Abraham Joel
Northumbria Healthcare NHS Foundation Trust
RCS Honorary Research Fellow
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Bowel cancer biomarkers - A novel longitudinal follow-up study
Ageing is the biggest risk factor for bowel cancer, the second commonest cause of cancer deaths in the UK. Colonoscopy, the current gold standard for detection of bowel cancer, carries significant discomfort and possible complications. Development of a non-invasive, easily accessible marker, e.g. in stool or blood, will improve screening participation, with considerable health benefits.
This is the first study looking at such markers over 12 years. We aim to identify such non-invasive tests to aid early detection and vastly improve bowel cancer management.
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Andrew Hotchen
University of Cambridge
Enid Linder Foundation Research Fellowship
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The role of mononuclear phagocytes in cartilage repair and regeneration
Understanding immune cells in cartilage regeneration.
The function of cartilage is to provide smooth movement of joints. Osteoarthritis is characterised by cartilage damage and is one of the fastest growing health problems in the UK, affecting over 8-million people.
Our research aims to increase the understanding of how cells that help control inflammation, called immune cells, can play a role in the process of cartilage repair. We will investigate how these cells can detect and respond to cartilage damage. This will improve our understanding of osteoarthritis, enabling the development of targeted treatments, reducing the associated patient, clinical and financial burden.
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Anisha Sukha
St Marks Hospital
RCS Honorary Research Fellowship
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Prospective cross-sectional study to identify molecular markers in adenomas
Investigating molecular markers in colorectal adenomas
Bowel cancer develops from pre-malignant adenomas, which are removed at colonoscopy, thus preventing bowel cancer.
Depending of the size, number and histology of the adenoma excised patients undergo a repeat colonoscopy at either one, three or five years according to guidelines.
Recent major advances in DNA and gene sequencing, combined with innovative data informatics, is changing the way diseases are managed.
This research will translate molecular medicine into clinical practice, to improve risk stratification and potentially avoid thousands of unnecessary colonoscopies on healthy patients and result in intensive surveillance on high risk patients
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Anna Kamocka
Imperial College London
Frances and Augustus Newman Foundation Fellowship
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Diabetes remission after a gastric bypass with a long biliopancreatic limb
Obesity is the main cause of the epidemic of diabetes. 62% of UK population is overweight or obese and 9% suffer from diabetes. Gastric bypass is a proven surgical procedure that produces major sustained weight loss of 25-35%, but only effectively cures diabetes in 4 out of 10 patients. To design a safe and even more successful procedure we have modified gastric bypass by extending the length of the bypassed small bowel and are testing it in the research setting to see if this improves the rate of diabetes cure.
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Babar Kayani
University College London Hospital
The Arthritis Research Trust Fellowship
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The impact of robotic-arm assistance on outcomes in knee arthroplasty
Robotics in knee replacement surgery
Knee arthritis affects one in six people and knee replacement surgery is undertaken in 90,000 patients per year in England and Wales. In knee replacement surgery, diseased and arthritic parts of the knee joint are replaced with artificial metal implants. The position of these implants is critical for getting the best outcomes after surgery. This research compares patient recovery, clinical outcomes, and accuracy of implant positioning between conventional manual techniques versus robotic-assistance for implant positioning. These findings will help develop the optimal knee replacement procedure for the fastest recovery, greatest clinical outcomes, and least complications.
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Benjamin Davies
Addenbrookes Hospital
The Sir Robert E Kelly Fellowship
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3D gait analysis for degenerative cervical myelopathy: toward mobile monitoring
Measuring walking to improve care in myelopathy
Cervical myelopathy is a degenerative disease of the neck which affects up to 5% of over 40-year olds. It causes progressive disability. Currently, patient care is unsatisfactory because the assessments are not accurate enough to detect small changes and time treatment perfectly: treatment too early carries risks, but too late can leave people permanently disabled. We believe that detailed 3D analysis of walking will overcome this, and we want to test our theory. Longer-term, if correct, this could be transferred to a patient's pocket using their mobile.
