Alfvén pulse driven spicule-like jets in the presence of thermal conduction and ion-neutral collision in two-fluid regime

We present the formation of quasi-periodic cool spicule-like jets in the solar atmosphere using 2.5-D numerical simulation in two-fluid regime (ions+neutrals) under the presence of thermal conduction and ion-neutral collision. The nonlinear, impulsive Alfvénic perturbations at the top of the photosphere trigger field aligned magnetoacoustic perturbations due to ponderomotive force. The transport of energy from Alfvén pulse to such vertical velocity perturbations due to ponderomotive force is considered as an initial trigger mechanism. Thereafter, these velocity perturbations steepen into the shocks followed by quasi-periodic rise and fall of the cool jets transporting mass in the overlying corona. This article is part of the theme issue 'Partially ionized plasma of the solar atmosphere: recent advances and future pathways'.

Molecular Modeling of Shockwave-Mediated Blood-Brain Barrier Opening for Targeted Drug Delivery

Bubble-enhanced shock waves induce the transient opening of the blood-brain barrier (BBB) providing unique advantages for targeted drug delivery of brain tumor therapy, but little is known about the molecular details of this process. Based on our BBB model including 28 000 lipids and 280 tight junction proteins and coarse-grained dynamics simulations, we provided the molecular-level delivery mechanism of three typical drugs for the first time, including the lipophilic paclitaxel, hydrophilic gemcitabine, and siRNA encapsulated in liposome, across the BBB. The results show that the BBB is more difficult to be perforated by shock-induced jets than the human brain plasma membrane (PM), requiring higher shock wave speeds. For the pores formed, the BBB exhibits a greater ability to self-heal than PM. Hydrophobic paclitaxel can cross the BBB and be successfully absorbed, but the amount is only one-third of that of PM; however, the absorption of hydrophilic gemcitabine was almost negligible. Liposome-loaded siRNAs only stayed in the first layer of the BBB. The mechanism analysis shows that increasing the bubble size can promote drug absorption while reducing the risk of higher shock wave overpressure. An exponential function was proposed to describe the relation between bubble and overpressure, which can be extended to the experimental microbubble scale. The calculated overpressure is consistent with the experimental result. These molecular-scale details on shock-assisted BBB opening for targeted drug delivery would guide and assist experimental attempts to promote the application of this strategy in the clinical treatment of brain tumors.

Investigating the Impact Behavior of Carbon Fiber/Polymethacrylimide (PMI) Foam Sandwich Composites for Personal Protective Equipment

To improve the shock resistance of personal protective equipment and reduce casualties due to shock wave accidents, this study prepared four types of carbon fiber/polymethacrylimide (PMI) foam sandwich panels with different face/back layer thicknesses and core layer densities and subjected them to quasi-static compression, low-speed impact, high-speed impact, and non-destructive tests. The mechanical properties and energy absorption capacities of the impact-resistant panels, featuring ceramic/ultra-high molecular-weight polyethylene (UHMWPE) and carbon fiber/PMI foam structures, were evaluated and compared, and the feasibility of using the latter as a raw material for personal impact-resistant equipment was also evaluated. For the PMI sandwich panel with a constant total thickness, increasing the core layer density and face/back layer thickness enhanced the energy absorption capacity, and increased the peak stress of the face layer. Under a constant strain, the energy absorption value of all specimens increased with increasing impact speed. When a 10 kg hammer impacted the specimen surface at a speed of 1.5 m/s, the foam sandwich panels retained better integrity than the ceramic/UHMWPE panel. The results showed that the carbon fiber/PMI foam sandwich panels were suitable for applications that require the flexible movement of the wearer under shock waves, and provide an experimental basis for designing impact-resistant equipment with low weight, high strength, and high energy absorption capacities.

Influence of the skull bone and brain tissue on the sound field in transcranial extracorporeal shock wave therapy: an ex vivo study

OBJECTIVES

Focused ultrasound is mainly known for focal ablation and localized hyperthermia of tissue. During the last decade new treatment options were developed for neurological indications based on blood-brain-barrier opening or neuromodulation. Recently, the transcranial application of shock waves has been a subject of research. However, the mechanisms of action are not yet understood. Hence, it is necessary to know the energy that reaches the brain during the treatment and the focusing characteristics within the tissue.

METHODS

The sound field of a therapeutic extracorporeal shock wave transducer was investigated after passing human skull bone (n=5) or skull bone with brain tissue (n=2) in this ex vivo study. The maximum and minimum pressure distribution and the focal pressure curves were measured at different intensity levels and penetration depths, and compared to measurements in water.

RESULTS

Mean peak negative pressures of up to -4.97 MPa were reached behind the brain tissue. The positive peak pressure was attenuated by between 20.85 and 25.38 dB/cm by the skull bone. Additional damping by the brain tissue corresponded to between 0.29 and 0.83 dB/cm. Compared to the measurements in water, the pulse intensity integral in the focal spot was reduced by 84 % by the skull bone and by additional 2 % due to the brain tissue, resulting in a total damping of up to 86 %. The focal position was shifted up to 8 mm, whereas the basic shape of the pressure curves was preserved.

CONCLUSIONS

Positive effects may be stimulated by transcranial shock wave therapy but damage cannot be excluded.

Shockwave Treatment vs Surgery for Proximal Fifth Metatarsal Stress Fractures in Soccer Players: A Pilot Study

BACKGROUND

To compare the clinical, radiologic, and functional outcomes between shockwave and operative treatments for proximal fifth metatarsal stress fractures in soccer players in a pilot study.

METHODS

Between 2017 and 2019, 18 soccer players with fifth metatarsal stress fractures attended at Mutualidad de Futbolistas Españoles-Delegación Catalana were included. Patients were randomly assigned into 2 groups receiving either surgery with an intramedullary screw (group 1) or high-energy focused extracorporeal shockwave treatment (group 2 performed once a week for 3 weeks using 2000 impulses at an energy flux density of 0.21 mJ/mm2 and 4 Hz frequency). Clinical (pain), radiologic (bone healing), and functional (Tegner Activity Scale and American Orthopaedic Foot & Ankle Society [AOFAS] ankle-hindfoot scales) outcomes before and after receiving the treatment were compared between both groups. In addition, ability and time to return to play was also compared between groups.

RESULTS

No patients were lost to follow-up. There were no statistically significant differences at last follow-up between surgery and extracorporeal shockwave treatment for bone healing, pain relief, AOFAS ankle-hindfoot score, Tegner score, and time return to play. No complications were reported in either of the 2 groups.

CONCLUSION

In this pilot study, extracorporeal shockwave treatment and operative treatment were found to be equally effective at reducing pain, achieving bone healing, and allowing the soccer players to return to play after proximal fifth metatarsal stress fractures. This study suggests that ESWT may be a good option for the management of proximal fifth metatarsal stress fractures in soccer players. If this approach proves successful in larger trials, the shockwave approach might help avoid known complications of the surgical treatment like wound problems, nerve injury, and hardware intolerance. Further investigations with larger sample size should be conducted in order to confirm the present conclusions.

LEVEL OF EVIDENCE

Level II, therapeutic, pilot randomized controlled trial.

Experimental and Numerical Study on Perforated Plate Mitigation Capacity to Near-Field Blasts

Based on the analysis of existing collective shockwave protection methods worldwide, this paper addresses the mitigation of shock waves by means of passive methods, namely the use of perforated plates. Employing specialized software for numerical analysis, such as ANSYS-AUTODYN 2022R1^®, the interaction of shock waves with a protection structure has been studied. By using this cost-free approach, several configurations with different opening ratios were investigated, pointing out the peculiarities of the real phenomenon. The FEM-based numerical model was calibrated by employing live explosive tests. The experimental assessments were performed for two configurations, with and without a perforated plate. The numerical results were expressed in terms of force acting on an armor plate placed behind a perforated plate at a relevant distance for ballistic protection in engineering applications. By investigating the force/impulse acting on a witness plate instead of the pressure measured at a single point, a realistic scenario can be considered. For the total impulse attenuation factor, the numerical results suggest a power law dependence, with the opening ratio as a variable.

The Entropy Density Behavior across a Plane Shock Wave

Entropy density behavior poses many problems when we study non-equilibrium situations. In particular, the local equilibrium hypothesis (LEH) has played a very important role and is taken for granted in non-equilibrium problems, no matter how extreme they are. In this paper we would like to calculate the Boltzmann entropy balance equation for a plane shock wave and show its performance for Grad's 13-moment approximation and the Navier-Stokes-Fourier equations. In fact, we calculate the correction for the LEH in Grad's case and discuss its properties.

