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Take a look at a selection of our recent media coverage:

Coeliac UK and Innovate UK announce £750k boost to research

31st January 2019

 
Coeliac UK, the national charity for people who need to live gluten free, has combined forces with Innovate UK, the UK’s innovation agency, to drive improvements worth £750,000 in the food technology, diagnostics and digital care industries.
 
The UK has been at the forefront of the most dynamic growth area in free from food retailing and Coeliac UK is the world’s largest support organisation for people with coeliac disease. This collaboration will build on these strengths by supporting research advances in food technology, diagnostic techniques and digital care.
 
Sarah Sleet, chief executive of Coeliac UK said: “Coeliac UK is a world leader on coeliac disease, supporting research that makes a real world impact. This new research to create a different diagnostic test could help unlock a worldwide problem for millions of people without a proper diagnosis of coeliac disease, while the research on innovative gluten free ingredients will keep the UK ahead in the food industry’s expansion into gluten free. Meanwhile our third funded project could offer real savings to the NHS in the management of the lifelong autoimmune condition that is coeliac disease providing a service model for the many other chronic long term conditions in the UK.” 
 
Dr Kath Mackay, Director of Ageing Society, Health and Nutrition at Innovate UK, said: “Stimulating innovation in our food and health sectors are crucial components of the government’s industrial strategy. By working with Coeliac UK we will be able to offer funding that results in improved quality of life for people with this condition and support and stimulate our vibrant health care and food technology sectors.”
 
The three projects reflect the key challenges of living with coeliac disease and a gluten free life:
 
New test to provide a less invasive way of diagnosing coeliac disease – Nonacus Ltd, Birmingham
The average time to gain a coeliac disease diagnosis is 13 years and there are half a million people in the UK undiagnosed – and in the tens of millions worldwide. Nonacus Ltd, working with researchers at the University of Cambridge led by Dr Elizabeth Soilleux, will together develop a test for coeliac disease. Current tests only work if patients are still eating gluten. The new test will rely on a proprietary laboratory test in conjunction with a patented computer algorithm. It’s a completely new way of looking at the immune cells and can identify patients with coeliac disease by predicting how likely immune cells are to be responding to gluten. It aims to develop a coeliac disease test for people who have already adopted a gluten free diet, as well as an improvement on the current method of analysing biopsy samples. This will not only save considerable patient suffering but will also provide savings to the NHS speeding up diagnosis journeys.
 
Development of three new plant proteins to help improve the ingredients used in gluten free bread – Nandi Proteins Ltd, Scotland
To improve gluten free bread by developing revolutionary new ingredients. Nandi Proteins Ltd (a protein technology company), Genius Foods (gluten free food manufacturer) AB Mauri (distributor of bakery ingredients) and Agrii (a plant science and technology company) will join researchers at Heriot Watt University to develop three kinds of new plant proteins. The proteins will be derived from crops which are underused in the UK: rapeseed cake, faba beans and naked oats. These new ingredients could replace the expensive egg and dairy based ingredients currently used, improve the nutrient profile, taste and texture of gluten free bread and reduce the need for E number additives. Development of these new ingredients will also open up new markets for UK grown crops and add value to the UK economy. Overall consumers could see cheaper and better quality gluten free products.
 
Software innovation to help in the ongoing management of coeliac disease – Cievert Ltd, Newcastle
Software will be developed to better manage coeliac disease. Working with leading researchers from Sheffield University, the goal is to find patients with coeliac disease that need more support, compared to those who are living well. The software, when developed, will let people receive the assurance of being clinically followed up without the inconvenience, time and cost of hospital appointments. Whilst those who need additional care will be identified quickly and easily so that they can access crucial support when they need it most. This could be technology that is applied to other conditions in the future resulting in substantial savings for the NHS.

Medicines will be prioritised over ‘vital food’ in no-deal Brexit, says UK’s health secretary

29th January 2019

The supply of medicines will be prioritised over “vital food” in the event of a no-deal Brexit, according to health secretary Matt Hancock.

Speaking before the Health and Social Care Committee yesterday, Mr Hancock assured MPs there will be continuity of the medicines supply in the UK, regardless of the Brexit scenario.

