論文 - 辻　哲也

Factors affecting the performance of activities of daily living in patients with advanced cancer undergoing inpatient rehabilitation: results from a retrospective observational study

Shimoda Kaori, Imai Hisao, Tsuji Tetsuya, Tsuchiya Kenji, Tajima Hiroshi, Kanemaki Hatsumi, Tozato Fusae

Journal of Physical Therapy Science （理学療法科学学会）  31 （ 10 ） 795 - 801 2019年

ISSN  0915-5287

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<p> [Purpose] Many clinicians believe that rehabilitation for patients with advanced cancer is futile. We determined factors affecting the performance of activities of daily living in patients with advanced cancer based on age, gender, marital status, living arrangement, rehabilitation intensity, type of cancer, impairment, metastasis, and active cancer treatment. [Participants and Methods] We assessed the Barthel Index to evaluate the performance of activities of daily living. Of the 120 adult patients with cancer who underwent inpatient rehabilitation, we analyzed the Barthel Index scores, consisting of 10 items, and reviewed the clinical characteristics from the medical records of 48 patients who completed supportive or palliative rehabilitation according to Dietz and showed an increased or maintained total Barthel Index score at final evaluation. [Results] The median total Barthel Index score increased from 45 (5–95) to 72.5 (5–100); the rehabilitation intensity was 320 (40–1,240) minutes. The analytical results showed that the increase of total Barthel Index score was positively associated with rehabilitation intensity (β=0.350) and negatively associated with the initial grooming score (β=−0.277). [Conclusion] Adequate rehabilitation positively affects performance of activities of daily living, especially in patients with advanced cancer who lost their grooming ability at the onset of rehabilitation. Importantly, rehabilitation may be beneficial for patients with advanced cancer.</p>

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Differences in Balance Function Between Cancer Survivors and Healthy Subjects: A Pilot Study

Morishita S., Mitobe Y., Tsubaki A., Aoki O., Fu J., Onishi H., Tsuji T.

Integrative cancer therapies （Integrative cancer therapies）  17 （ 4 ） 1144 - 1149 2018年12月

査読有り,  ISSN  15347354

　概要を見る

Older adults who have survived cancer experience significantly more falls compared with healthy adults. Adult cancer survivors may also have a lower balance function than healthy adults. We examined muscle strength and balance function among 19 cancer survivors and 14 healthy subjects. The mean age of the cancer survivors was 51.5 ± 11.2 years; 6 men and 13 women. Cancer diagnoses included breast cancer, retroperitoneal sarcoma, acute leukemia, lung cancer, colorectal cancer, thyroid cancer, Ewing's sarcoma, and tongue cancer. The mean age of healthy subjects was 47.4 ± 14 years; 3 men, 11 women. Muscle strength was assessed using hand grip and knee extensor strength tests. Balance function was evaluated using the Timed Up and Go (TUG) test, and body sway was tested using a force platform. No significant differences were found with respect to right and left grip strength or right and left knee extension strength between the 2 groups. A significantly higher TUG time was observed in cancer survivors than in healthy subjects ( P < .05). With eyes open, the area of the center of pressure was significantly larger in cancer survivors than in healthy subjects ( P < .05). Similarly, the length per area was significantly lower both with eyes open and closed for cancer survivors than for healthy subjects ( P < .05). TUG was significantly correlated with muscle strength in both groups ( P < .05). However, no body sway parameters were related to muscle strength in either group. Cancer survivors had lower balance function that might not have been related to muscle strength. Cancer survivors should be evaluated for balance function as there is a potential for impairment. The findings of this study will be relevant for planning the prevention of falls for cancer survivors.

