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That right? Or like? Ok. Hi everyone. Thank you for um coming to the uh academic evening tonight. Um We are, um, I'm just going to um introduce what we are about to do today. Um So can we go to the next slide, please? Ok. Ok. Thank you. Um So we're going to have a quick uh introduction about uh the uh the team. Um Then we have three lovely presentations today. Uh These are the titles. Um So each of the speakers is going to present for about 10 minutes. Um The focus should be on um if they come up with a project, uh what um made them come up with it. Um We'd love to hear more about um the process of um you getting involved in this research. Um And also if you have three quick sort of rapid fire suggestions um for the people today uh in the meeting, that would be brilliant. So that um that you, we can kind of network and share what we know about getting involved in research. And we are going to conclude the evening with uh top tips from uh the committee on committee on getting involved in research. Uh So do make sure to stick um around for that. Um We are also, uh it's quite exciting. We are going to have um a winner, so we're going to pick uh the, uh the best one out of the three. Um, e everybody did very well. Anyways, we received a lot of fantastic submissions. We're going to pick one of them and just announce it at the end. Um So, uh also do make sure if you have any questions along the night, just pop them in the chat and we'll, we'll answer them. Um And I'll pass it on to uh the rest of the team. OK. Right. Thank you. Thank you for the introduction, Adele. So, um just to introduce myself really briefly, um I'm Talita. Uh I'm a third year medical student and I study at Queens University of Belfast. Um So I started off um initially stepped my foot into the world of research through N Mra and it always has a special place in my heart. Um And the way I sort of got involved is I did a mentorship scheme when I was in my first year just over the summer and I applied for it and I got selected and then I ended up doing a project and I was assigned to a mentor who sort of um really motivated my team to come up with our own project and had a hands off, but also a hands on approach um in terms of really guiding us what to do, but never really telling us what to do. So in that, um in that aspect, and I really had a um role to play in terms of, you know, coming up with research projects and actually having a vision on how to complete it from the start to finish. So, on that basis, um N Mra is really an association that's founded on the principle of developing a strong student to student ne uh support network and also really um giving opportunity to students to conduct their own research and having all the skills in the process. Instead of that traditional approach of the supervisor telling you what to do here in an MRI, we learn how to do things and we really wish to establish a community where we can cater events like these and we do a lot of academic research based and career events um throughout the academic year. Um And again, like I said, um really just to empower um students to create a project uh of their own and, you know, really delve into something that they're interested in. Um And just on that note, we do host a year yearly mentorship scheme currently open to both mentors and mentees right now. So if you go on to our socials and just N Mra underscore UK, um and you can apply our applications are open for both, then they will uh close the end of April, I'm pretty sure. Um Yeah, end of April and we'll also have our teaching series start of May and it'll run about a month and a half long and really covering all the steps of the systematic review and a meta analysis. And this is these are very important skills to have as a doctor, even if you don't end up a, as an academic researcher because a lot of data that a lot of clinical data is based on these um evidence-based um papers. And it's just good to understand how to read one if you do fall upon one. OK. So um are we just doing quick introductions actually? Um Adele, do you wanna just quickly introduce yourself in the marriage? And then we'll go on to our first presentation and then we'll, yeah, we'll get started from there. Uh Yeah, I'm 1/4 year medical student at bars and I also got involved into an MRA. Uh was it a couple of years ago? Um I also did the summer mentorship scheme um and it was really good. Um I really didn't ii did an undergraduate degree before but um it th this was, I thought this was more useful uh because it actually had a sort of a tangible outcome. Uh It went very well and then I, yes, just I'm still here. Um Yeah. Nash, do you want to say something as well? Hi guys. Um So yeah, my name is NJ. I founded an Emery in January of 2022. So a little over two years ago, um back then I was a med medical student at UCL and I've since then, have progressed on to now I am a phd student doing cardiovascular sciences at the University of Leicester. Um but the goals and you know, what we do with NMR has not changed. It's still very much centered around getting people into research and, you know, giving them, even, even if, even if you're an established researcher, there's still scope to network to do projects with us to learn new skills. And if you want to, you can also help to pass on some of your, you know, your, your gift and your knowledge to other people as well. So there's, there's a real scope to, for everybody to get involved in, to add something to the community here. OK. Um Thank you. Um So now we're just gonna move on to our first presentation. Um And I think, do you Adele, do you know who I was sorry? Was it Jaden? Um Should we invite her? Two? Yeah, I can do that. I'm going to invite Nick as well visit. Yeah. Yes. Yeah. If you happen to have any questions uh on the mentorship scheme itself, you can contact us on social media. The the scheme is actually open internationally. So even if you're not from the UK, you can apply for it. Um OK. So it's the first speaker ready to go. Oh, he's just having some technical difficulties. It uh we'll give it a couple of minutes and then if not, we can move on to the next presentation, but it should be. Ok, hopefully. Ok. J OK. Yeah, there she is. Ok. Lovely. Uh Can you guys hear me? OK. Yeah. All good. Yes. OK. Um Sorry about that. Um I'll get the Yeah, I'll, I think I need to stop sharing and then it should be. Yes. Um I'm just trying to. So by sharing entire screen, I think that's normally the best way and then I won't be able to see the chat. But if you let me know if anyone asks any questions, of course. Yeah. So can you see that? Ok. Yeah. All good. Ok. So um thanks to Tolia Rodel. Um I have been invited to come and share just briefly a little bit about my research. Um as you can see that's a case report on a literature review looking at something called seatbelt syndrome, uh which we'll get onto in a second. So a little bit about me. I'm a third year at the University of Sheffield got some interest in emergency intensive care. I love pediatrics and medical education and like most medical students, I have really struggled getting research experience. Um I've collaborated on a couple of national studies and then as I was sort of struggling to hear back from a lot of people, I have um started to undertake projects like this more on an individual basis. So how this all started was um I did a six week sse with the major trauma team at the Northern General. Um Absolutely amazing experience. If anyone ever has the opportunity to work in major trauma, I'd really recommend it. So this was a mix of trauma team shifts, um ward rounds and then resource shifts. And as part of that, I had to do a written case report, which is how this project started. So we'll start by having a little look at the case, er and then work backwards. Um So the case was we had a code red trauma call which means there's catastrophic hemorrhage uh for a young man who'd been involved in a car accident. Um We brought him into A&E uh with an assessment and we found him to be peri arrest, severely hemodynamically unstable. Um His BP was unreadable. We couldn't get a sa um we were convinced he was hemorrhaging and we were fairly sure that this was due to a pelvic fracture. Um So we treated accordingly. We stabilized him with a massive transfusion pack and then we sent him over to CT uh We weren't quite expecting to see what we saw on the scan. There was no fractures anywhere. Um He had a very large hemoperitoneum, so a massive amount of blood in his abdomen. He had a 10 centimeter disruption to his abdominal wall, er, with herniation of bowel and fluid and he had a very large left pneumothorax with a lung collapse. Um, from this, the decision was immediately made by the general surgeons to transfer him immediately up to theater. The good thing about a code red call is that we had a theater on standby. Uh, when we took his pelvic binder off, it became a lot more apparent apparent what the issue was. His abdomen was much more distended than we'd originally thought. You could actually see his bowel sitting under his skin. Um, and he had a massive seatbelt sign, so a massive bruise over his lower abdomen. Um, so they opened him up, he immediately hemorrhaged