In a letter sent to the Government yesterday, leading retail companies including Sainsbury’s, Asda and Marks & Spencer warned MPs of major food shortages and increased prices post-Brexit, if the UK fails to reach a deal with the EU by the March deadline.

Asked by Labour MP Ben Bradshaw why supply issues of medicine would be any different to “vital food”, Mr Hancock said “medicines will be prioritised [over food] in the event of significant disruptions at the border”.

He continued: “We’ve been through detailed, line-by-line analysis of the 12,000 medicines that are licensed in the UK in order to ensure that there is a plan for the continuity of supply for all medicines in the event of a no-deal Brexit.

“The pharmaceutical industry have reason to this challenge and done their duty thus far. There is a lot more work that still needs to be done in the remaining time but we do have the time necessary to do what we need to do.”

This comes as new research reported rocketing fruit and vegetable prices – as a result of a no-deal Brexit – could lead to 12,400 extra deaths from heart disease and stroke over the next decade.

But Labour’s shadow health secretary Jonathan Ashworth MP said: “The fact that the health secretary is forced to make decisions over whether to prioritise medicine over food in the event of a Tory no-deal Brexit is simply astonishing.

“Playing Russian roulette with the national interest and putting people’s health at risk like this is shameful and scandalous,” he added.

This article was first published by our sister publication Pulse

Consultant honoured for dedication to improving the practice of cytology

28th January 2019

 
A top consultant who has played a leading role in helping to develop nationally and internationally recognised services supporting the diagnosis and prevention of cervical cancer has been recognised by the International Academy of Cytology for his outstanding contribution to the field.
 
Dr John Smith, consultant gynaecological histopathologist and cytopathologist at Sheffield Teaching Hospitals NHS Foundation Trust, is only the third person from the UK to be given the Maurice Goldblatt Award, which is awarded by the International Academy of Cytology in recognition of professionals who have dedicated their lives to cytology. 
 
The Awards are the highest bestowed on professionals working in the field, and have been given every year since 1961. Recipients have been 53 cytologists from 21 countries. The last UK doctor to receive the honour was in 1982.
 
He has held a number of influential positions, serving as president of the British Society for Clinical Cytology and vice-president of the International Academy of Cytology, and organiser of the highly successful 17th International Congress of Cytology in Edinburgh in 2010, which advanced knowledge and understanding by bringing together over 1000 scientists and clinicians from all over the world practising in cytology. 
 
Dr Smith first started working at the Northern General Hospital in 1987, taking on a consultant role that involved examination of cervical smear tests to detect and prevent cancer of the cervix. 
 
Using his scientific and diagnostic expertise, he became instrumental in helping to develop new and emerging practice that would eventually form the backbone of the now highly successful national cervical cancer screening programmes.
 
The specialist cervical screening cytology laboratory at the Royal Hallamshire Hospital, where he now works, was one of the first in the country to begin using liquid-based cytology. This technique – which at the time represented the first major change in the way cervical samples were prepared for examination in 50 years – involves processing cervical smear samples to produce a thin layer of cells on a slide to detect pre-cancerous changes rather than smearing them on a glass slide. Subsequently, from 2008, Sheffield Teaching Hospitals was one of six sites in England to pilot testing for human papillomavirus (HPV) – which is the known cause of cervical cancer – to further refine and improve the screening programme.
 
As Director of the North of England Pathology and Screening Education Centre (formerly the East Pennine Cytology Training Centre, which he founded in 1992), Dr Smith has played a pivotal role in evaluating cervical cancer screening practice and educated generations of trainee pathologists and laboratory scientists working in the NHS cervical screening programme.
 
Dr John Smith, consultant gynaecological histopathologist and cytopathologist at Sheffield Teaching Hospitals NHS Foundation Trust, said: “It is a great honour to receive this award. Cervical cytology is a highly specialist field, and I’ve been privileged to work with a fantastic team in Sheffield at the forefront of helping to develop the NHS cervical cancer screening programmes. I’m also proud to have been able to support the work of generations of pathologists across the north of England and to have worked both nationally and internationally to advance best practice. I feel truly humbled to have played a role in advancing specialist cytology practice, which through the development of national screening programmes, has benefited millions of women by given them access to earlier diagnosis and treatment.”
 
