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He J, Liu Y, Li S, Zhou P, Zhang Y. Enhanced Dynamic Surface EMG Decomposition Using the Non-Negative Matrix Factorization and Three-Dimensional Motor Unit Localization. IEEE Trans Biomed Eng 2024; 71:596-606. [PMID: 37656646 DOI: 10.1109/tbme.2023.3309969] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Surface electromyography (sEMG) signal decomposition is of great importance in examining neuromuscular diseases and neuromuscular research, especially dynamic sEMG decomposition is even more technically challenging. METHODS A novel two-step sEMG decomposition approach was developed. The linear minimum mean square error estimation was first employed to extract estimated firing trains (EFTs) from the eigenvector matrices constructed using the non-negative matrix factorization (NMF). The firing instants of each EFT were then classified into motor units (MUs) according to their specific three-dimensional (3D) space position. The performance of the proposed approach was evaluated using simulated and experimentally recorded sEMG. RESULTS The simulation results demonstrated that the proposed approach can reconstruct MUAPTs with true positive rates of 89.12 ± 2.71%, 94.34 ± 1.85% and 95.45 ± 2.11% at signal-to-noise ratios of 10, 20, and 30 dB, respectively. The experimental results also demonstrated a high decomposition accuracy of 90.13 ± 1.31% in the two-source evaluation, and a high accuracy of 91.86 ± 1.14% in decompose-synthesize-decompose- compare evaluation. CONCLUSIONS The adoption of NMF reduces the dimension of random pattern under the restriction of non-negativity, as well as keeps the information unchanged as much as possible. The 3D space information of MUs enhances the classification accuracy by tackling the issue of relative movements between MUs and electrodes during dynamic contractions. The accuracy achieved in this study demonstrates the good performance and reliability of the proposed decomposition algorithm in dynamic surface EMG decomposition. SIGNIFICANCE The spatiotemporal information is applied to the dynamic surface EMG decomposition.
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Xu L, Guo Z, Zheng D, Zhang J, Chen F, Liu R, Li C, Tan W. Editorial: AI empowered cerebro-cardiovascular health engineering. Front Physiol 2023; 14:1335573. [PMID: 38148898 PMCID: PMC10750346 DOI: 10.3389/fphys.2023.1335573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/05/2023] [Indexed: 12/28/2023] Open
Affiliation(s)
- Lisheng Xu
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
- Key Laboratory of Medical Image Computing, Ministry of Education, Shenyang, China
| | - Zengzhi Guo
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
- Key Laboratory of Medical Image Computing, Ministry of Education, Shenyang, China
| | - Dingchang Zheng
- Research Centre of Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Jianbao Zhang
- Department of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China
| | - Fei Chen
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Rong Liu
- School of Biomedical Engineering, Dalian University of Technology, Dalian, China
| | - Chunsheng Li
- Department of Biomedical Engineering, Shenyang University of Technology, Shenyang, China
| | - Wenjun Tan
- Key Laboratory of Medical Image Computing, Ministry of Education, Shenyang, China
- School of Computer Science and Engineering, Northeastern University, Shenyang, China
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Villa-Muñoz P, Albaladejo-Belmonte M, Nohales-Alfonso FJ, Alberola-Rubio J, Garcia-Casado J. Treatment of Vestibulodynia with Submucosal Injections of IncobotulinumtoxinA into Targeted Painful Points: An Open-Label Exploratory Study. Toxins (Basel) 2023; 15:476. [PMID: 37624233 PMCID: PMC10467121 DOI: 10.3390/toxins15080476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
The studies carried out to date on vulvodynia treatment with botulinum neurotoxin type A (BoNT/A) have followed generic injection protocols and reported contradictory outcomes on its effects. The aim of the present study was thus to propose a protocol for injecting BoNT/A into targeted painful points, to comprehensively assess the clinical effect of BoNT/A treatment and identify the risk/protective factors for successful treatment. Thirty-five vestibulodynia patients were treated with submucosal injections of incobotulinumtoxinA and assessed 8, 12 and 24 weeks after their treatment. Their clinical and pelvic statuses were assessed from self-reported questionnaires (Visual Analogue Scale (VAS), Female Sexual Function Index (FSFI), Marinoff's Dyspareunia Scale (MDS), Hospital Anxiety and Depression Scale (HADS), Catastrophizing Scale (CS)), physical examinations and surface electromyography (sEMG). The patients reported a reduction in provoked vestibulodynia ( FSFI, p < 0.01;
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Affiliation(s)
- Paula Villa-Muñoz
- Servicio De Ginecología Y Obstetricia, Hospital Universitari I Politècnic La Fe, 46026 Valencia, Spain; (P.V.-M.); (F.J.N.-A.)
