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One Year Research Fellowships - 2013-2014

Mr Zaid Awad Dr Matthew Jackson Mr John Saunders
Mr Matthew Bedford Mr Muhammad Javed Mr Vikram Sharma
Mr Andrew Cowie Mr Robert MacFarlane Miss Hannah Smith
Miss Katherine Gash Mr Oliver Old Dr Hew Torrance
Miss Michelle Griffin Ms Liza Osagie Dr Christopher West
Mr Nicholas Hamilton Mr Karl Pang Ms Michelle Wilkinson
Dr David Izadi Mr Keval Patel Miss Nuha Yassin

Mr Zaid Awad

 Zaid Awad

Imperial College, London

Simulation and assessment in ENT training, putting patient safety first

‘Simulation integrated training safer for patients'

The ENT curriculum requires trainees to achieve specific competencies prior to progression into independent practice. Regular structured assessments are essential to monitor performance, identify weaknesses and protect patient safety. At the moment, we have no validated assessments for operative competency and no robust method of identifying the failing trainee.

This research aims to:
1. Rigorously test and integrate simulation modules into the training programme to skills development in a patient-free environment.
2. Develop structured assessment tools that can be used in clinical practice and simulation.

Our recommendations can aid the delivery of  high-quality training without compromising patient safety.

Mr Matthew Bedford

 Matthew Bedford

School of Cancer Sciences, University of Birmingham

Iron chelators: the next generation of anti-neoplastic agents in colorectal cancer?

'Binding iron to treat bowel cancer'

Bowel cancer is the third most common cancer in the UK. Each year there are over 40,000 new cases of the disease and it is responsible for around 15,000 deaths. Patients commonly experience rectal bleeding, abdominal pain, blockage to the bowel, tiredness and weight loss. Chemotherapy is given to patients with advanced disease but it is not always effective.

This research aims to show that binding iron is a potential new way to treat bowel cancer. If successful then it may improve survival for patients with the disease.

Mr Andrew Cowie

 Andrew Cowie 

Cancer Sciences Division, University of Southampton.
Cancer Research UK Centre, Somers Cancer Research Building

Inhibitors of cancer associated fibroblast transdifferentiation in oesophageal adenocarcinoma

'Surgeon scientists lead the fight against oesophageal cancer'

Oesophageal (gullet/food pipe) cancer is the sixth biggest cancer killer in the UK. Approximately 8,500 people are diagnosed annually, mostly men in their 60s and 70s, although 10% are under the age of 55. Unfortunately less than 1 in 10 patients with oesophageal cancer survive for 5 years after diagnosis. More research is desperately needed.

Surgeon scientists at Southampton University are developing new ways to target cancer fibroblasts, key cells involved in cancer growth and development. They hope to discover new drug treatments to fight this disease.

Miss Katherine Gash

 Katherine Gash 

School of Cellular and Molecular Medicine, University of Bristol

NSAID induced response of colorectal cancer stem cells to chemo-radiotherapy

‘Aspirin inhibits cancer stem cell survival'

Bowel cancer is the second most common cause of cancer deaths in the UK, however, 40% of patients with advanced disease are resistant to treatment. Cells within cancers, known as cancer stem cells [CSC] drive tumour growth. These cells are resistant to conventional therapies; even if a patient has a good initial response to treatment, the CSCs can cause the cancer to re-grow in the future. This research investigates exciting new evidence that drugs such as aspirin [NSAIDs] can sensitize CSCs to chemo-radiotherapy, thus, enhancing the response to treatment and potentially improving patient survival.

Miss Michelle Griffin

 Michelle Griffin

Division of Surgery and Interventional Science, University College London (UCL)

Development of a nasal hybrid construct using nanocomposite material and stem cells

'Nose reconstruction using stem cells' 

Nose defects are caused by trauma, cancer, skin diseases and birth malformations. Currently, nose reconstruction uses the patient’s own tissue from elsewhere in the body. This is painful, has wound-healing complications and patient’s available tissue is limited. We performed the first UK nose reconstruction for a patient with nasal cancer using stem cells and a unique man-made polymer. We aim to improve our technique in developing nasal constructs by modifying the polymer’s physical and mechanical properties. This will lead to an alternative reconstruction option that overcomes complications with current techniques and can be modified for various nasal defects.

