Search results for: augmented reality visual aids
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3773

Search results for: augmented reality visual aids

1073 Development of Automatic Laser Scanning Measurement Instrument

Authors: Chien-Hung Liu, Yu-Fen Chen

Abstract:

This study used triangular laser probe and three-axial direction mobile platform for surface measurement, programmed it and applied it to real-time analytic statistics of different measured data. This structure was used to design a system integration program: using triangular laser probe for scattering or reflection non-contact measurement, transferring the captured signals to the computer through RS-232, and using RS-485 to control the three-axis platform for a wide range of measurement. The data captured by the laser probe are formed into a 3D surface. This study constructed an optical measurement application program in the concept of visual programming language. First, the signals are transmitted to the computer through RS-232/RS-485, and then the signals are stored and recorded in graphic interface timely. This programming concept analyzes various messages, and makes proper presentation graphs and data processing to provide the users with friendly graphic interfaces and data processing state monitoring, and identifies whether the present data are normal in graphic concept. The major functions of the measurement system developed by this study are thickness measurement, SPC, surface smoothness analysis, and analytical calculation of trend line. A result report can be made and printed promptly. This study measured different heights and surfaces successfully, performed on-line data analysis and processing effectively, and developed a man-machine interface for users to operate.

Keywords: laser probe, non-contact measurement, triangulation measurement principle, statistical process control, labVIEW

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1072 Hand Gesture Recognition for Sign Language: A New Higher Order Fuzzy HMM Approach

Authors: Saad M. Darwish, Magda M. Madbouly, Murad B. Khorsheed

Abstract:

Sign Languages (SL) are the most accomplished forms of gestural communication. Therefore, their automatic analysis is a real challenge, which is interestingly implied to their lexical and syntactic organization levels. Hidden Markov models (HMM’s) have been used prominently and successfully in speech recognition and, more recently, in handwriting recognition. Consequently, they seem ideal for visual recognition of complex, structured hand gestures such as are found in sign language. In this paper, several results concerning static hand gesture recognition using an algorithm based on Type-2 Fuzzy HMM (T2FHMM) are presented. The features used as observables in the training as well as in the recognition phases are based on Singular Value Decomposition (SVD). SVD is an extension of Eigen decomposition to suit non-square matrices to reduce multi attribute hand gesture data to feature vectors. SVD optimally exposes the geometric structure of a matrix. In our approach, we replace the basic HMM arithmetic operators by some adequate Type-2 fuzzy operators that permits us to relax the additive constraint of probability measures. Therefore, T2FHMMs are able to handle both random and fuzzy uncertainties existing universally in the sequential data. Experimental results show that T2FHMMs can effectively handle noise and dialect uncertainties in hand signals besides a better classification performance than the classical HMMs. The recognition rate of the proposed system is 100% for uniform hand images and 86.21% for cluttered hand images.

Keywords: hand gesture recognition, hand detection, type-2 fuzzy logic, hidden Markov Model

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1071 Assessing the Accessibility to Primary Percutaneous Coronary Intervention

Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

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Background: Ensuring patients with ST-elevation myocardial infarction (STEMI) access to hospitals that could perform percutaneous coronary intervention (PCI) in time is an important concern of healthcare managers. One commonly used the method to assess the coverage of population access to PCI hospital is the use GIS-estimated linear distance (crow's fly distance) between the district centroid and the nearest PCI hospital. If the distance is within a given distance (such as 20 km), the entire population of that district is considered to have appropriate access to PCI. The premise of using district centroid to estimate the coverage of population resident in that district is that the people live in the district are evenly distributed. In reality, the population density is not evenly distributed within the administrative district, especially in rural districts. Fortunately, the Taiwan government released basic statistical area (on average 450 population within the area) recently, which provide us an opportunity to estimate the coverage of population access to PCI services more accurate. Objectives: We aimed in this study to compare the population covered by a give PCI hospital according to traditional administrative district versus basic statistical area. We further examined if the differences between two geographic units used would be larger in a rural area than in urban area. Method: We selected two hospitals in Tainan City for this analysis. Hospital A is in urban area, hospital B is in rural area. The population in each traditional administrative district and basic statistical area are obtained from Taiwan National Geographic Information System, Ministry of Internal Affairs. Results: Estimated population live within 20 km of hospital A and B was 1,515,846 and 323,472 according to traditional administrative district and was 1,506,325 and 428,556 according to basic statistical area. Conclusion: In urban area, the estimated access population to PCI services was similar between two geographic units. However, in rural areas, the access population would be overestimated.

Keywords: accessibility, basic statistical area, modifiable areal unit problem (MAUP), percutaneous coronary intervention (PCI)

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1070 Clinical Outcomes and Surgical Complications in Patients with Cervical Disk Degeneration

Authors: Mirzashahi Babak, Mansouri Pejman, Najafi Arvin, Farzan Mahmoud

Abstract:

Introduction: There are several surgical treatment choices for cervical spondylotic myelopathy (CSM). The aim of this study is to evaluate clinical outcomes and surgical complications in patients with cervical disk degeneration (CDD) undergoing either anterior cervical discectomy with or without fusion or cervical laminectomy and fusion. Methods: This prospective case series study included 45 consecutive patients with cervical spondylotic myelopathy between January 2010 and November 2014. There were 28 males and 17 females, with a mean age of 47 (range 37-68) years. The mean clinical follow-up was 14 months (range 3-24 months). The Neck Disability Index (NDI), visual analog scale (VAS) neck and arm pain, Short Form-36 (SF-36) were used as the functional outcome measurements. All of the complications in our patients were recorded. Results: In our study group, 26 patients underwent only one or two level anterior cervical discectomy. Ten patients underwent anterior cervical discectomy and fusion (ACDF) and nine cases underwent posterior laminectomy and fusion. We have found a statistically significant improvement between mean preoperative (29, range 19-43) and postoperative (7, range 0-12) NDI scores following surgery (P < 0.05). Also, there was a statistically significant difference between pre and post-operative VAS and SF-36 score (p < 0.05). There was a 7% overall complication rate (n = 3). The only complication in our patients was surgical site cellulitis which has been managed with oral antibiotic therapy. Conclusion: Both anterior cervical discectomy with or without fusion or posterior laminectomy and fusion are safe and efficacious treatment options for the management of CSM. The clinical outcomes seem to be fairly reproducible.

