EPSRC-NIHR HTC Partnership Award 'Plus': UNIFY Plus

Lead Research Organisation: Loughborough University
Department Name: Wolfson Sch of Mech, Elec & Manufac Eng

Abstract

This proposal is focussed on addressing major unmet clinical needs in the repair and rehabilitation of non-union fractures. A non-union is a broken bone that fails to heal. These result from both civilian and military injuries and lead to pain, suffering and loss of dignity. The initial UNIFY network working with the Trauma Health Technology Cooperative has identified that more fundamental understanding is required of bone formation to address non-union and other closely related disease states. UNIFY Plus builds on UNIFY to permit work to better structure the field and feasibility studies of promising approaches to address the issues.

Planned Impact

UNIFY Plus will continue to expand the thirteen University partner and ten clinical user network initiated by UNIFY. It will use the UNIFY campaign plan way of working to focus on core user led science and engineering problems within pathological ossification with the potential to deliver to clinician and patient needs. We will continue to focus on growing our international, industry and patient linkages. Addressing the specific and challenging demands of defence medicine with the strong support of the Royal Centre for Defence Medicine, and recognising the importance of defence medicine as an innovator and early adopter provides a significant route to impact.

The outputs of the network in addition to those of UNIFY will be:
- An additional year of UNIFY/UNIFY network continuity bridging the EPSRC and clinical and other communities with a focus on resolving issues of non-union fracture and pathological ossification,
- Deeper understanding of pathological ossification and how it can be addressed by the results of four competitively awarded £62.5K feasibility studies with translational intent and where viable a focus on securing collaborators and funding to permit ultimate implementation,
- The results of foundational studies to shape the national landscape for research in heterotopic ossification and assist researcher access to data on an from material banked at the University of Birmingham, and to understand the approaches required to engineer meaningful models of complex and contaminated non-unions,
- Events promoting discussion and debate on the fundamentals of ossification and of surgical approaches to addressing non-union recognising the requirement to integrate the clinical, mechano-biological and the materials community;
- Researchers with increased translational emphasis and enhanced skills in translation and knowledge of the translational funding landscape.

Publications

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Description This Network activity continued the work of the UNIFY project but with an increased focus on the underlying science of the formation of bone and how the EPSRC community can help the understanding of this in order to address non-unions. Two sandpits took place to generate new project ideas and compete for pump priming funding. The first was focussed on a micro-level (small scale) perspective of the problem and the second at a macro-level (surgery level). Four projects, two large with UNIFY PLUS funding,and two smaller within UNIFY, were funded from the first sandpit. The two UNIFY PLUS projects address the prediction of non-union using a simple blood test and the creation of a framework linking macro to micro tissue movement .Three mid-size project proposals were taken forward the second sandpit are being taken forward and focussed on cell delivery and the prevention of infection, the detection of atypical oxidation at the fracture site, and a joint clinician-engineer project more closely examining the mechanics of intra-operative reduction and fixation. A workshop was held on the 30-31/10/17 at the National Firearms Centre on Blast and Ballistic Wound Modelling to communicate the severity of military injuries, discussion particularly highlighted the need to understand changes in civilian injury threat and the necessary long term medical response. The project closed with a two day dissemination meeting on the 12-13/12/18 with distinguished plenary speakers where the results of projects were presented and including discussions on way forward. Critically this prioritised key fundamental areas for work and consolidated key collaborations.
Exploitation Route The aims of the project were to pump prime areas of work and build collaborations between clinical problem owners and scientists and engineers with a particular focus on early career researchers with an informed understanding of the complexity of the problems. These have been successfully achieved. Two key cross disciplinary research areas were confirmed at the closing workshop, early callus formation and better understanding of the classes of mechanical environment, and proposals are in preparation in both of them.
Sectors Communities and Social Services/Policy,Healthcare,Manufacturing, including Industrial Biotechology,Culture, Heritage, Museums and Collections,Pharmaceuticals and Medical Biotechnology

 
Description The two sandpits within UNIFY Plus have consolidated the networks built with UNIFY and has created a new community with an improved and deeper understanding of the reality and complexity of the non-union (fractures that do not heal) problem. This understanding embraces both its scientific maturity and the changes as a consequence of the implementation of major trauma centres. This is important because it has significantly changed the approach from one that was initially a little naïve to one that is much more pragmatic and well informed and shared by a community of early career researchers much more strongly linked to clinical leading users. Because of the importance of non-unions as a consequence of ballistic wounding the work of UNIFY PLUS has also linked to that of the National Firearms Centre within the Royal Armouries Museum at Leeds.
Sector Communities and Social Services/Policy,Healthcare,Manufacturing, including Industrial Biotechology,Culture, Heritage, Museums and Collections,Pharmaceuticals and Medical Biotechnology
Impact Types Societal