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  1. Article ; Online: The Impact of Cognition on Motor Learning and Skill Acquisition Using a Robot Intervention in Infants With Cerebral Palsy.

    Chandrashekhar, Raghuveer / Wang, Hongwu / Rippetoe, Josiah / James, Shirley A / Fagg, Andrew H / Kolobe, Thubi H A

    Frontiers in robotics and AI

    2022  Volume 9, Page(s) 805258

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2022-02-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2781824-X
    ISSN 2296-9144 ; 2296-9144
    ISSN (online) 2296-9144
    ISSN 2296-9144
    DOI 10.3389/frobt.2022.805258
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  2. Article: Locomotor learning in infants at high risk for cerebral palsy: A study protocol.

    Prosser, Laura A / Skorup, Julie / Pierce, Samuel R / Jawad, Abbas F / Fagg, Andrew H / Kolobe, Thubi H A / Smith, Beth A

    Frontiers in pediatrics

    2023  Volume 11, Page(s) 891633

    Abstract: Background: Physical disability in individuals with cerebral palsy (CP) creates lifelong mobility challenges and healthcare costs. Despite this, very little is known about how infants at high risk for CP learn to move and acquire early locomotor skills, ...

    Abstract Background: Physical disability in individuals with cerebral palsy (CP) creates lifelong mobility challenges and healthcare costs. Despite this, very little is known about how infants at high risk for CP learn to move and acquire early locomotor skills, which set the foundation for lifelong mobility. The objective of this project is to characterize the evolution of locomotor learning over the first 18 months of life in infants at high risk for CP. To characterize how locomotor skill is learned, we will use robotic and sensor technology to provide intervention and longitudinally study infant movement across three stages of the development of human motor control: early spontaneous movement, prone locomotion (crawling), and upright locomotion (walking).
    Study design: This longitudinal observational/intervention cohort study (ClinicalTrials.gov Identifier: NCT04561232) will enroll sixty participants who are at risk for CP due to a brain injury by one month post-term age. Study participation will be completed by 18 months of age. Early spontaneous leg movements will be measured monthly from 1 to 4 months of age using inertial sensors worn on the ankles for two full days each month. Infants who remain at high risk for CP at 4 months of age, as determined from clinical assessments of motor function and movement quality, will continue through two locomotor training phases. Prone locomotor training will be delivered from 5 to 9 months of age using a robotic crawl training device that responds to infant behavior in real-time. Upright locomotor training will be delivered from 9 to 18 months of age using a dynamic weight support system to allow participants to practice skills beyond their current level of function. Repeated assessments of locomotor skill, training characteristics (such as movement error, variability, movement time and postural control), and variables that may mediate locomotor learning will be collected every two months during prone training and every three months during upright training.
    Discussion: This study will develop predictive models of locomotor skill acquisition over time. We hypothesize that experiencing and correcting movement errors is critical to skill acquisition in infants at risk for CP and that locomotor learning is mediated by neurobehavioral factors outside of training.
    Language English
    Publishing date 2023-02-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2023.891633
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  3. Article ; Online: Robot Reinforcement and Error-Based Movement Learning in Infants With and Without Cerebral Palsy.

    Kolobe, Thubi H A / Fagg, Andrew H

    Physical therapy

    2019  Volume 99, Issue 6, Page(s) 677–688

    Abstract: Background: Prone mobility, central to development of diverse psychological and social processes that have lasting effects on life participation, is seldom attained by infants with cerebral palsy (CP) and has no tested interventions. Reinforcement ... ...

