Intercalated BMedSci Degree

An intercalated degree involves an extra year of study, which is inserted between the years of the Bachelor of Dental Surgery (BDS) course, leading to the qualification of BMedSci.

Alice Rigby, dentistry student

Intercalation is an opportunity to obtain a deeper understanding of one of the subjects introduced in the BDS dental course, and will allow you to undertake a substantial research project. Research forms an essential part of your dental training, and this degree presents an early opportunity to develop research skills and potential.

An intercalated degree will also considerably enhance your CV, and broaden employment prospects. If you're interested in pursuing an academic career, it is even more worthwhile.

Although intercalating students do very diverse projects, all students have common aims and objectives that are fostered in the mandatory short course and in the supervisory element of the programme, as well as the your own self-directed study.

BMedSci (Intercalation) projects for 2020/2021

Development of an innervated 3D tissue-engineered oral mucosa model

Supervisors: Professor FM Boissonade, Dr C Murdoch and Dr HE Colley

Background:

Over the last decade our understanding of epithelial and stromal cell interaction has been greatly enhanced by the development of a wide range of 3D tissue-engineered constructs including models of skin and oral mucosa. These 3D tissue-engineered models can be used for a wide variety of purposes such as studies of toxicity, wound healing, tumour biology, and other skin disease. In addition to their uses for in vitro investigations, they are also beginning to deliver benefit in the clinic (usually in small-scale reconstructive surgery procedures). A number of cell types have been incorporated into these systems, thus allowing a closer approximation to the conditions found in human skin and oral mucosa in vivo. These cell types include keratinocytes, dermal fibroblasts and a range of immune cells. However to date there are very few models of skin or oral mucosa that incorporate neuronal cells.

There is now growing evidence that interaction between keratinocytes, fibroblasts and sensory neurones plays a significant role in both skin homeostasis and disease (eg wound healing, eczema and psoriasis). The neuropeptides calcitonin gene-related peptide (CGRP) and substance P have an established role in neurogenic inflammation and are thought to influence proliferation and morphogenesis of both keratinocytes and fibroblasts. Is it also well known that skin and oral mucosal cells produce a wide range of neurotrophic factors that have significant influence on neuronal development.

Aims:

To develop an innervated 3D tissue- engineered oral mucosa model, and study the effects of innervation on skin and mucosal morphology and response to injury.

Techniques:

A variety of cell culture techniques will be used. 3D oral mucosa and trigeminal ganglion neurones will be cultured using techniques developed in our laboratories. Successful co- culture will be determined by immunohistochemical identification of different cell types using methods that are well established in our laboratories.

References:

  • MacNeil S. Progress and opportunities for tissue-engineered skin. Nature 2007;445:874-880
  • Roggenkamp D, Kopnick S, Stab F et al. Epidermal nerve fibres modulate keratinocyte growth via neuropeptide signaling in an innervated skin model.
    J Investigative Dermatology 2013;133:1620-1628
  • Truzzi F, Marconi A, Pincelli C. Neurotrophins in healthy and diseased skin. Dermato-Endocrinology 2011;3:32-36
  • Yu XJ, Li CY, Xu YH, et al. Calcitonin gene-related peptide increases proliferation of human HaCaT keratinocytes by activation of MAP kinases.
    Cell Biol Int. 2009;33:1144-8
  • Colley HE, Eves PC, Pinnock A, Thornhill MH, Murdoch C. Tissue-engineered oral mucosa to study radiotherapy-induced oral mucositis. Int J Radiat Biol. 2013 Nov;89(11):907-14.

For further information please contact Professor F Boissonade on f.boissonade@sheffield.ac.uk

Viral smart missiles to combat antibiotic resistant infections

Supervisor: Dr G Stafford

Background:

While antibiotics have saved millions of lives since their introduction in the late 1940s, their efficacy is being increasingly curtailed by the rise in antibiotic resistance.  However, a solution in nature exists.  Since 1896 scientists have known of viruses that exist in the environment able to target and kill bacteria- these are known as bacteriophage.  These are species and often strain specific, and recent studies have begun to unlock their potential for use in human recalcitrant topical and systemic infections.

Enterococcus faecalis

Dr Stafford’s team in Sheffield have developed techniques and isolated a range bacteriophage targeting pathogenic strains of Enterococcus (which contribute to oral endodontic infections as well as more serious septicaemias and diabetic foot ulcers).

Aims:

In this project you will attempt to isolate and study novel bacteriophage that kill the causative agents of Denture stomatitis and angular cheilitis- namely Staphylococcus aureus.  These will then be tested for their ability to clear biofilm infections.

