[Purpose] The purpose of this study was to clarify whether sitting up independence of hemiplegic stroke patients is related to physical function. [Subjects] Participants were 53 hemiplegic stroke patients (mean age 66.9, SD12.9). [Methods] We assessed the relationships of the rising from bed independence score (RIS) with age, sex, affected side, days post stroke, stroke impairment assessment set (SIAS), and the test of active reverse pendulum (TARP). Spearman's correlation coefficients, the chi-square test and regression analyses were used. [Results] RIS had a significantly strong correlation with motor lower extremity and trunk in SIAS and TARP. [Conclusion] This finding suggests that sitting up independence of hemiplegic stroke patients is related to affected lower extremities and trunk function.

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[Purpose] This study examined the relationship between craniovertebral (CV) angle and the activity of the sternocleidomastoid (SCM) during performance of the cranio-cervical flexion test (CCFT) by healthy subjects. [Subjects] Ten volunteer subjects without neck pain enrolled in this study. [Methods] SCM electromyographic (EMG) activity was recorded at five incremental levels of CCFT. Side-view pictures of each subject were taken in the sitting position to assess forward head posture by measurement of the CV angle. [Results] The CV angle was negatively correlated with activity of the SCM muscles at 30 mmHg increments of CCFT (r= -0.75). [Conclusion] Greater activity of SCM was present during the highest stage of the CCFT in subjects with small CV angle. This suggests a small CV angle influences the activity of superficial neck flexors muscles.

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[Purpose] In this study we investigated the utility of the incrementally repeated stand-up test (IRST) as an evaluation of physical capacity. [Subjects] The subjects were 45 young healthy persons. [Methods] We measured maximum voluntary ventilation, muscle strength ratio, muscle mass of the lower extremity, the index of cardiopulmonary exercise testing (CPX), and IRST. [Results] There was a significant difference between peak oxygen uptake (peak VO₂) of CPX and peak oxygen uptake of IRST. We conduced regression analysis on repetitive rising motion times and peak VO₂ on CPX or on IRST. Regression analysis gave significant results for CPX Peak-VO₂=0.1 × repeated stand-up times +14.5 and IRST Peak-VO₂=0.07 × repeated stand-up times +18.1 [Conclusion] We consider that the repeated stand-up times can be used to predict peak VO₂.

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[Purpose] In this study, we aimed to identify the effects of expiratory muscle training (EMT) on the respiratory muscle strength and cough intensity of stroke patients. [Subjects] The subjects were 22 stroke patients who had experienced a stroke within the previous 6 months and had been hospitalized for rehabilitation. They were divided into 2 groups: an EMT group, 10 patients (mean age: 69.3 years) assigned to undergo standard rehabilitation plus 4-week EMT; and a control group, 12 patients (mean age: 70.8 years) assigned to undergo standard rehabilitation alone. [Methods] The EMT group performed EMT (3 sets of 15 repetitions) twice a day, 5 times a week, for 4 weeks using a positive expiratory pressure device (Threshold^TM PEP). MEP, MIP, FVC, FEV1.0, PEF, and PCF were measured and compared between the 2 groups. [Results] At 4 weeks after the training, MEP and FEVl.0 had significantly increased in the EMT group compared with the control group, but no significant differences were observed in PEF or PCF. [Conclusion] EMT increased the respiratory muscle strength of stroke patients. However, further studies are required for assessment of the effect of EMT on the cough intensity.

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[Purpose] This study sought to clarify whether home improvements funded by the long-term care insurance program for older individuals requiring care affect subjects' capacity to perform day-to-day tasks and activities. [Methods] The subjects of this study were 55 individuals, most of whom had been diagnosed with central nervous system, orthopedic, or circulatory conditions. To study the effects of home improvements on daily life activities, we compared the level of required care and information gathered in long-term care certification inspections performed both before and after home improvements. [Results] The most common improvements made were those for toilets, bath or shower areas, and installation of handrails in entrance halls. The level of required care was improved significantly. Significant improvements were observed in aspects subject to certification inspection: mobility, urination, daytime activity, and frequency of leaving the residence. Furthermore, home improvements that contributed to maintenance and improvement of daytime activities and frequency of leaving the residence included entrance hall improvements. [Conclusions] The results suggest that home improvements carried out based on a multifaceted analysis by experts can help maintain and improve the capacity to perform certain activities associated with daily life.

