Quantification of push-off and collision work during step-to-step transition in amputees walking at self-selected speed: Effect of amputation level

Maintaining forward walking during human locomotion requires mechanical joint work, mainly provided by the ankle-foot in non-amputees. In lower-limb amputees, their metabolic overconsumption is generally attributed to reduced propulsion. However, it remains unclear how altered walking patterns resulting from amputation affect energy exchange. The purpose of this retrospective study was to investigate the impact of self-selected walking speed (SSWS) on mechanical works generated by the ankle-foot and by the entire lower limbs depending on the level of amputation. 155 participants, including 47 non-amputees (NAs), 40 unilateral transtibial amputees (TTs) and 68 unilateral transfemoral amputees (TFs), walked at their SSWS. Positive push-off work done by the trailing limb (WStS+) and its associated ankle-foot (Wankle-foot+), as well as negative collision work done by the leading limb (WStS-) were analysed during the transition from prosthetic limb to contralateral limb. An ANCOVA was performed to assess the effect of amputation level on mechanical works, while controlling for SSWS effect. After adjusting for SSWS, NAs produce more push-off work with both their biological ankle-foot and trailing limb than amputees do on prosthetic side. Using the same type of prosthetic feet, TTs and TFs can generate the same amount of prosthetic Wankle-foot+, while prosthetic WStS+ is significantly higher for TTs and remains constant with SSWS for TFs. Surprisingly and contrary to theoretical expectations, the lack of propulsion at TFs' prosthetic limb did not affect their contralateral WStS-, for which a difference is significant only between NAs and TTs. Further studies should investigate the relationship between the TFs' inability to increase prosthetic limb push-off work and metabolic expenditure.

3D-printed contact-free devices designed and dispatched against the COVID-19 pandemic: The 3D COVID initiative

Direct contact with devices such as elevator buttons, beepers, telephones, computer mice and keyboards can contribute to spread viral diseases. Here, we report our experience in designing, producing and dispatching three 3D-printed objected intending to lower the risks of COVID-19 contamination by limiting direct contacts: (1) fixed hand-free door openers, (2) door hooks and (3) button pushers. These devices were produced in industrial quantities and made available for free for Greater Paris University Hospitals and various state institutions as part of the 3D COVID project. In this short technical note, we describe the sequential organisation of the design and production and highlight the advantages of additive manufacturing in dealing with specific aspects of sanitary crises.

G protein-coupled oestrogen receptor 1, oestrogen receptors and androgen receptor in the sand rat (Psammomys obesus) efferent ducts

BACKGROUND

The efferent ducts are mainly involved in the reabsorption of the seminiferous tubular fluid. Testosterone and oestrogens regulate efferent ducts functions via their receptors.

MATERIALS AND METHODS

This paper presents an experimental investigation on the location of the P450 aromatase, the 17-b oestradiol (E2), the androgen receptor (AR), the oestrogen receptor 1 (ESR1), the oestrogen receptor 2 (ESR2) and the G protein-coupled oestrogen receptor 1 (GPER1) in the efferent ducts using Psammomys obesus as an animal model to highlight the effect of the season on the histology and the distribution of these receptors.

RESULTS

We observed a proliferation of the connective tissue, decreasing in the height of the epithelium during the resting season compared to the breeding season. Ciliated cells expressed P450 aromatase, AR, E2, ESR1, ESR2 and GPER1 during both seasons. Basal cells showed a positive staining for the ESR1 and the GPER1 during both season, the AR and E2 during the breeding season and ESR2 during the resting season.

CONCLUSIONS

Our result shows that the expression of androgen receptor and oestrogen receptors in the efferent ducts vary by season witch suggest that they are largely involved in the regulation of the efferent ducts functions.

Microprocessor prosthetic ankles: comparative biomechanical evaluation of people with transtibial traumatic amputation during standing on level ground and slope

BACKGROUND

The compensations occurrence due to the alteration of the posture and the gait of persons with lower limb amputation is still an issue in prosthetic fitting. Recently, prosthetic feet designed to reproduce the physiological behaviour of the ankle using a microprocessor control have been commercialized to address this issue.

OBJECTIVES

Investigate the relevance of these microprocessor prosthetic ankles (MPAs) in the ability of standing on both level and inclined surfaces.

