Hazard Identification Platform to Assess the Health Impacts from Indoor and Outdoor Air Pollutant Exposures, through Mechanistic Toxicology
Lead Research Organisation:
University of Birmingham
Department Name: Sch of Geography, Earth & Env Sciences
Abstract
The focus on particulate matter (PM2.5) mass reductions in UK air quality policy reflects the metrics measured for regulatory compliance. Epidemiological approaches have struggled to untangle the relative hazard of PM constituents within this mass, as well as co-pollutant gases, such as NO2, leading to the contention that all PM2.5 components must be treated as being equally harmful to human health. This makes little toxicological sense. The lack of a relative hazard ranking of PM constituents and co-emitted gases means that policy focuses on blunt strategies based on overall reductions in pollutant concentrations, rather than a refined focus on health relevant sources and components. This poses risks of unintended consequences, e.g. focusing on the largest contributors to PM2.5 for regulatory compliance, rather than the most harmful fractions, may fail to deliver predicted health benefits to the most vulnerable members of our society. In outdoor air this has remained unresolved for over 20-years, but further complexity is introduced by the heterogeneous indoor environment which must be considered in a complete picture of exposure. To address this major knowledge gap, the UK requires integration and focus of toxicological resource methodologies to identify the most hazardous fractions of indoor and outdoor PM and to elucidate the causal pathways contributing to disease development and exacerbation.
Our proposed consortium brings together recognised UK expertise in atmospheric sciences, toxicology and biomedical sciences in a world-leading interdisciplinary collaboration to build an Air Pollution Hazard Identification Platform. This platform will deliver the capability to conduct controlled and characterised exposures to defined pollutant mixtures from different sources for in vitro, in vivo animal and human toxicological studies. We will use the large atmospheric simulation chamber at the University of Manchester to conduct experiments exposing human volunteers to diesel exhaust, woodsmoke, cooking emissions, secondary organic aerosol and NOx-enhanced mixtures, all at ambient atmospheric levels. These have been selected for their recognised substantial contributions to indoor and outdoor air pollution. The chamber exposures will be used as a reference and these experiments will be used to provide filtered samples of the PM for in vitro and transgenic animal exposures at the partner Institutions. Referenceable portable source units for all primary and secondary pollutant mixtures will be developed, characterised and deployed for in vitro and animal exposures to the full gas and particle mixture.
Within the proposal, we will demonstrate the capability of the platform to elucidate the toxicological mechanisms involved in the neurological impacts of air pollution, though any health outcomes are accessible to the platform. The in vitro studies will be used to explore possible direct and indirect mechanisms for neuroinflammation and injury, identifying the molecular pathways associated with cellular activation. Using a unique panel of transgenic stress-reporter mouse lines, the stress response on exposure to the various pollutants will be tracked in a tissue and cell specific manner in vivo and provide a hazard ranking of the pollutants that can be related back to the in vitro molecular signatures. Repeat experiments with mouse lines susceptible to Alzheimer's disease will examine changes in these stress responses. Epigenetic DNA signatures will be examined in target tissues. A panel of healthy aged human subjects with a family history of increased dementia risk will provide biosamples and be subjected to cognitive tests on exposure to the different mixtures, further enabling their hazard ranking for correlation with the in vitro and animal studies. The mechanistic linkages between the animal and human exposure responses will be explored using candidate driven biomarker and untargeted metabolomic and epigenetic studies.
Our proposed consortium brings together recognised UK expertise in atmospheric sciences, toxicology and biomedical sciences in a world-leading interdisciplinary collaboration to build an Air Pollution Hazard Identification Platform. This platform will deliver the capability to conduct controlled and characterised exposures to defined pollutant mixtures from different sources for in vitro, in vivo animal and human toxicological studies. We will use the large atmospheric simulation chamber at the University of Manchester to conduct experiments exposing human volunteers to diesel exhaust, woodsmoke, cooking emissions, secondary organic aerosol and NOx-enhanced mixtures, all at ambient atmospheric levels. These have been selected for their recognised substantial contributions to indoor and outdoor air pollution. The chamber exposures will be used as a reference and these experiments will be used to provide filtered samples of the PM for in vitro and transgenic animal exposures at the partner Institutions. Referenceable portable source units for all primary and secondary pollutant mixtures will be developed, characterised and deployed for in vitro and animal exposures to the full gas and particle mixture.
