MovePort: Multimodal Dataset of EMG, IMU, MoCap and Insole Pressure for Analyzing Abnormal Movements and Postures in Rehabilitation Training.

In most real world rehabilitation training, patients are trained to regain motion capabilities with the aid of functional/epidural electrical stimulation (FES/EES), under the support of gravity-assist systems to prevent falls. However, the lack of motion analysis dataset designed specifically for rehabilitation-related applications largely limits the conduct of pilot research. We provide an open access dataset, consisting of multimodal data collected via 16 electromyography (EMG) sensors, 6 inertial measurement unit (IMU) sensors, and 230 insole pressure sensors (IPS) per foot, together with a 26-sensor motion capture system, under different MOVEments and POstures for Rehabilitation Training (MovePort). Data were collected under diverse experimental paradigms. Twenty four participants first imitated multiple normal and abnormal body postures including (1) normal standing still, (2) leaning forward, (3) leaning back, and (4) half-squat, which in practical applications, can be detected as feedback to tune the parameters of FES/EES and gravity-assist systems to keep patients in a target body posture. Data under imitated abnormal gaits, e.g., (1) with legs raised higher under excessive electrical stimulation, and (2) with dragging legs under insufficient stimulation, were also collected. Data under normal gaits with low, medium and high speeds are also included. Pathological gait data from a subject with spastic paraplegia further increases the clinical value of our dataset. We also provide source codes to perform both intra- and inter-participant motion analyses of our dataset. We expect our dataset can provide a unique platform to promote collaboration among neurorehabilitation engineers.

A Robust and Real-Time Framework of Cross-Subject Myoelectric Control Model Calibration via Multi-Source Domain Adaptation.

Surface electromyogram (sEMG) has been widely used in hand gesture recognition. However, most previous studies focused on user-personalized models, which require a great amount of data from each new target user to learn the user-specific EMG patterns. In this work, we present a novel real-time gesture recognition framework based on multi-source domain adaptation, which learns extra knowledge from the data of other users, thereby reducing the data collection burdens on the target user. Additionally, compared with conventional domain adaptation methods which treat data from all users in the source domain as a whole, the proposed multi-source method treat data from different users as multiple separate source domains. Therefore, more detailed statistical information on the data distribution from each user can be learned effectively. High-density sEMG (256 channels) from 20 subjects was used to validate the proposed method. Importantly, we evaluated our method with a simulated real-time processing pipeline on continuous sEMG data stream, rather than well-segmented data. The false alarm rate during rest periods in an EMG data stream, which is typically neglected by previous studies performing offline analyses, was also considered. Our results showed that, with only 1 s sEMG data per gesture from the new user, the 10-gesture classification accuracy reached 87.66 % but the false alarm rate was reduced to 1.95 %. Our method can reduce the frustratingly heavy data collection burdens on each new user.

A Review on the Usability, Flexibility, Affinity, and Affordability of Virtual Technology for Rehabilitation Training of Upper Limb Amputees.

(1) Background: Prosthetic rehabilitation is essential for upper limb amputees to regain their ability to work. However, the abandonment rate of prosthetics is higher than 50% due to the high cost of rehabilitation. Virtual technology shows potential for improving the availability and cost-effectiveness of prosthetic rehabilitation. This article systematically reviews the application of virtual technology for the prosthetic rehabilitation of upper limb amputees. (2) Methods: We followed PRISMA review guidance, STROBE, and CASP to evaluate the included articles. Finally, 17 articles were screened from 22,609 articles. (3) Results: This study reviews the possible benefits of using virtual technology from four aspects: usability, flexibility, psychological affinity, and long-term affordability. Three significant challenges are also discussed: realism, closed-loop control, and multi-modality integration. (4) Conclusions: Virtual technology allows for flexible and configurable control rehabilitation, both during hospital admissions and after discharge, at a relatively low cost. The technology shows promise in addressing the critical barrier of current prosthetic training issues, potentially improving the practical availability of prosthesis techniques for upper limb amputees.

