I’ve got an elastic heart

Anastasia Nasopoulou is a post-doc in the Department of Biomedical Engineering. Her research focuses on improving the diagnosis of heart failure in the clinic by using medical imaging to detect how well the heart is functioning through its ‘stiffness’ or elasticity. In March 2019, she was awarded public engagement funds from the Wellcome EPSRC Centre for Medical Engineering (CME), which enabled her to host two public engagement events around her research; one as a pilot for her activities through a science stand at national Clinical Trials Day engaging patients and the latter as part of King’s Health Partners Summer School with school-aged young people.

Dr Anastasia Nasopoulou at her science stand as part of Clinical Trials Day 2019, St Thomas Hospital (NIHR #BePartOfResearch)

My journey in public engagement started in 2017 when I participated as a volunteer in the School’s Royal Society Summer Science Exhibition, entitled ‘Heart in Your Hands’. At the time, this was mostly due to “peer pressure” as many of my friends were attending! However, this was a great way to “break the ice” as a first timer, as it was a well organised team event and the audience was friendly and genuinely interested in the science we were presenting there. Participation in this event helped me practise my science communication skills and gave me confidence that I could organise a public engagement event myself, especially after I gained a “taste” of how people respond to different activities.

After this initial public engagement experience, I realised the joy of presenting my research to non-scientific audiences. I found that these interactions make you feel really good at the end of the day and fuel your passion for research as you realise people look at you hoping that you will provide solutions to healthcare problems that can drastically improve their lives. But for me personally, an important motivation in taking part in these events, is the chance to present my work to young children and inspiring them to love science, technology, engineering & mathematics (STEM), as well as offering them a sneak-peak of a possible career in biomedical engineering, in an area they may not have imagined existed before.

Clinical Trials Day is a national yearly event, celebrated across the UK through different activities. On 20th May 2019, I held a science stall in the afternoon in Central Hall at St Thomas’ Hospital. The aim of the stand was to showcase my research to patients and their families, healthcare staff, and hospital workers to increase their understanding of heart stiffness and its implications on blood flow and heart health. For this event, I created two posters; one with accessible background information on my research and one with a giant heart for collecting visitor feedback via heart-shaped post-its to tie in with the theme (and also providing stand decoration!). Owing to the location and nature of the stall and my audience, I understood that interactions with visitors would be time-limited, so I opted for simple, hands-on activities that would “catch the eye”, stimulate discussions and also be fun and relaxing.

[You are] offering them a sneak-peak of a possible career …in an area they may not have imagined existed before.

Dr Anastasia Nasopoulou, Biomedical Engineer Researcher

I designed and developed a bespoke “Elastic Heart” activity, which aimed to introduce the audience to the concept of ‘stiffness’, the challenges of measuring it as researchers and how changes in heart stiffness can affect heart function. Further I wanted to reuse resources between events (Clinical Trials Day & King’s Health Partners Summer School), so I had to carefully consider commonalities for activities for each of these specific audiences (patients vs. school children) and consider the space where each event was being held. As such, I bought a set of different size, length and coloured coils or springs to visually and tangibly demonstrate variation in stiffness. Secondly, I used small party balloons that acted as hearts and visitors had to race each other to fill with water (from buckets & water pumps) to imitate the pumping function of the heart. Some balloons were doubled up, to create extra stiffness, so visitors found them more difficult to fill. Both demonstrated the basic principles of my research by inviting visitors to interact with the props.

I recruited two of my colleagues, Mandy Nio and Suzy Lust: Mandy works with microbubbles for estimating heart pressure and Suzy is experimenting with cardiac cells to investigate the origins of bicuspid aortic valve disease. With the help of my team, we managed to engage different people at Clinical Trials Day, discussing our research, raising awareness of how the heart functions and how to improve heart health. We used two different methods to evaluate the success of our stall: (i) colour-coded tokens for visitors to answer questions related to the stall for quantitative feedback i.e., ‘Did you learn something interesting?’ ‘Was this fun?’ and (ii) post-it notes for visitors to give qualitative feedback. Both worked quite well in helping us to see whether we had achieved our aims. We generally received very good feedback (we counted 19 green tokens corresponding to positive reviews) and our biggest compliment was when a mum asked if ‘we could repeat the activity at her son’s school!’.

A mum asked if we could repeat the activity at her son’s school!

