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Sample records for inspiratory threshold loading

  1. Activity of latissimus dorsi muscle during inspiratory threshold loads.

    PubMed

    Orozco-Levi, M; Gea, J; Monells, J; Aran, X; Aguar, M C; Broquetas, J M

    1995-03-01

    The ability of the latissimus dorsi muscle (LD) to participate as an accessory inspiratory muscle has been the subject of controversy. Electromyographic (EGM) activity of LD was evaluated in 11 healthy subjects (aged 30 +/- 2 yrs; forced expiratory volume in one second (FEV1) 106 +/- 5% predicted; maximal inspiratory pressure (Pmax), 120 +/- 6 cmH2O) under different breathing conditions. The ipsilateral biceps brachii was chosen as the control muscle. The EMG was recorded from surface electrodes, but needle electrodes were also used for LD evaluation in a subset of three subjects. The EMG signal from both muscles was recorded simultaneously, rectified and integrated, with subtraction of the electrocardiographic signal. Situations evaluated were: 1) maximal voluntary contraction (MVC); 2) apnoea; and 3) breathing under progressive inspiratory threshold loads (20-100% Pmax, at 20% intervals). A close relationship was evident between LD recordings from surface and needle electrodes (r = 0.975). Activity of LD at baseline was 1.8 +/- 0.4% MVC, and showed a phasic increase during inspiration under loads. This change had a linear tendency and was significant for loads corresponding to 40, 60, 80 and 100% of Pmax when compared to the control muscle. At this latter level, LD activity was equivalent to 32 +/- 5% MVC (range 11-61%), whereas mean activity of the control muscle was less than 7.5% MVC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7789491

  2. Inspiratory muscle training in chronic airflow limitation: comparison of two different training loads with a threshold device.

    PubMed

    Lisboa, C; Muñoz, V; Beroiza, T; Leiva, A; Cruz, E

    1994-07-01

    The usefulness of inspiratory muscle training (IMT) in chronic airflow limitation (CAL) patients is a controversial issue, mainly due to differences in the training load. To further evaluate this aspect, we studied the effect of the magnitude of the load using a threshold pressure trainer. Ten CAL patients (5 males, 5 females) 67 +/- 2 yrs (mean +/- SEM) and forced expiratory volume in one second (FEV1) 36 +/- 2% pred, were trained for 30 min a day using a load of 30% of their maximal inspiratory mouth pressure (PImax) (Group 1). Another 10 CAL patients (5 males, 5 females), 73 +/- 2 yrs and FEV1 37 +/- 2% pred), were trained using only 12% of their PImax (Group 2). Training was assessed by PImax, inspiratory muscle power output (IMPO), sustainable inspiratory pressure (SIP), maximal inspiratory flow rate (VImax), pattern of breathing during loaded breathing, Mahler's dyspnoea score, and the 6 min walking distance (6MWD). After 5 weeks of training, Group 1 exhibited significant increments in: PImax (34 +/- 11%); IMPO (92 +/- 16%); SIP (36 +/- 9%); and VImax (34 +/- 13%). Dyspnoea was also reduced, and the 6MWD increased by 48 +/- 22 m. We observed no significant changes in Group 2. During loaded breathing, Group 1 showed a significant increment in tidal volume (VT) and mean inspiratory flow (VT/TI), and a reduction in inspiratory time (TI). In Group 2, VT and VT/TI also increased significantly, but the breathing frequency increased with a reduction of expiratory time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7925905

  3. Effect of inspiratory muscle training with an intermediate load on inspiratory power output in COPD.

    PubMed

    Villafranca, C; Borzone, G; Leiva, A; Lisboa, C

    1998-01-01

    There is very little information about the effect of inspiratory muscle training on inspiratory flow (V'I) and thus on power output (PO) in patients with chronic obstructive pulmonary disease (COPD). In this study we aimed to evaluate the changes induced by training on the determinants of PO. Thirty one patients with severe COPD were randomly divided into: Group 1, trained with 30% maximal inspiratory pressure (PI,max); Group 2, with 10% PI,max; and Group 3 also trained with 30% PI,max, but the breathing pattern was evaluated while performing the training manoeuvres along inspiratory muscle training (IMT). All groups used a threshold device for 10 weeks. The PO for each of the loads during an incremental threshold test was evaluated prior to and after training. Maximal PO (POmax) increased in all groups, but the increment was higher in groups trained with 30% PI,max (p<0.005), mainly due to an increase in V'I. Group 3 showed a progressive increase in V'I (p<0.001) during the training manoeuvres in spite of an increase in load along IMT. In addition, the load after IMT was overcome with a shorter inspiratory time (tI) (p<0.02), a smaller tI/total duration of the respiratory cycle (t(tot)), (p<0.001) with no change in tidal volume or t(tot). The increment in POmax in this group correlated with the V'I generated while training (r=0.85; p<0.0001). We conclude that in patients with chronic obstructive pulmonary disease, the use of an intermediate threshold load for training improves power output mainly by increasing inspiratory flow, an effect consistent with an increase in shortening velocity of inspiratory muscles. PMID:9543266

  4. Model analysis of respiratory responses to inspiratory resistive loads.

    PubMed

    Zin, W A; Rossi, A; Milic-Emili, J

    1983-11-01

    Based on experimental inspiratory driving pressure waveforms and active respiratory impedance data of anesthetized cats, we made model predictions of the factors that determine the immediate (first loaded breath) intrinsic (i.e., nonneural) tidal volume compensation to added inspiratory resistive loads. The time course of driving pressure (P) was given by P = atb, where a is the pressure at 1 s from onset of inspiration and represents the intensity of neuromuscular drive, t is time, and b is a dimensionless index of the shape of the driving pressure wave. For a given value of active respiratory impedance, tidal volume compensation to added resistive loads increases with increasing inspiratory duration and decreasing value of b but is independent of a. Model predictions of load compensation are compared to experimental results. PMID:6643192

  5. Evaluation of the THRESHOLD trainer for inspiratory muscle endurance training: comparison with the weighted plunger method.

    PubMed

    Johnson, P H; Cowley, A J; Kinnear, W J

    1996-12-01

    Inspiratory muscle training (IMT) has been shown to enhance exercise performance. The weighted plunger (WP) system of inspiratory threshold loading is the most commonly used method of IMT, but is expensive and cumbersome. We have evaluated a commercially available portable spring-loaded IMT device, the THRESHOLD trainer. The WP and THRESHOLD trainer devices were evaluated with their opening pressures set, in random order, at 10, 20, 30 and 40 cmH2O. Using an airpump, pressure at the valve inlet was recorded at the point at which the valve opened, and at airflow rates of 20, 40, 60, 80 and 100 L.min-1. Ten THRESHOLD trainers were then compared using the same opening pressures and airflow rates. Finally, 10 patients with stable chronic heart failure (CHF) inspired, in random order, through the WP and THRESHOLD trainer for 4 min each. The pressure-time product (PTP) was calculated for each 4 min period, to compare the work performed on inspiring through each device. The mean measured opening pressures for the WP set at 10, 20, 30 and 40 cmH2O, were 9.0, 19.3, 27.9 and 39.2 cmH2O, respectively, and there was little change over the range of flow tested. Corresponding values for the THRESHOLD trainer were 7.5, 16.9, 26.2 and 39.1 cmH2O, with the pressure being closer to the set pressure as flow increased to that seen in clinical practice. The 10 different trainers tested performed very similarly to one another. Work performed (as measured by PTP) on inspiring through the WP and THRESHOLD trainer was not significantly different. Although less accurate than the weighted plunger, the THRESHOLD trainer is an inexpensive device of consistent quality. In a clinical setting it would be a satisfactory option for inspiratory muscle training in most patients, but less so in patients with very low inspiratory flow rates. PMID:8980985

  6. Model analysis of tidal volume response to inspiratory elastic loads.

    PubMed

    Zin, W A; Rossi, A; Zocchi, L; Milic-Emili, J

    1984-07-01

    Based on experimental inspiratory driving pressure waveforms and active respiratory impedance data of anesthetized cats, we made model predictions of the factors that determine the immediate (first loaded breath) intrinsic (i.e., nonneural) tidal volume compensation to added inspiratory elastic loads. The time course of driving pressure (P) was given by P = atb, where a is the pressure at 1 s from onset of inspiration and represents the intensity of neuromuscular drive, t is time, and b is an index of the shape of the driving pressure wave. For a given active respiratory impedance, tidal volume compensation to added elastic loads decreases with increasing inspiratory duration and decreasing value of b but is independent of a. We have also assessed the validity of the "effective elastance" (Lynne-Davies et al., J. Appl. Physiol. 30: 512-516, 1971) as a predictor of tidal volume responses to elastic loads. In absence of vagal feedback, the effective elastance appears to be a reliable predictor, except for short inspiratory duration and a very high intrinsic resistance. PMID:6469787

  7. Comparison of incremental and constant load tests of inspiratory muscle endurance in COPD.

    PubMed

    Hill, K; Jenkins, S C; Philippe, D L; Shepherd, K L; Hillman, D R; Eastwood, P R

    2007-09-01

    The aim of the present study was to determine the relative value of incremental and constant load tests in detecting changes in inspiratory muscle endurance following high-intensity inspiratory muscle training (H-IMT) in chronic obstructive pulmonary disease. In total, 16 subjects (11 males; forced expiratory volume in one second (FEV(1)) 37.4+/-12.5%) underwent H-IMT. In addition, 17 subjects (11 males; FEV(1) 36.5+/-11.5%) underwent sham inspiratory muscle training (S-IMT). Training took place three times a week for 8 weeks. Baseline and post-training measurements were obtained of maximum threshold pressure sustained during an incremental load test (P(th,max)) and time breathing against a constant load (t(lim)). Breathing pattern was unconstrained. H-IMT increased P(th,max) and t(lim) relative to baseline and to any change seen following S-IMT. The effect size for P(th,max) was greater than for t(lim). Post-training tests were accompanied by changes in breathing pattern, including decreased duty cycle, which may have served to decrease inspiratory work and thereby contribute to the increase in P(th,max) and t(lim) in both groups. When assessing inspiratory muscle function in chronic obstructive pulmonary disease via tests in which the pattern of breathing is unconstrained, the current authors recommend incremental load tests be used in preference to constant load tests. However, to attribute changes in these tests to improvements in inspiratory muscle endurance, breathing pattern should be controlled. PMID:17504795

  8. Inspiratory muscle performance relative to the anaerobic threshold in patients with COPD.

    PubMed

    Wanke, T; Formanek, D; Lahrmann, H; Merkle, M; Rauscher, H; Zwick, H

    1993-09-01

    Rehabilitation programmes in chronic obstructive pulmonary disease (COPD) require exercise training above the anaerobic threshold. However, not all COPD patients develop metabolic acidosis during exercise. The hypothesis of this study was that non-exercise variables, characterizing the mechanical load on the inspiratory muscles during breathing at rest, can be used to reliably predict which patients with COPD are not able to develop metabolic acidosis during exercise. Thirty participants with COPD performed a symptom-limited cycle ergometer test. The oesophageal pressure/time index (PTIoes: the product of pressure magnitude and duration), the mean rate of pressure development during inspiration (Poes/TI), and the mean airway resistance (Raw)/maximal oesophageal pressure (Poesmax) ratio served as indices for the mechanical load on the inspiratory muscles. The oxygen uptake (VO2) at which plasma standard bicarbonate was seen to decrease from its baseline value was taken as the anaerboic threshold (AT). Mean Raw was significantly higher in those patients in whom the AT could not be detected. No other lung function parameters measured at rest allowed the accurate selection of those patients who did or did not develop exercise metabolic acidosis. On the other hand, Raw/Poesmax, PTIoes and Poes/TI were significantly different in the two patient groups. Additionally, whereas in the patient group with identifiable AT exercise hyperpnoea produced a non-linear increase of Poes/TI with respect to PTIoes above the AT, in the patient group without identifiable AT there was a linear relationship between Poes/TI and PTIoes throughout exercise. We conclude that the determination of inspiratory muscle load indices at rest may be useful in pulmonary rehabilitation programmes, for identifying those patients with COPD who do not develop exercise induced metabolic acidosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8224135

  9. Systemic inflammation after inspiratory loading in chronic obstructive pulmonary disease

    PubMed Central

    Fuster, Antonia; Sauleda, Jaume; Sala, Ernest; Barceló, Bernardí; Pons, Jaume; Carrera, Miguel; Noguera, Aina; Togores, Bernat; Agustí, Alvar GN

    2008-01-01

    Objective Patients with chronic obstructive pulmonary disease (COPD) present systemic inflammation. Strenuous resistive breathing induces systemic inflammation in healthy subjects. We hypothesized that the increased respiratory load that characterizes COPD can contribute to systemic inflammation in these patients. Patients and methods To test this hypothesis, we compared leukocyte numbers and levels of circulating cytokines (tumor necrosis factor alpha [TNFα], interleukin-1β [IL-1β], IL-6, IL-8, and IL-10), before and 1 hour after maximal incremental inspiratory loading in 13 patients with stable COPD (forced expiratory volume in one second [FEV1] 29 ± 2.5% ref) and in 8 healthy sedentary subjects (FEV1 98 ± 5% ref). Results We found that: (1) at baseline, patients with COPD showed higher leukocyte counts and IL-8 levels than controls (p < 0.01); and, (2) one hour after maximal inspiratory loading these values were unchanged, except for IL-10, which increased in controls (p < 0.05) but not in patients with COPD. Conclusions This study confirms the presence of systemic inflammation in COPD, shows that maximal inspiratory loading does not increase the levels of pro-inflammatory cytokines (IL-1β, IL-8) in COPD patients or controls, but suggests that the former may be unable to mount an appropriate systemic anti-inflammatory response to exercise. PMID:18488438

  10. Effects of inspiratory loading on the chaotic dynamics of ventilatory flow in humans.

    PubMed

    Samara, Ziyad; Raux, Mathieu; Fiamma, Marie-Noëlle; Gharbi, Alexandre; Gottfried, Stewart B; Poon, Chi-Sang; Similowski, Thomas; Straus, Christian

    2009-01-01

    Human ventilation at rest exhibits complexity and chaos. The aim of this study was to determine whether suprapontine interferences with the automatic breathing control could contribute to ventilatory chaos. We conducted a post hoc analysis of a previous study performed in awake volunteers exhibiting cortical pre-motor potentials during inspiratory loading. In eight subjects, flow was recorded at rest, while breathing against inspiratory threshold loads (median 21.5 cm H(2)O) and resistive loads (50 cm H(2)Ol(-1)s(-1)) loads, and while inhaling 7% CO(2)-93% O(2). Chaos was identified through noise titration (noise limit, NL) and the sensitivity to initial conditions was assessed through the largest Lyapunov exponent (LLE). Breath-by-breath variability was evaluated using the coefficient of variation of several ventilatory variables. Chaos was consistently present in ventilatory flow recordings, but mechanical loading did not alter NL, LLE, or variability. In contrast, CO(2) altered chaos and reduced variability. In conclusion, inspiratory loading - and any resultant respiratory-related cortical activity - were not associated with changes in ventilatory chaos in this study, arguing against suprapontine contributions to ventilatory complexity. PMID:19013545

  11. The effect of exercise training with an additional inspiratory load on inspiratory muscle fatigue and time-trial performance.

    PubMed

    McEntire, Serina J; Smith, Joshua R; Ferguson, Christine S; Brown, Kelly R; Kurti, Stephanie P; Harms, Craig A

    2016-08-01

    The purpose was to determine the effect of moderate-intensity exercise training (ET) on inspiratory muscle fatigue (IMF) and if an additional inspiratory load during ET (ET+IL) would further improve inspiratory muscle strength, IMF, and time-trial performance. 15 subjects were randomly divided to ET (n=8) and ET+IL groups (n=7). All subjects completed six weeks of exercise training three days/week at ∼70%V̇O2peak for 30min. The ET+IL group breathed through an inspiratory muscle trainer (15% PImax) during exercise. 5-mile, and 30-min time-trials were performed pre-training, weeks three and six. Inspiratory muscle strength increased (p<0.05) for both groups to a similar (p>0.05) extent. ET and ET+IL groups improved (p<0.05) 5-mile time-trial performance (∼10% and ∼18%) and the ET+IL group was significantly faster than ET at week 6. ET and ET+IL groups experienced less (p<0.05) IMF compared to pre-training following the 5-mile time-trial. In conclusion, these data suggest ET leads to less IMF, ET+IL improves inspiratory muscle strength and IMF, but not different than ET alone. PMID:27195511

  12. When Breathing Interferes with Cognition: Experimental Inspiratory Loading Alters Timed Up-and-Go Test in Normal Humans

    PubMed Central

    Nierat, Marie-Cécile; Demiri, Suela; Dupuis-Lozeron, Elise; Allali, Gilles; Morélot-Panzini, Capucine; Similowski, Thomas; Adler, Dan

    2016-01-01

    Human breathing stems from automatic brainstem neural processes. It can also be operated by cortico-subcortical networks, especially when breathing becomes uncomfortable because of external or internal inspiratory loads. How the “irruption of breathing into consciousness” interacts with cognition remains unclear, but a case report in a patient with defective automatic breathing (Ondine's curse syndrome) has shown that there was a cognitive cost of breathing when the respiratory cortical networks were engaged. In a pilot study of putative breathing-cognition interactions, the present study relied on a randomized design to test the hypothesis that experimentally loaded breathing in 28 young healthy subjects would have a negative impact on cognition as tested by “timed up-and-go” test (TUG) and its imagery version (iTUG). Progressive inspiratory threshold loading resulted in slower TUG and iTUG performance. Participants consistently imagined themselves faster than they actually were. However, progressive inspiratory loading slowed iTUG more than TUG, a finding that is unexpected with regard to the known effects of dual tasking on TUG and iTUG (slower TUG but stable iTUG). Insofar as the cortical networks engaged in response to inspiratory loading are also activated during complex locomotor tasks requiring cognitive inputs, we infer that competition for cortical resources may account for the breathing-cognition interference that is evidenced here. PMID:26978782

  13. When Breathing Interferes with Cognition: Experimental Inspiratory Loading Alters Timed Up-and-Go Test in Normal Humans.

    PubMed

    Nierat, Marie-Cécile; Demiri, Suela; Dupuis-Lozeron, Elise; Allali, Gilles; Morélot-Panzini, Capucine; Similowski, Thomas; Adler, Dan

    2016-01-01

    Human breathing stems from automatic brainstem neural processes. It can also be operated by cortico-subcortical networks, especially when breathing becomes uncomfortable because of external or internal inspiratory loads. How the "irruption of breathing into consciousness" interacts with cognition remains unclear, but a case report in a patient with defective automatic breathing (Ondine's curse syndrome) has shown that there was a cognitive cost of breathing when the respiratory cortical networks were engaged. In a pilot study of putative breathing-cognition interactions, the present study relied on a randomized design to test the hypothesis that experimentally loaded breathing in 28 young healthy subjects would have a negative impact on cognition as tested by "timed up-and-go" test (TUG) and its imagery version (iTUG). Progressive inspiratory threshold loading resulted in slower TUG and iTUG performance. Participants consistently imagined themselves faster than they actually were. However, progressive inspiratory loading slowed iTUG more than TUG, a finding that is unexpected with regard to the known effects of dual tasking on TUG and iTUG (slower TUG but stable iTUG). Insofar as the cortical networks engaged in response to inspiratory loading are also activated during complex locomotor tasks requiring cognitive inputs, we infer that competition for cortical resources may account for the breathing-cognition interference that is evidenced here. PMID:26978782

  14. Repetitive transcranial magnetic stimulation over the supplementary motor area modifies breathing pattern in response to inspiratory loading in normal humans

    PubMed Central

    Nierat, Marie-Cécile; Hudson, Anna L.; Chaskalovic, Joël; Similowski, Thomas; Laviolette, Louis

    2015-01-01

    In awake humans, breathing depends on automatic brainstem pattern generators. It is also heavily influenced by cortical networks. For example, functional magnetic resonance imaging and electroencephalographic data show that the supplementary motor area becomes active when breathing is made difficult by inspiratory mechanical loads like resistances or threshold valves, which is associated with perceived respiratory discomfort. We hypothesized that manipulating the excitability of the supplementary motor area with repetitive transcranial magnetic stimulation would modify the breathing pattern response to an experimental inspiratory load and possibly respiratory discomfort. Seven subjects (three men, age 25 ± 4) were studied. Breathing pattern and respiratory discomfort during inspiratory loading were described before and after conditioning the supplementary motor area with repetitive stimulation, using an excitatory paradigm (5 Hz stimulation), an inhibitory paradigm, or sham stimulation. No significant change in breathing pattern during loading was observed after sham conditioning. Excitatory conditioning shortened inspiratory time (p = 0.001), decreased tidal volume (p = 0.016), and decreased ventilation (p = 0.003), as corroborated by an increased end-tidal expired carbon dioxide (p = 0.013). Inhibitory conditioning did not affect ventilation, but lengthened expiratory time (p = 0.031). Respiratory discomfort was mild under baseline conditions, and unchanged after conditioning of the supplementary motor area. This is the first study to show that repetitive transcranial magnetic stimulation conditioning of the cerebral cortex can alter breathing pattern. A 5 Hz conditioning protocol, known to enhance corticophrenic excitability, can reduce the amount of hyperventilation induced by inspiratory threshold loading. Further studies are needed to determine whether and under what circumstances rTMS can have an effect on dyspnoea. PMID:26483701

  15. Reliability of an Electronic Inspiratory Loading Device for Assessing Pulmonary Function in Post-Stroke Patients

    PubMed Central

    Lee, Kyeong-Bong; Kim, Min-Kyu; Jeong, Ju-Ri; Lee, Wan-Hee

    2016-01-01

    Background The purpose of this study was to examine the inter- and intra-rater reliability of an electronic inspiratory loading device for the assessment of pulmonary functions: maximum inspiratory pressure, peak inspiratory flow, and vital capacity. Material/Methods Subjects were 50 patient volunteers in a rehabilitation hospital who had experienced their first episode of unilateral stroke with hemiparesis during the previous 6 months (26 men, 24 women; mean age [±SD], 55.96 [±12.81] years), with no use of medications that could induce drowsiness, evidence of restrictive lung disease, history of asthma, use of psychotropic drugs, or alcohol consumption habit. Maximum inspiratory pressure, peak inspiratory flow, and vital capacity for pulmonary functions were assessed using an electronic inspiratory loading device (PowerBreathe, K5, 2010) by 2 examiners, with patients in an unassisted sitting position, and 1 examiner re-assessed with same patients at the same time of a day after 1 week. Intra-class correlation coefficients were used to assess reliability. Results Intra-rater reliability ranged from intra-class correlation coefficients (ICCs)=0.959 to 0.986 in variables. For the inter-rater reliability between 2 examiners, the ICCs ranged from 0.933 to 0.985. Intra-rater and inter-rater reliability were good in variables (maximal inspiratory pressure, peak inspiratory flow, and vital capacity). Conclusions The intra- and inter-examiner reliability of the pulmonary function measurements, maximum inspiratory pressure, peak inspiratory flow, and vital capacity, for the post-stroke patients was very high. The results suggest that the electronic inspiratory loading device would be useful for clinical rehabilitative assessment of pulmonary function. PMID:26782369

  16. Acute and chronic responses of the upper airway to inspiratory loading in healthy awake humans: an MRI study.

    PubMed

    How, Stephen C; McConnell, Alison K; Taylor, Bryan J; Romer, Lee M

    2007-08-01

    We assessed upper airway responses to acute and chronic inspiratory loading. In Experiment I, 11 healthy subjects underwent T(2)-weighted magnetic resonance imaging (MRI) of upper airway dilator muscles (genioglossus and geniohyoid) before and up to 10 min after a single bout of pressure threshold inspiratory muscle training (IMT) at 60% maximal inspiratory mouth pressure (MIP). T(2) values for genioglossus and geniohyoid were increased versus control (p<0.001), suggesting that these airway dilator muscles are activated in response to acute IMT. In Experiment II, nine subjects underwent 2D-Flash sequence MRI of the upper airway during quiet breathing and while performing single inspirations against resistive loads (10%, 30% and 50% MIP); this procedure was repeated after 6 weeks of IMT. Lateral narrowing of the upper airway occurred at all loads, whilst anteroposterior narrowing occurred at the level of the laryngopharynx at loads > or =30% MIP. Changes in upper airway morphology and narrowing after IMT were undetectable using MRI. PMID:17341450

  17. Inspiratory muscle training with threshold or incentive spirometry: Which is the most effective?

    PubMed

    Paiva, Dulciane Nunes; Assmann, Laíse Bender; Bordin, Diogo Fanfa; Gass, Ricardo; Jost, Renan Trevisan; Bernardo-Filho, Mario; França, Rodrigo Alves; Cardoso, Dannuey Machado

    2015-01-01

    Inspiratory muscular training (IMT) increases the respiratory muscle strength, however, there is no data demonstrating its superiority over the incentive spirometry (IS) in doing so. Values of muscle strength after IMT (Threshold IMT(®)) and by the IS (Voldyne(®)) in healthy females was compared. Subjects (n=40) were randomly divided into control group (CG, n=14), IS group (ISG, n=13) and threshold group (TG, n=13). PImax was measured before (pre-IMT), at 15 and 30 days of IMT. There was an increase in PImax of the TG at 15 days (p<0.001) and 30 days of IMT (p<0.001). The same occurred with the ISG, which increased the PImax at 15 days (p<0.001) and 30 days of training (p<0.001). After 30 days of IMT, the TG presented a PImax which was significantly higher than ISG and the CG (p=0.045 and p<0.001, respectively). It can be concluded that IMT by threshold was more effective in increasing muscle strength than the Voldyne. PMID:25926370

  18. Training the inspiratory muscles improves running performance when carrying a 25 kg thoracic load in a backpack.

    PubMed

    Faghy, Mark A; Brown, Peter I

    2016-08-01

    Load carriage (LC) exercise in physically demanding occupations is typically characterised by periods of low-intensity steady-state exercise and short duration, high-intensity exercise while carrying an external mass in a backpack; this form of exercise is also known as LC exercise. This induces inspiratory muscle fatigue and reduces whole-body performance. Accordingly we investigated the effect of inspiratory muscle training (IMT, 50% maximal inspiratory muscle pressure (PImax) twice daily for six week) upon running time-trial performance with thoracic LC. Nineteen healthy males formed a pressure threshold IMT (n = 10) or placebo control group (PLA; n = 9) and performed 60 min LC exercise (6.5 km h(-1)) followed by a 2.4 km running time trial (LCTT) either side of a double-blind six week intervention. Prior to the intervention, PImax was reduced relative to baseline, post-LC and post-LCTT in both groups (pooled data: 13 ± 7% and 16 ± 8%, respectively, p < .05) and similar changes were observed post-PLA. Post-IMT only, resting PImax increased +31% (p < .05) and relative to pre-IMT was greater post-LC (+19%) and post-LCTT (+18%, p < .05), however, the relative reduction in PImax at each time point was unchanged (13 ± 11% and 17 ± 9%, respectively, p > .05). In IMT only, heart rate and perceptual responses were reduced post-LC (p < .05). Time-trial performance was unchanged post-PLA and improved 8 ± 4% after IMT (p < .05). In summary, when wearing a 25 kg backpack, IMT attenuated the cardiovascular and perceptual responses to steady-state exercise and improved high-intensity time-trial performance which we attribute in part to reduced relative work intensity of the inspiratory muscles due to improved inspiratory muscle strength. These findings have real-world implications for occupational contexts. PMID:26274785

  19. Inspiratory loading and limb blood flow in COPD: The modulating effects of resting lung hyperinflation.

    PubMed

    Berton, Danilo C; de Castro, Marina A; Merola, Pietro; Benedetto, Igor; Castilho, Mariah; Vieira, Paulo J C; Knorst, Marli M; Neder, J Alberto

    2016-07-01

    Inspiratory resistive loading (IRL) may have deleterious cardiocirculatory effects leading to poor peripheral perfusion in severely-hyperinflated patients with COPD. Nineteen patients (13 severely-hyperinflated with inspiratory capacity/total lung capacity ratio≤0.28) underwent calf blood flow (CBF) measurements by venous occlusion plethysmography at rest and during IRL at 60% maximal inspiratory pressure. Severely-hyperinflated patients had lower resting CBF and greater calf vascular resistance (CVR) than moderately-hyperinflated patients (p<0.05). All severely-hyperinflated patients had markedly reduced CBF (p=0.01). Opposite to our main hypothesis, however, IRL did not further reduce CBF in these patients (p>0.05). Conversely, it significantly decreased CBF and increased CVR in moderately-hyperinflated patients; in fact, end-trial CBF and CVR did not differ between the groups (p>0.05). In conclusion, marked impairments in resting appendicular blood flow in severely-hyperinflated patients with COPD were seen only after acute IRL in less hyperinflated patients. These findings set the stage for studies investigating the effects of lung deflation on peripheral hemodynamics in patients with severe hyperinflation. PMID:26965088

  20. High-intensity inspiratory muscle training in COPD.

    PubMed

    Hill, K; Jenkins, S C; Philippe, D L; Cecins, N; Shepherd, K L; Green, D J; Hillman, D R; Eastwood, P R

    2006-06-01

    The aim of the present study was to investigate the effects of an interval-based high-intensity inspiratory muscle training (H-IMT) programme on inspiratory muscle function, exercise capacity, dyspnoea and health-related quality of life (QoL) in subjects with chronic obstructive pulmonary disease. A double-blind randomised controlled trial was performed. Sixteen subjects (11 males, mean forced expiratory volume in one second (FEV(1)) 37.4+/-12.5%) underwent H-IMT performed at the highest tolerable inspiratory threshold load (increasing to 101% of baseline maximum inspiratory pressure). Seventeen subjects (11 males, mean FEV(1 )36.5+/-11.5%) underwent sham inspiratory muscle training (S-IMT) at 10% of maximum inspiratory pressure. Training took place three times a week for 8 weeks and was fully supervised. Pre- and post-training measurements of lung function, maximum inspiratory pressure, maximum threshold pressure, exercise capacity, dyspnoea and QoL (Chronic Respiratory Disease Questionnaire; CRDQ) were obtained. H-IMT increased maximum inspiratory pressure by 29%, maximum threshold pressure by 56%, 6-min walk distance by 27 m, and improved dyspnoea and fatigue (CRDQ) by 1.4 and 0.9 points per item, respectively. These changes were significantly greater than any seen following S-IMT. In conclusion, high-intensity inspiratory muscle training improves inspiratory muscle function in subjects with moderate-to-severe chronic obstructive pulmonary disease, yielding meaningful reductions in dyspnoea and fatigue. PMID:16772388

  1. Changes in the perception of inspiratory resistive loads during partial curarization.

    PubMed Central

    Campbell, E J; Gandevia, S C; Killian, K J; Mahutte, C K; Rigg, J R

    1980-01-01

    1. The ability of normal subjects to estimate the magnitude of resistive loads and to detect resistive loads was determined using standard psychophysical techniques. The experiments were repeated during maintained partial neuromuscular blockade with D-tubocurarine. 2. During curarization the ability to detect the presence of a small inspiratory resistive load was not significantly impaired. This finding is consistent with the view that changes in the usual breath-by-breath relation between pressure and flow mediate detection. 3. The size of resistive loads was over-estimated during partial curarization. Subjects thus placed more reliance on sensing the increased motor command required during curarization than on alternative peripheral signals related to pressure, flow or resistance. 4. The exponent for the power function relating the perceived magnitude of a resistive load to its actual size (Stevens, 1957) was reduced during partial neuromuscular blockade. 5. These results suggest that detection of resistive loads depends upon sensing apparent information arising from an unexpected pressure-flow disturbance but that estimation of the size of an added load depends, in part, on sensing the outgoing motor command. PMID:7252883

  2. Pulmonary Rehabilitation Using Modified Threshold Inspiratory Muscle Trainer (IMT) in Patients with Tetraplegia.

    PubMed

    Yasar, Funda; Tasci, Canturk; Savci, Sema; Tozkoparan, Ergun; Deniz, Omer; Balkan, Arzu; Bilgic, Hayati

    2012-01-01

    It is aimed to present the usefulness of inspiratory muscle trainer (IMT) in treatment of a 20-year-old male patient with diaphragmatic paralysis and tetraplegia due to spinal cord injury (SCI), and supporting effect of IMT in recovering from respiratory failure by rendering his diaphragm functions. The treatment was applied through the tracheostomy cannula by a modified IMT device. After applying IMT for three weeks, it was observed that the diaphragm recovered its functions in electromyography (EMG) test. As a result, in this study, we present a case where a patient could live without any respiratory device for the rest of his life with the help of modified IMT. PMID:22536264

  3. The respiratory response to inspiratory resistive loading during rapid eye movement sleep in humans

    PubMed Central

    Morrell, Mary J; Browne, Helen A K; Adams, Lewis

    2000-01-01

    We investigated the respiratory response to an added inspiratory resistive load (IRL) during rapid eye movement (REM) sleep in humans and compared this with those in non-REM (NREM) sleep and wakefulness. Results were obtained from 7 out of 15 healthy subjects (n = 7; 32 ± 9 years, mean ± s.d.). Linearised IRLs (4 and 12 cmH2O l−1 s−1) were applied for five breaths during NREM sleep (4-10 trials per subject; total 101), REM sleep (2-5 trials; total 46) and wakefulness (2-3 trials; total 40). Respiratory variables were compared, between unloaded breathing (UL: mean of 5 breaths preceding IRL) and the 1st (B1) and 5th (B5) loaded breaths in each state. During wakefulness, 12 cmH2O l−1 s−1 IRL produced an immediate respiratory compensation with prolongation of inspiratory time (TI; UL: 2.0 ± 0.6; B1: 2.6 ± 0.7 s) and an increase in tidal volume (VT; UL: 0.49 ± 0.12; B1: 0.52 ± 0.12 l). During REM sleep, TI was prolonged (UL: 2.0 ± 0.3; B1: 2.2 ± 0.5 s), although VT fell (UL: 0.27 ± 0.15; B1: 0.22 ± 0.10 l). For both wakefulness and REM sleep the TI response was significantly greater than seen in NREM sleep (UL: 1.9 ± 0.3; B1: 1.9 ± 0.3 s.). For VT, only the wakefulness response was significantly different from NREM sleep (UL: 0.31 ± 0.14; B1: 0.21 ± 0.10 l). The B5 responses were not significantly different between states for any of the variables. REM sleep is associated with partial respiratory load compensation suggesting that exacerbation of sleep disordered breathing in REM (compared to NREM) sleep is unlikely to be secondary to an inability to overcome increases in upper airway resistance. PMID:10878111

  4. Inspiratory High Frequency Airway Oscillation Attenuates Resistive Loaded Dyspnea and Modulates Respiratory Function in Young Healthy Individuals

    PubMed Central

    Morris, Theresa; Sumners, David Paul; Green, David Andrew

    2014-01-01

    Direct chest-wall percussion can reduce breathlessness in Chronic Obstructive Pulmonary Disease and respiratory function may be improved, in health and disease, by respiratory muscle training (RMT). We tested whether high-frequency airway oscillation (HFAO), a novel form of airflow oscillation generation can modulate induced dyspnoea and respiratory strength and/or patterns following 5 weeks of HFAO training (n = 20) compared to a SHAM-RMT (conventional flow-resistive RMT) device (n = 15) in healthy volunteers (13 males; aged 20–36 yrs). HFAO causes oscillations with peak-to-peak amplitude of 1 cm H2O, whereas the SHAM-RMT device was identical but created no pressure oscillation. Respiratory function, dyspnoea and ventilation during 3 minutes of spontaneous resting ventilation, 1 minute of maximal voluntary hyperventilation and 1 minute breathing against a moderate inspiratory resistance, were compared PRE and POST 5-weeks of training (2×30 breaths at 70% peak flow, 5 days a week). Training significantly reduced NRS dyspnoea scores during resistive loaded ventilation, both in the HFAO (p = 0.003) and SHAM-RMT (p = 0.005) groups. Maximum inspiratory static pressure (cm H2O) was significantly increased by HFAO training (vs. PRE; p<0.001). Maximum inspiratory dynamic pressure was increased by training in both the HFAO (vs. PRE; p<0.001) and SHAM-RMT (vs. PRE; p = 0.021) groups. Peak inspiratory flow rate (L.s−1) achieved during the maximum inspiratory dynamic pressure manoeuvre increased significantly POST (vs. PRE; p = 0.001) in the HFAO group only. HFAO reduced inspiratory resistive loading–induced dyspnoea and augments static and dynamic maximal respiratory manoeuvre performance in excess of flow-resistive IMT (SHAM-RMT) in healthy individuals without the respiratory discomfort associated with RMT. PMID:24651392

  5. [Inspiratory muscle training in patients with chronic obstructive pulmonary disease].

    PubMed

    Lisboa, C; Borzone, G; Cruz, E

    1998-05-01

    We analyze the effect of inspiratory muscle training (IMT) in patients with chronic obstructive pulmonary disease (COPD), with special emphasis on its effects on inspiratory muscle function and clinical outcomes. We reviewed only randomized, controlled studies that have either controlled both the load and the breathing pattern when using resistive training or have employed a threshold trainer in which the load is independent of the pattern of breathing, since methodological aspects may explain inconsistent results in the literature. In these circumstances, most of the studies demonstrated positive effects on inspiratory muscle function. Clinical effects were seldom evaluated; limited available data showed a reduction in dyspnea that was related to an increase in maximal inspiratory pressures (PIMax). When exercise capacity was evaluated through the distance the patients were able to walk in 6 or 12 minutes, most studies demonstrated a significant increase. Other reported positive effects were improvement in nocturnal SaO2, inspiratory muscle power output and maximal inspiratory flow rate. Based in this review, a recommended training regime appears to be an intermediate load (30-40% PIMax) using a threshold device for 30 minutes daily for at least 5 weeks. Although in the literature the criteria for selecting patients are not always well defined, we consider IMT as a helpful procedure for pulmonar rehabilitation in those patients with a moderately severe inspiratory muscle dysfunction presenting dyspnea during daily living activities despite optimal therapy. PMID:9731440

  6. Medicinal clays improve the endurance of loaded inspiratory muscles in COPD: a randomized clinical trial of nonpharmacological treatment

    PubMed Central

    Baldi, Simonetta; Pinna, Gian Domenico; Bruschi, Claudio; Caldara, Fabrizio; Maestri, Roberto; Dacosto, Elena; Rezzani, Antonella; Popovich, Ermanno; Bellinzona, Ezio; Crotti, Paola; Montemartini, Silvia; Fracchia, Claudio

    2015-01-01

    Background Inspiratory resistive breathing (IRB) challenges affect respiratory muscle endurance in healthy individuals, which is considered to be an interleukin 6 (IL-6)–dependent mechanism. Whether nonpharmacological thermal therapies promote the endurance of loaded inspiratory muscles in chronic obstructive pulmonary disease (COPD) is unclear. The objectives of this study were to compare the effects of two thermal interventions on endurance time (ET) and plasma IL-6 concentration following an IRB challenge. Methods This study was a randomized, parallel-group, unblinded clinical trial in a single-center setting. Forty-two patients (aged 42–76 years) suffering from mild to severe COPD participated in this study. Both groups completed 12 sessions of the mud bath therapy (MBT) (n=22) or leisure thermal activity (LTA) (n=19) in a thermal spa center in Italy. Pre- and postintervention spirometry, maximum inspiratory pressure, and plasma mediators were obtained and ET and endurance oxygen expenditure (VO2Endur) were measured following IRB challenge at 40% of maximum inspiratory pressure. Results There was no difference in ΔIL-6 between the intervention groups. But, IRB challenge increased cytokine IL-6 plasma levels systematically. The effect size was small. A statistically significant treatment by IRB challenge effect existed in ET, which significantly increased in the MBT group (P=0.003). In analysis of covariance treatment by IRB challenge analysis with LnVO2Endur as the dependent variable, ΔIL-6 after intervention predicted LnVO2Endur in the MBT group, but not in the LTA group. Adverse events occurred in two individuals in the MBT group, but they were mainly transient. One patient in the LTA group dropped out. Conclusion MBT model improves ET upon a moderate IRB challenge, indicating the occurrence of a training effect. The LnVO2Endur/ΔIL-6 suggests a physiologic adaptive mechanism in respiratory muscles of COPD patients allocated to treatment. Both thermal

  7. Inspiratory muscle training in patients with chronic obstructive pulmonary disease: structural adaptation and physiologic outcomes.