Mr Nicholas Hamilton

 Nicholas Hamilton

Lungs For Living Research, University College London (UCL)

Optimisation of scaffold matrix for epithelial regeneration on tissue engineered airway implants

'Rebuilding damaged airways'

Over 1,000 people each year undergo airway surgery requiring reconstruction with skin grafts or muscle flaps. These techniques replace the airway lining with a different cell type that clears airway secretions poorly and sheds its top layer leading to airway blockage.

We aim to take lung cells and grow them on different protein scaffolds to test which is the most effective at regenerating new airway lining. This novel work will help deliver a functioning sheet of new airway lining consisting of the patient’s own cells and in doing so greatly improve the safety and effectiveness of airway surgery.

Dr David Izadi

 David Izadi

Kennedy Institute of Rheumatology, University of Oxford

Targeting inflammatory pathways in Dupuytren's disease

‘Targeting inflammatory pathways of Dupuytren's disease'

Dupuytren's disease causes the fingers to irreversibly curl into the palm, leading to severe impairment of hand function. It is common, affecting 5% of the UK population. Established contractures are usually treated by surgery, but this has recurrence rates of up to 40%. Currently there is no specific treatment for early disease or to prevent recurrence.

I aim to better understand the factors driving the onset and progression of Dupuytren's disease. My objectives are to investigate the link between the disease and environmental factors and to investigate the molecular mechanisms that drive disease chronicity.

Dr Matthew Jackson

 Matthew Jackson 

Institute of Cellular Medicine, Newcastle University

A patient-reported outcome measure for disorders of the penis and urethra

‘Measuring and valuing penile health problems'

Disorders of the penis and urethra like narrowing of the urine channel and bending of the penis during sex are hidden but distressing health problems for three in a hundred men in the UK. I will find out which issues are important to men with these problems and create a questionnaire in the words of affected men themselves that can measure their distress and the worth of corrective treatment. This questionnaire will let people put a value on any benefit experienced so that the best treatments can be identified and used within the NHS.

Mr Muhammad Javed

 Muhammad Javed

NIHR Liverpool Pancreas Biomedical Research Unit & University of Liverpool

Evaluating TR040303 as a potential treatment of necrotizing pancreatitis

‘Developing a treatment for acute pancreatitis'

Pancreatitis is a common, serious illness - usually caused by gallstones or excess alcohol intake - for which there is no specific treatment. One in five people with pancreatitis have severe disease requiring intensive care and prolonged hospital treatment - chronic ill health or even death can result. Our research team has discovered that there is a special opening in cells, which if kept open is very harmful. The aim of this project is to study a new drug that blocks the opening, to help cells live and work normally, and make patients better.

Mr Robert MacFarlane

 Robert Macfarlane

Dept.of Chemical Engineering and Chemical Technology, Imperial College London

The encapsulation of human mesenchymal stem cells for bone tissue engineering applications

‘Stem cells for bone tissue enginnering'

Critical size bone defects are seen in patients who have sustained an injury resulting in pain, loss of limb function, and disability.

Current treatments are not always successful and can involve large operations, often on multiple occasions. Fixation of limbs, synthetic bone implants, bone grafts, partial bone replacement, and amputation, are current options but can be unrelaible treatments and risky. Patients often have persistent pain and disability. Using stem cells to create bone may help to provide more reliable treatment, reduce disability, and restore limb function.

