Effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in type 2 diabetes:A systematic review

BACKGROUND Type 2 diabetes mellitus(T2DM)is a chronic metabolic syndrome characterized by insulin resistance and hyperglycemia that may lead to endothelial dysfunction,reduced functional capacity and exercise intolerance.Regular aerobic exercise has been promoted as the most beneficial non-pharmacological treatment of cardiovascular diseases.High intensity interval training(HIIT)seems to be superior than moderate-intensity continuous training(MICT)in cardiovascular diseases by improving brachial artery flow-mediated dilation(FMD)and cardiorespiratory fitness to a greater extent.However,the beneficial effects of HIIT in patients with T2DM still remain under investigation and number of studies is limited.AIM To evaluate the effectiveness of high intensity interval training on cardiorespiratory fitness and endothelial function in patients with T2DM.METHODS We performed a search on PubMed,PEDro and CINAHL databases,selecting papers published between December 2012 and December 2022 and identified published randomized controlled trials(RCTs)in the English language that included community or outpatient exercise training programs in patients with T2DM.RCTs were assessed for methodological rigor and risk of bias via the Physiotherapy Evidence Database(PEDro).The primary outcome was peak VO_(2 ) and the secondary outcome was endothelial function assessed either by FMD or other indices of microcirculation.RESULTS Twelve studies were included in our systematic review.The 12 RCTs resulted in 661 participants in total.HIIT was performed in 310 patients(46.8%),MICT to 271 and the rest 80 belonged to the control group.Peak VO_(2 ) increased in 10 out of 12 studies after HIIT.Ten studies compared HIIT with other exercise regimens(MICT or strength endurance)and 4 of them demonstrated additional beneficial effects of HIIT over MICT or other exercise regimens.Moreover,4 studies explored the effects of HIIT on endothelial function and FMD in T2DM patients.In 2 of them,HIIT further improved endothelial function compared to MICT and/or the control group while in the rest 2 studies no differences between HIIT and MICT were observed.CONCLUSION Regular aerobic exercise training has beneficial effects on cardiorespiratory fitness and endothelial function in T2DM patients.HIIT may be superior by improving these parameters to a greater extent than MICT.

Spatial correlation of the high intensity zone in deep-water acoustic field

The spatial correlations of acoustic field have important implications for underwater target detection and other ap- plications in deep water. In this paper, the spatial correlations of the high intensity zone in the deep-water acoustic field are investigated by using the experimental data obtained in the South China Sea. The experimental results show that the structures of the spatial correlation coefficient at different ranges and depths are similar to the transmission loss structure in deep water. The main reason for this phenomenon is analyzed by combining the normal mode theory with the ray theory. It is shown that the received signals in the high intensity zone mainly include one or two main pulses which are contributed by the interference of a group of waterbome modes with similar phases. The horizontal-longitudinal correlations at the same receiver depth but in different high intensity zones are analyzed. At some positions, more pulses are received in the arrival structure of the signal due to bottom reflection and the horizontal-longitudinal correlation coefficient decreases accordingly. The multi-path arrival structure of receiving signal becomes more complex with increasing receiver depth.

Mechanism and Kinetic Model of In-situ TiB_2/7055Al Nanocomposites Synthesized under High Intensity Ultrasonic Field

In-situ TiB2/7055Al nanocomposites are fabricated by in situ melt chemical reaction from 7055Al-K2TiF6-KBF4 system under high intensity ultrasonic field,and the mechanism and kinetic model of in-situ melt chemical reaction are investigated.X-ray diffraction （XRD） and scanning electron microscope （SEM） analyses indicate that the sizes of in-situ TiB2 nanoparticles are in the range of 80-120 nm.The results of ice-water quenched samples show that the whole process contains four stages,and the overall in-situ reaction time is 10 minutes.The in situ synthesis process is controlled mainly by chemical reaction in earlier stage （former 3 minutes）,and by the particulate diffusing in later stage.The mechanism of key reaction between Al3Ti and AlB2 under high intensity ultrasonic in the 7055Al-K2TiF6-KBF4 system is the reaction-diffusion-crack-rediffusion.Furthermore,the reactive kinetic models in 7055Al-K2TiF6-KBF4 system are established.

