Peak Positive Pressure Research Articles

Evaluation of a Multimodal Confocal Therapeutic Focused Ultrasound Apparatus: Bridging Cavitation, Thermal Ablation, and Histotripsy in Preclinical Treatments

ObjectivesThe development of versatile and user-friendly preclinical platforms is vital for therapeutic ultrasound research. We introduce a flexible ultrasound-guided focused ultrasound (FUS) platform with two confocal therapeutic transducers, allowing thermal and mechanical modalities, and present its design and, features, with validation of potential applications in preclinical studies. MethodsThe probe's acoustic properties, energy delivery efficiency, and thermal and mechanical modalities are characterized. A computational model predicts thermal effects while optimizing treatment parameters. Ex vivo tissue samples are used to validate system performance, safety, and usability. In vivo experiments on mice with MC38 tumors are presented with immunohistochemistry (IHC) to validate treatment outcomes. ResultsElectroacoustic conversion efficiency levels were 80% and 40% for 1.1 MHz and 3.3 MHz, respectively. Confocal therapy transducers at 1.1 MHz and 3.3 MHz successfully demonstrated cavitation histotripsy and thermal treatments. At 1.1 MHz, for histotripsy, −20 MPa negative peak pressure is achieved, while at 3.3 MHz used for thermal ablation a maximum of 35 MPa is reached for positive peak pressure. Numerical analysis provides thermal treatment planning, aligning with in vitro and in vivo experiments for lesion prediction. Real-time in vivo cavitation monitoring was consistent with in vitro chemical dosimetry, ensuring treatment uniformity. ConclusionThe ultrasound platform induces thermal or mechanical lesions with precise spatial resolution, validated by IHC tissue characterization. Integrated cavitation monitoring enables real-time treatment monitoring. Coupling with thermal simulations provides optimization of thermal treatment parameters. This versatile “all-in-one” therapeutic platform supports multiple treatment modalities including cavitation, thermal ablation, and histotripsy, facilitating direct comparisons to assess their efficacy in diverse therapeutic settings.

Peak factors of wind load for main frame design of rooftop structures

ABSTRACT Technology is being developed to unitize structures installed on apartment rooftops during construction. The rooftop is located at the top of a high-rise building with a flexible structure. However, the rooftop structure itself is close to a rigid body and is not integrated with the building. Therefore, it is difficult to calculate the gust effect coefficient of the rooftop structure. The peak factor provided by the Korean Design Standard (KDS) uses an equation for general buildings and may be inaccurate to a certain extent when used to calculate the wind load on rooftop structures. Therefore, in this study, wind pressure tests were conducted on three research models to calculate the appropriate peak factors for rooftop structures. For each model, the peak factor trend was analyzed according to the wind pressure coefficient, and the peak factor was presented. When the evaluation time was 10 min, the positive pressure peak factor converged to three and the negative pressure peak factor converged to four. Additionally, a formula for calculating the peak factor of rooftop structures based on the wind load evaluation time is proposed. Hence, the peak factor of rooftop structures can be calculated based on various evaluation times.

Experimental study on the blast resistance of polyurea-coated aramid fabrics

This paper investigates overpressure attenuation capacity and failure mechanism of the polyurea-coated aramid fabric (PCAF) subjected to air-blast loading experimentally. The peak overpressure, arrival time and positive pressure duration of shock waves on the blast and back side of PCAFs were obtained in tests and analyzed. In addition, the failure mode and mechanism were revealed with the electron scanning microscope (SEM), meanwhile the effect of polyurea type, coating position and thickness ratio on the blast resistance were discussed. The results show that in the cases of scaled distances of 1.84 and 2.32 m/kg1/3, PCAFs, one-layer polyurea coated on three-layer aramid woven fabrics, can attenuate the peak overpressure by about 70 %, delay the arrival time by about 0.7 ms, and shorten the positive pressure duration by 10 %-50 %. This is due to the increased out-of plane stiffness and closure of interweaving apertures of the aramid fabric. Furthermore, perforation is the main failure mode of aramid fabrics, in which the tensile breakage in weft yarn and the frictional slip in warp yarn, while the failure modes of PCAF mainly include fracture and exfoliation, with both weft and warp yarns breakage and polyurea failure. It was concluded that the degree of infiltration between the polyurea and fabric affects mechanical properties of the fiber, changing the failure mode of PCAF. In terms of the extent of damage, the PCAF exhibits a superior blast resistance when the polyurea coated on the back side. The blast resistance of PCAF increases first then decreases with an increase in the thickness of the polyurea layer under the same areal density.

