Sound Pressure Research Articles

Long-term outcome of patients with Ménière's disease following cochlear implantation: a comprehensive outcome study with validated assessment tools.

Patients suffering from Ménière's disease (MD) experience vertigo, and impairments in hearing and quality of life (QoL). This study aims to investigate the impact of cochlear implantation (CI) on various aspects affecting patients with MD. A single tertiary centre's CI database for CI recipients with MD between 2014 and 2022 was screened retrospectively. Hearing, vertigo, tinnitus symptoms, and hearing-related QoL were assessed. Pre- and postoperative hearing tests in conjunction with subjective outcome measures by visual analogue scale (VAS) and validated tools such as the Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI) and Nijmegen Cochlear Implant Questionnaire (NCIQ), as well as the assessment of the pre- and postoperative Functional Level Scale (FLS) were examined. Eleven ears were included (median age: 59 years at implantation). Following implantation, there was a significant enhancement in Word Recognition Scores at sound levels of 65 dB and 80 dB compared to before treatment (preop vs. 12 months postop: p = 0.012). However, no significant enhancement was observed for 50 dB. MD-related impairments improved significantly postoperatively, as measured by the VAS (vertigo: p = 0.017; tinnitus: p = 0.042), DHI (p = 0.043), THI (p = 0.043) and NCIQ (p < 0.001). The FLS improved significantly (p = 0.020). CI has positive effects on all areas examined in our cohort. However, discrimination of speech at low sound pressure levels remained problematic postoperatively. In patients suffering from MD, the prioritized treatment goals include not only improved hearing but also the rehabilitation of vertigo and tinnitus, as well as the enhancement of QoL. Validated instruments are useful screening tools.

Effects of Speech Characteristics on Electroglottographic and Instrumental Acoustic Voice Analysis Metrics in Women With Structural Dysphonia Before and After Treatment.

Literature suggests a dependency of the acoustic metrics, smoothed cepstral peak prominence (CPPS) and harmonics-to-noise ratio (HNR), on human voice loudness and fundamental frequency (F0). Even though this has been explained with different oscillatory patterns of the vocal folds, so far, it has not been specifically investigated. In the present work, the influence of three elicitation levels, calibrated sound pressure level (SPL), F0 and vowel on the electroglottographic (EGG) and time-differentiated EGG (dEGG) metrics hybrid open quotient (OQ), dEGG OQ and peak dEGG, as well as on the acoustic metrics CPPS and HNR, was examined, and their suitability for voice assessment was evaluated. In a retrospective study, 29 women with a mean age of 25 years (± 8.9, range: 18-53) diagnosed with structural vocal fold pathologies were examined before and after voice therapy or phonosurgery. Both acoustic and EGG signals were recorded simultaneously during the phonation of the sustained vowels /ɑ/, /i/, and /u/ at three elicited levels of loudness (soft/comfortable/loud) and unconstrained F0 conditions. A linear mixed-model analysis showed a significant effect of elicitation effort levels on peak dEGG, HNR, and CPPS (all p < .01). Calibrated SPL significantly influenced HNR and CPPS (both p < .01). Furthermore, F0 had a significant effect on peak dEGG and CPPS (p < .0001). All metrics showed significant changes with regard to vowel (all p < .05). However, the treatment had no effect on the examined metrics, regardless of the treatment type (surgery vs. voice therapy). The value of the investigated metrics for voice assessment purposes when sampled without sufficient control of SPL and F0 is limited, in that they are significantly influenced by the phonatory context, be it speech or elicited sustained vowels. Future studies should explore the diagnostic value of new data collation approaches such as voice mapping, which take SPL and F0 effects into account.

Do Acoustic Characteristics of Dysarthria in People With Parkinson's Disease Differ Across Languages?

