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ONLINE AND OTHER ICT APPLICATIONS FOR COGNITIVE TRAINING AND ASSESSMENT
Online and other ICT Applications for
Cognitive Training and Assessment
http://dx.doi.org/10.3991/ijoe.v11i2.4360
Maria Karyotaki, Athanasios Drigas
N.C.S.R. ‘Demokritos’, Athens, Greece
Abstract—Cognitive training and assessment refers to ICTs
and their relation with students, students with learning
disabilities and adults with dementia. This article revises on
contemporary research concerning ICTs effectiveness on the
training and assessment of attention, memory and executive
control functions. Artificial intelligence seems to hold a
significant role in the field of cognitive training and rehabilitation as its adaptability and interactivity, enhance users’
motivation and involvement. Moreover, artificial intelligence in combination with other applications provides the
means for holistic and cost-effective cognitive interventions
through its integrative information processes. Evidently,
educators and therapists should advocate of improvements
in the engineering features of the applications as well as they
should, themselves, expand the implementation of the
aforementioned technological innovations in favour of the
users’ cognition.
Index Terms—cognitive skills, cognitive interventions, online
applications, online assessment & training.
I.
INTRODUCTION
Drigas et al. made a review study on the integration of
ICTs in the battle against memory deficits. Working
memory performance may be measured either through online or stand-on neuropsychological tests, whereas video
games may improve working memory capacity and performance. Long-term memory impairments may be dealt
with computer programs related to individuals’ personalised training and assessment as well as through artificial
intelligence techniques for supporting the elderly and
sufferers from severe memory impairments.
Howard-Jones et al. made a review analysis on the
common scientific field between neurosciences and technology-enhanced learning in an attempt to induce students’ learning potential. According to recent studies,
early years’ literacy and numeracy as well as creativity
and collaborative and social skills may be strongly benefited from technology, either through adaptive educational
programs, online platforms, free web-based applications
or artificial collaborators. Games have a pivotal role in
students’ learning and motivation, thus engage neuroscientists and educators in harnessing the beneficial effects of
technology.
Weng et al. revised research studies on cognitive skillsbased computer-assisted instruction for students with
disabilities on account of their learning potential and design features. Synthesized findings of the previous studies
verified of the fact that computer technology can largely
serve as learning boosters for students with disabilities,
although insufficient illustration on design features of the
computer-assisted instruction and lack of an in-depth
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analysis on a specific type of disability, limited studies’
overall consistency and cohesiveness. Tablet computers
offer contemporary means for performing further studies
in the field of cognitive skills-based computer-assisted
instruction for students with disabilities.
Fletcher-Watson revised on computer-assisted learning
for people with autism spectrum disorder. Evidence suggests that direct and immediate feedback of programs,
personalized reinforcement as well as the provision of
complementary support by a teacher lead to technological
impact expansion. Furthermore, touch screen and tangible
hardware may be of assistance in order to facilitate the use
of web, online gaming and virtual worlds for enhancing
autistic’s community both social, life and academic learning skills. The adaption of artificial intelligence elements
in the design and implementation of computer-assisted
learning accompanied with the evaluation of its direct and
indirect effects on autistics should be thoroughly looked
into in future studies.
Aresti-Bartolome et al. reviewed recent research on Autistic Spectrum Disorder sufferers in relevance to their
assessment and therapy through ICTs. Virtual reality applications, applications designed for computers, tablets or
mobiles, telehealth systems and robots were the technologies constituting the background of the interventions.
Technologies were further classified to communication
and interaction, social learning and imitation skills as well
as other associated conditions in Autism. In conclusion,
virtual reality applications offer the opportunities for Autistic individuals to improve their cognitive and social
skills through realistic situations, whereas applications for
computers, tablets or mobiles can be consistent training
tools as long as they are accompanied by human assistance. Moreover, telehealth systems may be useful as an
instant communication path with specialists, for both of
the counterparts: people with Autistic Spectrum Disorders
and their family members. Finally, robots with voice technology can be substantially important in the acquisition of
Autistic people’s social skills. Nevertheless, the aforementioned technologies have to be examined thoroughly as to
the transferred skills in Autistic individuals’ real life. In
addition, taking in mind individuals’ personal differences
should be a priority in the design of innovative technologies, for example through implementing adaptive systems
or through the combination of various technologies in the
same system.
