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Month: October 2022

“Born well, live well, die well” – BHP publishes report of activity 2020-2022

Following the expansion of its membership with three new partners, BHP has published its first report of activity covering September 2020 to August 2022.

Download the Birmingham Health Partners Report of Activity 2020 to 2022 pdf (4MB)

In publishing this report for our member institutions, stakeholders and influencers in the West Midlands and further afield, BHP highlights its progress in aligning the strategic objectives of its NHS and university partners to address major health challenges faced by the Midlands region and beyond.

Ed Smith, BHP’s chair, commented: “Our starting point has been to create a values-based partnership with key organisations in the city-region that allows us to deploy our research, innovation and healthcare capabilities to deal with major health issues. The problems encountered by the large socially- and ethnically-diverse population of the Birmingham region are similar to those faced nationally and globally, with health inequalities – driven by social determinants – leading to multimorbidity and chronic physical and mental ill-health.

“To address such deep-seated problems, it is increasingly recognised that we need health science clusters, based in large regional populations, that harness research and innovation to patient care. By integrating shared capabilities unselfishly and collaboratively, BHP is forming a powerful regional cluster to address health inequalities while also driving economic development – thereby contributing to both UK and global knowledge-based outcomes.”

Professor David Adams, Director BHP, added: “We hope that readers of this report will understand both the role played by BHP and the opportunities the partnership provides to support health innovation in our region. We aim to enhance the endeavours of individuals, teams and organisations by focussing on collaborating across institutional boundaries.

“As this report sets out, we have made substantial contributions over the last year including on training, funding, and health data and digital delivery. We are also proud of our convening role which brings together wide-ranging multidisciplinary expertise to deliver research that matters for our population and which promotes a wider innovation landscape.”

    Download the Birmingham Health Partners Report of Activity 2020 to 2022 pdf (4MB)

    Single-stranded suture threads could prevent pregnancy infection complications, finds C-STICH trial

    Women at risk of pregnancy loss who need a specialist surgical procedure are at a lower risk of infection if the procedure is carried out using a single-stranded suture thread, results from the C-STICH clinical trial found.

    The trial was the largest of its type and is published in the Lancet. It involved more than 2,000 expectant mothers who needed a procedure called a cerclage, where a purse string suture is placed around the cervix (the neck of the womb) during pregnancy. Women were randomly allocated to have the surgical procedure performed using either a single-stranded thread or a braided thread.

    Researchers tested whether there would be any difference in miscarriage or stillbirth, due to an increased risk of infection, from using a braided suture thread. The research, funded by the NIHR, demonstrated that single-stranded sutures could potentially improve outcomes for mothers at risk of preterm birth.

    The team led by researchers from Birmingham Women’s and Children’s Hospitals (BWC) and the University of Birmingham – both founder-members of BHP – found that the mothers treated with single-stranded threads had no differences in pregnancy loss or preterm birth but reported fewer instances of infection and sepsis. This could have important implications for the health outcomes of mothers and babies who are treated with a cervical cerclage in their pregnancy.

    Dr Vicky Hodgetts-Morton, NIHR Clinical Lecturer in Obstetrics at the University of Birmingham and Birmingham Women’s Hospital explained the implications of the trial results. Dr Hodgetts-Morton said:

    “Preterm birth is a significant problem, complicating approximately one in ten pregnancies around the world. The consequences of preterm birth may be significant with some babies being born too early to survive, and those that survive are at increased risk of health complications. One cause for preterm birth is cervical insufficiency, occurring in 0.5% to 1% of pregnant women for which the placement of a vaginal cervical cerclage can be an effective treatment.

    “Suture thread choice has the potential to improve how well a cerclage works in preventing miscarriage, stillbirth and preterm birth. Both single stranded and braided threads are commonly used to perform cerclages and our findings show no differences in pregnancy loss and preterm birth. The C-STICH trial results did show an increased risk of infections in labour and around the time of delivery with braided threads and this supported our hypothesis that a single stranded thread could reduce the risk of infection developing during the pregnancy.”

    Mr Philip Toozs-Hobson, Chief Investigator of the C-STICH project and Consultant Gynaecologist at the Birmingham Women’s Hospital said:

    “We are extremely grateful to all the women who trusted us by taking part in the study and also the dedication of the research teams at of the 72 maternity units who made the trial happen. Our aim, as ever, is to improve women’s experience in pregnancy through safer childbirth and to help the NHS achieve their target of reducing both pre-term birth and cerebral palsy. This work has added to our understanding relating to infection and sepsis.”