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[Purpose] The purpose of this study was to determine the effects of stretching guidance on the muscle flexibility of and the frequency of stretching performance in a week by junior youth soccer players. [Subjects] The subjects were 20 male junior youth soccer players. [Methods] Stretching guidance consisted of six stretching items. We evaluated muscle tightness and the frequency of stretching performance in a week. The stretching guidance was executed three times (once/month) by a physical therapist. [Results] Significant improvements in the tightness of hamstrings, quadriceps, iliopsoas and the frequency of stretching in a week were observed. [Conclusion] The results suggest that stretching guidance for junior youth soccer players is effective for injury prevention.

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[Purpose] The purpose of this study was to examine the influence of blowgun training on respiratory function and compare it with expiratory muscle training. [Subjects] The subjects were 19 healthy adults. [Method] The subjects were divided at random into a blowgun training (BT) group, 10 subjects, and an expiratory muscle training (ET) group, 9 subjects. The BT group performed blowgun training, and the ET group performed expiratory resistance load training utilizing the PEP threshold method. We measured vital capacity, forced vital capacity, forced expiratory volume in one second (FEV1), the FEV1 ratio, maximum expiratory flow (PEF), maximum expiratory pressure (PEmax), and maximum inspiratory pressure, and made within and between group comparisons. [Results] In the BT group, the values of PEF and PE max increased significantly, but no other differences in respiratory function were found. In the ET group, although the values of PEF and PEmax increased, the increases were found not to be significant. No other differences in respiratory function were found. In the inter-group comparison, no significant differences were found either. [Conclusion] The results suggest that blowgun training increases PEF and PEmax and has an effect on respiratory function which is similar to that of expiratory muscle training.

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[Objective] The objectives of the present study were to clarify the relationship between the static balance test (SBT) and performance in other tests, and to investigate its clinical usefulness. [Subjects] Subjects were 42 hemiplegic patients. [Methods] For the present study, static balance was evaluated using a four-point ordinal scale (Grades 1 - 4) in the following five positions: sitting, standing with feet apart, standing with feet together, one foot standing on the non-paralyzed leg and one foot standing on the paralyzed leg. Each subject was also asked to perform the following three tests: 30-second chair-stand test (CS-30); side-step test; and 10-m maximum walking test. Correlation coefficients and multiple regression analysis were used to analyze relationships between variables. [Results] A high degree of correlation was found between the SBT and each measure of performance. [Conclusions] The total score of SBT, a measure of static balance, enables prediction of dynamic balance ability, demonstrating the clinical usefulness of the SBT.

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[Purpose] This study examined transformations in the consciousness of students in physical therapy clinical practice. [Subjects] The subjects were 13 students (male 8, female 5, average age 23.6 ± 3.8 years) in physical therapy clinical practice. [Methods] The analysis examined daily notes using qualitative contents analysis and Hayashi's Type 3 quantification from the perspectives of knowledge/emotion/motivation. [Results] The study revealed that students in physical therapy clinical practice acquire a lot of knowledge regarding their profession, that they were under stress, and that they experienced introverted motivation throughout the period of clinical practice. Their consciousness structures consisted of two axes: "Knowledge-Emotion" and "Cool-vitality practice". Furthermore, their consciousness transformation process could be classified into seven patterns: "Emotion-dominance", "Knowledge- dominance", "Specialty-dominance", "Motivation-dominance", "Cool-dominance", "Vitality-dominance", and "Mixture". [Conclusion] This study revealed the consciousness transformation process in students in physical therapy clinical practice.

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[Purpose] This study examined the relationship between hip joint flexor and extensor strength and jump performance. [Subjects] The subjects were 16 healthy adults with no significant current medical problems. [Methods] Hip joint extensor / flexor muscle testing was undertaken at joint angular velocities of 60ÅE180ÅE300 deg/sec using an isokinetic sthenometer to establish peak torque to body weight ratio. Jump performance measurements were made of vertical jump, broad jump, triple jump, and 6m hop. The relationship between muscular strength and jump performance was analyzed using Pearson's correlation coefficient. The significance level was p<.05. [Results] Significant correlations were found between all jump conditions at angular velocities of 180, 300 deg/sec and hip joint flexor strength. Hip joint flexor strength at the angular velocity of 60 deg/sec was correlated with performance of vertical jump only. There was no significant correlation between extensor muscle strength and jump performance. [Conclusion] The results suggest that the hip joint flexor group of muscles plays a significant role in controlling stability of posture before jumping, control of pre-jump posture for output direction, and control of landing.