    PubMed

    Ramirez-Sarmiento, Alba; Orozco-Levi, Mauricio; Guell, Rosa; Barreiro, Esther; Hernandez, Nuria; Mota, Susana; Sangenis, Merce; Broquetas, Joan M; Casan, Pere; Gea, Joaquim

    2002-12-01

    The present study was aimed at evaluating the effects of a specific inspiratory muscle training protocol on the structure of inspiratory muscles in patients with chronic obstructive pulmonary disease. Fourteen patients (males, FEV1, 24 +/- 7% predicted) were randomized to either inspiratory muscle or sham training groups. Supervised breathing using a threshold inspiratory device was performed 30 minutes per day, five times a week, for 5 consecutive weeks. The inspiratory training group was subjected to inspiratory loading equivalent to 40 to 50% of their maximal inspiratory pressure. Biopsies from external intercostal muscles and vastus lateralis (control muscle) were taken before and after the training period. Muscle samples were processed for morphometric analyses using monoclonal antibodies against myosin heavy chain isoforms I and II. Increases in both the strength and endurance of the inspiratory muscles were observed in the inspiratory training group. This improvement was associated with increases in the proportion of type I fibers (by approximately 38%, p < 0.05) and in the size of type II fibers (by approximately 21%, p < 0.05) in the external intercostal muscles. No changes were observed in the control muscle. The study demonstrates that inspiratory training induces a specific functional improvement of the inspiratory muscles and adaptive changes in the structure of external intercostal muscles. PMID:12406842

  8. Inspiratory muscle training: integrative review.

    PubMed

    Padula, Cynthia A; Yeaw, Evelyn

    2006-01-01

    This article provides a critical review of inspiratory muscle training (IMT) in chronic obstructive pulmonary disease (COPD). Although extensive research on IMT has accumulated, its benefits have been debated, primarily because of methodological limitations of studies. Using relevant key words, multiple databases were searched from 1966. Selected studies used PImax (maximal inspiratory pressure) as an outcome variable. Overall, research demonstrated that a standard protocol of 30% or higher for a duration of 20 to 30 minutes per day for 10 to 12 weeks improves dyspnea and inspiratory strength and endurance with either inspiratory resistive or inspiratory threshold training. Regardless of method, IMT protocols for people with COPD and inspiratory muscle weakness and dyspnea are generally safe, feasible, and effective. Patient selectivity and study of subgroups are recommended. PMID:17190116

  9. Inspiratory muscle training in Morquio's syndrome: a case study.

    PubMed

    Savci, Sema; Ozturk, Melda; Inal-Ince, Deniz; Gultekin, Zuhal; Arikan, Hulya; Sivri, H Serap Kalkanoglu

    2006-12-01

    We reported a case of MPS IV A presented with dyspnea on exertion and respiratory muscle weakness. The patient underwent inspiratory muscle training (IMT) using threshold loading for 18 weeks. After 6 weeks of initial IMT, aerobic exercise training consisting of walking was added to the treatment program. Inspiratory muscle strength increased 70%, and 6-minute walk test (6MWT) distance increased to 47 m. With the inclusion of aerobic exercise training, additional increases in inspiratory muscle strength (7%) and 6MWT distance (26.5 m) were obtained. Exertional dyspnea improved from severe to slight after 6 weeks of IMT, and to very slight after additional 12 weeks of combined aerobic training and IMT. Health-related quality of life improved especially in social function, emotional function, vitality, and physical role. In conclusion, inspiratory muscles can be trained with the improvement of muscle strength in a patient with Morquio's syndrome. PMID:16998925

  10. Subjecting Elite Athletes to Inspiratory Breathing Load Reveals Behavioral and Neural Signatures of Optimal Performers in Extreme Environments

    PubMed Central

    Paulus, Martin P.; Flagan, Taru; Simmons, Alan N.; Gillis, Kristine; Kotturi, Sante; Thom, Nathaniel; Johnson, Douglas C.; Van Orden, Karl F.; Davenport, Paul W.; Swain, Judith L.

    2012-01-01

    Background It is unclear whether and how elite athletes process physiological or psychological challenges differently than healthy comparison subjects. In general, individuals optimize exercise level as it relates to differences between expected and experienced exertion, which can be conceptualized as a body prediction error. The process of computing a body prediction error involves the insular cortex, which is important for interoception, i.e. the sense of the physiological condition of the body. Thus, optimal performance may be related to efficient minimization of the body prediction error. We examined the hypothesis that elite athletes, compared to control subjects, show attenuated insular cortex activation during an aversive interoceptive challenge. Methodology/Principal Findings Elite adventure racers (n = 10) and healthy volunteers (n = 11) performed a continuous performance task with varying degrees of a non-hypercapnic breathing load while undergoing functional magnetic resonance imaging. The results indicate that (1) non-hypercapnic inspiratory breathing load is an aversive experience associated with a profound activation of a distributed set of brain areas including bilateral insula, dorsolateral prefrontal cortex and anterior cingulated; (2) adventure racers relative to comparison subjects show greater accuracy on the continuous performance task during the aversive interoceptive condition; and (3) adventure racers show an attenuated right insula cortex response during and following the aversive interoceptive condition of non-hypercapnic inspiratory breathing load. Conclusions/Significance These findings support the hypothesis that elite athletes during an aversive interoceptive condition show better performance and an attenuated insular cortex activation during the aversive experience. Interestingly, differential modulation of the right insular cortex has been found previously in elite military personnel and appears to be emerging as an important

  11. Incremental threshold loading: a standard protocol and establishment of a reference range in naive normal subjects.

    PubMed

    Johnson, P H; Cowley, A J; Kinnear, W J

    1997-12-01

    Incremental threshold loading (ITL) has been proposed as a test of inspiratory muscle strength and endurance. To date, however, there has been no standardized protocol for an ITL test, and no reference range, with different investigators using a variety of different pressure increments in small numbers of subjects. We developed an ITL test using the weighted plunger (WP) principle, which uses standard increments of pressure. In our protocol subjects inspire through the WP generating an initial threshold opening pressure of 10 cmH2O. This pressure is raised at 2 min intervals in increments of 5 cmH2O until they fail to lift the plunger on two consecutive attempted breaths. Sixty healthy volunteers (30 males and 30 females) aged 20-80 yrs performed the ITL test. Twelve subjects (six females and six males) performed the test twice to assess reproducibility and repeatability. Using stepwise multiple linear regression, we regressed the maximum threshold pressure sustained for a full 2 min (Pmax) against age, height, weight and static maximum inspiratory mouth pressure (MIP). Pmax was significantly related to age but not to either height or weight, the regression equation for males was Pmax (cmH2O)=103.8 - (1.0 x age in years), and for females was Pmax (cmH2O)=93.7 - (1.0 x age in years). The within-subject standard deviation for those repeating the ITL test was 5.4 cmH2O. Incremental threshold loading is a simple technique with good reproducibility, which most naive subjects can use without difficulty. By using standard pressure increments and performing the test in a large number of naive subjects, we have established a reference range that should be applicable wherever similar pressure increments are used. PMID:9493675

  12. Should viral load thresholds be lowered?

    PubMed Central

    Labhardt, Niklaus D.; Bader, Joëlle; Lejone, Thabo Ishmael; Ringera, Isaac; Hobbins, Michael A.; Fritz, Christiane; Ehmer, Jochen; Cerutti, Bernard; Puga, Daniel; Klimkait, Thomas

    2016-01-01

    Abstract The World Health Organization (WHO) guidelines on antiretroviral therapy (ART) define treatment failure as 2 consecutive viral loads (VLs) ≥1000 copies/mL. There is, however, little evidence supporting 1000 copies as an optimal threshold to define treatment failure. Objective of this study was to assess the correlation of the WHO definition with the presence of drug-resistance mutations in patients who present with 2 consecutive unsuppressed VL in a resource-limited setting. In 10 nurse-led clinics in rural Lesotho children and adults on first-line ART for ≥6 months received a first routine VL. Those with plasma VL ≥80 copies/mL were enrolled in a prospective study, receiving enhanced adherence counseling (EAC) and a follow-up VL after 3 months. After a second unsuppressed VL genotypic resistance testing was performed. Viruses with major mutations against ≥2 drugs of the current regimen were classified as “resistant”. A total of 1563 adults and 191 children received a first routine VL. Of the 138 adults and 53 children with unsuppressed VL (≥80 copies/mL), 165 (116 adults; 49 children) had a follow-up VL after EAC; 108 (74 adults; 34 children) remained unsuppressed and resistance testing was successful. Ninety of them fulfilled the WHO definition of treatment failure (both VL ≥1000 copies/mL); for another 18 both VL were unsuppressed but with <1000 copies/mL. The positive predictive value (PPV) for the WHO failure definition was 81.1% (73/90) for the presence of resistant virus. Among the 18 with VL levels between 80 and 1000 copies/mL, thereby classified as “non-failures”, 17 (94.4%) harbored resistant viruses. Lowering the VL threshold from 1000 copies/mL to 80 copies/mL at both determinations had no negative influence on the PPV (83.3%; 90/108). The current WHO-definition misclassifies patients who harbor resistant virus at VL below 1000 c/mL as “nonfailing.” Lowering the threshold to VL ≥80

  13. LOWER ESOPHAGEAL SPHINCTER PRESSURE MEASUREMENT UNDER STANDARDIZED INSPIRATORY MANEUVEURS

    PubMed Central

    RIBEIRO, Jeany Borges e Silva; DIÓGENES, Esther Cristina Arruda Oliveira; BEZERRA, Patrícia Carvalho; COUTINHO, Tanila Aguiar Andrade; de ALMEIDA, Cícera Geórgia Félix; SOUZA, Miguel Ângelo Nobre e

    2015-01-01

    Background: Through rhythmic variations, the diaphragm influence lower esophageal sphincter (LES) pressure acting as an external sphincter. LES pressure recording is characterized by increased pressure in inspiration due to contraction of the diaphragmatic crura that involves the sphincter. Aim: To describe a method of measuring LES pressure during standardized inspiratory maneuvers with increasing loads. Methods: The study population comprised of eight healthy female volunteers (average age of 31.5 years). An esophageal high-resolution manometry and impedance system was used for measuring the LES pressure during 3-second inspiratory efforts under 12, 24 and 48 cm H2O loads (Threshold maneuvers). Results: There was a significant difference between the average maximum LES pressure and the average maximum basal LES pressure during the first (76.19±17.92 difference, p=0.0008), second (86.92±19.01 difference, p=0.0004), and third seconds of the maneuver (90.86±17.93 difference, p=0.0002), with 12, 24 and 48 cmH2O loads. Conclusion: This maneuver is a standardization of the inspiratory LES pressure and may better differentiate patients with reflux disease from healthy individuals, and may also be useful for monitoring the treatment of these patients through inspiratory muscle training. PMID:26537140

  14. Effects of inspiratory muscle training on resistance to fatigue of respiratory muscles during exhaustive exercise.

    PubMed

    Segizbaeva, M O; Timofeev, N N; Donina, Zh A; Kur'yanovich, E N; Aleksandrova, N P

    2015-01-01

    The aim of this study was to assess the effect of inspiratory muscle training (IMT) on resistance to fatigue of the diaphragm (D), parasternal (PS), sternocleidomastoid (SCM) and scalene (SC) muscles in healthy humans during exhaustive exercise. Daily inspiratory muscle strength training was performed for 3 weeks in 10 male subjects (at a pressure threshold load of 60% of maximal inspiratory pressure (MIP) for the first week, 70% of MIP for the second week, and 80% of MIP for the third week). Before and after training, subjects performed an incremental cycle test to exhaustion. Maximal inspiratory pressure and EMG-analysis served as indices of inspiratory muscle fatigue assessment. The before-to-after exercise decreases in MIP and centroid frequency (fc) of the EMG (D, PS, SCM, and SC) power spectrum (P<0.05) were observed in all subjects before the IMT intervention. Such changes were absent after the IMT. The study found that in healthy subjects, IMT results in significant increase in MIP (+18%), a delay of inspiratory muscle fatigue during exhaustive exercise, and a significant improvement in maximal work performance. We conclude that the IMT elicits resistance to the development of inspiratory muscles fatigue during high-intensity exercise. PMID:25248344

  15. Generating Fatigue Crack Growth Thresholds with Constant Amplitude Loads

    NASA Technical Reports Server (NTRS)

    Forth, Scott C.; Newman, James C., J.; Forman, Royce G.

    2002-01-01

    The fatigue crack growth threshold, defining crack growth as either very slow or nonexistent, has been traditionally determined with standardized load reduction methodologies. Some experimental procedures tend to induce load history effects that result in remote crack closure from plasticity. This history can affect the crack driving force, i.e. during the unloading process the crack will close first at some point along the wake, reducing the effective load at the crack tip. One way to reduce the effects of load history is to propagate a crack under constant amplitude loading. As a crack propagates under constant amplitude loading, the stress intensity factor, K, will increase, as will the crack growth rate, da/dN. A fatigue crack growth threshold test procedure is developed and experimentally validated that does not produce load history effects and can be conducted at a specified stress ratio, R.

  16. Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review.

    PubMed

    Geddes, E Lynne; O'Brien, Kelly; Reid, W Darlene; Brooks, Dina; Crowe, Jean

    2008-12-01

    The purpose was to update an original systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). The original MEDLINE and CINAHL search to August 2003 was updated to January 2007 and EMBASE was searched from inception to January 2007. Randomized controlled trials, published in English, with adults with stable COPD, comparing IMT to sham IMT or no intervention, low versus high intensity IMT, and different modes of IMT were included. Nineteen of 274 articles in the original search met the inclusion criteria. The updated search revealed 17 additional articles; 6 met the inclusion criteria, all of which compared targeted, threshold or normocapneic hyperventilation IMT to sham IMT. An update of the sub-group analysis comparing IMT versus sham IMT was performed with 10 studies from original review and 6 from the update. Sixteen meta-analyses are reported. Results demonstrated significant improvements in inspiratory muscle strength (PI(max), PI(max) % predicted, peak inspiratory flow rate), inspiratory muscle endurance (RMET, inspiratory threshold loading, MVV), exercise capacity (Ve(max), Borg Score for Respiratory Effort, 6MWT), Transitional Dyspnea Index (focal score, functional impairment, magnitude of task, magnitude of effort), and the Chronic Respiratory Disease Questionnaire (quality of life). Results suggest that targeted, threshold or normocapneic hyperventilation IMT significantly increases inspiratory muscle strength and endurance, improves outcomes of exercise capacity and one measure of quality of life, and decreases dyspnea for adults with stable COPD. PMID:18708282

  17. Inspiratory muscle training in adults with chronic obstructive pulmonary disease: a systematic review.

    PubMed

    Geddes, E Lynne; Reid, W Darlene; Crowe, Jean; O'Brien, Kelly; Brooks, Dina

    2005-11-01

    The purpose of this study was to conduct a systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). A systematic review of the literature was conducted according the Cochrane Collaboration protocol using Medline and CINAHL. Nineteen of 274 extracted articles met the inclusion criteria and addressed comparisons of interest which included: IMT versus sham; IMT versus no intervention; low- versus high-intensity IMT; and two different modes of IMT. Thirteen meta-analyses were reported. Results indicate that targeted resistive or threshold IMT was associated with significant improvements in some outcomes of inspiratory muscle strength (PI(max) (cm H2O)) and endurance (Inspiratory Threshold Loading (kPa)), exercise capacity (Borg Scale for Respiratory Effort (modified Borg scale), Work Rate maximum (Watts)), and dyspnea (Transition Dyspnea Index), whereas IMT without a target or not using threshold training did not show improvement in these variables. There was no conclusive evidence regarding quality of life measures. IMT is effective for adults with COPD when using threshold or targeted devices that control or provide a target for training intensity. PMID:15894478

  18. Relationship between Respiratory Load Perception and Perception of Nonrespiratory Sensory Modalities in Subjects with Life-Threatening Asthma

    PubMed Central

    Davenport, Kathleen L.; Huang, Chien Hui; Davenport, Matthew P.; Davenport, Paul W.

    2012-01-01

    Subjects with life-threatening asthma (LTA) have reported decreased sensitivity to inspiratory resistive (R) loads. It is unknown if decreased sensitivity is specific for inspiratory R loads, other types of respiratory loads, or a general deficit affecting sensory modalities. This study hypothesized that impairment is specific to respiratory stimuli. This study tested perceptual sensitivity of LTA, asthmatic (A), and nonasthmatic (NA) subjects to 4 sensory modalities: respiratory, somatosensory, auditory, visual. Perceptual sensitivity was measured with magnitude estimation (ME): respiratory loads ME, determined using inspiratory R and pressure threshold (PT) loads; somatosensory ME, determined using weight ranges of 2–20 kg; auditory ME, determined using graded magnitudes of 1 kHz tones delivered for 3 seconds bilaterally; visual ME, determined using gray-to-white disk intensity gradations on black background. ME for inspiratory R loads lessened for LTA over A and NA subjects. There was no significant difference between the 3 groups in ME for PT inspiratory loads, weight, sound, and visual trials. These results demonstrate that LTA subjects are poor perceivers of inspiratory R loads. This deficit in respiratory perception is specific to inspiratory R loads and is not due to perceptual deficits in other types of inspiratory loads, somatosensory, auditory, or visual sensory modalities. PMID:22745905

  19. Inspiratory muscle training for patients with chronic obstructive pulmonary disease: a practical guide for clinicians.

    PubMed

    Hill, Kylie; Cecins, Nola M; Eastwood, Peter R; Jenkins, Sue C

    2010-09-01

    Reduced inspiratory muscle strength is common in people with chronic obstructive pulmonary disease (COPD) and is associated with dyspnea and decreased exercise capacity. Most studies of inspiratory muscle training (IMT) in COPD have demonstrated increased inspiratory muscle strength. Many have also shown improvements in dyspnea and exercise capacity. However, a persisting challenge when translating and applying the findings of these studies in clinical practice is the disparity in training loads, modalities, and outcomes measures used in the different studies. This commentary summarizes our clinical and research experience with a threshold IMT device with the aim of providing clinicians interested in prescribing IMT in this population with practical recommendations regarding patient selection, assessment, and implementation of training. We propose using an interval-based high-intensity threshold IMT program for people who are unable to participate fully in whole-body exercise training because of comorbidities such as severe musculoskeletal problems. Initial training loads equivalent to at least 30% of a person's maximum inspiratory pressure (PImax) are required for all people undertaking IMT. Supervision, which includes monitoring of oxygen saturation throughout the first training session, is recommended, and patients are warned to expect transient delayed-onset muscle soreness, a consequence of muscle adaptation to an unaccustomed activity. We recommend training be undertaken 3 times a week for 8 weeks, with loads progressively increased as symptoms permit. It is prudent to exclude people at risk of pneumothorax or spontaneous rib fracture. Evaluation of IMT should include measures of PImax, dyspnea, health-related quality of life, and exercise capacity. PMID:20801269

  20. Inspiratory muscle training in the patient with neuromuscular disease.

    PubMed

    McCool, F D; Tzelepis, G E

    1995-11-01

    Pulmonary complications due to respiratory muscle dysfunction are commonly a source of morbidity and mortality in patients with neuromuscular diseases. This review discusses the adverse effects of respiratory muscle weakness on pulmonary mechanics and examines the role that inspiratory muscle training may play in reversing pulmonary dysfunction in these individuals. In asymptomatic persons, it is well established that the inspiratory muscles can be trained to increase both force and endurance. In patients with neuromuscular diseases, the effects of training protocols on force and endurance are more controversial. This article reviews seven studies that have evaluated respiratory muscle training in a total of 75 patients with varied neuromuscular disorders. Training regimens included breathing through inspiratory resistive loads and isocapnic hyperpnea. Despite methodologic differences among studies, investigators have generally shown that the inspiratory muscles are similar to other skeletal muscle groups in that they can be trained for both force and endurance in these patients. The training-related improvements in inspiratory muscle performance are more pronounced in patients who are less severely affected by their disease. In those patients who have disease to the extent that they are already retaining carbon dioxide, there is little change in force or endurance with training. In these individuals, the inspiratory muscles may already be working at a level sufficiently severe to provide a training stimulus with each breath. No adverse effects of inspiratory muscle training were reported. Inspiratory muscle training can improve force and endurance in patients with neuromuscular weakness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7480122

  1. The effect of low cycle fatigue cracks and loading history on high cycle fatigue threshold

    NASA Astrophysics Data System (ADS)

    Moshier, Monty Allen

    High cycle fatigue (HCF) has been of great concern of late in light of the many HCF gas turbine engine failures experienced by the U.S. Air Force. Due to the high frequency, failures occur rapidly when components sustain damage from other sources. Low cycle fatigue (LCF) can initiate cracks that produce such damage. This study investigates the HCF threshold of Ti-6A1-4V when naturally initiated small surface cracks (2a = 25 mum--600 mum) are present. Small surface cracks are initiated in notched specimens using two different LCF loading histories at room temperature and 10 Hz. Direct current potential difference (DCPD) is used to detect crack initiation. Surface crack measurements are made using a scanning electron microscope prior to HCF testing. Heat tinting prior to HCF testing is used to mark the crack front to allow for post fracture crack measurements. HCF thresholds at R = 0.1 and R = 0.5 are determined for each specimen using step loading at room temperature and 600 Hz. Additionally, the HCF threshold is measured at R = 0.1 for specimens with small cracks that have been stress relief annealed to eliminate residual stresses and load history. Long crack thresholds are determined using a similar step loading procedure at R = 0.1 and R = 0.5 for specimens which have been precracked using a range of Kmax. Long crack threshold measurements are also determined for specimens which have been precracked using a range of Kmax, but stress relief annealed prior to testing. Comparisons show that HCF threshold measurements, when naturally initiated small cracks are present, are dependent on the load histories that are used to initiate the cracks. Further comparisons show that the measured small crack thresholds follow similar trends for load history effects which occur in the long crack threshold data. Additionally, it is found that thresholds can be measured free of load history effects by using a stress relief annealing process after the precracking and prior to the

  2. Inspiratory muscle strength training improves weaning outcome in failure to wean patients: a randomized trial

    PubMed Central

    2011-01-01

    Introduction Most patients are readily liberated from mechanical ventilation (MV) support, however, 10% - 15% of patients experience failure to wean (FTW). FTW patients account for approximately 40% of all MV days and have significantly worse clinical outcomes. MV induced inspiratory muscle weakness has been implicated as a contributor to FTW and recent work has documented inspiratory muscle weakness in humans supported with MV. Methods We conducted a single center, single-blind, randomized controlled trial to test whether inspiratory muscle strength training (IMST) would improve weaning outcome in FTW patients. Of 129 patients evaluated for participation, 69 were enrolled and studied. 35 subjects were randomly assigned to the IMST condition and 34 to the SHAM treatment. IMST was performed with a threshold inspiratory device, set at the highest pressure tolerated and progressed daily. SHAM training provided a constant, low inspiratory pressure load. Subjects completed 4 sets of 6-10 training breaths, 5 days per week. Subjects also performed progressively longer breathing trials daily per protocol. The weaning criterion was 72 consecutive hours without MV support. Subjects were blinded to group assignment, and were treated until weaned or 28 days. Results Groups were comparable on demographic and clinical variables at baseline. The IMST and SHAM groups respectively received 41.9 ± 25.5 vs. 47.3 ± 33.0 days of MV support prior to starting intervention, P = 0.36. The IMST and SHAM groups participated in 9.7 ± 4.0 and 11.0 ± 4.8 training sessions, respectively, P = 0.09. The SHAM group's pre to post-training maximal inspiratory pressure (MIP) change was not significant (-43.5 ± 17.8 vs. -45.1 ± 19.5 cm H2O, P = 0.39), while the IMST group's MIP increased (-44.4 ± 18.4 vs. -54.1 ± 17.8 cm H2O, P < 0.0001). There were no adverse events observed during IMST or SHAM treatments. Twenty-five of 35 IMST subjects weaned (71%, 95% confidence interval (CI) = 55% to 84

  3. The effect of progressive high-intensity inspiratory muscle training and fixed high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients

    PubMed Central

    Jung, Ju-hyeon; Kim, Nan-soo

    2015-01-01

    [Purpose] This study investigated the effects of progressive load and fixed load high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients. [Subjects] Twenty-one stroke patients were assigned to one of three groups: progressive load high-intensity inspiratory muscle training (n = 8), fixed load high-intensity inspiratory muscle training (n = 6), and controls (n = 7). [Methods] The progressive load and fixed load high-intensity inspiratory muscle training participants undertook an exercise program for 20 minutes, three times weekly, for 6 weeks. After each session, diaphragm thickness was measured using ultrasonography. The diaphragm asymmetry ratio and diaphragm thickening ratio were standardized using a formula. [Results] After intervention, the diaphragm asymmetry ratio significantly differed among the three groups, and the diaphragm asymmetry ratio significantly increased in the control group. A significant increase was identified in the diaphragm thickening ratio within the progressive load and fixed load high-intensity inspiratory muscle training groups. [Conclusion] Progressive load and fixed load high-intensity inspiratory muscle training decreased the asymmetry of diaphragm thickness in stroke patients; this effect, in turn, increased the diaphragm thickening ratio in stroke patients. The two interventions examined here should be selectively applied to individuals in the clinical field. PMID:26644689

  4. [Clinical effects of inspiratory muscle training in patients with chronic airflow limitation].

    PubMed

    Lisboa, C; Villafranca, C; Pertuzé, J; Leiva, A; Repetto, P

    1995-09-01

    The clinical role of inspiratory muscle training (IMT) in chronic obstructive pulmonary disease (COPD) has not been established, because data on its clinical effect is scarce and controversial. To further investigate these aspects we studied 20 COPD patients (FEV1 37 +/- 3% P) who were randomly and double blindly trained for 30 minutes a day during 10 weeks using a threshold inspiratory trainer with either 30% (group 1) or 10% (group 2) of PIMax as a training load. The training load was crossed after each patient completed 10 weeks of training. Effects were assessed through changes in PIMax, dyspnea through the transition dyspnea index (ITD) and the respiratory effort with Borg's score. Walking capacity was measured with the six minutes walking distance test (6WD) and depression symptoms with Beck's score. Daily life activities were also assessed. Results showed that after 10 weeks of IMT, PIMax increased in both groups (p < 0.05), dyspnea improved in group 1 as compared to group 2 (p < 0.04), 6WD increased significantly in patients of group 1, who also complained of less dyspnea (p < 0.05). Depression scores fell significantly in group 2. Daily activities improved more in group 1. After the crossover patients in group 1 disclosed a significant deterioration in PIMax whereas group 2 disclosed significant improvements in PIMax, dyspnea and 6WD. We conclude that IMT using a threshold device with 30% PIMax is a useful procedure for the treatment of severe COPD patients. PMID:8728734

  5. The effect of inspiratory muscle fatigue on breathing pattern and ventilatory response to CO2.

    PubMed Central

    Mador, M J; Tobin, M J

    1992-01-01

    1. The effects of inducing inspiratory muscle fatigue on the subsequent breathing pattern were examined during resting unstimulated breathing and during CO2 rebreathing. In addition, we examined whether induction of inspiratory muscle fatigue alters CO2 responsiveness. 2. Global inspiratory muscle fatigue and diaphragmatic fatigue were achieved by having subjects breathe against an inspiratory resistive load while generating a predetermined fraction of either their maximal mouth pressure or maximal transdiaphragmatic pressure until they were unable to generate the target pressure. 3. Induction of inspiratory muscle fatigue had no effect on the subsequent breathing pattern during either unstimulated breathing or during CO2 rebreathing. 4. Following induction of inspiratory muscle fatigue, the slope of the ventilatory response to CO2 was significantly decreased from 18.8 +/- 3.3 during control to 13.8 +/- 2.1 l min-1 (% end-tidal CO2 concentration)-1 with fatigue (P < 0.02). PMID:1484352

  6. Crack Growth Behavior in the Threshold Region for High Cyclic Loading

    NASA Technical Reports Server (NTRS)

    Forman, R.; Figert, J.; Beek, J.; Ventura, J.; Martinez, J.; Samonski, F.

    2011-01-01

    The present studies show that fanning in the threshold regime is likely caused by other factors than a plastic wake developed during load shedding. The cause of fanning at low R-values is a result of localized roughness, mainly formation of a faceted crack surface morphology , plus crack bifurcations which alters the crack closure at low R-values. The crack growth behavior in the threshold regime involves both crack closure theory and the dislocation theory of metals. Research will continue in studying numerous other metal alloys and performing more extensive analysis, such as the variation in dislocation properties (e.g., stacking fault energy) and its effects in different materials.

  7. Crack Growth Behavior in the Threshold Region for High Cycle Fatigue Loading

    NASA Technical Reports Server (NTRS)

    Forman, R. G.; Zanganeh, M.

    2014-01-01

    This paper describes the results of a research program conducted to improve the understanding of fatigue crack growth rate behavior in the threshold growth rate region and to answer a question on the validity of threshold region test data. The validity question relates to the view held by some experimentalists that using the ASTM load shedding test method does not produce valid threshold test results and material properties. The question involves the fanning behavior observed in threshold region of da/dN plots for some materials in which the low R-ratio data fans out from the high R-ratio data. This fanning behavior or elevation of threshold values in the low R-ratio tests is generally assumed to be caused by an increase in crack closure in the low R-ratio tests. Also, the increase in crack closure is assumed by some experimentalists to result from using the ASTM load shedding test procedure. The belief is that this procedure induces load history effects which cause remote closure from plasticity and/or roughness changes in the surface morphology. However, experimental studies performed by the authors have shown that the increase in crack closure is a result of extensive crack tip bifurcations that can occur in some materials, particularly in aluminum alloys, when the crack tip cyclic yield zone size becomes less than the grain size of the alloy. This behavior is related to the high stacking fault energy (SFE) property of aluminum alloys which results in easier slip characteristics. Therefore, the fanning behavior which occurs in aluminum alloys is a function of intrinsic dislocation property of the alloy, and therefore, the fanned data does represent the true threshold properties of the material. However, for the corrosion sensitive steel alloys tested in laboratory air, the occurrence of fanning results from fretting corrosion at the crack tips, and these results should not be considered to be representative of valid threshold properties because the fanning is

  8. The generation of loads in excess of the osteogenic threshold by physical movement.

    PubMed

    Shippen, James M

    2013-06-01

    This study investigates the use of physical movement to cause joint and bone loads that stimulate bone growth in order to reduce the adverse effects of osteoporosis. It has been established that stresses in bones in excess of the osteogenic threshold will stimulate bone growth; however, protocols for the generation of these stresses had not been established. Two trial movements were examined in the study: the plié and a movement requiring the subject to move a leg sequentially to 45° displaced positions - the star excursion balance test. Using inverse dynamics and an optimisation approach, the loads in the muscles crossing the hip and knee joints and the corresponding joint contact forces were calculated. It was found that the osteogenic threshold was exceeded in both these trials identifying them as suitable exercises in the maintenance of bone health. In the order of increasing bone load at the hip, and hence increasing bone growth stimulation, are the following demi plié, star excursion balance test with maximum reach criterion, grande plié and star excursion balance test with maximum speed criterion. In the order of increasing bone load at the knee are demi plié, grande plié, star excursion balance test with maximum reach criterion and star excursion balance test with maximum speed criterion. However, due to the high loads encountered, these exercises are not recommended for subjects with advanced osteoporosis although the boundary between therapeutic bone loading leading to increase in bone mineral density and loads capable of causing fracture is unclear. PMID:23636751

  9. Increased inspiratory esophagogastric junction pressure in systemic sclerosis: An add-on to antireflux barrier

    PubMed Central

    Nobre e Souza, Miguel Ângelo; Bezerra, Patrícia Carvalho; Nobre, Rivianny Arrais; Holanda, Esther Studart da Fonseca; dos Santos, Armênio Aguiar

    2015-01-01

    AIM: To investigate crural diaphragm (CD) function in systemic sclerosis (SSc) using high-resolution manometry and standardized inspiratory maneuvers. METHODS: Eight SSc volunteers (average age, 40.1 years; one male) and 13 controls (average age, 32.2 years; six males) participated in the study. A high-resolution manometry/impedance system measured the esophagus and esophagogastric junction (EGJ) pressure profile during swallows and two respiratory maneuvers: sinus arrhythmia maneuver (SAM; the average of six EGJ peak pressures during 5-s deep inhalations) and threshold maneuver (TM; the EGJ peak pressures during forced inhalation under 12 and 24 cmH2O loads). Inspiratory diaphragm lowering (IDL) was taken as the displacement of the EGJ high-pressure zone during the SAM. RESULTS: SSc patients had lower mean lower esophageal sphincter pressure than controls during normal breathing (19.7 ± 2.8 mmHg vs 32.2 ± 2.7 mmHg, P = 0.007). Sinus arrhythmia maneuver pressure was higher in SSc patients than in controls (142.6 ± 9.4 mmHg vs 104.6 ± 13.8 mmHg, P = 0.019). Sinus arrhythmia maneuver pressure normalized to IDL was also higher in SSc patients than in controls (83.8 ± 13.4 mmHg vs 37.5 ± 6.9 mmHg, P = 0.005). Threshold maneuver pressures normalized to IDL were also greater in SSc patients than in controls (TM 12 cmH2O: 85.1 ± 16.4 mmHg vs 43.9 ± 6.3 mmHg, P = 0.039; TM 24 cmH2O: 85.2 ± 16.4 mmHg vs 46.2 ± 6.6 mmHg, P = 0.065). Inspiratory diaphragm lowering in SSc patients was less than in controls (2.1 ± 0.3 cm vs 3 ± 0.2 cm, P = 0.011). CONCLUSION: SSc patients had increased inspiratory EGJ pressure. This is an add-on to EGJ pressure and indicates that the antireflux barrier can be trained. PMID:25717239

  10. Extubation process in bed-ridden elderly intensive care patients receiving inspiratory muscle training: a randomized clinical trial

    PubMed Central

    Cader, Samária Ali; de Souza Vale, Rodrigo Gomes; Zamora, Victor Emmanuel; Costa, Claudia Henrique; Dantas, Estélio Henrique Martin

    2012-01-01

    Background The purpose of this study was to evaluate the extubation process in bed-ridden elderly intensive care patients receiving inspiratory muscle training (IMT) and identify predictors of successful weaning. Methods Twenty-eight elderly intubated patients in an intensive care unit were randomly assigned to an experimental group (n = 14) that received conventional physiotherapy plus IMT with a Threshold IMT® device or to a control group (n = 14) that received only conventional physiotherapy. The experimental protocol for muscle training consisted of an initial load of 30% maximum inspiratory pressure, which was increased by 10% daily. The training was administered for 5 minutes, twice daily, 7 days a week, with supplemental oxygen from the beginning of weaning until extubation. Successful extubation was defined by the ventilation time measurement with noninvasive positive pressure. A vacuum manometer was used for measurement of maximum inspiratory pressure, and the patients’ Tobin index values were measured using a ventilometer. Results The maximum inspiratory pressure increased significantly (by 7 cm H2O, 95% confidence interval [CI] 4–10), and the Tobin index decreased significantly (by 16 breaths/ min/L, 95% CI −26 to 6) in the experimental group compared with the control group. The Chi-squared distribution did not indicate a significant difference in weaning success between the groups (χ2 = 1.47; P = 0.20). However, a comparison of noninvasive positive pressure time dependence indicated a significantly lower value for the experimental group (P = 0.0001; 95% CI 13.08–18.06). The receiver-operating characteristic curve showed an area beneath the curve of 0.877 ± 0.06 for the Tobin index and 0.845 ± 0.07 for maximum inspiratory pressure. Conclusion The IMT intervention significantly increased maximum inspiratory pressure and significantly reduced the Tobin index; both measures are considered to be good extubation indices. IMT was associated with a

  11. Crack Growth Behavior in the Threshold Region for High Cycle Fatigue Loading

    NASA Technical Reports Server (NTRS)

    Forman, Royce G.; Figert, J.; Beek, J.; Ventura, J.; Martinez, J.; Samonski, F.

    2011-01-01

    This presentation describes results obtained from a research project conducted at the NASA Johnson Space Center (JSC) that was jointly supported by the FAA Technical Center and JSC. The JSC effort was part of a multi-task FAA program involving several U.S. laboratories and initiated for the purpose of developing enhanced analysis tools to assess damage tolerance of rotorcraft and aircraft propeller systems. The research results to be covered in this presentation include a new understanding of the behavior of fatigue crack growth in the threshold region. This behavior is important for structural life analysis of aircraft propeller systems and certain rotorcraft structural components (e.g., the mast). These components are often designed to not allow fatigue crack propagation to exceed an experimentally determined fatigue crack growth threshold value. During the FAA review meetings for the program, disagreements occurred between the researchers regarding the observed fanning (spread between the da/dN curves of constant R) in the threshold region at low stress ratios, R. Some participants believed that the fanning was a result of the ASTM load shedding test method for threshold testing, and thus did not represent the true characteristics of the material. If the fanning portion of the threshold value is deleted or not included in a life analysis, a significant penalty in the calculated life and design of the component would occur. The crack growth threshold behavior was previously studied and reported by several research investigators in the time period: 1970-1980. Those investigators used electron microscopes to view the crack morphology of the fatigue fracture surfaces. Their results showed that just before reaching threshold, the crack morphology often changed from a striated to a faceted or cleavage-like morphology. This change was reported to have been caused by particular dislocation properties of the material. Based on the results of these early investigations, a

  12. Crack Growth Behavior in the Threshold Region for High Cycle Fatigue Loading

    NASA Technical Reports Server (NTRS)

    Forman, Royce G.; Zanganehgheshlaghi, Mohannad

    2014-01-01

    The research results described in this paper presents a new understanding of the behavior of fatigue crack growth in the threshold region. It is believed by some crack growth experts that the ASTM load shedding test method does not produce true or valid threshold properties. The concern involves the observed fanning of threshold region da/dN data plots for some materials in which the low R-ratio data fans out or away from the high R-ratio data. This data fanning or elevation of threshold values is obviously caused by an increase in crack closure in the low R-ratio tested specimens. This increase in crack closure is assumed by some investigators to be caused by a plastic wake on the crack surfaces that was created during the load shedding test phase. This study shows that the increase in crack closure is the result of an extensive occurrence of crack bifurcation behavior in some materials, particularly in aluminum alloys, when the crack tip cyclic yield zone size becomes less than the grain size of the alloy. This behavior is related to the high stacking fault energy (SFE) property of aluminum alloys which results in easier slip characteristics. Therefore, the particular fanning behavior in aluminum alloys is a function of intrinsic dislocation property of the materials and that the fanned data represents valid material properties. However, for corrosion sensitive steel alloys used in this study the fanning was caused by a build-up of iron oxide at the crack tip from fretting corrosion.

  13. Effects of Inspiratory and Expiratory Muscle Training in Normal Subjects

    PubMed Central

    Kurosawa, Hajime; Kohzuki, Masahiro

    2005-01-01

    The present study aimed to clarify the effects of inspiratory muscle training (IMT) and expiratory muscle training (EMT) on ventilatory muscle strength, pulmonary function and responses during exercise testing. Young healthy women were randomly assigned to 3 groups: IMT (n=16); EMT (n=16); or untrained normal controls (NC, n=8). Subjects in the IMT and EMT groups trained for 15 minutes twice daily over 2 weeks at loads of 30% maximal inspiratory and expiratory muscle strength, respectively. Ventilatory muscle strength (maximal inspiratory and expiratory muscle strength; PImax and PEmax, respectively), pulmonary function and progressive exercise testing was performed. Both PImax and PEmax increased in the IMT group, and PEmax increased in the EMT group. Neither trained group demonstrated any change in pulmonary function or peak values during exercise testing. In the IMT group, exercise-induced increases in heart rate, oxygen uptake (VO2/kg) and rating of perceived exertion (RPE) decreased with training, as did increases in VO2/kg and RPE in the EMT group. The increased ventilatory muscle strength in both IMT and EMT groups might improve ventilatory efficacy during exercise, and increased inspiratory muscle strength might facilitate oxygen delivery through improved circulatory responses. PMID:25792941

  14. [The effects of pulmonary rehabilitation combined with inspiratory muscle training on pulmonary function and inspiratory muscle strength in elderly patients with chronic obstructive pulmonary disease].

    PubMed

    Sudo, E; Ohga, E; Matsuse, T; Teramoto, S; Nagase, T; Katayama, H; Takizawa, H; Tanaka, M; Kikuchi, N; Kakurai, S; Fukuchi, Y; Ouchi, Y

    1997-11-01

    It has been suggested that pulmonary rehabilitation compined with inspiratory muscle training (IMT) might improve pulmonary function and respiratory muscle strength in elderly patients with chronic obstructive pulmonary disease (COPD). To test this hypothesis, inspiratory muscle strength (PImax), expiratory muscle strength (PEmax) and resting pulmonary function were measured in 13 elderly patients with COPD (aged 70.3 +/- 2.7 years). Inspiratory muscle training (IMT) was performed for 15 min twice a day, using a pressure threshold device, for a total of 12 weeks. The inspiratory threshold was set at 15% of maximal inspiratory pressure (PImax) for each individual. Pulmonary rehabilitation was performed for 12-h sessions over a 12-week period. Patients with COPD were assigned randomly to two groups: pulmonary rehabilitation combined with IMT (group A) (n = 7), and conventional pulmonary rehabilitation only (group B) (n = 6). Functional residual capacity (FRC) decreased significantly from 4.3 +/- 0.4 L at baseline to 3.9 +/- 0.4 L after rehabilitation (p < 0.01), Vp significantly increased from 4.6 +/- 0.8 L/sec at baseline to 5.1 +/- 0.7 L/sec after rehabilitation (p < 0.05) and the PImax increased significantly from 51.5 +/- 5.4 cmH2O at baseline to 80.9 +/- 7.0 cmH2O after rehabilitation (p < 0.02) in group A. However, these variables did not change in group B. There was no improvement in the 10-minutes walking distance of group A, but there was a significant increase in that of group B. It can be concluded that pulmonary rehabilitation combined with IMT improves pulmonary function and inspiratory muscle strength in elderly patients with COPD. PMID:9483953

  15. A New Load Residual Threshold Definition for the Evaluation of Wind Tunnel Strain-Gage Balance Data

    NASA Technical Reports Server (NTRS)

    Ulbrich, N.; Volden, T.

