The joints of the body are frequently involved in bone breaks, typically classified as intra-articular fractures. If a joint is to function properly again, that is to provide pain-free stability and movement, the broken pieces of the joint must be subjected to an anatomic reduction e.g. put back together as perfectly as possible. This project's aim is to set a research basis for creating a robotics device for precise anatomic reduction of complex, joints' fractures using the state of the art of 3D imaging, pattern recognition and robotics. The cost of trauma in hospitals is massive and a saving that robotics could potentially bring is promising. We believe that Bristol Robotics Laboratory's vibrant cross-disciplinary environment and its close association with Bristol Royal Infirmary places the investigators in an excellent position to exploit the opportunity of combining their robotics and clinical expertise with commercial 3D imaging software solutions developed by Simpleware.Trauma accounts for the highest proportion of healthcare expenditure. The BRI Limb unit has been at the forefront of injury research for the past three decades. BRL has, on the robotics side, been a fast developing robotics laboratory with a wide expertise in many areas of service and swarm robots. In order to promote the research in the area of orthopaedic robotics, we have formed a collaboration between the department of orthopedic surgery at the University of Bristol (Professor Roger Atkins), the Bristol Robotics Laboratory (Dr S Dogramadzi), the Centre for Fine Print Research at the University of the West of England (Dr P Walters and Dr D Huson) and a software company (Simpleware Ltd). This proposal is a first attempt to initiate the realization of an ambitious idea that can potentially bring benefits to a broad community of stakeholders. It is a feasibility study that aims to develop a novel robotic device capable of reducing complex joint fractures at the appropriate level of autonomy. An automated 3D jigsaw solving algorithm needs to be developed at this stage that would allow calculation of the optimum paths in overall alignment of the broken joint's segments. When the fracture is successfully reduced in simulation, the next step is to develop a robotic device to manipulate the fractured joint's parts using a fine wire circular frame applied across the joint. This will allow less exposure to CT scan for patients and staff, considerable resource saving, more rapid recovery and less scarring of the limb.Robot assisted surgery is an emerging interdisciplinary field that aims at improving the outcome of surgical procedures, reducing intra-operative time and radiation exposure to patients and staff as well as minimizing the invasiveness of a variety of surgical procedures. It seems very likely that Medical Robotics and Computer Assisted Surgery (MRCAS) will be a pervasive element of future society; there are many indications e.g. MRCAS report (http://www.piribo.com/publications/medical_devices/medical_robotics_computerassisted_surgery.html) that this will be a huge opportunity for life enhancement and commercial exploitation. The total worldwide market for MRCAS devices and equipment was around $1.3 billion in 2006 and is expected to reach $5.7 billion by 2011, an average annual grow rate of 34.7%. There is a natural synergy in this project; the PI has a track record in robotics and a strong background in mathematics and control, the Advisor is an experienced clinician with an academic portfolio of developments in orthopaedics surgery. The collaborating company Simpleware will provide their software licence for the duration of the project as well as the software support. BRL's rapid prototyping facilities will contribute to realisation of the project's hardware and the visualisation of the real fractures obtained from BRI's medical archives.

At some point during our lifetimes, eight out of ten of us will experience low back pain. For some, a course of painkillers and a period of recovery will be enough to alleviate the symptoms, but this is not always the case and many people continue to suffer long term pain and discomfort. In joints such as the hip and knee, replacement surgery has become commonplace and is highly successful in reducing pain and restoring movement. In the spine however, corresponding treatments are still in their infancy and have yet to prove their long term effectiveness.It may seem farfetched to imagine that in less than two decades spinal treatments could develop to a level where back pain will be effectively treated using keyhole surgery and other minimally invasive techniques. However it is not beyond the realms of possibility if progress in the basic sciences along with developments in imaging and computer modelling continue. Perhaps most importantly, the understanding accrued in these many disciplines must be effectively harnessed and integrated. The aim of this research is to enable such a step change in spinal treatments to occur. Through the Exploration Funding, computer models of the spine will be developed in collaboration with experts from the basic sciences as well as clinicians and industrialists. These models will be used to investigate new implant materials and treatment techniques for back pain.The spine constantly undergoes complex biological, biochemical and mechanical processes which must be taken into account if new treatments are to be effective. Experimental tests will be used to assess these factors in isolation and the results combined into the computer models. There is much variation in the properties of the spinal structures both from one patient to another, and even along the length of an individual's back. These variations will also be simulated in the computer models to see how effective a treatment will be for a range of different patients. The computer models will enable new spinal treatments to be developed and optimised to bring maximum benefit to the patient before they are introduced into hospitals.By the end of the five year period of the Exploration Funding, a new and reliable method of testing spinal interventions will have been developed and research initiated to create a range of novel optimised treatments for back pain. In ten years time, this could lead to a new range of treatment options and, by 2020, effective minimally invasive treatment for back pain could become a reality.