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[Purpose] This study was performed to examine the correlation between lumbar pain and abdominal muscle thickness. [Subjects] The subjects were 64 males. [Methods] The subjects were divided into 3 groups based on the results of an interview about lumbar pain. Images of the transversus abdominis, internal abdominal oblique muscle, and external abdominal oblique muscle at rest were obtained using ultrasonography. [Results] The thickness of the transversus abdominis in the group of subjects who had visited a hospital for lumbar pain was less than other groups. [Conclusion] It was suggested that the experience of lumbar pain was related to a decrease in the thickness of the transversus abdominis at rest due to reduced muscular activity and an increase in the thickness of the internal and external abdominal oblique muscles at rest due to excessive muscular activity.

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[Purpose] We investigated the changes in systolic blood pressure and autonomic nerve activity during high intensity resistance exercise in healthy subjects as a prelude to its implementation for heart disease patients. [Subjects] The subjects were 11 healthy males who did not customarily exercise. [Method] Using extended leg raises in the supine position, subjects attempted to perform 1RM 10 times at 80% load. We measured and compared systolic blood pressure and autonomic nerve activity before and after the exercise. [Results] Systolic blood pressure showed an increasing trend in line with the number of elevations, and LF/HF was significantly increased by exercise over the at rest value, and this somewhat elevated condition continued for 5 minutes after the end of exercise. [Conclusion] From the results of the sympathic nervous system after high intensity resistance exercise in healthy persons, we consider that care is needed in administering high intensity resistance exercise to heart disease patients, because in addition to heart disease patients having continuously elevated sympathic nervous activity from the resting state, there is an additional possibility of a continuously elevated state of elevated sympathic nervous activity after the end of exercise. Furthermore, the rises in blood pressure and sympathic nervous activity were seen to be coincident.

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[Objective] The purpose of this study was to investigate the effects of health classes for metabolic syndrome patients. [Methods] The subjects were 17 middle-aged men and women (age: 57.9 ± 6.3 years). The training program consisted of guidance (walking, nourishment, action, support etc) for 8 weeks. We measured total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), glucose (GUL), body fat volume, abdominal circumference, steps, and breath holding time before and after the 8-week training period. [Results] TC and TG showed a significant decrease (p<0.01) and steps showed a significant increase after the training period (p<0.05). [Conclusion] These results suggest that the training program for metabolic syndrome patients improves blood chemistry and increases steps.

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[Purpose] The aim of this study was to investigate the effect of different carriage of objects held in front of chest during level walking on energy expenditure. [Subjects and Method] Nine healthy subjects (5 men and 4 women aged 25 years old) volunteered to walk on a treadmill for 4 min at two different speeds, slow walking speed (1.5 km/h) and fast walking speed (3.5 km/h). Participants walked twice at each velocity: once carrying a square can holding two 1 kg belts (belt gait) and once carrying two 500cc cups almost filled with water (cup gait). The weight of the two conditions was almost equal. Oxygen consumption, heart rate and cadence were measured. [Results] At a slow walking speed a significant difference existed only in oxygen consumption between cup and belt gait. However, at a fast walking speed a significant difference existed in oxygen consumption, heart rate and cadence between the two conditions. [Conclusion] We conclude that the changes of metabolic cost and cadence were caused by the difference in the carriage of objects held in front of chest during level walking on a treadmill.

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[Purpose] The aim of this study was to develop a conversion equation for the work load of the sit-to-stand exercise (STSE) to the work rate of a cycle ergometer. [Subjects and Method] The conversion equation was derived using thirty-one healthy young male subjects, and verified with twelve healthy young male subjects. Both exercise methods were graded protocols. The items measuring work load were oxygen uptake and heart rate. The conversion equation was derived using multiple regression analysis. The object variable was the cycle ergometer work rate needed to generate the same oxygen uptake at each standing frequency. The explanatory variable were height, body weight etc. The conversion equation was verified at the same work rates for both exercise methods. [Results] The conversion equation was dependent on standing frequency, height, and body weight. The same work rates were used in both exercise methods, therefore oxygen uptake correlated with both methods. [Conclusion] The conversion equation can be used for young males.