METHODS

Six persons with transtibial amputation usually fitted with energy storing and returning (ESR) foot tested three MPAs: Elan^® Endolite (MPA1), Meridium^® Ottobock (MPA2), ProprioFoot^® Ossur (MPA3). Each MPA data acquisition was preceded of a 2 weeks adaptation period at home and followed by a 3-weeks wash-out period with their ESR. Lower limb angular position and moment, Centre of Pressure (CoP) position, Ground Reaction Forces (GRF) and functional scores were collected in static, on level ground and 12% inclined slope.

RESULTS

MPAs allowed a better posture and a reduction of residual knee moment on positive and/or negative slope compared to ESR. Results also reflect that the MPA2 allows the best control of the CoP in all situations.

CONCLUSIONS

An increased ankle mobility is associated with a better posture and balance on slope. Gait analysis would complete these outcomes.

CLINICAL RELEVANCE

This study compares three MPAs to ESR analysing static posture. Static analysis on level ground and slope represents the challenging conditions people with amputation have to cope with in their daily life, especially outdoors. Having a better understanding of the three MPAs behaviour could help to adequately fit the prosthesis to each patient. Implications for rehabilitation This is a study comparing three MPAs. The static analysis in standard and constraining conditions (slope) reflects the balance of people with amputation in their daily life, especially outdoors. Having a better understanding of the behaviour of each foot could help to adequately fit the prosthesis to each patient.

Blood mixtures: impact of puncture site on blood parameters

Various puncture routes, veins, arteries, heart, are used to take blood in animals. For anatomical reasons, differences in blood composition are expected among puncture sites. However, this issue has been rarely assessed and contrasted results have been reported: strong effects of puncture site versus a lack of effect. We captured free-ranging freshwater turtles from different locations to compare the mean concentrations of 12 blood parameters (metabolites, hormone, ions, and enzyme) among three puncture sites: (1) a lateral branch of the jugular vein, (2) a dorsal subcarapacial cervical plexus (sometimes incorrectly referred as the 'cervical sinus' in the literature), and (3) a caudal plexus site (sometimes incorrectly referred as the 'caudal sinus'). Because we used very small syringes (27-30G), we were able to separate lymph, blood, or blood-lymph mixtures. Our results show very strong effects of puncture site and of mixture level (mean maximal difference between sites was 250 %). We also found strong sex and geographical effects. Typically, there were differences in concentrations of blood solutes sampled from the lateral jugular vein and subcarapacial plexus, mainly due to sampling a mixture of blood and lymph from the 'blood' at the subcarapacial site and pure blood from the lateral jugular site, and likewise, samples from the caudal site were highly variable due to often sampling a mixture of blood and lymph. These results have technical and fundamental implications, especially when performing comparative analyses. Further, by selecting precise puncture sites, physiological differences between lymph and blood compartments could be investigated.

Artificial water ponds and camera trapping of tortoises, and other vertebrates, in a dry Mediterranean landscape

Context Mediterranean areas offer a mosaic of favourable microhabitats to reptiles (e.g. open zones, thorny bushes) and are considered as biodiversity hotspots for these organisms. However, in these dry and hot environments, reptiles remain sheltered most of the time. They generally escape observation, posing difficulties to perform inventories. Trap sampling or rock-turning surveys commonly used to detect reptiles entail important logistical constraints, may perturb fragile microhabitats, and are not appropriate for chelonians. Alternative simple and cost-effective methods are desired. Aims We tested the efficiency of camera trapping in a dry Mediterranean landscape, notably to detect threatened Hermann’s tortoises. We tested whether small artificial freshwater ponds could attract animals in the field of view of the cameras to increase detectability. We also tested whether sand tracks survey around ponds could improve the method. Methods We used a small number of cameras with ponds (5 in 2011, 7 in 2012), thereby maintaining low logistical costs. We randomly filled three ponds and emptied three ponds every 7 days. We set the time-lapse function of each camera with an interval of 5 min and inspected the sand tracks every 2 or 3 days. We used information from 39 radio-tracked tortoises to better estimate the detectability performances of the camera–pond system. Key results This technique was effective to detect tortoises (n = 348 observations) and five other reptiles (among the 11 species present in the study area). Large numbers of birds and mammals were observed (n = 4232, n = 43 species at least), thereby increasing the biodiversity list of the surveyed area. We detected 28% of the radio-tracked tortoises present in the monitored area. Filled ponds were more attractive and sand track survey completed camera monitoring. Conclusions Camera trapping associated with small ponds represent a useful tool to perform rapid inventories of the fauna in Mediterranean habitats, especially to detect the emblematic Hermann’s tortoise and other cryptic reptiles (e.g. snakes). Implications The low cost–efficiency ratio of this method allows performing multiple counting surveys, and thus may help collect robust data necessary to justify the protection of key habitats that are coveted by property developers.

