Sciences as this Service offers toxicological advice 24 h a day, 365 days a year. Otherwise, for non-urgent consultations on Clinical Toxicology, pharmacological aspects of antidotes or on drugs that can cause intoxications, it is possible to contact the experts of the Group of antidotes, specialized in assistance to acute intoxications in both adults and pediatrics, via an official email published on the official website.
It is necessary to guarantee an adequate stock of antidotes in those hospitals managing poisoned patients; however, this is not always simple to realize.
Making a database of refreshed supplies of antitoxins open to all medical clinics overseeing clinic crises is definitely not another thought. New Zealand emergency clinics have just recommended its creation as an answer for the inadequacies found [7, 8]. Similarly, the “Centro Antiveleni di Pavia - Centro Nazionale di Informazione Tossicologica” made the Banca Dati Nazionale degli Antidoti (BaNdA), in light of an investigation of the accessibility of antidotes in Italian Emergency Units, among others [9, 10, 11, 12, 13, 14, 15, 16]. It is an on-line stage that permits to discover refreshed information on the subjective and quantitative accessibility of counteractants in all the clinic units required, to look for a particular antitoxin by city or area and to get to all the contact information important to apply for an advance.
Some information on antitoxins and how they are arranged through Spanish antidote network as antitoxins are always a problem for both developing and developed countries. Particularly, some information on botulinum antitoxins and anti-venoms:
Botulism Antitoxin Heptavalent—A, B, C, D, E, F, G (BAT), solution for injection: Adult dosage administration: Dilute the vial in a ratio of 1:10 and administer at a speed of 0.5 mL/min for 30 min and increase to double the speed every 30 min up to a maximum of 2 mL/min. For child dosage: Between 20 and 100% of the vial according to body weight. In children under 1 year the dose is 10% of the vial regardless of body weight. For administration: Dilute the vial in a ratio of 1:10 and administer at a speed of 0.01 mL/kg/min and increase by 0.01 mL/kg/min every 30 min to a maximum of 0.03 mL/min without exceeding adult rates. For dilution: Since the filling volume of each vial varies depending on the lot number (approximately 10–22 mL per vial), 90–200 mL of saline solution will be required for dilution. Conservation conditions: Store frozen or below ≤−15°C until used. Once thawed, it can be stored at 2–8°C for up to 36 months or up to 48 months from the date of manufacture (whichever comes first). Do not refreeze the vial. Administer the drug at room temperature. To defrost it, leave it at room temperature for 1 h and then immerse it in a bath of water at 37°C until it defrosts completely.
Snake Venom Antiserum (Bulvio® and Viperfav®): Adult and child dosage:
Viperfav: IV Perfusion of 4 mL of serum (1 vial) in 100 mL SF at 50 ml/h.
Snake Venom Antiserum: 100 IU (5 mL) via SC, followed by a second IM dose in the buttock. 1,2 or more IM doses may be necessary depending on the patient’s condition and on the second and third days 1 or 2 more doses may be needed. Viperfav® has a low risk of anaphylactic reactions. On the other hand, in the case of Snake Venom Antiserum® it is recommended to carry out a hypersensitivity test prior to its administration.
Building up a network of antitoxins can improve correspondence between focuses that oversee harmed patients, adjust and institutionalize antidotes assets in various focuses, and accelerate credits if essential. Eventually, it can improve the nature of consideration for harmed patients.
Antidote Network could allow improved communication between centers involved in the management of poisoned patients, help in adjusting and harmonizing antidotes stock and accelerate antidote borrowing, if required.
Furthermore, this Antidote Network provide prompt and easy access to antidotes (especially expensive and rare-use ones), to rapidly find them in the nearby hospitals or regions (avoiding lengthy and expensive transport), and it is useful also to optimize antidote stockpiles with saving of resources.
As future proposals it would be very convenient to expand the network throughout the national territory and implement it in other countries, which would allow an increase in the quality of life of the patient and an improvement in public health.
The author declares no conflict of interest.