Evans Blue and Fluorescein Isothiocyanate-Dextran Double Labeling Reveals Precise Sequence of Vascular Leakage and Glial Responses after Exposure to Mild-Level Blast-Associated Shock Waves

Abstract Blast-induced shock waves (BSWs) are responsible for several aspects of psychiatric disorders that are collectively termed mild traumatic brain injury (mTBI). The pathophysiology of mTBI includes vascular leakage resulting from blood-brain barrier (BBB) disruption. In this study, the precise sequence of BBB breakdown was examined using an Evans blue and fluorescein isothiocyanate (FITC)-dextran double labeling technique. Evans blue solution was injected into the tail vein of male C57BL6/J mice just before and 4 h, 1 day, 3 days, and 7 days after a single BSW exposure at as low as 25-kPa peak overpressure. In contrast, the FITC-dextran solution was transcardially injected just before perfusion fixation. Differences in the labeling time-point revealed that BBB breakdown was initiated after approximately 3 h, with significant remodeling by 1 day, and continued until 7 days after BSW exposure. BBB breakdown was upregulated in three distinct regions, namely the brain surface and subsurface areas facing the skull, regions closely associated with capillaries, and the circumventricular organ and choroid plexus. These regions showed distinct responses to BSW; moreover, clusters of reactive astrocytes were closely associated with the sites of BBB breakdown. In severe cases, these reactive astrocytes recruited activated microglia. Our findings provide important insights into the pathogenesis underlying mTBI and indicate that even mild BSW exposure affects the whole brain.

Low-Energy Shock Wave Suppresses Prostatic Pain and Inflammation by Modulating Mitochondrial Dynamics Regulators on a Carrageenan-Induced Prostatitis Model in Rats

A low-energy shock wave (LESW) has therapeutic effects on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS); however, its mechanism of action remains unclear. We explored the effects of LESW on the prostate and mitochondrial dynamics regulators in a rat model of carrageenan-induced prostatitis. The imbalance of mitochondrial dynamics regulators may affect the inflammatory process and molecules and contribute to CP/CPPS. Male Sprague-Dawley rats received intraprostatic 3% or 5% carrageenan injections. The 5% carrageenan group also received LESW treatment at 24 h, 7 days, and 8 days. Pain behavior was evaluated at baseline, 1 week, and 2 weeks after a saline or carrageenan injection. The bladder and the prostate were harvested for immunohistochemistry and quantitative reverse-transcription polymerase chain reaction analysis. Intraprostatic carrageenan injection induced inflammatory reaction in the prostate and the bladder, decreased the pain threshold, and resulted in the upregulation of Drp-1, MFN-2, NLRP3 (mitochondrial integrity markers), substance P, and CGRP-RCP, whose effects were maintained for 1-2 weeks. LESW treatment suppressed carrageenan-induced prostatic pain, inflammatory reaction, mitochondrial integrity markers, and expression of sensory molecules. These findings support a link between the anti-neuroinflammatory effects of LESW in CP/CPPS and the reversal of cellular perturbations caused by imbalances in mitochondrial dynamics in the prostate.

Comparison between radial and focused types of extracorporeal shock-wave therapy in plantar calcaneal spur: A randomized sham-controlled trial

OBJECTIVES

Both radial and focused types of extracorporeal shock wave therapy (ESWT) have been used in patients with plantar calcaneal spur (PCS). However, no study has yet addressed the comparative effects of these treatments on the condition. Considering radial and focused waves are different from each other, their effectiveness may also be different in clinical practice. The aim of this study was to compare the effects of radial and focused types of ESWT on PCS.

METHODS

Ninety-nine patients with plantar calcaneal spur were randomised into three groups according to ESWT types: focused, radial, and sham. ESWT was applied as three sessions, with 2-4 days intervals (excluding weekends). All patients were evaluated at baseline (week 0) and weeks 1, 5, and 13. The Foot Function Index (FFI) scores were used as outcome measures.

RESULTS

Compared with baseline (week 0), at the end of treatment (week 1) and at the follow-up periods (weeks 5, and 13) the FFI scores were significantly reduced in both focused and radial ESWT groups (for all, p < 0.001). When considering the change in data from baseline to follow-up periods (weeks 5, and 13), both focused and radial ESWT groups were significantly superior to the sham group in the all outcome measures (for all, p < 0.05). Importantly, the radial group was significantly superior to focused group based on the changes in the FFI scores (for all, p < 0.05).

CONCLUSION

Both focused ESWT and radial ESWT are effective in plantar calcaneal spur. When considering the degree and continuity of the positive effects, radial ESWT is superior to focused ESWT in plantar calcaneal spur.

Evaluation of the Effects of Extracorporeal Shockwave Therapy in Patients With Peripheral Arterial Disease: A Meta-Analysis of Randomized Control Trials

The aim of this meta-analysis is to assess the efficacy of extracorporeal shockwave therapy (ESWT) in patients with peripheral arterial disease (PAD). This meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was conducted independently by two authors using PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to January 15, 2023. Primary clinical outcomes assessed in this meta-analysis were changes in maximum waking distance (MWD) and pain-free walking distance (PFWD) from baseline. Other outcomes assessed included change in ankle brachial pressure index (ABI) and degree of arterial stenosis. Four RCTs involving a total of 228 patients were included. Change of PFWD and MWD from baseline was significantly higher in patients randomized in the ESWT group as compared to the control group. No significant differences were reported between the two groups in terms of change in ABI from baseline. In conclusion, this meta-analysis of four randomized controlled trials found evidence that ESWT is an effective treatment for patients with PAD in terms of improving PFWD and MWD and reducing stenosis. However, there was no significant difference in the improvement of the ankle-brachial index between the study groups.

Structure of Shock Wave in Nanoscale Porous Nickel at Pressures up to 7 GPa

The structure of shock waves in pressed porous samples of nickel nanoparticles was investigated in a series of uniaxial planar plate impact experiments in the pressure range of 1.6-7.1 GPa. The initial porosity of the samples was about 50%. Wave profiles were obtained using laser velocimetry techniques. The nanomaterial demonstrated a complex response to shock loading including the development of a two-wave structure associated with precursor and compaction waves. The effect on profiles and measurements of the observed precursor reverberations propagating between the front of a compaction wave and a monitored sample surface was described. The obtained wave profiles were used to estimate the thicknesses of precursor and compaction wave fronts.

Effect of driver gas composition on production of scaled Friedlander waveforms in an open-ended shock tube model

With the evolution of modern warfare and the increased use of improvised explosive devices (IEDs), there has been an increase in blast-induced traumatic brain injuries (bTBI) among military personnel and civilians. The increased prevalence of bTBI necessitates bTBI models that result in a properly scaled injury for the model organism being used. The primary laboratory model for bTBI is the shock tube, wherein a compressed gas ruptures a thin membrane, generating a shockwave. To generate a shock wave that is properly scaled from human to rodent subjects the shock wave must have a short duration and high peak overpressure while fitting a Friedlander waveform, the ideal representation of a blast wave. A large variety of factors have been experimentally characterized in attempts to create an ideal waveform, however we found current research on the gas composition being used to drive shock wave formation to be lacking. To better understand the effect the driver gas has on the waveform being produced, we utilized a previously established murine shock tube bTBI model in conjunction with several distinct driver gasses. In agreement with previous findings, helium produced a shock wave most closely fitting the Friedlander waveform in contrast to the plateau-like waveforms produced by some other gases. The peak pressure at the exit of the shock tube and 5 cm from the exit have a strong negative correlation with the density of the gas being used: helium the least dense gas used produces the highest peak overpressure. Density of the driver gas also exerts a strong positive effect on the duration of the shock wave, with helium producing the shortest duration wave. Due to its ability to produce a Friedlander waveform and produce a waveform following proper injury scaling guidelines, helium is an ideal gas for use in shock tube models for bTBI.

A novel animal model of primary blast lung injury and its pathological changes in mice

BACKGROUND

Primary blast lung injury (PBLI) is a major cause of death in military conflict and terrorist attacks on civilian populations. However, the mechanisms of PBLI are not well understood, and a standardized animal model is urgently needed. This study aimed to establish an animal model of PBLI for laboratory study.

