Virtual reality and motor imagery for early post-stroke rehabilitation.

BACKGROUND: Motor impairment is a common consequence of stroke causing difficulty in independent movement. The first month of post-stroke rehabilitation is the most effective period for recovery. Movement imagination, known as motor imagery, in combination with virtual reality may provide a way for stroke patients with severe motor disabilities to begin rehabilitation. METHODS: The aim of this study is to verify whether motor imagery and virtual reality help to activate stroke patients' motor cortex. 16 acute/subacute (< 6 months) stroke patients participated in this study. All participants performed motor imagery of basketball shooting which involved the following tasks: listening to audio instruction only, watching a basketball shooting animation in 3D with audio, and also performing motor imagery afterwards. Electroencephalogram (EEG) was recorded for analysis of motor-related features of the brain such as power spectral analysis in the [Formula: see text] and [Formula: see text] frequency bands and spectral entropy. 18 EEG channels over the motor cortex were used for all stroke patients. RESULTS: All results are normalised relative to all tasks for each participant. The power spectral densities peak near the [Formula: see text] band for all participants and also the [Formula: see text] band for some participants. Tasks with instructions during motor imagery generally show greater power spectral peaks. The p-values of the Wilcoxon signed-rank test for band power comparison from the 18 EEG channels between different pairs of tasks show a 0.01 significance of rejecting the band powers being the same for most tasks done by stroke subjects. The motor cortex of most stroke patients is more active when virtual reality is involved during motor imagery as indicated by their respective scalp maps of band power and spectral entropy. CONCLUSION: The resulting activation of stroke patient's motor cortices in this study reveals evidence that it is induced by imagination of movement and virtual reality supports motor imagery. The framework of the current study also provides an efficient way to investigate motor imagery and virtual reality during post-stroke rehabilitation.

The effects of dynamic motion instability system training on motor function and balance after stroke: A randomized trial.

BACKGROUND: The balance and postural control of humans is related to the coordination of dynamic perception and movement. Multiple senses, such as vision, vestibular sense, proprioception, and/or a single sensory disorder, would lead to its integration disorder and induce imbalance and abnormal gait. OBJECTIVE: The present study aimed to determine the effects of dynamic motion instability system training (DMIST) on the balance and motor function of hemiplegic patients after stroke. METHODS: In this assessor-blinded, randomized controlled trial, the participants allocated to the intervention group (n = 20) received 30 minutes of conventional treatment and 20 minutes of DMIST training. Participants randomized to the control group (n = 20) received the same dose of conventional therapy and 20 minutes of general balance training. Rehabilitation was performed 5 times per week for 8 weeks. The primary outcome was the Fugl-Meyer assessment for the lower extremity (FMA-LE), and the secondary outcomes were the Berg balance scale (BBS) and gait function. Data were collected at baseline and immediately after the intervention. RESULTS: After 8 weeks (t1), both groups showed significant post-intervention improvements in BBS, FMA-LE, gait speed and stride length (P < 0.05); there were significant positive correlations between the increase in FMA-LE and gait speed and stride length. Compared with the control group, the DMIST group showed significant post-intervention improvements in FMA-LE, gait speed and stride length (P < 0.05). However, no significant differences between the groups were found over time with respect to BBS (P > 0.05). The experiences of patients with DMIST were positive, and no serious adverse events were related to the interventions. CONCLUSION: Supervised DMIST could be highly effective in treating lower-limb motor function in patients with stroke. Frequent (weekly) and medium-term (8 weeks) dynamic motion instability-guided interventions might be highly effective in enhancing motor function, and subsequently improving gait in stroke patients.

Virtual reality-induced motor function of the upper extremity and brain activation in stroke: study protocol for a randomized controlled trial.