Cross-language studies suggest more similarities than differences in how dysarthria affects the speech of people with Parkinson's disease (PwPD) who speak different languages. In this study, we aimed to identify the relative contribution of acoustic variables to distinguish PwPD from controls who spoke varieties of two Romance languages, French and Portuguese. This bi-national, cross-sectional, and case-controlled study included 129 PwPD and 124 healthy controls who spoke French or Portuguese. All participants underwent the same clinical examinations, voice/speech recordings, and self-assessment questionnaires. PwPD were evaluated off and on optimal medication. Inferential analyses included Disease (controls vs. PwPD) and Language (French vs. Portuguese) as factors, and random decision forest algorithms identified relevant acoustic variables able to distinguish participants: (a) by language (French vs. Portuguese) and (b) by clinical status (PwPD on and off medication vs. controls). French-speaking and Portuguese-speaking individuals were distinguished from each other with over 90% accuracy by five acoustic variables (the mean fundamental frequency and the shimmer of the sustained vowel /a/ production, the oral diadochokinesis performance index, the relative sound level pressure and the relative sound pressure level standard deviation of the text reading). A distinct set of parameters discriminated between controls and PwPD: for men, maximum phonation time and the oral diadochokinesis speech proportion were the most significant variables; for women, variables calculated from the oral diadochokinesis were the most discriminative. Acoustic variables related to phonation and voice quality distinguished between speakers of the two languages. Variables related to pneumophonic coordination and articulation rate were the more effective in distinguishing PwPD from controls. Thus, our research findings support that respiration and diadochokinesis tasks appear to be the most appropriate to pinpoint signs of dysarthria, which are largely homogeneous and language-universal. In contrast, identifying language-specific variables with the speech tasks and acoustic variables studied was less conclusive.

Acoustically Enhanced Triboelectric Stethoscope for Ultrasensitive Cardiac Sounds Sensing and Disease Diagnosis.

Electronic stethoscope used to detect cardiac sounds that contains essential clinical information is a primary tool for diagnosis of various cardiac disorders. However, the linear electro-mechanical constitutive relation makes conventional piezoelectric sensors rather ineffective to detect low-intensity, low-frequency heart acoustic signal without the assistance of complex filtering and amplification circuits. Herein, we find that triboelectric sensor features superior advantages over piezoelectric one for micro-quantity sensing originated from the fast saturated constitutive characteristic. As a result, the triboelectric sensor shows ultrahigh sensitivity (1215mV/Pa) than the piezoelectric counterpart (21mV/Pa) in the sound pressure range of 50 - 80dB under the same testing condition. By designing a trumpet-shaped auscultatory cavity with a power function cross-section to achieve acoustic energy converging and impedance matching, triboelectric stethoscope delivers 36dB signal-to-noise ratio for human test (2.3 times of that for piezoelectric one). Further combining with machine learning, five cardiac states can be diagnosed at 97% accuracy. In general, the triboelectric sensor is distinctly unique in basic mechanism, provides a novel design concept for sensing micromechanical quantities, and presents significant potential for application in cardiac sounds sensing and disease diagnosis. This article is protected by copyright. All rights reserved.

Optimizing the noise control in a two-layer conduit

In the modern world, noise pollution is a major concern due to its prevalence. This work focuses on optimizing noise control in a two-layer conduit. A conduit comprises an inlet and double-outlet zones (DOZ). The upper walls of the DOZ are lined with perforated absorbent material while the lower walls are layered with fibrous. Mathematically, the physical problem is formulated with a field wave equation together with rigid and impedance boundary conditions in the respective zones. Such governing boundary value problem (BVP) leads to the Sturm-Liouville (SL) category in which standard orthogonality relations (OR) are indispensable. The system of the linear equations of the BVP is acquired with semi-analytical Mode-Matching (MM) approach by implementing the continuity conditions of sound pressures and velocities at the matching junction with the aid of OR. These systems are truncated and solved numerically with computation learning to obtain the reflected and transmitted modal amplitudes in respective zones. Due to the lining's perforated upper walls, fibrous lower walls, and reversal in the DOZ, the analysis of the reflected and transmitted powers versus frequencies is significantly observed and is shown in graphical findings. The algebraic derivation is validated by satisfying the conservation law of power flux and matching continuity conditions for impedance, perforated, and fibrous lined boundaries.

