Naval Medical Research Unit

Lackland Air Force Base, TX, United States

Naval Medical Research Unit

Lackland Air Force Base, TX, United States
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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 10 more authors.
Journal of Clinical Virology | Year: 2012

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.


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 | Year: 2016

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.


Pusateri A.E.,U.S. Army | Weiskopf R.B.,University of California at San Francisco | Bebarta V.,U.S. Air force | Butler F.,Defense Health Board | And 22 more authors.
Shock | Year: 2013

A recent large civilian randomized controlled trial on the use of tranexamic acid (TXA) for trauma reported important survival benefits. Subsequently, successful use of TXA for combat casualties in Afghanistan was also reported. As a result of these promising studies, there has been growing interest in the use of TXA for trauma. Potential adverse effects of TXA have also been reported. A US Department of Defense committee conducted a review and assessment of knowledge gaps and research requirements regarding the use of TXA for the treatment of casualties that have experienced traumatic hemorrhage. We present identified knowledge gaps and associated research priorities. We believe that important knowledge gaps exist and that a targeted, prioritized research effort will contribute to the refinement of practice guidelines over time. Copyright © 2012 by the Shock Society.


PubMed | Biotherapeutics, Inc., University of Maryland, Baltimore, Iowa State University, Naval Medical Research Unit and 5 more.
Type: Journal Article | Journal: Science translational medicine | Year: 2016

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 -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 MERS-CoV infection and/or other emerging infectious diseases.


Oei J.D.,University of Texas Health Science Center at San Antonio | Zhao W.W.,University of Texas Health Science Center at San Antonio | Zhao W.W.,Naval Medical Research Unit | Chu L.,Naval Medical Research Unit | And 6 more authors.
Journal of Biomedical Materials Research - Part B Applied Biomaterials | Year: 2012

Polymethyl methacrylate (PMMA) is widely used to treat traumatic head injuries (cranioplasty) and orthopedic injuries (bone cement), but there is a problem with implant-centered infections. With organisms such as Acinetobacter baumannii and methicillin-resistant staphylococcus aureus developing resistance to antibiotics, there is a need for novel antimicrobial delivery mechanisms without risk of developing resistant organisms. Objectives: To develop a novel antimicrobial implant material by generating silver nanoparticles (AgNP) in situ in PMMA. Results: All PMMA samples with AgNP's (AgNP-PMMA) released Ag + ions in vitro for over 28 days. In vitro antimicrobial assays revealed that these samples (even samples with the slowest release rate) inhibited 99.9% of bacteria against four different strains of bacteria. Long-term antimicrobial assay showed a continued antibacterial effect past 28 days. Some AgNP-loaded PMMA groups had comparable Durometer-D hardness (a measure of degree of cure) and modulus to control PMMA, but all experimental groups had slightly lower ultimate transverse strengths. Conclusions: AgNP-PMMA demonstrated a tremendously broad-spectrum and long-intermediate-term antimicrobial effect with comparable mechanical properties to control PMMA. Current efforts are focused on further improving mechanical properties by reducing AgNP loading and assessing fatigue properties. © 2011 Wiley Periodicals, Inc.


Laccabue M.,Naval Medical Research Unit | Laccabue M.,Dental and Biomedical Research | Ahlf R.L.,Naval Medical Research Unit | Ahlf R.L.,Dental and Biomedical Research | Simecek J.W.,Naval Medical Research Unit
Operative Dentistry | Year: 2014

Statement of Problem: There are no recent data that describe the replacement rates of resin composite and dental amalgam restorations placed by US Navy dentists. Information is needed to provide the best possible care for our military personnel which would minimize the probability of dental emergencies, especially for those who are deployed. Purpose: The purpose of this study was to determine if the frequency of posterior restoration replacement in military personnel differed based on the type of restorative material utilized. Methods and Materials: Data contained in dental records in an observational study (retrospective cohort) were evaluated to identify resin composite and dental amalgam restorations placed by navy dentists in posterior teeth. The status of all erupted, unerupted, missing, and replaced teeth was documented. The type and condition of all existing restorations were recorded for each posterior tooth. Investigators reviewed 2921 dental records, and of those, 247 patients met the criteria for inclusion in the study. A total of 1050 restorations (485 resin composite and 565 amalgam) were evaluated. Results: A Cox proportional hazards model was adjusted for number of tooth surfaces restored, caries risk, and filled posterior surfaces at initial exam. The overall rate of replacement for all restorations in the sample was 5.7% during the average 2.8-year followup. No significant elevation of risk for restoration replacement existed when comparing resin composite and amalgam. Both the number of restored surfaces and caries risk status were independent risk factors for replacement. When restoring multisurface cavity preparations, providers placed amalgams by an approximate 2:1 ratio over resin composites for this study population. Conclusion: The results for this study show that no difference existed in the rate of replacement for amalgam vs resin composite. When restorations increased from just a single occlusal surface to additional surfaces, the rate of replacement was elevated and statistically significant for both materials. A higher caries risk status was also significant in elevating replacement rates for both materials.


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 | Year: 2010

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.


PubMed | University of Dayton, Air Force Research Lab, Naval Medical Research Unit and University of Alabama
Type: Journal Article | Journal: Human factors | Year: 2015

We tested the possibility that monitoring a display wherein critical signals for detection were defined by a stereoscopic three-dimensional (3-D) image might be more resistant to the vigilance decrement, and to temporal declines in cerebral blood flow velocity (CBFV), than monitoring a display featuring a customary two-dimensional (2-D) image.Hancock has asserted that vigilance studies typically employ stimuli for detection that do not exemplify those that occur in the natural world. As a result, human performance is suboptimal. From this perspective, tasks that better approximate perception in natural environments should enhance performance efficiency. To test that possibility, we made use of stereopsis, an important means by which observers interact with their everyday surroundings.Observers monitored a circular display in which a vertical line was embedded. Critical signals for detection in a 2-D condition were instances in which the line was rotated clockwise from vertical. In a 3-D condition, critical signals were cases in which the line appeared to move outward toward the observer.The overall level of signal detection and the stability of detection over time were greater when observers monitored for 3-D changes in target depth compared to 2-D changes in target orientation. However, the 3-D display did not retard the temporal decline in CBFV.These results provide the initial demonstration that 3-D displays can enhance performance in vigilance tasks.The use of 3-D displays may be productive in augmenting system reliability when operator vigilance is vital.


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 | Year: 2011

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.

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