METHODS

The animal model of PBLI was established using a self-made mini shock tube simulation device. In brief, mice were randomly divided into two groups: the control group and the model group, the model group were suffered 0.5 bar shock pressures. Mice were sacrificed at 2 hours, 4 hours, 6 hours, 12 hours, and 24 hours after injury. Lung tissue gross observation, hematoxylin and eosin staining and lung pathology scoring were performed to evaluated lung tissue damage. Evans blue dye leakage and bronchoalveolar lavage fluid examination were performed to evaluated pulmonary edema. The relative expression levels of inflammation factors were measured by real-time quantitative polymerase chain reaction and Western blotting analysis. The release of neutrophil extracellular traps was observed by immunofluorescence stain.

RESULTS

In the model group, the gross observation and hematoxylin and eosin staining assay showed the inflammatory cell infiltration, intra-alveolar hemorrhage, and damaged lung tissue structure. The Evans blue dye and bronchoalveolar lavage fluid examination revealed that the lung tissue permeability and edema was significantly increased after injury. Real-time quantitative polymerase chain reaction and Western blotting assays showed that IL-1β, IL-6, TNF-α were upregulated in the model group. Immunofluorescence assay showed that the level of neutrophil extracellular traps in the lung tissue increased significantly in the model group.

CONCLUSION

The self-made mini shock tube simulation device can be used to establish the animal model of PBLI successfully. Pathological changes of PBLI mice were characterized by mechanical damage and inflammatory response in lung tissue.

Experimental and Numerical Studies on Fixed Steel Sheets Subjected to Underwater Explosion

This study presents underwater explosion tests with three different TNT charge weights to investigate the dynamic responses of a fixed steel sheet. A finite element model was established and benchmarked by comparing the bubble development and deformation distribution from the tests. The steel sheet shows a deformation process of hogging, sagging, and hogging again, due to the actions of shock waves, bubble expansion, bubble collapse, and bubble pulsation. The air may be sucked into the bubble during the hogging process, making the bubble collapse earlier and resulting in a relatively lower sagging deformation for large charge weights of TNT. The deformation caused by bubble pulsation is larger than that by the shock waves, owing to the large time duration of bubble pulsation. A parametric analysis was conducted to study the influence of steel grade, plate thickness, detonation distance, and the shape and position of charges on the dynamic behavior of steel plates subjected to underwater explosions. It shows that the damage to the steel plate gradually decreases, with the increase in steel strength, plate thickness, and detonation distance. The influence of the shape and position of charges is limited. The largest deformation is observed when the detonation distance increases to bubble radius.

Measurement and Analysis of Shock Wave Pressure in Moving Charge and Stationary Charge Explosions

Shock wave pressure is one of the most important parameters in an explosion. However, there have been few experimental and analytical investigations of moving charge explosions. In this article, we present an experimental method to measure the shock wave pressure from a moving charge explosion. Tests of stationary charges and moving charges with speeds of 580 m/s, 703 m/s and 717 m/s were carried out. The shock wave pressure curves and parameters at different measurement points were obtained and analyzed. The theoretical calculation of the shock wave overpressure was studied and compared with the experimental result. The differences between the stationary charge and moving charge explosions were investigated. The results showed that the shock wave pressure distribution of a moving charge had strong directionality. The shock wave pressure parameters (including overpressure, arrival time, duration and impulse) were influenced by the charge's moving velocity, direction angle and distance from the blast point. The shock wave overpressure value was greater than that of a stationary charge explosion at angles between 0° and 90°. The correlation model based on the velocity vector superposition method could describe the relationship of overpressure between the stationary charge and moving charge explosions.

Turbulence Model Comparative Study for Complex Phenomena in Supersonic Steam Ejectors with Double Choking Mode

Scholars usually ignore the non-equilibrium condensing effects in turbulence-model comparative studies on supersonic steam ejectors. In this study, a non-equilibrium condensation model considering real physical properties was coupled respectively with seven turbulence models. They are the k-ε Standard, k-ε RNG, k-ε Realizable, k-ω Standard, k-ω SST, Transition SST, and Linear Reynolds Stress Model. Simulation results were compared with the experiment results globally and locally. The complex flow phenomena in the steam ejector captured by different models, including shock waves, choking, non-equilibrium condensation, boundary layer separation, and vortices were discussed. The reasons for the differences in simulation results were explained and compared. The relationship between ejector performance and local flow phenomena was illustrated. The novelty lies in the conclusions that consider the non-equilibrium condensing effects. Results show that the number and type of shock waves predicted by different turbulence models are different. Non-equilibrium condensation and boundary layer separation regions obtained by various turbulence models are different. Comparing the ejector performance and the complex flow phenomena with the experimental results, the k-ω SST model is proposed to simulate supersonic steam ejectors.

Controlling Shock-Induced Energy Release Characteristics of PTFE/Al by Adding Oxides

Polytetrafluoroethylene (PTFE)/aluminum (Al)-based energetic material is a kind of energetic material with great application potential. In this research, the control of the shock-induced energy release characteristics of PTFE/Al-based energetic material by adding oxides (bismuth trioxide, copper oxide, molybdenum trioxide, and iron trioxide) was studied by experimentation and theoretical analysis. Ballistic impact experiments with impact velocity of 735~1290 m/s showed that the oxides controlled the energy release characteristics by the coupling of impact velocities and oxide characteristics. In these experiments, the overpressure characteristics, including the quasi-static overpressure peak, duration, and impulse, were used to characterize the energy release characteristics. It turned out that when the nominal impact velocity was 735 m/s, the quasi-static overpressure peak of PTFE/Al/MoO₃ (0.1190 MPa) was 1.99 times higher than that of PTFE/Al (0.0598 MPa). Based on these experimental results, an analytical model was developed indicating that the apparent activation energy and impact shock pressure dominated the energy release characteristic of PTFE/Al/oxide. This controlling mechanism indicated that oxides enhanced the reaction after shock wave unloading, and the chemical and physical properties of the corresponding thermites also affected the energy release characteristics. These conclusions can guide the design of PTFE-based energetic materials, especially the application of oxides in PTFE-based reactive materials.

The influence of radial extracorporeal shock wave therapy on shoulder pain and structural abnormalities in stroke patients

Introduction

Structural abnormalities in the shoulder joint are a common complication post stroke, and the consequent pain and functional limitations become devastating quality of life problems for such patients. Shock wave therapy is a non-invasive method that can enhance the level of perfusion in ischaemic tissues, relieve inflammation, and promote healing. The aim of the study was to examine the efficacy of radial extracorporeal shock wave therapy (rESWT) on pain and disability levels in stroke patients with shoulder structural abnormalities.

Material and methods

Thirty subacute stroke patients aged between 40 and 60 years were randomly allocated into 2 equal groups after signing an institutional consent form. The real rESWT group (GA) underwent rESWT in addition to a designed program of physical therapy to the shoulder joint. The control group (GB) received sham rESWT in addition to the same physical therapy program as for GA. The treatment protocol for both groups was 2 times per week for a month. Baseline and post-intervention findings in both groups were assessed and compared for primary outcomes including shoulder structural changes, pressure pain threshold (PPT), and shoulder disability, measured by ultrasonography (USS), a handheld algometer, and the shoulder pain disability index (SPADI), respectively.

Results

Significant reduction of all post-treatment SPADI scores (pain, disability, and total scores) in both groups with a remarkable decrease in the rESWT group (GA) (p < 0.05). In addition, USS scores and PPT findings showed notable preference in favour of the GA group, which was demonstrated as significant decrease in USS score with an increase in PPT findings only in the rESWT group (GA) (p < 0.05).

Conclusions

The addition of radial extracorporeal shock wave therapy (rESWT) to a designed physical therapy program is more efficient in reducing shoulder structural abnormalities, pain, and disability in subacute stroke patients.

Low Intensity Ultrasound as an Antidote to Taxane/Paclitaxel-induced Cytotoxicity

The taxane family of compounds, including Taxol/paclitaxel and Taxotere/docetaxel, are surprisingly successful drugs used in combination or alone for the treatment of most major solid tumors, especially metastatic cancer. The drugs are commonly used in regimen with other agents (often platinum drugs) as frontline treatment, or used as a single agent in a dose dense regimen for recurrent cancer. The major side effects of taxanes are peripheral neuropathy, alopecia, and neutropenia, which are grave burden for patients and limit the full potential of the taxane drugs. Especially in the current treatment protocol for peripheral neuropathy, taxane dosage is reduced once the symptoms present, resulting in the loss of full or optimal cancer killing activity.