Mr Oliver Old

 Oliver Old

Gloucestershire Royal Hospital

Diagnosis of early oesophageal cancer and dysplasia using raman spectroscopy

‘Early diagnosis of oesophageal cancer'

Oesophageal cancer affects over 8,000 patients in the UK each year, and is becoming more common. Most patients are diagnosed late and are therefore incurable (only 13% survive 5 years from diagnosis). Barrett’s oesophagus is a recognised condition which can lead to cancer, but there is no reliable early diagnostic test to identify changes leading to cancer.

Raman spectroscopy is a laboratory-based technique that can potentially identify these changes. Our study will perform the further work needed to transfer this technique for use in patients, to allow treatment of ‘pre-cancer’ and thus prevent the cancer developing.

Ms Liza Osagie

 Liza Osagie 

Royal National Orthopaedic Hospital

Parathyroid hormone enhances osseointegration of a mesenchymal stem cell coated implant

‘Improving bone formation through stem-cell therapy'

The number of joint replacement procedures cases are exponentially increasing across the UK. A 600% surge in annual knee replacements is projected by 2030; evidence suggests 10% of patients will require revision surgery and a further 25% necessitating a third procedure. In contexts of major bone loss implant fixation is severely impeded resulting in a reduced quality of life.

This research will investigate whether stem cells can be treated to increase bone formation; this knowledge can help reduce the number of revision surgeries, costs to the NHS and patient morbidity facilitating an earlier return to function.

Mr Karl Pang

 Karl Pang 

Institute for Cancer Studies and Academic Urology Unit, University of Sheffield

Evaluation of the diagnostic role of a small RNA within PCA3 in prostate cancer

‘Role of PCA3 in prostate cancer'

Prostate cancer (PCa) is the most common cancer in UK men. In 2008, there were 37,000 new cases and 10,170 deaths. Investigating PCa includes performing prostate-specific antigen (PSA) blood test and prostate biopsy. PSA-testing often gives false positive results, leading to unnecessary biopsies, which puts patients at risk of physical/psychological complications. A urinary marker, Prostate Cancer-3 (PCA3) is being utilised to diagnosis PCa. However, its exact function and ability to predict biopsy outcomes is unclear. This research aims to explore this. Results would help guide biopsy decisions, enhance early diagnosis and reduce mortality.

Mr Keval Patel

 Keval Patel

Cancer Research UK, Cambridge Institute

The translational potential of circulating tumour DNA in urological cancers

‘Non-invasive monitoring of prostate cancer mutations'

Prostate cancer is the most common male cancer in the UK affecting 50% of 50-year-old men. Current methods of diagnosis rely on insensitive blood tests (PSA) and invasive prostate biopsies. However, patients with cancer have mutations in their DNA and now, we can detect these mutations non-invasively from a simple blood or urine sample. We hope to investigate this new test’s ability to monitor the progression prostate cancers in men.

In the future similar tests that detect cancerous DNA could accurately diagnose and predict aggressive cancers in people without the need for invasive tests. Furthermore, cancer.

Mr John Saunders

 John Saunders

Division of Pre-Clinical Oncology, University of Nottingham and Queens Medical Centre, Nottingham University Hosptials NHS Trust.

Using 3D 'in vitro' tumour models to develop personalised treatment of OG cancer

‘Developing personalised treatment for oesophago-gastric cancer '

The incidence of oesophago-gastric cancer (OG cancer) is growing alarmingly, and the UK mortality each year is equivalent to that of breast cancer. Half of patients undergoing pre-operative chemotherapy for OG cancer will not respond and thus suffer from chemotherapy side effects and further tumour progression. We have developed three-dimensional 'in vitro' tumour models to study the mechanisms of chemo-resistance in tumours. If these models successfully imitate the behaviour of individual human cancer chemotherapy responses, we can develop a test to predict each patient's individual chemotherapy response and provide personalised treatment for OG cancer.

Mr Vikram Sharma

 Vikram Sharma 

Weatherall Institute of Molecular Medicine,
University of Oxford

Improved diagnostic outcomes in craniofacial surgery by use of next generation DNA sequencing

‘New hope for craniofacial malformation diagnosis’

Craniofacial malformations (face and skull deformities) are serious disorders affecting 1 in 2,200 children. Over 80% result from craniosynostosis - premature fusion of sutures (‘joins’) between skull bones. Most require surgery, and 30% have long-term problems.

