LifeStories Magazine 2022

ISSUE 7

THE SHOWCASE MAGAZINE FOR WELSH LIFE SCIENCE 2022

The Welsh health sector making the connection between innovation and industry Innovation and collaboration in NHS Wales

Success stories from the Welsh life science industry

Forward thinking health research

SHOWCASING ADVANCES IN WELSH LIFESCIENCE

150 years protecting ideas

SHOWCASING ADVANCES IN WELSH LIFESCIENCE

Contents 6-15

Innovation and collaboration in NHS Wales 6 Using AI to reduce risks of out-of-hospital cardiac arrests in Wales

9 The Welsh Immunisation System plays pivotal role in Wales’ vaccination roll-out

12 TriTech Institute supports the innovation and development of new technologies in healthcare

7 Welsh heart research could find new triggers of heart attacks and strokes

10 Welsh Nursing Care Record - More time to care

14 Health Technology Wales

11 Your problem could be the next SBRI Innovation in Health

15 Supporting the adoption of innovation

8 New technology aims to deliver joined-up health and care in Wales

17-36

Success stories from the life science industry 18 Alpha Laboratories - Unlocking innovation in gastroenterology Diagnostics 19 Biophys Ltd - Supporting global life science from Wales 20 Bond Digital - Life after Covid: The future of lateral flow 21 Cansense - Revolutionary blood test set to transform the early diagnosis of bowel cancer 22 Cotton Mouton Diagnostics achieve accreditation for endotoxin testing service 23 Copner Biotech - Innovation in 3D cell culture scaffold technology 24 Creo Medical - Innovative treatment stopping bowel cancer in its tracks added to NHS Wales framework

37-52

25 Development Bank of Wales - Early stage seed funding and co-investment promotes opportunity and growth in Wales 26 eg technology - Product design & development: a guide for start-ups

31 Onya Therapeutics secures seed funding for wound care therapy 32 Open Medical - Digital midwife initiative 33 Pelican Healthcare wins prestigious international design award

27 EKF evolves medical device contract manufacturing in Cardiff

34 GX - Collaborating to combat UTIs and Covid

28 Forth - Female hormone mapping hormone intelligence at your fingertips

35 Sony - at the forefront of digital manufacturing technology

29 Kinsetsu - Empowering hospitals to locate oxygen cylinders during COVID-19

36 AliveCor - Keeping patients safe: antipsychotic medication monitoring using a pocket-sized six lead ECG

30 Objectivity - Improving patient outcomes with a remote cardiac monitoring solution

Forward thinking health research 38 Extensive Radiomics package helps HERO’s graphical programming environment for complex medical image analysis

43 Postpartum psychosis and bipolar disorder research establishes genetic difference for the first time

39 Agile Kinetic and Cardiff University Biomechanics Research Facility Collaborate to Validate AI Clinical Motion Analysis

44 USW specialists on community eye care research team

40 Dementia and the Welsh language 41 Quarter of home care workers in Wales sought mental health help during pandemic, study finds 42 Cycling down memory lane

LifeStories is produced and published by Teamworks for MediWales. www.teamworksdesign.com

45 New COVID-19 prediction tool utilises SAIL Databank 46 A year of impact - The Wales COVID - 19 Evidence Centre 47 Cardiff scientists awarded £230K grant to help unlock immunotherapy for men with prostate cancer

The Maltings, East Tyndall Street, Cardiff CF24 5EA Tel: +44 (0)29 2035 1453 Web: www.mediwales.com

48 Cancer patient benefits after routine clinical genomic data is used for research 49 The Future is Now! Working with RESCAPE to define virtual reality design healthcare standards 50 Pioneering more efficient and accurate 51 Breathing Innovation into lung health, wellness and wealth 56 SeRP, Swansea University’s data platform model hailed as future of health data research

Gwyn Tudor, CEO: gwyn.tudor@mediwales.com

Ella James, Events and Engagement Manager: ella.james@mediwales.com

Debbie Laubach, Operations Manager: debbie.laubach@mediwales.com

Katie Maxwell, Membership Manager: katherine.maxwell@mediwales.com

Thank you to our Partners

SUPPORTED BY WELSH GOVERNMENT

Welcome to the 2022 edition of MediWales Life Stories – the publication dedicated to sharing success stories from the Welsh health technology sector.

This edition of Life Stories has been published to coincide with MediWales Connects - NHS collaboration conference. This unique event is an opportunity for the patient facing health and care community in Wales to come together with industry and research colleagues to focus on innovation and collaboration. To share experiences, challenges and successes through presentations, exhibitions and workshops. Many of the teams behind the success stories featured in this edition will be presenting and exhibiting at MediWales Connects and will be on hand to discuss their projects in more detail on the day.

This edition of Life Stories is divided into three sections:

Innovation and collaboration in NHS Wales highlights successful projects completed

by NHS Wales Health Boards and Trusts. The Welsh NHS has a strong track record of working with partners from the third sector, industry and universities, resulting in many collaborative projects throughout the year.

Stories in this edition include the use of AI to reduce the risks of out-of-hospital cardiac arrests and a fantastic example of collaborative working to find new triggers of heart attacks and strokes involving Cardiff and Swansea Universities, Digital Health and Care Wales, Health and Care Research Wales and British Heart Foundation Cymru.

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Success stories from the life science industry

Forward thinking health research puts a spotlight on

demonstrates the success our members have had over the last year and beyond. We are always looking for ways to support our members and to showcase their successes.

Projects in this edition include; the rollercoaster ride to success for Bond Digital Health Solutions; a revolutionary blood test for the diagnosis of Bowel Cancer from CanSense; ground breaking work in 3D cell culture technology from Copner Biotech; advances in Female Hormone Mapping from Forth; and international award winning design from Pelican Healthcare.

the research and projects taking place within the Welsh research community, showcasing how universities work together with industry and health and care partners to undertake projects which will transform the future of our sector. Projects in this edition include; developments in medical imaging analysis from Cardiff University; work to highlight and address the Welsh language needs of dementia patients from Bangor University; an update of the work at the SAIL Databank at Swansea University; eye care research from University of South Wales and groundbreaking developments in prosthetics development from Cardiff Met.

Innovation and collaboration in NHS Wales I am pleased to see the excellent examples of innovation in this latest Life Stories publication. The pandemic has been, and continues to be, a true test of our health and social care system, but despite these difficult circumstances we have actively embraced and delivered transformation and innovation at pace in Wales. As we move ahead and learn to live with Covid-19 it is more important than ever that we are able to deliver high quality health and care. We must improve access to services through the use of new technologies and innovative ways of working and ensure that our plans have an emphasis on local economic growth, regeneration and community resilience in order to help address inequalities and the socio-economic determinants of health.

Whilst it is clear from the case studies in this document how the use of digital technology and research has enabled the continuation and progression of vital services, we have also seen changes in behaviours and increased collaboration and cooperation. By aligning our priorities and activities and pooling our collective knowledge we have had a greater impact in responding to challenges.

The scale of transformation that I have personally witnessed over the past two years, and the pace at which it has been delivered, has provided a real time demonstration of what is possible. It is important that we do not lose the innovative and impactful progress we have made. I am determined that we should continue to work across all sectors to harness the potential of digital and technology innovation and new ways of working together.

Judith Paget CBE Director General for Health and Social Services and Chief Executive NHS Wales

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Iechyd Cyhoeddus Cymru

Publiccollaboration Health Innovation and in NHS Wales Wales

Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust

HS Trust

Using AI to reduce risks of out-of-hospital cardiac arrests in Wales Artificial Intelligence (AI) is increasingly seen as an important tool that can help improve quality and efficiency of care in emergency medical services and the wider healthcare sector.

Within the United Kingdom, approximately 60,000 out-of-hospital cardiac arrests (OHCA) take place annually, and despite resuscitation efforts from NHS ambulance services, survival and hospital discharge figures currently range from 2.2% to 12%.

Despite being crucial, the evidence suggests that early recognition of OHCA by call takers within ambulance services is not achieved in around 25% of calls.

Corti, a Copenhagen based technology company, has developed an AI system to support and assist call takers with recognition of OHCA. The technology has already been implemented into ambulance services internationally.

The ASSIST study – which launched in December 2020 and is funded by the Assuring Autonomy International Programme within the University of York – aims to work with the various project collaborators, Welsh Ambulance Services NHS Trust (WAST), University of York, Corti, Human Factors Everywhere and Thimbleby Works, to adapt the existing Corti AI platform for use within WAST. This will include exploring ambulance service stakeholders’ understanding and attitudes towards the safety of using AI as a supportive decision tool in OHCA recognition and to create a clinical safety case for an AI decision support system.

The study consists of three work packages: Defining the real world - Work package 1 is research-based and includes semi structured interviews with employees within WAST, including call handlers, paramedics, call centre managers, IT staff, and risk and quality improvement managers. The aim of the interviews is to understand employees’ perceptions of AI in relation to training, effect on working practices, confidence in the safety of the system, interaction with users and potential barriers and enablers for adoption.

Development and safety assurance - Work package 2 is classed as service evaluation and consists of the development

of a safety case to determine the safety requirements of AI implementation.

This will be based on the evaluation of documents provided by Corti regarding the AI system, and analysis of the AI model (e.g., testing and inspection of the model).

Embedding into the real world Work package 3 contributes to best practice and standardisation for the safety assurance and regulation of AI products through stakeholder engagement. This involves engaging with stakeholders for the regulatory and ambulance service domains to build a community of practice.

www.ambulance.wales.nhs.uk

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Iechyd a Gofal Digidol Cymru Digital health and Care Wales

Welsh heart research could find new triggers of heart attacks and strokes A doctor from Rhondda Cynon Taf is investigating if there’s a link between patients having urinary tract infections (UTIs) and suffering a heart attack or stroke, in new research funded by British Heart Foundation Cymru. Dr Harry Ahmed is a GP and Senior Clinical Lecturer in Epidemiology at Cardiff University’s School of Medicine. He hopes the study could lead to better outcomes for patients in the future.

“When a person has an infection, the immune system responds in a way that could affect the circulatory system. These changes may increase the risk of having a heart attack or stroke.

Researchers previously found that the risk of heart attack or stroke is significantly higher following a respiratory tract infection like influenza or pneumonia. This work has led to a clinical trial where people leaving hospital after pneumonia will be given aspirin to see if it protects against heart attack.”

Dr Harry Ahmed GP & Senios Lecturer in Epidemiology School of Medicine Cardiff University

Dr Ahmed is leading a team of researchers at Cardiff University who have been awarded almost £220,000 by the British Heart Foundation (BHF) over three years to explore whether a connection can be made between patients who have been diagnosed with UTIs and an increased risk of heart attack or stroke. He adds, “Urinary tract infections are common but can be difficult to diagnose, particularly in elderly people, and can lead to significant illness and hospitalisation.”

Anonymised health information about patients in Wales can be accessed by approved researchers via the SAIL databank based at Swansea University, which stands for Secure

circulatory diseases. We urgently need the public’s support to keep our life saving research going, and to discover the treatments and cures of the future. It is only with donations from the public that the BHF can keep its life saving research going, helping us turn science fiction into reality.”

Adam adds, “We hope that by funding innovative research like Dr Ahmed’s, we will be able to identify those at risk of heart attack or stroke and prevent these life-threatening conditions before they happen.”

Len Drane, from Treharris, near Merthyr Tydfil, turned 60 on 7th January. He thought he was a fit and healthy, rugby-playing 42-year-old when he had a heart attack while playing golf in 2004.

Anonymised Information Linkage. The system is backed by the Welsh Government, funded by Health and Care Research Wales, and operates in partnership with NHS Wales’ Digital Health and Care Wales.

Dr Ahmed says, “Researchers will use the excellent data science capabilities of the SAIL Databank to link data from GP records, hospital admissions, and NHS laboratories, to investigate the link between urine infections and heart attacks or strokes, in more detail than ever before. If a link is found, it will pave the way for further clinical trials of treatments to see if these serious events can be prevented.”

In the 1960s more than 7 out of 10 heart attacks in the UK were fatal. For more than 60 years the BHF has funded life-saving research into the causes and treatments of heart and circulatory diseases, and today at least 7 out of 10 people who experience a heart attack survive.

Head of BHF Cymru, Adam Fletcher, says, “In Wales, as many as 5,000 hospital admissions each year are for heart attacks, that’s 1 every 100 minutes. The public’s generosity has funded BHF research that has turned ideas that once seemed like ‘science fiction’ into treatments and cures that save lives every day. But millions of people are still waiting for the next breakthrough.

“Today, in Wales, around 340,000 people are living with the daily burden of heart and

He was rushed to Caerphilly Miners’ hospital, where he spent five days before being transferred to Cardiff’s University Hospital of Wales to be fitted with a stent to help improve blood supply to his heart. The father of three then began rehabilitation which involved exercises to strengthen his heart.

He says research funded by the BHF helped save his life. “Anything which improves awareness and knowledge about the causes and treatments of heart attacks has to be a good thing. I am so grateful for the research, which meant I got the right treatment after my heart attack, and it’s wonderful to know that research taking place in Wales today could save lives tomorrow.”

Dr Ahmed says, “We are hugely grateful to the BHF for supporting this research, which allows us to capitalise on the substantial data science resources and expertise in Wales, to answer novel questions that could find new triggers of heart attacks or strokes and lead to trials of preventative treatments”.

The BHF has launched a campaign ‘This is Science’, calling for the public’s support to power science that could lead to new treatments and cures for all heart and circulatory diseases.

www.bhf.org.uk/this-is-science

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Innovation and collaboration in NHS Wales Iechyd a Gofal Digidol Cymru Digital health and Care Wales

New technology aims to deliver joined-up health and care in Wales NHS Wales is developing new technology that will support health and care providers to deliver joined-up health and care for patients and the Welsh public.

The Digital Services for Patients and the Public (DSPP) programme – set up by the Welsh Government and run by Digital Health and Care Wales – is creating the NHS Wales App, which will give patients and the public access to NHS services and information through their smartphones and tablets.

As well as developing the app, the DSPP is setting up additional technology services to support health and care providers across Wales wishing to develop their own digital services for the people they serve, faster and more effectively.

The programme aims to achieve this by developing core services, such as patient identity management services, user authentication processes, and communications tools (for example, text messaging services). Third party suppliers and health and care providers in Wales will be able to use these services to develop their own digital solutions, delivering significant benefits to people in Wales.

“The Covid-19 pandemic has created an opportunity for national digital services to work together with suppliers and local healthcare organisations to deploy digital services for patients across Wales, safely and securely. We want to give expert practitioners the tools they need to develop their own digital services, using their insight in particular areas of health. This will support them to deliver the best possible care to patients.”

Dr Sally Lewis Deputy Senior Responsible Officer for the DSPP National Clinical Lead for Value-based and Prudent Healthcare

www.dhcw.nhs.wales

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Iechyd a Gofal Digidol Cymru Digital health and Care Wales

The Welsh Immunisation System plays pivotal role in Wales’ vaccination roll-out Technology has a key role to play in helping Wales fight the COVID-19 pandemic, with the Welsh Immunisation System (WIS) at the heart of the response.

At the outset of the vaccination programme, Digital Health and Care Wales (DHCW) used its expertise and rapid development knowhow to build the Welsh Immunisation System. Designed to underpin every step of the vaccination process, the system was developed in-house and in partnership with the clinical community. Its aim was to reduce the administrative impact of the vaccination programme.

The system uses information on patient demographics, occupational groups and agreed priority levels for receiving the vaccination to allow healthcare professionals to schedule appointments for patients. It can create appointment slots, send out appointment letters and record details about each vaccination for every COVID-19 vaccine administered in Wales.