Substantial efforts have been made to address the problem of cytotoxic side effects of taxanes, though strategies remain very limited. Following administration of the taxane compound by infusion, taxane binds to cellular microtubules and is sequestered within the cells for several days. Taxane stabilizes and interferes with microtubule function, leading to ultimate death of cancer cells, but also damages hair follicles, peripheral neurons, and hemopoietic stem cells. Currently, cryo-treatment is practiced to limit exposure and side effects of the drug during infusion, though the effectiveness is uncertain or limited.

A recent laboratory finding may provide a new strategy to counter taxane cytotoxicity, that a brief exposure to low density ultrasound waves was sufficient to eliminate paclitaxel cytotoxicity cells in culture by transiently breaking microtubule filaments, which were then relocated to lysosomes for disposal. Thus, ultrasonic force to break rigid microtubules is an effective solution to counter taxane cytotoxicity. The discovery and concept of low intensity ultrasound as an antidote may have the potential to provide a practical strategy to counter paclitaxel-induced peripheral neuropathy and alopecia that resulted from chemotherapy.

Taxanes are a class of important drugs used in chemotherapy to treat several major cancers. This article reviews a new laboratory discovery that ultrasound can be used as an antidote for the peripheral cytotoxicity of taxane drugs and discusses the potential development and application of low intensity ultrasound to prevent side effects in chemotherapeutic treatment of cancer patients.

Analysis of Shock Wave Interaction with an Obstacle by Coupling Pressure Measurements and Visualization

Small-scale experiments are a good means of carrying out explosion and shock wave measurements. Commonly, the shock wave is tracked thanks to pressure sensors and sometimes with a high-speed camera. In the present study, these methods were used to analyze the interaction of a shock wave with an obstacle of simple geometry. The primary aim of the study was to demonstrate the need to correlate these different methods in order to analyze certain phenomena related to the three-dimensional interaction of a shock wave with an object. The correlation between the overpressure and the visualization made it possible to carry out a complex analysis. The visualization was carried out simultaneously on two planes, from the front and top views, thanks to the optical setup. Shock wave characteristics were taken at ground level downstream of the obstacle with pressure gauges. The correlation of the images obtained allows the identification of the waves on the profile and their contribution in intensity.

Molecular Effects of Low-Intensity Shock Wave Therapy on L6 Dorsal Root Ganglion/Spinal Cord and Blood Oxygenation Level-Dependent (BOLD) Functional Magnetic Resonance Imaging (fMRI) Changes in Capsaicin-Induced Prostatitis Rat Models

Neurogenic inflammation and central sensitization play a role in chronic prostatitis/chronic pelvic pain syndrome. We explore the molecular effects of low-intensity shock wave therapy (Li-ESWT) on central sensitization in a capsaicin-induced prostatitis rat model. Male Sprague–Dawley rats underwent intraprostatic capsaicin (10 mM, 0.1 cm³) injections. After injection, the prostate received Li-ESWT twice, one day apart. The L6 dorsal root ganglion (DRG)/spinal cord was harvested for histology and Western blotting on days 3 and 7. The brain blood oxygenation level-dependent (BOLD) functional images were evaluated using 9.4 T fMRI before the Li-ESWT and one day after. Intraprostatic capsaicin injection induced increased NGF-, BDNF-, and COX-2-positive neurons in the L6 DRG and increased COX-2, NGF, BDNF, receptor Trk-A, and TRPV1 protein expression in the L6 DRG and the dorsal horn of the L6 spinal cord, whose effects were significantly downregulated after Li-ESWT on the prostate. Intraprostatic capsaicin injection increased activity of BOLD fMRI responses in brain regions associated with pain-related responses, such as the caudate putamen, periaqueductal gray, and thalamus, whose BOLD signals were reduced after Li-ESWT. These findings suggest a potential mechanism of Li-ESWT on modulation of peripheral and central sensitization for treating CP/CPPS.

Analgesic Effect of Extracorporeal Shock-Wave Therapy in Individuals with Lateral Epicondylitis: A Randomized Controlled Trial

This study was conducted to investigate the effect of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in lateral epicondylitis. A sample of 40 patients with LE (21 males) was randomly allocated to either the ESWT experimental (n = 20) or the conventional-physiotherapy control group (n = 20). All patients received five sessions during the treatment program. The outcome measures used were the Visual Analog Scale (VAS), the Taiwan version of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and a dynamometer (maximal grip strength). Forty participants completed the study. Participants in both groups improved significantly after treatment in terms of VAS (pain reduced), maximal grip strength, and DASH scores. However, the pain was reduced and upper-extremity function and maximal grip strength were more significantly improved after ESWT in the experimental group. ESWT has a superior effect in reducing pain and improving upper-extremity function and grip strength in people with lateral epicondylitis. It seems that five sessions of ESWT are optimal to produce a significant difference. Further studies are strongly needed to verify our findings.

Mechanism Analysis of Rock Failure Process under High-Voltage Electropulse: Analytical Solution and Simulation

This work aims to investigate and analyse the mechanism of rock failure under high-voltage electropulses in order to evaluate and increase the efficiency of high-voltage pulse technology in geological well drilling, tunnel boring, and other geotechnical engineering applications. To this end, this paper discusses the equivalent circuit of electric pulse rock breaking, the model of shock wave in electro channel plasma, and, particularly, the model of rock failure in order to disclose the rock failure process when exposed to high-voltage electropulse. This article uses granite as an example to present an analytical approach for predicting the mechanical behaviour of high-voltage electropulses and to analyse the damage that occurs. A numerical model based on equivalent circuit, shock wave model, and elasto-brittle failure criterion is developed for granite under electropulse to further examine the granite failure process. Under the conditions described in this study, and using granite as an example, the granite is impacted by a discharge device (Marx generator) with an initial voltage U₀ that is 10 kV and a capacitance F that is 5 µF before it begins to degrade at about 40 µs after discharge, with the current reaching its peak at approximately 50 µs. The shock wave pressure then attains a peak at about 70 µs. Dense short cracks form around granite and the dominant cracks grow to an average length of about 20 cm at around 200 µs. The crack width d_cr is predicted to be approximately 1.6 mm. This study detects dense cracks in a few centimetres surrounding the borehole, while around seven dominant cracks expand outward. The distribution of the length of the dominating cracks can be inhomogeneous because of the spatial heterogeneity of granite’s tensile strength, however the heterogeneity has an insignificant effect on the crack growth rate, total cracked area, or the number of main cracks. The mechanism of rock failure under electropulse can be well supported by the findings of numerical simulations and analytical studies.

Ultraviolet Emissions from Explosive Detonation Breakout

Detailed spectroscopic measurements of high explosive detonation breakout in the ultraviolet region are presented. Molecular features associated with CN, NH, OH, and N₂ are observed and analyzed. Spectra indicate extreme temperatures well in excess of 5000 K in the first few microseconds after breakout. Molecular bands are found to originate from the detonation products, as opposed to the ambient air, and are strongly attenuated in the presence of oxygen. Implications for forensic analysis of source explosive are discussed.

Shock-induced plasticity and phase transformation in single crystal magnesium: an interatomic potential and non-equilibrium molecular dynamics simulations

An effective and reliable Finnis-Sinclair (FS) type potential is developed for large-scale molecular dynamics (MD) simulations of plasticity and phase transition of magnesium (Mg) single crystals under high-pressure shock loading. The shock-wave profiles exhibit a split elastic-inelastic wave in the [0001]_HCPshock orientation and a three-wave structure in the [10-10]_HCPand [-12-10]_HCPdirections, namely, an elastic precursor, a followed plastic front, and a phase-transition front. The shock Hugoniot of the particle velocity (U_p) vs the shock velocity (U_s) of Mg single crystals in three shock directions under low shock strength reveals apparent anisotropy, which vanishes with increasing shock strength. For the [0001]_HCPshock direction, the amorphization caused by strong atomic strain plays an important role in the phase transition and allows for the phase transition from an isotropic stressed state to the product phase. The reorientation in the shock directions [10-10]_HCPand [-12-10]_HCP, as the primary plasticity deformation, leads to the compressed hexagonal close-packed (HCP) phase and reduces the phase-transition threshold pressure. The phase-transition pathway in the shock direction [0001]_HCPincludes a preferential contraction strain along the [0001]_HCPdirection, a tension along [-12-10]_HCPdirection, an effective contraction and shear along the [10-10]_HCPdirection. For the [10-10]_HCPand [-12-10]_HCPshock directions, the phase-transition pathway consists of two steps: a reorientation and the subsequent transition from the reorientation hexagonal close-packed phase (RHCP) to the body-centered cubic (BCC). The orientation relationships between HCP and BCC are (0001)_HCP⟨-12-10⟩_HCP// {110}_BCC⟨001⟩_BCC. Due to different slipping directions during the phase transition, three variants of the product phase are observed in the shocked samples, accompanied by three kinds of typical coherent twin-grain boundaries between the variants. The results indicate that the highly concentrated shear stress leads to the crystal lattice instability in the elastic precursor, and the plasticity or the phase transition relaxed the shear stress.

