1917 results about "Upper limb" patented technology

The invention discloses a scene interactive limb active and passive rehabilitation training system based on a virtual three-dimensional game in the field of rehabilitation medical treatment. The scene interactive limb active and passive rehabilitation training system comprises a virtual scene generation module, a multi-mode motion capture module, an active and passive cooperative control module, a real-time feedback and excitation module and a data statistics module. And the virtual scene generation module is used for constructing various three-dimensional game scenes, so that scene tasks are strongly associated with actions of upper limbs, lower limbs or upper and lower limbs, and scene difficulty is dynamically adjusted. Compared with the prior art, the interactive guidance of the immersive virtual three-dimensional game scene is adopted, the boring rehabilitation training is converted into interesting game experience, and the participation enthusiasm and compliance of the patient are greatly improved. Compared with traditional two-dimensional animation game training, the patient is more willing to actively participate in training, and the conflict emotion caused by boring training is reduced.

A device and method for functional electrical stimulation intended to be positioned on an upper limb of a user for stimulation of the user's upper limb, includes an electrode configured to be disposed on an upper limb of the user, the electrode having a number of electrode pads adapted to generate stimulating electrical signals on the upper limb of the user, and a stimulator having an embedded sensor configured to detect a movement of the stimulator, and a control component configured to process the sensor measurements and determine an intention of the user to perform an action with his / her upper limb on which the electrode is disposed, and to control the activation and / or deactivation of the electrode pads based on the sensor measurements.

The invention relates to a shoulder two-degree-of-freedom upper limb lifting power-assisted exoskeleton. In order to overcome the defects in the prior art, the shoulder two-degree-of-freedom upper limb lifting assisting exoskeleton comprises a body fixing assembly, two energy storage supporting boxes and two upper arm fixing assemblies, the two energy storage supporting boxes are fixed to a body strap, the two upper arm fixing assemblies are fixed to the upper arms of a user, and the two upper arm fixing assemblies are fixed to the lower arms of the user. The upper arm fixing assembly comprises an upper arm supporting piece and an upper arm binding piece, an arm rod is hinged to the upper arm supporting piece, the lower end of the arm rod is directly or indirectly connected to the adjacent energy storage supporting box, an elastic body is arranged in the energy storage supporting box, an upper rotating seat is arranged at the top of the energy storage supporting box, and a lower rotating seat is arranged at the bottom of the upper rotating seat. The outer side of the shoulder joint piece is hinged to the upper rotating base through a transverse shaft, and the lower end of the arm rod is indirectly connected to the adjacent energy storage supporting box through the shoulder joint piece. According to the shoulder two-degree-of-freedom upper limb lifting power-assisted exoskeleton, left-right arm opening and closing are not limited, and application and popularization of the upper limb lifting power-assisted exoskeleton are facilitated.

A modular prosthetic system for an upper limb in which the functional commands of the mechanical limb can be generated by exploiting additional input data with respect to the only muscle contractions of the muscles present on the patient's stump, and the patient can receive a sensory feedback, the richer as possible, regarding to the functionality of the mechanical limb.The modularity of the prosthetic system allows the use of a mechanical artificial limb that essentially implements the pure operational and sensory functions, while the control functions by the patient, and the feedback functions provided to the patient, are managed by a subsystem (called control module) distinct and decoupled from the artificial limb, with which it interacts through appropriate interfaces.

A device (1) and method for functional electrical stimulation intended to be positioned on an upper limb of a user for stimulation of the user's upper limb, comprising an electrode (2) configured to be disposed on an upper limb of the user, the electrode (2) having a plurality of electrode pads (3) adapted to generate stimulating electrical signals on the upper limb of the user, and a stimulator (4) comprising an embedded sensor (5) configured to detect a movement of the stimulator (4), and control means (6) configured to process the sensor measurements and determine an intention of the user to perform an action with his / her upper limb on which the electrode (2) is disposed, and to control the activation and / or deactivation of the electrode pads (3) based on the sensor measurements.