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悪液質高リスクの高齢進行がん患者に対する在宅ベースの下肢筋力トレーニングプログラムの開発　NEXTAC-ONE試験の運動介入の詳細

立松 典篤, 岡山 太郎, 辻 哲也, 岩村 明, 田沼 明, 内藤 立暁, 光永 修一, 三浦 理, 大前 勝弘, 盛 啓太, 高山 浩一

Palliative Care Research （(NPO)日本緩和医療学会）  13 （ 4 ） 373 - 381 2018年12月

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【目的】悪液質リスクの高い高齢進行がん患者に対して、初回化学療法導入時より栄養と運動を組み合わせたマルチモーダルな介入プログラムを開発した。本研究の目的は、その中の下肢筋力トレーニングの詳細と安全性および忍容性を報告することである。【方法】対象は、初回化学療法導入予定の70歳以上の進行非小細胞肺がんおよび進行膵がん患者30例とした。下肢筋力トレーニングは約8週間の在宅ベースプログラムとし、対象者別にトレーニング内容および負荷量を設定した。【結果】介入期間中の下肢筋力トレーニングの実施割合は91(69〜95)%であった。治療継続や日常生活に影響を及ぼすような有害事象発生はなく、介入前後で身体機能や活動量の有意な低下は認められなかった。【結論】悪液質リスクの高い高齢進行がん患者において、われわれが開発した下肢筋力トレーニングは高い実施割合を有し、身体機能や身体活動量の維持に寄与した可能性が示唆された。(著者抄録)

肺がん患者が自宅復帰に至るまでの心理的適応

下田 佳央莉, 外里 冨佐江, 山谷 礼輝, 土屋 謙仕, 辻 哲也

ぐんま作業療法研究 （(一社)群馬県作業療法士会）  20   23 - 28 2018年08月

ISSN  1344-4344

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進行がん患者がdistress:苦痛を抱える可能性は高いが、その適切な介入法は確立していない。著者らは肺がん患者の自宅復帰支援を多職種で行う機会を得た。その結果、対象者は自身の身体機能の低下や疼痛に影響を受けながらも、日常生活動作能力を向上させると共に、distressの症状を軽減させた。我々は、(1)正のフィードバックを行い対象者の自尊心を保持する、(2)対象者や家族のニーズを聴取し、目標に向け多職種で協働する、(3)外泊訓練を実施するなどの取り組みを行った。本介入は、心身に配慮した多職種でのリハビリテーションは、対象者の自宅復帰に至るまでの再適応の心理的過程である、心理的適応を促進させる可能性を示した。(著者抄録)

Cancer survivors exhibit a different relationship between muscle strength and health-related quality of life/fatigue compared to healthy subjects

Morishita S., Tsubaki A., Fu J., Mitobe Y., Onishi H., Tsuji T.

European Journal of Cancer Care （European Journal of Cancer Care）  27 （ 4 ）  2018年07月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  09615423

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© 2018 John Wiley & Sons Ltd We investigated the difference in relationship between muscle strength and quality of life (QOL)/fatigue in long-term cancer survivors and healthy subjects. Thirty-six cancer survivors and 29 healthy subjects were assessed for body composition and bone status at the calcaneus using the Osteo Sono Assessment Index. Muscle strength was evaluated via handgrip and knee extensor strength. Health-related QOL was assessed using the Medical Outcome Study 36-item Short-Form Health Survey. Fatigue was measured using the brief fatigue inventory. Cancer survivors exhibited lower QOL scores in the physical functioning, physical role function, bodily pain and general health domains (p <.05). Grip and knee extension muscle strength in cancer survivors was positively correlated with the physical function and bodily pain of QOL (p <.05). The usual fatigue subscale score was only significantly higher in cancer survivors than in healthy subjects (p <.05). However, there were no correlations between muscle strength and fatigue in cancer survivors. Our results showed that muscle strength was an important factor for improving QOL in cancer survivors. We believe that the findings of this study will be relevant in the context of planning rehabilitation for cancer survivors.

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A randomized phase II study of the nutritional and exercise treatment for the elderly patients with advanced non-small cell lung or pancreatic cancer: The NEXTAC-TWO study.

Miura Satoru, Naito Tateaki, Mitsunaga Shuichi, Omae Katsuhiro, Mori Keita, Inano Toshimi, Yamaguchi Teiko, Mori Naoharu, Tatematsu Noriatsu, Okayama Taro, Morikawa Ayumu, Mouri Takako, Tsuji Tetsuya, Aragane Hideki, Inui Akio, Higashiguchi Takashi, Takayama Koichi

JOURNAL OF CLINICAL ONCOLOGY 36 （ 15 ）  2018年05月

ISSN  0732-183X

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リハビリテーション医学・医療のすべて 支持・緩和医療主体の時期のがんリハビリテーション医療

辻哲也

医学のあゆみ 2018年03月

研究論文（学術雑誌）, 単著

Anamorelin (ONO-7643) for the treatment of patients with non–small cell lung cancer and cachexia: Results from a randomized, double-blind, placebo-controlled, multicenter study of Japanese patients (ONO-7643-04)

Katakami N., Uchino J., Yokoyama T., Naito T., Kondo M., Yamada K., Kitajima H., Yoshimori K., Sato K., Saito H., Aoe K., Tsuji T., Takiguchi Y., Takayama K., Komura N., Takiguchi T., Eguchi K.