Effect of Botulinum Toxin Injection and Extracorporeal Shock Wave Therapy on Nerve Regeneration in Rats with Experimentally Induced Sciatic Nerve Injury

This study was designed to compare the roles of botulinum neurotoxin A (BoNT/A) and extracorporeal shock wave therapy (ESWT) in promoting the functional recovery and regeneration of injured peripheral nerves. A total of 45 six-week-old rats with sciatic nerve injury were randomly divided into two experimental groups and one control group. The experimental groups received a single session of intranerve BoNT/A or ESWT immediately after a nerve-crushing injury. The control group was not exposed to any treatment. Differentiation of Schwann cells and axonal sprouting were observed through immunofluorescence staining, ELISA, real-time PCR, and Western blot at 3, 6, and 10 weeks post-nerve injury. For clinical assessment, serial sciatic functional index analysis and electrophysiological studies were performed. A higher expression of GFAP and S100β was detected in injured nerves treated with BoNT/A or ESWT. The levels of GAP43, ATF3, and NF200 associated with axonal regeneration in the experimental groups were also significantly higher than in the control group. The motor functional improvement occurred after 7 weeks of clinical observation following BoNT/A and ESWT. Compared with the control group, the amplitude of the compound muscle action potential in the experimental groups was significantly higher from 6 to 10 weeks. Collectively, these findings indicate that BoNT/A and ESWT similarly induced the activation of Schwann cells with the axonal regeneration of and functional improvement in the injured nerve.

Temporal Evolution of Pressure Generated by a Nanosecond Laser Pulse Used for Assessment of Adhesive Strength of the Tungsten-Zirconium-Borides Coatings

The article presents theoretical and experimental study of shock waves induced by a nanosecond laser pulse. Generation of surface plasma pressure by ablation of the graphite absorption layer in water medium and shock wave formation were analyzed theoretically and experimentally. The amplitude and temporal variation of the shock wave pressure was determined basing on a proposed hydrodynamic model of nanosecond laser ablation and experimentally verified with use of a polyvinylidene fluoride (PVDF) piezoelectric-film sensor. The determined pressure wave was used for examination of adhesive strength of tungsten–zirconium–boride coatings on steel substrate. The magnetron sputtered (MS) W–Zr–B coatings show good adhesion to the steel substrate. The obtained experimental results prove the correctness of the proposed model as well as the suitability of the procedure for assessment of adhesive strength.

Why Did the Earwitnesses to the John F. Kennedy Assassination Not Agree About the Location of the Gunman?

Earwitnesses to the 1963 assassination of President John F. Kennedy (JFK) did not agree about the location of the gunman even though their judgments about the number and timing of the gunshots were reasonably consistent. Even earwitnesses at the same general location disagreed. An examination of the acoustics of supersonic bullets and the characteristics of human sound localization help explain the general disagreement about the origin of the gunshots. The key fact is that a shock wave produced by the supersonic bullet arrived prior to the muzzle blast for many earwitnesses, and the shock wave provides erroneous information about the origin of the gunshot. During the government's official re-enactment of the JFK assassination in 1978, expert observers were highly accurate in localizing the origin of gunshots taken from either of two locations, but their supplementary observations help explain the absence of a consensus among the earwitnesses to the assassination itself.

Simulation of the Transmission Spectrum of Long-Period Fiber Gratings Structures with a Propagating Acoustic Shock Front

In this paper, we investigate modification of transmission spectra of long-period fiber grating structures with an acoustic shock front propagating along the fiber. We simulate transmission through inhomogeneous long-period fiber gratings, π-shift and reflective π-shift gratings deformed by an acoustic shock front. Coupled mode equations describing interaction of co-propagating modes in a long-period fiber grating structures with inhomogeneous deformation are used for the simulation. Two types of apodization are considered for the grating modulation amplitude, such as uniform and raised-cosine. We demonstrate how the transmission spectrum is produced by interference between the core and cladding modes coupled at several parts of the gratings having different periods. For the π-shift long-period fiber grating having split spectral notch, the gap between the two dips becomes several times wider in the grating with the acoustic wave front than the gap in the unstrained grating. The behavior of reflective long-period fiber gratings depends on the magnitude of the phase shift near the reflective surface: an additional dip is formed in the 0-shift grating and the short-wavelength dip disappears in the π-shift grating.

Extracorporeal Shock Wave Enhances the Cisplatin Efficacy by Improving Tissue Infiltration and Cellular Uptake in an Upper Urinary Tract Cancer Animal and Human-Derived Organoid Model

Upper urinary tract urothelial carcinoma (UTUC) is a relatively rare cancer with a poor prognosis if diagnosed at an advanced stage. Although cisplatin-based chemotherapy is a common treatment strategy, it has a limited response rate. Shock wave lithotripsy is a common treatment for upper urinary tract stones. Low-energy shock waves (LESWs) temporarily increase tissue permeability and enhance drug penetration to the targeted tissue. However, no study has investigated the efficacy of the combination of shock wave lithotripsy and chemotherapy in UTUC. Hence, in this study, we aimed to identify the potential application of the combination of LESW and chemotherapy in UTUC. We evaluated the synergistic effects of LESW and cisplatin in vitro, in vivo, and in patient-derived organoid (PDO) models. Compared with cisplatin alone, the combination treatment caused more significant tumour suppression in vitro and in animal models, without increased toxicity. Histological examination showed that compared with animals treated with cisplatin alone, those who received the combination treatment showed more deteriorated cell arrangement and cell oedema. Moreover, LESW improved the cytotoxicity of cisplatin in the preclinical PDO model of UTUC. Thus, LESW combined with cisplatin is a potential new antitumour strategy for improving the treatment response in locally advanced UTUC.

"HIFU Beam:" A Simulator for Predicting Axially Symmetric Nonlinear Acoustic Fields Generated by Focused Transducers in a Layered Medium

"HIFU beam" is a freely available software tool that comprises a MATLAB toolbox combined with a user-friendly interface and binary executable compiled from FORTRAN source code (HIFU beam. (2021). Available: http://limu.msu.ru/node/3555?language=en). It is designed for simulating high-intensity focused ultrasound (HIFU) fields generated by single-element transducers and annular arrays with propagation in flat-layered media that mimic biological tissues. Numerical models incorporated in the simulator include evolution-type equations, either the Khokhlov-Zabolotskaya-Kuznetsov (KZK) equation or one-way Westervelt equation, for radially symmetric ultrasound beams in homogeneous and layered media with thermoviscous or power-law acoustic absorption. The software uses shock-capturing methods that allow for simulating strongly nonlinear acoustic fields with high-amplitude shocks. In this article, a general description of the software is given along with three representative simulation cases of ultrasound transducers and focusing conditions typical for therapeutic applications. The examples illustrate major nonlinear wave effects in HIFU fields including shock formation. Two examples simulate propagation in water, involving a single-element source (1-MHz frequency, 100-mm diameter, 90-mm radius of curvature) and a 16-element annular array (3-MHz frequency, 48-mm diameter, and 35-mm radius of curvature). The third example mimics the scenario of a HIFU treatment in a "water-muscle-kidney" layered medium using a source typical for abdominal HIFU applications (1.2-MHz frequency, 120-mm diameter, and radius of curvature). Linear, quasi-linear, and shock-wave exposure protocols are considered. It is intended that "HIFU beam" can be useful in teaching nonlinear acoustics; designing and characterizing high-power transducers; and developing exposure protocols for a wide range of therapeutic applications such as shock-based HIFU, boiling histotripsy, drug delivery, immunotherapy, and others.