all over the floor. Um, they found out that he'd avulsed his superior mesenteric artery and vein. Uh, we didn't initially believe these injuries to be survivable. So we opted for a damage control approach, er, resecting anything that would be non viable and just cutting off the blood supply. Um, so this involved us removing his right colon ileum and the majority of his jin over the following few days, we had a few more rooks, we resected a lot more and then we closed it, uh, using full thickness sutures to fix his abdominal wall defect. Unfortunately, long term. Um, you'll be glad to hear this. This patient has survived. He's done remarkably well. However, he's been left with only 50 centimeters of Jejunum and 45 centimeters of colon. Um, this isn't even sufficient to create a stoma. So we've had to insert two foley catheters as drainage, um, which are still in situ several months later. And he's remained in hospital as he cannot, he cannot be discharged with these foley catheters. Um, he's also been started on TPN. So total parenteral nutrition as he cannot have nutritional autonomy with this little bowel. Unfortunately, and he's been listed for a small bowel transplant as hopes of a definitive treatment. So I found this a really interesting case. None of the people I've worked with have ever heard of this kind of injury. It's so incredibly rare. So I started writing my case report and I did a little bit of research. And what I found was that there are two types of seatbelt injuries. So there's the seatbelt sign which I have a photo of uh this isn't the photo of our patient. This is just one off the internet, um which is the superficial abrasions just over the seatbelt distribution. And then seatbelt syndrome en encompasses all of the internal injuries that you can have as a result of this blunt force trauma. So its the chest neck, spine, vascular visceral end organ, anything you can imagine. Really? Now, a very rare type of injury that's associated with seatbelts is a traumatic abdominal wall hernia, which is what our patient had. Uh It's exactly what it sounds like. It's just an abdominal wall hernia that's been caused by a massive blunt force trauma ranging from a very tiny little hernia that can be fixed as an outpatient to complete evisceration of the bowel. And what I found about all this is that it's quite rare, this kind of abdominal seatbelt syndrome, um, abdominal wall hernias, particularly with vascular damage. I really struggled to find anything to do with it. Um, which is why I kind of wanted to do a bit more research and see if there was anything that I could do to sort of contribute to that, that knowledge. So I went into a bit more of a literature review leading on for my SSC assessment. Um There was a narrative literature review I thought about doing a systematic, but there was a real scarcity of papers. So it it made more sense to just sort of go through it from start to finish. Uh It was mostly case reports and case series, the other literature review that I looked at um and over time, I began to focus on how we could identify these intraabdominal injuries earlier. So by using seatbelt sign, all this abdominal wall hernia as a marker for a more severe injury. Uh what I found briefly was that the patients presenting with abdominal seatbelt sign, around 64% of them also had an abdominal injury and around 36% of them needed a laparotomy for surgical management. Um Similarly, for patients presenting with a traumatic abdominal wall hernia, 67.5 to 75% had an intraabdominal injury. Around 1% of these had a vascular injury normally to the aorta or the SMA. Uh and let's put it into context, these injuries cannot be missed. They have an extremely high mortality rate. Um So for any multi vessel injury in the abdomen, it's around 40% for S MA it's 33%. And for superior mesenteric vein, it's 60%. So linking this back to our case. So seatbelt sign. So we know that has a really high abdominal risk. But how can we exclude a pelvic injury? There wasn't really any literature linking seatbelt signs of pelvic injury. So it poses a bit of a problem to surgeons. Um using traumatic abdominal wall hernia. We know it's a really good indicator and we know that any patient with that kind of hernia needs to be monitored over several days to make sure that they don't also have any intraabdominal injuries. The issue is is that it's quite difficult to diagnose. So I've, I've attached to some of the grading from N SFL for these type of hernias. Our patient had a grade five and we missed it. Um Some of that was to do with the fact that he was intubated when he came in and he had a pelvic binder on. But a lot of studies have shown that this is actually quite hard to diagnose clinically and not a lot of people are aware of it. Um And in both the literature, in our case, we found that venous bleeding was actually more dangerous. Um Now, to explain that is to stop the arterial bleeding. In our case, we needed to clamp the aorta. Now, this was extremely difficult and took a very, very long time uh but was doable, however, with the venous bleeding, um because of the way that the veins are built when they're shredded in the way that they were tend to retract back into the mesentery. So, stopping the bleeding, actually required another surgeon to scrub in and just compress the entire mesentery. So it was very, very difficult. And what we can conclude from all of this is that our patient is very, very lucky to be alive. So some of the conclusions from this research without having a seatbelt sign, improved recognition, improved education on it. And perhaps a pathway leading from that as to having a very high index of suspicion for abdominal injuries would be beneficial. Perhaps some future research and how to differentiate between abdominal and a pelvic injury. When there is a seatbelt sign and looking at seatbelt sign and pelvic injuries and how they correlate and then improved education, diagnosis of traumatic abdominal wall hernias would be important as well. We can't always get act straight away. And if someone's hemorrhaging, ideally, we would have liked to have gone straight to theater, but we didn't really know what was wrong. Um Some studies have sort of said that you could maybe use a fast scan. So maybe in the future that could be incorporated into some fast scan trainings just to enable you to diagnose it a little bit quicker. Now, in terms of the research, this has been a really helpful experience for me now, as current this is unpublished, uh whether it will be published, I don't know, it's it's a case report and a literature review. So it's fairly low impact. Um However, there is still limited research on this topic. So it could be quite useful. I think if I was gonna do it, I would probably want a bit more surgical input from someone who knows a little bit more about general surgery than I do. Um But even without it being published, it's been massively beneficial for me academically. It's given me the experience in writing. I've had an exposure to a massive amount of literature. I made a poster that was presented as an E poster, a a virtual event. And it's also given me the experience of presenting to you guys today, which is a massive amount of experience. But I think the most important thing from this research and how it it was beneficial was that it aided patient care in ways that I didn't expect because this was such a, a rare injury profile and, and a lot of the major trauma consultants that I was working with are anesthetists or ed doctors. They're not general surgeons, having someone on the team who not only knew the case inside out but had done a lot of research into this kind of injury was quite beneficial for getting people up to speed. And as part of the consent form, um it got written consent from the patient to use his his case. Um This actually involved him reading the full case case report, which was really beneficial in opening up a dialogue. And it was the first time since the injury that this patient had asked a lot of questions and talked about the accident and talked about his injuries and it opened up a really useful dialogue between the trauma team and the patient. So just because it's not massively high impact research, it's not a big analysis or RT um randomized controlled trial or anything like that. It doesn't mean that it's not helping patients. And I think getting involved in lower level research is a really good pathway to just getting more engaged with not only your placement, but also with academia as a whole. Um So I've got some references there and then yeah, if you've got any questions, thank you so much for listening. Um I've put my email there in case anyone wants to reach out about questions to do with this or similar projects or anything. Really? Lovely. Thank you so much. Uh Does anybody want to type any questions in the chart if you have any. So, I just, the pool came up. Ok. Hi, Jaden. Uh, thanks for a really good, um, really good presentation. I just wanted to ask you if you could do any follow up study or anything next that would help, you know, kind of further your mission or the, the lack of information that is about the syndrome and it's, you know, how it's been diagnosed or what people know about it. What would you do? Um I'm not sure. I