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Institution

Monash University

EducationMelbourne, Victoria, Australia
About: Monash University is a education organization based out in Melbourne, Victoria, Australia. It is known for research contribution in the topics: Population & Poison control. The organization has 35920 authors who have published 100681 publications receiving 3027002 citations.


Papers
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Journal ArticleDOI
06 Oct 2020-JAMA
TL;DR: To determine whether hydrocortisone improves outcome for patients with severe COVID-19, an ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin was conducted.
Abstract: Importance Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures The primary end point was organ support–free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned –1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support–free days were 0 (IQR, –1 to 15), 0 (IQR, –1 to 13), and 0 (–1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support–free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support–free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration ClinicalTrials.gov Identifier:NCT02735707

630 citations

Journal ArticleDOI
TL;DR: The Galactic Archaeology with HERMES (GALAH) survey is a large high-resolution spectroscopic survey using the newly commissioned High Efficiency and Resolution Multi-element Spectrograph (HERMES) on the Anglo-Australian Telescope as discussed by the authors.
Abstract: The Galactic Archaeology with HERMES (GALAH) survey is a large high-resolution spectroscopic survey using the newly commissioned High Efficiency and Resolution Multi-Element Spectrograph (HERMES) on the Anglo-Australian Telescope. The HERMES spectrograph provides high-resolution (R ~ 28 000) spectra in four passbands for 392 stars simultaneously over a 2 deg field of view. The goal of the survey is to unravel the formation and evolutionary history of the Milky Way, using fossil remnants of ancient star formation events which have been disrupted and are now dispersed throughout the Galaxy. Chemical tagging seeks to identify such dispersed remnants solely from their common and unique chemical signatures; these groups are unidentifiable from their spatial, photometric or kinematic properties. To carry out chemical tagging, the GALAH survey will acquire spectra for a million stars down to V ~ 14. The HERMES spectra of FGK stars contain absorption lines from 29 elements including light proton-capture elements, α-elements, odd-Z elements, iron-peak elements and n-capture elements from the light and heavy s-process and the r-process. This paper describes the motivation and planned execution of the GALAH survey, and presents some results on the first-light performance of HERMES.

630 citations

Journal ArticleDOI
TL;DR: In this paper, the authors used CloudSat data to assess the realism of global model precipitation and found that the observed and modeled precipitation are significantly different from the character of liquid precipitation produced by global weather and climate models.
Abstract: [1] New, definitive measures of precipitation frequency provided by CloudSat are used to assess the realism of global model precipitation. The character of liquid precipitation (defined as a combination of accumulation, frequency, and intensity) over the global oceans is significantly different from the character of liquid precipitation produced by global weather and climate models. Five different models are used in this comparison representing state-of-the-art weather prediction models, state-of-the-art climate models, and the emerging high-resolution global cloud “resolving” models. The differences between observed and modeled precipitation are larger than can be explained by observational retrieval errors or by the inherent sampling differences between observations and models. We show that the time integrated accumulations of precipitation produced by models closely match observations when globally composited. However, these models produce precipitation approximately twice as often as that observed and make rainfall far too lightly. This finding reinforces similar findings from other studies based on surface accumulated rainfall measurements. The implications of this dreary state of model depiction of the real world are discussed.

629 citations

Journal ArticleDOI
24 May 2013-Science
TL;DR: An unusual phenomenon in magnesium alloys is reported: the equilibrium segregation of solute atoms into patterns within fully coherent terraces of deformation twin boundaries, leading to a concomitant but unusual situation in which annealing strengthens rather than weakens these alloys.
Abstract: The formability and mechanical properties of many engineering alloys are intimately related to the formation and growth of twins. Understanding the structure and chemistry of twin boundaries at the atomic scale is crucial if we are to properly tailor twins to achieve a new range of desired properties. We report an unusual phenomenon in magnesium alloys that until now was thought unlikely: the equilibrium segregation of solute atoms into patterns within fully coherent terraces of deformation twin boundaries. This ordered segregation provides a pinning effect for twin boundaries, leading to a concomitant but unusual situation in which annealing strengthens rather than weakens these alloys. The findings point to a platform for engineering nano-twinned structures through solute atoms. This may lead to new alloy compositions and thermomechanical processes.

629 citations

Journal ArticleDOI
TL;DR: Novel therapies derived from microbiome studies such as fecal microbiota transplantation, probiotic and prebiotics to target associated diseases have been reviewed to introduce the idea of how certain disease symptoms can be ameliorated through dysbiosis correction, thus revealing a new scientific approach toward disease treatment.
Abstract: Interest toward the human microbiome, particularly gut microbiome has flourished in recent decades owing to the rapidly advancing sequence-based screening and humanized gnotobiotic model in interrogating the dynamic operations of commensal microbiota. Although this field is still at a very preliminary stage, whereby the functional properties of the complex gut microbiome remain less understood, several promising findings have been documented and exhibit great potential toward revolutionizing disease etiology and medical treatments. In this review, the interactions between gut microbiota and the host have been focused on, to provide an overview of the role of gut microbiota and their unique metabolites in conferring host protection against invading pathogen, regulation of diverse host physiological functions including metabolism, development and homeostasis of immunity and the nervous system. We elaborate on how gut microbial imbalance (dysbiosis) may lead to dysfunction of host machineries, thereby contributing to pathogenesis and/or progression toward a broad spectrum of diseases. Some of the most notable diseases namely Clostridium difficile infection (infectious disease), inflammatory bowel disease (intestinal immune-mediated disease), celiac disease (multisystemic autoimmune disorder), obesity (metabolic disease), colorectal cancer, and autism spectrum disorder (neuropsychiatric disorder) have been discussed and delineated along with recent findings. Novel therapies derived from microbiome studies such as fecal microbiota transplantation, probiotic and prebiotics to target associated diseases have been reviewed to introduce the idea of how certain disease symptoms can be ameliorated through dysbiosis correction, thus revealing a new scientific approach toward disease treatment. Toward the end of this review, several research gaps and limitations have been described along with suggested future studies to overcome the current research lacunae. Despite the ongoing debate on whether gut microbiome plays a role in the above-mentioned diseases, we have in this review, gathered evidence showing a potentially far more complex link beyond the unidirectional cause-and-effect relationship between them.

629 citations


Authors

Showing all 36568 results

NameH-indexPapersCitations
Bert Vogelstein247757332094
Kenneth W. Kinzler215640243944
David J. Hunter2131836207050
David R. Williams1782034138789
Yang Yang1712644153049
Lei Jiang1702244135205
Dongyuan Zhao160872106451
Christopher J. O'Donnell159869126278
Leif Groop158919136056
Mark E. Cooper1581463124887
Theo Vos156502186409
Mark J. Smyth15371388783
Rinaldo Bellomo1471714120052
Detlef Weigel14251684670
Geoffrey Burnstock141148899525
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
2023250
20221,020
20219,402
20208,419
20197,409
20186,437