Mesoscale Mechanisms in Viscoplastic Deformation of Metals and Their Applications to Constitutive Models

Deformation of metals has attracted great interest for a long time. However, the constitutive models for viscoplastic deformation at high strain rates are still under intensive development, and more physical mechanisms are expected to be involved. In this work, we employ the newly-proposed methodology of mesoscience to identify the mechanisms governing the mesoscale complexity of collective dislocations, and then apply them to improving constitutive models. Through analyzing the competing effects of various processes on the mesoscale behavior, we have recognized two competing mechanisms governing the mesoscale complex behavior of dislocations, i.e., maximization of the rate of plastic work, and minimization of the elastic energy. Relevant understandings have also been discussed. Extremal expressions have been proposed for these two mesoscale mechanisms, respectively, and a stability condition for mesoscale structures has been established through a recently-proposed mathematical technique, considering the compromise between the two competing mechanisms. Such a stability condition, as an additional constraint, has been employed subsequently to close a two-phase model mimicking the practical dislocation cells, and thus to take into account the heterogeneous distributions of dislocations. This scheme has been exemplified in three increasingly complicated constitutive models, and improves the agreements of their results with experimental ones.

Numerical Study of Air Flow Induced by Shock Impact on an Array of Perforated Plates

This study is focused on the propagation behavior and attenuation characteristics of a planar incident shock wave when propagating through an array of perforated plates. Based on a density-based coupled explicit algorithm, combined with a third-order MUSCL scheme and the Roe averaged flux difference splitting method, the Navier–Stokes equations and the realizable k-ε turbulence model equations describing the air flow are numerically solved. The evolution of the dynamic wave and ring vortex systems is effectively captured and analyzed. The influence of incident shock Mach number, perforated-plate porosity, and plate number on the propagation and attenuation of the shock wave was studied by using pressure- and entropy-based attenuation rates. The results indicate that the reflection, diffraction, transmission, and interference behaviors of the leading shock wave and the superimposed effects due to the trailing secondary shock wave are the main reasons that cause the intensity of the leading shock wave to experience a complex process consisting of attenuation, local enhancement, attenuation, enhancement, and attenuation. The reflected shock interactions with transmitted shock induced ring vortices and jets lead to the deformation and local intensification of the shock wave. The formation of nearly steady jets following the array of perforated plates is attributed to the generation of an oscillation chamber for the inside dynamic wave system between two perforated plates. The vorticity diffusion, merging and splitting of vortex cores dissipate the wave energy. Furthermore, the leading transmitted shock wave attenuates more significantly whereas the reflected shock wave from the first plate of the array attenuates less significantly as the shock Mach number increases. The increase in the porosity weakens the suppression effects on the leading shock wave while increases the attenuation rate of the reflected shock wave. The first perforated plate in the array plays a major role in the attenuation of the shock wave.

Low Energy Shock Wave Therapy Attenuates Mitochondrial Dysfunction and Improves Bladder Function in HCl induced Cystitis in Rats

BACKGROUND

We examine the effects of low energy shock wave (LESW)) on bladder and mitochondrial function in a rat model of HCl induced cystitis, and the influence of dynamic bladder filling volume on LESW responses. Dysregulation of mitochondria function may impact the urothelial barrier and contribute to bladder dysfunction in patients with Interstitial cystitis/bladder pain syndrome (IC/BPS).

MATERIALS AND METHODS

Female Sprague-Dawley rats underwent urethral catheterization and intravesical instillation of 0.2 ml of 0.4N HCl (N=32) or 0.2 ml saline (N=8) kept for 90 s. After HCl instillation, the bladder received LESW treatment while filled with 0 ml, 0.2 ml or 0.4 ml saline or no LESW treatment. Continuous cystometry (CMG) was performed on day 8. The bladder was harvested after CMG for histology and Western blotting.

RESULTS

HCl provoked bladder overactivity, bladder wall inflammation marked by infiltration of mast cells, increased bax/bcl2 ratio consistent with increased TUNEL staining and increased release of mitochondrial-integrity markers (cleaved caspase 3 and Cytochrome c). LESW treatment suppressed HCl provoked bladder overactivity in association with lower inflammatory reaction, mast cells infiltration, and a lower bax/bcl2 ratio also reflected by reduced TUNEL staining and mitochondrial-integrity markers irrespective of the volume of saline in bladder at the time of LESW.

CONCLUSIONS

These findings support that antiinflammatory effect of LESW in chemical cystitis is associated with the reversal of the molecular-cellular perturbations in mitochondrial dependent intrinsic apoptotic pathway.

PVDF Based Pressure Sensor for the Characterisation of the Mechanical Loading during High Explosive Hydro Forming of Metal Plates

High explosive hydro forming (HEHF) is a suitable technique for large metal plate forming. Manufacturing stages of such a part requires an adapted design of explosive charge configurations to define the mechanical loading exerted on the part. This mechanical loading remains challenging to be experimentally determined but necessary for predictive numerical simulation in the design of parts to form. Providing that the actual mechanical impulse would allow the neglecting of the modelling of the detonation stage, this considerably increases the computational time. The present work proposes an experimental method for obtaining the exerted mechanical loading by HEHF on the part to form. It relies on the development of low-cost sensor based on a polyvinyliden fluorid (PVDF) gauge. In addition to it, an analytical approach based on shock physics is proposed for the sensor signal interpretation. The method considers the multi-layer aspect of the sensor and its intrusiveness with respect to waves propagation. Measurements were repeated to assess their relevance and the reproducibility by using steel and aluminium anvils in HEHF. Numerical modelling in 2D plane geometry of the experiments was performed with two commercial hydrocodes. The comparison of mechanical impulses shows an agreement in terms of chronology but a noticeable difference in terms of amplitude, explained by mesh size and numerical diffusion.

Novel Applications of Non-Invasive Intravesical Botulinum Toxin a Delivery in the Treatment of Functional Bladder Disorders

Although intravesical botulinum toxin type A (BoNT-A) injection for functional bladder disorders is effective, the injection-related problems-such as bladder pain and urinary tract infection-make the procedure invasive and inconvenient. Several vehicles have recently been developed to deliver BoNT-A without injection, thereby making the treatment less or non-invasive. Laboratory evidence revealed that liposome can carry BoNT-A across the uroepithelium and act on sub-urothelial nerve endings. A randomized placebo controlled study revealed that intravesical administration of liposome-encapsulated BoNT-A and TC-3 hydrogel embedded BoNT-A can improve urinary frequency, urgency, and reduce incontinence in patients with overactive bladders. A single-arm prospective study also revealed that intravesical administration of TC-3 hydrogel embedded BoNT-A can relieve bladder pain in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). We recently administered suprapubic energy shock wave (ESW) after BoNT-A intravesical administration in six patients with IC/BPS. Although pain reduction and symptom improvement were not significant, immunochemical staining showed cleaved synaptosome-associated protein 25 in the bladder after the procedure. This suggests that ESW can promote passage of BoNT-A across the uroepithelium. In conclusion, using vehicles to intra-vesically deliver BoNT-A for functional bladder disorders is promising. Further studies are necessary to confirm the efficacy and explore novel applications.

Temperature and Density on the Forsterite Liquid-Vapor Phase Boundary

The physical processes during planet formation span a large range of pressures and temperatures. Giant impacts, such as the one that formed the Moon, achieve peak pressures of 100s of GPa. The peak shock states generate sufficient entropy such that subsequent decompression to low pressures intersects the liquid-vapor phase boundary. The entire shock-and-release thermodynamic path must be calculated accurately in order to predict the post-impact structures of planetary bodies. Forsterite (Mg2SiO4) is a commonly used mineral to represent the mantles of differentiated bodies in hydrocode models of planetary collisions. Here, we performed shock experiments on the Sandia Z Machine to obtain the density and temperature of the liquid branch of the liquid-vapor phase boundary of forsterite. This work is combined with previous work constraining pressure, density, temperature, and entropy of the forsterite principal Hugoniot. We find that the vapor curves in previous forsterite equation of state models used in giant impacts vary substantially from our experimental results, and we compare our results to a recently updated equation of state. We have also found that due to under-predicted entropy production on the principal Hugoniot and elevated temperatures of the liquid vapor phase boundary of these past models, past impact studies may have underestimated vapor production. Furthermore, our results provide experimental support to the idea that giant impacts can transform much of the mantles of rocky planets into supercritical fluids.