Siberski et al. made a study on intellectually and developmental disabled adults’ computer-based cognitive training. Results showed positive trends in the target group’s
cognitive enhancement with special focus on the beneficial role of low complexity computer programs, such as
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computer games, on their motivation, attention and time
on task.
Singh et al. refers to some basic cognitive skills, such as
attention, memory, language, visual and spatial processing, logic and reasoning, interpersonal and intrapersonal skills in order to address to the issues of cognitive enhancement. Education, enriched environment and
mental training, including video games, symbolic programs, expert systems and search agents may lead to specific improvements in humans’ cognitive task performance.
Lauriks et al. explore current trends on ICT-based assistance and support for people with dementia and their carers. Stand-on and web-based applications provide the
technological means for stimulating patients’ memory and
enhance carers’ emotional state in addition to mobiles and
GPS devices, offering patients’ and their relatives’ instant
communication and feelings of safety and security. Advanced research should focus on integrated, personalized
systems regarding the monitoring of biological functions
as well as behavioural and psychological changes occurring in people suffering from dementia.
Koldrack et al. review Alzheimer patients’ assistive
technologies for cognition (ATC) and mobility to enhance
individuals’ autonomy and safety. Current dynamically
adaptive systems, such as reminding, micro-prompting,
navigation, storing and displaying, alerting or distraction
systems integrate individuals’ with dementia social needs
and cognitive abilities through their multi-modal operation. Such systems adapt to patients’ disease progress,
beginning from the early stages until the caregiver takes
over, aiming at maximizing users’ assistive effect, personalization and ease of use.
II.
ON LINE-WEB
Petchtone et al. examined the validity of a web-based
learning environment model aiming at the improvement of
undergraduate students’ cognitive skills and critical thinking. More specifically, the design principles of the model
as well as its usability and effectiveness were found consistent and congruent with the enhancement of students’
cognitive skills and critical thinking.
Lin et al. analyze cognitive processes in problemsolving activities through the integration of Facebook
discussions and simulation-based teaching software. The
results of the study indicated diverse and continuous cognitive processes taking place, such as remembering, understanding, applying and analyzing. Students' high-level
cognitive processing can be reached through social
knowledge construction computer-aided tools, such as
concept-mapping tools accompanied by the instructors’
task design and in-task support.
Howard-Jones et al. structured the design of a webbased application, called “zTP”, which shed light on the
potential importance of the teacher scaffolding learning in
addition to students’ gaming their score. Findings of the
study revealed developers’ and classroom stakeholders’
optimal interrelationship in the classroom.
Jelcic et al. point at the effects of lexical-semantic stimulation through videoconferencing on Alzheimer patients’
global cognition, language abilities, verbal and nonverbal
related memory domains, attention and executive functions as well as visual-spatial abilities. Cognitive stimulation treatment through teleconference seems to be less
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efficient on memory abilities than face to face treatment,
although in both cases global cognitive performance as
well as language abilities improved.
Riegler et al. adopted an online treatment, the Military
On-Line Problem Solving Videophone Intervention
(MOPS-VI) for improving cognitive functioning in veterans with mild traumatic brain injury (TBI) through the
incorporation of web-based modules and videophones
with a speech-language pathologist. The MOPS-VI intervention was found beneficial for veterans recovering from
mild TBI in terms of its positive cognitive outcomes and
its briefer therapy, compared to standard office-based
treatments.
Curcic introduce the Big6 Skills model as a scaffold
aimed to improve seventh and eighth grade students’ with
learning disabilities literacy skills, such as information
problem solving and writing from multiple we-based
sources. Overall, the treatment group improved in their
text length and organization quality. Further research is
needed into the relation between the nature of task, students’ motivation and performance.
Campbell et al. elaborate on the use of ICTs and especially the web in constructivist and inquiry-based learning,
which reinforces students’ communication and collaboration. Cyber-enabled resources, such as the open source,
modular, extendable platform called OpenSimulator 3D
Application Server with customizable terrain, weather and
physics as well as several databases and software, such as
the 3-D bar mapping with Google Earth can be used as
cognitive tools available for hands-on experimentation
and observation in biology and science classrooms.