Within the proposal, we will demonstrate the capability of the platform to elucidate the toxicological mechanisms involved in the neurological impacts of air pollution, though any health outcomes are accessible to the platform. The in vitro studies will be used to explore possible direct and indirect mechanisms for neuroinflammation and injury, identifying the molecular pathways associated with cellular activation. Using a unique panel of transgenic stress-reporter mouse lines, the stress response on exposure to the various pollutants will be tracked in a tissue and cell specific manner in vivo and provide a hazard ranking of the pollutants that can be related back to the in vitro molecular signatures. Repeat experiments with mouse lines susceptible to Alzheimer's disease will examine changes in these stress responses. Epigenetic DNA signatures will be examined in target tissues. A panel of healthy aged human subjects with a family history of increased dementia risk will provide biosamples and be subjected to cognitive tests on exposure to the different mixtures, further enabling their hazard ranking for correlation with the in vitro and animal studies. The mechanistic linkages between the animal and human exposure responses will be explored using candidate driven biomarker and untargeted metabolomic and epigenetic studies.
Publications
Faherty T
(2025)
Acute particulate matter exposure diminishes executive cognitive functioning after four hours regardless of inhalation pathway
in Nature Communications
Faherty T
(2024)
HIPTox-Hazard Identification Platform to Assess the Health Impacts from Indoor and Outdoor Air Pollutant Exposures, through Mechanistic Toxicology: A Single-Centre Double-Blind Human Exposure Trial Protocol
in International Journal of Environmental Research and Public Health
| Description | The project has developed a novel approach to assessing the impact of different air pollution mixtures upon human cognition. The approach allows for different domains of cognition to be probed, including executive function, working memory, psychomotor speed and motor control. |
| Exploitation Route | Too early to say (the award is still active) |
| Sectors | Chemicals Communities and Social Services/Policy Education Environment Healthcare Government Democracy and Justice Transport |
| Description | The project has generated significant debate about the impact of air pollution upon cognition and subsequent effects on long term neurodegenerative diseases, e.g. Alzheimer's Disease, and dementia. It has also generated discussion on how to control air pollution and its subsequent effects on cognition, education attainment and work place productivity. |
| First Year Of Impact | 2022 |
| Sector | Chemicals,Communities and Social Services/Policy,Education,Energy,Environment,Healthcare,Government, Democracy and Justice,Transport |
| Impact Types | Societal Economic Policy & public services |
| Description | Institution for Global Innovation Clean Air Proof-of-concept funding |
| Amount | £4,200 (GBP) |
| Funding ID | IGI-IAS ID 5054 |
| Organisation | University of Birmingham |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 05/2022 |
| End | 12/2022 |
| Title | Cognitive task and analysis scripts supporting the publication "Acute particulate matter exposure diminishes executive cognitive functioning after four hours, regardless of inhalation pathway: processed data" |
| Description | We investigated if the inhalation route (nasal or oral) of particulate matter (PM) air pollution affects cognition. PM exposure impaired selective attention and emotion recognition but not working memory or vigilance, with no mediation by inhalation. In this study participants were exposed to high PM concentrations (via burning and subsequent extinction of candles) or clean air, and were exposed either under conditions of normal inhalation or restriction of the olfactory pathway using a nose clip. Participants took part in all condition combinations. Prior to exposure, participants completed four cognitive tasks assessing working memory, selective attention, emotion expression discrimination, and psychomotor vigilance. 4-hours following exposure end, the tasks were administered again. The cognitive tasks for this experiment were administered using MATLAB, incorporating Psychtoolbox. The code for running the study tasks, as well as scripts for the first-level preprocessing analysis to derive variables of interest, are available on GitHub. |
| Type Of Material | Database/Collection of data |
| Year Produced | 2024 |
| Provided To Others? | Yes |
| Impact | The tasks are associated with a publication in Nature Communications (first author: Dr Thomas Faherty). Findings from this study informed essential adjustments to the tasks and methodology for the HIPTox human participant exposure study (WP2). |
| URL | https://github.com/fahertyt/PM_cognition |
| Title | HIPTox Cognitive Dataset |
| Description | Data collection is to complete for the study to assess and hazard rank the cognitive effects of prevalent indoor and outdoor pollutants. We used a single-centre investigation on the cognitive functioning of healthy human volunteers aged 50 and above with a familial predisposition to dementia (first or second degree relatives). Participants undertook five sequential controlled exposures. The sources of the air pollution exposures were wood smoke, diesel exhaust, cleaning products, and cooking emissions, with clean air serving as the control. Pre- and post-exposure spirometry, nasal lavage, blood sampling, and cognitive assessments were performed. The University of Birmingham team (Dr Thomas Faherty & Prof Francis Pope) were responsible for the cognitive assessments. Participants took part in five cognitive tasks, to measure several facets of cognitive function, i.e., motor control, executive function, socio-cognition, working memory, and pscyhomotor speed. A full dataset was collected from 13 participants (i.e., 5 pre- and 5-post exposure cognitive measures for all cognitive tasks). |
