Saturday 10 October 2015

Report on a scientific meeting: bone-tec 2015 (Stuttgart, 8th to 10th October 2015)

This blog is primarily for the benefit of my research group and collaborators back in Sheffield, but hopefully it might also shed some light on the purpose of scientific meetings for others who view these posts. With this in mind, in case you are not familiar, a scientific meeting is intended to bring the research community together to see and criticise each other's work, and to share ideas for future research that might result in scientific progress that in turn drives the development of new therapies. Many scientific meetings are huge, and while there are benefits in seeing the whole global family of biomaterials and tissue engineering in a single location, it can sometimes be a frustrating experience as the scale can inhibit the purpose.  This autumn I have been privileged to present at bone-tec, a much smaller meeting of around 100 people with a focus (quite obviously) on bone tissue regeneration. For me it has been a salient reminder of the benefits in attending a smaller, more focussed meeting compared to a European or World Congress.  Why is this the case?  The reasons are numerous but include the ease of attending only a single session (compared to dashing from theatre to theatre for different sessions), the opportunity to discuss current research with some of the world's leading scientists and engineers as well as PhD students and postdoctoral researchers.  Most importantly, you actually have the opportunity to give your full attention to an important field that will undoubtedly shape emerging new medical treatments in the forthcoming years and decades.
So what have I learnt, both generally and of use to my own group?  The bulk of the programme was centred on progress in the identification and use of small biological molecules that facilitate or accelerate the healing of challenging bone defects.  While some work considered the detailed mechanisms that underpinned the biological effects of known osteoinductive molecules (e.g. BMP2), other talks were on less well known but potentially important cytokines.  Many of these cell signalling molecules were related to inflammatory pathways and included several interleukins associated with early inflammation.  These papers collectively underlined the close relationship between inflammation and bone repair, and significant progress was demonstrated in what is still a complex and rapidly evolving field.  One other area that has grown recently is endochondral ossification and the potential use of hypertrophic cartilage (cells and/or matrix) to promote bone tissue healing.  While Sheffield-based academics have been engaged in this field for several years (in our early years, we were one of the few centres that recognised the potential value of these strategies), there is no doubt that today there are several major research teams making rapid and significant progress, and my view is that we are right to remain active in this specific field.  There were many other research themes covered where Sheffield has a track record including nanoscale ceramic gels where Richard Oreffo showed some very impressive laboratory models to evaluate their potential. My presentation on multi-functional materials that combined antimicrobial properties with promotion of bone healing attracted several questions and invitations to discuss collaboration.  I also saw a number of papers where it appeared that Sheffield might form useful partnerships, for example Jons Hillborn presented a particularly elegant study of delivery strategies for siRNA and related molecules that had considerable therapeutic potential (for example, in the treatment of cancers). As well as new data on biological compounds, a number of speakers covered innovations in bioceramics and bioglass research, and there is no doubt this field continues to evolve and will most likely see new clinical products in the near future. The hosts provided an impressive talk on the application of Raman to detection of mineral in tissue culture, a little too late for us to form a collaboration but very encouraging nevertheless.   In addition to a large number of high quality academic and clinical speakers, we also heard from industry. One notable speaker was from the company PreSens who have a wide range of non-invasive sensors to detect changes in in vitro systems including mass, pH and O2 levels, potentially very valuable for tissue culture based research programmes.
As well as a fairly intense scientific programme, there were some more relaxed moments. One of great significance was a "special" session where the organisers surprised Professor James Kirkpatrick with a series of talks dedicated to his career in bone and tissue engineering, timed to mark his official retirement from Mainz.  James has a long association with Sheffield through the EXPERTISSUES network where he was a frequent and memorable speaker on our courses, and also as an external examiner.  He is undoubtedly one of the most important figures in the global regenerative medicine community, and it was wonderful to be able to be part of a relatively small group to show our appreciation for his enormous contribution.  James assured me he would remain very active even after retirement!  The meeting ended on Saturday where Simon Pool and I were able to use the local wifi to watch the Wales v Australia before a very enjoyable conference dinner in a traditional restaurant. Katja Schenke-Layland had put together a very impressive scientific meeting where I think everybody left with good ideas for future research and new collaborations, the next meeting will be in Munich and it will be an essential destination for all of us.
.

Sunday 12 July 2015

Innovations in Healthcare Conference 2015!