Analysis of train-induced aerodynamic characteristics and pressure-relief measures relating to fully enclosed noise barriers installed on railway bridges

Fully enclosed noise barriers (FENBs) are increasingly being installed on high-speed railway bridges for noise pollution control. However, the aerodynamic effects of high-speed trains passing FENBs have an adverse impact on barrier durability and generate micro-pressure waves. In this paper, a numerical model of a train passing an FENB on a bridge is established. The aerodynamic pressure distribution along the FENB is analyzed for both a single train and two trains passing one another. The propagation characteristics and evolution mechanisms of pressure waves are then investigated. The results show that the pressure is lower at the ends of the FENB and higher in the middle along the direction of train travel. The peak positive and negative pressures at the mid-span are 1.95 and 4.47 times higher than those at the ends, respectively. This distribution is caused by the propagation, superposition, reflection, and attenuation of pressure waves. Compression waves account for 78.9% of the peak positive pressure. An amplification factor must be considered when estimating the impact of two trains passing one another. Analysis of five pressure-relief schemes shows that arranging a single pressure-relief hole at a high-pressure location effectively alleviates the over-pressure in the FENB. The overall pressure-relief effect is an exponential function of the single opening area. Considering a constant opening area, arranging several relief holes at equal spacing optimizes the adverse pressure distribution compared with the single-hole relief scheme. The equivalent forces of the multi-hole scheme are 3.35% and 7.58% lower than in the single-hole scheme.

Numerical investigation of the number of excitation elements-dependent acoustic field characteristics of a histotripter

Abstract Histotripsy is an emerging ultrasound technology for disintegrating various soft tissues noninvasively and accureately. However, it is difficult to characterize the acoustic field of a histotripter using the existing measurement methods (i.e., hydrophones) because of the damage potential of bubble cavitation on the sensing element under such high irradiation power. In this work, according to a quantitative relationship between the acoustic pressure and ultrasonic focusing gain G, nonlinearity β, attenuation coefficient α, a numerical reconstruction method is proposed to accurately and reliably estimate the acoustic field of a histotripter. The k-Wave toolbox was used to calculate the acoustic field produced from identical sectors on a common concave surface by gradually increasing the number of excitation elements (i.e., up to 256 that cover the whole surface). The excitation frequency is 0.8 MHz, and the initial pressure at the transducer surface is 0.4 MPa. The focusing gains, peak positive and negative pressure, positive to negative peak acoustic pressure ratio, and harmonic distributions in the focal region under different numbers of excited elements were analysed. It is found that when about a quarter of the transducer surface is excited (64 elements), the nonlinear effect becomes obvious, resulting in significant peak pressures and harmonics. Furthermore, the relationship between the positive and negative pressure peaks (p + and p ¬) and the number of excited elements fits a quadratic curve function quite well (R = 0.999). Altogether, the proposed method can be applied to estimate the acoustic pressure at an extremely high intensity that exceeds the range of current measurement apparatus. Acoustic pressures using a low number of excited elements are measured first and then extrapolated to the full surface coverage using the built-in regression models. In the near future, the field calculation scheme for the therapeutic focused transducers with higher irradiation power and larger dimensions, as well as experimental work, will be done to further validate our model.