think that because there's such limited research out there, I think I would want to follow it up, perhaps reaching out to other trauma centers around the UK, seeing if they've had any other similar cases, perhaps turning it more into a case series as well. And then from there, maybe trying to make the literature review a little bit more structured and get more information so it can have more weight in terms of recommendations going forward. I think just any education for more cases about this would be useful. Cos I don't think I really found many similar cases at all and I spent a lot of time looking. Ok. So, I mean, just to kind of for some context, how, how common is this? So in the UK, in a year, how many cases could you um that it's so rare that I couldn't really find anything about how rare it was. There were less than 100 pieces of literature about it worldwide. From the trauma team. I knew someone who'd worked there for 20 years and they'd never seen anything like it from a major trauma center. So, a, a couple prob, like probably more cases of traumatic abdominal wall hernia. I know that's about 1% of all blunt trauma cases to the abdomen will show that. But in terms of the complete, um, avulsion of the vasculature. It's, yeah, most of the surgeons have never seen anything like it before. I think you kind of summed it up when you said you couldn't find any literature on it because that says it. All right there, there's nothing on it. Yeah, there was, there was some but not a case that fit our a lot of the time this can present quite delayed. So you don't realize they've got a hernia till later or you don't realize they've got an injury till later. It's, I mean, maybe it's just quite rare that they survive long enough to get to hospital. Really cos I think we all kind of thought this was it. And have you. So when you were looking for the literature? So obviously this has happened um in the UK, right? Um So when you were looking for literature in, you said they were like you found a handle across the whole planet. Um Did you find a higher percentage of these cases in certain countries or did you, did you not really think about it or did you not really notice a pattern in these? Um, I did, I think a lot of them were American. I found one big review in, in America and I found one that I think was, I think it was either France or the Netherlands. Um It seems to be more commonly reported in Western countries. Um I think part of that is the reason that a risk factor for these kind of injuries is a high BMI so high BM I is associated with incorrect wearing of your seatbelt. So you're gonna have more of these type of injuries for a larger population, which is what we have in Western countries. But there were still reports, I think the first reports were 100 years ago and there were some reports from other countries as well. So it clearly is an issue that a lot of people are experiencing and not really knowing how to deal with. Yeah. No, I think this is very insightful and very interesting as well. Like this is not. Um I think when we were reading the abstract, we thought this was quite um the peculiar one and you, you talk about this um as a low level research, um you sometimes a case report can be extremely valuable. Um So of course they, they classify people, classify things, you know, run my control, trial, run control, trial letter to the editor, whatever, but like a a fantastic letter to the editor could have a CRE an incredible impact on his own as well. Um, so, um, yeah, so just cautious of time. Would you like, why don't you share with us, um, your top tips of, uh, getting involved, uh, to get involved in something, uh, like this? Ok. So I think for SSE s and electives pick something that you're genuinely interested in. I know it's really tempting to pick the placement where you go in one day a week. But if you pick something you're interested in and you take the assessment for it seriously, you can really go a lot further with it and have a lot more opportunities. Um Definitely um befriending the people on your, on your placement as well. The doctors, I think I mentioned I was doing this to one of the surgeons and he did a one hour lesson about critical analysis and it turns out he's an editor for a very large trauma journal. So making a good impression with clinicians and I think in general just being really keen and keeping an eye out for any kind of opportunity. Um A lot of med schools are always advertising very small stuff um and then meeting other med students and working with them is just, is a really good opportunity. Yeah. Oh, perfect. Ok. So shall we move on to the next presenter then? Um So I'll just share my screen for two seconds just for the background. Thanks guys. Yeah. Thank you. Very much. Thank you so much. Anybody that has any further questions, please do pop them in the chat, by the way, if anything comes up later. Yeah, I think we have uh you say no. Is that correct? Yeah. So the second presentation is about efficacy of virtual reality rehab and conventional therapy for patients suffering for motor dysfunction. So very, very interesting topic. Um I'll just not sure if he's able to come downstairs. Hi, sorry. Can I, can you hear me? Yeah. Yeah. OK. Good. OK. Yeah. Put the presentation. We just she screen. Yes. Uh Can everyone see that? Yeah. OK. So stop. So um hi guys. My name is Hussein. I'm currently um an integrating or fourth year medical student from the University of Liverpool. And I'm gonna be taking through, taking you through on the, on my basic best bet review slash systematic review on the use of virtual reality therapy and stroke rehabilitation. So, so developing the project. So this is part, this was one of these projects was part of my current integrated MSC at the University of Liverpool, which I'm currently doing at the moment. So it was one of our first topics and my M SE is in currently in a critical care and emergency medicine. Um It was, this first was conducted in a systematic review in the style of a best bet report. If you don't know what a best bet report is, it's kind of, it's, it's like a systematic review, but a very uh very niche topic you hold it on at a, at a bit smaller scale systematic review, but mainly used by emergency medicine physicians and, and de it, I think it was developed by the Manchester Royal Infirmary as well. So, and then I was assigned supervised in critical care and just sort of was given the topic of cognitive dysfunction first or to look into stroke patients. And this was kind of like a topic, a broad umbrella topic that was presented to me as an idea in critical care alongside um sort of like app technology or things like that for to aid patients with like cognitive dysfunction in critical care because that's what they see a lot of in critical, in critical care after patients have become critical illness as well. Um So are you saying sorry, sorry to interrupt? I think your screen isn't, the slides aren't moving on our end at least if you can. Ok. Now it is, I think it was lacking a bit if you try to full screen um plate from the beginning. And um let me just, is that working now? No, I think just try escaping the from the presentation for some reason, you might just be sharing a specific type of screen and not your whole screen. That might be the problem when you go on slideshow. It's not showing the whole um it's not actually even non slide show, right? Now um go back to metal and just um don't share window um sorry, click click instead of um clicking on sharing window, click on share screen and then share your screen entire screen. Yeah. Oh, ok, fine. Is that, is that what he asked what we're working on by? Yeah. Can you see that now? Yes and just move your slide. Yeah. Ok. Yeah, we can all see the animation stuff. Perfect. OK. Ok. So OK, fine, thank you. Um Sorry about that. Um So holding the topic, I think, I think a lot of this was through my own research and own sort of interest in where, where I wanted my project to go. Um II was given the idea of cognitive dysfunction, but put it straightly, I wasn't very interested in cognitive dysfunction when they first presented it to me. So um and I found it very difficult to find a topic or find an area of research because of the really small amount of literature out there on cognitive dysfunction. So then through my, I think through my own research, looking through different papers, reading different papers IFI found um sort of motor motor dysfunction after stroke specifically and a stroke was one of my areas that was presented to me. I was thinking, OK, this, this could be something interesting to look into and especially I think through my own knowledge of how the world is moving today in terms of technology and um sort of my own, my own reading through like exoskeleton use and things like that in stroke rehabilitation. I found that something this is possibly something where it can be really interesting to find out what, what the future holds in this cos this could potentially end up being the future of medicine in terms of these patients. Um Yeah, and obviously due to the novelty of these technology, I like there's something to focus on as well. So um now constructing the title. So this is from the best bet website. Um It's basically how I constructed