A5070304475- Viral gastroenteritis research and epidemiology
- Salmonella and Campylobacter epidemiology
- Machine Learning in Healthcare
- Sepsis Diagnosis and Treatment
- Reproductive tract infections research
- Molecular Biology Techniques and Applications
- Bacteriophages and microbial interactions
- Animal Disease Management and Epidemiology
- Travel-related health issues
- Antibiotic Resistance in Bacteria
- Urinary Tract Infections Management
- Vibrio bacteria research studies
- Inflammasome and immune disorders
- COVID-19 diagnosis using AI
- Syphilis Diagnosis and Treatment
- Emergency and Acute Care Studies
- Spaceflight effects on biology
- Climate Change and Health Impacts
- COVID-19 Clinical Research Studies
- Disaster Response and Management
- Bacterial Infections and Vaccines
- Porphyrin Metabolism and Disorders
- Enhanced Recovery After Surgery
- Fungal Infections and Studies
- vaccines and immunoinformatics approaches
Regional Medical Center
2017-2021
United States Naval Medical Research Unit SOUTH
2017-2020
Regional Medical Center
2020
Naval Medical Research Command
2013-2017
Uniformed Services University of the Health Sciences
2002-2014
United States Department of the Navy
2014
United States Navy
2014
University of the Ryukyus
2010
The University of Texas Health Science Center at San Antonio
2000-2002
University of North Carolina at Chapel Hill
2001
Currently, physicians are limited in their ability to provide an accurate prognosis for COVID-19 positive patients. Existing scoring systems have been ineffective identifying patient decompensation. Machine learning (ML) may offer alternative strategy. A prospectively validated method predict the need ventilation patients is essential help triage patients, allocate resources, and prevent emergency intubations associated risks. In a multicenter clinical trial, we evaluated performance of...
Background Gene-based vaccination using prime/boost regimens protects animals and humans against malaria, inducing cell-mediated responses that in animal models target liver stage malaria parasites. We tested a DNA prime/adenovirus boost vaccine Phase 1 clinical trial with controlled human infection. Methodology/Principal Findings The regimen was three monthly doses of two plasmids (DNA) followed four months later by single non-replicating serotype 5 adenovirus vectors (Ad). constructs...
Vibrio vulnificus and cholerae are Gram-negative pathogens that cause serious infectious disease in humans. The beta form of pro-IL-1 is thought to be involved inflammatory responses development during infection with these pathogens, but the mechanism production remains poorly defined. In this study, we demonstrate mouse macrophages two pathogenic triggers activation caspase-1 via NLRP3 inflammasome. Activation inflammasome was mediated by hemolysins multifunctional repeat-in-toxins produced...
Introduction Sepsis management is a challenge for hospitals nationwide, as severe sepsis carries high mortality rates and costs the US healthcare system billions of dollars each year. It has been shown that early intervention patients with septic shock associated higher survival. The Cape Regional Medical Center (CRMC) aimed to improve sepsis-related patient outcomes through revised approach. Methods In collaboration Dascena, CRMC formed quality improvement team implement machine...
The synthesis of meso-diaminopimelic acid (m-DAP) in bacteria is essential for both peptidoglycan and lysine biosynthesis. From genome sequencing data, it was unclear how the Chlamydiales order would synthesize m-DAP absence dapD, dapC, dapE, which are missing from genome. Here, we assessed biochemical capacity Chlamydia trachomatis serovar L2 to m-DAP. Expression chlamydial asd, dapB, dapF genes respective Escherichia coli auxotrophic mutants restored DAP prototrophy. Screening a C. genomic...
Prediction of patients at risk for mortality can help triage and assist in resource allocation.Develop evaluate a machine learning-based algorithm which accurately predicts COVID-19, pneumonia, mechanically ventilated patients.Retrospective study 53,001 total ICU patients, including 9166 with pneumonia 25,895 performed on the MIMIC dataset. An additional retrospective analysis was community hospital dataset containing 114 positive SARS-COV-2 by PCR test. The outcome interest in-hospital...
Background Severe sepsis and septic shock are among the leading causes of death in USA. While early prediction severe can reduce adverse patient outcomes, remains one most expensive conditions to diagnose treat. Objective The purpose this study was evaluate effect a machine learning algorithm for on in-hospital mortality, hospital length stay 30-day readmission. Design Prospective clinical outcomes evaluation. Setting Evaluation performed multiyear, multicentre data set real-world containing...
Antimicrobial peptides (APs) are important components of the innate defenses animals, plants, and microorganisms. However, some bacterial pathogens resistant to action APs. For example, Proteus mirabilis is highly APs, such as polymyxin B (PM), protegrin, synthetic protegrin analog IB-367. To better understand this resistance, a transposon mutagenesis approach was used generate P. mutants sensitive Four unique PM-sensitive were identified (these >2 >128 times more than wild type). Two these...
ABSTRACT Organisms of Chlamydia spp. are obligate intracellular, gram-negative bacteria with a dimorphic developmental cycle that takes place entirely within membrane-bound vacuole termed an inclusion. The chlamydial anomaly refers to the fact cell wall-active antibiotics inhibit growth and peptidoglycan (PG) synthesis genes present in genome, yet there is no biochemical evidence for PG. In this work, we undertook genetics-based approach reevaluate by characterizing MurA, UDP- N...
