NIHRDataInsights/HRCSData huggingface dataset:
Title: Topics in Pre-assessment (TiPs): A virtual, innovative, expert led education programme for pre-assessment nurses
Funder: Royal College of Anaesthetists

Abstract: Introduction Pre-operative anaesthetic clinics play a vital role in decreasing on-the-day cancellations in surgery, reduce morbidity and mortality and improve patient experience. Despite the importance of preassessment, there is no formal training for nurses in the UK at present. The Topics in Pre-assessment (TiPs) course was devised to provide an innovative, expert led education programme for preassessment nurses. The impact of Covid-19 has seriously hindered opportunities for teaching delivered in the workplace. As a result, TiPs is a fully online course and can be completed at a time and pace chosen by the user allowing the continuation of essential professional development and training in these testing times. TiPs aims to educate the users on common clinical conditions affecting surgery, teaches focused history and examination skills through video role-play and medications adjustment in preparation for theatre. TiPs also provides education on hot topics, including consent and shared decision making. Method Online e-learning modules have been created in conjunction with the Royal Marsden School of Nursing. These aim to provide students with a comprehensive overview of relevant topics for the pre-assessment of patients presenting for surgery. Students initially undertake the Foundation module where they will learn how to take a focused patient history and examination. They then progress on to additional modules including the Intermediate module, Pre-operative investigations and Medication management for surgery. Online e-learning has been developed consisting of elearning workbooks, role-play videos, virtual lectures and a platform for students to ask questions. These are presented by multidisciplinary healthcare professionals with a specialist interest in pre-assessment. Following each module there are self-assessment questions designed to reinforce learning and a certificate of completion. Conclusion The TiPs platform is currently undergoing a pilot assessment by 15 pre-assessment nurses. Following feedback, appropriate adjustments and improvements will be made prior to National distribution. In addition, we are currently seeking formal accreditation and funding. The overarching aim of this project is to provide high quality, effective, remotely accessible pre-assessment training which will translate to improved patient safety and care and will be an invaluable resource for all healthcare professionals involved in pre-assessment.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Evaluation of effectiveness and cost effectiveness of the implementation of bedside electronic transfusion checks
Funder: Barts Charity

Abstract: In March 2021 Barts Charity approved funding to replace the current bedside manual system at four hospitals in Barts Health Trust (or Barts) with electronic bedside system or bedside-electronic transfusion- checks (BETC). It is expected that the BETC will not only improve patient?s safety, but also (1) reduce incorrect sample-labelling for identification of blood grouping and (2) save staff time. It is important for funder to understand whether this investment is effective, cost-effective and well accepted by patients and staff. This study will aim to address this aim by answering the following four questions: ? How do patients benefit from the implementation of BETC? ? What are the net cost savings for Barts from BETC implementation? ? Are patients and staff more satisfied with BETC compared to manual system? ? What is current transfusion practice in England on the use of electronic transfusion systems and what are the barriers to greater implementation of BETC in NHS? We will use the changes of five types of near misses in transfusion as proxy to reflect the benefits to patients as the result of implementing BETC. The near misses are defined as: rates of incidents where wrong blood is collected in the tube, rates of mis-labelled samples, rates of cases who received the wrong blood due to errors related to bedside checks, rates of misidentification of the patient at the point of transfusion, and rates of wrong blood units collected from the fridge due to errors related to bedside checks. Cost-savings as the result of implementing BETC will be calculated. We will also conduct interviews with patients and staff at Barts to understand how satisfied they are with BETC and distribute a national survey to explore the potential barriers to wider rollout of BETC in NHS. The output of this research will be vital for policy makers to consider the wider rollout of BETC in NHS and understand the potential barriers.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Improving scientific and public health decision making by developing technologies to increase use of robust methods to calibrate and analyse complex mathematical models
Funder: Wellcome Trust

Abstract: Complex mathematical models are increasingly being used for research and decision making in academia, health and industry. However, the robust calibration and analysis of computationally intensive models is infeasible using currently accessible technologies, which limits the amount of information that can be extracted to inform decision making. We have developed methods (history matching; HM) that can be used to robustly calibrate and analyse complex models, but implementation requires the full-time involvement of a trained statistician. The major hurdle preventing routine use of these methods by mathematical modelers is the lack of accessible and usable computer software to conduct the different components of HM, such as fitting emulators, drawing implausibility/optical density plots, and sampling designs for training points. We will fill this technology gap by converting these specialist technologies into a comprehensive software package in R, accompanied by a series of ‘case studies’ demonstrating how these methods can be used by the academic, industry and health decision making communities. The technology will be created in a framework designed to sustain its use beyond the end of the project. This will improve the evidence available for academic, industry and health decision making communities; improve policy and practice; and, ultimately, save lives.