Monday 13th July sees Sheffield's Innovations in Healthcare Conference open a week long series of events that demonstrate the importance of health technologies and medical devices in Sheffield and the local region.  Innovations in Healthcare is again themed very much on making the University's significant research expertise and capacity even more accessible to the medical devices and related health technologies industry.  We have also extended this theme to include consideration of careers and employment, a natural extension from research collaboration.  These are all important subjects, related of course to the region's and indeed the UK's ability to innovate and remain at the forefront of a significant global industry.  However, the speaker I am most excited about will not be talking about the University or even our industrial partnerships, but she will instead tell us something of her life has been enhanced by healthcare technologies (as well as I'm sure sharing some of the limitations of what we in the academic community consider to be state-of-the-art!).
Claire Lomas is becoming increasingly well known as an adventurer who pushes the boundaries of what is meant to be achievable after a serious spinal injury.  Claire lost the use of her legs after a riding accident in 2007, yet in 2012 she donned a robotic exoskeleton and walked full London Marathon...in 17 days.  I like many tuned in to watch her cross the finish line, a moving and inspirational moment that coincidentally brought medical robotics into the public eye.  My recollection is that the London Marathon organisers refused to award her a medal for being too slow, although I note that most online sources say little about this and instead focus on the large number of runners who sent her their own medals in recognition of her accomplishment.  In the context of our Innovations in Healthcare Conference, Claire is significant because she reminds our community that research and its translation into real products and devices is intended primarily to help real people live full, pain free, and - sometimes - very exciting lives.  While doing this at the same time our research base and competitive manufacturing industry create and sustain many thousands of jobs, employment that reaches into an incredibly diverse supply chain and ultimately into UK society.  The diversity of our supply chains should not be underestimated, ranging from raw materials to quality assurance, intellectual property law, regulatory affairs, and of course clinical placement and use by real patients. Innovations in Healthcare will open a very full week that will see every aspect of medical devices and healthcare technologies covered.  Do check our many websites and news items, it might not be too late to make a last minute visit and be inspired!

https://www.eventbrite.co.uk/e/innovations-in-healthcare-conference-2015-tickets-16081967598

http://www.eventbrite.com/e/visible-difference-an-interdisciplinary-symposium-tickets-17095841121


Friday 5 June 2015

Final thoughts on REF2014 and UK Dental Schools


There has been relatively little critical analysis of the data from REF2014 compared to previous exercises.  While the reasons for this lack of interest remain unclear, it may be in part because individual Units of Assessment (UoAs) were so large as to make subject or institutional comparisons relatively meaningless.  The situation was made more complex by the different strategies adopted by institutions (and indeed different strategies developed by individual teams within institutions).  There have been very few criticisms of the large and often unusual combinations of subjects in different UoAs, either from the individual institutions, the wider academic community, or the media. It could therefore be assumed that the situation is generally approved or at least tolerated.  Inevitably though different research groups seek to compare their performance against peers, especially where critical analysis provides insight into best practice in terms of quality or impact.  The aim of this brief review is to determine how different institutions with Dental Schools performed in REF2014, and consider whether a more detailed and useful analysis could be performed on the basis of the data available.

The UK has 18 institutions with a Dental School or similar academic unit delivering dental education (see Table 1). Not all of these institutions made a return to UoA3, and even where they did it was not always possible to be certain that the institutional return included any staff active in dental research.  What is clear though is that the University of Liverpool, the University of Edinburgh, and the University of Aberdeen did not appear in the list of institutions that returned to UoA3, so in the event that dental and related research was submitted it would have been to a different UoA.  The remaining 15 institutions were listed in the UoA3 documentation available on the HEFCE website (http://www.ref.ac.uk/). 

Table 1:  UK academic institutions with a Dental School or related departmental activity alongside data from REF2014 for UoA3.  Note that this is the total number of staff submitted to UoA3 for each institution, the specific number of Dental School staff submitted to REF2014 is not known.