    2016-01-01

    A new definition of a threshold for the detection of load residual outliers of wind tunnel strain-gage balance data was developed. The new threshold is defined as the product between the inverse of the absolute value of the primary gage sensitivity and an empirical limit of the electrical outputs of a strain{gage. The empirical limit of the outputs is either 2.5 microV/V for balance calibration or check load residuals. A reduced limit of 0.5 microV/V is recommended for the evaluation of differences between repeat load points because, by design, the calculation of these differences removes errors in the residuals that are associated with the regression analysis of the data itself. The definition of the new threshold and different methods for the determination of the primary gage sensitivity are discussed. In addition, calibration data of a six-component force balance and a five-component semi-span balance are used to illustrate the application of the proposed new threshold definition to different types of strain{gage balances. During the discussion of the force balance example it is also explained how the estimated maximum expected output of a balance gage can be used to better understand results of the application of the new threshold definition.

  16. 'Functional' inspiratory and core muscle training enhances running performance and economy.

    PubMed

    Tong, Tomas K; McConnell, Alison K; Lin, Hua; Nie, Jinlei; Zhang, Haifeng; Wang, Jiayuan

    2014-08-26

    We compared the effects of two 6-week high-intensity interval training interventions. Under the control condition (CON), only interval training was undertaken, whilst under the intervention condition (ICT), interval training sessions were followed immediately by core training, which was combined with simultaneous inspiratory muscle training - 'functional' IMT. Sixteen recreational runners were allocated to either ICT or CON groups. Prior to the intervention phase, both groups undertook a 4-week programme of 'foundation' IMT to control for the known ergogenic effect of IMT [30 inspiratory efforts at 50% maximal static inspiratory pressure (P0) per set, 2 sets.d, 6 d.wk]. The subsequent 6-week interval running training phase, consisted of 3-4 sessions.wk. In addition, the ICT group undertook four inspiratory-loaded core exercises [10 repetitions.set, 2 sets.d, inspiratory load set at 50% post-IMT P0] immediately after each interval training session. The CON group received neither core training nor functional IMT. Following the intervention phase, global inspiratory and core muscle functions increased in both groups (P<0.05), as evidenced by P0 and a sport-specific endurance plank test performance (SEPT), respectively. Compared to CON, the ICT group showed larger improvements in SEPT, running economy at the speed of the OBLA, and 1-hr running performance (3.04% vs 1.57%, P<0.05). The changes in these variables were inter-individually correlated (r≥0.57, n=16, P<0.05). Such findings suggest that the addition of inspiratory-loaded core conditioning into a high-intensity interval training program augments the influence of the interval program upon endurance running performance, and that this may be underpinned by an improvement in running economy. PMID:25162653

  17. The influence of inspiratory and expiratory muscle training upon rowing performance.

    PubMed

    Griffiths, Lisa A; McConnell, Alison K

    2007-03-01

    We investigated the effect of 4 week of inspiratory (IMT) or expiratory muscle training (EMT), as well as the effect of a subsequent 6 week period of combined IMT/EMT on rowing performance in club-level oarsmen. Seventeen male rowers were allocated to either an IMT (n = 10) or EMT (n = 7) group. The groups underwent a 4 week IMT or EMT program; after interim testing, both groups subsequently performed a 6 week program of combined IMT/EMT. Exercise performance and physiological responses to exercise were measured at 4 and 10 week during an incremental rowing ergometer 'step-test' and a 6 min all-out (6MAO) effort. Pressure threshold respiratory muscle training was undertaken at the 30 repetition maximum load (approximately 50% of the peak inspiratory and expiratory mouth pressure, P (Imax) or P (Emax), respectively). P (Imax) increased during the IMT phase of the training in the IMT group (26%, P < 0.001) and was accompanied by an improvement in mean power during the 6MAO (2.7%, P = 0.015). Despite an increase in P (Emax) by the end of the intervention (31%, P = 0.03), the EMT group showed no significant changes in any performance parameters during either the 'step-test' or 6MAO. There were no significant changes in breathing pattern or the metabolic response to the 6MAO test in either group, but the IMT group showed a small decrease in HR (2-5%, P = 0.001). We conclude that there were no significant additional changes following combined IMT/EMT. IMT improved rowing performance, but EMT and subsequent combined IMT/EMT did not. PMID:17186299

  18. Fatigue crack growth threshold as a design criterion - statistical scatter and load ratio in the Kitagawa-Takahashi diagram

    NASA Astrophysics Data System (ADS)

    Kolitsch, S.; Gänser, H.-P.; Maierhofer, J.; Pippan, R.

    2016-03-01

    Cracks in components reduce the endurable stress so that the endurance limit obtained from common smooth fatigue specimens cannot be used anymore as a design criterion. In such cases, the Kitagawa-Takahashi diagram can be used to predict the admissible stress range for infinite life, at a given crack length and stress range. This diagram is constructed for a single load ratio R. However, in typical mechanical engineering applications, the load ratio R varies widely due to the applied load spectra and residual stresses. In the present work an extended Kitagawa-Takahashi diagram accounting for crack length, crack extension and load ratio is constructed. To describe the threshold behaviour of short cracks, a master resistance curve valid for a wide range of steels is developed using a statistical approach.

  19. Nasal peak inspiratory flow at altitude.

    PubMed

    Barry, P W; Mason, N P; Richalet, J P

    2002-01-01

    The present study investigated whether there are changes in nasal peak inspiratory flow (NPIF) during hypobaric hypoxia under controlled environmental conditions. During operation Everest III (COMEX '97), eight subjects ascended to a simulated altitude of 8,848 m in a hypobaric chamber. NPIF was recorded at simulated altitudes of 0 m, 5,000 m and 8,000 m. Oral peak inspiratory and expiratory flow (OPIF, OPEF) were also measured. Ambient air temperature and humidity were controlled. NPIF increased by a mean +/- SD of 16 +/- 12% from sea level to 8,000 m, whereas OPIF increased by 47 +/- 14%. NPIF rose by 0.085 +/- 0.03 L x s(-1) per kilometre of ascent (p<0.05), significantly less than the rise in OPIF and OPEF of 0.35 +/- 0.10 and 0.33 +/- 0.04 L x s(-1) per kilometre (p<0.0005). Nasal peak inspiratory flow rises with ascent to altitude. The rise in nasal peak inspiratory flow with altitude was far less than oral peak inspiratory flow and less than the predicted rise according to changes in air density. This suggests flow limitation at the nose, and occurs under controlled environmental conditions, refuting the hypothesis that nasal blockage at altitude is due to the inhalation of cold, dry air. Further work is needed to determine if nasal blockage limits activity at altitude. PMID:11843316

  20. Laryngomalacia and inspiratory obstruction in later childhood.

    PubMed Central

    Smith, G J; Cooper, D M

    1981-01-01

    Pulmonary function and symptoms were reviewed in 20 children in whom laryngomalacia had been diagnosed by direct laryngoscopy in infancy. Most children developed stridor in the first 2 weeks, but 3 children did not develop it until age 3 months. The mean duration of stridor was 4 years 2 months, with a range of 4 months to 12 years 7 months. Six children had marked posseting as infants. Airway dynamics were assessed by flow volume loops. All except one had normal expiratory flow volume curves. Inspiratory abnormalities were detected in 7 children; 6 were assessed as having variable extrathoracic inspiratory obstructions and 1 had a fixed obstruction consistent with subglottic stenosis. The mean ratios of maximal inspiratory flow at 50% of vital capacity divided by forced vital capacity in the laryngomalacia and control groups differed significantly, as did the mean ratios of maximal expiratory flow to maximal inspiratory flow at 50% of forced vital capacity. Laryngomalacia is not necessarily a benign disorder of limited duration; there may be persisting inspiratory obstruction in later childhood. PMID:7259255

  1. Inspiratory resistances facilitate the diaphragm response to transcranial stimulation in humans

    PubMed Central

    Locher, Chrystèle; Raux, Mathieu; Fiamma, Marie-Noelle; Morélot-Panzini, Capucine; Zelter, Marc; Derenne, Jean-Philippe; Similowski, Thomas; Straus, Christian

    2006-01-01

    Background Breathing in humans is dually controlled for metabolic (brainstem commands) and behavioral purposes (suprapontine commands) with reciprocal modulation through spinal integration. Whereas the ventilatory response to chemical stimuli arises from the brainstem, the compensation of mechanical loads in awake humans is thought to involve suprapontine mechanisms. The aim of this study was to test this hypothesis by examining the effects of inspiratory resistive loading on the response of the diaphragm to transcranial magnetic stimulation. Results Six healthy volunteers breathed room air without load (R0) and then against inspiratory resistances (5 and 20 cmH2O/L/s, R5 and R20). Ventilatory variables were recorded. Transcranial magnetic stimulation (TMS) was performed during early inspiration (I) or late expiration (E), giving rise to motor evoked potentials (MEPs) in the diaphragm (Di) and abductor pollicis brevis (APB). Breathing frequency significantly decreased during R20 without any other change. Resistive breathing had no effect on the amplitude of Di MEPs, but shortened their latency (R20: -0.903 ms, p = 0.03) when TMS was superimposed on inspiration. There was no change in APB MEPs. Conclusion Inspiratory resistive breathing facilitates the diaphragm response to TMS while it does not increase the automatic drive to breathe. We interpret these findings as a neurophysiological substratum of the suprapontine nature of inspiratory load compensation in awake humans. PMID:16875504

  2. Inspiratory Resistance Improves Postural Tachycardia: A Randomized Study

    PubMed Central

    Gamboa, Alfredo; Paranjape, Sachin Y.; Black, Bonnie K.; Arnold, Amy C.; Figueroa, Rocío; Okamoto, Luis E.; Nwazue, Victor C.; Diedrich, Andre; Plummer, W. Dale; Dupont, William D.; Robertson, David; Raj, Satish R.

    2015-01-01

    Background The objective of this study is to determine the effect of inspiratory resistance through an impedance threshold device (ITD) on orthostatic tolerance in patients with postural tachycardia syndrome (POTS). We hypothesized that the ITD would result in greater negative intrathoracic pressure to enhance cardiac venous return, improve stroke volume, and reduce heart rate in these patients. Methods and Results We compared the effect of a sham device (sham, no resistance) versus an ITD (increased inspiratory resistance), in 26 POTS patients in a randomized, single-blind, crossover study. Hemodynamic assessments were performed at baseline while supine and during head-up tilt (HUT) to 70 degrees for 10 minutes. We did not find differences in baseline hemodynamic parameters between the ITD and sham devices. After 10 minutes of HUT, the heart rate was lower with the ITD versus sham device (102±4 versus 109±4 beat/min, respectively; p=0.003). The ITD also improved stroke volume compared with the sham device (35±2 versus 26±1 mL, p=0.006). Conclusions These findings suggest that increasing negative intrathoracic pressure with ITD breathing improves heart rate control in POTS patients during upright posture. PMID:25792354

  3. Inspiratory muscle training reduces blood lactate concentration during volitional hyperpnoea.

    PubMed

    Brown, Peter I; Sharpe, Graham R; Johnson, Michael A

    2008-09-01

    Although reduced blood lactate concentrations ([lac(-)](B)) have been observed during whole-body exercise following inspiratory muscle training (IMT), it remains unknown whether the inspiratory muscles are the source of at least part of this reduction. To investigate this, we tested the hypothesis that IMT would attenuate the increase in [lac(-)](B) caused by mimicking, at rest, the breathing pattern observed during high-intensity exercise. Twenty-two physically active males were matched for 85% maximal exercise minute ventilation (.V(E) max) and divided equally into an IMT or a control group. Prior to and following a 6 week intervention, participants performed 10 min of volitional hyperpnoea at the breathing pattern commensurate with 85% .V(E) max. The IMT group performed 6 weeks of pressure-threshold IMT; the control group performed no IMT. Maximal inspiratory mouth pressure increased (mean +/- SD) 31 +/- 22% following IMT and was unchanged in the control group. Prior to the intervention in the control group, [lac(-)](B) increased from 0.76 +/- 0.24 mmol L(-1) at rest to 1.50 +/- 0.60 mmol L(-1) (P < 0.05) following 10 min volitional hyperpnoea. In the IMT group, [lac(-)](B) increased from 0.85 +/- 0.40 mmol L(-1) at rest to 2.02 +/- 0.85 mmol L(-1) following 10 min volitional hyperpnoea (P < 0.05). After 6 weeks, increases in [lac(-)](B) during volitional hyperpnoea were unchanged in the control group. Conversely, following IMT the increase in [lac(-)](B) during volitional hyperpnoea was reduced by 17 +/- 37% and 25 +/- 34% following 8 and 10 min, respectively (P < 0.05). In conclusion, increases in [lac(-)](B) during volitional hyperpnoea at 85% .V(E) max were attenuated following IMT. These findings suggest that the inspiratory muscles were the source of at least part of this reduction, and provide a possible explanation for some of the IMT-mediated reductions in [lac(-)](B), often observed during whole-body exercise. PMID:18560878

  4. The differential effects of inspiratory, expiratory, and combined resistive breathing on healthy lung

    PubMed Central

    Loverdos, Konstantinos; Toumpanakis, Dimitrios; Litsiou, Eleni; Karavana, Vassiliki; Glynos, Constantinos; Magkou, Christina; Theocharis, Stamatios; Vassilakopoulos, Theodoros

    2016-01-01

    Combined resistive breathing (CRB) is the hallmark of obstructive airway disease pathophysiology. We have previously shown that severe inspiratory resistive breathing (IRB) induces acute lung injury in healthy rats. The role of expiratory resistance is unknown. The possibility of a load-dependent type of resistive breathing-induced lung injury also remains elusive. Our aim was to investigate the differential effects of IRB, expiratory resistive breathing (ERB), and CRB on healthy rat lung and establish the lowest loads required to induce injury. Anesthetized tracheostomized rats breathed through a two-way valve. Varying resistances were connected to the inspiratory, expiratory, or both ports, so that the peak inspiratory pressure (IRB) was 20%–40% or peak expiratory (ERB) was 40%–70% of maximum. CRB was assessed in inspiratory/expiratory pressures of 30%/50%, 40%/50%, and 40%/60% of maximum. Quietly breathing animals served as controls. At 6 hours, respiratory system mechanics were measured, and bronchoalveolar lavage was performed for measurement of cell and protein concentration. Lung tissue interleukin-6 and interleukin-1β levels were estimated, and a lung injury histological score was determined. ERB produced significant, load-independent neutrophilia, without mechanical or permeability derangements. IRB 30% was the lowest inspiratory load that provoked lung injury. CRB increased tissue elasticity, bronchoalveolar lavage total cell, macrophage and neutrophil counts, protein and cytokine levels, and lung injury score in a dose-dependent manner. In conclusion, CRB load dependently deranges mechanics, increases permeability, and induces inflammation in healthy rats. ERB is a putative inflammatory stimulus for the lung. PMID:27499619

  5. Effect of inspiratory muscle work on peripheral fatigue of locomotor muscles in healthy humans

    PubMed Central

    Romer, Lee M; Lovering, Andrew T; Haverkamp, Hans C; Pegelow, David F; Dempsey, Jerome A

    2006-01-01

    The work of breathing required during maximal exercise compromises blood flow to limb locomotor muscles and reduces exercise performance. We asked if force output of the inspiratory muscles affected exercise-induced peripheral fatigue of locomotor muscles. Eight male cyclists exercised at ≥ 90% peak O2 uptake to exhaustion (CTRL). On a separate occasion, subjects exercised for the same duration and power output as CTRL (13.2 ± 0.9 min, 292 W), but force output of the inspiratory muscles was reduced (−56% versus CTRL) using a proportional assist ventilator (PAV). Subjects also exercised to exhaustion (7.9 ± 0.6 min, 292 W) while force output of the inspiratory muscles was increased (+80% versus CTRL) via inspiratory resistive loads (IRLs), and again for the same duration and power output with breathing unimpeded (IRL-CTRL). Quadriceps twitch force (Qtw), in response to supramaximal paired magnetic stimuli of the femoral nerve (1–100 Hz), was assessed pre- and at 2.5 through to 70 min postexercise. Immediately after CTRL exercise, Qtw was reduced −28 ± 5% below pre-exercise baseline and this reduction was attenuated following PAV exercise (−20 ± 5%; P < 0.05). Conversely, increasing the force output of the inspiratory muscles (IRL) exacerbated exercise-induced quadriceps muscle fatigue (Qtw=−12 ± 8% IRL-CTRL versus −20 ± 7% IRL; P < 0.05). Repeat studies between days showed that the effects of exercise per se, and of superimposed inspiratory muscle loading on quadriceps fatigue were highly reproducible. In conclusion, peripheral fatigue of locomotor muscles resulting from high-intensity sustained exercise is, in part, due to the accompanying high levels of respiratory muscle work. PMID:16373384

  6. 21 CFR 868.1780 - Inspiratory airway pressure meter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Inspiratory airway pressure meter. 868.1780... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1780 Inspiratory airway pressure meter. (a) Identification. An inspiratory airway pressure meter is a device used to measure the...

  7. 21 CFR 868.1780 - Inspiratory airway pressure meter.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Inspiratory airway pressure meter. 868.1780... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1780 Inspiratory airway pressure meter. (a) Identification. An inspiratory airway pressure meter is a device used to measure the...

  8. 21 CFR 868.1780 - Inspiratory airway pressure meter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Inspiratory airway pressure meter. 868.1780... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1780 Inspiratory airway pressure meter. (a) Identification. An inspiratory airway pressure meter is a device used to measure the...

  9. 21 CFR 868.1780 - Inspiratory airway pressure meter.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Inspiratory airway pressure meter. 868.1780... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1780 Inspiratory airway pressure meter. (a) Identification. An inspiratory airway pressure meter is a device used to measure the...

  10. Determination of dual parameter auto-sampling trigger thresholds for pollutant load monitoring in various land uses.

    PubMed

    Nnadi, Fidelia; Gurr, Eric

    2015-05-01

    Environmental pollutants are health hazards and are typically transported during runoff events. Monitoring the loadings of these pollutants with auto-samplers require precise trigger thresholds to effectively account for total maximum daily loads (TMDLs) entering natural water bodies. Traditionally, auto-samplers are triggered by delaying the start of sampling until pollutant wave is present during rainfall event. The rainfall-related triggers are typically limited to small watersheds, where lag and travel times are consistent and predictable. However, in large and more complex watersheds, flow or stage is typically used either by a set threshold on change in instantaneous flow rate or water level. Generally, trigger thresholds are difficult to establish due to seasonal fluctuations in stream flow and variations in rainfall. This study investigated dual parameter trigger based on instantaneous change and variance from a moving average for flow and stage. Nineteen auto-samplers, installed within six watersheds of varying land uses in City of Kissimmee, FL, were evaluated over 3-year period. The results suggested that using 20- to 30-min moving average of 5-min sampling interval for both parameters was sufficient to detect pollutant waves with minimal false triggers. Also, change from average flow rate (∆Qave) and a percent change from average stage (∆Have%) were found to the preferred parameters. The ∆Have% values ranging from -0.012 to 0.20% and ∆Qave ranging from 0.014 to 0.850 m(3)/s were found to give effective results for all stations in the study area. It was also observed that these trigger thresholds varied with land use, stream flow condition, and auto-sampler locations within the watershed. PMID:25838061

  11. Inspiratory muscle training improves 100 and 200 m swimming performance.

    PubMed

    Kilding, Andrew E; Brown, Sarah; McConnell, Alison K

    2010-02-01

    Inspiratory muscle training (IMT) has been shown to improve time trial performance in competitive athletes across a range of sports. Surprisingly, however, the effect of specific IMT on surface swimming performance remains un-investigated. Similarly, it is not known whether any ergogenic influence of IMT upon swimming performance is confined to specific race distances. To determine the influence of IMT upon swimming performance over 3 competitive distances, 16 competitive club-level swimmers were assigned at random to either an experimental (pressure threshold IMT) or sham IMT placebo control group. Participants performed a series of physiological and performance tests, before and following 6 weeks of IMT, including (1) an incremental swim test to the limit of tolerance to determine lactate, heart rate and perceived exertion responses; (2) standard measures of lung function (forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow) and maximal inspiratory pressure (MIP); and (3) 100, 200 and 400 m swim time trials. Training utilised a hand-held pressure threshold device and consisted of 30 repetitions, twice per day. Relative to control, the IMT group showed the following percentage changes in swim times: 100 m, -1.70% (90% confidence limits, +/-1.4%), 200 m, -1.5% (+/-1.0), and 400 m, 0.6% (+/-1.2). Large effects were observed for MIP and rates of perceived exertion. In conclusion, 6 weeks of IMT has a small positive effect on swimming performance in club-level trained swimmers in events shorter than 400 m. PMID:19841931

  12. Groundwater and stream threshold values for targeted and differentiated output based regulation of nutrient loadings to ecosystems

    NASA Astrophysics Data System (ADS)

    Hinsby, Klaus; Refsgaard, Jens Christian

    2015-04-01

    Currently more than 50 % of the European surface water bodies do not meet the objective of good ecological status primarily due to excessive nutrient loadings (mainly N and P) according to recent assessments, and there is a strong need to reduce nutrient loadings to freshwater as well as marine ecosystems. This has been recognized for decades and measures and regulations in many EU member states have been able to reduce the nutrient loadings to e.g. lakes and coastal waters significantly. However, recent assessments also demonstrate that the nutrient loadings to many aquatic ecosystems are still too high. A well known example is the Baltic Sea where the BONUS program has invested significant funds in understanding and reducing nutrient loadings to the Baltic Sea, which is currently considered one of the most polluted seas, globally, and which as a consequence has the largest dead sea-floor area presently known because of eutrophication and oxygen depletion partly due to high nutrient loadings. Hence, further reduction of nutrient loadings to the Baltic Sea is required to improve the ecological status of the Baltic Sea. The new "Soils2Sea" project ("Reducing nutrient loadings from agricultural soils to the Baltic Sea via groundwater and streams") in the BONUS program for the Baltic Sea, seeks to develop new measures and management techniques that can reduce nutrient loadings to the coastal waters of the Baltic Sea to levels ensuring a future good ecological status of this ecosystem. The Soils2Sea project investigates and assesses nutrient loadings from hillslope/field and sub-catchment scale to the scale of the whole Baltic Sea catchment and focus on development on differentiated regulations and land use that take into account reduction and retention of nitrate in groundwater and surface water systems. We suggest that an important management and governance tool would be to derive groundwater and stream threshold values at both river basin, sub-catchment and perhaps

  13. Prophylactic inspiratory muscle training in patients undergoing coronary artery bypass graft.

    PubMed

    Weiner, P; Zeidan, F; Zamir, D; Pelled, B; Waizman, J; Beckerman, M; Weiner, M

    1998-05-01

    Pulmonary complications after cardiac surgery are a leading cause of postoperative morbidity and mortality. Respiratory muscle weakness may contribute to the postoperative pulmonary abnormalities. We hypothesized that: (1) there is a decrease in inspiratory muscle strength (PImax at residual volume) and endurance (Pmpeak/PImax) following coronary artery bypass graft (CABG); (2) this weakness is associated with reduced pulmonary function tests (PFTs), impaired gas exchange, and a higher rate of pulmonary complications; and (3) prophylactic inspiratory muscle training (IMT) can prevent those changes. Eighty-four candidates for CABG, with ages ranging from 33 to 82 years, were evaluated prior to operation and randomized into two groups: 42 patients underwent IMT using a threshold trainer for 30 min/day for 2 weeks, 1 month before operation (group A); 42 patients served as a control group and underwent sham training (group B). There was a significant decrease in respiratory muscle function, PFTs, and gas exchange in the control group following CABG, whereas these parameters remained similar to those before entering the study in the training group. The differences between the groups were statistically significant. In addition 11 (26%) patients in the control group but only 2 (5%) in the training group needed postsurgical mechanical ventilation longer than 24 hours, CABGs have a significant deteriorating effect on inspiratory muscle function, PFTs, and arterial blood gases. The decrease in these parameters can be prevented by prophylactic inspiratory muscle training, which may also prevent postsurgical pulmonary complications. PMID:9564282

  14. Cardiorespiratory and Metabolic Responses to Loaded Half Squat Exercise Executed at an Intensity Corresponding to the Lactate Threshold

    PubMed Central

    Maté-Muñoz, José Luis; Domínguez, Raúl; Barba, Manuel; Monroy, Antonio J.; Rodríguez, Bárbara; Ruiz-Solano, Pedro; Garnacho-Castaño, Manuel V.

    2015-01-01

    This study was designed to identify the blood lactate threshold (LT2) for the half squat (HS) and to examine cardiorespiratory and metabolic variables during a HS test performed at a work intensity corresponding to the LT2. Twenty-four healthy men completed 3 test sessions. In the first, their one-repetition maximum (1RM) was determined for the HS. In the second session, a resistance HS incremental-load test was performed to determine LT2. Finally, in the third session, subjects performed a constant-load HS exercise at the load corresponding to the LT2 (21 sets of 15 repetitions with 1 min of rest between sets). In this last test, blood samples were collected for lactate determination before the test and 30 s after the end of set (S) 3, S6, S9, S12, S15, S18 and S21. During the test, heart rate (HR) was telemetrically monitored and oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE), respiratory exchange ratio (RER), ventilatory equivalent for O2 (VE·VO2-1) and ventilatory equivalent for CO2 (VE·VCO2-1) were monitored using a breath-by-breath respiratory gas analyzer. The mean LT2 for the participants was 24.8 ± 4.8% 1RM. Blood lactate concentrations showed no significant differences between sets 3 and 21 of exercise (p = 1.000). HR failed to vary between S6 and S21 (p > 1.000). The respiratory variables VO2, VCO2, and VE·VCO2-1 stabilized from S3 to the end of the constant-load HS test (p = 0.471, p = 0.136, p = 1.000), while VE and VE·VO2-1 stabilized from S6 to S21. RER did not vary significantly across exercise sets (p = 0.103). The LT2 was readily identified in the incremental HS test. Cardiorespiratory and metabolic variables remained stable during this resistance exercise conducted at an exercise intensity corresponding to the LT2. These responses need to be confirmed for other resistance exercises and adaptations in these responses after a training program also need to be addressed. Key points It can be identified

  15. Maximal inspiratory mouth pressure in Japanese elite male athletes.

    PubMed

    Ohya, Toshiyuki; Hagiwara, Masahiro; Chino, Kentaro; Suzuki, Yasuhiro

    2016-08-01

    Maximal inspiratory mouth pressure (MIP) is a common measurement of inspiratory muscle strength, which is often used in a variety of exercises to evaluate the effects of inspiratory muscle training. An understanding of elite athletes' MIP characteristics is needed to guide sport-specific inspiratory muscle training programs. The purpose of this study was to investigate and better understand the MIP characteristics of elite athletes from a variety of sports. A total of 301 Japanese elite male athletes participated in this study. MIP was assessed using a portable autospirometer with a handheld mouth pressure meter. Athletes with higher body mass tended to have stronger MIP values, in absolute terms. In relative terms, however, athletes who regularly experienced exercise-induced inspiratory muscle fatigue tended to have stronger MIP values. Our findings suggest that athletes could benefit from prescribed, sport-specific, inspiratory muscle training or warm-ups. PMID:27181330

  16. Inspiratory flow and intrapulmonary gas distribution

    SciTech Connect

    Rehder, K.; Knopp, T.J.; Brusasco, V.; Didier, E.P.

    1981-01-01

    The effect of flow of inspired gas on intrapulmonary gas distribution was examined by analysis of regional pulmonary /sup 133/Xe clearances and of total pulmonary /sup 133/Xe clearance measured at the mouth after equilibration of the lungs with /sup 133/Xe. Five awake healthy volunteers (24 to 40 yr of age) and another 5 healthy, anesthetized-paralyzed volunteers (26 to 28 yr of age) were studied while they were in the right lateral decubitus position. The awake subjects were studied at 3 inspiratory flows (0.4, 0.7, and 1.0 L/s) and the anesthetized-paralyzed subjects at 4 inspiratory flows (0.2, 0.5, 1.1, and 1.6 L/s). Interregional differences in /sup 133/Xe clearances along the vertical axis were significantly less during anesthesia-paralysis and mechanical ventilation than during spontaneous breathing in the awake state. No differences in the regional or total pulmonary /sup 133/Xe clearances were detected at these different flows in either of the two states, i.e., the difference between the awake and anesthetized-paralyzed states persisted.

  17. 21 CFR 868.1780 - Inspiratory airway pressure meter.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Inspiratory airway pressure meter. 868.1780 Section 868.1780 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... meter. (a) Identification. An inspiratory airway pressure meter is a device used to measure the...

  18. Effects of inspiratory muscle training on exercise responses in Paralympic athletes with cervical spinal cord injury.

    PubMed

    West, C R; Taylor, B J; Campbell, I G; Romer, L M

    2014-10-01

    We asked whether specific inspiratory muscle training (IMT) improves respiratory structure and function and peak exercise responses in highly trained athletes with cervical spinal cord injury (SCI). Ten Paralympic wheelchair rugby players with motor-complete SCI (C5-C7) were paired by functional classification then randomly assigned to an IMT or placebo group. Diaphragm thickness (B-mode ultrasonography), respiratory function [spirometry and maximum static inspiratory (PI ,max ) and expiratory (PE ,max ) pressures], chronic activity-related dyspnea (Baseline and Transition Dyspnea Indices), and physiological responses to incremental arm-crank exercise were assessed before and after 6 weeks of pressure threshold IMT or sham bronchodilator treatment. Compared to placebo, the IMT group showed significant increases in diaphragm thickness (P = 0.001) and PI ,max (P = 0.016). There was a significant increase in tidal volume at peak exercise in IMT vs placebo (P = 0.048) and a strong trend toward an increase in peak work rate (P = 0.081, partial eta-squared = 0.33) and peak oxygen uptake (P = 0.077, partial eta-squared = 0.34). No other indices changed post-intervention. In conclusion, IMT resulted in significant diaphragmatic hypertrophy and increased inspiratory muscle strength in highly trained athletes with cervical SCI. The strong trend, with large observed effect, toward an increase in peak aerobic performance suggests IMT may provide a useful adjunct to training in this population. PMID:23530708

  19. Inspiratory Muscle Training in Patients with Heart Failure: A Systematic Review

    PubMed Central

    Lin, Suh-Jen; McElfresh, Jessica; Hall, Benjamin; Bloom, Rachel; Farrell, Kellie

    2012-01-01

    Purpose The purpose of this review was to assess the quality of evidence on inspiratory muscle training (IMT) in patients with heart failure and to provide an overview on subject selection, training protocols, and outcome achieved with IMT. Methods Literature search was first performed via the PubMed database, and additional references were identified from the Scopus citation index. Articles of the review type and of clinical trials published in English were included. Quality of the articles was assessed using Sackett's levels of evidence and rigor of methodology was assessed using PEDro (Physiotherapy Evidence Database) criteria for randomized controlled trials and the Downs & Black tool for cohort studies. Results Twelve articles of clinical trials were included. Typical training protocols involved daily training with intensity greater than 30% of maximal inspiratory pressure (PImax), duration of 20 to 30 minutes (continuous or incremental) and using a pressure threshold muscle trainer. The effect sizes of PImax, walk test distance, and dyspnea were moderate to large across these studies. Effects on quality of life scores were inconsistent. Conclusion Inspiratory muscle training is beneficial for improving respiratory muscle strength, functional capacity, and dyspnea in patients with stable heart failure and respiratory muscle weakness. PMID:22993500

  20. Oxygen uptake kinetics and maximal aerobic power are unaffected by inspiratory muscle training in healthy subjects where time to exhaustion is extended.

    PubMed

    Edwards, A M; Cooke, C B

    2004-10-01

    The aim of this study was to determine whether 4 weeks of inspiratory muscle training (IMT) would be accompanied by alteration in cardiopulmonary fitness as assessed through moderate intensity oxygen uptake (V(.)O(2)) kinetics and maximal aerobic power (V(.)O(2max)). Eighteen healthy males agreed to participate in the study [training group (Tra) n=10, control group (Con) n=8]. Measurements of spirometry and maximal static inspiratory mouth pressure ( PI(max)) were taken pre- and post-training in addition to: (1) an incremental test to volitional exhaustion, (2) three square-wave transitions from walking to running at a moderate intensity (80% ventilatory threshold) and (3) a maximal aerobic constant-load running test to volitional fatigue for the determination of time to exhaustion ( T(lim)). Training was performed using an inspiratory muscle trainer (Powerbreathe). There were no significant differences in spirometry either between the two groups or when comparing the post- to pre-training results within each group. Mean PI(max) increased significantly in Tra ( P<0.01) and showed a trend for improvement ( P<0.08) in Con. Post-training T(lim) was significantly extended in both Tra [232.4 (22.8) s and 242.8 (20.1) s] ( P<0.01) and Con [224.5 (19.6) and 233.5 (12.7) s] ( P<0.05). Post-training T(lim) was significantly extended in Tra compared to Con ( P<0.05). In conclusion, the most plausible explanation for the stability in V(.)O(2) kinetics and V(.)O(2max) following IMT is that it is due to insufficient whole-body stress to elicit either central or peripheral cardiopulmonary adaptation. The extension of post-training T(lim) suggests that IMT might be useful as a stratagem for producing greater volumes of endurance work at high ventilatory loads, which in turn could improve cardiopulmonary fitness. PMID:15322855

  1. Vagal afferents, diaphragm fatigue, and inspiratory resistance in anesthetized dogs.

    PubMed

    Adams, J M; Farkas, G A; Rochester, D F

    1988-06-01

    This study tests three hypotheses regarding mechanisms that produce rapid shallow breathing during a severe inspiratory resistive load (IRL): 1) an intact vagal afferent pathway is necessary; 2) diaphragm fatigue contributes to tachypnea; and 3) hypoxia may alter the pattern of respiration. We imposed a severe IRL on pentobarbital sodium-anesthetized dogs, followed by bilateral vagotomy, then by supplemental O2. IRL alone produced rapid shallow breathing associated with hypercapnia and hypoxia. After the vagotomy, the breathing pattern became slow and deep, restoring arterial PCO2 but not arterial PO2 toward the control values. Relief of hypoxia had no effect, and at no time was there any evidence of fatigue of the diaphragm as measured by the response to phrenic nerve stimulation. We conclude that an intact afferent vagal pathway is necessary for the tachypnea resulting from a severe IRL, neither hypoxia nor diaphragm fatigue played a role, and, although we cannot rule out stimulation of vagal afferents, the simplest explanation for the increased frequency in our experiments is increased respiratory drive due to hypercapnia. PMID:3136122

  2. Diagnostic methods to assess inspiratory and expiratory muscle strength*

    PubMed Central

    Caruso, Pedro; de Albuquerque, André Luis Pereira; Santana, Pauliane Vieira; Cardenas, Leticia Zumpano; Ferreira, Jeferson George; Prina, Elena; Trevizan, Patrícia Fernandes; Pereira, Mayra Caleffi; Iamonti, Vinicius; Pletsch, Renata; Macchione, Marcelo Ceneviva; Carvalho, Carlos Roberto Ribeiro

    2015-01-01

    Impairment of (inspiratory and expiratory) respiratory muscles is a common clinical finding, not only in patients with neuromuscular disease but also in patients with primary disease of the lung parenchyma or airways. Although such impairment is common, its recognition is usually delayed because its signs and symptoms are nonspecific and late. This delayed recognition, or even the lack thereof, occurs because the diagnostic tests used in the assessment of respiratory muscle strength are not widely known and available. There are various methods of assessing respiratory muscle strength during the inspiratory and expiratory phases. These methods are divided into two categories: volitional tests (which require patient understanding and cooperation); and non-volitional tests. Volitional tests, such as those that measure maximal inspiratory and expiratory pressures, are the most commonly used because they are readily available. Non-volitional tests depend on magnetic stimulation of the phrenic nerve accompanied by the measurement of inspiratory mouth pressure, inspiratory esophageal pressure, or inspiratory transdiaphragmatic pressure. Another method that has come to be widely used is ultrasound imaging of the diaphragm. We believe that pulmonologists involved in the care of patients with respiratory diseases should be familiar with the tests used in order to assess respiratory muscle function.Therefore, the aim of the present article is to describe the advantages, disadvantages, procedures, and clinical applicability of the main tests used in the assessment of respiratory muscle strength. PMID:25972965

  3. Stroboscopic and acoustic measures of inspiratory phonation.

    PubMed

    Kelly, C L; Fisher, K V

    1999-09-01

    Inspiratory phonation (IP) is the production of voice as air is taken into the lungs. Although IP is promoted as a laryngeal assessment and voice treatment technique, it has been described quantitatively in very few speakers. This study quantified changes in laryngeal adduction, fundamental frequency, and intensity during IP relative to expiratory phonation (EP). We hypothesized that IP would increase laryngeal abduction and fundamental frequency. The experiment was a within-subjects, repeated measures design with each subject serving as her own control. Participants were 10 females (ages 19-50 years) who underwent simultaneous transoral videostrobolaryngoscopy and acoustic voice recording. We found that membranous vocal fold contact decreased significantly during IP relative to EP, while the trends for change of ventricular fold squeeze during IP varied across individuals. Vocal fundamental frequency increased significantly during IP relative to EP, but intensity did not vary consistently across conditions. Without teaching or coaching, changes that occurred during IP did not carry over to EP produced immediately following IP within the same respiratory cycle. PMID:10498055

  4. Airway occlusion pressure and diaphragm global electromyogram analysis for evaluation of inspiratory muscle drive and neuromechanical coupling in cattle.

    PubMed

    Desmecht, D J; Linden, A S; Rollin, F A; Lekeux, P M

    1994-06-01

    Although healthy and diseased bovine respiratory tracts have been intensively studied during the last years, to the authors' knowledge, there have been no attempts to objectively examine the inspiratory drive from the brain to the nerves and muscles and its transformation in pressure. Such technique would be useful in assessing the possibility of altered ventilatory drive or inspiratory muscle fatigue in the context of an animal with ventilatory failure. The relation among ventilation, airway opening occlusion pressure generated 100 milliseconds after onset of inspiration (Pawo100ms) and 6 indexes describing diaphragmatic electromyographic activity (EMGdi) recorded via implanted fishhooks was evaluated during free and impeded CO2 rebreathing in 6 young bulls. The best significant linear correlations (r > 0.8) with inspiratory center afferent stimulation, as judged by end-tidal CO2 concentration in expired air, were found for Pawo100ms, peak moving time average or variance EMGdi, and mean integrated EMGdi, whatever had been the respiratory impedance. However, with an inspiratory load, Pawo100ms responses systematically had greater increase for a given change in the driving EMGdi, implying dependence of the former not only on neural input, but also on configurational factors that determine inspiratory muscle excitation-pressure generation couplings. The reproducibility of EMGdi absolute values and changes was satisfactory up to 10 hours, but could not be repeated from one day to the other. It was concluded that, provided the constancy of the electrical coupling of the recording system to the tissue being studied is ensured, specific EMGdi and Pawo100ms values correlate reliably with amount of CO2 during free and loaded breathing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7944009

  5. The influence of inspiratory muscle work history and specific inspiratory muscle training upon human limb muscle fatigue

    PubMed Central

    McConnell, Alison K; Lomax, Michelle

    2006-01-01

    The purpose of this study was to assess the influence of the work history of the inspiratory muscles upon the fatigue characteristics of the plantar flexors (PF). We hypothesized that under conditions where the inspiratory muscle metaboreflex has been elicited, PF fatigue would be hastened due to peripheral vasoconstriction. Eight volunteers undertook seven test conditions, two of which followed 4 week of inspiratory muscle training (IMT). The inspiratory metaboreflex was induced by inspiring against a calibrated flow resistor. We measured torque and EMG during isometric PF exercise at 85% of maximal voluntary contraction (MVC) torque. Supramaximal twitches were superimposed upon MVC efforts at 1 min intervals (MVCTI); twitch interpolation assessed the level of central activation. PF was terminated (Tlim) when MVCTI was <50% of baseline MVC. PF Tlim was significantly shorter than control (9.93 ± 1.95 min) in the presence of a leg cuff inflated to 140 mmHg (4.89 ± 1.78 min; P = 0.006), as well as when PF was preceded immediately by fatiguing inspiratory muscle work (6.28 ± 2.24 min; P = 0.009). Resting the inspiratory muscles for 30 min restored the PF Tlim to control. After 4 weeks, IMT, inspiratory muscle work at the same absolute intensity did not influence PF Tlim, but Tlim was significantly shorter at the same relative intensity. The data are the first to provide evidence that the inspiratory muscle metaboreflex accelerates the rate of calf fatigue during PF, and that IMT attenuates this effect. PMID:16973699

  6. Prediction of load threshold of fibre-reinforced laminated composite panels subjected to low velocity drop-weight impact using efficient data filtering techniques

    NASA Astrophysics Data System (ADS)

    Farooq, Umar; Myler, Peter

    This work is concerned with physical testing of carbon fibrous laminated composite panels with low velocity drop-weight impacts from flat and round nose impactors. Eight, sixteen, and twenty-four ply panels were considered. Non-destructive damage inspections of tested specimens were conducted to approximate impact-induced damage. Recorded data were correlated to load-time, load-deflection, and energy-time history plots to interpret impact induced damage. Data filtering techniques were also applied to the noisy data that unavoidably generate due to limitations of testing and logging systems. Built-in, statistical, and numerical filters effectively predicted load thresholds for eight and sixteen ply laminates. However, flat nose impact of twenty-four ply laminates produced clipped data that can only be de-noised involving oscillatory algorithms. Data filtering and extrapolation of such data have received rare attention in the literature that needs to be investigated. The present work demonstrated filtering and extrapolation of the clipped data using Fast Fourier Convolution algorithm to predict load thresholds. Selected results were compared to the damage zones identified with C-scan and acceptable agreements have been observed. Based on the results it is proposed that use of advanced data filtering and analysis methods to data collected by the available resources has effectively enhanced data interpretations without resorting to additional resources. The methodology could be useful for efficient and reliable data analysis and impact-induced damage prediction of similar cases' data.

