Nottingham Molecular Pathology Node (NMPN) for Integrated Multi-platform Biomarker Research and Knowledge Transfer
Lead Research Organisation:
University of Nottingham
Department Name: School of Medicine
Abstract
The context of the research
There have been substantial recent investments in Stratified Medicine and Analytical Science by the MRC and EPSRC. A recent MRC Pathology Review has highlighted the need for a robust pathway and capability for the development and adoption of new diagnostic tests. Nottingham Molecular Pathology Node will provide the necessary path and capability to fill the needs identified by the MRC review.
Aims and objectives
To create an infrastructure to drive molecular diagnostic biomarker research down the development pathway utilizing molecular pathology/biobanking strengths and integrating computational/bioinformatics expertise
This initiative will bring together Nottingham's expertise in molecular pathology, East midlands Pathology (Empath) which is the largest clinical pathology service in Europe and has the largest repository of archival tissue in Europe, Nottingham Health Sciences Biobank which is the CRC UK National Biobank co-ordinating centre and Nottingham's Advanced data Analysis Centre (ADAC) which has strong computational expertise including bioinformatics, artificial neural networks, statistics and data interpretation skills for integrating knowledge from several platforms.
To use this infrastructure where Nottingham has existing translational research strengths
Our strategy will be to use the infrastructure to produce world-class innovative research and progress new biomarkers from discovery, down the development pathway into the clinic. Nottingham's major clinical research strengths are: (i) Respiratory and (ii) GI/liver diseases where we have critical mass, expertise, patient cohorts and infrastructure supported by MRC, NIHR, research charities, EU and industry funding.
To address areas of unmet clinical need
Chronic Obstructive Pulmonary Disease (COPD) affects over 1 million people in UK and kills 25,000/year. Idiopathic Pulmonary Fibrosis (IPF) is commoner than all leukaemias combined kills 50% within 3 years of diagnosis. Lymphangioleiomyomatosis (LAM) has no effective treatment and we host the UK centre. Cystic Fibrosis (CF), the commonest genetic disease and median age of death is 35-40 usually due to Pseudomonas infection. Hepatitis B/C affect more than 500,000 people in the UK. H. pylori affects 1 in 6 people in the UK and causes peptic ulceration and gastric cancer.
To use existing large patient cohorts to facilitate translation
Nottingham Respiratory Research Unit (NRRU) has well-phenotyped cohorts (n) including IPF (550), LAM (100), CF (400), and COPD (400). We contribute to national/international collaborations including IMI UBIOPRED, MRCMAP COPD, NIHR Respiratory TRP, MRC Rare Diseases Consortium, CRAFT Consortium. The NIHR Nottingham Digestive Disease Biomedical Research Unit (NDDBRU) hosts HCV Research UK, a national cohort (10,000) and clinical database/biorepository, and is a MRC Stratified Medicine Consortium STOP-HCV member. NDDBRU has non-alcoholic fatty liver disease (NAFLD; 300), compensated cirrhosis (200), Hepatitis B (200) and H.pylori cohorts.
To use the infrastructure to train the next generation of molecular pathologists
We will run high quality Master' levels programmes, short taught courses and summer training schools meeting NHS/industry needs for molecular pathologists in the genomic medicine era. NMPN will provide a platform for aligning ACL posts, PhDs and MSc projects.
Potential applications and benefits
Our approach will develop world leading translational molecular diagnostic capabilities in GI/liver and respiratory diseases. The work will lead to the development and clinical application of biomarkers/molecular diagnostics and computer modeling algorithms in several important infective, inflammatory and fibrotic diseases of the respiratory, GI systems and liver and will likely be applicable to diseases in other organ systems. It will benefit patients, scientists, industrial partners and the health and wealth of the nation.
There have been substantial recent investments in Stratified Medicine and Analytical Science by the MRC and EPSRC. A recent MRC Pathology Review has highlighted the need for a robust pathway and capability for the development and adoption of new diagnostic tests. Nottingham Molecular Pathology Node will provide the necessary path and capability to fill the needs identified by the MRC review.