the title. So I had to have a patient characteristic, the interventions and what the relevant outcomes would be. So my patient character was in adult patients suffering from stroke, suffering from motor dysfunction after after stroke, specifically, motor dysfunction, um does the use of virtual reality therapy compared to c is, is the use of virtual reality therapy better than the use of conventional therapy in a in treating motor dysfunction or re rehabilitating patients back to AAA smaller a close level of baseline essentially to what they were before, obviously, with how stroke works, it might not be. Um they probably might not go back to a baseline completely but get regain some sort of function afterwards after their stroke. Um the project itself. So there were some search terms I used. Um And II tried to get these things broad because how virtual and due to the novelty of virtual reality and this technology, it's very, it was very difficult to find a lot of papers specifically honing in on this topic. So this is why I kept the research terms broad when I used, when I searched different um databases. So virtual reality or, or augmented reality and stroke or stroke or cerebrovascular accidents. And essentially this, these five terms came up with about 700 abstracts like that. So, yeah, so if I was trying to increa um increase the niche a bit more, then it would be more difficult to find papers to try and try and write the project itself. Um So the the database I used used. Um so Ovid MEDLINE was probably the place I started due to the due to um it being a good database generally and then pubmed and then scopers. So in total 734 abstracts were screened and from the 6776 were on a full text review which 16 articles were included in the final review. Um All these articles are critically appraised the best be critical appraisal tool as well all 16 of as well. Um Yep. So in construct through the reading of the papers as well and in constructing the title, I defined some central objectives to what my systematic review was going to find out. I was going to prove to me and to potentially a larger audience. Um What? Yeah, so, so number one does the use of VR create a statistically significant increase in motor function. That was my main objective of the study. Number two, because of different technologies and how different technologies work in virtual reality. There, there's a difference between immersive and non immersive virtual reality. Is there a difference when using immersive or non immersive virtual reality? So immersive, if you think if you think if you go back, this is kind of immersive where in the goggles um kind of like Oculus and things like that. Um which is, which is used now for I think medical, medical education that is coming in as well. That's immersive. Non immersive essentially is something like Nintendo Wii for example, which I picked Nintendo Wii cos that was one of the one of the methods um One paper used that II want us to make across my research as well. And number three is VR therapy alone enough or is combining conven VR and conventional therapy the most efficacious. So this was found but, and I was reading through the papers a lot of papers actually compared VR and combined VR with CT. Um And I think this would, this would have been a nice, a nice way to prove um sort of like to compare the differences and how um like compare the differences and how the difference would be set out essentially. OK. So results. So in terms of non immersive, um not a must have VR seven out of the 10 studies showed a stat statistically significant difference when using VR therapy as a method for motor rehab for stroke patients. In terms of immersive. Four out of the six studies in this group showed statistically significant improvement in motor function when using VR as compared to conventional therapy. But combining the 2, 10 out of 16 studies, eight out of 10 showed a statistically significant improvement in motor function when combining the two methods and which ha would potentially even show comparing the results across the papers has actually showed like even greater increase in modes of function in some aspects as well, which was quite interesting. Cos not something I was expecting but some but definitely something which I would which I was taking forward in term er at the end of the systematic review. So the discussion of it um so did the does the use of VR create statistically significant increase in motor function in my opinion? Yes, it does. 11 out of the 16 study evaluated showed a statistically significant improvement when using VR S compared to CT conventional therapy. Um Number two, is there a difference when using non immersive or non immersive or non immersive? VR from my, from my understanding, no single type of VR technology is superior to one another. Both provide a strong evidence base to the efficacy and is VR therapy alone enough or is combining VR and CT the most efficacious evidence suggests as I explained before, evidence suggested that combining VR and CT may have slight advantage over just using V RCT alone. This could have been due to the fact that pro possibly more time was spent on rehabilitation in some areas where some pa some papers did say that more time was spent um ultimately using VR and CT than VR alone. But however, majority of the studies match the time that they were using on VR and CT on VR and CT. So yeah, some studies, some studies did this but very few did some others, most majority didn't. But from my understanding, combining VR and CC prove proved to be the most efficacious. But that doesn't mean to say that VR doesn't have a place because I think VR does have a place in terms of. So that comes onto my occlusion. Um VR does have a place in this, it does, this did prove prove to be more beneficial in multiple ways and to say that it's there's no way for VR to be uh virtual reality to be implemented in in rehabilitation. Um for stroke patients would be wrong from my, from my research. Um Well, I think no adverse effects were identified completely. Um And also this can improve the quality of life of patients. As a lot of the studies focus on activities of daily living and use those to simulate different environments while staying in the same physical environment essentially. So, improved activities of daily living and people were able to move around and do the normal things like you and me would, would not think of doing like cooking, pouring a cup of tea, walking around, things like that. So, yeah, thank you. That's the end of my presentation. Um Any questions, stop sharing. Yeah, thanks doctor. Thank you the same. I was the same. I was sorry, I can't hear the echo. Is it OK at all? You want to mute? M huh? There is an echo. Mute. Your mic, you can hear me now. Oh OK. Um Is that all right? OK. That was, that was really good. Hussein just have a couple of questions. Uh Ticka, you are blocked. OK. She's gone. Um That's good. I can ask the question. Um So basically what I was trying to figure out while I listen to your talk was what kind of differences were there with in the, the modalities of virtual reality that were used? Cause I get the feeling that you need to study something completely different was used. And I don't know how that lends to, you know, you making a comparison between them. Sorry, sorry. Can you, can you just repeat the question? So I, what I gathered from your talk was that there's a lot of variation in the different types of virtual reality that are being used in clinics and across different sites. How did you, what did you experience when, when you go to the literature? And how did that kind of affect how you made comparisons between different studies. OK. So I think a lot of, I think immersive, it's not immersive and immersive um kind of immersive used the same similar sort of technology. So immersive virtual reality was using the goggles, whether it was different brands like Oculus, things like that. They still use a simulate the same environments in the for the patients. But non imer I think they use sort of similar techniques even though they weren't the U they weren't the same sort of, for example, console or system specific system. They use similar techniques to kind of implement their, implement their view on a screen, for example and use different remote controllers to um to allow the patients to conduct activities of daily living as well. OK. No, that's, that's great. Thank you. Sorry, I cut off for a second. Is, am I back now? Is it a bit better? Yeah, you're good. Perfect. OK. Well, question was asked before or was it a different one? I didn't ask it was your friend? OK. OK. So um what I was trying to ask, I'm not gonna turn my camera on just cause I think my internet is really bad. But um just in terms of how, how was sort of what was the conventional therapy that was looked at in your studies and how was the motor function evaluated and um quantified? So a lot of the studies use very similar methods as I was specifically focusing on motor dysfunction. There were very few scores or scoring systems that we use. For example, for the upper limb, that's what a lot, a lot, a lot of studies use. They used a fo Mayer assessment and a lot of a lot of them as well, use a balance scale to test balance. And