The PATIENT research project hypothesizes that time-critical and curative treatment for bladder cancer can be revolutionised by creating implantable microsystems for a world-first in-situ photodynamic therapy (PDT). Through the complex optimisation and integration of photoactive, porous, and high surface area polymers within a wireless implantable microsystem, we aim to deliver in-situ Singlet Oxygen to enhance tumour cell kill either as a monotherapy or in combination with radiotherapy. This revolutionary new technology has the potential to address the unmet clinical needs of Bladder Cancer associated with late detection, limited treatment options, and a high mortality rate. Current clinical utilisation of PDT is impeded by the associated uptake of the photosensitizer in healthy normal tissue leading to toxicity when exposed to light and difficulties in penetrating the light source to deeper photosensitised cancerous tissues to activate the treatment. The wirelessly powered implantable microsystem targets these two primary limitations as it is designed to enable repeated singlet oxygen at the point of clinical interest because of the incorporation of a micro-light-emitting diode (micro-LED). The controlled delivery of singlet oxygen will sensitise malignant cells to radiation, with the microsystem body being used as an implanted marker for radiotherapy alignment. An extension of this creative concept, that exploits smart, functional materials within a nanoengineering hierarchy coupled with advanced wireless design is that functionalised polymer coatings can be used for post-treatment monitoring of precursor detection of cancer reoccurrence. This will provide a curative treatment pathway via a low-cost enabling technology to improve survival rates, reduce patient side-effects, and create a new post-treatment support option for cancer patients. The potential reward of the PATIENT project is that we will create a new cancer treatment that addresses an unmet clinical need, improving the survival rates for bladder cancer patients. The activation of the medical implant via an external excitation system will also positively impact waiting times, which are vital in high consequence medical interventions for cancer patients. The functionalised polymers in the nanoengineered microsystem will provide both ongoing medical treatment and post-treatment care to detect cancer reoccurrence precursors. Beyond cancer treatment, health boards across the UK are under unprecedented pressure, as evident with over 6 million patients on NHS England waiting lists. COVID-19 has exacerbated the challenges facing UK healthcare provision. The foundational learning within this project, could initiate a new generation of cyber-physical medical assistants that utilise implantable microsystems, providing affordable point of care treatment and diagnostics supporting accessibility (equity) in healthcare provision, reduction of escalating NHS costs, supporting workforce resilience due to levels of demand, and creating a responsive capability to the demands of an aging society with growing long-term care requirements.

The assessment of muscle activity has become an essential indicator in medical diagnosis, motor rehabilitation, health monitoring, and neuroprosthetic/robotic control. Recent technological advances allow diseases that affect muscles and peripheral nerves to be recorded and diagnosed remotely and continuously. Motivated by exploring the electrophysiological behaviour of the uterus before childbirth, magnetomyography (MMG) was used for health monitoring during pregnancy. In addition, MMG can be used to rehabilitate, for example, traumatic nerve injuries, spinal cord lesions, and entrapment syndrome. SUPREMISE is an ambitious, speculative, interdisciplinary, and creative fellowship programme of research that has the potential to address unmet clinical, leading to radically new technologies for muscle movement recording, creating a paradigm shift in neuromuscular patients and beyond e.g. human-machine interfacing for extended reality, gaming, and consumer electronics. The discoveries, research and new knowledge created within this fellowship will lead to a world-leading research group that will position the UK at the forefront of this emergent field. SUPREMISE will create the first wearable spintronic sensor for measuring MMG signals in the clinical setting. SUPREMISE will involve radical innovations in magnetic sensors, microelectronics, wearable devices, muscle neuroscience, and signal processing. A principal aim is to make a transformative impact on the lives of patients affected by neuromuscular diseases by developing novel sensing diagnosis wearables based on spintronics that record and measure muscle activity. A paradigm-shifting engineering technology will be proposed by interfacing cutting-edge theoretical, computational, and experimental physics with advanced biomedical modelling and testing. While muscle activity which is linked to neuromuscular diseases, has captured the attention of the healthcare community, the magnetic recording approach to diagnosis has not been systematically applied through a robust and reliable tool. SUPREMISE will standardize the efficient utilization of the MMG sensor to detect such muscle activity for clinical deployment. Miniaturizing magnetic sensing systems offer the prospect of replacing bulky laboratory instruments with easy-to-use wearable clinical platforms. It would decrease the cost (< £5), size, and noise floor by several orders of magnitude. Here, we propose a novel solution using nanofabricated spintronic TMR-based sensors integrated with the ASIC readout interface. This new wearable system with a small footprint, excellent sensitivity, ultralow noise, and excellent spatial resolution can detect low pico-Tesla (pT) magnetic fields generated by the muscle. Given my published and peer-reviewed pilot research, I believe that we are at the stage where a combination of modelling and experimental work will accelerate progress. The project's results will target the development of a new miniaturized platform for muscle assays that refines the measurement of the MMG signals and streamlines techniques for use by clinicians.

