{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:51:14Z","timestamp":1791870674971,"version":"4.3.4"},"posted":{"date-parts":[[2025,6,19]]},"group-title":"Bioengineering","reference-count":33,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.biorxiv.org\/about\/FAQ#license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1P20DK135107-03"],"award-info":[{"award-number":["1P20DK135107-03"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["2R01DK052985-27"],"award-info":[{"award-number":["2R01DK052985-27"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1R01DK138972-01A1"],"award-info":[{"award-number":["1R01DK138972-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1R01DK139109-01"],"award-info":[{"award-number":["1R01DK139109-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,6,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To investigate the fracture mechanism of impacted ureteral stones during laser lithotripsy (LL).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Impacted 6 x 6 mm cylindrical BegoStone samples embedded in a hydrogel ureter model were treated using either Holmium:YAG (Ho:YAG) laser or Thulium Fiber Laser (TFL) via three clinical strategies: \u201cdrill and core\u201d, contact, and non-contact modes. Laser pulses were delivered using three pulse energy\/frequency settings: 0.8 J\/12 Hz, 1.0 J\/10 Hz, and 1.2 J\/8 Hz with a 3 s on\/3 s off protocol, under continuous irrigation at 40 mL\/min. Crater formation, surface crack development, and bubble dynamics were assessed via optical coherence tomography, video, and high-speed photography. To delineate the contributions of different plausible damage mechanisms, bubble collapse was suppressed by leveraging the ureteroscope\u2019s proximity effect, and thermal ablation was minimized by treating donut-shaped stones with a central tunnel. The role of bubble expansion in stone fracture was further evaluated by systematically varying tunnel size or pulse energy.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Surface cracks and stone fracture were observed exclusively in Ho:YAG laser-treated stones using the \u201cdrill and core\u201d, but not the other two strategies. TFL produced deeper craters yet failed to induce any significant crack formation or propagation under all conditions. Suppression of bubble collapse or thermal ablation had minimal effect on surface crack formation and growth. In contrast, the extent and number of surface cracks correlated strongly with the maximum lateral diameter and expansion rate of the vapor bubbles \u2013 two parameters that were significantly greater for Ho:YAG laser than TFL. Importantly, the crack formation also showed an inverse correlation with the size of the initial crater or tunnel in the stone.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Intra-crater bubble expansion, rather than thermal ablation or bubble collapse, is the primary mechanism driving the fracture of impacted ureteral stone in LL.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.06.13.659568","type":"posted-content","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T01:00:16Z","timestamp":1750381216000},"source":"Crossref","is-referenced-by-count":2,"title":["Intra-Crater Bubble Expansion Drives the Fracture of Impacted Ureteral Stones in Laser Lithotripsy"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2653-1814","authenticated-orcid":false,"given":"Junqin","family":"Chen","sequence":"first","affiliation":[{"name":"Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2368-6151","authenticated-orcid":false,"given":"Pei","family":"Zhong","sequence":"additional","affiliation":[{"name":"Thomas Lord Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026041204181876000_2025.06.13.659568v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.11.013"},{"key":"2026041204181876000_2025.06.13.659568v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2012.11.021"},{"key":"2026041204181876000_2025.06.13.659568v1.3","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0641"},{"key":"2026041204181876000_2025.06.13.659568v1.4","doi-asserted-by":"publisher","DOI":"10.5173\/ceju.2019.0009"},{"key":"2026041204181876000_2025.06.13.659568v1.5","doi-asserted-by":"publisher","DOI":"10.1089\/end.2023.0689"},{"key":"2026041204181876000_2025.06.13.659568v1.6","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2016.172"},{"key":"2026041204181876000_2025.06.13.659568v1.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.10.147"},{"key":"2026041204181876000_2025.06.13.659568v1.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-023-01501-y"},{"key":"2026041204181876000_2025.06.13.659568v1.9","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16218"},{"key":"2026041204181876000_2025.06.13.659568v1.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-024-01585-0"},{"key":"2026041204181876000_2025.06.13.659568v1.11","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000003833"},{"key":"2026041204181876000_2025.06.13.659568v1.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2022.05.020"},{"key":"2026041204181876000_2025.06.13.659568v1.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2022.02.027"},{"key":"2026041204181876000_2025.06.13.659568v1.14","doi-asserted-by":"publisher","DOI":"10.1089\/end.2023.0168"},{"key":"2026041204181876000_2025.06.13.659568v1.15","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20893"},{"key":"2026041204181876000_2025.06.13.659568v1.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2022.05.017"},{"key":"2026041204181876000_2025.06.13.659568v1.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.04.029"},{"key":"2026041204181876000_2025.06.13.659568v1.18","doi-asserted-by":"publisher","DOI":"10.1089\/end.2021.0526"},{"key":"2026041204181876000_2025.06.13.659568v1.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultsonch.2023.106649"},{"key":"2026041204181876000_2025.06.13.659568v1.20","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1096-9101(1999)25:1&lt;22::aid-lsm4&gt;3.0.co;2-6"},{"key":"2026041204181876000_2025.06.13.659568v1.21","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11175048"},{"key":"2026041204181876000_2025.06.13.659568v1.22","doi-asserted-by":"publisher","DOI":"10.1089\/end.2020.0349"},{"issue":"1","key":"2026041204181876000_2025.06.13.659568v1.23","first-page":"25","article-title":"Use of the holmium laser in the upper urinary tract","volume":"1","year":"1995","journal-title":"Tech Urol. Spring"},{"key":"2026041204181876000_2025.06.13.659568v1.24","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16015"},{"key":"2026041204181876000_2025.06.13.659568v1.25","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-010-0298-x"},{"key":"2026041204181876000_2025.06.13.659568v1.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.engfracmech.2020.107357"},{"key":"2026041204181876000_2025.06.13.659568v1.27","doi-asserted-by":"publisher","DOI":"10.1364\/boe.9.004552"},{"key":"2026041204181876000_2025.06.13.659568v1.28","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.1900080403"},{"key":"2026041204181876000_2025.06.13.659568v1.29","doi-asserted-by":"crossref","unstructured":"Persson P-A , Holmberg R , Lee J . Rock blasting and explosives engineering. CRC press; 2018.","DOI":"10.1201\/9780203740514"},{"key":"2026041204181876000_2025.06.13.659568v1.30","doi-asserted-by":"publisher","DOI":"10.1007\/BF00963386"},{"key":"2026041204181876000_2025.06.13.659568v1.31","doi-asserted-by":"publisher","DOI":"10.1016\/0148-9062(71)90018-0"},{"key":"2026041204181876000_2025.06.13.659568v1.32","doi-asserted-by":"publisher","DOI":"10.1017\/jfm.2024.989"},{"key":"2026041204181876000_2025.06.13.659568v1.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsolstr.2023.112626"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.06.13.659568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T11:18:28Z","timestamp":1775992708000},"score":1,"resource":{"primary":{"URL":"http:\/\/biorxiv.org\/lookup\/doi\/10.1101\/2025.06.13.659568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,19]]},"references-count":33,"URL":"https:\/\/doi.org\/10.1101\/2025.06.13.659568","relation":{},"subject":[],"published":{"date-parts":[[2025,6,19]]},"subtype":"preprint"}}