Intraoperative Lung Mechanics In Post-Covid Healthy Pregnants Who Required Cesarean Section: A Randomized Controlled Trial

Objective: This study aimed to investigate whether lung mechanics were affected in patients recovering from Covid-19 without ARDS who did not undergo lung imaging during the active infection period. Methods: The study included pregnant patients undergoing cesarean section operations. Participants were divided into two groups: those who had recovered from Covid-19 within the past year (group 1, n=50) and those who had never been infected with Covid-19 (group 2, n=50). The study included 100 patients divided into two groups: those who had recovered from Covid-19 within the last year (group 1, n=50) and those who had never experienced Covid-19 infection (group 2, n=50). Peak pressure (Ppeak), plateau pressure (Pplato), dynamic compliance (Cdyn), and positive end-expiratory pressure (PEEP) values, measured by the anesthesia machine, were recorded at specified time intervals following intubation. Results: Comparisons of Ppeak, Pplato, ΔP, Cdyn, and R data at specified times (1 min, 5 min, 10 min, 20 min, 30 min, and 40 min) showed no significant differences between the groups (p>0.05). Conclusion: No significant differences in lung mechanics were found between the Covid-19-recovered patient group and the control group. Differences observed in SpO2, MAP, and Cdyn values in both groups are considered to be expected changes associated with routine procedures of general anesthesia

Research on shock wave driving technology of methane explosion

In order to improve the driving ability of the explosion wave simulation equipment, reduce the erosion effect of condensed explosives on the explosion wave simulation equipment, improve the safety of the test process, and make better use of the meteorological detonation driving method, it is necessary to optimize the source of the shock wave load in the driving section. Based on the finite volume method of FLACS, a methane detonation driving model corresponding to the test is established to explore the feasibility of using methane as an explosion source to test the structure against explosion shock wave. A methane detonation drive test was carried out to verify the accuracy of the numerical model. Finally, an engineering model for attenuation of shock wave overpressure peak value in pipeline is established by dimensional analysis, and the model coefficient is determined by numerical simulation and test data. The results show that the blast pressure is the highest when the methane volume ratio reaches 9.5 vol% in the methane-air mixture. Simply increasing oxygen content has little effect on the peak overpressure and positive pressure duration of shock wave. In the pure oxygen environment, the detonation effect can be achieved when the volume ratio of methane to oxygen is 1:2, and the incident pressure of the shock wave is proportional to the volume of the gas cloud. When the gas cloud volume is constant, a reasonable selection of methane-oxygen mixture ratio can achieve a better detonation effect, which can effectively increase the peak overpressure of the shock wave in the test section. The research results can provide technical reference for the development of new explosion wave simulation equipment.

Quantitative Comparison of Ventilation Parameters of Different Approaches to Ventilator Splitting and Multiplexing.

Amid the COVID-19 pandemic, this study delves into ventilator shortages, exploring simple split ventilation (SSV), simple differential ventilation (SDV), and differential multiventilation (DMV). The knowledge gap centers on understanding their performance and safety implications. Our hypothesis posits that SSV, SDV, and DMV offer solutions to the ventilator crisis. Rigorous testing was anticipated to unveil advantages and limitations, aiding the development of effective ventilation approaches. Using a specialized test bed, SSV, SDV, and DMV were compared. Simulated lungs in a controlled setting facilitated measurements with sensors. Statistical analysis honed in on parameters like peak inspiratory pressure (PIP) and positive end-expiratory pressure. Setting target PIP at 15 cm H2O for lung 1 and 12.5 cm H2O for lung 2, SSV revealed a PIP of 15.67 ± 0.2 cm H2O for both lungs, with tidal volume (Vt) at 152.9 ± 9 mL. In SDV, lung 1 had a PIP of 25.69 ± 0.2 cm H2O, lung 2 at 24.73 ± 0.2 cm H2O, and Vts of 464.3 ± 0.9 mL and 453.1 ± 10 mL, respectively. DMV trials showed lung 1's PIP at 13.97 ± 0.06 cm H2O, lung 2 at 12.30 ± 0.04 cm H2O, with Vts of 125.8 ± 0.004 mL and 104.4 ± 0.003 mL, respectively. This study enriches understanding of ventilator sharing strategy, emphasizing the need for careful selection. DMV, offering individualization while maintaining circuit continuity, stands out. Findings lay the foundation for robust multiplexing strategies, enhancing ventilator management in crises.