| | - Monica Albaladejo-Belmonte
- Centro De Investigación E Innovación En Bioingeniería (CI2B), Universitat Politècnica De València, 46022 Valencia, Spain;
| | - Francisco J. Nohales-Alfonso
- Servicio De Ginecología Y Obstetricia, Hospital Universitari I Politècnic La Fe, 46026 Valencia, Spain; (P.V.-M.); (F.J.N.-A.)
| | | | - Javier Garcia-Casado
- Centro De Investigación E Innovación En Bioingeniería (CI2B), Universitat Politècnica De València, 46022 Valencia, Spain;
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Surface EMG decomposition based on innervation zone mapping and an LMMSE framework. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Asimakidou E, Sidiropoulos C. A Bayesian Network Meta-Analysis and Systematic Review of Guidance Techniques in Botulinum Toxin Injections and Their Hierarchy in the Treatment of Limb Spasticity. Toxins (Basel) 2023; 15:toxins15040256. [PMID: 37104194 PMCID: PMC10145352 DOI: 10.3390/toxins15040256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Accurate targeting of overactive muscles is fundamental for successful botulinum neurotoxin (BoNT) injections in the treatment of spasticity. The necessity of instrumented guidance and the superiority of one or more guidance techniques are ambiguous. Here, we sought to investigate if guided BoNT injections lead to a better clinical outcome in adults with limb spasticity compared to non-guided injections. We also aimed to elucidate the hierarchy of common guidance techniques including electromyography, electrostimulation, manual needle placement and ultrasound. To this end, we conducted a Bayesian network meta-analysis and systematic review with 245 patients using the MetaInsight software, R and the Cochrane Review Manager. Our study provided, for the first time, quantitative evidence supporting the superiority of guided BoNT injections over the non-guided ones. The hierarchy comprised ultrasound on the first level, electrostimulation on the second, electromyography on the third and manual needle placement on the last level. The difference between ultrasound and electrostimulation was minor and, thus, appropriate contextualization is essential for decision making. Taken together, guided BoNT injections based on ultrasound and electrostimulation performed by experienced practitioners lead to a better clinical outcome within the first month post-injection in adults with limb spasticity. In the present study, ultrasound performed slightly better, but large-scale trials should shed more light on which modality is superior.
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Huang C, Lu Z, Chen M, Klein CS, Zhang Y, Li S, Zhou P. Muscle innervation zone estimation from monopolar high-density M-waves using principal component analysis and radon transform. Front Physiol 2023; 14:1137146. [PMID: 37008017 PMCID: PMC10050562 DOI: 10.3389/fphys.2023.1137146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
This study examined methods for estimating the innervation zone (IZ) of a muscle using recorded monopolar high density M waves. Two IZ estimation methods based on principal component analysis (PCA) and Radon transform (RT) were examined. Experimental M waves, acquired from the biceps brachii muscles of nine healthy subjects were used as testing data sets. The performance of the two methods was evaluated by comparing their IZ estimations with manual IZ detection by experienced human operators. Compared with manual detection, the agreement rate of the estimated IZs was 83% and 63% for PCA and RT based methods, respectively, both using monopolar high density M waves. In contrast, the agreement rate was 56% for cross correlation analysis using bipolar high density M waves. The mean difference in estimated IZ location between manual detection and the tested method was 0.12 ± 0.28 inter-electrode-distance (IED) for PCA, 0.33 ± 0.41 IED for RT and 0.39 ± 0.74 IED for cross correlation-based methods. The results indicate that the PCA based method was able to automatically detect muscle IZs from monopolar M waves. Thus, PCA provides an alternative approach to estimate IZ location of voluntary or electrically-evoked muscle contractions, and may have particular value for IZ detection in patients with impaired voluntary muscle activation.