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Catherine Pringle
Royal Manchester Children's Hospital
RCS Honorary Research Fellowship
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Machine learning techniques and outcome prediction in paediatric brain tumours
Brain tumours are the second most common childhood malignancy after leukaemia, and are the highest cause of paediatric cancer-related deaths.
Our research aims to generate personalised medicine profiles for newly presenting paediatric brain tumours through the use of artificial intelligence systems.
This will provide patients, parents and clinicians with invaluable information about predicted prognosis and recurrence rates at time of presentation, and will also allow our unit to predict and streamline follow up scanning regimens and appointments. We are aiming to support families at this difficult time by providing the most accurate information available.
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Catherine Zabkiewicz
Cardiff University
Freemasons' United Grand Lodge of England Research Fellowship
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Gremlin in HER2 positive breast cancers
20% of women with breast cancer have a high level of the protein HER2, which makes tumours grow aggressively. There is treatment that blocks HER2, but the breast cancer will come back in 25% of women treated. Tumours with HER2 are more likely to spread to other organs and patients have worse survival. If the HER2 positive tumour also has high levels of the protein Gremlin1, survival is even worse. Research to understand the link between Gremlin1 and HER2 may help identify patients with HER2 tumours at risk of treatment failing, or develop better treatments
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Daniel Lin
Newcastle University
Shears Foundation Northern Research Fellowships
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A preliminary investigation of IDO immune status in head and neck cancer
1. Exploring IDO - Head and Neck Cancer
2. Head and neck cancer (HNC) incidence is increasing in both middle and later life. Symptoms include neck lump, hoarse voice, pain, and difficulty swallowing. >8,000 new cases occur annually. 50% of patients die from disease. HNC survivorship is challenging for patients and carers, due to the profound functional and cosmetic consequences of treatment.
3. This preliminary work is my first step to determine the role of IDO immunosuppression during HNC treatment (to be completed as a PhD). The long-term goal is to evaluate the role of IDO inhibitors in HNC immunotherapy regimens.
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David Eldred-Evans
Imperial College
RCS Honorary Research Fellowship
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The PROSTAGRAM trial - Novel imaging techniques to screen for prostate cancer
Developing image-based prostate cancer screening
Prostate cancer is the most common male cancer and 1-in-23 men will die from the disease. In recent years, prostate cancer deaths have overtaken those from breast cancer. The PROSTAGRAM trial is designed to look at new imaging techniques to screen for aggressive prostate cancer. The aim is to find an imaging technique, like mammograms for breast cancer, which can be used to screen for prostate cancer. The study will investigate:
1. A fast MRI scan lasting <15 mins. Without radiation or contrast
2. An ultrasound test measuring the stiffness of the prostate
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Donald Davidson
University College London
Freemasons' Royal Arch Fellowship
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The Characterisation of Bacterial Biofilm in Peri-Prosthetic Joint Infection
UNDERSTANDING INFECTION IN JOINT REPLACEMENTS
Approximately 250,000 joint replacements are performed each year in the UK. Deep infection around joint replacements is a serious complication; 2% of primary and 10% of revision hip or knee replacements become infected. Deep infection is difficult to diagnose and treat and causes poor outcomes for the patients affected.
We do not fully understand where the deep infection is found within the joint and how it behaves so it is difficult to create new treatments. This research will improve our understanding and create a model on which new treatments will be designed and created.
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Ioannis Sarantitis
University of Liverpool
RCS Research Fellowship supported by the Harold Bridges Bequest and the Rosetrees Trust
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Clinical significance of SPINK1 pN34S genetic variant in idiopathic pancreatitis
SPINK1 and pancreatitis of unknown cause.
Acute pancreatitis can be life-threatening and repeated attacks can lead to chronic pancreatitis, a debilitating disease with immense personal, family, socioeconomic and health-care consequences. The cause of pancreatitis remains unknown for up to 25% of the sufferers.
