Search results for: motor complexity

Authors: A. M. Bumbea, A. Musetescu, P. Ciurea, A. Bighea

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Objectives: The authors present a Parsonage Turner syndrome, a rare disease characterized by onset in apparently healthy person with shoulder and/or arm pain, sensory deficit, motor deficit. The causes are not established, could be determinate by vaccination, postoperative, immunologic disease, post traumatic etc. Methods: The authors present a woman case, 32 years old, (in 2006), no medical history, with arm pain and no other symptom. The onset was sudden with pain at very high level quantified as 10 to a 0 to 10 scale, with no response to classical analgesic and corticoids. The only drugs which can reduce the intensity of pain were oxycodone hydrochloride, 60 mg daily and pregabalinum150 mg daily. After two weeks the intensity of pain was reduced to 5. The patient started a rehabilitation program. After 6 weeks the patient associated sensory and motor deficit. We performed electromyography for upper limb that showed incomplete denervation with reduced neural transmission speed. The patient receives neurotrophic drugs and painkillers for a long period and physical and kinetic therapy. After 6 months the pain was reduced to level 2 and the patient maintained only 150 mg pregabalinum for another 6 months. Then, the evaluation showed no pain but general amiotrophy in upper limb. Results: At the evaluation in 2009, the patient developed a rheumatoid syndrome with tender and swelling joints, but no positive inflammation test, no antibodies or rheumatoid factor. After two years, in 2011 the patient develops an increase of antinuclear antibodies. This context certifies the diagnosis of lupus and the patient receives the specific therapy. Conclusions: This case is not a typical case of onset of lupus with PTS, but the onset of PTS could include the onset of an immune disease.

Keywords: lupus, arm pain, patient, swelling

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Authors: Kyungae Jo, Eun Young Kim, Byungsoo Shin, Kwang Soon Shin, Hyung Joo Suh

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Gamma-aminobutyric acid (GABA) and 5-hydroxytryptophan (5-HTP) are amino acids of digested nutrients or food ingredients and these can possibly be utilized as non-pharmacologic treatment for sleep disorder. We previously investigated the GABA/5-HTP mixture is the principal concept of sleep-promoting and activity-repressing management in nervous system of D. melanogaster. Two experiments in this study were designed to evaluate sleep-promoting effect of GABA/5-HTP mixture, to clarify the possible ratio of sleep-promoting action in the Drosophila invertebrate model system. Behavioral assays were applied to investigate distance traveled, velocity, movement, mobility, turn angle, angular velocity and meander of two amino acids and GABA/5-HTP mixture with caffeine treated flies. In addition, differentially expressed gene (DEG) analyses from next generation sequencing (NGS) were applied to investigate the signaling pathway and functional interaction network of GABA/5-HTP mixture administration. GABA/5-HTP mixture resulted in significant differences between groups related to behavior (p < 0.01) and significantly induced locomotor activity in the awake model (p < 0.05). As a result of the sequencing, the molecular function of various genes has relationship with motor activity and biological regulation. These results showed that GABA/5-HTP mixture administration significantly involved the inhibition of motor behavior. In this regard, we successfully demonstrated that using a GABA/5-HTP mixture modulates locomotor activity to a greater extent than single administration of each amino acid, and that this modulation occurs via the neuronal system, neurotransmitter release cycle and transmission across chemical synapses.

Keywords: sleep, γ-aminobutyric acid, 5-hydroxytryptophan, Drosophila melanogaster

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Authors: Zabeehullah, Fahim Arif, Yawar Abbas

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Software Defined Network (SDN) is a next genera-tion networking model which simplifies the traditional network complexities and improve the utilization of constrained resources. Currently, most of the SDN based Internet of Things(IoT) environments use traditional network routing strategies which work on the basis of max or min metric value. However, IoT network heterogeneity, dynamic traffic flow and complexity demands intelligent and self-adaptive routing algorithms because traditional routing algorithms lack the self-adaptions, intelligence and efficient utilization of resources. To some extent, SDN, due its flexibility, and centralized control has managed the IoT complexity and heterogeneity but still Software Defined IoT (SDIoT) lacks intelligence. To address this challenge, we proposed a model called Deep Routing Strategy (DRS) which uses Deep Learning algorithm to perform routing in SDIoT intelligently and efficiently. Our model uses real-time traffic for training and learning. Results demonstrate that proposed model has achieved high accuracy and low packet loss rate during path selection. Proposed model has also outperformed benchmark routing algorithm (OSPF). Moreover, proposed model provided encouraging results during high dynamic traffic flow.

Keywords: SDN, IoT, DL, ML, DRS

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Authors: Naveen Kumar, Shyambihari Prajapati

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Industry 4.0 is the fourth industrial revolution that focuses on interconnectivity of machine to machine, human to machine and human to human via Internet of Things (IoT). Technologies of industry 4.0 facilitate communication between human and machine through IoT and forms Cyber-Physical Production System (CPPS). In CPPS, multiple shop floors sensor data are connected through IoT and displayed through sensor dashboard to the operator. These sensor dashboards have enormous amount of information to be presented which becomes complex for operators to perform monitoring, controlling and interpretation tasks. Designing handheld sensor dashboards for supervision task will become a challenge for the interface designers. This paper reports emerging technologies of industry 4.0, changing context of increasing information complexity in consecutive industrial revolutions and upcoming design challenges for interface designers in context of Industry 4.0. Authors conclude that information complexity of sensor dashboards design has increased with consecutive industrial revolutions and designs of sensor dashboard causes cognitive load on users. Designing such complex dashboards interfaces in Industry 4.0 context will become main challenges for the interface designers.