    Abstract Background: Prone mobility, central to development of diverse psychological and social processes that have lasting effects on life participation, is seldom attained by infants with cerebral palsy (CP) and has no tested interventions. Reinforcement learning (RL) and error-based movement learning (EBL) offer novel intervention possibilities.
    Objective: This study examined movement learning strategies in infants with or at risk for CP using RL and EBL during acquisition of prone locomotion.
    Design: The study was a randomized trial that used repeated measures.
    Setting: The study setting was a university physical therapy clinic in the United States.
    Patients: Thirty infants aged 4.5 to 6.5 months participated in the study: 24 had or were at risk for CP, and 6 were typically developing.
    Intervention: Infants with and at risk for CP were randomly assigned to a combination of RL and EBL (SIPPC-RE), or RL only (SIPPC-R) conditions. Infants with typical development comprised the RL-only reference group (SIPPC-TD). Infants trained in prone locomotion with the Self-Initiated Prone Progression Crawler (SIPPC) robotic system for three 5-minute trials, twice a week for 12 weeks in their homes or child care. All training sessions were videotaped for behavioral coding.
    Measurements: The SIPPC gathered robot and infant trunk/limb movement data. Randomized 2-way analysis of variance with repeated measures and Pearson r to analyze the data was used.
    Results: Results included the number of arm movements and trial-and-error activity distinguished between the SIPPC-RE and SIPPC-R groups. The mean change in arm movements from baseline for the SIPPC-RE and SIPPC-R groups was 4.8 m and -7.0 m, respectively. The mean differences in rotational amplitude (trial and error) from baseline to the end of the study were 278 degrees and 501 degrees, respectively. These changes were correlated with distance traveled and goal-directed movements. The latter increased over the 12 weeks for the SIPPC-RE and SIPPC-TD groups, but not the SIPPC-R group.
    Limitations: The CP groups were unequal due to reassignment and did not include a typically developing comparison group of a combination of RL and EBL.
    Conclusion: These findings suggest movement learning and retention in infants with CP is differentially affected by the use of RL and EBL, with a combination of both showing more promise than RL alone. The findings also implicate cognition, type of brain insult, emergence of reaching, and muscle force production, which must be explored in future studies.
    MeSH term(s) Cerebral Palsy/rehabilitation ; Child Development/physiology ; Female ; Humans ; Infant ; Male ; Movement/physiology ; Muscle, Skeletal/physiology ; Prone Position/physiology ; Robotics/methods
    Language English
    Publishing date 2019-06-24
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 415886-6
    ISSN 1538-6724 ; 0031-9023
    ISSN (online) 1538-6724
    ISSN 0031-9023
    DOI 10.1093/ptj/pzz043
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  4. Article ; Online: Comparing Temporospatial Performance During Brisk and Self-Paced Walking by Men With Osteomyoplastic Transfemoral Amputation and Controls Using Pressure and Muscle Activation Peak Times.

    Shotande, Monique O / Veirs, Kimberly P / Day, Jonathan D / Ertl, William J J / Fagg, Andrew H / Dionne, Carol P

    Frontiers in rehabilitation sciences

    2022  Volume 3, Page(s) 848657

    Abstract: Background: The aim of osteomyoplastic transfemoral amputation (OTFA) is to produce sustained, robust prosthetic gait performance by residuum reconstructing. A better understanding of residuum-socket interface pressures (RSI) and residuum muscle ... ...

    Abstract Background: The aim of osteomyoplastic transfemoral amputation (OTFA) is to produce sustained, robust prosthetic gait performance by residuum reconstructing. A better understanding of residuum-socket interface pressures (RSI) and residuum muscle activation should uniquely reveal gait stability to better inform long-term rehabilitation goals.
    Objectives: The objectives of this study are to characterize RSI pressures and residuum muscle activation in men with OTFA while walking at two speeds and compare temporospatial muscle activation with intact controls.
    Methods: In this study, we observed and compared healthy men with OTFA and controls during 2-min gait trials at brisk and self-paced speeds, two visits, and 1 year apart. RSI pressures and hip adductors, hamstrings, and quadriceps activation were recorded for those with OTFA. OTFA temporospatial muscle activation patterns were compared with the controls. Within the extracted strides, heel-strike and toe-off events and EMG activation peak times were characterized and compared. Peak times for pressure and EMG activity were examined in individual muscles and antagonist muscles of residual and intact limbs.
    Results: Six men with OTFA exhibited adductor, hamstring, and quadriceps co-contraction within intact and residual limbs, regardless of walking speed or trial. Co-contraction within their intact limb occurred throughout the gait cycle. Within the residuum, co-contraction occurred during weight transference. The 75% most likely RSI peaks occurred during stance. EMG peaks were 75% most likely to occur during early stance, terminal stance-initial swing, and terminal swing.
    Conclusion: Participants with OTFA demonstrated adductors-hamstrings-quadriceps co-contraction in the intact thigh and residuum with corresponding RSI pressure increase, primarily during transitions between stance and swing, indicating gait instability, demonstrating the need to explicitly address these deficits continuously in rehabilitation and wellness settings.
    Language English
    Publishing date 2022-05-06
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-6861
    ISSN (online) 2673-6861
    DOI 10.3389/fresc.2022.848657
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  5. Article: Applications of Biomechanical Foot Models to Evaluate Dance Movements Using Three-Dimensional Motion Capture: A Review of the Literature.