This research aims to fill the knowledge gaps about how pancreatitis of unknown cause progresses and what it the role of inherited genetic abnormalities and lifestyle factors as predictors of clinical outcomes and complications. This will allow personalised treatment with regards to investigations, follow up and screening and, in the long term, prevent further attacks of pancreatitis.
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James Fletcher
University of Bath
RCS Research Fellowship supported by the Vandervell Trust and Rosetrees Trust
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Developing a surgical aid for safer and stronger personalised fracture fixation
'Personalising screw fixation'
Millions of surgical screws are used each year in the UK, however the understanding of what value of screw tightness creates the optimal fixation and how to calculate this remain unknown. 47% of screws are overtightened or have stripped surrounding bone on insertion, causing irreparable damage and suboptimal fixation. These delay healing and increase the rates of fixation failure, especially in patients with osteoporosis, causing significant morbidity and mortality.
This research investigates the techniques needed for optimum screw fixation and will develop a surgical aid that uses patients' bone characteristics to predict the ideal tightness for any screw.
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Joseph Norris
University College London
Freemasons' United Grand Lodge of England Research Fellowship
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Modelling Prostate Biopsy Strategy in the Era of MRI-Guidance
Improving the Prostate Cancer Biopsy
In the UK, there are 47,000 men diagnosed with prostate cancer each year, and it has recently overtaken breast cancer in terms of numbers of people dying from the disease. Often there are no symptoms and early diagnosis is key. MRI can help with detection of prostate cancer and help the surgeon obtain the best possible tissue sample (biopsy). However, there are no current guidelines for how we should direct biopsy needles toward prostate tumours. This project will tackle this problem for the first time; working out exactly how surgeons should deploy their biopsy needles.
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Kathryn Parmar
University of Manchester
Enid Linder Research Fellowship
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Obesity-driven cancer mechanisms: hepatic fat and colorectal cancer metastases
Liver fat and bowel cancer progression
Obesity is the second commonest cause of cancer in the UK. It can increase the incidence and progression of bowel cancer. Liver fat is likely important in this process, but it is not yet possible to measure accurately without invasive biopsies.
A Manchester cancer research team run a long-term programme developing advanced imaging methods. This project uses these non-invasive scans to measure changes in liver fat after giving chemotherapy to treat bowel cancer that has spread to the liver, then tests whether these changes are related to liver injury and if they are reversible.
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Kate Harvey
University of Bristol
Joint RCS/Blond McIndoe Research Foundation Fellowship
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The Pre-BRA (Pre-pectoral Breast Reconstruction Evaluation) Study
Breast cancer affects over 55,000 women each year in the UK and up to 40% require mastectomy (removal of the breast). Loss of a breast can profoundly impact a woman's quality of life and breast reconstruction is offered to minimise this. Pre-pectoral breast reconstruction is a brand-new operation, but assessment is needed to demonstrate it's safe before it becomes routine. Research in this area is challenging and often not done to a high standard. This study aims to determine if surgeons can join forces to evaluate the technique effectively, allowing patients to benefit sooner
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Kevin Cao
University of Bristol
Joint RCS/BAPS Fellowship with support from the Rosetrees Trust
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The Molecular Basis of Bladder Dysfunction in Posterior Urethral Valves
1. Molecular and cellular pathways in foetal bladder fibrosis
2. Posterior Urethral valves occurs in 1 in 5,000 boys. A membrane obstructs the urethra leading to bladder dysfunction and scarring. Despite surgery, most children still have lifelong symptoms such as wetting, urine retention and end-stage kidney failure. Up to 25% require major bladder surgery and 20% require kidney transplant.
3. Improving our understanding of the genetics of PUV, the cellular signalling that leads to fibrosis and testing neonatal and prenatal treatments, we may improve therapies for children with the disease and children of future families born with PUV.