Soft Mango Firmness Assessment Based on Rayleigh Waves Generated by a Laser-Induced Plasma Shock Wave Technique

Many methods based on acoustic vibration characteristics have been studied to indirectly assess fruit ripeness via fruit firmness. Among these, the frequency of the ₀S₂ vibration mode measured on the equator has been examined, but soft-flesh fruit do not show the ₀S₂ vibration mode. In this study, a Rayleigh wave is generated on a soft mango fruit using the impulse excitation force generated by a laser-induced plasma shock wave technique. Then, the flesh firmness of mangoes is assessed in a non-contact and non-destructive manner by observing the Rayleigh wave propagation velocity because it is correlated with the firmness (shear elasticity), density, and Poisson's ratio of an object. If the changes in the density and Poisson's ratio are small enough to be ignored during storage, then the Rayleigh wave propagation velocity is strongly correlated to fruit firmness. Here, we measure the Rayleigh wave propagation velocity and investigate the effect of storage time. Specifically, we investigate the changes in firmness caused by ripening. The Rayleigh wave propagation velocity on the equator of Kent mangoes tended to decrease by over 4% in 96 h. The Rayleigh wave measured on two different lines propagated independent distance and showed a different change rate of propagation velocity during 96-h storage. Furthermore, we consider the reliability of our method by investigating the interaction of a mango seed on the Rayleigh wave propagation velocity.

Original experimental rat model of blast-induced mild traumatic brain injury: a pilot study

OBJECTIVE

Diagnosing blast-induced mild traumatic brain injury (mTBI) is difficult due to minimal imaging findings. This study aimed to establish a rat model of behavioral abnormality caused by blast-induced mTBI and detect new findings for therapeutic intervention.

METHODS

We used a bench-top blast wave generator with the blast wave exiting through a 20-mm I.D. nozzle aimed at the focused target. The blast wave was directed at the head of male Wistar rats under general anesthesia positioned prone 2.5 cm below the nozzle. Peak shock wave pressure was 646.2 ± 70.3 kPa.

RESULTS

After blast injury, mTBI rats did not show the findings of brain hemorrhage or contusion macroscopically and on hematoxylin-eosin-stained frozen sections but did show anorexia and weight loss in the early post-injury phase. Behavioral experiments revealed short-term memory impairment at 2 weeks and depression-like behavior at 2 and 6 weeks. Diffusion-weighted ex vivo MRI showed high-intensity areas in layers of the bilateral hippocampus. Immunohistochemical analysis revealed accumulation of reactive microglia and GFAP-positive astrocytes in the same region and loss of NeuN-positive neurons in the hippocampal pyramidal cell layer.

CONCLUSIONS

This model can reflect the pathophysiology of blast-induced mTBI and could potentially be used to develop therapeutic interventions in the future.

Effectiveness of Shock Wave Therapy as a Treatment for Spasticity: A Systematic Review

BACKGROUND

The purpose of this study was to collect and analyse the available scientific evidence on the effectiveness of shock wave therapy as a treatment for spasticity.

METHODS

the search was performed in the following databases: PubMed, PEDro, Cochrane, Embase, and the Virtual Health Library. All publications from November 2009 to November 2019 were selected that included a sample of patients with spasticity and prior suspension of botulinum toxin, to whom shock wave therapy was applied. The methodological quality of the articles was evaluated using the Jadad scale and the pyramid of quality of scientific evidence.

RESULTS

25 studies involving 866 participants with spasticity were selected. The results obtained suggest that shock wave therapy appears to be effective in reducing spasticity levels irrespective of the age of the participants, the type of injury, and the tool used to measure the effect.

CONCLUSIONS

shock wave therapy reports evidence of improvement in motor function, motor impairment, pain, and functional independence, applied independently of botulinum toxin. However, due to the heterogeneity of the protocols, there is no optimum protocol for its application, and it would be appropriate to gain more high-quality scientific evidence through primary studies.

Extracorporeal Shock Wave Therapy Enhances the In Vitro Metabolic Activity and Differentiation of Equine Umbilical Cord Blood Mesenchymal Stromal Cells

Extracorporeal shock wave therapy (ESWT) has been shown to induce different biological effects on a variety of cells, including regulation and stimulation of their function and metabolism. ESWT can promote different biological responses such as proliferation, migration, and regenerations of cells. Recent studies have shown that mesenchymal stromal cells (MSCs) secrete factors that enhance the regeneration of tissues, stimulate proliferation and differentiation of cells, and decrease inflammatory and immune reactions. Clinically, the combination of these two therapies has been used as a treatment for tendon and ligament lesions in horses; however, there is no scientific evidence supporting this combination of therapies in vivo. Therefore, the objectives of the study were to evaluate the effects of ESWT on equine umbilical cord blood mesenchymal stromal cells (CB-MSCs) proliferative, metabolic, migrative, differentiation, and immunomodulatory properties in vitro. Three equine CB-MSC cultures from independent donors were treated using an electrohydraulic shock wave generator attached to a water bath. All experiments were performed as triplicates. Proliferation, viability, migration and immunomodulatory properties of the cells were evaluated. Equine CB-MSCs were induced to evaluate their trilineage differentiation potential. ESWT treated cells had increased metabolic activity, showed positive adipogenic, osteogenic, and chondrogenic differentiation, and showed higher potential for differentiation toward the adipogenic and osteogenic cell fates. ESWT treated cells showed similar immunomodulatory properties to none-ESWT treated cells. Equine CB-MSCs are responsive to ESWT treatment and showed increased metabolic, adipogenic and osteogenic activity, but unaltered immunosuppressive properties. In vivo studies are warranted to determine if synergistic effects occur in the treatment of musculoskeletal injuries if ESWT and equine CB-MSC therapies are combined.

Hydrodynamic and Thermodynamic Nonequilibrium Effects around Shock Waves: Based on a Discrete Boltzmann Method

A shock wave that is characterized by sharp physical gradients always draws the medium out of equilibrium. In this work, both hydrodynamic and thermodynamic nonequilibrium effects around the shock wave are investigated using a discrete Boltzmann model. Via Chapman–Enskog analysis, the local equilibrium and nonequilibrium velocity distribution functions in one-, two-, and three-dimensional velocity space are recovered across the shock wave. Besides, the absolute and relative deviation degrees are defined in order to describe the departure of the fluid system from the equilibrium state. The local and global nonequilibrium effects, nonorganized energy, and nonorganized energy flux are also investigated. Moreover, the impacts of the relaxation frequency, Mach number, thermal conductivity, viscosity, and the specific heat ratio on the nonequilibrium behaviours around shock waves are studied. This work is helpful for a deeper understanding of the fine structures of shock wave and nonequilibrium statistical mechanics.

Blast Alleviation of Sacrificial Cladding with Graded and Uniform Cellular Materials

Graded cellular material is a superb sandwich candidate for blast alleviation, but it has a disadvantage for the anti-blast design of sacrificial cladding, i.e., the supporting stress for the graded cellular material cannot maintain a constant level. Thus, a density graded-uniform cellular sacrificial cladding was developed, and its anti-blast response was investigated theoretically and numerically. One-dimensional nonlinear plastic shock models were proposed to analyze wave propagation in density graded-uniform cellular claddings under blast loading. There are two shock fronts in a positively graded-uniform cladding; while there are three shock fronts in a negatively graded-uniform cladding. Response features of density graded-uniform claddings were analyzed, and then a comparison with the cladding based on the uniform cellular material was carried out. Results showed that the cladding with uniform cellular materials is a good choice for the optimal mass design, while the density graded-uniform cladding is more advantageous from the perspective of the critical length design indicator. A partition diagram for the optimal length of sacrificial claddings under a defined blast loading was proposed for engineering design. Finally, cell-based finite element models were applied to verify the anti-blast response results of density graded-uniform claddings.

Extracorporeal shock wave therapy: an update

Extracorporeal shock wave therapy (ESWT) is a safe therapy and there are only a few side effects known (such as pain during ESWT and minor haematomata), but no severe complications are to be expected if it is performed as recommended.

Contraindications are severe coagulopathy for high-energy ESWT, and ESWT with focus on the foetus or embryo and focus on severe infection.

The effect mechanism of ESWT is still a component of diverse studies, but as far as we can summarize today, it is a similar process to a cascade triggered by mechano-transduction: mechanical energy causes changes in the cellular skeleton, which provokes a reaction of the cell core (for example release of mRNA) to influence diverse cell structures such as mitochondria, endoplasmic reticulum, intracellular vesicles, etc., so the enzymatic response leads to the improvement of the healing process.