III.
MOBILES
Chen et al. studied on the different text display types of
mobiles and their effects on learners’ reading comprehension, sustained attention and cognitive load. Experimental
results showed that the mixed text display type improved
reading comprehension in mobile reading contexts when
the reader was sited and kept a constant speed of reading.
Nevertheless individuals’ personal reading speed did not
always match to the scrolling speed of the mobile text
display, thus augmenting readers’ extraneous cognitive
load. In other words, readers’ experiencing appropriate
cognitive load through differentiated text scrolling speeds
is a determining factor in promoting mobile active reading.
Brouillette et al. shed light on the use of an innovative
smartphone-based application for the assessment of cognitive function in the elderly. The aforementioned application was found to be a reliable and valid measure of processing speed and attention in the elderly, although the
relatively small screen of the smartphone should better be
replaced by a tablet device, which combines both larger
screen and higher computing capacity. Furthermore, such
smartphones or tablet-based applications may well be a
useful tool for mastering geriatric populations’ health
interventions through real-time monitoring, assessment
and support.
IV.
PC-BASED APPLICATIONS
Gabriele et al. incorporated a Robotics-based learning
approach to develop adult students’ cognitive/metacognitive skills. Researchers deployed a Robotics kit in
combination with tasks that required students’ develop-
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ment of programming strategies in order to build and
control the robot’s behaviour. Results of the study depict
students’ acquired abilities to analyze problems and select
only the relevant information for the task solution as well
as the stimulation of their problem solving and creative
thinking skills. Finally, students found this project-based
learning approach quite challenging and sociable.
Packiam Alloway et al. used a computerized and standardized tool, the Automated Working Memory Assessment (AWMA) to measure individuals’ with Attention
Deficit Hyperactivity Disorder (ADHD) and individuals’
with specific language impairment (SLI) respective working memory performance in conjunction with specific
cognitive skills. Findings of the study suggest that in both
categories, verbal skills predict verbal-based academic
tests as compared to visuo-spatial skills predicting, likewise, domain-specific academic tests. However, working
memory is differentially linked to learning in ADHD and
SLI without co-morbidity. ADHD participants performed
better in some tasks of verbal abilities, whereas children
with SLI had relative strengths in some nonverbal tasks.
Therefore, in both cases emphasis should be placed on
supporting difficulties in specific cognitive domains so as
to come forth with specific learning gains.
Vugs et al. investigated on working memory performance and executive function behaviors in young children
with specific language impairment (SLI) by using the
validated and standardized test of Automated Working
Memory Assessment. The SLI group had a serious lack in
verbal and visuospatial memory as well as in executive
and attentional control functions. Present findings indicate
the importance of creating detailed profiles of the
strengths and weaknesses of these children in order to
design more personalized learning interventions through
the adoption of simple visual information strategies.
Rute-Pérez et al. present PESCO, a series of computerized and standardized tests as an open-software application for cognitive evaluation and stimulation of the elderly. The aforementioned modules proved valid in terms of
cognitive status assessment as well as in the improvement
of the aging population’s attention, working memory and
planning skills. In continuance to current research, opensource virtual and augmentative reality software, which is
called VIRTRA-EL (Virtual Training for the Elderly) is
currently being developed to offer the means for real-time
supervision and communication between the elderly and
their carers.
Johnson et al. introduce the Social Annotation ModelLearning System (SAM-LS) created to develop students’
reading comprehension, critical thinking and metacognitive skills through the appropriate implementation of
social annotation technology. The study results intensified
of the key role of students’ collaborating with one another
while working with the tool in regards to the formers’
basic comprehension and meta-cognition effect. Further
steps ahead suggest scrutinizing changes in students’ performance in an attempt to advance design and implementation process of the technology tool, thereby inducing its
effectiveness.
Demiris et al. introduce an informatics platform that integrates physiological, functional, cognitive, mental, spiritual and social data in order to assess and visualize of
older adults’ wellness. The researchers’ pilot study verified of its utility and accessibility in addition to creating a
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holistic profile of older adults’ diverse and complex needs.