Cybersecurity in neural interfaces: Survey and future trends.

With the joint advancement in areas such as pervasive neural data sensing, neural computing, neuromodulation and artificial intelligence, neural interface has become a promising technology facilitating both the closed-loop neurorehabilitation for neurologically impaired patients and the intelligent man-machine interactions for general application purposes. However, although neural interface has been widely studied, few previous studies focused on the cybersecurity issues in related applications. In this survey, we systematically investigated possible cybersecurity risks in neural interfaces, together with potential solutions to these problems. Importantly, our survey considers interfacing techniques on both central nervous systems (i.e., brain-computer interfaces) and peripheral nervous systems (i.e., general neural interfaces), covering diverse neural modalities such as electroencephalography, electromyography and more. Moreover, our survey is organized on three different levels: (1) the data level, which mainly focuses on the privacy leakage issue via attacking and analyzing neural database of users; (2) the permission level, which mainly focuses on the prospects and risks to directly use real time neural signals as biometrics for continuous and unobtrusive user identity verification; and (3) the model level, which mainly focuses on adversarial attacks and defenses on both the forward neural decoding models (e.g. via machine learning) and the backward feedback implementation models (e.g. via neuromodulation and stimulation). This is the first study to systematically investigate cybersecurity risks and possible solutions in neural interfaces which covers both central and peripheral nervous systems, and considers multiple different levels to provide a complete picture of this issue.

Identification of stable reference genes for quantitative gene expression analysis in the duodenum of meat-type ducks.

Quantitative polymerase chain reaction (qPCR) is an important method to detect gene expression at the molecular level. The selection of appropriate housekeeping genes is the key to accurately calculating the expression level of target genes and conducting gene function studies. In this study, the expression of eight candidate reference genes, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), beta-actin (ß-actin), 18S ribosomal RNA (18S rRNA), hydroxymethylbilane synthase (HMBS), hypoxanthine phosphoribosyltransferase 1 (HPRT1), TATA box binding protein (TBP), ribosomal protein L13 (RPL13), and tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein (YWHAZ), in the duodenal epithelial tissue of 42-day-old meat-type ducks were detected using qPCR. Furthermore, their expression stability was analyzed using the geNorm, NormFinder, and BestKeeper programs. The results indicated that HMBS and YWHAZ were the most stably expressed genes. All three programs indicated that the expression of 18S rRNA was the least stable, making it unsuitable for the study of gene expression in meat-type duck tissues. This study provides stable reference genes for gene expression analysis and contributes to further studies on the gene function of meat-type ducks.

Complete Mitochondrial Genome, Genetic Diversity and Phylogenetic Analysis of Pingpu Yellow Chicken (Gallus gallus).

In this study, the complete mitochondrial genome sequence of one female Pingpu Yellow chicken (PYC) and the D-loop sequences obtained from 60 chickens were analyzed to investigate their genetic diversity and phylogeny. The total length of the PYC mitogenome is 16,785 bp and that of the complete D-loop is 1231 to 1232 bp. The mitogenome comprises 22 transfer ribonucleic acids (tRNAs), 2 ribosomal ribonucleic acids (rRNAs), 13 protein-coding genes (PCGs), and 1 non-coding control region (D-loop). Additionally, the total length of the 13 PCGs is 11,394 bp, accounting for 67.88% of the complete mitogenome sequence, and the PCGs region has 3798 codons. A majority of the PCGs have ATG as the start codon. The haplotype and nucleotide diversity of PYC were 1.00000 ± 0.00029 and 0.32678 ± 0.29756, respectively. In the D-Loop data set, we found 25 polymorphic sites, which determined 18 haplotypes and 3 major haplogroups (A-C). Therefore, PYC has a classical vertebrate mitogenome, with comparatively high nucleotide diversity and potentially three maternal lineages. The neighbor-joining (NJ) tree analysis results showed PYC grouped with the Luhua (MT555049.1) and Nandan chickens (KP269069.1), which indicates that PYC is closely related to these two breeds.

