THE ASSOCIATION OF PHYSICIANS of GREAT BRITAIN and IRELAND

Renold Building, The University of Manchester PROGRAMME12 – 13 April 2018

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The origins of medicine in Manchester

Medical teaching in Manchester began when Charles White founded the Manchester Infirmary (later the Manchester RoyalInfirmary), in 1752. In 1814, Joseph Jordan opened the first anatomy school in the English provinces. Previous lecture courseshad included a series given by Peter Mark Roget, then a physician at Manchester Infirmary (1804–8), who became betterknown in later years for his Thesaurus. Jordan offered dissections as well as lectures, and medical education proved goodbusiness for a variety of outfits over the following decades. Eventually, in 1874 The Medical School, opened by Thomas HenryHuxley, was formed when the preeminent private medical school of the day became incorporated with Owens College. Theunion had not always been welcomed. Owens College had opened its doors in 1851 but an earlier attempt to include medicinein 1856 was refused because the Trustees feared medical students would lower the tone.

The medical building was extended in the 1880s and 1890s to make Manchester one of the largest and best-equipped medicalschools in England. Its staff before World War I included Sheridan Delépine, a Swiss-born pathologist who developed publichealth bacteriology, and Grafton Elliot Smith, an Australian anatomist who modernised his subject to include X-rays,functional anatomy and anthropology. Among Smith’s pupils were three Manchester graduates who helped lead Manchestermedicine past World War II: Sir Geoffrey Jefferson, one of the British founders of neurosurgery; Harry Platt, the notedorthopaedic surgeon; and Lord John Sebastian Bach Stopford who after World War I followed Elliot Smith as Professor ofAnatomy, before becoming, successively, Dean of Medicine, Vice-Chancellor of the University and then, under the new NHS,the first Chairman of the Manchester Regional Hospital Board. In 1974 the medical school moved to its current headquarters inthe building which still bears Stopford’s name. Today, Manchester is the UK’s largest medical school with over 2,000undergraduate medical students at any one time. Manchester Royal Infirmary is now one of several hospitals in the ManchesterUniversity NHS Foundation Trust (MFT), one of the country’s largest, which includes Trafford General Hospital whereAneurin Bevan launched the NHS in 1948. MFT, Salford Royal NHS Foundation Trust and The Christie NHS Foundation Trusttogether deliver the major part of Greater Manchester’s hospital services under the landmark devolution of health and socialcare budgets which came into force in April 2016.

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Registration Information

Registration for Annual Meeting• Registration fee for bookings on or before 12 March 2018 £220.00• Registration fee for bookings from 12 March 2018 £250.00• Registration fee for Senior Members aged 65 and above £125.00

Career Development Workshop Fees• Clinician-scientists (e.g. intermediate fellowship holders) £150.00

Conference Secretariat APAM 2018 c/o BCD M&E VIP RoomInternational Conference CentreExCeLLondon E16 1XL

Registration in ManchesterThe Registration Desk will be open at the following times:Thursday 12 April 2018 8:30 a.m. – 5:30 p.m.Friday 13 April 2018 8:30 a.m. – 3:30 p.m.

Social Programme

Reception, Thursday 12 April at 6:30 p.m. – 7:45 p.m. Manchester Museum, The University of Manchester, Oxford Road, Manchester M13 9PL

The origins of The Manchester Museum lie in the collection of the Manchester manufacturer and collector John Leigh Philips(1761-1814). After his death, a small group of wealthy men banded together to buy his ‘cabinet’, and in 1821 they set up theManchester Natural History Society. By the 1860s the Natural History Society had little money and the building was full. Themuseum was transferred in 1868 to Owens College, which later became the University of Manchester. The College asked thefamous architect Alfred Waterhouse to design a museum building, which was opened to the public in 1890. Waterhouse alsodesigned Manchester’s Town Hall and the Natural History Museum in London.

Now known as the ‘Manchester Museum’, the collections were used by many people, from Owens College professors toschoolchildren. Many more objects were donated and the Museum was extended in 1912-1913 and again in 1927. Over thetwentieth century, the collection was split into archery, archaeology, botany, Egyptology, entomology, ethnography, mineralogy,palaeontology, numismatics and zoology, as well as live specimens in the aquarium and vivarium. Overall, the collection grewto six million items, and the staff expanded from four ‘keepers’ to over 70 museum professionals.