Background: The benefits of virtual reality (VR)-based rehabilitation were reported in patients after stroke, but there is insufficient evidence about how VR promotes brain activation in the central nervous system. Hence, we designed this study to explore the effects of VR-based intervention on upper extremity motor function and associated brain activation in stroke patients. Methods/design: In this single-center, randomized, parallel-group clinical trial with a blinded assessment of outcomes, a total of 78 stroke patients will be assigned randomly to either the VR group or the control group. All stroke patients who have upper extremity motor deficits will be tested with functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and clinical evaluation. Clinical assessment and fMRI will be performed three times on each subject. The primary outcome is the change in performance on the Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE). Secondary outcomes are functional independence measure (FIM), Barthel Index (BI), grip strength, and changes in the blood oxygenation level-dependent (BOLD) effect in the ipsilesional and contralesional primary motor cortex (M1) on the left and right hemispheres assessed with resting-state fMRI (rs-fMRI), task-state fMRI (ts-fMRI), and changes in EEG at the baseline and weeks 4 and 8. Discussion: This study aims to provide high-quality evidence for the relationship between upper extremity motor function and brain activation in stroke. In addition, this is the first multimodal neuroimaging study that explores the evidence for neuroplasticity and associated upper motor function recovery after VR in stroke patients. Clinical trial registration: Chinese Clinical Trial Registry, identifier: ChiCTR2200063425.

The Effect of Swallowing Action Observation Therapy on Resting fMRI in Stroke Patients with Dysphagia.

Objective: Many stroke victims have severe swallowing problems. Previous neuroimaging studies have found that several brain regions scattered in the frontal, temporal, and parietal lobes, such as Brodmann's areas (BA) 6, 21, and 40, are associated with swallowing function. This study sought to investigate changes in swallowing function and resting-state functional magnetic resonance imaging (rs-fMRI) in stroke patients with dysphagia following action observation treatment. It also sought to detect changes in brain regions associated with swallowing in stroke patients. Methods: In this study, 12 healthy controls (HCs) and 12 stroke patients were recruited. Stroke patients were given 4 weeks of action observation therapy. In order to assess the differences in mfALFF values between patients before treatment and HCs, the fractional amplitude of low-frequency fluctuations (fALFF) in three frequency bands (conventional frequency band, slow-4, and slow-5) were calculated for fMRI data. The significant brain regions were selected as regions of interest (ROIs) for subsequent analysis. The mfALFF values were extracted from ROIs of the three groups (patients before and after treatment and HCs) and compared to assess the therapeutic efficacy. Results: In the conventional band, stroke patients before treatment had higher mfALFF in the inferior temporal gyrus and lower mfALFF in the calcarine fissure and surrounding cortex and thalamus compared to HCs. In the slow-4 band, there was no significant difference in related brain regions between stroke patients before treatment and HCs. In the slow-5 band, stroke patients before treatment had higher mfALFF in inferior cerebellum, inferior temporal gyrus, middle frontal gyrus, and lower mfALFF in calcarine fissure and surrounding cortex compared to HCs. We also assessed changes in aberrant brain activity that occurred both before and after action observation therapy. The mfALFF between stroke patients after therapy was closed to HCs in comparison to the patients before treatment. Conclusion: Action observation therapy can affect the excitability of certain brain regions. The changes in brain function brought about by this treatment may help to further understand the potential mechanism of network remodeling of swallowing function.

Genetic variation for terminal heat stress tolerance in winter wheat.

In many regions worldwide wheat (Triticum aestivum L.) plants experience terminal high temperature stress during the grain filling stage, which is a leading cause for single seed weight decrease and consequently for grain yield reduction. An approach to mitigate high temperature damage is to develop tolerant cultivars using the conventional breeding approach which involves identifying tolerant lines and then incorporating the tolerant traits in commercial varieties. In this study, we evaluated the terminal heat stress tolerance of 304 diverse elite winter wheat lines from wheat breeding programs in the US, Australia, and Serbia in controlled environmental conditions. Chlorophyll content and yield traits were measured and calculated as the percentage of non-stress control. The results showed that there was significant genetic variation for chlorophyll retention and seed weight under heat stress conditions. The positive correlation between the percent of chlorophyll content and the percent of single seed weight was significant. Two possible mechanisms of heat tolerance during grain filling were proposed. One represented by wheat line OK05723W might be mainly through the current photosynthesis since the high percentage of single seed weight was accompanied with high percentages of chlorophyll content and high shoot dry weight, and the other represented by wheat Line TX04M410164 might be mainly through the relocation of reserves since the high percentage of single seed weight was accompanied with low percentages of chlorophyll content and low shoot dry weight under heat stress. The tolerant genotypes identified in this study should be useful for breeding programs after further validation.