Deep Brain Stimulation Initiative: Toward Innovative Technology, New Disease Indications, and Approaches to Current and Future Clinical Challenges in Neuromodulation Therapy.

Deep brain stimulation (DBS) is one of the most important clinical therapies for neurological disorders. DBS also has great potential to become a great tool for clinical neuroscience research. Recently, the National Engineering Laboratory for Neuromodulation at Tsinghua University held an international Deep Brain Stimulation Initiative workshop to discuss the cutting-edge technological achievements and clinical applications of DBS. We specifically addressed new clinical approaches and challenges in DBS for movement disorders (Parkinson's disease and dystonia), clinical application toward neurorehabilitation for stroke, and the progress and challenges toward DBS for neuropsychiatric disorders. This review highlighted key developments in (1) neuroimaging, with advancements in 3-Tesla magnetic resonance imaging DBS compatibility for exploration of brain network mechanisms; (2) novel DBS recording capabilities for uncovering disease pathophysiology; and (3) overcoming global healthcare burdens with online-based DBS programming technology for connecting patient communities. The successful event marks a milestone for global collaborative opportunities in clinical development of neuromodulation to treat major neurological disorders.

Decompressive hemicraniectomy versus medical treatment of malignant middle cerebral artery infarction: a systematic review and meta-analysis.

OBJECTIVES: To estimate evidence for decompressive hemicraniectomy (DHC) versus medical treatment effects on survival rate and favorable functional recovery among patients of malignant middle cerebral artery infarction (MMCAI) in randomized controlled trials (RCTs). DESIGN: The present study is a systematic review and meta-analysis of RCTs. SETTING: The MEDLINE/PubMed, EMBASE, Springer, Cochrane Collaboration database, China National Knowledge Infrastructure (CNKI) database, and Wanfang database were comprehensively searched for RCTs regarding the effects of DHC versus medical treatment among patients of MMCAI in these English and Chinese electronic databases from inception to 1 June 2019. Two reviewers independently retrieved RCTs and extracted relevant information. The methodological quality of the included trials was estimated using the Cochrane risk of bias tool. Review Manager5.3.5 software was used for statistical analyses. The statistical power of meta-analysis was estimated by Power and Precision, version 4 software. PARTICIPANTS: Nine RCTs with a total of 425 patients with MMCAI, containing 210 cases in the DHC group and 215 cases in the medical treatment group, met the inclusion criteria were included. Primary outcomes were measured by survival rate, defined as modified Rankin scale (mRS) score 0-5 and favorable functional recovery as mRS score 0-3. The follow-up time of all studies was at 6-12months. RESULTS: First, compared with the medical treatment group, DHC was associated with a statistically significant increase survival rate (RR: 1.96, 95%CI 1.61-2.38, P < 0.00001) and favorable functional recovery (RR: 1.62, 95%CI 1.11-2.37, P = 0.01). Second, subgroup analysis: (1) Compared with the medical treatment group among patients age ≤60 years, DHC was associated with a statistically significant increase survival rate (RR = 2.20, 95%CI 1.60-3.04, P < 0.00001); (2) Compared with the medical treatment group among patients of age >60 years, DHC was also associated with a statistically significant increase survival rate (RR: 1.93, 95%CI 1.45-2.59, P < 0.00001); (3) Compared with the medical treatment group, the time of DHC was preformed within 48 h from the onset of stroke that could statistically significant increase survival rate (RR: 2.16, 95%CI 1.69-2.75, P < 0.00001). Third, sensitivity analyses that measured the results were consistent, indicating that the results were stable. Fourth, the results of statistical power analysis were ≥80%. Finally, the funnel plot of the survival rate included nine RCTs showed no remarkable publication bias. CONCLUSIONS: Our study results indicated that DHC could increase survival rate and favorable functional recovery among patients age ≤60 or >60 years. The optimal time for DHC might be no more than 48 h from the onset of symptoms. However, due to the limitations of this research, it is necessary to design high quality, large-scale RCTs to further evaluate these findings.

