Naval Aerospace Medical Institute

Inhibition of endothelial cell (EC) death is essential for normal angiogenesis. The E3 ubiquitin ligase HOIP, the catalytic subunit of the linear ubiquitin chain assembly complex (LUBAC), is particularly important for EC survival during embryogenesis. The stability of HOIP is critical for LUBAC function. However, the mechanisms underlying the regulation of HOIP stability are largely unknown. Here, we uncovered a novel role of G protein pathway suppressor 2 (GPS2) in regulating EC survival and embryonic vascularization via control of HOIP stability. EC-specific GPS2 deletion mice (Gps2ECKO) are embryonic lethal at embryonic day 16.5 (E16.5) due to defective vascularization. Deficiency of GPS2 in ECs results in aberrant TNFR1-mediated cell death. TNFR1 deletion in Gps2ECKO mice restores normal vascularization and rescues embryonic lethality. At the molecular level, GPS2 binds to the NZF domain of HOIP and inhibits K48-linked polyubiquitination of HOIP at K579, K737, and K988 residues. GPS2 prevents HOIP proteasomal degradation and thus maintains LUBAC stability and activity. GPS2 deficiency in ECs leads to HOIP degradation and LUBAC instability, which in turn attenuates TNF-induced NF-κB activation and exacerbates the formation of the cell-death-inducing complex-II, ultimately increasing EC death. Overall, our data demonstrate that GPS2 is required for maintaining vascular integrity during embryogenesis by inhibiting TNFR1-mediated EC death via stabilizing HOIP.

This study examines whether aeromedical officer (AMO) training enhances outcomes for Navy and Marine Corps aviation personnel. The conceptual approach of this research is grounded in the literature on the importance of cultural competence in military mental health services; thus, this study hypothesizes that AMO-trained providers yield better outcomes than nontrained providers. Utilizing a sample of 501 waiver requests for personnel diagnosed with mental health conditions, we compared waiver approval rates and career impacts between those evaluated by AMO-trained and nontrained providers. Results from a binary logic regression indicated that individuals assessed by AMO-trained providers were 2.1 times more likely to be granted waivers, thus reducing the chance of career disruption, as well as reducing operational costs and loss of mission-ready personnel. Additionally, AMOs facilitated a more seamless waiver process, avoiding unnecessary delays in obtaining a waiver. Findings suggest that AMO training significantly improves service delivery by enhancing providers' cultural competence, leading to more favorable outcomes for both individuals and commands, underscoring the need for specialized training in mental health services. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This is a rare case describing the management of a traumatic chylous effusion discovered during operative fixation of a Sanders type III calcaneus fracture in a 58-year-old man, sustained after a fall from height. Chylous effusions are uncommon and can mimic septic arthritis. Given the concern for possible infection intraoperatively, provisional K-wire-assisted reduction was performed and definitively maintained through antibiotic mixed polymethylmethacrylate cement. Despite foregoing traditional fixation techniques, an excellent outcome was achieved. This case outlines the use of antibiotic cement as a reduction aid for an intra-articular calcaneus fracture in the setting of a traumatic chylous effusion.

IntroductionResearch over the last couple of decades has demonstrated a relationship between psychophysiological measures, specifically cardiac functions, and cognitive performance. Regulation of the cardiac system under parasympathetic control is commonly referred to as cardiac vagal tone and is associated with the regulation of cognitive and socioemotional states. The goal of the current study was to capture the dynamic relationship between cardiac vagal tone and performance in a vigilance task.Method/ResultsWe implemented a longitudinal growth curve modeling approach which unveiled a relationship between cardiac vagal tone and vigilance that was non-monotonic and dependent upon each person.DiscussionThe findings suggest that cardiac vagal tone may be a process-based physiological measure that further explains how the vigilance decrement manifests over time and differs across individuals. This contributes to our understanding of vigilance by modeling individual differences in cardiac vagal tone changes that occur over the course of the vigilance task.

Objectives: To find out the clinical feature and outcomes of febrile seizures. Methods: After written informed consent, detailed clinical history of each patient including a time of presentation, the onset of fever and associated symptoms, data regarding demographic details, duration and type of seizure, history of seizures, and antiepileptic drug, repetition of seizure within 24 h, past history of seizures, birth history, family history was taken and entered in predesigned pro forma. Collected data were checked and verified for correctness and accuracy, which was then analyzed using statistical methods. Results: In the present study male-to-female ratio was 1.75:1. The maximum number (82.5%) of patients lacked a family history of febrile seizure, while 17.5% of patients had a positive family history of FS. 70% of the pediatric patients had upper respiratory tract infection. The maximum number of patients had simple febrile seizures, which are 81.25%, whereas 18.75% of patients had complex febrile seizures. The majority (73.75%) of patients in the present study had anemia. WBC count >11×109/L was found in 45 patients out of 80 (56.25%), and WBC count<4.5×109/L was found in 6 out of 80 (7.5%). Conclusion: Majority of patients with febrile seizures presented at a younger age which might represent the vulnerability of the developing brain to fever. As all the patients were discharged without any complication, so this study further adds to the knowledge of the benign nature of this disease.