The invention relates to equipment (12) for positioning and supporting an upper limb of a patient (14) intended to undergo a medical procedure, the equipment being characterised in that it further comprises: a cavity (22) for accommodating the elbow of the upper limb of the patient, configured to define a space for positioning and supporting the elbow of the patient; gripping means (24) for gripping, by a hand, the upper limb of the patient; means (30a, 30b, 34) for moving the gripping means (24) in translation in a longitudinal direction relative to the cavity (22) for accommodating the elbow of the patient so that the upper limb of the patient can extend, once the gripping means (24) have been grasped by the patient and the elbow is accommodated in the accommodating cavity (22), between the elbow accommodating cavity and the gripping means, regardless of the length of the upper limb of the patient.

The invention discloses a seven-degree-of-freedom upper limb exoskeleton and an on-demand auxiliary control method thereof, provides mechanical structure design and joint modular design of the seven-degree-of-freedom upper limb exoskeleton, and deduces kinematics and dynamics models of an upper limb exoskeleton system according to the mechanical structure design and the joint modular design. On the basis, the design of a control system of an upper limb exoskeleton system is provided, an outer ring uses an impedance model for auxiliary force calculation, an energy function and a Horf controller are combined for online adjustment of training trajectory frequency, radius, auxiliary force and the like, the auxiliary force is converted into an expected trajectory of an exoskeleton through the impedance model, and the expected trajectory is transmitted to an inner ring controller; a trajectory tracking controller based on BLF design is used in an inner ring, and dynamic characteristics are estimated based on time delay estimation and an RBF neural network. According to the method, the adaptability of the upper limb exoskeleton mechanical structure and the human body is improved, the influence of dynamic characteristics in the trajectory tracking process is effectively reduced, the training trajectory can be adjusted online, and a good on-demand auxiliary effect is achieved.

The gait assistance mechanism according to one example of the present invention may comprise one or more tendons connecting an upper limb, a trunk, and a lower limb of a wearer and a fixing part fixing the one or more tendons to the body of the wearer, and the one or more tendons may comprise a driving tendon connecting the lower limb and the upper limb on the same side of the wearer.

The invention provides a device for achieving brachial artery compression hemostasis, and relates to the technical field of medical instruments.The device for achieving brachial artery compression hemostasis comprises a wearing assembly suitable for being bound to the upper arm of the human body and achieving device wearing; the pressure applying unit array assembly is arranged on the wearing assembly and is used for carrying out compression operation on a puncture point area on the upper arm of the human body; the distributed pressure sensing assembly is arranged on the wearing assembly, located on the outer side of the pressure applying unit array assembly and used for sensing contact pressure information of the pressure applying unit array assembly and the puncture point area; and the controller is used for regulating and controlling the compression operation based on the dynamic pressure distribution represented by the contact pressure information so as to maintain effective compression on the puncture point. According to the technical scheme, compression failure caused by slight change of the posture of the upper limbs of the patient can be effectively reduced.

The invention relates to the field of upper limb joint rehabilitation training, in particular to an upper limb joint rehabilitation training method and system based on an exoskeleton mechanical arm, and the method comprises the steps: collecting sEMG signals of a target muscle group of a user in real time in a training process; calculating the root mean square of the amplitude of the sEMG signal in the current time window; if the root mean square is smaller than a muscle force insufficient threshold value, a training mode is switched to a full-assistance mode; if the root mean square is not smaller than the muscle force insufficient threshold value and smaller than the normal muscle force threshold value, the training mode is switched to a semi-assistance mode; if the root mean square is larger than or equal to the normal muscle force threshold value, the training mode is switched to an anti-resistance training mode. The rehabilitation training effect of the upper limb joints can be effectively improved.

The invention provides a horizontal limb joint rehabilitation physiotherapy device, and relates to the field of limb joint rehabilitation physiotherapy. A horizontal limb joint rehabilitation physical therapy device comprises a fixing plate which serves as a supporting structure for horizontal limb joint rehabilitation physical therapy, supporting seats which are evenly distributed are installed at the bottom of the fixing plate, and first ball cage type universal joints used for driving an upper limb assembly and a lower limb assembly to rotate are installed on the two sides of the fixing plate and the two sides of one end of the fixing plate; the two driving assemblies are arranged at the two ends of the top of the base correspondingly and used for driving the upper limb assembly and the lower limb assembly; and the ankle joint assembly is mounted at one end of the lower limb assembly and drives the ankle back to stretch and the plantar flexion through a servo motor. The upper limbs and the lower limbs can be driven to conduct rehabilitation training through the driving assembly, and meanwhile rehabilitation training can be conveniently conducted on one sides of the upper limbs and one sides of the lower limbs through cooperation of a first electromagnet, a first magnet, a second electromagnet and a second magnet.