Coronal synostosis (early fusion of the suture running from ear to ear) was thought to have a genetic basis, but until recently, this could not be proven.

This exciting project has used new DNA technology to find the first of hopefully more altered genes to give a formal diagnosis, improve knowledge, tailor surgical management and aid genetic counselling.

Miss Hannah Smith

 Hannah Smith 

University of Warwick

Does cadaveric simulation training lead to better surgeons and safer patients?

'Training safer surgeons using simulation’

It has never been more important to train surgeons how to do safe operations. An ageing population means that operations for joint replacement and broken hips are being carried out in increasingly great numbers. These operations are generally safe, but even a small increase in the quality of the operation will have significant benefits for patients in view of the large numbers.

The government has identified a need for research into “simulated surgery” as a training tool to teach surgeons-in-training how to perform operations before they do them for the first time on a real patient.

Dr Hew Torrance

 Hew Torrance 

Royal London Hospital

Exploring the immunological response to severe trauma and identifying potential treatment options

‘Reducing in-hospital mortality following trauma'

Trauma refers to a diverse array of incidents (traffic accidents, assaults etc) causing physical injury. Trauma remains the main killer of young people. Patients tend to die either immediately or much later in an intensive care unit from infectious complications. Trauma alters the immune system making patients susceptible to infections.

Although the immediate trauma mortality is falling with better emergency care the later death rates remain stubbornly high as we fail to understand fully the intricacies of the immune dysfunctions.

This project will explore how trauma influences immune function and will identify potential new treatments.

Dr Christopher West

 Christopher West 

MRC Centre for Regenerative Medicine, University of Edinburgh

Polymer guided chondrogenesis of human adipose derived perivascular stem cells - developing scaffolds for auricular reconstruction

‘Growing ears from fat stem cells'

1 in 6,000 children are born without an ear. Surgical reconstruction involves the removal of ribs and using this cartilage to carve a new ear. This surgery has many risks and can be very painful.

We have developed ways to extract stem cells from excess fat tissue that given an appropriate environment can to turn into cartilage.

We plan to investigate artificial scaffolds that support the growth of fat-derived stem cells into cartilage. The ultimate aim is to grow ears for use in humans, thus preventing many of the complications associated with this operation.

Miss Michelle Wilkinson

Michelle Wilkinson 

Royal Marsden Hospital NHS Foudation Trust

VIPER: A phase I study of vaccinia virus delivered by isolated limb perfusion

‘Targeted viral therapy of cancer'

Melanoma and sarcoma of the limbs cause severe disease often requiring limb amputation. Isolated limb perfusion (ILP) is a specialist surgical procedure that delivers high doses of chemotherapy directly to the disease without side-effects in the rest of the body. Whilst this procedure saves the limb in 60-70% of patients, it does not work for everyone. The disease usually relapses and it does not treat distant sites of disease.

We are using a novel cancer treatment, oncolytic virotherapy, delivered by ILP to improve response rates in the limb, trigger anti-tumour immunity and improve overall survival.

Miss Nuha Yassin

 Nuha Yassin

St Mark's Hospital and Academic Institute

Aetiological factors in fistulating perianal Crohn’s disease

'Understanding the causes of perianal Crohn's fistulas'

Crohn’s is a chronic inflammatory bowel disease, affecting approximately 60,000 young people in the UK. Up to 45% of Crohn's patients develop perianal fistulas, the symptoms of which are debilitating and the condition difficult to treat.

We don’t understand why fistulas form, persist or are more common and difficult to treat in Crohn’s disease. We would like to identify microbiological and immunological factors which drive fistula inflammation. This will lead to further research in the area and new treatment options. The findings are likely to translate into clinical applications in the future.


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