Dr David Throssell, medical director at Sheffield Teaching Hospitals NHS Foundation Trust, said: “I am so pleased that John’s talent and dedication to the NHS have been recognised. This is a thoroughly deserved, once-in-a lifetime award which acknowledges the significant contribution John has made to the practice of cytology over the last 30 years. His invaluable work has helped many patients living in Sheffield and the surrounding regions and further afield.”
 
Dr Smith will receive his award at the 20th International Congress of Cytology in Sydney on 5 May. He will receive a gold medal, diploma and deliver a scientific presentation to an audience of international experts. As the Congress is held on a three-yearly basis, Dr Smith will be presented with the 2017 Maurice Goldblatt Award.

UK Government announces ‘enhanced’ role of pharmacists to address antimicrobial resistance

25th January 2019

Pharmacists will play a crucial role in the Government’s bid to cut antibiotic use by 15%, according to its five-year national plan to tackle antimicrobial resistance.

The document, published yesterday (24 January) alongside a 20-year vision, outlines a number of actions aimed at reducing drug resistance by ensuring people take fewer antibiotics.

To help achieve that, the document says that “the UK will enhance the role of pharmacists in primary care to review the dose and duration of antimicrobial prescriptions (especially long-term or repeat ones) and work with prescribers to review those that are inappropriate through evidence-based, system-wide interventions”.

This will contribute to strengthening antimicrobial stewardship programmes across the UK. In addition, pharmacists in all settings can work together to share knowledge and learning to boost appropriate prescribing of antibiotics.

Under the plans, the National Institute of Health and Care Excellence (NICE) and NHS England will be tasked with looking at a new way of paying for medicines to help improve stewardship.

It is hoped the model will shift from one that pays pharmaceutical companies based on how many antibiotics are sold, to one that instead focuses on how valuable they are to the NHS.

Health and social care secretary Matt Hancock said: “Each and every one of us benefits from antibiotics, but we all too easily take them for granted, and I shudder at the thought of a world in which their power is diminished.

“Antimicrobial resistance is as big a danger to humanity as climate change or warfare. That’s why we need an urgent global response.”

Misuse of antibiotics – including taking the wrong type of medicine, not using them as directed, and inappropriate doses – is a leading cause of antimicrobial resistance. If human consumption continues to grow at current rates, it will rise by up to 200% by 2030.

The UK has successfully reduced antibiotic use by more than 7% since 2014. The target figure is 15% in the next five years.

Other targets outlined in the Government’s proposals include cutting the number of drug-resistant infections by 10% (5,000 infections) by 2025, and preventing at least 15,000 patients from contracting infections as a result of their healthcare each year by 2024.

Patients aged 18-29 receive worst asthma care in UK, charity reveals

23rd January 2019

Those aged 18-29 are the most likely to suffer an asthma attack and least likely to receive life-saving asthma care than any other age group, research has revealed.

Two-thirds (67%) of patients in this group are not receiving basic asthma care – higher than any other age group – a survey of more than 10,000 asthma patients by the charity Asthma UK revealed.

Patients in this age group are also twice as likely to receive emergency asthma care than patients aged over 60, the charity said.

Almost a third (28%) did not attend their asthma review, with 12% saying they could not book this with their GP.

Younger people could also be more likely to suffer an asthma attack because of the turbulent housing market because poor-quality housing containing mould and damp ay exacerbate symptoms, Asthma UK said.

National guidelines state that basic asthma care for patients includes a personalised action plan explaining how to manage the condition day-to-day, a yearly asthma review and being taught the correct inhaler technique.

Asthma UK’s director of research and policy Dr Samantha Walker said: “Millennials are getting a raw deal, with the worst asthma care of any age group. As a result, thousands needed emergency care for their asthma last year and were at risk of dying from an asthma attack.

“This could be avoided if they received the basic care they should be getting and if they were better engaged to manage their own health.”

NICE recommends Verzenios with an aromatase inhibitor to treat metastatic breast cancer

21st January 2019

The National Institute of health and Care Excellence (NICE) has recommended Verzenios (abemaciclib) in combination with an aromatase inhibitor (AI) to treat metastatic breast cancer.

Eli Lilly and Company announced on 18 January that the drug is recommended by NICE within its marketing authorisation as an option for treating locally advanced or metastatic, hormone receptor- positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer as first endocrine-based therapy in adults.

