{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:12:40Z","timestamp":1792109560724,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100013318","name":"Shanxi Provincial Science and Technology Department","doi-asserted-by":"publisher","award":["20210302123245"],"award-info":[{"award-number":["20210302123245"]}],"id":[{"id":"10.13039\/501100013318","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Easy fatigability, the clinical hallmark of generalized myasthenia gravis (GMG), cannot be detected in a dynamic way. The aim of this study was to assess respiratory function dynamically through diaphragmatic ultrasonography (DUS) in GMG patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>GMG patients and controls were recruited in a 1:1 ratio. DUS was performed during one quiet breath and 15 consecutive deep breaths. The diaphragm thicknesses were measured at different positions. Diaphragm thickening fraction (TFdi) and the maximal change in diaphragm thickness (Tmax) during 15 consecutive deep breaths were calculated and transformed to normality, named N\u2010TFdi and N\u2010Tmax, respectively. The percentages of changes in TFdi and Tmax compared with baseline were named \u0394TFdi and \u0394Tmax, respectively. The diagnostic parameter for respiratory muscle fatigue was chosen from \u0394TFdi and \u0394Tmax at different deep breath times according to their ability to distinguish GMG patients from controls and the interrater reliability of TFdi and Tmax.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010four GMG patients and 30 healthy controls were enrolled. N\u2010TFdi and N\u2010Tmax significantly changed as the number of deep breaths increased (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) in GMG patients, but not in controls. \u0394Tmax of the 15th deep breath (\u0394Tmax15) was selected as the diagnostic parameter for respiratory muscle fatigue. There were no significant differences in percentage of predicted values of forced vital capacity and arterial partial pressure of carbon dioxide between patients with normal and abnormal \u0394Tmax15.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>DUS could identify diaphragm fatiguability in GMG patients, which may be more reliable and sensitive in assessment of diaphragm fatigue than conventional methods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.28020","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T03:39:40Z","timestamp":1703129980000},"page":"199-205","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Diaphragmatic ultrasonography as a predictor of respiratory muscle fatigue in myasthenia gravis"],"prefix":"10.1002","volume":"69","author":[{"given":"Jing","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Neurology First Hospital of Shanxi Medical University  Taiyuan China"},{"name":"First Clinical Medical College Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiqiu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology First Hospital of Shanxi Medical University  Taiyuan China"},{"name":"First Clinical Medical College Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Neurology First Hospital of Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology First Hospital of Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongjuan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology First Hospital of Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology First Hospital of Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueli","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology First Hospital of Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhong","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology First Hospital of Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4434-5599","authenticated-orcid":false,"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology First Hospital of Shanxi Medical University  Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10378"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcn152"},{"issue":"7","key":"e_1_2_13_4_1","first-page":"531","article-title":"A comparison of the maximum voluntary ventilation with the forced expiratory volume in one second: an assessment of subject cooperation","volume":"24","author":"Campbell SC","year":"1982","journal-title":"J Occup Med"},{"issue":"9","key":"e_1_2_13_5_1","first-page":"310","article-title":"Evaluation of respiratory muscle function (maximal respiratory pressures) in myasthenia gravis","volume":"5","author":"D\u00edez Tejedor E","year":"1990","journal-title":"Neurologia"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.53.5.1083"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.1140"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.47.8.640"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/0028\u20103886.304128"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.5.9154859"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/17482968.2012.729595"},{"key":"e_1_2_13_12_1","doi-asserted-by":"crossref","unstructured":"MatamisD SoilemeziE TsagouriasM et al.Sonographic evaluation of the diaphragm in critically ill patients. 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