Keywords: cervical, myelopathy, discectomy, fusion, laminectomy

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1069 Analysis of Weld Crack of Main Steam Governing Valve Steam Turbine Case

Authors: Sarakorn Sukaviriya

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This paper describes the inspection procedure, root cause analysis, the rectification of crack, and how to apply the procedure with other similar plants. During the operation of the steam turbine (620MW), instruments such as speed sensor of steam turbine, the servo valve of main stop valve and electrical wires were malfunction caused by leakage steam from main steam governing valve. Therefore, the power plant decided to shutdown steam turbines for figuring out the cause of leakage steam. Inspection techniques to be applied in this problem were microstructure testing (SEM), pipe stress analysis (FEM) and non-destructive testing. The crack was initially found on main governing valve’s weldment by visual inspection. To analyze more precisely, pipe stress analysis and microstructure testing were applied and results indicated that the crack was intergranular and originated from the weld defect. This weld defect caused the notch with high-stress concentration which created crack and then propagated to steam leakage. The major root cause of this problem was an inappropriate welding process, which created a weld defect. To repair this joint from damage, we used a welding technique by producing refinement of coarse grain HAZ and eliminating stress concentration. After the weldment was completely repaired, other adjacent weldments still had risk. Hence, to prevent any future cracks, non-destructive testing (NDT) shall be applied to all joints in order to ensure that there will be no indication of crack.

Keywords: steam-pipe leakage, steam leakage, weld crack analysis, weld defect

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1068 A Case of Myelofibrosis-Related Arthropathy: A Rare and Underrecognized Entity

Authors: Geum Yeon Sim, Jasal Patel, Anand Kumthekar, Stanley Wainapel

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A 65-year-old right-hand dominant African-American man, formerly employed as a security guard, was referred to Rehabilitation Medicine with bilateral hand stiffness and weakness. His past medical history was only significant for myelofibrosis, diagnosed 4 years earlier, for which he was receiving scheduled blood transfusions. Approximately 2 years ago, he began to notice stiffness and swelling in his non-dominant hand that progressed to pain and decreased strength, limiting his hand function. Similar but milder symptoms developed in his right hand several months later. There was no history of prior injury or exposure to cold. Physical examination showed enlargement of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints with finger flexion contractures, Swan-neck and Boutonniere deformities, and associated joint tenderness. Changes were more prominent in the left hand. X-rays showed mild osteoarthritis of several bilateral PIP joints. Anti-nuclear antibodies, rheumatoid factor, and cyclic citrullinated peptide antibodies were negative. MRI of the hand showed no erosions or synovitis. A rheumatology consultation was obtained, and the cause of his symptoms was attributed to myelofibrosis-related arthropathy with secondary osteoarthritis. The patient was tried on diclofenac cream and received a few courses of Occupational Therapy with limited functional improvement. Primary myelofibrosis (PMF) is a rare myeloproliferative neoplasm characterized by clonal proliferation of myeloid cells with variable morphologic maturity and hematopoietic efficiency. Rheumatic manifestations of malignancies include direct invasion, paraneoplastic presentations, secondary gout, or hypertrophic osteoarthropathy. PMF causes gradual bone marrow fibrosis with extramedullary metaplastic hematopoiesis in the liver, spleen, or lymph nodes. Musculoskeletal symptoms are not common and are not well described in the literature. The first reported case of myelofibrosis related arthritis was seronegative arthritis due to synovial invasion of myeloproliferative elements. Myelofibrosis has been associated with autoimmune diseases such as systemic lupus erythematosus, progressive systemic sclerosis, and rheumatoid arthritis. Gout has been reported in patients with myelofibrosis, and the underlying mechanism is thought to be related to the high turnover of nucleic acids that is greatly augmented in this disease. X-ray findings in these patients usually include erosive arthritis with synovitis. Treatment of underlying PMF is the treatment of choice, along with anti-inflammatory medications. Physicians should be cognizant of recognizing this rare entity in patients with PMF while maintaining clinical suspicion for more common causes of joint deformities, such as rheumatic diseases.

Keywords: myelofibrosis, arthritis, arthralgia, malignancy

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1067 Visual Inspection of Road Conditions Using Deep Convolutional Neural Networks

Authors: Christos Theoharatos, Dimitris Tsourounis, Spiros Oikonomou, Andreas Makedonas

Abstract:

This paper focuses on the problem of visually inspecting and recognizing the road conditions in front of moving vehicles, targeting automotive scenarios. The goal of road inspection is to identify whether the road is slippery or not, as well as to detect possible anomalies on the road surface like potholes or body bumps/humps. Our work is based on an artificial intelligence methodology for real-time monitoring of road conditions in autonomous driving scenarios, using state-of-the-art deep convolutional neural network (CNN) techniques. Initially, the road and ego lane are segmented within the field of view of the camera that is integrated into the front part of the vehicle. A novel classification CNN is utilized to identify among plain and slippery road textures (e.g., wet, snow, etc.). Simultaneously, a robust detection CNN identifies severe surface anomalies within the ego lane, such as potholes and speed bumps/humps, within a distance of 5 to 25 meters. The overall methodology is illustrated under the scope of an integrated application (or system), which can be integrated into complete Advanced Driver-Assistance Systems (ADAS) systems that provide a full range of functionalities. The outcome of the proposed techniques present state-of-the-art detection and classification results and real-time performance running on AI accelerator devices like Intel’s Myriad 2/X Vision Processing Unit (VPU).

Keywords: deep learning, convolutional neural networks, road condition classification, embedded systems

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1066 Life Stories: High Quality of Life until the End with the Narrative Medicine and the Storytelling

Authors: Danila Zuffetti, Lorenzo Chiesa

Abstract:

Background: A hospice narrative interview aims at putting the sick at the core of disease and treatment allowing them to explore their most intimate facets. The aim of this work is to favor authentic narration by leading towards awareness and acceptance of terminality and to face death with serenity. Narration in palliative care aims at helping to reduce the chaos generated by the disease and to elaborate interpretations on the course of reality, besides, the narration delivered to the doctor is fundamental and communicates the meaning given to symptoms. Methods: The narrative interview has become a regular activity in the Castellini Foundation since 2017. Patients take part every week, and for more days, in one hour sessions, in a welcoming and empathic setting and the interaction with the operator leads to a gradual awareness of their terminality. Patients are submitted with free answer questions with the purpose of facilitating and stimulating self-narration. Narration has not always been linear, but patients are left free to shift in time to revisit their disease process by making use of different tools, such as digital storytelling. Results: The answers provided by the patients show to which extent the narrative interview is an instrument allowing the analysis of the stories and gives the possibility to better understand and deepen the different implications of patient and caregiver’s background. Conclusion: The narration work in the hospice demonstrates that narrative medicine is an added value. This instrument has proven useful not only in the support of patients but also for the palliative doctor to identify wishes for accompanying them to the end with dignity and serenity. The narrative interview favors the construction of an authentic therapeutic relationship. The sick are taken wholly in charge, and they are guaranteed a high quality of life until their very last instant.

