710 A Novel Ventriculoperitoneal Shunt Design Aiming to Reduce Shunt Failure Rates

Introduction

Ventriculoperitoneal (VP) shunt insertion is the most common surgical treatment for hydrocephalus. While shunt obstructions are frequent and subsequent revision operations carry significant morbidity, there is limited advancement in shunt design to address this problem.

Method

A literature review of aetiology and mechanism of shunt blockage was performed. Design concepts of current medical and non-medical grade devices were studied. Design improvements to VP shunt were focused on the proximal catheter and lumen configuration. Concept dimensions and computer flow simulations using different diameters were generated.

Results

An improved prototype VP shunt design was proposed. It has multiple lumens and communicating channels between neighbouring lumens to provide alternative routes for cerebrospinal fluid drainage in the event of individual lumen obstruction. Our design also features a novel cone-shaped proximal end to minimise occlusion by nearby choroid plexus.

Conclusions

By targeting common causes of VP shunt blockage through proposed novel design, the mean service-life of shunts can be extended, necessitating fewer revision procedures and reducing both patient health and financial burdens. Further investigation, optimisation, and validation of this proposed shunt design is required before further product development.

Effect of different stent configurations using Lattice Boltzmann method and particles image velocimetry on artery bifurcation aneurysm problem

Proper design of stent for application at specific aneurysm effect arteries could help to reduce the issues with thrombosis and aneurysm. In this paper, four types of stent configuration namely half-Y (6 mm), half-Y (4 mm), cross-bar, and full-Y configuration will implanted on real 3D artery bifurcation aneurysm effected arteries. Comparisons were then conducted based on the flow patterns after stent placement using both LBM-based solver and PIV experimental findings. According to the data obtained from all 4 stent designs, the flow profiles and the computed velocity from both methods were in agreement with each other. Both methods found that half-Y (6 mm) stent configuration is by far the best configuration in reducing the blood velocity at the vicinity of the aneurysm sac. The analysis also show that the half-Y (6 mm) stent configuration recorded the highest percentage of velocity reduction and managed to substantially reduce the pressure at the bifurcation region. This high flow velocity reduction through the use of half-Y stent could consequently promote the formation of thrombus thereby reducing the risk of rupture in the aneurysm sac.

Turbulence Model Selection for Low Reynolds Number Flows

One of the major flow phenomena associated with low Reynolds number flow is the formation of separation bubbles on an airfoil's surface. NACA4415 airfoil is commonly used in wind turbines and UAV applications. The stall characteristics are gradual compared to thin airfoils. The primary criterion set for this work is the capture of laminar separation bubble. Flow is simulated for a Reynolds number of 120,000. The numerical analysis carried out shows the advantages and disadvantages of a few turbulence models. The turbulence models tested were: one equation Spallart Allmars (S-A), two equation SST K-ω, three equation Intermittency (γ) SST, k-kl-ω and finally, the four equation transition γ-Reθ SST. However, the variation in flow physics differs between these turbulence models. Procedure to establish the accuracy of the simulation, in accord with previous experimental results, has been discussed in detail.

Photoluminescence and thermoluminescence properties of Li₂O-Na₂O-B₂O₃ glass

Influence of Nd(3+) concentration on the optical and thermoluminescence (TL) properties of melt-annealed synthesized 10 Na2O: 20 Li2O: (70-x) B2O3 : xNd2O3, where 0.1≤ x ≤0.7 (LNB) glasses are determined. The absence of sharp peaks in X-ray diffraction patterns confirms the amorphous nature of the prepared glasses. The photoluminescence spectra under 800 nm laser excitations at room temperature exhibit three prominent peaks centred at 538, 603 and 675 nm corresponding to the transitions of (4)G(7/2) → (4)I(9/2), [(4)G(7/2) → (4)I(11/2), (4)G(5/2) → (4)I(9/2)] and [(4)G(7/2) → (4)I(13/2), (4)G(5/2) → (4)I(11/2)], respectively. The TL glow curve exhibits a prominent peak (T(m)) at 180°C. The best performance of the prepared glass was found at 0.5 mol% of Nd2O3. We achieved a good linearity of TL response against dose between 0.5 to 4.0 Gy. The calculated value of the effective atomic number, Z(eff), is 7.55 which is nearly tissue equivalent (Z(eff) = 7.42). These promising features demonstrate the capability of the aforementioned glass to be used as a radiation dosimeter.

HIGHLIGHTS

The thermoluminescence and optical properties of new compositions of lithium sodium borate glasses doped with Nd(3+) ions were reported. Attractive features were obtained from the TL, PL and UV-Vis light analysis. Three upconversion luminescences permitting green, orange and red emissions were observed.

Transtibial prosthesis suspension systems: systematic review of literature

BACKGROUND

Today a number of prosthetic suspension systems are available for transtibial amputees. Consideration of an appropriate suspension system can ensure that amputee's functional needs are satisfied. The higher the insight to suspension systems, the easier would be the selection for prosthetists. This review attempted to find scientific evidence pertaining to various transtibial suspension systems to provide selection criteria for clinicians.

METHODS

Databases of PubMed, Web of Science, and ScienceDirect were explored to find related articles. Search terms were as follows: "Transtibial prosthesis (32), prosthetic suspension (48), lower limb prosthesis (54), below-knee prosthesis (58), prosthetic liner (20), transtibial (193), and prosthetic socket (111)". Two reviewers separately examined the papers. Study design (case series of five or more subjects, retrospective or prospective), research instrument, sampling method, outcome measures and protocols were reviewed.

FINDINGS

Based on the selection criteria, 22 articles (15 prospective studies, and 7 surveys) remained. Sweat control was found to be a major concern with the available suspension liners. Donning and doffing procedures for soft liners are also problematic for some users, particularly those with upper limb weakness. Moreover, the total surface bearing (TSB) socket with pin/lock system is favored by the majority of amputees.

INTERPRETATION

In summary, no clinical evidence is available to suggest what kind of suspension system could have an influential effect as a "standard" system for all transtibial amputees. However, among various suspension systems for transtibial amputees, the Iceross system was favored by the majority of users in terms of function and comfort.