Dr Anastasia Nasopoulou & team, Clinical Trials Day

I was quite happy with the way the event turned out, although there was definitely room for improvement! However, this type of event was a great way to test pilot my engagement activities, increase my own knowledge and understanding around my subject area, build my science communication skills and manage a team of people, a budget and my time. All of which are important transferable skills in life and especially helped in the planning and delivery of my second event two months later…

King’s Health Partners (KHP) Summer School 2019 pupils at King’s College London/St Thomas’ Hospital (with Coordinator, Claire O’Neill)

In July 2019, I hosted a workshop as part of King’s Health Partners (KHP) Summer School. As the format and audience was different, I adapted parts of my previous stand to better suit the needs and interests of the GCSE-level school students from Lambeth and Southwark. The aim of this workshop was to introduce the students to my research area and the possibility of a career in biomedical engineering and imaging sciences.

Dr Anastasia Nasopoulou presenting to 16-year-old local school pupils at her workshop as part of KHP Summer School 2019

For the KHP Summer School, as planned, I recycled all my previous resources and reoriented the activity, focusing more on the educational/career aspect. For this, I found that the heart poster I had originally created with accessible information about the background of my research was very useful. I wanted to provide some context into what I do day-to-day as a researcher but avoid oversimplification of the science (that might make the teenagers loose interest), so I additionally created an interactive game in software I use daily as a scientist (Matlab) where I demonstrated how varying the stiffness in patient’s hearts altered their deformation. And for the “finale”, I adapted my balloon activity by co-designing with Public Engagement Officer, Bella Spencer, a giant aorta blood vessel on the floor (using masking tape!), that the students had to use as a maze to carry balloons filled with water to the end of the room (rather than simply filling in buckets). This was to mimic the motion of blood cells being pushed down the aorta when the heart beats to the ‘hungry cells’ that need oxygen/water/nutrients in the body! It was crude but created a fun and physical way for the pupils to learn and understand my research.

Dr Anastasia Nasopoulou with her heart vessel maze activity

I had different groups of 8 pupils for short 15-minute workshops over an hour – needless to say, I found the KHP Summer School a lot more demanding! Although I was happy with the participation of the students, seeing them engaged and excited with the concepts described, time was very tight and I should have rehearsed the activities beforehand to make sure there was a smoother running time and transition between each. This way I could have also guided them into doing the evaluation tasks (tokens and heart post-it feedback) that we ended up having no time for. Upon reflection, I would have further simplified the activities as it was too much to include in the time slot allocated.

My experience in organising and delivering the “Elastic Heart” activity in Clinical Trials Day and KHP Summer School was definitely invaluable. My interaction with the CME PE team (Bella and Mel) helped me see the public engagement process more holistically. Also seeing a project through from the conceptual level, designing and planning, to delivering my event for different audiences, offered a rich learning experience. I was able to improve my time management and organisational skills, develop my independent and team working experience, as well as gain a real confidence boost – especially when things go wrong – or well! You get a positive response from the people you designed it for.

I realised my research can have a significant impact on people’s lives and has helped re-boost my work with positive energy

Dr Anastasia Nasopoulou

I also found that interacting with audiences from different backgrounds forced me to see my research in a different light, while having to explain concepts in lay terms helped consolidate concepts and made me think outside the box, forging new correlations in my mind. But most importantly the gain was to actually meet and discuss my work with its real beneficiaries and in the case of the KHP Summer School the future generation of colleagues! The genuine interest people showed me helped with my motivation, as I realised my research can have significant impact on people’s lives and has helped re-boost my work with positive energy.

I absolutely intend to do more public engagement. For the next little while, I will need to focus on my research but I plan to come back soon with an exciting set of activities!

3D-printed hearts for Valentine’s Day

Dr Shaihan Malik is a Reader in Medical Imaging and gave a talk to a large group of 3-5 year old children in nursery and reception class at a primary school in North London. He writes about his engagement experience here.

“[The] teacher invited me to speak to the class about ‘people with jobs that help others’

Dr Shaihan Malik, BMEIS

I visited my local primary school in North London and spoke to 54 nursery and reception class children (aged 3-5 years old). My son is in the nursery class, and his teacher invited me to speak to the class about “people with jobs that help others”, after he told his teacher that his dad works in a hospital.