Lay abstract: Mathematical models are routinely used in public health and other fields, to help predict the future and make policy decisions, such as 'how should we best prepare for the next flu pandemic?'. The usefulness of models for decision making relies on how well they can be matched to real data (model calibration), and how well the uncertainty in model results can be estimated. In recent years, models have become increasingly complex. Methods have been developed to calibrate and analyse these models, but they currently require specialised statistical support. We will develop a software package and tutorials that will make these methods much more accessible to modellers, without additional support. More widespread use of these methods would improve the quality of predictions and evidence that modellers can provide to policy makers. This would allow policy makers to make better-informed decisions, leading to improvements in public health.

Research activity codes: 1.4 METHODOLOGIES AND MEASUREMENTS
Health categories: GENERIC HEALTH RELEVANCE
Title: Integrated primary eye care interventions in Ethiopia
Funder: Wellcome Trust

Abstract: Context: There are 2.2 billion visually impaired people globally. About 90% of these live in low-and-middle- income countries, 80% have avoidable conditions, which are amenable to well-established cost- effective interventions. WHO is promoting Universal Eye Health through integration of Primary Eye Care (PEC) into Primary Health Care (PHC). However, there is little evidence how and what interventions work to effectively and sustainably integrate PEC services into PHC in low-income settings.Proposed Research: The following studies will be conducted in Ethiopia in four phases:Phase 1: Population-based cross-sectional studies to assess eye care need, inequalities, eye health-seeking behaviour and capabilities.Phase 2: Health System Preparedness Evaluation Study to assess the health system's capacity and gaps to deliver integrated PEC interventions.Phase 3: Intervention Development, informed by Phase 1 & 2, through Participatory Action Research (PAR) to develop contextually appropriate, feasible, community owned-and-led integrated & sustainable PEC services.Phase 4: Iterated testing and piloting of the identified PEC interventions both individually and as integrated package at community, health facility, and healthcare organisation level to identify a working PEC intervention that will inform scaled-up delivery of equitably accessible, quality, and sustainable PEC services integrated with PHC.

Lay abstract: Nine out of every ten people with visual impairment globally live in low-and-middle-income countries. This imbalance is largely attributable to insufficient services. The World Health Organisation promotes the integration of Primary eyecare (PEC) services into Primary Healthcare (PHC). However, little evidence exists on how such integration can be achieved in low-income settings.We will implement a four-phase research project in Ethiopia which will: 1. measure the needs and care seeking behaviours of communities, 2. evaluate the health system's capacity for integration, 3. co-develop, with the community and stakeholders, acceptable PEC intervention packages, 4. test and pilot the interventions in repeated processes to identify a working PEC interventions that will inform the delivery of accessible, high-quality, equitable and sustainable PEC services integrated with PHC. This project will provide data on intervention strategies that may help sustainably deliver integrated PEC services with PHC and contribute to the reduction of visual impairment in low-income settings.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Screening for stunting in east London
Funder: Barts Charity

Abstract: Poor growth in childhood can be due to underlying medical causes or socioeconomic disadvantage. Currently there is no systematic screening programme for linear growth (height) in UK children. We will first map child heights nationally and see if East London is a hotspot for poor linear growth, give its high deprivation index. We will then develop a screening algorithm using national data from 19,000 children to see if one additional pre-school height measurement at 3 years of age could identify poor growth early. Finally, we will pilot this screening programme in East London, refer children with severe growth failure to hospital for investigation, and undertake detailed assessments to see if healthy children with poor linear growth have impaired pre-school cognitive development. Screening would therefore enable early referral and treatment of underlying medical disorders, and targeting of pre-school interventions for children whose poor height growth predicts reduced future educational attainment.


Research activity codes: 2.4 SURVEILLANCE AND DISTRIBUTION;4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: GENERIC HEALTH RELEVANCE
Title: Understanding the role of nuclear pores in 3D genome organisation and function
Funder: Wellcome Trust

Abstract: The 3D organisation of the genome is a subject of intensive investigation internationally. In this proposal, we aim to understand what determines how heterochromatin is organised in the human nucleus. We recently discovered that a specific protein of the nuclear pore complex -TPR – is responsible for excluding heterochromatin from in front of nuclear pores and is essential for the heterochromatin re-organisation that occurs during oncogene-induced senescence. By manipulating TPR we are able to reversibly change the spatial organisation of heterochromatin from localisation along the nuclear periphery to clustering in internal foci. In this proposal our goals are to determine how this heterochromatin reorganisation occurs, and then to investigate the properties of TPR and how this large protein, located on the nuclear pore basket, excludes heterochromatin from pores. Finally, we will investigate what happens to gene expression and RNA processing when heterochromatin is allowed to occlude nuclear pores. Through this study we will gain new insights into the molecular mechanisms and dynamic properties underlying a fundamental feature of the 3D human genome – the organisation of heterochromatin.