Hayley Gale, Immunisation Nurse Facilitator, spoke about her experience using the system during the first weeks of the vaccination programme:

to provide a clear picture of who has been vaccinated, where and when, plus how many people are currently booked in to be vaccinated.

“In the initial weeks there was just an awareness of the sheer volume of vaccinations we would have to get through. It only dawned on us later that we needed to keep a record and consider how we would do that. To have WIS and a computer system which took away paper filing and recorded information immediately all at our disposal removed a huge workload from us which otherwise would have been immense.”

He explained: “It was only once Wales started getting some esteem for the way we were delivering the programme in terms of where we were on first and second doses, that other countries from all over the world got interested - particularly our UK colleagues in Scotland, as well as others in Australia and Germany. They were interested in knowing how we can track where our vaccine is, how we do a stock take, and all the quality governance around vaccine control we had at our fingertips.”

Jeremy Griffith, Chief Operating Officer of NHS Wales’ Test Trace Protect (TTP) COVID-19 Vaccination Programme and Director of NHS Wales Delivery Unit, said that use of the COVID-19 data hub and WIS has helped his team make more informed, nationwide decisions throughout the pandemic. The COVID-19 data hub provides up to date vaccination data from all health boards,

By Spring 2022, over seven million vaccinations were administered in Wales with the support of WIS. The system remains dynamic, responding to the needs of healthcare professionals currently, with hopes to adapt the system for it to be used for other immunisations.

In March 2022 the system was honoured at the UK Digital Impact Awards, picking up the People’s Choice Award for its impact during the pandemic. It competed with 36 other national contenders in the People’s Choice category, including NHS COVID Pass, the UK Cabinet Office, Riverford Organic Farmers and the BT Green Tech Innovation Platform.

Following the award, Anne Marie Cunningham, Associate Medical Director at DHCW, said: “It’s been one of the major success stories that have emerged from the pandemic. Once you get vaccinated, your chances of dying of COVID-19 reduce by 80%. We were part of that, and we’re really proud of this achievement.”

www.dhcw.nhs.wales

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Bae Abertawe Swansea Bay University Health Board

Innovation and collaboration in NHS Wales Iechyd a Gofal Bwrdd Iechyd Prifysgol Digidol Cymru Aneurin Bevan Digital health University Health Board and Care Wales

Caerdydd a’r Fro Cardiff and Vale University Health Board

Bwrdd Iechyd Prifysgol Cwm Taf Morgannwg University Health Board

Welsh Nursing Care Record – More time to care Bwrdd Iechyd Prifysgol Betsi Cadwaladr University Health Board

Bwrdd Iechyd As health and care in Wales undergoes a Addysgu Powys digital transformation, nurses are taking Powys Teaching their place at the forefront of innovation.

Health Board

Bwrdd Iechyd Prifysgol Hywel Dda University Health Board

Iechyd Cyhoeddus Staff Nurse at Withybush Hospital, Stacie Cymru Hall, commented: “It’s better to capture all the Public Health information with the patient so you canWales go through everything in one go. It definitely saves time, and I think it’s better for patient care because it means we can spend more time with them”.

“We have improved the quality, safety and experience for patients admitted to our adult inpatient Over the past year, nurses across Wales have wards across five health boards swapped their clipboards and paper documents and Velindre Trust, through the for tablets and laptops, and are now recording Ymddiriedolaeth GIG implementation of the WNCR. This Ymddiriedolaeth Gwasanaethau Ambiwlans Cymru patient data digitally, through the Welsh Nursing There are also many benefits of the WNCR that is a significant point in nursing GIG Prifysgol Felindre Welsh Ambulance Services Care Record (WNCR). aren’t immediately visible to the patient. The Velindre University NHS Trust history – moving from paper to NHS Trust system’s ability to share patient information digital has enabled us to improve The digital system, delivered by Digital Health and instantly across wards and hospitals in Wales the compliance and completeness Care Wales (DHCW), - has transformed the way allows for smoother transitions between hospitals. of our adult inpatient assessments nurses record, store and access information. It Alongside this, reducing the scope for human error and nursing documentation allows nurses to complete an online assessment saves time, improves accuracy and minimises through the standardisation form at a patient’s bedside, saving time and duplication. and digitisation of nursing improving patient safety. information. We have much more Greg Dix, Executive Nurse Director at Cwm Taf Since its launch in spring 2021, the system has to do and look forward to the next Morgannwwg, declared that it’s been a ‘gamebecome the new way of working and nurses steps as we continue to develop the changer’ for the staff in both releasing time to report that they ‘can’t imagine what they did WNCR.” care and for the level of assurance that the system without it’. provides from an audit perspective.

Claire Bevan The ability to complete assessments at a Senior Responsible Owner Within its first year of inception, the Welsh Nursing patient’s bedside on a handheld device has taken WNCR Care Record was implemented in six different away much of the time-consuming paperwork health boards and 72 wards across 20 hospital and enabled them to place a greater focus on the sites, with full rollout scheduled for the end of 2022. patient experience.

www.dhcw.nhs.wales

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Your problem could be the next SBRI innovation in health Following on from their article in the last issue of Life Stories, the SBRI Centre of Excellence have wrapped up some of those projects and are now looking for the next set of challenges to take forward.

The SBRI Centre of Excellence would like to hear from you and the problems and challenges you face within Health. Their focus areas for this year include:

•

• • • • • •

Continuing to reduce the impact that COVID 19 has had on the overall health system Mental Health Cancer Preventative health Genomics Early diagnosis Giving patients the information they require

If you work in the Public Sector and have a challenge that you would like to discuss with the SBRI team, you can contact them at sbri.coe@ wales.nhs.uk or visit their website where you can read about previous and current projects: https://sbriwales.co.uk The Centre can take care of all aspects, including engaging key stakeholders, governance, administration and project management. For challenge owners who wish to be involved with project management, there is mentorship available if required.

Some recent projects include:

Simulation Training in Healthcare This project has now closed with solutions being developed using virtual reality platforms for tracheostomy training and other clinical training.

Paul Twose from Cardiff and Vale University Health Board said: “What has been achieved in a short space of time is incredible. The Covid-19 pandemic provided significant challenges to the traditional ways in which we provided education

and simulation training for tracheostomy skills.

Through this project, solutions have been designed that not only overcome the challenges, but also have provided insight to the future of healthcare education through the use of virtual reality. Working with the SBRI has been incredible, and I/we hope to do so again in the near future!”

Outpatient Transformation Two companies were taken through to Phase 2 and are now working with NHS Wales to develop and test their solutions.

The first solution is an app to support patients digitally through their disease pathway which will digitise the ‘see on symptoms’ process used by many consultants across different specialities and Health Boards, along with providing resources for self-care and monitoring symptoms.

The second uses an artificial intelligence platform to support pathologists to diagnose prostate cancer cases.

You can contact the SBRI Centre about any of these projects or to discuss your own challenges at sbri.coe@wales.nhs.uk.

www.sbriwales.co.uk

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Innovation and collaboration in NHS Wales

TriTech Institute supports the innovation and development of new technologies in healthcare TriTech Institute is a multi-disciplinary team of scientists, engineers and clinicians, facilitating and driving the development of innovative new medical technologies. During the past year, TriTech has worked on a number of clinical evaluation studies, consultancies and initiatives with Med Tech companies across the UK. The team uses an outcome-based healthcare approach to develop innovative healthcare technology solutions with partners and affiliates through the support of research, innovation and evaluation.

TriTech has continued to develop a number of important collaborations in the academic and commercial sectors and has recently developed additional memorandums of understanding with the Welsh Wound Innovation Centre and Welsh Institute for Digital Information.

Several projects are also funded through the Bevan Commission, Health and Care Research Wales (HCRW) and Accelerate.

For work carried out with Bond Digital Health on the development of an application to improve the management of COPD, TriTech Institute was recently awarded the Health and Social Care Research Partnership with Industry Award at the MediWales Innovation Awards 2021. Head of TriTech, Professor Chris Hopkins, said: “We are absolutely delighted to have won the Health and Social Care Research Partnership Award with Industry. Our congratulations to all of the award winners and thank you to MediWales, Health and Care Research Wales, Life Science Hub Wales, and all of the sponsors.”

The official TriTech Launch Event took place on 16th November 2021 and was well received, with a keynote speech by Dr Andrew Goodall, Permanent Secretary within Welsh Government.

The event highlighted the various collaborative partners and projects being undertaken by TriTech. TriTech offers a unique support service to clinical, academic and commercial health technology developers to support health technology adoption within the NHS.

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Project set-up and implementation at TriTech One of TriTech’s specialities is connecting industry and academic partners to clinical staff within the health boards in Wales. This helps to facilitate ‘realworld’ testing of innovative healthcare solutions and devices.

During project setup it is important to capture the client’s overall goals and objectives for any work that is to be carried out. The team handles this using a scoping process where they focus on understanding what is needed and how best to cater for their client’s needs. This could mean testing a new solution in its intended clinical

environment to inform updates or changes so that it is more fit for purpose, or exploring a specific area of healthcare to investigate what kinds of solutions would have the most positive impact.

A very important part of these early stages of a project is the buy-in or interest from practicing clinicians. A technology could be very well thought out and designed from an engineering perspective, but if the relevant clinicians don’t see a place for it in their practice, then finding out why is important. By structuring these ‘real world’ evaluations in this way. industry partners get the data they need to get their innovations into routine clinical care and clinicians have an opportunity to help shape upcoming innovations to better fit their needs.

Evaluation Case Study – Multimodal Prostate Cancer A.I. Every year in Wales, more than 2,500 men are diagnosed with prostate cancer and around 600 men die from the disease. JivaRDX is a diagnostic aid for prostate cancer that promptly highlights the existence of tumours on MRI scans. The tool enables radiologists to make more informed decisions faster. This reduces misdiagnosis, and therefore unnecessary treatment costs and complications, whilst creating better patient outcomes. Such an AI tool supports the post-COVID requirement for rapid outpatient turnaround. In this project led by Prof Chris Hopkins and Mr Sohail Moosa, working with JIVA.AI as the commercial partner and with funding from Moondance Cancer, TriTech Institute will demonstrate the first innovative deployments of JivaRDX within NHS Wales.

Another key aspect of these evaluations is the validity and integrity of results that are captured. TriTech work closely with their partners during projects, but also ensure that the results stay as true to real case results as possible. Capturing negative as well as positive aspects of any technology or innovation is important to help ensure its success in the long term.

Key results from the latest evaluation report show that the most reported benefits by patients were ‘lowered infection rate’ (94.2%) and ‘saved travel and parking’ (92%). Clinicians agreed with these benefits, but also noted other benefits such as ‘reduced waiting times’ (68.6%) and ‘more efficient use of their clinical time/space’ (74.8%).

TriTech Institute Health and Social Care Challenge The inaugural TriTech Challenge was recently conducted, with the aim of bringing health and social care professionals and academics together with digital and technology industry partners to solve challenges across the health care system in Wales. The challenge identified four different healthcare technology projects, each of which were

awarded £20,000, with the intention of solving key clinical challenges.

Through the TriTech Challenge, TriTech aims to support and accelerate the development and deployment of these new innovations with the aim of improving patient outcomes and experiences.

www.tritech.nhs.wales

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Innovation and collaboration in NHS Wales

Health Technology Wales Health Technology Wales (HTW) was established by Ministerial recommendation in 2017 to support a strategic, national approach to the identification, appraisal, and adoption of new technologies into health and care settings.

It is funded by the Welsh Government and hosted within the Velindre University NHS Trust but is independent of both.

Since being established, HTW has published 23 pieces of national guidance on health and care technologies which have the potential to impact 188,680 individuals each year in Wales.

The organisation now plans to significantly increase its evidence appraisal and guidance output.

Dr Susan Myles, Director of HTW, said: “We have ambitious goals to drive improvements in population health and social care services by continuing to support the identification, appraisal and adoption of innovative health and social care technologies in Wales.

“HTW continues to build on the strong progress it has made since 2017 and its partnerships with stakeholders across the health and social care sectors.”

Throughout 2021 HTW, continued to assess non-medicine health and care technologies and issued six pieces of national guidance, while also supporting Welsh Government in their response to the COVID-19 pandemic.

It was appointed a Collaborating Partner of the Wales COVID-19 Evidence Centre in March 2021 and since then has carried out a series of rapid evidence reviews and summaries on COVID-19 related topics that supported - policy decisionmaking during the pandemic.

Having set up a new working partnership with Social Care Wales in 2021, HTW has been working to better support the social care sector in Wales. Last year it published its first piece of

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social care guidance on START – a programme to support carers of those with dementia.

HTW continues to focus efforts on finding technologies to support the social care sector and launched its first social care topic call in March 2022.

The COVID-19 pandemic has led to a rapid acceleration in the adoption of digital technology within the health and care sectors in Wales. In response to this growing demand HTW will launch a digital topic call in 2022.

While its core work continues to focus on health technology assessment, in 2021 HTW commenced a pilot to audit the adoption of its guidance across Wales. This exercise will now be completed on an annual basis.

HTW continues to engage with stakeholders, both in the UK and globally, collaborating with international partners to create position statements for the International Network of Agencies for Health Technology Assessment (INAHTA).

Meanwhile HTW always strives to ensure that patient groups and those receiving and using care services are involved in the health technology assessment process through patient and public involvement (PPI) work.

“Our vision is to continue to develop a world-class HTA organisation that ensures that health technologies which have the most potential to improve the health and care of people and offer the greatest value are recognised and adopted in Wales. We look forward to continuing to work with our partners across the health and care sectors in 2022.”

Professor Peter Groves Chair Health Technology Wales

www.healthtechnology.wales

Supporting the adoption of innovation Innovating in life sciences can transform our health and social care systems and boost our overall quality of life, which can lead to economic growth. However, we all know this can be challenging due to many organisations and individuals being involved, complex processes and limited resources.

Life Sciences Hub Wales is here to help you overcome such hurdles by acting as a catalyst to drive innovation and collaboration between industry, health and social care partners. They work closely with health and social care colleagues to understand the challenges they face, then support industry in addressing them.

This is important within the current landscape in Wales as leaders look to invest in delivering life sciences innovation to improve health and economic wellbeing. The recent Programme for Government in Wales and their own work reflects this – focussing on creating effective healthcare, alongside building a sustainable economy supporting future industries and services. This is also recognised in the UK Government’s Life Sciences Vision, which discusses the importance of innovation in areas such as early detection and oncology.

How are Life Sciences Hub Wales supporting this?

The Life Science Hub Wales has defined their work plans to maximise this appetite for transformation. With prevention at its core, they will bring forward health innovations to support wellness and wellbeing, taking health and social care services closer to home, and supporting transformation in our secondary care infrastructure.

This is through our two priority areas, which reflect what people innovating across life sciences need:

Digital, AI and Robotics Continuing to expand digital infrastructure and services across healthcare can improve patient journeys and give staff technology that they value.

Their work focusses on digital health and social care including artificial intelligence and robotics.

This includes coordination and support of the Digital Solutions Fund, allowing the rapid piloting of digital technologies across Health Boards in Wales. One example was the Huma project, where patients with heart failure used remote monitoring technology to manage their conditions.

They also supported the establishment of the National Robotic Assisted Surgery Programme in collaboration with Welsh Government, the Moondance Cancer Initiative, Health Boards and CMR Surgical. This will provide minimally invasive surgery that is closer to home for cancer patients in Wales.

Precision Medicine Advances in genetics mean that clinicians can develop treatment plans that are the best fit for individual patients, resulting in more effective and fewer unnecessary treatments. Their work here includes early diagnostics, genomics, and advanced therapies.