Successful management of pulmonary edema secondary to accidental electrocution in a young dog

BackgroundHuman records describe pulmonary edema as a life-threatening complication of electric shock. Successful management requires prompt recognition and intensive care. However, in companion animals, electrocutions are rarely reported, even though domestic environments are full of electrical devices and there is always the possibility of accidental injury. Therefore, it is important for veterinarians to know more about this condition in order to achieve successful patient outcomes.Case presentationA 3-month-old male Labrador Retriever was presented with a history of transient loss of consciousness after chewing on a household electrical cord. On admission, the puppy showed an orthopneic position with moderate respiratory distress. Supplemental oxygen via nasal catheter was provided, but the patient showed marked worsening of respiratory status. Point-of-care ultrasound exams suggested neurogenic pulmonary edema due to electrical shock close to the central nervous system and increased B-lines without evidence of cardiac abnormalities. Mechanical ventilation of the patient was initiated using volume-controlled mode with a tidal volume of 9 to 15 ml/kg until reaching an end-tidal carbon dioxide ≤ 40 mm Hg, followed by a stepwise lung-recruitment maneuver in pressure-controlled mode with increases of the peak inspiratory pressure (15 to 20 cm H2O) and positive end-expiratory pressure (3 to 10 cm H2O) for 30 min, and return to volume-controlled mode with a tidal volume of 15 ml/kg until reaching a peripheral oxygen saturation ≥ 96%. Weaning from the ventilator was achieved in six hours, and the patient was discharged two days after admission without neurological or respiratory deficits.ConclusionsWe present a rather unusual case of a neurogenic pulmonary edema subsequent to accidental electrocution in a dog. Timely diagnosis by ultrasound and mechanical ventilation settings are described. Our case highlights that pulmonary edema should be considered a potentially life-threatening complication of electrical shock in small animal emergency and critical care medicine.

Field measurements of aerodynamic pressures induced by suburban rail transit train passing through double-track tunnel with mid-partition wall

ABSTRACT Suburban rail lines, which provide fast connections between city centre and the surrounding suburbs, are attracting more and more attention from cities. As a train passes through the tunnel quickly, it tends to produce significant aerodynamic effects. In this study, a series of field measurement experiments were carried out in two tunnels with the mid-partition wall. The influence of train speed and tunnel length on the aerodynamic pressure was analysed. The aerodynamic pressure in adjacent tunnel was also discussed. Furthermore, the attenuation law and coefficient of aerodynamic pressure in tunnels with mid-partition walls were discussed. On this basis, a theoretical calculation model for predicting the peak positive pressure inside tunnels with different lengths and attenuation characteristics was established. The results show that the tunnel length not only affects the amplitude of the pressure, but also significantly affects the distribution trend of the pressure peak in the longitudinal direction. The propagation and reflection processes of pressure waves also exist in the adjacent tunnel on the other side of the partition, and they are synchronous. For the horse-shaped tunnel with mid-partition walls, the peak pressure inside the tunnel is directly proportional to the 2.05–2.20 power of the train speed, and the peak pressure decays exponentially with time. The pressure attenuation coefficient is greatly influenced by the placement of the measuring point, ranging from 4.957 × 10 − 5 to 8.184 × 10 − 5 depending on the position of the measurement point. This work provides important data support for studying the tunnel aerodynamic effects and verifying related numerical simulations.

Peak positive pressure matters in acoustic droplet vaporization

We demonstrate the significance of the positive pressure component of an ultrasound wave in acoustic droplet vaporization. Theory and acoustic simulations reveal that the distorted compression part of the incoming wave, which includes a broad spectrum of frequencies above the fundamental, presents a pronounced shift in phase when focusing within the droplet and crossing the focal point. The extent of this so-called Gouy phase shift is sufficient to change the sign of the compression phase of the wave, actively creating a tension region in the droplet bulk in the same location where we experimentally observe vapor nucleation. A sign reversal of the rarefaction component of the ultrasound wave is, on the other hand, not expected. The extent of distortion of the incoming ultrasound wave can influence the occurrence of droplet vaporization, even at constant peak negative pressure, which may partially explain the broad range of vaporization threshold values reported in literature. The results suggest that vaporization can be achieved exploiting ultrasound waves with high peak positive pressures and reduced peak negative pressures.

