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This paper presents a new, simple model to evaluate the instrumental random errors in kinematic analysis of human movements using stereophotogrammetry. By means of equations analogous to that relate linear or angular momentum with linear or angular velocities, a direct measurement of instantaneous motion can be made without previous finite displacement analysis. Single explicit expressions can be obtained to evaluate the influence of instrumental random errors in the accuracy of the kinematic variables. From these expressions, some conclusions about the effect of marker cluster design on the experimental errors are obtained. An experiment has been carried out in order to validate the proposed technique and to assess the experimental errors in linear and angular velocity measurement and its influence in instantaneous helical axis determination. [ABSTRACT FROM AUTHOR]

This paper explores methods that make use of visual cues aimed at generating actual haptic sensation to the user, namely pseudo-haptics. We propose a new pseudo-haptic feedback-based method capable of conveying 3D haptic information and combining visual haptics with force feedback to enhance the user's haptic experience. We focused on an application related to tumor identification during palpation and evaluated the proposed method in an experimental study where users interacted with a haptic device and graphical interface while exploring a virtual model of soft tissue, which represented stiffness distribution of a silicone phantom tissue with embedded hard inclusions. The performance of hard inclusion detection using force feedback only, pseudo-haptic feedback only, and the combination of the two feedbacks was compared with the direct hand touch. The combination method and direct hand touch had no significant difference in the detection results. Compared with the force feedback alone, our method increased the sensitivity by 5%, the positive predictive value by 4%, and decreased detection time by 48.7%. The proposed methodology has great potential for robot-assisted minimally invasive surgery and in all applications where remote haptic feedback is needed. [ABSTRACT FROM AUTHOR]

This paper presents a three-dimensional (3D) reconstruction system of the human spine for the routine evaluation of musculoskeletal pathologies like idiopathic scoliosis. The main objective of this 3D reconstruction system is to offer a versatile and robust tool for the 3D analysis of spines in any healthcare centre with standard clinical setup using standard uncalibrated radiographic images. The novel system uses a self-calibration algorithm and a weak-perspective method to reconstruct the 3D coordinates of anatomical landmarks from bi-planar radiographic images of a patient's trunk. Additionally, a small planar object of known dimensions is proposed to warrant an accurately scaled model of the spine. In order to assess the validity of the 3D reconstructions yielded by the proposed system, a clinical study using 60 pairs of digitized X-rays of adolescents was conducted. The subject cohort in the study group was composed of 51 scoliotic and 9 non-scoliotic patients, with an average Cobb angle on the frontal plane of 25 degrees. For each case, a 3D reconstruction of the spine and pelvis was obtained with the previous system used at our hospital (which requires a positioning apparatus and a calibration jacket), and with the proposed method. Results show that 3D reconstructions obtained with the new system using uncalibrated X-ray images yield geometrically accurate models with insignificant differences for 2D and 3D clinical indexes commonly used in the evaluation of spinal deformities. This demonstrates the system to be a viable and accurate tool for clinical studies and biomechanical analysis purposes, with the added advantage of versatility to any clinical setup for routine follow-ups and surgical planning. [ABSTRACT FROM AUTHOR]

This paper presents an inertial based sensing system for real-time three-dimensional measurement of human spinal motion, in a portable and non-invasive manner. Applications of the proposed system range from diagnosis of spine injury to postural monitoring, on-field as well as in the lab setting. The system is comprised of three inertial measurement sensors, respectively attached and calibrated to the head, torso and hips, based on the subject's anatomical planes. Sensor output is transformed into meaningful clinical parameters of rotation (twist), flexion-extension and lateral bending of each body segment, with respect to calibrated global reference space. Modeling the spine as a compound flexible pole model allows dynamic measurement of three-dimensional spine motion, which can be animated and monitored in real-time using our interactive GUI. The accuracy of the proposed sensing system has been verified with subject trials using a VICON optical motion measurement system. Experimental results indicate an error of less than 3.1 degrees in segment orientation tracking. [ABSTRACT FROM AUTHOR]