The Museum expanded again in 1977 into the former Dental School. In 1997 the Museum was awarded a £12.5 million grantfrom the Heritage Lottery Fund and this, together with money from the European Regional Development Fund, the Universityof Manchester, the Wellcome Trust, The Wolfson Foundation and other sponsors has enabled the Museum to undertake therefurbishment and building which opened in 2003.

Exhibition – available to view before dinner.

Cost: Included in registration fee for registered delegates.

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Conference Organisers Host InstitutionBCD M&E Professor Neil Hanley, Professor of MedicineVIP Room, International Conference Centre University of Manchester, Manchester M13 9PTExCeL, London E16 1XL katrina.scrivner@manchester.ac.uk

Annual Dinner, Thursday 12 April 7:45 p.m. for 8:00 p.m.Whitworth Hall, The University of Manchester, Oxford Road, Manchester M13 9PL

The ceremonial Whitworth Hall was built between 1898 and 1902 to commemorate the Manchester engineer JosephWhitworth (1803-1887). It was funded by Richard Copley Christie, his lawyer and legatee.

After a difficult childhood Joseph became a mechanic in Manchester. In 1825 he married and went to London, to theengineering works of Henry Maudslay, a national ‘nursery’ of engineering talent. After working for other leading Londonengineers, including a contribution to Charles Babbage’s pioneering calculating machine, he returned to Manchester and set upa business making machine tools such as lathes.

From 1854, at the request of the British government during the Crimean War, Whitworth experimented with new designs forrifles. He demonstrated them in the grounds of his Manchester home, now part of Chancellor’s, the University’s conferencecentre in Fallowfield.

Whitworth was a generous man and he left most of his wealth (about £900,000, or £55 million in today’s money) to his threetrustees for causes dear to Whitworth, especially education, including a national system of engineering scholarships. InManchester they provided land for teaching hospitals to be built on Oxford Road and for a new technical college on SackvilleStreet, the site of Whitworth’s early factory. They also created what are now the Whitworth Art Gallery and Whitworth Park;and their several donations to Owens College included the magnificent Whitworth Hall.

The hall, like the rest of the quadrangle, was designed by Alfred Waterhouse, one of Britain’s best-known architects, who alsodesigned Manchester Town Hall and the Natural History Museum in London. Building started in 1898 and was completed in1902 under Paul Waterhouse, Alfred’s son. Panels inside the hall commemorate the many local citizens who have supported theUniversity from its origins nearly two centuries ago.

Cost: Included in registration fee for registered delegates, additional guest tickets £85 each.

NOTIFICATION OF 2019 ANNUAL MEETING

THE 113TH ANNUAL MEETING WILL BE HELD AT THE UNIVERSITY OF GLASGOW28 TO 29 MARCH 2019

The Annual Dinner will be held on Thursday evening

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ADMINISTRATIVE BUSINESS

THURSDAY 12 APRIL 20183:00 p.m. to 3:15 p.m.

LECTURE THEATRERENOLD BUILDING, THE UNIVERSITY OF MANCHESTER

Meeting chaired by: Professor Colin Dayan, Honorary Secretary and Professor Salim Khakoo, Honorary Treasurer

PROGRAMME

The attendance Books for Senior Members will be open for signature during the meeting

Attendance for Ordinary Members will be confirmed on collection of Registration Items

ASSOCIATION OF PHYSICIANS OF GREAT BRITAIN AND IRELAND

ADMINISTRATIVE BUSINESS

1. Minutes

2. Matters Arising

3. Election of Officers and Committee

4. Election of Honorary Members

5. Election of Senior Members

6. Election of Ordinary Members

7. Secretary’s Business

8. Treasurer’s Business

9. Grant Schemes

10. Report of the Editor of the Quarterly Journal of Medicine

11. Future Programme – Meetings in 2019 and 2020

12. Any Other Business

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PROGRAMME

SCIENTIFIC BUSINESSTHURSDAY 12 April 2018

RENOLD C2RENOLD BUILDING, THE UNIVERSITY OF MANCHESTER

10:00 – 12:30 p.m. Career Development Workshop (Clinician Scientists)