The invention discloses a multi-signal fusion upper limb muscular tension increase detection method and device, and relates to the technical field of muscular tension increase detection. The method comprises a data acquisition process, a parameter fitting process, a model training process and a muscular tension increase detection process, passive elbow flexion and elbow extension are carried out at a set speed by driving a forearm with an elbow joint as an axis, mechanical data, kinematics data and myoelectricity data in the movement process are collected, and after the collected various data are preprocessed, the obtained data are subjected to model training and muscular tension increase detection. And training the muscular tension grade prediction model by taking a clinical evaluation result of a doctor on the muscular tension grade as a label, and predicting the muscular tension grade and the contribution degree of each feature to the prediction result through the trained muscular tension grade prediction model. According to the multi-signal fusion upper limb muscular tension increase detection method and device provided by the invention, accurate quantification of muscular tension levels is realized, and meanwhile, the reliability and interpretability of a detection result are enhanced.

An exercise apparatus supports plank and core-strength movements by engaging a user's upper limbs and supporting the user above a ground surface. A rigid frame carries at least one upper-limb support pad arranged to support a portion of the upper limb; a hand grip can be grasped while the limb rests on the pad. The pad and grip can be repositioned, re-oriented, or spaced to suit different body sizes, exercise variants, or load angles. A ground-engaging surface permits placement for use on indoor floors, mats, or outdoor terrain.

The invention relates to the technical field of orthopedic surgery equipment, and discloses a movable traumatic orthopedic multifunctional surgery device which is arranged on a bed body and comprises first mounting frames, second mounting frames, a third mounting frame and a fourth mounting frame. The second mounting frame is arranged on one side of the bed body; the traction mechanism is detachably arranged on the first mounting frame and the second mounting frame and comprises a mounting assembly and a traction assembly; through the traction mechanism, the traction assembly can be installed according to the part needing traction treatment of a patient under the action of the installation assembly, so that the traction device is suitable for treatment of limbs of different parts of the traumatic orthopedics patient, the installation mode is simple and convenient, the traction device can be rapidly disassembled when not used, the size is effectively reduced, and the whole device is convenient to move; the conditions that traditional traction equipment cannot perform traction treatment on limbs of different parts of a patient and is large in size and inconvenient to move are avoided; the problems that an existing traction device is inconvenient to conduct synchronous traction treatment on the upper limb and the lower limb of a patient and inconvenient to move and install are solved.

The invention provides a control method and system of a rehabilitation robot, a readable storage medium and a computer. The method comprises the steps that a motion control sketch is constructed according to motion data, collected in real time, of the rehabilitation robot and upper limbs of a patient; calculating displacement data of an end effector according to the motion control sketch and a kinematics model of the rehabilitation robot; according to the kinematics model of the equalization mechanism of the rehabilitation robot, the displacement data of the end effector and the kinematics model, the maximum motion space of the end effector is established; the effective working space of the rehabilitation robot is calculated through the end effector and the maximum movement space of the upper limb hemiplegic patient, and the rehabilitation robot is controlled through the effective working space. According to the method, the displacement data of the end effector is calculated by utilizing the kinematic model and the motion control sketch, and the mechanical model of the rehabilitation robot is established by utilizing the kinetic model and the displacement data, so that the rehabilitation robot is controlled.

The invention discloses an auxiliary device for armless disabled people, and relates to the technical field of brain-computer interfaces. In order to solve the problems that in the prior art, an invasive type and a semi-invasive type of existing wearable auxiliary devices for providing life assistance for people with upper limb disability need surgical operation, electrodes are implanted into the cerebral cortex, but the surgical risk is large, complications such as infection and bleeding are possibly caused, and long-term maintenance is needed after implantation; in order to solve the technical problems that a non-invasive interbrain interface is relatively small in risk, convenient to use, simple to operate, low in cost and relatively low in control precision, the technical scheme provided by the invention is as follows: the auxiliary system for the armless disabled person comprises a brain signal acquisition module for acquiring an electroencephalogram signal of a user in a non-invasive manner; the visual control module is used for collecting target object positioning information; and the main control module is used for generating grabbing action group signals according to the signals acquired by the brain signal acquisition module and the visual control module. The auxiliary grabbing device is suitable for being applied to auxiliary grabbing work of the arm-free handicapped.