  7. Gap junctions and inhibitory synapses modulate inspiratory motoneuron synchronization.

    PubMed

    Bou-Flores, C; Berger, A J

    2001-04-01

    Interneuronal electrical coupling via gap junctions and chemical synaptic inhibitory transmission are known to have roles in the generation and synchronization of activity in neuronal networks. Uncertainty exists regarding the roles of these two modes of interneuronal communication in the central respiratory rhythm-generating system. To assess their roles, we performed studies on both the neonatal mouse medullary slice and en bloc brain stem-spinal cord preparations where rhythmic inspiratory motor activity can readily be recorded from both hypoglossal and phrenic nerve roots. The rhythmic inspiratory activity observed had two temporal characteristics: the basic respiratory frequency occurring on a long time scale and the synchronous neuronal discharge within the inspiratory burst occurring on a short time scale. In both preparations, we observed that bath application of gap-junction blockers, including 18 alpha-glycyrrhetinic acid, 18 beta-glycyrrhetinic acid, and carbenoxolone, all caused a reduction in respiratory frequency. In contrast, peak integrated phrenic and hypoglossal inspiratory activity was not significantly changed by gap-junction blockade. On a short-time-scale, gap-junction blockade increased the degree of synchronization within an inspiratory burst observed in both nerves. In contrast, opposite results were observed with blockade of GABA(A) and glycine receptors. We found that respiratory frequency increased with receptor blockade, and simultaneous blockade of both receptors consistently resulted in a reduction in short-time-scale synchronized activity observed in phrenic and hypoglossal inspiratory bursts. These results support the concept that the central respiratory system has two components: a rhythm generator responsible for the production of respiratory cycle timing and an inspiratory pattern generator that is involved in short-time-scale synchronization. In the neonatal rodent, properties of both components can be regulated by interneuronal

  8. Determinants of inspiratory muscle strength in healthy humans.

    PubMed

    Brown, Peter I; Johnson, Michael A; Sharpe, Graham R

    2014-06-01

    We investigated (1) the relationship between the baseline and inspiratory muscle training (IMT) induced increase in maximal inspiratory pressure (P(I,max)) and (2) the relative contributions of the inspiratory chest wall muscles and the diaphragm (P(oes)/P(di)) to P(I,max) prior to and following-IMT. Experiment 1: P(I,max) was assessed during a Müeller manoeuvre before and after 4-wk IMT (n=30). Experiment 2: P(I,max) and the relative contribution of the inspiratory chest wall muscles to the diaphragm (P(oes)/P(di)) were assessed during a Müeller manoeuvre before and after 4-wk IMT (n=20). Experiment 1: P(I,max) increased 19% (P<0.01) post-IMT and was correlated with baseline P(I,max) (r=-0.373, P<0.05). Experiment 2: baseline P(I,max) was correlated with P(oe)/P(di) (r=0.582, P<0.05) and after IMT PI,max increased 22% and Poe/Pdi increased 5% (P<0.05). In conclusion, baseline P(I,max) and the contribution of the chest wall inspiratory muscles relative to the diaphragm affect, in part, baseline and IMT-induced P(I,max). Great care should be taken when designing future IMT studies to ensure parity in the between-subject baseline P(I,max). PMID:24598814

  9. Preoperative inspiratory muscle training to prevent postoperative pulmonary complications in patients undergoing esophageal resection (PREPARE study): study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Esophageal resection is associated with a high incidence of postoperative pneumonia. Respiratory complications account for almost half of the readmissions to the critical care unit. Postoperative complications can result in prolonged hospital stay and consequently increase healthcare costs. In cardiac surgery a preoperative inspiratory muscle training program has shown to prevent postoperative pneumonia and reduce length of hospital stay. While in some surgical centers inspiratory muscle training is already used in the preoperative phase in patients undergoing esophageal resection, the added value of this intervention on the reduction of pulmonary complications has not yet been investigated in large surgical populations other than cardiac surgery in a randomized and controlled study design. Methods/Design The effect of a preoperative inspiratory muscle training program on the incidence of postoperative pneumonia in patients undergoing esophageal resection will be studied in a single blind multicenter randomized controlled trial (the PREPARE study). In total 248 patients (age >18 years) undergoing esophageal resection for esophageal cancer will be included in this study. They are randomized to either usual care or usual care with an additional inspiratory muscle training intervention according to a high-intensity protocol which is performed with a tapered flow resistive inspiratory loading device. Patients have to complete 30 dynamic inspiratory efforts twice daily for 7 days a week until surgery with a minimum of 2 weeks. The starting training load will be aimed to be 60% of maximal inspiratory pressure and will be increased based on the rate of perceived exertion. The main study endpoint is the incidence of postoperative pneumonia. Secondary objectives are to evaluate the effect of preoperative inspiratory muscle training on length of hospital stay, duration of mechanical ventilation, incidence of other postoperative (pulmonary) complications

  10. Effect of upper airway negative pressure on inspiratory drive during sleep.

    PubMed

    Eastwood, P R; Curran, A K; Smith, C A; Dempsey, J A

    1998-03-01

    To determine the effect of upper airway (UA) negative pressure and collapse during inspiration on regulation of breathing, we studied four unanesthetized female dogs during wakefulness and sleep while they breathed via a fenestrated tracheostomy tube, which was sealed around the permanent tracheal stoma. The snout was sealed with an airtight mask, thereby isolating the UA when the fenestration (Fen) was closed and exposing the UA to intrathoracic pressure changes, but not to flow changes, when Fen was open. During tracheal occlusion with Fen closed, inspiratory time (TI) increased during wakefulness, non-rapid-eye-movement (NREM) sleep and rapid-eye-movement (REM) sleep (155 +/- 8, 164 +/- 11, and 161 +/- 32%, respectively), reflecting the removal of inhibitory lung inflation reflexes. During tracheal occlusion with Fen open (vs. Fen closed): 1) the UA remained patent; 2) TI further increased during wakefulness and NREM (215 +/- 52 and 197 +/- 28%, respectively) but nonsignificantly during REM sleep (196 +/- 42%); 3) mean rate of rise of diaphragm EMG (EMGdi/TI) and rate of fall of tracheal pressure (Ptr/TI) were decreased, reflecting an additional inhibitory input from UA receptors; and 4) both EMGdi/TI and Ptr/TI were decreased proportionately more as inspiration proceeded, suggesting greater reflex inhibition later in the effort. Similar inhibitory effects of exposing the UA to negative pressure (via an open tracheal Fen) were seen when an inspiratory resistive load was applied over several breaths during wakefulness and sleep. These inhibitory effects persisted even in the face of rising chemical stimuli. This inhibition of inspiratory motor output is alinear within an inspiration and reflects the activation of UA pressure-sensitive receptors by UA distortion, with greater distortion possibly occurring later in the effort. PMID:9480970

  11. Effects of a 10-Week Inspiratory Muscle Training Program on Lower-Extremity Mobility in People with Multiple Sclerosis

    PubMed Central

    Fry, Donna

    2011-01-01

    Pulmonary muscle weakness is common in ambulatory people with multiple sclerosis (MS) and may lead to deficits in mobility function. The purpose of this study was to examine the effect of a 10-week home-based exercise program using an inspiratory muscle threshold trainer (IMT) on the results of four lower-extremity physical performance tests in people with MS. The study design was a two-group (experimental-control), pretest-posttest study. Outcome measures consisted of pulmonary function measures including maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and maximal voluntary ventilation (MVV), and the following lower-extremity physical performance measures: the 6-Minute Walk (6MW) distance, gait velocity (GV), the Sit-to-Stand Test (SST), the Functional Stair Test (FST), and a balance test (BAL). A total of 46 ambulatory participants (Expanded Disability Status Scale [EDSS] score, 2.0–6.5) with MS were randomly assigned to an intervention group (mean EDSS score, 4.1) that received 10 weeks of home-based inspiratory muscle training or a nontreatment control group (mean EDSS score, 3.2). Of the original 46 participants, 20 intervention group participants and 19 control group participants completed the study. Compared with the control group, the intervention group made significantly greater gains in inspiratory muscle strength (P = .003) and timed balance scores (P = .008). A nonsignificant improvement in 6MW distance (P = .086) was also noted in the IMT-trained group as compared with the control group. This is the first study directly linking improvement in respiratory function to improvement in physical performance function in people with mild-to-moderate disability due to MS. PMID:24453703

  12. The effect of inspiratory muscle training upon maximum lactate steady-state and blood lactate concentration.

    PubMed

    McConnell, Alison K; Sharpe, Graham R

    2005-06-01

    Several studies have reported that improvements in endurance performance following respiratory muscle training (RMT) are associated with a decrease in blood lactate concentration ([Lac](B)). The present study examined whether pressure threshold inspiratory muscle training (IMT) elicits an increase in the cycling power output corresponding to the maximum lactate steady state (MLSS). Using a double-blind, placebo-controlled design, 12 healthy, non-endurance-trained male participants were assigned in equal numbers to an experimental (IMT) or sham training control (placebo) group. Cycling power output at MLSS was initially identified using a lactate minimum protocol followed by a series of constant power output rides (2.5% increments) of 29.5 min duration; MLSS was reassessed following six weeks of IMT or sham IMT. Maximum inspiratory mouth pressure increased significantly (26%) in the IMT group, but remained unchanged in the placebo group. The cycling power output corresponding to MLSS remained unchanged in both groups after the intervention. After IMT, [Lac](B) decreased significantly at MLSS power in the IMT group [-1.17 (1.01) mmol l(-1) after 29.5 min of cycling; mean (SD)], but remained unchanged in the placebo group [+0.37 (1.66) mmol l(-1)]. These data support previous observations that IMT results in a decrease in [Lac](B )at a given intensity of exercise. That such a decrease in [Lac](B) was not associated with a substantial (>2.5%) increase in MLSS power is a new finding suggesting that RMT-induced increases in exercise tolerance and reductions in [Lac](B) are not ascribable to a substantial increase in the 'lactate threshold'. PMID:15765241

  13. Relative activity of respiratory muscles during prescribed inspiratory muscle training in healthy people

    PubMed Central

    Jung, Ju-hyeon; Kim, Nan-soo

    2016-01-01

    [Purpose] This study aimed to determine the effects of different intensities of inspiratory muscle training on the relative respiratory muscle activity in healthy adults. [Subjects and Methods] Thirteen healthy male volunteers were instructed to perform inspiratory muscle training (0%, 40%, 60%, and 80% maximal inspiratory pressure) on the basis of their individual intensities. The inspiratory muscle training was performed in random order of intensities. Surface electromyography data were collected from the right-side diaphragm, external intercostal, and sternocleidomastoid, and pulmonary functions (forced expiratory volume in 1 s, forced vital capacity, and their ratio; peak expiratory flow; and maximal inspiratory pressure) were measured. [Results] Comparison of the relative activity of the diaphragm showed significant differences between the 60% and 80% maximal inspiratory pressure intensities and baseline during inspiratory muscle training. Furthermore, significant differences were found in sternocleidomastoid relative activity between the 60% and 80% maximal inspiratory pressure intensities and baseline during inspiratory muscle training. [Conclusion] During inspiratory muscle training in the clinic, the patients were assisted (verbally or through feedback) by therapists to avoid overactivation of their accessory muscles (sternocleidomastoid). This study recommends that inspiratory muscle training be performed at an accurate and appropriate intensity through the practice of proper deep breathing. PMID:27134409

  14. Recruitment of some respiratory muscles during three maximal inspiratory manoeuvres.

    PubMed Central

    Nava, S; Ambrosino, N; Crotti, P; Fracchia, C; Rampulla, C

    1993-01-01

    BACKGROUND--A study was undertaken to determine the level of recruitment of the muscles used in the generation of respiratory muscle force, and to ascertain whether maximal diaphragmatic force and maximal inspiratory muscle force need to be measured by separate tests. The level of activity of three inspiratory muscles and one expiratory muscle during three maximal respiratory manoeuvres was studied: (1) maximal inspiration against a closed airway (Muller manoeuvre or maximal inspiratory pressure (MIP)); (2) maximal inspired manoeuvre followed by a maximal expiratory effort (combined manoeuvre); and (3) maximal inspiratory sniff through the nose (sniff manoeuvre). METHODS--All the manoeuvres were performed from functional residual capacity. The gastric (PGA) and oesophageal (POES) pressures and their difference, transdiaphragmatic pressure (PDI), and the integrated EMG activity of the diaphragm (EDI), the sternomastoid (ESTR), the intercostal parasternals (ERIC), and the rectus abdominis muscles (ERA) were recorded. RESULTS--Mean (SD) PDI values for the Muller, combined, and sniff manoeuvres were: 127.6 (19.4), 162.7 (22.2), and 136.6 (24.8) cm H2O, respectively. The pattern of rib cage muscle recruitment (POES/PDI) was similar for the Muller and sniff manoeuvres (88% and 80% respectively), and was 58% in the combined manoeuvre, confirming data previously reported in the literature. Peak EDI amplitude was greater during the sniff manoeuvre in all subjects (100%) than during the combined (88.1%) and Muller (61.1%) manoeuvres. ESTR and EIC were more active in the Muller and the sniff manoeuvres. The contribution of the expiratory muscle (ERA) to the three manoeuvres was 100% in the combined, 26.1% for the sniff, and 11.5% for the Muller manoeuvre. CONCLUSIONS--Each of these three manoeuvres results in different mechanisms of inspiratory and expiratory muscle activation and the intrathoracic and intra-abdominal pressures generated are a reflection of the interaction

  15. Forced respiration during the deeper water immersion causes the greater inspiratory muscle fatigue in healthy young men.

    PubMed

    Yamashina, Yoshihiro; Yokoyama, Hisayo; Naghavi, Nooshin; Hirasawa, Yoshikazu; Takeda, Ryosuke; Ota, Akemi; Imai, Daiki; Miyagawa, Toshiaki; Okazaki, Kazunobu

    2016-01-01

    [Purpose] The purpose of the present study was to evaluate the effect of water immersion at different water depths on respiratory function and the effect of inspiratory load breathing (ILB) during water immersion at different water depths on respiratory muscle strength evaluated by maximum inspiratory and expiratory pressures (PImax and PEmax, respectively). [Subjects] Eight healthy men participated randomly in three trials. [Methods] All sessions were conducted with the participants in a sitting position immersed in a water bath. We evaluated respiratory function, PImax and PEmax during submersion at three different levels of water depth (umbilicus; 4th-rib; or clavicle, CL) and after subsequent 15-min ILB. [Results] Decreases in vital capacity and expiratory reserve volume from baseline by water immersion were significantly greater in the CL trial than those in the other trials. In the CL trial, PImax was immediately reduced after ILB compared to that at baseline, and the reduction was significantly greater than those in the other trials. PEmax was not affected by ILB in any of the trials. [Conclusion] Forced respiration during deeper water immersion caused greater inspiratory muscle fatigue in healthy young men. PMID:27064401

  16. Forced respiration during the deeper water immersion causes the greater inspiratory muscle fatigue in healthy young men

    PubMed Central

    Yamashina, Yoshihiro; Yokoyama, Hisayo; Naghavi, Nooshin; Hirasawa, Yoshikazu; Takeda, Ryosuke; Ota, Akemi; Imai, Daiki; Miyagawa, Toshiaki; Okazaki, Kazunobu

    2016-01-01

    [Purpose] The purpose of the present study was to evaluate the effect of water immersion at different water depths on respiratory function and the effect of inspiratory load breathing (ILB) during water immersion at different water depths on respiratory muscle strength evaluated by maximum inspiratory and expiratory pressures (PImax and PEmax, respectively). [Subjects] Eight healthy men participated randomly in three trials. [Methods] All sessions were conducted with the participants in a sitting position immersed in a water bath. We evaluated respiratory function, PImax and PEmax during submersion at three different levels of water depth (umbilicus; 4th-rib; or clavicle, CL) and after subsequent 15-min ILB. [Results] Decreases in vital capacity and expiratory reserve volume from baseline by water immersion were significantly greater in the CL trial than those in the other trials. In the CL trial, PImax was immediately reduced after ILB compared to that at baseline, and the reduction was significantly greater than those in the other trials. PEmax was not affected by ILB in any of the trials. [Conclusion] Forced respiration during deeper water immersion caused greater inspiratory muscle fatigue in healthy young men. PMID:27064401

  17. Discharge properties of dorsal medullary inspiratory neurons in newborn pigs.

    PubMed

    Sica, A L; Donnelly, D F; Steele, A M; Gandhi, M R

    1987-04-01

    The discharges of medullary inspiratory neurons were recorded in newborn pigs. They were classified by discharge pattern; response to lung inflation; synaptic relation to phrenic motoneurons. Our results showed: these neurons have similar discharge patterns and responses to lung inflation as adult cats; most neurons do not project to phrenic motoneurons. It is suggested that our sampled population of neurons is involved in integrating pulmonary afferent inputs. PMID:3594209

  18. Trend of tunnel magnetoresistance and variation in threshold voltage for keeping data load robustness of metal–oxide–semiconductor/magnetic tunnel junction hybrid latches

    SciTech Connect

    Ohsawa, T.; Ikeda, S.; Hanyu, T.; Ohno, H.; Endoh, T.

    2014-05-07

    The robustness of data load of metal–oxide–semiconductor/magnetic tunnel junction (MOS/MTJ) hybrid latches at power-on is examined by using Monte Carlo simulation with the variations in magnetoresistances for MTJs and in threshold voltages for MOSFETs involved in 90 nm technology node. Three differential pair type spin-transfer-torque-magnetic random access memory cells (4T2MTJ, 6T2MTJ, and 8T2MTJ) are compared for their successful data load at power-on. It is found that the 4T2MTJ cell has the largest pass area in the shmoo plot in TMR ratio (tunnel magnetoresistance ratio) and V{sub dd} in which a whole 256 kb cell array can be powered-on successfully. The minimum TMR ratio for the 4T2MTJ in 0.9 V < V{sub dd} < 1.9 V is 140%, while the 6T2MTJ and the 8T2MTJ cells require TMR ratio larger than 170%.

  19. Inspiratory muscle training enhances pulmonary O(2) uptake kinetics and high-intensity exercise tolerance in humans.

    PubMed

    Bailey, Stephen J; Romer, Lee M; Kelly, James; Wilkerson, Daryl P; DiMenna, Fred J; Jones, Andrew M

    2010-08-01

    Fatigue of the respiratory muscles during intense exercise might compromise leg blood flow, thereby constraining oxygen uptake (Vo(2)) and limiting exercise tolerance. We tested the hypothesis that inspiratory muscle training (IMT) would reduce inspiratory muscle fatigue, speed Vo(2) kinetics and enhance exercise tolerance. Sixteen recreationally active subjects (mean + or - SD, age 22 + or - 4 yr) were randomly assigned to receive 4 wk of either pressure threshold IMT [30 breaths twice daily at approximately 50% of maximum inspiratory pressure (MIP)] or sham treatment (60 breaths once daily at approximately 15% of MIP). The subjects completed moderate-, severe- and maximal-intensity "step" exercise transitions on a cycle ergometer before (Pre) and after (Post) the 4-wk intervention period for determination of Vo(2) kinetics and exercise tolerance. There were no significant changes in the physiological variables of interest after Sham. After IMT, baseline MIP was significantly increased (Pre vs. Post: 155 + or - 22 vs. 181 + or - 21 cmH(2)O; P < 0.001), and the degree of inspiratory muscle fatigue was reduced after severe- and maximal-intensity exercise. During severe exercise, the Vo(2) slow component was reduced (Pre vs. Post: 0.60 + or - 0.20 vs. 0.53 + or - 0.24 l/min; P < 0.05) and exercise tolerance was enhanced (Pre vs. Post: 765 + or - 249 vs. 1,061 + or - 304 s; P < 0.01). Similarly, during maximal exercise, the Vo(2) slow component was reduced (Pre vs. Post: 0.28 + or - 0.14 vs. 0.18 + or - 0.07 l/min; P < 0.05) and exercise tolerance was enhanced (Pre vs. Post: 177 + or - 24 vs. 208 + or - 37 s; P < 0.01). Four weeks of IMT, which reduced inspiratory muscle fatigue, resulted in a reduced Vo(2) slow-component amplitude and an improved exercise tolerance during severe- and maximal-intensity exercise. The results indicate that the enhanced exercise tolerance observed after IMT might be related, at least in part, to improved Vo(2) dynamics, presumably as a

  20. Tonic activity in inspiratory muscles during continuous negative airway pressure.

    PubMed

    Meessen, N E; van der Grinten, C P; Folgering, H T; Luijendijk, S C

    1993-05-01

    We studied tonic inspiratory activity (TIA) induced by continuous negative airway pressure (CNAP) in anaesthetized, spontaneously breathing cats. TIA in the diaphragm and parasternal intercostal muscles (ICM) was quantified in response to tracheal pressure (PTR) = -0.3 to -1.2 kPa. To differentiate between reflexes from rapidly adapting receptors (RARs), slowly adapting receptors (SARs) and C-fiber endings different temperatures of the vagus nerves (TVG) were used between 4 and 37 degrees C. At PTR = -1.2 kPa mean TIA values were 41% and 62% of peak inspiratory EMG activity of control breaths for the diaphragm and ICM, respectively. After vagotomy and for TVG < 6 degrees C CNAP did not induce TIA anymore. Changes in inspiratory and expiratory time during vagal cooling down to 4 degrees C confirmed the selective block of conductance in vagal afferents of the three types of lung receptors. We conclude that CNAP-induced TIA results from stimulation of RARs. Our data strongly indicate that stimulation of SARs suppresses TIA, whereas C-fiber endings are not involved in TIA at all. The results suggest that part of the hyperinflation in bronchial asthma may be caused by TIA in response to mechanical stimulation of RARs. PMID:8327788

  1. Systematic Review of Inspiratory Muscle Training After Cerebrovascular Accident.

    PubMed

    Martín-Valero, Rocío; De La Casa Almeida, Maria; Casuso-Holgado, Maria Jesus; Heredia-Madrazo, Alfonso

    2015-11-01

    This systematic review examines levels of evidence and recommendation grades of various therapeutic interventions of inspiratory muscle training in people who have had a stroke. Benefits from different levels of force and resistance in respiratory muscles are shown in this population. This review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) directives and was completed in November 2014. The search limits were studies published in English between 2004 and 2014. Relevant studies were searched for in MEDLINE, PEDro, OAIster, Scopus, PsycINFO, Web of Knowledge, CINAHL, SPORTDiscus, DOAJ, Cochrane, Embase, Academic Search Complete, Fuente Académica, and MedicLatina. Initially, 20 articles were identified. After analyzing all primary documents, 14 studies were excluded. Only 6 studies were relevant to this review. Three different types of interventions were found (maximum inspiratory training, controlled training, and nonintervention) in 3 different groups. One specific study compared 3 inspiratory muscle training groups with a group of breathing exercises (diaphragmatic exercises with pursed lips) and a control group. Future long-term studies with larger sample sizes are needed. It is necessary to apply respiratory muscle training as a service of the national health system and to consider its inclusion in the conventional neurological program. PMID:26493591

  2. The role of mean inspiratory effort on daytime sleepiness.

    PubMed

    Pelin, Z; Karadeniz, D; Oztürk, L; Gözükirmizi, E; Kaynak, H

    2003-04-01

    This study has investigated the role of average maximum inspiratory effort in excessive daytime sleepiness in patients with obstructive sleep apnoea syndrome (OSAS) and upper airway resistance syndrome (UARS). Fifteen patients diagnosed with UARS and 32 patients with OSAS, with >5.5 h total sleep time (TST) during 8 h of nocturnal polygraphic recordings, were included in the study. Demographical data, polysomnographical data and data about daytime sleepiness, including Epworth sleepiness scale (ESS) and multiple sleep latency test (MSLT), were evaluated. In order to compute the average maximum inspiratory effort from oesophageal pressure (Poes) measurements, maximum Poes was obtained from 20 representative obstructive respiratory events (obstructive apnoeas, hypopnoeas or flow limitations) for each sleep stage in both supine and side positions. From Poes measurements during sleep, the increase in Poes (deltaPoes) during respiratory events was also calculated. The average maximum Poes, deltaPoes, respiratory disturbance index (RDI) and arousal index were significantly correlated with ESS in OSAS patients. In patients with UARS, the only significant correlation was obtained between average maximum Poes and ESS. The MSLT score did not show any significant correlation with arousal index, number of stage variations, RDI, average Poes, deltaPoes, minimum oxygen saturation (Sa,O2) and percentage of TST with an Sa,O2 <90% in both UARS and OSAS patients. The results of multiple regression analysis showed that average maximum Poes correlates best with the variance in ESS for OSAS patients. In conclusion, the data from this study indicate the possible important role of average inspiratory effort in determining subjective sleepiness in both obstructive sleep apnoea syndrome and upper airway resistance syndrome patients. PMID:12762358

  3. Effects of inspiratory muscle training on exercise capacity and spontaneous physical activity in elderly subjects: a randomized controlled pilot trial.

    PubMed

    Aznar-Lain, S; Webster, A L; Cañete, S; San Juan, A F; López Mojares, L M; Pérez, M; Lucia, A; Chicharro, J L

    2007-12-01

    Inspiratory muscle training (IMT) has been shown to improve exercise capacity in diseased populations. We chose to examine the effects of eight weeks of IMT on exercise capacity and spontaneous physical activity in elderly individuals. Eighteen moderately active elderly subjects (68.1 +/- 6.8 years [mean +/- SD]; range 58 - 78 years) were randomly assigned to either an experimental group (n = 9) or a control group (n = 9) in a double-blind manner. All subjects underwent inspiratory muscle testing, treadmill exercise testing and a four-day measurement period of spontaneous physical activity (using accelerometry) both pre- and post-intervention. The experimental group underwent eight weeks of incremental IMT using a pressure threshold device, while the control group underwent sham training using identical devices. After IMT training, inspiratory muscle strength (mean + 21.5 cm H (2)O; 95 % CI: 9.3, 33.7; p = 0.002), V.O (2peak) (+ 2.8 ml x min (-1) x kg (-1); 95 % CI: 0.5, 5.2; p = 0.022), time to exhaustion during a fixed workload treadmill test (+ 7.1 min; 95 % CI: 1.8, 2.4; p = 0.013) and time engaged in moderate-to-vigorous physical activity (+ 59 min; 95 % CI: 15, 78; p = 0.008) improved. Except for a decline in moderate-to-vigorous physical activity, no significant changes were seen in the control group. Therefore, IMT may be a useful technique for positively influencing exercise capacity and physical activity in elderly individuals. PMID:17534784

  4. Effects of inspiratory flow waveforms on arterial blood gases and respiratory mechanics after open heart surgery.

    PubMed

    Polese, G; Lubli, P; Poggi, R; Luzzani, A; Milic-Emili, J; Rossi, A

    1997-12-01

    The clinical usefulness of inspiratory flow pattern manipulation during mechanical ventilation remains unclear. The aim of this study was to investigate the effects of different inspiratory flow waveforms, i.e. constant, sinusoidal and decelerating, on arterial blood gases and respiratory mechanics, in mechanically ventilated patients. Eight patients recovering after open heart surgery for valvular replacement and/or coronary bypass were studied. The ventilator inspiratory flow waveform was changed according to a randomized sequence, keeping constant the other variables of the ventilator settings. We measured arterial blood gases, flow, volume and pressure at the proximal (airway opening pressure (Pao)) and distal (Ptr) ends of the endotracheal tubes before and after 30 min of mechanical ventilation with each inspiratory flow waveform. We computed breathing pattern, respiratory mechanics (pressures and dynamic elastance) and inspiratory work, which was then partitioned into its elastic and resistive components. We found that: 1) arterial oxygen tension (Pa,O2) and arterial carbon dioxide tension (Pa,CO2) were not affected by changes in the inspiratory flow waveform; and 2) peak Pao and Ptr were highest with sinusoidal inspiratory flow, whilst mean Pao and Ptr and total work of breathing were least with constant inspiratory flow, mainly because of a concomitant decrease in resistive work during constant flow inflation. The effects of the inspiratory flow profile on Pao, Ptr and total inspiratory work performed by the ventilator were mainly due to the resistive properties of the endotracheal tubes. We conclude that the ventilator inspiratory flow waveform can influence patients' respiratory mechanics, but has no impact on arterial oxygen and arterial carbon dioxide tension. PMID:9493667

  5. Pontine respiratory activity involved in inspiratory/expiratory phase transition

    PubMed Central

    Mörschel, Michael; Dutschmann, Mathias

    2009-01-01

    Control of the timing of the inspiratory/expiratory (IE) phase transition is a hallmark of respiratory pattern formation. In principle, sensory feedback from pulmonary stretch receptors (Breuer–Hering reflex, BHR) is seen as the major controller for the IE phase transition, while pontine-based control of IE phase transition by both the pontine Kölliker–Fuse nucleus (KF) and parabrachial complex is seen as a secondary or backup mechanism. However, previous studies have shown that the BHR can habituate in vivo. Thus, habituation reduces sensory feedback, so the role of the pons, and specifically the KF, for IE phase transition may increase dramatically. Pontine-mediated control of the IE phase transition is not completely understood. In the present review, we discuss existing models for ponto-medullary interaction that may be involved in the control of inspiratory duration and IE transition. We also present intracellular recordings of pontine respiratory units derived from an in situ intra-arterially perfused brainstem preparation of rats. With the absence of lung inflation, this preparation generates a normal respiratory pattern and many of the recorded pontine units demonstrated phasic respiratory-related activity. The analysis of changes in membrane potentials of pontine respiratory neurons has allowed us to propose a number of pontine-medullary interactions not considered before. The involvement of these putative interactions in pontine-mediated control of IE phase transitions is discussed. PMID:19651653

  6. Sympathetic skin response following thermal, electrical, acoustic, and inspiratory gasp stimulation in familial dysautonomia patients and healthy persons.

    PubMed

    Hilz, M J; Azelrod, F B; Schweibold, G; Kolodny, E H

    1999-08-01

    To determine whether sympathetic skin response (SSR) testing evaluates afferent small or efferent sympathetic nerve fiber dysfunction, we studied SSR in patients with familial dysautonomia (FD) in whom both afferent small and efferent sympathetic fibers are largely reduced. We analyzed whether the response pattern to a combination of stimuli specific for large or small fiber activation allows differentiation between afferent and efferent small fiber dysfunction. In 52 volunteers and 13 FD patients, SSR was studied at palms and soles after warm, cold and heat as well as electrical, acoustic, and inspiratory gasp stimulation. In addition, thermal thresholds were assessed at four body sites using a Thermotest device (Somedic; Stockholm, Sweden). In volunteers, any stimulus induced reproducible SSRs. Only cold failed to evoke SSR in two volunteers. In all FD patients, electrical SSR was present, but amplitudes were reduced. Five patients had no acoustic SSR, four had no inspiratory SSR. Thermal SSR was absent in 10 patients with abnormal thermal perception and present in one patient with preserved thermal sensation. In two patients, thermal SSR was present only when skin areas with preserved temperature perception were stimulated. In patients with FD, preserved electrical SSR demonstrated the overall integrity of the SSR reflex but amplitude reduction suggested impaired sudomotor activation. SSR responses were dependent on the perception of the stimulus. In the presence of preserved electrical SSR, absent thermal SSR reflects afferent small fiber dysfunction. A combination of SSR stimulus types allows differentiation between afferent small or efferent sympathetic nerve fiber dysfunction. PMID:10574280

  7. Adaptive Thresholds

    SciTech Connect

    Bremer, P. -T.

    2014-08-26

    ADAPT is a topological analysis code that allow to compute local threshold, in particular relevance based thresholds for features defined in scalar fields. The initial target application is vortex detection but the software is more generally applicable to all threshold based feature definitions.

  8. Trapping volumetric measurement by multidetector CT in chronic obstructive pulmonary disease: Effect of CT threshold

    SciTech Connect

    Wang, Xiaohua; Yuan, Huishu; Duan, Jianghui; Du, Yipeng; Shen, Ning; He, Bei

    2013-08-15

    Purpose: The purpose of this study was to evaluate the effect of various computed tomography (CT) thresholds on trapping volumetric measurements by multidetector CT in chronic obstructive pulmonary disease (COPD).Methods: Twenty-three COPD patients were scanned with a 64-slice CT scanner in both the inspiratory and expiratory phase. CT thresholds of −950 Hu in inspiration and −950 to −890 Hu in expiration were used, after which trapping volumetric measurements were made using computer software. Trapping volume percentage (Vtrap%) under the different CT thresholds in the expiratory phase and below −950 Hu in the inspiratory phase was compared and correlated with lung function.Results: Mean Vtrap% was similar under −930 Hu in the expiratory phase and below −950 Hu in the inspiratory phase, being 13.18 ± 9.66 and 13.95 ± 6.72 (both lungs), respectively; this difference was not significant (P= 0.240). Vtrap% under −950 Hu in the inspiratory phase and below the −950 to −890 Hu threshold in the expiratory phase was moderately negatively correlated with the ratio of forced expiratory volume in one second to forced vital capacity and the measured value of forced expiratory volume in one second as a percentage of the predicted value.Conclusions: Trapping volumetric measurement with multidetector CT is a promising method for the quantification of COPD. It is important to know the effect of various CT thresholds on trapping volumetric measurements.

  9. Inspiratory muscle training compared with other rehabilitation interventions in adults with chronic obstructive pulmonary disease: a systematic literature review and meta-analysis.

    PubMed

    Crowe, Jean; Reid, W Darlene; Geddes, E Lynne; O'Brien, Kelly; Brooks, Dina

    2005-09-01

    The purpose of this systematic review was to determine the effect of inspiratory muscle training (IMT) (alone or combined with exercise and/or pulmonary rehabilitation) compared to other rehabilitation interventions such as: exercise, education, other breathing techniques or exercise and/or pulmonary rehabilitation among adults with chronic obstructive pulmonary disease (COPD). A systematic review of the literature on IMT and COPD was conducted according to the Cochrane Collaboration protocol. Inclusion criteria for the review included randomized controlled trials, published in English, comparing IMT or combined IMT and exercise/pulmonary rehabilitation with other rehabilitation interventions such as general exercise, education, other breathing techniques or exercise/pulmonary rehabilitation among adults with COPD. 274 articles were retrieved, and 16 met the inclusion criteria. Seven meta-analyses were performed that compared targeted or threshold IMT to exercise (n = 3) or to education (n = 4). Results showed significant improvements in inspiratory muscle strength and endurance, and in the dyspnea scale on a quality of life measure, for participants in the IMT versus education group. In other instances where meta-analyses could not be performed, a qualitative review was performed. IMT results in improved inspiratory muscle strength and endurance compared to education. Further trials are required to investigate the effect of IMT (or combined IMT) compared to other rehabilitation inventions for outcomes such as dyspnea, exercise tolerance, and quality of life. PMID:17146997

  10. Effects of a 10-week inspiratory muscle training program on lower-extremity mobility in people with multiple sclerosis: a randomized controlled trial.

    PubMed

    Pfalzer, Lucinda; Fry, Donna

    2011-01-01

    Pulmonary muscle weakness is common in ambulatory people with multiple sclerosis (MS) and may lead to deficits in mobility function. The purpose of this study was to examine the effect of a 10-week home-based exercise program using an inspiratory muscle threshold trainer (IMT) on the results of four lower-extremity physical performance tests in people with MS. The study design was a two-group (experimental-control), pretest-posttest study. Outcome measures consisted of pulmonary function measures including maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and maximal voluntary ventilation (MVV), and the following lower-extremity physical performance measures: the 6-Minute Walk (6MW) distance, gait velocity (GV), the Sit-to-Stand Test (SST), the Functional Stair Test (FST), and a balance test (BAL). A total of 46 ambulatory participants (Expanded Disability Status Scale [EDSS] score, 2.0-6.5) with MS were randomly assigned to an intervention group (mean EDSS score, 4.1) that received 10 weeks of home-based inspiratory muscle training or a nontreatment control group (mean EDSS score, 3.2). Of the original 46 participants, 20 intervention group participants and 19 control group participants completed the study. Compared with the control group, the intervention group made significantly greater gains in inspiratory muscle strength (P = .003) and timed balance scores (P = .008). A nonsignificant improvement in 6MW distance (P = .086) was also noted in the IMT-trained group as compared with the control group. This is the first study directly linking improvement in respiratory function to improvement in physical performance function in people with mild-to-moderate disability due to MS. PMID:24453703

  11. Acute effects of inspiratory muscle warm-up on pulmonary function in healthy subjects.

    PubMed

    Özdal, Mustafa

    2016-06-15

    The acute effects of inspiratory muscle warm-up on pulmonary functions were examined in 26 healthy male subjects using the pulmonary function test (PFT) in three different trials. The control trial (CON) did not involve inspiratory muscle warm-up, while the placebo (IMWp) and experimental (IMW) trials involved inspiratory muscle warm-up. There were no significant changes between the IMWp and CON trials (p>0.05). All the PFT measurements, including slow vital capacity, inspiratory vital capacity, forced vital capacity, forced expiratory volume in one second, maximal voluntary ventilation, and maximal inspiratory pressure were significantly increased by 3.55%, 12.52%, 5.00%, 2.75%, 2.66%, and 7.03% respectively, in the subjects in the IMW trial than those in the CON trial (p<0.05). These results show that inspiratory muscle warm-up improved the pulmonary functions. The mechanisms responsible for these improvements are probably associated with the concomitant increase in the inspiratory muscle strength, and the cooperation of the upper thorax, neck, and respiratory muscles, and increased level of reactive O2 species in muscle tissue, and potentially improvement of muscle O2 delivery-to-utilization. However, further investigation is required to determine the precise mechanisms responsible from among these candidates. PMID:26903486

  12. Sniff nasal inspiratory pressure in patients with chronic obstructive pulmonary disease.

    PubMed

    Uldry, C; Janssens, J P; de Muralt, B; Fitting, J W

    1997-06-01

    In subjects with normal lung mechanics, inspiratory muscle strength can be reliably and easily assessed by the sniff nasal inspiratory pressure (SNIP), which is the pressure measured in an occluded nostril during a maximal sniff performed through the contralateral nostril. The aim of this study was to assess the validity of the SNIP in patients with chronic obstructive pulmonary disease (COPD), where pressure transmission from alveoli to upper airways is likely to be dampened. Twenty eight patients with COPD were studied (mean forced expiratory volume in one second (FEV1) = 36% of predicted). The SNIP and the sniff oesophageal pressure (sniff Poes) were measured simultaneously during maximal sniffs, and were compared to the maximal inspiratory pressure obtained against an occlusion (MIP). All measurements were performed from functional residual capacity in the sitting position. The ratio SNIP/sniff Poes was 0.80, and did not correlate with the degree of airflow limitation. The ratio MIP/sniff Poes was 0.87, and the ratio SNIP/MIP was 0.97. Inspiratory muscle weakness, as defined by a low sniff Poes, was present in 17 of the 28 patients. A false diagnosis of weakness was made in eight patients when MIP was considered alone, in four when SNIP was considered alone, and in only three patients when MIP and SNIP were combined. We conclude that both the sniff nasal inspiratory pressure and the maximal inspiratory pressure moderately underestimate sniff oesophageal pressure in chronic obstructive pulmonary disease. Although suboptimal in this condition, the sniff nasal inspiratory pressure appears useful to complement the maximal inspiratory pressure for assessing inspiratory muscle strength in patients with chronic obstructive pulmonary disease. PMID:9192931

  13. Pre-operative inspiratory muscle training preserves postoperative inspiratory muscle strength following major abdominal surgery – a randomised pilot study

    PubMed Central

    Kulkarni, SR; Fletcher, E; McConnell, AK; Poskitt, KR; Whyman, MR

    2010-01-01

    INTRODUCTION The aim of this pilot study was to assess the effect of pre-operative inspiratory muscle training (IMT) on respiratory variables in patients undergoing major abdominal surgery. PATIENTS AND METHODS Respiratory muscle strength (maximum inspiratory [MIP] and expiratory [MEP] mouth pressure) and pulmonary functions were measured at least 2 weeks before surgery in 80 patients awaiting major abdominal surgery. Patients were then allocated randomly to one of four groups (Group A, control; Group B, deep breathing exercises; Group C, incentive spirometry; Group D, specific IMT). Patients in groups B, C and D were asked to train twice daily, each session lasting 15 min, for at least 2 weeks up to the day before surgery. Outcome measurements were made immediately pre-operatively and postop-eratively. RESULTS In groups A, B and C, MIP did not increase from baseline to pre-operative assessments. In group D, MIP increased from 51.5 cmH2O (median) pre-training to 68.5 cmH2O (median) post-training pre-operatively (P < 0.01). Postoperatively, groups A, B and C showed a fall in MIP from baseline (P < 0.01, P < 0.01) and P = 0.06, respectively). No such significant reduction in postoperative MIP was seen in group D (P = 0.36). CONCLUSIONS Pre-operative specific IMT improves MIP pre-operatively and preserves it postoperatively. Further studies are required to establish if this is associated with reduced pulmonary complications. PMID:20663275

  14. Inspiratory flow dynamics during phrenic nerve stimulation in awake normals during nasal breathing.

    PubMed

    Sériès, F; Demoule, A; Marc, I; Sanfaçon, C; Derenne, J P; Similowski, T

    1999-08-01

    The loss of upper airway (UA) dilators preactivation before inspiratory muscle contraction is an important determinant of the pathophysiology of obstructive sleep apnea. We hypothetized that phrenic nerve stimulation could provide a practical way to explore the effects of the dissociation between UA dilators and inspiratory muscles, and possibly to determine UA critical closing pressure during wakefulness. The pattern of inspiratory airflow was therefore studied in normal awake subjects during diaphragm twitches induced by either electrical phrenic stimulation (ES) or cervical magnetic stimulation (CMS) (n = 9) and with and without a nasal stent during ES (n = 7). End-expiratory stimulations applied during exclusive nasal breathing induced 200 to 300 ms twitch inspiratory flow. The average maximal twitch flow of flow-limited twitches was higher during CMS than ES (1.18 +/- 0.29 L. PMID:10430737

  15. REDUCTION IN INSPIRATORY FLOW ATTENUATES IL-8 RELEASE AND MAPK ACTIVATION OF LUNG OVERSTRETCH

    EPA Science Inventory

    Lung overstretch involves mechanical factors, including large tidal volumes (VT), which induce inflammatory responses. The current authors hypothesised that inspiratory flow contributes to ventilator-induced inflammation. Buffer-perfused rabbit lungs were ventilated for 2 h with ...