They have supported this by hosting the ‘Innovation for Early Detection and Diagnosis of Cancer in Wales’ event with the Wales Cancer Network and Moondance Cancer Initiative. Here, experts, key opinion leaders and practitioners came together to explore trends, challenges and opportunities – opening the door to potential collaborations.

They are also convening innovators working across precision medicine to identify challenges and solutions to help progress the field.

How Life Sciences Hub Wales can help you The team provides bespoke support to accelerate all innovation journeys, whether that’s supporting a clinician with a need for an innovative product or service or facilitating partnerships with multinational life sciences networks and organisations.

Cari-Anne Quinn, Chief Executive Officer, Life Sciences Hub Wales

www. lshubwales.com/innovation-support

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Innovation and collaboration in NHS Wales

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Success stories from the life science industry

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Success stories from the life science industry

Unlocking innovation in gastroenterology diagnostics Alpha Laboratories is passionate about finding new ways to help science improve people’s lives through its evolving range of diagnostic and laboratory solutions. Over the past 45-years, Alpha has supported healthcare providers and innovators to modernise care pathways for the betterment of healthcare services and patients.

Get FIT Alpha Laboratories has worked alongside key opinion leaders on the development of new guidelines for faecal immunochemical testing (FIT), which is now a staple in lower-GI diagnostic pathways. The FIT-kit provides an efficient and convenient solution for patients to collect their sample at home with the testing device and post it back to the lab. At the MediWales conference in 2021, Alpha Laboratories won the prestigious Partnership with the NHS Award, in recognition of their collaborative work with the Clinical Biochemistry team at Cwm Taf Morgannwg University Health Board, resulting in the successful rollout of their FIT service.

Healthcare in the Patient’s hands Faecal calprotectin (FC) is a valuable biomarker in the assessment of inflammatory bowel disease (IBD), but during the pandemic hospitals reported reduced access to FC testing (Kennedy et. al., 2020). To continue effective management of these patients, the pathway needed to be reviewed and one option was to issue the sample collection device directly to patients.

The BÜHLMANN CALEX® extraction device is designed to simplify sample handling.

It provides convenient, hygienic and safe sample collection, and provides a quality, ready extracted sample for analysis in the clinic. By moving the extraction process to patients, strides can be taken to improve efficiency and patient care simultaneously.

However, fCAL testing can go further.

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IBDoc® allows IBD-positive patients to monitor their fCAL levels from home; with smart phone integration and clinic access portals, the patient and healthcare provider monitor the results and can act quickly. Feedback published by Jere, et. al. (2021) includes: ‘my son gets very anxious at hospital, so this kit is perfect to keep him happy’; ‘my daughter prefers it as it’s less messy, she’s in control and it’s a more private experience’; and ‘it was easy, I feel more comfortable’. It is clear that with faecal samples, it is possible to review a pathway to improve compliance, access and patient satisfaction without compromising the performance.

Logistics Underpinning innovation in healthcare is a robust logistics network: engaging with patients, home-testing kits, and distribution of products all depend on efficient logistics.

With the ShuttlePouch™ (manufactured by Shuttlepac™), a sample transport pouch,

winning the UK Packaging Awards 2021, home-sampling and testing is in a better position to support pathway development.

Easy-to-use, robust, and suitable for use in UN3373 mailing, the ShuttlePouch™ facilitates pathway changes and encourages patient engagement and compliance.

Sustainability Alpha Laboratories continues to work on improving sustainability through innovation in many working practices. From greener manufacturing and distribution, to supporting local schools and community projects, Alpha is keen to continue on the path of a more sustainable healthcare supply network.

www.alphalabs.co.uk

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Biophys Ltd – Supporting global life science from Wales Biophys Ltd is a Life Science mentoring and partnerships consultancy service based in South Wales, offering Life Science businesses the opportunity to work with an integrated team to achieve robust and reliable scientific business outputs. Biophys harnesses company culture through a mentoring approach to do things differently in the here-andnow and to sustain change in the future with resilient teams.

They have supported life sciences and biotechnology companies in Wales and beyond, proving that even with a modest team, their combined achievements around the globe really do speak for themselves. Biophys has reached many companies around the world, including Oceans in Canada, Enzimas SA in Argentina, the University of Copenhagen in Denmark, Fullhold Pharma in South Africa and Enzyme King in China. There are also a number of live projects which could have exciting results for all involved.

Non-traditional antimicrobials Biophys have been involved in a partnership with the University of Copenhagen and the Technical University of Denmark on the development of a new antimicrobial, Disperazol. It tackles old problems with new thinking, with Disperazol representing a promising new solution that disperses catheter associated UTI-causing Pseudomonas aeruginosa biofilms. This enables better health and also helps to slow down antimicrobial resistance (AMR), which poses a significant threat to public health, causing around 700k deaths worldwide every year. It’s been important to Biophys to be part of the movement to change this.

Alzheimer’s Disease Biophys is currently working with Academisch Centrum Tandheelkunde Amsterdam (ACTA) to investigate the links between inflammations in the oral cavity and Alzheimer’s disease.

Alzheimer’s disease (AD) is the most common cause of dementia, affecting one in 10 people aged 65 years or older. To date, the development of disease-modifying treatments has largely targeted one of its pathological hallmarks, amyloid beta (Aβ), and to a lesser extent tau, with notably high failure rates in clinical trials. Recent evidence from human genetics, neuroimaging and in vivo modelling has strongly implicated additional disease mechanisms in AD, not reflected by the established Aβ and tau biomarkers. These potential pathophysiological processes, including inflammation in the oral cavity, are less frequently targeted, and remain less well understood.

Pancreatic enzyme replacement therapy

Pancreatic Enzyme Replacement Therapy, which replace enzymes that the human pancreas would normally produce. This therapy is used when patients are unable to produce digestive enzymes and without therapy would not be able to extract nutrients from the food they eat.

Science in Parliament Published four times a year, the journal of the Parliamentary and Scientific Committee presents a comprehensive record of technology, engineering, mathematics and science within both Houses of Parliament. It focuses on issues where science and politics meet, demonstrating the relevance of scientific and technological developments, public interest and national policies. Biophys is extremely proud to be part of this publication, providing crucial research, content and intelligence for presentation to Parliamentarians and highlighting their expertise in life sciences.

Biophys have worked with a number of businesses globally, including Enzimas SA in Argentina and BBI Enzymes in South Africa, on

www.biophys.co.uk

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Success stories from the life science industry

Life after Covid: The future of lateral flow

From relative obscurity to worldwide recognition, the lateral flow test has been on quite a journey over the last two years.

The distribution of millions of these diagnostic devices during the pandemic has allowed asymptomatic people to test themselves for Covid-19 and helped the world to keep moving and working.

The tests have even been described by some as the unsung “heroes” of the pandemic for being affordable and easy to use and for providing rapid and accurate results.

Now the world appreciates the worth of lateral flow technology, test developers and manufacturers have an incredible opportunity to innovate to make it even more valuable.

Bond Digital Health has been on its own journey of growth since 2020, and at times their story has seemed intertwined with that of lateral flow.

During that time, working in challenging circumstances through several lockdowns, they developed and brought to market their flagship product Transform®, a unique data management system for lateral flow tests.

Bond have expanded their team, including building a new development team from the ground up, they have won several industry awards and received investment of more than £3m.

Fast forward to today and Bond have several international customers using Transform® with their tests and more in the process of signing up.

Now the team are on a mission to transform lateral flow and other point-of-care testing to make it fit for the future.

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Adding digital connectivity to a lateral flow test means you’ve immediately transformed a simple test into a powerful, real-time data-sharing system, enabling organisations and public health bodies to make faster, better decisions regarding deployment of PPE and medicines and vaccines.

Lateral flow test results and other subject data can be recorded easily and in real time without a reader.

End users get instant feedback and meaningful results through easy-to-use smartphone apps and desktop dashboards.

The usefulness and potential of lateral flow doesn’t begin and end with the pandemic, nor even with human infectious diseases.

This empowers them to make informed decisions, whether it’s an individual managing their own health or a farmer monitoring a disease outbreak in a herd.

Lateral flow already has many applications, including human health and wellbeing, animal health, food and drink testing, and agricultural and environmental testing, with innovative new applications being developed all the time.

And, with experts warning that Covid-19 might not be the last viral pandemic we see in our lifetime, such a system could prove invaluable to governments and health authorities when it comes to managing the next one.

The next obvious evolution of lateral flow technology is for test developers to really embrace digital transformation with data capture – and that’s where Bond comes in.

In fact, the next viral health challenge is already here – sexually transmitted diseases (STDs) are on the rise across the world, but in the USA they are at epidemic levels.

STD cases in the USA reached an all-time high for the sixth consecutive year in 2019, and there are fears that lockdowns and restrictions hampered testing efforts during the pandemic, meaning the current figures are now much higher.

A screening programme using digitally connected lateral flow tests to gather data could be of real value in this situation.

Test developers and manufacturers must now stop thinking of and marketing their tests as a “throwaway” technology, and instead realise their potential to become powerful diagnostic tools with multiple applications.

By using Transform®, they can turn that potential into reality.

About Bond Digital Health Based in Cardiff, UK, Bond Digital Health Ltd is the only company in the world offering bespoke digital products and services specifically for lateral flow devices. Bond is digitising an entire industry and helping with global efforts to decentralise health testing. Bond has developed Transform®, a readyto-go SaaS solution that allows lateral flow/IVD test data capture in real time. Featuring an app, dashboards and secure cloud storage, Transform® is fully regulated and compliant with medical device software regulations.

www.bondhealth.co.uk

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Revolutionary blood test set to transform the early diagnosis of bowel cancer A SIMPLE blood test that detects bowel cancer earlier – and improves the chances of survival for thousands of patients – is one step closer to being available on the NHS, after showing excellent results in a primary care trial.

The Raman Spectrometry (RS) blood test has been developed by researchers at Swansea University, led by Professors Dean Harris and Peter Dunstan, with funding from Cancer Research Wales and Health and Care Research Wales.

Support from Life Sciences Hub Wales has now enabled Welsh start-up business ‘CanSense’ to secure an additional £1.2 million from the National Institute for Health and Care Research (NIHR) to further develop the blood test to use in clinical practice across Wales.

Results from the ground-breaking study – involving 27 practices and 595 patients across West Wales – showed 79 per cent of early-stage bowel cancers and 100 per cent of advanced bowel cancers were picked up by the test. Early comparisons with other tests currently available in primary care have shown the RS blood test to have greater sensitivity for the detection of bowel cancer. It is hoped the non-invasive test will dramatically cut waiting times for diagnosis and reduce the need for invasive procedures such as colonoscopies.

Bowel cancer is currently the second leading cause of cancer death in Wales, with waiting times for diagnosis and treatment representing some of the longest in the developed world.

Sadly, many of the 2,200 diagnosed cases in Wales each year are detected at an advanced stage, like Lynda, 66, from Swansea.

Lynda said: “I was diagnosed with bowel cancer in June of 2021. I went to the GP with a small amount of blood in my stool and I was referred to the hospital for investigation. I didn’t have many symptoms. I am a very fit and active person, so I thought my weight loss was just down to being very physically active in the pool, gym, and on my bike. It came as a huge shock to me to find out I had 12cm of cancer in my bowel – and I needed immediate treatment to save my life. I believe by introducing blood tests like this we can save many more lives in the future and prevent late diagnoses of bowel cancer in the majority of cases.”

Lynda is now has a stoma and is cancer free.

Currently, a high number of unnecessary colonoscopies are conducted in Wales to ensure cases of bowel cancer are detected. Since the start of the pandemic, waiting lists for the procedure have significantly increased. The blood test CanSense is developing could change this

by providing accurate results within 48 hours, preventing unnecessary colonoscopies and relieving pressure on the NHS. Dr Cerys Jenkins, Co-founder and Director at CanSense, began research into Raman technology eight years ago when she was funded by Cancer Research Wales to complete a PhD at Swansea University.

Cerys – whose grandfather had bowel cancer – said: “The goal for this research has always been to translate it into something that fits into the existing patient pathway. Having this test available at the triage stage would save time and money, but most importantly would save the patients from anxiety and unnecessary diagnostic tests. My grandfather was diagnosed with bowel cancer 30 years ago, and he said the colonoscopy was the most humiliating experience of his life. And although we would never seek to replace colonoscopies as the gold standard in diagnostics, the Raman test could become an important tool in improving health outcomes across Wales.”

Adam Bryant, CEO and Business Founder of CanSense, said: “For the past eight years, our team has dedicated itself to creating something that we believe is as exciting as it is revolutionary. We now have a proven, rapid, and affordable test that can save thousands of lives. With continued collaboration and funding, we now have a clear path to making this test available to GPs in Wales and beyond.”

Funding secured via the UK’s NIHR with the support of Life Sciences Hub Wales will now allow the research team at Swansea to develop the test into a certified format to use in GP surgeries across the UK. The £1.2 million Invention for Innovation grant provides a roadmap for regulatory approval and product development to allow the test to be used within the NHS within 2 years.

www.cansenseltd.com

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Success stories from the life science industry

Cotton Mouton Diagnostics achieve accreditation for endotoxin testing service It’s been an exciting first half of 2022 for Cardiff-based SME, Cotton Mouton Diagnostics Ltd (CMD). Having secured an Innovation Loan from Innovate UK to complete the late-stage development and first batch manufacture of their endotoxin testing system, αBET®, CMD completed an investment round in April to enable commercial launch of the system and the establishment of a state-of-the-art, ISO accredited contact testing facility at their base in Greenmeadow Springs Business Park.

Endotoxin is all around, and it normally doesn’t pose a threat to human health unless it enters our bloodstream. Even if very tiny amounts enter our circulation, such an enormous immune response can be launched that it can be fatal. One way for endotoxin to get into our bloodstream is via the injection of medicines contaminated with endotoxin. It is therefore a regulatory requirement that medicines intended for administration via injection are screened for endotoxin prior to release. As the demand for new and innovative medicines grows, so does the endotoxin testing sector.

In addition to offering routine endotoxin testing, they are also able to carry out low endotoxin recovery studies as well as assay development and validation work for customers. The centre is a collaboration with the LAL division of FUJIFILM Wako Chemicals U.S.A. Corporation. FUJIFILM Wako manufacture the PYROSTAR™ ES-F line of endotoxin testing reagents, which provide best in-class sensitivity whilst ensuring no cross reactivity with other microbial contaminants.

CMD’s own endotoxin detection system, αBET®, will be launched later this year and will allow end-users to measure the level of endotoxin in samples in under half the time of existing assays without compromising on sensitivity and performance. Suited to both in-process and final product testing applications, the αBET® system utilises just a fraction of the reagent and sample volume of conventional tests, providing a sustainable solution to customers.

“We’re thrilled to have secured ISO 17025 and ISO 9001 accreditation for our endotoxin testing service.

The CMD team have worked diligently over the last 12 months to ensure that the service we offer is of the highest quality and to have this formally recognised via these accreditations is fantastic.

Collaboration with the FUJIFILM Wako team ensures a consistent supply of first-class testing reagents. We’re very much looking forward to growing the testing business and to providing our own solution to end-users later in 2022.”

Jenna Bowen CEO Cotton Mouton Diagnostics

CMD have secured both ISO 9001 and ISO/ IEC 17025 accreditation for their endotoxin testing centre.

The αBET® endotoxin testing system

www.cm-dx.com

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Innovation in 3D cell culture scaffold technology The benefits of 3D cell culture over conventional 2D culture are widely accepted in the scientific community.

Traditional 2D cell culture methods subject cells to an un-physiological architectural state. When cultured in 2D, mammalian cells assume a bipolar state with a basal and apical side. In order to tackle this unnatural morphology, cytoskeletal remodelling takes place and the subsequent ultrastructure of the cell is greatly altered. Cells cultured in 2D also have unlimited access to oxygen, nutrients and metabolites – which is not the case in their respective tissues in vivo.