Firstly, the children had to try to guess my ‘helping job’ but none of them correctly suggested “scientist”. After revealing my occupation to them, I asked what they thought a scientist does and received many interesting answers including:

“wears glasses” (true in my case)

“does experiments” (impressive!)

“goes into space” (if only)

Answers from 3-5 year old school children on ‘what a scientist does

I went on to explain to the children that science is about understanding things that nobody knows yet. This was something that genuinely surprised a lot of them, since in their worlds the adults already know everything.

Valentine’s Day: 3D-printed human hearts of different sizes: adult, child and baby

To avoid showing them a slide show, I bought along some printed pictures of MRI scanners, and some MRI brain images (below), along with 3D-printed models of brains and different sized hearts, borrowed from the School’s public engagement resources. The children particularly liked the comparison between baby, child and adult hearts and brains. Since the visit was on Valentine’s Day, seeing a real heart as opposed to the cartoon version was also a bit of a surprise for them!

“One of the children went to collect all the toys in the classroom that contained magnets to show me the connection with the magnets in our MRI scanners”

After Dr Shaihan Malik’s talk to 3-5 year school children

Afterwards, there were some fun and interesting questions including, “how does a magnifying glass work?” and one of the children went to collect all the toys in the classroom that contained magnets to show me the connection with the magnets in our MRI scanners.

Overall, even though this was by far the youngest age group I have engaged with about my research area in Biomedical Engineering, I think the children were genuinely interested and enjoyed it – as did I!

Dr Shaihan Malik is a Reader in Medical Imaging at School of BMEIS, King’s College London

Work Experience with Professor Prashant Jha

In November 2019, Elaina, a Year 12 applied science student from Harrow College, joined Professor Prashant Jha for a one-week work experience placement. Professor Prashant Jha is Head of Affordable Medical Technologies at the School of Biomedical Engineering & Imaging Sciences. He and his team gave Elaina an insight into laparoscopic surgery, medical devices and methods of communication in the industry.

Why did you want to carry out work experience in the School for Biomedical Engineering and Imaging Sciences?
I wanted to carry outwork experience in the School for Biomedical Engineering and Imaging Sciences as I believed it would help me gain skills and experience. In the future, I would like to work in the healthcare sector and I hoped this experience would help me to stand out to potential employers. I thought that it would help my work ethic to become stronger. The School itself is known for its excellence in research and helps to address some of the issues in healthcare today, which made the opportunity even better.

What did you do during your week?
On my first day, I was introduced to the team and felt very welcome. My supervisor was Professor Prashant Jha, Head of Affordable Medical Technologies. I was given the list of tasks I was to complete for the week based off what I hoped to achieve; which was to increase my knowledge and understanding of the biomedical engineering and imaging sciences and to improve my communication skills, especially in terms of presenting and emailing. My first task was to research companies who provide medical devices. My second task was to research laparoscopy (keyhole surgery of the abdomen) including its history and development. The third task was to create an email template that could be sent to companies that specialise in medical devices. On the following day, I had to research the percentages of laparoscopies carried out in each hospital in the UK. My third day involved researching the number of laparoscopies carried out globally. On my fourth day my research topic was the role of robotics in laparoscopies.

What was the most interesting thing you learnt during your visit?
The most interesting thing I learnt during my visit was how to create an email template that could be sent to companies specialized in medical devices. After creating a draft, I presented it to the group who gave me advice on how to improve.

What do you want to do after you finish school?
Originally, I was unsure of what career I wanted to pursue. This experience has increased my interest in biomedical engineering, as it helps solve medical and biological problems that we face. In this field I could contribute to the progress of medicine and be able to improve lives which is something I always wanted to do.

If you are school pupil interested in a similar opportunity there are a number of schemes available such as Nuffield Research Placements and K+. Unfortunately, the School for Biomedical Engineering and Imaging Sciences is only able to provide work experience on an irregular basis.

“Hot stuff” on tour

‘Hot Stuff’ was a public engagement stand at the Royal Society Summer Science Exhibition 2018, led by a team of researchers from the School of Biomedical Engineering & Imaging Sciences, King’s College London, about how radioactivity can be used to detect, monitor or treat human diseases. Two years on, one of the team, Maggie Copper, shares how she has been taking elements of the successful stall around the country to continue engaging other public groups on how radioactivity is used for cancer care.

