2,155 research outputs found

    The Spiritual Care of the Seriously Ill

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    Surface mechanomyography and electromyography provide non-invasive indices of inspiratory muscle force and activation in healthy subjects

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    The current gold standard assessment of human inspiratory muscle function involves using invasive measures of transdiaphragmatic pressure (Pdi) or crural diaphragm electromyography (oesEMGdi). Mechanomyography is a non-invasive measure of muscle vibration associated with muscle contraction. Surface electromyogram and mechanomyogram, recorded transcutaneously using sensors placed over the lower intercostal spaces (sEMGlic and sMMGlic respectively), have been proposed to provide non-invasive indices of inspiratory muscle activation, but have not been directly compared to gold standard Pdi and oesEMGdi measures during voluntary respiratory manoeuvres. To validate the non-invasive techniques, the relationships between Pdi and sMMGlic, and between oesEMGdi and sEMGlic were measured simultaneously in 12 healthy subjects during an incremental inspiratory threshold loading protocol. Myographic signals were analysed using fixed sample entropy (fSampEn), which is less influenced by cardiac artefacts than conventional root mean square. Strong correlations were observed between: mean Pdi and mean fSampEn |sMMGlic| (left, 0.76; right, 0.81), the time-integrals of the Pdi and fSampEn |sMMGlic| (left, 0.78; right, 0.83), and mean fSampEn oesEMGdi and mean fSampEn sEMGlic (left, 0.84; right, 0.83). These findings suggest that sMMGlic and sEMGlic could provide useful non-invasive alternatives to Pdi and oesEMGdi for the assessment of inspiratory muscle function in health and disease.Peer ReviewedPostprint (published version

    An Energetic AGN Outburst Powered by a Rapidly Spinning Supermassive Black Hole or an Accreting Ultramassive Black Hole

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    Powering the 10^62 erg nuclear outburst in the MS0735.6+7421 cluster central galaxy by accretion implies that its supermassive black hole (SMBH) grew by ~6x10^8 solar masses over the past 100 Myr. We place upper limits on the amount of cold gas and star formation near the nucleus of <10^9 solar masses and <2 solar masses per year, respectively. These limits imply that an implausibly large fraction of the preexisting cold gas in the bulge must have been consumed by its SMBH at the rate of ~3-5 solar masses per year while leaving no trace of star formation. Such a high accretion rate would be difficult to maintain by stellar accretion or the Bondi mechanism, unless the black hole mass approaches 10^11 solar masses. Its feeble nuclear luminosities in the UV, I, and X-ray bands compared to its enormous mechanical power are inconsistent with rapid accretion onto a ~5x10^9 solar mass black hole. We suggest instead that the AGN outburst is powered by a rapidly-spinning black hole. A maximally-spinning, 10^9 solar mass black hole contains enough rotational energy, ~10^62 erg, to quench a cooling flow over its lifetime and to contribute significantly to the excess entropy found in the hot atmospheres of groups and clusters. Two modes of AGN feedback may be quenching star formation in elliptical galaxies centered in cooling halos at late times. An accretion mode that operates in gas-rich systems, and a spin mode operating at modest accretion rates. The spin conjecture may be avoided in MS0735 by appealing to Bondi accretion onto a central black hole whose mass greatly exceeds 10^10 solar mass. The host galaxy's unusually large, 3.8 kpc stellar core radius (light deficit) may witness the presence of an ultramassive black hole.Comment: Accepted for publication in ApJ. Modifications: adopted slightly higher black hole mass using Lauer's M_SMBH vs L_bulge relation and adjusted related quantities; considered more seriously the consequences of a ultramassive black hole, motivated by new Kormendy & Bender paper published after our submission; other modifications per referee comments by Ruszkowsk

    Noninvasive assessment of inspiratory muscle neuromechanical coupling during inspiratory threshold loading

