The Neuromod+ network will represent UK research, industry, clinical and patient communities, working together to address the challenge of minimally invasive treatments for brain disorders. Increasingly, people suffer from debilitating and intractable neurological conditions, including neurodegenerative diseases and mental health disorders. Neurotechnology is playing an increasingly important part in solving these problems, leading to recent bioelectronic treatments for depression and dementia. However, the invasiveness of existing approaches limits their overall impact. Neuromod+ will bring together neurotechnology stakeholders to focus on the co-creation of next generation, minimally invasive brain stimulation technologies. The network will focus on transformative research, new collaborations, and facilitating responsible innovation, partnering with bioethicists and policy makers. As broadening the accessibility of brain modification technology my lead to unintended consequences, considering the ethical and societal implications of these technological development is of the utmost importance, and thus we will build in bioethics research as a core network activity. The activities of NEUROMOD+ will have global impact, consolidating the growing role of UK neurotechnology sector.

During pregnancy, the developing baby receives nutrients from mother via the placenta. However, in the common pregnancy complication, intrauterine growth restriction (IUGR), blood flow to the placenta and nutrient transfer are dramatically reduced. Affected babies are also at increased short term risks during labour and are at increased risk of heart disease, diabetes and raised blood pressure in adult life. Cortisol is a steroid hormone whose levels are increased by stress. Recent research has shown that high cortisol levels can alter baby‘s growth and development. If the mother is stressed during pregnancy, for example following a bereavement, her blood cortisol levels rise. Preterm labour treatments also increase cortisol in Mum‘s blood. The placenta has an inactivating enzyme to protect the baby from increased cortisol levels in Mother‘s blood. In IUGR, however, levels of this enzyme are thought to be reduced. It is not known how cortisol alters the way the placenta works. My study will investigate if cortisol alters blood flow by assessing blood vessel behaviour directly. I will also look at how cortisol alters the proteins in the placenta that move nutrients to the baby during pregnancy. Understanding how cortisol alters the function of the placenta will assist design of future treatment strategies for IUGR and ensure the safe use of steroid hormones in preterm labour.

Cancer is the second most common cause of death globally, accounting for 8.8 million deaths in 2015. It is estimated that radiotherapy is used in the treatment of approximately half of all cancer patients. In the UK, one new NHS proton-beam therapy facility has recently come online in Manchester and a second will soon be brought into operation in London. In addition, several new private proton-beam therapy facilities are being developed. The use of these new centres, and the research that will be carried out to enhance the efficacy of the treatments they deliver, will substantially increase demand. Worldwide interest in particle-beam therapy (PBT) is growing and a significant growth in demand in this technology is anticipated. By 2035, 26.9 million life-years in low- and middle-income countries could be saved if radiotherapy capacity could be scaled up. The investment required for this expansion will generate substantial economic gains. Radiotherapy delivered using X-ray beams or radioactive sources is an established form of treatment widely exploited to treat cancer. Modern X-ray therapy machines allow the dose to be concentrated over the tumour volume. X-ray dose falls exponentially with depth so that the location of primary tumours in relation to heart, lungs, oesophagus and spine limits dose intensity in a significant proportion of cases. The proximity of healthy organs to important primary cancer sites implies a fundamental limit on the photon-dose intensities that may be delivered. Proton and ion beams lose the bulk of their energy as they come to rest. The energy-loss distribution therefore has a pronounced 'Bragg peak' at the maximum range. Proton and ion beams overcome the fundamental limitation of X-ray therapy because, in comparison to photons, there is little (ions) or no (protons) dose deposited beyond the distal tumour edge. This saves a factor of 2-3 in integrated patient dose. In addition, as the Bragg peak occurs at the maximum range of the beam, treatment can be conformed to the tumour volume. Protons with energies between 10MeV and 250MeV can be delivered using cyclotrons which can be obtained `off the shelf' from a number of suppliers. Today, cyclotrons are most commonly used for proton-beam therapy. Such machines are not able to deliver multiple ion species over the range of energies required for treatment. Synchrotrons are the second most common type of accelerator used for proton- and ion-beam therapy and are more flexible than cyclotrons in the range of beam energy that can be delivered. However, the footprint, complexity and maintenance requirements are all larger for synchrotrons than for cyclotrons, which increases the necessary investment and the running costs. We propose to lay the technological foundations for the development of an automated, adaptive system required to deliver personalised proton- and ion-beam therapy by implementing a novel laser-driven hybrid accelerator system dedicated to the study of radiobiology. Over the two years of this programme we will: * Deliver an outline CDR for the 'Laser-hybrid Accelerator for Radiobiological Applications', LhARA; * Establish a test-bed for advanced technologies for radiobiology and clinical radiotherapy at the Clatterbridge Cancer Centre; and * Create a broad, multi-disciplinary UK coalition, working within the international Biophysics Collaboration to place the UK in pole position to contribute to, and to benefit from, this exciting new biomedical science-and-innovation initiative.

