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Brighton & Sussex Medical School

Research in action

BSMS > Undergraduate > What our students say > Research in action

Research in action

BSMS students discuss their own research interests, which they explored through their Individual Research Projects (IRPs) in Year 4.

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Robyn Stocks

Robyn Stocks

Baseline fatigue severity predicts inflammation-induced autonomic hyperactivity and pain sensitivity in fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome

One factor that drew me to BSMS originally was the opportunity to complete an IRP during the fourth year of study. I became further interested in research whilst intercalating at the University of Leeds in Sports Science (BSc). Physiology, and how the psyche interacts with somatic functions, was an area I became particularly interested in. This led me to conduct a research project based on brain-body interactions in fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), under the supervision of Dr Jessica Eccles and team at the Trafford Centre.

My role in the project largely involved data entry and analysis. Fibromyalgia and ME/CFS are both poorly understood chronic pain conditions and are thought to have a common mechanism underpinning their pathophysiology. Some previously identified mechanisms include hyperactivity of the autonomic nervous system (ANS), increased sensitivity to pain and inflammatory disturbance.

Our research built on these findings by investigating whether pain sensitivity and ANS hyperactivity are modulated by an inflammatory challenge. Additionally, we looked at this in relation to baseline fatigue levels.

Most interestingly, we found that baseline fatigue levels predicted ANS hyperactivity induced by an inflammatory challenge in the combined fibromyalgia and ME/CFS group. This suggests an interaction between inflammation and the ANS in these chronic pain conditions. As this is ongoing research, this was a preliminary finding. Once data collection is complete the results will be reanalysed, and I look forward to exploring the final outcomes of the project. This is an important area of research, as understanding mechanisms will direct future research into therapies for these conditions.

Through my IRP I have had the opportunity to present my research internationally. I attended the American Psychosomatic Society's annual meeting this year in Vancouver, for which I was awarded a travel award for my abstract. I also received the Luke Fernandes award for best clinical rheumatology presentation at the IRP conference, as well as the Medico-Chirurgical Society Gold Award for overall IRP performance.

Overall, I have thoroughly enjoyed my IRP project and it has furthered my interest in pursuing an academic career!

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Sara Abou Sherif 

SaraAbouSherif IRP 

Measuring the outcomes of patients undergoing open heart surgery versus those undergoing aminimally invasive aortic valve replacement (MIAVR) operation

Having carried out an MSc in cardiovascular research for my intercalated degree, I was keen on further exploring my interest in the field of cardiac surgery for my Individual Research Project (IRP). Cardiac surgery remains the gold standard treatment for replacing and repairing heart valves, with open heart surgery being the standard approach. Over the last 20 years, however, minimally invasive surgery has been increasingly adopted with the aim of improving the recovery of patients following heart surgery, however its benefits remain controversial.

Under the supervision of Mr Ishtiaq Ahmed, a cardiac surgeon at the Royal Sussex County Hospital, I explored and compared the outcomes of patients undergoing open heart surgery versus those undergoing aminimally invasive aortic valve replacement (MIAVR) operation. By collaborating with various healthcare professionals, including anaesthetists and scrub nurses, I was able to collect a range of useful data. I also learned how to perform a propensity score analysis, a statistical method of matching patients with similar baseline characteristics to minimise confounding effects on post-operative outcomes.

We found MIAVR to be as safe as the standard approach and patients who underwent the minimally invasive approach bled less and required less fresh frozen plasma transfused in the post-operative period. They also tended to require a shorter period of time of breathing support following surgery and remained in hospital for less time. Our results offer an exciting insight into how advancements in surgical techniques can optimise patients’ recovery following heart surgery.

Since my IRP I’ve had the opportunity to share our research at various national and international conferences. I was awarded best oral presentation prize at the 2017 British and Irish Society for Minimally Invasive Cardiac Surgery annual meeting. This included funding to attend the International Society’s annual meeting in New York in 2019, and I travelled to Vancouver, Canada to present my poster at the 2018 meeting.

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Trisha Hughes

Trisha Hughes

Erythropoietin-induced gene expressionchanges in differentiating CG4 oligodendrocytes 

Neurological conditions, such as multiplesclerosis (MS), stroke and Alzheimer’s disease can be devastating, leading to considerable disability and can be fatal. Currently, there isn’t a cure for these conditions, therefore I have always been fascinated by the use of basic science to explore how the brain could repair itself. 

My lab-based IRP was part of a larger project at BSMS studying the mechanisms by which the hormone erythropoietin (EPO) helps the brain to produce myelin, the coating around nerve fibres that allows for effective conduction of signals in the nervous system. Specialised brain cells called oligodendrocytes play a key role in the production of myelin, and we know that these cells are damaged in many neurological diseases. Current research has shown that EPO helps oligodendrocytes to produce myelin. 

