2018 AMREP EMCR Best Paper Awards

Since 2015, the EMCR Committee has developed the EMCR Best Paper Awards to honour the outstanding early and mid-career researchers who have published in the area of Biomedical Research, Clinical Research, and Public Health. Thank you to all of you for submitting your papers to the 2017 AMREP EMCR Best Paper Awards. The competition was fierce this year and the judging very tight. All winners will receive $500 to support their research career.  Congratulations to all winners.

AMREP EMCR Best Paper Awards category, eligibility criteria, sub-committee and application details are announced during March each year.  Applications close in September.

2018 EMCR Best Paper Awards winners

Public Health / Clinical Research

Dr Emma Ridley (Monash SPHPM)

Ridley EJ, Davies AR, Hodgson CL, Deane A, Bailey M, Cooper DJ. Delivery of full predicted energy from nutrition and the effect on mortality in critically ill adults: A systematic review and meta-analysis of randomised controlled trials. Clinical Nutrition. 2018; 37:1913-1925. doi: 10.1016/j.clnu.2017.09.026.

Summary
Best practice guidelines recommend that energy delivery should approximate energy requirements in critical illness. The impact of this on clinical outcomes is unknown however due to issues with the delivery of energy close to the requirements. Internationally, only 50-60% of predicted requirements are received due to delayed commencement of nutrition following injury or illness, interruptions to nutrition for procedures, and tolerance issues related to critical illness and the function of the gastrointestinal tract. These issues also persist in research- with very few interventions able to deliver close to recommended requirements for the same reasons. This is the first and only review to compare standard care energy delivery in critical illness to amounts recommended by best practice guidelines. It is also the most comprehensive review on this topic to date, screening over 9000 articles and therefore comprehensively identifying the available literature. No clinically or statistically significant findings were found between energy delivery at recommended amounts and clinical outcomes, but a very important finding was that the existing body of literature is of low quality. This is a key finding for clinicians making practice decisions using this evidence.

Dr Ziad Nehme (Monash SPHPM)

Nehme Z, Andrew E, Bernard S, Patsamanis H, Cameron P, Bray JE, Meredith IT, Smith K. Impact of a public awareness campaign on out-of-hospital cardiac arrest incidence and mortality rates. European Heart Journal. 2017; 38 (21): 1666-1673. doi: 10.1093/eurheartj/ehw500.

Summary
For decades, public awareness campaigns have been used to overcome the psychological barriers that inhibit early action after the onset of heart attack symptoms. Between 2009 and 2013, a powerful public awareness campaign devised by the Heart Foundation targeted the public’s knowledge of heart attack symptoms and encouraged early action. In this first-of-a-kind study, we assessed whether these campaigns were effective at reducing the incidence of a common cause of death from heart attacks, out-of-hospital cardiac arrest (OHCA). Using 10 years of surveillance data from Victorian Ambulance Cardiac Arrest Registry, the study demonstrated that when compared to the period before the commencement of campaign activity, the period with campaign activity was associated with a 15.2% and 16.6% reduction in the incidence of, and deaths from OHCA, respectively. The study concluded that the public awareness campaign may have helped prevent 1 in 6 deaths from OHCA in the Melbourne region. The article, which was published alongside an editorial, received considerable media exposure. Dr Ziad Nehme was awarded the Heart Foundations President’s Award for recognition of the impact of the research on cardiovascular health. The article has also been instrumental in securing additional funding for current projects, including an NHMRC ECF and Centre for Research Excellence.

Associate Professor Yuming Guo (Monash SPHPM)

Guo Y, Gasparrini A, Armstrong BG, Tawatsupa B, Tobias A, Lavigne E, Coelho MSZS, Pan X, Kim H, Hashizume M, Honda Y, Guo YL, Wu CF, Zanobetti A, Schwartz JD, Bell ML, Scortichini M, Michelozzi P, Punnasiri K, Li S, Tian L, Garcia SDO, Seposo X, Overcenco A, Zeka A, Goodman P, Dang TN, Dung DV, Mayvaneh F Saldiva PHN, Williams G, Tong S. Heat Wave and Mortality: A Multicountry, Multicommunity Study. Environmental Health Perspectives. 2017; 125 (8): 087006. doi: 10.1289/EHP1026.

Summary
Globally, there is increasing interest in assessing heatwave–related health effects after major heatwaves in the United States and Europe, for example, Chicago in 1995 and Europe in 2003. The frequency, intensity, and duration of heatwaves will increase in the future, which has the potential to greatly exacerbate the health impacts of heat. Thus, understanding the relationship between heatwaves and health is crucial for better adaptation and mitigation strategies. We have recently established an international collaborative network to assess impacts of weather on mortality. This setting provides a unique opportunity to examine the effects of heatwaves on mortality in 400 communities in 18 countries/ regions. We found that the higher the temperature threshold used to define heatwaves, the higher heatwave associations on mortality. However, heatwave duration did not modify the impacts. The association between heatwaves and mortality appeared acutely and lasted for 3 and 4 days. This is the largest original study to examine heatwave–mortality associations using consistent methods for 400 communities across 18 countries/regions, including countries from both developing and developed regions with different climates (i.e., tropical, subtropical, and temperate).