The CogScreen-Aeromedical Edition (CogScreen-AE) is a computerized neurocognitive assessment screening tool developed for the Federal Aviation Administration as a rapid, reliable means of measuring neurocognitive deficiency in civilian airline pilots. This has potential use and assessment of military aviators flying high performance aircraft under extreme conditions; however, no data exist on how the dynamic flight environment affects CogScreen-AE scores. The objectives of this study were to determine what changes in performance on CogScreen-AE scores are seen post-flight in Naval Aviators flying high performance aircraft and to determine the potential for use of CogScreen-AE as a screening tool to evaluate degree of impairment, recovery from neurological illness, and return to duty status of a military aviator. Repeated measures, within-subjects experimental design with three CogScreen-AE administrations-introduction session, preflight session, and postflight session. An experimental study group was exposed to dynamic flight between preflight and postflight sessions, while a control group flew a desktop computer flight simulator between sessions. Data were analyzed by mixed model ANOVA using Statistical Package for the Social Sciences to compare CogScreen-AE pre- and postflight performance on 5 composite scores of variables that account for 45% of the variance in predicting flight performance. Preflight versus postflight scores demonstrated no significant differences in performance attributable to flight in high performance aircraft. The CogScreen-AE performance is shown to be consistent preflight to post-flight. These data show that CogScreen-AE may be a reliable clinical instrument for assessing aviators' cognitive function with regard to return to flight duty decision-making. We anticipate future work in determining how CogScreen-AE can be utilized in the operational environment and documenting recovery from neurologic illness.

Iron deficiency anemia is a common type of anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues. As the name implies, iron deficiency anemia is due to insufficient iron. HbA1c shows patient’s glycemic status of last 3 months. Some previous studies have been reported that iron deficiency anemia may increase the level of HbA1c.
 AIM: To assess the status of HbA1c in patients of iron deficiency anemia & correlate HbA1c level with Serum Iron, Ferritin level.
 MATERIALS AND METHODS: It is a cross sectional comparative study conducted in 1 yrs of duration. A total number of 60 subjects between the ages of 18 to 60 years were enrolled for the present study. Detailed medical history and relevant clinical examination data and written consent were obtained from all subjects by explaining the study procedure.
 RESULTS: Haematological parameter like Hb, MCV, MCH, HCT and RDW were showed significantly difference in iron deficiency case and control groups. Total haemoglobin, MCV, MCH, HCT were significantly reduced in IDA case group whereas there is increase RDW level in case group as compare to control (p<0.001).
 CONCLUSION: There is negative correlation of HbA1c with Haemoglobin, Serum Iron and ferritin level whereas positive correlation is detected with TIBC. The correlation of HbA1c is found to be significant with serum iron and MCH.
 Keywords: Hb, MCV, MCH, HCT and RDW

The Direction Orientation Task (DOT) was developed as a test of spatial ability and processing speed. It is used by several US military services as part of their respective cognitive selection batteries for military aviators. Previous attempts to improve the task exposed an additional concern: specifically, the majority of participants were applying a mathematical strategy to the task, and these participants were outperforming those using a spatial strategy. This paper discusses the development of a newer version of the DOT designed to push participants towards using a spatial strategy. A group of student Naval Aviators completed the new version and were more than twice as likely to employ a spatial strategy compared to a math strategy. Because the original DOT is the only measure of spatial ability currently used to select naval aviation candidates, additional testing should assess whether it is actually measuring the desired construct.

Psoriatic patients on tumor necrosis factor alpha inhibitors (TNFi) may be at increased risk for upper respiratory tract infections, including chronic rhino-sinusitis (CRS). Rarely, CRS can progress to orbital cellulitis (OC), an emergent ophthalmic complication wherein respiratory flora from paranasal sinus disease intrude the retro-orbital space. Single case report. We report the first case, to our knowledge, of an invasive sinusitis that rapidly evolved into OC in a patient receiving adalimumab treatment for plaque psoriasis and psoriatic arthritis. After TNFi withdrawal and appropriate medical and surgical intervention, the patient fully recovered. However, on resumption of TNFi therapy, symptoms of recalcitrant CRS returned. More investigation is needed to explore how TNFi might predispose to chronic, refractory rhino-sinusitis and subsequent progression to OC. Military physicians and other medical providers should be aware of this proposed new disease entity and the potential for rapidly evolving and invasive infections in immunocompromised patients. Screening and monitoring for chronic infectious disease, such as CRS before initiating and during TNFi therapy is warranted.

This paper presents data loss figures from three experiments, varying in length and visual complexity, in which low-cost eye tracking data were collected. Analysis of data from the first two experiments revealed higher levels of data loss in the visually complex task environment and that task duration did not appear to impact data loss. Results from the third experiment demonstrate how data loss can be mitigated by including periodic eye tracking data quality assessments, which are described in detail. The paper concludes with a discussion of overall findings and provides suggestions for researchers interested in employing low-cost eye tracking in human subject experiments.