The oral CDK4 and CDK6 inhibitor is only recommended only if the company provides it according to the commercial arrangement, the manufacturer added.

As a result of the recommendation, abemaciclib is now available for use in NHS England initially via interim funding by the Cancer Drugs Fund until routine NHS baseline funding is in place.

Senior medical director at Eli Lilly and Company UK and Northern Europe Dr Arash Tahbaz said: “Breast cancer is the most common cancer in the UKand despite advancements in medicine, metastatic or advanced breast cancer remains a difficult-to-treat disease. The NICE recommendation allows doctors to offer an additional treatment option for this group of patients.”

New rapid blood tests for TB could accelerate diagnosis

18th January 2019

Researchers from Imperial College London have shown that rapid blood tests used by the NHS are unable to rule out tuberculosis (TB) and should be replaced with a new, more accurate test.
 
Diagnosing and treating the condition early is essential for the health of the patient as well as for preventing the spread of TB to others. There is therefore a need for rapid, convenient tests to rule out a TB diagnosis in suspected cases based on a blood sample.
 
In the largest study to date of rapid TB tests used by the NHS, results showed that available tests are not sensitive enough to rule out a diagnosis of TB in suspected cases, and so have limited clinical use.
 
The study, published in Lancet Infectious Diseases,1 also looked at a new second generation rapid blood test, developed at Imperial, and found it to be substantially more accurate than the existing tests.
 
According to the team, once implemented the new test could enable doctors to quickly detect or rule out TB infection and help them to distinguish patients who need further investigation and treatment from those who do not and pose no infectious risk to others. 
 
Professor Ajit Lalvani, Chair in Infectious Diseases at the National Heart & Lung Institute at Imperial College London, who led the study, said: “Tens of thousands of patients undergo diagnostic assessment for symptoms suggestive of TB, resulting in over 5000 cases of TB diagnosed each year. Stopping the use of the existing, inadequate tests could save the NHS a lot of money. In contrast, the new, more accurate rapid blood test, will improve and accelerate diagnostic assessment of patients with suspected TB.”
 
Currently available rapid tests for TB used by the NHS, known as interferon-gamma release-assays (IGRAs), can help to indicate if a patient has TB infection by detecting their immune response to TB bacteria based on a blood sample. The findings would then be confirmed with cultured patient samples in the laboratory.
 
In the latest prospective study, co-led with Professor Onn Min Kon, researchers compared existing commercially available IGRA tests against new generation tests in 845 patients with suspected TB in 10 NHS hospitals in England. Patient blood samples were analysed using both sets of tests, the results of which benchmarked against a confirmed diagnoses based on positive culture results.
 
Analysis of the rapid test results revealed that the second-generation test has a diagnostic sensitivity of 94% in patients with confirmed TB – meaning it gives a positive result for 94% of patients with infection – significantly and substantially higher than either of the existing commercially available IGRA tests (which range from 67.3% and 81.4%).
 
The findings indicate the test would be much more accurate at ruling out TB infection in suspected cases of TB, so saving time and resources and enabling patients to receive treatment more rapidly.
 
According to the researchers, the medical need for better TB diagnostics is so high that despite a lack of evidence to support their use in patients with suspected TB, existing tests are widely used in clinical practice in the UK and other developed countries. They add that stopping use of the existing tests could save the NHS over £2 million per year, with further savings likely generated by implementing the new tests – which could be available to health services within one to two years, pending regulatory approval.
 
Our study shows definitively that existing rapid tests are not effective enough for diagnosing active TB and should not be used. This important result will change clinical practice,” explained Professor Lalvani. 
 
Professor Lalvani, added: “This study provides definitive, generalisable evidence on the clinical utility of the new test. The next step is now to take this new test through regulatory approval so that it can be made commercially available and used in routine clinical practice.”
 
Reference
  1. Whitworth H et al. Clinical utility of existing and second-generation interferon-gamma release assays for diagnostic evaluation of tuberculosis: an observational cohort study. Lancet Infectious Diseases DOI: 10.1016/S1473-3099(18)30613-3

New treatment for prostate cancer receives European licence

17th January 2019

Janssen has announced that the European Commission (EC) has licensed Erleada (apalutamide), for the treatment of men with non-metastatic castration-resistant prostate cancer (nmCRPC) who are at high risk of developing metastatic disease.
 