Spatial variability of metallic and organic contamination of anguilliform fish in New Caledonia

New Caledonia is one of the main hot spots of biodiversity on the planet. Large amounts of contaminants are discharged into the lagoon as a result of increasing anthropogenic activities such as intense mining, urbanization, and industrialization. Concentrations of 14 trace elements and 26 persistent organic pollutants (POPs: PCBs and pesticides) were measured in the muscles of two anguilliform fish species, over a coast to barrier reef gradient in two lagoon areas differently exposed to anthropic disturbances. This study emphasizes the high trace element contamination status of anguilliform fish and also highlights slight but perceptible organic pollution. The contamination extends throughout the lagoon, from coast to barrier reef, even in areas remote from emission points. High levels of trace elements, especially those linked to mining activities (i.e., Co, Cr, Fe, Mn, and Ni), were detected in coastal sites. Furthermore, the large dispersion of most POPs throughout the entire lagoon poses the question of their potential toxicity on marine organisms from numerous habitats. Our results underline the need for long-term monitoring of various contaminants over large spatial and time scales.

Body condition and habitat use by Hermann's tortoises in burnt and intact habitats

In Mediterranean regions, fires threaten terrestrial tortoises. Nevertheless, varying proportions of adults survive fire; these surviving individuals can play a central role for population recovery. The regions devastated by fire often include important habitat of Hermann's tortoises (Testudo hermanni hermanni), so assessing the ability of survivors to persist is essential for conserving the species. Body-condition indices provide an integrative estimate of how well individuals cope with environmental variations and impacts, including fires. Between 2002 and 2009, we monitored Hermann's tortoises in intact and burnt habitats in southeastern France. In summer 2003, a strong fire ravaged half of the surveyed zone, providing an opportunity to compare body condition of tortoises between intact and burnt areas over time. Six years later, the impact of fire on vegetation was still marked; large trees were abundant in the intact area, whereas open shrub vegetation prevailed in the burnt area. In both areas, the mean body condition of tortoises fluctuated over time; however, there were no differences between the two areas. A radio-tracking experiment demonstrated that individuals from each area were residents, and not vagrants commuting between areas. We also assessed changes in body condition and microhabitat use in radio-tracked individuals. We found no significant differences between the tortoises living in the burnt and intact areas, despite subtle differences in habitat use.

IN CONCLUSION

(i) surviving tortoises in an area ravaged by fire can maintain their body condition like individuals living in an intact area, and thus, individuals from burnt areas should not be translocated to supposedly better areas; and (ii) depopulated burnt areas are likely to be appropriate for population-augmentation programmes.

Ambient temperature and pregnancy influence cortisol levels in female guinea pigs and entail long-term effects on the stress response of their offspring

Mammals generally respond to the important metabolic requirements imposed by thermoregulation and pregnancy by increasing plasma concentrations of glucocorticoid that promote the mobilization of body reserves and enhance energy use by tissues. This study examined the impact of distinct ambient temperatures and reproductive status on cortisol plasma levels in female guinea pigs (Cavia aperea f. porcellus). We also examined cortisol profiles of their offspring. Forty adult females were placed in individual boxes, 20 were exposed to a neutral thermal regime (mean ambient temperature 22.1 ± 1.5 °C) and 20 were maintained under a cool thermal regime (15.1 ± 1.5 °C). Within each treatment, 12 females were pregnant and 8 were non-pregnant. Pregnancy generated a marked elevation of baseline cortisol. Ambient temperature also affected cortisol concentrations. Compared to the pregnant females from the neutral thermal regime, pregnant females maintained under cool conditions exhibited lower baseline levels of cortisol, were less active, but they displayed a greater stress response (i.e. rapid increase of plasma cortisol) following handling. Thermal treatment did not influence reproductive output, reproductive effort, or offspring characteristics. This suggests that pregnant female guinea pigs cope with cool (but not extreme) thermal conditions by reducing activity and baseline cortisol levels, possibly to save energy via an adaptive response. Interestingly, the greater amplitude of the stress response of the cool regime females was also observed in their offspring 2 months after parturition, suggesting that hormonal ambience experienced by the individuals in utero shaped their stress response long after birth.