    The study also highlighted that while single stranded suture threads led to better outcomes around infection, clinicians mentioned that such suture threads were subjectively more difficult to remove and more often required surgery to help remove under a general anaesthetic.

    £35.4 million funding boost for brain and mental health research

    The University of Birmingham is part of a significant programme to deliver innovative treatments and therapies in brain health thanks to a £35.4 million award.

    The award, made to the NIHR Oxford Health Biomedical Research Centre, is part of a package of funding from the National Institute for Health and Care Research (NIHR) for Biomedical Research Centres (BRC) and the Oxford Health BRC is one of just two centres in the country currently wholly dedicated to mental health.

    The University of Birmingham is a partner in the programme, along with fellow BHP member the Birmingham Women’s and Children’s NHS Foundation Trust, and the second city’s mental health trusts.

    Thematic areas of research – including depression therapeuticsmental health in development with a focus on children and young people, psychological treatments and brain technologies – can now be advanced by leading scientists, clinicians and academics who are linked via a network of centres of excellence in brain health.

    These include NHS organisations and universities complemented by collaborations around the globe. Together they will make it possible to directly translate research into potential new treatments, diagnostic tests and medical technologies for NHS patients.

    Professor Matthew Broome, Director of the Institute of Mental Health at the University of Birmingham said: “Birmingham is a young and diverse city with high levels of deprivation and mental health morbidity. This important investment will support discovery science in emerging and established mental illness, offer our population the benefits of new therapeutic advances for depression and psychosis, and lead the development of a clinical data analysis pipeline for new brain imaging technologies.

    “This collective expertise will help improve our mechanistic understanding of health and illness, and will prioritise the experiences of young people throughout, working closely with them and their communities to support their flourishing and wellbeing.”

    “It builds on the success of the current centre which has, over the past five years, delivered new psychological and digital treatments, advances in drug discovery and new ways of integrating research and clinical care.

    “The new award now provides us with a wonderful opportunity to transform care for mental and brain health and wellbeing across the whole country and, actually, the world. We can now translate the best research from UK biomedical science, data science and engineering, social science and arts and the humanities for the benefit of clinical care and population health.

    “We are enormously grateful to the NIHR and the International Panel for both understanding and generously supporting our ambitious plans and vision. We are now looking forward to co-designing with patients and the public powerful new approaches that can be tested, refined and then implemented across the NHS and beyond.”

    What are the new Oxford Health BRC themes?

    The 11 themes all have extensive scientific collaborations between Oxford Health BRC and academic and NHS site across the country. They are

        • Better Sleep (with the University of Surrey) will exploit new sleep and circadian science to develop, test, and translate innovations to improve health.
        • Brain Technologies (Birmingham and the University of Surrey) will deliver brain technologies for use in psychological, psychiatric and brain disorders.
        • Data Science will deliver tools to personalise care of individual patients with mental health disorders by combining routine clinical and research data
        • Dementia will preserve cognitive health and prevent cognitive decline by refining cognitive, imaging and blood-based biomarkers at-scale in the general population and in people experiencing memory problems.
        • Depression Therapeutics (Birmingham) will use human neurocognitive models to help identify and develop new and improved treatments for depression
        •  Flourishing and Wellbeing (Birmingham and Brighton) will enable flourishing initiatives and interventions for patients and non-patients, delivered in spaces beyond the clinic.
        •  Mental Health in Development (Universities of Birmingham, Liverpool, Oxford Brookes and Reading, with Berkshire Healthcare Foundation Trust) will develop targeted, effective, and accessible mental health interventions that meet the needs of diverse children and young people.
        •  Molecular targets (Birmingham) will create a pipeline to translate and back-translate between discovery neuroscience and the clinic, to identify and test new therapeutic targets.
        •  Pain will identify and target chronic pain brain-based mechanisms
        •  Preventing multiple morbidities (Universities of Liverpool, Oxford Brookes, and Sheffield with Sheffield Health & Social Care NHS FT) in whole and high-risk populations will improve population health, reduce inequalities by co-developing and testing population interventions to prevent non-communicable disease and individual interventions for people with mental illness at greatest need.
        • Psychological Treatments (national reach) will develop new effective and efficient psychological interventions that precisely target core psychological mechanism

    Birmingham consultant academic appointed national haematology lead at NIHR

    Dr Gill Lowe, a haematology consultant at University Hospitals Birmingham and Honorary Senior Clinical Lecturer at the University of Birmingham, has been appointed as National Institute of Health and Care Research (NIHR) National Haematology Specialty Lead.