Cancer （Cancer）  124 （ 3 ） 606 - 616 2018年02月

査読有り,  ISSN  0008543X

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© 2017 American Cancer Society BACKGROUND: Cachexia, described as weight loss (mainly in lean body mass [LBM]) and anorexia, is common in patients with advanced cancer. This study examined the efficacy and safety of anamorelin (ONO-7643), a novel selective ghrelin receptor agonist, in Japanese cancer patients with cachexia. METHODS: This double-blind clinical trial (ONO-7643-04) enrolled 174 patients with unresectable stage III/IV non–small cell lung cancer (NSCLC) and cachexia in Japan. Patients were randomized to daily oral anamorelin (100 mg) or a placebo for 12 weeks. The primary endpoint was the change from the baseline LBM (measured with dual-energy x-ray absorptiometry) over 12 weeks. The secondary endpoints were changes in appetite, body weight, quality of life, handgrip strength (HGS), and 6-minute walk test (6MWT) results. RESULTS: The least squares mean change (plus or minus the standard error) in LBM from the baseline over 12 weeks was 1.38 ± 0.18 and −0.17 ± 0.17 kg in the anamorelin and placebo groups, respectively (P <.0001). Changes from the baseline in LBM, body weight, and anorexia symptoms showed significant differences between the 2 treatment groups at all time points. Anamorelin increased prealbumin at weeks 3 and 9. No changes in HGS or 6MWT were detected between the groups. Twelve weeks' treatment with anamorelin was safe and well tolerated in NSCLC patients. CONCLUSIONS: Anamorelin significantly increased LBM and improved anorexia symptoms and the nutritional state, but not motor function, in Japanese patients with advanced NSCLC. Because no effective treatment for cancer cachexia is currently available, anamorelin can be a beneficial treatment option. Cancer 2018;124:606-16. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Anamorelin (ONO-7643) for the Treatment of Patients with Non-small Cell Lung Cancer and Cachexia: Results from a Randomized, Double-Blind, Placebo-Controlled, Multicenter, Study on Japanese Patients (ONO-7643-04)

Katakami N, Uchino J, Yokoyama T, Naito T, Kondo M, Yamada K, Kitajima H, Yoshimori K, Sato K, Saito H, Aoe K, Tsuji T, Takiguchi Y, Takayama K, Komura N, Takiguchi T, Eguchi K

Cancer 2018年02月

研究論文（学術雑誌）, 共著, 査読有り

悪液質高リスクの高齢進行がん患者に対する在宅ベースの下肢筋力トレーニングプログラムの開発─NEXTAC-ONE試験の運動介入の詳細─

立松 典篤, 盛 啓太, 高山 浩一, 岡山 太郎, 辻 哲也, 岩村 明, 田沼 明, 内藤 立暁, 光永 修一, 三浦 理, 大前 勝弘

Palliative Care Research （日本緩和医療学会）  13 （ 4 ） 373 - 381 2018年

　概要を見る

<p>【目的】悪液質リスクの高い高齢進行がん患者に対して，初回化学療法導入時より栄養と運動を組み合わせたマルチモーダルな介入プログラムを開発した．本研究の目的は，その中の下肢筋力トレーニングの詳細と安全性および忍容性を報告することである．【方法】対象は，初回化学療法導入予定の70歳以上の進行非小細胞肺がんおよび進行膵がん患者30例とした．下肢筋力トレーニングは約8週間の在宅ベースプログラムとし，対象者別にトレーニング内容および負荷量を設定した．【結果】介入期間中の下肢筋力トレーニングの実施割合は91（69〜95）％であった．治療継続や日常生活に影響を及ぼすような有害事象発生はなく，介入前後で身体機能や活動量の有意な低下は認められなかった．【結論】悪液質リスクの高い高齢進行がん患者において，われわれが開発した下肢筋力トレーニングは高い実施割合を有し，身体機能や身体活動量の維持に寄与した可能性が示唆された．</p>