Acoustical analysis and optimization design of the hair dryers

Abstract The sound qualities and wind speeds of the four commercial hair dryers (Panasonic, Confu, Flyco, and Philips) were investigated through experimental methods in the present study. The sound qualities included loudness, sharpness, roughness, and fluctuation strength. The experimental results showed that the maximum sound pressure level (SPL) of all hair dryers occurred at about 200 Hz except Flyco hair dryer, which occurred at about 400 Hz. The highest loudness and highest sharpness were found when the hair dryers were set to hot mode and cold mode, respectively. No consistent relationship was found between the effect of room space and SPLs of the hair dryers. The Box–Behnken design method was used to design 13 pieces of oval and rectangular nozzles, and their sound levels and wind speeds were measured. Thereafter, these experimental results were used to derive correlation coefficients between the hair dryer nozzle area, aspect ratio, nozzle length, loudness, and wind speed using the Anova analysis method. Finally, an oval nozzle and a rectangular nozzle with an area of 0.0005 m 2 {}^{2} , an aspect ratio of 1, and nozzle lengths of 0.052 and 0.055 m, respectively, were designed and were tested. These nozzles managed to reduce the sound loudness by 15 and 9.6%, respectively, while maintaining the same level of wind speed.

C-Phycocyanin Attenuates Noise-Induced Cochlear Synaptopathy via the Inhibition of Oxidative Stress and Intercellular Adhesion Molecule-1 in the Cochlea

The synapses between inner hair cells (IHCs) and spiral ganglion neurons (SGNs) are the most vulnerable structures in the noise-exposed cochlea. Cochlear synaptopathy results from the disruption of these synapses following noise exposure and is considered the main cause of poor speech understanding in noisy environments, even when audiogram results are normal. Cochlear synaptopathy leads to the degeneration of SGNs if damaged IHC-SGN synapses are not promptly recovered. Oxidative stress plays a central role in the pathogenesis of cochlear synaptopathy. C-Phycocyanin (C-PC) has antioxidant and anti-inflammatory activities and is widely utilized in the food and drug industry. However, the effect of the C-PC on noise-induced cochlear damage is unknown. We first investigated the therapeutic effect of C-PC on noise-induced cochlear synaptopathy. In vitro experiments revealed that C-PC reduced the H2O2-induced generation of reactive oxygen species in HEI-OC1 auditory cells. H2O2-induced cytotoxicity in HEI-OC1 cells was reduced with C-PC treatment. After white noise exposure for 3 h at a sound pressure of 118 dB, the guinea pigs intratympanically administered 5 μg/mL C-PC exhibited greater wave I amplitudes in the auditory brainstem response, more IHC synaptic ribbons and more IHC-SGN synapses according to microscopic analysis than the saline-treated guinea pigs. Furthermore, the group treated with C-PC had less intense 4-hydroxynonenal and intercellular adhesion molecule-1 staining in the cochlea compared with the saline group. Our results suggest that C-PC improves cochlear synaptopathy by inhibiting noise-induced oxidative stress and the inflammatory response in the cochlea.

Numerical prediction of mean flow and acoustic field of a supersonic impinging jet

The three-dimensional turbulent mean flow and acoustic field of a supersonic jet impinging on a solid plate is studied computationally using the general purpose CFD code Ansys Fluent. A pressure-based coupled solver formulation with the second order weighted central-upwind spatial discretization is applied to compute transient solutions. Cold and hot jet thermal conditions are considered. Mean flow characteristics are investigated by a steady-state modeling approach. Acoustic radiation of impingement tones is simulated using a transient time-domain formulation. The effects of turbulence in steady-state are modeled by the SST k-ω turbulence model. The Wall-Modeled Large-Eddy Simulation (WMLES) model is applied to compute transient solutions. The near-wall mesh on the impingement plate is fine enough to resolve the viscosity-affected near-wall region all the way to the laminar sublayer. Nozzle-to-plate distance is parameterized in the model for automatic re-generation of the mesh and results. Steady-state predictions of hover lift loss and mean jet velocity distributions are compared with experimental data, and favorable agreement is reported. The transient solution reproduces the mechanism of impingement tone generation by the interaction of large scale vortical structures with the impingement plate. The acoustic near-field is directly resolved by Computational Aeroacoustics (CAA) to accurately propagate impingement tone waves to near-field microphone locations. Calculated impingement tone frequencies and sound pressure levels agree with experimental values.

