Researchers Robert Kerrison and Gerard Cummins talk to Sam about Samplecam, an innovative new type of capsule endoscopy currently in the works. They explain their research on Samplecam, which is a video capsule endoscopy that will also be capable of taking samples of the bowel as it travels through it. They discuss what a video capsule endoscopy normally does, how this technology will be different, and the potential impact on the patient. The episode also includes recordings from other members of this research team explaining how the technology could be used in primary care settings and why people with Lynch syndrome are being focused on at first. Rob also explains how patients have had their say in the direction of this research.
Transcript
Sam
Welcome to Can I Butt In, the Bowel Research UK podcast where we welcome bowel cancer and bowel disease, patients, researchers, healthcare professionals and carers to butt in and share their experiences. We’re picking a topic every episode and getting to the bottom of it. I’m your host, Sam Alexandra Rose. I’m the Patient and Public Involvement Manager at Bowel Research UK, and as a patient myself, I’m excited to bring more patient and researcher voices into the spotlight.
Welcome everybody to a new episode of Can I Butt In. Today we’re looking at a new type of video capsule endoscopy and here to talk about their research in this area are Robert Harrison and Gerard Cummins. Robert Harrison is a senior lecturer in cancer care at the University of Surrey, where he co-leads the cancer care cluster with Professor Katrina Whittaker. Rob is also co-chair of the World Endoscopy Organisation coalition to reduce inequalities in colorectal cancer screening and a co-investigator on the NIHR Policy Research Unit for cancer awareness screening and early diagnosis, Well, what a mouthful! I am already tripping over myself.
Rob
You did very well.
Sam
Thank you. And Gerard Cummings is an assistant professor in the School of Engineering and leads the Medical Microsystems lab. His core research interest is in applying micro engineering techniques to benefit healthcare. by developing smart, miniaturised diagnostic and therapeutic implants, ingestible and wearable devices. So to me and you, stuff that we swallow and stuff that we wear to help diagnose conditions. So Rob and Gerard, welcome to the podcast.
Gerard
Great to be here.
Rob
Thanks for having us.
Sam
And throughout this episode, we’ll also be adding in recordings from other members of this research team, and we will introduce those or they will introduce themselves as they come up. So talking about something today called Samplecam and first to kind of set the context of what all of this is about, I think that we just need to explain to everybody what is a capsule endoscopy. So Gerard, could you please start us off with that?
Gerard
Yeah, sure. So first of all, I just explain what endoscopy is for anyone who doesn’t know. If you go for, if you’re suspected of colorectal cancer generally, what will happen is you go into hospital for an appointment and they will insert an endoscope through your rectum. It can be quite uncomfortable. A lot of people don’t like it for obvious reasons, and so back in the 2000s a new technology was developed which negates the need for a basically a tube to be inserted in your rectum that has a lot of issues. So this technology that developed in 2000 was the capsule endoscope and the capsule endoscope is basically a swallowable camera pill, it’s 3 centimetres long and one centimetre wide. Many people can swallow it quite safely and it goes down your mouth and through the entire length of your gastrointestinal tract, so the entire length of the gut and is able to send a lot of images out to a belt that you wear around your stomach, which has a recorder on it. And the images are sent out. Are collected by the recorder, and they’re later given to the clinician, who will then diagnose it. So it’s pretty minimally invasive, it does the entire length of the GI tract and it’s a lot more painless than the endoscope. So that’s what capsule endoscopy is. It’s a swallowable camera pill.
Sam
And I can testify as well, cause I’ve I have to have a capsule endoscopy every year, although mine is slightly different now. So I used to just swallow it, sort of the traditional way and I can sort of testify to it. It’s surprisingly easy to swallow considering it is, it looks quite large when you’re looking at it as in you have to put this in your mouth.
Gerard
Yeah.
Sam
But yeah, I mean now I have to have mine placed via gastroscopy because I’ve had Whipple surgery and all my insides of all different plumbing in different shapes. So yeah, I do long for the days where I could just swallow something, cause it was a lot easier, entirely painless. I do like to just to take a slightly off track here. I do like to sometimes just dispel some things that people say about capsule endoscopies because. So I had my first capsule endoscopy in 2018 and I think even then it had been around for a little while, hadn’t it? Yeah.
Gerard
Was first reported into 2000s, yeah.