The usage of ESWT should be taught, to improve the outcome. Courses should be organized by national societies, since the legal framework conditions are different from one country to another.

In this update the musculoskeletal indications are addressed (mainly bone and tendons): pseudoarthrosis, delayed fracture healing, bone marrow oedema and osteonecrosis in its early stages, insertional tendinopathies such as plantar fasciitis and Achilles tendon fasciitis, calcifying tendonitis of the rotator cuff, tennis elbow, and wound healing problems.

Cite this article: EFORT Open Rev 2020;5:584-592. DOI: 10.1302/2058-5241.5.190067

Proteomic Analysis of Peri-Wounding Tissue Expressions in Extracorporeal Shock Wave Enhanced Diabetic Wound Healing in a Streptozotocin-Induced Diabetes Model

Our former studies have demonstrated that extracorporeal shock wave therapy (ESWT) could enhance diabetic wound healing but the bio-mechanisms remain elusive. This study investigated the changes of topical peri-wounding tissue expressions after ESWT in a rodent streptozotocin-induced diabetic wounding model by using the proteomic analysis and elucidated the molecular mechanism. Diabetic rats receiving ESWT, normal control, and diabetic rats receiving no therapy were analyzed. The spots of interest in proteome analysis were subjected to mass spectrometry to elucidate the peptide mass fingerprints. Protein expression was validated using immunohistochemical staining and related expression of genes were analyzed using real-time RT-PCR. The proteomic data showed a significantly higher abundance of hemopexin at day 3 of therapy but down-regulation at day 10 as compared to diabetic control. In contrast, the level of serine proteinase inhibitor (serpin) A3N expression was significantly decreased at day 3 therapy but expression was upregulated at day 10. Using real-time RT-PCR revealed that serpin-related EGFR-MAPK pathway was involved in ESWT enhanced diabetic wound healing. In summary, proteome analyses demonstrated the expression change of hemopexin and serpin with related MAPK signaling involved in ESWT-enhanced diabetic wound healing. Modulation of hemopexin and serpin related pathways are good strategies to promote wound healing.

Therapeutic Angiogenesis with Sound Waves

Along with the progress of global aging, the prognosis of severe ischemic heart disease (IHD) remains poor, and thus the development of effective angiogenic therapy remains an important clinical unmet need. We have developed low-energy extracorporeal cardiac shock wave therapy as an innovative minimally invasive angiogenic therapy and confirmed its efficacy in a porcine chronic myocardial ischemia model in animal experiments as well as in patients with refractory angina. Since ultrasound is more advantageous for clinical application than shock waves, we then aimed to develop ultrasound therapy for IHD. We demonstrated that specific conditions of low-intensity pulsed ultrasound (LIPUS) therapy improve myocardial ischemia in animal models through the enhancement of angiogenesis mediated by endothelial mechanotransduction. To examine the effectiveness of our LIPUS therapy in patients with severe angina pectoris, we are now conducting a prospective multicenter clinical trial in Japan. Furthermore, to overcome the current serious situation of dementia pandemic but with no effective treatments worldwide, we have recently demonstrated that our LIPUS therapy also improves cognitive impairment in mouse models of Alzheimer's disease and vascular dementia. Here, we summarize the progress in our studies to develop angiogenic therapies with sound waves.

Comparison of the added effects of kinesio taping and extracorporeal shockwave therapy to exercise alone in knee osteoarthritis

INTRODUCTION

Pain and functional limitations affect quality of life of patients with knee osteoarthritis (OA).

PURPOSE

The purpose of this study was to compare the effects of two different applications (Kinesio taping; KT and Extracorporeal Shock Wave Therapy; ESWT) added to an home-exercise program on pain, strength and function in patients with knee OA.

METHODS

Sixty voluntary female subjects were randomly assigned into groups of; KT (n = 22), ESWT (n = 18) and control (CON) (n = 20) respectively. KT and ESWT were applied for 6 weeks and all the groups were taken home exercise program during 12 weeks in all groups. The outcome measures were; Visual Analog Scale for pain (during squat, rest and sleep), Isokinetic strength for quadriceps and hamstring strength, 'The Knee Injury and Osteoarthritis Outcome Survey', Timed Up & Go and 10 m Walk tests for function. The assessments were carried out at baseline, 6th and 12th weeks.

RESULTS

The mean age was 58.8 ± 6.2 years. Significant improvements were observed in all groups in all tests (p < .05). There was no difference found between groups (p > .05) except pain levels during sleep. CON group showed significant reduction in pain during sleep compared to ESWT group (p < .05).

CONCLUSION

KT and ESWT have similar effects in terms of decreasing pain, improving knee strength and function in patients with knee OA. However it can be said that if a well-designed home exercise program were done by the patients correctly and regularly then it will be the best treatment option for patients with knee OA.

Riveting hammer vibration damages mechanosensory nerve endings

Hand-arm vibration syndrome (HAVS) is an irreversible neurodegenerative, vasospastic, and musculoskeletal occupational disease of workers who use powered hand tools. The etiology is poorly understood. Neurological symptoms include numbness, tingling, and pain. This study examines impact hammer vibration-induced injury and recoverability of hair mechanosensory innervation. Rat tails were vibrated 12 min/d for 5 weeks followed by 5 week recovery with synchronous non-vibrated controls. Nerve fibers were PGP9.5 immunostained. Lanceolate complex innervation was compared quantitatively in vibrated vs sham. Vibration peak acceleration magnitudes were characterized by frequency power spectral analysis. Average magnitude (2515 m/s² , root mean squared) in kHz frequencies was 109 times that (23 m/s² ) in low Hz. Percentage of hairs innervated by lanceolate complexes was 69.1% in 5-week sham and 53.4% in 5-week vibration generating a denervation difference of 15.7% higher in vibration. Hair innervation was 76.9% in 5-weeks recovery sham and 62.0% in 5-week recovery vibration producing a denervation difference 14.9% higher in recovery vibration. Lanceolate number per complex (18.4 ± 0.2) after vibration remained near sham (19.3 ± 0.3), but 44.9% of lanceolate complexes were abnormal in 5 weeks vibrated compared to 18.8% in sham. The largest vibration energies are peak kHz accelerations (approximately 100 000 m/s² ) from shock waves. The existing ISO 5349-1 standard excludes kHz vibrations, seriously underestimating vibration injury risk. The present study validates the rat tail, impact hammer vibration as a model for investigating irreversible nerve damage. Persistence of higher denervation difference after 5-week recovery suggests repeated vibration injury destroys the capability of lanceolate nerve endings to regenerate.

Development of a Shock-Wave Catheter Ablation System for Ventricular Tachyarrhythmias: Validation Study in Pigs In Vivo

Background

Although radiofrequency catheter ablation is the current state‐of‐the‐art treatment for ventricular tachyarrhythmias, it has limited success for several reasons, including insufficient lesion depth, prolonged inflammation with subsequent recurrence, and thromboembolisms due to myoendocardial thermal injury. Because shock waves can be applied to deep lesions without heat, we have been developing a shock‐wave catheter ablation (SWCA) system to overcome these fundamental limitations of radiofrequency catheter ablation. In this study, we evaluated the efficacy and safety of our SWCA system for clinical application to treat ventricular tachyarrhythmia.

Methods and Results

In 33 pigs, we examined SWCA in vivo for the following 4 protocols. First, in an epicardial substrate model (n=8), endocardial SWCA significantly decreased the sensing threshold (pre‐ versus postablation: 11.4±3.8 versus 6.8±3.6 mV; P<0.05) and increased the pacing threshold (pre‐ versus postablation: 1.6±0.8 versus 2.0±1.1 V; P<0.05), whereas endocardial radiofrequency catheter ablation failed to do so. Second, in a myocardial infarction model (n=3), epicardial SWCA of the border zone of the infarcted lesion was as effective as ablation of the normal myocardium. Third, in a coronary artery application model (n=10), direct application of shock waves to the epicardial coronary arteries caused no adverse effects in either the acute or chronic phase. Fourth, with an epicardial approach (n=8), we found that 90 shots per site provided an ideal therapeutic condition to create deep lesions with less superficial damage.

Conclusions

These results indicate that our new SWCA system is effective and safe for treatment of ventricular tachyarrhythmias with deep arrhythmogenic substrates.