Monday, 24 July 2017

Margaret Murray places 3rd in Faculty 3MT finals

Congratulations to SCS PhD student Margaret Murray who was placed third in the Faculty's 3MT Finals.

A PhD candidate in the Department of Nurtition, Dietetics and Food, Margaret is investigating the benefits of seaweed polyphenols and whether they may reduce the risk of chronic disease.

Watch Margaret's 3MT presentation HERE.

Monash researcher sheds light on therapy resistance in cancer

Dr Luciano Martelotto
Collaborative research including Monash University has uncovered the principles behind why some tumours may become resistant to targeted therapies, paving the way for new and more effective cancer treatments.

Published last week in Nature Medicine, a team of researchers including Dr Luciano Martelotto from the School of Clinical Sciences at Monash Health (SCS) in collaboration with Dr Piro Lito’s laboratory at the Memorial Sloan Kettering Cancer Center, New York, have found a mechanism that explains why and how resistance to therapy occurs in certain cancers, and identified types of therapies to prevent this process from occurring.

Lead author Dr Martelotto said that until now, the way that tumours respond and become resistant to therapies has been poorly understood.

“In our study, we generated models of melanoma and lung patients’ tumour cells and used modern DNA sequencing technologies to examine the genetic information of many individual malignant cells to better understand how tumour DNA changes in response to therapy,” Dr Martelotto said.

“This is important because it helps explain how these changes in the genetic material help the cancer escape the effects of the treatment.”

“For the first time, we’ve demonstrated that solid tumours like melanoma and lung cancers can grow back shortly after therapy, but when they do they are made of genetically diverse sub-groups of malignant cells—and, scarily enough, all of these are resistant to treatment. This genetic diversity is what allows the cancers to adapt to the treatment and resist it.”

The research team used their results to create a hypothetical model of resistance (called a fitness threshold model), enabling them to understand how the resistance mechanism works.

“We knew that drugs targeting different parts of the same cellular pathway have distinct mechanisms and, as a consequence, we proposed that they should also exert different selective pressures on cancer cells,” Dr Martelotto said.

The research team’s fitness threshold model links the effect of a given drug with the selection of resistance-causing alterations in DNA, resulting in significant implications for the treatment of cancer patients.

“We’ve now shown that sequentially treating tumours with drugs that neutralise different parts of the same pathway is ineffective; however, when the drugs are combined and administered in an intermittent regime, the treatment becomes highly effective and without apparent toxicity,” Dr Martelotto said.

Dr Martelotto said that these findings are important for oncologists and patients because they show that the way that drugs are administered during therapy can have a critical impact on the outcome of the response to treatment.

“In our work, we showed that intermittent administration enables simultaneous delivery of multiple targeted therapies while maintaining lower toxicity, and our fitness threshold model explains how other resistance-causing alterations may develop during targeted therapy,” Dr Martelotto said.

This important finding sheds light into the development of new therapeutic designs to more effectively treat patients.



Monash University collaboration to improve stroke care in India

Associate Professor Dominique Cadilhac
Monash University researchers are members of an international collaboration seeking to improve outcomes for patients with stroke in India.

The research project, led by The University of Central Lancashire, has received £1.9m from the National Institute for Health Research (NIHR) to support further implementation of best practice stroke care in India.

Associate Professor Dominique Cadilhac, Head of the Translational Public Health and Evaluation Division, Stroke and Ageing Research will lead the Monash University research efforts.

Associate Professor Cadilhac said the project is due to start immediately and will build on existing stroke unit care with a focus on implementing and evaluating best practice stroke care, and further developing research capability that will not only help developing countries, but will inform implementation of best practice globally.

“Stroke incidence in India is rising. The average age of people suffering a stroke in India is in the 50s, compared to the 70s in Australia and the UK,” Associate Professor Cadilhac said.

“This is largely due to change in lifestyle of the population in addition to environmental factors such as poor living conditions, lack of health awareness and fragmented healthcare infrastructure.”

There are currently around 50 dedicated stroke units in India. As part of this project, researchers will be working with existing stroke units at Christian Medical College, Ludhiana; All India Institute of Medical Science, New Delhi and Sree Chitra Tirunal Institute for Medical Sciences and Technology. They will look to determine the most effective processes for stroke assessment, care, monitoring and therapy, as well as determining the most economical approaches to assessment.