Biotech use to produce these scaffolds enables nutrient and oxygen gradients to maximise cell growth. By developing better models for labbased testing, this allows us to develop better drugs and better models to understand different disease conditions, ultimately providing better treatments for patients.” – Dr. Aled Bryant.

Recent studies demonstrate the importance of discrete oxygen gradients in cell movement across the scaffold interface (Ardakani et al, 2014). Cells grown on woodpile structures typically have a heterogenous distribution, with cell population clusters common. By introducing a discrete oxygen gradient across the interface of their 3D PETG scaffold through bespoke design and fabrication,

Copner Biotech have successfully encouraged cell proliferation from the centre to the periphery.

The result is a more balanced system of cells on the scaffold, with confluency patterns like that of in vivo tissue.

The company have conducted a successful commercial launch across the UK and Ireland through their distributor, 2BScientific, and now look to expand further overseas in European, Middle Eastern and Indian markets over 2022 and 2023. Further to their game-changing scaffold offering, Copner Biotech have also built a reputation of working closely with customers in optimising their experimental workflows using their products.

These limitations ultimately mean those laboratories undertaking assays on cells in this unnatural environment yield less reliable results in vitro.

Established in 2020, Copner Biotech is a biotechnology company based in Ebbw Vale, with its focus on 3D cell culture and associated technologies. What started as an initial concept of next-generation 3D printing technology has gone from strength to strength, creating an impressive portfolio of technology, products and services for the 3D cell culture markets. In July 2021, Copner Biotech was presented with the Global Health and Pharma International Life Sciences Award for Innovation, for their work in 3D cell culture technologies – most notably, their method of fabrication of 3D PETG scaffolds, which has been shown to optimise cell capture and attachment whilst using low cell numbers for seeding.

Figure 1 - Scanning Electron Microscopy (SEM) images of L929 cells grown on PETG scaffold at day 7 (50K cells seeded at day 1). Cells demonstrate a successful migration from the centre to the periphery of the scaffold, creating a balanced, confluent cell system in the process.

In March 2021, the company embarked on a collaborative project with Swansea University Healthcare Technology Centre, funded by the Accelerate program. The project set out to validate Copner Biotech’s novel scaffolds in a biological setting, using human derived cells to conduct well-established assays followed by scanning electron microscopy to map cell motility.

Not only did the project confirm the scaffold’s superior ability compared to other polymeric lattices in encouraging cell proliferation, but it also demonstrated a unique ability to generate spheroids reliably.

Figure 2 - SEM images of dermal spheroids cultured on 3D PETG Scaffold. Fibroblasts and keratinocytes were cultured for 7 days, after seeding at 100K concentration on day 1. Spheroids were easily harvested from scaffolds by aspirating with pipette and showed reduced damage compared to methods of harvesting from hydrogel systems.

“The innovative element of this collaboration is, while there are different 3D models to grow cells on the market, the dedicated software Copner

www.copnerbiotech.com

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Success stories from the life science industry

Innovative treatment stopping bowel cancer in its tracks added to NHS Wales framework Speedboat Inject, Chepstow-based Creo Medical’s endoscopic alternative to traditional surgery in the bowel, has been added to the NHS Wales framework.

With its 5-in-1 functionality, and by using both advanced bipolar energy and microwave energy through a single power source, the device is able to remove pre-cancerous lesions in the bowel as a day case as opposed to a surgical operation. This means that those treated by Speedboat Submucosal Dissection (SSD) typically do so without the need for general anesthetic, without the traditional side effects or aftereffects of surgery, with better patient outcomes and with patients able to be treated far quicker - often leaving the same day.

This in turn has potential benefits to NHS hospitals, with cost savings of £10k per procedure compared to traditional surgery and associated freed up bed spaces, and reduced waiting lists.

The device, powered by Creo Medical’s multi-patented Kamaptive energy source, is already treating patients across the world and was recently also added to the NHS England framework – where it has been adopted by numerous hospitals.

It will now be readily available to NHS Wales healthcare providers, with Creo Medical opening up further training opportunities to satisfy the post-covid backlog.

Creo CEO Craig Gulliford said: “As a Welsh company with products which are having a transformative positive impact on the lives of patients across the world, it’s fantastic to see Speedboat awarded onto the NHS Wales framework, along with our supply of Interventional Cardiology, Radiology, Endoscopy and Surgical Urology Consumables.

“It’s a challenging tender process, made even more so by Covid, so it’s excellent to have secured this agreement across our key product ranges.

“We will now open up increased training and mentoring opportunities in the UK to facilitate the post-covid backlog of interest in Speedboat and associated SSD procedures and look forward to working with interested parties to help bring improved patient outcomes, cost savings and increased bed space to NHS Wales.”

It’s been quite a year for Creo Medical, having opened regional hubs in the US and Singapore; announced exciting partnerships; and advanced

Speedboat and various other devices used across the world. Their technology has the potential to lead a paradigm shift in the way many surgical procedures are performed and it’s fantastic to see the clear appetite there is for their products, and the Kamaptive energy source which powers them, globally.

www. creomedical.com

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Early stage seed funding and co-investment promotes opportunity and growth in Wales Out of adversity comes innovation and invention. The coronavirus pandemic has seen huge advances in the life sciences sector as start-ups are created and more established businesses pivot to develop innovative healthcare solutions that are helping to digitalise the industry and meet the urgent need to address early diagnosis and the backlog in patient care.

Here in Wales, very early-stage med-tech companies are accessing funding to help develop and exploit their technology. With entry equity investment of up to £2 million plus follow-on investments of typically up to £5 million, the Development Bank of Wales is working as a coinvestor with companies from startup through to IPO, or exit.

Cardiff-based Ceryx Medical is one of the latest health-tech start-ups to benefit from investment by the Development Bank. Early stage investment of £3.8 million by Icehouse Ventures, Parkwalk Advisors, Business Growth Fund, a consortium of angel investors and the Development Bank will be used to fund the first-in-human clinical study of Ceryx’s innovative cardiac rhythm management device, Cysoni, later this year.

over 20 years’ experience of technology transfer and venture capital investment including helping to set up an innovation fund at Swansea University that co-invested in exciting new spinout companies.

“Our investment in Ceryx is our first venture co-investment alongside the Business Growth Fund and it is a great example of how, as early-stage investors, our equity funding can make a real difference. As a co-investor, we’re not here to compete with the private sector. Our role is focussed on accelerating growth and enabling investment; giving institutional funders the confidence to back Welsh businesses safe in the knowledge that we’ve already completed the due diligence necessary to take a risk and start building investment readiness. As forward-thinking investors, we’re the catalyst to future growth so we’re very thorough in our approach.”

Mark Bowen Deputy Fund Manager Development Bank of Wales

The investment comes at a critical time for Ceryx as it seeks to capitalise on advancements it has made over the last two years. Following initial seed backing by the Development Bank, ParkWalk and angels in 2020, the company was able to accelerate preclinical evaluation of its technology, culminating in the results being published in a leading cardiology publication and positioning the company for progression into a first-in-human study.

Dr Richard Thompson is a Senior Investment Executive and founding member of the Development Bank’s tech ventures team.

He has held national and international roles in research and development, commercialisation and manufacturing. He works closely with Mark Bowman. He said: “There is a strong ecosystem in Wales – universities, incubators, hubs and finance all working together. We’re very much at the heart of it all; helping businesses to develop technology, scale and commercialise.

Dr Mark Bowman is a Deputy Fund Manager in the tech ventures team. He joined the Development Bank in January 2020 bringing

“Med-tech companies are choosing to set-up or relocate to Wales because of our unique support. Indeed, our previous equity

investments in Creo Medical are a great example of how we can support companies through multiple funding rounds. We helped them to set up in Wales and the company is one of five portfolio companies to list on AIM. Creo successfully raised over £20 million with its initial public offering (IPO) in December 2016 and has raised substantially more since then. We’ve since gone on to co-invest with Creo alongside other funders as part of a £1.5 million equity round and then a £4.5m equity round into IQ Endoscopes Ltd, who also relocated to Wales. That investment is being used to fund the development of the IQ platform - a range of single use flexible endoscopes which provide images of the full length of the gut, helping in diagnostics and therapeutic procedures.

“There is no doubt that Wales is a good place to develop and grow a life sciences business.

There is an exceptionally close knit ecosystem so connections and opportunities are easy to facilitate. There is also a large network of co-investors and angels with significant global experience who can help strengthen management teams. Just like any industry, it’s all about people and relationships.”

Dr Bowman added: “Our role is to help enable and bring innovation to the market. We’re taking the risk at an earlier stage than many other funders to help the sector to flourish in Wales. We’ve got a robust and exciting portfolio of companies with a pipeline of interesting opportunities that are proving to be of real interest to later-stage investors. The appetite is definitely strong so we expect this trend to continue.

“Fundraising is a journey and we’re here for the long-term.”

www.developmentbank.wales

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Success stories from the life science industry

Product design & development: a guide for start-ups The gulf between innovation and a market-ready product is vast and requires a deep understanding of engineering, human factors, market insight, regulatory requirements, and funding. But what key programme elements should start-ups incorporate to successfully navigate the complexity of product design & development?

A company which aims to streamline the route to market is eg technology, an experienced ISO 13485 accredited, product engineering design and development consultancy, who specialise in turning innovation into real, marketable products.

They aim to save clients the cost and complexity of sourcing, integrating, and operating a ’best

of breed’ solution, by using refined processes and knowledge of the development pathway.

Clients are allocated a project manager to map out the development pathway, so that each key step, from risk management and user research to supplier evaluations and process failure mode and effects analysis, is integrated and optimised.

Each programme should have a clear outline from the very start. A detailed list may include finding (or developing) the right technology, establishing the target market, working out the shape of the team that you will need to build, understanding the regulatory requirements, confirming the user needs, and raising finance.

Understand the competitive landscape and clearly define your USP. Freedom-to-operate, patents, designs and trademarks should be key considerations within your process, helping to drive the development forward. As with risk analysis, the sooner problematic patents and pre-registered designs are identified, the sooner these can be factored into your programme.

35% of start-ups fail as there is no (or insufficient) market need for their product (CB Insights). For a product to be successful, it needs to solve a common problem but be unique in its solution. Usability is about gaining early insight on the users, user tasks, interface, use scenarios and use environment across the product lifecycle and allows you to manage expectations and challenge assumptions within your development. Continuously testing and incorporating feedback into your process will result in a far better product, that addresses your users’ pain points.

There is always room for the unexpected to occur when developing a product, so it is wise to raise more funding than you need. Looking for funding sources through established sources such as accelerators, grant funding and angel investors will often yield success.

www.egtechnology.co.uk

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EKF evolves medical device contract manufacturing in Cardiff The COVID-19 pandemic presented a huge challenge to diagnostic businesses around the world. Within the space of a few months an entire industry was looked upon to develop testing methods that were quick, accurate and economical in the face of unprecedented demand.

One of the businesses who grasped this opportunity is Cardiff-based EKF Diagnostics. EKF saw its medical device contract manufacturing business grow significantly throughout 2020 and 2021.

Now, with changing needs for COVID-19 testing, EKF has had to evolve its contract manufacturing arm; not only with further applications for its novel microbial sample collection kits, but also with a broadened offering of its extensive in-house medical device manufacturing expertise.

During the COVID-19 pandemic, EKF expanded its UK operations into larger manufacturing facilities at Llandough Trading Estate, Cardiff.

This was to increase production of their PrimeStore® MTM viral transport media and sample collection kits, a key component for the COVID-19 testing regime. With the subsequent decline in COVID-19 testing, EKF has fused the experience it gained during the pandemic with its long-established reputation for diagnostic enzyme, reagent and custom product manufacture in the UK. This means EKF now offers a full wing-to-wing contract manufacturing service for UK-based medical device companies.

From its 2,000m2 manufacturing area in Llandough, which includes cleanroom facilities and warehousing, and also its R&D laboratory in Penarth, EKF now offers large-scale formulation, fill-finish and kitting; as well as full capability for marketing, commercialisation, regulatory and product development support.

“At the height of the pandemic we were filling up to 100,000 PrimeStore MTM tubes daily to meet an ever-increasing demand from the UK and EU. Although this demand has scaled-back, we’ve found a clear need for UKbased medical device contract manufacturing. Now the UK is outside the EU, many businesses wish to manufacture their products within the UK and are seeking local partners with the necessary knowledge and skills.”

Gavin Jones Managing Director, UK EKF

EKF is adding further skilled labour to its team in Cardiff, including chemists and formulation scientists. The team not only supports established companies with manufacturing and developing new markets for home test kits, for example, but also start-up companies looking to develop a new product.

One UK business making full use of EKF’s expanded services is ProtonDx, a point-ofcare molecular diagnostics company recently spun-out from Imperial College London.

Working closely with ProtonDx’s team, EKF has provided solutions and guidance navigating the tricky start-up landscape and ensuring top-tier products. Recently the partnership produced an RUO product for ProtonDx’s first client.

“EKF Diagnostics have been instrumental in our development as a company. Working above and beyond their remit to ensure the successful completion of our pivotal milestones, including our first RUO product. Meeting very timesensitive deadlines at short notice, they ensured we made it to the finish line,” said Elliot Quigley, Project Manager, ProtonDx. “Furthermore, EKF have been extremely receptive and adaptive to our evolving product, helping us every step of the way. This continual support is going to be extremely useful in achieving CE validation, and we have no doubt that EKF are going prove to be influential in us securing this.”

www.ekfdiagnostics.com

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Success stories from the life science industry

Female Hormone Mapping Hormone intelligence at your fingertips Dr Nicky Keay Chief Medical Officer of Forth

Hormones are key players in determining mental and physical health. Hormones can be affected by our lifestyle choices around exercise, nutrition and sleep.

Female hormones are the most complex out of all the hormone networks. Furthermore, female hormones change over a woman’s lifespan. Women have to balance exercise, work and family considerations to maintain healthy hormone networks to enable them to reach their personal best. Perimenopause is a challenging time for many women as ovarian hormone production winds down.

With increased life expectancy women may

live up to a third of their life in menopause when ovarian hormones are very low. This situation increases the risk of osteoporosis and cardiovascular disease, the latter being the main cause of death in post-menopausal women. Hormone Replacement Therapy (HRT) improves both quality of life and reduces risk of health problems.

However, the challenge is that women are individuals, with personal timing, concentrations and biological response to female hormones. Therefore, a personalised approach to female hormones is required to empower women to make informed decisions.

At Forth we have combined medical, mathematical and technological expertise through artificial intelligence techniques to provide female hormone intelligence at a woman’s finger tips. A woman takes a simple capillary (finger prick) blood test on day 14 and day 21 of her menstrual cycle and logs wellbeing metrics and menstrual cycle information. As soon as the second sample has been analysed in a UK accredited laboratory, graphs, explanation and advice are provided through a mobile App. The advice delivered is evidence-based and actionable. A woman can monitor the effects of recommendations by reassessing with a Female Hormone Mapping report every 4-6 months.

By using Female Hormone Mapping throughout her lifespan, a woman can build up her own personal evolving hormone fingerprint. This enables women to make informed decisions over their personal hormone journey about hormonal contraception, fertility and later about when to consider HRT.

Female Hormone Mapping is currently available for women. This innovative advance for female health has also been used in studies of professional dancers and football players. Further forthcoming use in research studies will provide more evidence for Female Hormone Mapping as a valuable clinical tool for women.

www.forthwithlife.co.uk

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Empowering hospitals to locate oxygen cylinders during COVID-19 During the pandemic, oxygen supply became an even more critical service than usual across the NHS, with supply within A&E, acute wards, ambulatory and community care being unimaginably stretched.