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[Purpose] The purpose of this study was to verify the reliability of measurements of pelvic lateral tilt and clinical utility, including rater's measurement error and reproducibility of subject's posture. [Subjects] In this study, 10 healthy subjects (10 male; aged 19 to 23) participated from whom informed consent was received. [Methods] We measured pelvic lateral tilt in 4 static postures (supine, standing with feet together, apart feet and feet wide apart) using a goniometer and a inclinometer. Two investigators measured pelvic lateral tilt in all positions. To estimate intra-rater and inter-rater reliability, the intra-class correlation coefficient (ICC) was calculated for the experimental data. [Results] Intra-rater reliabilities ranged from 0.652(ICC1,1)/0.790(ICC1,2) for standing with feet together to 0.886/0.940 for standing with the feet wide apart. Inter-rater reliabilities ranged from 0.784(ICC2,1)/0.879(ICC2,2) for standing with feet apart to 0.884/0.938 for the supine position. [Conclusion] We conclude that this measurement method has reasonable reliability and clinical utility.

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[Purpose and Methods] Gender influences gait as well as age. Recently, gait stability has been assessed objectively using stride-to-stride time variability (STV) and other gait parameters such as root-mean-square (RMS) and auto-correlation (AC) of acceleration during walking. We investigated gender differences in gait stability using a tri-axial accelerometer attached to the lower trunk during 25 m free walking by comparing 24 healthy young males with 22 healthy young females. [Results] STV was significantly increased in females compared to males. Females exhibited significantly higher RMS of vertical and anterior-posterior axes and lower AC of vertical axes than males. [Conclusion] These results suggest that females have lower gait stability than males in healthy young subjects.

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[Purpose] The purpose of this study was to investigate the relationship between the floor reaction force of initiation of movement and the motion of the trunk during lateral transfer in the sitting position. [Subjects] Eleven healthy adults participated in this study. [Methods] From data measured by a 3D motion analysis system and forceplates the relationships among the force at initiation of lateral transfer, the translational and rotational movements of the pelvis and the thorax during transfer, in the frontal plane were investigated. [Results] Both the translational and rotational movements of the thorax, which were set off by the force of the foot of the side opposite to the transfer side, were smaller in movement than the force of the buttock. [Conclusion] During initiation of movement the function of the foot on the side opposite to the transfer side was important for the ability to hold the thorax erect.

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[Purpose] The purpose of this study was to consider the best way of activating the lumbar multifidus. [Subjects] Ten healthy men participated in this study. [Methods] We measured low back muscles at moderate anterior tilt and moderate posterior tilt of pelvis in sitting under two conditions (rest and hollowing abdominals). Surface electromyography of the right lumbar erecter spinae and lumbar multifidus was recorded. [Results] The results demonstrated that moderate anterior tilt of the pelvis facilitated the lumbar multifidus without over-activation of lumbar erecter spinae under both conditions.

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[Purpose] We measured the circumference of the thigh and thickness of the quadriceps femoris of elderly females, and investigated their relationships with quadriceps femoris strength and walking and balance abilities. [Subjects] The subjects were 56 community-dwelling elderly females: average age, 71.6 ± 6.5. [Method] We measured the circumference of the thigh at 10, 15 and 20 cm above the patella and the quadriceps femoris thickness, and investigated their relationships with quadriceps femoris strength, walking speed and the timed up-and-go test (TUG) using Pearson's correlation coefficient. [Results] Significant relationships were found between all of the values of thigh circumference and quadriceps femoris thickness and quadriceps femoris strength, and the muscle thicknesses at 15 and 20 cm above the patella had high correlation coefficients. Furthermore, significant correlations with TUG and walking speed were found only for muscle thicknesses at 15 and 20 cm above the patella. [Conclusion] The results suggest that quadriceps femoris thickness at 15 and 20 cm above the patella will be a useful index, reflecting not only the muscle strength but also walking and balance abilities.

