Up to 1 in 5 patients hospitalised by COVID-19 have evidence of heart muscle injury as measured from a blood test. This is associated with a high death rate. Using an MRI scan of the heart we aim to investigate how often, and in what way, the heart becomes damaged, and how the heart recovers 6 months later. We need to know how heart muscle damage and recovery is affected by age, sex, ethnicity and other medical conditions (such as diabetes, high blood pressure, heart disease and narrowing of blood vessels), as these are also known to be associated with high death rates. We also want to see if we can improve the diagnosis of viral heart damage from a simple ECG, which may save patients having invasive heart tests which can be uncomfortable, are expensive and carry a small risk of serious complications and may put healthcare staff at increased risk of exposure to COVID-19.

Awaiting Public Project Summary

A Brand New Sense (BraNeS) aims to create a digital tool that makes movement fun and aids creative expression and intergenerational exchange within the user's home setting and/or community environments. Just like anyone else, when they exercise, old people experience important health benefits. They are able to move better, accomplish daily and routine tasks easier and experience a positive shift in their mood. However, a major challenge is how to get people to become active in a way that they enjoy. Research has shown that a combination of movement and music is enjoyable, and people are more likely to adhere to exercise programmes that involve music. Studies have also shown that the social dimension of physical activity is an important factor of enjoyment. BraNeS explores the use of movement sonification as a form of physical activity that combines creative expression and social interaction. Movement sonification is the synchronous production of sound and movement through a digital device. It is an emerging practice which, on the on hand, is spreading within youth and music subcultures through new products aimed at primarily young audiences. It is also being tested within health and clinical settings for the treatment of health conditions and/or the improvement of physical performance. Through developing an existing prototype, BraNeS capitalises on this trend, in order to develop an intuitive, affordable and accessible tool that can be used in the user's living environment and increase mobility, aid creative expression and encourage intergenerational social interaction.

Microbubbles (MBs) are tiny bubbles of gas about 1/100th of a hair's breadth in diameter and surrounded by a thin elastic shell. When used with ultrasound (US) imaging they provide increased image contrast. Importantly, it is possible to attach molecules to the MB shell enabling them to bind specifically to target cells, for example in tumours. This allows direct imaging of cancers. Furthermore, it is also possible to attach drug payloads to these targeted MBs. These therapeutic MBs can then be targeted directly to the tumour and their drug payload released by bursting the MBs, using a specific US trigger, leading to localised release of drug. Many cancer drugs are highly toxic, which limits their use and can cause extreme side effects. Therapeutic MBs offer the potential for significantly reducing these side effects, whilst allowing for higher dose drug delivery to the tumour. Our focus for this application will be on Colorectal Cancer (CRC), the third most common cancer in the UK. Around 40,700 people were diagnosed with bowel cancer in 2010 in the UK with an estimated 1.24 million new cases diagnosed worldwide in 2008. It is anticipated that as our elderly population increases, CRC will increase in prevalence (www.nice.org.uk) raising important issues relating to treatment in elderly patients balanced with quality-of-life and health economics considerations. Our aim is to deliver cost-effective, less invasive treatments with fewer side effects and improved quality of life for patients. Our Programme of research addresses several key challenges that need to be resolved to allow the clinical development of MBs as combined therapy and diagnostic agents. In our recent EPSRC Programme we succeeded in building an instrument for the manufacture of MBs (that have a targeting agent and conjugated drug payload). This enabled us to test their ability to target cancer cells and to effectively treat tumours in pre-clinical models. In order to progress our MBs to the point where they could be used for first-in-man trials we need to satisfy regulatory agencies that our MBs are safe, and have clear clinical benefit. We will also need to demonstrate that they are cost effective, if providers are eventually to take-up this treatment modality. We have developed a two-pronged approach to developing microbubbles for drug based delivery: 1) Many drugs fail to reach clinical trials because, whilst they are potent as drugs, they are difficult to deliver into cells, or tissue because of poor solubility or becasue they are too toxic to use. For this we propose to develop a new integrated screening platform, that will use the combination of MB+ultrasound, for aiding the delivery of such drugs into cells (and tumour models). This will not only allow re-assessment of many existing drugs but will also speed up the screening of new drugs. Through partnership with the Medicines Discovery Catapult we will promote uptake of this technology with pharmaceutical companies and thereby reduce cost for the identification of new drug candidates. 2) We will develop our, patented, MB production instrument to the point where it could be manufactured by an external company for the first-in-human trials. As part of this we need to optimise how we make the MBs, modify how the drugs and targeting agents are linked to each other and address issues such as ease of use, sterility etc. We also need to show that we can eliminate tumours completely using our MB+US approach. By using materials that have been manufactured according to specific standards (GMP), that are suitable for clinical trials, and processes that are in accord with Good Laboratory Practice we will undertake the necessary in-vitro and in-vivo testing required for moving this "Investigational Medicinal Product" to Phase 1 (First in Human) Clinical trials.

The EPSRC-NIHR Healthcare Technology Co-operatives Partnership Network in Medical Image Analysis seeks to bring leading UK researchers in medical image analysis together to identify new opportunities for medical image analysis methodology research within the clinical areas of high morbidity/unmet need of the NIHR Cardiovascular HTC and HTC in Colorectal Therapies. The HTCs are working with patient groups and clinicians on identifying unmet clinical needs in these areas. An aim of the new Medical Image Analysis Network is to bring together imaging scientists with different skills sets and experiences to consider how technological advances in how images are acquired and images (and associated information) are analysed can be applied to solve some of these problems. A purpose of the Network is to encourage new collaborations to be set up between academic healthcare technologists, clinicians and industry partners to develop and evaluate new solutions. We anticipate that Network members will jointly work on some of the hardest medical image analysis problems there are today. The hope is that the resulting research will lead to new image-based biomarkers which allow earlier detection of disease, better stratification of disease so that the most appropriate therapy can be selected for a patient, and new image-based quantitative tools to increase the success of interventions and therapies and improve the overall well-being of patients with these conditions. How will the Network achieve this goal? The Network will aim to encourage the development of new collaborations through workshops, joint meetings with other networks/organisations, small scale feasibility studies, Clinical Readiness events and Challenge competitions which will be open to the broader imaging research community. The hub for promotion of Network activities, dissemination of network outputs, and recruitment of new members (particularly from academia and industry not already involved in the HTCs) will be the Network website which will also act as an information source for imaging researchers interested in these clinical areas.