Biomedical Research

Dr Cheng Xue Qin (Baker IDI)

Qin CX, May LT, Li R, Cao N, Rosli S, Deo M, Alexander AE, Horlock D, Bourke JE, Yang YH, Stewart AG, Kaye DM, Du XJ, Sexton PM, Christopoulos A, Gao XM, Ritchie RH. Small-molecule-biased formyl peptide receptor agonist compound 17b protects against myocardial ischaemia-reperfusion injury in mice. Nature Communications. 2017; 8: 14232. doi: 10.1038/ncomms14232.

Summary
Heart attack leading to heart failure remains a significant health burden calling for a novel pharmacological therapy. We explored a novel approach to drug activity, biased agonism, in heart attack to keep heart muscle alive and reduce inflammation. The new biased agonist teaches a family of cell-surface proteins, formyl peptide receptors involved in regulating inflammation, a “new trick” to selectively activate desirable signals inside the cell, without triggering detrimental signals that could contribute to side effects (excess inflammation and death of heart muscle cells). This unique small molecule activates peptide receptors to favour signalling away from detrimental pro-inflammatory, pro-fibrotic mechanisms, and is thus superior to conventional means of activating such receptors. Our compelling observations provide a powerful impetus for the development of biased, small molecule formyl peptide receptor agonists as a novel strategy to treat heart attack, limiting cardiac inflammation whilst preserving cardiomyocyte viability and contractile function. This discovery could pave the way for the development of a new paradigm in treatment of people suffering heart attack. This innovative work not only attracted considerable scientific attention, but also significant interest from media. . The intellectual property has been patented and a company (Limulus Therapeutics Pty Ltd) established to accelerate the drug development process. The new drug under development could open the door to a novel approach to protecting the heart muscle and hopefully reducing the growing incidence of post-infarction cardiac failure.

Dr Melanie Ziegler (Baker IDI)

Ziegler M, Hohmann JD, Searle AK, Abraham MK, Nandurkar HH, Wang X, Peter K. A single-chain antibody-CD39 fusion protein targeting activated platelets protects from cardiac ischaemia/reperfusion injury. European Heart Journal. 2018; 39(2): 111-116. doi: 10.1093/eurheartj/ehx218.

Summary
In the submitted paper we describe a novel therapeutic approach to strongly reduce the damage of the heart tissue after a heart attack. CD39 is an enzyme with anti-inflammatory and anti-thrombotic effects and appears to be an attractive therapeutic drug candidate. However, its clinical use has been limited by its detrimental side effect of bleeding complications. The described innovative approach of targeted delivery of CD39 overcomes these current limitations as it provides high and efficient local concentrations and low systemic concentrations. Indeed, this study shows a systematic assessment of cardiac injury including sensitive plasma biomarkers, advanced ultrasound measurements as well as histological assessments and demonstrates impressive effects of targeted-CD39 for the treatment of a heart attack without causing any bleeding complications. Overall, our approach of targeted drug delivery for therapy holds promise to overcome current bleeding risks and will provide benefits to a large patient cohort for whom so far anti-thrombotic treatment was contraindicated. Seeing these effects in the heart it has potential to provide benefits to patients suffering of other ischemia/reperfusion injuries like stroke. This work has potential to substantially reduce mortality and morbidity of cardiovascular diseases in Australia and globally.

Dr Yung Chih Chen (Baker IDI)

Htun NM*, Chen YC*, Lim B, Schiller T, Maghzal GJ, Huang AL, Elgass KD, Rivera J, Schneider HG, Wood BR, Stocker R, Peter K. Near-infrared autofluorescence induced by intraplaque hemorrhage and heme degradation as marker for high-risk atherosclerotic plaques. Nature Communications. 2017; 8(1): 75. doi: 10.1038/s41467-017-00138-x.
*Co-first author

Summary
Heart attack is the most frequent single cause of death worldwide and is mainly triggered by the rupture of unstable atherosclerotic plaques in the artery. We have found that these types of plaques will emit red light like a Christmas tree, when hit by a laser light at a specific frequency. While traditionally, diagnosis of heart attack required invasive coronary imaging, we have been able to use this red signal to detect unstable plaques non-invasively in a small animal model. The discovery of this red light has now been incorporated as one of the biomarkers for the validation of unstable plaques phenotypes. We have further discovered the source of this red light which greatly contributed to our understanding of plaque growth/instability biology. The finding of high risk atherosclerotic plaques that cause death in myocardial infarction patients, is the holy grail in cardiovascular medicine. We have demonstrated the novel near-infrared autofluorescence (NIRAF) as a new biomarker for these high risk plaques.

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