  16. Preoperative Ambulatory Inspiratory Muscle Training in Patients Undergoing Esophagectomy. A Pilot Study

    PubMed Central

    Agrelli, Taciana Freitas; de Carvalho Ramos, Marisa; Guglielminetti, Rachel; Silva, Alex Augusto; Crema, Eduardo

    2012-01-01

    A major decline in pulmonary function is observed on the first day after upper abdominal surgery. This decline can reduce vital and inspiratory capacity and can culminate in restrictive lung diseases that cause atelectasis, reduced diaphragm movement, and respiratory insufficiency. The objective of this study was to evaluate the efficacy of preoperative ambulatory respiratory muscle training in patients undergoing esophagectomy. The sample consisted of 20 adult patients (14 men [70%] and 6 women [30%]) with a diagnosis of advanced chagasic megaesophagus. A significant increase in maximum inspiratory pressure was observed after inspiratory muscle training when compared with baseline values (from −55.059 ± 18.359 to −76.286 ± 16.786). Preoperative ambulatory inspiratory muscle training was effective in increasing respiratory muscle strength in patients undergoing esophagectomy and contributed to the prevention of postoperative complications. PMID:23113846

  17. Preoperative ambulatory inspiratory muscle training in patients undergoing esophagectomy. A pilot study.

    PubMed

    Agrelli, Taciana Freitas; de Carvalho Ramos, Marisa; Guglielminetti, Rachel; Silva, Alex Augusto; Crema, Eduardo

    2012-01-01

    A major decline in pulmonary function is observed on the first day after upper abdominal surgery. This decline can reduce vital and inspiratory capacity and can culminate in restrictive lung diseases that cause atelectasis, reduced diaphragm movement, and respiratory insufficiency. The objective of this study was to evaluate the efficacy of preoperative ambulatory respiratory muscle training in patients undergoing esophagectomy. The sample consisted of 20 adult patients (14 men [70%] and 6 women [30%]) with a diagnosis of advanced chagasic megaesophagus. A significant increase in maximum inspiratory pressure was observed after inspiratory muscle training when compared with baseline values (from -55.059 ± 18.359 to -76.286 ± 16.786). Preoperative ambulatory inspiratory muscle training was effective in increasing respiratory muscle strength in patients undergoing esophagectomy and contributed to the prevention of postoperative complications. PMID:23113846

  18. Intraoperative Autotriggered Pressure Support Ventilation Resistant to Increased Flow Trigger Threshold.

    PubMed

    Benitez Lopez, Julio; Rao, Sripad P; McNeer, Richard R; Dudaryk, Roman

    2016-07-01

    Oscillations from cardiac pulsations are normally transmitted to mediastinal structures without any consequence. Autotriggering (AT) of mechanical ventilation occurs when an inspiratory trigger, typically negative inspiratory flow in anesthesia ventilators, is met in the absence of patient effort. AT can lead to respiratory alkalosis, opioid overdose, prolonged mechanical ventilation, and lung hyperinflation. This entity has been reported in both critical care and operating room environments. Increasing the flow trigger usually resolves AT in all cases. We report a case of AT that failed to respond to increasing the flow trigger threshold to its maximal value on the GE Datex-Ohmeda Avance S5® anesthesia station. PMID:27224041

  19. Discharge properties and recruitment of human diaphragmatic motor units during voluntary inspiratory tasks

    PubMed Central

    Butler, J E; McKenzie, D K; Gandevia, S C

    1999-01-01

    The behaviour of inspiratory motoneurones is poorly understood in humans and even for limb muscles there are few studies of motoneurone behaviour under concentric conditions. The current study assessed the discharge properties of the human phrenic motoneurones during a range of non-isometric voluntary contractions. We recorded activity from 60 motor units in the costal diaphragm of four subjects using an intramuscular electrode while subjects performed a set of voluntary inspiratory contractions. These included a range of inspiratory efforts above and below the usual tidal range: breaths of different sizes (5-40% vital capacity, VC) at a constant inspiratory flow (5% VC s−1) and breaths of a constant size (20% VC) at different inspiratory flows (2.5-20% VC s−1). For all the voluntary tasks, motor units were recruited throughout inspiration. For the various tasks, half-way through inspiration, 61-87% of the sampled motor units had been recruited. When the inspiratory task was deliberately altered, most single motor units began their discharge at a particular volume even when the rate of contraction had altered. The initial firing frequency (median, 6.5 Hz) was consistent for tasks with a constant flow regardless of the size of the breath. However, for breaths of a constant size the initial firing frequencies increased as the inspiratory flow increased (range across tasks, 4.8-9.3 Hz). The ‘final’ firing frequency at the end of inspiration increased significantly above the initial frequency for each task (by 0.8-5.2 Hz) and was higher for those tasks with higher final lung volumes and higher inspiratory flows (range across tasks, 7.8-11.0 Hz). There was no correlation within a task between the time of recruitment and the initial or final firing frequency for each motor unit. However, for each inspiratory task, initial and final firing frequencies were positively correlated. Because the discharge of three to four units could be recorded simultaneously in a

  20. Inspiratory muscle training to enhance recovery from mechanical ventilation: a randomised trial

    PubMed Central

    Bissett, Bernie M; Leditschke, I Anne; Neeman, Teresa; Boots, Robert; Paratz, Jennifer

    2016-01-01

    Background In patients who have been mechanically ventilated, inspiratory muscles remain weak and fatigable following ventilatory weaning, which may contribute to dyspnoea and limited functional recovery. Inspiratory muscle training may improve inspiratory muscle strength and endurance following weaning, potentially improving dyspnoea and quality of life in this patient group. Methods We conducted a randomised trial with assessor-blinding and intention-to-treat analysis. Following 48 hours of successful weaning, 70 participants (mechanically ventilated ≥7 days) were randomised to receive inspiratory muscle training once daily 5 days/week for 2 weeks in addition to usual care, or usual care (control). Primary endpoints were inspiratory muscle strength and fatigue resistance index (FRI) 2 weeks following enrolment. Secondary endpoints included dyspnoea, physical function and quality of life, post-intensive care length of stay and in-hospital mortality. Results 34 participants were randomly allocated to the training group and 36 to control. The training group demonstrated greater improvements in inspiratory strength (training: 17%, control: 6%, mean difference: 11%, p=0.02). There were no statistically significant differences in FRI (0.03 vs 0.02, p=0.81), physical function (0.25 vs 0.25, p=0.97) or dyspnoea (−0.5 vs 0.2, p=0.22). Improvement in quality of life was greater in the training group (14% vs 2%, mean difference 12%, p=0.03). In-hospital mortality was higher in the training group (4 vs 0, 12% vs 0%, p=0.051). Conclusions Inspiratory muscle training following successful weaning increases inspiratory muscle strength and quality of life, but we cannot confidently rule out an associated increased risk of in-hospital mortality. Trial registration number ACTRN12610001089022, results. PMID:27257003

  1. Inspiratory muscle training improves cycling time-trial performance and anaerobic work capacity but not critical power.

    PubMed

    Johnson, Michael A; Sharpe, Graham R; Brown, Peter I

    2007-12-01

    We examined whether inspiratory muscle training (IMT) improved cycling time-trial performance and changed the relationship between limit work (W (lim)) and limit time (T (lim)), which is described by the parameters critical power (CP) and anaerobic work capacity (AWC). Eighteen male cyclists were assigned to either a pressure-threshold IMT or sham hypoxic-training placebo (PLC) group. Prior to and following a 6 week intervention subjects completed a 25-km cycling time-trial and three constant-power tests to establish the W (lim)-T (lim) relationship. Constant-power tests were prescribed to elicit exercise intolerance within 3-10 (Ex1), 10-20 (Ex2), and 20-30 (Ex3) min. Maximal inspiratory mouth pressure increased by (mean +/- SD) 17.1 +/- 12.2% following IMT (P < 0.01) and was accompanied by a 2.66 +/- 2.51% improvement in 25-km time-trial performance (P < 0.05); there were no changes following PLC. Constant-power cycling endurance was unchanged following PLC, as was CP (pre vs. post: 249 +/- 32 vs. 250 +/- 32 W) and AWC (30.7 +/- 12.7 vs. 30.1 +/- 12.5 kJ). Following IMT Ex1 and Ex3 cycling endurance improved by 18.3 +/- 15.1 and 15.3 +/- 19.1% (P < 0.05), respectively, CP was unchanged (264 +/- 62 vs. 263 +/- 61 W), but AWC increased from 24.8 +/- 5.6 to 29.0 +/- 8.4 kJ (P < 0.05). In conclusion, these data provide novel evidence that improvements in constant-power and cycling time-trial performance following IMT in cyclists may be explained, in part, by an increase in AWC. PMID:17874123

  2. Determination of a Viral Load Threshold To Distinguish Symptomatic versus Asymptomatic Rotavirus Infection in a High-Disease-Burden African Population.

    PubMed

    Bennett, A; Bar-Zeev, N; Jere, K C; Tate, J E; Parashar, U D; Nakagomi, O; Heyderman, R S; French, N; Iturriza-Gomara, M; Cunliffe, N A

    2015-06-01

    We evaluated quantitative real-time PCR to establish the diagnosis of rotavirus gastroenteritis in a high-disease-burden population in Malawi using enzyme immunoassay as the gold standard diagnostic test. In 146 children with acute gastroenteritis and 65 asymptomatic children, we defined a cutoff point in the threshold cycle value (26.7) that predicts rotavirus-attributable gastroenteritis in this population. These data will inform the evaluation of direct and indirect rotavirus vaccine effects in Africa. PMID:25854480

  3. Inspiratory Flow Limitation in a Normal Population of Adults in São Paulo, Brazil

    PubMed Central

    Palombini, Luciana O.; Tufik, Sergio; Rapoport, David M.; Ayappa, Indu A.; Guilleminault, Christian; de Godoy, Luciana B. M.; Castro, Laura S.; Bittencourt, Lia

    2013-01-01

    Study Objectives: Inspiratory flow limitation (IFL) during sleep occurs when airflow remains constant despite an increase in respiratory effort. This respiratory event has been recognized as an important parameter for identifying sleep breathing disorders. The purpose of this study was to investigate how much IFL normal individuals can present during sleep. Design: Cross-sectional study derived from a general population sample. Setting: A “normal” asymptomatic sample derived from the epidemiological cohort of São Paulo. Patients and Participants: This study was derived from a general population study involving questionnaires and nocturnal polysomnography of 1,042 individuals. A subgroup defined as a nonsymptomatic healthy group was used as the normal group. Interventions: N/A. Measurements and Results: All participants answered several questionnaires and underwent full nocturnal polysomnography. IFL was manually scored, and the percentage of IFL of total sleep time was considered for final analysis. The distribution of the percentage of IFL was analyzed, and associated factors (age, sex, and body mass index) were calculated. There were 95% of normal individuals who exhibited IFL during less than 30% of the total sleep time. Body mass index was positively associated with IFL. Conclusions: Inspiratory flow limitation can be observed in the polysomnography of normal individuals, with an influence of body weight on percentage of inspiratory flow limitation. However, only 5% of asymptomatic individuals will have more than 30% of total sleep time with inspiratory flow limitation. This suggests that only levels of inspiratory flow limitation > 30% be considered in the process of diagnosing obstructive sleep apnea in the absence of an apnea-hypopnea index > 5 and that < 30% of inspiratory flow limitation may be a normal finding in many patients. Citation: Palombini LO; Tufik S; Rapoport DM; Ayappa IA; Guilleminault C; de Godoy LBM; Castro LS; Bittencourt L

  4. Relation of lung function, maximal inspiratory pressure, dyspnoea, and quality of life with exercise capacity in patients with chronic obstructive pulmonary disease.

    PubMed Central

    Wijkstra, P. J.; TenVergert, E. M.; van der Mark, T. W.; Postma, D. S.; Van Altena, R.; Kraan, J.; Koëter, G. H.

    1994-01-01

    BACKGROUND--Several studies have shown that both objective and subjective measurements are related to exercise capacity in patients with chronic obstructive pulmonary disease (COPD). In this study the relative contribution of lung function, maximal inspiratory pressure, dyspnoea, and quality of life to the performance in a walking distance test and a bicycle ergometer test was investigated. METHODS--Static lung volumes, forced expiratory volume in one second (FEV1), inspiratory slow vital capacity (IVC), transfer factor for carbon monoxide (TLCO) divided by the alveolar volume (TLCO/VA), static compliance (Cst), and maximal inspiratory peak pressure (PImaxPOES) were measured in 40 patients with COPD with severe airways obstruction (mean FEV1 44% predicted, mean FEV1/IVC 37% predicted). Quality of life was assessed by the Chronic Respiratory Questionnaire (CRQ) and dyspnoea by the Borg category scale. Exercise capacity was measured by both a six minute walking distance (test) and a maximal work load of the bicycle ergometer test (Wmax). RESULTS--Spirometric values and maximal inspiratory pressure were modestly correlated with both the six minute walking test and Wmax, r values ranging from 0.50 to 0.58. The TLCO was strongly correlated with the six minute walking test (r = 0.62) and with Wmax (r = 0.78). Quality of life showed no correlation with exercise capacity, while there was a correlation between dyspnoea and the six minute walking test (r = -0.41). Backward linear regression analysis selected TLCO and PImaxPOES as the most significant determinants for exercise performance. They explained 54% and 69% of the variance in the six minute walking test and Wmax, respectively. CONCLUSIONS--The results show that exercise capacity in patients with COPD with severe airways obstruction is more strongly related to inspiratory muscle strength and lung function than to dyspnoea and quality of life. The significant correlation between dyspnoea and the six minute walking test

  5. [Evaluation of the inspiratory muscle strength using the nasal pressure of the sniff].

    PubMed

    Fitting, J W; Héritier, F; Uldry, C

    1996-10-01

    The measurement of oesophageal pressure during maximal sniffs (Poes sniff) is useful to assess inspiratory muscle strength. The aim of this study was to develop a noninvasive test of inspiratory muscle strength based on the sniff manoeuvre. The sniff nasal inspiratory pressure (SNIP) was measured through a plug occluding one nostril during sniffs performed through the contralateral nostril. In 10 normal subjects and in 12 patients with neuromuscular or skeletal disorders, the SNIP reliably reflected the Poes sniff. Nasal mucosa congestion was induced in four normal subjects by nebulization of increasing doses of histamine. The SNIP accurately reflected Poes sniff when nasal congestion was moderate, but failed to do so when congestion was severe. Reference values of SNIP were established in a group of 160 healthy subjects aged 20-80 years. For both men and women, SNIP was negatively correlated with age, and was similar in the sitting and in the supine positions. SNIP was higher than maximal inspiratory pressure (P1 max) in most subjects, but the wide limits of agreement showed that these two methods are not interchangeable but complementary. The SNIP represents a useful noninvasive test of inspiratory muscle strength. PMID:8999474

  6. Patterns of expiratory and inspiratory activation for thoracic motoneurones in the anaesthetized and the decerebrate rat

    PubMed Central

    de Almeida, Anoushka T R; Al-Izki, Sarah; Denton, Manuel Enríquez; Kirkwood, Peter A

    2010-01-01

    The nervous control of expiratory muscles is less well understood than that of the inspiratory muscles, particularly in the rat. The patterns of respiratory discharges in adult rats were therefore investigated for the muscles of the caudal intercostal spaces, with hypercapnia and under either anaesthesia or decerebration. With neuromuscular blockade and artificial ventilation, efferent discharges were present for both inspiration and expiration in both external and internal intercostal nerves. This was also the case for proximal internal intercostal nerve branches that innervate only internal intercostal and subcostalis muscles. If active, this region of muscle in other species is always expiratory. Here, inspiratory bursts were almost always present. The expiratory activity appeared only gradually and intermittently, when the anaesthesia was allowed to lighten or as the pre-decerebration anaesthesia wore off. The intermittent appearance is interpreted as the coupling of a slow medullary expiratory oscillator with a faster inspiratory one. The patterns of nerve discharges, in particular the inspiratory or biphasic activation of the internal and subcostalis layers, were confirmed by observations of equivalent patterns of EMG discharges in spontaneously breathing preparations, using denervation procedures to identify which muscles generated the signals. Some motor units were recruited in both inspiratory and expiratory bursts. These patterns of activity have not previously been described and have implications both for the functional role of multiple respiratory oscillators in the adult and for the mechanical actions of the muscles of the caudal intercostal spaces, including subcostalis, which is a partly bisegmental muscle. PMID:20530111

  7. Midline section of the medulla abolishes inspiratory activity and desynchronizes pre-inspiratory neuron rhythm on both sides of the medulla in newborn rats.

    PubMed

    Onimaru, Hiroshi; Tsuzawa, Kayo; Nakazono, Yoshimi; Janczewski, Wiktor A

    2015-04-01

    Each half of the medulla contains respiratory neurons that constitute two generators that control respiratory rhythm. One generator consists of the inspiratory neurons in the pre-Bötzinger complex (preBötC); the other, the pre-inspiratory (Pre-I) neurons in the parafacial respiratory group (pFRG), rostral to the preBötC. We investigated the contribution of the commissural fibers, connecting the respiratory rhythm generators located on the opposite side of the medulla to the generation of respiratory activity in brain stem-spinal cord preparation from 0- to 1-day-old rats. Pre-I neuron activity and the facial nerve and/or first lumbar (L1) root activity were recorded as indicators of the pFRG-driven rhythm. Fourth cervical ventral root (C4) root and/or hypoglossal (XII) nerve activity were recorded as indicators of preBötC-driven inspiratory activity. We found that a midline section that interrupted crossed fibers rostral to the obex irreversibly eliminated C4 and XII root activity, whereas the Pre-I neurons, facial nerve, and L1 roots remained rhythmically active. The facial and contralateral L1 nerve activities were synchronous, whereas right and left facial (and right and left L1) nerves lost synchrony. Optical recordings demonstrated that pFRG-driven burst activity was preserved after a midline section, whereas the preBötC neurons were no longer rhythmic. We conclude that in newborn rats, crossed excitatory interactions (via commissural fibers) are necessary for the generation of inspiratory bursts but not for the generation of rhythmic Pre-I neuron activity. PMID:25717158

  8. Immediate response to resistive loading in anesthetized humans.

    PubMed

    Zin, W A; Behrakis, P K; Luijendijk, S C; Higgs, B D; Baydur, A; Böddener, A; Milic-Emili, J

    1986-02-01

    In eight spontaneously breathing anesthetized subjects (halothane: approximately 1 minimal alveolar concn; 70% N2O-30% O2), we determined 1) the inspiratory driving pressure by analysis of the pressure developed at the airway opening (Poao) during inspiratory efforts against airways occluded at end expiration; 2) the active inspiratory impedance; and 3) the immediate (first loaded breath) response to added inspiratory resistive loads (delta R). Based on these data we made model predictions of the immediate tidal volume response to delta R. Such predictions closely fitted the experimental results. The present investigation indicates that 1) in halothane-anesthetized humans the shape of the Poao wave differs from that in anesthetized animals, 2) the immediate response to delta R is not associated with appreciable changes in intensity, shape, and timing of inspiratory neural drive but depends mainly on intrinsic (nonneural) mechanisms; 3) the flow-dependent resistance of endotracheal tubes must be taken into account in studies dealing with increased neuromuscular drive in intubated subjects; and 4) in anesthetized humans Poao reflects the driving pressure available to produce the breathing movements. PMID:3949656

  9. Respiration in man affected by TVR contractions elicited in inspiratory and expiratory intercostal muslces.

    PubMed

    Homma, I; Eklund, G; Hagbarth, K E

    1978-12-01

    Vibration-induced effects on respiration in man were studied by recording the electrical activity (EMG) from the intercostal muscles and the diaphragm. The vibration was applied in an upper thoracic region where inspiratory muscle activity prevailed or in a lower thoracic region where expiratory muscle activity prevailed. The effects were also studied by recording the movements of the thorax and the respiratory air flow. Sustained vibration in the upper region enhanced the activity of the underlying inspiratory muscles and caused an expansion of the rib cage whereas it had little or weak effects on diaphragm-activity or on expiratory intercostal muscles. Sustained vibration in the lower region enhanced the activity of the underlying expiratory muscles, often inhibited the inspiratory activity and caused a depression of the rib cage. It also tended to inhibit the diaphragm activity. It was also found that bilateral vibration, timed by the respiratory movements and alternating between upper and lower regions could aid or counteract the ventilation if it was applied respectively 'in phase' or 'out of phase' with the rhythmical contractions in the underlying muscles. The motor responses described are largely explicable in terms of tonic vibration reflexes (TVR) arising in the inspiratory and expiratory intercostal muscles underlying the vibrators. PMID:741110

  10. Impact of a Behavioral-Based Intervention on Inspiratory Muscle Training Prescription by a Multidisciplinary Team

    ERIC Educational Resources Information Center

    Simms, Alanna M.; Li, Linda C.; Geddes, E. Lynne; Brooks, Dina; Hoens, Alison M.; Reid, W. Darlene

    2012-01-01

    Introduction: Our goal was to compare behavioral- and information-based interventions aimed at increasing prescription of inspiratory muscle training (IMT) for people with chronic obstructive pulmonary disease (COPD) by interdisciplinary teams during pulmonary rehabilitation (PR). Methods: Six hospital PR programs were randomly assigned to a…

  11. [Measurement of the reserve function of inspiratory muscle and its clinical significance].

    PubMed

    Xiao, X; Luo, Y; Chen, W; Yuan, Y; He, T; Zeng, J

    1995-06-01

    The principles of measuring inspiratory muscle tension-time index (TTim) and the ratio of the works of inspiration over the maximal works of inspiration (Wi/Wi(max)) were investigated and their formulae were deduced, i.e. TTim = (Pi x Ti)/(MIP x Ttot) and Wi/Wi(max) = (Pi x VT)/(MIP x IC). The importance of the inspiratory pressure and the maximal inspiratory pressure (MIP) measured at function residual capacity (FRC) level was emphasized. Both TTim and Wi/Wi(max) were measured in 35 normal subjects and 89 patients with chronic obstructive pulmonary disease (COPD). The results showed that normal value of TTim was 0.0253 +/- 0.0055 which corresponds to the normal value of the diaphragm tension-time index (TTdi = 0.02-0.03) reported by Bellemare. Patients with COPD had a mean TTim much higher than that of normals (P < 0.01). The works of inspiration (Wi) in patients with COPD increased, while the maximal works of inspiration (Wi(max)) declined, so Wi/Wi(max) became significantly greater than that of normals (P < 0.01). The results also showed that there was a linear relationship between Pi/Pimax and TTim or Wi/Wimax (r = 0.7891, 0.9738, 0.6459, 0.9327, P < 0.01). Therefore, we suggest that both TTim and Wi/Wimax can be used as clinical indices to reflect the reserve function of inspiratory muscles. PMID:7490035

  12. Target-flow inspiratory muscle training: breathing patterns and metabolic costs.

    PubMed

    Dekhuijzen, P N; Hopman, M T; Binkhorst, R A; Folgering, H T

    1991-01-01

    In target-flow inspiratory muscle training (TF-IMT), the generated inspiratory mouth pressure and the duration of the inspiration and expiration are standardized to given an adequate training stimulus to the inspiratory muscles. The acute effects of TF-IMT on the efficiency of breathing were studied in a group of 12 COPD patients with a ventilatory limitation of their exercise capacity (mean age 58, mean FEV1 46.2% of predicted) and in 15 normal subjects (mean age 30). Also, the effect of a 10 week period of TF-IMT on the maximal inspiratory mouth pressure (PImax) in the COPD patients was measured. After an unloaded baseline period, the subjects started to inspire through a target-flow device during 15 min, followed by a recovery phase of 5 min. During TF-IMT minute ventilation (VE) decreased only in the COPD group. The ventilatory equivalent for O2 (VE/VO2) and the dead space to tidal volume ratio (VD/VT) decreased in both groups. During recovery, VE, VE/VO2 and VD/VT remained below baseline values in the COPD group, but not in the control group. PCO2 and lactate concentrations did not change during TF-IMT. After the 10 week training period, PImax [means) (SD] increased from 5.7(2.2) to 8.2(2.7) kPa (p less than 0.05). The results indicate that with standardized TF-IMT, the inspiratory muscles can be trained effectively in COPD patients with a ventilatory limitation. The persistence of the decrease in VE, VE/VO2 and VD/VT after a training session may be an additional beneficial effect of TF-IMT. PMID:1783476

  13. Ventral respiratory group bulbospinal inspiratory neurons participate in vestibular-respiratory reflexes.

    PubMed

    Miller, A D; Yamaguchi, T; Siniaia, M S; Yates, B J

    1995-03-01

    1. The vestibular system responds to accelerations of the head and produces reflex responses that serve a variety of compensatory functions. The neuronal circuitry that mediates vestibulo-respiratory reflexes is largely unknown. The purpose of the present study was to investigate the possible role of bulbospinal inspiratory neurons located in the para-ambigual region of the ventral respiratory group (VRG) in mediating these reflexes. Experiments were carried out in cats that were decerebrated, paralyzed, and artificially ventilated. 2. Activation of the vestibular nerve by electrical stimulation produced prominent bilateral reflex responses recorded from the phrenic nerve, which supplies the diaphragm. The responses could be complex and consisted of a decrease and/or increase in nerve discharge. 3. Extracellular recordings were made from 35 VRG inspiratory neurons that were antidromically activated from the upper cervical spinal cord. Almost one-half of these neurons (15/35, 43%) responded to vestibular stimulation. The neuronal response patterns were consistent with VRG inspiratory neurons contributing to the vestibular reflex response simultaneously recorded from the phrenic nerve. 4. The present results indicate that approximately one-half of VRG bulbospinal inspiratory neurons contribute to vestibulo-respiratory reflexes. These findings are in contrast to our recent neuroanatomic and electrophysiological studies which revealed a paucity of vestibular inputs to the dorsal respiratory group (DRG) located in the ventrolateral nucleus of the solitary tract. Thus there appears to be a difference between inspiratory neurons in the DRG and VRG in regard to participating in vestibulo-respiratory reflexes. PMID:7608773

  14. Thresholding in PET images of static and moving targets

    NASA Astrophysics Data System (ADS)

    Yaremko, Brian; Riauka, Terence; Robinson, Don; Murray, Brad; Alexander, Abraham; McEwan, Alexander; Roa, Wilson

    2005-12-01

    Continued therapeutic gain in the treatment of non-small-cell lung cancer (NSCLC) will depend upon our ability to escalate the dose to the primary tumour while minimizing normal tissue toxicity. Both these objectives are facilitated by the accurate definition of a target volume that is as small as possible. To this end, both tumour immobilizations via deep inspiratory breath-hold, along with positron emission tomography (PET), have emerged as two promising approaches. Though PET is an excellent means of defining the general location of a tumour focus, its ability to define exactly the geometric extent of such a focus strongly depends upon selection of an appropriate image threshold. However, in clinical practice, the image threshold is typically not chosen according to consistent, well-established criteria. This study explores the relationship between image threshold and the resultant PET-defined volume using a series of F-18 radiotracer-filled hollow spheres of known internal volumes, both static and under oscillatory motion. The effects of both image threshold and tumour motion on the resultant PET image are examined. Imaging data are further collected from a series of simulated gated PET acquisitions in order to test the feasibility of a patient-controlled gating mechanism during deep inspiratory breath-hold. This study illustrates quantitatively considerable variability in resultant PET-defined tumour volumes depending upon numerous factors, including image threshold, size of the lesion, the presence of tumour motion and the scanning protocol. In this regard, when using PET in treatment planning for NSCLC, the radiation oncologist must select the image threshold very carefully to avoid either under-dosing the tumour or overdosing normal tissues.

  15. [Effect of methylphenidatum on inspiratory muscles function in patients with chronic obstructive pulmonary disease and its mechanism].

    PubMed

    Wang, Y; Luo, Y; Chen, W; Yuan, Y; He, T; Zeng, J

    1997-03-01

    To have a better understanding of the effect of methylphenidatum on inspiratory muscles function, we studied the respiratory force parameters of 70 patients with chronic obstructive pulmonary disease by intravenous infusion methylphenidatum in a randomized controlled clinical trial. The indices of respiratory force parameter included maximal inspiratory mouth pressure (MIP), maximal midinspiratory flow (MMIF), forced inspiratory capacity (FIC), maximal works of inspiration (Wimax) and airway occlusion pressure (P0.1), etc. Aminophylline and Nikethamidi were chosen as controls. The results showed that MIP, MMIF, FIC, Wimax, P0.1 and minute ventilation (Vr) were significantly increased after administration of methylphenidatum and aminophylline. There were no significant differences in MIP, MMIF, FIC and Wimax after administration of Nikethamidi, but P0.1 was significantly increased and the increase was higher than that after administration of methylphenidatum and aminophylline groups. We conclude that methylphenidatum can significantly improve the function of inspiratory muscles as aminophylline can do. PMID:10684069

  16. Tolerance to external breathing resistance with particular reference to high inspiratory resistance

    NASA Technical Reports Server (NTRS)

    Bentley, R. A.; Griffin, O. G.; Love, R. G.; Muir, D. C. F.; Sweetland, K. F.

    1972-01-01

    The ability of men to exercise while breathing through graded inspiratory resistances was studied in order to define acceptable respiratory mouthpiece assembly standards. Experimental results with subjects wearing breathing masks and walking for 30 min on treadmills were used to calculate expiratory work rates. It is concluded that the airflow must be appropriate to the upper limit of minute ventilation likely to be encountered in the men wearing the apparatus.

  17. Effect of inspiratory resistance and PEEP on /sup 99m/Tc-DTPA clearance

    SciTech Connect

    O'Brodovich, H.; Coates, G.; Marrin, M.

    1986-05-01

    Experiments were performed to determine the effect of markedly negative pleural pressure (Ppl) or positive end-expiratory pressure (PEEP) on the pulmonary clearance (k) of technetium-99m-labeled diethylenetriaminepentaacetic acid (/sup 99m/Tc-DTPA). A submicronic aerosol containing /sup 99m/Tc-DTPA was insufflated into the lungs of anesthetized intubated sheep. In six experiments k was 0.44 +/- 0.46% (SD)/min during the initial 30 min and was unchanged during the subsequent 30-min interval (k = 0.21 +/- 12%/min) when there was markedly increased inspiratory resistance. A 3-mm-diam orifice in the inspiratory tubing created the resistance. It resulted on average in a 13-cmH2O decrease in inspiratory Ppl. In eight additional experiments sheep were exposed to 2, 10, and 15 cmH2O PEEP (20 min at each level). During 2 cmH2O PEEP k = 0.47 +/- 0.15%/min, and clearance increased slightly at 10 cmH2O PEEP (0.76 +/- 0.28%/min, P less than 0.01). When PEEP was increased to 15 cmH2O a marked increase in clearance occurred (k = 1.95 +/- 1.08%/min, P less than 0.001). The experiments demonstrate that markedly negative inspiratory pressures do not accelerate the clearance of /sup 99m/Tc-DTPA from normal lungs. The effect of PEEP on k is nonlinear, with large effects being seen only with very large increases in PEEP.

  18. Effect of phase shifts in pressure-flow relationship on response to inspiratory resistance.

    PubMed

    Younes, M; Sanii, R

    1989-08-01

    Inspiratory prolongation is an integral component of the response to added inspiratory resistance. To ascertain whether this response depends on the relation between inspiratory flow (V) and the pressure perturbation, we compared the responses when this relationship was made progressively less distinct by creating phase shifts between V and the resulting negative mouth pressure (Pm). This was done with an apparatus that altered Pm in proportion to V (J. Appl. Physiol. 62:2491-2499, 1987). V was passed through low-pass electronic filters of different frequency responses before serving as the command signal to the apparatus. In six normal subjects the average neural inspiratory duration (TI) response (delta TI) was sharply (P less than 0.01) reduced (0.32 +/- 0.07 to 0.12 +/- 0.07 s) when the filter's frequency response decreased from 7.5 to 3.0 Hz. The TI response was essentially flat between tube resistance (i.e., no lag, delta TI = 0.36 +/- 0.11 s) and the 7.5-Hz filter, and there was no further change in TI response with filters having a frequency response less than 3.0 Hz, with all TI responses in this range being not significant. Subjects could not consciously perceive a difference between various filter settings. We conclude that the TI response is critically influenced by the phase of the negative pressure wave relative to TI. Furthermore the TI responses are not deliberate, although consciousness is required for their elicitation. PMID:2676945

  19. Inspiratory muscle training during pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomized trial.

    PubMed

    Beaumont, M; Mialon, P; Le Ber-Moy, C; Lochon, C; Péran, L; Pichon, R; Gut-Gobert, C; Leroyer, C; Morelot-Panzini, C; Couturaud, F

    2015-11-01

    Although recommended by international guidelines, the benefit of inspiratory muscle training (IMT) in addition to rehabilitation remains uncertain. The objective was to demonstrate the effectiveness of IMT on dyspnea using Borg scale and multidimensional dyspnea profile questionnaire at the end of a 6-minute walk test (6MWT) in patients with chronic obstructive pulmonary disease (COPD) with preserved average maximum inspiratory pressure (PImax) of 85 cm H2O (95% of predicted (pred.) value) and admitted for a rehabilitation program in a dedicated center. In a randomized trial, comparing IMT versus no IMT in 32 COPD patients without inspiratory muscle weakness (PImax >60 cm H2O) who were admitted for pulmonary rehabilitation (PR) for 3 weeks, we evaluated the effect of IMT on dyspnea, using both Borg scale and multidimensional dyspnea profile (MDP) at the end of the 6MWT, and on functional parameters included inspiratory muscle function (PImax) and 6MWT. All testings were performed at the start and the end of PR. In unadjusted analysis, IMT was not found to be associated with an improvement of either dyspnea or PImax. After adjustment on confounders (initial Borg score) and variables of interaction (forced expiratory volume in 1 second (FEV1)), we found a trend toward an improvement of "dyspnea sensory intensity", items from MDP and a significant improvement on the variation in the 2 items of MDP ("tight or constricted" and "breathing a lot"). In the subgroup of patients with FEV1 < 50% pred., 5 items of MDP were significantly improved, whereas no benefit was observed in patients with FEV1 > 50% pred. IMT did not significantly improve dyspnea or functional parameter in COPD patients with PImax > 60 cm H2O. However, in the subgroup of patients with FEV1 < 50% pred., MDP was significantly improved. PMID:26170421

  20. Cycle ergometer and inspiratory muscle training in chronic obstructive pulmonary disease.

    PubMed

    Larson, J L; Covey, M K; Wirtz, S E; Berry, J K; Alex, C G; Langbein, W E; Edwards, L

    1999-08-01

    In patients with chronic obstructive pulmonary disease (COPD) the intensity of aerobic training is limited by dyspnea. Improving strength of the inspiratory muscles could enhance aerobic exercise training by reducing exercise-related dyspnea. We examined effects of home-based inspiratory muscle training (IMT) and cycle ergometry training (CET) in 53 patients with moderate to severe COPD (FEV(1)% pred, 50 +/- 17 [mean +/- SD]). Patients were randomly assigned to 4 mo of training in one of four groups: IMT, CET, CET + IMT, or health education (ED). Patients were encouraged to train to the limits of their dyspnea. Inspiratory muscle strength and endurance increased in IMT and CET + IMT groups compared with CET and ED groups (p < 0. 01). Peak oxygen uptake increased and heart rate, minute ventilation, dyspnea, and leg fatigue decreased at submaximal work rates in the CET and CET + IMT groups compared with the IMT and ED groups (p < 0. 01). There were no differences between the CET and CET + IMT groups. Home-based CET produced a physiological training effect and reduced exercise-related symptoms while IMT increased respiratory muscle strength and endurance. The combination of CET and IMT did not produce additional benefits in exercise performance and exercise-related symptoms. This is the first study to demonstrate a physiological training effect with home-based exercise training. PMID:10430720

  1. Respiratory Muscle Activity During Simultaneous Stationary Cycling and Inspiratory Muscle Training.

    PubMed

    Hellyer, Nathan J; Folsom, Ian A; Gaz, Dan V; Kakuk, Alynn C; Mack, Jessica L; Ver Mulm, Jacyln A

    2015-12-01

    Inspiratory muscle training (IMT) strengthens the muscles of respiration, improves breathing efficiency, and increases fitness. The IMT is generally performed independently of aerobic exercise; however, it is not clear whether there is added benefit of performing the IMT while simultaneously performing aerobic exercise in terms of activating and strengthening inspiratory muscles. The purpose of our study was to determine the effect of IMT on respiratory muscle electromyography (EMG) activity during stationary cycling in the upright and drops postures as compared with that when the IMT was performed alone. Diaphragm and sternocleidomastoid EMG activity was measured under different resting and cycling postures, with and without the use of the IMT at 40% maximal inspiratory pressure (n = 10; mean age 37). Cycling in an upright posture while simultaneously performing the IMT resulted in a significantly greater diaphragm EMG activity than while performing the IMT at rest in upright or drops postures (p ≤ 0.05). Cycling in drops postures while performing the IMT had a significantly greater diaphragm EMG activity than when performing the IMT at rest in either upright or drops postures (p ≤ 0.05). Sternocleidomastoid muscle activity increased with both cycling and IMT, although posture had little effect. These results support our hypothesis in that the IMT while cycling increases respiratory EMG activity to a significantly greater extent than when performing the IMT solely at rest, suggesting that the combination of IMT and cycling may provide an additive training effect. PMID:26584054

  2. Inspiratory muscle performance in endurance-trained elderly males during incremental exercise.

    PubMed

    Chlif, Mehdi; Keochkerian, David; Temfemo, Abdou; Choquet, Dominique; Ahmaidi, Said

    2016-07-01

    The aim of this study was to compare the inspiratory muscle performance during an incremental exercise of twelve fit old endurance-trained athletes (OT) with that of fit young athletes (YT) and healthy age-matched controls (OC). The tension-time index (TT0.1) was determined according to the equation TT0.1=P0.1/PImax×ti/ttot, where P0.1 is the mouth occlusion pressure, PImax the maximal inspiratory pressure and ti/ttot the duty cycle. For a given VCO2, OT group displayed P0.1, P0.1/PImax ratio, TT0.1 and effective impedance of the respiratory muscle values which were lower than OC group and higher than YT group. At maximal exercise, P0.1/PImax ratio and TT0.1 was still lower in the OT group than OC group and higher than YT group. This study showed lower inspiratory muscle performance attested by a higher (TT0.1) during exercise in the OT group than YT group, but appeared to be less marked in elderly men having performed lifelong endurance training compared with sedentary elderly subjects. PMID:26994757

  3. Acute effects of different inspiratory efforts on ventilatory pattern and chest wall compartmental distribution in elderly women.

    PubMed

    Muniz de Souza, Helga; Rocha, Taciano; Campos, Shirley Lima; Brandão, Daniella Cunha; Fink, James B; Aliverti, Andrea; de Andrade, Armele Dornelas

    2016-06-15

    It is not completely described how aging affect ventilatory kinematics and what are the mechanisms adopted by the elderly population to overcome these structural modifications. Given this, the aim was to evaluate the acute effects of different inspiratory efforts on ventilatory pattern and chest wall compartmental distribution in elderly women. Variables assessed included: tidal volume (Vt), total chest wall volume (Vcw), pulmonary rib cage (Vrcp%), abdominal rib cage (Vrca%) and abdominal compartment (Vab%) relative contributions to tidal volume. These variables were assessed during quiet breathing, maximal inspiratory pressure maneuver (MIP), and moderate inspiratory resistance (MIR; i.e., 40% of MIP). 22 young women (age: 23.9±2.5 years) and 22 elderly women (age: 68.2±5.0 years) participated to this study. It was possible to show that during quiet breathing, Vab% was predominant in elderly (p<0.001), in young, however, Vab% was similar to Vrcp% (p=0.095). During MIR, Vrcp% was predominant in young (p<0.001) and comparable to Vab% in elderly (p=0.249). When MIP was imposed, both groups presented a predominance of Vrcp%. In conclusion, there are differences in abdominal kinematics between young and elderly women during different inspiratory efforts. In elderly, during moderate inspiratory resistance, the pattern is beneficial, deep, and slow. Although, during maximal inspiratory resistance, the ventilatory pattern seems to predict imminent muscle fatigue. PMID:26900004

  4. Protocol: inspiratory muscle training for promoting recovery and outcomes in ventilated patients (IMPROVe): a randomised controlled trial

    PubMed Central

    Leditschke, I Anne; Paratz, Jennifer D; Boots, Robert J

    2012-01-01

    Introduction Inspiratory muscle weakness is a known consequence of mechanical ventilation and a potential contributor to difficulty in weaning from ventilatory support. Inspiratory muscle training (IMT) reduces the weaning period and increases the likelihood of successful weaning in some patients. However, it is not known how this training affects the residual inspiratory muscle fatigability following successful weaning nor patients' quality of life or functional outcomes. Methods and analysis This dual centre study includes two concurrent randomised controlled trials of IMT in adult patients who are either currently ventilator-dependent (>7 days) (n=70) or have been recently weaned from mechanical ventilation (>7 days) in the past week (n=70). Subjects will be stable, alert and able to actively participate and provide consent. There will be concealed allocation to either treatment (IMT) or usual physiotherapy (including deep breathing exercises without a resistance device). Primary outcomes are inspiratory muscle fatigue resistance and maximum inspiratory pressures. Secondary outcomes are quality of life (Short Form-36v2, EQ-5D), functional status (Acute Care Index of Function), rate of perceived exertion (Borg Scale), intensive care length of stay (days), post intensive care length of stay (days), rate of reintubation (%) and duration of ventilation (days). Ethics and dissemination Ethics approval has been obtained from relevant institutions, and results will be published with a view to influencing physiotherapy practice in the management of long-term ventilator-dependent patients to accelerate weaning and optimise rehabilitation outcomes. Trial registration number ACTRN12610001089022. PMID:22389363

  5. Effects of diaphragmatic control on the assessment of sniff nasal inspiratory pressure and maximum relaxation rate

    PubMed Central

    Benício, Kadja; Dias, Fernando A. L.; Gualdi, Lucien P.; Aliverti, Andrea; Resqueti, Vanessa R.; Fregonezi, Guilherme A. F.