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Affiliation(s)
- Chengjun Huang
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
| | - Zhiyuan Lu
- School of Rehabilitation Science and Engineering, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
- *Correspondence: Zhiyuan Lu, ; Ping Zhou,
| | - Maoqi Chen
- School of Rehabilitation Science and Engineering, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Cliff S. Klein
- Guangdong Work Injury Rehabilitation Center, Guangzhou, Guangdong, China
| | - Yingchun Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX, United States
| | - Sheng Li
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX, United States
- TIRR Memorial Hermann Hospital, Houston, TX, United States
| | - Ping Zhou
- School of Rehabilitation Science and Engineering, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
- *Correspondence: Zhiyuan Lu, ; Ping Zhou,
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Liu Y, Chen YT, Zhang C, Zhou P, Li S, Zhang Y. Motor unit distribution and recruitment in spastic and non-spastic bilateral biceps brachii muscles of chronic stroke survivors. J Neural Eng 2022; 19:10.1088/1741-2552/ac86f4. [PMID: 35926440 PMCID: PMC9526353 DOI: 10.1088/1741-2552/ac86f4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 08/04/2022] [Indexed: 11/11/2022]
Abstract
Objective.This study aims to characterize the motor units (MUs) distribution and recruitment pattern in the spastic and non-spastic bilateral biceps brachii muscles (BBMs) of chronic stroke survivors.Approach.High-density surface electromyography (HD-sEMG) signals were collected from both spastic and non-spastic BBMs of fourteen chronic stroke subjects during isometric elbow flexion at 10%, 30%, 50% and 100% maximal voluntary contractions (MVCs). By combining HD-sEMG decomposition and bioelectrical source imaging, MU innervation zones (MUIZs) of the decomposed MUs were first localized in the 3D space of spastic and non-spastic BBMs. The MU depth defined as the distance between the localized MUIZ and its normal projection on the skin surface was then normalized to the arm radius of each subject and averaged at given contraction level. The averaged MU depth at different contraction levels on a specific arm side (intra-side) and the bilateral depths under a specific contraction level (inter-side) were compared.Main results.The average depth of decomposed MUs increased with the contraction force and significant differences observed between 10% vs 50% (p< 0.0001), 10% vs 100% (p< 0.0001) and 30% vs 100% MVC (p= 0.0017) on the non-spastic side, indicating that larger MUs with higher recruitment threshold locate in deeper muscle regions. In contrast, no force-related difference in MU depth was observed on the spastic side, suggesting a disruption of orderly recruitment of MUs with increase of force level, or the MU denervation and the subsequent collateral reinnervation secondary to upper motor neuron lesions. Inter-side comparison demonstrated significant MU depth difference at 10% (p= 0.0048) and 100% force effort (p= 0.0026).Significance.This study represents the first effort to non-invasively characterize the MU distribution inside spastic and non-spastic bilateral BBM of chronic stroke patients by combining HD-sEMG recording, EMG signal decomposition and bioelectrical source imaging. The findings of this study advances our understanding regarding the neurophysiology of human muscles and the neuromuscular alterations following stroke. It may also offer important MU depth information for botulinum toxin injection in clinical post-stroke spasticity management.
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Affiliation(s)
- Yang Liu
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204 USA
| | - Yen-Ting Chen
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX 77030, United States
- TIRR Memorial Hermann Hospital, Houston, TX 77030, USA
- Department of Health and Kinesiology, Northeastern State University, Broken Arrow, OK 74014, USA
| | - Chuan Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204 USA
| | - Ping Zhou
- Faculty of Rehabilitation Engineering, University of Health and Rehabilitation Sciences, Qingdao 266024, China
| | - Sheng Li
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX 77030, United States
- TIRR Memorial Hermann Hospital, Houston, TX 77030, USA
| | - Yingchun Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204 USA
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Jiménez P, Corchuelo R. An Experimental Study of Neural Approaches to Multi-Hop Inference in Question Answering. Int J Neural Syst 2022; 32:2250011. [PMID: 35172705 DOI: 10.1142/s0129065722500113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Question answering aims at computing the answer to a question given a context with facts. Many proposals focus on questions whose answer is explicit in the context; lately, there has been an increasing interest in questions whose answer is not explicit and requires multi-hop inference to be computed. Our analysis of the literature reveals that there is a seminal proposal with increasingly complex follow-ups. Unfortunately, they were presented without an extensive study of their hyper-parameters, the experimental studies focused exclusively on English, and no statistical analysis to sustain the conclusions was ever performed. In this paper, we report on our experience devising a very simple neural approach to address the problem, on our extensive grid search over the space of hyper-parameters, on the results attained with English, Spanish, Hindi, and Portuguese, and sustain our conclusions with statistically sound analyses. Our findings prove that it is possible to beat many of the proposals in the literature with a very simple approach that was likely overlooked due to the difficulty to perform an extensive grid search, that the language does not have a statistically significant impact on the results, and that the empirical differences found among some existing proposals are not statistically significant.
