Amyotrophic lateral sclerosis (ALS) is a type of neurodegenerative disease involving upper and lower motor neuron loss. ALS patients usually die of respiratory failure due to breathing muscle weakness from motor neuron death. It is important to better understand how breathing changes in ALS to design effective treatments to target breathing insufficiency. Breathing capacity is preserved until late stages of disease in the SOD1G93A rodent model of ALS. Possible mechanisms preserving breathing in ALS rats include: 1) spinal synaptic plasticity; 2) neuromuscular junction plasticity; and 3) transition in balance from more affected muscles (eg. diaphragm) to less affected accessory respiratory muscles. If these mechanisms also exist in humans with ALS, we predict that characteristic patterns of altered respiratory muscle activity would precede ventilatory failure, assessed via traditional pulmonary function tests. Thus, using surface EMGs (sEMG) in ALS patients, we tested the hypothesis that ALS patients exhibit differential recruitment patterns of inspiratory muscle activity during a maximal inspiratory pressure (MIP) test versus healthy age‐ and sex‐ matched controls. EMG electrodes (Bagnoli surface electrode, Delsys, Massachusetts, USA) were bilaterally placed on the diaphragm, 2nd parasternal, scalene and sternocleidomastoid muscles. Subjects (8 patients and 8 controls) were instructed to perform the MIP test. The test was repeated until 3 measurements were obtained within 10% variability. RMS EMG amplitude of MIP testing was calculated using a 100ms sliding window with MATLAB v.9.2., and relationships between MIP and EMG activity were evaluated using a linear regression. A moderate relationship (r=0.65) was seen between parasternal muscle activity and MIP in ALS patients, while the controls showed moderate correlations between neck muscle activity (sternocleidomastoid and scalene) and MIP (rSCM= 0.56 and rscalene=0.69). Moreover, MIP‐generated parasternal (r=0.76) and diaphragm (r=0.7) activity corresponded strongly with disease severity of patients, as measured by the ALS‐FRS scale. Interestingly, we did not see a clear relationship between diaphragm surface EMG activity and MIP in either patients or controls. Several factors could account for this, including the use of surface electrodes and the mass‐effort nature of the MIP test. Further analyses are underway to assess respiratory muscle activity during other inspiratory challenges and compare the amount of sEMG output distribution between controls and ALS patients. These preliminary results support the idea that ALS patients use a different pattern of muscle activity during maximal breathing effort from controls. Support or Funding Information Supported by: UF Clinical and Translational Science Institute (supported byNIH UL1TR001427), UF “Moonshot” grant initiative, and UF McKnight Brain Institute
IntroductionPompe disease is an inherited disease characterized by a deficit in acid-α-glucosidase (GAA), an enzyme which degrades lysosomal glycogen. The phrenic-diaphragm motor system is affected preferentially, and respiratory failure often occurs despite GAA enzyme replacement therapy. We hypothesized that the continued use of diaphragm pacing (DP) might improve ventilator-dependent subjects' respiratory outcomes and increase ventilator-free time tolerance.MethodsSix patients (3 pediatric) underwent clinical DP implantation and started diaphragm conditioning, which involved progressively longer periods of daily, low intensity stimulation. Longitudinal respiratory breathing pattern, diaphragm electromyography, and pulmonary function tests were completed when possible, to assess feasibility of use, as well as diaphragm and ventilatory responses to conditioning.ResultsAll subjects were eventually able to undergo full-time conditioning via DP and increase their maximal tolerated time off-ventilator, when compared to pre-implant function. Over time, 3 of 6 subjects also demonstrated increased or stable minute ventilation throughout the day, without positive-pressure ventilation assistance.DiscussionRespiratory insufficiency is one of the main causes of death in patients with Pompe disease. Our results indicate that DP in Pompe disease was feasible, led to few adverse events and stabilized breathing for up to 7 years.
The current method for rework inspection of previously defective surface areas on aircraft landing gear components involves manual inspection. Measuring tools such as micrometers and gauges are utilized to obtain positions and dimensions of reworks. This information is required for determining whether re-entry of the component into service is possible. Overall, the manual process is time-consuming, highly dependent on the skill and experience of the inspector, and prone to errors. This paper presents a novel approach to inspect reworks on aircraft landing gear components using a robotic inspection system based on white light interferometry (WLI). The proposed method is aimed at improving accuracy, repeatability as well as efficiency of rework inspection. The robotic system handles the WLI and positions it over the component, allowing for detailed 3D measurements of the surface and reworked area. Considering the typical measuring spot size of a WLI, the overall positioning accuracy of industrial robots is crucial. Measures to address this problem as well as general limitations and the potential of the system for the use case are discussed. An exemplary rework inspection validates the applicability and demonstrates the potential of this approach. Future research and optimizations are discussed which could lead to more widespread adoption of this technology and further advancements in the maintenance of aircraft landing gears.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.