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    Diaphragm neuromechanical coupling (NMC), which reflects the efficiency of conversion of neural activation to transdiaphragmatic pressure (Pdi), is increasingly recognized to be a useful clinical index of diaphragm function and respiratory mechanics in neuromuscular weakness and cardiorespiratory disease. However, the current gold standard assessment of diaphragm NMC requires invasive measurements of Pdi and crural diaphragm electromyography (oesEMGdi), which complicates the measurement of diaphragm NMC in clinical practice. This is the first study to compare invasive measurements of diaphragm NMC (iNMC) using the relationship between Pdi and oesEMGdi, with noninvasive assessment of NMC (nNMC) using surface mechanomyography (sMMGlic) and electromyography (sEMGlic) of lower chest wall inspiratory muscles. Both invasive and noninvasive measurements were recorded in twelve healthy adult subjects during an inspiratory threshold loading protocol. A linear relationship between noninvasive sMMGlic and sEMGlic measurements was found, resulting in little change in nNMC with increasing inspiratory load. By contrast, a curvilinear relationship between invasive Pdi and oesEMGdi measurements was observed, such that there was a progressive increase in iNMC with increasing inspiratory threshold load. Progressive recruitment of lower ribcage muscles, serving to enhance the mechanical advantage of the diaphragm, may explain the more linear relationship between sMMGlic and sEMGlic (both representing lower intercostal plus costal diaphragm activity) than between Pdi and crural oesEMGdi. Noninvasive indices of NMC derived from sEMGlic and sMMGlic may prove to be useful indices of lower chest wall inspiratory muscle NMC, particularly in settings that do not have access to invasive measures of diaphragm function.Peer ReviewedPostprint (published version

    Frequency support using multi-terminal HVDC systems based on DC voltage manipulation

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    This paper investigates the use of multi-terminal HVDC systems to provide primary frequency support to connected AC networks via coordinated DC voltage manipulation. Control schemes for multi-terminal HVDC systems to allow redistribution of active power, based on the idea of “power priority” are proposed. Inertia response from DC connected large offshore wind farms can also be incorporated based on the detection of DC voltage derivation at the offshore converter terminal without the need for telecommunication between the DC terminals. Simulation studies based on a three - terminal HVDC system connecting one large wind farm and two separate AC networks validate the operation of the system during frequency events

    The effect of the ionosphere on ultra-low-frequency radio-interferometric observations

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    Context. The ionosphere is the main driver of a series of systematic effects that limit our ability to explore the low-frequency (&lt;1 GHz) sky with radio interferometers. Its effects become increasingly important towards lower frequencies and are particularly hard to calibrate in the low signal-to-noise ratio (S/N) regime in which low-frequency telescopes operate. Aims. In this paper we characterise and quantify the effect of ionospheric-induced systematic errors on astronomical interferometric radio observations at ultra-low frequencies (&lt;100 MHz). We also provide guidelines for observations and data reduction at these frequencies with the LOw Frequency ARray (LOFAR) and future instruments such as the Square Kilometre Array (SKA). Methods. We derive the expected systematic error induced by the ionosphere. We compare our predictions with data from the Low Band Antenna (LBA) system of LOFAR. Results. We show that we can isolate the ionospheric effect in LOFAR LBA data and that our results are compatible with satellite measurements, providing an independent way to measure the ionospheric total electron content (TEC). We show how the ionosphere also corrupts the correlated amplitudes through scintillations. We report values of the ionospheric structure function in line with the literature. Conclusions. The systematic errors on the phases of LOFAR LBA data can be accurately modelled as a sum of four effects (clock, ionosphere first, second, and third order). This greatly reduces the number of required calibration parameters, and therefore enables new efficient calibration strategies

    Contributors to the December Issue/Notes

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    Notes by Warren A. Deahl, W. J. Rafferty, Timothy M. Green, Bernard F. Grainey, and Jerome Gold

    Contributors to the December Issue/Notes

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    Notes by Warren A. Deahl, W. J. Rafferty, Timothy M. Green, Bernard F. Grainey, and Jerome Gold
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