Aims and objectives
To create an infrastructure to drive molecular diagnostic biomarker research down the development pathway utilizing molecular pathology/biobanking strengths and integrating computational/bioinformatics expertise
This initiative will bring together Nottingham's expertise in molecular pathology, East midlands Pathology (Empath) which is the largest clinical pathology service in Europe and has the largest repository of archival tissue in Europe, Nottingham Health Sciences Biobank which is the CRC UK National Biobank co-ordinating centre and Nottingham's Advanced data Analysis Centre (ADAC) which has strong computational expertise including bioinformatics, artificial neural networks, statistics and data interpretation skills for integrating knowledge from several platforms.
To use this infrastructure where Nottingham has existing translational research strengths
Our strategy will be to use the infrastructure to produce world-class innovative research and progress new biomarkers from discovery, down the development pathway into the clinic. Nottingham's major clinical research strengths are: (i) Respiratory and (ii) GI/liver diseases where we have critical mass, expertise, patient cohorts and infrastructure supported by MRC, NIHR, research charities, EU and industry funding.
To address areas of unmet clinical need
Chronic Obstructive Pulmonary Disease (COPD) affects over 1 million people in UK and kills 25,000/year. Idiopathic Pulmonary Fibrosis (IPF) is commoner than all leukaemias combined kills 50% within 3 years of diagnosis. Lymphangioleiomyomatosis (LAM) has no effective treatment and we host the UK centre. Cystic Fibrosis (CF), the commonest genetic disease and median age of death is 35-40 usually due to Pseudomonas infection. Hepatitis B/C affect more than 500,000 people in the UK. H. pylori affects 1 in 6 people in the UK and causes peptic ulceration and gastric cancer.
To use existing large patient cohorts to facilitate translation
Nottingham Respiratory Research Unit (NRRU) has well-phenotyped cohorts (n) including IPF (550), LAM (100), CF (400), and COPD (400). We contribute to national/international collaborations including IMI UBIOPRED, MRCMAP COPD, NIHR Respiratory TRP, MRC Rare Diseases Consortium, CRAFT Consortium. The NIHR Nottingham Digestive Disease Biomedical Research Unit (NDDBRU) hosts HCV Research UK, a national cohort (10,000) and clinical database/biorepository, and is a MRC Stratified Medicine Consortium STOP-HCV member. NDDBRU has non-alcoholic fatty liver disease (NAFLD; 300), compensated cirrhosis (200), Hepatitis B (200) and H.pylori cohorts.
To use the infrastructure to train the next generation of molecular pathologists
We will run high quality Master' levels programmes, short taught courses and summer training schools meeting NHS/industry needs for molecular pathologists in the genomic medicine era. NMPN will provide a platform for aligning ACL posts, PhDs and MSc projects.
Potential applications and benefits
Our approach will develop world leading translational molecular diagnostic capabilities in GI/liver and respiratory diseases. The work will lead to the development and clinical application of biomarkers/molecular diagnostics and computer modeling algorithms in several important infective, inflammatory and fibrotic diseases of the respiratory, GI systems and liver and will likely be applicable to diseases in other organ systems. It will benefit patients, scientists, industrial partners and the health and wealth of the nation.
Technical Summary
NMPN brings together pathologists, molecular biologists, clinicians, computer scientists, the Nottingham Health Science Biobank (NHSB), Nottingham University Hospitals NHS Trust (NUH), Empath, Pharma/biotech companies and electronic engineering companies.
Co-localisation of expertise, an exceptional tissue repository with linked real-time stratified patient data and well-defined clinical cohorts are resources we aim to use to create a new and original infrastructure encompassing informatics, computational modelling and molecular pathology. This will allow (i) biomarker testing to reveal hidden disease strata (discovery push), (ii) testing clinically stratified patient cohorts to reveal discriminatory biomarkers (clinical pull) and (iii) robust biomarker validation enabling early clinical translation. NMPN models will integrate multi-platform data including DNA/RNA/Proteomic/Metabolomic profiles, digital image analysis, genomic profiling of pathogens as well as data from other sources (e.g. radiology) to provide clinical decision support.