A secondary aim will be to examine whether it is possible to isolate similar agents targeting the common oral infection Candida albicans- so called mycoviruses, using similar techniques.

Techniques/Methods:

  • Microbial culture and viral plaque assays
  • Transmission electron Micrography (to assess viral structure)
  • Genome sequencing (of isolated viruses)
  • Biofilm killing assays (using simple and complex models)

References

Identification of novel bacteriophages with therapeutic potential targeting Enterococcus faecalis. Al-Zubidi M, Widziolek M, Court EK, Gains AF, Smith RE, Ansbro K, Alrafaie A, Evans C, Murdoch C, Mesnage S, Douglas CWI, Rawlinson A, Stafford GP. Infect Immun. 2019 Aug 26. pii: IAI.00512-19.doi: 10.1128/IAI.00512-19

Fish R, Kutter E, Wheat G, Blasdel B, Kutateladze M, Kuhl S. (2018) Compassionate Use ofBacteriophage Therapy for Foot Ulcer Treatment as an Effective Step for Moving Toward Clinical.   Trials Methods Mol Biol. 2018;1693:159-170. doi: 10.1007/978-1-4939-7395-8_14.

Rebekah M. Dedrick, Carlos A. Guerrero-Bustamante, Rebecca A. Garlena, Daniel A. Russell, Katrina Ford, Kathryn Harris, Kimberly C. Gilmour, James Soothill, Deborah Jacobs-Sera, Robert T. Schooley, Graham F. Hatfull & Helen Spencer (2019)

Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus.   Nature Medicine volume 25, pages730–733 (2019)

For further information please contact Dr G Stafford on g.stafford@sheffield.ac.uk

An in vitro models of human salivary gland tumours

Supervisors: Dr L Bingle and Dr A Khurram

Background:

Salivary gland tumours are uncommon but histologically heterogeneous and so are often very difficult to diagnose, even for experienced pathologists. They most commonly occur in the major glands but are also relatively frequently found in the minor glands associated with the palate. Very little is known about the pathogenesis of tumour growth and development but associations with the presence of novel fusion proteins and viral infections has been established.

Hypothesis/Aim:

The aim of this project is to establish in vitro models of human salivary gland tumours, as an in vitro model, replicating the complex glandular structure, would provide an extremely useful tool to investigate tumourigenesis and could also have potential as a first screen for the novel biomarkers desperately needed as prognostic/diagnostic tools.

Method/Experimental plan/Techniques:

We have already developed 3D models of normal, human salivary glands from excess surgical tissue. We will similar methods to grow 3D tumour models using tissue from human salivary gland tumours as our starting material. We aim to develop a number of models with different cell phenotypes to reflect the heterogeneity of salivary gland tumours. These will allow us to determine the processes involved in the development of a tumour, particularly the role of fusion proteins and viruses. Functional assays will allow characterisation of the aggressiveness of tumours in relation to cell phenotype, heterogeneity and involvement of fusion proteins.

For further information please contact Dr L Bingle on l.bingle@sheffield.ac.uk or Dr A Khurram on s.a.khurram@sheffield.ac.uk

Dental students’ perception of research

Supervisor: Dr S Whawell

Background:

Research intensive universities such as Sheffield pride themselves on their research outputs along with the impact and reputational enhancement that result. Published literature suggests that whilst research is valued by undergraduate students, the perception of this esoteric activity is at least variable. At UCAS interviews for dentistry, candidates often highlight the research achievements of the School and for some time I have asked how they think it will impact them as an undergraduates. Answers have tended to relate to keeping up to date with new technologies, teachers as experts and the ability to actually do research. This project aims to investigate this formally and carry out a more detailed examination of the ‘value’ of research to dental undergraduates.

Aims:

  1. To gain an understanding of dental students’ understanding and perceptions of research and how/if this will impact them as undergraduates.
  2. Assess how the students are made aware of this activity and its relative importance.
  3. Compare responses between those that have and have not completed a BMedSci and assess whether the length of time students have been at the School has an influence on responses.
  4. To draw upon previously published research to design a questionnaire and data collection method to assess the above.

Techniques/Method:

Following consideration of the relevant ethical issues, a questionnaire will be designed and circulated to current undergraduate dental students ensuring that it is representative of all years and includes those who have previously completed a BMedSci. As far as possible responses will be unstructured so that analysis can be used to obtain themes which can be probed further using focus groups if time permits. The study will be conducted in such a way as to enable the findings to be publishable in a peer reviewed journal.