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[Purpose] The aim of this study was to investigate the relationship between weight bearing and the activities of the ankle dorsiflexors in order to devise a new assessment method for ankle dorsiflexor muscles. [Subjects] The subjects were 21 healthy adults: average age, 21 ± 3. [Method] For muscle activity measurements, we chose the right tibialis anterior muscle. The subjects adopted a standing pose leaning against a wall, and performed ankle dorsiflexion through the full range of motion with the right lower limb bearing weight. We measured the muscle activities at 20, 40, 60, 80 and 100% body weight load, and investigated and compared them with multiple comparisons and Friedman's test between each weight-bearing condition. [Results] Significant differences in muscle activity were found among the different weight-bearing conditions. [Conclusion] The results suggest the possibility of an ankle dorsiflexor assessment which uses weight bearing in muscle strengths above MMT Fair.

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[Purpose] The aim of this research was to investigate the preventive effect of 30-minute continuous daily stretching on ankle joint contracture in order to maintain the movement of the joint. [Subjects and Method] The subjects were twenty, 8-week-old, female Wistar rats, and the experimental period was 7 days. The rats were divided at random into two groups of ten animals. The right hindlimb ankles of 10 rats were fixed in plaster at maximum plantar flexion for 7 days, the "fixed" limb, without intervention on the left side, the "control" limb. The other 10 rats had their right hindlimb ankles fixed in maximum plantar flexion, and from the 2nd through to the 6th day of the experimental period, the cast was removed, and the limb stretched in the direction of dorsiflexion, the "stretched" limb. To judge the effects of the intervention, the joint range of motion of the fixed, stretched and control limbs was measured on the 7th day; stretching of the stretch limb was not performed on the 7th day. [Results] Before the start of the experiment, no significant differences in the dorsiflexion angles of the 3 limb groups were found. At the end of the experiment we found both the fixed and stretched limbs showed significant differences from the control limb, but there was no significant difference between the fixed and stretch limbs. [Conclusion] The results show that 30-minute continuous daily stretching, which has been said up till now to prevent joint contracture, does not prevent joint contracture.

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[Purpose] The aim of this study was to clarify the characteristics of external knee adduction moment of knee osteoarthritis (KOA) sufferers using principal component analysis. [Subjects] The subjects were 19 limbs of 10 women with KOA and 10 limbs of 10 middle-aged women without knee joint pain. [Method] The movement task was gait initiation, and we calculated the external knee adduction moment of the stance limb using a 3D motion analysis system and a force plate. Then, we performed a between group comparison of the principal components obtained by principal component analysis of the temporal changes in external knee adduction moment during gait initiation. [Results] In the between group comparison of the first three principal components, we found a significant difference between the KOA group and the controls only for the first principal component. [Conclusion] In this study, we revealed that the external knee adduction moment of KOA sufferers is consistently large from the start of gait initiation. Accordingly, it is necessary to consider the status of lower limb alignment during standing, as it is one of the factors influencing the magnitude of external knee adduction moment of KOA patients.

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[Purpose] We conducted intervention studies using problem-solving therapies with the objective of improving lifestyle, and investigated their influence on the prevention of metabolic syndrome. [Subjects] The subjects were 20 persons in a metabolic syndrome prevention group who were split into an intervention group (11 persons) and a control group (9 persons). [Method] For the intervention group, we conducted an intervention using problem-solving therapy involving the setting of behavior targets for improvement of lifestyle. [Results] There were no changes in lifestyle in either group. Total cholesterol and body mass index of the intervention group were significantly reduced compared with the control group. [Conclusion] It cannot be said that the problem-solving therapy had any effect on lifestyle; however, we presume the improvements seen in blood lipids etc, were the result of changes in the intervention group's behavior.

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[Purpose] The aim of this study was to identify the factors related to discharge outcomes of acute stage rehabilitation stroke patients. [Subjects] The subjects were 135 stroke patients, admitted to and discharged from hospital for stroke treatment, who had performed acute stage rehabilitation. [Method] We performed related factor analysis using discharge outcome (discharged to home, transferred to another hospital) as the object variable, and age, gender, days before start of rehabilitation, days of hospital stay, presence of impaired consciousness, presence of motor paralysis, and the functional independence measure (FIM) at the start of rehabilitation as the explanatory variables. [Results] In factor analysis for each item, presence of impaired consciousness, presence of motor paralysis and FIM score were found to be outcome related, and it was revealed that those having high FIM scores without impaired consciousness or motor paralysis were discharged to home. After adjusting for age and gender in multiple regression analysis, only the FIM score was related to the outcome. [Conclusion] FIM subscale item analysis, together with family situation and housing condition are issues for future analysis directed at revealing the mechanisms determining discharge outcome as well as prognosis.

