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Hafid A, Gunnarsson E, Ramos A, Rödby K, Abtahi F, Bamidis PD, Billis A, Papachristou P, Seoane F. Sensorized T-Shirt with Intarsia-Knitted Conductive Textile Integrated Interconnections: Performance Assessment of Cardiac Measurements during Daily Living Activities. SENSORS (BASEL, SWITZERLAND) 2023; 23:9208. [PMID: 38005593 PMCID: PMC10675781 DOI: 10.3390/s23229208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
The development of smart wearable solutions for monitoring daily life health status is increasingly popular, with chest straps and wristbands being predominant. This study introduces a novel sensorized T-shirt design with textile electrodes connected via a knitting technique to a Movesense device. We aimed to investigate the impact of stationary and movement actions on electrocardiography (ECG) and heart rate (HR) measurements using our sensorized T-shirt. Various activities of daily living (ADLs), including sitting, standing, walking, and mopping, were evaluated by comparing our T-shirt with a commercial chest strap. Our findings demonstrate measurement equivalence across ADLs, regardless of the sensing approach. By comparing ECG and HR measurements, we gained valuable insights into the influence of physical activity on sensorized T-shirt development for monitoring. Notably, the ECG signals exhibited remarkable similarity between our sensorized T-shirt and the chest strap, with closely aligned HR distributions during both stationary and movement actions. The average mean absolute percentage error was below 3%, affirming the agreement between the two solutions. These findings underscore the robustness and accuracy of our sensorized T-shirt in monitoring ECG and HR during diverse ADLs, emphasizing the significance of considering physical activity in cardiovascular monitoring research and the development of personal health applications.
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Affiliation(s)
- Abdelakram Hafid
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
- School of Innovation, Design and Engineering, Mälardalen University, 722 20 Västerås, Sweden
| | - Emanuel Gunnarsson
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
| | - Alberto Ramos
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
- UDIT—University of Design, Innovation and Technology, 28016 Madrid, Spain
| | - Kristian Rödby
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
| | - Farhad Abtahi
- Institute for Clinical Science, Intervention and Technology, Karolinska Institutet, 141 83 Stockholm, Sweden;
- Department of Medical Care Technology, Karolinska University Hospital, 141 57 Huddinge, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, 141 57 Huddinge, Sweden
| | - Panagiotis D. Bamidis
- Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (P.D.B.); (A.B.)
| | - Antonis Billis
- Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (P.D.B.); (A.B.)
| | - Panagiotis Papachristou
- Academic Primary Health Care Center, Region Stockholm, 104 31 Stockholm, Sweden;
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden
| | - Fernando Seoane
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
- Institute for Clinical Science, Intervention and Technology, Karolinska Institutet, 141 83 Stockholm, Sweden;
- Department of Medical Care Technology, Karolinska University Hospital, 141 57 Huddinge, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, 141 57 Huddinge, Sweden
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Bollepalli SC, Sevakula RK, Au-Yeung WTM, Kassab MB, Merchant FM, Bazoukis G, Boyer R, Isselbacher EM, Armoundas AA. Real-Time Arrhythmia Detection Using Hybrid Convolutional Neural Networks. J Am Heart Assoc 2021; 10:e023222. [PMID: 34854319 PMCID: PMC9075394 DOI: 10.1161/jaha.121.023222] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Accurate detection of arrhythmic events in the intensive care units (ICU) is of paramount significance in providing timely care. However, traditional ICU monitors generate a high rate of false alarms causing alarm fatigue. In this work, we develop an algorithm to improve life threatening arrhythmia detection in the ICUs using a deep learning approach. Methods and Results This study involves a total of 953 independent life-threatening arrhythmia alarms generated from the ICU bedside monitors of 410 patients. Specifically, we used the ECG (4 channels), arterial blood pressure, and photoplethysmograph signals to accurately detect the onset and offset of various arrhythmias, without prior knowledge of the alarm type. We used a hybrid convolutional neural network based classifier that fuses traditional handcrafted features with features automatically learned using convolutional neural networks. Further, the proposed architecture remains flexible to be adapted to various arrhythmic conditions as well as multiple physiological signals. Our hybrid- convolutional neural network approach achieved superior performance compared with methods which only used convolutional neural network. We evaluated our algorithm using 5-fold cross-validation for 5 times and obtained an accuracy of 87.5%±0.5%, and a score of 81%±0.9%. Independent evaluation of our algorithm on the publicly available PhysioNet 2015 Challenge database resulted in overall classification accuracy and score of 93.9% and 84.3%, respectively, indicating its efficacy and generalizability. Conclusions Our method accurately detects multiple arrhythmic conditions. Suitable translation of our algorithm may significantly improve the quality of care in ICUs by reducing the burden of false alarms.