    2015-01-01

    OBJECTIVE: To assess the influence of diaphragmatic activation control (diaphC) on Sniff Nasal-Inspiratory Pressure (SNIP) and Maximum Relaxation Rate of inspiratory muscles (MRR) in healthy subjects. METHOD: Twenty subjects (9 male; age: 23 (SD=2.9) years; BMI: 23.8 (SD=3) kg/m2; FEV1/FVC: 0.9 (SD=0.1)] performed 5 sniff maneuvers in two different moments: with or without instruction on diaphC. Before the first maneuver, a brief explanation was given to the subjects on how to perform the sniff test. For sniff test with diaphC, subjects were instructed to perform intense diaphragm activation. The best SNIP and MRR values were used for analysis. MRR was calculated as the ratio of first derivative of pressure over time (dP/dtmax) and were normalized by dividing it by peak pressure (SNIP) from the same maneuver. RESULTS: SNIP values were significantly different in maneuvers with and without diaphC [without diaphC: -100 (SD=27.1) cmH2O/ with diaphC: -72.8 (SD=22.3) cmH2O; p<0.0001], normalized MRR values were not statistically different [without diaphC: -9.7 (SD=2.6); with diaphC: -8.9 (SD=1.5); p=0.19]. Without diaphC, 40% of the sample did not reach the appropriate sniff criteria found in the literature. CONCLUSION: Diaphragmatic control performed during SNIP test influences obtained inspiratory pressure, being lower when diaphC is performed. However, there was no influence on normalized MRR. PMID:26578254

  6. Preinspiratory and inspiratory hypoglossal motor output during hypoxia-induced plasticity in the rat

    PubMed Central

    Fuller, David D.

    2010-01-01

    Respiratory-related discharge in the hypoglossal (XII) nerve is composed of preinspiratory (pre-I) and inspiratory (I) activity. Our first purpose was to test the hypothesis that hypoxia-induced plasticity in XII motor output is differentially expressed in pre-I vs. I XII bursting. Short-term potentiation (STP) of XII motor output was induced in urethane-anesthetized, vagotomized, and ventilated rats by exposure to isocapnic hypoxia (PaO2 of ∼35 Torr). Both pre-I and I XII discharge abruptly increased at beginning of hypoxia (i.e., acute hypoxic response), and the relative increase in amplitude was much greater for pre-I (507 ± 46% baseline) vs. I bursting (257 ± 16% baseline; P < 0.01). In addition, STP was expressed in I but not pre-I bursting following hypoxia. Specifically, I activity remained elevated following termination of hypoxia but pre-I bursting abruptly returned to prehypoxia levels. Our second purpose was to test the hypothesis that STP of I XII activity results from recruitment of inactive or “silent” XII motoneurons (MNs) vs. rate coding of active MNs. Single fiber recordings were used to classify XII MNs as I, expiratory-inspiratory, or silent based on baseline discharge patterns. STP of I XII activity following hypoxia was associated with increased discharge frequency in active I and silent MNs but not expiratory-inspiratory MNs. We conclude that the expression of respiratory plasticity is differentially regulated between pre-I and I XII activity. In addition, both recruitment of silent MNs and rate coding of active I MNs contribute to increases in XII motor output following hypoxia. PMID:20150564

  7. Immediate effect of manual therapy on respiratory functions and inspiratory muscle strength in patients with COPD

    PubMed Central

    Yilmaz Yelvar, Gul Deniz; Çirak, Yasemin; Demir, Yasemin Parlak; Dalkilinç, Murat; Bozkurt, Bülent

    2016-01-01

    Objective The objective of this study was to investigate the immediate effect of manual therapy (MT) on respiratory functions and inspiratory muscle strength in patients with COPD. Participants and methods Thirty patients with severe COPD (eight females and 22 males; mean age 62.4±6.8 years) referred to pulmonary physiotherapy were included in this study. The patients participated in a single session of MT to measure the short-term effects. The lung function was measured using a portable spirometer. An electronic pressure transducer was used to measure respiratory muscle strength. Heart rate, breathing frequency, and oxygen saturation were measured with a pulse oximeter. For fatigue and dyspnea perception, the modified Borg rating of perceived exertion scale was used. All measurements were taken before and immediately after the first MT session. The ease-of-breathing visual analog scale was used for rating patients’ symptoms subjectively during the MT session. Results There was a significant improvement in the forced expiratory volume in the first second, forced vital capacity, and vital capacity values (P<0.05). The maximal inspiratory pressure and maximal expiratory pressure values increased significantly after MT, compared to the pre-MT session (P<0.05). There was a significant decrease in heart rate, respiratory rate (P<0.05), and dyspnea and fatigue perception (P<0.05). Conclusion A single MT session immediately improved pulmonary function, inspiratory muscle strength, and oxygen saturation and reduced dyspnea, fatigue, and heart and respiratory rates in patients with severe COPD. MT should be added to pulmonary rehabilitation treatment as a new alternative that is fast acting and motivating in patients with COPD. PMID:27382271

  8. Horses Auto-Recruit Their Lungs by Inspiratory Breath Holding Following Recovery from General Anaesthesia

    PubMed Central

    Mosing, Martina; Waldmann, Andreas D.; MacFarlane, Paul; Iff, Samuel; Auer, Ulrike; Bohm, Stephan H.; Bettschart-Wolfensberger, Regula; Bardell, David

    2016-01-01

    This study evaluated the breathing pattern and distribution of ventilation in horses prior to and following recovery from general anaesthesia using electrical impedance tomography (EIT). Six horses were anaesthetised for 6 hours in dorsal recumbency. Arterial blood gas and EIT measurements were performed 24 hours before (baseline) and 1, 2, 3, 4, 5 and 6 hours after horses stood following anaesthesia. At each time point 4 representative spontaneous breaths were analysed. The percentage of the total breath length during which impedance remained greater than 50% of the maximum inspiratory impedance change (breath holding), the fraction of total tidal ventilation within each of four stacked regions of interest (ROI) (distribution of ventilation) and the filling time and inflation period of seven ROI evenly distributed over the dorso-ventral height of the lungs were calculated. Mixed effects multi-linear regression and linear regression were used and significance was set at p<0.05. All horses demonstrated inspiratory breath holding until 5 hours after standing. No change from baseline was seen for the distribution of ventilation during inspiration. Filling time and inflation period were more rapid and shorter in ventral and slower and longer in most dorsal ROI compared to baseline, respectively. In a mixed effects multi-linear regression, breath holding was significantly correlated with PaCO2 in both the univariate and multivariate regression. Following recovery from anaesthesia, horses showed inspiratory breath holding during which gas redistributed from ventral into dorsal regions of the lungs. This suggests auto-recruitment of lung tissue which would have been dependent and likely atelectic during anaesthesia. PMID:27331910

  9. CARA Risk Assessment Thresholds

    NASA Technical Reports Server (NTRS)

    Hejduk, M. D.

    2016-01-01

    Warning remediation threshold (Red threshold): Pc level at which warnings are issued, and active remediation considered and usually executed. Analysis threshold (Green to Yellow threshold): Pc level at which analysis of event is indicated, including seeking additional information if warranted. Post-remediation threshold: Pc level to which remediation maneuvers are sized in order to achieve event remediation and obviate any need for immediate follow-up maneuvers. Maneuver screening threshold: Pc compliance level for routine maneuver screenings (more demanding than regular Red threshold due to additional maneuver uncertainty).

  10. Effects of Abdominal Stimulation during Inspiratory Muscle Training on Respiratory Function of Chronic Stroke Patients

    PubMed Central

    Jung, Ju-hyeon; Shim, Je-myung; Kwon, Hae-yeon; Kim, Ha-roo; Kim, Bo-in

    2014-01-01

    [Purpose] The purpose of the present study was to verify a new method for improving respiratory functions by applying both abdominal stimulation and inspiratory muscle training (IMT) to train the inspiratory muscle and the expiratory muscle simultaneously, to improve the efficiency of IMT of chronic stroke patients. [Subjects] Eighteen stroke patients were randomly assigned to an experimental group (n = 9) and a control group (n = 9). [Methods] The experimental group was administered IMT with abdominal stimulation, and the control group was administered only IMT. During the intervention period, the experimental group and control group received training 20 min/day, 3 times/wk, for 4 weeks. To examine the lung functions of the subjects, FVC, FEV1, PEF, and FEF25–75 were measured using an electronic spirometer. The diaphragm thickness ratio was calculated from measurements made with a 7.5-MHz linear probe ultrasonic imaging system. [Result] The experimental group and the control group showed significant increases in diaphragm thickness ratio on the paretic side, but not on the non-paretic side. With regard to lung function, the experimental group showed significant increases in FEV1, PEF, and FEF25–75. The changes between before and after the intervention in the two groups were compared with each other, and the results showed significant differences in FEV1 and PEF. [Conclusion] The present study identified that IMT accompanied by abdominal stimulation improved the pulmonary function of chronic stroke patients. PMID:24567679

  11. In normal subjects bracing impairs the function of the inspiratory muscles.

    PubMed

    Prandi, E; Couture, J; Bellemare, F

    1999-05-01

    Normal subjects can increase their capacity to sustain hyperpnoea by bracing their arms on fixed objects, a procedure which is also known to reduce dyspnoea in patients with chronic obstructive pulmonary disease (COPD). In the present study, it was tested whether bracing per se could improve the function of the diaphragm. The effect of bracing on diaphragm function was studied in six normal subjects by recording changes in oesophageal (delta Poes) and transdiaphragmatic (delta Pdi) pressure during inspiratory capacity (IC) manoeuvres in the seated and upright postures, and in the seated posture, also during bilateral phrenic nerve stimulation (BPNS) at functional residual capacity (FRC). The pattern of ribcage motion and deformation associated with bracing and with diaphragm contraction was also evaluated using inductance plethysmography and magnetometers. Bracing increased FRC by >300 mL and reduced IC by approximately 200 mL, in both postures. Delta Pdi during BPNS decreased on average by 15% indicating an impaired diaphragmatic function. The ribcage was deformed with bracing and was more distortable during BPNS. In conclusion, in normal subjects, bracing impairs the function of the inspiratory muscles and reduces ribcage stability. These negative effects cannot explain the improved capacity to sustain hyperpnoea when the arms are braced. PMID:10414407

  12. Dbx1 precursor cells are a source of inspiratory XII premotoneurons

    PubMed Central

    Revill, Ann L; Vann, Nikolas C; Akins, Victoria T; Kottick, Andrew; Gray, Paul A; Del Negro, Christopher A; Funk, Gregory D

    2015-01-01

    All behaviors require coordinated activation of motoneurons from central command and premotor networks. The genetic identities of premotoneurons providing behaviorally relevant excitation to any pool of respiratory motoneurons remain unknown. Recently, we established in vitro that Dbx1-derived pre-Bötzinger complex neurons are critical for rhythm generation and that a subpopulation serves a premotor function (Wang et al., 2014). Here, we further show that a subpopulation of Dbx1-derived intermediate reticular (IRt) neurons are rhythmically active during inspiration and project to the hypoglossal (XII) nucleus that contains motoneurons important for maintaining airway patency. Laser ablation of Dbx1 IRt neurons, 57% of which are glutamatergic, decreased ipsilateral inspiratory motor output without affecting frequency. We conclude that a subset of Dbx1 IRt neurons is a source of premotor excitatory drive, contributing to the inspiratory behavior of XII motoneurons, as well as a key component of the airway control network whose dysfunction contributes to sleep apnea. DOI: http://dx.doi.org/10.7554/eLife.12301.001 PMID:26687006

  13. Threshold quantum cryptography

    SciTech Connect

    Tokunaga, Yuuki; Okamoto, Tatsuaki; Imoto, Nobuyuki

    2005-01-01

    We present the concept of threshold collaborative unitary transformation or threshold quantum cryptography, which is a kind of quantum version of threshold cryptography. Threshold quantum cryptography states that classical shared secrets are distributed to several parties and a subset of them, whose number is greater than a threshold, collaborates to compute a quantum cryptographic function, while keeping each share secretly inside each party. The shared secrets are reusable if no cheating is detected. As a concrete example of this concept, we show a distributed protocol (with threshold) of conjugate coding.

  14. Threshold Concepts in Biochemistry

    ERIC Educational Resources Information Center

    Loertscher, Jennifer

    2011-01-01

    Threshold concepts can be identified for any discipline and provide a framework for linking student learning to curricular design. Threshold concepts represent a transformed understanding of a discipline, without which the learner cannot progress and are therefore pivotal in learning in a discipline. Although threshold concepts have been…

  15. CONTRIBUTION OF INSPIRATORY FLOW TO ACTIVATION OF EGFR, RAS, MAPK, ATF-2 AND C-JUN DURING LUNG STRETCH

    EPA Science Inventory

    Contribution of Inspiratory Flow to Activation of EGFR, Ras, MAPK, ATF-2 and c-Jun during Lung Stretch

    R. Silbajoris 1, Z. Li 2, J. M. Samet 1 and Y. C. Huang 1. 1 NHEERL, ORD, US EPA, RTP, NC and 2 CEMALB, UNC-CH, Chapel Hill, NC .

    Mechanical ventilation with larg...

  16. Diaphragmatic amplitude and accessory inspiratory muscle activity in nasal and mouth-breathing adults: a cross-sectional study.

    PubMed

    Trevisan, Maria Elaine; Boufleur, Jalusa; Soares, Juliana Corrêa; Haygert, Carlos Jesus Pereira; Ries, Lilian Gerdi Kittel; Corrêa, Eliane Castilhos Rodrigues

    2015-06-01

    The purpose of this study was to evaluate the electromyographic activity of the accessory inspiratory muscles and the diaphragmatic amplitude (DA) in nasal and mouth-breathing adults. The study evaluated 38 mouth-breathing (MB group) and 38 nasal-breathing (NB group) adults, from 18 to 30years old and both sexes. Surface electromyography (sEMG) was used to evaluate the amplitude and symmetry (POC%) of the sternocleidomastoid (SCM) and upper trapezius (UT) muscles at rest, during nasal slow inspiration at Lung Total Capacity (LTC) and, during rapid and abrupt inspiration: Sniff, Peak Nasal Inspiratory Flow (PNIF) and Maximum Inspiratory Pressure (MIP). M-mode ultrasonography assessed the right diaphragm muscle amplitude in three different nasal inspirations: at tidal volume (TV), Sniff and inspiration at LTC. The SCM activity was significantly lower in the MB group during Sniff, PNIF (p<0.01, Mann-Whitney test) and MIP (p<0.01, t-test). The groups did not differ during rest and inspiration at LTC, regarding sEMG amplitude and POC%. DA was significantly lower in the MB group at TV (p<0.01, Mann-Whitney) and TLC (p=0.03, t-test). Mouth breathing reflected on lower recruitment of the accessory inspiratory muscles during fast inspiration and lower diaphragmatic amplitude, compared to nasal breathing. PMID:25900327

  17. How many manoeuvres should be done to measure maximal inspiratory mouth pressure in patients with chronic airflow obstruction?

    PubMed Central

    Fiz, J A; Montserrat, J M; Picado, C; Plaza, V; Agusti-Vidal, A

    1989-01-01

    To determine the number of maximal mouth pressure manoeuvres needed to obtain a reproducible value of maximal inspiratory mouth pressure (MIP), we studied 44 patients with chronic airflow obstruction, with a mean (SD) % predicted FEV1 value of 53.9 (25), who were clinically stable. Maximal inspiratory mouth pressure was determined with an anaeroid manometer during maximal inspiratory efforts in a quasi static condition at residual volume. All patients performed 20 consecutive maximal inspiratory mouth manoeuvres, each one separated by 30-40 seconds. The mean (SD) values of MIP varied from 71.5 (25.5) cm H2O at the first measurement to 80.1 (27) cm H2O at the last measurement. Maximal values of MIP were usually achieved after nine determinations. It is concluded that to obtain a reproducible MIP value in patients with chronic airflow obstruction who are untrained and unexperienced in such manoeuvres a minimum of nine technically acceptable maximal mouth pressure manoeuvres should be performed. PMID:2763242

  18. Three-dimensional inspiratory flow in the upper and central human airways

    NASA Astrophysics Data System (ADS)

    Banko, A. J.; Coletti, F.; Schiavazzi, D.; Elkins, C. J.; Eaton, J. K.

    2015-06-01

    The steady inspiratory flow through an anatomically accurate model of the human airways was studied experimentally at a regime relevant to deep inspiration for aerosol drug delivery. Magnetic resonance velocimetry was used to obtain the three-component, mean velocity field. A strong, single-sided streamwise swirl was found in the trachea and persists up to the first bifurcation. There, the swirl and the asymmetric anatomy impact both the streamwise momentum distribution and the secondary flows in the main bronchi, with large differences compared to what is found in idealized branching tubes. In further generations, the streamwise velocity never recovers a symmetric profile and the relative intensity of the secondary flows remains strong. Overall, the results suggest that, in real human airways, both streamwise dispersion (due to streamwise gradients) and lateral dispersion (due to secondary flows) are very effective transport mechanisms. Neglecting the extrathoracic airways and idealizing the bronchial tree may lead to qualitatively different conclusions.

  19. Automated logging of inspiratory and expiratory non-synchronized breathing (ALIEN) for mechanical ventilation.

    PubMed

    Chiew, Yeong Shiong; Pretty, Christopher G; Beatson, Alex; Glassenbury, Daniel; Major, Vincent; Corbett, Simon; Redmond, Daniel; Szlavecz, Akos; Shaw, Geoffrey M; Chase, J Geoffrey

    2015-01-01

    Asynchronous Events (AEs) during mechanical ventilation (MV) result in increased work of breathing and potential poor patient outcomes. Thus, it is important to automate AE detection. In this study, an AE detection method, Automated Logging of Inspiratory and Expiratory Non-synchronized breathing (ALIEN) was developed and compared between standard manual detection in 11 MV patients. A total of 5701 breaths were analyzed (median [IQR]: 500 [469-573] per patient). The Asynchrony Index (AI) was 51% [28-78]%. The AE detection yielded sensitivity of 90.3% and specificity of 88.3%. Automated AE detection methods can potentially provide clinicians with real-time information on patient-ventilator interaction. PMID:26737491

  20. Inspiratory and expiratory steady flow analysis in a model symmetrically bifurcating airway.

    PubMed

    Zhao, Y; Brunskill, C T; Lieber, B B

    1997-02-01

    Steady inspiratory and expiratory flow in a symmetrically bifurcating airway model was studied numerically using the finite element method (FIDAP). Flows of Reynolds number of 500 and 1000 during inspiration and a flow of Reynolds number of 500 during expiration were analyzed. Since the geometry of the bifurcation model used in this study is exactly the same as the model used in the experimental studies, the computed results were compared to the experimental findings. Results show that most of the important flow features that were observed in the experiment, such as the skewed velocity profiles in the daughter branches during inspiration and velocity peak in the parent tube during expiration, were captured in the numerical simulation. Quantitatively, the computed velocity profiles are in good agreement with the measured profiles. This comparison validates the computational simulations. PMID:9083849

  1. Changes in capillary filling do not influence inspiratory-induced vasoconstrictive episodes

    NASA Astrophysics Data System (ADS)

    Rauh, Robert; Ochsmann, Elke; Kessler, Manfred; Mueck-Weymann, Michael

    2007-05-01

    Deep inspiration leads to sympathetically mediated vasoconstriction at the fingertip. This so-called inspiratory gasp response (IGR) is usually assessed by laser Doppler fluxmetry (LDF) and provides interesting information on the activity of the sympathetic nervous system. In this study we investigated if simple maneuvers which affect microcirculation have an effect on the IGR. For this we detected IGR with LDF in rest, after elevation of the arm to lower capillary filling, after venous congestion to increase capillary filling, and after heating up in warm water to induce vasodilation. Capillary filling was monitored with the Erlangen Microlightguide Spectrophotometer (EMPHO) by determination of the relative hemoglobin concentration. We found that IGR was not affected by microcirculatory starting conditions. Therefore, we conclude that diagnostic results of the IGR are not influenced by different capillary filling levels.

  2. Histamine-induced end-tidal inspiratory activity and lung receptors in cats.

    PubMed

    Meeseen, N E; van der Grinten, C P; Folgering, H T; Luijendijk, S C

    1995-12-01

    Hyperinflation in acute asthma has been associated with inspiratory muscle activity, which persist during expiration. The main objective of the present study was to evaluate the role of rapidly adapting receptors (RARs), slowly adapting receptors (SARs) and C-fibre endings in generating end-tidal inspiratory activity (ETIA). ETIA was induced by intravenous administration of histamine and continuous negative airway pressure (CNAP) in anaesthetized, spontaneously breathing cats. To differentiate between reflex activities from the three types of lung receptors, both vagus nerves were cooled to eight different temperatures (Tvg) between 4 and 37 degrees C. It is known that CNAP stimulates RARs and inhibits SARs. Histamine was used to stimulate RARs, and this was combined with continuous positive airway pressure (CPAP) to further stimulate SARs. ETIA was evoked in the diaphragm and in parasternal intercostal muscles by both stimuli (histamine and CNAP) in 8 out of 18 cats. After vagotomy, neither histamine nor CNAP evoked ETIA any more. At Tvg = 37 degrees C, CPAP suppressed histamine-induced ETIA; whereas, this suppression was diminished at Tvg between 14 and 8 degrees C. ETIA sharply declined for Tvg between 8 degrees and 4 degrees C, and at Tvg = 4 degrees C ETIA had virtually disappeared. At Tvg = 37 degrees and 22 degrees C values of ETIA during CNAP were larger than those in response to histamine; whereas, at Tvg = 10 degrees C comparable ETIA values were obtained. It was shown that ETIA is a vagal reflex activity in which C-fibre endings are not involved. Histamine-induced ETIA originates from stimulation of RARs, and is inhibited by stimulation of SARs. Mechanical stimulation of RARs is a forceful stimulus to induce ETIA. This suggests that hyperinflation in acute asthma might be due, at least in part, to ETIA resulting from an imbalance between SAR and RAR activity. PMID:8666106

  3. Unidirectional Expiratory Valve Method to Assess Maximal Inspiratory Pressure in Individuals without Artificial Airway

    PubMed Central

    Grams, Samantha Torres; Kimoto, Karen Yumi Mota; Azevedo, Elen Moda de Oliveira; Lança, Marina; de Albuquerque, André Luis Pereira; de Brito, Christina May Moran; Yamaguti, Wellington Pereira

    2015-01-01

    Introduction Maximal Inspiratory Pressure (MIP) is considered an effective method to estimate strength of inspiratory muscles, but still leads to false positive diagnosis. Although MIP assessment with unidirectional expiratory valve method has been used in patients undergoing mechanical ventilation, no previous studies investigated the application of this method in subjects without artificial airway. Objectives This study aimed to compare the MIP values assessed by standard method (MIPsta) and by unidirectional expiratory valve method (MIPuni) in subjects with spontaneous breathing without artificial airway. MIPuni reproducibility was also evaluated. Methods This was a crossover design study, and 31 subjects performed MIPsta and MIPuni in a random order. MIPsta measured MIP maintaining negative pressure for at least one second after forceful expiration. MIPuni evaluated MIP using a unidirectional expiratory valve attached to a face mask and was conducted by two evaluators (A and B) at two moments (Tests 1 and 2) to determine interobserver and intraobserver reproducibility of MIP values. Intraclass correlation coefficient (ICC[2,1]) was used to determine intraobserver and interobserver reproducibility. Results The mean values for MIPuni were 14.3% higher (-117.3 ± 24.8 cmH2O) than the mean values for MIPsta (-102.5 ± 23.9 cmH2O) (p<0.001). Interobserver reproducibility assessment showed very high correlation for Test 1 (ICC[2,1] = 0.91), and high correlation for Test 2 (ICC[2,1] = 0.88). The assessment of the intraobserver reproducibility showed high correlation for evaluator A (ICC[2,1] = 0.86) and evaluator B (ICC[2,1] = 0.77). Conclusions MIPuni presented higher values when compared with MIPsta and proved to be reproducible in subjects with spontaneous breathing without artificial airway. PMID:26360255

  4. Effectiveness of Inspiratory Termination Synchrony with Automatic Cycling During Noninvasive Pressure Support Ventilation

    PubMed Central

    Chen, Yuqing; Cheng, Kewen; Zhou, Xin

    2016-01-01

    Background Pressure support ventilation (PSV) is a standard method for non-invasive home ventilation. A bench study was designed to compare the effectiveness of patient-ventilator inspiratory termination synchronization with automated and conventional triggering in various respiratory mechanics models. Material/Methods Two ventilators, the Respironics V60 and Curative Flexo ST 30, connected to a Hans Rudolph Series 1101 lung simulator, were evaluated using settings that simulate lung mechanics in patients with chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), or normal lungs. Ventilators were operated with automated (Auto-Trak) or conventional high-, moderate-, and low-sensitivity flow-cycling software algorithms, 5 cmH2O or 15 cmH2O pressure support, 5 cmH2O positive end-expiratory pressure (PEEP), and an air leak of 25–28 L/min. Results Both ventilators adapted to the system leak without requiring adjustment of triggering settings. In all simulated lung conditions, automated cycling resulted in shorter triggering delay times (<100 ms) and lower triggering pressure-time product (PTPt) values. Tidal volumes (VT) increased with lower conventional cycling sensitivity level. In the COPD model, automated cycling had higher leak volumes and shorter cycling delay times than in conventional cycling. Asynchronous events were rare. Inspiratory time (Tinsp), peak expiratory flow (PEF), and cycling off delay time (Cdelay) increased as a result of reduction in conventional cycling sensitivity level. In the ARDS and normal adult lung models, premature cycling was frequent at the high-sensitive cycling level. Conclusions Overall, the Auto-Trak protocol showed better patient-machine cycling synchronization than conventional triggering. This was evident by shorter triggering time delays and lower PTPt. PMID:27198165

  5. Effectiveness of Inspiratory Termination Synchrony with Automatic Cycling During Noninvasive Pressure Support Ventilation.

    PubMed

    Chen, Yuqing; Cheng, Kewen; Zhou, Xin

    2016-01-01

    BACKGROUND Pressure support ventilation (PSV) is a standard method for non-invasive home ventilation. A bench study was designed to compare the effectiveness of patient-ventilator inspiratory termination synchronization with automated and conventional triggering in various respiratory mechanics models. MATERIAL AND METHODS Two ventilators, the Respironics V60 and Curative Flexo ST 30, connected to a Hans Rudolph Series 1101 lung simulator, were evaluated using settings that simulate lung mechanics in patients with chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), or normal lungs. Ventilators were operated with automated (Auto-Trak) or conventional high-, moderate-, and low-sensitivity flow-cycling software algorithms, 5 cmH2O or 15 cmH2O pressure support, 5 cmH2O positive end-expiratory pressure (PEEP), and an air leak of 25-28 L/min. RESULTS Both ventilators adapted to the system leak without requiring adjustment of triggering settings. In all simulated lung conditions, automated cycling resulted in shorter triggering delay times (<100 ms) and lower triggering pressure-time product (PTPt) values. Tidal volumes (VT) increased with lower conventional cycling sensitivity level. In the COPD model, automated cycling had higher leak volumes and shorter cycling delay times than in conventional cycling. Asynchronous events were rare. Inspiratory time (Tinsp), peak expiratory flow (PEF), and cycling off delay time (Cdelay) increased as a result of reduction in conventional cycling sensitivity level. In the ARDS and normal adult lung models, premature cycling was frequent at the high-sensitive cycling level. CONCLUSIONS Overall, the Auto-Trak protocol showed better patient-machine cycling synchronization than conventional triggering. This was evident by shorter triggering time delays and lower PTPt. PMID:27198165

  6. The 400- and 800-m Track Running Induces Inspiratory Muscle Fatigue in Trained Female Middle-Distance Runners.

    PubMed

    Ohya, Toshiyuki; Yamanaka, Ryo; Hagiwara, Masahiro; Oriishi, Marie; Suzuki, Yasuhiro

    2016-05-01

    Inspiratory muscle fatigue (IMF) may limit exercise performance. A few studies have reported that IMF occurs after short-duration swimming exercise, but whether short-duration running can induce IMF remains unclear. Intra-abdominal pressure is increased during running through diaphragmatic activation to stabilize the spine during movements of the upper limbs. This occurs along with the increased inspiratory muscle effort associated with increased respirations during exercise; thus, we hypothesized that short-duration running exercise would induce IMF. To test this hypothesis, we measured maximal inspiratory pressure (MIP) before and after 400- and 800-m track running sessions. Eight female middle-distance (400, 800 m) runners performed a 400- and 800-m running test. Maximal inspiratory pressure was measured before and after each test using a portable autospirometer. The mean MIPs were significantly lower after running than before running; values obtained were 107 ± 25 vs. 97 ± 27 cmH2O (p = 0.01, effect size [ES] = 0.65) and 108 ± 26 vs. 92 ± 27 cmH2O (p = 0.01, ES = 0.74) before vs. after the 400- and 800-m tests, respectively. The mean MIP after the 800-m test was significantly lower than after the 400-m test (p = 0.04, ES = 0.48). There was no correlation between IMF value and running time (r = 0.53 and r = -0.28 for either the 400- and 800-m tests, respectively; p > 0.05). In conclusion, IMF occurs after short-duration running exercise. Coaches could consider prescribing inspiratory muscle training or warm-up in an effort to reduce the inevitable IMF associated with maximal effort running. PMID:26422611

  7. Inspiratory activation is not required for episodic hypoxia-induced respiratory long-term facilitation in postnatal rats

    PubMed Central

    Tadjalli, Arash; Duffin, James; Li, Yan Mei; Hong, Hyunwook; Peever, John

    2007-01-01

    Episodic hypoxia causes repetitive inspiratory activation that induces a form of respiratory plasticity termed long-term facilitation (LTF). While LTF is a function of the hypoxic exposures and inspiratory activation, their relative importance in evoking LTF is unknown. The aims of this study were to: (1) dissociate the relative roles played by episodic hypoxia and respiratory activation in LTF; and (2) determine whether the magnitude of LTF varies as a function of hypoxic intensity. We did this by examining the effects of episodic hypoxia in postnatal rats (15–25 days old), which unlike adult rats exhibit a prominent hypoxia-induced respiratory depression. We quantified inspiratory phrenic nerve activity generated by the in situ working-heart brainstem before, during and for 60 min after episodic hypoxia. We demonstrate that episodic hypoxia evokes LTF despite the fact that it potently suppresses inspiratory activity during individual hypoxic exposures (P < 0.05). Specifically, we show that after episodic hypoxia (three 5 min periods of 10% O2) respiratory frequency increased to 40 ± 3.3% above baseline values over the next 60 min (P < 0.001). Continuous hypoxia (15 min of 10% O2) had no lasting effects on respiratory frequency (P > 0.05). To determine if LTF magnitude was affected by hypoxic intensity, the episodic hypoxia protocol was repeated under three different O2 tensions. We demonstrate that the magnitude and time course of LTF depend on hypoxic severity, with more intense hypoxia inducing a more potent degree of LTF. We conclude that inspiratory activation is not required for LTF induction, and that hypoxia per se is the physiological stimulus for eliciting hypoxia-induced respiratory LTF. PMID:17932158

  8. Effect of Simulated Microgravity and Lunar Gravity on Human Inspiratory Muscle Function: 'Selena-T' 2015 Study.

    PubMed

    Segizbaeva, M O; Aleksandrova, N P; Donina, Z A; Baranova, E V; Katuntsev, V P; Tarasenkov, G G; Baranov, V M

    2016-01-01

    As a part of the multi-disciplinary "SELENA-T"-2015 Bed Rest Study, we investigated the pattern of inspiratory muscles fatigue in 22 healthy male subjects during incremental exercise test to exhaustion before and after 21 days of hypokinesia evoked by bed rest. Hypokinesia consisted of head-down bed rest (HDBR) at a minus 6° angle, simulating microgravity present on orbiting spacecraft, in 10 subjects. The remaining 12 subjects spent the first 5 days of hypokinesia in HDBR position and the subsequent 16 days in head-up bed rest (HUBR) at a plus 9.6° angle, as a presumed analog of lunar gravity that is six times less than Earth's gravity. Maximal inspiratory pressure (MIP) and electromyograms (EMG) of the diaphragm (D), parasternal (PS), sternocleidomastoid (SCM), and scalene (S) muscles served as indices of inspiratory muscle function. Before both HDBR and HUBR, exercise decreased MIP and centroid frequency (fc) of EMG (D, PS, SCM, and S) power spectrum (p < 0.05). After 3 weeks of HDBR, but not HUBR, inspiratory muscles fatigue was more expressed compared with control (p < 0.05). We conclude that HDBR lowers inspiratory muscles resistance to fatigue during high-intensity exercise while HUBR has no such effect. These changes may limit maximal ventilation and may contribute to exercise intolerance observed after prolonged simulated microgravity. The physiological mechanisms of respiratory muscle dysfunction after HDBR consist primarily of postural effects, and are not due only to hypokinesia. PMID:27241510

  9. Pausing at the Threshold

    ERIC Educational Resources Information Center

    Morgan, Patrick K.

    2015-01-01

    Since about 2003, the notion of threshold concepts--the central ideas in any field that change how learners think about other ideas--have become difficult to escape at library conferences and in general information literacy discourse. Their visibility will likely only increase because threshold concepts figure prominently in the Framework for…

  10. Threshold Concepts in Economics

    ERIC Educational Resources Information Center

    Shanahan, Martin

    2016-01-01

    Purpose: The purpose of this paper is to examine threshold concepts in the context of teaching and learning first-year university economics. It outlines some of the arguments for using threshold concepts and provides examples using opportunity cost as an exemplar in economics. Design/ Methodology/Approach: The paper provides an overview of the…

  11. Bayesian Threshold Estimation

    ERIC Educational Resources Information Center

    Gustafson, S. C.; Costello, C. S.; Like, E. C.; Pierce, S. J.; Shenoy, K. N.

    2009-01-01

    Bayesian estimation of a threshold time (hereafter simply threshold) for the receipt of impulse signals is accomplished given the following: 1) data, consisting of the number of impulses received in a time interval from zero to one and the time of the largest time impulse; 2) a model, consisting of a uniform probability density of impulse time…

  12. On Generating Fatigue Crack Growth Thresholds

    NASA Technical Reports Server (NTRS)

    Forth, Scott C.; Newman, James, Jr.; Forman, Royce G.

    2003-01-01

    The fatigue crack growth threshold, defining crack growth as either very slow or nonexistent, has been traditionally determined with standardized load reduction methodologies. These experimental procedures can induce load history effects that result in crack closure. This history can affect the crack driving force, i.e. during the unloading process the crack will close first at some point along the wake or blunt at the crack tip, reducing the effective load at the crack tip. One way to reduce the effects of load history is to propagate a crack under constant amplitude loading. As a crack propagates under constant amplitude loading, the stress intensity factor range, Delta K, will increase, as will the crack growth rate. da/dN. A fatigue crack growth threshold test procedure is experimentally validated that does not produce load history effects and can be conducted at a specified stress ratio, R. The authors have chosen to study a ductile aluminum alloy where the plastic deformations generated during testing may be of the magnitude to impact the crack opening.

  13. Rib Fracture Fixation Restores Inspiratory Volume and Peak Flow in a Full Thorax Human Cadaveric Breathing Model

    PubMed Central

    Slobogean, Gerard P.; Kim, Hyunchul; Russell, Joseph P.; Stockton, David J.; Hsieh, Adam H.; O’Toole, Robert V.