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She performed research in perioperative autotransfusion and obtained the degree of PhD in 1993 publishing Peri-operative autotransfusion by means of a blood cell separator.\nBlood transfusion had her special interest being the president of the Haemovigilance Chamber TRIP and performing several tasks in local and national blood bank and anticoagulant-blood transfusion guidelines committees. Currently, she is working as an associate professor and up till recently was the dean at the Albert Schweitzer Hospital Dordrecht. She performed (inter)national tasks as vice-president of the Concilium Anaesthesia and related committees. \nShe performed research in several fields, with over 100 publications in (inter)national journals and numerous papers on scientific conferences. \nShe received several awards and is a member of Honour of the Dutch Society of Anaesthesia.",institutionString:null,institution:{name:"Albert Schweitzer Hospital",country:{name:"Gabon"}}},{id:"83089",title:"Prof.",name:"Aaron",middleName:null,surname:"Ojule",slug:"aaron-ojule",fullName:"Aaron Ojule",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Port Harcourt",country:{name:"Nigeria"}}},{id:"295748",title:"Mr.",name:"Abayomi",middleName:null,surname:"Modupe",slug:"abayomi-modupe",fullName:"Abayomi Modupe",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/no_image.jpg",biography:null,institutionString:null,institution:{name:"Landmark University",country:{name:"Nigeria"}}},{id:"94191",title:"Prof.",name:"Abbas",middleName:null,surname:"Moustafa",slug:"abbas-moustafa",fullName:"Abbas Moustafa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94191/images/96_n.jpg",biography:"Prof. Moustafa got his doctoral degree in earthquake engineering and structural safety from Indian Institute of Science in 2002. He is currently an associate professor at Department of Civil Engineering, Minia University, Egypt and the chairman of Department of Civil Engineering, High Institute of Engineering and Technology, Giza, Egypt. He is also a consultant engineer and head of structural group at Hamza Associates, Giza, Egypt. Dr. Moustafa was a senior research associate at Vanderbilt University and a JSPS fellow at Kyoto and Nagasaki Universities. He has more than 40 research papers published in international journals and conferences. He acts as an editorial board member and a reviewer for several regional and international journals. His research interest includes earthquake engineering, seismic design, nonlinear dynamics, random vibration, structural reliability, structural health monitoring and uncertainty modeling.",institutionString:null,institution:{name:"Minia University",country:{name:"Egypt"}}},{id:"84562",title:"Dr.",name:"Abbyssinia",middleName:null,surname:"Mushunje",slug:"abbyssinia-mushunje",fullName:"Abbyssinia Mushunje",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Fort Hare",country:{name:"South Africa"}}},{id:"202206",title:"Associate Prof.",name:"Abd Elmoniem",middleName:"Ahmed",surname:"Elzain",slug:"abd-elmoniem-elzain",fullName:"Abd Elmoniem Elzain",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Kassala University",country:{name:"Sudan"}}},{id:"98127",title:"Dr.",name:"Abdallah",middleName:null,surname:"Handoura",slug:"abdallah-handoura",fullName:"Abdallah Handoura",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"École Supérieure des Télécommunications",country:{name:"Morocco"}}},{id:"91404",title:"Prof.",name:"Abdecharif",middleName:null,surname:"Boumaza",slug:"abdecharif-boumaza",fullName:"Abdecharif Boumaza",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Abbès Laghrour University of Khenchela",country:{name:"Algeria"}}},{id:"105795",title:"Prof.",name:"Abdel