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Affiliation(s)
- Patricia Jiménez
- Universidad de Sevilla, ETSI Informática, Avda. de la Reina Mercedes, s/n. Sevilla E-41012, Spain
| | - Rafael Corchuelo
- Universidad de Sevilla, ETSI Informática, Avda. de la Reina Mercedes, s/n. Sevilla E-41012, Spain
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Chen YT, Liu Y, Zhang C, Magat E, Zhou P, Zhang Y, Li S. Comprehensive Assessment of the Time Course of Biomechanical, Electrophysiological and Neuro-Motor Effects after Botulinum Toxin Injections in Elbow Flexors of Chronic Stroke Survivors with Spastic Hemiplegia: A Cross Sectional Observation Study. Toxins (Basel) 2022; 14:toxins14020104. [PMID: 35202132 PMCID: PMC8875179 DOI: 10.3390/toxins14020104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 11/28/2022] Open
Abstract
Botulinum neurotoxin (BoNT) is commonly used to manage focal spasticity in stroke survivors. This study aimed to a perform comprehensive assessment of the effects of BoNT injection. Twelve stroke subjects with spastic hemiplegia (age: 52.0 ± 10.1 year; 5 females) received 100 units of BoNT to the spastic biceps brachii muscles. Clinical, biomechanical, electrophysiological, and neuro-motor assessments were performed one week (wk) before (pre-injection), 3 weeks (wks) after, and 3 months (mons) after BoNT injection. BoNT injection significantly reduced spasticity, muscle strength, reflex torque, and compound muscle action potential (CMAP) amplitude of spastic elbow flexors (all p < 0.05) during the 3-wks visit, and these values return to the pre-injection level during the 3-mons visit. Furthermore, the degree of reflex torque change was negatively correlated to the amount of non-reflex component of elbow flexor resistance torque. However, voluntary force control and non-reflex resistance torque remained unchanged throughout. Our results revealed parallel changes in clinical, neurophysiological and biomechanical assessment after BoNT injection; BoNT injection would be more effective if hypertonia was mainly mediated by underlying neural mechanisms. BoNT did not affect voluntary force control of spastic muscles.
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Affiliation(s)
- Yen-Ting Chen
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (Y.-T.C.); (E.M.)
- TIRR Memorial Hermann Hospital, Houston, TX 77030, USA
- Department of Health and Kinesiology, Northeastern State University, Broken Arrow, OK 74014, USA
| | - Yang Liu
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA; (Y.L.); (C.Z.); (Y.Z.)
| | - Chuan Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA; (Y.L.); (C.Z.); (Y.Z.)
| | - Elaine Magat
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (Y.-T.C.); (E.M.)
- TIRR Memorial Hermann Hospital, Houston, TX 77030, USA
| | - Ping Zhou
- Faculty of Biomedical and Rehabilitation Engineering, University of Health and Rehabilitation Sciences, Qingdao 266024, China;
| | - Yingchun Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA; (Y.L.); (C.Z.); (Y.Z.)
| | - Sheng Li
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (Y.-T.C.); (E.M.)
- TIRR Memorial Hermann Hospital, Houston, TX 77030, USA
- Correspondence:
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Huang C, Chen M, Li X, Zhang Y, Li S, Zhou P. Neurophysiological Factors Affecting Muscle Innervation Zone Estimation Using Surface EMG: A Simulation Study. BIOSENSORS-BASEL 2021; 11:bios11100356. [PMID: 34677312 PMCID: PMC8534086 DOI: 10.3390/bios11100356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/16/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022]
Abstract
Surface electromyography (EMG) recorded by a linear or 2-dimensional electrode array can be used to estimate the location of muscle innervation zones (IZ). There are various neurophysiological factors that may influence surface EMG and thus potentially compromise muscle IZ estimation. The objective of this study was to evaluate how surface-EMG-based IZ estimation might be affected by different factors, including varying degrees of motor unit (MU) synchronization in the case of single or double IZs. The study was performed by implementing a model simulating surface EMG activity. Three different MU synchronization conditions were simulated, namely no synchronization, medium level synchronization, and complete synchronization analog to M wave. Surface EMG signals recorded by a 2-dimensional electrode array were simulated from a muscle with single and double IZs, respectively. For each situation, the IZ was estimated from surface EMG and compared with the one used in the model for performance evaluation. For the muscle with only one IZ, the estimated IZ location from surface EMG was consistent with the one used in the model for all the three MU synchronization conditions. For the muscle with double IZs, at least one IZ was appropriately estimated from interference surface EMG when there was no MU synchronization. However, the estimated IZ was different from either of the two IZ locations used in the model for the other two MU synchronization conditions. For muscles with a single IZ, MU synchronization has little effect on IZ estimation from electrode array surface EMG. However, caution is required for multiple IZ muscles since MU synchronization might lead to false IZ estimation.
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Affiliation(s)
- Chengjun Huang
- Guangdong Work Injury Rehabilitation Center, Guangzhou 510970, China;
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Maoqi Chen
- Faculty of Rehabilitation Engineering, University of Health and Rehabilitation Sciences, Qingdao 266024, China;
| | - Xiaoyan Li
- Department of Bioengineering, University of Maryland, College Park, MD 20742, USA;
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Yingchun Zhang
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA;
| | - Sheng Li
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Ping Zhou
- Faculty of Rehabilitation Engineering, University of Health and Rehabilitation Sciences, Qingdao 266024, China;
- Correspondence:
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