Folates are tripartite molecules comprising pterin, para-aminobenzoate (PABA), and glutamate moieties, which essential cofactors involved in DNA amino acid synthesis. The obligately intracellular Chlamydia species have lost several biosynthetic pathways for nutrients they can obtain from their host but retained the capacity to synthesize folate. In most bacteria, synthesis of pterin moiety folate requires FolEQBK enzymes, while PABA is carried out by PabABC enzymes. Bioinformatic analyses...
Background Racial disparities in health care are well documented the United States. As machine learning methods become more common settings, it is important to ensure that these do not contribute racial through biased predictions or differential accuracy across groups. Objective The goal of research was assess a algorithm intentionally developed minimize bias in-hospital mortality between white and nonwhite patient Methods Bias minimized preprocessing training data. We performed...
Salmonella enterica serovar Typhimurium encounters antimicrobial peptides (AP) within the phagosomes of professional phagocytes and at intestinal mucosal surfaces. utilizes two-component regulatory system PmrA-PmrB, which is activated in response to environmental conditions encountered vivo, regulate resistance several AP, including polymyxin B (PM). Random MudJ transposon mutagenesis was used identify PmrA-PmrB-regulated genes, as well genetic loci necessary for PM resistance. Three...
Aeromonas spp. are Gram-negative bacteria that cause serious infectious disease in humans. Such have been shown to induce apoptosis infected macrophages, yet the host responses triggered by macrophage death largely unknown. In this study, we demonstrate infection of mouse bone marrow-derived macrophages with veronii biotype sobria triggers activation caspase-1 ensuing release IL-1β and pyroptosis. Caspase-1 response A. requires adaptor apoptosis-associated speck-like protein containing a...
Abstract Aeromonas hydrophila is a Gram‐negative pathogen that causes serious infectious disease in humans. A. induces apoptosis infected macrophages, but the host proinflammatory responses triggered by macrophage death are largely unknown. Here, we demonstrate infection of mouse macrophages with triggers activation caspase‐1 and release IL‐1β. Caspase‐1 was abrogated deficient Nod‐like receptor family, pyrin domain containing 3 (NLRP3) apoptosis‐associated speck‐like protein caspase...
Summary Recent characterization of chlamydial genes encoding functional peptidoglycan (PG)‐synthesis proteins suggests that the Chlamydiaceae possess ability to synthesize PG yet biochemical evidence for synthesis has be demonstrated. The presence D‐amino acids in is a hallmark bacteria. do not appear encode amino acid racemases however, D‐alanyl‐D‐alanine (D‐Ala‐D‐Ala) ligase homologue (Ddl) encoded genome. Thus, we undertook genetics‐based approach demonstrate and characterize D‐Ala‐D‐Ala...
Travelers' diarrhea (TD) is the most common ailment affecting travelers, including deployed U.S. military. Continuing Promise 2011 was a 5-month humanitarian assistance/disaster response (HA/DR) military and non-governmental organization training mission aboard hospital ship USNS Comfort, which to Central South America Caribbean between April September 2011. Enhanced TD surveillance undertaken during this for public health purposes. Passive (clinic visits), active (self-reported...
Campylobacter jejuni is a leading cause of diarrheal disease worldwide, and currently no preventative interventions are available. C. an invasive mucosal pathogen that has variety polysaccharide structures on its surface, including capsule. In phase 1 studies, capsule conjugate vaccine was safe but poorly immunogenic when delivered alone or with aluminum hydroxide. Here, we report enhanced immunogenicity the liposome adjuvants containing monophosphoryl lipid A without QS-21, known as ALF...
The effects of hemagglutinin (HA) fusion peptide (X-31) on poly(ethylene glycol)- (PEG-) mediated vesicle in three different systems have been compared: dioleoylphosphatidylcholine (DOPC) small unilamellar vesicles (SUV) and large (LUV) palmitoyloleoylphosphatidylcholine (POPC) perturbed (pert. LUV). POPC LUVs were asymmetrically by hydrolyzing 2.5% the outer leaflet lipid with phospholipase A2 removing hydrolysis products BSA. mixing contents showed that these fused presence PEG as did DOPC...
ABSTRACT The PhoP-PhoQ two-component system is necessary for the virulence of Salmonella spp. and responsible regulating several modifications lipopolysaccharide (LPS). Mutagenesis transcriptional regulator phoP resulted in identification a mutant able to activate transcription regulated genes ∼100-fold absence PhoQ. Sequence analysis showed two single-base alterations resulting amino acid changes at positions 93 (S93N) 203 (Q203R). These mutations were individually created, although each...
Campylobacter jejuni is the leading bacterial cause of diarrhea worldwide. A capsular polysaccharide (CPS) conjugate vaccine under development and requires determination valency. However, distribution CPS types circulating globally presently poorly described. We aimed to determine whether type in Peru differs from that other endemic regions. used a multiplex polymerase chain reaction (PCR) assay for detection encoding genes capable distinguishing all 35 on isolates two prospective...
Here we report the first incidence of New Delhi metallo-β-lactamase (NDM-1)-producing Acinetobacter baumannii in Peru, identified via a strain-based nosocomial surveillance project carried out Lima and Iquitos. The blaNDM-1 gene was detected by multiplex polymerase chain reaction (PCR) confirmed loci sequencing. is nearly ubiquitous promiscuous pathogen, acquisition A. may facilitate an increase prevalence this important resistance marker other pathogens.