| Type Of Material | Database/Collection of data |
| Year Produced | 2023 |
| Provided To Others? | No |
| Impact | This dataset will be analysed within 2024 and results used within journal publications, conference presentations, and other dissemination. |
| Title | Research data supporting the publication "Acute particulate matter exposure diminishes executive cognitive functioning after four hours, regardless of inhalation pathway: processed data" |
| Description | We investigated if the inhalation route (nasal or oral) of particulate matter (PM) air pollution affects cognition. PM exposure impaired selective attention and emotion recognition but not working memory or vigilance, with no mediation by inhalation. In this study participants were exposed to high PM concentrations (via burning and subsequent extinction of candles) or clean air, and were exposed either under conditions of normal inhalation or restriction of the olfactory pathway using a nose clip. Participants took part in all condition combinations. Prior to exposure, participants completed four cognitive tasks assessing working memory, selective attention, emotion expression discrimination, and psychomotor vigilance. 4-hours following exposure end, the tasks were administered again. Data was analysed from 26 participants, available on The University of Birmingham eData Repository. Raw and processed demographic, cognitive, and air quality data generated in the study and used for analysis have been deposited in the University of Birmingham eData Repository Within both consolidated and raw data files, rows represent individual trials or time points, while columns contain identifiers and corresponding data. The top row serves as the header, describing the meaning of each column. Data includes outcomes from all the cognitive tasks as well as measurements of CO, CO2, and PM for all conditions. |
| Type Of Material | Database/Collection of data |
| Year Produced | 2024 |
| Provided To Others? | Yes |
| Impact | The data is associated with a publication in Nature Communications (first author: Dr Thomas Faherty). Findings from this study informed essential adjustments to the tasks and methodology for the HIPTox human participant exposure study (WP2). |
| URL | https://doi.org/10.25500/edata.bham.00001145 |
| Description | Collaboration with the Centre for Human Brain Health, University of Birmingham |
| Organisation | University of Birmingham |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | Dr Thomas Faherty and Prof. Francis Pope approached Andy Bagshaw, co-director of the Centre for Human Brain Health (CHBH), with an innovative idea to investigate the impact of acute particulate matter air pollution exposure on cognitive functioning. The study aimed to use brain imaging to identify the areas of the brain most susceptible to its effects. Dr Thomas Faherty subsequently developed the idea into a formal proposal, taking the lead on completing ethical approval, risk assessments, and equipment feasibility testing, with support from Prof. Francis Pope and Andy Bagshaw. After following formal processes, including presenting the project proposal, the plan was accepted by the CHBH, and scanner time was granted to proceed with the project. |
| Collaborator Contribution | Professor Andrew Bagshaw, co-director of the Centre for Human Brain Health (CHBH), responded positively to the proposal and provided critical support in its preparation, particularly in the areas of ethical review, risk assessments, and guidance on brain imaging parameters and best practices. Nina Salman, the chief radiographer at CHBH, has been instrumental in conducting feasibility assessments and will play a key role in the project's success as the designated MRI scanner operator. With approvals secured at the centre, school, and college levels of the University, 78 hours of MRI scanner time were allocated for the project. This represents an in-kind contribution from CHBH valued at £47,931. The allocation was calculated based on the number of participants (26) multiplied by the number of visits (2), session duration (1.5 hours or 90 minutes), and the scanner cost per hour (£614.50): Centre for Human Brain Health MRI Scanner: 78.00 units @ £614.50/hour = £47,931. |
| Impact | Ethical approval for this study has been granted, and data collection is set to commence shortly (as of 16 January 2025). This multidisciplinary collaboration has already yielded ideas and demonstrated evidence of teamwork, culminating in a full-scale grant proposal submitted to the Biotechnology and Biological Sciences Research Council (BBSRC) on 15 January 2025. |
| Start Year | 2024 |
| Description | Collaboration with the School of Psychology, University of Birmingham |
| Organisation | University of Birmingham |
| Department | School of Psychology Birmingham |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | Prof Francis Pope (F.P.) & Dr Thomas Faherty (T.F.) formulated the research question. T.F. conducted the experiment, collected data, and analysed the results. T.F. wrote the original version of a results paper manuscript with continued support from F.D.P. |
| Collaborator Contribution | Prof Jane Raymond (J.R.) aided in the conception and design of the experiment, particular focus on the cognitive tasks. J.R. provided a location for data collection. J.R. reviewed and edited the results manuscript paper . |