Designing a benign prostatic hyperplasia dual-mode cavitation cloud and boiling histotripsy therapy transducer

Benign prostatic hyperplasia (BPH) is a condition that causes an enlarged prostate leading to lower urinary tract symptoms (LUTS), affecting quality of life. Histotripsy is a non-invasive focused ultrasound technique that mechanically disintegrates tissue wherein cavitation cloud (CH) and boiling histotripsy (BH) are the two commonly used therapy modes. Recent studies have shown successful ablation of BPH tissue in vitro by transducers that were designed for a transabdominal approach. However, this approach may not be successful in treating tissue in vivo, as evidenced in some of the clinical studies, due to challenges with the anatomical position of prostate within humans. Therefore, a need exists in treating it transrectally with a transducer that can perform both CH and BH for efficient ablation. Initial design studies were performed to determine the appropriate source parameters and materials needed for fabricating the combinational therapy transducer for in vivo use. A 3 MHz multi-element source with a focal length of 40 mm and gain of 64 was chosen. The equivalent aperture is 48.5 mm with a 10 mm central opening for image guidance. Non-linear simulations show sufficient peak positive and negative pressures can be achieved for performing both regimes. Further details on the fabrication and characterization of the transducer with benchtop results will be presented.

Harmonic Motion Imaging-Guided Focused Ultrasound Ablation: Comparison of Three Focused Ultrasound Interference Filtering Methods

Harmonic motion imaging (HMI) is an acoustic radiation force-based elasticity imaging technique, which can be used to monitor changes in tissue mechanical properties caused by focused ultrasound (FUS)-induced thermal ablation. In conventional HMI, the amplitude-modulated FUS sequence and imaging pulse are transmitted simultaneously. With this method, the high-amplitude FUS signal must be separated from the imaging data for tissue displacement estimation. Frequency domain notch filtering and bandpass filtering were previously used to filter FUS interference from imaging data. However, FUS interference becomes more pronounced at the increased intensities and durations necessary for thermal ablation, rendering frequency domain filtering challenging. In this study, three methods for FUS interference filtering during HMI-guided FUS ablation (HMIgFUS) were compared. The methods were notch filtering; interleaved HMIgFUS, with interleaved FUS and imaging pulses; and FUS-net, a convolutional neural network-based U-Net autoencoder developed by our group for FUS interference filtering in radiofrequency data. FUS-net was applied here for the first time for the purpose of ablation displacement monitoring. The three filtering methods were tested during 20 HMIgFUS acquisitions in an ex vivo canine liver using a range of peak positive pressures from 11 to 18 MPa and durations ranging from 60 to 180 seconds. The B-mode mean squared errors (MSEs) and displacement amplitude contrast-to-noise ratios (CNRs) of the three methods were calculated and compared. The interleaved method for HMIgFUS was found to be significantly robust in avoiding FUS interference in all tested cases for FUS ablation monitoring, especially cases with high FUS pressure and long durations, as opposed to traditional notch filtering and FUS-net filtering. CNRs obtained from displacement amplitude maps in the interleaved data set were significantly higher in all cases than those obtained from the notch filtered and FUS-net data sets. There was not a significant trend in displacement CNR between the FUS-net and notch filtered data sets. However, B-mode MSE was found to be significantly higher when comparing the FUS-net and interleaved data sets as opposed to the notch filtered and interleaved data sets, suggesting further potential of FUS-net as an FUS interference filtering method. These findings indicate the robustness of interleaved HMIgFUS in avoiding FUS interference during HMIgFUS monitoring and the advantages, limitations and future potential of FUS-net and notch filtering.