Identification of denatured and normal biological tissues based on compressed sensing and refined composite multi-scale fuzzy entropy during high intensity focused ultrasound treatment

In high intensity focused ultrasound(HIFU)treatment,it is crucial to accurately identify denatured and normal biological tissues.In this paper,a novel method based on compressed sensing(CS)and refined composite multi-scale fuzzy entropy(RCMFE)is proposed.First,CS is used to denoise the HIFU echo signals.Then the multi-scale fuzzy entropy(MFE)and RCMFE of the denoised HIFU echo signals are calculated.This study analyzed 90 cases of HIFU echo signals,including 45 cases in normal status and 45 cases in denatured status,and the results show that although both MFE and RCMFE can be used to identify denatured tissues,the intra-class distance of RCMFE on each scale factor is smaller than MFE,and the inter-class distance is larger than MFE.Compared with MFE,RCMFE can calculate the complexity of the signal more accurately and improve the stability,compactness,and separability.When RCMFE is selected as the characteristic parameter,the RCMFE difference between denatured and normal biological tissues is more evident than that of MFE,which helps doctors evaluate the treatment effect more accurately.When the scale factor is selected as 16,the best distinguishing effect can be obtained.

Femoral neck stress fracture and medial tibial stress syndrome following high intensity interval training: A case report and review of literature

BACKGROUND Femoral and tibial stress injuries are commonly found in long distance running athletes.Stress fractures have rarely been reported in athletes performing high intensity interval training(HIIT)exercise.The objective of this study was to report a case of a patient who presented with medial tibial stress syndrome and femoral neck stress fracture after performing HIIT exercises.CASE SUMMARY A 26 year old female presented with bilateral medial tibial pain.She had been performing HIIT exercise for 45 min,five times weekly,for a seven month period.Her tibial pain was gradual in onset,and was now severe and worse on exercise,despite six weeks of rest.Magnetic resonance imaging(MRI)revealed bilateral medial tibial stress syndrome.As she was taking norethisterone for birth control,a dual energy X-ray absorbitometry scan was performed which demonstrated normal bone mineral density of her lumbar spine and femoral neck.She was managed conservatively with analgesia and physiotherapy,but continued to exercise against medical advice.She presented again six months later with severe right hip pain.MRI of her right hip demonstrated an incomplete stress fracture of her subtrochanteric region.Her symptoms resolved with strict rest and physiotherapy.CONCLUSION HIIT may cause stress injury of the tibia and femur in young individuals.

Novel Automotive High Intensity Discharge(HID) Lamps with Electronic Ballasts

A new scheme of automotive high intensity discharge(HID) lamps with electronic ballasts is proposed. The design of the proposed ballast and some experimental results are presented. The proposed scheme is consisted of the high frequency DC-DC converter and the low frequency DC-AC inverter. This system separates the input voltage of the ignitor from DC link voltage using auxiliary winding, then it could use the lower voltage rating power devices for HID lamp ballast system and reduce the size of HID lamp ballast. The proposed ballast controller using micro-controller unit(MCU) controls the frequency to operate the DC-DC converter in critical conduction mode, which reduces the noise of the circuit and improves the efficiency by 2%~4%.

High intensity focused ultrasound in combination with chemotherapy by the regime of PFC: a clinical study for advanced gastric carcinoma

Objective： To evaluate the recent curative efficacy and security of High intensity focused ultrasound （HIFU） in combination with chemotherapy（PFC） in patients with advanced gastric carcinoma. Method： Sixty patients with measurable advanced gastric carcinoma, proved pathologically, were divided into Group A and Group B. Group A： Patients were treated by HIFU（FEP-BY01） in combination with chemotherapy（PFC, paclitaxel, cisplatin and 5-fluorouracil）. Group B： Patients were treated with the single regime of PFC. Results： All cases could be evaluated, ha group A, 5 patients achieved complete response, 17 patients achieved partial response,and a response rate was 73.3%. The stable disease（SD） and the inefficiency all were 13.3% （4/30） respectively, and msurvival time（MST） was 13.9 months. In group B, 2 patients achieved complete response, 14 patients achieved partial response, and a response rate was 53.3%. The stable disease（SD） was 23.3%（7/30）. The inefficiency all were 23.3%（7/30） respectively, and median survival time was 9.6 months. There was significant difference between two groups MST（ P 〈 0.05）. Major toxicities included bone marrow depression, nausea, vomiting and alopecia, without significant differences between two groups（ P 〉 0.05）. Conclusion： This study shows that HIFU in combination with chemotherapy（PFC） was a new efficent and secure therapy for the patients with advanced gastric carcinoma. It was observed that the MST was prolonged. Prospective trials should be warranted to determine the result.