Keywords: construction of an authentic therapy relationship, gradual awareness of their terminality, narrative interview, reduce the chaos generated by the desease

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1065 Impact of Story-Telling through Indian Textiles: Mata Ni Pachedi and Pabuji Ki Phad

Authors: Lavina N. Bhaskar, Ashima Tiwari

Abstract:

In the endeavour of connecting culture to stories, textile to narratives and people to material, authors analyse the impact of narratives in two popular Indian textiles namely - Mata Ni Pachedi and Pabuji Ki Phad. These textiles narrate people’s tale or Folk tale. Each textile has a style or format in which the story is told (and it is visual). Mata Ni Pachedi, when translated into the English language literally means behind the mother goddess. Mata Ni Pachedi is an Indian textile from the province of Gujarat which constitutes an entire temple of the goddess, with the idol herself in it. On the other hand, Pabuji ki Phad is scroll painting of folk deities of Rajasthan, narrated by Bhopas (the Priest singers of Rajasthan). These textiles narrate stories of ordinary people with extraordinary courage, of social reform, and people’s belief in the divine. Authors take to task their years of craft-cluster study conducted in the past and use existing literature to map their journey in the preliminary phase of research. And then carried out an ethnographic study by visiting the origins of these textiles in Rajasthan and Gujrat (in India), met artisans and their families who are still practicing these dying art form, in order to understand the format and impact of textile story-telling. This research paper talks about the narrative in Indian textiles; the stories in them, artisans and their life as metaphorical representations of the People in Mata Ni Pachedi and Pabuji Ki Phad.

Keywords: cultural derivatives, folk-tale, Indo-Narratives, Indology

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1064 Modelling the Antecedents of Supply Chain Enablers in Online Groceries Using Interpretive Structural Modelling and MICMAC Analysis

Authors: Rose Antony, Vivekanand B. Khanapuri, Karuna Jain

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Online groceries have transformed the way the supply chains are managed. These are facing numerous challenges in terms of product wastages, low margins, long breakeven to achieve and low market penetration to mention a few. The e-grocery chains need to overcome these challenges in order to survive the competition. The purpose of this paper is to carry out a structural analysis of the enablers in e-grocery chains by applying Interpretive Structural Modeling (ISM) and MICMAC analysis in the Indian context. The research design is descriptive-explanatory in nature. The enablers have been identified from the literature and through semi-structured interviews conducted among the managers having relevant experience in e-grocery supply chains. The experts have been contacted through professional/social networks by adopting a purposive snowball sampling technique. The interviews have been transcribed, and manual coding is carried using open and axial coding method. The key enablers are categorized into themes, and the contextual relationship between these and the performance measures is sought from the Industry veterans. Using ISM, the hierarchical model of the enablers is developed and MICMAC analysis identifies the driver and dependence powers. Based on the driver-dependence power the enablers are categorized into four clusters namely independent, autonomous, dependent and linkage. The analysis found that information technology (IT) and manpower training acts as key enablers towards reducing the lead time and enhancing the online service quality. Many of the enablers fall under the linkage cluster viz., frequent software updating, branding, the number of delivery boys, order processing, benchmarking, product freshness and customized applications for different stakeholders, depicting these as critical in online food/grocery supply chains. Considering the perishability nature of the product being handled, the impact of the enablers on the product quality is also identified. Hence, study aids as a tool to identify and prioritize the vital enablers in the e-grocery supply chain. The work is perhaps unique, which identifies the complex relationships among the supply chain enablers in fresh food for e-groceries and linking them to the performance measures. It contributes to the knowledge of supply chain management in general and e-retailing in particular. The approach focus on the fresh food supply chains in the Indian context and hence will be applicable in developing economies context, where supply chains are evolving.

Keywords: interpretive structural modelling (ISM), India, online grocery, retail operations, supply chain management

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1063 Combating Contraflow to Creativity Amongst Preservice Teachers in Teacher Arts Education

Authors: Michael Flannery, Annie ó Breacháin

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Teaching the creative arts in preservice teacher education can be challenging. Some students find artistic self-expression and its related creative processes overwhelming. Low creative self-efficacy levels and creative habits of mind can impede their levels of motivation, engagement and persistence. For some, creative arts engagement can induce a state of anxiety and distress as opposed to flow. Flow theory posits that learners are happiest when they are learning in a state of flow. During the flow state, students feel, think and perform their best. They become so involved in the learning experience that nothing else seems to matter. The creative flow state is a crucial conduit of artistic processes to enable learners to explore and produce their best work. Despite the research conducted on flow state across several contexts, the phenomenon of personal flow state remains quite elusive. While some research has examined flow in relation to characteristics, conditions and personality traits, no research has investigated individuals' personal experiences of flow in a visual and tangible manner nor explored a relationship between flow state and teachers’ artistic development. This explorative case study explores preservice teachers’ impressions of flow using an arts-based approach. It identifies, categorizes and discusses patterns of commonality and difference. Grounded by theory concerning flow, self-efficacy and creative habits, this study ponders how emerging findings regarding flow impressions might aid teacher arts educators in helping preservice teachers who struggle with creative self-expression.

Keywords: creative arts, flow theory, presence, self-efficacy, teacher education

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1062 Tourism Development and Its Role in the Urban Expansion of Al-Khomse City, Libya

Authors: Khaled Klib, Yousri Azzam, Ibrahim Maarouf

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Tourism is one of the most important and fastest growing economic activities in the world, which has a prominent role in the growth and development of countries and has become increasingly important as business and trade after the World War II. The tourism development is one of the most important aspects of urban development, which aims to plan and develop tourist attractions and improve the urban environment within cities. Tourism development has become a priority for the urban development policy of cities, particularly those which have many tourist potentials. Complementary services, such as infrastructure, roads’ networks, transportation, and communications are needed for these potentials to function properly. In order to achieve these functionalities, also a new planning for the new areas as an expansion is required, or developing and renovating the existing urban areas according to pre-prepared plans to avoid random expansion of the urban structure of the city. This paper aims to determine the tourist attractions of Al-Khomse city, by reviewing the most important tourist attractions such as the Roman city (Leptis Magna), the geographical location on the Mediterranean coast, the temperate climate and diversity of the natural environment. The paper also examines the reality of the infrastructure and tourist services in the city and its suitability to serve the tourism sector. The paper also includes a proposed for tourism development in the city as one of the city's urban expansion trends, which can guide the development strategy in the future. The paper concludes with a vision for the tourism development areas as one of the trends for urban expansion in the future. The paper also concludes tourism development will have an effective role in the growth and development of urban, economic and social, in addition to preserving the natural environment. The paper recommended the need to emphasize the role of tourism development as one of the pillars and trends for the development policy and expansion of Al-Khomse city, preservation of tourist attractions and natural resources and developing infrastructure and tourist services such as accommodation, entertainment, mobility, and accessibility.