Keywords: Industry4.0, sensor dashboard design, cyber-physical production system, Interface designer

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Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

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Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

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Authors: Louise Moles, Steve Riley, Sarah D. Lichenstein, Marzieh Babaeianjelodar, Robert Kohler, Annie Cheng, Corey Horien Abigail Greene, Wenjing Luo, Jonathan Ahern, Bohan Xu, Yize Zhao, Chun Chieh Fan, R. Todd Constable, Sarah W. Yip

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Background: Risks for depression are myriad and include both genetic and brain-based factors. However, relationships between these systems are poorly understood, limiting understanding of disease etiology, particularly at the developmental level. Methods: We use a data-driven machine learning approach connectome-based predictive modeling (CPM) to identify functional connectivity signatures associated with polygenic risk scores for depression (DEP-PRS) among youth from the Adolescent Brain and Cognitive Development (ABCD) study across diverse brain states, i.e., during resting state, during affective working memory, during response inhibition, during reward processing. Results: Using 10-fold cross-validation with 100 iterations and permutation testing, CPM identified connectivity signatures of DEP-PRS across all examined brain states (rho’s=0.20-0.27, p’s<.001). Across brain states, DEP-PRS was positively predicted by increased connectivity between frontoparietal and salience networks, increased motor-sensory network connectivity, decreased salience to subcortical connectivity, and decreased subcortical to motor-sensory connectivity. Subsampling analyses demonstrated that model accuracies were robust across random subsamples of N’s=1,000, N’s=500, and N’s=250 but became unstable at N’s=100. Conclusions: These data, for the first time, identify neural networks of polygenic depression risk in a large sample of youth before the onset of significant clinical impairment. Identified networks may be considered potential treatment targets or vulnerability markers for depression risk.

Keywords: genetics, functional connectivity, pre-adolescents, depression

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Authors: V. Saccà, A. Sarica, F. Novellino, S. Barone, T. Tallarico, E. Filippelli, A. Granata, P. Valentino, A. Quattrone

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The work aim was to evaluate how well Random Forest (RF) and Support Vector Machine (SVM) algorithms could support the early diagnosis of Multiple Sclerosis (MS) from resting-state functional connectivity data. In particular, we wanted to explore the ability in distinguishing between controls and patients of mean signals extracted from ICA components corresponding to 15 well-known networks. Eighteen patients with early-MS (mean-age 37.42±8.11, 9 females) were recruited according to McDonald and Polman, and matched for demographic variables with 19 healthy controls (mean-age 37.55±14.76, 10 females). MRI was acquired by a 3T scanner with 8-channel head coil: (a)whole-brain T1-weighted; (b)conventional T2-weighted; (c)resting-state functional MRI (rsFMRI), 200 volumes. Estimated total lesion load (ml) and number of lesions were calculated using LST-toolbox from the corrected T1 and FLAIR. All rsFMRIs were pre-processed using tools from the FMRIB's Software Library as follows: (1) discarding of the first 5 volumes to remove T1 equilibrium effects, (2) skull-stripping of images, (3) motion and slice-time correction, (4) denoising with high-pass temporal filter (128s), (5) spatial smoothing with a Gaussian kernel of FWHM 8mm. No statistical significant differences (t-test, p < 0.05) were found between the two groups in the mean Euclidian distance and the mean Euler angle. WM and CSF signal together with 6 motion parameters were regressed out from the time series. We applied an independent component analysis (ICA) with the GIFT-toolbox using the Infomax approach with number of components=21. Fifteen mean components were visually identified by two experts. The resulting z-score maps were thresholded and binarized to extract the mean signal of the 15 networks for each subject. Statistical and machine learning analysis were then conducted on this dataset composed of 37 rows (subjects) and 15 features (mean signal in the network) with R language. The dataset was randomly splitted into training (75%) and test sets and two different classifiers were trained: RF and RBF-SVM. We used the intrinsic feature selection of RF, based on the Gini index, and recursive feature elimination (rfe) for the SVM, to obtain a rank of the most predictive variables. Thus, we built two new classifiers only on the most important features and we evaluated the accuracies (with and without feature selection) on test-set. The classifiers, trained on all the features, showed very poor accuracies on training (RF:58.62%, SVM:65.52%) and test sets (RF:62.5%, SVM:50%). Interestingly, when feature selection by RF and rfe-SVM were performed, the most important variable was the sensori-motor network I in both cases. Indeed, with only this network, RF and SVM classifiers reached an accuracy of 87.5% on test-set. More interestingly, the only misclassified patient resulted to have the lowest value of lesion volume. We showed that, with two different classification algorithms and feature selection approaches, the best discriminant network between controls and early MS, was the sensori-motor I. Similar importance values were obtained for the sensori-motor II, cerebellum and working memory networks. These findings, in according to the early manifestation of motor/sensorial deficits in MS, could represent an encouraging step toward the translation to the clinical diagnosis and prognosis.

Keywords: feature selection, machine learning, multiple sclerosis, random forest, support vector machine

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Authors: Larry Hawkins, Scott K. Sakakura, Michael J. Salopek

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The Marshall Space Flight Center is designing and building a next-generation CO₂ removal system, the Four Bed Carbon Dioxide Scrubber (4BCO₂), which will use the International Space Station (ISS) as a testbed. The current ISS CO2 removal system has faced many challenges in both performance and reliability. Given that CO2 removal is an integral Environmental Control and Life Support System (ECLSS) subsystem, the 4BCO2 Scrubber has been designed to eliminate the shortfalls identified in the current ISS system. One of the key required upgrades was to improve the performance and reliability of the blower that provides the airflow through the CO₂ sorbent beds. A magnetically levitated blower, capable of higher airflow and pressure than the previous system, was developed to meet this need. The design and qualification testing of this next-generation blower are described here. The new blower features a high-efficiency permanent magnet motor, a five-axis, active magnetic bearing system, and a compact controller containing both a variable speed drive and a magnetic bearing controller. The blower uses a centrifugal impeller to pull air from the inlet port and drive it through an annular space around the motor and magnetic bearing components to the exhaust port. Technical challenges of the blower and controller development include survival of the blower system under launch random vibration loads, operation in microgravity, packaging under strict size and weight requirements, and successful operation during 4BCO₂ operational changeovers. An ANSYS structural dynamic model of the controller was used to predict response to the NASA defined random vibration spectrum and drive minor design changes. The simulation results are compared to measurements from qualification testing the controller on a vibration table. Predicted blower performance is compared to flow loop testing measurements. Dynamic response of the system to valve changeovers is presented and discussed using high bandwidth measurements from dynamic pressure probes, magnetic bearing position sensors, and actuator coil currents. The results presented in the paper show that the blower controller will survive launch vibration levels, the blower flow meets the requirements, and the magnetic bearings have adequate load capacity and control bandwidth to maintain the desired rotor position during the valve changeover transients.