A fast emittance measurement unit for high intensity DC beam

A combined unit, which has the ability to measure the current and emittance of the high intensity direct current（DC）ion beam, is developed at Peking University（PKU）. It is a multi-slit single-wire（MSSW）-type beam emittance meter combined with a water-cooled Faraday Cup, named high intensity beam emittance measurement unit-6（HIBEMU-6）. It takes about 15 seconds to complete one measurement of the beam current and its emittance. The emittance of a 50-mA@50-kV DC proton beam is measured.

Formation of Nanoscale Intermetallic Phases in Ni Surface Layer at High Intensity Implantation of Al Ions

The results of experimental study of nanoscale intermetallic formation in surface layer of a metal target at ion implantation are presented. To increase the thickness of the ion implanted surface layer the high intensive ion implantation is used. Compared with the ordinary ion implantation, the high intensive ion implantation allows a much thicker modified surface layer. Pure polycrystalline nickel was chosen as a target. Nickel samples were irradiated with Al ions on the vacuum-arc ion beam and plasma flow source 'Raduga-5'. It was shown that at the high intensity ion implantation the fine dispersed particles of Ni3AI, NiAl intermetallic compounds and solid solution Al in Ni are formed in the nickel surface layer of 200 nm and thicker. The formation of phases takes place in complete correspondence with the Ni-AI phase diagram.

Meta-analysis of the effects of high-intensity intermittent exercise on cardiopulmonary function rehabilitation in patients with stroke

Objective:Systematically evaluate the rehabilitation effect of high-intensity intermittent exercise(HIIT)on cardiovascular function in stroke patients,in order to provide a basis for selecting the best rehabilitation plan for stroke patients.Methods:Computer retrieval of CNKI,WanFang Data,VIP,CBM,Pubmed,EMbase,Web of science,The Cochrane Library databases was conducted from the establishment of the database until March 2023.Randomized controlled trials on HIIT improving cardiovascular function in stroke patients were included,and the included literature was screened,data extracted,and bias risk evaluated.Then,metaanalysis was conducted using RevMan 5.4 software and Stata17.0 software.Results:In the end,9 articles met the research criteria,with a total of 428 patients.The meta-analysis results showed that compared with the control group,HIIT had significant effects on peak oxygen uptake(VO2peak)[MD=3.87,95%CI(3.43,4.31),P<0.00001],minute ventilation(VE)[MD=7.14,95%CI(4.34,9.94),P<0.00001],peak power(WRpeak)[MD=17.13,95%CI(13.7320.54),P<0.00001],6-minute walking distance(6MWD)[MD=43.82,95%CI(16.08,71.56),P=0.002],The intervention effect of the 10 meter walking test(10MWT)[MD=-2.00,95%CI(-2.91,-1.08),P<0.0001]was better than that of the control group.Conclusion:The current analysis results show that compared to conventional rehabilitation therapy or continuous aerobic exercise,HIIT has more advantages in improving the cardiopulmonary function of stroke patients.

Suppressive effects of exercise-conditioned serum on cancer cells:A narrative review of the influence of exercise mode,volume,and intensity

Cancer is a major cause of morbidity and mortality worldwide,and the incidence is increasing,highlighting the need for effective strategies to treat this disease.Exercise has emerged as fundamental therapeutic medicine in the management of cancer,associated with a lower risk of recur-rence and increased survival.Several avenues of research demonstrate reduction in growth,proliferation,and increased apoptosis of cancer cells,including breast,prostate,colorectal,and lung cancer,when cultured by serum collected after exercise in vitro(i.e.,the cultivation of cancer cell lines in an experimental setting,which simplifies the biological system and provides mechanistic insight into cell responses).The underlying mechanisms of exercise-induced cancer suppressive effects may be attributed to the alteration in circulating factors,such as skeletal muscle-induced cytokines(i.e.,myokines)and hormones.However,exercise-induced tumor suppressive effects and detailed information about training interventions are not well investigated,constraining more precise application of exercise medicine within clinical oncology.To date,it remains unclear what role different training modes(i.e.,resistance and aerobic training)as well as volume and intensity have on exercise-condi-tioned serum and its effects on cancer cells.Nevertheless,the available evidence is that a single bout of aerobic training at moderate to vigorous intensity has cancer suppressive effects,while for chronic training interventions,exercise volume appears to be an influential candidate driving cancer inhibitory effects regardless of training mode.Insights for future research investigating training modes,volume and intensity are provided to further our understanding of the effects of exercise-conditioned serum on cancer cells.