Our models will be tested in infection/inflammation/fibrosis and repair - disease processes with variable outcomes and treatment responses and providing an ideal template for stratification. NMPN will focus on upper & lower gastrointestinal tract, liver and respiratory tract, which feature amongst Nottingham's major research strengths. Although developed for infection/inflammation/fibrosis the models will be transferable to other diseases and easily disseminated to other nodes.
We will work closely with industry and align with other nodes to transfer knowledge and ensure research is translated from bench-to-bedside. NMPN will provide in-depth training for PhD students, new Fellowships in Molecular Pathology, rotation of NHS clinical pathology trainees through the Node, and creation of a new Associate Professor post. We will deliver a distance-learning MSc course for the network and organise annual summer training schools.
Co-localisation of expertise, an exceptional tissue repository with linked real-time stratified patient data and well-defined clinical cohorts are resources we aim to use to create a new and original infrastructure encompassing informatics, computational modelling and molecular pathology. This will allow (i) biomarker testing to reveal hidden disease strata (discovery push), (ii) testing clinically stratified patient cohorts to reveal discriminatory biomarkers (clinical pull) and (iii) robust biomarker validation enabling early clinical translation. NMPN models will integrate multi-platform data including DNA/RNA/Proteomic/Metabolomic profiles, digital image analysis, genomic profiling of pathogens as well as data from other sources (e.g. radiology) to provide clinical decision support.
Our models will be tested in infection/inflammation/fibrosis and repair - disease processes with variable outcomes and treatment responses and providing an ideal template for stratification. NMPN will focus on upper & lower gastrointestinal tract, liver and respiratory tract, which feature amongst Nottingham's major research strengths. Although developed for infection/inflammation/fibrosis the models will be transferable to other diseases and easily disseminated to other nodes.
We will work closely with industry and align with other nodes to transfer knowledge and ensure research is translated from bench-to-bedside. NMPN will provide in-depth training for PhD students, new Fellowships in Molecular Pathology, rotation of NHS clinical pathology trainees through the Node, and creation of a new Associate Professor post. We will deliver a distance-learning MSc course for the network and organise annual summer training schools.
Planned Impact
Who will benefit?
1. Patients and the public
2. Respiratory and GI/Liver translational researchers
3. Discovery Scientists
4. The wider scientific community
5. Pharmaceutical and diagnostics companies
6. Other molecular pathology nodes
7. Government and policymakers
How will they benefit?
Patients and the public: This proposal is aimed at developing new molecular diagnostics/biomarkers for stratifying a number of important diseases with a view to allowing appropriate targeting with existing or novel therapies. This will help ensure that in future patients are treated with the right drug for their condition at the most appropriate time and there will be suitable biomarkers to evaluate the response to treatment. In the medium to long term this is likely to improve the quality of life and longevity of patients with a number of conditions, which currently have high morbidity and mortality. There is therefore a real possibility of a major impact on the nation's health.
Respiratory and GI/Liver researchers: The areas of disease we are researching are those that there is a real need to develop biomarkers of infection, biomarkers predicting decline and the appropriate point to intervene with different therapies. Our results are likely to have wide recognition within the respective scientific communities.
Discovery scientists: The node will provide a vehicle for the translation of excellent basic discovery research making sure that cutting edge discovery science is not wasted and is able to reap its full benefit.
The wider scientific community: Although our node will focus on respiratory, GI and liver diseases the platform created could be used to facilitate research in diseases in other organs as the techniques developed, knowledge of disease mechanisms and modeling algorithms developed may be applicable to a much wider range of infective, inflammatory and fibrotic diseases.
Pharmaceutical and diagnostics companies: Pharmaceutical companies interested in drug development will benefit from developing stratified models and companion diagnostic which indicate the phenotypes of patient that their products can best target. The route to market will be more rapid and the chance of test and drug adoption into routine clinical practice will be considerably enhanced.
Other molecular pathology nodes: The platforms, techniques and modeling algorithms we set up will be shared with other molecular pathology nodes in the network giving added value to their work. This is likely to be a twoway exchange of knowledge in an ongoing manner. By integrating the training components with training taking place in the other nodes we will ensure that the UK has one of the most comprehensive training structures for molecular pathology worldwide.