Are snake populations in widespread decline?

Long-term studies have revealed population declines in fishes, amphibians, reptiles, birds and mammals. In birds, and particularly amphibians, these declines are a global phenomenon whose causes are often unclear. Among reptiles, snakes are top predators and therefore a decline in their numbers may have serious consequences for the functioning of many ecosystems. Our results show that, of 17 snake populations (eight species) from the UK, France, Italy, Nigeria and Australia, 11 have declined sharply over the same relatively short period of time with five remaining stable and one showing signs of a marginal increase. Although the causes of these declines are currently unknown, we suspect that they are multi-faceted (such as habitat quality deterioration, prey availability), and with a common cause, e.g. global climate change, at their root.

EOS orthopaedic imaging system to study patellofemoral kinematics: assessment of uncertainty

BACKGROUND

Accurate knowledge of knee joint kinematics, especially patellofemoral joint kinematics,is essential for prosthetic evaluation so as to further improve total knee arthroplasty performances. Improving the evaluation of the functioning of the extensor apparatus appears,in this respect, particularly important in this optimization effort.

OBJECTIVES

The aim of this study was to propose a new experimental setup for the analysis of knee joint kinematics and to validate its relevance in terms of accuracy and uncertainty.The technique developed herein combines 3D reconstruction imaging with the use of a motion capture system.

MATERIAL AND METHODS

Eight pairs of fresh-frozen cadaver specimens with no evidence of previous knee surgery were studied using a new test rig where the femur remains fixed and the tibia is free to rotate. The flexion-extension cycles were executed using computer-controlled traction of the quadriceps tendon combined with an antagonist force applied to the distal part of the tibia. Knee joint kinematics were tracked using an optoelectronic motion capture system after a preliminary stage of data acquisition of bone geometry and markers position. This stage was carried out using a new digital stereophotogrammetric system, EOS, combined with specific 3D reconstruction software that also determined the coordinate system used in the kinematic analysis. The resulting uncertainty was assessed as was its impact on the estimated kinematics.

RESULTS

Test results on eight knees validated the setup designed for the analysis of knee joint kinematics during the flexion-extension cycle. More specifically, the statistical results show that measurement uncertainty for rotations and translations remains below 0.4 and 1.8 mm,respectively, for the tibia and 0.4 and 1.2 mm for the patella (+/- 2 S.D. for all four measurements).

DISCUSSION

The combination of 3D imaging and motion capture enables the proposed method to track the real-time motion of any bone segment during knee flexion-extension cycle. In particular,the new test rig introduced in this paper allows in vitro measurements of the patello femoral and tibiofemoral kinematics with a good level of accuracy. Moreover, this personalized experimental analysis can provide a more objective approach to the evaluation of knee implants as well as the validation of the finite-elements-based models of the patellofemoral joint.

Skeletal landmarks for TKR implantations: evaluation of their accuracy using EOS imaging acquisition system

INTRODUCTION

Lower extremity alignment remains one essential objective during total knee replacement. Implants positioning analysis requires selecting reliable skeletal landmarks. Our objective was to in vivo evaluate the precision of the implemented skeletal landmarks. This evaluation was based on multiple three-dimensional (3D) computer reconstructions of the lower extremity derived from an EOS biplanar low-dose X-ray system acquisition. A 3D angle measurement protocol was used.

HYPOTHESIS

Currently defined landmarks carry a tolerable uncertainty margin, which can still probably be further improved.

MATERIAL AND METHODS

Nine lower extremity 3D computer reconstructions were obtained from an EOS protocol based on seven simultaneous A-P and lateral views performed in standing position. A database was established by four operators; finally, building up a total of 99 in vivo 3D reconstructions of these nine lower extremities. Specific algorithms were used for such 3D reconstructions of lower extremities based on bone points and pre-identified contours on X-ray. Four femoral landmarks and four tibial landmarks were thus defined. For each bone and each landmark studied, a mean landmark for the 11 consecutive series elements was established. The deviation from each constructed landmark to the corresponding mean landmark was calculated based on the anteroposterior (x), longitudinal (y) and mediolateral axes (z), in translation (Tx, Ty, Tz) and in rotation (Rx, Ry, Rz). Uncertainty was estimated by the 95% confidence interval (95% CI).

