Issue 5
C4TS WINTER 2015 NEWSLETTER 2
C4TS WINTER 2015 newsletter
WELCOME
Welcome to the Winter 2015 edition of the Barts Centre for Trauma Sciences (C4TS) Newsletter. This time around, we describe a new patient-centered initiative AfterTrauma.org, which provides on-line resources and a chatroom for trauma survivors and their families. In November last year, C4TS was proud to host the first Trauma Sciences Colloquium at the iconic Chicheley Hall. We provide a brief report, and we also highlight a pre-clinical neurotrauma study undertaken at Seville University.
Karen Hoffman; Research Fellow, Trauma Outcomes
New Help for Survivors of Trauma AfterTrauma.org In December 2014, C4TS launched a new website called AfterTrauma. AfterTrauma is the first on-line resource in the UK dedicated to helping survivors of traumatic injury recover. AfterTrauma provides information about different kinds of traumatic injuries, the clinical and emotional experience of trauma, and practical tips for survivors and their families. Key features include survivor stories and an on-line forum/ chatroom to help survivors and their families connect and support each other. AfterTrauma has been informed by our work in the C4TS research Outcomes core where we routinely collect functional, rehabilitation complexity, and quality of life data from patients from acute admission, and conduct follow up in hospital up to 12 months after injury. The development of the website has drawn input from patients and clinicians from major trauma centres throughout England and Wales, and international providers such as the American Trauma Survivors Network.
By Karen Hoffman: Research Fellow, Trauma Outcomes Figure 1: Home page of the AfterTrauma website. The site features information about recovery and a community forum
Why is AfterTrauma needed? I have worked for many years as an
occupational therapist, specialising in traumatic injury. Over and over again, my colleagues and I have seen patients and their families shocked and confused about what is happening to them in hospital and feeling lost and alone when they return home from hospital – despite receiving the best care in our major trauma centres. People who have suffered traumatic injury often find their lives (and the lives of their families) changed forever, not least because many are left with permanent disabilities, both physical and emotional. Until now, there has been no ‘one place’ they can go to get all the information that they may need and – very importantly – find other survivors and carers to share stories and help each other feel less alone.
Many patients and their carers have told me they’d like a website and chat room that would help them fill that gap. Next steps AfterTrauma will be officially launched in March 2015. However, it is a resource that will continue to evolve as survivors, carers and clinicians engage with the site and provide suggestions for enhancement. Over time, C4TS hopes to be able engage users of AfterTrauma in research projects. If you have any ideas and comments you’d like to share, feel free to email: enquiries@aftertrauma.org or you can send us a tweet. We’ve also set up an AfterTrauma YouTube channel - feel free to join and post more video links. Click here to find out more about other C4TS research projects.
C4TS WINTER 2015 NEWSLETTER | Issue 4
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Research Project Spotlight TBI – research collaboration By
Dr Ping Yip
Lecturer in Neurotrauma
Science in Seville! In December 2014, Miguel Burguillos and I were happy to fly out of the London cold to Seville, where the streets are lined with orange trees, even in the middle of winter! We had been invited there by Professor Jose Luis Venero from the University of Seville (Department of Biochemistry and Molecular Biology, Pharmacy Faculty) to collaborate on an intensive series of neurotrauma experiments.
Figure 2: Lovely Seville at dusk
Objectives The aim of our research trip was to find out more about the role of galectin-3 (a protein) in acute traumatic brain injury (TBI). We have preliminary data to suggest that within 24 hours of TBI, galectin-3 levels are dramatically elevated in microglia /macrophages (types of brain cells with important immune defence roles for the central nervous system). We want to know if this increase in galectin-3 is good or bad for the patient. More precisely, we want to understand the mechanism(s) and impact of such neuroinflammation after injury. We compared the effect of TBI on galectin-3 knockout mice (i.e. no galectin-3) and wild type mice. We examined the mice at 2h, 24h and 72h post injury, looking for changes in neuronal survival, axonal integrity and inflammatory response.
First Chicheley Hall Trauma Sciences Colloquiium: Nov 2014 18-21 November 2014 saw the inaugural C4TS-sponsored Trauma Sciences Colloquium, hosted at the Royal Society’s Chicheley Hall, Milton Keynes. The objective of the 2-day meeting was to create a unique opportunity for experts in the field of trauma (both clinical and academic) to debate current status of the field and to set a collective agenda for future global collaborative research to progress the trauma sciences and clinical care. 35 invitees from around the world attended, including from Australia, America and Europe.