The global supply chain issues caused by COVID-19 only exacerbated the problem, leading to the supply of oxygen cylinders being constrained globally.

Cym Taf Morgannwg University Health Board’s key challenge was to understand the location and usability status of cylinders across hospital sites – a traditionally manual, labour-intensive, and timely process.

Rising to the challenge, Northern Ireland based Kinsetsu developed a solution to help track the location of oxygen cylinders across several hospitals in Wales.

Kinsetsu worked alongside key stakeholders at Cwm Taf Morgannwg (including R&D Lead Pharmacists, Clinical Procurement Leads, Clinical Engineering, Nursing and Porter teams) to create a solution that leveraged their existing RFID architecture, supplementing that investment with sensors to understand location awareness of cylinders within the estate.

Through Kinsetsu’s mapping and analytic platform, instant visibility of the location and flow of oxygen cylinders was enabled throughout Cwm Taf Morgannwg’s hospitals – both the Royal Glamorgan and Princess of Wales.

The solution’s sustainability was paramount, so instead of using throw-away RFID tags, the company selected durable and reusable plastic tags that could be re-coded for new cylinders, and provided an environmentally friendly method of attaching the tags to the cylinders.

The project was delivered across numerous phases, with initial meetings focused on requirements analysis and project definition, delivered in accordance with PRINCE2 guidelines.

Kinsetsu’s ground-breaking technology led to supply risks across both sites being greatly diminished, with cylinders now being located more quickly for patient use or for oxygen replenishment.

Time savings across services have also been realised, with potential risks to patient safety by mistaken utilisation of expired cylinders vastly reduced.

Instantly visualising where cylinders are on meaningful digital maps, combined with analytics highlighting how long cylinders have been in a location and where oxygen is approaching its use-bydate, has enhanced the service availability and greatly reduced risks of lack of supply.

“This has been a hugely significant project whereby we seamlessly connected physical assets to drive efficiencies for Cwm Taf Morgannwg, whilst simultaneously lowering patient risk. The fact we can deliver this critical service for assets that travel in and out of hospitals, throughout the community, and back and forth to oxygen replenishment companies, brings the Kinsetsu team a huge sense of pride.”

Mia Churchyard Business Development Manager Kinsetsu

.

www.kinsetsu.co.uk

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Success stories from the life science industry

Improving patient outcomes with a remote cardiac monitoring solution Objectivity Ltd. is a values-driven digital transformation partner with an excellent track record of supporting the UK healthcare sector with the development and delivery of innovative solutions.

Currently, the company is developing a bespoke cardiac home monitoring system for Alder Hey Innovation Centre. The “Little Hearts at Home” programme will be implemented across the Northwest Congenital Heart Network to improve patient experience and outcomes.

Approximately 1 in 1000 babies are born with severe congenital heart defects and require multiple stages of surgery to survive into adulthood. The initial surgery is performed within the first week of life, and the second one is typically carried out 4-6 months later. Alder Hey’s robust remote monitoring solution will enable real-time recording and statistical display of the newborn patient’s condition as they await the next stage of treatment. It will introduce a proactive and preventative model of care, allowing for timely interventions and providing better support to patients and their families.

The “Little Hearts at Home” solution will leverage a blend of mobile, remote monitoring, reporting, and cloud technologies to grant clinicians instant access to their patients’ critical data and enable informed decision-making.

In the ongoing project, Objectivity cooperates closely with Alder Hey’s and patients’ representatives to ensure excellent user experience, accessibility, and security. The solution will be interoperable with other healthcare systems thanks to standardised data architecture (FHIR).

The key features of the solution include digital communication channels, electronic documentation, and intelligent alerts for increased support to clinicians and contributing to better patient outcomes. The application will also help to avoid unnecessary admissions when patients can receive the required care at home, further supporting and considering the needs of the patient and their family. Enhanced monitoring and informed treatment planning will contribute to increased carer satisfaction and, it is expected, will enable more efficient use of resources. Furthermore, the designed architecture will allow the platform to be appropriately scaled to support other healthcare organisations in the future. It might even be possible to scale and spread the solution so that it serves patients nationally and supports Alder Hey Innovation Centre’s future research and technology initiatives as the IP is potentially licenced.

The project is making excellent progress, with the Discovery phase already concluded. The Healthcare Division of Objectivity has, at its core, a strong belief in supporting clients by delivering the Quadruple Aim of Healthcare. “We are

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excited to help Alder Hey support newborns and infants to receive proactive and preventative care closer to home. Alder Hey is looking to the future of care and how best to support children and their families. We are proud to be part of that journey and partner with a like-minded organisation that is so forward-thinking and values-driven,” says Andrew Smith, Director of Healthcare Services at Objectivity Ltd. The “Little Hearts at Home” programme is another initiative where Objectivity Ltd. teams up with a leading NHS organisation to deliver innovation to patient care. Recent examples of this include the cooperation with Health Innovation Manchester to create a digital platform that supports its Smokefree Pregnancy Programme — resulting in a reduction of participants’ smoking rate from 13% to 9%.

Objectivity Ltd. was also the Greater Manchester Combined Authority’s partner as they developed their award-winning Early Years app. These and other healthcare projects enable Objectivity Ltd. to employ its ethical framework and bring its technical capabilities to help healthcare organisations realise their vision.

www.objectivity.co.uk

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Onya Therapeutics secures seed funding for wound care therapy Onya Therapeutics, a start-up company based in Abertillery focused on enhancing wound care, has secured seed funding for the pre-clinical development of its first asset, OTX PP01. The company is engaged in building a pipeline of products that will improve patients’ quality of life, reduce the dependence on the use of antibiotics and address the issue of antimicrobial resistance in wounds.

A new therapy for challenging wounds The first product, OTX PP01, is a novel therapeutic patch, initially being developed for the Chronic wound market. Chronic wounds have a huge impact on the quality of life for both the patient and those who care for them.

The economic burden of wounds on the healthcare system is well documented, with an estimated £8.3bn spent by the NHS on wound care in 2018/2019.

In clinicians’ hands by 2024 The ability to tailor the technology will enable the development of numerous product formats that: l are active, and fit well with the standard of care (ultimately these therapies transforming the standard of care); l reduce harm to the wound from prolonged exposure to exudate; and l reduce the risk of infection, and/ or treat infection.

The therapies in development have applications across a wide range of wound types, including highly exudative chronic and acute wounds, trauma wounds, and malignant wounds.

The thin, flexible patch is suitable for use in all anatomical locations.

The secured funding will be used to advance Onya Therapeutics’ first asset through preclinical development to be ready for phase II clinical trials within 18 months. Trials will target both diabetic foot ulcers, due to their underlying risk of infection, and venous leg ulcers, to counteract the fluid dynamics and pressure these wounds can experience.

Future technology expansion will result in further therapeutic interventions that will enhance the standard of care of wounds and contribute to the scientific understanding of wound healing and infection.

With an exciting development pipeline, and secured funding to advance its first asset, Onya Therapeutics has begun its journey. In addition to the two positions already created, as the company continues to grow, further employment opportunities are anticipated.

The growth in antimicrobial resistance (AMR) has meant that treatment options are becoming more and more limited for clinicians, hence there is an urgent need for new therapeutics. OTX PP01 will seek to address this need.

The patch being developed will treat highly exuding wounds re-instating a moist environment, shown to be optimal for wound healing, whilst removing the conditions that microorganisms can thrive in, thereby decreasing the risk of infection. Patients’ quality of life will be improved as the patch addresses the issues associated with excess wound exudate such as skin maceration and heavily saturated or leaking dressings.

The technology has multiple clinical applications Onya Therapeutics’ patented technology re-purposes a known and safe compound, delivering it to the wound in a consistent, targeted and controlled manner.

www.onyatherapeutics.com

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Success stories from the life science industry

Open Medical - Digital Midwife initiative

the digital agenda, allowing maternity care to fully benefit from these digital initiatives.

These solutions are moving maternity care in the right direction, but more needs to be done in delivering safe and effective care.

Digital solutions not only need to provide staff with a full end-to-end care pathway following the entire pregnancy journey, but also enable clinical interventions should any complications occur. Many trusts are now moving towards paperless maternity notes, however there is still a tendency to use paper-based records, which bring about their own complications. Digital adoption takes away the inherent problems that come with paper record keeping, the most important improvement being patient safety.

Many maternity based digital solutions have already been launched, such as: The Royal College of Midwives (RCM) announced a new positioning statement to call for a Digital Midwife in every maternity service in the next 12 months. This initiative and drive by the Royal College recognises the significant importance of NHS-led maternity departments and the critical need to adopt digital solutions to deliver first-class care to expectant mothers and their families.

Hermione Jackson, Digital Advisor, Royal College of Midwives, recently said to HealthTech Newspaper: “For too long maternity services have been overlooked, passed over and generally left at the back of the queue when it comes to digital investment. Investing in digital technology and giving staff the training and equipment they need will lead to better care, regardless of where that care is delivered.

“There is clear evidence that more and better use of digital technology is supported by women, midwives, maternity support workers and other maternity staff. Improvements have been happening but at a snail’s pace and we need to see this move much more rapidly simply to catch-up with other areas of the NHS.”

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l The Birmingham Symptomspecific Obstetric Triage System (BSOTS) - created to provide a ‘standardised method of safely and efficiently assessing women’; and l Liverpool Women’s NHS Trust ‘My Pregnancy Notes’ - enabling all women to have access to their maternity notes online, including access to personalised care plan, appointment details, information, certificates and a notes section to include questions for appointments.

Delivering technology-based solutions to maternity units can help transform the way care is delivered and address some of the issues that have been recently reported. The positive measures and speed of technology adoption during the pandemic is a clear sign that the NHS is actively seeking to embrace technology-based solutions to deliver improved patient care. Now is the perfect time for the NHS to take forward

Rapid action is being taken to transform maternity services throughout the UK, with maternity services in England set to receive an extra £95.9m year on year, some of which will be allocated to help trusts digitise their maternity departments. The funding is in response to the Ockenden First Report which recommended seven immediate and essential actions needed to make maternity services safer, including issues focussed on informed consent and putting the voice of women and their families first.

A further £52 million is being invested in NHS maternity services to fast track its Long-Term Plan commitment to ensure that all women will have access to all of their maternity notes and information through a smartphone or other device by 2023/24.

Open Medical has recently launched its maternity pathway at Northwick Park Hospital, to help digitise the department and deliver a streamlined service to expectant mothers. For more information on how Open Medical can digitise your maternity unit, email info@openmedical.co.uk.

www.openmedical.co.uk

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Pelican Healthcare wins prestigious international design award a Smart Structure, meaning the pouch fills up uniformly, making it easier to wear; and a new Discretion Fold, allowing users to discreetly fold their pouch depending on their needs. Added to this is a new water-resistant fabric, allowing users to feel fresher for longer; and a new large viewing window, allowing users to monitor any potential leaks day or night. Lastly, a choice of colours to help users choose one better suited to them and their attire.”

These features reinforce Pelican’s core value of focusing on outcomes and doing things that make a difference to users.

Cardiff-based Pelican Healthcare Ltd, one of the UK’s leading manufacturers of disposable stoma products in the UK and Ireland healthcare markets, has won a prestigious iF DESIGN AWARD for its latest innovative ostomy pouch range, ModaVi. Launched in Germany in 1953, the iF seal signifies good design for consumers and the design community. One hundred thirty-two high profile design experts from over 20 countries made up this year’s iF jury panel whose task it was to find and award submissions with the greatest innovative power. A record number of 10,776 products and projects from 49 nations were registered for the iF DESIGN AWARD 2022.

The ModaVi product was judged on a wide range of criteria, including: its function and how it can be used so easily, how it’s made, its ability to support the user, what new components it possesses, and how it serves society.

Based on feedback and extensive insight from nurses and ostomates, the ModaVi range was developed to not only deliver clinical performance, but also with lifestyle in mind, a key component in

its award win. It has features that allow ostomates greater independence and more control of their day to day lives in line with Pelican’s values of ‘improving the lives of the UK ostomy community’.

ModaVi was three years in the making and resulted from significant investment, which included a million pounds on new machinery at Pelican Healthcare’s HQ in Cardiff. The range has patent protected features and was trialled extensively with positive feedback from ostomates and nurses.

The lifestyle approach is a game-changer within the ostomate market, and Stuart Welland, Chief Commercial Officer at Pelican Healthcare, believes this was crucial to the iF award success.

He says: “We are absolutely delighted to have won this highly prestigious award and for ModaVi to be recognised in this way. It has some unique design features which really make a difference to the end user and are crucial to its success, including

ModaVi was co-designed between the in-house design team at Eakin Healthcare and Kinneir Dufort, a product development consultancy based in Bristol. Commenting on the impact of the product, Sue Watson, R&D Director, said: “We are a leader in the healthcare sector, a trusted partner to our customers, constantly striving to deliver the best possible products and service through investment in R&D and engagement with our customers. The ModaVi range is a tangible demonstration of that approach and has our customers firmly at its heart.

“Its design was centred on challenging stigma, and making a difference to someone’s life, not allowing people to be defined by a stoma.

ModaVi provides the support, freedom and quality of life someone living with a stoma deserves. For the product to be recognised for its design qualities is really the icing on the cake.”

The ModaVi product also complements the #BeTheChange campaign which aims to educate the public and garner greater understanding of the needs of people living with hidden illnesses such as a stoma.

Part of Eakin Healthcare, Pelican Healthcare offers a wide range of innovative ostomy and continence products, including pouches, skin care products, support garments and other lines.

Through its sister company, Respond Healthcare, it provides prescription dispensing, home delivery and support services to the stoma and continence care community throughout the UK.

www.pelicanhealthcare.co.uk

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Success stories from the life science industry

Collaborating to combat UTIs and Covid

As a product design company with over 35 years’ experience, GX are experts at finding practical ways of solving problems.

The company is also a keen collaborator with the Welsh life science and health technology community, facilitated by MediWales. One such collaboration saw GX working with the University of South Wales and Llusern Scientific to develop a Rapid Point-of-Care UTI Tester Diagnosing Urinary Tract Infections (UTIs) in people and pets can be a time-consuming and costly process, involving sending multiple samples away to laboratories to diagnose the type of infection so that the correct antibiotic

“UTI is one of the most common bacterial infections worldwide, affecting at least 100 million people a year and causing approx.

5,000 deaths a year in England and Wales alone. Our mission is to revolutionise diagnostic testing with our high-performance, affordable and easy-to-use molecular technology.”

can be prescribed. The aim of this project was to make a device that’s fully portable, so that doctors’ surgeries, hospitals and veterinary practices can have access to fast and accurate onsite UTI testing.

Saving time and money through practical design Using the Rapid Point-of-Care UTI Tester, medical staff can now take a sample, run the test and, within 30 mins, diagnose the infection and issue the correct prescription. Shortening the process, from several days down to a single visit, and providing patients with a fast diagnosis reduces the risk of the infection worsening.

Six different samples can be tested at the same time or multiple different pathogens can be checked for in a single test. The accompanying app makes it quick and easy to view the results and data can be exported for analysis.

Until now UTI diagnostic equipment has been prohibitively expensive, costing upwards of £25,000. This Rapid Pointof-Care UTI Tester is available at a fraction of the cost and is compact and portable, making it accessible to individual medical and veterinary practices.

Innovation during a worldwide pandemic GX’s innovative and agile approach allows them to adapt products they’re developing to meet alternative uses. During the pandemic, the potential for adapting the UTI Tester for rapid Covid testing was recognised and development duly accelerated. The product proved to be highly accurate and received Covid testing validation. Major investment has also been secured on the back of the success achieved.