Keywords: tourism, tourist attractions, tourism development, urban expansion

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1061 Pre-Exsisting Attitude, Service Failure, and Recovery: Effect, Attributes, and Process in an Islamic Country

Authors: Niloofar Mobasem, Kambiz Heidarzadeh Hanzaee

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Purpose: The study aimed to measure the customer satisfaction with service recovery through the conflict management framework, especially assessing the role of pre-existing attitudes for measuring the customer response to the service failure. Design/ methodology/ approach: The study is based on the experimental research method. The factorial designs are used in the research that measures the variables in two separate studies. In the first study, the factorial design is 3 conflict management style: cooperative, competitive, avoiding; - 3 service performance: exceed expectation, meet expectation, fail to meet expectation; and in the second study includes: - 3 conflict management style: cooperative, competitive, avoiding; - 2 service performance: exceed expectation, fail to meet expectation; - 2 pre-existing attitude: positive, negative. Finding: The results of study based on a scenario indicate that the conflict management style affected on customer satisfaction by service recovery efforts as well as the pre-existing attitudes affected the customer interpretation for service providers (conflict management style) and those who have positive pre-existing attitudes are interested to response to the cooperative approach in dealing with service failure. Research limitation/ implication: According to all researches, the study has several limitations. The nature of scenario in this study may cause to hit the reality of life. Although, the similar scenario approaches commonly are used for such researches, but the approaches are not without criticism. Practical implications: Given the importance of service recovery, companies can understand the importance of creating customer satisfaction achieved by the positive results due to the service recovery during the shortness or service failure by the mentioned companies. Originality/ value: The study highlights the importance of service failure and providing the education in relation to the service recovery.

Keywords: service recovery, pre-existing attitude, service failure, customer satisfaction

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1060 Developing Proof Demonstration Skills in Teaching Mathematics in the Secondary School

Authors: M. Rodionov, Z. Dedovets

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The article describes the theoretical concept of teaching secondary school students proof demonstration skills in mathematics. It describes in detail different levels of mastery of the concept of proof-which correspond to Piaget’s idea of there being three distinct and progressively more complex stages in the development of human reflection. Lessons for each level contain a specific combination of the visual-figurative components and deductive reasoning. It is vital at the transition point between levels to carefully and rigorously recalibrate teaching to reflect the development of more complex reflective understanding. This can apply even within the same age range, since students will develop at different speeds and to different potential. The authors argue that this requires an aware and adaptive approach to lessons to reflect this complexity and variation. The authors also contend that effective teaching which enables students to properly understand the implementation of proof arguments must develop specific competences. These are: understanding of the importance of completeness and generality in making a valid argument; being task focused; having an internalised locus of control and being flexible in approach and evaluation. These criteria must be correlated with the systematic application of corresponding methodologies which are best likely to achieve success. The particular pedagogical decisions which are made to deliver this objective are illustrated by concrete examples from the existing secondary school mathematics courses. The proposed theoretical concept formed the basis of the development of methodological materials which have been tested in 47 secondary schools.

Keywords: education, teaching of mathematics, proof, deductive reasoning, secondary school

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1059 Developing VR-Based Neurorehabilitation Support Tools: A Step-by-Step Approach for Cognitive Rehabilitation and Pain Distraction during Invasive Techniques in Hospital Settings

Authors: Alba Prats-Bisbe, Jaume López-Carballo, David Leno-Colorado, Alberto García Molina, Alicia Romero Marquez, Elena Hernández Pena, Eloy Opisso Salleras, Raimon Jané Campos

Abstract:

Neurological disorders are a leading cause of disability and premature mortality worldwide. Neurorehabilitation (NRHB) is a clinical process aimed at reducing functional impairment, promoting societal participation, and improving the quality of life for affected individuals. Virtual reality (VR) technology is emerging as a promising NRHB support tool. Its immersive nature fosters a strong sense of agency and embodiment, motivating patients to engage in meaningful tasks and increasing adherence to therapy. However, the clinical benefits of VR interventions are challenging to determine due to the high heterogeneity among health applications. This study explores a stepwise development approach for creating VR-based tools to assist individuals with neurological disorders in medical practice, aiming to enhance reproducibility, facilitate comparison, and promote the generalization of findings. Building on previous research, the step-by-step methodology encompasses: Needs Identification– conducting cross-disciplinary meetings to brainstorm problems, solutions, and address barriers. Intervention Definition– target population, set goals, and conceptualize the VR system (equipment and environments). Material Selection and Placement– choose appropriate hardware and software, place the device within the hospital setting, and test equipment. Co-design– collaboratively create VR environments, user interfaces, and data management strategies. Prototyping– develop VR prototypes, conduct user testing, and make iterative redesigns. Usability and Feasibility Assessment– design protocols and conduct trials with stakeholders in the hospital setting. Efficacy Assessment– conduct clinical trials to evaluate outcomes and long-term effects. Cost-Effectiveness Validation– assess reproducibility, sustainability, and balance between costs and benefits. NRHB is complex due to the multifaceted needs of patients and the interdisciplinary healthcare architecture. VR has the potential to support various applications, such as motor skill training, cognitive tasks, pain management, unilateral spatial neglect (diagnosis and treatment), mirror therapy, and ecologically valid activities of daily living. Following this methodology was crucial for launching a VR-based system in a real hospital environment. Collaboration with neuropsychologists lead to develop A) a VR-based tool for cognitive rehabilitation in patients with acquired brain injury (ABI). The system comprises a head-mounted display (HTC Vive Pro Eye) and 7 tasks targeting attention, memory, and executive functions. A desktop application facilitates session configuration, while database records in-game variables. The VR tool's usability and feasibility were demonstrated in proof-of-concept trials with 20 patients, and effectiveness is being tested through a clinical protocol with 12 patients completing 24-session treatment. Another case involved collaboration with nurses and paediatric physiatrists to create B) a VR-based distraction tool during invasive techniques. The goal is to alleviate pain and anxiety associated with botulinum toxin (BTX) injections, blood tests, or intravenous placements. An all-in-one headset (HTC Vive Focus 3) deploys 360º videos to improve the experience for paediatric patients and their families. This study presents a framework for developing clinically relevant and technologically feasible VR-based support tools for hospital settings. Despite differences in patient type, intervention purpose, and VR system, the methodology demonstrates usability, viability, reproducibility and preliminary clinical benefits. It highlights the importance approach centred on clinician and patient needs for any aspect of NRHB within a real hospital setting.