Aquatic strength training improves postural stability and walking function in stroke patients.

OBJECTIVE: This study aims to explore the effects of aquatic strength training on the postural balance and walking function of stroke patients. METHODS: A total of 56 chronic stroke patients more than 6 months post-stroke with walking and balance impairments were included in this study. After baseline evaluations, patients were randomly assigned to either the experiment group (n = 29) or control group (n = 27). Patients in the control group underwent conventional hydrotherapy, whereas patients in the experiment group received conventional hydrotherapy combined with aquatic lower extremity strength training. After six weeks of rehabilitation, all patients were evaluated by a blinded assessor, and the functional assessments including: Berg Balance Scale (BBS); Timed Up and Go Test (TUG and mTUG); 2 Minute Walk Test (2MWMT); and Gait analysis. RESULTS: There were no significant differences (P > .05) between the two groups in all evaluation indexes before rehabilitation. Six weeks after treatments, the results from both groups showed significant improvements compared with those in the baseline evaluations (P < .05). Notably, compared with the control group, BBS, TUG and mTUG, 2MWMT, and Gait analysis including stride length in the non-hemiplegic side, stride length, as well as walking speed and stride frequency in the hemiplegic side in experiment group were markedly improved (P < .05). CONCLUSION: Aquatic strength training can improve postural balance and lower extremity motor functions in chronic stroke patients.

A VR-Based Motor Imagery Training System With EMG-Based Real-Time Feedback for Post-Stroke Rehabilitation.

Rehabilitation is essential for post-stroke body function recovery. Supported by the mirror neuron theory, motor imagery (MI) has been proposed as a potential stroke therapy capable of facilitating the rehabilitation. However, it is often quite difficult to estimate the degree of the participation of patients during traditional MI training as well as difficult to evaluate the efficacy of MI based rehabilitation methods. The goal of this paper is to develop a virtual reality (VR) based MI training system combining electromyography (EMG) based real-time feedback for poststroke rehabilitation, with the immersive scenario of the VR system providing a shooting basketball training for bilateral upper limbs. Through acquiring electroencephalography (EEG) signal, the brain activity in alpha and beta frequency bands was mapped and the correlation analysis could be achieved. Furthermore, EMG data of each patient was collected and calculated as threshold with root-mean-square algorithm for feedback of the performance score of the shooting basketball training in virtual environment. To investigate the feasibility of this newly-built rehabilitation training system, four experiments namely initial assessment experiment, motor imagery (MI), action observation (AO), and combined motor imagery and action observation (MI+AO) were carried out on stroke patients at different recovery stages. The result shows that MI+AO can generate more pronounced event-related desynchronization (ERD) in alpha band compared to other cases and induce relatively obvious ERD in beta band compared to AO, which demonstrates that VR-based observation has ability to facilitate MI training. Furthermore, it has been found that the muscle strength from MI+AO is the highest through the EMG analysis. This proves that the feedback of EMG can be used to quantify patient's training engagement and promote MI training at a certain extent. Hence, by incorporating such an EMG feedback, a VR-based MI training system has the potential to achieve higher efficacy for post-stroke rehabilitation.

Effects of Virtual Reality-Based Exercise on Balance in Patients With Stroke: A Systematic Review and Meta-analysis.