Ghani",middleName:null,surname:"Aissaoui",slug:"abdel-ghani-aissaoui",fullName:"Abdel Ghani Aissaoui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/105795/images/system/105795.jpeg",biography:"Abdel Ghani AISSAOUI is a Full Professor of electrical engineering at University of Bechar (ALGERIA). He was born in 1969 in Naama, Algeria. He received his BS degree in 1993, the MS degree in 1997, the PhD degree in 2007 from the Electrical Engineering Institute of Djilali Liabes University of Sidi Bel Abbes (ALGERIA). He is an active member of IRECOM (Interaction Réseaux Electriques - COnvertisseurs Machines) Laboratory and IEEE senior member. He is an editor member for many international journals (IJET, RSE, MER, IJECE, etc.), he serves as a reviewer in international journals (IJAC, ECPS, COMPEL, etc.). He serves as member in technical committee (TPC) and reviewer in international conferences (CHUSER 2011, SHUSER 2012, PECON 2012, SAI 2013, SCSE2013, SDM2014, SEB2014, PEMC2014, PEAM2014, SEB (2014, 2015), ICRERA (2015, 2016, 2017, 2018,-2019), etc.). His current research interest includes power electronics, control of electrical machines, artificial intelligence and Renewable energies.",institutionString:"University of Béchar",institution:{name:"University of Béchar",country:{name:"Algeria"}}},{id:"99749",title:"Dr.",name:"Abdel Hafid",middleName:null,surname:"Essadki",slug:"abdel-hafid-essadki",fullName:"Abdel Hafid Essadki",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"École Nationale Supérieure de Technologie",country:{name:"Algeria"}}},{id:"101208",title:"Prof.",name:"Abdel Karim",middleName:"Mohamad",surname:"El Hemaly",slug:"abdel-karim-el-hemaly",fullName:"Abdel Karim El Hemaly",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/101208/images/733_n.jpg",biography:"OBGYN.net Editorial Advisor Urogynecology.\nAbdel Karim M. A. El-Hemaly, MRCOG, FRCS � Egypt.\n \nAbdel Karim M. A. El-Hemaly\nProfessor OB/GYN & Urogynecology\nFaculty of medicine, Al-Azhar University \nPersonal Information: \nMarried with two children\nWife: Professor Laila A. Moussa MD.\nSons: Mohamad A. M. El-Hemaly Jr. MD. Died March 25-2007\nMostafa A. M. El-Hemaly, Computer Scientist working at Microsoft Seatle, USA. \nQualifications: \n1.\tM.B.-Bch Cairo Univ. June 1963. \n2.\tDiploma Ob./Gyn. Cairo Univ. April 1966. \n3.\tDiploma Surgery Cairo Univ. Oct. 1966. \n4.\tMRCOG London Feb. 1975. \n5.\tF.R.C.S. Glasgow June 1976. \n6.\tPopulation Study Johns Hopkins 1981. \n7.\tGyn. Oncology Johns Hopkins 1983. \n8.\tAdvanced Laparoscopic Surgery, with Prof. Paulson, Alexandria, Virginia USA 1993. \nSocieties & Associations: \n1.\t Member of the Royal College of Ob./Gyn. London. \n2.\tFellow of the Royal College of Surgeons Glasgow UK. \n3.\tMember of the advisory board on urogyn. FIGO. \n4.\tMember of the New York Academy of Sciences. \n5.\tMember of the American Association for the Advancement of Science. \n6.\tFeatured in �Who is Who in the World� from the 16th edition to the 20th edition. \n7.\tFeatured in �Who is Who in Science and Engineering� in the 7th edition. \n8.\tMember of the Egyptian Fertility & Sterility Society. \n9.\tMember of the Egyptian Society of Ob./Gyn. \n10.\tMember of the Egyptian Society of Urogyn. \n\nScientific Publications & Communications:\n1- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Asim Kurjak, Ahmad G. Serour, Laila A. S. Mousa, Amr M. Zaied, Khalid Z. El Sheikha. \nImaging the Internal Urethral Sphincter and the Vagina in Normal Women and Women Suffering from Stress Urinary Incontinence and Vaginal Prolapse. Gynaecologia Et Perinatologia, Vol18, No 4; 169-286 October-December 2009.