Keywords: blower, carbon dioxide removal, environmental control and life support system, magnetic bearing, permanent magnet motor, validation testing, vibration

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Authors: Mehdi Asgarkhani

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Today, investment on Information Technology (IT) solutions in most organizations is the largest component of capital expenditure. As capital investment on IT continues to grow, IT managers and strategists are expected to develop and put in practice effective decision making models (frameworks) that improve decision-making processes for the use of IT in organizations and optimize the investment on IT solutions. To be exact, there is an expectation that organizations not only maximize the benefits of adopting IT solutions but also avoid the many pitfalls that are associated with rapid introduction of technological change. Different organizations depending on size, complexity of solutions required and processes used for financial management and budgeting may use different techniques for managing strategic investment on IT solutions. Decision making processes for strategic use of IT within organizations are often referred to as IT Governance (or Corporate IT Governance). This paper examines IT governance - as a tool for best practice in decision making about IT strategies. Discussions in this paper represent phase I of a project which was initiated to investigate trends in strategic decision making on IT strategies. Phase I is concerned mainly with review of literature and a number of case studies, establishing that the practice of IT governance, depending on the complexity of IT solutions, organization's size and organization's stage of maturity, varies significantly – from informal approaches to sophisticated formal frameworks.

Keywords: IT governance, corporate governance, IT governance frameworks, IT governance components, aligning IT with business strategies

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Authors: P. Zackiewicz, M. Hreczka, R. Kolano, A. Kolano-Burian

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New types of materials applied as the stators in the Permanent Magnet Brushless Direct Current motors used in the heart supporting pumps are presented. The main focus of this work is the research on the fabrication of a hybrid nine-pole soft magnetic core consisting of a soft magnetic carrier ring with rectangular notches, made from the FeSi3 strip, and nine soft magnetic poles. This soft magnetic core is made in three stages: (a) preparation of the carrier rings from soft magnetic material with the lowest possible power losses and suitable stiffness, (b) preparation of trapezoidal soft magnetic poles from Metglas 2605 SA1 type ribbons, and (c) making durable connection between the poles and the carrier ring, capable of withstanding a four-times greater tearing force than that present during normal operation of the motor pump. All magnetic properties measurements were made using Remacomp C-1200 (Magnet Physik, Germany) and 450 Gaussometer (Lake Shore, USA) and the electrical characteristics were measured using laboratory generator DF1723009TC (NDN, Poland). Specific measurement techniques used to determine properties of the hybrid cores were presented. Obtained results allow developing the fabrication technology with an account of the intended application of these cores in the stators of the low-power PMBLDC motors used in implanted heart operation supporting pumps. The proposed measurement methodology is appropriate for assessing the quality of the stators.

Keywords: amorphous materials, heart supporting pump, PMBLDC motor, soft magnetic materials

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Authors: Ami Fadhillah Amir Abdul Nasir, Amanda C. Niehaus, Skye F. Cameron, Frank A. Von Hippel, John Postlethwait​, Robbie S. Wilson

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For suicidal breeders, the physiological stresses and energetic costs of breeding are fatal. Environmental stressors such as pollution should compound these costs, yet suicidal breeding is so rare among mammals that this is unknown. Here, we explored the consequences of metal contamination to the health, aging and performance of endangered, suicidally-breeding northern quolls (Dasyurus hallucatus) living near an active manganese mine on Groote Eylandt, Northern Territory, Australia. We found respirable manganese dust at levels exceeding international recommendations even 20km from mining sites and substantial accumulation of manganese within quolls’ hair, testes, and in two brain regions—the neocortex and cerebellum, responsible for sensory perception and motor function, respectively. Though quolls did not differ in sprint speeds, motor skill, or manoeuvrability, those with higher accumulation of manganese crashed at lower speeds during manoeuvrability tests, indicating a potential effect on sight or cognition. Immune function and telomere length declined over the breeding season, as expected with ageing, but manganese contamination exacerbated immune declines and suppressed cortisol. Unexpectedly, male quolls with higher levels of manganese had longer telomeres, supporting evidence of unusual telomere dynamics among Dasyurids—though whether this affects their lifespan is unknown. We posit that sublethal contamination via pollution, mining, or urbanisation imposes physiological costs on wildlife that may diminish reproductive success or survival.

Keywords: ecotoxicology, heavy metal, manganese, telomere length, cortisol, locomotor

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Authors: Jiaxin Chen

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Translations have been labeled as more simplified than non-translations, featuring less diversified and more frequent lexical items and simpler syntactic structures. Such simplified linguistic features have been identified in other bilingualism-influenced language varieties, including non-native and learner language use. Therefore, it has been proposed that translation could be studied within a broader framework of constrained language, and simplification is one of the universal features shared by constrained language varieties due to similar cognitive-physiological and social-interactive constraints. Yet contradicting findings have also been presented. To address this issue, this study intends to adopt Shannon’s entropy-based measures to quantify complexity in language use. Entropy measures the level of uncertainty or unpredictability in message content, and it has been adapted in linguistic studies to quantify linguistic variance, including morphological diversity and lexical richness. In this study, the complexity of lexical and syntactic choices will be captured by word-form entropy and pos-form entropy, and a comparison will be made between constrained and non-constrained language use to test the simplification hypothesis. The entropy-based method is employed because it captures both the frequency of linguistic choices and their evenness of distribution, which are unavailable when using traditional indices. Another advantage of the entropy-based measure is that it is reasonably stable across languages and thus allows for a reliable comparison among studies on different language pairs. In terms of the data for the present study, one established (CLOB) and two self-compiled corpora will be used to represent native written English and two constrained varieties (L2 written English and translated English), respectively. Each corpus consists of around 200,000 tokens. Genre (press) and text length (around 2,000 words per text) are comparable across corpora. More specifically, word-form entropy and pos-form entropy will be calculated as indicators of lexical and syntactical complexity, and ANOVA tests will be conducted to explore if there is any corpora effect. It is hypothesized that both L2 written English and translated English have lower entropy compared to non-constrained written English. The similarities and divergences between the two constrained varieties may provide indications of the constraints shared by and peculiar to each variety.