Hyperthermia plays an important role in oncological therapies, most often being used in combination with radiotherapy, chemotherapy and immunotherapy. The success of this therapy is strongly dependent on the precision and control of thermal deposition. Hyperthermia based on induction heating, with thermally self-regulating thermoseeds inserted into the tumorous mass, is used for interstitial treatment. The technique was the subject of the numerical study presented in the paper. The analysis was carried out using coupled electromagnetic heating and thermo-fluid dynamic FEM simulations. During thermal deposition by induction heating of inserted seeds, the simulations estimated the thermal field inside and outside the tumour, as well as the sensitivity of the thermal field to variations regarding seed temperature, configuration and proximity to vessels. The method, for which accurate anatomical patient's information is essential, is suitable for providing useful qualitative and quantitative information about thermal transients and power density distribution for hyperthermic treatment. Several grid steps were analysed and compared. A 1 cm seed grid was resulted in good homogeneity and effectiveness of the thermal deposition. The cold spot effect caused by large vessels was demonstrated and quantified. Simulations of the heating of a tumorous mass in the liver showed that an indcutor generator operating at 200 kHz frequency and 500 A current, producing a pulsating magnetic field of H = 60 A cm(-1), was adequate for the treatment. The seeds that perform best among those tested (Nicu (28% Cu), PdNi (27.2% Ni), PdCo (6.15% Co) and ferrite core) were the PdNi (1 mm radius, 10 mm length), as they have a low Curie temperature (52 degrees C), which is the closest to the desired treatment temperature and thus reduces the risk of hot spots. [ABSTRACT FROM AUTHOR]

Surface-recorded somatosensory-evoked potentials (SEPs) are neural signals elicited by an external stimulus. In the case of electrically induced SEPs, the artifact generated by the stimulation process can severely distort the signal. In some cases, the artifact tail often lasts well into the initiation of the SEP making the determination of absolute latency very difficult. In this work, a new approach was taken to identify factors that affect the tail of the artifact. The methodology adopted was the development of a lumped electrical circuit model of the artifact generation process. While the modeling of the instrumentation hardware is relatively simple, this is not the case with tissue and electrode/skin interface effects. Consequently, this paper describes a novel tissue modeling approach that uses an autoregressive moving average (ARMA) parametric technique and an artificial neural network (ANN) to estimate tissue parameters from experimental data. This coupled with an estimation of the stimulation electrode-skin impedance completes the lumped circuit model. Simulink (The Mathworks Inc.) was used to evaluate the model under several different conditions. These results show that both the stimulation electrode-skin interface impedance and nature of the body tissue directly under the recording electrodes have a profound effect on the appearance of the stimulus artifact tail. This was verified by experimentally recorded data obtained from the median nerve using surface electrodes. Conclusions drawn from this work include that stimulation electrodes with low series capacitance should be used whenever possible to minimize the duration of the artifact tail. [ABSTRACT FROM AUTHOR]

The paper describes the design and construction of a selective surface electrode for use in a clinical environment. The main criterion of the design was to enable the recognition of individual motor unit action potential trains (MUAPTs) at moderate force levels. The main features of the electrode are, first, a small concentric bipolar arrangement to avoid electrode/muscle fibre alignment problems and to allow measurements within a small, well defined probed volume; secondly, the non-requirement for conducting paste or gel; and thirdly, the casing acting as an earth plate. All of these simplify its use. The results of tests undertaken with the electrode showed that it was able to pick up individual MUAPTs at up to 20 per cent of maximum voluntary contraction from the first dorsal interosseous muscle. Tests were carried out on the small hand muscles to further demonstrate the usefulness of the electrode. A computer program was written to calculate the shift in frequency of the power spectrum of the recorded myoelectric signal with muscle fatigue and hence indirectly to demonstrate the ability of the electrode to detect the reduction in muscle fibre conduction velocity. [ABSTRACT FROM AUTHOR]

The extracorporeal CO2 removal device (ECCO2RD) is used in clinics to treat patients suffering from respiratory failures like acute respiratory distress syndrome (ARDS) or chronic obstructive pulmonary disease (COPD). The aim of this device is to decarboxylate blood externally with low blood flow. A mathematical model is proposed to describe protective ventilation, ARDS, and an extracorporeal CO2 removal therapy (ECCO2RT). The simulations are compared with experimental data carried out on ten pigs. The results show a good agreement between the mathematical simulations and the experimental data, which provides a nice validation of the model. This model is thus able to predict the decrease of PCO2 during ECCO2RT for different blood flows across the extracorporeal lung support. [ABSTRACT FROM AUTHOR]