12:30 p.m. – 1:20 p.m. LUNCH AND POSTER VIEWING

1:20 p.m. – 1:30 p.m. ‘Welcome to Manchester’Andy BurnhamMayor of Greater Manchester

1:30 – 2:00 p.m. THE OSLER LECTURE‘Diseases affecting the small circle of life’Professor Sir Doug TurnbullProfessor of Neurology, University of Newcastle upon Tyne and Honorary Consultant Neurologist, Newcastle upon TyneHospitals NHS Foundation Trust. National lead of the National Highly Specialised Services for Rare MitochondrialDiseases of Children and Adults.

Chair: Professor Neil HanleyPresident, Association of Physicians of Great Britain & Ireland

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2:00 p.m. 1) Blocking CLEC-2 dependent platelet activation enhances neutrophil driven liver recovery after paracetamoloverdose Dr Abhishek Chauhan, Dr Trish Lalor, Professor Stephen Watson, Professor David Adams

Paracetamol (APAP) overdose is the leading cause of ALF in the West; the mechanisms that lead to ALF in APAP overdoseremain poorly understood. We hypothesised that platelets could be important players in this process.

The platelet receptor CLEC-2 mediates powerful platelet activation independently of haemostasis through its ligandpodoplanin (PDPN). We sought to investigate the role of CLEC-2 dependent platelet activation in ALF.

2:20 p.m.2) Endothelin receptor antagonism improves lipid profiles & lowers PCSK9 in patients with chronic kidney diseaseDr Tariq Edward Farrah, Dr Atul Anand, Dr Robert Kimmitt, Professor Nicholas L Mills, Professor David J Webb, Dr Neeraj Dhaun

2:40 p.m.3) Kisspeptin Increases Glucose Stimulated Insulin Secretion and Changes the Metabonomic Profile in HumansDr Chioma Izzi-Engbeaya, Dr Alexander N Comninos, Dr Sophie Clarke, Ms Anne Jomard, Dr Lisa Yang, Dr Sophie Jones,Dr Ali Abbara, Dr Shakunthala Narayanaswamy, Dr Pei Chia Eng, Mrs Debbie Papadopoulou, Dr Julia Prague, Dr Paul Bech, Dr Ian F Godsland, Mr Paul Bassett, Caroline Sands, Maria Gomez Romero, Dr Jake T M Pearce, Dr Matthew R Lewis, Prof Elaine Holmes, Prof Jeremy K Nicholson, Prof Tricia Tan, Dr Risheka Ratnasabapathy, Dr Ming Hu, Dr Gaelle Carrat, Lorenzo Piemonti, Marco Bugliani, Piero Marchetti, Patrick E MacDonald, Jocelyn E Manning Fox, Paul R Johnson, Stephen J Hughes, Prof Guy A Rutter, Prof Waljit S Dhillo

3:00 – 3:15 p.m. Association Administrative Business

3:15 – 3:30 p.m. Afternoon Tea

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3:30 p.m.4) Epigenetic alterations at diagnosis predict susceptibility, prognosis and treatment escalation in InflammatoryBowel Diseases: IBD Character ConsortiumDr Rahul Kalla, Dr Alex Adams, Dr Simen Vatn, Dr Ferdinando Bonfliglio, Dr Elaine Nimmo, Dr Nicholas Kennedy, Dr Nicholas Ventham, Professor Morten Vatn, Dr Petr Ricanek, Dr Jonas Halfvarson, Dr Johan Soderhollm, Dr Marieke Pierik, Dr Leif Torkvist, Dr Fernando Gomollon, Dr Ivo Gut, Professor Jorgen Jahnsen, Professor Jack Satsangi

Biomarker discovery to predict disease outcomes is a key focus in Inflammatory Bowel Disease (IBD). We havecharacterized disease-associated methylation changes in newly diagnosed IBD, defined the relationship to genetic variation(meQTL) and assessed its prognostic utility in IBD.