Keywords: constrained language use, entropy-based measures, lexical simplification, syntactical simplification

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Authors: Justyna Rybicka, Ashutosh Tiwari, Shane Enticott

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In the age of automation and computation aiding manufacturing, it is clear that manufacturing systems have become more complex than ever before. Although technological advances provide the capability to gain more value with fewer resources, sometimes utilisation of the manufacturing capabilities available to organisations is difficult to achieve. Flexible manufacturing systems (FMS) provide a unique capability to manufacturing organisations where there is a need for product range diversification by providing line efficiency through production flexibility. This is very valuable in trend driven production set-ups or niche volume production requirements. Although FMS provides flexible and efficient facilities, its optimal set-up is key in achieving production performance. As many variables are interlinked due to the flexibility provided by the FMS, analytical calculations are not always sufficient to predict the FMS’ performance. Simulation modelling is capable of capturing the complexity and constraints associated with FMS. This paper demonstrates how discrete event simulation (DES) can address complexity in an FMS to optimise the production line performance. A case study of an automotive FMS is presented. The DES model demonstrates different configuration options depending on prioritising objectives: utilisation and throughput. Additionally, this paper provides insight into understanding the impact of system set-up constraints on the FMS performance and demonstrates the exploration into the optimal production set-up.

Keywords: discrete event simulation, flexible manufacturing system, capacity performance, automotive

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Authors: Natsuki Tsuda, Kiyotaka Obunai, Kazuya Okubo, Hideyuki Tashiro, Yoshinori Yamaji, Hideyuki Kato

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The objective of this study is to investigate the effect of belt stiffness on the performance of the CVT unit, such as the required pulley thrust force and the ratio coverage. The CVT unit consists of the V-grooved pulleys and the rubber CVT belt. The width of the driving pulley groove was controlled by the stepper motor, while that of the driven pulley was controlled by the hydraulic pressure. The generated mechanical power on the motor was transmitted from the driving axis to the driven axis through the CVT unit. The rotational speed and the transmitting torque of both axes were measured by the tachometers and the torque meters attached with these axes, respectively. The transmitted, mechanical power was absorbed by the magnetic powder brake. The thrust force acting on both pulleys and the force between both shafts were measured by the load cell. The back face profile of the rubber CVT belt along with width direction was measured by the 2-dimensional laser displacement meter. This paper found that when the stiffness of the rubber CVT belt in the belt width direction was reduced, the thrust force required for shifting was reduced. Moreover, when the stiffness of the rubber CVT belt in the belt width direction was reduced, the ratio coverage of the CVT unit was reduced. Due to the decrement of stiffness in belt width direction, the excessive concave deformation of belt in pulley groove was confirmed. Because of this excessive concave deformation, apparent wrapping radius of belt would have been reduced. Proposed model could be effectively estimated the difference of ratio coverage due to concave deformation. The proposed model could also be utilized for designing the rubber CVT belt with optimal bending stiffness in width direction.

Keywords: CVT, countinuously variable transmission, rubber, belt stiffness, transmission

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Authors: Jason Chen, Jennifer Chen, Shiyu Li

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We examine whether managerial ability (MA), the passing of Sarbanes-Oxley in 2002 (SOX), and corporate operational complexity affect the accuracy of environmental capital expenditure projections of the environmentally sensitive industries (ESI). Prior studies found that firms in the ESI manipulated their projected environmental capital expenditures as a tool to achieve corporate legitimation and suggested that human factors must be examined to determine whether they are part of the determinants. We use MA to proxy for the latent human factors to examine whether MA affects the accuracy of financial disclosures in the ESI. To expand Chen and Chen (2020), we further investigate whether (1) SOX and (2) firms with complex operations and financial reporting in conjunction with MA affect firms’ projection accuracy. We find, overall, that MA is positively correlated with firm’s projection accuracy in the annual 10-Ks. Furthermore, results suggest that SOX has a positive, yet temporary, effect on MA, and that leads to better accuracy. Finally, MA matters for firms with more complex operations and financial reporting to make less projection errors than their less-complex counterparts. These results suggest that MA is a determinant that affects the accuracy of environmental capital expenditure projections for the firms in the ESI.

Keywords: managerial ability, environmentally sensitive industries, sox, corporate operational complexity

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Authors: Larissa Pliska, Isabel Neitzel, Michael Buschermöhle, Olga Kunina-Habenicht, Ute Ritterfeld

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Visual preferences, which can be assessed using eye tracking technologies, are considered one of the defining hallmarks of Autism Spectrum Disorder (ASD). Specifically, children with ASD show a decreased preference for social images rather than geometric images compared to typically developed (TD) children. Such differences are already prevalent at a very early age and indicate the severity of the disorder: toddlers with ASD who preferred geometric images when confronted with social and geometric images showed higher ASD symptom severity than toddlers with ASD who showed higher social attention. Furthermore, the complexity of social pictures (one child playing vs. two children playing together) as well as the mode of stimulus presentation (video or image), are not decisive for the marker. The average age of diagnosis for ASD in Germany is 6.5 years, and visual preference data on this age group is missing. In the present study, we therefore investigated whether visual preferences persist into school age. We examined the visual preferences of 16 boys aged 6 to 11 with ASD and unimpaired cognition as well as TD children (1:1 matching based on children's age and the parent's level of education) within an experimental setting. Different stimulus presentation formats (images vs. videos) and different levels of stimulus complexity were included. Children with and without ASD received pairs of social and non-social images and video stimuli on a screen while eye movements (i.e., eye position and gaze direction) were recorded. For this specific use case, KIZMO GmbH developed a customized, native iOS app (KIZMO Face-Analyzer) for use on iPads. Neither the format of stimulus presentation nor the complexity of the social images had a significant effect on the visual preference of children with and without ASD in this study. Despite the tendency for a difference between the groups for the video stimuli, there were no significant differences. Overall, no statistical differences in visual preference occurred between boys with and without ASD, suggesting that gaze preference in these groups is similar at primary school age. One limitation is that the children with ASD were already receiving Autism-specific intervention. The potential of a visual preference task as an indicator of ASD can be emphasized. The article discusses the clinical relevance of this marker in elementary school children.