Variable- versus constant-frequency deep-brain stimulation in patients with advanced Parkinson's disease: study protocol for a randomized controlled trial.

BACKGROUND: Deep-brain stimulation targeting the subthalamic nucleus (STN) can be used to treat motor symptoms and dyskinesia in the advanced stages of Parkinson's disease (PD). High-frequency stimulation (HFS) of the STN can lead to consistent, long-term improvement of PD symptoms. However, the effects of HFS on the axial symptoms of PD, specifically freezing of gait, can be limited or cause further impairment. While this can be alleviated via relatively low-frequency stimulation (LFS) in selected patients, LFS does not control all motor symptoms of PD. Recently, the National Engineering Laboratory for Neuromodulation reported preliminary findings regarding an efficient way to combine the advantages of HFS and LFS to form variable-frequency stimulation (VFS). However, this novel therapeutic strategy has not been formally tested in a randomized trial. METHODS/DESIGN: We propose a multicenter, double-blind clinical trial involving 11 study hospitals and an established deep-brain stimulation team. The participants will be divided into a VFS and a constant-frequency stimulation group. The primary outcome will be changes in stand-walk-sit task scores after 3 months of treatment in the "medication off" condition. Secondary outcome measures include specific item scores on the Freezing of Gait Questionnaire and quality of life. The aim of this trial is to investigate the efficacy and safety of VFS compared with constant-frequency stimulation. DISCUSSION: This is the first randomized controlled trial to comprehensively evaluate the effectiveness and safety of VFS of the STN in patients with advanced PD. VFS may represent a new option for clinical treatment of PD in the future. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03053726. Registered on February 15, 2017.

Deep Brain Stimulation at Variable Frequency to Improve Motor Outcomes in Parkinson's Disease.

INTRODUCTION: Deep brain stimulation (DBS) with high frequency (HFS) is a well-established therapy for Parkinson's disease (PD); however, low frequency DBS (LFS) may control axial symptoms including freezing of gait (FOG). We conducted a pilot safety and feasibility study to examine if a novel DBS paradigm of variable frequency stimulation (VFS) that combined HFS and LFS would capture a broader set of motor symptoms. METHODS: Four PD patients with bilateral STN DBS and FOG were enrolled. A UPDRS III and 10 m timed up and go (TUG) task were performed off medications-off DBS and then one hour after HFS and one hour after VFS programming. RESULTS: The UPDRS III motor score improved by additional 14% during VFS setting when compared to HFS. VFS also increased gait speed (mean change 45%) and reduced the number of freezing episodes (mean change 58%). CONCLUSIONS: VFS improves UPDRS and FOG in PD when compared to HFS.Copyright © 2018 International Parkinson and Movement Disorder Society.

Patient perspectives on the efficacy of a new kind of rechargeable deep brain stimulators(1).

PURPOSE/AIM OF THE STUDY: Rechargeable deep brain stimulation (DBS) system with longer battery life has become available for treating movement disorders. However, little information exists about the safety and management after implantation. Therefore, there is an urgent need to evaluate the recharging performance through long-term observations. MATERIALS AND METHODS: Fifty-three Parkinson's disease (PD) patients were implanted with a new rechargeable device (G102R, PINS Medical). They were observed at the baseline and 3 months, 6 months and 12 months after surgery, with measurement of the acceptance, frequency, recharging time and feeling during recharging. RESULTS: The patients with the ages between 34 and 70 (57.64 ± 7.34) years thought the system was very easy to recharge. The favorite time interval for recharging was 1 week, and 10 days and half a month also chosen. Most of the patients spent around 1 hour recharging, with no unacceptable hot feelings reported. CONCLUSIONS: The PD patients could easily and safely recharge this new rechargeable implantable neurostimulators. Thus, these neurostimulators might be an excellent choice for PD patients.

Vagus Nerve Stimulation for Pediatric and Adult Patients with Pharmaco-resistant Epilepsy.

