Author: Louise Stanley

AI engineering technique offers solution to patient-specific knee implants

Written by Louise Stanley on 24/10/2022. Posted in Birmingham Health Partners.

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 Autodesk, Manufacturing 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

Written by Louise Stanley on 18/10/2022. Posted in Birmingham Health Partners, Clinical trials, Early diagnosis and detection, Experimental medicine, Inflammation and chronic disease.

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

First Midlands research collaboration to focus on patient safety

Written by Louise Stanley on 14/10/2022. Posted in Early diagnosis and detection, Health inequalities, Maternal health.

Expectant mums and anyone needing emergency treatment will both benefit from funding for new research to improve patient safety and reduce the risk of harm.

BHP founder-members the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust will be establishing the first research collaboration focused on patient safety based in the Midlands, thanks to new funding from the National Institute for Health and Care Research. The announcement made today by the Department for Health and Social Care will see £3.4m invested in world-leading research that supports patient safety in maternal and acute care settings.

The newly announced NIHR Midlands Patient Safety Research Collaboration (PSRC) will bring together NHS trusts, universities, and private business to evaluate how digital tools can support clinical decision making and reduce risks for patients.

Professor Alice Turner is a Professor of Respiratory Medicine in the Institute for Applied Health Research at the University of Birmingham, Honorary Consultant Respiratory Physician at University Hospitals Birmingham, and Co-Director of the NIHR Midlands Patient Safety Research Collaboration along with Professor Richard Lilford, Professor of Public Health at the University of Birmingham.

She commented: “Patient safety is at the forefront of every clinician’s mind and runs at the heart of the whole healthcare system. The power of new technology available to us means that we can address one of the ongoing areas of risk for patients, which is effective communication and clinical decision making.

“Thanks to the new funding from NIHR and with the support of partners, the new collaboration will be looking at how digital tools can make a real difference to reduce risks and support patient safety in the key areas of acute medicine and maternal health.”

Acute Care

Patients requiring emergency medical care in acute services will benefit as new digital decision-making tools could improve prescribing and personalised management.

Thanks to the funding, the NIHR Midlands PSRC will trial digital clinical decision support tools which will provide smoother flow of information between healthcare professionals in acute care. Working with acute care hospitals, primary care providers and the West Midlands Ambulance Service, the researchers will review how the digital tools can reduce risks of patient harm at key points in acute care management.

Professor Elizabeth Sapey, Director of the Institute of Inflammation and Ageing at the University of Birmingham and an Honorary Respiratory Consultant at the University Hospitals Birmingham said: “The vision is that every healthcare professional involved in a patients journey in acute care has access to the same information, the same decision-making support, and is able to both spot and flag any point where patients might be at increased risk of harm.

“We know that a disproportionate number of medical errors happen in acute services, and around half of patients experience a clinical error in what can be a complex journey. As acute care becomes more heavily relied on, it is critical that we use technology available to us to ensure that our patients are kept safe and risk is managed.”

Maternal Health

Mothers and babies will benefit from the new research collaboration to look at how digital tools can support antenatal decision making.

The collaboration will examine the effectiveness of clinical decision-making tools to recognise risks among expectant mothers, particularly among marginalised groups who experience worse outcomes and quality of care compared to the general population.

Professor Shakila Thangaratinam, Co-Director of WHO Collaborating Centre for Global Women’s Health at the University of Birmingham and Consultant Obstetrician at the Birmingham Women’s Hospital said: “Maternal and perinatal mortality reports in the UK have highlighted that there are real issues when it comes to identifying and responding to risk. One of the key priorities is identifying early in pregnancy those mothers who need the extra support and care, thereby ensuring that women receive individualised care during pregnancy.

“With this new funding from the NIHR, we can evaluate how digital tools can help clinicians ensure that no mum falls ‘through the net’ in identifying risk, and ensure every family receives the right level of support.”

Partners involved in the NIHR Midlands Patient Safety Research Collaboration

University Hospitals Birmingham NHS Foundation Trust (BHP)
University of Birmingham (BHP)
Birmingham Women’s and Children’s NHS Foundation Trust (BHP)
Health Innovation West Midlands (BHP)
NHS Birmingham and Solihull Integrated Care Board
University of Warwick
University of Aberdeen
Clevermed Limited
West Midlands Ambulance Service University NHS Foundation Trust
Shrewsbury and Telford Hospital NHS Trust

Exterior photo of Aston University campus

Aston University joins Birmingham Health Partners

Written by Louise Stanley on 13/10/2022. Posted in Birmingham Health Partners.