Maggie engaging community group members at local church, Wirral, Merseyside

Our ‘hot stuff’ exhibition has been on tour ‘up north’ to Merseyside as I took the activities into the school my kids attend in Liverpool and also gave a presentation to a community group who meet in our local church on the Wirral.  

I work part-time as a post-doctoral research fellow in the department of Biomedical Engineering and Imaging Sciences at King’s College London. My work involves getting exciting new radioactive drugs that are developed in the laboratories into real patients in the hospital.  

I also already help with some science classes in the school with Year 8 and Year 10 students. The first topic I helped with happened to be radioactivity for GCSE students and I saw how some students struggled with the concepts of half-lives and types of radiation decay so I suggested bringing the ‘hot stuff’ activities to the school as a bit of an introduction to the topic of radioactivity for year 7 and 8 students.  

Originally designed for the Royal Society Summer Science Exhibition 2018 in London by my colleagues (supported by the Wellcome EPSRC Centre for Medical Engineering), the ‘hot stuff’ activities show how radioactivity is all around us, how radiation is used in medical imaging and how we can use radioactivity to treat diseases such as cancer. 

After the success of the presentation in the school, I decided to take it to a community group on the Wirral that my husband and I help with in our local church. Several of the people who attend the group have medical problems that have required imaging of one kind or another so the presentation was relevant and informative to them. 

Radioactivity is all around us 

People are often scared of radioactivity but actually radioactivity is all around us and it’s really about getting things into perspective. So, to demonstrate this we played a game. The idea is to put some common everyday objects in order of how radioactive they are. Actually, two of the items aren’t radioactive at all but the others are to a greater or lesser extent, radioactive. I’m not sure if the kids or the adults group enjoyed this more but it was pretty competitive even though the prize was just a slightly over-ripe banana!  Just for fun, this is the list of items that they had to put in order. 

  • A banana 
  • A smoke alarm 
  • An old watch – the type that has a glow in the dark dial (not needing light to make it glow) 
  • A rubber duck 
  • A packet of brazil nuts 
  • A packet of Lo-Salt salt 
  • An apple 
  • A rock – demonstrating part of Cornwall 

Nobody got them all in the right order – but then again neither did I when I had a go at this game as a guinea pig to test it out last summer! 

However, what it does demonstrate is that radiation is all around us and, in fact, it might be more dangerous to be an airline pilot, exposed to cosmic rays on long haul flights, than to be a scientist working with radioactivity every day.  

Radioactivity can be used to image disease 

We talked about how we can attach a radioactive isotope to a drug so that the drug goes to the area of the body that we want to image so that we can work out whether there is a problem or not. Images taken this way have some advantage over other methods of imaging such as ultrasound, X-rays, CT and MRI in that they can give an idea of how well a particular part of the body is functioning rather than just giving a picture. We talked about how nowadays different ways of imaging were being combined so that we had really useful cameras that can take radionuclide images at the same time as CT or MRI images (PET/CT, SPECT and PET/MRI) and make it much easier for doctors to make a diagnosis. 

Whole body fused PET and CT image of a patient with prostate cancer. This image shows multiple areas of abnormal 18F-fluoride uptake throughout the skeleton (red/yellow spots) indicating spread of the cancer to these sites. Whilst the extent of spread of cancer is large, the uptake would predict that this patient should respond well to targeted radionuclide treatment, such as 223-Radium Chloride

In order to better demonstrate this, we used some aprons which have the different organs stuck onto them. I was particularly impressed that the children were able to correctly identify the different organs in the body like the lungs, the liver, the heart, the trachea etc. The aprons had been specially modified so that in one organ on each apron there was a small radioactive source inside. 

When patients attend the clinic (in the Nuclear Medicine department) they are injected with a small amount of a radioactive drug and then they are imaged under either a gamma camera or a PET camera. We used radionuclide detectors to work out where the radioactivity was in the body in the same way as the doctor would look to see where the radioactive drug was in the patient. It was great fun trying to work out which organ was radioactive by scanning each other with the detectors. 

Radioactivity is used to treat disease 

We then talked a little bit about diseases such as cancer and how normal cells in the body could go bad but how we could use a different type of radioactivity to treat these diseases. We talked about how there were often markers on the surface of cancer cells that made them look slightly different from normal cells and how we could use drugs to specifically target these differences in the cells. We could then make these drugs radioactive with a radioisotope which could kill the cancer cells. 

