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Aubry M.,Institute Louis Malarde | Aubry M.,University of French Polynesia | Roche C.,Institute Louis Malarde | Dupont-Rouzeyrol M.,Institute Pasteur Of Nouvelle Caledonie | And 11 more authors.
Journal of Clinical Virology

Background: In Pacific Island Countries (PICs) the epidemiology of dengue is characterized by long-term transmission of a single dengue virus (DENV) serotype. The emergence of a new serotype in one island country often indicates major outbreaks with this serotype will follow in other PICs. Objectives: Filter paper (FP) cards on which whole blood or serum from dengue suspected patients had been dried was evaluated as a method for transportation of this material by standard mail delivery throughout the Pacific. Study design: Twenty-two FP-dried whole blood samples collected from patients in New Caledonia and Wallis & Futuna Islands, during DENV-1 and DENV-4 transmission, and 76 FP-dried sera collected from patients in Yap State, Majuro (Republic of Marshall Islands), Tonga and Fiji, before and during outbreaks of DENV-2 in Yap State and DENV-4 in Majuro, were tested for the presence of DENV RNA, by serotype specific RT-PCR, at the Institut Louis Malardé in French Polynesia. Results: The serotype of DENV could be determined, by a variety of RT-PCR procedures, in the FP-dried samples after more than three weeks of transport at ambient temperatures. In most cases, the sequencing of the envelope gene to genotype the viruses also was possible. Conclusions: The serotype and genotype of DENV can be determined from FP-dried serum or whole blood samples transported over thousands of kilometers at ambient, tropical, temperatures. This simple and low-cost approach to virus identification should be evaluated in isolated and resource poor settings for surveillance for a range of significant viral diseases. © 2012. Source

Campbell J.,University of Southern California | Tirapelle L.,Pasadena City College | Yates K.,University of Southern California | Clark R.,University of Southern California | And 7 more authors.
Journal of Surgical Education

Objective: This study explored the effects of a cognitive task analysis (CTA)-informed curriculum to increase surgical skills performance and self-efficacy beliefs for medical students and postgraduate surgical residents learning how to perform an open cricothyrotomy. Methods: Third-year medical students and postgraduate year 2 and 3 surgery residents were assigned randomly to either the CTA group (n = 12) or the control group (n = 14). The CTA group learned the open cricothyrotomy procedure using the CTA curriculum. The control group received the traditional curriculum. Results: The CTA group outperformed the control group significantly based on a 19-point checklist score (CTA mean score: 17.75, standard deviation [SD] = 2.34; control mean score: 15.14, SD = 2.48; p = 0.006). The CTA group also reported significantly higher self-efficacy scores based on a 140-point self-appraisal inventory (CTA mean score: 126.10, SD = 16.90; control: 110.67, SD = 16.8; p = 0.029). Conclusions: The CTA curriculum was effective in increasing the performance and self-efficacy scores for postgraduate surgical residents and medical students performing an open cricothyrotomy. © 2011 Association of Program Directors in Surgery. Source

Burns C.J.,U.S. Army | Burns C.J.,Naval Medical Research Unit | Chung K.K.,U.S. Army | Aden J.K.,U.S. Army | And 4 more authors.
Journal of Burn Care and Research

The aim of this article was to determine the effect of cirrhosis on mortality in thermally injured adult patients. We conducted a retrospective review of patients admitted to our burn center during 2003 to 2010. Eight hundred eight patients were included in this study, of whom 24 had the diagnosis of cirrhosis established from electronic medical records and/or autopsy reports. The mortality rate for the cirrhotic patients was 50%, and for the noncirrhotic patients it was 14.8%. On logistic regression, age (odds ratio [OR], 1.08; confidence interval [CI], 1.06-1.10), TBSA (OR, 1.08; CI, 1.06-1.10), inhalation injury (OR, 3.17, CI, 1.61-6.25), and cirrhosis (OR, 8.78; CI, 2.97-25.98) had independent effects on mortality. Of the 24 cirrhotic patients in this study, the admission Model for End-Stage Liver Disease score for the patients who survived hospitalization was 12.1 ± 4.0, and for the patients who died it was 13.8 ± 6.0 (P = .4). When comparing patients with 10 to 50% TBSA burn, the mortality rate for cirrhotic patients was 83.3% (10/12), and for the noncirrhotic patients it was only 12.7% (50/394), P < .0001. Adults with cirrhosis are rarely able to survive burn injuries > 10% TBSA. Although we did not detect a significant association between admission Model for End-Stage Liver Disease score and death, the presence of cirrhosis is a high premorbid contributor and, therefore, new strategies are needed to improve outcomes. © 2013 by the American Burn Association. Source