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[Purpose] To safely estimate knee extensor strength in the elderly, we examined whether or not ultrasound imaging measurement of quadriceps muscle thickness and stiffness enhanced the estimation of knee extensor strength. [Subjects] The subjects were 240 community-dwelling elderly day-service users aged over 65 years (average ± SD: 80.6 ± 4.8) with different exercise frequencies and daily living habits. [Methods] Quadriceps muscle thickness and stiffness were measured by an ultrasound imaging system. Knee extensor strength, body mass index, hand-grip strength, one-legged standing with eyes open, and 5-m walking test (normal and maximum) were measured. Exercise frequency and daily living habits were evaluated by questionnaires. [Results] When knee extensor strength was a dependent variable and the independent variables included sex, quadriceps thickness, and quadriceps stiffness, a statistically significant regression equation was derived by multiple linear regression analysis (R=0.508, adjusted R²=0.248). When variables related to physical function and daily living were added to the independent variables, the contribution rate was increased (R=0.716, adjusted R²=0.486). [Conclusion] Quadriceps thickness and stiffness did not predict knee extensor strength precisely enough, but prediction accuracy could be increased by adding other variables related to physical function and daily living.

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[Purpose] The present study was designed to clarify whether errors in measurement of angles of goniometry are different among sites in digital pictures or digital cameras. [Methods] Four goniometric angles were put on 9 sites on a wall and recorded using 3 cameras. Five physical therapists measured them using graphic software for personal computer. [Results] Intraclass correlation coefficients (1,1) and (2,1) were calculated and showed 1.00 for all sites and cameras. Also, no statistically significant differences were observed in measurement errors for site and camera. [Conclusion] The present results indicate that measurement angle using software may be a useful tool for assessing patients who receive physical therapy.

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[Purpose] This study examined the inter-rater and intra-rater reliability for the measurement of bathing transfer ability. [Subjects] Thirty-five frail elderly persons participated in the measurements for inter-rater reliability, and 15 for intra-rater reliability. [Subjects and Methods] To measure the bathing transfer ability, we made a 10 cm wide obstacle. The height of the obstacle could be adjusted from 10 to 50 cm. Subjects negotiated the obstacle with and without a handrail. We measured the highest obstacle height subjects could negotiate. To assess the reliability, we calculated the kappa coefficient. [Results] The kappa coefficient for inter-rater reliability ranged from 0.57 to 0.82, for intra-rater reliability it was 0.64 (with handrail) and 0.54 (without handrail). [Conclusion] The newly developed measurement was proven to be appropriate for use in the clinical evaluation of the bathing transfer ability of frail elderly persons.

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[Purpose] To investigate the influence of ADL and IADL training based on Modified Fall Efficacy Scale (MFES) scores on fear of falling of hospitalized elderly patients. [Subjects] This study was conducted with 64 hospitalized elderly patients as subjects. [Methods] The patients were divided into 2 groups: intervention group, 33; control group, 31. The magnitude of changes in MFES scores before and after intervention was compared, and factors influencing the MFES scores were analyzed. [Results] After intervention, the MFES score significantly improved only in the intervention group. In the intervention group, a significant positive correlation was observed between changes in the MFES score and changes in ADL. [Conclusion] These findings suggest that ADL and IADL training, based on MFES scores, is useful for reducing fear of falling of hospitalized elderly patients.

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[Purpose] In this study, we investigated the changes in the thoracic kyphosis and lumbar lordosis angles of subjects standing still while wearing shoes with heels of different heights. [Subjects] The subjects were 27 healthy adult females: average age, 21.4 ± 2.5; average height, 158.3 ± 5.0 cm; average foot length, 23.8 ± 0.5 cm. [Method] We took measurements with subjects looking straight ahead while standing upright with naked feet and wearing shoes with heel heights of 3, 6 and 9 cm, and we compared the changes in thoracic kyphosis and lumbar lordosis angles. [Results] Although the angles of both thoracic kyphosis and lumbar lordosis changed with heel height, no significant differences were found. [Conclusion] The results suggest that wearing heeled shoes doesn't influence spinal curvature in the standing position.

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