    The NIHR is the government’s major funder of clinical, public health, social care and translational research, with a mission to “improve the health and wealth of the nation through research” and a budget of over £1.2 billion in 2020–2.

    In her role as a consultant at UHB, Dr Lowe treats patients who have blood clotting disorders, blood problems relating to pregnancy , and immune blood disorders. Additionally, she works within Research Development and Innovation at the Trust as Deputy Clinical Director of Research. She completed a PhD looking at patients with inherited platelet disorders within the University’s Birmingham Platelet Group between 2010-2013, and continues to lecture in haematology.  She is particularly interested in integrating clinical research in to everyday practice, and in provision of education in her clinical field.

    The main aim of her new role at NIHR is to be able to promote and offer clinical research studies to all patients as part of their routine care.

    Dr Lowe commented: “I’m very excited to have been appointed National Haematology Specialty Lead. Over a number of years, I have been involved in the great work of the Haematology National Specialty Group, and I look forward to continuing to be part of this.

    “There is a lot of scope to improve research for certain patient groups, such as those with sickle cell disease, and trials of new drug treatments for thrombosis. It is incredibly important that we keep patients at the heart of research.”

    She will commence the role on 31 October 2022.

    Professor Matthew Brookes, Clinical Director of the NIHR Clinical Research Network West Midlands added: “It is great news for our region that Dr Lowe will now be leading nationally on Haematology research, as well as continuing to lead on this on a local level across the West Midlands. We very much look forward to continuing to work with Dr Lowe.”

    Professor Roy Bicknell, Director of the Institute of Cardiovascular Sciences at the University of Birmingham said: “The appointment Dr Lowe to this role demonstrates the sector leading excellence in cardiovascular work taking place in Birmingham, and the benefits of a close partnership between NHS Trusts and academia. Dr Lowe completed her PhD in 2013 with the Birmingham Platelet Group and her ongoing work with the group, and commitment to clinical research is supporting leading research to improve treatments and outcomes for people with blood disorders and thrombosis”.

    Tim Jones, Chief Innovation Officer, said: “We are very pleased that Dr Gillian Lowe has been appointed to this national role which builds on her excellent work at UHB not only in caring for our patients but also her pivotal  role in supporting research and education both within Haematology but also more widely across the Trust. It is a well-deserved appointment and we wish her well in her new role.”

    AI engineering technique offers solution to patient-specific knee implants

    Researchers at BHP founder-members the University of Birmingham and University Hospitals Birmingham have used a technique called Generative Design to produce a knee implant that can be used to treat osteoarthritis.

    A proof-of-concept paper – describing in detail the comprehensive workflow of design and advanced manufacturing processes for a generatively-designed, patient-specific bone fixation device – has been published in Progress for Additive Manufacturing by the BHP members working in partnership with design software specialists AutodeskManufacturing Technology Centre (The UK National Centre for Additive Manufacturing).

    Generative design uses artificial intelligence (AI) and machine learning to design parts that are absolutely optimal for their end use when manufactured, and this study is the first known application of Generative Design to a biomedical implantable device.

    Using this technology in medical applications is advantageous for several reasons. For example, knee arthritis is currently treated with implants that are only manufactured in a limited number of shapes and sizes. Although the use of new 3D printing techniques to make implants designed to an individual patient is emerging, this doesn’t take into account the constraints imposed by surgical planning, or the patient’s weight or activity levels. These are important elements to understand how a patient’s anatomy and a knee implant will interact and are crucial to both implant design and post-surgical rehabilitation.

    Generative design however allows the implants to be biomechanically specific, so the implant is tailored to the load it will be bearing. This also allows the end product to be lighter, less prominent and minimally invasive, which means the patient will heal more quickly, and is also less likely to need revision surgery.

    In the new study, researchers set out how the design produced by Autodesk’s software can be manufactured and processed into a functional prototype, including how much of the process can be automated.