\n2- Abdel Karim M. El Hemaly*, Laila A. S. Mousa Ibrahim M. Kandil, Fatma S. El Sokkary, Ahmad G. Serour, Hossam Hussein.\nFecal Incontinence, A Novel Concept: The Role of the internal Anal sphincter (IAS) in defecation and fecal incontinence. Gynaecologia Et Perinatologia, Vol19, No 2; 79-85 April -June 2010.\n3- Abdel Karim M. El Hemaly*, Laila A. S. Mousa Ibrahim M. Kandil, Fatma S. El Sokkary, Ahmad G. Serour, Hossam Hussein.\nSurgical Treatment of Stress Urinary Incontinence, Fecal Incontinence and Vaginal Prolapse By A Novel Operation \n"Urethro-Ano-Vaginoplasty"\n Gynaecologia Et Perinatologia, Vol19, No 3; 129-188 July-September 2010.\n4- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Laila A. S. Mousa and Mohamad A.K.M.El Hemaly.\nUrethro-vaginoplasty, an innovated operation for the treatment of: Stress Urinary Incontinence (SUI), Detursor Overactivity (DO), Mixed Urinary Incontinence and Anterior Vaginal Wall Descent. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/ urethro-vaginoplasty_01\n\n5- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamed M. Radwan.\n Urethro-raphy a new technique for surgical management of Stress Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/\nnew-tech-urethro\n\n6- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamad A. Rizk, Nabil Abdel Maksoud H., Mohamad M. Radwan, Khalid Z. El Shieka, Mohamad A. K. M. El Hemaly, and Ahmad T. El Saban.\nUrethro-raphy The New Operation for the treatment of stress urinary incontinence, SUI, detrusor instability, DI, and mixed-type of urinary incontinence; short and long term results. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=urogyn/articles/\nurethroraphy-09280\n\n7-Abdel Karim M. El Hemaly, Ibrahim M Kandil, and Bahaa E. El Mohamady. Menopause, and Voiding troubles. \nhttp://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly03/el-hemaly03-ss\n\n8-El Hemaly AKMA, Mousa L.A. Micturition and Urinary\tContinence. Int J Gynecol Obstet 1996; 42: 291-2. \n\n9-Abdel Karim M. El Hemaly.\n Urinary incontinence in gynecology, a review article.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/abs-urinary_incotinence_gyn_ehemaly \n\n10-El Hemaly AKMA. Nocturnal Enuresis: Pathogenesis and Treatment. \nInt Urogynecol J Pelvic Floor Dysfunct 1998;9: 129-31.\n \n11-El Hemaly AKMA, Mousa L.A.E. Stress Urinary Incontinence, a New Concept. Eur J Obstet Gynecol Reprod Biol 1996; 68: 129-35. \n\n12- El Hemaly AKMA, Kandil I. M. Stress Urinary Incontinence SUI facts and fiction. Is SUI a puzzle?! http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly/el-hemaly-ss\n\n13-Abdel Karim El Hemaly, Nabil Abdel Maksoud, Laila A. Mousa, Ibrahim M. Kandil, Asem Anwar, M.A.K El Hemaly and Bahaa E. El Mohamady. \nEvidence based Facts on the Pathogenesis and Management of SUI. http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly02/el-hemaly02-ss\n\n14- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Mohamad A. Rizk and Mohamad A.K.M.El Hemaly.\n Urethro-plasty, a Novel Operation based on a New Concept, for the Treatment of Stress Urinary Incontinence, S.U.I., Detrusor Instability, D.I., and Mixed-type of Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/urethro-plasty_01\n\n15-Ibrahim M. Kandil, Abdel Karim M. El Hemaly, Mohamad M. Radwan: Ultrasonic Assessment of the Internal Urethral Sphincter in Stress Urinary Incontinence. The Internet Journal of Gynecology and Obstetrics. 2003. Volume 2 Number 1. \n\n\n16-Abdel Karim M. El Hemaly. Nocturnal Enureses: A Novel Concept on its pathogenesis and Treatment.\nhttp://www.obgyn.net/urogynecolgy/?page=articles/nocturnal_enuresis\n\n17- Abdel Karim M. El Hemaly. Nocturnal Enureses: An Update on the pathogenesis and Treatment.