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Immediate effects of active exercise with compression therapy on lower-limb lymphedema

Fukushima T, Tsuji T, Sano Y, Miyata C, Kamisako M, Hohri H, Yoshimura C, Asakura M, Okitsu T, Muraoka K, Liu M

Supportive Care in cancer 25 （ 8 ） 2603 - 2610 2017年

研究論文（学術雑誌）, 共著, 査読有り

Feasibility of a respiratory movement evaluation tool to quantify thoracoabdominal movement for neuromuscular diseases

Liu F., Kawakami M., Tamura K., Taki Y., Shimizu K., Otsuka T., Tsuji T., Miyata C., Tashiro S., Wada A., Mizuno K., Aoki Y., Liu M.

Respiratory Care 62 （ 4 ） 423 - 431 2017年

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  00201324

　概要を見る

BACKGROUND: An objective method to evaluate thoracoabdominal movement is needed in daily clinical practice to detect patients at risk of hypoventilation and to allow for timely interventions in neuromuscular diseases. The clinical feasibility, reliability, and validity of a newly developed method for quantifying respiratory movement using fiber grating sensors, called the Respiratory Movement Evaluation Tool (RMET), was evaluated. METHODS: The time needed to measure respiratory movement and the usability of the measurement were determined by 5 clinicians using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2.0 questionnaire. Thoracoabdominal movement was measured using RMET 3 times in 10 healthy subjects to evaluate intraclass correlation coefficients (ICC). The subjects were encouraged to breathe 10 times while voluntarily changing the amount of air during ventilation simultaneously with the RMET and a spirometer, and their correlations were evaluated to test validity using Pearson’s product-moment correlation coefficients. The same measurements were also performed in 10 subjects with Duchenne muscular dystrophy. RESULTS: Real-time recordings of thoracoabdominal movements were obtained over a mean time of 374 ± 23.9 s. With QUEST 2.0, the median score of each item exceeded 3 (more or less satisfied). In healthy subjects, ICC(1,1) ranged from 0.82 to 0.99, and ICC(2,1) ranged from 0.83 to 0.97. Significant correlations were observed between the respiratory amplitudes measured with RMET, and the amount of air during ventilation was measured with a spirometer (r = 0.995, P <.001). In subjects with Duchenne muscular dystrophy, ICC(1,1) ranged from 0.87 to 0.97, and ICC(2,1) ranged from 0.84 to 0.99. The respiratory amplitudes measured with RMET correlated significantly with the amount of air during ventilation with a spirometer (r = 0.957, P <.001). CONCLUSIONS: We developed a novel method of quantifying respiratory movement called RMET that was feasible to use in daily clinical practice.

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Physical frailty in older people with severe aortic stenosis

Fukui S, Kawakami M, Otaka Y, Ishikawa A, Mizuno K, Tsuji T, Hayashida K, Inohara T, Yashima F, Liu M

Aging Clinical and Experimental Research 28 （ 6 ） 1081 - 1087 2016年

研究論文（学術雑誌）, 共著, 査読有り

Spatial and temporal dynamics of visual search tasks distinguish subtypes of unilateral spatial neglect

Mizuno Katsuhiro, Kato Kenji, Tsuji Tetsuya, Shindo Keiichiro, Kobayashi Yukiko, Liu Meigen

Neuropsychological Rehabilitation    1 - 25 2015年06月

ISSN  0960-2011

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<p>We developed a computerised test to evaluate unilateral spatial neglect (USN) using a touchscreen display, and estimated the spatial and temporal patterns of visual search in USN patients. The results between a viewer-centered USN patient and a stimulus-centered USN patient were compared. Two right-brain-damaged patients with USN, a patient without USN, and 16 healthy subjects performed a simple cancellation test, the circle test, a visuomotor search test, and a visual search test. According to the results of the circle test, one USN patient had stimulus-centered neglect and a one had viewer-centered neglect. The spatial and temporal patterns of these two USN patients were compared. The spatial and temporal patterns of cancellation were different in the stimulus-centered USN patient and the viewer-centered USN patient. The viewer-centered USN patient completed the simple cancellation task, but paused when transferring from the right side to the left side of the display. Unexpectedly, this patient did not exhibit rightward attention bias on the visuomotor and visual search tests, but the stimulus-centered USN patient did. The computer-based assessment system provided information on the dynamic visual search strategy of patients with USN. The spatial and temporal pattern of cancellation and visual search were different across the two patients with different subtypes of neglect.</p>