Government and policymakers: By setting up a series of molecular pathology nodes this initiative will give the UK an international lead and is increase its competitiveness as a marketplace for new molecular diagnostic and biomarker research. It will also improve flow from outside of the UK into the UK of trainees capitalizing on excellent training opportunities MSc and PhD's in molecular pathology. It is likely therefore to contribute to the nations wealth. It will provide data on new ways of stratifying the phenotypes of patients with disease which will be helpful to organisations such as NICE when developing guidelines for disease treatment and monitoring.
1. Patients and the public
2. Respiratory and GI/Liver translational researchers
3. Discovery Scientists
4. The wider scientific community
5. Pharmaceutical and diagnostics companies
6. Other molecular pathology nodes
7. Government and policymakers
How will they benefit?
Patients and the public: This proposal is aimed at developing new molecular diagnostics/biomarkers for stratifying a number of important diseases with a view to allowing appropriate targeting with existing or novel therapies. This will help ensure that in future patients are treated with the right drug for their condition at the most appropriate time and there will be suitable biomarkers to evaluate the response to treatment. In the medium to long term this is likely to improve the quality of life and longevity of patients with a number of conditions, which currently have high morbidity and mortality. There is therefore a real possibility of a major impact on the nation's health.
Respiratory and GI/Liver researchers: The areas of disease we are researching are those that there is a real need to develop biomarkers of infection, biomarkers predicting decline and the appropriate point to intervene with different therapies. Our results are likely to have wide recognition within the respective scientific communities.
Discovery scientists: The node will provide a vehicle for the translation of excellent basic discovery research making sure that cutting edge discovery science is not wasted and is able to reap its full benefit.
The wider scientific community: Although our node will focus on respiratory, GI and liver diseases the platform created could be used to facilitate research in diseases in other organs as the techniques developed, knowledge of disease mechanisms and modeling algorithms developed may be applicable to a much wider range of infective, inflammatory and fibrotic diseases.
Pharmaceutical and diagnostics companies: Pharmaceutical companies interested in drug development will benefit from developing stratified models and companion diagnostic which indicate the phenotypes of patient that their products can best target. The route to market will be more rapid and the chance of test and drug adoption into routine clinical practice will be considerably enhanced.
Other molecular pathology nodes: The platforms, techniques and modeling algorithms we set up will be shared with other molecular pathology nodes in the network giving added value to their work. This is likely to be a twoway exchange of knowledge in an ongoing manner. By integrating the training components with training taking place in the other nodes we will ensure that the UK has one of the most comprehensive training structures for molecular pathology worldwide.
Government and policymakers: By setting up a series of molecular pathology nodes this initiative will give the UK an international lead and is increase its competitiveness as a marketplace for new molecular diagnostic and biomarker research. It will also improve flow from outside of the UK into the UK of trainees capitalizing on excellent training opportunities MSc and PhD's in molecular pathology. It is likely therefore to contribute to the nations wealth. It will provide data on new ways of stratifying the phenotypes of patients with disease which will be helpful to organisations such as NICE when developing guidelines for disease treatment and monitoring.
Organisations
Publications
Da Silva Filipe A
(2018)
Reply to: "Reply to: 'Response to DAA therapy in the NHS England Early Access Programme for rare HCV subtypes from low and middle income countries'".
in Journal of hepatology
Kasi M
(2018)
Seeding of hepatocellular carcinoma into the stomach wall following endoscopic ultrasound and fine-needle aspiration biopsy.
in Oxford medical case reports
Hurley MN
(2018)
Early Respiratory Bacterial Detection and Antistaphylococcal Antibiotic Prophylaxis in Young Children with Cystic Fibrosis.
in Annals of the American Thoracic Society
Deacon K
(2018)
PINX1 and TERT Are Required for TNF-a-Induced Airway Smooth Muscle Chemokine Gene Expression.
in Journal of immunology (Baltimore, Md. : 1950)
Robinson L
(2018)
MDM2 expression in the progression of Barrett's oesophagus.
in Histopathology
Walker AJ
(2018)
Host genetic factors associated with hepatocellular carcinoma in patients with hepatitis C virus infection: A systematic review.