There were loads of questions especially from the children in the school but also some interesting questions from the community group, some of whom had had scans in the Nuclear Medicine department in the hospital. It was great that as a result of the talk and activities they seemed to have understood what the scan was about, how the radioactive drugs could detect the medical problem and what the images meant.  

An introduction to the topic of radioactivity to Year 7 & 8 school students (12-14 years old)   

The children really engaged in the activities and I hope that it got some of them thinking about the field of Nuclear Medicine where a range of different professionals (doctors, nurses, physicists, technicians, radiographers, pharmacists) work side-by-side and where scientist in universities are working hard to try to develop new radiopharmaceuticals to diagnose and treat patients.  

Feedback from parents was very positive with many telling me how much their children had enjoyed it although they had become a bit fed up with hearing for the millionth time that bananas are actually radioactive! The community group were also really appreciative and were keen to take away the information cards. 

Year 7 & 8 school students use a Geiger Counter to try to detect which organ contains the small radioactive source (stitched inside) on the modified apron to help understand how radionuclide detectors work when imaging radioactivity in patients to detect disease   

This was a great experience for me to take my work and talk to ‘real’ people about it. I would highly recommend others having a go at this and just getting out there and letting people know about the interesting work that we are doing. The enthusiasm of the children was amazing and so rewarding. I was overwhelmed by their questions and how interested they were in everything that I talked about. 

The ‘Hot Stuff’ exhibition showcased at the Royal Society Summer Science Exhibition 2018 and the ‘Hot Stuff on Tour’ activities were both supported and funded by the Wellcome EPSRC Centre for Medical Engineering within the School of Biomedical Engineering & Imaging Sciences, King’s College London.

Coding for Girls

Jonny Jackson is a student from the Centre for Doctoral Training (CDT) based within the School of Biomedical Engineering and Imaging Sciences. In February 2019, he ran a series of ‘Coding for Girls’ workshops for a local Lambeth Girl Guides. Jonny writes of his experiences here: 

My PhD focuses on how artificial intelligence can be used in healthcare. My experiences to date have shown me both how valuable coding skills are to broaden career horizons, and that there is a lack of quality coding education in school. I didn’t learn any coding skills until university and I think that’s the same story for most people. To combat this, I decided to run Coding for Girls; a series of two coding workshops for local Girl Guides. My aim was to develop their interest, confidence and skills in coding.

Over two workshops we covered the basics of coding using ‘Scratch’- a building block version of coding language developed by Massachusetts Institute of Technology (MIT), USA. I wanted to ensure that the girls developed the skills to create something independently and that they increased their understanding of what coding could be used for. I was surprised to find out that a lot of the girls already knew about artificial intelligence (AI), how it works and what it means. There was even a debate about whether replacing robots with doctors would ever happen and, if it did, whether it would be a good or a bad thing. It was really interesting to find out that these 10 year olds were familiar with such advanced technologies.

During the first workshop, the girls completed all the activities on the computer. However, the Girl Guide Leader noted in her feedback that some individuals struggled to concentrate and were distracted from the coding tasks. It was really valuable to hear this, and we took it on board to develop a hands-on activity for the second workshop. During this task, the girls rearranged printed instructions to code a human robot- aka. one of them! This helped them to develop coding skills, such as, how to use repetition and decision making when writing a programme. As this session fell on St Valentine’s Day, their task was to programme robots to pick flowers and write poetry. One of my favourite moments was watching the two teams act out the coding in a ‘robot-war’ style! It was great to see everyone get behind their team and realise how easy it is for instructions to be mistaken or misinterpreted. If instructions weren’t quite specific enough, their robot went a bit haywire – that was really fun to watch!

As there is currently a male dominance in the coding industry, I also wanted to demonstrate that women have been involved in coding throughout history. I told the girls about women such as Ada Lovelace, who developed the first computer programming language. We had asked the girls to draw what they thought a coder looked at the start of the first session and again at the end of the second session. It was fantastic to see that the drawings had changed from pictures of old men in glasses (!) to drawings of men and women in teams. That was a really rewarding moment, and made it feel like we’d achieved the aim of the programme.

Comments from the second workshop

This was such a great opportunity for me to explore how best to engage students and young people with coding. In the future I hope to run a longer and larger scale project to encourage more young people to take up coding. Stay tuned!