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Affiliation(s)
| | - Rahul K Sevakula
- Cardiovascular Research Center Massachusetts General Hospital Boston MA
| | | | - Mohamad B Kassab
- Cardiovascular Research Center Massachusetts General Hospital Boston MA
| | | | - George Bazoukis
- Second Department of Cardiology Evangelismos General Hospital of Athens Athens Greece
| | - Richard Boyer
- Anesthesia Department Massachusetts General Hospital Boston MA
| | | | - Antonis A Armoundas
- Cardiovascular Research Center Massachusetts General Hospital Boston MA.,Institute for Medical Engineering and Science Massachusetts Institute of Technology Cambridge MA
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Castelyn G, Laranjo L, Schreier G, Gallego B. Predictive performance and impact of algorithms in remote monitoring of chronic conditions: A systematic review and meta-analysis. Int J Med Inform 2021; 156:104620. [PMID: 34700194 DOI: 10.1016/j.ijmedinf.2021.104620] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/27/2021] [Accepted: 10/09/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND The use of telehealth interventions, such as the remote monitoring of patient clinical data (e.g. blood pressure, blood glucose, heart rate, medication use), has been proposed as a strategy to better manage chronic conditions and to reduce the impact on patients and healthcare systems. The use of algorithms for data acquisition, analysis, transmission, communication and visualisation are now common in remote patient monitoring. However, their use and impact on chronic disease management has not been systematically investigated. OBJECTIVES To investigate the use, impact, and performance of remote monitoring algorithms across various types of chronic conditions. METHODS A literature search of MEDLINE complete, CINHAL complete, and EMBASE was performed using search terms relating to the concepts of remote monitoring, chronic conditions, and data processing algorithms. Comparable outcomes from studies describing the impact on process measures and clinical and patient-reported outcomes were pooled for a summary effect and meta-analyses. A comparison of studies reporting the predictive performance of algorithms was also conducted using the Youden Index. RESULTS A total of 89 articles were included in the review. There was no evidence of a positive impact on healthcare utilisation [OR 1.09 (0.90 to 1.31); P = .35] and mortality [OR 0.83 (0.63 to 1.10); P = .208], but there was a positive effect on generic health status [SDM 0.2912 (0.06 to 0.51); P = .010] and diabetes control [SDM -0.53 (-0.74 to -0.33); P < .001; I2 = 15.71] (with two of the three diabetes studies being identified as having a high risk of bias). While the majority of impact studies made use of heuristic threshold-based algorithms (n = 27,87%), most performance studies (n = 36, 62%) analysed non-sequential machine learning methods. There was considerable variance in the quality, sample size and performance amongst these studies. Overall, algorithms involved in diagnosis (n = 22, 47%) had superior performance to those involved in predicting a future event (n = 25, 53%). Detection of arrythmia and ischaemia utilising ECG data showed particularly promising results. CONCLUSION The performance of data processing algorithms for the diagnosis of a current condition, particularly those related to the detection of arrythmia and ischaemia, is promising. However, there appears to exist minimal testing in experimental studies, with only two included impact studies citing a performance study as support for the intervention algorithm used. Because of the disconnect between performance and impact studies, there is currently limited evidence of the effect of integrating advanced inference algorithms in remote monitoring interventions. If the field of remote patient monitoring is to progress, future impact studies should address this disconnect by evaluating high performance validated algorithms in robust clinical trials.
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Affiliation(s)
| | - Liliana Laranjo
- Westmead Applied Research Centre, Sydney Medical School, The University of Sydney, Sydney, Australia; NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.
| | - Günter Schreier
- Digital Health Information Systems, Center for Health and Bioresources, AIT Austrian Institute of Technology GmbH, Graz, Austria.
| | - Blanca Gallego
- Centre for Big Data Research in Health (CBDRH), Faculty of Medicine & Health, University of New South Wales, Sydney, Australia.