    Postgraduate and lead researcher, Mr Sanjeevan Kanagalingam, of the University of Birmingham, said: “The ‘one-size-fits-all’ approach used in knee surgery to treat osteoarthritis can result in major complications, primarily due to overengineered implant designs and therefore limits surgical adoption and patient outcomes. This AI integrated design interface allows us to configure tailored surgical planning parameters and take personal biomechanical information into account, and synergistically combine it with the embedded manufacturing intelligence to model medical-grade titanium implants that are specific to each patient.”

    Principal Investigator and Senior Lecturer, Dr Lauren Thomas-Seale, also at the University of Birmingham, added: “The combination of the academic, industrial and clinical knowledge of the team working on this project, and the vast design space offered by Generative Design, has yielded implant designs beyond anything that has been seen before. Such an approach, noting the diversity of the project team, has enabled the development of a design process which can take into account the many differences between patients, for example the variation between male and female body mass.”

    The next steps will be to mechanically test the devices to see how much they bend and flex under loads. If successful, the team will eventually move on to clinical testing.

    Kanagalingam concluded: “This generative design approach not only increases the patient-specificity of bone fixations but also serve as a novel, versatile framework in the design of load-bearing patient-specific implants for the hips, shoulders and maxillofacial surgeries”

    Birmingham BRC receives £30m boost to improve treatment of inflammatory diseases

    Increased funding for the renewed NIHR Birmingham Biomedical Research Centre will enable continuation of major developments around inflammatory diseases and new technologies and systems

    The NIHR Birmingham Biomedical Research Centre (BRC) has been awarded more than £30 million in funding from the National Institute for Health and Care Research, a major funder of global health research and training, to support world-leading research into inflammation – including the development of new diagnostic tools and treatments for those with cancer, liver and heart disease, and many more illnesses.

    The centre brings together multiple BHP members – including leading NHS providers led by the University Hospitals Birmingham NHS Foundation Trust and academic institutions led by the University of Birmingham – as well as other organisations working closely with charities and businesses. Its aim is to support research into inflammation which causes or worsens many common long-term illnesses including arthritis, liver disease and cancer.

    This new investment represents an almost threefold increase in funding for the NIHR Birmingham BRC and will enable researchers to focus on eight areas of illness including heart disease, women’s health, and common complications from inflammation. Researchers will also be empowered to consider new tests and biomarkers for disease, health technologies including stem cells and gene therapy, patient experiences and data science.

    Professor Phil Newsome, Director of the NIHR Birmingham BRC, said: “Inflammation plays a central role in many health conditions, with millions of people in the UK alone experiencing inflammatory diseases such as arthritis and bronchitis. This significant increase in funding will enable us to provide an outstanding environment for world-leading clinical research and allow us to make a step-change in our work tackling different forms of cancer, trialling new drugs for liver disease, and dealing with antimicrobial resistance.”

    Patients will benefit from the increased funding thanks to the BRC’s collaborative research that has seen nearly 1,000 clinical trials and informed UK clinical guidelines.

    Researchers will look at eight themes to continue to understand and help patients manage inflammation-based diseases including cancer, arthritis, and liver disease. The investment of the NIHR funding in biomedical research will enable clinicians, researchers, patients and supporters to find new treatments such as the development of new immunotherapies, which are types of cancer treatments to support the body to fight cancer.

    Professor David Adams, Director of BHP, commented: “The investment from NIHR is hugely important for researchers working across the BRC partner institutions, to continue to tackle some of the critical health themes that affect our region. The funding will allow us to deliver new therapies and diagnostic tests for a range of chronic inflammatory diseases for which we currently have few effective treatments.”

    Professor Lucy Chappell, Chief Executive of the NIHR, said: “Research by NIHR Biomedical Research Centres has led to a number of ground-breaking new treatments, such as new gene therapies for haemophilia and motor neurone disease, the world-first treatment for Creutzfeldt–Jakob disease, a nose-drop vaccine for whooping cough, and the first UK-wide study into the long-term impact of COVID-19.

    “This latest round of funding recognises the strength of expertise underpinning health and care research across the country and gives our nation’s best researchers more opportunities to develop innovative new treatments for patients.”

    The Birmingham Biomedical Research Centre is made up of the following BHP member organisations:

    • University Hospitals Birmingham NHS Foundation Trust
    • University of Birmingham
    • Sandwell and West Birmingham NHS Trust
    • Birmingham Women’s and Children’s NHS Foundation Trust
    • Aston University

    Working closely with partners:

    • Birmingham Community Healthcare NHS Foundation Trust
    • Keele University
    • University of Oxford