Keywords: neurological disorders, neurorehabilitation, stepwise development approach, virtual reality

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1058 Technoeustress in Higher Education Teachers: A Study on Positive Stress

Authors: Ligia Nascimento, Manuela Faia Correia

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Nowadays, Information and Communication Technologies (ICT) are embedded in most professions. Technostress - or stress induced by the use of ICTs, has been studied in various sectors of activity and in different geographical areas, mainly from the perspective of its harmful impacts. In the context of work, the technological contexts capable of causing stress have been examined in-depth, as well as the type of individuals most likely to experience its negative effects. However, new lines of the research argue that the stress generated by the use of ICTs may not necessarily be detrimental (technodistress), admitting that, in contrast, and in addition, it may actually be beneficial to organizations and their employees (technoeustress). Any measures that succeed in reducing technodistress do not necessarily lead to the creation of technoeustress, justifying the study of this phenomenon in a focused and independent manner. Adopting the transactional model of stress as the basic theoretical framework, an ongoing research project aims to study technoeustress independently. Given the role played in the qualification and progress of society and the economy, it becomes particularly critical to care for the well-being of the higher education teacher. Particularly in recent times, when teleworking is prevalent, these professionals have made a huge, compulsive effort to adapt to a new teaching reality. Rather than limiting itself to mitigating adverse effects of ICT use, which featured earlier approaches, the present study seeks to understand how to activate the positive side of technostress in higher education teachers in order to obtain favorable personal and organizational outcomes from ICT use at work. The research model seeks to understand, upstream, the ICT characteristics that increase the perception of technoeustress among higher education teachers, studying the direct and moderating effects of individual and organizational variables and, downstream, the impacts that technoeustress has on job satisfaction and performance. This research contributes both to expanding the knowledge of the technostress phenomenon and to identify possible recommendations for management.

Keywords: higher education teachers, ICT, stress, technoeustress

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1057 Improving Predictions of Coastal Benthic Invertebrate Occurrence and Density Using a Multi-Scalar Approach

Authors: Stephanie Watson, Fabrice Stephenson, Conrad Pilditch, Carolyn Lundquist

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Spatial data detailing both the distribution and density of functionally important marine species are needed to inform management decisions. Species distribution models (SDMs) have proven helpful in this regard; however, models often focus only on species occurrences derived from spatially expansive datasets and lack the resolution and detail required to inform regional management decisions. Boosted regression trees (BRT) were used to produce high-resolution SDMs (250 m) at two spatial scales predicting probability of occurrence, abundance (count per sample unit), density (count per km2) and uncertainty for seven coastal seafloor taxa that vary in habitat usage and distribution to examine prediction differences and implications for coastal management. We investigated if small scale regionally focussed models (82,000 km2) can provide improved predictions compared to data-rich national scale models (4.2 million km2). We explored the variability in predictions across model type (occurrence vs abundance) and model scale to determine if specific taxa models or model types are more robust to geographical variability. National scale occurrence models correlated well with broad-scale environmental predictors, resulting in higher AUC (Area under the receiver operating curve) and deviance explained scores; however, they tended to overpredict in the coastal environment and lacked spatially differentiated detail for some taxa. Regional models had lower overall performance, but for some taxa, spatial predictions were more differentiated at a localised ecological scale. National density models were often spatially refined and highlighted areas of ecological relevance producing more useful outputs than regional-scale models. The utility of a two-scale approach aids the selection of the most optimal combination of models to create a spatially informative density model, as results contrasted for specific taxa between model type and scale. However, it is vital that robust predictions of occurrence and abundance are generated as inputs for the combined density model as areas that do not spatially align between models can be discarded. This study demonstrates the variability in SDM outputs created over different geographical scales and highlights implications and opportunities for managers utilising these tools for regional conservation, particularly in data-limited environments.

Keywords: Benthic ecology, spatial modelling, multi-scalar modelling, marine conservation.

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1056 Re-Thinking Design/Build Curriculum in a Virtual World

Authors: Bruce Wrightsman

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Traditionally, in architectural education, we develop studio projects with learning agendas that try to minimize conflict and reveal clear design objectives. Knowledge is gleaned only tacitly through confronting the reciprocity of site and form, space and light, structure and envelope. This institutional reality can limit student learning to the latent learning opportunities they will have to confront later in practice. One intent of academic design-build projects is to address the learning opportunities which one can discover in the messy grey areas of design. In this immersive experience, students confront the limitations of classroom learning and are exposed to challenges that demand collaborative practice. As a result, design-build has been widely adopted in an attempt to address perceived deficiencies in design education vis a vis the integration of building technology and construction. Hands-on learning is not a new topic, as espoused by John Dewey, who posits a debate between static and active learning in his book Democracy and Education. Dewey espouses the concept that individuals should become participants and not mere observers of what happens around them. Advocates of academic design-build programs suggest a direct link between Dewey’s speculation. These experiences provide irreplaceable life lessons: that real-world decisions have real-life consequences. The goal of the paper is not to confirm or refute the legitimacy and efficacy of online virtual learning. Rather, the paper aims to foster a deeper, honest discourse on the meaning of ‘making’ in architectural education and present projects that confronted the burdens of a global pandemic and developed unique teaching strategies that challenged design thinking as an observational and constructive effort to expand design student’s making skills and foster student agency.

