A hub for device personalisation in the treatment of congenital diseases

每100个婴儿中有2到5个出生时就有一些缺陷，可能需要医疗干预。身体异常的临床治疗通常涉及侵入性手术，这可能会导致严重的并发症、长时间的重症监护、长时间的住院，甚至死亡。由于专门为治疗天生患有这些缺陷的儿童而设计的设备和工具很少，临床医生往往只能凑合着，根据儿童的身体调整成人设备。这是因为与成人人口市场相比，儿科市场的规模很小，但更重要的是，与成人世界相比，出生缺陷的情况差异很大。患有相同综合症的儿童表现出许多不同形状和大小的身体缺陷。显然，在这些情况下，与老年人的治疗不同，一种设备不能满足所有人的需求。我们应该更努力地开发新的方法和技术，为儿科患者创造合适的设备。这些治疗应该为每个患者定制，以便提供最好和最安全的治疗。个性化和定制设备在人们的生活中已经很常见了：眼镜、牙冠、鞋垫。定制应该更加重要，应该发挥关键作用，因为设备本身可以决定生死。然而，生物医药行业无法满足其生产成本和时间需求，因为测试每个设备的安全性和有效性的研究努力太高。此外，生物工程行业没有足够的临床知识和对不同儿童疾病的了解来开发这种设备。我是一名训练有素的工程师，但在过去10年里，我一直在大奥蒙德街儿童医院工作，这是一家公认的世界领先的儿童医院，也是英国最大的儿科中心。在这里，我获得了关于临床环境、出生缺陷和当前临床治疗的重要知识。我对工程技术有很好的了解，并与机械工程部(Gaetano Burriesci博士)在与设备开发和测试相关的所有方面密切合作。在这个项目中，我建议作为工程师和临床医生、大学和行业之间的纽带，推动为天生患有身体缺陷的儿童和年轻人开发定制设备和量身定做的治疗方法。我计划使用工程方法和计算机虚拟现实来研究患者缺陷的形状，并根据需要设计可以轻松定制的新设备。我将创建缺陷的计算机模型，以及虚拟模拟，以开发针对每个患者的特定解剖结构的设备。通过研究放置装置的位置和装置本身之间的相互作用，可以确定设计变化，并在实际植入之前预测装置的成功或失败，而不需要动物和实验台实验。我在这个研究项目中开发的方法将适用于未来许多不同的装置和为治疗儿童而设计的技术。这可能最终导致制造的原型数量(这将降低开发新技术的成本)和研究工作中的动物实验数量大幅减少。此外，设备故障和其他问题预计会减少，因为我们将在真正的手术前对患者特定的模型进行练习，首次预测问题并进行相应调整以避免它们。

Between two and five babies in 100 are born with some defects that may require medical interventions. Clinical treatment of physical abnormalities often involves invasive surgery, which can be associated with serious complications, long stays in intensive care, prolonged hospitalisation, and even death. As devices and tools purposefully designed for treating children born with these defects are rare, clinicians often have to make do, adapting adult devices to the child's body. This is due to the small size of the paediatric market compared to the adult population market, but also, more importantly, to the huge variations that are encountered in birth defects compared to the adult world. Children born with the same syndrome present many different shapes and sizes of their physical defect. It is clear that in these cases, and unlike treatment of the elderly, one device cannot fit all.More effort should be put into the development of new methods and technologies to create suitable devices for paediatric patients. These should be customisable for each individual patient in order to offer the best and safest treatment. Personalisation and bespoke devices are already commonly available in people's life: glasses, dental crowns, foot insoles. Customisation should be even more important and should play a critical role, when the device itself can make the difference between life and death. However, the cost and time demand of their production cannot be met by the biomedical industry, as the research efforts to test each device safety and efficacy are too high. In addition, the bioengineering industry does not have sufficient clinical knowledge and the understanding of different childhood diseases to develop such devices.I am an engineer by training, but I have spent the last 10 years at Great Ormond Street Hospital for Children, a recognised world-leading children's hospital and the UK's largest paediatric centre. Here I have gained important knowledge of the clinical environment, birth defects and current clinical treatments. I have good understanding of the engineering technologies and work in close collaboration with the Mechanical Engineering Department (Dr Gaetano Burriesci) for all aspects related to device development and testing. In this project, I am proposing to work as a link between engineers and clinicians, university and industry, to drive the development of bespoke devices and tailored therapies for children and young adults born with physical defects.I plan to use engineering methods and computer virtual reality to study the shape of the patient defects, and design new devices that can be easily tailored to individual need, on demand. I will create computer models of the defects, as well as virtual simulations to enable development of devices tailored to the specific anatomy of each patient. By studying the interaction between the site where the device is placed and the device itself, it will be possible to determine design changes, and predict device success or failure before the actual implantation, with no need for animal and bench experiments.The methods I develop during this research project would be applicable to many different devices and technologies designed for treating children in the future. This may ultimately lead to significant reductions in both the number of manufactured prototypes (which will reduce cost of developing new technology) and the number of animal experiments in research work. Furthermore, device failure and other problems are expected to decrease, as we would be practising on patient-specific models before the real procedure, for the first time anticipating problems and adjusting accordingly to avoid them.