Studies should broaden their research field in community
based informatics platforms to provide more personalized,
accessible and holistic health care services for older
adults.
Rocha Dores et al. present virtual reality technology in
the neuropsychological assessment and rehabilitation of
people with executive dysfunction due to Acquired Brain
Injury (ABI). The main advantage of the ComputerAssisted Rehabilitation Program – Virtual Reality (CARPVR) stands in its applicability and usability for it can
simulate realistic experiences from distance as if the patient could live his everyday life. This application is immersive and interactive, thus growing patients’ motivation
to take part in the rehabilitation process. It is worthy noticing that virtual reality does not substitute therapists’ role
in the program, as the latest are the coordinators of the
interventions aiming to provide a holistic approach in
patients’ treatment.
V.
GAMES
Lee et al. argue that while attention, memory and executive control functions are substantially improved while
playing video games, any training/learning program
should be largely scrutinized in regards to generalizing on
its brain-mind-behavior effects, assisted by neurofeedback
interaction and formative assessment practices originating
in ICT engineering.
Lee et al. recommend an evaluation method concerning
the potential cognitive and emotional effects of a walking
tangible game. The experiment resulted in the need to
perform long term research in the aforementioned field by
placing extra emphasis on human cognitive components in
setting clearly defined stimuli on experimental tasks. Serious game design effectiveness depends largely on the
participating group’s precise classification as well as on
defining the most adequate characteristics on account of
the application.
Frutos-Pascual et al. point out the role of biofeedback
and serious games techniques as part of a validation protocol, succeeding a cognitive rehabilitation program for
children with ADHD. The aforementioned validation
protocol should hence be adjusted to the respective study
setting and it should be followed by researchers in computer science and other professionals working in this kind
of study validation.
Robert et al. recommend the use of serious games in
Alzheimer patients’ treatment, stimulation and rehabilitation with emphasis on creating game interfaces adapted to
the users’ capacities and interests. Additional strengths of
gaming encompass less stress over assessment processes,
real-time performance measurement and immediate feedback delivery accompanied with home-based skill practice. Interestingly, serious games introduce innovative
ways for social bonding through games with multiple
players physically co-present, or in groups. Moreover, real
life simulation and control of stimuli facilitate rehabilitation purposes of dementia-related disorders. Future studies
should focus on creating and implementing serious games,
specifically targeting the aforementioned populations.
In the study of Redick et al. videogames as cognitive
interventions are related to spatial imagery improvement,
although the transfer effect on spatial ability is rather
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ambiguous due to small sample sizes and inappropriate
experimental control procedures.
Oei et al. deal with the mechanism of transfer in action
videogames (AVGs) training regimes. Perceptual and
attentional skills acquired through repeated playing of a
videogame need to be verified by a specific test, designed
to measure the aforementioned cognitive skills. Furthermore, neuroimaging and working memory training literature also support specific over general transfer effects.
Future research should focus on the specifity of the transfer effects through a quantifiable metric, hence, leading to
adequate training of cognitive skills. The properties to be
taken under consideration in an effective training session
encompass, specifying on an exact set of cognitive skills
as well as the latest’ durability of transfer effects, regardless of subjects’ individual differences.
Oei et al. investigated on the transfer effects in executive functioning as a result of a variety of video games
training, during which complex planning, strategizing and
reframing skills were on demand. Results showed that the
puzzle video game with changing requirements improved
executive functions, considering the large effect sizes for
improvements between pre and post-training. Executing
function improvements attained by respective skills were
underdocumented.
Mc Dermott et al. study on the relation between
memory and action video games. Action video game
players’ (AVGPs) weighting of speed contrary to accuracy
was attributed to the different strategies selected by players in four multiple memory abilities tasks as substantial
evidence on the long-term memory capacity improvement
were insufficient. Nonetheless, speed of processing increased as well as visual short-term memory was enhanced, both related to the common action video game
players’ cognitive demands.
Boot et al. looked into the gamers’ video game experience as a basic factor for improving attention, memory
and executive functions. Although, habitual gamers (experts) outperformed non-gamers in various tasks, the improvement itself was rather insignificant. Researchers
explained that the aforementioned result is related to the
task features as they centred on accuracy over speed. Furthermore, improved performance in cognitive-related
tasks is a complex issue, in which game-specific transfer
effects demand respective game features and strategies.