I cultured oligodendrocytes and treated them with and without EPO, and then measured gene expression using molecular techniques.This was a great opportunity to learn new lab skills. Our results showed that EPO-induced genes may work to break down lipids (fat molecules) in oligodendrocytes. Lipids could be used in two key pathways for myelin production. 

Firstly, they are a key component of the myelin structure and secondly they could be used as a source of cellular energy to fuel the production of myelin itself. This complex mechanism suggests that these genes could be potential targets for treatment of neurological conditions.These novel findings have helped to further the current understanding around the role of EPO in the production of myelin and have contributed to a wider study published in the journal Frontiers in Immunology.

One day our work around EPO may even contribute to the development of new treatments for these disabling neurological conditions. 

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Anokhee Patel

Anokhee Patel2

Pilot Study to Investigate the Acceptability ofthe Pirate Adventure Autism Assessment Toolin Mainstream Typically Developing Children

I’ve always had a strong interest in paediatrics and prior to attending BSMS I worked closely with children with disabilities. So when I got the opportunity to work on developing a new app to assist in the diagnosis of autistic spectrum disorder (ASD) among children as my IRP, I jumped at the chance. Currently, the process for a child to undergo an ASD assessment is time consuming, expensive and has long waiting lists.  

While we cannot ‘cure’ autism, it’s important that children are diagnosed in a timely manner so they get the support they need, both at school and at home. My supervisors, Dr Ian Male and Dr Will Farr, developed the Lego pirate-themed iPad game, which allows clinicians to carry out an initial 10-minute screening for ASD, and could flag up children who might need further testing. Children work through a number of questions in the pirate ‘story’ — each of these will test a particular area that may get a different response from a child with autism. So you might test the ability to read emotions orunderstand idioms by asking, “What does the treasure will cost an arm and a leg mean?” Also there is evidence that children with ASD interact better with technology, so the iPad seemed like the perfect format to use, particularly as most kids are familiar with it. 

I tested the app among 32 typically developing children in a primary school, to see how they responded to it and what could be improved. Overall the kids loved it, but I made a couple of suggestions for improvement, for exampledeveloping more female characters and different themes to make it more attractive to girls. 

The app is now being copyrighted and we hope to launch it in the app store for use by clinicians in the near future. 

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Sam Owen

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Health interventions in men who have sex with men (MSM): findings of a service evaluation

Online dating apps have become increasingly common over the past decade and have created a new and accessible way to meet local partners. I was curious to discover if there was an association between online dating app use and numbers of sexually transmitted infections (STIs). The current academic literature is divided over this issue, with some finding that online dating apps lead to more candid conversations about sex generally and should therefore lead to safer sex. However, others argue that increased numbers of sexual partners, along with overlap may lead to increased numbers of STIs.

With this in mind, I wanted my IRP to quantify if there is a link between online dating app use and numbers of STIs in men who have sex with men. My project involved 1,186 participants and was one of the largest conducted in England so far. I found that use of certain online dating apps was significantly related to numbers of STIs, which also correlated to increased frequency of dating application use. These outcomes allowed me to present my findings as an oral presentation at the British Association for Sexual Health and HIV national conference
in Oxford.

My IRP also allowed me to undertake clinical work in sexual health, working in weekly testing clinics, and I really enjoyed this balance between research and clinical work. This project has been one of my best experiences at medical school and BSMS really encourages you to choose a project you can really get behind – if you have an idea you would like to pursue, you can and the right supervisor to support you through your project.

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Fenella Prowse 

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Carrying a genetic risk for dementia: cognitive and neural signatures of the APOE e4 gene in mid-age

It is predicted that by 2025,1million people in the UK will suffer from dementia, but we still have no cure or effective treatment. This is one of the reasons I became interested in this field. There has been a great deal of research into Alzheimer’s but an understanding of exactly what causes the disease has yet to be discovered.

Research has shown that carriers of a particular gene called APOE e4 (roughly 14% of the population) are 12 times more likely to develop the disease than non-carriers. The cognitive pro le of e4-carriers also changes across the lifespan, with younger e4 carriers showing cognitive advantage over their non-carrier peers, followed by a reversal in cognitive abilities later in life.

My IRP focused on a mid-aged population, as this is where there may be important changes to cognitive function, and a potential time where intervention could help prevent the onset of Alzheimer’s.

I recruited healthy mid-aged people to the study; they were a mixture of e4 carriers
and non-carriers, but this was blinded to the participants and the researchers to reduce bias and maintain confidentiality. I scanned the participants’ brains using functional MRI while they performed memory tasks. The overall results showed reduced activity in areas of the brain involved in memory, such as the hippocampus, in e4 carriers. It is possible this represents the early effects of Alzheimer’s disease in certain parts of the brain, before any cognitive changes are noted. This has helped us understand the disease process, even before the onset of Alzheimer’s, and may assist in the future development of preventative treatment.

It was a great opportunity for me to further my interest in Alzheimer’s disease and
get some research experience, as well
as contribute to the expanding literature on the e4 gene.