that's I thought would, would be included as well to be able to balance. You need that course of sort of proprioception, the most mode of function to be able to handle that as well. And I think convention, conventional rehabilitation ultimately boiled down to, for example, um getting patients just getting patients to walk, repeating the same movements, basic physiotherapy essentially was what the main study foc a lot of the studies focused on. So, yeah, I hope that answers. It does. Thank you. Um And just one more question just in terms of um what your opinions about, you know, what, what do you think are some of the major um resistance um of involving and integrating virtual reality in clinical practice? Um So I think there's, there are quite a few barriers to this at the moment. First of all, it's very, very new only. So like the study included from, from my study only has span from about 2010 to now. Um So the method is very new, it needs a lot of so people need to be trained on how to use these systems as well. And I think, especially for patients trying to, trying to teach them a new, completely new different topic, especially when you're looking at stroke patients who are most likely gonna think that they're a lot older. They're not exactly gonna be young. Um, they could be, but more likely gonna be older. For example, they're gonna be not sort of in their twenties, thirties, forties, but more so in their fifties, sixties. So that can be a barrier. And as learning a new technology, especially while some like a lot of older people do find technology nowadays sometimes very confusing to use. Um I think that's a potential barrier as well. And I think also also a bigger fact is the cost, I mean a lot. Uh it is, it is, it is cheaper but there's still a huge cost implemented and to implement something like virtual reality and implement new different technologies over the w to widespread over the NHS. I think there will be, there needs to be a lot more sort of funding and research into this before. It's actually saying yes, we can do this and yes, this provides a strong evidence base that this is better than what we are doing currently. Yeah, I was actually gonna ask you about um cost effectiveness of this. So you, you actually ended up answering all the questions I was going to ask you. So when uh were the studies published? And um was there any mention of cost effectiveness um which we can infer from what you said that, that, that that would be um a problem. Um Yes, I think this was really great. Uh Does anybody has any other questions? Yeah, I don't see any on the chart. Ok. Um and yeah, why don't we uh wrap up? Yeah, thank you for your presentation. Why don't you wrap up? Why don't we wrap up with uh three quick tips on getting involved in research from your point of view? Ok. So, yeah, so probably like, like everyone else research is very hard to get into at medical school. Um I think one of the tips that I would say is just whether wherever you, whether you want to do, regardless of what you want to do in the future specialty is try to get involved because just having a foot in the door essentially will open up, will open up to a lot more possibilities regardless whether you wanna do surgery or medicine or cardiology or plastic surgery or orthopedics. So regardless it's not at this stage, probably not the, not, not the main thing to focus on. Probably just try and get your foot in the door and then it will open up to more possibilities, I think as well. Just being active with doctors. For example, if you're sitting in a clinic with a doctor for the whole afternoon. And as I say, yeah, you, um you are, they're very talkative and they're very teaching and you're actually engaging with very, very good conversations with them. Um, ask them, do you have any, do you have any research I can get involved in? Is there any audits I can do? Because not only will that help, help you learn more about research, it's also gonna be good for your applications in the future for, um, for specialties as well. Um, and I think as well, um, this might be, this might be sort of um a bit mean but um maybe focus, sorry, uh probably focus on the ST eight s on the specialties, specialty trainees possibly. Um cos they, I mean, they're the ones that are gonna be very enthusiastic about research, cos um they're gonna be wanting to get the consultancy, post and consultancy exams done. So, yeah, probably a bit like probably not the 11 piece of advice I'll give, but that's one thing I would say if you want, if you really want to help with something, we're gonna be more enthusiastic about helping you. Probably not the same for every consultant, obviously. But yeah, I think, I think that's all very fair. Yeah, thank you. Uh Again, if anybody has any questions do feel to drop them in the chat and we'll move on to the final presenter. Um Yes, sure. Wait. Are you, did you guys do the project? Uh Yes. Yeah, you did go to. Bye bye today. No, I haven't one sec well, I could try to figure this out. I've done it. Do you get it? I think so, please. Here we go. Invited him to stage if you hadn't but she was lovely. I Yes. Hm. Ok, perfect. Um Yeah, we'll now move on to the LA the last uh the last talk. So tha can you stop sharing? And Nick and Harris can go? Lovely. Are you guys able to share your presentation? Uh I'm just trying now. Can I see? So, yeah, if you can share it or something cause we just see a whole uh we just kind of see like a web page now. Uh How about this? OK. Is there any way you can zoom in? It's a bit blurry. I don't know if that's my internet or is this um in full screen? Yeah. Um So it, it is slightly blurry but um can you guys see the full screen? So, yeah, we can see the full screen. This is, this is slightly blurry. Um But I think if you guys don't um I think if this is FD, this is it, we can just go ahead uh with the presentation potentially. Um Maybe I can like, try to zoom in and yeah, try that. Yeah, try that. Yeah. Yeah. OK. I think the full screen doesn't quite work. Um So, yeah. Uh OK. Um But are you guys able to see like the um writings and the what as well? Uh Yeah, we can we can see some, some of it? Yeah. What is Friday? Oh, ok. Um Should I make a stop? Yeah, thank you. Ok. Sure. So, um yeah, uh just to introduce myself, my name's Nick um in my third year at bars. Um So our research project was on um a novel therapy um verapamil and we um looked at if it's effective for patients um with chronic sinusitis with nasal polyps and this was a systematic review. So, um I've done this with my friend Harris who is also speaker and uh we collaborated with a ent surgeon that I met on my placement at uh hospital. Um So um I didn't come up with the uh title of the research. Um So it was this ent surgeon. He was quite keen on um finding new therapies for chronic rhino sinusitis, which as you may or may not know is a quite um difficult pathology to manage um in ent um due to its uh symptom relapse and uh lack of effective treatments. So, just going into the uh introduction, uh CRS affects around 10% of the adult population. Um and a specific type of CRS. Uh CR SWN P which is short for uh chronic rhinosinusitis with nasal polyposis affects around 25 to uh 40% of the CRS patients. So, as you can see if it's a very um common pathology. And um it is characterized by uh type two inflammation and nasal polyposis um and it's associated with the overexpression of a transporter called P glycoprotein. Uh PGP for short. So if you, if I can draw your attention to the uh image at the bottom, you can see is a endoscopic imaging of the nasal septum. And uh on your right is the nasal septum and on the left is the nasal polyp and you can see it's blocking the uh middle turbinate and is uh really obstructing the airflow. Um creating a lot of um poor experiences for the patients um with breathing and sleeping um et cetera. So, um yeah, we really want to um management m manage it um well, and prevent relapses. So, what we looked at was verapamil. Um and of course, normally is used for um hy hypertension. Um But however, it's also been found that is a uh first generation inhibitor of PGP. Um So therefore, it's been studied as a potential treatment for CRS uh W MP. So, uh if I can draw your attention to the diagram in the conclusion, um as you can see in the middle, there is a nasal epithelial cell and um like we talked about, there's a lot of inflammation um due to the nasal epithelial cell releasing a lot of the cytokines. Um as you can see, there are the PGP transporters which are responsible for releasing the those cytokines such as L5, uh IL six and TSL P um which then lead to um further th two activation and differentiation uh and also is in the maturation and B cell and uh neutrophil recruitment. So, what verapamil does is by in inhibiting those PGP uh transporters, uh it can lead to uh less inflammation and uh better symptom control. So, this is this was the objective to um look at if verapamil is clinically uh able to do this and uh reduce the burdens of the patients. So, what we did was we um had looked at a lot of uh databases such as PUBMED, uh MBA Ovid MEDLINE culturing uh database and Google scholar. And they were searched up until uh 28th of December 2023. And in total, we identified uh 262 studies. Um And