We estimated the dynamic cell metabolic activity and the distribution of the pH value and oxygen concentration in tissue samples cultured in vitro by using real-time sensor records and a numerical simulation of the underlying reaction-diffusion processes. As an experimental tissue model, we used chicken spleen slices. A finite element method model representing the biochemical processes and including the relevant sensor data was set up. By fitting the calculated results to the measured data, we derived the spatiotemporal values of the pH value, the oxygen concentration and the absolute metabolic activity (extracellular acidification and oxygen uptake rate) of the samples. Notably, the location of the samples in relation to the sensors has a great influence on the detectable metabolic rates. The long-term vitality of the tissue samples strongly depends on their size. We further discuss the benefits and limitations of the model. [ABSTRACT FROM AUTHOR]

50 microm tungsten microneedles have been used as a means to introduce longitudinal intra-fascicular electrodes (LIFE) into small peripheral nerve fascicles. However, recent attempts to implant LIFEs into larger, human sized nerves with the same needles resulted in buckling failure of the introducer needle. In the present study, the implantation mechanics (penetration forces and penetration dimple depth) of electrosharpened tungsten microneedles ranging in diameters from 50 to 200 microm into freshly excised porcine peripheral nerve trunks between 3 and 5 mm in thickness was characterized to understand the implantation mechanics and to find the minimum needle diameter that would result in successful penetration. The implant success rate was found to be highest with needles having diameters between 80 and 120 microm. The force of successful penetration ranged from 7.2 +/- 0.6 to 71.8 +/- 19.5 mN, and increased monotonically with needle diameter. It also had a tendency to increase with increasing tip angles. The dimple depth for successful penetrations varied between 1 and 1.5 mm, and also tended to increase with increasing tip angles, although it was generally not affected by increased needle diameter. Only the smallest penetration dimple depth was found to be different from the others and was associated with the smallest diameter needle (50 microm). Analysis based on the critical buckling force and the measured implantation forces indicated a 15 mm long needle of 80 microm diameter would be necessary and sufficient to penetrate medium to large sized nerves. [ABSTRACT FROM AUTHOR]

To minimize time-consuming and expensive in vitro and in vivo testing, information regarding the effects of implantation and the implants on measurements should be available during the designing of active implantable devices measuring bioelectric signals such as electrocardiograms (ECG). Modeling offers a fairly inexpensive and effective means of studying and demonstrating the effects of implantation on ECG measurements prior to any in vivo tests, and can thus provide the designer with valuable information. Finite difference model (FDM) and lead field approaches offer straightforward and effective modeling methods supporting the designing of active implantable ECG devices. The present study demonstrates such methods in developing and studying ECG implants. They were applied in demonstrating the effects of implant dimensions and of electrode implantation on the measurement sensitivity of the ECG device. The results of the simulations indicated that the interelectrode distance is the factor of the implant design determining the lead sensitivity. Other parameters related implant dimensions and shape have minor effect on the morphology of the ECG or on the average sensitivity of the measurement. This is shown for example when the interelectrode distance was reduced to 1/3 of original the average lead sensitivity decreased by 69.1% while larger relative changes in other dimensions produced clearly smaller changes. It was also observed here that implanting the electrodes deeper under the skin has major effects on the local sensitivities in heart muscle and thus affect to the morphology of the ECG. The study indicated also that non-conducting medium (i.e. implant insulated body) between the electrodes increases the sensitivity on heart muscle compared to cases where only electrodes are implanted. [ABSTRACT FROM AUTHOR]