Luke T.,U.S. Navy | Wu H.,Biotherapeutics, Inc. | Zhao J.,University of Iowa | Zhao J.,Guangzhou University | And 24 more authors.
Science Translational Medicine

As of 13 November 2015, 1618 laboratory-confirmed human cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 579 deaths, had been reported to the World Health Organization. No specific preventive or therapeutic agent of proven value against MERS-CoV is currently available. Public Health England and the International Severe Acute Respiratory and Emerging Infection Consortium identified passive immunotherapy with neutralizing antibodies as a treatment approach that warrants priority study. Two experimental MERS-CoV vaccines were used to vaccinate two groups of transchromosomic (Tc) bovines that were genetically modified to produce large quantities of fully human polyclonal immunoglobulin G (IgG) antibodies. Vaccination with a clade A γ-irradiated whole killed virion vaccine (Jordan strain) or a clade B spike protein nanoparticle vaccine (Al-Hasa strain) resulted in Tc bovine sera with high enzyme-linked immunosorbent assay (ELISA) and neutralizing antibody titers in vitro. Two purified Tc bovine human IgG immunoglobulins (Tc hIgG), SAB-300 (produced after Jordan strain vaccination) and SAB-301 (produced after Al-Hasa strain vaccination), also had high ELISA and neutralizing antibody titers without antibody- dependent enhancement in vitro. SAB-301 was selected for in vivo and preclinical studies. Administration of single doses of SAB-301 12 hours before or 24 and 48 hours after MERS-CoV infection (Erasmus Medical Center 2012 strain) of Ad5-hDPP4 receptor-transduced mice rapidly resulted in viral lung titers near or below the limit of detection. Tc bovines, combined with the ability to quickly produce Tc hIgG and develop in vitro assays and animal model(s), potentially offer a platform to rapidly produce a therapeutic to prevent and/or treat MERSCoV infection and/or other emerging infectious diseases. Copyright 2016 by the American Association for the Advancement of Science; all rights reserved. Source

Singh V.,North Carolina State University | Ajeet A.,Nvidia | Kwatra N.,North Carolina State University | Cela C.J.,North Carolina State University | And 3 more authors.
IEEE Transactions on Electromagnetic Compatibility

We report the use of the alternating direction implicit (ADI) finite-difference time-domain (FDTD) method in a D-H formulation to compute induced current densities and recruitment volumes in the human body due to contact electrodes for human electromuscular incapacitation devices at frequencies below 200kHz. A computational model resolution of 1 mm has been used for most of the human body model, including regions proximal to the electrode contact points, while a progressively coarser resolution up to 5 mm is utilized, according to an expanding grid scheme for body regions distant from the source, such as the lower extremities. Using quasi-static assumptions, discrete Fourier transforms have been used to average the electric field values at the desired frequencies for times much shorter than their time periods. The field values induced in the human body were then obtained as ratios with respect to the source, which can be scaled depending on the magnitude. This study suggests that the ADI-FDTD method can be used for the solution of low-frequency large-scale bioelectromagnetic problems. It is shown that, when used with quasi-static assumptions, Fourier series decomposition, and expanding grid, the D-H ADI-FDTD can be an effective computational bioelectromagnetics tool. © 2010 IEEE. Source

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