Keywords: design/build, making, remote teaching, architectural curriculum

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1055 A Serious Game to Upgrade the Learning of Organizational Skills in Nursing Schools

Authors: Benoit Landi, Hervé Pingaud, Jean-Benoit Culie, Michel Galaup

Abstract:

Serious games have been widely disseminated in the field of digital learning. They have proved their utility in improving skills through virtual environments that simulate the field where new competencies have to be improved and assessed. This paper describes how we created CLONE, a serious game whose purpose is to help nurses create an efficient work plan in a hospital care unit. In CLONE, the number of patients to take care of is similar to the reality of their job, going far beyond what is currently practiced in nurse school classrooms. This similarity with the operational field increases proportionally the number of activities to be scheduled. Moreover, very often, the team of nurses is composed of regular nurses and nurse assistants that must share the work with respect to the regulatory obligations. Therefore, on the one hand, building a short-term planning is a complex task with a large amount of data to deal with, and on the other, good clinical practices have to be systematically applied. We present how reference planning has been defined by addressing an optimization problem formulation using the expertise of teachers. This formulation ensures the gameplay feasibility for the scenario that has been produced and enhanced throughout the game design process. It was also crucial to steer a player toward a specific gaming strategy. As one of our most important learning outcomes is a clear understanding of the workload concept, its factual calculation for each caregiver along time and its inclusion in the nurse reasoning during planning elaboration are focal points. We will demonstrate how to modify the game scenario to create a digital environment in which these somewhat abstract principles can be understood and applied. Finally, we give input on an experience we had on a pilot of a thousand undergraduate nursing students.

Keywords: care planning, workload, game design, hospital nurse, organizational skills, digital learning, serious game

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1054 “In Their Own Words”: An Exploration of the Use of Narratives with Children in Counselling

Authors: Alison Brown

Abstract:

Through stories, children make sense of their world, see themselves through the eyes of another, and process emotions and lived experiences in a non-threatening and indirect manner. Building on research around the use of narrative techniques with adults and families, this research looked directly at the use of narratives as a therapeutic technique with children in counseling. Based on individual therapy sessions with children over a six-year period, this work of collective case studies tells the story of a practice incorporating children’s narratives, of children’s experiences in writing and sharing their narratives, and of the clinical impact of the use of narratives with children. Not all stories were narratives of success or happiness. Children documented their fears and anger as well as their achievements and hope for the future. What emerged through this study was an awareness of recurring themes in the way children responded to the narrative process and in the benefits and limitations of story writing with children. Consistent with previous studies focusing on narrative work with adults and families, the use of narratives with children provided opportunities for healing, acceptance, developing greater understanding, externalizing, and re-authoring a preferred future. In terms of the children’s experiences in writing and sharing their narratives, consistent themes emerged again, with many children finding the experience cathartic and liberating, empowering and hopeful, but most importantly, an opportunity that allowed them to feel and understand that they were not alone. Whilst a small collection of case studies tells the stories of a limited number of children, it is hoped that this research provides both a model and inspiration for others to explore similar uses of narratives with children. As a greater number of children’s narratives are created, the potential to share and benefit from the many rich stories and experiences of other children becomes more of a reality. Across cultures, economic and social settings, rural and urban environments, and varying family structures, it is important that we hear the voices of our children – ‘In their own words’.

Keywords: narrative therapy children counselling, social, emotional, zone of proximal development, scaffolding

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1053 A Flexible Real-Time Eco-Drive Strategy for Electric Minibus

Authors: Felice De Luca, Vincenzo Galdi, Piera Stella, Vito Calderaro, Adriano Campagna, Antonio Piccolo

Abstract:

Sustainable mobility has become one of the major issues of recent years. The challenge in reducing polluting emissions as much as possible has led to the production and diffusion of vehicles with internal combustion engines that are less polluting and to the adoption of green energy vectors, such as vehicles powered by natural gas or LPG and, more recently, with hybrid and electric ones. While on the one hand, the spread of electric vehicles for private use is becoming a reality, albeit rather slowly, not the same is happening for vehicles used for public transport, especially those that operate in the congested areas of the cities. Even if the first electric buses are increasingly being offered on the market, it remains central to the problem of autonomy for battery fed vehicles with high daily routes and little time available for recharging. In fact, at present, solid-state batteries are still too large in size, heavy, and unable to guarantee the required autonomy. Therefore, in order to maximize the energy management on the vehicle, the optimization of driving profiles offer a faster and cheaper contribution to improve vehicle autonomy. In this paper, following the authors’ precedent works on electric vehicles in public transport and energy management strategies in the electric mobility area, an eco-driving strategy for electric bus is presented and validated. Particularly, the characteristics of the prototype bus are described, and a general-purpose eco-drive methodology is briefly presented. The model is firstly simulated in MATLAB™ and then implemented on a mobile device installed on-board of a prototype bus developed by the authors in a previous research project. The solution implemented furnishes the bus-driver suggestions on the guide style to adopt. The result of the test in a real case will be shown to highlight the effectiveness of the solution proposed in terms of energy saving.

Keywords: eco-drive, electric bus, energy management, prototype

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1052 Family Depression and Its Relationship with Disability

Authors: Humara Bano, Nyla Anjum

Abstract:

Disability in any form has great impact not only for the person facing it but also for its family members too. This effect may be so severe that may lead to mal adjustment of any member of the family in society as well. This impact has also been multiplied due to negative attitudes of the society, unawareness about the needs of special needs and no legislation for the parents of children with special needs. As a result not only the separations among the parents have been reported but also the normal siblings in the home are also badly affected in their daily lives. The situation is more challenging when more than one child with disability is present in the family. The main objectives of this paper are to unfold the relationship of variety of disabilities (hearing, visual or physical impairment, mental retardation, speech impairment) in i) developing depression in home setting, ii) social exclusion, iii) anxiety and aggression and iv) development of insecure feelings among family members of the persons with disabilities, as well as, v) to identify coping strategies to manage the special needs by family members too. To reach on conclusion about fifty families (having any sort of disability in their homes) have been interviewed on basis of convenient sampling. Correlation, ANOVA and different analysis have been used to identify the relationship of disability in developing depression among family members in line of above mentioned problems. Results revealed that depression due to disability among families is a common phenomenon and adversely have affected their lives in daily routines as well as in following their life achievements. Coping with the situation and recommending various remedies by parents is the positive reflection of this study too that can help to families in managing their mental health.