in Journal of viral hepatitis
Mallia-Milanes B
(2018)
TAILS proteomics reveals dynamic changes in airway proteolysis controlling protease activity and innate immunity during COPD exacerbations.
in American journal of physiology. Lung cellular and molecular physiology
Maher TM
(2018)
Investigating the effects of nintedanib on biomarkers of extracellular matrix turnover in patients with IPF: design of the randomised placebo-controlled INMARK®trial.
in BMJ open respiratory research
Sargeant JA
(2018)
Effects of sprint interval training on ectopic lipids and tissue-specific insulin sensitivity in men with non-alcoholic fatty liver disease.
in European journal of applied physiology
Kaewkangsadan V
(2018)
Tumour-draining axillary lymph nodes in patients with large and locally advanced breast cancers undergoing neoadjuvant chemotherapy (NAC): the crucial contribution of immune cells (effector, regulatory) and cytokines (Th1, Th2) to immune-mediated tumour cell death induced by NAC.
in BMC cancer
Sargeant JA
(2018)
The effect of exercise training on intrahepatic triglyceride and hepatic insulin sensitivity: a systematic review and meta-analysis.
in Obesity reviews : an official journal of the International Association for the Study of Obesity
Caylor RC
(2018)
Correction to: Incidental diagnosis of tuberous sclerosis complex by exome sequencing in three families with subclinical findings.
in Neurogenetics
Friedman SL
(2018)
A randomized, placebo-controlled trial of cenicriviroc for treatment of nonalcoholic steatohepatitis with fibrosis.
in Hepatology (Baltimore, Md.)
Wong N
(2018)
HER2 testing of gastro-oesophageal adenocarcinoma: a commentary and guidance document from the Association of Clinical Pathologists Molecular Pathology and Diagnostics Committee
in Journal of Clinical Pathology
Ilyas M
(2018)
Atomic Resolution Structures of Human Bufaviruses Determined by Cryo-Electron Microscopy.
in Viruses
Gupta N
(2018)
Reply to Yanagisawa: Treatment of Pulmonary Lymphangioleiomyomatosis during Pregnancy.
in American journal of respiratory and critical care medicine
Athwal VS
(2018)
SOX9 regulated matrix proteins are increased in patients serum and correlate with severity of liver fibrosis.
in Scientific reports
Raghu G
(2018)
Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline.
in American journal of respiratory and critical care medicine
Ahankari AS
(2017)
Risk factors for maternal anaemia and low birth weight in pregnant women living in rural India: a prospective cohort study.
in Public health
Htwe SS
(2017)
Role of Rho-Associated Coiled-Coil Forming Kinase Isoforms in Regulation of Stiffness-Induced Myofibroblast Differentiation in Lung Fibrosis.
in American journal of respiratory cell and molecular biology
Pourabdollah A
(2017)
A new dynamic approach for non-singleton fuzzification in noisy time-series prediction
Athwal VS
(2017)
SOX9 predicts progression toward cirrhosis in patients while its loss protects against liver fibrosis.
in EMBO molecular medicine
Thomas J
(2017)
Long-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis
in Annals of Internal Medicine
Baloch K
(2017)
Equilibrative nucleoside transporter 1 expression in primary human hepatocytes is highly variable and determines uptake of ribavirin.
in Antiviral chemistry & chemotherapy
Agrawal S
(2017)
Visual morphometry and three non-invasive markers in the evaluation of liver fibrosis in chronic liver disease.
in Scandinavian journal of gastroenterology
West J
(2017)
Risk of hepatocellular carcinoma among individuals with different aetiologies of cirrhosis: a population-based cohort study.
in Alimentary pharmacology & therapeutics
Kullak-Ublick GA
(2017)
Drug-induced liver injury: recent advances in diagnosis and risk assessment.
in Gut
Allen RJ
(2017)
Genetic variants associated with susceptibility to idiopathic pulmonary fibrosis in people of European ancestry: a genome-wide association study.
in The Lancet. Respiratory medicine
Ebili HO
(2017)
"Squirrel" Primer-Based PCR Assay for Direct and Targeted Sanger Sequencing of Short Genomic Segments.
in Journal of biomolecular techniques : JBT
Robinson K
(2017)
The Human Stomach in Health and Disease: Infection Strategies by Helicobacter pylori.