    Veirs, Kimberly P / Fagg, Andrew H / Haleem, Amgad M / Jeffries, Lynn M / Randall, Ken / Sisson, Susan B / Dionne, Carol P

    Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science

    2022  Volume 26, Issue 2, Page(s) 69–86

    Abstract: Dance movement requires excessive, repetitive range of motion (ROM) at the foot-ankle complex, possibly contributing to the high rate of injury among dancers. However, we know little about foot biomechanics during dance movements. Researchers are using ... ...

    Abstract Dance movement requires excessive, repetitive range of motion (ROM) at the foot-ankle complex, possibly contributing to the high rate of injury among dancers. However, we know little about foot biomechanics during dance movements. Researchers are using three-dimensional (3D) motion capture systems to study the in vivo kinematics of joint segments more frequently in dance-medicine research, warranting a literature review and quality assessment evaluation. The purpose of this literature review was to identify and evaluate studies that used 3D motion capture to analyze in vivo biomechanics of the foot and ankle for a cohort of dancers during dance-specific movement. Three databases (PubMed, Ovid MEDLINE, CINAHL) were accessed along with hand searches of dance-specific journals to identify relevant articles through March 2020. Using specific selection criteria, 25 studies were identified. Fifteen studies used single-segment biomechanical foot models originally created to study gait, four used a novel two-segment model, and six utilized a multi-seg- ment foot model. Nine of the studies referenced common and frequently published gait marker sets and four used a dance-specific biomechanical model with purposefully designed foot segments to analyze the dancers' foot and ankle. Description of the biomechanical models varied, reducing the reproducibility of the models and protocols. Investigators concluded that there is little evidence that the extreme total, segmental, and inter-segmental foot and ankle ROM exerted by dancers are being evaluated during dance-specific movements using 3D motion capture. Findings suggest that 3D motion capture is a robust measurement tool that has the capability to assist researchers in evaluating the in vivo, inter-segmental motion of the foot and ankle to potentially discover many of the remaining significant factors predisposing dancers to injury. The literature review synthesis is presented with recommendations for consideration when evaluating results from studies that utilized a 3D biomechanical foot model to evaluate dance-specific movement.
    MeSH term(s) Ankle Joint ; Biomechanical Phenomena ; Dancing/injuries ; Humans ; Movement ; Range of Motion, Articular ; Reproducibility of Results
    Language English
    Publishing date 2022-03-15
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 1089-313X
    ISSN 1089-313X
    DOI 10.12678/1089-313X.061522a
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  6. Article ; Online: The Impact of Cognition on Motor Learning and Skill Acquisition Using a Robot Intervention in Infants With Cerebral Palsy

    Raghuveer Chandrashekhar / Hongwu Wang / Josiah Rippetoe / Shirley A. James / Andrew H. Fagg / Thubi H. A. Kolobe

    Frontiers in Robotics and AI, Vol

    2022  Volume 9

    Abstract: Background: Cerebral Palsy (CP) is a neurodevelopmental disorder that encompasses multiple neurological disorders that appear in infancy or early childhood and persist through the lifespan of the individual. Early interventions for infants with CP ... ...

    Abstract Background: Cerebral Palsy (CP) is a neurodevelopmental disorder that encompasses multiple neurological disorders that appear in infancy or early childhood and persist through the lifespan of the individual. Early interventions for infants with CP utilizing assisted-motion robotic devices have shown promising effects in rehabilitation of the motor function skills. The impact of cognitive function during motor learning and skill acquisition in infants using robotic technologies is unclear.Purpose: To assess the impact of cognitive function of infants with and without CP on their motor learning using the Self-Initiated Prone Progression Crawler (SIPPC) robot.Methods: Statistical analysis was conducted on the data obtained from a randomized control trial in which the movement learning strategies in infants with or at risk for CP was assessed during a 16-week SIPPC robot intervention. Cognitive function was measured by the Bayley scales of Infant and Toddler Development–Third edition (Bayley-III) and motor function was measured by the Movement Observation Coding Scheme (MOCS). The infants were categorized into three distinct groups based on their cognitive scores at baseline: “above average” (n1 = 11), “below average” (n2 = 10), and “average” (n3 = 26). Tri-weekly averages of the MOCS scores (observations at five time points) were used for the analyses. This study involved computing descriptive statistics, data visualization, repeated measures analysis of variances (rmANOVA), and survival analyses.Results: The descriptive statistics were calculated for the MOCS and Bayley III scores. The repeated measures ANOVAs revealed that there was a statistically significant effect of time (p < 0.0001) on scores of all subscales of the MOCS. A statistically significant effect of interaction between group and time (p < 0.05) was found in MOCS scores of subscales 1 and 2. The survival analyses indicated that infants in different cognition groups significantly differed (p < 0.0001) in their ability to achieve the crawling ...
    Keywords cognition ; robot ; human robot interaction interface ; motor learning ; cerebral palsy ; Mechanical engineering and machinery ; TJ1-1570 ; Electronic computers. Computer science ; QA75.5-76.95
    Subject code 629
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
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  7. Article ; Online: Utility of machine learning algorithms in degenerative cervical and lumbar spine disease: a systematic review.