Birmingham Health Partners, the second city’s University-NHS partnership, has further expanded its membership by welcoming Aston University on board as its seventh member. Aston is the second University to join the partnership which now includes four NHS members (University Hospitals Birmingham, Birmingham Women’s and Children’s Hospitals, Sandwell and West Birmingham Hospitals and most recently the Royal Orthopaedic Hospital NHS Foundation Trust), with the University of Birmingham (UoB) and West Midlands Academic Health Sciences Network (WMAHSN) completing the alliance.

Based in the centre of Birmingham, Aston was granted University status after receiving a Royal Charter from Queen Elizabeth II in 1966. The institution provides education to more than 18,000 students from over 120 countries across its three Colleges including the College of Health and Life Sciences which is home to Aston Medical School.

Aston hosts a range of research institutes and its mission aligns directly with BHP’s – to deliver research that changes lives for the better. For over 70 years, the University has pushed boundaries at the heart of the second city and empowered researchers with access to cutting-edge facilities and investment opportunities. Like BHP, it aims to magnify the impact of its research beyond academia, to the benefit of all.

Prior to formally becoming part of BHP, Aston has collaborated with other member organisations on research in areas as diverse as concussion and spinal cord injury; rare and complex paediatric syndromes; advanced therapies; atrial fibrillation; and cystic fibrosis.

Aston University will be represented at board level by Professor Aleks Subic, Vice-Chancellor and Chief Executive of Aston University, while Professor Anthony Hilton, Pro-Vice-Chancellor & Executive Dean of the College of Health and Life Sciences will join the executive group of BHP.

Professor Hilton said: “We are excited to join BHP because it gives Aston University the chance to develop cross-institutional collaborations under one umbrella. It provides an important forum for engagement with our regional NHS trusts and beneficiaries for both research, education and knowledge exchange.

“We are keen to see how the alliance will support the funding of future research, enabling us to share innovation at the boundaries of each institutional expertise. By having a unified West Midlands approach, we can harness key skills, expertise and our resources to have an impact on health in the region.”

Managing Director at BHP, John Williams said: “It gives me great pleasure to welcome Aston University to be part of Birmingham Health Partners.

“Alongside our NHS partners we will make use of our shared capabilities as employers, educators and researchers to positively impact the health and economic growth of our region.”

BHP is committed to achieving health and economic impact through harnessing the combined strength and expertise of its members.

The BHP Starter Fellowship – Amy’s story

Written by Louise Stanley on 03/10/2022. Posted in Birmingham Health Partners.

Dr Amy Coulden is a Specialist Registrar in Endocrinology and Diabetes, currently at the Queen Elizabeth Hospital Birmingham, and a Clinical Research Fellow within the University of Birmingham’s Institute of Metabolism and Systems Research. She’s a recent alumna of the BHP Starter Fellowship, having completed it between 2021 and 2022, and is now taking time out of clinical training to undertake a Metchley Park Clinical research fellowship investigating the role of ganglioside GM3 in acromegaly – a rare endocrinological disorder characterised by a growth hormone secreting tumour in the pituitary.

What attracted you to apply for the fellowship?

I have also been interested in research, ever since I did an intercalated BSc during my medical degree which involved four months of experience in the laboratory that I thoroughly enjoyed. I have also enjoyed clinical research and being involved in projects that can help instigate change, such as audits I did in my early training after qualifying. I was not aware of the fellowship before it was alerted to me by one of my consultants who thought I would be a good fit.

I knew that I was interested in doing a PhD or MD at some point during my registrar training (in Diabetes and Endocrinology), but I was unsure what I would want to study or whether or not it would be a large undertaking given that my research background was pretty limited. I thought a one-year fellowship would be a perfect way to experience research life for a year, while not taking a large amount of time out of clinical training.

The project that I have is excellent with a fantastic opportunity to work with some world renowned researchers, which definitely attracted me to doing the fellowship.

What were the benefits of fellowship?

It’s allowed me a ‘taster’ what both clinical and basic science research is, as well as giving me a qualification of an MSc at the end. It has reassured me that the research world and career is definitely for me and I am currently applying for funding to convert my MSc into a PhD!

I have learnt so much! Firstly, skills in the lab, from tissue culture, to using ELISA and qPCR. I have learnt skills in writing- both for publication but also for grants/ fellowship application and interview skills- all of which have been invaluable.

I have learnt how to organise my time, especially as research often does not go to plan. Balancing different projects and learning how to use the downtime when there is not much going on in the lab has been a challenge but has improved my organisational skills.