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Comparison of machine learning classifiers: A case study of temperature alarms in a pharmaceutical supply chain. INFORM SYST 2021. [DOI: 10.1016/j.is.2021.101759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Zhu Z, Li J, Zhang S, Geng N, Xu L, Greenwald SE. Quality evaluation of signals collected by portable ECG devices using dimensionality reduction and flexible model integration. Physiol Meas 2020; 41:105001. [PMID: 32947264 DOI: 10.1088/1361-6579/abba0b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Portable devices for collecting electrocardiograms (ECGs) and telemedicine systems for diagnosis are available to residents in deprived areas, but ECGs collected by non-professionals are not necessarily reliable and may impair the accuracy of diagnosis. We propose an algorithm for accurate ECG quality assessment, which can help improve the reliability of ECGs collected by portable devices. APPROACH Using challenge data from CinC (2019), signals were classified as 'acceptable' and 'unacceptable' by annotators. The training set contained 998 12-lead ECGs and the test set contained 500. A 998 × 84 feature matrix, S, was formed by feature extraction and three basic models were obtained through training SVM, DT and NBC on S. The feature subsets S1, S2 and S3 were obtained by dimensionality reduction on S using SVM, DT and NBC, respectively. Three other basic models were obtained through training SVM on S1, DT on S2 and NBC on S3. By combining these six basic models, several integrated models were formed. An iterative method was proposed to select the integrated model with the highest accuracy on the training set. Having compared differences between the output labels and the original data labels, evaluation criteria were calculated. MAIN RESULTS An accuracy of 98.70% and 98.60% was achieved on the training and test datasets, respectively. High F1 score and Kappa values were also obtained. SIGNIFICANCE The proposed algorithm has advantages over previously reported approaches during automatic assessment of ECG quality and can thus help to reduce reliance on highly trained professionals when assessing the quality of ECGs.
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Affiliation(s)
- Zeyang Zhu
- Collage of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110819, Liaoning, People's Republic of China
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Biswas M, Levy A, Weber R, Tarakji K, Chung M, Noseworthy PA, Newton-Cheh C, Rosenberg MA. Multicenter Analysis of Dosing Protocols for Sotalol Initiation. J Cardiovasc Pharmacol Ther 2019; 25:212-218. [PMID: 31707834 DOI: 10.1177/1074248419887710] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Sotalol, a Vaughan-Williams Class III antiarrhythmic medication, is used to manage atrial arrhythmias. Due to its QT-prolonging effect and subsequent increased risk of torsade de pointes, many centers admit patients during the initial dosing period. Despite its widespread use, little information is available regarding dosing protocols during this period. In this multicenter investigation, dosing protocols in patients initiating sotalol therapy were examined to identify predictors of successful sotalol initiation. Over a 4-year period, patients admitted to 5 hospitals in the United States for inpatient telemetry monitoring during initiation for nonresearch purposes were enrolled. A 3-day course of 5 of 6 doses of sotalol was considered successful completion of the loading protocol. Of the 213 enrolled patients, over 90% were successfully discharged on sotalol. Significant bradycardia, ineffectiveness, and excessive QT prolongation were reasons for failed completion. Absence of a dose adjustment was a strong predictor of successful initiation (odds ratio: 6.6, 95% confidence interval: 1.3-32.7, P = .02). Hypertension, use of a calcium channel blocker, use of a separate β-blocker, and presence of a pacemaker were predictors of dose adjustments. Marginal structural models (ie, inverse probability weighting based on probability of a dose adjustment) verified that these factors also predicted successful initiation via preventing any dose adjustment and suggests that considering these factors may result in a higher likelihood of successful initiation in future investigations. In conclusion, we found that the majority of patients admitted for sotalol initiation are successfully discharged on the medication. The study findings suggest that factors predicting need for dose adjustment can be used to identify patients who could undergo outpatient initiation. Prospective studies are needed to verify this approach.
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Affiliation(s)
- Minakshi Biswas
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Andrew Levy
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rachel Weber
- Division of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA
| | - Khaldoun Tarakji
- Center for Atrial Fibrillation, Section of Cardiac Pacing and Electrophysiology, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Mina Chung
- Center for Atrial Fibrillation, Section of Cardiac Pacing and Electrophysiology, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Peter A Noseworthy
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Christopher Newton-Cheh
- Cardiovascular Research Center, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Michael A Rosenberg
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Realization and Technology Acceptance Test of a Wearable Cardiac Health Monitoring and Early Warning System with Multi-Channel MCGs and ECG. SENSORS 2018; 18:s18103538. [PMID: 30347695 PMCID: PMC6210769 DOI: 10.3390/s18103538] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/03/2022]
Abstract
In this work, a wearable smart clothing system for cardiac health monitoring with a multi-channel mechanocardiogram (MCG) has been developed to predict the myo-cardiac left ventricular ejection fraction (LVEF) function and to provide early risk warnings to the subjects. In this paper, the realization of the core of this system, i.e., the Cardiac Health Assessment and Monitoring Platform (CHAMP), with respect to its hardware, firmware, and wireless design features, is presented. The feature values from the CHAMP system have been correlated with myo-cardiac functions obtained from actual heart failure (HF) patients. The usability of this MCG-based cardiac health monitoring smart clothing system has also been evaluated with technology acceptance model (TAM) analysis and the results indicate that the subject shows a positive attitude toward using this wearable MCG-based cardiac health monitoring and early warning system.