Three different discrete controllers were designed and tuned to be used in conjunction with a rotary blood pump during cardiopulmonary heart-lung support. The controllers were designed to operate in both steady and pulsatile modes. The system and methods were tested in a circulatory haemodynamic simulator. To guarantee stable control of the non-linear circulatory system in the presence of patient parameter uncertainties, a proportional plus integral (PI) and an H∞ controller were robustly tuned, using a non-linear time-varying model. (H∞ refers to the Hardy space, the set of bounded functions, analytic in the right half plane. The H∞ controller is the solution to the H∞ norm optimisation problem.) A self-tuning general predictive controller (GPC), together with an adaptive Kalman filter (KF) estimator, was compared with the two robustly tuned controllers. The closed-loop blood flow control circuit was set up in simulation routines first. The blood flow controllers were validated in a circulatory hydrodynamic simulator (MOCK) combined with a rotary blood pump. Parameters of the system simulator were changed continuously, and the controllers were tested over a wide range of different operating points. Disturbances in the form of discontinuous additive parameter uncertainties were applied. The closed-loop systems remained robustly stable. The robustly tuned H∞ controller showed the best control performance, in contrast to the GPC controller, which was near instability in regions of strongly varying non-linear system gain. Compared with the H∞ controller, the PI controller showed slightly worse behaviour, but the closed-loop response was acceptable, even in regions of strongly varying non-linear system gain and during pulsatile perfusion. The rotary blood pump could provide stationary and pulsatile perfusion under control conditions. Controlled variables were hereby mean blood flow, pulsatility index and heart rate. All three controllers were developed for an arterial mean flow of 0-6 l min-1 and a heart rate of up to 70 beats per minute. Pulsatile closed-loop perfusion could provide up to 30 mmHg pressure variation in the simulated ascending aorta at a mean flow of 31 min-1. [ABSTRACT FROM AUTHOR]

The objective of this research was to develop a purely biomechanical model, intended to predict the long-term secondary stability of the implant starting from the biomechanical stability immediately after the operation. A continuous rule-based adaptation scheme was formulated as a dynamic system, and the work verified if such a model produced unique and clinically meaningful solutions. It also investigated whether this continuous model provided results comparable with those of a simpler, discrete-states model used in a previous study. The proposed model showed stable convergence behaviour with all investigated initial conditions, with oscillatory behaviour limited to the first steps of the simulation. The results obtained with the wide range of initial conditions support the hypothesis of the existence and uniqueness of the solution for all initial conditions. The differences between the continuous model and the simpler and more efficient finite-states model were found to be extremely modest (less than 4% over the predicted bonded area). Because of these minimal differences, the use of the much faster finite-states model is recommended to investigate asymptotic conditions, and the continuous model described should be used to investigate the evolution over time of the adaptive process. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the potential for using natural frequency (NF) as an indicator for assessing the stability of a magnetic keeper device used in prosthodontic treatment. A three-dimensional finite element (FE) model of a root keeper-cement-dentine system was established for NF analysis. The model was first validated against a series of in vitro experiments. Then, NF values of the first vibrational mode of the FE model with various boundary conditions were calculated. The in vitro results showed that the measured NF values of the root keeper-incisor units decreased significantly (p<0.01) from 9.07 +/- 0.37 to 5.73 +/- 0.10 kHz when the units were embedded in simulated bony tissue. Results obtained from FE simulations demonstrated that the root keeper would fully loosen when the constant values of the spring elements were lower than 10(4) N-m(-1). Furthermore, a linear increase in the NF values of the model was observed from 6.16 to 15.52 kHz, when the constant was increased from 10(4) to 10(7) N-m(-1), and the values then reached a plateau. The results indicate that the NF value of a root keeper has the potential to be used for monitoring the stability of such a device. [ABSTRACT FROM AUTHOR]

The accuracy of high-intensity focused ultrasound (HIFU) lesion prediction modelling was evaluated for a truncated spherical transducer designed for prostate cancer treatment. The modelling adapted the bio heat transfer equation (BHTE) to take into account the activity of cavitation bubbles generated during HIFU exposure. This modelling was used to predict the lesions produced by three different transducer geometries: fixed-focus, concentric-ring and 1.5D phased-array. Lesions were predicted for different ultrasound exposure conditions close to those used in prostate cancer treatment. Twenty-one in vitro and nine in vitro experiments were performed on pig liver to validate the accuracy of the predictions. A good match was found between the predicted and experimental lesion shapes. Lesion dimensions (maximum depth and length, area at the centre of the lesion or central surface area) were measured on experimental and predicted lesions. The central surface area was predicted by the model with a range of error of O. 15-6.5% for in vitro tests and 0.97-9% in vivo. For comparison, BHTE without bubbles had a range of error of 0.4-55.5% (in vitro) and 9-25.5% (in vivo). The model should be accurate enough to predict HIFU lesions under ultrasound exposure conditions used in prostate cancer treatment. [ABSTRACT FROM AUTHOR]