Lay abstract: The way that the human genome is arranged in three-dimensions (3D) inside the nucleus of our cells can affect how the genome works and particularly how genes are expressed. Our focus in this proposal is regions of our genome that are mainly inactive, and packaged into a compact structure called heterochromatin. Taking advantage of state-of-the-art imaging technologies and genome-editing we aim to understand the principles that determine whether heterochromatin is located at the edge of the nucleus, or not. In particular, we will investigate a protein called TPR which we believe actively keeps heterochromatin away from channels that perforate the edge of the nucleus. These channels are important for getting molecules into and out of the nucleus. We expect our work to reveal new fundamental organising principles of the nucleus.

Research activity codes: 1.1 NORMAL BIOLOGICAL DEVELOPMENT AND FUNCTIONING
Health categories: GENERIC HEALTH RELEVANCE
Title: High Parameter Flow Cytometry in Health and Disease
Funder: Wellcome Trust

Abstract: High-parameter flow cytometry is an innovative and powerful analytical tool that enables researchers to classify and analyse distinct cellular subtypes and phenotypes in the typically heterogeneous cell populations that make up normal and diseased tissues. The BD FACSymphony A5 is a state-of-the-art multi-parameter flow cytometer, which in its current typical set-up (5 lasers/31 parameters), is equipped with the UV, Violet, Blue, Yellow-Green and Red lasers, allowing simultaneous detection of two relative physical properties (forward and side scatter), as well as the analysis of up to 29 different colours. A distinct advantage of this instrument is the ease with which it allows investigators to identify rare cell populations through deep immune profiling with no loss of cellular information. This added depth will transform the studies of many research groups at Queen’s University Belfast and beyond. Furthermore, due to the similarity with existing, simpler flow cytometry platforms the BD FACSymphony A5 will make it easier for our current flow cytometry users to "scale-up" their existing panels compared to other new cytometric technologies (e.g. mass cytometry).

Lay abstract: In recent years, there have been major technology advances that allow us to measure many different molecules on cells at the same time. We will purchase a state-of-the-art instrument called a BD FACSymphony A5 which is now capable of detecting 30+ distinctive products on cells and it will help us study differences from healthy and diseased tissue and from very rare cell types. Importantly, this instrument will be used across many different research areas, particularly those that study immune responses which include cancer, regenerative medicine and drug development. This will help our research teams to make new discoveries about how diseases arise and whether new potential medicine alleviate disease, particularly in the case of personalised medicine. The FACSymphony A5 will be able to overcome our current limitations and have an extraordinary impact on our research, catalysing a vital transformation in our ability to enhance knowledge, improve health and drive innovation.

Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: GENERIC HEALTH RELEVANCE
Title: Three Photon Microscopy Suite
Funder: Wellcome Trust

Abstract: We propose the establishment of a dedicated facility for three-photon live imaging of deep tissue. This will comprise a dedicated multiphoton microscope (Scientifica Hyperscope or similar) with optical components anti-reflectance coated for long-wavelength light (up to 1700 nm) for three photon imaging, together with a suitable laser excitation source. Funding is requested for a high power ultrafast laser (Amplitude Systems Satsuma 40/40 or similar) producing up to 40W at 1030nm, pumping an Optical Parametric Amplifier (APE/Amplitude Mango SP or similar) to produce 1150-1700 nm light at a 2 MHz repetition rate, optimised for three photon excitation of both green and red fluorophores. The microscope will be mounted on a single large antivibration table. The three-photon microscope will be installed in a Home-Office designated small animal imaging suite. A dedicated facility manager (with substantial expertise of in vivo multiphoton imaging including biomedical optics), will run the facility, ensuring continued high imaging performance, and maximising effective and collaborative use of the facility. The imaging suite will provide a unique capability for deep tissue imaging by Wellcome Trust funded researchers across a range of biomedical application areas, including neuroscience, cardiology, stem cell biology and respiratory physiology.