Keywords: autism spectrum disorder, eye tracking, hallmark, visual preference

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Authors: Vidar Hepsø

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The energy and oil companies on the Norwegian Continental shelf come from a situation where each asset control and manage their energy supply (island mode) and move towards a situation where the assets need to collaborate and coordinate energy use with others due to increased cost and scarcity of electric energy sharing the energy that is provided. Currently, several areas are electrified either with an onshore grid cable or are receiving intermittent energy from offshore wind-parks. While the onshore grid in Norway is well regulated, the offshore grid is still in the making, with several oil and gas electrification projects and offshore wind development just started. The paper will describe the shift in the mindset that comes with operating this new offshore grid. This transition process heralds an increase in collaboration across boundaries and integration of energy management across companies, businesses, technical disciplines, and engagement with stakeholders in the larger society. This transition will be described as a function of the new challenges with increased complexity of the energy mix (wind, oil/gas, hydrogen and others) coupled with increased technical and organization complexity in energy management. Organizational complexity denotes an increasing integration across boundaries, whether these boundaries are company, vendors, professional disciplines, regulatory regimes/bodies, businesses, and across numerous societal stakeholders. New practices must be developed, made legitimate and institutionalized across these boundaries. Only parts of this complexity can be mitigated technically, e.g.: by use of batteries, mixing energy systems and simulation/ forecasting tools. Many challenges must be mitigated with legitimated societal and institutionalized governance practices on many levels. Offshore electrification supports Norway’s 2030 climate targets but is also controversial since it is exploiting the larger society’s energy resources. This means that new systems and practices must also be transparent, not only for the industry and the authorities, but must also be acceptable and just for the larger society. The paper report from ongoing work in Norway, participant observation and interviews in projects and people working with offshore grid development in Norway. One case presented is the development of an offshore floating windfarm connected to two offshore installations and the second case is an offshore grid development initiative providing six installations electric energy via an onshore cable. The development of the offshore grid is analyzed using a capability platform framework, that describes the technical, competence, work process and governance capabilities that are under development in Norway. A capability platform is a ‘stack’ with the following layers: intelligent infrastructure, information and collaboration, knowledge sharing & analytics and finally business operations. The need for better collaboration and energy forecasting tools/capabilities in this stack will be given a special attention in the two use cases that are presented.

Keywords: capability platform, electrification, carbon footprint, control rooms, energy forecsting, operational model

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Authors: S. H. Jang

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Posterior reversible encephalopathy syndrome (PRES) is characterized by acute neurologic symptoms (visual loss, headache, altered mentality and seizures) and by typical imaging findings (bilateral subcortical and cortical edema with predominatly posterior distribution). Nephrotic syndrome is a syndrome comprising signs of proteinuria, hypoalbuminemia, and edema. It is well known that hypertension predispose patient with nephrotic syndrome to PRES. A 45-year old male was referred for suddenly developed vertigo, disequilibrium. He had previous history of nephrotic syndrome. His medical history included diabetes controlled with medication. He was hospitalized because of generalized edema a few days ago. His vital signs were stable. On neurologic examination, his mental state was alert. Horizontal nystagmus to right side on return to primary position was observed. He showed good grade motor weakness and ataxia in right upper and lower limbs without other sensory abnormality. Brain MRI showed increased signal intensity in FLAIR image, decreased signal intensity in T1 image and focal enhanced lesion in T1 contrast image at whole midbrain, pons and cerebellar peduncle symmetrically, which was compatible with vasogenic edema. Laboratory findings showed severe proteinuria and hypoalbuminemia. He was given intravenous dexamethasone and diuretics to reduce vasogenic edema and raise the intra-vascular osmotic pressure. Nystagmus, motor weakness and limb ataxia improved gradually over 2 weeks; He recovered without any neurologic symptom and sign. Follow-up MRI showed decreased vasogenic edema fairly. We report a case of brain stem PRES in normotensive, nephrotic syndrome patient.

Keywords: posterior reversible encephalopathy syndrome, MRI, nephrotic syndrome, vasogenic brain edema

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Authors: A. Luft, S. Bremen, N. Balc

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The task of flexibility planning and design, just like factory planning, for example, is to create the long-term systemic framework that constitutes the restriction for short-term operational management. This is a strategic challenge since, due to the decision defect character of the underlying flexibility problem, multiple types of flexibility need to be considered over the course of various scenarios, production programs, and production system configurations. In this context, an evaluation model has been developed that integrates both conventional and additive resources on a basic task level and allows the quantification of flexibility enhancement in terms of mix and volume flexibility, complexity reduction, and machine capacity. The model helps companies to decide in early decision-making processes about the potential gains of implementing additive manufacturing technologies on a strategic level. For companies, it is essential to consider both additive and conventional manufacturing beyond pure unit costs. It is necessary to achieve an integrative view of manufacturing that incorporates both additive and conventional manufacturing resources and quantifies their potential with regard to flexibility and manufacturing complexity. This also requires a structured process for the strategic production systems design that spans the design of various scenarios and allows for multi-dimensional and comparative analysis. A respective guideline for the planning of additive resources on a strategic level is being laid out in this paper.

Keywords: additive manufacturing, production system design, flexibility enhancement, strategic guideline

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Authors: Marc Sebastián-Romagosa, Woosang Cho, Rupert Ortner, Christy Li, Christoph Guger

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Neurorehabilitation based on Brain-Computer Interfaces (BCIs) shows important rehabilitation effects for patients after stroke. Previous studies have shown improvements for patients that are in a chronic stage and/or have severe hemiparesis and are particularly challenging for conventional rehabilitation techniques. For this publication, seven stroke patients in the chronic phase with hemiparesis in the lower extremity were recruited. All of them participated in 25 BCI sessions about 3 times a week. The BCI system was based on the Motor Imagery (MI) of the paretic ankle dorsiflexion and healthy wrist dorsiflexion with Functional Electrical Stimulation (FES) and avatar feedback. Assessments were conducted to assess the changes in motor improvement before, after and during the rehabilitation training. Our primary measures used for the assessment were the 10-meters walking test (10MWT), Range of Motion (ROM) of the ankle dorsiflexion and Timed Up and Go (TUG). Results show a significant increase in the gait speed in the primary measure 10MWT fast velocity of 0.18 m/s IQR = [0.12 to 0.2], P = 0.016. The speed in the TUG was also significantly increased by 0.1 m/s IQR = [0.09 to 0.11], P = 0.031. The active ROM assessment increased 4.65º, and IQR = [ 1.67 - 7.4], after rehabilitation training, P = 0.029. These functional improvements persisted at least one month after the end of the therapy. These outcomes show the feasibility of this BCI approach for chronic stroke patients and further support the growing consensus that these types of tools might develop into a new paradigm for rehabilitation tools for stroke patients. However, the results are from only seven chronic stroke patients, so the authors believe that this approach should be further validated in broader randomized controlled studies involving more patients. MI and FES-based non-invasive BCIs are showing improvement in the gait rehabilitation of patients in the chronic stage after stroke. This could have an impact on the rehabilitation techniques used for these patients, especially when they are severely impaired and their mobility is limited.