Figure 3: Drs Ping Yip and Miguel Burguillos
It was a great opportunity for C4TS to co-develop our research interests with the Spanish collaborators, who were particularly interested in learning from us how to model TBI. Maximising the potential impact of these cooperative experiments, we also collected blood and cerebrospinal fluid (CSF) samples which were taken back to London for further processing and future biomarker and genome-wide expression analysis. We believe this was the first experiment of its kind – modelling TBI on this particular kind of mouse (i.e. mice bred without the galectin-3 gene) – allowing us to specifically investigate its behavior in the trauma model and potentially its role in the body’s response to injury. Interestingly, the galectin-3 knockout mice seemed to recover faster from injury than the wild-type. This more rapid recovery suggests that the genetic/chemical inhibition of galectin3 may potentially decrease the inflammatory response, thereby presenting a novel opportunity for therapeutic intervention. This finding has fuelled both our ideas for further collaborative experiments and for conducting more science in Seville! Click here for more information about brain and spinal cord injury
Figure 4 – attendees at the first Chicheley Hall Trauma Sciences Colloquium (Nov-2014)
The format of the meeting was deliberately set such that it ‘flipped’ the usual scientific meeting agenda. Specifically themed sessions were led by short introductions by experts in that topic and then the majority of the session was given over to the attendees to share and discuss their very latest findings and opinions. The colloquium received a lot of positive feedback and produced an agreed list of research priorities to address as a global collective including; publication of a Trauma community position statement, a trauma dictionary to standardise terminology, and proposals for new global translational collaborative studies. For more information about the colloquium and follow up actions, please contact s.eaglestone@qmul.ac.uk
C4TS WINTER 2015 NEWSLETTER
NEW RESEARCH STAFF
Issue 4
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Trauma Education In October 2014, Dr Kash Akhtar took up the position of course director for the new distance learning MSc in Orthopaedic Trauma Science. Kash is fellowship trained in all aspects of complex knee surgery, with a specialist interest in traumatic knee dislocations and multiligament injuries. He gained further experience of these as a Winston Churchill Fellow in the USA and is excited to share his experience with C4TS MSc students:
Dr Kash Akhtar, Senior Clinical Academic Lecturer and Consultant Trauma and Orthopaedic Surgeon, Royal London Hospital
“The course provides a broad and critical understanding of the most up-to-date science and practice of trauma care, with a particular focus on orthopaedic and ortho-plastic management. It combines an international expert faculty with technologyenhanced learning so that students from around the world can readily access knowledge at a time and place of their choosing.”
NEW RESEARCH
ENGAGE WITH US ENGAGE WITH US ENGAGE WITH US ENGAGE WITH US ENGAGE WITH US ENGAGE WITH US
Click here for more information about C4TS MSc courses.
Outreach Activities This summer the Trauma team has two public engagement events coming up. The first is part of Sevenoaks’ School Science and Digital Skills week (March 2-6). Last year, this annual event attracted over 12,000 students and we are happy to be invited back again.
(Above - starting from the top)
Julian-Dario Rembe “I am a medical student from Cologne who has joined C4TS’s international exchange program to work on the TACTIC study. I am interested in trauma induced bleeding and coagulopathy, soft-tissue damage including post-trauma infections, sepsis and wound healing. At the moment I am working on several in-vitro projects regarding wound healing.”
The second is the Big Bang Fest South East, an annual STEM event being held this year at the South of England showgrounds (June 30). Both events will see us take along our trauma mannequin which allows children to practice a ‘damage control surgery’ following a traumatic injury. We also have a ‘clotplunk’ which we use to talk about blot clots and clot breakdown. We’d like to incorporate a simple basic science-like experiment too so if anyone has any ideas I’d love to hear them! Please contact s.gillespie@qmul.ac.uk if you or your family would like to know more. ANNOUNCEMENTS
Thanks to the help of the C4TS public health and policy team, the UK’s National Emergency Medicine Dataset now includes the first comprehensive injury data collection Click here to find out more and to watch video recordings of the presentations. since 2002. Congratulations to C4TS’s Amy Bowes who won the coveted B Braun 2014 Undergraduate Research Prize for Neurosurgery. Amy’s research showed that Docosahexaunoic acid (DHA) is able to enhance neuroprotective microglia responses to injury. More information about our discoveries here can be found in our 2014 Summer edition.
Scarlett Gillespie “I joined C4TS after completing my PhD at Imperial College during which I looked at the effect of sulforaphane (a naturally occurring phytochemical) on leukocyteendothelial interactions with in the brain, as well as platelet aggregatory responses I was excited to join the group due to the investigations in TIC and the role that platelets played within this.” Susan Hibbert “I am a Research Database Assistant for the ACIT study. Its detail work but I love it! My job also involves lab analysis of patient samples recruited into the study from A&E and supporting the Clinical Fellows on-call.” ENGAGE WITH US Please do connect with us via our website (www.C4TS.qmul.ac.uk) and via Twitter NEW RESEARCH (@CommsC4TS).