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Liam Convie
South Eastern Health and Social Care Trust, Headquarters, BELFAST
RCS Honorary Research Fellowship
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Determining the validity of informed consent for surgery
1. Measuring the quality of consent.
2. Consent is fundamental to good medical practice. In England, approximately 4 million surgical procedures are performed each year. Many have attempted to improve the quality of consent; however, it is unclear which methods are most effective and why. Clinicians are, therefore, uncertain how to best develop their consent practices.
3. This research aims to develop a core outcome set to measure the quality of informed consent for surgery. This core outcome set would ensure future consent research uses the same outcomes so as clinicians may establish the most effective techniques for improving consent.
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Lottie McIntyre
Imperial College
The Dr Shapurji H Modi Memorial Research Fellowship
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The Effect of Multinodular Goitres on the Airway
1. The effect of large thyroid goitres on the airway
2. More than 10,000 thyroid surgeries take place every year in the UK. A large number of these are for enlarged thyroid glands which can cause symptoms such as difficulty breathing. At present, we don't have a diagnostic tool to help us decide which patients will benefit from surgery. Surgery comes with significant risks and therefore this decision-making process is extremely important.
3. We are developing a clinical tool to aid surgical decision making that will predict which patients will benefit from surgery thereby reducing unnecessary surgery.
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Michelle Johnpulle
Leeds Teaching Hospital
Bowel Cancer UK/RCS Research Fellowship
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The development of 3D colorectal cancer cells and chemo-resistance
'Fighting chemotherapy resistant colorectal cancer.'
The 5-year survival of colorectal cancer (CRC) patients is just 12.5% and 90% develop widespread disease. Acquired drug-resistance is a clinical problem, associated with down-regulation of genetic template proteins, which normally fight cancer. The efficacy of viruses that selectively kill tumour cells has historically been modeled on 2D cell structures. This project will use novel 3D structures, that better mimick human tissue to test the efficacy of such tumour killing viruses, in three ways; alone, in combination with chemotherapy and as carrier agents to reverse the down-regulation of genetic template proteins expression - thus enhancing chemotherapy.
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Rachel Clifford
University of Liverpool
RCS Honorary Research Fellowship
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CRISPR manipulation of acid ceramidase in a 3D in-vitro model of rectal cancer
Rectal cancer: Improving response to radiotherapy
Rectal cancer affects 7,000 patients annually across the UK. Locally advanced cancers often require x-ray treatment to shrink them prior to surgery. Response to this treatment can vary and be unpredictable. Surgery when required is major, often requiring life altering stoma formation.
Novel treatments that improve radiotherapy response are a key research goal of the colorectal community. Our research group has already established a potential target that may be used to improve response; reducing the need or magnitude of surgery.
The proposed project will confirm the role of this target in advanced rectal cancer
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Rishabh Singh
Royal Surrey County Hospital
RCS Research Fellowship
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IGFBP-7/TIMP-2 for the prediction of AKI following Major Abdominal Surgery
Protecting Kidneys after Surgery: Quicker diagnosis
Kidneys filter the bodys waste. Abdominal surgery risks Kidney Injury in 20% of patients. Effects are serious, including infections, needing dialysis, and death.
Conventional methods of assessing kidneys only detect injury after 48 hours. The longer undetected, the lower the chance of recovery.
A new biomarker test exists. Research in heart surgery shows it can detect Kidney Injury within 4 hours of an operation. We hope to find the same in abdominal surgery.
If a way is found of detecting Kidney Injury earlier, protective strategies can be started sooner, potentially preserving kidney function.
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Robert Staruch
University of Oxford
RCS Honorary Research Fellowship
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Investigating the interaction between Blast Shock Waves and Muscle Homeostasis
Enhancing muscle survival from explosive blast
Casualties of explosive blast in recent conflict sustained progressive deterioration of muscle tissue despite adequate debridement and resuscitation. This contributed to systemic illness, and resulted in more proximal limb amputations. This effected rehabilitation and quality of life. The outcomes of this research will inform clinicians how to counteract this mechanical stimulus through developing new therapies. This research will impact not only this field of trauma, but translate to improving current wound care materials utilised heavily by the National Health Service. Finally the real beneficiaries are the patients, particularly the servicemen who sustain life changing injuries whilst on operations.