Sam
Right. But sometimes you see news articles that say such and such hospital is doing this brand new capsule thing for the first time and you look and the way that it’s kind of written in the newspaper sometimes makes it sound like it’s a brand new thing, when actually it’s probably new for the hospital but it’s actually been around for quite a while.
Gerard
It’s quite an established technology, yeah. You do see more and more of it being used since the pandemic to try and address some backlogs, there’s been and there’s also been some stuff in remote areas of Scotland and the Highlands to use it in a kind of a telemedicine type approach as well.
Sam
Right. Because yeah, the good thing about the capsule is that you can sort of basically go home for kind of when it’s taking place. Another thing that the newspapers say is like, oh, this is something that you can do at home. It’s like, well, yeah, kind of. But you still have to go to the hospital. You have to swallow it, you know, with sort of supervision. You have to be given the recording equipment belt to wear around you, and then you can go home and kind of go about your day while this thing is taking pictures. And then it kind of goes through your system during the day and then basically.
Gerard
Mm-hmm.
Sam
You poop it out.
Gerard
Yep, and flush it away. Yeah.
Sam
You flush it away. They don’t want it back. And yeah. And then you give the recording equipment back at the end of the day or the next morning. So there’s a bit of hospital visits, but generally it’s a lot less invasive and more pleasant than a colonoscopy.
Gerard
And it doesn’t need as much hospital resources to manage compared to conventional colonoscopy.
Sam
Yeah. Especially if like somebody might need like sedation, for example, for a colonoscopy and or all of that sort of stuff.
Gerard
Yeah.
Sam
And I guess the benefit of the capsule is that actually say it sees the whole of the digestive tract. So am I right in thinking that a colonoscopy is just for looking at the large colon, whereas the capsule can see basically from like the minute, like even before you swallow it, it’s kind of turned on. It’s taking pictures of the ceiling before you, you swallow it and then it. So then it will see the digestive tract, the large bowel and the small bowel. Basically everything from ceiling to toilet.
Gerard
Yeah. That’s a key advantage of it because, yeah, colonoscopy does basically the large bowel and then conventional endoscopy would go down the throat. There is that area in between. It’s really hard to reach using conventional endoscopy in that small intestine. So this is really kind of expanded our understanding of the small intestine. But that’s not to say they’re, like the capsule endoscopy is a wonderful technology, but that’s not to say there is still not a place for conventional colonoscopy. One disadvantage, perhaps of capsule endoscopy, is that the resolution of the images isn’t as great as conventional colonoscopy. That’s something to bear in mind when you discuss what’s best for you when you go to talk to your clinician really.
Sam
Oh, that’s interesting. Yeah, I didn’t know that. My second question was sort of what does a regular video capsule do? Which I guess we’ve kind of covered all already, that it sort of takes pictures as it’s going all the way down. And as we said, you sort of, you, you pass it and it ends up in the toilet and but all it does is sort of take pictures. It can’t sort of take samples or anything like that, which I guess leads us into Samplecam. So tell us about Samplecam and what does it do that’s different from a traditional capsule?
Gerard
Yeah. OK, so Samplecam is using, is basically trying to see if we can use the same technology as capsule endoscopy, but instead of imaging the bowel, we’re keen to explore whether we can do imaging and sampling at the same time. So the imaging is done by our colleague in Kings College London, Heather, and using artificial intelligence with image collected from the clinical trial that our colleague Elena is doing and what I’m working on in the University of Birmingham is the sampling aspects. So we’re trying to see if we can use these capsules to sample the contents that well, the lining of our gut. Because there’s a lot of information that can be gathered from the lining of the gut, so the mucus layer effectively, and that includes everything from, there might be changes in the microbiome that might be associated with an early warning of colorectal cancer. We don’t know, but this tool could potentially open up the possibilities of investigating that. There could be with the mechanism we’re used for sampling, we might even be able to capture precancerous cells from the lining of the gut. Again, if we’re able to detect those in the sample that we acquire, that could be an early form of detection. So this technology is being developed really to really try and push the boundaries of how early can you detect colorectal cancer.
Sam
And I suppose the first thing that I think of when I’m thinking about being a patient and in the process the difference as well is that you will want the Samplecam back because of course it will have a sample in it.
Gerard
Yeah.
Sam
So what would that retrieval…? That’s always the first thing that came comes to my head. What would the retrieval be like?