Sound pressure level determination around the transformer using coherent and incoherent analytical summation methods

In this paper, coherent and incoherent analytical summation methods from elementary sound sources on the transformer’s tank are presented. They aim to determine a one-third-octave spectrum of sound pressure levels (SPL) in points around the transformer. Each part of the transformer’s surface is treated as a separate plane source so the analytical calculation can be applied to find SPL in the surroundings. Reflections from the ground are also considered by putting an image of the plane sources on the other side of the reflecting plane and adding its contributions to the total pressure in the desired points. Grid-like vibration measurements of vibration velocity on the tank surfaces are used as input parameters. Vibrations and sound pressure levels are measured to validate the method on the 5 MVA transformer experimental object. The SPL around the transformer in short-circuit (SC) and open-circuit (OC) tests is measured in the semi-anechoic chamber to compare it with theoretical results. By analyzing the results, the coherent calculation with reflection provided the most accurate results. In the SC operating condition, the normalized root mean square error (NRMSE) is 17.2%, and in the OC operating condition, it is 10.9%. The novelty of the presented method is that it considers complicated transformer geometry where each surface is calculated as a separate noise source. It calculates noise at a distance from the elementary vibration sources, considering phase and reflection from the hard ground, and provides detailed noise maps that can be used for noise modeling around the substations.

Design Approaches and Electromechanical Modeling of Conformable Piezoelectric‐Based Ultrasound Systems

AbstractPainless, needleless delivery of drugs through the skin can be realized through aphenomenon called sonophoresis by applying an ultrasound field to the biological tissue. Development of wearable embodiments of such systems demands comprehensive characterization of both the physical mechanism of sonophoresisas well as wearability parameters. Here, we present a framework for analyzing disk‐type piezoelectric transducers in a polymeric substrate to create acoustic cavitation in a fluid coupling medium for sonophoresis applications. The device design and operating parameters such as the working frequency, applied voltage range, acoustic pressure distribution, and transducer spacing were determine dusing a finite element methods (FEM),and verified with experimental measurements. The influence of the surrounding water and tank reflections on the acoustic pressure field, and the interaction between the elements in the array structure were also studied.Finally, the impact of skin and the substrate geometry on the acoustic pressure fields was characterized to simulate the invivo use‐case of the system. These analytical models can be used to guide critical parameters for device design such as the separation distance of the piezoelectric transducer from the skin boundary. We envision that this tool boxwill support rapid design iteration for realization of wearable ultrasound systems.

Recent Advances in Ferroelectret Fabrication, Performance Optimization and Applications.

The growing demand for wearable devices has sparked a significant interest in ferroelectret films. They possess flexibility and exceptional piezoelectric properties due to strong macroscopic-dipoles formed by charges trapped at the interface of their internal cavities. This review of ferroelectrets focuses on the latest progress in fabrication techniques for high temperature resistant ferroelectrets with regular and engineered cavities, strategies for optimizing their piezoelectric performance, and novel applications. The charging mechanisms of bipolar and unipolar ferroelectrets with closed and open-cavity structures are explained first. Next, the preparation and piezoelectric behavior of ferroelectret films with closed, open and regular cavity structures using various materials are discussed. Three widely used models for predicting the piezoelectric coefficients (d33) are outlined. Methods for enhancing the piezoelectric performance such as optimized cavity design, utilization of fabric electrodes, injection of additional ions, application of DC bias voltage and synergy of foam structure and ferroelectric effect are illustrated. A variety of applications of ferroelectret films in acoustic devices, wearable monitors, pressure sensors and energy harvesters are presented. Finally, the future development trends of ferroelectrets towards fabrication and performance optimization are summarized along with its potential for integration with intelligent systems and large-scale preparation. This article is protected by copyright. All rights reserved.