Keywords: neuroscience, brain computer interfaces, rehabilitat, stroke

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Authors: Ron Dick, P. S. D. V. Prasadarao, Glenn Coltman

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Agenesis of the corpus callosum (ACC) is a failure to develop corpus callosum - the large bundle of fibers of the brain that connects the two cerebral hemispheres. It can occur as a partial or complete absence of the corpus callosum. In the general population, its estimated prevalence rate is 1 in 4000 and a wide range of genetic, infectious, vascular, and toxic causes have been attributed to this heterogeneous condition. The diagnosis of ACC is often achieved by neuroimaging procedures. Though persons with ACC can perform normally on intelligence tests they generally present with a range of neuropsychological and social deficits. The deficit profile is characterized by poor coordination of motor movements, slow reaction time, processing speed and, poor memory. Socially, they present with deficits in communication, language processing, the theory of mind, and interpersonal relationships. The present paper illustrates the role of neuropsychological assessment with implications to psychosocial management in a case of agenesis of the corpus callosum. Method: A 27-year old left handed Caucasian male with a history of ACC was self-referred for a neuropsychological assessment to assist him in his employment options. Parents noted significant difficulties with coordination and balance at an early age of 2-3 years and he was diagnosed with dyspraxia at the age of 14 years. History also indicated visual impairment, hypotonia, poor muscle coordination, and delayed development of motor milestones. MRI scan indicated agenesis of the corpus callosum with ventricular morphology, widely spaced parallel lateral ventricles and mild dilatation of the posterior horns; it also showed colpocephaly—a disproportionate enlargement of the occipital horns of the lateral ventricles which might be affecting his motor abilities and visual defects. The MRI scan ruled out other structural abnormalities or neonatal brain injury. At the time of assessment, the subject presented with such problems as poor coordination, slowed processing speed, poor organizational skills and time management, and difficulty with social cues and facial expressions. A comprehensive neuropsychological assessment was planned and conducted to assist in identifying the current neuropsychological profile to facilitate the formulation of a psychosocial and occupational rehabilitation programme. Results: General intellectual functioning was within the average range and his performance on memory-related tasks was adequate. Significant visuospatial and visuoconstructional deficits were evident across tests; constructional difficulties were seen in tasks such as copying a complex figure, building a tower and manipulating blocks. Poor visual scanning ability and visual motor speed were evident. Socially, the subject reported heightened social anxiety, difficulty in responding to cues in the social environment, and difficulty in developing intimate relationships. Conclusion: Persons with ACC are known to present with specific cognitive deficits and problems in social situations. Findings from the current neuropsychological assessment indicated significant visuospatial difficulties, poor visual scanning and problems in social interactions. His general intellectual functioning was within the average range. Based on the findings from the comprehensive neuropsychological assessment, a structured psychosocial rehabilitation programme was developed and recommended.

Keywords: agenesis, callosum, corpus, neuropsychology, psychosocial, rehabilitation

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Authors: Svanik Garg

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Static Test Pads are stationary mechanisms that hold a solid rocket motor, measuring the different parameters of its operation including thrust and temperature to better calibrate it for launch. This paper outlines a specific STP designed to test high powered rocket motors with a thrust upwards of 4000N and limited to 6500N. The design includes a specific portable mechanism with cost an integral part of the design process to make it accessible to small scale rocket developers with limited resources. Using curved surfaces and an ergonomic design, the STP has a delicately engineered façade/case with a focus on stability and axial calibration of thrust. This paper describes the design, operation and working of the STP and its widescale uses given the growing market of aviation enthusiasts. Simulations on the CAD model in Fusion 360 provided promising results with a safety factor of 2 established and stress limited along with the load coefficient A PCB was also designed as part of the test pad design process to help obtain results, with visual output and various virtual terminals to collect data of different parameters. The circuitry was simulated using ‘proteus’ and a special virtual interface with auditory commands was also created for accessibility and wide-scale implementation. Along with this description of the design, the paper also emphasizes the design principle behind the STP including a description of its vertical orientation to maximize thrust accuracy along with a stable base to prevent micromovements. Given the rise of students and professionals alike building high powered rockets, the STP described in this paper is an appropriate option, with limited cost, portability, accuracy, and versatility. There are two types of STP’s vertical or horizontal, the one discussed in this paper is vertical to utilize the axial component of thrust.

Keywords: static test pad, rocket motor, thrust, load, circuit, avionics, drag

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Authors: Zhangquan Zhou, Guilin Qi

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Materialization is an important reasoning service for applications built on the Web Ontology Language (OWL). To make materialization efficient in practice, current research focuses on deciding tractability of an ontology language and designing parallel reasoning algorithms. However, some well-known large-scale ontologies, such as YAGO, have been shown to have good performance for parallel reasoning, but they are expressed in ontology languages that are not parallelly tractable, i.e., the reasoning is inherently sequential in the worst case. This motivates us to study the problem of parallel tractability of ontology materialization from a theoretical perspective. That is we aim to identify the ontologies for which materialization is parallelly tractable, i.e., in the NC complexity. Since the NC complexity is defined based on Boolean circuit that is widely used to investigate parallel computing problems, we first transform the problem of materialization to evaluation of Boolean circuits, and then study the problem of parallel tractability based on circuits. In this work, we focus on datalog rewritable ontology languages. We use Boolean circuits to identify two classes of datalog rewritable ontologies (called parallelly tractable classes) such that materialization over them is parallelly tractable. We further investigate the parallel tractability of materialization of a datalog rewritable OWL fragment DHL (Description Horn Logic). Based on the above results, we analyze real-world datasets and show that many ontologies expressed in DHL belong to the parallelly tractable classes.