Radio-frequency thermokeratoplasty (RF-TKP) is a technique used to reshape the cornea curvature by means of thermal lesions using radio-frequency currents. This curvature change allows refractive disorders such as hyperopia to be corrected. A new electrode with ring geometry is proposed for RF-TKP. It was designed to create a single thermal lesion with a full-circle shape. Finite element models were developed, and the temperature distributions in the cornea were analysed for different ring electrode characteristics. The computer results indicated that the maximum temperature in the cornea was located in the vicinity of the ring electrode outer perimeter, and that the lesions had a semi-torus shape. The results also indicated that the electrode thickness, electrode radius and electrode thermal conductivity had a significant influence on the temperature distributions. In addition, in vitro experiments were performed on rabbit eyes. At 5 W power, the lesions were fully circular. Some lesions showed non-uniform characteristics along their circular path. Lesion depth depended on heating duration (60% of corneal thickness for 20 s, and 30% for 10 s). The results suggest that the critical shrinkage temperature (55-63 degrees C) was reached at the central stroma and along the entire circular path in all the cases. [ABSTRACT FROM AUTHOR]

Laser Doppler perfusion monitoring and imaging technologies generate time traces and two-dimensional flow maps of the microcirculation. With the goal of reaching different tissue depths, these technologies are equipped with lasers operating at different wavelengths lambda. The fact that the average scattering angle, at a single scattering event, between a photon and a red blood cell increases with lambda is compensated for by a 1/lambda effect in the scattering vector, rendering the average frequency shift virtually independent of the choice of wavelength. Monte Carlo simulations showed that the corresponding spectral signature of the Doppler signals for lambda = 632.8 nm and 780 nm were close to identical. The theoretical predictions were verified by calculating the centre-of-gravity (COG) frequency of the laser Doppler power spectral density for the two wavelengths from forearm and finger skin, representing a low and high perfusion area, respectively (forearm COG= 123 against 121 Hz, finger COG = 220 against 212 Hz). When the wavelength changes from 632.8 nm to 780 nm, the heterodyne efficiency of the detector and, thereby, the inherent system amplification increase. For tissues with identical microvascular flow conditions, the output signal therefore tends to increase in magnitude when shifting to longer wavelengths. [ABSTRACT FROM AUTHOR]

The aim of the work is to optimise the image processing of a motion analyser. This is to improve accuracy, which is crucial for neurophysiological and rehabilitation applications. A new motion analyser, ELITE-S2, for installation on the International Space Station is described, with the focus on image processing. Important improvements are expected in the hardware of ELITE-S2 compared with ELITE and previous versions (ELITE-S and Kinelite). The core algorithm for marker recognition was based on the current ELITE version, using the cross-correlation technique. This technique was based on the matching of the expected marker shape, the so-called kernel, with image features. Optimisation of the kernel parameters was achieved using a genetic algorithm, taking into account noise rejection and accuracy. Optimisation was achieved by performing tests on six highly precise grids (with marker diameters ranging from 1.5 to 4 mm), representing all allowed marker image sizes, and on a noise image. The results of comparing the optimised kernels and the current ELITE version showed a great improvement in marker recognition accuracy, while noise rejection characteristics were preserved. An average increase in marker co-ordinate accuracy of +22% was achieved, corresponding to a mean accuracy of 0.11 pixel in comparison with 0.14 pixel, measured over all grids. An improvement of +37%, corresponding to an improvement from 0.22 pixel to 0.14 pixel, was observed over the grid with the biggest markers. [ABSTRACT FROM AUTHOR]

The absolute quantified measurement of haemoglobin skin blood saturation from collected reflectance spectra of the skin is complicated by the fact that the blood content of tissues can vary both in the spatial distribution and in the amount. These measurements require an understanding of which vascular bed is primarily responsible for the detected signal. Knowing the spatial detector depth sensitivity makes it possible to find the best range of different probe geometries for the measurements of signal from the required zones and group of vessels inside the skin. To facilitate this, a Monte Carlo simulation has been developed to estimate the sampling volume offered by fibre-optic probes with a small source-detector spacing (in the current report 250 microm, 400 microm and 800 microm). The optical properties of the modelled medium are taken to be the optical properties of the Caucasian type of skin tissue in the visible range of the spectrum. It is shown that, for a small source-detector separation (800 microm and smaller), rough boundaries between layers of different refractive index can play a significant role in skin optics. Wavy layer interfaces produce a deeper and more homogeneous distribution of photons within the skin and tend to suppress the direct channelling of photons from source to detector. The model predicts that a probe spacing of 250 microm samples primarily epidermal layers and papillary dermis, whereas spacings of 400-800 microm sample upper blood net dermis and dermis. [ABSTRACT FROM AUTHOR]