Jeroen Nieuwland, PhD CSO Llusern Scientific

www.gxgroup.com

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Sony - at the forefront of digital manufacturing technology Sony UK TEC has been at the forefront of cutting-edge digital manufacturing technologies for the past three decades, with almost 50 years of experience in South Wales. Through a varied portfolio of technology manufactured over the years, they have developed expertise in every stage of the product lifecycle.

As Europe’s flagship Sony site, Sony Technology Centre manufacture and service the highest quality professional broadcast and imaging products utilised in some of the world’s leading healthcare and sporting events, concerts, and news programmes.

In addition, a significant arm of Sony UK TEC’s portfolio is providing collaborative manufacturing services to businesses who require a manufacturing partner; providing end to end solutions, supporting manufacturing design, varying supply chain models, distribution for

worldwide sales and after-sales service whilst maintaining a highly competitive price point. The production of high-value, low-quantity products, as well as low-cost, high-volume products for third party clients are what makes Sony UK TEC’s strategy so unique.

created its very own Learning & Development Academy to attract, onboard, develop and engage current and future employees. Sony UK TEC considers its team members its greatest asset, and their knowledge, skill and expertise are what makes success possible.

Despite the implications of the COVID-19 pandemic, the manufacturing facility has continued to achieve targets and goals while meeting the demands of its customer base.

Innovation is not a stand-alone activity for UK TEC but is rather engraved in their DNA. This is reflected in their mid-range plan and the company ethos to continuously look for “new ways of working”, in everything they do.

Sony UK Technology Centre (UK TEC) is particularly proud of its role in developing specialists and leaders for the next generation which supports its ever-diversifying operation.

Their ability to adapt, innovate and embrace new technologies has never been so prominent given the challenges faced over the past two years, which is testimony to the agile, highly skilled and committed workforce at Sony Pencoed.

Outside of investment in equipment, new technology and innovative solutions, one of the most significant investments the company has made is in the development and upskilling of its team. In 2015, Sony UK Technology Centre

The company has also boosted its reputation in manufacturing. Out of over 40 Sony manufacturing sites across the globe, UK TEC was recognised by Sony HQ in Japan as the leader in innovation and selected to become the development laboratory for future work.

In addition to this, they were recently crowned winners of two prestigious awards for Innovation and Developing Future Talent at the Make UK National Manufacturing Awards. This combination of industry knowledge and continuous innovation practices allows the business to deliver products effortlessly, all under the same roof.

www.sonypencoed.co.uk

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Success stories from the life science industry

Keeping patients safe: antipsychotic medication monitoring using a pocket-sized six lead ECG Tees, Esk and Wear Valleys NHS

COVID-19 transmission for both parties.

Previously, monitoring was ordinarily done by a 12-lead ECG connected to the patient who is required to partially undress, have their skin prepared, and have ten separate leads attached.

Staff and patients have found the six-lead device less intrusive, as no clothing needs to be removed and patients can use the device themselves. The whole process lasts five minutes and the ECG can be sent instantly and electronically from the Kardia app to a clinician’s secure NHS email address to measure and report on the QTc immediately.

The team at TEWV (Dr M Santhana Krishnan, Consultant in Old Age Psychiatry & Senior Clinical Director, and Lauren Bennett, Innovations Coordinator) identified that the six-lead AliveCor device could be used to monitor patients in the community during the COVID-19 pandemic. Their patients include those who are on, or are to be started on, psychiatric medication and need to be carefully monitored for detection of potentially dangerous QT prolongation. A prolonged QTc can lead to a potentially fatal effect, called druginduced sudden cardiac death (DI-SCD).

The team has produced a user guidance document, ‘The Tees Remote ECG Pathway’, and a resource page which can be found at ahsnnenc.org.uk. Dr Krishnan ran webinars for staff and recorded a step-by-step video guide on how to operate, record and transmit the ECG safely following all the Trust guidelines. With support from NHSX, there are now 100 KardiaMobile 6L devices in use across community teams at TEWV NHS Foundation Trust and 40 in use across inpatient wards at Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust.

Foundation Trust (TEWV) have introduced the use of KardiaMobile 6L by AliveCor – the world’s only six-lead personal ECG device that health care professionals use to support patients in the community. This ensures that patients can be remotely monitored without going to a hospital setting, therefore reducing the risk of

The Academic Health Science Network for the North East and North Cumbria assisted throughout the project, offering advice and funding to test, roll out and scale up the pathway.

“The AHSN NENC was instrumental in the procurement and roll-out of the AliveCor KardiaMobile 6L device within our Trust. This is an excellent digital solution which has been rapidly deployed at pace and scale, providing our community teams with a device which reduces the risk of COVID-19 transmission. It is promising to see this has been extended to further Trusts in our region, so that NHS staff and patients can benefit from this unique technology and also the innovative pathway which was developed at TEWV.”

Dr M Santhana Krishna Consultant in Old Age Psychiatry & Senior Clinical DirectorTees, Esk and Wear Valleys NHS Foundation Trust

www.alivecor.co.uk

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Forward thinking health research

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Forward thinking health research

Extensive Radiomics package helps HERO’s graphical programming environment for complex medical image analysis “We are thrilled to have our SPAARC radiomics code operating seamlessly within one of the most intuitive graphical programming platforms on the market. We are making available to the research community our highquality radiomics algorithms integrated within a very powerful environment for advanced image analytics.”

Emiliano Spezi Professor of Healthcare Engineering Cardiff University

Personalised medicine is the goal of modern oncology and leads to improved patient outcomes by identifying those who are likely to benefit the most from treatment. Medical imaging has traditionally relied on visual interpretation to guide assessment; however, the emergence of artificial intelligence and big data has enabled a technological revolution. Advances in digital imaging and computing now allow for extracting many quantitative features, providing new opportunities for improved cancer detection and diagnosis. This very fastgrowing area of research is known as Radiomics.

Radiomics has emerged as an important translational endeavour, the goal of which is to uncover associations between the qualitative and quantitative information obtained from clinical images and clinical data, to support evidence-based clinical decision-making. The hypothesis is based on the premise that both morphological and functional clinical images reveal the fundamental pathophysiology of a presented disease. Radiomic analysis can be achieved in tumour regions, metastatic lesions, as well as in normal tissues. Instead of relying only on selective biopsies, determining phenotype by analysing the entire tumour is a clear clinical advantage. It is well recognised that phenotypic variability affects clinical outcome, therefore medical imaging in this context offers an efficient and non-invasive

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means to diagnose, stage and provide key prognostic insights that will inform therapeutic recommendations.

The Life Imaging and Data Analytics (LIDA) laboratory at Cardiff University School of Engineering, led by Professor Emiliano Spezi, has a long-established programme of medical image analysis techniques, including segmentation, texture, shape, intensity and wavelet analysis. LIDA is a founding member of the Image Biomarker Standardisation Initiative (IBSI), which works towards developing standardised radiomics algorithms and reporting guidelines that can make radiomics analyses reproducible and comparable. With the technical lead of Dr Philip Whybra, the team developed Spaarc Pipeline for Automated Analysis and Radiomics Computing (SPAARCRadiomics), a tool for multimodal quantitative image analysis incorporating 164 features all compliant and validated in accordance with the IBSI recommendations. Features include morphology, intensity-based statistics, intensity and intensity volume histograms, and grey level matrixes.

Hero Imaging is a spin-off company founded by imaging researchers at Umeå University Sweden. Its core product, Hero, is a sophisticated tool to perform advanced medical image analysis in a graphical “drag and drop” environment. It is used by researchers in Europe, USA, Asia and Australia performing research in several fields, including radiotherapy and radiology.

“Radiomics is a rapidly growing research field as the world looks for image-based biomarkers, and it is a tremendous opportunity for us to collaborate with one of the strongest research groups in Europe. This collaboration blueprints how we hope to bring our users novelties and rapidly expand our value offer to cover more research fields.”

Simon Lindgren CEO HERO Imaging

Cardiff University and HERO Imaging are now collaborating to commercialise the SPAARC-Radiomics package. The project is funded by Cardiff University’s Innovation for All Programme 2021-22. SPAARC-Radiomics will be released in summer 2022 as an optional application integrated in HERO and it will help accelerate the development of non-invasive imaging biomarkers and the implementation of personalised decision-making approaches at the point of care.

To know more about SPAARC-Radiomics, please contact Professor Emiliano Spezi, Cardiff University School of Engineering.

Email: espezi@cardiff.ac.uk.

www.cardiff.ac.uk/engineering

Agile Kinetic and Cardiff University Biomechanics Research facility collaborate to validate AI clinical motion analysis Across Wales there are growing waiting lists of patients requiring support with musculoskeletal (MSK) health issues. It’s thought that as many as 1 in 3 people are living with an MSK condition in the UK. Welsh company Agile Kinetic are addressing this demand, through their development of innovative digital technology to offer MSK rehabilitation services outside of traditional clinical settings. A small independent start-up, Agile Kinetic – based in Cwmbran – have a mission to make learning from movement accessible and sustainable.

Through their established Mobility Hub platform, Agile Kinetic, they aim to facilitate interaction between surgeons, physiotherapists and patients via a consumer application available for the patient to use on their smart device. Mobility Hub supports patients to undertake rehabilitation exercises independently at home. The interactive platform offers demonstrations of the personalised exercise and activity programmes set by the clinician, along with gentle motivation, progress and symptom tracking. This encourages patient engagement and promotes self-care – a significant improvement over the traditional approach which relied on printed leaflets and time distinct follow-up appointments. Mobility Hub saves time for both clinician and patient and promotes faster recovery as patient updates are available in real time.

The collaboration is providing validation of the AI tool to internationally recognised clinical standards using the research facility’s gold standard human movement laboratory. The parameters being tested have been agreed with physiotherapists at Cardiff and Value University Health Board to ensure that they deliver the information most required by clinicians. Whilst the work is currently focussed on supporting recovery from orthopaedic surgery, the digital assessment of human movement has thousands of use cases and widespread benefit in healthcare and related fields.

Agile Kinetics’ next development - the design of an innovative AI digital pose estimation tool.

This patent pending tool enables the remote measurement of patients’ movements using the video captured on a smart device camera. This digital assessment of the patients’ 3D movements will deliver real time patient feedback on performance, as well as provide the clinician with

relevant information, including key biomechanical measurements usually only available through face-to-face assessments.

The Accelerate support programme was established to facilitate and speed up the translational pipeline from the identification of healthcare needs, through to the delivery of evidence-based innovation. Accelerate is partfunded by the European Regional Development Fund (ERDF) through the Welsh Government and focuses on the delivery of innovative healthcare solutions driven by expert collaborations between clinicians, industry, academia, and the third sector. The Cardiff University Innovation Accelerator is one of four key partners, the others being the Life Sciences Hub, the Assistive Technology Innovation Centre ATiC (University of Wales Trinity St David) and the Healthcare Technology Centre (Swansea University).

Agile Kinetic are actively engaging with clinicians, health boards and medical companies seeking to innovate using their technology. More information can be found at https://www.agilekinetic.com.

The resources at the MSKBRF are available to clinicians, sports teams and businesses requiring biomechanical, clinical or physiological data.

Please get in touch to view or book the facility.

A new Accelerate funded project is enabling Cardiff University Musculoskeletal Biomechanics Research Facility (MSKBRF) to apply its unique research equipment and expertise to support

www.agilekinetic.com

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Forward thinking health research

Dementia and the Welsh language

People living with dementia that converse naturally in Welsh need to be supported to discuss their symptoms and feelings in their mother tongue. The 2011 Welsh Language measure finally gave equal status to both English and Welsh languages in Wales; however, there is only limited research into the experiences of native minority groups in terms of Dementia Care.

an update on policy and action in accordance with the recommendations from the Welsh speaker’s dementia care report, published by the Alzheimer’s Society Cymru and the Welsh Language Commissioner. Research in care homes by Dr Connor Martin and Angharad Higgins highlighted the importance of a shared culture and language to ensure that residents feel ‘at home’ and staff can provide the best care to meet their needs.

The Welsh Government have recently commissioned research to validate the Welsh language translation of the cognitive assessments. You can read more about why this is important and the stages ahead in the word transcript of presentations by Hanna Thomas and Dr Kathryn Jones.

A recent online event arranged by Dr Catrin Hedd Jones from Bangor University and The Centre for Ageing and Dementia Research (CADR) –and author of a briefing published by the National Assembly for Wales on access to dementia services for bilingual residents – shared the latest research work in this area. The event started with writer, Beti George sharing some of the personal experiences captured in a recent book ‘Datod’. Huw Owen shared

If you are interested in this work and would like to discuss this further, please contact Dr Catrin Hedd Jones on 01248 388872 or at c.h.jones@bangor.ac.uk.

www.healthandcareresearchwales.org

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Quarter of home care workers in Wales sought mental health help during pandemic, study finds The impact of the COVID-19 pandemic on the health of domiciliary care workers in Wales has been revealed in the initial findings of a study led by Cardiff University.

The research, unveiled in an interim policy report out today, found a quarter (28%) sought medical help or received treatment related to mental ill health in the first 12 months of the pandemic in Wales from 1 March 2020.

The findings suggest 12% of care workers tested positive for COVID-19. Low rates during the first wave up to August 2020 then rose sharply in the second from 1 September 2020, the study found.

The researchers analysed routine health data of 15,727 care workers and also interviewed 24 of them to build a picture of how Wales’ domiciliary care workforce fared during the last year.

“Our findings reveal the significant personal burden placed on care workers during the pandemic.

There are multiple factors at play – disrupted workforce organisation, staff availability, isolated working practices and uncertainties over work environments. It has been humbling to hear how care workers have adapted and risen to the challenge of supporting their clients during the pandemic. Our initial recommendations focus on how we can provide better care for our carers. Strategies to support individuals and teams are vital to address the emotional burden of pandemic working for carers and ensure continuity of care to clients. My concern is that this burden may be even greater and last longer than we have so far been able to demonstrate with the data we have.”

Professor Mike Robling Director of Population Health Trials Cardiff University’s Centre for Trials Research and principal investigator on the study.

One carer said the pandemic had been the “biggest challenge” the care sector had faced.

“PPE shortages, staff shortages, caring for individuals who have contracted the virus while also trying to keep yourself safe – it’s been a struggle,” said Sarah Edmunds, service manager for Radis Community Care in Newport.

“The mental health of staff was extremely underestimated. Staff have worked long, hard hours in full PPE, the only fresh air they got was when they managed to find a few minutes to step outside and take their PPE off.

“Staff were getting ill with minor ailments; however, these were knocking them off their feet for lengthy periods of time, they just weren’t recovering as fast as they used to, probably due to the exhaustion the previous year had caused them.

“Mentioning future possible lockdowns and restrictions has a massive negative effect on staff, just the thought of having to do all of it again is heartbreaking, but if it comes, we will be there, standing strong as a team as we always have.”

The policy report said mental health problems were recorded by diagnoses, medication or contacts and suggested “a high level of need during the pandemic”. However, it is not yet known if this represents an increase on prepandemic levels.

Interviews with care staff raised issues over the availability of PPE and testing, while strategies such as bonus payments, risk assessments and staff training were “sub-optimally deployed and insufficiently tailored” to the needs of carers, the report said. Carers said they remained motivated to support their clients but reported additional burdens, such as others also visiting or working in the client’s home, a pressure to work when not fully well, access to adequate childcare, and fears for themselves, their family and their clients related to COVID-19.

“While many people have been able to work from home during the pandemic, home care workers have been on the front line, providing help and support to some of the most vulnerable people in our society,” said Professor Robling.

“It is vital the issues raised are addressed at both an organisational and policy level to keep care workers safe and well, so they are able to continue helping those most in need.”