Simulation and experimental investigation of material removal profile based on ultrasonic vibration polishing of K9 optical glass

Ultrasonic vibration polishing (UVP) is an important method for the precision processing of optical glass, which is good for improving surface quality and processing efficiency. So far, the material removal mechanism in UVP is not well understood and the various process parameters involved are not considered. To achieve ultra-precision polishing under optical glass, this paper carries out the axial UVP method. The material removal profile (MRP) is critical to affect the surface accuracy. A new MRP is developed for UVP based on the Urick attenuation model and the proposed material removal coefficient distribution function, considering the dynamic pressure changes under ultrasonic vibration, the attenuation effect of the acoustic pressure propagation process and the inhomogeneous distribution of the abrasive particles in the contact area during the ultrasonic electro-spindle rotation. Through a series of polishing experiments and simulations, the results show that the maximum errors of the actual material removal depth (MRD) and the actual material removal rate (MRR) from the model simulation results are 8.54% and 9.92%, respectively. The accuracy of the model is further demonstrated by the Pearson correlation coefficient. When the amplitude of UVP is 9 µm, Sa and Ra are 60 nm and 68 nm, which are reduced by 37.50% and 22.73%, respectively, compared with conventional polishing. This research can contribute to the deterministic processing of UVP, and provide a theoretical basis for the application of optical glass.

Symphonies of Growth: Unveiling the Impact of Sound Waves on Plant Physiology and Productivity

The application of sound wave technology to different plant species has revealed that variations in the Hz, sound pressure intensity, treatment duration, and type of setup of the sound source significantly impact the plant performance. A study conducted on cotton plants treated with Plant Acoustic Frequency Technology (PAFT) highlighted improvements across various growth metrics. In particular, the treated samples showed increases in the height, size of the fourth expanded leaf from the final one, count of branches carrying bolls, quantity of bolls, and weight of individual bolls. Another study showed how the impact of a 4 kHz sound stimulus positively promoted plant drought tolerance. In other cases, such as in transgenic rice plants, GUS expression was upregulated at 250 Hz but downregulated at 50 Hz. In the same way, sound frequencies have been found to enhance the osmotic potential, with the highest observed in samples treated with frequencies of 0.5 and 0.8 kHz compared to the control. Furthermore, a sound treatment with a frequency of 0.4 kHz and a sound pressure level (SPL) of 106 dB significantly increased the paddy rice germination index, as evidenced by an increase in the stem height and relative fresh weight. This paper presents a complete, rationalized and updated review of the literature on the effects of sound waves on the physiology and growth parameters of sound-treated plants.

Estimation of the effect of thin-plated surface on a three-staged looped thermoacoustic engine for low-grade heat recovery

This paper introduces two novel structures of looped thermoacoustic engines designed for outdoor low-frequency sound sources. The system consists of three thermoacoustic engines in a loop and a stub for sound radiating, which is characterized by reliability, high efficiency, and compactness. Two thin plates are used to prevent the Gedeon flow, facilitate sound propagation, and adjust the acoustic field. The system with a straight stub achieved a maximum Sound Pressure Level of 126.09 dB at 1 m away, surpassing highest reported records by 25.96 %. The system also achieves a high output efficiency of 3.86 %. The system with tapered stub and a 0.1 mm silicone plate, achieved an SPL of 120.76 dB at 1 m. To maintain the predetermined acoustic field, it is important to consider a thin plate with small Young's modulus and thickness. The effect on the acoustic field must be considered when the thickness exceeds 0.8 mm. The addition of the 0.28 mm thin plate in system with tapered stub resulted in a 7.8 W increase in acoustic power compared to that of system without the thin plate.