 

Professor Dame Caroline Watkins, Faculty Director of Research and Innovation in the Faculty of Health and Wellbeing at the University of Central Lancashire, said “A stroke is one of the most serious life-threatening conditions that people can suffer, which is why prompt and effective diagnosis and aftercare is incredibly important”.

“For example accurate diagnosis of whether a stroke is caused by a haemorrhage or blood clot, and precise assessment of associated disorders, will determine the correct type of treatment. This also provides invaluable insight into the most relevant acute stroke care for those most at risk of long-term damage,” Professor Watkins said.

“A country the size of India should have around 3,500 dedicated stroke units to cater for the scale of the problem. The prevalence of stroke is becoming more common and funding is limited, so it is vital that we are able to assess the current working practices and outline the most cost-effective ways of providing high-quality care to stroke patients.”

SCS medical student wins Faculty-wide Pathology Scholarship Prize

Ali Taher
Congratulations to SCS Year 3 medical student Mohammdali (Ali) Taher who has won this year's Faculty-wide Pathology Scholarship prize.  The scholarship is offered by the Royal Australian College of Pathologists and is offered to each major Medical School across Australia and New Zealand.

Ali's project is investigating Chronic Villitis of Unknown Etiology (CVUE), a cause of adverse pregnancy outcomes. The goal of the study is to determine CVUE incidence rate at Monash Health hospitals and to investigate its associated risk factors and their causal relationships. In addition, the project will study pregnancy complications and birth outcomes in confirmed CVUE cases.

Ali's supervisors are Dr Moghimi MD FRCPA and Dr Dickinson from Hudson Institute of Medical Research.
We wish Ali well with his project.

Monash University State of the Art Simulation Facility to Train Students for Pediatric Emergencies

Dr Ram Nataraja
In the same way that flight simulators are used to prepare pilots for emergencies a new world-class facility at Monash Children’s Hospital is preparing the next generation of paediatricians and paediatric surgeons to predict, prevent and manage emergencies in a busy hospital environment.

Monash University’s Paediatric Simulation Centre, which operates fully in the new Monash Children’s Hospital, has a purpose built operating  theatre, paediatric and neonatal ward and procedures rooms. These are controlled, videoed and monitored remotely to provide students with “real life” emergencies such as resuscitating a baby in a ward, or inserting a catheter into a child with cancer (a major source of infection if done poorly).

Monash University medical intern, Dr Sam Alexander, recently completed a study, to be published later this year, that compared experienced paediatric surgeons, surgical trainees and medical students on how they performed two types of complex laparoscopic procedures using a surgical simulation model.

The models have been designed to easily and cheaply produced and able to be taken  home by students for practice. 

The study found that the scores achieved by each of the three groups mirrored the level of surgical experience. 

According to Dr Alexander, the study showed that simple surgical models like the ones developed by him – which included high tensile plastic to simulate muscle and thin, tearable material to represent more delicate tissue – can assist in the training of medical students. 

“As a student I would have had access to the expensive surgical models at best 4 times during my training, and always under supervision,” he said.

“Developing new, transportable, cheap simulation models means that students can develop strong surgical techniques at home, and they can also be used in training doctors in remote areas.”

Director of the Surgical Simulation Unit and Co-Chair of MCH Simulation, Dr Ram Nataraja, says the facilities are unique in Australia and have been designed with the goal of training students in all types of paediatric emergencies, “so that they are better prepared when the real event happens.”

The simulation rooms –simulating wards for either a newborn and/or a child and the operating room – are set up exactly as they would be in a hospital. 

“My experience is that medical students, put into a hospital or surgical environment tend to stay in corners, often too intimidated by their environment to ask questions or even come forward and observe,” Dr Nataraja said. 

“This is something that I remember from my student days, and these educational spaces allows students to become familiar with these clinical environments earlier than usual”.

“These facilities also allow us to let students make mistakes in a safe environment, to find their role in an emergency.”

The rooms are monitored through a one-way mirror and the supervisor can trigger an emergency, using a very life like model of a child or baby, that sends a normal ward room into one where a child needs emergency resuscitation.

The whole process is filmed and then the students review how the procedure went with their supervisor. In some cases, according to Dr Nataraja, the situations are so life like that students can become very distressed, “and we have a private debriefing room for those students who may become a bit overwhelmed, in addition to the normal debriefing room following the simulation activities”

MCH Simulation with Monash University will also become a centre for research into Simulation-Based Medical Education, helping to improve the evidence base for this important part of medical education. 