RESULTS

The landmarks located at the middle of the segment joining the center of each posterior condyle and at the barycenter of the plateaux showed a greater reliability; these landmarks uncertainty (95% CI) of Tx, Ty, Tz was less than 1, 0.5, 1.5 mm for the femur and 1.5, 0.6, 0.6 mm for the tibia, respectively. The femoral landmarks using the center or posterior edge of the posterior condyles to define the mediolateral axis were retained; for rotations Rx, Ry, and Rz, uncertainty remained less than 0.3, 4, and 0.5 degrees. All of the tibial landmarks had a comparable reliability in rotation, 95% of the Rx and Rz deviations were under 0.5 and 1.3 degrees, respectively, with a mean error less than 1 degrees . For the tibial rotation Ry, the mean error was greater (4 degrees), with uncertainty (95% CI) at 11.2 degrees. All tibial translations showed a mean error of 1 mm. The 3D implantation angles were measured on two patients using preoperative 3D skeletal reconstructions and 3D geometric models of the implants repositioned on postoperative EOS knee X-rays.

DISCUSSION

The posterior condyles are rarely involved in the arthritic wear process, making them an anatomic landmark of choice in the analysis of the femoral component positioning. The femoral landmarks using the posterior condyles were sufficiently reliable for clinical use. However, the posterior contours of the tibial plateaux were less precise. The knees should be staggered from an anteroposterior perspective on the EOS lateral images so that they can be visualized separately. The anatomic zones on which the skeletal landmarks are based are usually removed by the bone cuts, making it preferable to save the preoperative computer reconstructions to analyze the postimplantation 3D reconstruction.

CONCLUSION

The lower extremity skeletal landmarks precision relates to the quality of the corresponding 3D reconstructions. Except for tibial rotation, all the translation and rotation parameters were estimated within a mean error margin inferior to 1.2 mm and 1.3 degrees, respectively. Making the reconstruction algorithms more robust would render certain anatomic zones even more precise. Biplanar low-dose EOS X-ray system is a tool of the future to generate 3D knee X-rays that can improve the evaluation and follow-up of total knee arthroplasty patients.

A functional evaluation of prosthetic foot kinematics during lower-limb amputee gait

This paper reports on a functional evaluation of prosthetic feet based on gait analysis. The aim is to analyse prosthetic feet behaviour under loads applied during gait in order to quantify user benefits for each foot. Ten traumatic amputees (six trans-tibial and four trans-femoral) were tested using their own prosthetic foot. An original protocol is presented to calculate the forefoot kinematics together with the overall body kinematics and ground reaction forces during gait. In this work, sagittal motion of the prosthetic ankle and the forefoot, time-distance parameters and ground reaction forces were examined. It is shown that an analysis of not only trans-tibial but also trans-femoral amputees provides an insight in the performance of prosthetic feet. Symmetry and prosthetic propulsive force were proved to be mainly dependant on amputation level. In contrast, the flexion of the prosthetic forefoot and several time-distance parameters are highly influenced by foot design. Correlations show influential of foot and ankle kinematics on other parameters. These results suggest that prosthetic foot efficiency depends simultaneously on foot design and gait style. The evaluation, proposed in this article, associated to clinical examination should help to achieve the best prosthetic foot match to a patient.

Changes in plasma progesterone in relation to vitellogenesis and gestation in the viviparous snake Vipera aspis