in the end, we uh selected three RCT S. Um So, um and we extracted the primary endpoints including the quality life questionnaires and imaging ratings. Um So, uh just to summarize the uh results, we've um from those three RCT S, um we've extracted the treatment group, the control group and the outcome measurements. Um So, um as you can see in the treatment group, all of them used uh verapamil as the um uh treatment. But uh it is worth noting that salam meal, they've used topical uh verapamil which is different to um of course the um oral verapamil pills. Um and the outcomes we've um looked at the subjective and objective uh gradings. Um So the subjective one was the snot 22 which was a questionnaire of the um patients symptom uh severity and uh the objective ones were um L MS, uh L KS and T MPS. So some of them were CT scans and some of them were uh endoscopic um imagings. Um So what we found was um there was significant um main differences between uh the treatment group and the control group. Um So, uh they were all negative values, which means uh negative value means um there is a better symptom control. Um So, yeah, in all of the subjective uh gradings, all of them are significant. However, in the endoscopic uh imagings, um only two of them were significant enough. Um And we also performed a uh meta analysis of these three studies. Uh It might be a small uh number of studies, but we thought it was necessary um just to compare um the uh effect of ril to the uh control group. Um So I think at this point, I will pass on to my uh colleague, Carri who will talk more about the um uh data aly. Yeah. Hi. Um Yeah, just to introduce myself as well. I'm Harris. I'm 1/4 year medical student at part in London at the moment. Um Yes. So I work with Nick on this um this piece of systematic systematic review. Um Essentially we did our meta analysis on this um because of the differences between the different types of outcome we um did a subgroup analysis. So as Nick was saying before snot 22 was a subjective questionnaire. Um And this is quite similar to TN SS which was examined in um the other study. So we use, we compared both of those. Um and an L KS and T MPS are both studies based on endoscopic findings. So we were able to do a sub analysis based on that as well. Um So if I share my screen as well, one second, maybe I understand take care. So here, if we look at the meta analysis that we performed, I just as zoom in a little bit. So here we're looking at snot 22 which is quite a cool name because it's basically looking at how your um essentially your symptomatic um effects are we're comparing the bar Ol and Mi AKI at all, we use a effects model instead of the fixed effect model because um it was more suitable for this type of data. Um And if you look at looking at the the effect sizes when they compared added together in a random effects model, we were able to see um negative 1.1. So that's quite promising. As Nick was saying earlier, a negative value, it's indicative of an improvement. Uh If you look at health strate as well, it's about 0% which is very promising. Um because it shows that data themselves between the two studies is quite similar um And then looking at L KS and T mps as well, um It's very similar outcome there. Um We have negative 0.1 there as well and a decrease in this is also quite promising as an improvement. Cos it shows it has gone down P value is 0.56 as well. So that shows that there's not too much difference between the two of them. And then looking across at the, um L MS which is based on um ct findings, um, there was a bit more heterogenity here. So the Barbi et al um showed a increase of 000.08 which is not so promising. Uh Whereas Miei el, which was a piece of gray literature that we looked at, um showed a decrease of 1.12. Um So there's quite a lot of heterogeneity in those findings, uh which makes the results a bit more difficult to um to interpret. But if we look at our overall picture and our results showing in our results, um overall, you can see there's quite a lot of negatives. Um So if we're looking at our sort of conclusion that we're able to draw from this, um across a total of 100 and 16 participants, we saw quite significant improvements across pretty much all of the subjective metrics and two out of three of your uh objective metrics. As I was saying earlier, there is a slight increase in the L MS in one of the other studies, the clinical research is obviously very early uh in stages. Given the limited number of studies that we were able to include in our research, initially, we planned this is more of a meta analysis but given a full meta analyses. But given the sort of limited nature of studies available, we sort of limited it more towards a systematic review. Um but future studies should in general recruit a clinically significant number of patients along with a variety of demographics. Um One thing that will also be particularly important is better endo typing such as measuring this mucus PGP. So we're able to see whether or not an increased PGP is linked to a better response to rail. So it's not all of the studies um did sort of a analysis of this based on their patients. Um a bit more homogeneity and the methodological design is also quite important as Nick was saying earlier, Sam meal use topical verapamil and there's also slight differences in terms of whether or not um irrigation was used. So these studies. Oh, sorry, sorry. Um Yeah, so a bit more homo would be quite useful. Um Yeah, that's about it. Um Any questions that would be great helpful. I II maybe stop sharing. Fantastic, uh you know, very well done. So you clearly you guys had a lot, a lot of detail to go into there. Um So tell me this. Um if you can pull your the slide back up for a second. Um The poster. Yeah, please. Yeah, sure. One second. And um I'll, I'll ask him a question but the slide can come when it comes. Um So with these three studies, all of them have different treatment and control. So you've got oral verapamil and then topical verapamil and you know, there, there is that variation there. So how in your mind would that impact a the validity of the result in your pa in your review, but also be the impact on the patient itself. Um I think in general, the overall methods of action of the verapamil itself um doesn't differ depending on how it's delivered to the target site. So while one of them is oral and one of them is topical and the overall delivery to the targeted site may not be exactly the same. The overall effect that we're able to see should be quite similar between um the three different studies, albeit topical may perhaps show a bigger increase versus the oral verapamil. But the overall sort of methods of action should be quite similar. So we should see similar results. OK, fine. And when you did your statistical comparison, did, did you see that, is that something you or you could ascertain? Um Yeah. So if I go back to the sort of um meta analysis that we did here, you can see it's quite similar between um the sort of random effects model is showing that there's overall decrease between L KS and T MPS, not 22 it's all negative. And if we go looking at their outcomes themselves, the main difference is the, that you see which shows good uh mean difference between it's not 22 in NBA and Miei. While it's not exactly the same amount of difference, there is an overall negative picture which is significantly different. So it is quite similar in terms of there being a negative difference. OK. Um So just for the sake of every uh the, the audience and everyone who's, you know, you've, you've clearly, you've tried to do a uh a meta analysis here for, er, as well as your, your systematic review. Um Just talk them through a little bit about what methodology you used and how that was conducted, please. Uh Yeah, I'll let Nick uh on that. Oh yeah, sure. Um maybe also to add on to the previous points of uh Harris. So, uh I think uh surely there was a lot of uh hydrogen uh that's uh nothing to be denied of but uh I don't think that should uh negate the actual output of the um uh uh efficacy or the mechanism of, of ril itself. And also else you can see the main difference is quite um similar. So it's um nearly to zero. So that, that shows a um similar effects, therapeutic effect of um vil to uh Betroths, which is the conventional um treatment. So you can see it's roughly similar um sort of effect. Um So how we did the meta analysis. So we've um this was quite difficult. Um I'm not gonna lie. Um But uh we've tried to uh use a variety of uh software. So our studio and there was another useful uh calculator from online was the Cambridge effect size calculator. So we used the Coh D to calculate the uh effect size. Um Yeah, and then we plotted the graph. Um Yeah, lovely. Um Great. Yeah, thanks for answering my questions. Does anybody have any other questions in that they want to write in the chart? Um And for the sake of time, we'll just move on to the final portion of the the talk if, if that's not the case um do stick around until the end. Um I'm going to try and share my screen. No. Um no, just bear with me. Um mm It. No. Ok. Sorry guys. Um might have to. Ok. Um No, hang on. Can you do it one second? Ok. No, it's fine. One sec. Yeah. So the final portion of uh the evening