The summary data for UoA3 shows that 83 institutions made 94 submissions in total (as a number of institutions made multiple or joint submissions).  While this situation makes comparison more challenging, of the universities listed in Table 1 only four made multiple returns to UoA3 (Queens Belfast, Kings College London, Sheffield, and University College London).   The results of REF2014 were analysed by a number of independent parties including the Times Higher Education Supplement (THES), Research Fortnight, The Guardian, and a number of professional blogging sites such as Wonkhe (who utilised additional data made available by Exeter Consulting Ltd.).  Further data on staffing levels was made available after the release of the REF results by HESA, and this shed more light on differences between institutions. While few sources agreed on their detailed analyses, there appears to a be general consensus that (1) the data generated was probably less meaningful than REF2008, (2) the main winners of the exercise were the “golden triangle” institutions (especially large universities in London), and (3) of course the majority of individual institutions were able to generate “good news” headlines for their websites and press releases.  
Research Professional usefully combined the separate submissions made by individual institutions to UoA3 to produce a simplified institutional ranking i.e. each institution only appeared once in its league tables. This data was available on their secure website for subscribers at the time of writing, see (https://www.researchprofessional.com/media/pdf/UoA03_Allied_Health.pdf).  They weighted the data to create a number of useful metrics including Quality Index (a weighting based on the funding allocation, where 4* research is awarded 75% and 3* 25%), Power (how the Quality Index compares to the top performing University in terms of numbers of staff submitted) and Market Share (an estimate of the proportion of actual funding the institution will receive based on REF performance).  This data can be applied to produce league tables for institutions returned to UoA3 where it might be reasonably assumed that dental school staff contributed to the data.  Ranked by number of staff submitted to UoA3, Sheffield was one of the major contributors.  Again it is impossible to know how many dental staff were part of the overall figures (and even where a UoA3 return was named “dentistry”, this was misleading as it typically included staff from other health professions such as nursing or communication science).  By combining knowledge of the affiliation of UK Dental School with this combined REF data, it is possible to produce the institutional rankings given in Figure 1 below.



It may be argued that REF2014 was relatively unhelpful if one wanted to determine differences between specific subjects or departments as well as institutions (and therefore this was most likely the intention of those who were most closely involved in planning and execution).  Extending this argument, the only real beneficiaries were the “golden triangle” including the large London institutions, and it might also be concluded that they in some way disproportionately influenced the planning with this objective in mind.  It is therefore surprising how little public criticism there has been of REF2014 to date, with the few critical comments appearing to focus on the usual arguments i.e. how wasteful (in terms of time and resources) the whole exercise is, and how unhelpful the REF is as a tool to inspire and motivate academics to produce great research and scholarship.  That said, while my personal view is that there has been relatively little in depth or critical analysis of REF2014 compared to previous exercises, it should be acknowledged that a number of very good articles and blogs do stand out.  For example, the Times Higher Education Supplement has reflected some of the wider frustrations in the academic community, and John O’Leary produced a very insightful blog for Wonkhe (http://www.wonkhe.com/blogs/rankings-data-tables-and-spin/).  It would be wise for academics to promote ongoing discussion towards a fairer and more insightful analysis if this activity is going to be repeated in 2020, if the community remains silent we will undoubtedly see something that closely resembles the unremarkable REF2014.
With respect to the relative position of UK Dental Schools, at first sight it may appear impossible to compare performances using the results of REF2014.   Relatively few of the institutions returned in UoA had a dental school, some institutions chose not to return to this UoA, and others split their return across two or three submissions. Even where a split return was termed “dentistry”, an unknown proportion of the actual staff and subjects concerned would have been drawn from outside of the dental schools.  That said, almost all institutions and indeed dental schools have found some pieces of processed data to include on their web sites to demonstrate success in REF2014, but it is widely acknowledged this is related far more to marketing than any meaningful measure of difference.  Rankings of UoA3 based on power rating, then corrected for proportion of eligible staff returned, would provide useful comparisons but currently this is not possible (and it is unlikely to become possible in the future).  If it is essential that Dental Schools are compared, then this can only realistically be performed at the level of combined entries to UoA3 under power rating.  Sheffield lies 3rd among institutions with a Dental School on the basis of both quality and power, in many ways a very satisfactory result. Ultimately though it is the financial benefits of a strong REF performance that matters most, and any artificial ranking will be less relevant in the absence of a cash reward.  The information that has emerged thus far suggests that this REF and subsequent adjustment of the national funding formula has been an exercise to further concentrate investment in London, Oxford and Cambridge at the expense of the N8, and northern Dental Schools could therefore suffer the ill effects of a badly executed REF for several years to come.  There now needs to be some response from the academic community who understand the value of an exercise performed well, and this includes the majority of UK Dental Schools who wish to maintain their important, distinctive and clinically relevant research for the benefit of the UK, including our industry and ultimately our patients.


Additional notes and data:  Research Professional also ranked institutional submissions to UoA3 by their Quality Index (Figure 2).  Differences in Quality Index were not as great as those seen in Figure 1 (above), with the greater discrimination by Power in part due to the number of institutional staff returned to this unit of assessment.  The different institutional policies are apparent here, for example KCL made a large return and benefitted in the Power Rating ranking (Figure 1), whereas Cardiff made a smaller return with a greater focus on quality, therefore coming 2nd in the Quality Index but falling to 5th in Power (it has been argued that as Cardiff are separately funded to the other UK institutions they were more interested in external perceptions of quality rather than the final HEFCE financial calculation).