The laser-Doppler method is frequently used in clinical experiments for blood perfusion measurement. A multichannel laser-Doppler probe was constructed, and calibrated and evaluated using a flow model and real examination of healthy subjects. Results obtained on a three-capillary flow model suggest that the probe can be used to obtain information from superficial and deeper layers of the tissue. The influence of the optical arrangement of the laser-Doppler probe on the parameters of post-occlusive reactive hyperaemia was investigated in a group of 15 healthy subjects. A statistically significant increase of biological zero with distance between emitting and detecting fibres was noted. [ABSTRACT FROM AUTHOR]

A model study introduces the use of statistical signal processing to analyse the signals from an intracavitary probe. A complete derivation is given for the detection of one type of arrhythmogenic substrate, myocardial infarctions (MIs). Both the use of statistical signal processing and the detection of VT substrates, as opposed to activation maps, are unique. A quasi-stationary electromagnetic model with simplified geometry is presented. The model is used to simulate ventricular pacing in the presence of MI. The likelihood ratio is used for detection. A tabulation of the results from this model shows that an intracavitary probe can be used to detect MIs as small as 400 mm2 in 1 mV of noise with a detectability index of 0.495, where 0.5 indicates perfect detection. Sensitivity to noise can be reduced by analysing multiple heart beats. The results are only slightly affected by changing the probe from a cage frame design, which mechanically supports the electrodes on thin spokes, to a balloon design, which supports the electrodes on the surface of an insulating balloon. [ABSTRACT FROM AUTHOR]

A computer controlled mechanical lung model has been developed for testing lung function equipment, validation of computer programs and simulation of impaired pulmonary mechanics. The construction, function and some applications are described. The physical model is constructed from two bellows and a pipe system representing the alveolar lung compartments of both lungs and airways, respectively. The bellows are surrounded by water simulating pleural and interstitial space. Volume changes of the bellows are accomplished via the fluid by a piston. The piston is driven by a servo-controlled electrical motor whose input is generated by a microcomputer. A wide range of breathing patterns can be simulated. The pipe system representing the trachea connects both bellows to the ambient air and is provided with exchangeable parts with known resistance. A compressible element (CE) can be inserted into the pipe system. The fluid-filled space around the CE is connected with the water compartment around the bellows; The CE is made from a stretched Penrose drain. The outlet of the pipe system can be interrupted at the command of an external microcomputer system. An automatic sequence of measurements can be programmed and is executed without the interaction of a technician. [ABSTRACT FROM AUTHOR]

A self-contained automated system for venous occlusion plethysmography is described. The system is microprocessor controlled and performs the complete venous occlusion plethysmographic process of measurement, analysis and printout of results at the command of two keypresses on a keypad. Limb circulation is modelled by a linear model. Limb volume change is measured by electrical impedance plethysmography. The system is convenient to use clinically, either for the measurement of blood flow in the legs or for the diagnosis of venous thromboembolic disease. The hardware and data processing software of the system are described and examples from clinical use of the system are presented. [ABSTRACT FROM AUTHOR]

Previous experiments indicated that the mechanical properties (compliance and mobility) of spinal cord tissue vary by ±50 per cent from the mean in different individuals of the same species. In order to apply a consistent force or compression to tissues of varying mechanical properties, feedback control of the contusion device would be desirable. A new device has been designed and used by the author which will produce experimental spinal cord injuries in animals by direct contusion of the exposed cord. The motion of the impact head is feedback controlled through all phases of advance, compression and withdrawal. Force and displacement are recorded in computer random access memory for later processing and graphical printout. A wide range of impact intensities and resultant injuries are achievable. The correlation coefficients between linear compression of the cord and gait scores and lesion volume range from 0·70 to 0·89. Thus, the neural deficit is highly predictable from the impact parameters. This should result in a significant reduction in the number of animals needed in any one experimental group. [ABSTRACT FROM AUTHOR]