Shawn Green et al. researched on action video gamers’
task-switching skill. Three experiments took place in
which, task-related goal, features and cognition aspects
were measured. Action video gamers performed better
than non-action video gamers in reducing the switch-cost
between tasks as a result of their training. Although
AVGs’ reaction time, after training, was only marginally
reduced, action video games gradually win grounds on the
aspiring challenge of improving multi-media taskers’ taskswitching abilities.
Akinlofa et al. showed that spatial navigational skills
acquisition and mental representation tasks through gamebased experiences are interrelated issues under the provision of standardized task complexity as well as participant’s spatial orientation ability.
Baniqued et al. deployed casual video games that were
highly correlated with performance on working memory
and reasoning tasks, including across-session adaptive
games for studying on their effectiveness in improving
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cognition. Although young adults’ divided attention skill
was improved, transfer to other cognitive domains, such
as working memory capacity or fluid intelligence was not
observed. Overall, cognitive enhancement seems to be
strongly related to individuals’ being occupied with various and complex in strategy, reasoning games for developing their working memory function and eventually their
problem solving and attention skills. Further research in
the attentional control tasks may specify on the planning
or reasoning abilities that can be observed while performing tasks that demand higher attention skills, thus advancing the transfer of real-life skills.
VI.
ARTIFICIAL INTELLIGENCE
According to Nicholson et al., the WOMBAT (Situational Awareness and Stress Tolerance Test) is an adaptive comprehensive computer-based assessment tool that
allows for the prediction of real-world dynamic decisionmaking performances. More specifically, the WOMBAT
integrates and measures firefighting personnel’s working
memory, visual attention and spatial reasoning skills,
forming their situational awareness, thus predicting the
transfer of their dynamic decision-making performance in
a variety of operational settings and cognitive loads.
Montani et al. designed a trial-by-trial adaptive videogame, the “Labyrinth”, aiming at the cognitive rehabilitation of brain-damaged patients. The adaptive algorithm
maximizes the benefit of the training program, which
captures patients’ both attention and interest. The game’s
principles centre on participants’ attention skill by deploying multi-tasking and task-switching stimuli. Validation
research of the game verified of its capacity to stimulate
subject’s high levels of attention functions, related to
control and flexibility.
Lamb et al. made use of the Serious Educational Games
as part of students’ science learning enhancement. The
authors created a mode of cognitive assessment with an
emphasis on complex cognitive processes through an
Artificial Neural Network, leading to a specific set of
tasks with the aim to address to students’ individual cognitive needs. Furthermore, science curricula and Serious
Game design could be refined in order, first, to
acknowledge students’ varied cognitive skills and second,
to improve the latest’s’ learning effects.
Wetzel et al. present an adaptive model of play against
a computational antagonist over a visuo-spatial strategy
game. Novice player’s psychophysical data, originating
from his eye movements in addition to his strategies in the
whole game are interpreted so as to maintain a satisfying
behavior during play. Test participants experienced low
levels of frustration and higher levels of fun on account of
the fact that they were given a positive reinforcement
through their antagonist’ being able to adapt to their skill
efficacy, thus evoking their personal improvement.
Azeem Abbas et al. adopted two mobile applications,
the first for learning purposes and the second for evaluating young children’s learning gains, originating from the
aforementioned application. OntoCog, a knowledge model
using artificial intelligence for specifying the vocabulary
of terms and their semantics, enhances dynamic content
creation by adding new information to respective user’s
previously stored interlinked contents. CogSkills targeted
at the acquired cognitive skills upon implementation of
the latest application and verified of its potential to build
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on pre-schoolers’ classification, relatedness and memory
skills.
Azeem Abbas et al. propose an intelligent tutoring system (ITS), called MySekolah, which uses knowledge
representation for the creation of dynamic learning contents, both for practicing and evaluating child’s cognitive
skills, such as classification, relatedness, comparison (sequencing, discrimination, size etc.) and reasoning skills.