3:50 p.m.5) Multicentre validation of the Troponin-only Manchester Acute Coronary Syndromes decision aid using a singlenear-patient troponin testProf Richard Body, Ms Malak Almashali, Dr Garry McDowell

The Troponin-only Manchester Acute Coronary Syndromes (T-MACS) computer decision aid can ‘rule in’ and ‘rule out’acute myocardial infarction (AMI) with one blood test at the time of arrival in the Emergency Department (ED). Successfulvalidation with a near-patient cardiac troponin (cTn) assay would reduce turnaround time, helping to unburden crowdedEDs. We aimed to prospectively validate T-MACS with a contemporary near-patient cTn assay.

4:10 p.m.6) Controlled Antenatal Thyroid Screening Study: Obstetric Outcomes Dr Peter Taylor, Mr Arron Lacey, Dr Aled Rees, Professor Marian Ludgate, Professor Colin Dayan, Professor John Lazarus,Professor Scott Nelson, Dr Onyebuchi Okosieme

Low thyroid function in pregnancy is associated with adverse obstetric outcomes. We investigated whether screening andtreating subclinical hypothyroidism and isolated hypothyroxinemia during pregnancy improves obstetric outcomes.

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4:30 p.m.7) Effects of Remote Ischaemic Preconditioning on Coronary Artery Function in Patients with Stable CoronaryArtery Disease: The RIC-COR mechanistic trial Dr David Corcoran, Dr Robin Young, Dr Pio Ciadella, Dr Peter McCartney, Dr Amrit Bajrangee, Dr Barry Hennigan, Dr Damien Collison, Dr David Carrick, Dr Aadil Shaukat, Dr Richard Good, Dr Stuart Watkins, Dr Margaret McEntegart, Dr Jonathan Watt, Dr Paul Welsh, Prof Naveed Sattar, Dr Alex McConnachie, Prof Keith Oldroyd, Prof Colin Berry

Remote ischaemic preconditioning (RIPC) is a cardioprotective intervention invoking intermittent periods of ischaemia in atissue or organ remote from the heart. The mechanisms of this effect are incompletely understood. We hypothesised that RIPCmight enhance coronary vasodilatation by an endothelium-dependent mechanism.

4:50 p.m. – 5:20 p.m.PLENARY LECTURE‘NICE: science, politics and money’Sir Andrew DillonChief Executive of NICE

Chair: Professor Colin DayanHonorary Secretary, Association of Physicians of Great Britain & Ireland

5:20 p.m. Scientific Business Concludes

6:30 p.m. – 7:45 p.m.RECEPTIONManchester Museum, The University of Manchester, Oxford Road, Manchester M13 9PL

Welcome reception speaker: Professor Dame Nancy Rothwell, President and Vice-Chancellor of The University ofManchester

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8:00 p.m. THE ANNUAL DINNERWhitworth Hall, The University of Manchester, Oxford Road, Manchester M13 9PL

Dinner Address: Sir Howard Bernstein, former Chief Executive of Manchester City Council (1998-2017) and former Headof the Paid Service for the Greater Manchester Combined Authority (2011-2017).

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SCIENTIFIC BUSINESSFRIDAY 13 April 2018

RENOLD C2RENOLD BUILDING, THE UNIVERSITY OF MANCHESTER

9:00 a.m. – 9:30 a.m.PLENARY LECTURE‘Liquid Biopsy for Precision Medicine and the management of cancer patients’Professor Caroline Dive CBE Deputy Director & CEP Group Leader, Cancer Research UK Manchester Institute

Chair: Professor Salim KhakooHonorary Treasurer, Association of Physicians of Great Britain & Ireland

9:30 a.m.8) An Immunoglobulin Heavy Chain Gene is the Major Susceptibility Locus for Rheumatic Heart Disease amongPacific Islanders and Northern IndiansDr Tom Parks, Dr Kathryn Auckland, Dr Alexander J. Mentzer, Dr Joseph Kado, Dr Mariana M. Mirabel, Associate Professor John K. Kauwe, Dr Kathryn J. Robson, Professor Balraj Mittal, Associate Professor Andrew C. Steer,Professor Adrian V. S. Hill

Rheumatic heart disease is an important but neglected cause of morbidity and premature mortality in developing countries.Considered heritable for more than a century, we sought to investigate genetic susceptibility by using the latest approaches.