    2015-01-01

    Background: Multiple rib fractures cause significant pain and potential for chest wall instability. Despite an emerging trend of surgical management of flail chest injuries, there are no studies examining the effect of rib fracture fixation on respiratory function. Objectives: Using a novel full thorax human cadaveric breathing model, we sought to explore the effect of flail chest injury and subsequent rib fracture fixation on respiratory outcomes. Patients and Methods: We used five fresh human cadavers to generate negative breathing models in the left thorax to mimic physiologic respiration. Inspiratory volumes and peak flows were measured using a flow meter for all three chest wall states: intact chest, left-sided flail chest (segmental fractures of ribs 3 - 7), and post-fracture open reduction and internal fixation (ORIF) of the chest wall with a pre-contoured rib specific plate fixation system. Results: A wide variation in the mean inspiratory volumes and peak flows were measured between specimens; however, the effect of a flail chest wall and the subsequent internal fixation of the unstable rib fractures was consistent across all samples. Compared to the intact chest wall, the inspiratory volume decreased by 40 ± 19% in the flail chest model (P = 0.04). Open reduction and internal fixation of the flail chest returned the inspiratory volume to 130 ± 71% of the intact chest volumes (P = 0.68). A similar 35 ± 19% decrease in peak flows was seen in the flail chest (P = 0.007) and this returned to 125 ± 71% of the intact chest following ORIF (P = 0.62). Conclusions: Negative pressure inspiration is significantly impaired by an unstable chest wall. Restoring mechanical stability of the fractured ribs improves respiratory outcomes similar to baseline values. PMID:26848471

  14. Inhibition of the pontine Kölliker-Fuse nucleus abolishes eupneic inspiratory hypoglossal motor discharge in rat.

    PubMed

    Bautista, T G; Dutschmann, M

    2014-05-16

    The pontine Kölliker-Fuse nucleus (KF) has established functions in the regulation of inspiratory-expiratory phase transition and the regulation of upper airway patency via laryngeal valving mechanisms. Here we studied the role of the KF in the gating and modulation of eupneic hypoglossal motor activity (HNA) using the in situ perfused brainstem preparation, which displays robust inspiratory HNA. Microinjection of glutamate into the KF area triggered complex and often biphasic modulation (excitation/inhibition or inhibition/excitation) of HNA. Subsequent transient pharmacological inhibition of KF by unilateral microinjection of GABA-A receptor agonist isoguvacine reduced HNA and while bilateral microinjections completely abolished HNA. Our results indicate that mixed and overlapping KF pre-motor neurons provide eupneic drive for inspiratory HNA and postinspiratory vagal nerve activity. Both motor activities have important functions in the regulation of upper airway patency during eupnea but also during various oro-pharyngeal behaviors. These results have potential implications in the contribution of state-dependent modulation of KF hypoglossal pre-motor neurons during sleep-wake cycle to obstructive sleep apnea. PMID:24603053

  15. Temporal dynamics of lactate concentration in the human brain during acute inspiratory hypoxia

    PubMed Central

    Harris, Ashley D; Roberton, Victoria H; Huckle, Danielle L; Saxena, Neeraj; Evans, C John; Murphy, Kevin; Hall, Judith E; Bailey, Damian M; Mitsis, Georgios; Edden, Richard A E; Wise, Richard G

    2012-01-01

    Purpose To demonstrate the feasibility of measuring the temporal dynamics of cerebral lactate concentration and examine these dynamics in human subjects using MRS during hypoxia. Methods A respiratory protocol consisting of 10 min baseline normoxia, 20 min inspiratory hypoxia and ending with 10 min normoxic recovery was used, throughout which lactate-edited MRS was performed. This was repeated four times in three subjects. A separate session was performed to measure blood lactate. Impulse response functions using end-tidal oxygen and blood lactate as system inputs and cerebral lactate as the system output were examined to describe the dynamics of the cerebral lactate response to a hypoxic challenge. Results The average lactate increase was 20%±15% during the last half of the hypoxic challenge. Significant changes in cerebral lactate concentration were observed after 400s. The average relative increase in blood lactate was 188%±95%. The temporal dynamics of cerebral lactate concentration was reproducibly demonstrated with 200s time bins of MRS data (coefficient of variation 0.063±0.035 between time bins in normoxia). The across subject coefficient of variation was 0.333. Conclusions The methods for measuring the dynamics of the cerebral lactate response developed here would be useful to further investigate the brain’s response to hypoxia. PMID:23197421

  16. Maximum inspiratory pressure and rapid shallow breathing index as predictors of successful ventilator weaning

    PubMed Central

    Bien, Umilson dos Santos; Souza, Gerson Fonseca; Campos, Elisangela Siqueira; Farah de Carvalho, Etiene; Fernandes, Matheus Guedes; Santoro, Ilka; Costa, Dirceu; Arena, Ross; Sampaio, Luciana Maria Malosá

    2015-01-01

    [Purpose] To investigate the predictive value of maximum inspiratory pressure (MIP) and the rapid shallow breathing index (RSBI) in a ventilator weaning protocol and to evaluate the differences between clinical and surgical patients in the intensive care unit. [Subjects and Methods] Patients aged ≥15 years who underwent orotracheal intubation for mechanical ventilation and who met the criteria of the weaning protocol were included in the study. Receiver operating characteristic (ROC) curves were calculated for the analysis of each index. [Results] Logistic regression analysis was also performed. MIP showed greater sensitivity and specificity [area under the curve (AUC): 0.95 vs. 0.89] and likelihood ratios (LR) (positive(+): 20.85 vs. 9.45; negative(−): 0.07 vs. 0.17) than RSBI in the overall sample (OS) as well as in clinical patients (CP) (AUC: 0.99 vs. 0.90; LR+: 24.66 vs. 7.22; LR-: 0.01 vs. 0.15) and surgical patients (SP) (AUC: 0.99 vs. 0.87; LR+: 9.33 vs. 5.86; LR−: 0.07 vs. 0.14). The logistic regression analysis revealed that both parameters were significantly associated with the weaning success. The MIP showed greater accuracy than the RSBI (OS: 0.93 vs. 0.85; CP: 0.98 vs. 0.87; SP: 0.93 vs. 0.87). [Conclusion] Both parameters are good predictors of successful ventilator weaning. PMID:26834339

  17. Maximum inspiratory pressure and rapid shallow breathing index as predictors of successful ventilator weaning.

    PubMed

    Bien, Umilson Dos Santos; Souza, Gerson Fonseca; Campos, Elisangela Siqueira; Farah de Carvalho, Etiene; Fernandes, Matheus Guedes; Santoro, Ilka; Costa, Dirceu; Arena, Ross; Sampaio, Luciana Maria Malosá

    2015-12-01

    [Purpose] To investigate the predictive value of maximum inspiratory pressure (MIP) and the rapid shallow breathing index (RSBI) in a ventilator weaning protocol and to evaluate the differences between clinical and surgical patients in the intensive care unit. [Subjects and Methods] Patients aged ≥15 years who underwent orotracheal intubation for mechanical ventilation and who met the criteria of the weaning protocol were included in the study. Receiver operating characteristic (ROC) curves were calculated for the analysis of each index. [Results] Logistic regression analysis was also performed. MIP showed greater sensitivity and specificity [area under the curve (AUC): 0.95 vs. 0.89] and likelihood ratios (LR) (positive(+): 20.85 vs. 9.45; negative(-): 0.07 vs. 0.17) than RSBI in the overall sample (OS) as well as in clinical patients (CP) (AUC: 0.99 vs. 0.90; LR+: 24.66 vs. 7.22; LR-: 0.01 vs. 0.15) and surgical patients (SP) (AUC: 0.99 vs. 0.87; LR+: 9.33 vs. 5.86; LR-: 0.07 vs. 0.14). The logistic regression analysis revealed that both parameters were significantly associated with the weaning success. The MIP showed greater accuracy than the RSBI (OS: 0.93 vs. 0.85; CP: 0.98 vs. 0.87; SP: 0.93 vs. 0.87). [Conclusion] Both parameters are good predictors of successful ventilator weaning. PMID:26834339

  18. Effects of Exercise Training and Inspiratory Muscle Training in Spinal Cord Injury: A Systematic Review

    PubMed Central

    Sheel, A. William; Reid, Wendy Darlene; Townson, Andrea F; Ayas, Najib T; Konnyu, Kristin J

    2008-01-01

    Objective: To provide a systematic review of the studies assessing exercise training and inspiratory muscle training (IMT) in individuals for the improved respiratory function of patients with spinal cord injury (SCI). Methods: Thirteen studies (5 exercise training, 8 IMT) were identified. Articles were scored for their methodological quality using the Physiotherapy Evidence Database scores and Downs and Black tools for randomized and nonrandomized studies, respectively. Conclusions were based on the most rigorously executed studies using Sackett's levels of evidence. Results: Study comparison was compromised by diverse research designs; small sample sizes; and heterogeneity of studied populations, protocols, and outcome measures. Based on current literature, there is level 2 evidence supporting exercise training as an intervention to improve respiratory strength and endurance and level 4 evidence to support exercise training as an intervention that might improve resting and exercising respiratory function in people with SCI. There is level 4 evidence to support IMT as an intervention that might decrease dyspnea and improve respiratory function in people with SCI. Conclusions: There are insufficient data to strongly support the use of exercise training or IMT for improved respiratory function in people with SCI. There is some evidence of efficacy of both regimens; however, the evidence is not of the best possible quality. PMID:19086707

  19. Usefulness of inspiratory capacity measurement in COPD patients in the primary care setting

    PubMed Central

    Madueño, Antonio; Martín, Antonio; Péculo, Juan-Antonio; Antón, Esther; Paravisini, Alejandra; León, Antonio

    2009-01-01

    Objective: To determine if inspiratory capacity (IC) assessment could be useful for chronic obstructive pulmonary disease (COPD) patient management in the primary care setting. Methods: A descriptive cross-sectional study was conducted in 93 patients diagnosed with COPD according to Spanish Thoracic Society (SEPAR) criteria. Patients were recruited in eight primary care centers in Andalusia, Spain. Anthropometric, sociodemographic, resting lung function (forced expiratory volume in one second [FEV1], forced vital capacity, synchronized vital capacity, IC), and quality of life data based on the Spanish version of Saint George’s Respiratory Questionnaire (SGRQ) were obtained. Results: Lung function results expressed as percentages of the predicted values were as follows: FEV1, 49.04 (standard deviation [SD]: 16.23); IC, 61.73 (SD: 15.42). The SGRQ mean total score was 47.5 (SD 17.98). The Spearman’s Rho correlation between FEV1 and SGRQ was r = −0.36 (95% confidence interval [CI]: −0.529 to −0.166), between IC and SGRQ was r = −0.329 (95% CI −0.502 to −0.131), and between FEV1 and IC was r = −0.561. Conclusions: Measurement of IC at rest could be used as a complementary functional exploration to forced spirometry in the monitorization of patients with COPD in the primary care setting. We found a poor correlation between IC and quality of life at the same level as in FEV1. PMID:20360907

  20. Finger microvascular responses to deep inspiratory gasp assessed and quantified using wavelet analysis.

    PubMed

    Allen, John; Di Maria, Costanzo; Mizeva, Irina; Podtaev, Sergey

    2013-07-01

    The physiological changes following a deep inspiratory gasp (DIG) manoeuvre have been described in the literature. However, the lack of a reliable signal processing technique to visualize and quantify these physiological changes has so far limited the applicability of the test to the clinical setting. The main aim of this study was to assess the feasibility of using wavelet analysis to quantify the pulse arrival time (PAT) and its changes during the DIG manoeuvre. Vascular responses were extracted from cardiac (electrocardiogram, ECG) and peripheral pulse (photoplethysmography, PPG) waveforms. Wavelet analysis characterized their cardiovascular responses in healthy adult subjects in the time-frequency space, and for the ECG-PPG inter-relationship in terms of the PAT. PAT showed a characteristic biphasic response to gasp, with an increase of 59 ± 59 ms (p = 0.001) compared to the maximum value reached during quiet breathing, and a decrease of -38 ± 55 ms (p < 0.01) compared to the minimum value during quiet breathing. The response measures were repeatable. This pilot study has successfully shown the feasibility of using wavelet analysis to characterize the cardiovascular waveforms and quantify their changes with DIG. PMID:23771176

  1. Effect of inspiratory resistance to prolonged exercise in a hot environment wearing protective clothing

    NASA Astrophysics Data System (ADS)

    Jetté, Maurice; Quenneville, Josée; Thoden, James; Livingstone, Sydney

    1992-09-01

    The effects of inspiratory resistance on prolonged work in a hot environment wearing a nuclear, bacteriological and chemical warfare (NBCW) mask and overgarment were assessed in 10 males. Subjects walked on a treadmill at 5 km/hr, 2% gradient, until their core temperature reached 39° C or for a duration of 90 min. Rectal temperature, heart rate, ventilation, oxygen consumption and rate of perceived breathing were measured. There were no differences between break-point time without the canister (62.2 ± 21 min) and with the canister (58.9 ± 17 min). Regression analysis indicated that the mean core temperature increased by 0.02° C for every minute of work performed and heart rate by 6 beats/min for every increase of 0.2° C in core temperature. Reduction in heat transfer brought about by wearing the protective overgarment and mask with or without the canister will significantly increase core temperature and limit the performance of moderate work to approximately 1 h in a moderately fit individual.

  2. Hydrodynamics of sediment threshold

    NASA Astrophysics Data System (ADS)

    Ali, Sk Zeeshan; Dey, Subhasish

    2016-07-01

    A novel hydrodynamic model for the threshold of cohesionless sediment particle motion under a steady unidirectional streamflow is presented. The hydrodynamic forces (drag and lift) acting on a solitary sediment particle resting over a closely packed bed formed by the identical sediment particles are the primary motivating forces. The drag force comprises of the form drag and form induced drag. The lift force includes the Saffman lift, Magnus lift, centrifugal lift, and turbulent lift. The points of action of the force system are appropriately obtained, for the first time, from the basics of micro-mechanics. The sediment threshold is envisioned as the rolling mode, which is the plausible mode to initiate a particle motion on the bed. The moment balance of the force system on the solitary particle about the pivoting point of rolling yields the governing equation. The conditions of sediment threshold under the hydraulically smooth, transitional, and rough flow regimes are examined. The effects of velocity fluctuations are addressed by applying the statistical theory of turbulence. This study shows that for a hindrance coefficient of 0.3, the threshold curve (threshold Shields parameter versus shear Reynolds number) has an excellent agreement with the experimental data of uniform sediments. However, most of the experimental data are bounded by the upper and lower limiting threshold curves, corresponding to the hindrance coefficients of 0.2 and 0.4, respectively. The threshold curve of this study is compared with those of previous researchers. The present model also agrees satisfactorily with the experimental data of nonuniform sediments.

  3. Mitochondrial threshold effects.

    PubMed Central

    Rossignol, Rodrigue; Faustin, Benjamin; Rocher, Christophe; Malgat, Monique; Mazat, Jean-Pierre; Letellier, Thierry

    2003-01-01

    The study of mitochondrial diseases has revealed dramatic variability in the phenotypic presentation of mitochondrial genetic defects. To attempt to understand this variability, different authors have studied energy metabolism in transmitochondrial cell lines carrying different proportions of various pathogenic mutations in their mitochondrial DNA. The same kinds of experiments have been performed on isolated mitochondria and on tissue biopsies taken from patients with mitochondrial diseases. The results have shown that, in most cases, phenotypic manifestation of the genetic defect occurs only when a threshold level is exceeded, and this phenomenon has been named the 'phenotypic threshold effect'. Subsequently, several authors showed that it was possible to inhibit considerably the activity of a respiratory chain complex, up to a critical value, without affecting the rate of mitochondrial respiration or ATP synthesis. This phenomenon was called the 'biochemical threshold effect'. More recently, quantitative analysis of the effects of various mutations in mitochondrial DNA on the rate of mitochondrial protein synthesis has revealed the existence of a 'translational threshold effect'. In this review these different mitochondrial threshold effects are discussed, along with their molecular bases and the roles that they play in the presentation of mitochondrial diseases. PMID:12467494

  4. CO2 elimination at varying inspiratory pause in acute lung injury.

    PubMed

    Aboab, J; Niklason, L; Uttman, L; Kouatchet, A; Brochard, L; Jonson, B

    2007-01-01

    Previous studies have indicated that, during mechanical ventilation, an inspiratory pause enhances gas exchange. This has been attributed to prolonged time during which fresh gas of the tidal volume is present in the respiratory zone and is available for distribution in the lung periphery. The mean distribution time of inspired gas (MDT) is the mean time during which fractions of fresh gas are present in the respiratory zone. All ventilators allow setting of pause time, T(P), which is a determinant of MDT. The objective of the present study was to test in patients the hypothesis that the volume of CO(2) eliminated per breath, V(T)CO(2), is correlated to the logarithm of MDT as previously found in animal models. Eleven patients with acute lung injury were studied. When T(P) increased from 0% to 30%, MDT increased fourfold. A change of T(P) from 10% to 0% reduced V(T)CO(2) by 14%, while a change to 30% increased V(T)CO(2) by 19%. The relationship between V(T)CO(2) and MDT was in accordance with the logarithmic hypothesis. The change in V(T)CO(2) reflected to equal extent changes in airway dead space and alveolar PCO(2) read from the alveolar plateau of the single breath test for CO(2). By varying T(P), effects are observed on V(T)CO(2), airway dead space and alveolar PCO(2). These effects depend on perfusion, gas distribution and diffusion in the lung periphery, which need to be further elucidated. PMID:17204030

  5. Prenatal nicotine exposure increases apnoea and reduces nicotinic potentiation of hypoglossal inspiratory output in mice

    PubMed Central

    Robinson, Dean M; Peebles, Karen C; Kwok, Henry; Adams, Brandon M; Clarke, Lan-Ling; Woollard, Gerald A; Funk, Gregory D

    2002-01-01

    We examined the effects of in utero nicotine exposure on postnatal development of breathing pattern and ventilatory responses to hypoxia (7.4 % O2) using whole-body plethysmography in mice at postnatal day 0 (P0), P3, P9, P19 and P42. Nicotine delayed early postnatal changes in breathing pattern. During normoxia, control and nicotine-exposed P0 mice exhibited a high frequency of apnoea (fA) which declined by P3 in control animals (from 6.7 ± 0.7 to 2.2 ± 0.7 min−1) but persisted in P3 nicotine-exposed animals (5.4 ± 1.3 min−1). Hypoxia induced a rapid and sustained reduction in fA except in P0 nicotine-exposed animals where it fell initially and then increased throughout the hypoxic period. During recovery, fA increased above control levels in both groups at P0. By P3 this increase was reduced in control but persisted in nicotine-exposed animals. To examine the origin of differences in respiratory behaviour, we compared the activity of hypoglossal (XII) nerves and motoneurons in medullary slice preparations. The frequency and variability of the respiratory rhythm and the envelope of inspiratory activity in XII nerves and motoneurons were indistinguishable between control and nicotine-exposed animals. Activation of postsynaptic nicotine receptors caused an inward current in XII motoneurons that potentiated XII nerve burst amplitude by 25 ± 5 % in control but only 14 ± 3 % in nicotine-exposed animals. Increased apnoea following nicotine exposure does not appear to reflect changes in basal activity of rhythm or pattern-generating networks, but may result, in part, from reduced nicotinic modulation of XII motoneurons. PMID:11826179

  6. Yield threshold decision framework

    SciTech Connect

    Judd, B.R.; Younker, L.W.; Hannon, W.J.

    1989-08-17

    The USA is developing a decision analysis framework for evaluating the relative value of lower yield thresholds and related verification policies. The framework facilitates systematic analysis of the major issues in the yield threshold decision. The framework can be used to evaluate options proposed either in the inter-agency process or in the negotiations. In addition, the framework can measure the importance of uncertainties and alternative judgments, and thereby determine the advantages of additional research. Since the model is explicit and quantitative, it provides a rational, defensible approach for reaching important treaty and verification decisions. 9 figs.

  7. The effect of home-based inspiratory muscle training on exercise capacity, exertional dyspnea and pulmonary function in COPD patients

    PubMed Central

    Bavarsad, Maryam Bakhshandeh; Shariati, Abdolali; Eidani, Esmaeil; Latifi, Mahmud

    2015-01-01

    Background: Chronic obstructive pulmonary disease (COPD) is currently the fourth cause of mortality worldwide. Patients with COPD experience periods of dyspnea, fatigue, and disability, which impact on their life. The objective of this study was to investigate the effect of short-term inspiratory muscle training on exercise capacity, exertional dyspnea, and pulmonary lung function. Materials and Methods: A randomized, controlled trial was performed. Thirty patients (27 males, 3 females) with mild to very severe COPD were randomly assigned to a training group (group T) or to a control group (group C). Patients in group T received training for 8 weeks (15 min/day for 6 days/week) with flow-volumetric inspiratory exerciser named (Respivol). Each patient was assessed before and after 8 weeks of training for the following clinical parameters: exercise capacity by 6-min walking test (6MWT), exertional dyspnea by Borg scale, and pulmonary lung function by spirometry. Patients used training together with medical treatment. The data were analyzed using paired t-test and independent t-test. Results: Results showed statistically significant increase in 6MWT at the end of the training from 445.6 ± 22.99 to 491.06 ± 17.67 meters? (P < 0.001) and statistically significant decrease in dyspnea from 3.76 ± 0.64 to 1.13 ± 0.36 (P = 0.0001) in the training group but not in the control group. The values for exercise capacity and dyspnea improved after 8 weeks in group T in comparison with group C (P = 0.001 and P = 0.0001, respectively). No changes were observed in any measure of pulmonary function in both groups. Conclusions: Short-term inspiratory muscle training has beneficial effects on exercise capacity and exertional dyspnea in COPD patients. PMID:26457101

  8. The classical Starling resistor model often does not predict inspiratory airflow patterns in the human upper airway

    PubMed Central

    Edwards, Bradley A.; Sands, Scott A.; Butler, James P.; Eckert, Danny J.; White, David P.; Malhotra, Atul; Wellman, Andrew

    2014-01-01

    The upper airway is often modeled as a classical Starling resistor, featuring a constant inspiratory airflow, or plateau, over a range of downstream pressures. However, airflow tracings from clinical sleep studies often show an initial peak before the plateau. To conform to the Starling model, the initial peak must be of small magnitude or dismissed as a transient. We developed a method to simulate fast or slow inspirations through the human upper airway, to test the hypothesis that this initial peak is a transient. Eight subjects [4 obstructive sleep apnea (OSA), 4 controls] slept in an “iron lung” and wore a nasal mask connected to a continuous/bilevel positive airway pressure machine. Downstream pressure was measured using an epiglottic catheter. During non-rapid eye movement (NREM) sleep, subjects were hyperventilated to produce a central apnea, then extrathoracic pressure was decreased slowly (∼2–4 s) or abruptly (<0.5 s) to lower downstream pressure and create inspiratory airflow. Pressure-flow curves were constructed for flow-limited breaths, and slow vs. fast reductions in downstream pressure were compared. All subjects exhibited an initial peak and then a decrease in flow with more negative pressures, demonstrating negative effort dependence (NED). The rate of change in downstream pressure did not affect the peak to plateau airflow ratio: %NED 22 ± 13% (slow) vs. 20 ± 5% (fast), P = not significant. We conclude that the initial peak in inspiratory airflow is not a transient but rather a distinct mechanical property of the upper airway. In contrast to the classical Starling resistor model, the upper airway exhibits marked NED in some subjects. PMID:24458746

  9. Acute respiratory failure induced by mechanical pulmonary ventilation at a peak inspiratory pressure of 40 cmH2O.

    PubMed

    Tsuno, K; Sakanashi, Y; Kishi, Y; Urata, K; Tanoue, T; Higashi, K; Yano, T; Terasaki, H; Morioka, T

    1988-09-01

    The effects of high pressure mechanical pulmonary ventilation at a peak inspiratory pressure of 40 cmH(2)O were studied on the lungs of healthy newborn pigs (14-21 days after birth). Forty percent oxygen in nitrogen was used for ventilation to prevent oxygen intoxication. The control group (6 pigs) was ventilated for 48 hours at a peak inspiratory pressure less than 18 cmH(2)O and a PEEP of 3-5 cmH(2)O with a normal tidal volume, and a respiratory rate of 20 times/min. The control group showed few deleterious changes in the lungs for 48 hours. Eleven newborn pigs were ventilated at a peak inspiratory pressure of 40 cmH(2)O with a PEEP of 3-5 cmH(2)O and a respiratory rate of 20 times/min. To avoid respiratory alkalosis, a dead space was placed in the respiratory circuit, and normocarbia was maintained by adjusting dead space volume. In all cases in the latter group, severe pulmonary impairments, such as abnormal chest roentgenograms, hypoxemia, decreased total static lung compliance, high incidence of pneumothorax, congestive atelectasis, and increased lung weight were found within 48 hours of ventilation. When the pulmonary impairments became manifest, 6 of the 11 newborn pigs were switched to the conventional medical and ventilatory therapies for 3-6 days. However, all of them became ventilator dependent, and severe lung pathology was found at autopsy. These pulmonary insults by high pressure mechanical pulmonary ventilation could be occurring not infrequently in the respiratory management of patients with respiratory failure. PMID:15236077

  10. Peripheral chemoreceptors tune inspiratory drive via tonic expiratory neuron hubs in the medullary ventral respiratory column network.

    PubMed

    Segers, L S; Nuding, S C; Ott, M M; Dean, J B; Bolser, D C; O'Connor, R; Morris, K F; Lindsey, B G

    2015-01-01

    Models of brain stem ventral respiratory column (VRC) circuits typically emphasize populations of neurons, each active during a particular phase of the respiratory cycle. We have proposed that "tonic" pericolumnar expiratory (t-E) neurons tune breathing during baroreceptor-evoked reductions and central chemoreceptor-evoked enhancements of inspiratory (I) drive. The aims of this study were to further characterize the coordinated activity of t-E neurons and test the hypothesis that peripheral chemoreceptors also modulate drive via inhibition of t-E neurons and disinhibition of their inspiratory neuron targets. Spike trains of 828 VRC neurons were acquired by multielectrode arrays along with phrenic nerve signals from 22 decerebrate, vagotomized, neuromuscularly blocked, artificially ventilated adult cats. Forty-eight of 191 t-E neurons fired synchronously with another t-E neuron as indicated by cross-correlogram central peaks; 32 of the 39 synchronous pairs were elements of groups with mutual pairwise correlations. Gravitational clustering identified fluctuations in t-E neuron synchrony. A network model supported the prediction that inhibitory populations with spike synchrony reduce target neuron firing probabilities, resulting in offset or central correlogram troughs. In five animals, stimulation of carotid chemoreceptors evoked changes in the firing rates of 179 of 240 neurons. Thirty-two neuron pairs had correlogram troughs consistent with convergent and divergent t-E inhibition of I cells and disinhibitory enhancement of drive. Four of 10 t-E neurons that responded to sequential stimulation of peripheral and central chemoreceptors triggered 25 cross-correlograms with offset features. The results support the hypothesis that multiple afferent systems dynamically tune inspiratory drive in part via coordinated t-E neurons. PMID:25343784

  11. Elaborating on Threshold Concepts

    ERIC Educational Resources Information Center

    Rountree, Janet; Robins, Anthony; Rountree, Nathan

    2013-01-01

    We propose an expanded definition of Threshold Concepts (TCs) that requires the successful acquisition and internalisation not only of knowledge, but also its practical elaboration in the domains of applied strategies and mental models. This richer definition allows us to clarify the relationship between TCs and Fundamental Ideas, and to account…

  12. Effects of normoxia and hyperoxia on the rate of fatigue development in human respiratory muscles under conditions of intensive resistive load.

    PubMed

    Segizbaeva, M O; Mironenko, M A

    2008-11-01

    We evaluated the rate of fatigue development in the inspiratory muscles of healthy trained individuals during graded bicycle exercise and high resistive resistance to breath under conditions of normoxia and hyperoxia. Fatigue of the respiratory muscles was assessed by tension-time index (TT(m)=P(m)I/P(m)I(maxx)T(I)/T(T)), by the dynamics of changes in the ratio of respiratory volume to inspiratory muscles force, and by ratio of the mean amplitudes of electrical activity in high and low frequency ranges. It was found that the limit of extreme working capacity in humans during heavy resistive load is related to fatigue of the inspiratory muscles developing with the same rate under conditions of normoxia or hyperoxia. PMID:19526089

  13. Effect of the Prolonged Inspiratory to Expiratory Ratio on Oxygenation and Respiratory Mechanics During Surgical Procedures.

    PubMed

    Park, Jin Ha; Lee, Jong Seok; Lee, Jae Hoon; Shin, Seokyung; Min, Nar Hyun; Kim, Min-Soo

    2016-03-01

    Prolonged inspiratory to expiratory (I:E) ratio ventilation has been researched to reduce lung injury and improve oxygenation in surgical patients with one-lung ventilation (OLV) or carbon dioxide (CO2) pneumoperitoneum. We aimed to confirm the efficacy of the 1:1 equal ratio ventilation (ERV) compared with the 1:2 conventional ratio ventilation (CRV) during surgical procedures. Electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched.Prospective interventional trials that assessed the effects of prolonged I:E ratio of 1:1 during surgical procedures. Adult patients undergoing OLV or CO2 pneumoperitoneum as specific interventions depending on surgical procedures. The included studies were examined with the Cochrane Collaboration's tool. The data regarding intraoperative oxygenation and respiratory mechanics were extracted, and then pooled with standardized mean difference (SMD) using the method of Hedges. Seven trials (498 total patients, 274 with ERV) were included. From overall analysis, ERV did not improve oxygenation at 20 or 30 minutes after specific interventions (SMD 0.193, 95% confidence interval (CI): -0.094 to 0.481, P = 0.188). From subgroup analyses, ERV provided significantly improved oxygenation only with laparoscopy (SMD 0.425, 95% CI: 0.167-0.682, P = 0.001). At 60 minutes after the specific interventions, ERV improved oxygenation significantly in the overall analysis (SMD 0.447, 95% CI: 0.209-0.685, P < 0.001) as well as in the subgroup analyses with OLV (SMD 0.328, 95% CI: 0.011-0.644, P = 0.042) and laparoscopy (SMD 0.668, 95% CI: 0.052-1.285, P = 0.034). ERV provided lower peak airway pressure (Ppeak) and plateau airway pressure (Pplat) than CRV, regardless of the type of intervention. The relatively small number of the included articles and their heterogeneity could be the main limitations. ERV improved oxygenation at all of the

  14. Effect of the Prolonged Inspiratory to Expiratory Ratio on Oxygenation and Respiratory Mechanics During Surgical Procedures

    PubMed Central

    Park, Jin Ha; Lee, Jong Seok; Lee, Jae Hoon; Shin, Seokyung; Min, Nar Hyun; Kim, Min-Soo

    2016-01-01

    Abstract Prolonged inspiratory to expiratory (I:E) ratio ventilation has been researched to reduce lung injury and improve oxygenation in surgical patients with one-lung ventilation (OLV) or carbon dioxide (CO2) pneumoperitoneum. We aimed to confirm the efficacy of the 1:1 equal ratio ventilation (ERV) compared with the 1:2 conventional ratio ventilation (CRV) during surgical procedures. Electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched. Prospective interventional trials that assessed the effects of prolonged I:E ratio of 1:1 during surgical procedures. Adult patients undergoing OLV or CO2 pneumoperitoneum as specific interventions depending on surgical procedures. The included studies were examined with the Cochrane Collaboration's tool. The data regarding intraoperative oxygenation and respiratory mechanics were extracted, and then pooled with standardized mean difference (SMD) using the method of Hedges. Seven trials (498 total patients, 274 with ERV) were included. From overall analysis, ERV did not improve oxygenation at 20 or 30 minutes after specific interventions (SMD 0.193, 95% confidence interval (CI): −0.094 to 0.481, P = 0.188). From subgroup analyses, ERV provided significantly improved oxygenation only with laparoscopy (SMD 0.425, 95% CI: 0.167–0.682, P = 0.001). At 60 minutes after the specific interventions, ERV improved oxygenation significantly in the overall analysis (SMD 0.447, 95% CI: 0.209–0.685, P < 0.001) as well as in the subgroup analyses with OLV (SMD 0.328, 95% CI: 0.011–0.644, P = 0.042) and laparoscopy (SMD 0.668, 95% CI: 0.052–1.285, P = 0.034). ERV provided lower peak airway pressure (Ppeak) and plateau airway pressure (Pplat) than CRV, regardless of the type of intervention. The relatively small number of the included articles and their heterogeneity could be the main limitations. ERV improved oxygenation

  15. Network problem threshold

    NASA Technical Reports Server (NTRS)

    Gejji, Raghvendra, R.

    1992-01-01

    Network transmission errors such as collisions, CRC errors, misalignment, etc. are statistical in nature. Although errors can vary randomly, a high level of errors does indicate specific network problems, e.g. equipment failure. In this project, we have studied the random nature of collisions theoretically as well as by gathering statistics, and established a numerical threshold above which a network problem is indicated with high probability.

  16. Elaborating on threshold concepts

    NASA Astrophysics Data System (ADS)

    Rountree, Janet; Robins, Anthony; Rountree, Nathan

    2013-09-01

    We propose an expanded definition of Threshold Concepts (TCs) that requires the successful acquisition and internalisation not only of knowledge, but also its practical elaboration in the domains of applied strategies and mental models. This richer definition allows us to clarify the relationship between TCs and Fundamental Ideas, and to account for both the important and the problematic characteristics of TCs in terms of the Knowledge/Strategies/Mental Models Framework defined in previous work.

  17. The Role of Inspiratory Muscle Training in Sickle Cell Anemia Related Pulmonary Damage due to Recurrent Acute Chest Syndrome Attacks

    PubMed Central

    Camcıoğlu, Burcu; Boşnak-Güçlü, Meral; Karadallı, Müşerrefe Nur; Akı, Şahika Zeynep; Türköz-Sucak, Gülsan

    2015-01-01

    Background. The sickling of red blood cells causes a constellation of musculoskeletal, cardiovascular, and pulmonary manifestations. A 32-year-old gentleman with sickle cell anemia (SCA) had been suffering from recurrent acute chest syndrome (ACS). Aim. To examine the effects of inspiratory muscle training (IMT) on pulmonary functions, respiratory and peripheral muscle strength, functional exercise capacity, and quality of life in this patient with SCA. Methods. Functional exercise capacity was evaluated using six-minute walk test, respiratory muscle strength using mouth pressure device, hand grip strength using hand-held dynamometer, pain using Visual Analogue Scale, fatigue using Fatigue Severity Scale, dyspnea using Modified Medical Research Council Scale, and health related quality of life using European Organization for Research and Treatment of Cancer QOL measurement. Results. A significant improvement has been demonstrated in respiratory muscle strength, functional exercise capacity, pain, fatigue, dyspnea, and quality of life. There was no admission to emergency department due to acute chest syndrome in the following 12 months after commencing regular erythrocytapheresis. Conclusion. This is the first report demonstrating the beneficial effects of inspiratory muscle training on functional exercise capacity, respiratory muscle strength, pain, fatigue, dyspnea, and quality of life in a patient with recurrent ACS. PMID:26060589

  18. The Role of Inspiratory Muscle Training in Sickle Cell Anemia Related Pulmonary Damage due to Recurrent Acute Chest Syndrome Attacks.

    PubMed

    Camcıoğlu, Burcu; Boşnak-Güçlü, Meral; Karadallı, Müşerrefe Nur; Akı, Şahika Zeynep; Türköz-Sucak, Gülsan

    2015-01-01

    Background. The sickling of red blood cells causes a constellation of musculoskeletal, cardiovascular, and pulmonary manifestations. A 32-year-old gentleman with sickle cell anemia (SCA) had been suffering from recurrent acute chest syndrome (ACS). Aim. To examine the effects of inspiratory muscle training (IMT) on pulmonary functions, respiratory and peripheral muscle strength, functional exercise capacity, and quality of life in this patient with SCA. Methods. Functional exercise capacity was evaluated using six-minute walk test, respiratory muscle strength using mouth pressure device, hand grip strength using hand-held dynamometer, pain using Visual Analogue Scale, fatigue using Fatigue Severity Scale, dyspnea using Modified Medical Research Council Scale, and health related quality of life using European Organization for Research and Treatment of Cancer QOL measurement. Results. A significant improvement has been demonstrated in respiratory muscle strength, functional exercise capacity, pain, fatigue, dyspnea, and quality of life. There was no admission to emergency department due to acute chest syndrome in the following 12 months after commencing regular erythrocytapheresis. Conclusion. This is the first report demonstrating the beneficial effects of inspiratory muscle training on functional exercise capacity, respiratory muscle strength, pain, fatigue, dyspnea, and quality of life in a patient with recurrent ACS. PMID:26060589

  19. Inspiratory muscle fatigue affects latissimus dorsi but not pectoralis major activity during arms only front crawl sprinting.

    PubMed

    Lomax, Mitch; Tasker, Louise; Bostanci, Ozgur

    2014-08-01

    The purpose of this study was to determine whether inspiratory muscle fatigue (IMF) affects the muscle activity of the latissimus dorsi and pectoralis major during maximal arms only front crawl swimming. Eight collegiate swimmers were recruited to perform 2 maximal 20-second arms only front crawl sprints in a swimming flume. Both sprints were performed on the same day, and IMF was induced 30 minutes after the first (control) sprint. Maximal inspiratory and expiratory mouth pressures (PImax and PEmax, respectively) were measured before and after each sprint. The median frequency (MDF) of the electromyographic signal burst was recorded from the latissimus dorsi and pectoralis major during each 20-second sprint along with stroke rate and breathing frequency. Median frequency was assessed in absolute units (Hz) and then referenced to the start of the control sprint for normalization. After IMF inducement, stroke rate increased from 56 ± 4 to 59 ± 5 cycles per minute, and latissimus dorsi MDF fell from 67 ± 11 Hz at the start of the sprint to 61 ± 9 Hz at the end. No change was observed in the MDF of the latissimus dorsi during the control sprint. Conversely, the MDF of the pectoralis major shifted to lower frequencies during both sprints but was unaffected by IMF. As the latter induced fatigue in the latissimus dorsi, which was not otherwise apparent during maximal arms only control sprinting, the presence of IMF affects the activity of the latissimus dorsi during front crawl sprinting. PMID:24402450

  20. Laser threshold magnetometry

    NASA Astrophysics Data System (ADS)

    Jeske, Jan; Cole, Jared H.; Greentree, Andrew D.

    2016-01-01

    We propose a new type of sensor, which uses diamond containing the optically active nitrogen-vacancy (NV-) centres as a laser medium. The magnetometer can be operated at room-temperature and generates light that can be readily fibre coupled, thereby permitting use in industrial applications and remote sensing. By combining laser pumping with a radio-frequency Rabi-drive field, an external magnetic field changes the fluorescence of the NV- centres. We use this change in fluorescence level to push the laser above threshold, turning it on with an intensity controlled by the external magnetic field, which provides a coherent amplification of the readout signal with very high contrast. This mechanism is qualitatively different from conventional NV--based magnetometers which use fluorescence measurements, based on incoherent photon emission. We term our approach laser threshold magnetometer (LTM). We predict that an NV--based LTM with a volume of 1 mm3 can achieve shot-noise limited dc sensitivity of 1.86 fT /\\sqrt{{{Hz}}} and ac sensitivity of 3.97 fT /\\sqrt{{{Hz}}}.

  1. Coloring geographical threshold graphs

    SciTech Connect

    Bradonjic, Milan; Percus, Allon; Muller, Tobias

    2008-01-01

    We propose a coloring algorithm for sparse random graphs generated by the geographical threshold graph (GTG) model, a generalization of random geometric graphs (RGG). In a GTG, nodes are distributed in a Euclidean space, and edges are assigned according to a threshold function involving the distance between nodes as well as randomly chosen node weights. The motivation for analyzing this model is that many real networks (e.g., wireless networks, the Internet, etc.) need to be studied by using a 'richer' stochastic model (which in this case includes both a distance between nodes and weights on the nodes). Here, we analyze the GTG coloring algorithm together with the graph's clique number, showing formally that in spite of the differences in structure between GTG and RGG, the asymptotic behavior of the chromatic number is identical: {chi}1n 1n n / 1n n (1 + {omicron}(1)). Finally, we consider the leading corrections to this expression, again using the coloring algorithm and clique number to provide bounds on the chromatic number. We show that the gap between the lower and upper bound is within C 1n n / (1n 1n n){sup 2}, and specify the constant C.

  2. Load cell

    DOEpatents

    Spletzer, Barry L.

    2001-01-01

    A load cell combines the outputs of a plurality of strain gauges to measure components of an applied load. Combination of strain gauge outputs allows measurement of any of six load components without requiring complex machining or mechanical linkages to isolate load components. An example six axis load cell produces six independent analog outputs which can be combined to determine any one of the six general load components.

  3. Load cell

    DOEpatents

    Spletzer, B.L.

    1998-12-15

    A load cell combines the outputs of a plurality of strain gauges to measure components of an applied load. Combination of strain gauge outputs allows measurement of any of six load components without requiring complex machining or mechanical linkages to isolate load components. An example six axis load cell produces six independent analog outputs, each directly proportional to one of the six general load components. 16 figs.

  4. Load cell

    DOEpatents

    Spletzer, Barry L.

    1998-01-01

    A load cell combines the outputs of a plurality of strain gauges to measure components of an applied load. Combination of strain gauge outputs allows measurement of any of six load components without requiring complex machining or mechanical linkages to isolate load components. An example six axis load cell produces six independent analog outputs, each directly proportional to one of the six general load components.

  5. Oscillatory Threshold Logic

    PubMed Central

    Borresen, Jon; Lynch, Stephen

    2012-01-01

    In the 1940s, the first generation of modern computers used vacuum tube oscillators as their principle components, however, with the development of the transistor, such oscillator based computers quickly became obsolete. As the demand for faster and lower power computers continues, transistors are themselves approaching their theoretical limit and emerging technologies must eventually supersede them. With the development of optical oscillators and Josephson junction technology, we are again presented with the possibility of using oscillators as the basic components of computers, and it is possible that the next generation of computers will be composed almost entirely of oscillatory devices. Here, we demonstrate how coupled threshold oscillators may be used to perform binary logic in a manner entirely consistent with modern computer architectures. We describe a variety of computational circuitry and demonstrate working oscillator models of both computation and memory. PMID:23173034

  6. Learning foraging thresholds for lizards

    SciTech Connect

    Goldberg, L.A.; Hart, W.E.; Wilson, D.B.

    1996-01-12

    This work gives a proof of convergence for a randomized learning algorithm that describes how anoles (lizards found in the Carribean) learn a foraging threshold distance. This model assumes that an anole will pursue a prey if and only if it is within this threshold of the anole`s perch. This learning algorithm was proposed by the biologist Roughgarden and his colleagues. They experimentally confirmed that this algorithm quickly converges to the foraging threshold that is predicted by optimal foraging theory our analysis provides an analytic confirmation that the learning algorithm converses to this optimal foraging threshold with high probability.

  7. Hairpin Vortex Regeneration Threshold

    NASA Astrophysics Data System (ADS)

    Sabatino, Daniel; Maharjan, Rijan

    2015-11-01

    A free surface water channel is used to study hairpin vortex formation created by fluid injection through a narrow slot into a laminar boundary layer. Particle image velocimetry is used to calculate the circulation of the primary hairpin vortex head which is found to monotonically decrease in strength with downstream distance. When a secondary hairpin vortex is formed upstream of the primary vortex, the circulation strength of the head is comparable to the strength of the primary head at the time of regeneration. However, the legs of the primary vortex strengthen up to the moment the secondary hairpin is generated. Although the peak circulation in the legs is not directly correlated to the strength of the original elongated ring vortex, when the circulation is scaled with the injection momentum ratio it is linearly related to scaled injection time. It is proposed that the injection momentum ratio and nondimensionalized injection time based on the wall normal penetration time can be used to identify threshold conditions which produce a secondary vortex. Supported by the National Science Foundation under Grant CBET- 1040236.

  8. Probabilistic Threshold Criterion

    SciTech Connect

    Gresshoff, M; Hrousis, C A

    2010-03-09

    The Probabilistic Shock Threshold Criterion (PSTC) Project at LLNL develops phenomenological criteria for estimating safety or performance margin on high explosive (HE) initiation in the shock initiation regime, creating tools for safety assessment and design of initiation systems and HE trains in general. Until recently, there has been little foundation for probabilistic assessment of HE initiation scenarios. This work attempts to use probabilistic information that is available from both historic and ongoing tests to develop a basis for such assessment. Current PSTC approaches start with the functional form of the James Initiation Criterion as a backbone, and generalize to include varying areas of initiation and provide a probabilistic response based on test data for 1.8 g/cc (Ultrafine) 1,3,5-triamino-2,4,6-trinitrobenzene (TATB) and LX-17 (92.5% TATB, 7.5% Kel-F 800 binder). Application of the PSTC methodology is presented investigating the safety and performance of a flying plate detonator and the margin of an Ultrafine TATB booster initiating LX-17.

  9. Microbial load monitor

    NASA Technical Reports Server (NTRS)

    Caplin, R. S.; Royer, E. R.

    1978-01-01

    Attempts are made to provide a total design of a Microbial Load Monitor (MLM) system flight engineering model. Activities include assembly and testing of Sample Receiving and Card Loading Devices (SRCLDs), operator related software, and testing of biological samples in the MLM. Progress was made in assembling SRCLDs with minimal leaks and which operate reliably in the Sample Loading System. Seven operator commands are used to control various aspects of the MLM such as calibrating and reading the incubating reading head, setting the clock and reading time, and status of Card. Testing of the instrument, both in hardware and biologically, was performed. Hardware testing concentrated on SRCLDs. Biological testing covered 66 clinical and seeded samples. Tentative thresholds were set and media performance listed.