| Impact | Publication in Nature Communications: "Acute particulate matter exposure diminishes executive cognitive functioning after four hours regardless of inhalation pathway". |
| Start Year | 2022 |
| Description | Franco-UK Collaboration - Université Gustave Eiffel |
| Organisation | Gustave Eiffel University |
| Country | France |
| Sector | Academic/University |
| PI Contribution | Dr Thomas Faherty and Professor Francis Pope, along with colleagues from the University of Birmingham's School of Geography, Earth and Environmental Sciences (Professor Roy Harrison and Dr Laura-Jayne Bradford), applied for seed-meeting funding from the French Embassy in the UK to establish a new Franco-UK collaboration. Dr Thomas Faherty drafted the initial proposal, incorporating feedback from all team members. The application was submitted in December 2024 and has since been approved. Meeting dates are yet to be confirmed. |
| Collaborator Contribution | Dr Aurélie Charron, Dr Alexandra Fort, Mr Ilann Mahou (PhD student), Dr Elie Almarj, Dr Lise Giorgis-Allemand, and Dr Ludivine Nohales, who are collaborating with Professor Roy Harrison on ongoing research, identified the funding source and contributed to refining the written application. |
| Impact | The seed meeting is scheduled to take place in 2025 at the French Embassy in London, UK. Its purpose is to review the current literature on acute exposure to air pollution and its impact on cognitive functioning. This partnership is crucial for laying the foundation of future research. By collaborating, the teams will address complex challenges and work together to secure significant funding (i.e., EU Horizon) for groundbreaking studies. The collaboration is multi-disciplinary, uniting experts from environmental toxicology, atmospheric chemistry, neuroscience, psychology, and medicine. |
| Start Year | 2025 |
| Description | NHS Manchester Foundation Trust -- HIPTox Human Exposures |
| Organisation | Manchester University NHS Foundation Trust |
| Country | United Kingdom |
| Sector | Public |
| PI Contribution | Experience to clinical research staff on non-typical assessment and experimentation i.e., exposure to air pollutants, nasal wash, cognitive assessments Experience to clinical research staff on recruiting health volunteers Experience to clinical research staff on public engagement and academic presentations |
| Collaborator Contribution | Location of HIPTox study and staff to undertake physiological and cognitive measurements A view into inner workings of clinical research for Dr Tom Faherty, including Good Clinical Practice Training Experience collaborating with non-university staff and organisations to achieve successful project implementation |
| Impact | Collection of data for the HIPTox, human exposures project. |
| Start Year | 2022 |
| Description | Atmospheric Science Conference Attendance 2022 |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Postgraduate students |
| Results and Impact | Attendance at the Atmospheric Science Conference, 2022. Gave talk to 50+ postgraduate students and early career researchers, and had a panel discussion afterwards. The audience was made up of environmental scientists, so detailing the impact of air quality on human brain health was new to most and prompted longer discussions, especially related to particulate pollution and violent crime incidence |
| Year(s) Of Engagement Activity | 2022 |
| URL | https://www.atmosphericscienceconference.uk/july-2022 |
| Description | BBC News (Article & Broadcast) |
| Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | The BBC came to the Manchester Clinical Research Facility on 23rd May 2023 & 11th September 2023 to film and interview staff and one participant for the HIPTox study. The study was broadcast on BBC News throughout the day on 15th December 2023; an article was released by Rebecca Morelle and Alison Francis on 16th December 2023 in the BBC Science and Technology section. Whilst no official figures are available, it is believed this has reached an international audience. |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://www.bbc.co.uk/news/science-environment-67031322 |
| Description | Care group visit |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | Talk given for Together Dementia in Whythenshawe. 20 carers of dementia sufferers attended for a talk on the physical and cognitive health effects of air pollution exposure, methods of reducing personal exposure to harmful air, and information about upcoming study (HIPTox Human Exposures) |
| Year(s) Of Engagement Activity | 2023 |
| Description | Community Outreach |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Public/other audiences |
| Results and Impact | Talk given at Mums for Lungs event in Didsbury. Parents and other members of the public attended for a talk on the physical and cognitive health effects of air pollution exposure, methods of reducing personal exposure to harmful air, and information about upcoming study (HIPTox Human Exposures) |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://www.eventbrite.co.uk/e/cleaner-air-for-manchester-how-you-can-support-action-tickets-5358946... |
| Description | Community group visit |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Public/other audiences |
| Results and Impact | Talk given for Chorlton Good Neighbours Coffee Morning 50+ members of the general public attended for an interactive talk/debate on the physical and cognitive health effects of air pollution exposure, methods of reducing personal exposure to harmful air, and information about upcoming study (HIPTox Human Exposures) |