References:

Imafuku R et al. Int. J Med Ed 2015; 6: 47-55.

Buckley CA Innovation in Education and Teaching International 2011; 48: 313-327.

Visser-Wijnveen GJ et al. High Educ. 2016; 71: 473-488.

For further information please contact Dr Whawell on s.whawell@sheffield.ac.uk

Neural–stromal interactions in tumour progression

Supervisors: Professor FM Boissonade and Dr DW Lambert

Background:

There is growing evidence that neural mediators play a role in the tumour microenvironment, and they have been implicated in tumour progression in breast, pancreatic and prostate cancer. However, the molecular mechanisms underlying their effects are poorly understood. Our recent studies have demonstrated significant cross-talk between neurones and oral squamous cell carcinomas (OSCC) cells.

We have identified receptors for specific neural mediators in OSCC-derived cell lines and have demonstrated that neural mediators have significant chemoattractant and proliferative effects on these cell lines. We have also shown that nerve growth factor (NGF) is elevated in OSCC-derived cell lines (relative to normal oral keratinocytes), and that NGF secretion from cancer-associated fibroblasts (CAFs) is significantly increased compared with that from normal oral fibroblasts. These findings suggest that neural mediators are capable of enhancing proliferation and migration of OSCC cells – potentially enhancing tumour progression – and that OSCC cells and CAFs may influence nerve growth in tumours (Fig. 1). Thus neuronal factors may have potential as therapeutic targets for cancer treatment.

Figure 1. Left – co-culture of trigeminal ganglion neurones and OSCC cells. Centre and right – cultures of trigeminal neurones in absence (centre) and presence (right) of media from OSCC cells.

Aim:

To further evaluate the effects of neural mediators and their antagonists on proliferation and migration of OSCC-derived cell lines alone and in the presence of other cell types, and to identify the mechanisms underlying these effects.

Techniques:

Quantitative polymerase chain reaction (qPCR) and immunocytochemistry will be used to identify specific neural mediators and components of their receptors in normal oral keratinocytes (NOKs); dysplastic, cancerous and metastatic cell lines; and neurones. Co-culture systems, cell proliferation and migration assays, will be used to identify functional cross-talk between neurones, cancer cells and fibroblasts (the predominant cell type of the tumour microenvironment). Enzyme-linked immunosorbent assays (ELISA) and qPCR will be employed to identify secreted factors involved in neural–tumour interactions.

This project will identify specific neural mediators and receptors that affect OSCC cell migration and proliferation, and that may provide novel targets for cancer treatment.

A short video related to this work can be seen at: https://youtu.be/QgZdtRd6FPI

References:

  • Hoffmann P, Hoeck K, Deters S, et al. Substance P and calcitonin gene related peptide induce TGF-alpha expression in epithelial cells via mast cells and fibroblasts. Regul Pept 2010; 161: 33–37.
  • Magnon C, Hall SJ, Lin J, et al. Autonomic nerve development contributes to prostate cancer progression. Science 2013; 341: 1236361.
  • Toda M, Suzuki T, Hosono K, et al. Neuronal system-dependent facilitation of tumor angiogenesis and tumor growth by calcitonin gene-related peptide. Proc Natl Acad Sci USA 2008; 105: 13550–13555.
  • Venkatesh H, Monje M. Neuronal activity in ontogeny and oncology. Trends Cancer 2017; 3: 89–112.
  • Yu XJ, Li CY, Xu YH, et al. Calcitonin gene-related peptide increases proliferation of human HaCaT keratinocytes by activation of MAP kinases. Cell Biol Int 2009; 33: 1144–1148.

For further information please contact Prof FM Boissonade on f.boissonade@sheffield.ac.uk

Use of optical coherence tomography (OCT) for the early diagnosis and monitoring of oral dysplasia and cancer.

Supervisors: Dr C Murdoch, Dr S Danby, Dr S Jurge and Professor K Hunter

Background:

Many suspicious oral lesions, including pre-malignant lesions, require an invasive surgical biopsy followed by histopathological analysis for diagnosis. Patients that are subsequently diagnosed with oral dysplasia, a condition that has a ~20% chance of progressing to oral cancer, require long term monitoring. However, frequent repeat biopsy in these patients is not practical. A non-invasive, real-time, point-of-care method of imaging the structure of the oral epithelium to identify patients with potentially cancerous lesions from other lesions could greatly improve the chances of early diagnosis and also aid in the long-term monitoring of patients with diagnosed oral dysplasia without the need for repeat biopsy.