OBJECTIVE: The aim of the study is to quantify the effects of virtual reality-based exercise on balance after stroke. DESIGN: The PubMed, Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature, and Web of Science databases were searched until December 31, 2021. Independent investigators abstracted data, assessed the quality of the evidence, and rated the certainty of the evidence. The intergroup differences were determined by calculating mean difference and 95% confidence interval by RevMan 5.3 software. RESULTS: Fourteen randomized controlled trials involving 423 stroke patients were included. Patients who received virtual reality-based exercise illustrated marked improvements in the Berg Balance Scale (mean difference, 1.35; 95% confidence interval, 0.58 to 1.86; P < 0.00001; I2 = 44%), Timed Up and Go test (mean difference, -0.81; 95% confidence interval, -1.18 to -0.44; P < 0.0001; I2 = 0%), Functional Reach Test (mean difference, 3.06; 95% confidence interval, 1.31-4.80; P = 0.0006; I2 = 0%), 10-Meters Walking Test (mean difference, -1.53; 95% confidence interval, -2.92 to -0.13; P = 0.03; I2 = 33%), and Modified Barthel Index (mean difference, 5.26; 95% confidence interval, 1.70 to 8.82; P = 0.004; I2 = 0%) compared with the control group. CONCLUSIONS: Existing low-evidence analyses showed that virtual reality-based exercise could effectively and safely improve balance in chronic stroke. Longer-term virtual reality-based exercise was more effective on functional ability of stroke.

Simvastatin alleviates epithelial-mesenchymal transition and oxidative stress of high glucose-induced lens epithelial cells in vitro by inhibiting RhoA/ROCK signaling.

Diabetic cataracts (DC) is one of the main causes of blindness among patients with diabetes mellitus. The aim of the present study was to examine the effect of simvastatin on lens epithelial cells in DC and the underlying mechanism. The viability of SRA01/04 cells treated with different concentrations of simvastatin was detected using a Cell Counting Kit-8 assay before and after high glucose (HG) treatment. The expression levels of E-cadherin, N-cadherin, Vimentin and α-smooth muscle actin (α-SMA), proteins associated with epithelial-mesenchymal transition (EMT), in addition to RhoA, Rho-associated kinases (ROCK)1 and ROCK2, proteins related to RhoA/ROCK signaling, were also measured in SRA01/04 cells treated with HG and simvastatin, with or without U46619, using western blot analysis. DCFH-DA dyes, superoxide dismutase (SOD) and glutathione (GSH)/glutathione disulfide (GSSG) kits were used to measure the levels of oxidative stress parameters in SRA01/04 cells treated with HG and simvastatin with or without U46619. The cell viability of SRA01/04 cells treated with simvastatin was found to be significantly elevated after HG treatment. The protein expression levels of E-cadherin were increased but those of N-cadherin, Vimentin and α-SMA decreased after HG and simvastatin treatment, and this was reversed by U46619. The levels of SOD and GSH-GSSG were found to be increased whereas reactive oxygen species levels were decreased, effects that were reversed by U46619. Additionally, the protein expression levels of RhoA, ROCK1 and ROCK2 were markedly decreased. These findings provided evidence that simvastatin increased HG-induced SRA01/04 cell viability and exerted inhibitory effects on EMT and oxidative stress that occurs during DC.

Error-Related Negativity-Based Robot-Assisted Stroke Rehabilitation System: Design and Proof-of-Concept.

Conventional rehabilitation systems typically execute a fixed set of programs that most motor-impaired stroke patients undergo. In these systems, the brain, which is embodied in the body, is often left out. Including the brains of stroke patients in the control loop of a rehabilitation system can be worthwhile as the system can be tailored to each participant and, thus, be more effective. Here, we propose a novel brain-computer interface (BCI)-based robot-assisted stroke rehabilitation system (RASRS), which takes inputs from the patient's intrinsic feedback mechanism to adapt the assistance level of the RASRS. The proposed system will utilize the patients' consciousness about their performance decoded through their error-related negativity signals. As a proof-of-concept, we experimented on 12 healthy people in which we recorded their electroencephalogram (EEG) signals while performing a standard rehabilitation exercise. We set the performance requirements beforehand and observed participants' neural responses when they failed/met the set requirements and found a statistically significant (p < 0.05) difference in their neural responses in the two conditions. The feasibility of the proposed BCI-based RASRS was demonstrated through a use-case description with a timing diagram and meeting the crucial requirements for developing the proposed rehabilitation system. The use of a patient's intrinsic feedback mechanism will have significant implications for the development of human-in-the-loop stroke rehabilitation systems.