Experimental Study of Laser-Induced Cavitation Bubbles near Wall: Plasma Shielding Observation

To investigate the plasma shielding of laser-induced cavitation bubbles near a wall, a pulsed laser with different energies was selected to induce cavitation bubbles on the surface of 7050-T7451 aluminum alloy. A high-speed camera captured the evolution of the cavitation bubble, while a fiber-optic hydrophone system collected the acoustic signals during the evolution. Finally, a confocal microscope was used to view and analyze the surface morphology of 7050 aluminum alloy. The experimental results indicate that as the laser energy increases, the diameter, the evolution time, the pressure of the bubble, and both the pit diameter and depth all increase. Beyond an energy level of 1.4 J, the maximum diameter and the evolution time of the laser-induced cavitation bubble begin to decrease; the maximum diameter decreases by 2.04%, and the first evolution time decreases by 3.26%. Plasma shielding was observed in this experiment. Considering that the essence of a laser-induced cavitation bubble is the interaction between a high-energy laser and a liquid medium, the abnormal decrease in the maximum diameter, evolution time, and sound pressure epitomizes the manifestation of plasma shielding.

Vibration and underwater noise simulation of a river-crossing tunnel based on a 2.5D structural-acoustic finite element method

To protect the underwater ecosystem and species, the vehicle-induced vibration and underwater radiated noise of river-crossing tunnels need to be calculated efficiently and accurately. For this purpose, this study proposed a 2.5-dimensional (2.5D) structural-acoustic finite element method which combines 2.5D finite element vibration algorithm and 2.5D infinite element acoustic algorithm. The proposed method utilizes the spatial wave number transformation theory and the acoustic transfer vector (ATV) method. Based on a river-crossing tunnel, a 2.5D numerical simulation model was established in this study to analyze the vehicle-induced tunnel-soil vibration as well as the underwater radiated noise during operation. The results showed that the tunnel vibration and the associated radiated noise mainly distributed in the range of 10 to 40 Hz, with two peaks at 15.6 Hz and 31.5 Hz, respectively. The total sound pressure level (SPL) of the predicted noise at each field point reached a maximum value of 126 dB. The 2.5D algorithm proposed in this study achieves higher computational efficiency compared to traditional 3D vibration and noise analysis methods, which can provide theoretical and technical supports for the protection of underwater ecological diversity.

Analysis of the co-rotating vortex pair as a test case for computational aeroacoustics

The co-rotating vortex pair arrangement is a frequently applied test case in computational aeroacoustics. Its flow quantities and far-field radiated sound pressure can be computed analytically, assuming delta-distribution potential vortices. When this configuration is used for verification in a numerical computation, the singular vortex cores cannot be modeled directly; they have to be desingularized, which affects the associated flow and acoustical fields. Closed-form expressions for the aeroacoustic source terms are derived for the Scully vortex model and used for detailed numerical computations of the radiated sound pressure. The effects of desingularization and finite source region size are analyzed in the frequency domain for Lighthill’s equation and the perturbed convective wave equation by means of an efficient numerical approach that computes the convolution of the aeroacoustic source terms and the 2D free-field Green’s function. It is shown that the deviations of the far-field radiated sound pressure from the idealized analytical solution depend on the Mach number, vortex core radius, and truncation limit of the source region. A significant increase in the effective size of the source region due to the desingularization is demonstrated. Minimal error bounds compared to the analytic far-field pressure solution are established. The presented converged numerical results serve as reference solutions for validating implementations of hybrid computational aeroacoustic workflows.