    Stephens, Mark E / O'Neal, Christen M / Westrup, Alison M / Muhammad, Fauziyya Y / McKenzie, Daniel M / Fagg, Andrew H / Smith, Zachary A

    Neurosurgical review

    2021  Volume 45, Issue 2, Page(s) 965–978

    Abstract: Machine learning is a rapidly evolving field that offers physicians an innovative and comprehensive mechanism to examine various aspects of patient data. Cervical and lumbar degenerative spine disorders are commonly age-related disease processes that can ...

    Abstract Machine learning is a rapidly evolving field that offers physicians an innovative and comprehensive mechanism to examine various aspects of patient data. Cervical and lumbar degenerative spine disorders are commonly age-related disease processes that can utilize machine learning to improve patient outcomes with careful patient selection and intervention. The aim of this study is to examine the current applications of machine learning in cervical and lumbar degenerative spine disease. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of PubMed, Embase, Medline, and Cochrane was conducted through May 31st, 2020, using the following terms: "artificial intelligence" OR "machine learning" AND "neurosurgery" AND "spine." Studies were included if original research on machine learning was utilized in patient care for degenerative spine disease, including radiographic machine learning applications. Studies focusing on robotic applications in neurosurgery, navigation, or stereotactic radiosurgery were excluded. The literature search identified 296 papers, with 35 articles meeting inclusion criteria. There were nine studies involving cervical degenerative spine disease and 26 studies on lumbar degenerative spine disease. The majority of studies for both cervical and lumbar spines utilized machine learning for the prediction of postoperative outcomes, with 5 (55.6%) and 15 (61.5%) studies, respectively. Machine learning applications focusing on degenerative lumbar spine greatly outnumber the current volume of cervical spine studies. The current research in lumbar spine also demonstrates more advanced clinical applications of radiographic, diagnostic, and predictive machine learning models.
    MeSH term(s) Algorithms ; Cervical Vertebrae/surgery ; Humans ; Lumbar Vertebrae/surgery ; Machine Learning ; Spinal Diseases/diagnosis ; Spinal Diseases/surgery
    Language English
    Publishing date 2021-09-07
    Publishing country Germany
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 6907-3
    ISSN 1437-2320 ; 0344-5607
    ISSN (online) 1437-2320
    ISSN 0344-5607
    DOI 10.1007/s10143-021-01624-z
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1445: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: Comparing Temporospatial Performance During Brisk and Self-Paced Walking by Men With Osteomyoplastic Transfemoral Amputation and Controls Using Pressure and Muscle Activation Peak Times

    Monique O. Shotande / Kimberly P. Veirs / Jonathan D. Day / William J. J. Ertl / Andrew H. Fagg / Carol P. Dionne

    Frontiers in Rehabilitation Sciences, Vol

    2022  Volume 3

    Abstract: BackgroundThe aim of osteomyoplastic transfemoral amputation (OTFA) is to produce sustained, robust prosthetic gait performance by residuum reconstructing. A better understanding of residuum-socket interface pressures (RSI) and residuum muscle activation ...

    Abstract BackgroundThe aim of osteomyoplastic transfemoral amputation (OTFA) is to produce sustained, robust prosthetic gait performance by residuum reconstructing. A better understanding of residuum-socket interface pressures (RSI) and residuum muscle activation should uniquely reveal gait stability to better inform long-term rehabilitation goals.ObjectivesThe objectives of this study are to characterize RSI pressures and residuum muscle activation in men with OTFA while walking at two speeds and compare temporospatial muscle activation with intact controls.MethodsIn this study, we observed and compared healthy men with OTFA and controls during 2-min gait trials at brisk and self-paced speeds, two visits, and 1 year apart. RSI pressures and hip adductors, hamstrings, and quadriceps activation were recorded for those with OTFA. OTFA temporospatial muscle activation patterns were compared with the controls. Within the extracted strides, heel-strike and toe-off events and EMG activation peak times were characterized and compared. Peak times for pressure and EMG activity were examined in individual muscles and antagonist muscles of residual and intact limbs.ResultsSix men with OTFA exhibited adductor, hamstring, and quadriceps co-contraction within intact and residual limbs, regardless of walking speed or trial. Co-contraction within their intact limb occurred throughout the gait cycle. Within the residuum, co-contraction occurred during weight transference. The 75% most likely RSI peaks occurred during stance. EMG peaks were 75% most likely to occur during early stance, terminal stance-initial swing, and terminal swing.ConclusionParticipants with OTFA demonstrated adductors-hamstrings-quadriceps co-contraction in the intact thigh and residuum with corresponding RSI pressure increase, primarily during transitions between stance and swing, indicating gait instability, demonstrating the need to explicitly address these deficits continuously in rehabilitation and wellness settings.
    Keywords transfemoral osteomyoplastic amputation ; gait cycle ; residuum socket pressures/forces ; electromyography (EMG) ; co-contraction ; Other systems of medicine ; RZ201-999 ; Medical technology ; R855-855.5
    Subject code 796
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: A dual process account of coarticulation in motor skill acquisition.