There are more than 10 million people in the U.K., one in six, with some form of hearing impairment. The only assistive technology currently available to them are hearing aids. However, they can only aid people with a particular type of hearing impairment, and hearing aid users still have major problems with understanding speech in noisy backgrounds. A lot of effort has therefore been devoted on signal processing to reduce the background noise in complex sounds, but this has not yet been able to significantly improve speech intelligibility. The research vision of this project is to develop a radically different technology for assisting people with hearing impairments to understand speech in noisy environments, namely through simplified visual and tactile signals that are engineered from a speech signal and that can be presented congruently to the sound. Visual information such as lip reading can indeed improve speech intelligibility significantly. Haptic information, such as through a listener touching the speakers face, can enhance speech perception as well. However, touching a speakers face in real life is often not an option, and lip reading is often not available such as when a speaker is too far or not in the field of view. Moreover, natural visual and tactile stimuli are highly complex and difficult to substitute when they are not available naturally. In this project I will engineer simplistic visual and tactile signals from speech that will be designed to enhance the neural response to the rhythm of speech and thereby its comprehension. This builds on recent breakthroughs in our understanding of the neural mechanisms for speech processing. These breakthroughs have uncovered a neural mechanism by which neural activity in the auditory areas of the brain tracks the speech rhythm, set by the rates of syllables and words, and thus parses speech into these functional constituents. Strikingly, this speech-related neural activity can be enhanced by visual and tactile signals, improving speech comprehension. These remarkable visual-auditory and somatosensory-auditory interactions thus open an efficient and non-invasive way of increasing the intelligibility of speech in noise through providing congruent visual and tactile information. The required visual and tactile stimuli need to be engineered to efficiently drive the cortical response to the speech rhythm. Since the speech rhythm is evident in the speech envelope, a single temporal signal, either from a single channel or a few channels (low density) will suffice for the required visual and tactile signals. They can therefore later be integrated with non-invasive wearable devices such as hearing aids. Because this multisensory speech enhancement will employ existing neural pathways, the developed technology will not require training and will therefore be able to benefit young and elderly people alike. My specific aims are (1) to engineer synthetic visual stimuli from speech to enhance speech comprehension, (2) to engineer synthetic tactile stimuli from speech to enhance speech comprehension, (3) to develop a computational model for speech enhancement through multisensory integration, (4) to integrate the engineered synthetic visual and tactile stimuli paired to speech presentation, and (5) to evaluate the efficacy of the developed multisensory stimuli for aiding patients with hearing impairment. I will achieve these aims by working together with six key industrial, clinical and academic partners. Through inventing and demonstrating a radically new approach to hearing-aid technology, this research will lead to novel, efficient ways for improving speech-in-noise understanding, the key difficulty of people with hearing impairment. The project is excellently aligned with the recently founded Centre for Neurotechnology at Imperial College, as well as more generally with the current major U.S. and E.U. initiatives on brain research.

It is widely assumed that physical activity affects weight loss outcomes for severely obese patients, but there is a scarcity of robust research on this subject. We propose to use smartphone sensors and advanced data mining techniques to conduct detailed investigations addressing this important question. The research participants will be obese people having bariatric (or weight-loss) surgery (e.g. gastric bypass), but our results will also benefit other people with weight problems and patients with other conditions where exercise is helpful. In England just over a quarter of adults were classified as obese in 2010. This group is more likely to suffer from a range of illnesses (e.g. type-2 diabetes) and to have a lower life expectancy. Surgery is recommended for those with severe and complex obesity that has not responded to other therapies, and is highly cost effective in achieving weight loss, overcoming associated illnesses and promoting longer term health. However long-term success is far from guaranteed, with up to 15% of gastric bypass and 50% of gastric band procedures being ultimately unsuccessful. Obese people often lead very sedentary lives, both before and after surgery. Research has shown that even small long-term increases in routine physical activity could be very significant for weight loss, so we are very interested in how we can motivate people to do that little bit more in their daily lives. Patients attending the Imperial Weight Centre (IWC) are reminded to exercise during their hospital visits, but what they ideally need is a personal trainer to encourage them every day. Recognising this, patients have asked us if there are any devices that can help, and so we began our research into how sensors and mobile phones can seamlessly track activity and deliver timely, personalised feedback and encouragement. IWC Patients have tried wristbands such as the Nike Fuelband - but despite initial enthusiasm the novelty soon wears off. These devices do not provide sufficiently detailed or meaningful information. Smartphone apps such as MyFitnessPal are also popular, but soon become tedious since users must log everything they eat or do: many trying them did not persevere for more than a few days. With the advent of new apps it is now possible to track physical activity effortlessly just by carrying around one's smartphone, using its inbuilt sensors. Data is processed in the "internet cloud" where it can be analysed by new software we are developing. These apps also produce a complete daily "storyline" detailing a user's travels, and the amount and type of activity at each location. Our pilot users have been delighted to be able to see their physical activity progress and said that they felt motivated to challenge themselves to do more each day. This project sets out to objectively monitor physical activites on a daily basis so that we can follow almost 1000 patients over protracted periods of time and throughout their weight loss journey. We will use advanced data mining tools to understand individual differences and responses to surgery in terms of physical activity and how these relate to weight loss and weight maintenance over time. We shall use our analysis and understanding of behaviour change methods to devise ways to encourage users to do better and thereby achieve longer and healthier lives. For example, individualised prompts could incorporate weather and location information to suggest suitable walks on fine days, support positive goal setting or inspire competition with other users. This project will pave the way for further behavioural studies, for example using emerging wearable-sensor technologies and should offer long-term benefits for obese people and others with many different types of health problems, where exercise helps - lifestyle recommendations and advice can be produced that will be more personalised and useful for individuals looking to optimise their health.