BACKGROUND: Over past two decades, vagus nerve stimulation (VNS) has been widely used and reported to alleviate seizure frequency worldwide, however, so far, only hundreds of patients with pharmaco-resistant epilepsy (PRE) have been treated with VNS in mainland China. The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender. METHODS: We retrospectively assessed the clinical outcome of 94 patients with PRE, who were treated with VNS at Beijing Fengtai Hospital and Beijing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients. The clinical data analysis was retrospectively examined. RESULTS: Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve. At last follow-up, we found McHugh classifications of Class I in 33 patients (35.1%), Class II in 27 patients (28.7%), Class III in 20 patients (21.3%), Class IV in 3 patients (3.2%), and Class V in 11 patients (11.7%). Notably, 8 (8.5%) patients were seizure-free while ≥50% seizure frequency reduction occurred in as many as 60 patients (63.8%). Furthermore, with regard to the modified Engel classification, 12 patients (12.8%) were classified as Class I, 11 patients (11.7%) were classified as Class II, 37 patients (39.4%) were classified as Class III, 34 patients (36.2%) were classified as Class IV. We also found that the factors of gender or age are not associated with clinical outcome. CONCLUSIONS: This comparative study confirmed that VNS is a safe, well-tolerated, and effective treatment for Chinese PRE patients. VNS reduced the seizure frequency regardless of age or gender of studied patients.

Immune responses of BALB/c mice to subcutaneously injected multi-walled carbon nanotubes.

Carbon nanotubes have been shown to have the ability to transport therapeutic and detective reagents into cells. However, the rapid advances in new carbon nanotube-based materials and technologies have raised concerns about their safety. Such concerns require a fundamental understanding of the toxicological properties of carbon nanotubes. In particular, the use of carbon nanotubes as drug or probe delivery platforms may depend on the prevention of stimulatory side-effects to the immune system. In this study, we investigated the immunological properties of oxidized water dispersible multi-walled carbon nanotubes (MWCNTs) in healthy BALB/c mice. We injected the MWCNTs subcutaneously, and the immune responses of the mice were monitored over time. We show that the MWCNTs induce complement activation and the production of pro-inflammatory cytokines early after injection of the mice, and that the levels of complement and cytokines return to normal levels over time. With the exception of the lymph nodes, there was no obvious accumulation of MWCNTs observed in the liver, spleen, kidney, or heart. In addition, we did not observe injury in the organs or lymph nodes. Our results indicate that local, subcutaneous administration of MWCNTs induces obvious short-term immunological reactions, which can be eliminated over time.

Subcutaneous injection of water-soluble multi-walled carbon nanotubes in tumor-bearing mice boosts the host immune activity.

The immunological responses induced by oxidized water-soluble multi-walled carbon nanotubes on a hepatocarcinoma tumor-bearing mice model via a local administration of subcutaneous injection were investigated. Experimental results show that the subcutaneously injected carbon nanotubes induced significant activation of the complement system, promoted inflammatory cytokines' production and stimulated macrophages' phagocytosis and activation. All of these responses increased the general activity of the host immune system and inhibited the progression of tumor growth.

[Current researches on the mechanisms of carbon nanotubes entering cells and their location in the cells].

Carbon nanotube (CNT) is an important class of artificial nanomaterials with diverse potentials of nanobiomedical application. Before being introduced into bio-systems, it is necessary to explore the behavior and fate of CNTs in cells. However, limited understandings or information has been currently obtained in this realm, even some experimental results from different labs are conflicted. In this review, we focused on the location of CNTs in various cells as well as on the mechanisms of CNTs crossing the cell membranes. On the basis of data analysis shown by the current literatures, it was suggested that CNTs could enter cell's nucleus in certain conditions. Endocytosis and diffusion both exist; however, in some cases, one of them exhibited as major path, while the other one was not detectable because of the challenge resulting from the complex biological environments. The obstacles to powerful and standard characterizations of CNTs have also been discussed.