Navigation among learning contents depends on the assessment results of the child’s solutions. The aforementioned system was found consistent, efficient and effective
in regards to its use and design purposes.
Lancheros-Cuesta et al. make a thorough analysis on
the algorithms and techniques utilized in an adaptive elearning system of a course in order to enhance the learning process for students with mild cognitive disabilities or
learning difficulties. The teacher could assign specific
activities in content and information display to assist the
particular learning process of these students, according to
their respective disabilities, preferences, learning styles,
performance in language, attention and memory aspects.
Future research should be directed to the assessment of
students’ learning pace and performance in the process of
prioritizing the adaptation variables for addressing diverse
and mild cognitive disabilities.
Whent et al. initiate an online model that uses a data
warehouse of relevant data sources in order to screen and
thus, provide additional support towards students’ cognitive development. The model compares children’s performance in approximately 100 video games and in similar
comparison groups, according to age, ethnic background,
social background and learning or physical level. The data
integration algorithm is constructed based on games data
and children’s cognitive data in the fields of auditory
processing, visual processing, sequential/rational processing, conceptual/abstract processing, speed and executive functioning skills. Remediation could be centered on
children’s cognitive weaknesses in the form of playing
more in-target games.
Mandiliotis et al. created an innovative humancomputer interaction (HCI) environment called Symbiosis, which consists of three interconnected modules with
diverse functionalities either for the Patient, the Caregiver
or the Doctor. The aforementioned system provides integrated solutions, forming a holistic approach to a series of
problems related with Alzheimer by taking into account
patients’ needs for improvement in memory, attention,
orientation, visual and space perception skills. In addition,
patients’ frequent monitoring and up to date information
supply as well as caregivers’ psychological support aim to
facilitate professionals’ work efficiency. Ultimately, personalization and multimodal interaction are the main characteristics of Symbiosis.
Video games’ specific transfer effects are extensively
discussed in this review as their measurement or durability
in real-life contexts is still questioned. More specifically,
attention, perception, memory and executive functions and
their relation to video games are under examination,
aimed to address the needs of rehabilitation programs for
people with dementia or children with Attention Deficit
Hyperactivity Disorder (ADHD).
Artificial intelligence-based rehabilitation and training
programs leverage individuals’ cognitive skills, such as
attention, memory, classification, relatedness, comparison
and reasoning skills largely through their adaptability and
personalization features. Users’ motivation and interest
originate from the fact that the tasks or games provided
are cognitively stimulating and demand strategic thinking
as well as they adapt to users’ psychological data.
Mobiles are outperformed by tablets in the field of cognitive assessment for the elderly, whereas in the reading
comprehension process, text scrolling speeds were found
significant for mobile active reading.
Web-based application, such as students’ high level
cognitive processing tasks, concept-mapping tools and
scaffoldings are some cognitive interventions leading to
learning gains, whereas videoconferences and online
modules serve as demented patients’ cognitive stimulants.
Therefore, ICTs implementation in the assessment and
treatment of cognitive skills is attributed to the formers’
usefulness, flexibility and users’ perceived stimulation,
mainly through their adaptable and personalized features.
Attention, memory and executive functions are supported
by interactive, collaborating and immersive applications,
especially video games in conjunction with artificial intelligence. Artificial intelligence either in video games, mobiles or other pc-based systems, improve users’ learning
potential or treatment progress through motivating and
realistic experiences as well as through integrative information processes. Finally, ICTs offer their assistance to
caregivers, educators and medical staff and do not substitute them as the former enhance communication and interactivity, thus promoting holistic and cost-effective interventions.
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AUTHORS
A. Drigas is with N.C.S.R. ‘Demokritos’, Institute of
Informatics and Telecommunications, Telecoms Lab - Net
Media Lab, Agia Paraskevi, 153 10, Athens, Greece ( email: dr@iit.demokritos.gr)
M. Karyotaki is with N.C.S.R. ‘Demokritos’, Institute
of Informatics and Telecommunications, Telecoms Lab Net Media Lab, Agia Paraskevi, 153 10, Athens, Greece
(e-mail: karyotakimaria@gmail.com)
Submitted 30 December 2014. Published as resubmitted by the authors 10 March 2015.
http://www.i-joe.org