Keywords: depression, anxiety and aggression, social exclusion, parents of children with special needs

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1051 Service Business Model Canvas: A Boundary Object Operating as a Business Development Tool

Authors: Taru Hakanen, Mervi Murtonen

Abstract:

This study aims to increase understanding of the transition of business models in servitization. The significance of service in all business has increased dramatically during the past decades. Service-dominant logic (SDL) describes this change in the economy and questions the goods-dominant logic on which business has primarily been based in the past. A business model canvas is one of the most cited and used tools in defining end developing business models. The starting point of this paper lies in the notion that the traditional business model canvas is inherently goods-oriented and best suits for product-based business. However, the basic differences between goods and services necessitate changes in business model representations when proceeding in servitization. Therefore, new knowledge is needed on how the conception of business model and the business model canvas as its representation should be altered in servitized firms in order to better serve business developers and inter-firm co-creation. That is to say, compared to products, services are intangible and they are co-produced between the supplier and the customer. Value is always co-created in interaction between a supplier and a customer, and customer experience primarily depends on how well the interaction succeeds between the actors. The role of service experience is even stronger in service business compared to product business, as services are co-produced with the customer. This paper provides business model developers with a service business model canvas, which takes into account the intangible, interactive, and relational nature of service. The study employs a design science approach that contributes to theory development via design artifacts. This study utilizes qualitative data gathered in workshops with ten companies from various industries. In particular, key differences between Goods-dominant logic (GDL) and SDL-based business models are identified when an industrial firm proceeds in servitization. As the result of the study, an updated version of the business model canvas is provided based on service-dominant logic. The service business model canvas ensures a stronger customer focus and includes aspects salient for services, such as interaction between companies, service co-production, and customer experience. It can be used for the analysis and development of a current service business model of a company or for designing a new business model. It facilitates customer-focused new service design and service development. It aids in the identification of development needs, and facilitates the creation of a common view of the business model. Therefore, the service business model canvas can be regarded as a boundary object, which facilitates the creation of a common understanding of the business model between several actors involved. The study contributes to the business model and service business development disciplines by providing a managerial tool for practitioners in service development. It also provides research insight into how servitization challenges companies’ business models.

Keywords: boundary object, business model canvas, managerial tool, service-dominant logic

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1050 Technological Developments to Reduce Wind Blade Turbine Levelized Cost of Energy

Authors: Pedro Miguel Cardoso Carneiro, Ricardo André Nunes Borges, João Pedro Soares Loureiro, Hermínio Maio Graça Fernandes

Abstract:

Wind energy has been exponentially growing over the last years and will allow countries to progress regarding the decarbonization objective. In parallel, the maintenance activities have also been increasing in consequence of ageing and deterioration of the wind farms. The time available for wind blade maintenance is given by the weather window that is based upon weather conditions. Most of the wind blade repair and maintenance activities require a narrow window of temperature and humidity. Due to this limitation, the current weather windows result only on approximately 35% days/year are used for maintenance, that takes place mostly during summertime. This limitation creates large economic losses in the energy production of the wind towers, since they can be inoperative or with the energy production output reduced for days or weeks due to existing damages. Another important aspect is that the maintenance costs are higher due to the high standby time and seasonality imposed on the technicians. To reduce the relevant maintenance costs of blades and energy loses some technological developments were carried out to significantly improve this reality. The focus of this activity was to develop a series of key developments to have in the near future a suspended access equipment that can operate in harsh conditions, wind rain, cold/hot environment. To this end we have identified key areas that need to be revised and require new solutions to be found; a habitat system, multi-configurable roof and floor, roof and floor interface to blade, secondary attachment solutions to the blade and to the tower. On this paper we will describe the advances produced during a national R&D project made in partnership with an end-user (Onrope) and a test center (ISQ).

Keywords: wind turbine maintenance, cost reduction, technological innovations, wind turbine blade

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1049 Counter-Terrorism and De-Radicalization as Soft Strategies in Combating Terrorism in Indonesia: A Critical Review

Authors: Tjipta Lesmana

Abstract:

Terrorist attacks quickly penetrated Indonesia following the downfall of Soeharto regime in May 1998. Reform era was officially proclaimed. Indonesia turned to 'heaven state' from 'authoritarian state'. For the first time since 1966, the country experienced a full-scale freedom of expression, including freedom of the press, and heavy acknowledgement of human rights practice. Some religious extremists previously run away to neighbor countries to escape from security apparatus secretly backed home. Quickly they consolidated the power to continue their long aspiration and dream to establish 'Shariah Indonesia', Indonesia based on Khilafah ideology. Bali bombings I which shocked world community occurred on 12 October 2002 in the famous tourist district of Kuta on the Indonesian island of Bali, killing 202 people (including 88 Australians, 38 Indonesians, and people from more than 20 other nationalities). In the capital, Jakarta, successive bombings were blasted in Marriott hotel, Australian Embassy, residence of the Philippine Ambassador and stock exchange office. A 'drunken Indonesia' is far from ready to combat nationwide sudden and massive terrorist attacks. Police Detachment 88 (Densus 88) Indonesian counter-terrorism squad, was quickly formed following 2002 Bali Bombing. Anti-terrorism Provisional Act was immediately erected, as well, due to urgent need to fight terrorism. Some Bali bombings criminals were deadly executed after sentenced by the court. But a series of terrorist suicide attacks and another Bali bombings (the second one) in Bali, again, shocked world community. Terrorism network is undoubtedly spreading nationwide. Suspicion is high that they had close connection with Al Qaeda’s groups. Even 'Afghanistan alumni' and 'Syria alumni' returned to Indonesia to back up the local mujahidins in their fights to topple Indonesia constitutional government and set up Islamic state (Khilafah). Supported by massive aids from friendly nations, especially Australia and United States, Indonesia launched large scale operations to crush terrorism consisted of various radical groups such as JAD, JAS, and JAADI. Huge energy, money, and souls were dedicated. Terrorism is, however, persistently entrenched. High ranking officials from Detachment 88 squad and military intelligence believe that terrorism is still one the most deadly enemy of Indonesia.

Keywords: counter-radicalization, de-radicalization, Khalifah, Union State, Al Qaedah, ISIS

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1048 Public Squares and Their Potential for Social Interactions: A Case Study of Historical Public Squares in Tehran

Authors: Asma Mehan

Abstract:

Under the thrust of technological changes, population growth and vehicular traffic, Iranian historical squares have lost their significance and they are no longer the main social nodes of the society. This research focuses on how historical public squares can inspire designers to enhance social interactions among citizens in Iranian urban context. Moreover, the recent master plan of Tehran demonstrates the lack of public spaces designed for the purpose of people’s social gatherings. For filling this gap, first the current situation of 7 selected primary historical public squares in Tehran including Sabze Meydan, Arg, Topkhaneh, Baherstan, Mokhber-al-dole, Rah Ahan and Hassan Abad have been compared. Later, the influencing elements on social interactions of the public squares such as subjective factors (human relationships and memories) and objective factors (natural and built environment) have been investigated. As a conclusion, some strategies are proposed for improving social interactions in historical public squares like; holding cultural, national, athletic and religious events, defining different and new functions in public squares’ surrounding, increasing pedestrian routs, reviving the collective memory, demonstrating the historical importance of square, eliminating visual obstacles across the square, organization the natural elements of the square, appropriate pavement for social activities. Finally, it is argued that the combination of all influencing factors which are: human interactions, natural elements and built environment criteria will lead to enhance the historical public squares’ potential for social interaction.