which has been really great so far is going to be uh best tips on getting involved from research mainly done by Niraj, who is the president founder of N Mra. Um And they're very useful. Um So I'd highly recommend basically to come into this. I've definitely found them useful myself. Let me try again. Um mm I can share my entire screen. OK. Can you see my screen? Nope. Mm Don't worry about it. II got it. Uh Yeah, this will have to do. Can you see that? Thank you. Yeah. Yeah, scroll down. We were here. So we've, we've done all of the presentations. Let's go straight onto this. Um So yeah, as you can probably see uh hopefully the the the way I'm gonna structure this is, is in two chunks. So there's the first chunk which is kind of self reflection in goal setting. Um I don't want to become a motivational speaker when I say this, but it's, it's kind of the benchmark of what you, what you really need to ascertain to decide what kind of researcher you wanna be. And you know, I guess where you want to go in the world of research. So w when, when we, you know, when we do a mentorship scheme or whatever, any time someone approaches me about research, I always often ask them a bunch of questions and I'm always trying to ascertain what kind of research they do wanna be. So, does that mean are they looking to do medical work? Do they want to be translational? Do they wanna just chip in and out? Whe when they have time? Um What kind of specialties they like also, I guess what kind of things do they want to achieve? Um I think there's this kind of perception of what you can and can't do as a researcher. So, you know, a lot of, a lot of, um, students just kind of think. Well, I'm a med student. I need to do papers. I need to be active in the worst of, well, the research I'm just gonna go and do a systematic review or a letter to the editor or whatever. Nothing wrong with that. Fair enough, uh, to each their own. But I think you should ask yourself what's, what's the point? Um I've kind of put here, ask yourself why until you can't anymore. And um II think it's like this kind of five year old's curiosity of like, you know, why are you doing this review? Because whatever topic is interesting, why is it interesting? Well, because I actually enjoy doing XY and Z. Well, why do you enjoy it? And you kind of go down this rabbit hole and the more you ask the questions of yourself, the more you learn about your own motivation to do the project, but also what that work actually means to you and what it means to be done. Um You know, there's, there's a very famous statistic where 87% of research funding and research output is kind of junk. It doesn't actually lead to any clinical change or any real movement at all. Um And since the, you know, this was, the study was done at least 15 years ago, there's been a lot of movement in terms of cutting down medical funding and making sure we don't waste resources on studies that are just being done for the sake of them. And I think you should ask the same questions of yourself. You know, you gotta do if you're gonna do research, do it because it actually meaningful and you care about it. And ideally, you should be able to see a, an end benefit if that's, you know. So for example, so for my P HDI do real world evidence, which means we look at registry data for um the UK hospitals and um linked to primary care. So that's, you know, multiple, we're talking a six figure data set. Some of the some of the bigger builds can have over a million patients in them. And we have the power statistically to then obviously make big assumptions for cohorts across the globe and say, well, well, this is the risk factors we found or this is whatever medication works for this field. And because of that, we then have the ability to e essentially move to clinical practice because once that paper comes out, there will be evidence that on a national scale XYZ drug is good or bad and that will move clinical practice. So there is a clear end goal of what we're doing and why and that's what keeps me going because I know that my work will actually be useful to multiple people across both patients and um clinical g er clinical guidelines and you know, people who actually set the agenda for what we do in this, in this healthcare system. So that's very important. But also you've gotta think about what can you actually do? Um you know, in terms of, do you want to do clinical trials? Do you wanna do lab work? What kind of skills does that involve? Does that involve stats? Does that involve, um Do you want to be someone who's, who's in the lab all the time or you gotta learn how to do things like Western blots and other techniques? So there's a lot of soul searching that is required um Following on from that, I've kind of put down identifying relevant people around you that can assist in your journey. Um I think that goes bother professionally and personally um professionally. I think obviously you want to find people who have bend down the alley where you wish to go, but are a little bit further ahead. They will then be able to guide you. They'll be tell you what not to do. They will open doors for you and they can obviously show you resources or things that will help. Um Absolutely, you know, seize those opportunities because not everything needs to be done from scratch. Um You know, II as much as I don't agree with the hierarchy of supervision, I also think that having someone who can help you out and someone who's willing to support your journey is, is completely, you know, a very noble thing that they offered you and you'd be a fool not to take it. But I think you should also consider value exchange. I was talking about this last month in my talk about research mentors, you've gotta ask yourself. But why would someone want to work with you? What's in it for them to sit and tell you and get, spend all their time and effort to train you to be a better researcher. Like w what, what's the benefit for them? Um For some people, it may genuinely be as simple as well. They like you and, you know, they want to help you, some people, it might be that you're actually gonna contribute to their work. You can chip in and do projects with them, you can help with um assisting down the line. Maybe there, there's a phd for you or, you know, maybe there's a, there's a AAA job that they, they're kind of hoping you pick up down the line if I in a clinical setting or whatever that may be. Um, you know, don't, you know, if that does happen, people will be kind of scouted from, you know, if you're like a late med school student and they're thinking, yeah, he might be good for my A FP or whatever that, that does happen. Um I, I've seen that for myself. So, you know, you, you've gotta ask yourself what do I bring to the table? What does this guy bring to the table? How do we make this relationship actually seem equal and, well, in not those exact words, but it's probably good to have those conversations very early on. Um, so once you've kind of identified what you wanna do, who you're gonna do it with and where you need to go the next step, in my opinion, in the second half of this is personal development. I think once you've identified that it, then it's just a case of, you know, each step along the way gets you a, 100 miles. Um So if you want to do, for example, clinical trials, you should probably go and pursue AAA qualification or experience within statistics and trial er stat and manipulation that would be very useful for you. Similarly, if you want to be in a lab, you know, get some, get some internship or go and pursue time in, in a relevant wet lab or whatever you can do, you have to just get stuck in and pursue relevant skills and courses and open your eyes to what exactly you're signing up for and what you need to get there. Um You know, like I've put down working with relevant teams are working in that area. Again, it's about getting your foot in the door. Um Some work, I mean, at the end of more, we, we kind of glorify this, this idea that you can do a lot of research on your own. And I think that, that, that is by and large. True. Um So, you know, for example, all three of these projects that, that have been put up today, they are the kind of work that, you know, we would do with N Mra ourselves and you know, with, with students. So, you know, we'd be more than happy to support projects like that. And, and if any of you guys who presented today, you, you want to do work with us or you want us to help you with getting that work, the next stage publishing whatever you know, please do get in contact with us. Um Because, you know, there is something to be said about research that you do for yourself and by yourself. But some things, you know, it's not physically possible to do, you can't do a trial in your living room, it just doesn't make sense. Um So, yeah, within limitation, seek out people who, who can open doors for you when they're needed. Um And then the, the most important point I'll always say is ex is network, you need to expand your horizons. Um Because you know, if you keep doing the same thing again and again, you're gonna get the same outcomes. So meet new people, get new ideas for your research projects and just look, you know, you, if you let me put it this way, people who are good researchers