Over the last five years the interest in developing patient-specific numerical solution to human body related problems has grown tremendously. This is due to the fact that both computing power and appropriate tools needed to carry out such studies have been emerging over the last few years. Although there are a large number of difficulties remain to be addressed, the patient-specific numerical modelling has great potential to study and understand several aspects of human body related illnesses, which are otherwise not possible. For instance, a detailed and prolong flow structure near an aortic aneurysm is only possible via a fluid dynamics study. Such a flow pattern and associated forces will help the surgeons to plan a surgery on an aortic aneurysm. Patient-specific studies will also give us the post-operative conditions a priori to a surgery and help the clinicians to make decisions. Many other examples of biomechanics, respiratory systems and urinary tract can be studied in a patient-specific sense. In short, a patient-specific study constructs a full picture from minimum available patient-specific information.The proposed network will bring a group of people from different disciplines together to address the difficulties faced by patient-specific modelling community and support a faster growth in this area. The network will pay particular attention to exploring the possibility of providing support to NHS trust hospitals. At least four formal workshops will be held during the proposed period of the network to move the research forward in the area of patient-specific modelling. A dedicated webpage will be developed and hosted from Swansea. This webpage will have a robust database for registered participants to upload and share patient-specific modelling related material. All the attempts will be made beyond the project period to sustain the network. This includes conducting larger workshops, approaching other funding agencies, charities and private medical industries.

The cost and safety of the important elements of our life - energy, transport, manufacturing - depend on the engineering materials we use to fabricate components and structures. Engineers need to answer the question of how fit for purpose is a particular component or a system: a pressure vessel in a nuclear reactor; an airplane wing; a bridge; a gas turbine; at both the design stage and throughout their working life. The current cost of unexpected structural failures, 4% of GDP, illustrates that the answers given with the existing engineering methods are not always reliable. These methods are largely phenomenological, i.e. rely on laboratory length- and time-scale experiments to capture the overall material behaviour. Extrapolating such behaviour to real components in real service conditions carries uncertainties. The grand problem of current methods is that by treating materials as continua, i.e. of uniformly distributed mass, they cannot inherently describe the finite nature of the materials aging mechanisms leading to failure. If we learn how to overcome the constraint of the lab-based phenomenology, we will be able to make predictions for structural behaviour with higher confidence, reducing the cost of construction and maintenance of engineering assets and thus the cost of goods and services to all individuals and society. For example, by extending the life of one civil nuclear reactor the produced electricity each hour will cost £10k-15k less than from a new built nuclear reactor, or from a conventional power plant. This project is about the creation of a whole new technology for high-fidelity design and assessment of engineering structures. I will explore an original geometric theory of solids to overcome the phenomenological constraint, produce a pioneering software platform for structural analysis, validate the theory at several length scales, and demonstrate to the engineers how the new technology solves practical problems for which the present methods are inadequate. In contrast to the classical methods, the engineering materials will be seen as discrete collections of finite entities, or cells; importantly this is not a discretization of a continuum, such as those used in the current numerical methods, but a reflection of how materials organise at any length scale of observation - from atomic through to the polycrystalline aggregates forming engineering components. The cellular structure is characterised by distinct elements - cells, faces, edges and nodes - and the theory proposes an inventive way to describe how such a structure behaves by linking energy and entropy to the geometric properties of these elements - volumes, areas, lengths, positions. This theory will be implemented in a highly efficient software platform by adopting and modernising existing algorithms and developing new ones for massively parallel computations, which will enable engineers and scientists to exploit the impending acceleration in hardware power. With the expected leaps of computing power over the next five years (1018 operations per second by 2020) the new technology will allow for calculating the behaviour of engineering components and structures zooming in and out across length-scales from the atomic up to the structural. The verification and validation of the theory at multiple length-scales are now possible due to exceptionally powerful experimental techniques, such as lab- or synchrotron-based tomography, combined by image analysis techniques, such as digital volume correlation. Once verified, the technology will be applied to a series of engineering problems of direct industrial relevance, such as cleavage and ductile fracture and fatigue crack growth, providing convincing demonstrations to the engineering community. The product of the work will make a step change in the modelling and simulation of structures, suitable for the analysis of high value, high risk high reward engineering cases.

The motorway and trunk road system in England has a total length of over 12,000 km and an asset value of £60bn. Extrapolating this to the whole of the UK road network of some 400,000 km and allowing for the much lower value per km of non-motorway/trunk roads gives a total highway asset worth some £600bn. Maintaining and rehabilitating this asset, while at the same time sustaining undisturbed traffic flows, has placed increased emphasis on the need for high-performance and increasingly more durable pavement materials. The majority of roads in the UK and throughout the world are constructed using asphalt mixtures with over 340 million tonnes being produced in Europe in 2007. The most important factor influencing the durability of asphalt mixtures is the presence of water in the pavement structure and the detrimental effect that water has on the properties of the mixture. Moisture-induced damage is an extremely complicated mode of distress that leads to the loss of stiffness and structural strength of the asphalt and eventually to the costly failure of the road structure. An improved understanding of moisture-induced damage in asphalt and more moisture resistant materials could have a significant impact on road maintenance expenditure, particularly where rainfall is predicted to increase due to global warming. In this project, for the first time, the micro-mechanical processes that result in moisture induced damage at meso- and macro-scale in asphaltic pavements, will be analysed in a comprehensive manner in which both cohesive and adhesive types of damage will be addressed and evaluated as a function of the physio-chemical characteristics of the components of the asphalt mix. This project will involve the use of X-Ray CT to characterise the internal microstructure of the asphalt, the development of tools for the processing and conversion of these images into accurate 3D finite element meshes which will then be ised in a Finite Element simultion to investigate moisture damage in asphalt. A significant experimental programme will be required to determine the mechanical properties of the asphalt mixture components (and interfaces between the components) required by the FE analysis. From the combined experimental and computational analyses it will become possible to reach unprecedented insight into the dominant parameters controlling moisture induced damage in asphaltic mixes. On the basis of the conclusions of the combined numerical-experimental studies, recommendations for practise shall be drafted focused on the improvement of the moisture resistance of typical asphalt mixtures and contributing thus to the sustainability of the UK road network.