An Immersive Motor Imagery Training System for Post-Stroke Rehabilitation Combining VR and EMG-based Real-Time Feedback.

Motor imagery combining virtual reality (VR) technique has recently been reported to have an increasingly positive impact on post-stroke rehabilitation. However, there is a common problem that the engagement of patients cannot be confirmed during motor imagery training due to a lack of effective feedback control. This paper proposes a VR-based motor imagery training system for post-stroke rehabilitation, using surface electromyographic (EMG)-based real-time feedback to enable the personalized training and quantitative assessment of participation degree. Three different experiments including assessment experiment, action observation (AO), combined motor imagery and action observation (MI+AO) experiment were performed on 4 post-stroke patients to verify the system. The immersive scenario of the VR system provides a shooting basketball training for bilateral upper limbs. The EMG data of assessment of each participant was collected to calculate the thresholds, which was utilized in the subsequent experiments based on real-time feedback of EMG. The result reveals significant differences of the muscle strength between AO and MI+AO experiments. This demonstrates that the EMG-based feedback is effective to be of use in assessment of participation degree. The primary application shows that VR-assisted motor imagery system has potential to provide personalized and more engaged training for post-stroke rehabilitation.

Assessing the Security of Campus Networks: The Case of Seven Universities.

The network security situation of campus networks on CERNET (China Education and Research Network) has received great concern. However, most network managers have no complete picture of the network security because of its special management and the rapid growth of network assets. In this investigation, the security of campus networks belonging to seven universities in Wuhan was investigated. A tool called "WebHunt" was designed for campus networks, and with its help, the network security risks were found. Differently from existing tools for network probing, WebHunt can adopt the network scale and special rules of the campus network. According to the characteristics of campus websites, a series of functions were integrated into WebHunt, including reverse resolution of domain names, active network detection and fingerprint identification for software assets. Besides, WebHunt builds its vulnerability intelligence database with a knowledge graph structure and locates the vulnerabilities through matching knowledge graph information. Security assessments of seven universities presents WebHunt's applicability for campus networks. Besides, it also shows that many security risks are concealed in campus networks, such as non-compliance IP addresses and domain names, system vulnerabilities and so on. The security reports containing risks have been sent to the relevant universities, and positive feedback was received.

Occupational Therapy Assessment for Upper Limb Rehabilitation: A Multisensor-Based Approach.

Most post-stroke patients experience varying degrees of impairment in upper limb function and fine motor skills. Occupational therapy (OT) with other rehabilitation trainings is beneficial in improving the strength and dexterity of the impaired upper limb. An accurate upper limb assessment should be conducted before prescribing upper limb OT programs. In this paper, we present a novel multisensor method for the assessment of upper limb movements that uses kinematics and physiological sensors to capture the movement of the limbs and the surface electromyogram (sEMG). These sensors are Kinect, inertial measurement unit (IMU), Xsens, and sEMG. The key assessment features of the proposed model are as follows: (1) classification of OT exercises into four classes, (2) evaluation of the quality and completion of the OT exercises, and (3) evaluation of the relationship between upper limb mobility and muscle strength in patients. According to experimental results, the overall accuracy for OT-based motion classification is 82.2%. In addition, the fusing of Kinect and Xsens data reveals that muscle strength is highly correlated with the data with a correlation coefficient (CC) of 0.88. As a result of this research, occupational therapy specialists will be able to provide early support discharge, which could alleviate the problem of the great stress that the healthcare system is experiencing today.

Improved cyber-physical system captured post-flowering high night temperature impact on yield and quality of field grown wheat.