The study, led by Cardiff University, in partnership with Public Health Wales and Swansea University and supported by Social Care Wales, is funded by UK Research and Innovation.

The Centre for Trials Research at Cardiff University is core funded by Welsh Government through Health and Care Research Wales and Cancer Research UK.

www.healthandcareresearchwales.org

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Forward thinking health research

Cycling down memory lane Can you imagine the memories flooding back when you’re cycling down your childhood street or on a family bike ride on one of your favourite holidays?

Researchers at Swansea University are investigating the physical and cognitive benefits of cycling as part of their latest research project, BikeAround.

Lead researchers, Melitta McNarry, Kelly Mackintosh and Andrea Tales are using the latest technology to investigate the impact of memory cycling in care homes across Wales, with two ENRICH Care homes already onboard ready for delivery of their stationary bikes.

Participants will cycle on a stationary bike with a virtual reality dome projecting images from google maps of familiar places and childhood haunts.

Baseline health checks, including heart rate and the sit-to-stand test, will be conducted along with a series of survey questions for those who use the bike regularly and compared with those who don’t, to find out the overall impact on health.

“We know exercise has a whole host of benefits for brain function but coupling that with memories will be something really interesting. We are looking forward to starting the study and can’t wait to see it in practice.”

Professor Kelly Mackintosh, who specialises in physical health using technology, said: “This concept was something I initially heard about from Professor Ralph Maddison, who specialises in Physical Activity and Disease Prevention in Australia, and it tied in very closely with our work in Swansea University. We’re delighted to be collaborating with him on it.

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Deborah Morgan, ENRICH Cymru coordinator, said: “After the challenges of the past 24 months, the BikeAround study sounds like a breath of fresh air, to bring some fun back into the care homes.

“We already have two care homes across Wales on board, with residents looking forward to starting their journey. Those with cognitive impairments aren’t eligible at this stage, but we’re hoping to develop the study in the future.

for knowing whether this concept is feasible to improve health and well-being.”

“We’re planning to follow 10 residents, including those using the bike regularly, those who don’t get on with it, as well as social care practitioners, to learn about their experience. Knowing how people use it and their experiences is critical

Professor Melitta, who specialises in cardiorespiratory fitness, said: “Quality of life is often forgotten and there’s a stereotype that older people don’t like using technology, but that’s not the case.

“This study sounds perfect for both researchready care homes along with those who’ve never been part of research before. We’re looking forward to following the research project and supporting where possible to hopefully determine a clear impact and infiltrate change in Wales.”

www.healthandcareresearchwales.org

Postpartum psychosis and bipolar disorder: research establishes genetic difference for the first time Research Assistant Jessica Yang tells us about a new research paper on postpartum psychosis and its link to bipolar disorder, and the impact the research will have.

Published in The Lancet medical journal, the research, led by researchers in the Division of Psychological Medicine and Clinical Neurosciences at Cardiff University, has substantiated differences between postpartum psychosis and bipolar disorder for the first time.

Similar conditions, but different

postpartum psychosis had similar risk levels that were higher than the controls.

There are some differences as some women with first-onset postpartum psychosis are less likely to relapse.

But if we looked at risk for major depression, women with first-onset postpartum psychosis had similar risk levels to controls, yet were lower than women with bipolar disorder.

We therefore wanted to compare the genetics for these disorders to better understand their differences and similarities.

We compared women with first-onset postpartum psychosis, where postpartum psychosis was their first psychiatric episode, and women with bipolar disorder, who had a recurrence during the postpartum and a group of control women.

It’s caused considerable confusion for clinicians and women, with potentially negative consequences.

The UK study involved 203 women with first onset postpartum psychosis, along with 1,225 women with bipolar disorder who had given birth, and 2,809 control women from the general population who did not experience the conditions.We specifically looked at their genetic risk for schizophrenia, major depression and bipolar disorder.

We aimed to explore whether bipolar disorder and postpartum psychosis are as similar in symptoms, prognosis and risk factors as thought to be.

When looking at their risk for schizophrenia and bipolar disorder, women with bipolar disorder and women with first-onset

For more than 150 years postpartum psychosis has been shrouded in controversy, hindering research.

Establishing differences for the first time Our research suggests that postpartum psychosis may be partially genetically distinct from bipolar disorder with a postpartum recurrence, where these experiences were previously considered to be comparable.

In the past, researchers have shown that there are clinical differences between the two, but this is the first time these differences have been substantiated.

It suggests that there are different but overlapping biological mechanisms at work in the two disorders.

Research leading to better treatment for women This provides evidence to suggest that women with bipolar disorder who have a postpartum recurrence and women with first-onset postpartum psychosis may benefit from different treatment and management programmes.

We hope it will also help to raise awareness of postpartum psychosis and support its recognition as its own disease entity within the bipolar disorder spectrum.

In future research we’re hoping to expand on this study by collecting a larger sample of women with postpartum psychosis, collecting samples globally, as this sample was made up of people of European ancestry only.

We’re also hoping to develop assessment tools for postpartum psychosis which can be used in different countries and cultures, with the help of healthcare professionals and women with lived experience.

www.healthandcareresearchwales.org

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Forward thinking health research

USW specialists on community eye care research team In 2020, researchers at the University of South Wales (USW) joined a team investigating the value of monitoring chronic eye care conditions in the community.

Professor Carolyn Wallace, Dr Mark Davies and Rebecca Nicholls of USW are part of the team, leading on the qualitative research. Experts are also on-board from Cardiff University, Swansea University, Sight Cymru, Aneurin Bevan University Health Board (UHB), and Optometry Wales. Professor Barbara Ryan, who is an optometrist at Aneurin Bevan UHB, is the Project Lead.

Further collaboration also comes from the Macular Society, International Glaucoma Association, and the Wales Council for the Blind.

“Over recent years the workload on the hospital eye service in the UK has continued to expand beyond the capability of the available workforce,” said Prof Wallace.

“Since 2017, ophthalmology has had the highest number of outpatient episodes of any speciality in the NHS.” A number of novel approaches to managing this has developed across the UK. Wales has primarily pursued improvements in training of primary care optometry.

“Optometrists are eyecare professionals that can work within the hospital environment, but more commonly work within the community providing eye examination services,” Prof Wallace added.

“Further training and qualification have allowed these primary care healthcare professionals to begin to provide services in the community that have historically been provided in the hospital setting.

“However, what services are provided and where are, at present, variable across the region. One reason for this variability is the lack

of quality evidence to support the best a pproach to take.

“Therefore, this group, H2C Co-Lab Cymru (Hospital to Community Collaboration Cymru), has developed this project to better inform decisions taken at health board and Welsh Government level.”

The project aims to define the “value” of community optometrists managing, in the community, the common sight-threatening eye conditions of Age-Related Macular Degeneration and Glaucoma.

It will not just focus on financial value, but have a patient-centred focus on the right management, in the right place, at the right time.

www.healthandcareresearchwales.org

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New COVID-19 prediction tool utilises SAIL Databank New research offers an external and independent assessment of the first QCovid prediction tool used to estimate the risk of a person being hospitalised, or dying from COVID-19.

scientific research. It is also crucial for validating prediction systems that use routine data, where the results may be used to plan clinical management of individual patients.

Building on previous research, this latest study provides an important contribution as to the validity of the QCovid tool to predict the inherent risks of COVID-19 across the UK and its possible application to other populations.

The study was designed to evaluate the validity of the original QCovid algorithm for COVID-19-related deaths in the Welsh adult population.

QCovid’s development was led by Oxford University in early 2020 and was subsequently used by the National Health Service (NHS) to identify high-risk individuals for the shielding programme and later for vaccine prioritisation.

These findings helped guide risk management decisions and target vaccination and treatment programs for the most vulnerable individuals in society. The researchers are in the process of conducting further analyses to determine the validity of the latest QCOVID models in predicting hospitalisation resulting from COVID-19 infection and the effects of the vaccine programme in Wales.

The latest study, which uses Welsh population data to validate QCovid, was led by the Population Data Science group at Swansea University, Health Data Research (HDR) UK, in collaboration with teams at the universities of Oxford, Edinburgh, and Leicester, as well as the Office for National Statistics. It was funded by HDR UK and the Medical Research Council.

The team used anonymised, individual-level, population-scale data held in the Secure Anonymised Information Linkage (SAIL) Databank.

This included all individuals aged 19 to 100 years, living in Wales on 24th January 2020 (the date of the first confirmed COVID-19 case in the UK) and registered with a general practice (GP) contributing data to SAIL. The SAIL Databank contains electronic health record (EHR) data from approximately 83% of all GPs in Wales. SAIL achieves this through a partnership with NHS Wales’ Digital Health and Care Wales (DHCW), acting as a trusted third party, enabling the data anonymisation and transfer process to SAIL. The researchers studied the data retrospectively in SAIL using robust statistical analysis methods. The team evaluated and determined that the QCovid prediction tool has a high degree of accuracy for the Welsh population.

This was achieved by analysing the number of COVID-19 deaths attributed to each influencing factor used in the QCovid model for the population of Wales; for example, age, ethnicity and the pre-existence of health conditions, amongst other factors. By studying data in this way, pooled together from an anonymised individual-level, the team could compare the real-world risks

of COVID-19-related deaths with the QCovid prediction tool.

This study of the Welsh population replicates a recently published study validating QCovid in 35 million adult residents of England by the Office for National Statistics.

The availability and use of the SAIL Databank was important in this study. It provided a populationscale health data source that was independent of the original study population in England, used in QCovid’s initial validation. Being able to repeat the study and achieve similar results in diverse populations is an important component of

HDR UK Wales and Northern Ireland Research Officer & Data Scientist, Jane Lyons, who led the research, said, “Validation studies are an important part of all research, and we have been able to show that the original QCovid models predict COVID-19 deaths in the Welsh population as effectively as they have in the English population.

This study is a great example of a collaborative team science approach across multiple organisations in the UK. Following on from this study, we are currently in the process of validating the updated QCovid risk prediction algorithms in estimating the risk of COVID-19-related deaths and hospital admissions in Welsh adults following one or two doses of COVID-19 vaccination.”

SAIL Databank’s co-director and QCovid coinvestigator, Ronan Lyons, said, “This study highlights the importance of the SAIL Databank in assessing the relevance and validity of algorithms developed in England and other countries to the Welsh population. The results were fed to policy makers in the Welsh Government COVID-19 Technical Advisory Group and have helped to influence policies designed to protect the Welsh population.”

www.healthandcareresearchwales.org

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Forward thinking health research

A year of impact - The Wales COVID-19 Evidence Centre The first research centre of its kind in Wales to provide evidence that helped ministers make critical decisions during the pandemic will mark its first anniversary this week.

Analysing essential evidence The £3m Wales COVID-19 Evidence Centre was established by the Welsh Government in March 2021 to analyse crucial scientific research to help tackle some of the emerging health and social care challenges created by COVID-19.

The Centre provides rapid reviews of key international research findings as well as focused research studies to guide decision-making by ministers, and leaders in the NHS and social care sectors.

Its work will be showcased at an event attended

by First Minister Mark Drakeford, and Judith Paget, NHS Wales Chief Executive and Director General for Health and Social Services.

Making an impact In the last 12 months, the Centre has completed 25 reviews, compiling research on topics such as vaccine uptake in disadvantaged communities, the mental health impact on key workers, and the effectiveness of face masks – a significant review which underpinned the Welsh Government’s advice to keep face coverings on public transport, in shops and in health and social care settings.

The Centre’s review of disinfectants and ventilation in schools led to targeting of resources towards carbon dioxide monitors to assess the effectiveness of ventilation, and these are now a key part of day-to-day protection in schools.

Most recently, the Centre provided evidence about vaccine safety during pregnancy to support Public Health Wales in its campaign to encourage pregnant women to have the vaccine after it was revealed that vaccine uptake in pregnant women was low, contributing to increased hospital admissions.

The Centre is led by GP and Cardiff University academic, Professor Adrian Edwards, whose core team works closely with collaborating partners such as Health Technology Wales, Wales Centre for Evidence-Based Care, Specialist Unit for Review Evidence, SAIL Databank, Bangor Institute

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for Health & Medical Research, Health and Care Economics Cymru, and the Public Health Wales Evidence Observatory.

Director of the Wales COVID-19 Evidence Centre, Professor Adrian Edwards He said: “All of these issues matter greatly to us, and we are really pleased to have been able to provide the best evidence available to support Welsh Government, Public Health Wales and others in good time to inform the decisions they make to manage them to help us all.

“Going forward we are looking at how government, through research, can help groups in society who may have been especially affected – women, disabled people, the LGBTQ+ community, people who are homeless or in prison, people with long COVID and ethnic minority staff in the NHS. “Both for Long COVID, and more generally, we are also now starting a programme of new research studies. Building this directly on our evidence reviews is a major development of the Wales COVID-19 Evidence Centre for 2022, which will be a first for Wales among the COVID evidence centres around the world. I’m proud of the work of the team and the contribution we have made to address some of the serious challenges posed by the pandemic.”

First Minister Professor Mark Drakeford He said: “Scientific research and data are vital tools to enable us to make informed decisions about how we tackle some of the most challenging issues we face as a result of the pandemic. The Wales COVID-19 Evidence Centre has played a crucial role in providing the evidence to support decisions made by the Welsh Government and will continue to do so as we support our communities to tackle the farreaching impacts of COVID-19.”

Director of Health and Care Research Wales, Professor Kieran Walshe He said: “The Wales COVID-19 Evidence Centre has focused on how COVID-19 has changed the health and care sector now and in the long-term and it brings together the key research that helps us understand the pandemic now and for our future decisions in the recovery phase.

“Ending the pandemic relies fundamentally on research delivering solutions to diagnosis, treatment and prevention, and I am really grateful to Professor Edwards and his team for the work so far in addressing some of the far-reaching impacts of COVID-19.”

The full work programme, including published reviews to date, can be found on the Health and Care Research Wales website.

www.healthandcareresearchwales.org

Cardiff scientists awarded £230K grant to help unlock immunotherapy for men with prostate cancer The team, led by Professor Aled Clayton, have received a grant worth over £230,000 to help them pinpoint which men could benefit from powerful new immunotherapy treatments. The grant is part of £1.7m that Prostate Cancer UK has awarded to five projects across the UK. Immunotherapies have been very effective in treating other forms of cancer, but to date have had limited success in men with prostate cancer.

To overcome this, Professor Aled Clayton and his team will use state-of-the-art technology to map out the immune cells present in prostate cancer tumours, and identify molecules released by the cancer that can stop these immune cells from working.

By studying samples from different stages of the disease, the researchers hope to understand how prostate cancer affects the immune system over time, so they can find

better ways of predicting and monitoring men’s response to immunotherapy.

Professor Clayton, based at Cardiff University’s School of Medicine and the Wales Cancer Research Centre, said: “Prostate cancer cells release small packages of molecules into the blood which can block immune cells from attacking them. We aim to develop new methods to identify these packages, so we can gain a clearer understanding of why some prostate cancers respond to immunotherapy and some do not.

“In the future, we hope this could lead to blood tests which could check whether a particular form of immunotherapy is likely to work or not.

This would help to ensure men are receiving the best possible treatment for their cancer.”

Prostate cancer is the most common cancer in men and kills one man every 45 minutes in the UK.

“Immunotherapy has revolutionised the treatment of many types of cancer, but so far this approach has only been successful in small numbers of men with prostate cancer. That’s why we’re investing over £1.7 million in research to accelerate progress in this field and help develop more effective treatments for men diagnosed with prostate cancer.

Funding innovative studies that tackle prostate cancer from new angles is vital to stop so many men dying from the disease. We look forward to seeing how Professor Clayton’s project progresses over the next few years and the difference it will make to men’s lives.”

