A model for calculating EM field in layered medium with application to biological implants

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Modern wireless telecommunication devices (GSM Mobile system) (cellular telephones and wireless modems on laptop computers) have the potential to interfere with implantable medical devices/prostheses and cause possible malfunction. An implant of resonant dimensions within a homogeneous dielectric lossy sphere can enhance local values of SAR (the specific absorption rate). Also antenna radiation pattern and other characteristics are significantly altered by the presence of the composite dielectric entities such as the human body. Besides, the current safety limits do not take into account the possible effect of hot spots arising from metallic implants resonant at mobile phone frequencies. Although considerable attention has been given to study and measurement of scattering from a dielectric sphere, no rigorous treatment using electromagnetic theory has been given to the implanted dielectric spherical head/cylindrical body. This thesis aims to deal with the scattering of a plane electromagnetic wave from a perfectly conducting or dielectric spherical/cylindrical implant of electrically small radius (of resonant length), embedded eccentrically into a dielectric spherical head model. The method of dyadic Green's function (DGF) for spherical vector wave functions is used. Analytical expressions for the scattered fields of both cylindrical and spherical implants as well as layered spherical head and cylindrical torso models are obtained separately in different chapters. The whole structure is assumed to be uniform along the propagation direction. To further check the accuracy of the proposed solution, the numerical results from the analytical expressions computed for the problem of implanted head/body are compared with the numerical results from the Finite-Difference Time-Domain (FDTD) method using the EMU-FDTD Electromagnetic simulator. Good agreement is observed between the numerical results based on the proposed method and the FDTD numerical technique. This research presents a new approach, away from simulation work, to the study of exact computation of EM fields in biological systems. Its salient characteristics are its simplicity, the saving in memory and CPU computational time and speed.Cochlear UK Limited and EPSR

Screening out irrelevant cell-based models of disease

The common and persistent failures to translate promising preclinical drug candidates into clinical success highlight the limited effectiveness of disease models currently used in drug discovery. An apparent reluctance to explore and adopt alternative cell-and tissue-based model systems, coupled with a detachment from clinical practice during assay validation, contributes to ineffective translational research. To help address these issues and stimulate debate, here we propose a set of principles to facilitate the definition and development of disease-relevant assays, and we discuss new opportunities for exploiting the latest advances in cell-based assay technologies in drug discovery, including induced pluripotent stem cells, three-dimensional (3D) co-culture and organ-on-a-chip systems, complemented by advances in single-cell imaging and gene editing technologies. Funding to support precompetitive, multidisciplinary collaborations to develop novel preclinical models and cell-based screening technologies could have a key role in improving their clinical relevance, and ultimately increase clinical success rates

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society