\nhttp://www.obgyn.net/urogynecology/?page=/ENHLIDH/PUBD/FEATURES/\nPresentations/ Nocturnal_Enuresis/nocturnal_enuresis\n\n18-Maternal Mortality in Egypt, a cry for help and attention. The Second International Conference of the African Society of Organization & Gestosis, 1998, 3rd Annual International Conference of Ob/Gyn Department � Sohag Faculty of Medicine University. Feb. 11-13. Luxor, Egypt. \n19-Postmenopausal Osteprosis. The 2nd annual conference of Health Insurance Organization on Family Planning and its role in primary health care. Zagaziz, Egypt, February 26-27, 1997, Center of Complementary Services for Maternity and childhood care. \n20-Laparoscopic Assisted vaginal hysterectomy. 10th International Annual Congress Modern Trends in Reproductive Techniques 23-24 March 1995. Alexandria, Egypt. \n21-Immunological Studies in Pre-eclamptic Toxaemia. Proceedings of 10th Annual Ain Shams Medical Congress. Cairo, Egypt, March 6-10, 1987. \n22-Socio-demographic factorse affecting acceptability of the long-acting contraceptive injections in a rural Egyptian community. Journal of Biosocial Science 29:305, 1987. \n23-Plasma fibronectin levels hypertension during pregnancy. The Journal of the Egypt. Soc. of Ob./Gyn. 13:1, 17-21, Jan. 1987. \n24-Effect of smoking on pregnancy. Journal of Egypt. Soc. of Ob./Gyn. 12:3, 111-121, Sept 1986. \n25-Socio-demographic aspects of nausea and vomiting in early pregnancy. Journal of the Egypt. Soc. of Ob./Gyn. 12:3, 35-42, Sept. 1986. \n26-Effect of intrapartum oxygen inhalation on maternofetal blood gases and pH. Journal of the Egypt. Soc. of Ob./Gyn. 12:3, 57-64, Sept. 1986. \n27-The effect of severe pre-eclampsia on serum transaminases. The Egypt. J. Med. Sci. 7(2): 479-485, 1986. \n28-A study of placental immunoreceptors in pre-eclampsia. The Egypt. J. Med. Sci. 7(2): 211-216, 1986. \n29-Serum human placental lactogen (hpl) in normal, toxaemic and diabetic pregnant women, during pregnancy and its relation to the outcome of pregnancy. Journal of the Egypt. Soc. of Ob./Gyn. 12:2, 11-23, May 1986. \n30-Pregnancy specific B1 Glycoprotein and free estriol in the serum of normal, toxaemic and diabetic pregnant women during pregnancy and after delivery. Journal of the Egypt. Soc. of Ob./Gyn. 12:1, 63-70, Jan. 1986. Also was accepted and presented at Xith World Congress of Gynecology and Obstetrics, Berlin (West), September 15-20, 1985. \n31-Pregnancy and labor in women over the age of forty years. Accepted and presented at Al-Azhar International Medical Conference, Cairo 28-31 Dec. 1985. \n32-Effect of Copper T intra-uterine device on cervico-vaginal flora. Int. J. Gynaecol. Obstet. 23:2, 153-156, April 1985. \n33-Factors affecting the occurrence of post-Caesarean section febrile morbidity. Population Sciences, 6, 139-149, 1985. \n34-Pre-eclamptic toxaemia and its relation to H.L.A. system. Population Sciences, 6, 131-139, 1985. \n35-The menstrual pattern and occurrence of pregnancy one year after discontinuation of Depo-medroxy progesterone acetate as a postpartum contraceptive. Population Sciences, 6, 105-111, 1985. \n36-The menstrual pattern and side effects of Depo-medroxy progesterone acetate as postpartum contraceptive. Population Sciences, 6, 97-105, 1985. \n37-Actinomyces in the vaginas of women with and without intrauterine contraceptive devices. Population Sciences, 6, 77-85, 1985. \n38-Comparative efficacy of ibuprofen and etamsylate in the treatment of I.U.D. menorrhagia. Population Sciences, 6, 63-77, 1985. \n39-Changes in cervical mucus copper and zinc in women using I.U.D.�s. Population Sciences, 6, 35-41, 1985. \n40-Histochemical study of the endometrium of infertile women. Egypt. J. Histol. 