A5035548522- Cardiac, Anesthesia and Surgical Outcomes
- Airway Management and Intubation Techniques
- Birth, Development, and Health
- Pregnancy and preeclampsia studies
- Neonatal Respiratory Health Research
- Hemodynamic Monitoring and Therapy
- Neonatal and fetal brain pathology
- Cardiac Arrest and Resuscitation
- Gestational Diabetes Research and Management
- Neuroscience of respiration and sleep
- Frailty in Older Adults
- Respiratory Support and Mechanisms
- Anesthesia and Sedative Agents
- COVID-19 and healthcare impacts
- Domain Adaptation and Few-Shot Learning
- Sepsis Diagnosis and Treatment
- Nutrition and Health in Aging
- Mitochondrial Function and Pathology
- Adversarial Robustness in Machine Learning
- Neonatal Health and Biochemistry
- High Altitude and Hypoxia
- Lipoproteins and Cardiovascular Health
- Anesthesia and Pain Management
- Adipose Tissue and Metabolism
- Trauma and Emergency Care Studies
University of Cambridge
2014-2025
James Cook University Hospital
2020-2024
Royal College of Anaesthetists
2023-2024
South Tees Hospitals NHS Foundation Trust
2022-2024
Hull York Medical School
2024
Gateshead Health NHS Foundation Trust
2024
Health Foundation
2024
North Yorkshire County Council
2023
University College London
2021
Institut de Recherche en Sciences de la Santé
2020
We propose a dual pathway, 11-layers deep, three-dimensional Convolutional Neural Network for the challenging task of brain lesion segmentation. The devised architecture is result an in-depth analysis limitations current networks proposed similar applications. To overcome computational burden processing 3D medical scans, we have efficient and effective dense training scheme which joins adjacent image patches into one pass through network while automatically adapting to inherent class...
Fetal hypoxia is a common complication of pregnancy. It has been shown to programme cardiac and endothelial dysfunction in the offspring adult life. However, mechanisms via which this occurs remain elusive, precluding identification potential therapy. Using an integrative approach at isolated organ, cellular molecular levels, we tested hypothesis that oxidative stress fetal heart vasculature underlies basis prenatal programmes cardiovascular later In longitudinal study, effects maternal...
Detailed contemporary knowledge of the characteristics surgical population, national anaesthetic workload, techniques and behaviours are essential to monitor productivity, inform policy direct research themes. Every 3-4 years, Royal College Anaesthetists, as part its National Audit Projects (NAP), performs a snapshot activity survey in all UK hospitals delivering anaesthesia, collecting patient-level encounter data from cases under care an anaesthetist. During November 2021, NAP7,...
Summary The 7th National Audit Project (NAP7) of the Royal College Anaesthetists studied peri‐operative cardiac arrest. Additional inclusion criteria for obstetric anaesthesia were: arrest associated with neuraxial block performed by an anaesthetist outside operating theatre (labour epidural analgesia); and remifentanil patient‐controlled analgesia. There were 28 cases in patients, representing 3% all arrests reported to NAP7, giving incidence 7.9 per 100,000 (95%CI 5.4–11.4 100,000)....
Summary The 7th National Audit Project (NAP7) of the Royal College Anaesthetists studied complications airway and respiratory system during anaesthesia care including peri‐operative cardiac arrest. Among 24,721 surveyed cases, occurred commonly (n = 421 n 264, respectively). most common were: laryngospasm (157, 37%); failure (125, 30%); aspiration (27, 6%). Emergency front neck was rare (1 in 8370, 95%CI 1 2296–30,519). severe ventilation difficulty (97, hyper/hypocapnia (63, 24%);...
Summary The 7th National Audit Project of the Royal College Anaesthetists studied peri‐operative cardiac arrest in UK, a topic importance to patients, anaesthetists and surgeons. Here we report results 12‐month registry, from 16 June 2021 15 2022, focusing on epidemiology clinical features. We reviewed 881 cases arrest, giving an incidence 3 10,000 anaesthetics (95%CI 3.0–3.5 per 10,000). Incidence varied with patient surgical factors. Compared denominator survey activity, patients arrest:...
Complications and critical incidents arising during anaesthesia due to patient, surgical or anaesthetic factors, may cause harm themselves progress more severe events, including cardiac arrest death. As part of the 7th National Audit Project Royal College Anaesthetists, we studied a prospective national cohort unselected patients. Anaesthetists recorded anonymous details all cases undertaken over 4 days at their site through an online survey. Of 416 hospital sites invited participate, 352...
Summary The 7th National Audit Project of the Royal College Anaesthetists studied peri‐operative cardiac arrest. An activity survey estimated UK paediatric anaesthesia annual caseload as 390,000 cases, 14% total. Paediatric arrests accounted for 104 (12%) reports giving an incidence 3 in 10,000 anaesthetics (95%CI 2.2–3.3 per 10,000). arrest was highest neonates (27, 26%), infants (36, 35%) and children with congenital heart disease (44, 42%) most were from tertiary centres (88, 85%)....