Gerard
We are aware that obviously patients have issues with handling stool. You don’t need to be a rocket science to figure that out, but it is something we’re trying to solve. At the moment the project we’re working at the moment is very exploratory. It’s at the kind of the pilot stage really. So while we are aware that that is an issue, it is probably something that we’re probably going to have to figure out down the line. At the moment we’re really focusing on getting the basic science working, showing that we can collect samples, showing that we can detect things using AI images, and then once we’ve shown that the next step will be refining the project, refining the device.
Sam
Yeah, it sounds like a really great thing that if you can gather samples, if you can even kind of as you say, take out sort of precancerous cells. I mean, do you see it as like something that could potentially in the future actually detect polyps like pre-cancerous or cancerous polyps and remove them in the same way that you would remove a polyp during colonoscopy.
Gerard
So with capsule endoscopy, it’s led to an explosion in the range of kind of, it’s led to an explosion in ingestible device research and one thing that a lot of people are looking at is trying to miniaturise effectively surgical intervention into a capsule. So there have been some studies, some exploratory studies, where they have shown on their control conditions that these devices could be used to exercise polyps or excise tissue or do biopsies. But it’s still a long way to go before that’s going to be in the clinic. It’s still very much high level research being done. But yeah, the capsule endoscope has really opened up a wide variety of new avenues for diagnosis, surgical intervention and even therapy.
Sam
To me it sounds quite a complicated thing to develop. I suppose for anybody, it sounds like quite a complicated thing to develop, because I guess if you have that sample, you also need the capsule to ensure that the sample is secure as it travels the rest of the way. So I guess the sample will sort of be encapsulated kind of inside the capsule.
Gerard
So that’s a, that’s a key challenge is ensuring that the sample is secure, that it is, there’s a degree of integrity to that sample, because the last thing you want to do is have that sample be contaminated and a misdiagnosis occur. So that is a crucial technological challenge that we’re trying to overcome here.
Sam
Is there any AI involved in this? I know there’s AI involved in lots of stuff, but I guess especially for healthcare at the moment, you hear about loads of research being done with AI. It just occurred to me like again quite a while down the line, but if it’s sort of detecting what to take, what samples to take. Would there need to be sort of AI images fed to that so that it knows what it’s looking for and what it needs to sample?
Gerard
Yeah, so AI is a big part of capsule endoscopy because as you mentioned, you’re recording a lot of footage and you can imagine it takes a lot of time for a clinician to go through that footage of someone’s gut. So a lot of the companies that create capsule endoscopes are investing in these for AI to help flag up areas of interest. But AI is also the heart of this product as well, with the work has been done in Kings College and in the Royal Marsden Trust where our colleague Elena is running a small clinical trial to acquire images from a subset of the population. People who live with a condition called Lynch syndrome to try and see if that data could be used to train AI to sample or detect areas that need sampling. So rather than sampling the entire GI tract, entire gut, the AI could be used to detect the regions that sampling needs to occur in.
Sam
Well, now might be a good time to bring in Elenas’s recording that that she kindly did for us to talk about why we’re focusing on patients with Lynch syndrome with this research. And I’ll just briefly explain to anybody listening who isn’t aware of what Lynch syndrome is. So Lynch syndrome is a genetic condition that increases people’s risk of getting different types of cancer and it’s inherited through families and if you listened before, you’ll know that both of my parents have Lynch syndrome, and I very unusually, inherited Lynch syndrome from both of them. So I’m quite a bit of a rarer animal because I have something called constitutional mismatch repair deficiency, which is when you very unusually happen to have two people who have Lynch syndrome have a baby, and the child inherits Lynch syndrome from both. So that’s me. But I’m quite different. But yeah. So Lynch syndrome increases people’s risk particularly of bowel cancer. And the thing about Lynch syndrome as well is that they think that 95% of people don’t actually realise that they have Lynch syndrome. So there’s a lot of people sort of wandering around with this and not knowing of their potential risk. But yes, we’ll, we’ll pop Elena’s message just here about why patients with Lynch syndrome have been focused on particularly for this research.
