Research in action

Joel Chilaka

"I did my individual research project on human factors, which covers a range of things from dealing with authority, communication skills and working as a team, all key things you need in medicine.

"I chose to do my iindividual research project on human factors because I found that a lot of the these were the soft skills that actually we missed out through medical school. When it comes to the real world, it's good having all the knowledge, it's good having all the clinical practice, having all the surgical experitse. However, if you don't have the ability to work in the team well, you don't have these other soft skills, especially dealing with stress and other things like that, it can actually make it really difficult to work effectively." 

Sara Abou Sherif 

Measuring the outcomes of patients undergoing open heart surgery versus those undergoing aminimally invasive aortic valve replacement (MIAVR) operation

Having carried out an MSc in cardiovascular research for my intercalated degree, I was keen on further exploring my interest in the field of cardiac surgery for my Individual Research Project (IRP). Cardiac surgery remains the gold standard treatment for replacing and repairing heart valves, with open heart surgery being the standard approach. Over the last 20 years, however, minimally invasive surgery has been increasingly adopted with the aim of improving the recovery of patients following heart surgery, however its benefits remain controversial.

Under the supervision of Mr Ishtiaq Ahmed, a cardiac surgeon at the Royal Sussex County Hospital, I explored and compared the outcomes of patients undergoing open heart surgery versus those undergoing aminimally invasive aortic valve replacement (MIAVR) operation. By collaborating with various healthcare professionals, including anaesthetists and scrub nurses, I was able to collect a range of useful data. I also learned how to perform a propensity score analysis, a statistical method of matching patients with similar baseline characteristics to minimise confounding effects on post-operative outcomes.

We found MIAVR to be as safe as the standard approach and patients who underwent the minimally invasive approach bled less and required less fresh frozen plasma transfused in the post-operative period. They also tended to require a shorter period of time of breathing support following surgery and remained in hospital for less time. Our results offer an exciting insight into how advancements in surgical techniques can optimise patients’ recovery following heart surgery.

Since my IRP I’ve had the opportunity to share our research at various national and international conferences. I was awarded best oral presentation prize at the 2017 British and Irish Society for Minimally Invasive Cardiac Surgery annual meeting. This included funding to attend the International Society’s annual meeting in New York in 2019, and I travelled to Vancouver, Canada to present my poster at the 2018 meeting.

Anokhee Patel

Pilot Study to Investigate the Acceptability of the Pirate Adventure Autism Assessment Tool in Mainstream Typically Developing Children

I’ve always had a strong interest in paediatrics and prior to attending BSMS I worked closely with children with disabilities. So when I got the opportunity to work on developing a new app to assist in the diagnosis of autistic spectrum disorder (ASD) among children as my IRP, I jumped at the chance. Currently, the process for a child to undergo an ASD assessment is time consuming, expensive and has long waiting lists.  

While we cannot ‘cure’ autism, it’s important that children are diagnosed in a timely manner so they get the support they need, both at school and at home. My supervisors, Dr Ian Male and Dr Will Farr, developed the Lego pirate-themed iPad game, which allows clinicians to carry out an initial 10-minute screening for ASD, and could flag up children who might need further testing. Children work through a number of questions in the pirate ‘story’ — each of these will test a particular area that may get a different response from a child with autism. So you might test the ability to read emotions or understand idioms by asking, “What does the treasure will cost an arm and a leg mean?” Also there is evidence that children with ASD interact better with technology, so the iPad seemed like the perfect format to use, particularly as most kids are familiar with it. 

I tested the app among 32 typically developing children in a primary school, to see how they responded to it and what could be improved. Overall the kids loved it, but I made a couple of suggestions for improvement, for example, developing more female characters and different themes to make it more attractive to girls. 

The app is now being copyrighted and we hope to launch it in the app store for use by clinicians in the near future. 

Fenella Prowse 

Carrying a genetic risk for dementia: cognitive and neural signatures of the APOE e4 gene in mid-age

It is predicted that by 2025,1million people in the UK will suffer from dementia, but we still have no cure or effective treatment. This is one of the reasons I became interested in this field. There has been a great deal of research into Alzheimer’s but an understanding of exactly what causes the disease has yet to be discovered.

Research has shown that carriers of a particular gene called APOE e4 (roughly 14% of the population) are 12 times more likely to develop the disease than non-carriers. The cognitive pro le of e4-carriers also changes across the lifespan, with younger e4 carriers showing cognitive advantage over their non-carrier peers, followed by a reversal in cognitive abilities later in life.

My IRP focused on a mid-aged population, as this is where there may be important changes to cognitive function, and a potential time where intervention could help prevent the onset of Alzheimer’s.

I recruited healthy mid-aged people to the study; they were a mixture of e4 carriers
and non-carriers, but this was blinded to the participants and the researchers to reduce bias and maintain confidentiality. I scanned the participants’ brains using functional MRI while they performed memory tasks. The overall results showed reduced activity in areas of the brain involved in memory, such as the hippocampus, in e4 carriers. It is possible this represents the early effects of Alzheimer’s disease in certain parts of the brain, before any cognitive changes are noted. This has helped us understand the disease process, even before the onset of Alzheimer’s, and may assist in the future development of preventative treatment.

It was a great opportunity for me to further my interest in Alzheimer’s disease and
get some research experience, as well
as contribute to the expanding literature on the e4 gene.