think outside the box. But I guess if you network and you keep learning more things, the size of that box will change over time. So what you'll find is that there's more ways to innovate and there's more things that you will be able to add because you already have such a cutting edge knowledge of what's going on around you. So yeah, take the time to build up your skills and your knowledge and when you do that, it will make the rest of your journey easy. Because if you've already got previous experience or you, you've taken the time to work with N Mra or even by yourself, you've developed those skills. If you approach a research group and you say I've done Xy and Z, I'm looking to further myself, I'd like to work with you guys. That value exchange looks a lot more beneficial. There's actually something that they can see you, you've, you've invested into being a researcher. And so they're more likely to want to work with you and you're more likely to get something out of it because you are intimately familiar with what's going on and where you might be able to contribute more hands on. Whereas if you're kind of learning on the job, you might spend a lot of time just acclimatizing to a new environment where you're not uh that productive and you're not learning as much because you're still figuring out what to do. So this way you'll be to get more work done and you'll be able to hit the ground running, which is a win, win. And they'll see that people who work with you will say, oh, this guy knew exactly what he was gonna do. He came in with the right attitude and he got more work done. They will respect you more and that's what you want because research is that fundamentally it's a small world. Everybody knows everyone or well the that the people who network know everyone. And so, you know, people will remember a good, a, a good impression you made by trying hard and making a name for yourself early on. But um yeah, that's, that's what I had planned to talk about. Um I'm happy to kind of stick around for a few minutes, take questions or, you know, if you wanna email in or whatever that looks like I'm happy to continue the conversation and, you know, there's always more space for people to join an Mra or talk with, talk with us, discuss projects, whatever that looks like. Very happy to do that. I um I'm just going to send our email uh here again if you have any questions or if you want to ask anything directly. Um I've also shared the um open recruitment form. Um We recruit um on a rolling basis throughout the year. We have multiple teams that are working on again, multiple uh branches. We have an outreach team media team, finance team, um welfare, research, education. Um and more. Um and we're always looking for more people to join us. Uh So if you're interested, do definitely uh consider it. Um And also I've reha the mentees recruitment formula and the mentor recruitment form. And um if you are interested, potentially, um I um you could definitely a, a apply for the mentor uh to be a mentor in our scheme as well. Um Even if you might have, if you might think you might not have, have done enough research, but that's, that might not be the case necessarily. Um So again, you consider these, um we have a question in the chat um from Mohammed Hamza and he is asking if um clinical phd projects are mostly uh trial based or uh they can be mixed with lab work. I think that depends on your definition of a clinical phd. Um So, for example, depending on your funding body and what project you're doing, um you can have projects that are essentially lab based but they're translational. So, you know, you could um so in my lab uh in my department, sorry, there, there's a lab that are doing essentially mouse modeling, but they're, they're looking to develop drugs uh kind of drug precursors. So they're testing whether they've identified an appropriate protein channel and whether this drug target might actually be viable. And then that's going to lead into clinical human trial in the next few years, but each individual step can be its own trial. Uh And it's each and therefore it can be its own phd like you could do a whole phd just on the mouse model bit, but equally the next, you know, in the next 34 years there could be another phd that's just doing the human stuff. Um But then that's kind of drug development side. There's obviously what I do in real world evidence, which is clinical because we literally deal with 100s of thousands and millions of patients in with the, the data sets we have. So it's clinical because it's pure hospital data. Um You know, then there's people who do imaging based studies, people who do you to look at A I, you know, um there's, there's a lot of scope to kind of convert what you're doing differently. And um yeah, by the way to answer your question at all. Um So yeah, there's lots of different ways to approach a clinical phd depending on what your question is and what you want to achieve out of it. Um At the moment, I'm happy to do real world evidence because it's got the most kind of short term immediate yield of good o outputs and clinical benefit. But down the line, you know, I'd love to kind of transition into trials, probably do a bit more of that work because it is more, I guess seen as more robust in the world of research, I don't agree. Um, but, you know, to each of their own, um, I think the mark of a good researcher is someone who, who can recognize that there's a certain project that fits every end goal that you'd like to achieve. But, uh, yeah, thanks for your question though. That was, you know, quite interesting. And something else that, um, I noticed is everybody kind of talks a lot about how difficult it is to get involved in researchers as a med student, which ii agree with. Um But also, um I think the idea of it being very difficult also stops you sometimes from just going ahead. Um And you can get lots of opportunities just by cold emails. Um And 11 kind of personal tip that I've, that ended up being quite useful, maybe, maybe it's useful, maybe it's not, we'll have to see in the long run. But uh it's just getting involved uh in different things. Um You never know you might get involved in a committee and if you're very research inclined, uh you might end up just coming up with a really good idea and just, just from being part of the committee, you could just end up with like a really cool project together, um which you maybe just didn't start that way. Um And again, just by being involved by being involved in one thing, then maybe you just create a connection, they didn't think you vote and then from that to that connection, something else can happen and then just that can just lead to a whole bunch of more opportunities for everybody. Um And yeah, yeah, you just never, never know. And then maybe you find something you were interested in that you didn't, not existed before. Um And you just echoing what Nira said earlier, you really, then you can just kind of, you end up shaping your own um interests all just depending on again what you, you, you shape the reality according to what your desires are. So you wa you want to get involved in randomized control trials on one specific topic, you can do that. Um And then just kind of suddenly happens basically. Um Do you want to add anything? Does anybody have any other questions? No, you're good. Um Yeah, just to back up the whole thing about cold emailing. I genuinely got my first research project through just cold emailing like 80 people. And I think two of them replied, I didn't like one of the projects. So I did, I went with you, I went with the other guy and he's been one of my mentors for the last eight years ever since. So, you know, it does happen. Um You just got, I think that there's a small amount of kind of confidence you need to, to put yourself out there and to understand what you, what you wanna do and how that person is gonna help you but yeah, anyone can do it. Yeah. No, sometimes the the most unexpected professors as well might be the ones that reply. And in my case again, I started this whole process with very little experience. But through the mentorship scheme a couple of years ago, I've ended up again in a very short amount of time. I can, I can just basically do my own project on my own. Um And if you, if you, that is very powerful tool, um If you can do all the steps people with will want to work with you. Uh Especially if you are reliable, you know what you're talking about, you can bring in your own perspectives. Um and even professors, et cetera, they will uh and that can be like a relationship that's good for both people because then they can have a interesting relationship with you and then you can have one interesting relationship with them basically just off of um the, the, the the job. Um OK. So thank you everyone very much. Uh Please do fill in, fill in the feedback so you can get your certificate for being here tonight. And um yeah, check us out on online and we're going to start our systematic review me analog teaching series in a, a couple of weeks time which is going to get advertised um the next couple of days. Um and yes, get in touch if you are interested in working with us. OK, lovely. I'm just going to stop the meeting now. Yes. Um, I don't know how to do that. Yes. 10.