Key points The in vivo fetal cardiovascular defence to chronic hypoxia has remained by and large an enigma because no technology been available induce significant prolonged whilst recording longitudinal changes regional blood flow as the hypoxic pregnancy is developing. We introduce a new technique able maintain chronically instrumented maternal sheep preparations under isobaric for most of gestation, beyond levels that can be achieved high altitude relevance magnitude human intrauterine...
Aging and developmental programming are both associated with oxidative stress endothelial dysfunction, suggesting common mechanistic origins. However, their interrelationship has been little explored. In a rodent model of programmed cardiovascular dysfunction we determined function vascular telomere length in young (4 mo) aged (15 adult offspring normoxic or hypoxic pregnancy without maternal antioxidant treatment. We show loss [maximal arterial relaxation to acetylcholine (71 ± 3 vs. 55 3%)...
Evidence derived from human clinical studies and experimental animal models shows a causal relationship between adverse pregnancy increased cardiovascular disease in the adult offspring. However, translational isolating mechanisms to design intervention are lacking. Sheep humans share similar precocial developmental milestones anatomy physiology. We tested hypothesis sheep that maternal treatment with antioxidants protects against fetal growth restriction programmed hypertension adulthood...
Cardiac arrest in the peri-operative period is rare but associated with significant morbidity and mortality. Current reporting systems do not capture many such events, so there an incomplete understanding of incidence outcomes. As cardiac rare, hospitals may only see a small number cases over long periods, anaesthetists be involved for years. Therefore, large-scale prospective cohort needed to gain deep events leading up arrest, management itself patient Consequently, Royal College...
Summary The 7th National Audit Project of the Royal College Anaesthetists studied peri‐operative cardiac arrest in UK, a topic importance to patients, anaesthetists and surgeons. We report results 12‐month registry phase, from 16 June 2021 15 2022, focusing on management outcomes. Among 881 cases arrest, initial rhythm was non‐shockable 723 (82%) cases, most commonly pulseless electrical activity. There were 665 (75%) patients who survived event 384 (52%) hospital discharge. A favourable...
Summary The Royal College of Anaesthetists' 7th National Audit Project baseline survey assessed knowledge, attitudes, practices and experiences peri‐operative cardiac arrests among UK anaesthetists Anaesthesia Associates. We received 10,746 responses, representing a 71% response rate. In‐date training in adult paediatric advanced life support was reported by 9646 (90%) 7125 (66%) anaesthetists, respectively. There were 8994 (84%) respondents who confident leading arrest, with males more than...
Summary We report the results of Royal College Anaesthetists' 7th National Audit Project organisational baseline survey sent to every NHS anaesthetic department in UK assess preparedness for treating peri‐operative cardiac arrest. received 199 responses from 277 departments, representing a 72% response rate. Adult and paediatric care was provided by 188 (95%) 165 (84%) hospitals, respectively. There no intensive unit on‐site 144 (87%) hospitals caring children, meaning transfer critically...
Summary Background We analysed the clinical practice of anaesthesia associates in UK, as reported to 7th National Audit Project Royal College Anaesthetists, and compared these with medically qualified anaesthetists. Methods included data from our baseline survey, activity survey case registry other reports project. Results Among 197 departments anaesthesia, 52 (26%) employed associates. Of 10,009 responding care providers, 71 (< 1%) were associates, whom 33 (47%) reporting working nights...
In addition to lowering cholesterol, statins increase nitric oxide (NO) bioavailability, improving endothelial function. the fetus, enhanced NO during acute hypoxia opposes fetal peripheral vasoconstrictor response, part of brain-sparing defence. This study tested hypothesis that treatment with depresses circulatory response hypoxic stress via increasing bioavailability. Under anaesthesia, 12 sheep at 118 ± 1 days gestation (term ca 145 days) were instrumented vascular catheters and a...
Background: Fetal hypoxia is common and in vitro evidence supports its role the programming of adult cardiovascular dysfunction through generation oxidative stress. Whether fetal chronic programmes alterations control vivo, if these can be prevented by antioxidant treatment, unknown. This study investigated effects prenatal hypoxia, with without maternal supplementation vitamin C, on basal stimulated function vivo offspring at 4 months age rat. Methods Results: From days 6 to 20 pregnancy,...
Progress in the study of pregnancy complicated by chronic hypoxia large mammals has been held back inability to measure long-term significant reductions fetal oxygenation at values similar those measured human growth restriction. Here, we introduce a technique for physiological research able maintain chronically instrumented maternal and sheep prolonged periods gestation under controlled isolated beyond levels that can be achieved habitable high altitude. This model permits measurement...
Abstract Background Chronic hypoxemia is a common cause of fetal growth restriction and can have significant effects on the developing lung. Maternal antioxidant treatment in hypoxic pregnancy protects against offspring cardiovascular dysfunction. The antenatal antioxidants lung development chronically restricted fetus unknown. Methods We investigated effect maternal daily Vitamin C (200 mg/kg i.v. vs. Saline) for month late gestation molecular markers regulating maturation between normoxic...