Elena
Hi, I’m Dr Elena Cojocaru, medical oncologist and clinical research fellow at the Royal Marsden Hospital. My main area of research is early diagnosis and detection. With the focus on individuals who are at high risk of developing cancers due to a genetic predisposition, including those people with lynch or Li-Fraumeni syndrome. We designed the PillCam studies so we can obtain images from both colonoscopy and video capsule and use those images to train an artificial intelligence algorithm to potentially detect colon tumours early in their development. When we designed the study, we focused on Lynch syndrome because these individuals have a colonoscopy every two years. So the chances of catching a tumour when it’s very early is higher than in people who present to the hospital with symptoms. I’m pleased to say that we have just enrolled our first patient and we were able to obtain good quality images from both video capsule and colonoscopy after our patient underwent only one bowel preparation for both investigations. We are hoping to enrol up to 25 participants by the end of this year and if the study is considered safe and achievable, we might wish to increase the number of participants in future studies to obtain more data and help to develop a more reliable artificial intelligence tool.
Sam
And it’s not just people with Lynch syndrome. Let’s also hear from Dr Sam Merriel about how Samplecam could be used by GPS in primary care.
Sam Merriel
So I think Samplecam presents a number of exciting opportunities for application in the NHS to improve early cancer diagnosis. So we’re talking about the kind of patient groups we’re gonna be testing Samplecam in. And I think that represents an obvious potential for the population to roll it out in. So if we had a test that we could use on a regular basis to try and pick up bowel cancers in an early stage in a high risk group that didn’t involve invasive procedures like colonoscopy, that would be potentially beneficial to patients in terms of having less invasive procedures. It could be more cost effective for the NHS if it just involved the patient swallowing a camera and having some readings taken and potentially you know with the extra technology that we’re looking to add in to Samplecam, make it a more accurate way of picking these cancers up early. Obviously if a lesion was detected On a PillCam or Samplecam, then further tests will be needed, but it could be a good way of picking things up early. I guess it would be really helpful as a GP in primary care to have more tests available for us to try and detect cancers early. We only have very few cancer specific tests that we can currently use and having additional tests in our armoury to use for certain patient presentations or certain patients, I think would be really, really helpful. You know, we know that the vast majority of patients with cancer will present to primary care before they get diagnosed on earlier in their diagnostic journey. And we know there are windows of opportunity for some patients with some cancer types that we can pick it up early. We can get it detected, get it investigated, get it treated and improve outcomes for patients and I’m quite excited about the potential of new technologies like Samplecam being developed and then being tried and tested in primary care to see if they can help us contribute to early cancer detection.
Sam
Back to you then. Gerard, where are you developing this device?
Gerard
So we’re developing in the School of Engineering at the University of Birmingham in my lab. So at the moment we are pulling together the various parts to assemble the prototype and we’re testing it using something called a tissue phantom. So rather than jump straight into in vivo testing, usually what is done is we use things called tissue phantoms, which I suppose are non biological mimics of specific organs or specific parts of the body, so we’re using a basically a gut mimic to test it. So we’re getting towards that stage now. We’ll be testing on that gut mimic in Birmingham, yeah.
Sam
We also have a recording from Heba Sailem about where she’s developing the device as well.
Speaker 6
Hello I’m Heba Sailem and I lead the biomedical AI and data science group at Kings College London. So imagine that the camera imaging view from the inside, from the comfort of your home. This is what PillCam will allow us to do and this is give us a fantastic opportunity to examine the health of the gut. Of course this will result in millions of images of the gut. And this means that it’s almost impossible for an expert to go through all these images and look for changes. So what my group is doing is we are developing artificial intelligence tools that can detect patterns indicative of early disease. And we are very excited by this because we can imagine that in the future this can be used for detecting various diseases in the gut.
Sam
So Rob, then, let’s continue talking about the patients and how have patients been involved with this research from a sort of patient and public involvement point of view.
Rob
Sure. So patients have been involved in this project in a number of different ways. The first way that they’ve been involved is as participants in the trial that Elena is running at the Royal Marsden Hospital. So they’re currently undergoing both PillCam and a colonoscopy. And then the data from those investigations will be used to inform the development of the artificial intelligence, and I’m sure they’ve both spoken more about that in their recordings. Then the second way in which we’ve involved patients in this research is in focus groups. So we’ve been conducting focus groups with people with Lynch syndrome. And people who do not have Lynch syndrome. To find out more from them what they think of this idea of developing a PillCam that can take sample from the colon, and those have been really, really fascinating and really fun to do. I have to admit, I think Gerard’s got the short end of the stick a little bit with this project having to, you know, do all the complicated stuff of developing the technology while I get to, you know, speak to patients about it. And yeah, as I say, those have been really fun and they’ve been really insightful. So we’ve been describing this device that we’re wanting to develop to them and then asking them for their thoughts and their feedback and sort of like, you know, what they see is some of the benefits and limitations of this of this technology in in relation to colonoscopy. So that’s another way in which we’ve been involving patients. And then the final way is that we’ve also got a couple of patients who sit in our scientific meetings so they attend these scientific meetings and they have an opportunity to kind of share their lived experience with us and tell us how we can do the research better.