Lay abstract: We are requesting funding for the development of an advanced facility for three-photon microscopy, an imaging technique with substantial demand but extremely limited availability within the UK. We will build on our world leading expertise of multiphoton fluorescence imaging in live tissue. Two-photon microscopy is limited to a depth of ~600 µm into tissue by the build-up of out-of-focus background light due to scattering. For many applications, it is necessary to image deeper than this in order to understand tissue function in health and disease. Imaging up to 2 mm deep can be accomplished with three-photon microscopy, as it dramatically reduces out-of-focus background light. Applications enabled include visualizing structures within lung the following inhalation of allergens or pathogens, studying brain circuit changes associated with Alzheimer's Disease, and watching the migration of stem cells within bone marrow during infection.

Research activity codes: 1.1 NORMAL BIOLOGICAL DEVELOPMENT AND FUNCTIONING
Health categories: GENERIC HEALTH RELEVANCE
Title: Health and economic impacts of urban heat islands and greenspace
Funder: Wellcome Trust

Abstract: We will address all 3 focus areas in the context of Urban Heat Islands (UHIs) and green infrastructure: 1. Developing methods, resources and tools; 2. Documenting health co-benefits and costs of green infrastructure and reduction of overheating in cities; 3. Evaluating the health impacts of climate change and urban adaptation strategies. Overheating in cities due to the UHI is a global public health problem, leading to decreased productivity, morbidity and mortality, and affecting disadvantaged communities disproportionately. Loss of green infrastructure though land use change exacerbates health risks, whilst mitigation and adaptation measures can lead to expansion or improvement of urban green infrastructure, with potential co-benefits. These benefits and costs are not well quantified for either the environment or human health. To properly quantify the impact of changes to urban green infrastructure, we propose an interdisciplinary approach, simulating local environmental data and linking with existing demographic databases to analyse health impacts, including development of an environment and health economics tool. We will focus on international cities (including London, Beijing, Nairobi), to investigate health impacts on urban populations, the potential impacts of climate change and the co-benefits of mitigation and adaptation measures in reducing overheating risk, and increasing access to urban greenspace.

Lay abstract: Environmental change can negatively impact human health: air pollution, hot and cold weather and extreme events can reduce general health and wellbeing, increase illness, and even lead to early death. Urban populations are particularly vulnerable to overheating due to the urban heat island effect (i.e. increased temperatures in towns and cities compared with rural areas). These health impacts are likely to increase due to climate change, and the fact that globally more people now live in urban areas than ever before. One way to reduce overheating is through green infrastructure (e.g. parks, green roofs, walls, etc). Greenspaces have added health benefits; they can promote healthy, active lifestyles and improve mental health and well-being. We will investigate potential health and monetary benefits of increasing green infrastructure in cities to help decide how we can build cities which improve health and wellbeing, and reduce inequalities in urban populations.

Research activity codes: 2.2 FACTORS RELATING TO PHYSICAL ENVIRONMENT
Health categories: GENERIC HEALTH RELEVANCE
Title: Next Generation Drug Discovery Enabled by Digital Molecular Technologies: Machine learning enabled high throughput synthesis to repurpose drugs and failed clinical candidates
Funder: Wellcome Trust

Abstract: Access to novel biologically-active molecules that treat disease is a bottleneck in drug discovery, costing thousands of lives and £millions per-year. For every drug marketed, more than 50 programs fail, often due to toxicity detected late in the process. We will develop a transformative system that uses novel MLIAI-based models to understand the mechanism of toxicity, and predict how these endpoints can be mitigated through late-stage functionalization. In parallel, we will merge state-ofthe- art high-throughput synthesis with machine-learning technology to implement structural modifications, turning existing drugs or failed candidates into potential new medicines ready for testing, in a matter of days rather than months. The existing substances will already have optimized biological properties and so a chemical system that introduces pinpoint changes in a controlled fashion will immediately change and improve their properties, thereby dramatically accelerating access to new potential medicines. Importantly, this platform can be applied to any disease area.

Lay abstract: Access to novel biologically-active molecules that treat disease is a bottleneck in drug discovery, costing thousands of lives and £millions per-year. For every drug marketed, more than 50 programs fail, often due to toxicity detected late in the process. We will develop a transformative system that uses novel ML/AI-based models to understand the mechanism of toxicity, and predict how these endpoints can be mitigated through late-stage functionalization. In parallel, we will merge state-of-the-art high-throughput synthesis with machine-learning technology to implement structural modifications, turning existing drugs or failed candidates into potential new medicines ready for testing, in a matter of days rather than months. The existing substances will already have optimized biological properties and so a chemical system that introduces pinpoint changes in a controlled fashion will immediately change and improve their properties, thereby dramatically accelerating access to new potential medicines. Importantly, this platform can be applied to any disease area.

Research activity codes: 4.1 DISCOVERY AND PRECLINICAL TESTING OF MARKERS AND TECHNOLOGIES
Health categories: GENERIC HEALTH RELEVANCE