Keywords: historical square, Iranian public square, social interaction, Tehran

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1047 Gender Equality: A Constitutional Myth When Featured with Domestic Violence

Authors: Suja S. Nayar, Mayuri Pandya

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The foundation of legal system of any nation is its constitution and the strive to achieve equality amongst different classes prevailing in the social system. The most traditional form of inequality that is prevailing in the society is the gender inequality. The existence of inequality on the basis of gender prevails since the ancient era which has with the passing time merely continued and aggravated to a great extent. The founding fathers of our constitution were well aware of the then prevailing situation and being concerned about the future if this inequality continued to prevail, and in such view, the provisions of Article 14, 15, 38 and 44 of our Constitution were enacted with specific intent for the upliftment of women. The strive for equality is the rule of law embodied with the principle of foreseeability which is necessitated in the stability of justice system of any nation, and when it comes to equality, the first form of equality we need to achieve is gender equality. Time and again various initiatives have been announced and attempted to achieve the objective of gender equality, but analysis of the ground reality always have yielded disappointing results. The research that is proposed to be undertaken intends to cover all the above issues concerning the failures ineffective implementation of the gender-specific laws especially the provisions concerning the protection provided under Domestic Violence Act. The researchers will analyze the judgment of last five years' judgments of Supreme Court of India. In Hiral P. Harsora and ors. v Kusum Narottamdas Harsora and Ors. the Hon'ble Supreme Court recently deleting the words 'adult male' from the definition of respondent disclosed it is intent and understanding that domestic violence is being caused by a female on female also and not only restricted to males on females only. The procedure as prescribed under the act for claiming reliefs though is as per the criminal mandate, but the reliefs are of civil nature and so same needs to deal emphatically which now makes it a lengthier process. The pros and cons of such pronouncements are being weighed on the balance of constitution and social equality that is strived by the entire women fraternity.

Keywords: domestic, violence, constitution, gender, equality, women

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1046 Krembo Wings Youth Movement for Children with and without Disabilities: An Inclusive Model from an Educational Perspective to a Professional Approach

Authors: Claudia Koby, Merav Boaz, Meirav Zaiger Kober

Abstract:

Krembo Wings is an all-inclusive youth movement which brings children and youth with any disability together with their able-bodied peers (counselors) for weekly fun and educational social activities. Krembo Wings utilizes a socio-educational framework to create and lead social change through members with and without disabilities. All the work that Krembo Wings engages in stems from its central goal of promoting inclusion and integration using social and psychological theories to develop its unique model and approach. The key to Krembo Wings' approach in promoting inclusion is active participation – each member, with and without disabilities, is enabled to participate to their fullest capacity in the youth movement and its activities. In order for this to be achieved, all activities are adjustable and are modified to fit the abilities of each member. Additionally, youth counselors – most of whom are members without disabilities – go through extensive training in order to act as 'intermediaries' for their partner with disabilities, enabling and facilitating their partner's participation in a way that allows them to be as independent and active as possible. The relationship is one of friendship and not of caretaking. There is always a nurse on-hand to tend to any caretaking needs. Two essential elements of Krembo Wings' model is the broadening of concepts – shifting and changing the understanding of certain concepts such as what it means to be 'independent' or 'able' – and the development of a unique language – creating a language which both reflects and shapes reality. These elements of Krembo Wings' model foster the development of the values of acceptance and appreciation of those who are 'different'. It instills in members and counselors a new way of perceiving the world, one in which inclusion and integration are achievable and natural. Krembo Wings is certain that implementation of this model will promote the participation and inclusion of individuals with disabilities in society while promoting diversity. This model can serve as a platform which can be replicated and adjusted to suit any environment.

Keywords: innovative model for inclusion, socio-educational movement, youth leadership, youth with and without disabilities

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1045 Investigation of the Effects of Dry Needling With Stretching Upper Trapezius Muscle on Clinical Outcomes in Participants With Active Myofascial Trigger Point.

Authors: Marzieh Yassin, Fereshteh Navaee, Javad Sarrafzadeh, Reza Salehi

Abstract:

Introduction: Myofascial trigger point (MTrP) is one of the most common sources of musculoskeletal pain. Approximately 30-85% of the patients with musculoskeletal pains would experience MTrP in their life. The prevalence of MTrP has reported in the patients seen in a general orthopedic clinic, general medical clinic and specialty pain management centers, 21%, 30% and 93% respectively. Nowadays, dry needling is suggested as a standard treatment for MTrPs. The purpose of the present study was to examine the effectiveness of dry needling with stretching upper trapezius muscle on pain and pain pressure threshold in participants with active myofascial trigger point. Methods: Thirty participants with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the treatments for three weeks. The outcomes were pain intensity and pain pressure threshold that were assessed with visual analogue scale and algometer respectively. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. Also, the results showed a significant difference in measurements between two groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in participants with active myofascial trigger points.

Keywords: dry needling, myofascial pain syndrome, myofascial trigger point, stretching

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1044 Epidemiology, Clinical, Immune, and Molecular Profiles of Microsporidiosis and Cryptosporidiosis among HIV/AIDS patients

Authors: Roger WUMBA

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The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients. In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk. Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of ,100 cells/mm³, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of ,100 cells/mm³, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of ,100 cells/mm³ (OR = 4.60; 95% CI 1.70–12.20; P = 0.002), no ART (OR = 5.00; 95% CI 1.90–13.20; P , 0.001), and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048) were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites. E. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and treating opportunistic intestinal parasites that may be acquired through fecal–oral transmission, surface water, normal immunity, rural area-based person–person and animal–human nfection, and transmission of HIV. Therapy, including ART and treatment with fumagillin, is needed.

Keywords: diarrhea, enterocytozoon bieneusi, cryptosporidium hominis, cryptosporidium parvum, risk factors, africans

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