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Fiber grating(FG)センサーを用いた胸腹部運動の定量化手法の開発と妥当性の検討

里宇 文生, 大塚 友吉, 清水 克己, 滝 良仁, 田村 仁優, 安西 敦子, 和田 彩子, 青木 義満, 辻 哲也, 里宇 明元

The Japanese Journal of Rehabilitation Medicine （(公社)日本リハビリテーション医学会）  52 （ Suppl. ） S368 - S368 2015年05月

ISSN  1881-3526

Brain-computer interface training combined with transcranial direct current stimulation in patients with chronic severe hemiparesis: Proof of concept study

Kasashima-Shindo Y., Fujiwara T., Ushiba J., Matsushika Y., Kamatani D., Oto M., Ono T., Nishimoto A., Shindo K., Kawakami M., Tsuji T., Liu M.

Journal of Rehabilitation Medicine 47 （ 4 ） 318 - 324 2015年04月

ISSN  1650-1977

　概要を見る

Objective: Brain-computer interface technology has been applied to stroke patients to improve their motor function. Event-related desynchronization during motor imagery, which is used as a brain-computer interface trigger, is sometimes difficult to detect in stroke patients. Anodal transcranial direct current stimulation (tDCS) is known to increase event-related desynchronization. This study investigated the adjunctive effect of anodal tDCS for brain-computer interface training in patients with severe hemiparesis. Subjects: Eighteen patients with chronic stroke. Design: A non-randomized controlled study. Methods: Subjects were divided between a brain-computer interface group and a tDCS-brain-computer interface group and participated in a 10-day brain-computer interface training. Event-related desynchronization was detected in the affected hemisphere during motor imagery of the affected fingers. The tDCS-brain-computer interface group received anodal tDCS before brain-computer interface training. Event-related desynchronization was evaluated before and after the intervention. The Fugl-Meyer Assessment upper extremity motor score (FM-U) was assessed before, immediately after, and 3 months after, the intervention. Results: Event-related desynchronization was significantly increased in the tDCS-brain-computer interface group. The FM-U was significantly increased in both groups. The FM-U improvement was maintained at 3 months in the tDCS brain-computer interface group. Conclusion: Anodal tDCS can be a conditioning tool for brain-computer interface training in patients with severe hemiparetic stroke.

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Fiber grating(FG)センサーを用いた胸腹部運動の定量化手法の開発

里宇 文生, 清水 克己, 滝 良仁, 田村 仁優, 青木 義満, 大塚 友吉, 安西 敦子, 和田 彩子, 片平 真佐子, 辻 哲也, 里宇 明元

The Japanese Journal of Rehabilitation Medicine （(公社)日本リハビリテーション医学会）  51 （ Suppl. ） S282 - S282 2014年05月

ISSN  1881-3526

Executive dysfunction is related with decreased frontal lobe blood flow in patients with subarachnoid haemorrhage

Uchikawa K., Inaba M., Kagami H., Ichimura S., Fujiwara T., Tsuji T., Otaka Y., Liu M.