Sam
Brilliant. I love to hear about a project that has such a sort of strong connection with patients and making sure that their views are kind of heard and implemented. And I was really gutted to not be able to come to the focus group because I was. I was signed up and I was ready to come. And then I was Ill and I couldn’t make it and it sounded like it was going to be really, really interesting. So yeah, I was disappointed to not be there, but it’s OK because you can tell me now what has the patient feedback been like?
Rob
Yeah, I mean we were disappointed not to have you there, but you know, we forgive you and I think it was, you know, understandable reasons that you weren’t able to attend. So yeah, the feedback’s been really positive overall. You know, patients have been very optimistic about this, this device that we’re wanting to develop. They’ve highlighted a number of potential benefits that they can see with it. So for example, they see this as a, as a you know, an additional layer of care that they could receive, they’ve told me about how, actually, between colonoscopies, they can become quite anxious. Some patients are waiting maybe two to three years for a surveillance colonoscopy to monitor their Lynch syndrome. And yeah, of course, during that time, you know, there’s concerns that things would grow or develop and they’ve expressed to me that they think, you know, having a PillCam or Samplecam between colonoscopies could be a great way of providing them with some reassurance that actually, you know, everything is OK. Or if there is a problem that they’re able to find out sooner rather than later, and seek treatment for that, you know that could be removing polyps or it could be something. And they’ve also expressed some concerns, which I think it’s completely understandable and those aren’t overly different from the concerns that they would have with the conventional PillCam, so there are some concerns around things like ingesting a camera you know, or a device that contains a battery and is that safe? And of course, we’ll be doing lots of research to ensure that that is safe. And there is lots of research already to show that you know these devices are very safe. But. Yeah. So they’ve been really interesting and they’ve also been coming up with some suggestions as to how we might tackle some of the issues that have been mentioned already today. So for example, we were talking about, you know, the need to retrieve the PillCam in this particular, for this particular device that we’re developing. And yeah, they’ve come up with a number of innovative solutions to that, yes.
Sam
Can you share any of those?
Rob
Well, yeah. I think one of them, which is something that I think Gerard had already been considering was using a magnet. So that would, you know, eliminate the need to actually kind of get your hands dirty, as it were. Another is to include, you know kind of mesh which you could put over the toilet bowl to make it easier so you know not having to sort of actually put your hands in the water or anything like that. Devices like that do already exist, so that is something that we could easily include with this device if it was something that we were to implement in the future. Yeah, I’m sure there have been other suggestions, but those are the first ones that spring to mind.
Sam
Yeah, my idea was just to have one of those, you know, in in the hospital when you have to give like a urine samples, like that kind of cardboard bed pan type things – give me a handful of those and at least it’s easier than, yeah. As you say putting your hand in the water and digging it out. Yeah, I didn’t know about the mesh thing. Yeah, that sounds quite useful.
Rob
They’re not widely used, but yeah, they do exist and they are available.
Sam
I can understand peoples’s concern as well around the length of time waiting for colonoscopies, especially when the NHS is quite stretched. Or you might not be getting your surveillance as on time as you would like. And also because I believe that Lynch syndrome tumours can potentially grow faster than other types of cancer. So. Yeah, I I can imagine that there’s a lot of concern there that this Samplecam could hopefully help to alleviate.
Gerard
Yeah.
Sam
Was there anything else that patients fed back that surprised you or anything else that they mentioned that we haven’t talked about?
Rob
I think what I would say is I’ve really enjoyed the interviews and the focus groups with patients. They’ve been really fun. I’ve been really, I suppose, impressed by just how knowledgeable they are about their condition. And. You know, I think I’ve learned a lot from speaking to them about Lynch syndrome. Yeah, they’ve been really, really engaged, really engaged with the focus groups, they’ve been really helpful in coming up with sort of ideas for how we could improve the device, how we can make it better. They’ve highlighted a number of potential issues that I hadn’t thought about and a number of potential ways in which we could use this device. So another example is some patients who have had hysterectomy find colonoscopy particularly painful or uncomfortable, and so for those patients specifically, I think there’s a need to consider other investigations other than colonoscopy. Another example would be those patients who typically don’t have polyps found.