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Roshani Patel
St Mark's Hospital and Academic Institute
Bowel Cancer UK/RCS Research Fellowship
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Restorative proctocolectomy in FAP: can we predict outcome?
Who gets cancer in their Pouch?
Familial Adenomatous Polyposis is a rare inherited bowel cancer, caused by a genetic mutation leading to a 100% risk of cancer in the colon if undetected. Prophylactic surgery (to remove the colon and rectum) has improved life expectancy significantly. To restore continence, a pouch (to mimic the rectum) is made from remaining small
bowel. By 10 years 50% of patients develop adenomas (pre-cursor of cancer) in their pouch.
Understanding genetic and environmental risk factors for developing adenomas in the pouch will allow individualised surgical decision making and impact our knowledge of most colorectal cancers.
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Sally Hallam
University of Birmingham
Freemasons' Royal Arch Fellowship
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Establishing a clinical, molecular classifier for peritoneal malignancy
Improving outcomes for advanced bowel cancer
Bowel cancer spreads to the peritoneum in 15% of cases. Traditional treatments aim to relieve symptoms but not cure the cancer. Cytoreductive surgery and heated intra-operative intra-peritoneal chemotherapy (CRS + HIPEC) is an operation which improves survival. CRS + HIPEC is however a large operation with long hospital stay and many side effects.
This research aims to identify bio-molecular markers of response to CRS + HIPEC and to develop a marker of peritoneal recurrence. This will improve patient selection for treatment and allow detection of recurrence allowing treatment at an early stage.
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Sam Parker
University College London
RCS Honorary Research Fellowship
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Predicting recurrence; Prognostic modelling in Abdominal Wall Reconstruction;
1.Predicting abdominal wall hernia recurrence
2.An increasingly obese population has resulted in an increasing incidence of abdominal wall hernia. Many suffer from chronic abdominal pain, diarrhoea and poor respiratory function. We perform over 45,000 abdominal wall hernia repairs annually in the UK, one in five are complex requiring expert surgery.
3.Recurrence rates after abdominal wall hernia repair remain high (30% recur). Being able to predict recurrence, will inform us when not to operate. This will, in the short-term, prevent subjecting patients to early post-operative complications (e.g. MI, pneumonia), and in the long term prevent futile surgery and hernia recurrence.
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Thomas Leyton
University of Oxford
RCS Honorary Research Fellowship
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Single cell analysis of the fibrotic landscape in Dupuytren's disease
1) Identifying and exploring novel myofibroblast markers in Dupuytren's Disease.
2) Dupuytren's disease (DD) is a fibrotic disorder of the hand affecting 4% of the UK population. It leads to impairment of hand function as the fingers curl irreversibly into the palm. The cells responsible for the deposition of the excessive tissue and contraction are myofibroblasts. However, we still lack a clear understanding of these cells and this has hampered efforts to develop new treatments. We aim to better understand the myofibroblast in DD by defining genes specific to these cells compared to control cells from the same patients, and subsequently exploring their function
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Veena Surendrakumar
Cambridge University Hospital
RCS Honorary Research Fellowship
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Identifying immune signatures that predict rejection after heart transplantation
Predicting future heartbreak
Heart failure affects 900,000 people in the UK and occurs because the heart cannot pump blood around the body effectively. Heart transplantation involves replacing a diseased heart with a healthy one. This is transformative in patients, allowing them to return to normal activities.
Despite modern medications, the immune system may attack the transplanted heart (rejection), causing it to fail and the patient to die. Often there are no signs that rejection is occurring until the transplanted heart is already severely damaged.
This study aims to detect clues of rejection in blood tests before irreversible damage has occurred.
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