Simon Grieveson Head of Research Prostate Cancer UK

3d illustration of T cells attacking cancer cells

www.prostatecanceruk.org/research

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Forward thinking health research

Cancer patient benefits after routine clinical genomic data is used for research A cancer patient in Wales, who had not reacted well to the standard cancer therapy, was facing a situation of having very limited treatment options available to them. Analysis of their cancer’s genomic data provided a new avenue of treatment. Just before Christmas 2021, they were able to be recruited to a clinical trial for a new targeted therapy. Their latest imaging tests have shown that the cancer has shrunk in response to this new trial treatment. This is an excellent example of personalised treatment and highlights the value of genomics in improving care for cancer patients.

In 2019 the patient had received cancer surgery through the NHS in Wales after being diagnosed with colorectal cancer. They had gone to their GP

with symptoms (of bleeding from the rectum), who referred them for endoscopy, which was used to confirm the diagnosis. They received chemotherapy but experienced an adverse reaction to the drug, meaning they had to stop receiving the treatment. Unfortunately, the patient had a relapse and the cancer spread to their lungs. A different chemotherapy treatment was unable to stop the disease progressing, leaving very few treatment options available to them.

At this point, Wales Gene Park, working with the clinical genomics diagnostic lab in Wales (All Wales Medical Genomics Service) and the NHS clinical oncology team, analysed stored genomic data to identify patients potentially eligible to participate in a clinical trial for a new targeted cancer therapy.

The clinical trial is testing a new drug that specifically targets a rare genetic variant present

in less than 5% of all colorectal cancers. Analysis of the patient’s cancer genomic data identified the required rare gene variant that meant they could take part in the trial. They started treatment as part of the trial, and recent check-ups have shown that the treatment appears to be working at these early stages.

This case demonstrates how reanalysis of clinical genomic data can lead to the identification of rare genetic variants which can sometimes enable patients to join clinical trials. In doing so, this allows the possibility of providing more personalised treatments that have the potential to improve outcomes for cancer patients.

www.healthandcareresearchwales.org

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The Future is Now! Working with RESCAPE to define virtual reality design healthcare standards Associate Professor Joanne Davies, Director of Simulation Education, Faculty of Medicine, Swansea University has been working in collaboration with academic, clinical and industry partners on an innovative VR (Virtual Reality) healthcare training platform.

The project, funded through Cardiff Capital Region’s challenge fund, used a collaborative approach to develop 3 education modules, using VR technology, for the care of patients with a tracheostomy, a bronchoscopy session, and the insertion of an intercostal drain.

The team, from Rescape, Swansea University and the SBRI worked alongside clinical specialists led by consultant therapist Paul Twose (Cardiff and Vale UHB) and Dr Craig Dyer (University Hospital of Wales) who created the content for the modules.

The team’s approach was to ensure high standards of educational design principles, but also go beyond the idea that this was mainly an individual skills training platform and embed what has been learned from many years of simulationbased education. The project used a combination of 360-degree video technology and avatar designed education sessions.

Part of the SBRI project was to evaluate the modules across 3 healthcare sites, Cardiff and Vale University Health Board, Aneurin Bevan University Health Board and Cwm Taf Morgannwg University Health Board. Part of this process was to ensure that the clinical education leads had orientation opportunities and felt comfortable using the system in order to support the implementation which was driven by Paul Twose and his team.

Paul Twose - “The coronavirus pandemic causes significant challenges to the way that we delivered tracheostomy education, at a time where more patients than ever required a tracheostomy, staff were redistributed to unfamiliar clinical environments and the health service was under unprecedented pressure. We have demonstrated that virtual reality has the potential to not only overcome those challenges, but to augment and improve existing training making it more immersive and accessible to all staff across NHS Wales and beyond.”

Key findings l Over 97% of the interprofessional learners felt that VR was an educational tool that could impact patient safety and was an effective tool for healthcare training. l Novice learners to VR adapted to the system well with an average of just two attempts before the team members were independently adopting the training. l 100% of learners felt that training in a VR setting is an effective team training method for a range of clinical roles. l The team also learned valuable lessons in the way materials were presented and improvements that can be adopted for the platform. The need for orientation and support for early adopters to VR technology was key to a successful implementation to ensure valid and meaningful learning opportunities. l To the team was the real need for adoption of this form of education into curriculums and healthcare systems with larger scale analysis of the effectiveness and impact to help to solve a real-world problem regarding the amount of training that is required across all healthcare systems.

www.rescape.health

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Forward thinking health research

Pioneering more efficient and accurate digital prosthetics through computer-aided technologies Maxillofacial Prosthetists, Reconstructive Scientists and Dental Technicians are dedicated to reconstructing head and neck, and body defects following trauma, disease or congenital abnormality. Blending art with science, the techniques they use require an intimate knowledge of the materials, design methods and manufacturing processes that are required to create lifelike prostheses made of artificial materials.

For over twenty years, Morriston Hospital’s Maxillofacial Laboratory team has collaborated with Cardiff Metropolitan University to pioneer more efficient, reliable and accurate head and neck reconstruction methods.

Technologies, organisational challenges, and regulatory conditions have also evolved significantly over the last two decades. Close co-operation between healthcare providers, researchers, industry partners and regulatory bodies are still required to ensure sustainable development of in-hospital custom medical device design and manufacturing service.

Facial prostheses – immediate nasal reconstruction The teams at Cardiff Metropolitan University and Morriston Hospital have published extensively on how computer-aided design technologies can be used in facial prosthetics.

Rhinectomy involves surgical removal of all or part of the nose, usually as a result of cancer. Nasal prostheses restore contours and are designed to blend seamlessly into the surrounding anatomy using thin edges that flex with facial expressions. Prostheses are normally made around six weeks post-surgery, leaving the patient without a nose until this time. Recent innovations mean patients are now offered a temporary prosthetic nose immediately after surgery.

This eases the impact of losing a nose and creates a transition to the definitive prosthesis fabricated further along in the recovery process.

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Computer aided design software is used to create a digital nasal prosthesis prior to surgery. Low-cost 3D printing methods are then used to create a mould tool, around which a colour matched sheet of silicone is formed in layers that mimic natural skin tones. Following sterilisation, prostheses are either stitched to the patient’s face or worn on glasses until post-surgery swelling reduces and treatment is completed.

Custom breast prostheses The COVID-19 pandemic has been highly disruptive to many areas of healthcare, particularly surgery. There are now a high number of women awaiting surgical breast reconstruction following mastectomy, which has led to research, originally published in 2010, being deployed to meet the massive increase in demand for custom external breast prostheses.

Morriston Hospital is the only NHS service offering women the opportunity for a custom breast prosthesis. Custom prostheses offer improved comfort over non-custom, which is particularly beneficial for large breast cases or

complex anatomy. The techniques used were developed through collaboration. Threedimensional surface scanning is used to capture the remaining breast form and/or mastectomy region. Computer aided design is then used to create the perfect shaped prosthesis. A pattern is then 3D printed, before being made into a long-lasting plaster mould. The final prosthesis is moulded in lightweight foamed silicone using specially developed techniques.

www.cardiffmet.ac.uk

Breathing Innovation into lung health, wellness and wealth Through Collaboration and Innovation Respiratory Innovation Wales (RIW) is aiming to be a world leading gateway providing a range of professional services to NHS, Academia, and Industry.

Respiratory disease covers a large and diverse range of mainly incurable conditions including chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, cystic fibrosis, and

lung cancer. Finding ways to prevent, treat and manage respiratory disease effectively could bring about improved health outcomes and reduce the economic burden of these diseases.

The RIW team aims to enhance and develop respiratory products, services, and treatments using real world insights through advanced data science and digital engineering and to expand research and innovation activities to support respiratory innovation.

RIW’s specialist team, of practising clinicians, researchers and technical staff provide a range of bespoke services tailored to your needs.The team are looking for partners who want to enhance their respiratory products, services, or treatments.

Who seek real world insights to benefit their innovations and developments. They research in collaboration with other organisations. The team want to talk to businesses who need support with implementing and delivering multi-site trials across Wales.

Examples of some current and recent projects include: l SMART Housing – building a more sustainable future - RIW are proposing a disruptive

approach to defining SMART housing, as the lack of definition and a tendency for reliance on well-established technologies is causing confusion and is being seen as a hinderance to its development. RIW believes that living smarter is living better, and this concept should be the core descriptor in the definition of the SMART housing. RIW in partnership with Welsh Institute of Digital Information (WIDI) are proposing an exercise to establish the scope of SMART housing within Wales and establish thematic work areas to enable better collaboration. Currently SMART housing is seen as a contributory factor in establishing a more sustainable future for housing in Wales but is undefined in how it contributes to strategic goals in housing and health and social care. l Mobile Respiratory Unit - RIW in collaboration with Cwm Taf Morgannwg University Health

Board, Hywel Da University Health Board, and Life Sciences Hub Wales, have brought together a mobile unit to address the shortfall within community services and provide increased access to respiratory diagnostics. The Mobile Unit offers an innovative, timely, equitable, and accessible service for patients closer to home, representing a major initiative for planned care recovery in Wales. l Dedicated Portal for NHS and Academic 3D printing - A collaborative project between

University College London IXN programme (UCL IXN), Respiratory Innovation Wales and Cwm Taf Morgannwg University Health Board. Developing an online repository for 3D printable designs and product risk files to enable NHS hospitals to rapidly print suitable medical device parts and anatomical models. l Voice pattern recognition and analysis to support care in chronic disease - Chronic disease

can often alter breathing and speech patterns. Subtle changes in patients with raised physiological stress, exercise or speech might not at first be apparent. ARIA uses the power of artificial intelligence to aid detection of clinically relevant information that might previously have been undetected.

The RIW team have the opportunity to translate good ideas into products and approaches that will improve the respiratory health and well-being in Wales and beyond.

www.riwales.com

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Forward thinking health research

SeRP, Swansea University’s data platform model hailed as future of health data research SeRP - the Secure eResearch Platform - is a data solutions technology housed within Population Data Science at Swansea University Medical School.

SeRP provides the underlying technology that powers the SAIL Databank; a data safe haven entrusted with a wealth of anonymised health data representing the Welsh population for the purposes of research to benefit patients and society.

SeRP has been recognised as a model for future Trusted Research Environment (TRE) development in the health data landscape in an independent report published by the UK Government’s Department of Health and Social Care, commissioned by the Secretary of State for Health & Social Care.

Published in April 2022, Clinical Researcher at the University of Oxford and Director of the Bennett Institute for Applied Data Science, Professor Ben Goldacre, led the report into the safe and effective use of health data for research.

The report aims to identify improvements in the way health data is stored, accessed and used, by investigating factors such as technical infrastructure, data quality, transparency, privacy concerns and cultural considerations.

“The rewards of getting it right are profound, with not just lives saved but longer, healthier and happier lives too…I am confident that the future of health research will be bright.” - Sajid Javid, Secretary of State for Health and Social Care.

The comprehensive report recognises the value, and potential value, of the UK’s health data to provide global health insights owing to its richness and diversity. It makes a total of 30 overarching recommendations and concludes that, with sufficient investment, using this

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data safely and effectively could substantially accelerate public health advancements through research.

“Secure platforms can be built for less than the cost of digitising one hospital. If this job is done well, then the system can finally unleash the full power of all NHS data ever collected…” – University of Oxford’s Professor Ben Goldacre.

The report writes descriptively and extensively about TRE’s as the data infrastructure with the potential to unlock NHS data for the public good. Therein, SeRP has been spotlighted several times.

In considering the practical components of stand-out TRE’s, SeRP’s approach to governance, platform customisation, collaboration and knowledge sharing was examined and recommended as a blueprint for the future establishment of successful TRE’s.

“It has been my pleasure to contribute to a report of this scope and magnitude. I hope doing so will provide the clinical and health data research community an opportunity to build on and exploit the advancements we’ve made here at SeRP, and in TRE’s elsewhere, to maximise the enormous potential that health data holds for our collective benefit.”

Professor David Ford Director SeRP

Also praised in the report were the personnel behind SeRP – a team of experts responsible for creating, maintaining and progressing SeRP’s robust framework. “…the excellent work at SAIL/SeRP… where open collaborative working with modern computational data science techniques has been the norm for many years.”

www.serp.ac.uk

Taking a Wales-wide approach to deliver research

When you’re faced with the reality of having only hours and days to set up and deliver urgent public health research, collaboration is essential.

The global pandemic has taught us many things, including how to work better together across Wales to deliver safe and effective research.

Through a One Wales approach, Health and Care Research Wales has been able to set up and deliver 119 COVID-19 studies, including 7 vaccine trials, providing an opportunity for around 60,000 people in Wales to take part in research.

One Wales

Better access to research

The Health and Care Research Wales mission is to promote, support and provide collective oversight of health and social care research in Wales to ensure it is of the highest international scientific quality, is relevant to the needs and challenges of health and social care in Wales, and makes a difference to policy and practice in ways that improve the lives of patients, people and communities in Wales.

Around 60,000 people took part in COVID-19 research studies in Wales during the pandemic. Access to research opportunities varied from attending mass vaccination centres to taking antiviral medication at home.

Through a nationwide, collaborative response to the pandemic, Health and Care Research Wales has successfully implemented and improved a range of approaches to research delivery under the One Wales model. These include a range of efficient ways of working across the country to ensure quick turnaround and faster study set-up and delivery in Wales. Their national oversight means that quality remains paramount for their research teams, for study leads and sponsors wanting to carry out research here.

The One Wales model is not just relevant to COVID-19, it is designed to be used across all research areas.

“We were used to having months to set up research studies but suddenly we were faced with the prospect of only having days to do this, while meeting all the same strict regulations. For vaccine research, we set up a national vaccine hub, introduced a Wales lead Principal Investigator, and we also established a single site for Wales, Public Health Wales. Our model means we can do things once for Wales, including national standard contracts, which helped speed up the process. We’re proud to have delivered seven vaccine studies, the results of which have helped to inform the COVID-19 vaccination programme across the UK. We’ve also delivered key COVID-19 treatment studies – including PRINCIPLE, RECOVERY and REMAP-CAP – that have determined which drugs are effective and importantly which drugs are not effective.”

Dr Nicola Williams Director of Support and Delivery Health and Care Research Wales

”

Learning from COVID-19 One of the first non-COVID studies to be rolled out using the model is SYMPLIFY, which is evaluating a new multi-cancer early detection test that can detect over 50 types of cancers.

The aim of the SYMPLIFY study is to demonstrate how the test could be used to increase cancer detection rates and simplify diagnosis.

The SYMPLIFY trial has recruited 1,164 participants at 19 district hospitals, across all seven Health Boards in Wales, coordinated by Velindre University NHS Trust, as the single site for Wales.

Reputation and services The One Wales model allows Health and Care Research Wales to make sure they have oversight of research studies across Wales, so they can make sure they follow the studies through from set up to delivery.

“Our proactive, national approach means we have greater opportunity to meet recruitment targets, on time, with a fast escalation process to rapidly spot and resolve study performance issues. This is demonstrated by our proven track record for study delivery during the pandemic,” said Dr Williams.

“We also plan to build on this through our new Health and Care Research Wales Faculty, which makes sure health and social care researchers have the right training and support to develop their careers – creating a clear professional pathway and strengthening our ability to deploy the best research people when and where they’re needed.”

www.healthandcareresearchwales.org 53

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By choosing The Maltings as their base, Life Science tenants are immersed in a rich mix of people and companies, with the flexibility to accommodate growth. The collaborative coworking atmosphere allows businesses to benefit from an ever-expanding network of contacts, to develop new opportunities whether it be potential clients, suppliers, or even business partners.

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