The invention discloses an intelligent positioning system capable of conveniently adjusting the standing posture of a patient and a method thereof, and relates to the technical field of intelligent medical treatment. Comprising the following steps of initial posture evaluation and skeleton modeling, gravity center and supporting point distribution calculation, spine curvature and inclination detection, intelligent laser-assisted posture adjustment, dynamic muscle activation feedback monitoring, pelvis and lower limb alignment correction, posture balance prediction and guidance, upper limb posture and shoulder blade stability correction and real-time adjustment of biological feedback driving. And carrying out long-term attitude optimization and habit remodeling, and carrying out system construction based on the method. According to the intelligent positioning system convenient for adjusting the standing posture of the patient and the method thereof, accurate detection, real-time adjustment and long-term optimization of the standing posture problem of the patient are realized by setting and combining multi-modal data acquisition, a dynamic feedback mechanism and biomechanical analysis. The problems of low static evaluation precision, lack of dynamic feedback and poor long-term effect in the prior art are effectively solved.

The invention provides an intervention method and system for esophageal reflux in airway management, and relates to the technical field of medical treatment. The method comprises the following steps: S1, collecting a risk assessment result of whether a patient has the risk of esophageal reflux aspiration or not; s2, under the condition that the patient has the risk of esophageal reflux aspiration, the current body position of the patient is recognized; based on the current body position, a target body position is judged, and a body position adjusting scheme is generated; and S3, adjusting the body position of the upper limb and / or the lower limb of the patient through a body position adjusting device, and moving the limb of the patient from the first position to the second position, so that the limb of the patient reaches the characteristics conforming to the target body position in the body position adjusting scheme. According to the method, the body position adjusting scheme can be generated based on the current body position of the patient, and the current body position of the patient is adjusted, so that the risk of esophageal reflux aspiration caused by an inappropriate body position is reduced.

The invention belongs to the technical field of wearable exoskeletons, and particularly relates to a forearm power assisting device, a forearm power assisting method and an upper limb power assisting system. The forearm power assisting device comprises an angle transmission mechanism, an angle amplification mechanism, an elastic energy storage mechanism and a tension output mechanism; wherein the buckling angle of the front arm is transmitted through the angle transmission mechanism, and after the buckling angle is amplified through the angle amplification mechanism, the elastic energy storage mechanism is driven, so that the flexible traction cable outputs pulling force linked with the buckling angle of the front arm. The forearm power assisting device is a system based on the pure mechanical transmission and energy storage principle, forearm flexion and extension angle changes can be directly converted into self-adaptive tension linked with the forearm flexion and extension angle changes, and therefore forearm muscle fatigue in long-time fine operation can be effectively relieved without an external power source.

The present disclosure relates to the field of artificial limbs for amputees and specifically to a passive compliant wrist unit 210 for upper limb prosthesis. The passive compliant can comprise a plurality of fingers controlled by a compliant four bar mechanism. The arm is capable of extension / flexion, radial / ulnar deviation on application of a force on the snap joint. The limb is also capable of pronation / supination actions. By application of a force on an arm snap joint, the flexible wrist 216 can be adapted to perform extension / flexion, radial / ulnar deviation.

The invention relates to the technical field of medical auxiliary instruments, in particular to a newborn body position fixator of an invasive ventilator. Comprising a mounting rod, hinge rods are hinged to the two ends of the mounting rod, sliding rods are slidably arranged on the hinge rods, connecting rods are hinged to the sliding rods, and the lower ends of the connecting rods slidably penetrate through corresponding lower limb supporting plates and upper limb lifting plates; the telescopic end of the second electric push rod is connected with a connecting frame, and the two sides of the connecting frame are in contact fit with the bottom ends of the connecting rods on the same side. By introducing the lifting mechanism and the limiting mechanism, accurate adjustment and stable fixation of the body position of the newborn are achieved, the two mechanisms can operate independently and can also be used in a combined mode, a surrounding type limiting structure is formed, more stable and reliable support is provided compared with a traditional soft material, body position deviation of the newborn during treatment is prevented, and the treatment effect of the newborn is improved. Therefore, the treatment effect is guaranteed.