The EMERGENCE network aims to create a sustainable eco-system of researchers, businesses, end-users, health and social care commissioners and practitioners, policy makers and regulatory bodies in order to build knowledge and capability needed to enable healthcare robots to support people living with frailty in the community. By adopting a person-centred approach to developing healthcare robotics technology we seek to improve the quality of life and independence of older people at risk of, and living with frailty, whilst helping to contain spiralling care costs. Individuals with frailty have different needs but, commonly, assistance is needed in activities related to mobility, self-care and domestic life, social activities and relationships. Healthcare can be enhanced by supporting people to better self-manage the conditions resulting from frailty, and improving information and data flow between individuals and healthcare practitioners, enabling more timely interventions. Providing cost-effective and high-quality support for an aging population is a high priority issue for the government. The lack of adequate social care provisions in the community and funding cuts have added to the pressures on an already overstretched healthcare system. The gaps in ability to deliver the requisite quality of care, in the face of a shrinking care workforce, have been particularly exposed during the ongoing Covid-19 crisis. Healthcare robots are increasingly recognised as solutions in helping people improve independent living, by having the ability to offer physical assistance as well as supporting complex self-management and healthcare tasks when integrated with patient data. The EMERGENCE network will foster and facilitate innovative research and development of healthcare robotic solutions so that they can be realised as pragmatic and sustainable solutions providing personalised, affordable and inclusive health and social care in the community. We will work with our clinical partners and user groups to translate the current health and social care challenges in assessing, reducing and managing frailty into a set of clear and actionable requirements that will inspire novel research and enable engineers to develop appropriate healthcare robotics solutions. We will also establish best practice guidelines for informing the design and development of healthcare robotics solutions, addressing assessment, reduction and self-management of frailty and end-user interactions for people with age-related sensory, physical and cognitive impairments. This will help the UK develop cross-cutting research capabilities in ethical design, evaluation and production of healthcare robots. To enable the design and evaluation of healthcare robotic solutions we will utilize the consortium's living lab test beds. These include the Assisted Living Studio in the Bristol Robotics Lab covering the South West, the National Robotarium in Edinburgh together with the Health Innovation South East Scotland's Midlothian test bed, the Advanced Wellbeing Research Centre and HomeLab in Sheffield, and the Robot House at the University of Hertfordshire covering the South East. Up to 10 funded feasibility studies will drive co-designed, high quality research that will lead to technologies capable of transforming community health and care. The network will also establish safety and regulatory requirements to ensure that healthcare robotic solutions can be easily deployed and integrated as part of community-based frailty care packages. In addition, we will identify gaps in the skills set of carers and therapists that might prevent them from using robotic solutions effectively and inform the development of training content to address these gaps. This will foster the regulatory, political and commercial environments and the workforce skills needed to make the UK a global leader in the use of robotics to support the government's ageing society grand challenge.