Monash postdoc receives award to develop expertise in Doubly Labelled Water

Dr Kay Nguo
Monash researcher Dr Kay Nguo has been awarded the Golden Key Asia-Pacific Alumni Professional Development Grant to develop her skills in the use of stable isotopes in metabolic research.

Having completed her PhD at Monash University’s Department of Nutrition, Dietetics and Food last year, Dr Nguo is now a postdoctoral researcher.  She will use this grant towards attendance at the 4th International Conference on Recent Advances and Controversies in Measuring Energy Metabolism (RACMEM) in Switzerland.

“A primary element of my position at Monash University is working with a dual inlet Isotope Ratio Mass Spectrometer (IRMS) to analyse stable isotopes (oxygen 18 and deuterium) for the determination of body composition and energy expenditure in humans,” Dr Nguo said.

This gold standard technique is called Doubly Labelled Water (DLW), a measurement used to determine energy expenditure in free living individuals.

 “There are few nutrition scientists with knowledge of the DLW technique in Australia, so this training will have broader benefits in that it will help to greatly increase our capacity to further explore and conduct metabolic research and to undertake analysis relevant to others in the field.”

As far as we know, only two universities in Australia have capabilities to specifically perform DLW, and Monash University will be the first facility in Victoria.

Dr Nguo said attendance at the conference will help her acquire the skills to conduct nutrition research projects that require accurate measurement of energy expenditure and total body water in humans for the exploration of the concepts surrounding energy balance.
Earlier this year, Dr Nguo was also awarded the Australia Nutrition Trust Fund (ANTF) Travelling Fellowship to visit Professor Dale Schoeller at the University of Wisconsin, USA.

“An internationally recognised expert in energy metabolism and body composition, Professor Schoeller was the first person to apply the doubly labelled water technique for the measurement of energy expenditure in humans in 1982,” Dr Nguo said.
  
Dr Nguo acknowledges Professor Helen Truby, Head of the Department of Nutrition, Dietetics and Food for her support and the opportunity to be involved in this research.


MEET THE DEAN AT THE SCSMH FACULTY STAFF FORUM, 25 July

All staff are invited to Meet the Dean at the SCS Faculty Staff Forum.


Tuesday 25 July, 4.30-6.30pm
Seminar Rooms 1 & 2, TRF, MHTP

The purpose of this Forum is to meet with the Dean and Senior Faculty Staff and learn of recent important Monash University and Faculty developments, and to engage with other Senior Faculty colleagues. This is also an opportunity for senior staff to discuss with Faculty Senior Management potential opportunities and local concerns, and to provide feedback to the Faculty.


SCS Xmas in July celebration, 26 July


Translational Research Symposium Speaker Spotlight: Professor Richard Kitching

Professor Richard Kitching
Monash University's 3rd annual Translational Research Symposium is being hosted by its three metropolitan clinical schools on 31 July 2017. The symposium will host a diverse group of medical researchers presenting their work into translational research. RSVP here.

Professor Richard Kitching is a head of the Autoimmune Kidney Disease and Vasculitis research group at Monash School of Clinical Sciences and a leading Nephrologist at Monash Health.

Professor Kitching will be discussing "A new mechanism determining the risk of autoimmune disease". Abstract:
The highly polymorphic HLA system is critical to foreign and self-protein recognition by the immune system. A key question in autoimmune disease is how this HLA system, genetically linked to almost all autoimmune diseases, mediates disease risk. Furthermore, conditions such as type I diabetes mellitus, multiple sclerosis and Goodpasture’s disease (GPD) not only feature risk MHC Class II (HLA) alleles, but also exhibit dominant HLA-mediated protection, i.e. some HLA alleles are protective, even when inherited with a risk allele. We used GPD that causes life-threatening glomerulonephritis and pulmonary haemorrhage, to address this fundamental question. GPD is caused by autoimmunity to the non-collagenous domain of the α3 chain of type IV collagen, α3(IV)NC1, found in glomerular and pulmonary basement membranes, with the dominant CD4+ T cell epitope being the α3135-145 peptide. HLA-DR15+ people have a relative risk of GPD of 8.5, but HLA-DR1+ only 0.3. This HLA-DR15-associated risk is abrogated by HLA-DR1 co-inheritance.