According to the technical scheme, the four-limb joint supporting structure comprises an upper supporting part, a lower supporting part and a connecting part, and the upper supporting part and the lower supporting part can be bent to be in an arc surface shape from the two sides and are used for being attached to the upper limb and the lower limb at the joints of a patient; the two ends of the connecting part are connected to the upper supporting part and the lower supporting part respectively and used for being attached to the joint position, and the width of the connecting part is smaller than that of the upper supporting part and that of the lower supporting part so that two grooves can be formed between the connecting part and the upper supporting part and between the connecting part and the lower supporting part. The utility model has the beneficial effects that the connecting part is formed between the upper supporting part and the lower supporting part through the groove, the connecting part is bent and attached to the joint, the generation of a break angle is avoided, the bending can be extremely simplified, no matter whether the material has enough ductility or not, the requirements can be met, the structure is simple, the complexity degree is low, the production process is simple, and the operability is high; the device is suitable for shoulder joints, elbow joints, ankles and the like, and the structural design has certain universality.

The utility model discloses a movable radial artery puncture auxiliary device, and belongs to the technical field of medical equipment. Comprising a movable base which moves under the action of external force, a lifting component installed in the center of the top face of the movable base and an angle adjusting piece installed on the top of the lifting component in the longitudinal direction, the angle adjusting component reciprocates in the longitudinal direction under the action of the lifting component, and the angle adjusting piece has two degrees of freedom. The arm support is transversely placed and installed at the top of the angle adjusting piece, the corrugated support is arranged at the end of the arm support, and a restraint strap is installed at the end, away from the arm support, of the corrugated support. The angle adjusting piece is matched with the corrugated support and medical staff, adjustment is carried out according to the condition of a patient, the success rate of radial artery puncture catheterization and the comfort degree of the patient are increased, the restraint strap is matched, the upper limbs of the patient can be effectively prevented from moving or being not matched during radial artery puncture, operation is easy and convenient, and practicability is high.

The invention provides a rapid binding device for traumatic orthopedics, and relates to the technical field of medical instruments. The rapid binding device for the traumatic orthopedics department comprises a reciprocating mechanism, the driving end of the upper end of the reciprocating mechanism is fixedly connected with a driving plate, a supporting mechanism is arranged on the right side of the front end of the reciprocating mechanism, a binding mechanism is arranged at the front end of the supporting plate and comprises a semicircular ring, and a rotating rod is rotationally connected to the interior of a limiting hole in the upper side; and a bandage collecting roller is inserted into the outer portion of the rotating rod, the periphery of the semicircular ring is fixedly connected with a crescent outer gear ring, the crescent outer gear ring is connected with a limiting gear and a driving gear in a meshed mode, the middle of the limiting gear is fixedly connected with a fixing shaft, and the middle of the driving gear is fixedly connected with a driving shaft. Through the cooperation of the driving mechanism, the binding mechanism and the reciprocating mechanism, the wound part of the injured upper limb or lower limb of the patient is bound automatically, and the binding efficiency is improved.

The embodiment of the invention discloses a lymphedema identification method and device applied to breast cancer postoperation. A specific embodiment of the method comprises the following steps: constructing an upper limb three-dimensional model according to an acquired upper limb image sequence; performing upper limb state recognition according to the upper limb image sequence and the upper limb three-dimensional model to generate upper limb state information; according to the upper limb state information, the collected chief complaint information, breast cancer operation treatment information corresponding to the to-be-recognized object and a pre-trained lymphedema recognition model, lymphedema recognition information is generated; and in response to the lymphedema identification information, representing that the to-be-identified object has lymphedema, and according to the lymphedema identification information, generating rehabilitation suggestion information corresponding to the to-be-identified object. By means of the implementation mode, the patient after the breast cancer operation can find out the lymphedema of the patient as soon as possible, and the patient can be prevented and treated as soon as possible when the lymphedema occurs.

