A study of stone fragmentation in shock wave lithotripsy by customizing the acoustic field and waveform shape

Shock wave lithotripsy is the preferred treatment modality for kidney stones in the United States. Despite clinical use for over twenty-five years, the mechanisms of stone fragmentation are still under debate. A piezoelectric array was employed to examine the effect of waveform shape and pressure distribution on stone fragmentation in lithotripsy. The array consisted of 170 elements placed on the inner surface of a 15 cm-radius spherical cap. Each element was driven independently using a 170 individual pulsers, each capable of generating 1.2 kV. The acoustic field was characterized using a fiber optic probe hydrophone with a bandwidth of 30 MHz and a spatial resolution of 100 μm. When all elements were driven simultaneously, the focal waveform was a shock wave with peak pressures p+ =65±3MPa and p−=−16±2MPa and the −6 dB focal region was 13 mm long and 2 mm wide. The delay for each element was the only control parameter for customizing the acoustic field and waveform shape, which was done with the aim of investigating the hypothesized mechanisms of stone fragmentation such as spallation, shear, squeezing, and cavitation. The acoustic field customization was achieved by employing the angular spectrum approach for modeling the forward wave propagation and regression of least square errors to determine the optimal set of delays. Results from the acoustic field customization routine and its implications on stone fragmentation will be discussed.

An Historical and Theological Analysis of Campus Crusade for Christ's Evangelistic Practice in Two American University Contexts

This dissertation, an exercise in practical theology, consists of a critical conversation between the evangelistic practice of Campus Crusade for Christ in two American university contexts, Bryan Stone's ecclesiologically grounded theology of evangelism, and William Abraham's eschatologically grounded theology of evangelism. It seeks to provide these evangelizing communities several strategic proposals for a more ecclesiologically and eschatologically grounded practice of evangelism within a university context. The current literature on evangelism is long on evangelistic strategy and activity, but short on theological analysis and reflection. This study focuses on concrete practices, but is grounded in a thick description of two particular contexts (derived from qualitative research methods) and a theological analysis of the ecclesiological and eschatological beliefs embedded within their evangelistic activities. The dissertation provides an historical overview of important figures, ideas, and events that helped mold the practice of evangelism inherited by the two ministries of this study, beginning with the famous Haystack Revival on Williams College in 1806. Both ministries, Campus Crusade for Christ at Bowling Green State University (Ohio) and at Washington State University, inherited an evangelistic practice sorely infected with many of the classic distortions that both Abraham and Stone attempt to correct. Qualitative research methods detail the direction that Campus Crusade for Christ at Bowling Green State University (Ohio) and Washington State University have taken the practice of evangelism they inherited. Applying the analytical categories that emerge from a detailed summary of Stone and Abraham to qualitative data of these two ministries reveals several ways evangelism has morphed in a manner sympathetic to Stone's insistence that the central logic of evangelism is the embodied witness of the church. The results of this analysis reveal the subversive and pervasive influence of modernity on these evangelizing communities—an influence that warrants several corrective strategic proposals including: 1) re-situating evangelism within a reading of the biblical narrative that emphasizes the present, social, public, and realized nature of the gospel of the kingdom of God rather than simply its future, personal, private, and unrealized dimensions; 2) clarifying the nature of the evangelizing communities and their relationship to the church; and 3) emphasizing the virtues that characterize a new evangelistic exemplar who is incarnational, intentional, humble, and courageous.