Brain Injury 28 （ 1 ） 15 - 19 2014年

ISSN  0269-9052

　概要を見る

Objective: This study evaluated executive dysfunction in patients with subarachnoid haemorrhage (SAH) using the Behavioural Assessment of the Dysexecutive Syndrome (BADS) and correlated the occurrence of executive dysfunction with cerebral blood flow (CBF) reduction in the frontal lobe as assessed by single photon emission computed tomography (SPECT). Design: Correlational study. Subjects: Twenty-Two patients who underwent microsurgical clipping at least 3 months after SAH. Methods: This study evaluated the BADS and the Wechsler Adult Intelligence Scale-III (WAIS-III). In addition, it assessed activities of daily living (ADL). CBF was evaluated using SPECT. The patients were divided into the following groups according to the results of SPECT: (1) those with reduced CBF in the frontal lobe (reduced CBF group, n = 8) and (2) those with intact CBF (intact CBF group, n = 14). Results: The BADS score was significantly lower in the reduced CBF group compared with that of the intact CBF group, while there was no significant difference in the WAIS-III scores and ADL scale between the two groups. Conclusion: Although this result was conducted with a small sample size, executive dysfunction correlates with reduced CBF in the frontal lobes of SAH patients. A detailed evaluation of executive function is suggested in SAH patients, even if the patient's intelligence test and ADL scale reveal no abnormalities. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.

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Cancer functional assessment set: A new tool for functional evaluation in cancer

Miyata C., Tsuji T., Tanuma A., Ishikawa A., Honaga K., Liu M.

American Journal of Physical Medicine and Rehabilitation 93 （ 8 ） 656 - 664 2014年

ISSN  0894-9115

　概要を見る

OBJECTIVE: The aim of this study was to develop and evaluate the psychometric properties of a new measurement tool, the Cancer Functional Assessment Set (cFAS). DESIGN: A total of 119 inpatients with cancer participated in this prospective cohort study. This study took place in three phases: (1) item generation, literature search, and a round-table discussion by 32 rehabilitation specialists; (2) item reduction and selection of appropriate items from the first item pool; and (3) evaluation of psychometric properties. Concurrent validity (Spearman correlation coefficients with existing scales), internal reliability (Cronbach coefficient alpha), interrater reliability (weighted kappa statistics and intraclass correlation coefficient), cross-validation, and responsiveness (standardized response mean values) were examined. RESULTS: The cFAS consisted of 24 items. Significant correlations were found between the cFAS and existing scales. Cronbach α for the total score was 0.92. Weighted κ values for each item ranged from 0.74 to 1.00. The intraclass correlation for the total score was 0.97. Concurrent validity and internal consistency were similar at two different hospitals. The cFAS was more responsive to changes than the other tools. CONCLUSIONS: The cFAS has acceptable psychometric properties, supporting its broad generalizability. It can be a useful tool in clinical trials and can contribute to the development of cancer rehabilitation. Copyright © 2014 Lippincott Williams & Wilkins.

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Early visual processing is affected by clinical subtype in patients with unilateral spatial neglect: A magnetoencephalography study

Mizuno K., Tsuji T., Rossetti Y., Pisella L., Ohde H., Liu M.

Frontiers in Human Neuroscience 7 （ JUL ）  2013年07月

ISSN  1662-5161

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Objective: To determine whether visual evoked fields (VEFs) elicited by right and left hemifield stimulation differ in patients with unilateral spatial neglect that results from cerebrovascular accident. Methods: Pattern-reversal stimulation of the right and left hemifield was performed in three patients with left unilateral spatial neglect. Magnetoencephalography was recorded using a 160-channel system, and VEFs were quantified in the 400 ms after each stimulus. The presence or absence of VEF components at around 100 ms (P100m component) and 145 ms (N145m component) after stimulus onset was determined. The source of the VEF was determined using a single equivalent current dipole model for spherical volume conduction. All patients were evaluated using the behavioral inattention test (BIT). Results: In response to right hemifield stimulation, the P100m and N145m components of the VEF were evident in all three patients. In response to left hemifield stimulation, both components were evident in Patient 3, whereas only the P100m component was evident in Patient 1 and only the N145m component was evident in Patient 2. Patient 1 exhibited impairments on the line bisection and cancellation tasks of the BIT, Patient 2 exhibited impairments on the copying, drawing and cancellation tasks of the BIT, and Patient 3 exhibited impairments on the cancellation task of the BIT. Conclusions: These results demonstrate that early VEFs are disrupted in patients with unilateral spatial neglect and support the concept that deficits in visual processing differ according to the clinical subtype of unilateral spatial neglect and the lesion location. This study also demonstrates the feasibility of using magnetoencephalography to explore subtypes of neglect. © 2013 Mizuno, Tsuji, Rossetti, Pisella, Ohde and Liu.

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