We used in vitro and in vivo systems in HLA-DR15, DR1 and DR15/DR1 transgenic mice, together with samples from both GPD patients and from fully HLA-typed health donors. CD4+ α3135-145-specific T helper cells are central to disease and α3135-145 responses define HLA-DR1’s dominant protection. The molecular structure of the α3135-145-HLA-DR complex differs markedly between HLA-DR15 and of HLA-DR1, resulting in different α3135-145-specific T cell selection. Furthermore, most α3135-145-specific CD4+ T cells in HLA-DR15+ mice and humans are conventional T cells (with the potential to become autoreactive pro-inflammatory cells). However, when educated by HLA-DR1, the resultant α3135-145-specific CD4+ cells are anti-inflammatory regulatory T cells (Tregs) that maintain tolerance to α3(IV)NC1. Even in the presence of HLA-DR15, it is these α3135-145-specific specific Tregs, generated by HLA-DR1-peptide interactions, that potently protect from autoimmunity and GPD.
These findings answer a central question in autoimmune disease, providing a mechanistic basis for understanding HLA-mediated susceptibility and protection. Peptide-HLA/T cell interactions could be used in disease diagnosis and risk stratification, and the potency of Tregs specific for immunodominant autoepitopes mean that they may be more specific therapies for autoimmune diseases.

We look forward to welcoming Professor Kitching for the Symposium!

More information:
Translational Research Symposium
  • Date: Monday 31 July, 2017
  • Time: 8:30 for 9:00am start - 7:00pm close
  • RSVP here
Find out more about the symposium and our speaker program.

Next Big Idea Award - register now for workshop - attention ALL PhD students and ECRs, 28 July

Register now for the preparatory workshop:
Friday, 28 July, 10am, MIMR building, Level 3, Boardroom A&B.
To participate in the workshop, registration is essential.  See the Next Big Idea Award Guidelines.

In under four minutes, pitch your Next Big Idea for commercialising research to a panel of industry and academic experts.
$2,200 prizes to be awarded for commercial potential and innovation.
·         Learn about biomedical research commercialisation
·         Fast track your career
·         Network with other entrepreneurs
·         Help patients
Pitch Day: Thursday, 17 August, 2-4pm, Translational Research Facility, Level 2, Seminar Rooms 1&2.
Registration is compulsory and strongly recommended:  

2017/8 Joint Arts-Medicine Interdisciplinary Research (IDR) Seed Funding Scheme - APPLICATIONS NOW OPEN

The Faculty of Medicine, Nursing and Health Sciences is very pleased to announce that applications for the 2017/8 J​oint  Arts-Medicine IDR ​S​eed F​unding scheme are now open.

The total budget for the scheme is $100,000. The maximum available funding for each individual application is $25,000.
​The ​scheme guidelines, application form and faculty research priorities documents, further information and resources are ​available at 

Applications are due by 5pm on ​ Friday ​29 September 2017.

If you have any questions about the scheme or would like to apply, please contact
​ 
the Arts Research and Business Development Office (arts-research-enquiries@monash.edu​ or 990 58557).​

We look forward to receiving your applications.

CID weekly seminar, "Human Amniotic Epithelial Cells, a novel therapy for Inflammatory Bowel Disease", 25 July

Tuesday 25 July, 12:00 - 1:00pm, Seminar Room 1, TRF Building

Mr Nathan Kuk
Postgraduate student
Centre for Inflammatory Diseases


Human Amniotic Epithelial Cells, a novel therapy for Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD) encompasses a group of idiopathic, chronic and relapsing inflammatory conditions that affect the gastrointestinal tract, notably Crohn's disease and Ulcerative Colitis. It is most frequently diagnosed between the ages 15-40 and as such has life changing effects due to its chronic disabling symptoms. As IBD is incurable, immunomodulation remains the mainstay therapy with treatments aimed at maintaining disease remission and preventing flare ups. However immunomodulation has associated side effects and some patients are refractory to conventional therapy. Because of this, stem cells have been presented as an alternative therapeutic option. 

Haematopoetic and Mesenchymal Stem Cells have been studied both in animal models and humans (as part of a Phase 2 and 3 trial) with variable results. However, human amniotic epithelial cells (hAECs) have never been transplanted in an IBD model. Possessing anti-inflammatory and anti-fibrotic properties, hAECs have enormous potential and as such will be explored in this talk. 