Imaging of low back pain： comparative role of high intensity zone in diagnosing the discogenic low back pain with evidence-based radiology

Background Discography is a gold standard for the diagnosis of the low back pain （LBP）, but it has potential dangers for the development of discitis, cerebral spinal fluid leakage, retroperitoneal bleeding, acute new back pain and the tremendous radiation exposure to the patient. Using ＂evidence-based radiology＂ methods, the comparative roles of high intensity zone （HIZ） in diagnosing discogenic LBP were evaluated. Methods A focused clinical question was designed and a Pubmed and manual search were performed to identify the role of HIZ on MRI T2WI compared with discography. The studies retrieved were assessed for validity and strength. Sensitivity, specificity, likelihood ratios （LRs） and graphs of conditional probability were evaluated from the best current study by evidence-based radiology. Results Best evidence was retrieved in ten articles from 1992 to 2007. The best evidence level was lb and the strength of the evidence included： sensitivity 0.63 （0.51,0.76）, specificity 0.97 （0.92, 1.00）, positive predictive value 0.95, negative predictive value 0.72, positive LRs 18.37 and negative LRs 0.38. The gold standard of discogenic LBP is the provocative discography. Conclusions For suspected discogenic LBP, HIZ is limited for the diagnosis if HIZ is positive, which suggests further discography. In contrast HIZ is a good test for diagnosis if HIZ is negative, which indicates the disease can be excluded.

Dose estimation and shielding calculation for X-ray hazard at high intensity laser facilities

An ionizing radiation hazard produced from the interaction between high intensity lasers and solid targets has been observed. Laser-plasma interactions create “hot” electrons, which generate bremsstrahlung X-rays when they interact with ions in the target. However, up to now only limited studies have been conducted on this laser-induced radiological protection issue. In this paper, the physical process and characteristics of the interaction between high intensity lasers and solid targets are analyzed. The parameters of the radiation sources are discussed,including the energy conversion efficiency from laser to hot electrons, hot electron energy spectrum and electron temperature, and the bremsstrahlung X-ray energy spectrum produced by hot electrons. Based on this information,the X-ray dose generated with high-Z targets for laser intensities between 10^14 and 10^20W/cm^2 is estimated. The shielding effects of common shielding items such as the glass view port, aluminum chamber wall and concrete wall are also studied using the FLUKA Monte Carlo code. This study provides a reference for the dose estimation and the shielding design of high intensity laser facilities.

Sonablate-500^(TM) Transrectal High-intensity Focused Ultrasound (HIFU) for Benign Prostatic Hyperplasia Patients

To evaluate the safety and efficacy of transrectal high-intensity focused ultrasound （HIFU） in the treatment of benign prostatic hyperplasia （BPH）, serial studies were conducted in 150 BPH patients before and 30 min, 1, 2, 6 and 12 month（s） after Sonablate-500TM HIFU treatment. A silicon-coated indwelling 16F latex catheter was placed during the determination of the therapy zone. Preoperative and postoperative evaluations were made by using the international prostate symptom score （IPSS）, quality of life （QOL）, uroflowmetric findings and transrectal ultrasound, and incidence of complications. The cystourethrography was done in 23 patients within 1 year postoperatively. The results showed that after HIFU treatment, IPSS and QOL scores were significantly decreased at 1, 2, 6 and 12 month（s） （P〈0.01）. Maximum urine flow rate （6.0 to 17.2 mL/s, P〈0.01）, PVR （75.0 to 30.3, P〈0.01） and prostatic volume （65.0 to 38.1 mL, P〈0.05） were significantly improved 12 months after the operation. Recurrent urinary retention （17=2） and urethrorectal fistula （n=1） occurred at the 15th postoperative day. The duration of the HIFU prostate ablation was 25-90 min. The mean time for an indwelling catheter was 3-19 days. These data demonstrate that treatment of BPH with Sonab- late-500TM HIFU is safe and effective.