Optical coherence tomography (OCT) is a non-invasive imaging technology that uses coherent near infra-red light to interact with biological tissue and is able to image tissue to depths of over 1 mm. We have previously shown that OCT can distinguish between normal, healthy oral epithelium and cancerous epithelium in laboratory-produced, tissue engineered in vitro models. Our preliminary data using a commercially available OCT scanner designed for use on skin shows that the epithelium and underlying connective tissue structure of the buccal oral mucosa can be easily identified (image below).  

Aims:

  • To determine if OCT is able to distinguish between the different types of epithelium in the oral cavity of healthy individuals.
  • To determine if OCT is able to distinguish between normal healthy oral mucosa and mucosa presenting with different types of oral lesions.

Techniques/Method:

The OCT scanner is available for use within Sheffield Dermatology Research based at the Hallamshire Hospital. OCT scans will be performed on several different anatomical sites of the oral mucosa in healthy volunteers and scans compared to archival histological sections or normal tissue. Patients presenting with oral lesions and undergoing routine, standard of care diagnosis and treatment will be invited to participate in the study with written, informed consent (ethical approval) and OCT scans performed. OCT scans will be compared to the histological image of the same oral biopsy taken as part of the standard care of treatment to determine if the OCT image is representative of the lesion.

References:

  • Gentile E, Maio C, Romano A, Laino L, Lucchese A. (2017) The potential role of in vivo optical coherence tomography for evaluating oral soft tissue: A systematic review. Oral Pathol Med. 46(10):864-876.
  • Green B, Tsiroyannis , Brennan PA. (2016) Optical diagnostic systems for assessing head and neck lesions. Oral Dis. 22(3):180-4.
  • Boadi J, Fernandes J, Mittar S, Hearnden V, Lu Z, MacNeil S, Thornhill MH, MurdochC, Hunter KD, Matcher SJ (2015). Imaging of 3-D tissue engineered models of oral cancer using 890 and 1300 nm optical coherence tomography. Sovremennye Tehnologii v Medicine/Modern Technologies in Medicine. 7(1): 60-67.
  • Smith LE, Hearnden V, Lu Z, Smallwood R, Hunter KD, Matcher SJ, Thornhill MH, Murdoch C, MacNeil S. (2011) Evaluating the use of optical coherence tomography for the detection of epithelial cancers in vitro. J Biomed Optics. 16(11): 116015.

For further information please contact Dr C Murdoch on c.murdoch@sheffield.ac.uk

How much is enough?

Supervisors: Dr S Zijlstra-Shaw and Professor C Stokes

Background:

Traditionally the transition from clinical skills to the clinical treatment of patients has been difficult for students (1) However, there is little published evidence on the amount and type of supervision that students need. There is some evidence for the role of simulation (both ‘in plastic’ clinical skills and virtual reality) but most of the evidence for the difficulty of this transition is anecdotal.

Aims:

The aim of this project is to explore student perceptions of the amount and type of support they need during their transition from clinical skills to clinical practice.

Techniques/Method:

Using a qualitative approach, for example focus groups or semi-structured interviews, with 2nd BDS students undergoing this transition. The data will be analysed using a ‘framework’ approach to draw out the types of feedback and support that students feel they need, possibly basing the project on transformative learning theory .

The outcome of this investigation would explore the students’ experience and identify what staff support they would like at this pivotal time.

References:

  • Zijlstra-Shaw, S. (2019) Transformative Learning Theory and the transition from clinical skills to clinic. URL: http://dental-stepping-stones.blogspot.com/2019/06/transformative-learning-theory-and.html [Accessed October 2019]
  • Towers, A. et al (2019) A scoping review of the use and application of virtual reality in pre-clinical dental education. British Dental Journal226(5), p.358.
  • Ritchie, J., Lewis, J., Nicholls, C.M. and Ormston, R. eds., (2013) Qualitative research practice: A guide for social science students and researchers. Sage.
  • Mezirow, J., (2003). Transformative learning as discourse. Journal of Transformative Education, 1(1), pp.58-63. (The Wikipedia page on Tranformative Learning is a good primer for this paper).

For further information please contact Dr Zijlstra-Shaw on s.zijlstra-shaw@sheffield.ac.uk

Meet students who have intercalated

Jamie Hall talks about his experience of the BMedSci programme at the University of Sheffield School of Clinical Dentistry.