Prostate cancer is the most common cancer in men in the UK,1 resulting in over 47,000 diagnoses each year, or 129 each day.2
 
The licence is based on the results of the phase III SPARTAN trial, which found that apalutamide in combination with androgen deprivation therapy (ADT) significantly decreased risk of death or distant metastasis by 72%, compared to ADT alone.3 It was also found to improve median metastasis-free survival (MFS) by over three years (40.5 months) compared to just over one year (16.2 months) in the placebo group.3
 
The most common Grade 3/4 treatment-emergent adverse events in the SPARTAN study were hypertension (14.3 % vs. 11.8%), rash (5.2% vs. 0.3%), fall (1.7% vs. 0.8%) and fracture (2.7% vs. 0.8%).3 Treatment discontinuation due to adverse events was 10.6 percent in the apalutamide arm compared to 7 percent in the placebo arm.3 Rates of serious adverse events were similar in the apalutamide in combination with ADT arm versus placebo in combination with ADT arm (24.8% vs. 23.1% respectively).3
 
Prostate cancer is the most common cancer diagnosed in males in England,4 and approximately 84% (34,010 people) of those diagnosed suffer from the non-metastatic form of the disease, meaning that the cancer has not spread to other parts of the body (for example, the bones).5 If the disease is castration-resistant, it no longer responds to medical or surgical treatments that lower testosterone.6 90% of patients with nmCRPC will eventually develop bone metastases,7 which is a turning point in prostate cancer, as it is a key cause of complications and death.3 Extending the period without metastases is therefore an important treatment goal.3,7,8
 
Commenting on the EC licence, Dr Simon Chowdhury, Consultant Medical Oncologist, Guy’s and St Thomas’ Hospitals, said: “Apalutamide is one of the first treatments shown to be effective in this group of patients, as phase III clinical data demonstrated that it significantly prolonged the time that patients with non-metastatic castration-resistant prostate cancer survived without their cancer becoming metastatic.”
 
We are pleased that the EC has authorised apalutamide for the treatment of patients with high-risk non-metastatic castration-resistant prostate cancer.” said Mohamed Lockhat, Therapeutic Area Medical Affairs Director for Oncology at Janssen UK. “At Janssen, we remain committed to our goal of developing and delivering innovative medicines that transform patients’ lives, and today’s approval brings us one step closer to achieving this.”
 
References
  1. Cancer Research UK. Prostate cancer incidence. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/s…. Last accessed January 2019.
  2. PCUK. About Prostate Cancer. Available at: https://prostatecanceruk.org/prostate-information/about-prostate-cancer. Last accessed January 2019.
  3. Smith, R. M. et al. Apalutamide treatment and metastasis-free survival in prostate cancer. N Engl J Med 2018; 378:1408-1418. Available at: https://www.nejm.org/doi/full/10.1056/NEJMoa1715546?query=featured_home. Last accessed January 2019.
  4. Office for National Statistics (2018) Cancer registration statistics, England, 2016. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/… Last accessed January 2019.
  5. National Prostate Cancer Audit. Annual Report 2017. Available at: https://www.npca.org.uk/content/uploads/2018/02/NPCA-2017-Annual-Report_…. Last accessed January 2019.
  6. Saad. F. Guidelines for the management of castrate-resistant prostate cancer. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997826/ Last accessed January 2019.
  7. Hotte SJ, Saad F. Current management of castrate-resistant prostate cancer. Curr Oncol. 2010; 17(Suppl 2): S72–S79. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935714/. Last accessed January 2019.
  8. Coleman RE. Clinical Features of Metastatic Bone Disease and Risk of Skeletal Morbidity. Clin Cancer Res. Available at: http://clincancerres.aacrjournals.org/content/12/20/6243s.long. Last accessed December 2018.

Keele University awarded over £2m to investigate opioid overprescribing

16th January 2019

A university has been given more than £2m to conduct research into opiod overprescribing in the NHS.

Keele University received a £2.4m grant from the state-funded body the National Institute for Health Research (NIHR) to explore the causes of painkiller overprescribing and train GP pharmacists to better help patients with long-term pain.

In December, health and social care secretary Matt Hancock announced the launch of a review looking at “problematic polypharmacy” in the NHS, which will be led by England’s chief pharmaceutical officer Keith Ridge.