Winter wheat (Triticum aestivum L.) is essential to maintain food security for a large proportion of the world's population. With increased risk from abiotic stresses due to climate variability, it is imperative to understand and minimize the negative impact of these stressors, including high night temperature (HNT). Both globally and at regional scales, a differential rate of increase in day and night temperature is observed, wherein night temperatures are increasing at a higher pace and the trend is projected to continue into the future. Previous studies using controlled environment facilities and small field-based removable chambers have shown that post-anthesis HNT stress can induce a significant reduction in wheat grain yield. A prototype was previously developed by utilizing field-based tents allowing for simultaneous phenotyping of popular winter wheat varieties from US Midwest and advanced breeding lines. Hence, the objectives of the study were to (i) design and build a new field-based infrastructure and test and validate the uniformity of HNT stress application on a scaled-up version of the prototype (ii) improve and develop a more sophisticated cyber-physical system to sense and impose post-anthesis HNT stress uniformly through physiological maturity within the scaled-up tents; and (iii) determine the impact of HNT stress during grain filling on the agronomic and grain quality parameters including starch and protein concentration. The system imposed a consistent post-anthesis HNT stress of + 3.8 °C until maturity and maintained uniform distribution of stress which was confirmed by (i) 0.23 °C temperature differential between an array of sensors within the tents and (ii) statistically similar performance of a common check replicated multiple times in each tent. On average, a reduction in grain-filling duration by 3.33 days, kernel weight by 1.25% per °C, grain number by 2.36% per °C and yield by 3.58% per °C increase in night temperature was documented. HNT stress induced a significant reduction in starch concentration indicating disturbed carbon balance. The pilot field-based facility integrated with a robust cyber-physical system provides a timely breakthrough for evaluating HNT stress impact on large diversity panels to enhance HNT stress tolerance across field crops. The flexibility of the cyber-physical system and movement capabilities of the field-based infrastructure allows this methodology to be adaptable to different crops.

An Efficient Deep Learning Based Method for Speech Assessment of Mandarin-Speaking Aphasic Patients.

Speech assessment is an important part of the rehabilitation process for patients with aphasia (PWA). Mandarin speech lucidity features such as articulation, fluency, and tone influence the meaning of the spoken utterance and overall speech clarity. Automatic assessment of these features is important for an efficient assessment of the aphasic speech. Hence, in this paper, a standardized automatic speech lucidity assessment method for Mandarin-speaking aphasic patients using a machine learning based technique is presented. The proposed assessment method adopts the Chinese Rehabilitation Research Center Aphasia Examination (CRRCAE) standard as a guideline. Quadrature based high-resolution time-frequency images with a convolutional neural network (CNN) are utilized to develop a method that can map the relationship between the severity level of aphasic patients' speech and the three speech lucidity features. The results show a linear relationship with statistically significant correlations between the normalized true-class output activations (TCOA) of the CNN model and patients' articulation, fluency, and tone scores, i.e., 0.71 (p < 0.001), 0.60 (p < 0.001) and 0.58 (p < 0.001), respectively. The linearity of the proposed Mandarin aphasic speech assessment method and its significant correlation with the speech severity levels show the efficacy of the method in predicting the severity of impaired Mandarin speech. The outcome of this research envisages assisting speech-language pathologists in Mandarin-speech impairment assessment and promoting early support discharge; hence could alleviate the stress that the healthcare system is currently experiencing in China nationwide. The framework of the proposed Mandarin aphasic speech assessment method can be readily extended to other languages.

Interactive Compliance Control of a Wrist Rehabilitation Device (WReD) with Enhanced Training Safety.

Interaction control plays an important role in rehabilitation devices to ensure training safety and efficacy. Compliance adaptation of interaction is vital for enabling robot movements to better suit the patient's requirements as human joint characteristics vary. This paper proposes an interactive compliance control scheme on a wrist rehabilitation device (WReD) for enhanced training safety and efficacy. This control system consists of a low-level trajectory tracking loop and a high-level admittance loop. Experiments were conducted with zero load and human interaction, respectively. Satisfactory trajectory tracking responses were obtained, with the normalized root mean square deviation (NRMSD) values being 1.08% with zero load and the NRMSD values no greater than 1.4% with real-time disturbance and interaction from human users. Results demonstrate that such an interactive compliance control method can adaptively adjust the range of training motions and encourage active engagement from human users simultaneously. These findings suggest that the proposed control method of the WReD has great potentials for clinical applications due to enhanced training safety and efficacy. Future work will focus on evaluating its efficacy on a large sample of participants.