The invention discloses a magneto-rheological three-dimensional force feedback type upper limb active and passive rehabilitation training device which comprises a bearing base, and a first bearing seat, a second bearing seat, a first torque motor base, a second torque motor base and an encoder base which are installed on the bearing base through bolts and fixed through bolts. The bearing base is provided with 21 groove-shaped holes which are connected with the transmission system, the transmission system is arranged above the bearing base, a first-class three-dimensional rod piece is arranged above the bearing base, and a magneto-rheological joint module is arranged above the bearing base. The magneto-rheological three-dimensional force feedback type upper limb active and passive rehabilitation training device has more comprehensive freedom of motion, so that the rehabilitation training requirements of patients are better met, compared with an exoskeleton robot, the magneto-rheological three-dimensional force feedback type upper limb active and passive rehabilitation training device is simple in structure, high in adaptability and more convenient to install and debug, and meanwhile personalized adjustment can be conducted according to specific conditions of different patients.

The invention provides an elbow joint exoskeleton control system based on myoelectricity angle prediction and a use method thereof, the elbow joint exoskeleton control system comprises a dual-channel surface myoelectricity signal acquisition device and an advanced one-step prediction model OSA: the dual-channel surface myoelectricity signal acquisition device acquires myoelectricity signals and provides input data for the system; establishing an advanced one-step prediction model OSA based on a non-linear autoregressive model NARX with exogenous input, performing offline training, and determining a mapping relation between the electromyographic signals and the actions; and realizing online intention estimation and real-time control of the upper limb elbow joint exoskeleton system by using an advanced one-step prediction model OSA. By means of the technical scheme, the electromyographic signals can be detected in real time, the exoskeleton is driven to assist in completing elbow joint flexion and extension movement, neural function reconstruction and motor ability recovery are promoted, and the risk of muscle disuse atrophy is reduced.

The invention discloses an upper limb shoulder joint accurate evaluation and rehabilitation training system and method based on a remote sensor, and is applied to the technical field of rehabilitation medical engineering.The method comprises the steps that original multi-modal data is preprocessed, shoulder joint motion data and voice data are processed in combination with baseline data, and a multi-modal standardized data set is generated; multi-dimensional feature extraction is carried out on the multi-modal standardized data set to generate a feature set, and the feature set comprises time domain features, frequency domain features, nonlinear dynamic features and voice features; on the basis of the feature set, a comprehensive evaluation score of the shoulder joint function is calculated by using a linear and nonlinear combined comprehensive scoring model; inputting the feature set and the comprehensive evaluation score into a pre-trained LSTM time sequence prediction model, predicting a rehabilitation trend and abnormal fluctuation, and generating future score change and rehabilitation inflection point early warning information; and based on the comprehensive evaluation score, the prediction result and multi-modal feature fusion analysis, generating rehabilitation training feedback and adjustment information.

The invention belongs to the technical field of exoskeleton robots, and discloses an upper limb power-assisted exoskeleton robot which comprises a back plate, a rotary elastic series driver, a linear structure, a tensioning structure, a width adjusting structure, an upper limb structure and a rope transmission structure, the rope transmission structure comprises a rope and a pulley, and the rope comprises a driving rope and a differential rope. One end of the driving rope is fixed to the output end of the rotary elastic series driver, the other end of the driving rope is fixed to the linear structure, the differential rope bypasses the linear structure, the tensioning structure and the width adjusting structure and extends towards the two upper limb structures, the two ends of the differential rope are located on the two upper limb structures, and the upper limb structures are connected to the width adjusting structure. The width adjusting structure is used for driving the upper limb structure to be close to or away from the vertical center line of the back plate. According to the invention, the single driving motor can provide auxiliary torque for single-arm or double-arm overhead operation.

The invention relates to the technical field of medical rehabilitation, in particular to a post-stroke upper limb function recovery training system combined with a vr technology, which comprises a fixed base, and a motor is fixedly connected to the center of an inner cavity of the fixed base. The upper limb rehabilitation training device has the advantages that the angle adjusting and rotating functions are achieved, a personalized training plan can be made according to the specific conditions of a patient, and therefore upper limb rehabilitation training of the patient is more effectively promoted; through cooperative use of a fixed base, a motor, a fixed column, a supporting rod, a fixed sleeve, a rotating rod, an adjusting rod, an electric push rod, a lifting block, a seat and a sliding rod, the rotating and angle adjusting functions of the seat can be achieved, it is ensured that a patient can obtain the best comfort degree and experience feeling in the training process, the angle is flexibly adjusted through the seat, and the training efficiency is improved. A patient can experience a more real training scene in an immersive manner, and the brain is stimulated to generate strong neural feedback, so that the movement function recovery of the upper limbs is effectively promoted.