Muscle synergies have been proposed as a strategy employed by the central nervous system to control movements. Muscle synergy analysis is a well-established framework to examine the pathophysiological basis of neurological diseases and has been applied for analysis and assessment in clinical applications in the last decades, even if it has not yet been widely used in clinical diagnosis, rehabilitative treatment and interventions. Even if inconsistencies in the outputs among studies and lack of a normative pipeline including signal processing and synergy analysis limit the progress, common findings and results are identifiable as a basis for future research. Therefore, a literature review that summarizes methods and main findings of previous works on upper limb muscle synergies in clinical environment is needed to i) summarize the main findings so far, ii) highlight the barriers limiting their use in clinical applications, and iii) suggest future research directions needed for facilitating translation of experimental research to clinical scenarios. Articles in which muscle synergies were used to analyze and assess upper limb function in neurological impairments were reviewed. The literature research was conducted in Scopus, PubMed, and Web of Science. Experimental protocols (e.g., the aim of the study, number and type of participants, number and type of muscles, and tasks), methods (e.g., muscle synergy models and synergy extraction methods, signal processing methods), and the main findings of eligible studies were reported and discussed. 383 articles were screened and 51 were selected, which involved a total of 13 diseases and 748 patients and 1155 participants. Each study investigated on average 15 ± 10 patients. Four to forty-one muscles were included in the muscle synergy analysis. Point-to-point reaching was the most used task. The preprocessing of EMG signals and algorithms for synergy extraction varied among studies, and non-negative matrix factorization was the most used method. Five EMG normalization methods and five methods for identifying the optimal number of synergies were used in the selected papers. Most of the studies report that analyses on synergy number, structure, and activations provide novel insights on the physiopathology of motor control that cannot be gained with standard clinical assessments, and suggest that muscle synergies may be useful to personalize therapies and to develop new therapeutic strategies. However, in the selected studies synergies were used only for assessment; different testing procedures were used and, in general, study-specific modifications of muscle synergies were observed; single session or longitudinal studies mainly aimed at assessing stroke (71% of the studies), even though other pathologies were also investigated. Synergy modifications were either study-specific or were not observed, with few analyses available for temporal coefficients. Thus, several barriers prevent wider adoption of muscle synergy analysis including a lack of standardized experimental protocols, signal processing procedures, and synergy extraction methods. A compromise in the design of the studies must be found to combine the systematicity of motor control studies and the feasibility of clinical studies. There are however several potential developments that might promote the use of muscle synergy analysis in clinical practice, including refined assessments based on synergistic approaches not allowed by other methods and the availability of novel models. Finally, neural substrates of muscle synergies are discussed, and possible future research directions are proposed. This review provides new perspectives about the challenges and open issues that need to be addressed in future work to achieve a better understanding of motor impairments and rehabilitative therapy using muscle synergies. These include the application of the methods on wider scales, standardization of procedures, inclusion of synergies in the clinical decisional process, assessment of temporal coefficients and temporal-based models, extensive work on the algorithms and understanding of the physio-pathological mechanisms of pathology, as well as the application and adaptation of synergy-based approaches to various rehabilitative scenarios for increasing the available evidence.

Clinical studies have shown that speech pauses can reflect the cognitive function differences between Alzheimer’s Disease (AD) and non-AD patients, while the value of pause information in AD detection has not been fully explored. Herein, we propose a speech pause feature extraction and encoding strategy for only acoustic-signal-based AD detection. First, a voice activity detection (VAD) method was constructed to detect pause/non-pause feature and encode it to binary pause sequences that are easier to calculate. Then, an ensemble machine-learning-based approach was proposed for the classification of AD from the participants’ spontaneous speech, based on the VAD Pause feature sequence and common acoustic feature sets (ComParE and eGeMAPS). The proposed pause feature sequence was verified in five machine-learning models. The validation data included two public challenge datasets (ADReSS and ADReSSo, English voice) and a local dataset (10 audio recordings containing five patients and five controls, Chinese voice). Results showed that the VAD Pause feature was more effective than common feature sets (ComParE: 6373 features and eGeMAPS: 88 features) for AD classification, and that the ensemble method improved the accuracy by more than 5% compared to several baseline methods (8% on the ADReSS dataset; 5.9% on the ADReSSo dataset). Moreover, the pause-sequence-based AD detection method could achieve 80% accuracy on the local dataset. Our study further demonstrated the potential of pause information in speech-based AD detection, and also contributed to a more accessible and general pause feature extraction and encoding method for AD detection.

In this article, to reduce the complexity and improve the generalization ability of current gesture recognition systems, we propose a novel SE-CNN attention architecture for sEMG-based hand gesture recognition. The proposed algorithm introduces a temporal squeeze-and-excite block into a simple CNN architecture and then utilizes it to recalibrate the weights of the feature outputs from the convolutional layer. By enhancing important features while suppressing useless ones, the model realizes gesture recognition efficiently. The last procedure of the proposed algorithm is utilizing a simple attention mechanism to enhance the learned representations of sEMG signals to perform multi-channel sEMG-based gesture recognition tasks. To evaluate the effectiveness and accuracy of the proposed algorithm, we conduct experiments involving multi-gesture datasets Ninapro DB4 and Ninapro DB5 for both inter-session validation and subject-wise cross-validation. After a series of comparisons with the previous models, the proposed algorithm effectively increases the robustness with improved gesture recognition performance and generalization ability.

Nano drugs have attracted increased attention due to their unique mode of action that offers tumor-inhibiting effects. Therefore, we have previously explored functionalized and drug-loaded graphene-gold nanocomposites that induced cancer cell apoptosis. In the present study, we developed a combination of monoclonal P-glycoprotein (P-gp) antibodies, folic acid (FA) and miR-122-loaded gold nanoparticles on graphene nanocomposites (GGMPN), which promoted drug-resistant HepG2 cell apoptosis with drug targeting and controlled release properties. We also investigated related apoptosis proteins and apoptosis signal pathways by GGMPN treatment in vitro and in vivo. Moreover, we further demonstrated the inhibition of tumor growth and the apoptosis-inducing effect by means of GGMPN with a semiconductor laser in a xenograft tumor model. In conclusion, our results collectively suggested that GGMPN could serve as a novel therapeutic approach to control tumor cell apoptosis and growth.

Currently, graphene oxide has attracted growing attention as a drug delivery system due to its unique characteristics. Furthermore, utilization of microRNAs as biomarkers and therapeutic strategies would be particularly attractive because of their biological mechanisms and relatively low toxicity. Therefore, we have developed functionalized nanocompounds consisted of graphene oxide, quantum dots and microRNA, which induced cancer cells apoptosis along with targeted imaging. In the present study, we synthesized a kind of graphene-P-gp loaded with miR-122-InP@ZnS quantum dots nanocomposites (GPMQNs) that, in the presence of glutathione, provides controlled release of miR-122. The miR-122 actively targeted liver tumor cells and induced their apoptosis, including drug-resistant liver tumor cells. We also explored the near-infrared fluorescence and potential utility for targeting imaging of InP@ZnS quantum dots. To further understand the molecular mechanism of GPMQNs-induced apoptosis of drug-resistant HepG2/ADM hepatoma cells, the relevant apoptosis proteins and signal pathways were explored in vitro and in vivo. Furthermore, near-infrared GPMQNs, which exhibited reduced photon scattering and auto-fluorescence, were applied for tumor imaging in vivo to allow for deep tissue penetration and three-dimensional imaging. In conclusion, techniques using GPMQNs could provide a novel targeted treatment for liver cancer, which possessed properties of targeted imaging, low toxicity, and controlled release.