| Year(s) Of Engagement Activity | 2023 |
| Description | Interview for national and international news outlets - Guardian, Daily Mail, Times, Press Trust of India |
| Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Public/other audiences |
| Results and Impact | A press release and interview follow-ups from major national and international media outlets as a response to the publication "Acute particulate matter exposure diminishes executive cognitive functioning after four hours regardless of inhalation pathway'. Nat Commun 16, 1339 (2025). https://doi.org/10.1038/s41467-025-56508-3 Interviews and queries from: The Guardian, UK: https://www.theguardian.com/environment/2025/feb/06/air-pollution-affects-peoples-ability-to-focus-on-everyday-tasks-study-finds The Times, UK: https://www.thetimes.com/uk/environment/article/air-pollution-candles-impairs-brain-function-study-ptn0bfw9j The Daily Mail, UK Cadena SER, Spain Press Trust of India The University of Birmingham Press Office estimates this activity was reached by a potential audience of 1 billion worldwide. As of 7th March 2025, the altmetric score for this publication and resultant media activity is 755, close to the top 0.1% of all tracked outputs: https://www.altmetric.com/details/173905973 |
| Year(s) Of Engagement Activity | 2025 |
| URL | https://www.theguardian.com/environment/2025/feb/06/air-pollution-affects-peoples-ability-to-focus-o... |
| Description | Manchester Dementia Care Home Visits |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | On 5th May 2023 Dr Thomas Faherty & Dr Huda Badri visited 10+ Dementia care homes to promote the HIPTox study and provide advertisements to reception areas for carers/relatives of those in the care homes. The study purpose was explained to a range of interested people throughout the day, however it is not believed there was any conversion from advertisements to participation. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Presentation in the University of Birmingham Air Pollution & Atmospheric Chemistry seminar series |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Postgraduate students |
| Results and Impact | A presentation was given on 15th December 2023 in the Air Pollution & Atmospheric Chemistry seminar to members of the University of Birmingham school of Geography, Earth and Environmental Sciences as well as potential future collaborators from the Universite Gustav Eiffel, France. This presentation contained details of the HIPTox pilot study and audience members were engaged with the topic and reported surprise at the effect that a candle extinction event could impact cognitive function. |
| Year(s) Of Engagement Activity | 2023 |
| Description | Public Seminar, Imperial College London |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Public/other audiences |
| Results and Impact | On 24th April 2023, a presentation was completed by Dr Ian Mudway & Dr Roland Wolf to 50+ members of the public and academics regarding the impact of air quality on the brain and the HIPTox project. Dr Thomas Faherty supported resultant discussions and audience queries following the presentation in the follow-up drinks reception. |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://www.imperial.ac.uk/events/158555/the-relationship-between-air-pollution-and-declining-cognit... |
| Description | Public forum visit |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Public/other audiences |
| Results and Impact | Talk given for Didsbury Civic Society at Didsbury Baptist Church. 50 members of the general public attended for a talk on the physical and cognitive health effects of air pollution exposure, methods of reducing personal exposure to harmful air, and information about upcoming study (HIPTox Human Exposures) |
| Year(s) Of Engagement Activity | 2023 |
| Description | Strategic Priorities Fund Workshop |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Professional Practitioners |
| Results and Impact | Attendance at UKRI Strategic Priorities Fund conference/workshop/networking event to discuss what the HIPTox project entailed and gain feedback from other researchers / professionals as to potential issues with the proposal and any future work following the successful completion of the project |
| Year(s) Of Engagement Activity | 2022 |
| Description | Study Recruitment and community outreach |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Public/other audiences |
| Results and Impact | Brain Health Day, Saturday 18th March 2023 at Manchester Central Library. Attendance to recruit possible participants for upcoming human exposure study and answer queries related to air quality and brain health |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://stroke-impact.org/brain-health-day/ |
| Description | Talk / Participant Recruitment at Alzheimer's Research UK Mildlands Event |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Public/other audiences |
| Results and Impact | Approximately 60 members of the general public / academics involved in Alzheimer's Research UK Midlands attended Aston University on 5th April 2023. The purpose of the day was a mixture between Alzheimer's awareness discussion/activities and research presentations. We gave a presentation about the impact of both indoor and outdoor air quality on human health (especially brain health) and publicised the HIPTox Human Exposures study in Manchester. One participant was recruited through this event and other members of the public followed-up our presented facts with further queries |
| Year(s) Of Engagement Activity | 2023 |
| URL | https://allevents.in/birmingham/alzheimers-research-uk-midlands-network-public-event/100005156664412... |