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8
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PCA weight and Johnson transformation based alarm threshold optimization in chemical processes. Chin J Chem Eng 2018. [DOI: 10.1016/j.cjche.2017.10.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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On the Design of an Efficient Cardiac Health Monitoring System Through Combined Analysis of ECG and SCG Signals. SENSORS 2018; 18:s18020379. [PMID: 29382098 PMCID: PMC5856087 DOI: 10.3390/s18020379] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/21/2018] [Accepted: 01/24/2018] [Indexed: 12/17/2022]
Abstract
Cardiovascular disease (CVD) is a major public concern and socioeconomic problem across the globe. The popular high-end cardiac health monitoring systems such as magnetic resonance imaging (MRI), computerized tomography scan (CT scan), and echocardiography (Echo) are highly expensive and do not support long-term continuous monitoring of patients without disrupting their activities of daily living (ADL). In this paper, the continuous and non-invasive cardiac health monitoring using unobtrusive sensors is explored aiming to provide a feasible and low-cost alternative to foresee possible cardiac anomalies in an early stage. It is learned that cardiac health monitoring based on sole usage of electrocardiogram (ECG) signals may not provide powerful insights as ECG provides shallow information on various cardiac activities in the form of electrical impulses only. Hence, a novel low-cost, non-invasive seismocardiogram (SCG) signal along with ECG signals are jointly investigated for the robust cardiac health monitoring. For this purpose, the in-laboratory data collection model is designed for simultaneous acquisition of ECG and SCG signals followed by mechanisms for the automatic delineation of relevant feature points in acquired ECG and SCG signals. In addition, separate feature points based novel approach is adopted to distinguish between normal and abnormal morphology in each ECG and SCG cardiac cycle. Finally, a combined analysis of ECG and SCG is carried out by designing a Naïve Bayes conditional probability model. Experiments on Institutional Review Board (IRB) approved licensed ECG/SCG signals acquired from real subjects containing 12,000 cardiac cycles show that the proposed feature point delineation mechanisms and abnormal morphology detection methods consistently perform well and give promising results. In addition, experimental results show that the combined analysis of ECG and SCG signals provide more reliable cardiac health monitoring compared to the standalone use of ECG and SCG.
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Jafari Tadi M, Lehtonen E, Hurnanen T, Koskinen J, Eriksson J, Pänkäälä M, Teräs M, Koivisto T. A real-time approach for heart rate monitoring using a Hilbert transform in seismocardiograms. Physiol Meas 2016; 37:1885-1909. [PMID: 27681033 DOI: 10.1088/0967-3334/37/11/1885] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Heart rate monitoring helps in assessing the functionality and condition of the cardiovascular system. We present a new real-time applicable approach for estimating beat-to-beat time intervals and heart rate in seismocardiograms acquired from a tri-axial microelectromechanical accelerometer. Seismocardiography (SCG) is a non-invasive method for heart monitoring which measures the mechanical activity of the heart. Measuring true beat-to-beat time intervals from SCG could be used for monitoring of the heart rhythm, for heart rate variability analysis and for many other clinical applications. In this paper we present the Hilbert adaptive beat identification technique for the detection of heartbeat timings and inter-beat time intervals in SCG from healthy volunteers in three different positions, i.e. supine, left and right recumbent. Our method is electrocardiogram (ECG) independent, as it does not require any ECG fiducial points to estimate the beat-to-beat intervals. The performance of the algorithm was tested against standard ECG measurements. The average true positive rate, positive prediction value and detection error rate for the different positions were, respectively, supine (95.8%, 96.0% and ≃0.6%), left (99.3%, 98.8% and ≃0.001%) and right (99.53%, 99.3% and ≃0.01%). High correlation and agreement was observed between SCG and ECG inter-beat intervals (r > 0.99) for all positions, which highlights the capability of the algorithm for SCG heart monitoring from different positions. Additionally, we demonstrate the applicability of the proposed method in smartphone based SCG. In conclusion, the proposed algorithm can be used for real-time continuous unobtrusive cardiac monitoring, smartphone cardiography, and in wearable devices aimed at health and well-being applications.
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Affiliation(s)
- Mojtaba Jafari Tadi
- Department of Cardiology and Cardiovascular Medicine, Faculty of Medicine, University of Turku, Finland. Technology Research Center, University of Turku, Turku, Finland
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