The Keele University study aims to reduce “inappropriate” opioid prescribing and improve the quality of life for people suffering persistent pain caused by conditions such as osteoarthritis.

The researchers will also look for alternatives to opioid use, support patients to self-care and train practice-based pharmacists to better assist patients with long-term pain.

Study lead Dr Julie Ashworth said: “Patients with persistent pain often see no alternative to continuing opioids, even when they are no longer helpful or cause troublesome side-effects.

“In addition to reducing use of medicines that may be harming rather than helping patients, if successful, this research will ultimately also reduce NHS prescribing costs and free-up scarce resources to reinvest in more effective treatments.”

It is estimated that the use of morphine-like painkillers increased by a third between 1998 and 2016. People relying on opioids are more likely to have a poor quality of life and suffer bone fracture, addiction and overdoses than those who do not take the medicines, according to research.

The UK’s pharmacy minister Steve Brine said that intervening more efficiently at primary care level could “prevent the complications that arise from long-term opioid use, which improves the quality of care for patients and reduces the burden on the NHS in the long-term”.

He added: “This exciting research comes at a time when we are tackling overprescribing head on to improve the care of those with long-term conditions and to reduce prescribing costs across the whole NHS.”

Patients to take part in landmark irritable bowel syndrome trial

15th January 2019

Sheffield Teaching Hospitals NHS Foundation Trust has been named as one of 20 UK sites involved in a landmark trial assessing whether a drug commonly used to prevent nausea and sickness after surgery, radiotherapy or chemotherapy could help treat patients suffering with the agonising symptoms of irritable bowel syndrome.
 
Researchers taking part in the nationwide TRITON trial, funded by the National Institute for Health Research, will look to assess whether a much lower dose of the drug ondansetron could successfully alleviate agonising symptoms experienced by those living with irritable bowel syndrome accompanied predominantly by diarrhoea and loose bowel movements.
 
Ondansetron was originally developed to treat the side effects of chemotherapy, and works by blocking abnormally high amounts of serotonin, a natural substance that stimulates receptors in the gut that send signals to the part of the brain that causes nausea and controls vomiting.
 
Once these signals are interrupted, the sickness can be stopped.
 
Researchers hope that by using a lower dose of ondansetron in patients with irritable bowel syndrome the drug can block the excess levels of serotonin that are found in the intestine of some patients with irritable bowel syndrome. 
 
They will also look to see if the response to the drug is dependent on genetic factors so variation in the gene controlling the production of serotonin will be explored.
 
During the 12-week trial, 400 patients recruited from across the UK will be asked to keep a detailed diary and respond to daily text messages to document their symptoms. This will help doctors to assess any potential benefits of the new medication.
 
Half of the volunteers taking part will be prescribed the drug, while the other half will receive a placebo. 
 
Professor David Sanders, consultant gastroenterologist at Sheffield Teaching Hospitals NHS Foundation Trust and Professor of Gastroenterology at the University of Sheffield, said:  “Irritable bowel syndrome is a debilitating, incurable, condition which affects people in a variety of ways, disrupting daily activities, and impacting on the quality of people’s lives, physically, emotionally and socially.
 
We are delighted that Sheffield will be playing a leading role in this landmark trial as the possibility of this drug providing a treatment for patients with the condition who predominantly suffer with loose bowel movements and diarrhoea is fantastic.
 
Only a small number of people have had this treatment before for irritable bowel syndrome so it will be a great chance to benchmark this research. We’re also delighted that Dr Imran Aziz, an internationally renowned expert in irritable bowel syndrome, has returned from Sweden to run the Sheffield trial from our centre of excellence at Sheffield Teaching Hospitals.”
 
The trial, which is being led nationwide by researchers from the University of Nottingham, is being carried out in collaboration with Nottingham University NHS Hospital Trust, as part of the National Institute for Health Research Nottingham Biomedical Research Centre.  The Sheffield study is being supported by the Sheffield National Institute for Health Research Clinical Research Facility.
 
Patients from Sheffield and South Yorkshire will be recruited through gastrointestinal clinics run by Sheffield Teaching Hospitals NHS Foundation Trust.
 
For further information email [email protected] or visit the dedicated TRITON website https://ctru.leeds.ac.uk/triton.

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