A new compact structure for a high intensity low-energy heavy-ion accelerator

A new compact accelerating structure named Hybrid RFQ is proposed to accelerate a high-intensity low-energy heavy ion beam in HISCL （High Intensive heavy ion SuperConducting Linear accelerator）, which is an injector of HIAF （Heavy Ion Advanced Research Facility）. It is combined by an alternative series of acceleration gaps and RFQ sections. The proposed structure has a high accelerating ability compared with a conventional RFQ and is more compact than traditional DTLs. A Hybrid RFQ is designed to accelerate 238U34＋ from 0.38 MeV/u to 1.33 MeV/u. The operation frequency is described to be 81.25 MHz at CW （continuous wave） mode. The design beam current is 1.0 mA. The results of beam dynamics and RF simulation of the Hybrid RFQ show that the structure has a good performance at the energy range for ion acceleration. The emittance growth is less than 5% in both directions and the RF power is less than 150 kW. In this paper, the results of beam dynamics and RF simulation of the Hybrid RFQ are presented.

Radiation force on absorbing targets and power measurements of a high intensity focused ultrasound (HIFU) source

Based on the analytic expressions for the radiated field of a circular concave piston given by Hasegawa et al.,an integral for calculation of the radiation force on a plane absorbing target in a spherically focused field is derived.A general relation between acoustic power P and normal radiation force Fn is obtained under the condition of kr 1.Numerical computation is carried out by using the symbolic computation program for practically focused sources and absorbing circular targets.The results show that,for a given source,there is a range of target positions where the radiation force is independent of the target's position under the assumption that the contribution of the acoustic field behind the target to the radiation force can be neglected.The experiments are carried out and confirm that there is a range of target positions where the measured radiation force is basically independent of the target's position even at high acoustic power (up to 700 W).It is believed that when the radiation force method is used to measure the acoustic power radiated from a focused source,the size of the target must be selected in such a way that no observable sound can be found in the region behind the target.

A New Full Bridge High Intensity Focused Ultrasound Power System with Harmonic Cancellation

The feasibility of a new full bridge high intensity focused ultrasound(HIFU) amplifier system with harmonic cancellation is evaluated in this study. Harmonic cancellation technique is applied to these power amplifiers, which can eliminate the 3rd harmonic and all even harmonics. Since this technique requires two channels of phase signal to control one channel of power amplifier, the signal generator is required to double its output. The transducer array proposed in this study has 100 elements. So we choose an FPGA chip to generate 200 driving signals, and each channel has a phase resolution of 2ns, less than 1°. The phase signal from the FPGA meets the requirement of driving the power amplifiers. The output waveform of one channel of power amplifier(voltage across the transducer) is evaluated, and shows fewer harmonic components.

A digital transmission system for high intensity pulsed radial detection

A digital transmission system with 900 MHz bandwidth and over 40 dB linear dynamic range for high intensity pulsed radial detection is designed. The transient signals （with a subnanoseconds rising edge） from the detectors can be transmitted to diagnosing systems kilometers away with high fidelity. It can adapt to interference and a hostile detecting environment by using the intelligent functions of this system. The feasibility and reliability of this system is verified by system evaluation tests.

Numerical investigation and potential tunability scheme on e^+e^- and π^+π^- stimulated pair creation from vacuum using high intensity laser beams

Numerical estimates for electrons and mesons particle–antiparticle creation from vacuum in the presence of strong electromagnetic fields are derived, using the complete probability density relation of Popov's imaginary time method(Popov, JETP Lett. 13, 185(1971); Sov. Phys. JETP 34, 709(1972); Sov. Phys. JETP 35, 659(1972); Popov and Marinov, Sov. J. Nucl. Phys. 16, 449(1973); JETP Lett. 18, 255(1974); Sov. J. Nucl. Phys. 19, 584(1974));(Popov,Phys. Let. A 298, 83(2002)), and within the framework of an experimental setup like the E144(Burke et al., Phys. Rev.Lett. 79, 1626(1997)). The existence of crossing point among pair creation efficiency curves of different photon energies and the role of odd/even multiphoton orders in the production rates are discussed. Finally a kind of tunability process between the two creation processes is discussed.

Cardiac ablation by transesophageal high intensity focused ultrasound

Cardiac ablation is an important modality of invasive therapy in modem cardiology, especially in the treatment of arrhythmias, as well as other diseases such as hypertrophic obstructive cardiomyopathy （HOCM）. Since Huang et alI used radiofrequency （RF） to ablate canine atrial ventricular junction, RF has developed into the leading energy source in catheter ablation of arrhythmias. However, there are several limitations associated with RF ablation, one of which is that it requires good contact and the depth of the lesion formed is usually limited. Thus, it is often very difficult to ablate arrhythmias originated at the epicardium with a routine endocardial RF delivery.