Heather Wallis talks about her experience of the BMedSci programme at the University of Sheffield School of Clinical Dentistry

More information about the BMedSci (Intercalated degree)

Programme aims
  • To provide an enhanced knowledge and understanding of biomedical research and its methods
  • To develop skills in research evaluation, communication and ethics
  • To allow you to apply the above through an extended research project
Programme outcomes
  • The place of research in dentistry
  • Current dental research and its methods
  • The conduct of research in accordance with correct research methodologies and procedures
  • The importance of conducting research in accordance with up-to-date ethical guidelines and policies
  • The fundamental principles of designing research projects and protocols
Academic and intellectual skills
  • Design a research project in accordance with appropriate research methodologies and ethical principles
  • Exercise independent judgment and critical thinking
  • Apply basic statistical methods to data evaluation and interpretation
  • Present work orally and in writing to an academic audience
  • Where their project requires it, carry out practical experiments and tasks in a laboratory setting in accordance with health and safety guidelines
  • Produce a well-structured and substantial dissertation to present the results of their research project
  • Conduct an extensive literature review using relevant sources
Transferable skills
  • Apply good time-management skills to structure their work and meet deadlines
  • Effectively use a wide range of IT packages for a variety of tasks
  • Work independently on a project
  • Display good written and oral communication skills
  • Understand and apply basic statistical methods
  • Self-direct their learning
Taught element

If you undertake the BMedSci, you are required to attend a taught element of the programme. The taught element consists of:

  • Introductory Short Course - including ethics
  • Introduction to Statistics Course
The introductory short course

The Introductory Short Course runs during the first month of the BMedSci Programme and provides an introduction to conducting a research project, including literature searching and guidance on writing dissertations. You'll be issued with the timetable for this course via email/ Minerva

Ethics course

An ethics course will run over 6 weeks, including lectures, tutorials, practical sessions and online training. At the end of this course, you'll be required to complete an ethics assessment which constitutes 10% of the final degree mark as well as complete an e-learning package. The Ethics Course Leads will provide separate information on the ethics teaching and assessment.

Statistics course

The Introduction to Statistics Course runs over 8 weeks. It comprises lectures, tutorials and practical sessions, including guidance on SPSS. The lectures are delivered online and you'll be expected to attend tutorial sessions. A separate timetable for this course will be available on Minerva. During this course, you'll will be issued with your statistics assignment.

Summative assessment

The three elements comprising the summative assessment of the BMedSci are:

  • Statistics assignment worth 20% of the final mark
  • Ethics assignment worth 10% of the final mark
  • Dissertation worth 70% of the final mark.
External employment

In accordance with the guidelines set out in the University’s Students’ Charter, students are reminded that they are advised to undertake no more than 16 hours of external work per week in addition to that required by their programme of study.

Frequently asked questions 

What sort of work does the BMedSci involve?

This will really depend on the type of project you undertake. Everyone will do a statistics and ethics module, which is led by the medical school, and is assessed via coursework and a group presentation. The rest of your time is up to you to structure and will be very varied. Some projects will have lots of time spent in the different laboratories working with PhD students and also independently.

Will I be eligible for student finance during my BMedSci?

You will still be able to get student finance for a maintenance loan and to cover fees. However, the NHS bursary means even if you do the BMedSci you only need to cover 4 years of fees. This means that you’ll pay the fees during your BMedSci year but not during 4th or 5th BDS. There are also bursaries to apply for and whilst funding can’t be guaranteed there is often money available towards fees and /or living costs.

Will I deskill clinically during my BMedSci?

During your BMedSci you will still continue to have restorative dentistry clinics around once a week. Many previous students actually felt more confident clinically after their BMedSci and were also in the position of having done extra work to count towards their targets.

Will it be difficult fitting into a new year group?

During your BMedSci clinics you will join in with the year group below after the Easter holiday which is a good way to get to know people. You also end up with friends in both your original year and new year groups.

Is it OK if I’ve not had any research experience before?

Yes, most people will not have any research experience before starting their BMedSci. Supervisors are really helpful as are the PhD students in the different research groups. You also have the statistics and ethics teaching which can help too. The BMedSci is a great way to work out whether further research or an academic role would suit you in the future.

Why is it worth doing a BMedSci?

It is an interesting course which is very different to the BDS degree. It gives you chances to present your work at conferences and potentially become published. You also develop useful skills including independent working and an understanding of different scientific techniques.

For more information about the BMedSci (Intercalated degree), please contact:

Programme Lead
Professor Fiona Boissonade
f.boissonade@sheffield.ac.uk
0114 215 9314

Administrative Officer
Leyna Wright
leyna.wright@sheffield.ac.uk
0114 215 9304

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