Gerard
Mm-hmm.
Rob
Perhaps there’s less of a need for colonoscopy for those patients. Because of course, colonoscopy is great in that it allows you to remove polyps there and then. But actually, if patients typically don’t have polyps found, perhaps there’s less of a need for them in particular to have colonoscopy. So one of their suggestions has been that this could be a device that’s used for specific groups of patients, where perhaps colonoscopy is less. Sort of desperately needed.
Sam
Yeah. I didn’t know about potentially being more uncomfortably of people who have had hysterectomies, and that’s really interesting. I’d like to see some research actually just about discomfort of colonoscopies with like people with varying sort of conditions and different organs removed and stuff cause. Yeah, it really does sort of change various sensations. Yeah, depending on what you’ve had removed. Yeah. It’s interesting. So are there any other opportunities for patients to get involved with the research going forward?
Rob
So at this moment in time, we’re still conducting the trials to develop the artificial intelligence, as I say, that involves patients having both a colonoscopy and a PillCam. And Elena’s has just done the first of these with a patient. So we’ve now got one patient recruited in the study. We’re hoping to do 25 patients as part of this current trial. And then in the future, we’ll be looking to do larger trials I think. So there’ll be opportunities for patients to participate in those trials if they want to and of course, we’ll also do more studies further down the line to develop this technology. So we’ve done focus groups already as I mentioned. But we may want to do interviews with patients who actually have the procedure to find out what their experience was and how we can improve it. So there will definitely be more opportunities I think for people to get involved.
Gerard
I think it’s really important to have that patient engagement, especially for development of new technology to ensure that that technology will actually be adopted by the end users. Otherwise, there’s a risk that no-one would use it.
Sam
Absolutely. And yeah, especially with this population with Lynch syndrome, it’s so important that people do go for their screening and yeah, make sure they’re sort of up to date with that and anything that can sort of alleviate anxiety around that or make it more comfortable. It’s definitely a win in my book. And I also just wanted to give a shout out. It’s gonna sound weird. Just give a shout out to the microbiome because you mentioned that Gerard.
Gerard
Yeah
Sam
About potentially sort of collecting samples from the microbiome and it really feels like the microbiome is having a moment right now. You know, there’s lots of people sort of interested in it. At Bowel Research UK, basically, I think 2024 is our year of the microbiome as we’re having, sort of different research being done around that. So yeah, it could potentially help not just people with Lynch syndrome, but sort of a whole variety of things that the microbiome could affect and that’s relevant for everybody.
Gerard
Yeah, there’s some studies are right on where they’re ingestible devices have been used to try and unlock the secrets of the microbiome. So I think this device could have as much impact in that area as it could have in colorectal cancer, definitely.
Sam
And on that note, then one final question that I have for both of you is what’s next in terms of this research or any future plans, yeah, what would you like people to take away sort of a final thought of what’s next for this research?
Gerard
So from, I suppose the technology perspective, I want to refine the technology, eventually push along the translational pipeline so patients would benefit from it. So the patient engagement that we mentioned before is quite key for that. It’s as important as the actual technology development itself. So yeah, I’m keen to further develop this technology and eventually hopefully see how things go, push it into the clinic.
Rob
And then from my end I suppose it’s about wanting to do more work with the patients themselves, the patients who ultimately go on to have this test to find out more about their experience and how we can improve it moving forward, as Gerard also mentioned. So this project’s been funded so far by Cancer Research UK. They’re funding this as part of an innovation award to try and develop new technologies to improve the early diagnosis of cancer. So moving forward, we will be keen to, you know, seek further funding from them or potentially other charities to enable us to continue doing this research.
Gerard
Yeah.
Sam
Well I’ll be really excited to see where this goes and you know, maybe even have you back on the podcast in a little while to check in on, on how things are going. Yeah, how things have progressed. Good luck with all of it.
Gerard
Delighted to be back, yeah.
Rob
That’d be fantastic. Thank you.
Sam
Well, thanks so much for coming on the podcast today. It’s been really great talking to you about your exciting research.
Gerard
Great to be here.
Rob
Thanks for having us.
Sam
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