Influence of the door opening on the pressure transient caused by the high-speed subway train passing through the double-track tunnel with the mid-partition wall

Double track tunnel with mid-partition wall is a widely used subway tunnel. In such tunnels, in order to avoid the fire door on the middle partition wall from invading the gauge, the fire door is often removed to form door openings. The existence of door opening connects two parallel tunnels, which affects the aerodynamic effect caused by high-speed subway train passing through the tunnel. In this study, a double track tunnel with mid-partition wall was taken as an example to analyze the aerodynamic effect of high-speed subway train under the door opening conditions, moreover, the surface pressure of two adjacent tunnels and train surface pressure was also analyzed. In addition, the propagation mechanism of pressure wave in open door tunnel was analyzed in detail, and the superposition law of branch pressure wave caused by open door was pointed out. The results indicated that the presence of door openings is beneficial for controlling the peak pressure on the tunnel surface and train surface. For a door opening with a cross-sectional area of 5 m2 (cross-sectional area ratio of 0.116), when the door opening is located 300 m and 700 m away from the tunnel entrance, the peak positive pressure can be reduced by up to 21.9 % and the peak negative pressure can be reduced by 21.1 %. The cross-sectional area and number of door openings have a limited effect on reducing the peak pressure of the tunnel. Compared to the number of door openings, the position of the door opening has a more significant impact on the peak pressure inside the tunnel and on the surface of the train.

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

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

Exploring the impact of vertically separated flows on wind loads of multi-level structures

The complex dynamics of vertically separated flows pose a significant challenge when it comes to assessing the wind loads on multi-level structures, demanding a nuanced understanding of the intricate interplay between atmospheric conditions and architectural designs. Previous studies and wind loading standards provide insufficient guidance for designing wind pressures on multi-level buildings. The behavior of wind around perpendicularly attached surfaces is not quite similar to that of individual flat roofs or walls. When a body is composed of several surfaces with right or oblique angles, the separated flow from surfaces and their interactions will cause complex flow patterns around each surface. A wind tunnel experimental study was carried out on bluff bodies with attached flat plates and other adjacent bluff bodies with different heights to examine the wind-induced pressures on such complex shapes. Mean and peak pressure coefficients were measured to determine the flow interaction patterns and location of localized peak pressures. The results were compared to the Tokyo Polytechnic University Aerodynamic Database of isolated low-rise buildings without eaves. The research findings indicated that there was a noteworthy disparity between the minimum and maximum values and locations of peak pressures on both the wall and roof surfaces of the models used in this study, as compared to the results obtained by the Tokyo Polytechnic University. Moreover, the study conceivably pointed to the difference between the peak negative and positive pressure coefficient locations with the ASCE 7-22 wind loading zones. The peak suction zones were affected by the combined flows at perpendicular faces, and as a result, different wind load zones were obtained dissimilar to those introduced by ASCE 7-22. Wind loading standards may need to be modified to account for the wind pressures on complex building structures with an emphasis on the location of the peak negative pressure zones.

Altitude influence on the explosion shock wave pressure distribution

The explosion shock wave pressure distribution law is significantly affected by the altitude. It is very important to clarify the altitude impact on the explosion shock wave pressure propagation law for guiding the shock wave pressure test and accurately evaluating the ammunition damage power. The paper reviews the finite element numerical simulation and actual testing results of researchers at home and abroad regarding the propagation of explosive shock wave pressure through different air and water mediums, and clarifies the impact of altitude on characterization parameters of shock wave pressure such as peak pressure, impulse, and positive pressure duration. Based on the current research status both domestically and internationally, we have pointed out the main problems that still exist in the current research process and proposed research directions that need to be focused on in subsequent studies.

Noninvasive mechanical destruction of liver tissue and tissue decellularisation by pressure-modulated shockwave histotripsy.