Error-Related Neural Responses Recorded by Electroencephalography During Post-stroke Rehabilitation Movements.

Error-related potential (ErrP) based assist-as-needed robot-therapy can be an effective rehabilitation method. To date, several studies have shown the presence of ErrP under various task situations. However, in the context of assist-as-needed methods, the existence of ErrP is unexplored. Therefore, the principal objective of this study is to determine if an ErrP can be evoked when a subject is unable to complete a physical exercise in a given time. Fifteen stroke patients participated in an experiment that involved performing a physical rehabilitation exercise. Results showed that the electroencephalographic (EEG) response of the trials, where patients failed to complete the exercise, against the trials, where patients successfully completed the exercise, significantly differ from each other, and the resulting difference of event-related potentials resembles the previously reported ErrP signals as well as has some unique features. Along with the highly statistically significant difference, the trials differ in time-frequency patterns and scalp distribution maps. In summary, the results of the study provide a novel basis for the detection of the failure against the success events while executing rehabilitation exercises that can be used to improve the state-of-the-art robot-assisted rehabilitation methods.

A Novel Multistandard Compliant Hand Function Assessment Method Using an Infrared Imaging Device.

Many post-stroke patients suffer varying degrees of hand function and fine motor skills impairment. Both passive and active hand rehabilitation training are beneficial in improving the strength and dexterity of the hands. However, hand rehabilitation programs should be prescribed based on an accurate assessment of hand function. In this paper, we propose a novel method for hand function assessment, which can accurately measure multiple joint angles of a hand simultaneously using a portable infrared based imaging device. Different from traditional assessment methods that are often based on a clinician's subjective observations and ordinal charts, this method provides an accurate, fast, and objective evaluation using infrared imaging sensors. Performance evaluation and benchmarking for the proposed measurement system were carried out using the correlation coefficient (CC) method, the root mean squared error, and the percentage residual difference method (PRD). A clinical trial involving 25 participants resulted in a higher correlation with CC of 0.9672 and PRD of 8.8%, which indicated that the developed assessment framework is compliant with multiple assessment standards such as Swanson impairment evaluation and Fugl-Meyer assessment. The new hand function assessment method can be used to replace traditional methods for fine hand function modeling and assessment in rehabilitation medicine and can also play an important role in precision post-stroke function analysis.

Expression of a rice soluble starch synthase gene in transgenic wheat improves the grain yield under heat stress conditions.

Wheat (Triticum aestivum L.) is a temperate cereal with an optimum temperature range of 15-22°C during the grain filling stage. Heat stress is one of the major environmental constraints for wheat production worldwide. Temperatures above 25°C during the grain filling stage significantly reduced wheat yield and quality. This reduction was reported due to the inactivation of the soluble starch synthase, a key heat-labile enzyme in starch transformation of wheat endosperm. To improve wheat productivity under heat stress, the rice soluble starch synthase I, under the control of either a constitutive promoter or an endosperm-specific promoter, was expressed in wheat and the transgenic lines were monitored for expression and the effects on yield-related traits. The results showed that the transgenic wheat events expressed rice soluble starch synthase I at a high level after four generations, and transgenic plants produced grains of greater weight during heat stress. Under heat stress conditions, the thousand kernel weight increased 21-34% in T2 and T3 transgenic plants compared to the non-transgenic control plants. In addition, the photosynthetic duration of transgenic wheat was longer than in non-transgenic controls. This study demonstrated that the engineering of a heat tolerant soluble starch synthase gene can be a potential strategy to improve wheat yield under heat stress conditions.