Viviparity has arisen from oviparity on more than 100 independent occasions in squamate reptiles, providing an unique opportunity to investigate the ways in which endocrine control of gestation length has been modified by natural selection during this major transition in reproductive modes. Intuitively, the evolution of viviparity might be expected to involve an increasingly important role for the steroid hormone progesterone, rather than estradiol. Unfortunately, published data on this topic in snakes are scarce and often contradictory. Females of the viviparous snake Vipera aspis reproduce with a lower than annual frequency, providing the opportunity to examine steroid profiles simultaneously in vitellogenic, pregnant, and postparturient versus nonreproductive females. From 1990 to 1994, more than 500 blood samples were collected from more than 100 females. Progesterone, estradiol-17beta, and several plasma metabolites were assayed by radioimmunoassay and spectrophotometry. In contrast to earlier studies, we found significant differences between plasma progesterone levels in reproducing (10.5 +/- 9.1 ng ml(-1), N = 168) and nonreproducing (5.1 +/- 4.2 ng ml(-1), N = 121) females. Estradiol reached high levels during vitellogenesis (4.8 +/- 4.0 ng ml(-1), N = 16), and progesterone levels increased during gestation (from 3.7 ng ml(-1) before gestation to 18.7 ng ml(-1) at midgestation). However, experimental elevation of plasma progesterone levels with implants (up to 44.4 ng ml(-1)) did not modify plasma metabolite levels or delay parturition.

The influence of body condition on 17-beta estradiol levels in relation to vitellogenesis in female Vipera aspis (Reptilia, Viperidae)

Seventy-six wild Vipera aspis females were caught over 3 years and placed in outdoor enclosures; 39 reproduced and 37 did not. Almost all the reproductive females had a body condition index (BCI) greater than 0.70 when vitellogenesis began. Monthly blood samples were taken by cardiac puncture. The main plasma parameters of vitellogenesis were measured by spectrophotometry: total plasma calcium, phosphorus, phospholipids, cholesterol, triglycerides, proteins, and albumin. Plasma 17-beta estradiol levels were determined by RIA. Vitellogenesis started soon after hibernation in reproductive females with very high 17-beta estradiol concentrations (average of 4.00 ng/ml) and there was a marked mobilization of maternal reserves (fat bodies, liver, and vertebral bone) associated with very high values of plasma calcium, phosphorus, phospholipids, cholesterol, triglycerides, and proteins. The kinetics of the main plasma components were described throughout the vitellogenesis period (from March to early June), when all plasma parameters differed markedly between reproductive and nonreproductive females. After ovulation, the differences between the two groups of females disappeared except in the case of albumin, which remained at a very low level in reproductive females for 6 months. All nonreproductive females had low 17-beta estradiol plasma levels during vitellogenesis (average of 0.08 ng/ml) and there was no suggestion of mobilization of maternal reserves. After vitellogenesis plasma concentrations of estradiol were low in reproductive (an average of 0.08 ng/ml) and in nonreproductive animals (0.06 ng/ml). Five nonreproductive females kept in the laboratory were estrogenized by 17-beta estradiol silastic implants. The 17-beta estradiol concentrations were close to those measured in reproductive females during vitellogenesis. Maternal reserves were mobilized, with almost all metabolic parameters exhibiting the vitellogenic pattern. When the silastic implants were removed, 17-beta estradiol concentrations dropped sharply to a basal level, but the other components were maintained near the vitellogenic values for several months. In contrast to previous studies on viviparous snakes, these results suggest that in V. aspis 17-beta estradiol levels are linked strictly to vitellogenesis.

[Use of a body condition index (BCI) for the study of the reproduction in snakes]

A body condition index (BCI = actual body mass/optimal theoritical body mass of the studied animal) was estimated in females of 3 species of snake. From dissections of 88 Vipera aspis and 18 Coluber viridiflavus, strong relationships between body reserves (such as mass of fat bodies and liver) and BCI were found. Furthermore, BCI explained most of the variance in the mass of the fat bodies and in the mass of the liver; however BCI and body length together increased the percentage of variation explained. Thus, a satisfactory estimation of body reserves in relation to body length is possible in living snakes. We have studied reproductive parameters (clutch size and litter size) in Vipera aspis (Viperidae) and Elaphe longissima (Colubridae) during a 3 year period. In the two species positive relationships between maternal body length and number of offspring were found. At the beginning of vitellogenesis, litter size is related to the BCI level in V. aspis but not in E. longissima. In both species, BCI must exceed a threshold value for reproduction to take place. However this threshold value is much lower in E. longissima (0.55) than in V. aspis (0.70). This indicates that in the latter species, large body reserves are necessary for the induction of vitellogenesis. In E. longissima, maternal body length is an important determinant of reproductive success, body reserves playing a minor role. In contrast, in female V. aspis the reproductive success is related to BCI and to a lesser extent to body length.(ABSTRACT TRUNCATED AT 250 WORDS)