in Current topics in microbiology and immunology
Robinson K
(2017)
Helicobacter: Inflammation, immunology and vaccines.
in Helicobacter
Taye B
(2017)
Association between infection with Helicobacter pylori and atopy in young Ethiopian children: A longitudinal study
in Clinical & Experimental Allergy
Jenkins RG
(2017)
An Official American Thoracic Society Workshop Report: Use of Animal Models for the Preclinical Assessment of Potential Therapies for Pulmonary Fibrosis.
in American journal of respiratory cell and molecular biology
Dongre A
(2017)
Cathepsin K in Lymphangioleiomyomatosis: LAM Cell-Fibroblast Interactions Enhance Protease Activity by Extracellular Acidification.
in The American journal of pathology
Baldry E
(2017)
Effects of short-term energy restriction on liver lipid content and inflammatory status in severely obese adults: R esults of a randomized controlled trial using 2 dietary approaches
in Diabetes, Obesity and Metabolism
Ebili H
(2017)
QMC-PCRx: a novel method for rapid mutation detection
in Journal of Clinical Pathology
Lewis S
(2017)
Frequency of stepping down antibiotics and nebuliser treatment is lower at weekends compared to weekdays: an observational study.
in Clinical medicine (London, England)
Nicoletti P
(2017)
Association of Liver Injury From Specific Drugs, or Groups of Drugs, With Polymorphisms in HLA and Other Genes in a Genome-Wide Association Study.
in Gastroenterology
Ilyas M
(2017)
Next-Generation Sequencing in Diagnostic Pathology.
in Pathobiology : journal of immunopathology, molecular and cellular biology
Harris R
(2017)
Prevalence of clinically significant liver disease within the general population, as defined by non-invasive markers of liver fibrosis: a systematic review.
in The lancet. Gastroenterology & hepatology
Gupta N
(2017)
Lymphangioleiomyomatosis Diagnosis and Management: High-Resolution Chest Computed Tomography, Transbronchial Lung Biopsy, and Pleural Disease Management. An Official American Thoracic Society/Japanese Respiratory Society Clinical Practice Guideline.
in American journal of respiratory and critical care medicine
Fateen W
(2017)
Healthcare costs of transarterial chemoembolization in the treatment of hepatocellular carcinoma.
in Journal of hepatocellular carcinoma
Urban TJ
(2017)
Minocycline hepatotoxicity: Clinical characterization and identification of HLA-B*35:02 as a risk factor.
in Journal of hepatology
Parker R
(2017)
Clinical and microbiological features of infection in alcoholic hepatitis: an international cohort study.
in Journal of gastroenterology
| Description | NIHR BRC |
| Amount | £23,400,000 (GBP) |
| Organisation | University of Leicester |
| Department | NIHR Biomedical Research Centre |
| Sector | Hospitals |
| Country | United Kingdom |
| Start | 03/2017 |
| End | 03/2022 |
| Description | IGNITE event |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Public/other audiences |
| Results and Impact | Day of interactive events to educate public |
| Year(s) Of Engagement Activity | 2016,2017,2018 |
| Description | Mayfest/Wonder University of Nottingham |
| Form Of Engagement Activity | Participation in an open day or visit at my research institution |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Public/other audiences |
| Results and Impact | Open day where research presented |
| Year(s) Of Engagement Activity | 2015,2016,2017 |
| Description | NIHR BRC Annual Meeting |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Industry/Business |
| Results and Impact | Annual NIHR BRC meeting |
| Year(s) Of Engagement Activity | 2018,2019,2020 |
| Description | Nottingham Molecular Pathology Node Annual Meeting |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Industry/Business |
| Results and Impact | Annual meeting pathology node |
| Year(s) Of Engagement Activity | 2017,2018,2019,2020 |
| Description | Presentation ATS |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | ATS presentations |
| Year(s) Of Engagement Activity | 2017,2018 |
| Description | Presentation at American Thoracic Society accepted |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Research findings will be presented Will disseminate findings, stimulate discussion |
| Year(s) Of Engagement Activity | 2015,2016,2017,2018 |