Were there any challenges during the fellowship?

My challenges are probably very common! Firstly, research takes time – often much longer than you expect and this should be factored in when planning. There are often delays, for example many of my reagents that I need for experiments have taken far longer to arrive than anticipated which delays the project. Sometimes the results you get aren’t what you are expecting, and this often means changes to your protocols and additional repeats. And sometimes things go wrong!

While these have been frustrating, they have taught me so much about planning and execution of research as well as troubleshooting.

How much clinical work did you do while undertaking your fellowship?

I have not done too much clinical work, mostly because the focus of this year was to be a pure research year. I have attended a couple of clinics a month but also regular MDTs and endocrinology meetings as well as the regular teaching training days. I have opted to do ad hoc locum shifts in General Internal Medicine every few months to ensure I don’t deskill.

Did the fellowship help with your clinical practice?

I have done many additional projects this year outside my main fellowship project such as case reports, poster presentations and reviews. This has allowed me to research and review certain clinical conditions and as a result I’ve improved my knowledge around these. The clinical work that I have done during the fellowship (such as fortnightly pituitary MDTs and clinics) have helped me in clinical practice.

Do you feel that the fellowship has helped you with your career development and aspirations?

Absolutely! I knew that I wanted to explore research but I was nervous about taking a large amount of time out of training of do a PhD or MD if it wasn’t suited to me. This fellowship has confirmed my love of research and how I want my future career to look. I am now starting an academic clinical lecturer post in August and applying for PhD fellowship this Autumn- neither of which would have been possible without this fellowship.

What would your advice be to anyone thinking of applying for a BHP fellowship?

If you are interested in research, but don’t have much experience or you are unsure if you want to embark on a longer degree but would like a ‘taster’ of research, this is for you!

Fourth NHS member for Birmingham Health Partners extends specialist expertise

Written by Louise Stanley on 26/09/2022. Posted in Birmingham Health Partners.

Birmingham Health Partners (BHP), the second city’s University-NHS partnership, has further expanded its membership by welcoming the Royal Orthopaedic Hospital NHS Foundation Trust (ROH) on board – its fourth NHS member. The ROH joins fellow Trusts University Hospitals Birmingham (UHB), Birmingham Women’s and Children’s Hospitals and Sandwell and West Birmingham Hospitals as BHP’s NHS members, with the University of Birmingham (UoB) and West Midlands Academic Health Sciences Network (WMAHSN) completing the alliance.

The ROH is one of Europe’s largest specialist orthopaedic units, offering a comprehensive range of treatments including joint replacement, orthopaedic oncology, spinal surgery, as well as physiotherapy, hydrotherapy, pain management and a range of musculoskeletal services. Its dynamic portfolio of clinical trials and research programmes includes exploration of advanced therapies to regenerate diseased bone tissue; new prosthetics to restore normal joint function; and new pharmaceutical treatments which reduce the need for invasive surgery and speed up recovery.

It is also a renowned teaching and training trust, hosting students from Birmingham Medical School on placements since 1891, and was already an established collaborative partner of BHP organisations prior to formally joining the alliance. Most recently, a team from the ROH, UoB and the University of Bath identified a new and specific cell population that influences how arthritis affects the body and the levels of pain individual patients experience, paving the way for more precise pain-relieving therapeutics.

BHP Director Professor David Adams, who is Head of UoB’s College of Medical and Dental Sciences, explained: “Birmingham is home to a concentration of leading centres of excellence, and a particular area of expertise – both in patient care and research – is orthopaedics and trauma. UHB hosts the renowned Royal Centre for Defence Medicine at the Queen Elizabeth Hospital and also, in partnership with UoB, the NIHR Surgical Reconstruction Microbiology Research Centre which improves trauma and orthopaedic care and outcomes for patients through translational research built on military, NHS and scientific partnership. Extending the partnership of BHP to the ROH – the longest-established hospital of its kind in the UK – is therefore a natural progression, and all partners are committed to collaborating on research that matters to patients: specifically in areas such as inflammation, arthritis, bone and soft tissue cancer, and trauma.”

Jo Williams, Chief Executive of the ROH, commented: “We’re excited to join BHP because it provides us with an opportunity to collaborate and innovate. As a specialist Trust, ROH is a knowledge leader in orthopaedics, and we look forward to being part of such a distinguished network of peers and the impact this will have in the future.”

BHP is committed to achieving health and economic impact through harnessing the combined strength and expertise of its members.