Keywords: ontology materialization, parallel reasoning, datalog, Boolean circuit

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Authors: Linda Blümel, Bettina Bert, Jan Brosda, Heidrun Fink, Melanie Hamann

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Age-related cognitive decline can eventually lead to dementia, the most common mental illness in elderly people and an immense challenge for patients, their families and caregivers. Cholinesterase inhibitors constitute the most commonly used antidementia prescription medication. The standardized Ginkgo biloba leaf extract EGb 761® is approved for treating age-associated cognitive impairment and has been shown to improve the quality of life in patients suffering from mild dementia. A clinical trial with 96 Alzheimer´s disease patients indicated that the combined treatment with donepezil and EGb 761® had fewer side effects than donepezil alone. In an animal model of cognitive aging, we compared the effect of combined treatment with EGb 761® or donepezil monotherapy and vehicle. We compared the effect of chronic treatment (15 days of pretreatment) with donepezil (1.5 mg/kg p. o.), EGb 761® (100 mg/kg p. o.), or the combination of the two drugs, or vehicle in 18 – 20 month old male OFA rats. Learning and memory performance were assessed by Morris water maze testing, motor behavior in an open field paradigm. In addition to chronic treatment, the substances were administered orally 30 minutes before testing. Compared to the first day and to the control group, only the combination group showed a significant reduction in latency to reach the hidden platform on the second day of testing. Moreover, from the second day of testing onwards, the donepezil, the EGb 761® and the combination group required less time to reach the hidden platform compared to the first day. The control group did not reach the same latency reduction until day three. There were no effects on motor behavior. These results suggest a superiority of the combined treatment of donepezil with EGb 761® compared to monotherapy.

Keywords: age-related cognitive decline, dementia, ginkgo biloba leaf extract EGb 761®, learning and memory, old rats

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Authors: João Pedro Zanella, Michel J. O. Fagundes

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Introduction: Drug use has been practised by humans universally for millennia, not excluding any population from these habits, however, the rampant drug use is a global concern due to the harm that affects the health of the world population. In this sense, it is observed the reduction of lasting and effective public policies for the resolution, increasing the demand for treatment services. With this comes ibogaine, an alkaloid derived from the root of an African bush (Tabernanthe Iboga), found mostly in Gabon and used widely by the native Bwiti population in rituals, and also other social groups, which demonstrates efficacy against chemical dependence, psychic and emotional disorders, opioid withdrawal was first confirmed by a study in rats done by Michailo Dzoljic and associates in 1988 and again in 1994. Methods: A brief description of the plant, its neurohumoral potential and the effects caused by ingested doses, in a simplified and objective way, will be discussed in the course of this abstract. Results: Ibogaine is not registered or passed by Anvisa, regarding safety and efficacy, and cannot be sold in Brazil. Its illegal trade reaches R$ 5 thousand for a session with the proceeds of the root, and its effect can last up to 72 hours, attributing Iboga's psychoactive effects to the alkaloid called ibogaine. The shrub where Ibogaine is located has pink and yellow flowers, and its fruit produced does not have psychoactive substances, but its root bark contains 6 to 7% indolic alkaloids. Besides extraction from the iboga plant, ibogaine hydrochloride can be semisynthesized from voacangine, another plant alkaloid that acts as a precursor. Its potential has the ability to perform multiple interactions with the neurotransmitter system, which are closely associated with addiction, including nicotinic, opioid and serotoninergic systems. Studies carried out by Edwards found that the doses administered of Iboga should be determined by a health professional when its purpose is to treat individuals for dependence on other drugs. Its use in small doses may cause an increase in sensibility, impaired vision and motor alterations; in moderate quantities, hallucinations, motor and neurological alterations and impaired vision; in high quantities it may cause hallucinations with personal events at a deeper level lasting up to 24 hours or more, followed by motor and visual alterations. Conclusion: The product extracted from the Iboga plant is of great importance in controlling addiction, reducing the need for the use of narcotics by patients, thus gaining a space of extreme importance in the treatment of users of psychoactive substances. It is remarkable the progress of the latest’s research about the usefulness of Ibogaine, and its benefits for certain treatments, even with the restriction of its sale in Brazil. Besides this, Ibogaine has an additional benefit of helping the patient to gain self-control over their destructive behaviours.

Keywords: alkaloids, dependence, Gabon, ibogaine

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Authors: Agryzkov Taras, Oliver Jose L., Tortosa Leandro, Vicent Jose

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This paper aims to demonstrate how the consideration of cities as a special kind of complex network, called urban network, may lead to the use of design tools coming from network theories which, in fact, results in a quite sustainable approach. There is no doubt that the irruption in contemporary thought of Gaia as an essential political agent proposes a narrative that has been extended to the field of creative processes in which, of course, the activity of Urban Design is found. The rationalist paradigm is put in crisis, and from the so-called sciences of complexity, its way of describing reality and of intervening in it is questioned. Thus, a new way of understanding reality surges, which has to do with a redefinition of the human being's own place in what is now understood as a delicate and complex network. In this sense, we know that in these systems of connected and interdependent elements, the influences generated by them originate emergent properties and behaviors for the whole that, individually studied, would not make sense. We believe that the design of cities cannot remain oblivious to these principles, and therefore this research aims to demonstrate the potential that they have for decision-making in the urban environment. Thus, we will see an example of action in the field of public mobility, another example in the design of commercial areas, and a third example in the field of redensification of sprawl areas, in which different aspects of network theory have been applied to change the urban design. We think that even though these actions have been developed in European cities, and more specifically in the Mediterranean area in Spain, the reflections and tools could have a broader scope of action.

