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Heating from high intensity focused ultrasound (HIFU) can be used to control bleeding, both from individual blood vessels as well as from gross damage to the capillary bed. The presence of vascularity can limit one's ability to elevate the temperature owing to convective heat transport. In an effort to better understand the heating process in tissues with vascular structure we have developed a numerical simulation that couples models for ultrasound propagation, acoustic streaming, ultrasound heating and blood cooling in a Newtonian viscous medium. The 3-D simulation allows for the study of complicated biological structures and insonation geometries. We have also undertaken a series of in vitro experiments employing non-uniform flow-through tissue phantoms and designed to provide verification of the model predictions. We show that blood flow of 2 cm/s (6.4 ml/min through a 2.6 mm 'vessel') can reduce peak temperature in a vessel wall by 25%. We also show that HIFU intensities of 6.5 x 10(5) W/m2 can induce acoustic streaming with peak velocities up to 5 cm/s and this can reduce heating near a vessel wall by more than 10%. These results demonstrate that convective cooling is important in HIFU and can be accounted for within simulation models.

The onset and presence of inertial cavitation and near-boiling temperatures in high-intensity focused ultrasound (HIFU) therapy have been identified as important indicators of energy deposition for therapy guidance. Passive cavitation detection is commonly used to detect bubble emissions, where a fixed-focus single-element acoustic transducer is typically used as a passive cavitation detector (PCD). This technique is suboptimal for clinical applications, because most PCD transducers are tightly focused and afford limited spatial coverage of the HIFU focal region. A Terason 2000 Ultrasound System was used as a PCD array to expand the spatial detection region for cavitation by operating in passive mode, obtaining the radiofrequency signals corresponding to each scan line and filtering the contribution from scattering of the HIFU signal harmonics. This approach allows for spatially resolved detection of both inertial and stable cavitation throughout the focal region. Measurements with the PCD array during sonication with a 1.1-MHz HIFU source in tissue phantoms were compared with single-element PCD and thermocouple sensing. Stable cavitation signals at the harmonics and superharmonics increased in a threshold fashion for temperatures >90 degrees C, an effect attributed to high vapor pressure in the cavities. Incorporation of these detection techniques in a diagnostic ultrasound platform could result in a powerful tool for improving HIFU guidance and treatment.

It has been established that while the inherent presence of bubbles increases heat generation due to scattering and absorption, inertial cavitation is responsible for elevated heating during high-intensity focused ultrasound (HIFU) application. The contribution of bubble-induced heating can be an important factor to consider, as it can be several times greater than the expected heat deposition from absorption of energy from the primary ultrasound field. The temperature and cavitation signal near the focus were measured for 5.5-s continuous-wave 1.1-MHz HIFU sonications in tissue mimicking phantoms. The measured temperature was corrected for heating predicted from the primary ultrasound absorption to isolate the temperature rise from the bubble activity. The temperature rise induced from cavitation correlates well with a measurement of the instantaneous "cavitation power" as indicated by the mean square voltage output of a 15-MHz passive cavitation detector. The results suggest that careful processing of the cavitation signals can serve as a proxy for measuring the heating contribution from inertial cavitation.

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Acoustic metasurfaces represent a family of planar wavefront-shaping devices garnering increasing attention due to their capacity for novel acoustic wave manipulation. By precisely tailoring the geometry of these engineered surfaces, the effective refractive index may be modulated and, consequently, acoustic phase delays tuned. Despite the successful demonstration of phase engineering using metasurfaces, amplitude modulation remains overlooked. Herein, we present a class of metasurfaces featuring a horn-like space-coiling structure, enabling acoustic control with simultaneous phase and amplitude modulation. The functionality of this class of metasurfaces, featuring a gradient in channel spacing, has been investigated theoretically and numerically and an equivalent model simplifying the structural behavior is presented. A metasurface featuring this geometry has been designed and its functionality in modifying acoustic radiation patterns experimentally validated. This class of acoustic metasurface provides an efficient design methodology enabling complete acoustic wave manipulation, which may find utility in applications including biomedical imaging, acoustic communication, and non-destructive testing.

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Background Hand rehabilitation is core to helping stroke survivors regain activities of daily living. Recent studies have suggested that the use of electroencephalography-based brain-computer interfaces (BCI) can promote this process. Here, we report the first systematic examination of the literature on the use of BCI-robot systems for the rehabilitation of fine motor skills associated with hand movement and profile these systems from a technical and clinical perspective. Methods A search for January 2010–October 2019 articles using Ovid MEDLINE, Embase, PEDro, PsycINFO, IEEE Xplore and Cochrane Library databases was performed. The selection criteria included BCI-hand robotic systems for rehabilitation at different stages of development involving tests on healthy participants or people who have had a stroke. Data fields include those related to study design, participant characteristics, technical specifications of the system, and clinical outcome measures. Results 30 studies were identified as eligible for qualitative review and among these, 11 studies involved testing a BCI-hand robot on chronic and subacute stroke patients. Statistically significant improvements in motor assessment scores relative to controls were observed for three BCI-hand robot interventions. The degree of robot control for the majority of studies was limited to triggering the device to perform grasping or pinching movements using motor imagery. Most employed a combination of kinaesthetic and visual response via the robotic device and display screen, respectively, to match feedback to motor imagery. Conclusion 19 out of 30 studies on BCI-robotic systems for hand rehabilitation report systems at prototype or pre-clinical stages of development. We identified large heterogeneity in reporting and emphasise the need to develop a standard protocol for assessing technical and clinical outcomes so that the necessary evidence base on efficiency and efficacy can be developed.