Boiling histotripsy (BH) is a promising High Intensity Focused Ultrasound (HIFU) technique that can be used to mechanically fractionate solid tumours at the HIFU focus noninvasively, promoting tumour immunity. Because of the occurrence of shock scattering phenomenon during BH process, the treatment accuracy of BH is, however, somewhat limited. To induce more localised and selective tissue destruction, the concept of pressure modulation has recently been proposed in our previous in vitro tissue phantom study. The aim of the present study was therefore to investigate whether this newly developed histotripsy approach termed pressure-modulated shockwave histotripsy (PSH) can be used to induce localised mechanical tissue fractionation in in vivo animal model. In the present study, 8 Sprague Dawley rats underwent the PSH treatment and were sacrificed immediately after the exposure for morphological and histological analyses (paraffin embedded liver tissue sections were stained with H&E and MT). Partially exteriorised rat's left lateral liver lobe in vivo was exposed to a 2.0 MHz HIFU transducer with peak positive (P +) and negative (P -) pressures of 89.1 MPa and -14.6 MPa, a pulse length of 5 to 34 ms, a pressure modulation time at 4 ms where P + and P - decreased to 29.9 MPa and - 9.6 MPa, a pulse repetition frequency of 1 Hz, a duty cycle of 1% and number of pulses of 1 to 20. Three lesions were produced on each animal. For comparison, the same exposure condition but no pressure modulation was also employed to create a number of lesions in the liver. Experimental results showed that a partial mechanical destruction of liver tissue in the form of an oval in the absence of thermal damage was clearly observed at the HIFU focus after the PSH exposure. With a single pulse length of 7 ms, a PSH lesion created in the liver was measured to be a length of 1.04 ± 0.04 mm and a width of 0.87 ± 0.21 mm which was 2.37 times in length (p = 0.027) and 1.35 times in width (p = 0.1295) smaller than a lesion produced by no pressure modulation approach (e.g., BH). It was also observed that the length of a PSH lesion gradually grew towards the opposite direction to the HIFU source along the axial direction with the PSH pulse length, eventually leading to the generation of an elongated lesion in the liver. In addition, our experimental results demonstrated the feasibility of inducing partial decellularisation effect where liver tissue was partially destructed with intact extracellular matrix (i.e., intact fibrillar collagen) with the shortest PSH pulse length. Taken together, these results suggest that PSH could be used to induce a highly localised tissue fractionation with a desired degree of mechanical damage from complete tissue fractionation to tissue decellularisation through controlling the dynamics of boiling bubbles without inducing the shock scattering effect.

Low inflating pressures during neonatal tidal volume targeted ventilation: occurrence and significance.

We investigated the inflating pressures (Pinfl, the difference between peak inspiratory pressure and positive end-expiratory pressure) in infants receiving volume targeted ventilation. Data were collected and analysed from 195 infants. Median Pinfl was determined before each blood gas (n = 3425). Ventilator parameters and blood gases were compared between periods when Pinfl was <5 mbar and periods when it was higher. 1-hour periods when median Pinfl was <5 mbar occurred in 30% of the babies and were associated with similar tidal volumes and minutes ventilation as periods with higher Pinfl. Babies triggered more ventilator inflations, had more spontaneous breaths and lower oxygen requirement when Pinfl was low. There was no difference in blood gases when Pinfl was <5 mbar or when it was higher. Episodes of low inflating pressure occur frequently in babies receiving volume targeted ventilation, but they do not lead to changes in blood gases.

Fiber-optic hydrophone for detection of high-intensity ultrasound waves.

Fiber-optic hydrophones (FOHs) are widely used to detect high-intensity focused ultrasound (HIFU) fields. The most common type consists of an uncoated single-mode fiber with a perpendicularly cleaved end face. The main disadvantage of these hydrophones is their low signal-to-noise ratio (SNR). To increase the SNR, signal averaging is performed, but the associated increased acquisition times hinder ultrasound field scans. In this study, with a view to increasing SNR while withstanding HIFU pressures, the bare FOH paradigm is extended to include a partially reflective coating on the fiber end face. Here, a numerical model based on the general transfer-matrix method was implemented. Based on the simulation results, a single-layer, 172 nm TiO2-coated FOH was fabricated. The frequency range of the hydrophone was verified from 1 to 30 MHz. The SNR of the acoustic measurement with the coated sensor was 21 dB higher than that of the uncoated one. The coated sensor successfully withstood a peak positive pressure of 35 MPa for 6000 pulses.