EMBER will establish a 'Breathomics' node to ensure the development and adoption of new, non-invasive, diagnostic tools, for stratified medicine and to provide training in next generation pathology. EMBER has six workstreams aligned to our objectives:

Workstream 1 Innovation management

Team leader: Chris Brightling

The EMBER project builds on pre-existing collaborations between clinical academics, BRUs, scientists, NHS- including the new pathology services (Empath), the East Midlands AHSN andSMEs.

EMBER will establish a management and governance structure comprising of an executive management board, a scientific board, an operations group and an external advisory board.

Workstream 2 Ex-clinic 'breathomic' systems- knowledge management, bioinformatics and Biostatistics

Team leader: Paul Thomas

Integrated IT platforms that bring together clinical data from heath care records and aligned omic data has been established through our BRUs and will be applied here. This knowledge platform will inform discovery within EMBER and beyond.

Workstream 3 In–clinic 'breathomic' technologies- optimisation of sample collection and technical Validation

Team leader: Paul Monks

EMBER shall optimise breathomic technologies and establish an analytical pipeline using stateof- the-art techniques (e.g. CIMS-TOF-MS, GC/GC-MS-IMS) to identity biomarker VOCs which will enable the creation of metabolomic compound libraries. These will be used to „autotune‟ point-of-care digital sensors beyond mass spectroscopy (e.g. ion mobility spectrometry- IMS and FAIMS) developed by EMBER industry partners.

Workstream 4 Clinical disease cohorts- 'breathomic' discovery and clinical validation

Team leader: Salman Siddiqui

EMBER's initial exemplar clinical projects will be the 'breathless' patient to include airways disease, heart failure and respiratory infection in the acute and clinic setting in adults and children and lung cancer compared with healthy volunteers. With support from our BRUs, clinical research network and UHL NHS Trust breathomics is embedded into our phenomic strategy for the breathless patient attending the acute emergency setting and will be extended to the clinic. Breathomics in lung cancer, supported by our CRCUK Centre and Respiratory BRU, is closer to clinical application and candidate signatures have been developed, optimised using the FAIMS platform and we are validating them against standard histopathology.

Workstream 5 Training

Team leader: Jacqui Shaw

EMBER shall integrate breathomic modules into our existing MSc courses, set-up local and national workshops for scientists and health care professionals, develop a PhD programme and support clinicians and scientists in fellowship applications.

Workstream 6 Dissemination, Exploitation, and implementation

Team leader: Jane Blower

EMBER will establish an adoption plan with support from the AHSN to take breathomic platforms through the 'Technology Readiness Levels (TRL)' from discovery, optimisation, and validation to adoption.