Traffic noise measurement, mapping, and modeling using soft computing techniques for mid-sized smart Indian city

The present study presents an investigation into the utilization of artificial neural networks (ANN) and multiple linear regression model (MLR) for the prediction of traffic noise levels in various locations of Dhanbad city at varying intervals. Traffic noise indices measurements were carried out using sound pressure level meter (SLM). The prediction of equivalent A-weighted sound level (LAeq) and the sound level exceeding 10 percent of the time (L10) is carried out using various influencing factors such as number of cars, number of 2 wheelers, number of 3 wheelers, number of heavy vehicle, number of medium commercial vehicles, and traffic speed. The findings demonstrate the ANN model's proficiency in comparison of MLR model for providing precise prediction accuracy of traffic noise indices with a R2 of 0.94 for LAeq and 0.91 for L10. Furthermore, the frequency spectrum analysis reveals that high peaks were observed at lower frequencies ranging from 31.5 Hz to 50 Hz, middle frequencies from 500 to 800 Hz and higher frequencies from 3.5 kHz to 5 kHz. The noise maps at varying intervals revealed that most of the locations are having higher noise levels due to increase in vehicular movement. The study emphasizes on the potential significance of the proposed neural network-based prediction model in collaboration with noise mapping as a vital tool for the anticipation of traffic noise levels and the formulation of noise mitigation strategies in context of the mid-sized smart city like Dhanbad, India.

Extension of interval between adjacent pulse delivery cycles to deal with myocardial ischemia by intravascular lithotripsy: case report

BackgroundIntravascular lithotripsy (IVL) represents a novel approach in the management of coronary calcification. This technique employs acoustic pressure waves, generated by a shockwave balloon, to effectively fracture both superficial and deep calcification in situ. The efficacy and safety of IVL have been convincingly demonstrated through the Disrupt CAD I-IV studies. While IVL is associated with the occurrence of atrial and ventricular arrhythmias, there is no evidence to indicate it causes myocardial ischemia.Case DescriptionA 71-year-old man was admitted presenting with chest pain. His previous coronary angiography revealed stenosis and calcification in the left anterior descending branch. An attempt to predilate the lesion using two Lacrosse non-slip element balloons was unsuccessful. Ventricular premature beats and transient ST-segment depression were captured during the utilization of IVL. The operator gradually extended the pulse emission interval across two consecutive cycles to mitigate myocardial ischemia. Notably, when the interval reached 30s, the patient had no chest pain or ST-segment changes. Subsequent images of intravascular ultrasound confirmed calcification ruptures. Therapeutic intervention included the placement of a stent and the application of a drug-coated balloon in the left anterior descending branch. A telephonic follow-up six months later indicated the patient had no discomfort.ConclusionsThis case underscores the effectiveness of gradually extending the pulse emission interval as a strategic complement to the clinical application of IVL. In certain clinical scenarios, it may become imperative to suspend the pulse delivery to improve myocardial blood supply.

Optimal treatment conditions for low-intensity pulsed ultrasound therapy for Alzheimer's disease: applications from mice to humans.

We previously developed a novel therapy with low-intensity pulsed ultrasound (LIPUS) that ameliorates cognitive decline through upregulation of endothelial nitric oxide synthase (eNOS) in mouse models of Alzheimer's disease (AD). In a randomized, double-blind, placebo-controlled pilot trial, we demonstrated that whole-brain LIPUS therapy is safe and tends to suppress the cognitive decline in early AD patients. We herein report the findings of our basic experiments that we performed for the pilot trial in order to apply whole-brain LIPUS therapy to humans, as well. First, we examined the relationship between bone density/thickness and ultrasound transmittance using human temporal bone. Next, based on the results of ultrasound transmittance, we further examined mRNA expression of VEGF, FGF2, and eNOS in response to variable ultrasound frequencies, duty cycles, and sound pressures. There was a significant correlation between bone thickness and transmittance (1.0MHz, P < 0.001), while there was no significant correlation between bone density and transmittance (1.0MHz, P = 0.421). At a frequency of 0.5MHz, the optimum duty cycle was considered to be up to 20%. When the tissue amplitude was in the range of 0.05-0.5MPa, VEGF, FGF2, and eNOS were significantly upregulated by LIPUS. Thus, the conditions necessary for LIPUS therapy for the human brain were identified as sound pressure just below the probe 1.3MPa (tissue amplitude 0.15MPa), duty cycle 5%, and frequency 0.5MHz. We successfully identified the optimal treatment conditions for LIPUS therapy for patients with AD.