  10. Stiffness threshold of randomly distributed carbon nanotube networks

    NASA Astrophysics Data System (ADS)

    Chen, Yuli; Pan, Fei; Guo, Zaoyang; Liu, Bin; Zhang, Jianyu

    2015-11-01

    For carbon nanotube (CNT) networks, with increasing network density, there may be sudden changes in the properties, such as the sudden change in electrical conductivity at the electrical percolation threshold. In this paper, the change in stiffness of the CNT networks is studied and especially the existence of stiffness threshold is revealed. Two critical network densities are found to divide the stiffness behavior into three stages: zero stiffness, bending dominated and stretching dominated stages. The first critical network density is a criterion to judge whether or not the network is capable of carrying load, defined as the stiffness threshold. The second critical network density is a criterion to measure whether or not most of the CNTs in network are utilized effectively to carry load, defined as bending-stretching transitional threshold. Based on the geometric probability analysis, a theoretical methodology is set up to predict the two thresholds and explain their underlying mechanisms. The stiffness threshold is revealed to be determined by the statical determinacy of CNTs in the network, and can be estimated quantitatively by the stabilization fraction of network, a newly proposed parameter in this paper. The other threshold, bending-stretching transitional threshold, which signs the conversion of dominant deformation mode, is verified to be well evaluated by the proposed defect fraction of network. According to the theoretical analysis as well as the numerical simulation, the average intersection number on each CNT is revealed as the only dominant factor for the electrical percolation and the stiffness thresholds, it is approximately 3.7 for electrical percolation threshold, and 5.2 for the stiffness threshold of 2D networks. For 3D networks, they are 1.4 and 4.4. And it also affects the bending-stretching transitional threshold, together with the CNT aspect ratio. The average intersection number divided by the fourth root of CNT aspect ratio is found to be

  11. Life below the threshold.

    PubMed

    Castro, C

    1991-01-01

    This article explains that malnutrition, poor health, and limited educational opportunities plague Philippine children -- especially female children -- from families living below the poverty threshold. Nearly 70% of households in the Philippines do not meet the required daily level of nutritional intake. Because it is often -- and incorrectly -- assumed that women's nutritional requirements are lower than men's, women suffer higher rates of malnutrition and poor health. A 1987 study revealed that 11.7% of all elementary students were underweight and 13.9% had stunted growths. Among elementary-school girls, 17% were malnourished and 40% suffered from anemia (among lactating mothers, more than 1/2 are anemic). A 1988 Program for Decentralized Educational Development study showed that grade VI students learn only about 1/2 of what they are supposed to learn. 30% of the children enrolled in grade school drop out before they reach their senior year. The Department of Education, Culture and Sports estimates that some 2.56 million students dropped out of school in l989. That same year, some 3.7 million children were counted as part of the labor force. In Manila alone, some 60,000 children work the streets, whether doing odd jobs or begging, or turning to crime or prostitution. the article tells the story of a 12 year-old girl named Ging, a 4th grader at a public school and the oldest child in a poor family of 6 children. The undernourished Ging dreams of a good future for her family and sees education as a way out of poverty; unfortunately, her time after school is spend working in the streets or looking after her family. She considers herself luckier than many of the other children working in the streets, since she at least has a family. PMID:12285009

  12. Fitness Load and Exercise Time in Secondary Physical Education Classes.

    ERIC Educational Resources Information Center

    Li, Xiao Jun; Dunham, Paul, Jr.

    1993-01-01

    Investigates the effect of secondary school physical education on fitness load: the product of the mean heart rate above threshold (144 bpm) and the time duration of heart rate above that threshold. Highly and moderately skilled students achieved fitness load more frequently than their lower skilled colleagues. (GLR)

  13. Threshold Hypothesis: Fact or Artifact?

    ERIC Educational Resources Information Center

    Karwowski, Maciej; Gralewski, Jacek

    2013-01-01

    The threshold hypothesis (TH) assumes the existence of complex relations between creative abilities and intelligence: linear associations below 120 points of IQ and weaker or lack of associations above the threshold. However, diverse results have been obtained over the last six decades--some confirmed the hypothesis and some rejected it. In this…

  14. The Nature of Psychological Thresholds

    ERIC Educational Resources Information Center

    Rouder, Jeffrey N.; Morey, Richard D.

    2009-01-01

    Following G. T. Fechner (1966), thresholds have been conceptualized as the amount of intensity needed to transition between mental states, such as between a states of unconsciousness and consciousness. With the advent of the theory of signal detection, however, discrete-state theory and the corresponding notion of threshold have been discounted.…

  15. Threshold Concepts and Information Literacy

    ERIC Educational Resources Information Center

    Townsend, Lori; Brunetti, Korey; Hofer, Amy R.

    2011-01-01

    What do we teach when we teach information literacy in higher education? This paper describes a pedagogical approach to information literacy that helps instructors focus content around transformative learning thresholds. The threshold concept framework holds promise for librarians because it grounds the instructor in the big ideas and underlying…

  16. Threshold selection for regional peaks-over-threshold data

    NASA Astrophysics Data System (ADS)

    Roth, Martin; Jongbloed, Geurt; Adri Buishand, T.

    2016-04-01

    A hurdle in the peaks-over-threshold approach for analyzing extreme values is the selection of the threshold. A method is developed to reduce this obstacle in the presence of multiple, similar data samples. This is for instance the case in many environmental applications. The idea is to combine threshold selection methods into a regional method. Regionalized versions of the threshold stability and the mean excess plot are presented as graphical tools for threshold selection. Moreover, quantitative approaches based on the bootstrap distribution of the spatially averaged Kolmogorov-Smirnov and Anderson-Darling test statistics are introduced. It is demonstrated that the proposed regional method leads to an increased sensitivity for too low thresholds, compared to methods that do not take into account the regional information. The approach can be used for a wide range of univariate threshold selection methods. We test the methods using simulated data and present an application to rainfall data from the Dutch water board Vallei en Veluwe.

  17. Suspended Load

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The suspended load of rivers and streams consists of the sediments that are kept in the water column by the upward components of the flow velocity. Suspended load may be divided into cohesive and non-cohesive loads which are primarily discriminated by sediment particle size. Non-cohesive sediment ...

  18. Modeling the Interactions Between Multiple Crack Closure Mechanisms at Threshold

    NASA Technical Reports Server (NTRS)

    Newman, John A.; Riddell, William T.; Piascik, Robert S.

    2003-01-01

    A fatigue crack closure model is developed that includes interactions between the three closure mechanisms most likely to occur at threshold; plasticity, roughness, and oxide. This model, herein referred to as the CROP model (for Closure, Roughness, Oxide, and Plasticity), also includes the effects of out-of plane cracking and multi-axial loading. These features make the CROP closure model uniquely suited for, but not limited to, threshold applications. Rough cracks are idealized here as two-dimensional sawtooths, whose geometry induces mixed-mode crack- tip stresses. Continuum mechanics and crack-tip dislocation concepts are combined to relate crack face displacements to crack-tip loads. Geometric criteria are used to determine closure loads from crack-face displacements. Finite element results, used to verify model predictions, provide critical information about the locations where crack closure occurs.

  19. Bayesian estimation of dose thresholds

    NASA Technical Reports Server (NTRS)

    Groer, P. G.; Carnes, B. A.

    2003-01-01

    An example is described of Bayesian estimation of radiation absorbed dose thresholds (subsequently simply referred to as dose thresholds) using a specific parametric model applied to a data set on mice exposed to 60Co gamma rays and fission neutrons. A Weibull based relative risk model with a dose threshold parameter was used to analyse, as an example, lung cancer mortality and determine the posterior density for the threshold dose after single exposures to 60Co gamma rays or fission neutrons from the JANUS reactor at Argonne National Laboratory. The data consisted of survival, censoring times and cause of death information for male B6CF1 unexposed and exposed mice. The 60Co gamma whole-body doses for the two exposed groups were 0.86 and 1.37 Gy. The neutron whole-body doses were 0.19 and 0.38 Gy. Marginal posterior densities for the dose thresholds for neutron and gamma radiation were calculated with numerical integration and found to have quite different shapes. The density of the threshold for 60Co is unimodal with a mode at about 0.50 Gy. The threshold density for fission neutrons declines monotonically from a maximum value at zero with increasing doses. The posterior densities for all other parameters were similar for the two radiation types.

  20. Excess VO2 during ramp exercise is positively correlated to intercostal muscles deoxyhemoglobin levels above the gas exchange threshold in young trained cyclists.

    PubMed

    Oueslati, Ferid; Girard, Olivier; Tabka, Zouhair; Ahmaidi, Said

    2016-07-01

    We assessed respiratory muscles oxygenation responses during a ramp exercise to exhaustion and further explored their relationship with the non-linear increase of VO2 (VO2 excess) observed above the gas-exchange threshold. Ten male cyclists completed a ramp exercise to exhaustion on an electromagnetically braked cycle-ergometer with a rate of increment of 30Wmin(-1) with continuous monitoring of expired gases (breath-by-breath) and oxygenation status of intercostal muscles. Maximal inspiratory and expiratory pressure measurements were taken at rest and at exhaustion. The VO2 excess represents the difference between VO2max observed and VO2max expected using linear equation between the VO2 and the intensity before gas-exchange threshold. The deoxyhemoglobin remained unchanged until 60% of maximal aerobic power (MAP) and thereafter increased significantly by 37±18% and 40±22% at 80% and 100% of MAP, respectively. Additionally, the amplitude of deoxyhemoglobin increase between 60 and 100% of MAP positively correlated with the VO2 excess (r=0.69, p<0.05). Compared to exercise start, the oxygen tissue saturation index decreased from 80% of MAP (-4.8±3.2%, p<0.05) onwards. At exhaustion, maximal inspiratory and expiratory pressures declined by 7.8±16% and 12.6±10% (both p<0.05), respectively. In summary, our results suggest a significant contribution of respiratory muscles to the VO2 excess phenomenon. PMID:26996071

  1. Numerical modeling of steady inspiratory airflow through a three-generation model of the human central airways.

    PubMed

    Wilquem, F; Degrez, G

    1997-02-01

    Two-dimensional steady inspiratory airflow through a three-generation model of the human central airways is numerically investigated, with dimensions corresponding to those encountered in the fifth to seventh generations of the Weibel's model. Wall curvatures are added at the outer walls of the junctions for physiological purposes. Computations are carried out for Reynolds numbers in the mother branch ranging from 200 to 1200, which correspond to mouth air breathing at flow rates ranging from 0.27 to 1.63 liters per second. The difficulty of generating grids in a so complex configuration is overcome using a nonoverlapping multiblock technique. Simulations demonstrate the existence of separation regions whose number, location, and size strongly depend on the Reynolds number. Consequently, four different flow configurations are detected. Velocity profiles downstream of the bifurcations are shown to be highly skewed, thus leading to an important unbalance in the flow distribution between the medial and lateral branches of the model. These results confirm the observations of Snyder et al. and Tsuda et al. and suggest that a resistance model of flow partitioning based on Kirchhoff's laws is inadequate to simulate the flow behavior accurately within the airways. When plotted in a Moody diagram, airway resistance throughout the model is shown to fit with a linear relation of slope -0.61. This is qualitatively in good agreement with the experimental investigations of Pedley et al, and Slutsky et al. PMID:9083850

  2. Estimation of inspiratory pressure drop in neonatal and pediatric endotracheal tubes.

    PubMed

    Jarreau, P H; Louis, B; Dassieu, G; Desfrere, L; Blanchard, P W; Moriette, G; Isabey, D; Harf, A

    1999-07-01

    Endotracheal tubes (ETTs) constitute a resistive extra load for intubated patients. The ETT pressure drop (DeltaP(ETT)) is usually described by empirical equations that are specific to one ETT only. Our laboratory previously showed that, in adult ETTs, DeltaP(ETT) is given by the Blasius formula (F. Lofaso, B. Louis, L. Brochard, A. Harf, and D. Isabey. Am. Rev. Respir. Dis. 146: 974-979, 1992). Here, we also propose a general formulation for neonatal and pediatric ETTs on the basis of adimensional analysis of the pressure-flow relationship. Pressure and flow were directly measured in seven ETTs (internal diameter: 2.5-7.0 mm). The measured pressure drop was compared with the predicted drop given by general laws for a curved tube. In neonatal ETTs (2.5-3.5 mm) the flow regime is laminar. The DeltaP(ETT) can be estimated by the Ito formula, which replaces Poiseuille's law for curved tubes. For pediatric ETTs (4.0-7.0 mm), DeltaP(ETT) depends on the following flow regime: for laminar flow, it must be calculated by the Ito formula, and for turbulent flow, by the Blasius formula. Both formulas allow for ETT geometry and gas properties. PMID:10409556

  3. The influence of crack closure on fatigue crack growth thresholds in 2024-T3 aluminum alloy

    NASA Technical Reports Server (NTRS)

    Phillips, Edward P.

    1988-01-01

    Crack opening loads were determined in load-shedding fatigue crack growth threshold tests on 2024-T3 aluminum alloy at stress ratios R of -2, -1, 0, 0.33, 0.5, and 0.7. The effects of load-shedding procedure and rate were investigated. Values of threshold Delta-K were found to vary significantly with R, whereas values of threshold effective Delta-K did not. That is, the variation of threshold Delta-K with R was almost completely explained by accounting for the measured variation in crack opening load behavior with R. The load-shedding guidelines of ASTM Test Method for Measurement of Fatigue Crack Growth (E 647) produced a threshold Delta-K value for R = 0.7 that was in agreement with the value determined using a procedure that should minimize closure effects. At both R = 0 and R = 0.7, high load-shedding rates produced high values of threshold Delta-K caused by large closure effects.

  4. Threshold models in radiation carcinogenesis

    SciTech Connect

    Hoel, D.G.; Li, P.

    1998-09-01

    Cancer incidence and mortality data from the atomic bomb survivors cohort has been analyzed to allow for the possibility of a threshold dose response. The same dose-response models as used in the original papers were fit to the data. The estimated cancer incidence from the fitted models over-predicted the observed cancer incidence in the lowest exposure group. This is consistent with a threshold or nonlinear dose-response at low-doses. Thresholds were added to the dose-response models and the range of possible thresholds is shown for both solid tumor cancers as well as the different leukemia types. This analysis suggests that the A-bomb cancer incidence data agree more with a threshold or nonlinear dose-response model than a purely linear model although the linear model is statistically equivalent. This observation is not found with the mortality data. For both the incidence data and the mortality data the addition of a threshold term significantly improves the fit to the linear or linear-quadratic dose response for both total leukemias and also for the leukemia subtypes of ALL, AML, and CML.

  5. Toward a new methodology for measuring the threshold Shields number

    NASA Astrophysics Data System (ADS)

    Rousseau, Gauthier; Dhont, Blaise; Ancey, Christophe

    2016-04-01

    A number of bedload transport equations involve the threshold Shields number (corresponding to the threshold of incipient motion for particles resting on the streambed). Different methods have been developed for determining this threshold Shields number; they usually assume that the initial streambed is plane prior to sediment transport. Yet, there are many instances in real-world scenarios, in which the initial streambed is not free of bed forms. We are interested in developing a new methodology for determining the threshold of incipient motion in gravel-bed streams in which smooth bed forms (e.g., anti-dunes) develop. Experiments were conducted in a 10-cm wide, 2.5-m long flume, whose initial inclination was 3%. Flows were supercritical and fully turbulent. The flume was supplied with water and sediment at fixed rates. As bed forms developed and migrated, and sediment transport rates exhibited wide fluctuations, measurements had to be taken over long times (typically 10 hr). Using a high-speed camera, we recorded the instantaneous bed load transport rate at the outlet of the flume by taking top-view images. In parallel, we measured the evolution of the bed slope, water depth, and shear stress by filming through a lateral window of the flume. These measurements allowed for the estimation of the space and time-averaged slope, from which we deduced the space and time-averaged Shields number under incipient bed load transport conditions. In our experiments, the threshold Shields number was strongly dependent on streambed morphology. Experiments are under way to determine whether taking the space and time average of incipient motion experiments leads to a more robust definition of the threshold Shields number. If so, this new methodology will perform better than existing approaches at measuring the threshold Shields number.

  6. Guidelines for Auditory Threshold Measurement for Significant Threshold Shift.

    PubMed

    Campbell, Kathleen; Hammill, Tanisha; Hoffer, Michael; Kil, Jonathan; Le Prell, Colleen

    2016-09-01

    The purpose of this article is to provide guidelines for determining a Significant Noise-Induced Threshold Shift in clinical trials involving human populations. The article reviews recommendations for the standards to be referenced for human subjects, equipment, test environment, and personnel. Additional guidelines for military populations are provided. Guidelines for the calibration of audiometers, sound booth noise levels, and immitance equipment are provided. In addition the guidance provides specific suggestions for the subjects history before study onset, and otoscopy.Test frequencies for threshold determination and methods of threshold determination are reviewed for both air conduction and bone conduction for both baseline testing and later determination of either a temporary (TTS) or permanent threshold shift (PTS). Once a Significant Noise-Induced Threshold Shift has been determined, subjects should be retested, conductive component should be ruled out or addressed, and the subject should be counseled or referred for additional medical evaluation. Guidance for reporting procedures and the computerized study database are described. Finally, experimental designs suggested for noise-induced otoprotection clinical trials are described. PMID:27518134

  7. Damage thresholds for terahertz radiation

    NASA Astrophysics Data System (ADS)

    Dalzell, Danielle R.; McQuade, Jill; Vincelette, Rebecca; Ibey, Bennet; Payne, Jason; Thomas, Robert; Roach, W. P.; Roth, Caleb L.; Wilmink, Gerald J.

    2010-02-01

    Several international organizations establish minimum safety standards to ensure that workers and the general population are protected against adverse health effects associated with electromagnetic radiation. Suitable standards are typically defined using published experimental data. To date, few experimental studies have been conducted at Terahertz (THz) frequencies, and as a result, current THz standards have been defined using extrapolated estimates from neighboring spectral regions. In this study, we used computational modeling and experimental approaches to determine tissue-damage thresholds at THz frequencies. For the computational modeling efforts, we used the Arrhenius damage integral to predict damage-thresholds. We determined thresholds experimentally for both long (minutes) and short (seconds) THz exposures. For the long exposure studies, we used an in-house molecular gas THz laser (υ= 1.89 THz, 189.92 mW/cm2, 10 minutes) and excised porcine skin. For the short exposure studies, we used the Free Electron Laser (FEL) at Jefferson Laboratory (υ= 0.1-1.0 THz, 2.0-14.0 mW/cm2, 2 seconds) and wet chamois cloths. Thresholds were determined using conventional damage score determination and probit analysis techniques, and tissue temperatures were measured using infrared thermographic techniques. We found that the FEL was ideal for tissue damage studies, while our in-house THz source was not suitable to determine tissue damage thresholds. Using experimental data, the tissue damage threshold (ED50) was determined to be 7.16 W/cm2. This value was in well agreement with that predicted using our computational models. We hope that knowledge of tissue-damage thresholds at THz frequencies helps to ensure the safe use of THz radiation.

  8. Physiological and performance consequences of heavy thoracic load carriage in females.

    PubMed

    Phillips, Devin B; Stickland, Michael K; Petersen, Stewart R

    2016-07-01

    The purposes of this experiment were to study physiological responses to graded exercise to exhaustion (Part I) and ventilatory responses during 45 min of exercise (Part II) with and without a 25-kg backpack. In Part I, on separate days, 24 females completed randomly ordered modified Balke treadmill tests. Analysis revealed significant decreases in absolute peak oxygen uptake (3.5%), peak power output (20%), and test duration (40%) under load. There was a significant but modest negative relationship between body mass and the change in test duration between conditions (r = -0.44). While physiological responses to peak exercise were similar, exercise performance was negatively impacted under load. On separate days in Part II, 14 females completed randomly ordered, loaded and unloaded exercise challenges of submaximal treadmill walking at matched oxygen demands. Under load, breathing frequency, dead space, and minute ventilation were increased by 19.9%, 29.8%, and 11.6% (P < 0.05), respectively, while tidal volume and end-inspiratory lung volume decreased by 13.6% and 6.0% (P < 0.05), respectively. After loaded exercise, maximal inspiratory pressure was decreased by 11.5% (P < 0.05) with no changes in maximal expiratory pressure in either condition. Despite matched oxygen uptake between loaded and unloaded exercise challenges, perceived exertion and breathing discomfort were higher (P < 0.05) under load. With heavy load carriage, the altered breathing pattern led to increased dead space and minute ventilation, which likely contributed to higher perceptions of exercise stress and breathing discomfort. These results are similar to previous research in males and underscore the impact of heavy load carriage during exercise. PMID:27337671

  9. Neutrino floor at ultralow threshold

    NASA Astrophysics Data System (ADS)

    Strigari, Louis E.

    2016-05-01

    By lowering their energy threshold, direct dark matter searches can reach the neutrino floor with experimental technology that is now in development. The 7Be flux can be detected with ˜10 eV nuclear recoil energy threshold and 50 kg/yr exposure. The p e p flux can be detected with ˜3 ton/yr exposure, and the first detection of the CNO flux is possible with similar exposure. The p p flux can be detected with threshold of ˜eV and only ˜ kg /yr exposure. These can be the first pure neutral current measurements of the low-energy solar neutrino flux. Measuring this flux is important for low mass dark matter searches and for understanding the solar interior.

  10. Fatigue Crack Growth Threshold Testing of Metallic Rotorcraft Materials

    NASA Technical Reports Server (NTRS)

    Newman, John A.; James, Mark A.; Johnson, William M.; Le, Dy D.

    2008-01-01

    Results are presented for a program to determine the near-threshold fatigue crack growth behavior appropriate for metallic rotorcraft alloys. Four alloys, all commonly used in the manufacture of rotorcraft, were selected for study: Aluminum alloy 7050, 4340 steel, AZ91E Magnesium, and Titanium alloy Ti-6Al-4V (beta-STOA). The Federal Aviation Administration (FAA) sponsored this research to advance efforts to incorporate damage tolerance design and analysis as requirements for rotorcraft certification. Rotorcraft components are subjected to high cycle fatigue and are typically subjected to higher stresses and more stress cycles per flight hour than fixed-wing aircraft components. Fatigue lives of rotorcraft components are generally spent initiating small fatigue cracks that propagate slowly under near-threshold cracktip loading conditions. For these components, the fatigue life is very sensitive to the near-threshold characteristics of the material.

  11. Explosive percolation in thresholded networks

    NASA Astrophysics Data System (ADS)

    Hayasaka, Satoru

    2016-06-01

    Explosive percolation in a network is a phase transition where a large portion of nodes becomes connected with an addition of a small number of edges. Although extensively studied in random network models and reconstructed real networks, explosive percolation has not been observed in a more realistic scenario where a network is generated by thresholding a similarity matrix describing between-node associations. In this report, I examine construction schemes of such thresholded networks, and demonstrate that explosive percolation can be observed by introducing edges in a particular order.

  12. Surface characterizations of color threshold

    NASA Technical Reports Server (NTRS)

    Poirson, Allen B.; Wandell, Brian A.; Varner, Denise C.; Brainard, David H.

    1990-01-01

    The paper evaluates how well three different parametric shapes, ellipsoids, rectangles, and parallelograms, serve as models of three-dimentional detection contours. The constraints of the procedures for deriving the best-fitting shapes on inferences about the theoretical visual detection mechanisms are described. Results of two statistical tests show that only the parallelogram fits the data with more precision than the variance in repeated threshold measurements, and thus provides a slightly better fit than the other two shapes. Nevertheless it does not serve as a better guide than the ellipsoidal model for interpolating from the measurements to thresholds in novel color directions.

  13. Thresholds in chemical respiratory sensitisation.

    PubMed

    Cochrane, Stella A; Arts, Josje H E; Ehnes, Colin; Hindle, Stuart; Hollnagel, Heli M; Poole, Alan; Suto, Hidenori; Kimber, Ian

    2015-07-01

    There is a continuing interest in determining whether it is possible to identify thresholds for chemical allergy. Here allergic sensitisation of the respiratory tract by chemicals is considered in this context. This is an important occupational health problem, being associated with rhinitis and asthma, and in addition provides toxicologists and risk assessors with a number of challenges. In common with all forms of allergic disease chemical respiratory allergy develops in two phases. In the first (induction) phase exposure to a chemical allergen (by an appropriate route of exposure) causes immunological priming and sensitisation of the respiratory tract. The second (elicitation) phase is triggered if a sensitised subject is exposed subsequently to the same chemical allergen via inhalation. A secondary immune response will be provoked in the respiratory tract resulting in inflammation and the signs and symptoms of a respiratory hypersensitivity reaction. In this article attention has focused on the identification of threshold values during the acquisition of sensitisation. Current mechanistic understanding of allergy is such that it can be assumed that the development of sensitisation (and also the elicitation of an allergic reaction) is a threshold phenomenon; there will be levels of exposure below which sensitisation will not be acquired. That is, all immune responses, including allergic sensitisation, have threshold requirement for the availability of antigen/allergen, below which a response will fail to develop. The issue addressed here is whether there are methods available or clinical/epidemiological data that permit the identification of such thresholds. This document reviews briefly relevant human studies of occupational asthma, and experimental models that have been developed (or are being developed) for the identification and characterisation of chemical respiratory allergens. The main conclusion drawn is that although there is evidence that the

  14. Evaluation of an Impedance Threshold Device as a VIIP Countermeasure

    NASA Technical Reports Server (NTRS)

    Ebert, D.; Macias, B.; Garcia, K.; Stenger, M.; Hargens, A.; Johnston, S.

    2016-01-01

    Visual Impairment /Intracranial Pressure (VIIP) is a top human spaceflight risk for which NASA does not currently have a proven mitigation strategy. Thigh cuffs (Braslets) and lower body negative pressure (LBNP; Chibis) devices have been or are currently being evaluated as a means to reduce VIIP signs and symptoms, but these methods alone may not provide sufficient relief of cephalic venous congestion and VIIP symptoms. Additionally, current LBNP devices are too large and cumbersome for their systematic use as a countermeasure. Therefore, a novel approach is needed that is easy to implement and provides specific relief of symptoms. This investigation will evaluate an impedance threshold device (ITD) as a VIIP countermeasure. The ITD works by providing up to 7 cm H2O (approximately 5 mmHg) resistance to inspiratory air flow, effectively turning the thorax into a vacuum pump upon each inhalation which lowers the intrathoracic pressure (ITP) and facilitates venous return to the heart. The ITD is FDA-approved and was developed to augment venous return to the central circulation and increase cardiac output during cardiopulmonary resuscitation (CPR) and in patients with hypotension. While the effect of ITD on CPR survival outcomes is controversial, the ITD's ability to lower ITP with a concomitant decrease in intracranial pressure (ICP) is well documented. A similar concept that creates negative ITP during exhalation (intrathoracic pressure regulator; ITPR) decreased ICP in 16 of 20 patients with elevated ICP in a hospital pilot study. ITP and central venous pressure (CVP) have been shown to decrease in microgravity however ITP drops more than CVP, indicating an increased transmural CVP. This could explain the paradoxical distention of jugular veins (JV) in microgravity despite lower absolute CVP and also suggests that JV transmural pressure is not dramatically elevated. Use of an ITD may lower JV pressure enough to remove or relieve cephalic venous congestion. During

  15. Evaluation of an Impedance Threshold Device as a VIIP Countermeasure

    NASA Technical Reports Server (NTRS)

    Ebert, Douglas; Macias, Brandon; Sargsyan, Ashot; Garcia, Kathleen; Stenger, Michael; Hargens, Alan; Johnston, Smith; Kemp, David; Danielson, Richard

    2016-01-01

    Visual Impairment/Intracranial Pressure (VIIP) is a top human spaceflight risk for which NASA does not currently have a proven mitigation strategy. Thigh cuffs (Braslets) and lower body negative pressure (LBNP; Chibis) devices have been or are currently being evaluated as a means to reduce VIIP signs and symptoms, but these methods alone may not provide sufficient relief of cephalic venous congestion and VIIP symptoms. Additionally, current LBNP devices are too large and cumbersome for their systematic use as a countermeasure. Therefore, a novel approach is needed that is easy to implement and provides specific relief of symptoms. This investigation will evaluate an impedance threshold device (ITD) as a VIIP countermeasure. The ITD works by providing up to 7 cm H2O (approximately 5 mmHg) resistance to inspiratory air flow, effectively turning the thorax into a vacuum pump upon each inhalation which lowers the intrathoracic pressure (ITP) and facilitates venous return to the heart. The ITD is FDA-approved and was developed to augment venous return to the central circulation and increase cardiac output during cardiopulmonary resuscitation (CPR) and in patients with hypotension. While the effect of ITD on CPR survival outcomes is controversial, the ITD's ability to lower ITP with a concomitant decrease in intracranial pressure (ICP) is well documented. A similar concept that creates negative ITP during exhalation (intrathoracic pressure regulator; ITPR) decreased ICP in 16 of 20 patients with elevated ICP in a hospital pilot study. ITP and central venous pressure (CVP) have been shown to decrease in microgravity however ITP drops more than CVP, indicating an increased transmural CVP. This could explain the paradoxical distention of jugular veins (JV) in microgravity despite lower absolute CVP and also suggests that JV transmural pressure is not dramatically elevated. Use of an ITD may lower JV pressure enough to remove or relieve cephalic venous congestion. During

  16. Estimating Conservation Thresholds on Rangelands

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Conservation Effects Assessment Project (CEAP) is a multi-agency effort designed to quantify the environmental and economic impacts of land conservation practices. One of USDA’s goals is to identify Conservation Thresholds, the point at which accelerated erosion occurs, and to examine the usefu...

  17. Threshold Concepts and Pedagogic Representation

    ERIC Educational Resources Information Center

    Meyer, Jan H. F.

    2016-01-01

    Purpose: The purpose of this paper is to present a brief exposure to the development of the threshold concepts framework (TCF), the intention being to illuminate for interested readers a broader landscape of research activity than that perhaps conveyed by the individual contributions to this special edition. Design/Methodology/Approach: There is…

  18. New states above charm threshold

    SciTech Connect

    Eichten, Estia J.; Lane, Kenneth; Quigg, Chris; /Fermilab

    2005-11-01

    We revise and extend expectations for the properties of charmonium states that lie above charm threshold, in light of new experimental information. We refine the Cornell coupled-channel model for the coupling of c{bar c} levels to two-meson states, defining resonance masses and widths by pole positions in the complex energy plane, and suggest new targets for experiment.

  19. Crossing Thresholds in Academic Reading

    ERIC Educational Resources Information Center

    Abbott, Rob

    2013-01-01

    This paper looks at the conceptual thresholds in relation to academic reading which might be crossed by undergraduate English Literature students. It is part of a wider study following 16 students through three years of undergraduate study. It uses theoretical ideas from Bakhtin and Foucault to analyse interviews with English lecturers. It…

  20. Methylxanthines do not affect rhythmogenic preBötC inspiratory network activity but impair bursting of preBötC-driven motoneurons.

    PubMed

    Panaitescu, B; Kuribayashi, J; Ruangkittisakul, A; Leung, V; Iizuka, M; Ballanyi, K

    2013-01-01

    Clinical stimulation of preterm infant breathing with methylxanthines like caffeine and theophylline can evoke seizures. It is unknown whether underlying neuronal hyperexcitability involves the rhythmogenic inspiratory active pre-Bötzinger complex (preBötC) in the brainstem or preBötC-driven motor networks. Inspiratory-related preBötC interneuronal plus spinal (cervical/phrenic) or cranial hypoglossal (XII) motoneuronal bursting was studied in newborn rat en bloc brainstem-spinal cords and brainstem slices, respectively. Non-respiratory bursting perturbed inspiratory cervical nerve activity in en bloc models at >0.25mM theophylline or caffeine. Rhythm in the exposed preBötC of transected en bloc preparations was less perturbed by 10mM theophylline than cervical root bursting which was more affected than phrenic nerve activity. In the preBötC of slices, even 10mM methylxanthine did not evoke seizure-like bursting whereas >1mM masked XII rhythm via large amplitude 1-10Hz oscillations. Blocking A-type γ-aminobutyric (GABAA) receptors evoked seizure-like cervical activity whereas in slices neither XII nor preBötC rhythm was disrupted. Methylxanthines (2.5-10mM), but not blockade of adenosine receptors, phosphodiesterase-4 or the sarcoplasmatic/endoplasmatic reticulum ATPase countered inspiratory depression by muscimol-evoked GABAA receptor activation that was associated with a hyperpolarization and input resistance decrease silencing preBötC neurons in slices. The latter blockers did neither affect preBötC or cranial/spinal motor network bursting nor evoke seizure-like activity or mask corresponding methylxanthine-evoked discharges. Our findings show that methylxanthine-evoked hyperexcitability originates from motor networks, leaving preBötC activity largely unaffected, and suggest that GABAA receptors contribute to methylxanthine-evoked seizure-like perturbation of spinal motoneurons whereas non-respiratory XII motoneuron oscillations are of different

  1. Crane-Load Contact Sensor

    NASA Technical Reports Server (NTRS)

    Youngquist, Robert; Mata, Carlos; Cox, Robert

    2005-01-01

    impedance between the pins and the load. The instrument includes a signal generator and voltage-measuring circuitry, and is connected to the load and the base as shown in Figure 2. The output of the signal generator (typically having amplitude of the order of a volt) is applied to the load via a 50-resistor, and the voltage between the load and the pins is measured. When the load and the pins are not in contact, the impedance between them is relatively high, causing the measured voltage to exceed a threshold value. When the load and the pins are in contact, the impedance between them falls to a much lower value, causing the voltage to fall below the threshold value. The voltage-measuring circuitry turns on a red light-emitting diode (LED) to indicate the lower-voltage/ contact condition. Whenever the contact has been broken and the non-contact/higher-voltage condition has lasted for more than 2 ms, the voltage-measuring circuitry indicates this condition by blinking a green LED.

  2. Load controller and method to enhance effective capacity of a photovoltaic power supply using a dynamically determined expected peak loading

    DOEpatents

    Perez, Richard

    2005-05-03

    A load controller and method are provided for maximizing effective capacity of a non-controllable, renewable power supply coupled to a variable electrical load also coupled to a conventional power grid. Effective capacity is enhanced by monitoring power output of the renewable supply and loading, and comparing the loading against the power output and a load adjustment threshold determined from an expected peak loading. A value for a load adjustment parameter is calculated by subtracting the renewable supply output and the load adjustment parameter from the current load. This value is then employed to control the variable load in an amount proportional to the value of the load control parameter when the parameter is within a predefined range. By so controlling the load, the effective capacity of the non-controllable, renewable power supply is increased without any attempt at operational feedback control of the renewable supply.

  3. Respiratory signal derived from the smartphone built-in accelerometer during a Respiratory Load Protocol.

    PubMed

    Estrada, Luis; Torres, Abel; Sarlabous, Leonardo; Jané, Raimon

    2015-08-01

    The scope of our work focuses on investigating the potential use of the built-in accelerometer of the smartphones for the recording of the respiratory activity and deriving the respiratory rate. Five healthy subjects performed an inspiratory load protocol. The excursion of the right chest was recorded using the built-in triaxial accelerometer of a smartphone along the x, y and z axes and with an external uniaxial accelerometer. Simultaneously, the respiratory airflow and the inspiratory mouth pressure were recorded, as reference respiratory signals. The chest acceleration signal recorded in the z axis with the smartphone was denoised using a scheme based on the ensemble empirical mode decomposition, a noise data assisted method which decomposes nonstationary and nonlinear signals into intrinsic mode functions. To distinguish noisy oscillatory modes from the relevant modes we use the detrended fluctuation analysis. We reported a very strong correlation between the acceleration of the z axis of the smartphone and the reference accelerometer across the inspiratory load protocol (from 0.80 to 0.97). Furthermore, the evaluation of the respiratory rate showed a very strong correlation (0.98). A good agreement was observed between the respiratory rate estimated with the chest acceleration signal from the z axis of the smartphone and with the respiratory airflow signal: Bland-Altman limits of agreement between -1.44 and 1.46 breaths per minute with a mean bias of -0.01 breaths per minute. This preliminary study provides a valuable insight into the use of the smartphone and its built-in accelerometer for respiratory monitoring. PMID:26737847

  4. A threshold for dissipative fission

    SciTech Connect

    Thoennessen, M.; Bertsch, G.F.

    1993-09-21

    The empirical domain of validity of statistical theory is examined as applied to fission data on pre-fission data on pre-fission neutron, charged particle, and {gamma}-ray multiplicities. Systematics are found of the threshold excitation energy for the appearance of nonstatistical fission. From the data on systems with not too high fissility, the relevant phenomenological parameter is the ratio of the threshold temperature T{sub thresh} to the (temperature-dependent) fission barrier height E{sub Bar}(T). The statistical model reproduces the data for T{sub thresh}/E{sub Bar}(T) < 0.26 {plus_minus} 0.05, but underpredicts the multiplicities at higher T{sub thresh}/E{sub Bar}(T) independent of mass and fissility of the systems.

  5. Hadronic resonances enhanced by thresholds

    NASA Astrophysics Data System (ADS)

    Caramés, T. F.; Valcarce, A.

    2016-07-01

    We present a neat example of a meson-baryon system where the vicinity of two different thresholds enhances the binding of a hadronic resonance, a pentaquark. As a consequence the pattern of states may change when moving among different flavor sectors, what poses a warning on naive extrapolations to heavy flavor sectors based on systematic expansions. For this purpose we simultaneously analyze the N D bar and NB two-hadron systems looking for possible bound states or resonances. When a resonance is controlled by a coupled-channel effect, going to a different flavor sector may enhance or diminish the binding. This effect may, for example, generate significant differences between the charmonium and bottomonium spectra above open-flavor thresholds or pentaquark states in the open-charm and open-bottom sectors.

  6. Low Threshold Quantum Dot Lasers.

    PubMed

    Iyer, Veena Hariharan; Mahadevu, Rekha; Pandey, Anshu

    2016-04-01

    Semiconductor quantum dots have replaced conventional inorganic phosphors in numerous applications. Despite their overall successes as emitters, their impact as laser materials has been severely limited. Eliciting stimulated emission from quantum dots requires excitation by intense short pulses of light typically generated using other lasers. In this Letter, we develop a new class of quantum dots that exhibit gain under conditions of extremely low levels of continuous wave illumination. We observe thresholds as low as 74 mW/cm(2) in lasers made from these materials. Due to their strong optical absorption as well as low lasing threshold, these materials could possibly convert light from diffuse, polychromatic sources into a laser beam. PMID:26978011

  7. LOADING DEVICE

    DOEpatents

    Ohlinger, L.A.

    1958-10-01

    A device is presented for loading or charging bodies of fissionable material into a reactor. This device consists of a car, mounted on tracks, into which the fissionable materials may be placed at a remote area, transported to the reactor, and inserted without danger to the operating personnel. The car has mounted on it a heavily shielded magazine for holding a number of the radioactive bodies. The magazine is of a U-shaped configuration and is inclined to the horizontal plane, with a cap covering the elevated open end, and a remotely operated plunger at the lower, closed end. After the fissionable bodies are loaded in the magazine and transported to the reactor, the plunger inserts the body at the lower end of the magazine into the reactor, then is withdrawn, thereby allowing gravity to roll the remaining bodies into position for successive loading in a similar manner.

  8. Roots at the Percolation Threshold

    NASA Astrophysics Data System (ADS)

    Kroener, E.; Ahmed, M. A.; Kaestner, A.; Vontobel, P.; Zarebanadkouki, M.; Carminati, A.

    2014-12-01

    Much of the carbon assimilated by plants during photosynthesis is lost to the soil via rhizodepositions. One component of rhizopdeposition is mucilage, a hydrogel that dramatically alters the soil physical properties. Mucilage was assumed to explain unexpectedly low rhizosphere rewetting rates during irrigation (Carminati et al. 2010) and temporarily water repellency in the rhizosphere after severe drying (Moradi et al. 2012).Here, we present an experimental and theoretical study for the rewetting behaviour of a soil mixed with mucilage, which was used as an analogue of the rhizosphere. Our samples were made of two layers of untreated soils separated by a thin layer (ca. 1 mm) of soil treated with mucilage. We prepared soil columns of varying particle size, mucilage concentration and height of the middle layer above the water table. The dry soil columns were re-wetted by capillary rise from the bottom.The rewetting of the middle layer showed a distinct dual behavior. For mucilage concentrations lower than a certain threshold, water could cross the thin layer almost immediately after rewetting of bulk soil. At slightly higher mucilage concentrations, the thin layer was almost impermeable. The mucilage concentration at the threshold strongly depended on particle size: the smaller the particle size the larger the soil specific surface and the more mucilage was needed to cover the entire particle surface and to induce water repellency.We applied a classic pore network model to simulate the experimental observations. In the model a certain fraction of nodes were randomly disconnected to reproduce the effect of mucilage in temporarily blocking the flow. The percolation model could qualitatively reproduce well the threshold characteristics of the experiments. Our experiments, together with former observations of water dynamics in the rhizosphere, suggest that the rhizosphere is near the percolation threshold, where small variations in mucilage concentration sensitively

  9. Carbohydrate Loading.

    ERIC Educational Resources Information Center

    Csernus, Marilyn

    Carbohydrate loading is a frequently used technique to improve performance by altering an athlete's diet. The objective is to increase glycogen stored in muscles for use in prolonged strenuous exercise. For two to three days, the athlete consumes a diet that is low in carbohydrates and high in fat and protein while continuing to exercise and…

  10. Program For Thresholding In Digital Images

    NASA Technical Reports Server (NTRS)

    Nolf, Scott R.; Avis, Elizabeth L.; Matthews, Christine G.; Stacy, Kathryn

    1994-01-01

    THRTOOL program applies thresholding techniques to Sun rasterfiles. Provides for choice among four methods of thresholding. Written in C language and implemented on Sun series and Silicon Graphics IRIS machines.