Keywords: graphs, complexity sciences, urban networks, urban design

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Authors: Bara M Yousef, Naresh B Raj, Nadiah W Arfah, Brightlin N Dhas

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Background: Executive function (EF) impairment is common in children with autism spectrum disorder (ASD). EF strategies are considered effective in improving the therapeutic outcomes of children with ASD. Aims: This study primarily aims to explore whether integrating EF strategies combined with regular occupational therapy intervention is more effective in improving daily life skills (DLS) and sensory integration/processing (SI/SP) skills than regular occupational therapy alone in children with ASD and secondarily aims to assess treatment outcomes on improving visual motor integration (VMI) skills. Procedures: A total of 92 children with ASD will be recruited and, following baseline assessments, randomly assigned to the treatment group (45-min once weekly individual occupational therapy plus EF strategies) and control group (45-min once weekly individual therapy sessions alone). Results and Outcomes: All children will be evaluated systematically by assessing SI/SP, DLS, and VMI, skills at baseline, 7 weeks, and 14 weeks of treatment. Data will be analyzed using ANCOVA and T-test. Conclusions and Implications: This single-blind, randomized controlled trial will provide empirical evidence for the effectiveness of EF strategies when combined with regular occupational therapy programs. Based on trial results, EF strategies could be recommended in multidisciplinary programs for children with ASD. Trial Registration: The trial has been registered in the clinicaltrail.gov for a registry, protocol ID: MRC-01-22-509 ClinicalTrials.gov Identifier: NCT05829577, registered 25th April 2023

Keywords: autism spectrum disorder, executive function strategies, daily life skills, sensory integration/processing, visual motor integration, occupational therapy, effectiveness

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Authors: Francois Defay, Martim Calao, Jean Francois Dassieu, Laurent Salvetat

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Electrical vehicles are a solution for reducing the pollution using green energy. The shell Eco-Marathon provides rules in order to minimize the battery use for the race. The use of solar panel combined with efficient motor control and race strategy allow driving a 60kg vehicle with one pilot using only the solar energy in the best case. This paper presents a complete modelization of a solar vehicle used for the shell eco-marathon. This project called Helios is cooperation between non-graduated students, academic institutes, and industrials. The prototype is an ultra-energy-efficient vehicle based on one-meter square solar panel and an own-made brushless controller to optimize the electrical part. The vehicle is equipped with sensors and embedded system to provide all the data in real time in order to evaluate the best strategy for the course. A complete modelization with Matlab/Simulink is used to test the optimal strategy to increase the global endurance. Experimental results are presented to validate the different parts of the model: mechanical, aerodynamics, electrical, solar panel. The major finding of this study is to provide solutions to identify the model parameters (Rolling Resistance Coefficient, drag coefficient, motor torque coefficient, etc.) by means of experimental results combined with identification techniques. One time the coefficients are validated, the strategy to optimize the consumption and the average speed can be tested first in simulation before to be implanted for the race. The paper describes all the simulation and experimental parts and provides results in order to optimize the global efficiency of the vehicle. This works have been started four years ago and evolved many students for the experimental and theoretical parts and allow to increase the knowledge on electrical self-efficient vehicle.

Keywords: electrical vehicle, endurance, optimization, shell eco-marathon

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Authors: Durjoy Lahiri, Vishal Madhukar Sawale, Ashwani Bhat, Souvik Dubey, Gautam Das, Biman Kanti Roy, Suparna Chatterjee, Goutam Gangopadhyay

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Crossed aphasia has been an area of considerable interest for cognitive researchers as it offers a fascinating insight into cerebral lateralization for language function. We conducted an observational study in the stroke unit of a tertiary care neurology teaching hospital in eastern India on subjects with crossed aphasia over a period of four years. During the study period, we detected twelve cases of crossed aphasia in strongly right-handed patients, caused by ischemic stroke. The age, gender, vernacular language and educational status of the patients were noted. Aphasia type and severity were assessed using Bengali version of Western Aphasia Battery (validated). Computed tomography, magnetic resonance imaging and angiography were used to evaluate the location and extent of the ischemic lesion in brain. Our series of 12 cases of crossed aphasia included 7 male and 5 female with mean age being 58.6 years. Eight patients were found to have Broca’s aphasia, 3 had trans-cortical motor aphasia and 1 patient suffered from global aphasia. Nine patients were having very severe aphasia and 3 suffered from mild aphasia. Mirror-image type of crossed aphasia was found in 3 patients, whereas 9 had anomalous variety. In our study crossed aphasia was found to be more frequent in males. Anomalous pattern was more common than mirror-image. Majority of the patients had motor-type aphasia and no patient was found to have pure comprehension deficit. We hypothesize that in Bengali-speaking right-handed population, lexical-semantic system of the language network remains loyal to the left hemisphere even if the phonological output system is anomalously located in the right hemisphere.

Keywords: aphasia, crossed, lateralization, language function, vascular

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Authors: Winncy Du, Jeremy Nguyen, Harpinder Dhillon, Reinardus Justin Halim, Clayton Haske, Trent Hughes, Marissa Ortiz, Rozy Saini

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Stroke often causes death or cerebro-vascular (CV) brain damage. Most patients with CV brain damage lost their motor control on their limbs. This paper focuses on developing a reliable, safe, and non-invasive EEG-based robot-assistant stroke rehabilitation system to help stroke survivors to rapidly restore their motor control functions for their limbs. An electroencephalogram (EEG) recording device (EPOC Headset) and was used to detect a patient’s brain activities. The EEG signals were then processed, classified, and interpreted to the motion intentions, and then converted to a series of robot motion commands. A six-axis articulated robot (AdeptSix 300) was employed to provide the intended motions based on these commends. To ensure the EEG device, the computer, and the robot can communicate to each other, an Arduino microcontroller is used to physically execute the programming codes to a series output pins’ status (HIGH or LOW). Then these “hardware” commends were sent to a 24 V relay to trigger the robot’s motion. A lookup table for various motion intensions and the associated EEG signal patterns were created (through training) and installed in the microcontroller. Thus, the motion intention can be direct determined by comparing the EEG patterns obtaibed from the patient with the look-up table’s EEG patterns; and the corresponding motion commends are sent to the robot to provide the intended motion without going through feature extraction and interpretation each time (a time-consuming process). For safety sake, an extender was designed and attached to the robot’s end effector to ensure the patient is beyond the robot’s workspace. The gripper is also designed to hold the patient’s limb. The test results of this rehabilitation system show that it can accurately interpret the patient’s motion intension and move the patient’s arm to the intended position.

Keywords: brain waves, EEG sensor, motion control, robot-assistant stroke rehabilitation

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