Nathan is an MBBS/PhD student currently in his final year of his PhD. Under the supervision of Professor William Sievert and Drs Gregory Moore and Alex Hodge, Nathan has developed a keen interest in gastroenterology, with his experiments involving human amniotic epithelial cell therapy in models of non-alcoholic fatty liver disease, acute colitis and chronic colitis. He will be returning to his final year of medicine in 2018 and endeavours to specialise in gastroenterology. 


A light lunch is served prior to the seminar at 11:45am in the seminar room foyer, level 2, TRF Building.

Further information, including the link to add the seminar series to your google calendar, is available from CID Weekly Seminar Series website [http://www.med.monash.edu.au/scs/medicine/cid/seminar-series.html]

CiiiD Tuesday seminar - 25 July: Dr Helen Cumming / Dr Ross Chapman

CiiiD's Tuesday seminar, this week 25 July, will feature Dr Helen Cumming and Dr Ross Chapman, both post-doctoral bioinformaticians and research scientists from the Regulation of Interferon and Innate Signalling Laboratory, headed by Prof Paul Hertzog.

Helen's presentation is titled 'Getting the most out of fluidigm; using microarray methods to analyse high throughput quantitative PCR'. 

Ross' presentation is titled 'Division from unity: An in-depth analysis of the interferome'. 

1-2pm, Tuesday 25 July, Seminar Room 1, Level 2, TRF
Chair: Dr Nicole de Weerd

At 12pm in Seminar Room 2, Level 2, TRF, there will be a Commercialisation Workshop, vital for researchers considering funding outside government sources. Please see here for more information: http://hudson.org.au/commercialisation/translation-seminars/.  Major discussion points:
•ARC Linkage Grants are effective and reasonably accessible
•The CRC-P process –what to gain to be involved
•Accessing private capital is challenging but rewarding
•Think differently –take the challenge,and be determined and take advice
•Commercialisation has rewards for seeing discovery utilized

At 12pm in Seminar Room 1, Level 2, TRF, CID will hold its weekly seminar. The CID seminar schedule can be found here: http://www.med.monash.edu.au/scs/medicine/cid/seminar-series.html.  


Michael Chae mid-candidature review: "Developing applications for 3D printing in plastic & reconstructive surgery", 26 July

All staff and students are invited to Michael Chae's mid-candidature review.

Wednesday 26 July, 4pm, Surgery seminar room, Level 5, Block E, Monash Medical Centre Clayton

Synopsis: 
Advanced modern imaging has become an essential component of preoperative planning in plastic surgery. Since the advent of free tissue transfer approximately 40 years ago, constant improvement particularly in the preoperative planning phase has led to improved patient outcomes. The use of relatively simple techniques, such as handheld Doppler ultrasound, to advanced imaging techniques, such as computed tomographic angiography (CTA) and magnetic resonance angiography (MRA), for purposes of preoperative planning is now routine. Pre-operative planning for perforator based free flaps, in particular, is important due to the high degree of anatomical variations. Therefore, patients with favourable, and more importantly unfavourable, anatomy can be identified, and the optimal perforator of choice can be utilised. These are important considerations in improving outcomes, decreasing morbidity, and reducing operative time and stress, perhaps to be achieved through constant improvement and evolution of pre-operative planning. 

In breast reconstructive surgery, the introduction of computed tomographic angiography (CTA) has enabled surgeons to accurately and reliably select the donor site, flap, perforators, and the optimal mode of dissection, which has translated to an improvement in the clinical outcomes. Recent development of three-dimensional (3D) and 4D CTA techniques have enhanced spatial appreciation of the perforator vessels, their vascular territory and dynamic flow characteristics preoperatively. However, current imaging modalities are limited by being displayed on a 2D surface, such as a computer screen. In contrast, a 3D printed haptic biomodel allows the surgeon to interact hands-on with the patient-specific anatomy and facilitates a superior understanding for operative planning. Despite its significant potential, technically challenging 3D softwares and the high prices of early 3D printers have forced clinicians to outsource 3D printing and the cost of outsourcing precluded it from being implemented widely.

A range of 3D printing techniques has been developed for industrial use; however, for clinical application, mainly fused filament fabrication (FFF) has been used due to its affordability, ready accessibility and convenience. For this research project, we’d like to establish accuracy and reproducibility of our bedside 3D printing technique and demonstrate its application in various plastic and reconstructive surgical cases.

Supervisors: Prof Julian Smith, A/Prof David Hunter-Smith, A/Prof Warren Rozen 
Panel Chair: Prof Graham Jenkin

Independent Assessors: Dr Stuart Marshall, Mr George Pratt