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Shaking creates foam, introduces air bubbles, and causes physical stress that degrades the peptide through a process called denaturation

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They describe laboratory findings related to peptide signaling, cellular behavior, and structural pathway studies

Here's what's actually happening during treatment: the acoustic waves create controlled microtrauma in the damaged tissue

In the CY 2011 PFS final rule (75 FR 73256), we acknowledged that we typically update the GPCI cost share weights concurrently with the most recent MEI rebasing and revision, but in consideration of the commenters' concerns in response to the proposed rule, we did not use the revised cost share weights for the CY 2011 GPCIs and instead finalized the implementation of the rebased and revised MEI cost share weights through subsequent rulemaking