8(1) 63-66, 1985. \n41-Genital flora in pre- and post-menopausal women. Egypt. J. Med. Sci. 4(2), 165-172, 1983. \n42-Evaluation of the vaginal rugae and thickness in 8 different groups. Journal of the Egypt. Soc. of Ob./Gyn. 9:2, 101-114, May 1983. \n43-The effect of menopausal status and conjugated oestrogen therapy on serum cholesterol, triglycerides and electrophoretic lipoprotein patterns. Al-Azhar Medical Journal, 12:2, 113-119, April 1983. \n44-Laparoscopic ventrosuspension: A New Technique. Int. J. Gynaecol. Obstet., 20, 129-31, 1982. \n45-The laparoscope: A useful diagnostic tool in general surgery. Al-Azhar Medical Journal, 11:4, 397-401, Oct. 1982. \n46-The value of the laparoscope in the diagnosis of polycystic ovary. Al-Azhar Medical Journal, 11:2, 153-159, April 1982. \n47-An anaesthetic approach to the management of eclampsia. Ain Shams Medical Journal, accepted for publication 1981. \n48-Laparoscopy on patients with previous lower abdominal surgery. Fertility management edited by E. Osman and M. Wahba 1981. \n49-Heart diseases with pregnancy. Population Sciences, 11, 121-130, 1981. \n50-A study of the biosocial factors affecting perinatal mortality in an Egyptian maternity hospital. Population Sciences, 6, 71-90, 1981. \n51-Pregnancy Wastage. Journal of the Egypt. Soc. of Ob./Gyn. 11:3, 57-67, Sept. 1980. \n52-Analysis of maternal deaths in Egyptian maternity hospitals. Population Sciences, 1, 59-65, 1979. \nArticles published on OBGYN.net: \n1- Abdel Karim M. El Hemaly*, Ibrahim M. Kandil, Laila A. S. Mousa and Mohamad A.K.M.El Hemaly.\nUrethro-vaginoplasty, an innovated operation for the treatment of: Stress Urinary Incontinence (SUI), Detursor Overactivity (DO), Mixed Urinary Incontinence and Anterior Vaginal Wall Descent. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/ urethro-vaginoplasty_01\n\n2- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamed M. Radwan.\n Urethro-raphy a new technique for surgical management of Stress Urinary Incontinence.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/\nnew-tech-urethro\n\n3- Abdel Karim M. El Hemaly, Ibrahim M Kandil, Mohamad A. Rizk, Nabil Abdel Maksoud H., Mohamad M. Radwan, Khalid Z. El Shieka, Mohamad A. K. M. El Hemaly, and Ahmad T. El Saban.\nUrethro-raphy The New Operation for the treatment of stress urinary incontinence, SUI, detrusor instability, DI, and mixed-type of urinary incontinence; short and long term results. \nhttp://www.obgyn.net/urogyn/urogyn.asp?page=urogyn/articles/\nurethroraphy-09280\n\n4-Abdel Karim M. El Hemaly, Ibrahim M Kandil, and Bahaa E. El Mohamady. Menopause, and Voiding troubles. \nhttp://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly03/el-hemaly03-ss\n\n5-El Hemaly AKMA, Mousa L.A. Micturition and Urinary\tContinence. Int J Gynecol Obstet 1996; 42: 291-2. \n\n6-Abdel Karim M. El Hemaly.\n Urinary incontinence in gynecology, a review article.\nhttp://www.obgyn.net/urogyn/urogyn.asp?page=/urogyn/articles/abs-urinary_incotinence_gyn_ehemaly \n\n7-El Hemaly AKMA. Nocturnal Enuresis: Pathogenesis and Treatment. \nInt Urogynecol J Pelvic Floor Dysfunct 1998;9: 129-31.\n \n8-El Hemaly AKMA, Mousa L.A.E. Stress Urinary Incontinence, a New Concept. Eur J Obstet Gynecol Reprod Biol 1996; 68: 129-35. \n\n9- El Hemaly AKMA, Kandil I. M. Stress Urinary Incontinence SUI facts and fiction. Is SUI a puzzle?! http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly/el-hemaly-ss\n\n10-Abdel Karim El Hemaly, Nabil Abdel Maksoud, Laila A. Mousa, Ibrahim M. Kandil, Asem Anwar, M.A.K El Hemaly and Bahaa E. El Mohamady. \nEvidence based Facts on the Pathogenesis and Management of SUI. http://www.obgyn.net/displayppt.asp?page=/English/pubs/features/presentations/El-Hemaly02/el-hemaly02-ss\n\n11- Abdel Karim M. El Hemaly*, Ibrahim M. 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