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9:50 a.m.9) Deep-immunoprofiling of early rheumatoid arthritis patients reveals a treatment predictive endotypeDr Moeed Akbar, Dr Megan Forrester, Dr Aysin Tulunay Virlan, Ms Ashley Gilmour, Mrs Carol Wallace, Mrs Caron Paterson, Professor David Reid, Dr Stefan Siebert, Professor Duncan Porter, Professor Janet Liversidge,Professor Iain McInnes, Professor Carl Goodyear

There is a pressing need in rheumatoid arthritis (RA) to identify pre-treatment biomarkers that can stratify patients intoresponders/non-responders to first-line disease-modifying anti-rheumatic drugs (DMARDs). We sought to identify theexistence of discrete immunologic endotypes and to evaluate whether such endotypes could predict response to DMARDs.

10:10 a.m.10) SOX9 Loss Protects Against Liver Fibrosis and Histological Quantification Predicts Progressive Liver FibrosisRisk in Patients with Chronic Hepatitis CDr Varinder Athwal, Dr James Pritchett, Dr Abed Zaitoun, Professor William Irving, Dr Indra Neil Guha, Professor Neil A Hanley, Dr Karen Piper Hanley

1. Assess in vivo action of SOX9 in liver fibrosis.2. Define human expression of SOX9 during advancing fibrosis.3. Explore SOX9 expression as a tool to predict risk of progressive fibrosis.

10:30 a.m. – 10:50 a.m. Morning Coffee

10:50 a.m.11) Genomic and transcriptomic studies driving precision medicine in Connective Tissue DiseasesDr Tracy Briggs, Dr John Reynolds, Dr Gillian Rice, Dr Vincent Bondet, Dr Ellen Bruce, Professor Yanick Crow, Dr Darragh Duffy, Dr Ben Parker, Professor Ian Bruce

To study the relationship between phenotypic, serological, genomic and transcriptomic characteristics in adults withConnective Tissue Diseases (CTDs).

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11:10 a.m.12) PAK1 represents a novel therapeutic target for urgently needed anti-fibrotic drug development in liver fibrosis Dr Katherine Martin, Dr James Pritchett, Miss Aoibheann Mullan, Dr Jessica Llewellyn, Dr Varinder Athwal, Dr Leo Zeef,Prof Stuart Farrow, Prof Charles Streuli, Prof Neil Henderson, Prof Scott Friedman, Prof Neil Hanley, Dr Karen Piper Hanley

Identify downstream mediators of integrin beta1 (Itgb1) signalling amenable to targeting in liver fibrosis.

11:30 a.m. – 12:00 p.m.THE GEORGE GRIFFIN LECTURE‘NIHR and future priorities for health research’Professor Chris WhittyChief Scientific Adviser for the Department of Health

Joint Chairs:Professor David LomasFormer President, Association of Physicians of Great Britain & Ireland

Professor Neil HanleyPresident, Association of Physicians of Great Britain & Ireland

12:00 p.m. – 13:00 p.m. LUNCH

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1:00 p.m. – 3:00 p.m.JOINT SYMPOSIUM WITH THE ACADEMY OF MEDICAL SCIENCES: ‘Advances in healthcare from large-scale data and informatics’Professor Sir Rory CollinsSize matters: the need for some large-scale population studiesBHF Professor of Medicine and Epidemiology at the BHF Centre of Research Excellence, University of Oxford, ClinicalTrial Service Unit & Epidemiological Studies UnitPrincipal Investigator and Chief Executive of the UK Biobank

Professor Martin GibsonUsing electronic health resources to support care and researchMartin Gibson is Chief Executive of Northwest EHealth, Director of the NIHR Clinical Research for Greater Manchesterand Research and Informatics Director for the Greater Manchester AHSN

Dr. Paul Varghese Medicine and Information Technology: Opportunities and ChallengesHead, Health Informatics at Verily (Google Life Sciences)

Professor Jill Pell CBEBig data: Why big is beautifulProfessor Jill Pell is the Director of the Institute of Health and Wellbeing and Henry Mechan Professor of Public Health atthe University of Glasgow

Joint Chairs:Professor Neil HanleyPresident, Association of Physicians of Great Britain & Ireland

Professor Paul StewartVice-President, Academy of Medical Sciences

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