    Shah, Ashvin / Barto, Andrew G / Fagg, Andrew H

    Journal of motor behavior

    2013  Volume 45, Issue 6, Page(s) 531–549

    Abstract: Many tasks, such as typing a password, are decomposed into a sequence of subtasks that can be accomplished in many ways. Behavior that accomplishes subtasks in ways that are influenced by the overall task is often described as "skilled" and exhibits ... ...

    Abstract Many tasks, such as typing a password, are decomposed into a sequence of subtasks that can be accomplished in many ways. Behavior that accomplishes subtasks in ways that are influenced by the overall task is often described as "skilled" and exhibits coarticulation. Many accounts of coarticulation use search methods that are informed by representations of objectives that define skilled. While they aid in describing the strategies the nervous system may follow, they are computationally complex and may be difficult to attribute to brain structures. Here, the authors present a biologically- inspired account whereby skilled behavior is developed through 2 simple processes: (a) a corrective process that ensures that each subtask is accomplished, but does not do so skillfully and (b) a reinforcement learning process that finds better movements using trial and error search that is not informed by representations of any objectives. We implement our account as a computational model controlling a simulated two-armed kinematic "robot" that must hit a sequence of goals with its hands. Behavior displays coarticulation in terms of which hand was chosen, how the corresponding arm was used, and how the other arm was used, suggesting that the account can participate in the development of skilled behavior.
    MeSH term(s) Biomechanical Phenomena/physiology ; Computer Simulation ; Humans ; Learning/physiology ; Models, Neurological ; Motor Skills/physiology ; Movement/physiology ; Psychomotor Performance/physiology ; Reinforcement (Psychology)
    Language English
    Publishing date 2013
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2066611-1
    ISSN 1940-1027 ; 0022-2895
    ISSN (online) 1940-1027
    ISSN 0022-2895
    DOI 10.1080/00222895.2013.837423
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  10. Article ; Online: Differences in motor cortical representations of kinematic variables between action observation and action execution and implications for brain-machine interfaces.

    Willett, Francis R / Suminski, Aaron J / Fagg, Andrew H / Hatsopoulos, Nicholas G

    Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference

    2015  Volume 2014, Page(s) 1334–1337

    Abstract: Observing an action being performed and executing the same action cause similar patterns of neural activity to emerge in the primary motor cortex (MI). Previous work has shown that the neural activity evoked during action observation (AO) is informative ... ...

    Abstract Observing an action being performed and executing the same action cause similar patterns of neural activity to emerge in the primary motor cortex (MI). Previous work has shown that the neural activity evoked during action observation (AO) is informative as to both the kinematics and muscle activation patterns of the action being performed, although the neural activity recorded during action observation contains less information than the activity recorded during action execution (AE). In this study, we extend these results by comparing the representation of different kinematic variables in MI single /multi unit activity between AO and AE conditions in three rhesus macaques. We show that the representation of acceleration decreases more significantly than that of position and velocity in AO (population decoding performance for acceleration decreases more steeply, and fewer neurons in AO encode acceleration significantly as compared to AE). We discuss the relevance of these results to brain-machine interfaces that make use of neural activity during AO to initialize a mapping function between neural activity and motor commands.
    MeSH term(s) Animals ; Biomechanical Phenomena ; Brain-Computer Interfaces ; Electrodes, Implanted ; Exoskeleton Device ; Macaca mulatta ; Motor Cortex/physiology ; Movement ; Neurons/physiology
    Language English
    Publishing date 2015-01-06
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ISSN 2694-0604
    ISSN (online) 2694-0604
    DOI 10.1109/EMBC.2014.6943845
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