Products Portfolio

USAMRMC

U.S. Army Medical Research and Materiel Command

Products Portfolio

USAMRMC

U.S. Army Medical Research and Materiel Command

For more information, contact:

Public Affairs Officer • USAMRMC • 504 Scott Street • Fort Detrick, MD 21702-5012 • Phone: 301-619-2736

https://mrmc.amedd.army.mil
Introduction

USAMRMC............................................ x Work with Us ...................................... xiv

Military Infectious Diseases

Overview ............................................1-2

Adenovirus Vaccine, Types 4 and 7...1-8

Aerosol Generator, Ultra-Low

Volume, Electric .................................1-8

Camouflaged Bednet Shelter.............1-9

Combined Camouflage Face Paint....1-9

Doxycycline (Vibramycin).................1-10

Electronic Surveillance System for

the Early Notification of CommunityBased Epidemics .............................1-10

Global Emerging Infections

System .............................................1-10

Hepatitis A Vaccine (Havrix®)........... 1-11

Hepatitis B Vaccine.......................... 1-11

Influenza Virus Vaccine ................... 1-11

Japanese Encephalitis Vaccine 

(IXIAROR)......................................... 1-12

Meningococcal Vaccine

(Menomune)..................................... 1-12

Oral Live Typhoid Vaccine

(Vivotif)............................................. 1-13

Pesticide Dispersal Unit,

Multicapability, Helicopter Slung...... 1-13

Rubella Vaccine (Meruvax, now 

Meruvax II) ....................................... 1-13

Chloroquine (Aralen)........................ 1-14

Primaquine ....................................... 1-14

Sulfadoxine-Pyrimethamine

(Fansidar)......................................... 1-14

Malaria Rapid Diagnostic Device..... 1-15

Atovaquone-Proguanil (Malarone)...1-16

Chloroquine-Primaquine..................1-16

Diarrheal Disease Supplement........ 1-17

Intravenous Artesunate for

Treatment of Severe Malaria............ 1-18

Topical Antileishmanial Treatment

Drug (Paromomycin)........................ 1-19

Leishmania PCR Diagnostic

Device ..............................................1-20

Leishmania Rapid Diagnostic

Device ..............................................1-20

Leishmania Skin Test.......................1-20

Rapid Human Diagnostic Assays ....1-21

Alternate Insect Repellent................1-22

Dengue Fever Vaccine.....................1-23

Diarrheal Disease Vaccines.............1-24

Drug for Malaria Prophylaxis ...........1-25

Malaria Vaccines..............................1-26

Meningococcal Type B Vaccine.......1-27

Military HIV Research Program.......1-28

Vaccines to Prevent Hemorrhagic

Fever with Renal Syndrome.............1-29

Antimalarial Drugs............................1-30

Publications......................................1-32

Combat Casualty Care

Overview ............................................2-2

Chitosan Hemorrhage Control

Dressing (HemCon Bandage)............2-6

Combat Application Tourniquet..........2-6

Combat Gauze ...................................2-7

Demand Oxygen Controller ...............2-7

Field Medical Oxygen-Generating

and Distribution System.....................2-7

Golden Hour Blood Container............2-8

Hypothermia Prevention and 

Management Kit.................................2-8

Impedance Threshold Device............2-8

Improved First Aid Kit.........................2-9

Individual Chemical Resuscitation 

Device ................................................2-9

Low-Power Blood Cooling and

Storage Device...................................2-9

Optimal Fluid Resuscitation

Guidelines ........................................2-10

Rapid Blood Sterilization System ....2-10

Rapid Intravenous Infusion Pump....2-10

Spray-On Protective Bandage......... 2-11

Thermal Infusion System (formerly 

Cartledge Infuser)............................ 2-11

Ventilatory Assist Device for

Anesthesia Machine......................... 2-11

Antimicrobials for Orthopedic

Injuries.............................................. 2-12

Splints, Extremity and Pelvic ........... 2-13

TABLE OF CONTENTS

ii

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Advanced Medic Training

Technologies.................................... 2-14

Army Medical Department Interim

Tent System ..................................... 2-14

Chemical Warfare Agent Protective 

Patient Wrap..................................... 2-15

Emergency Hypothermia and

Smart Aortic Catheter ...................... 2-15

Field Computed Tomography

Scanner............................................ 2-15

Field Operating Table

Improvement ....................................2-16

Field Optometry Set.........................2-16

Fluid Warming System.....................2-16

Folding Decontaminable Litter......... 2-17

High-Speed Mini-Sterilizer............... 2-17

Life Support for Trauma and

Transport System............................. 2-18

Medical Supply Envelope................. 2-18

Military Transportable Field 

Radiographic and Fluoroscopic

System ............................................. 2-19

Mine-Resistant Ambush-Protected 

Ambulance .......................................2-19

Operating Room Table.....................2-20

Pain Control Pump...........................2-20

Patient Holding and Evacuation

Heater Unit .......................................2-20

Portable Field X-Ray Table..............2-21

Reactive Skin Decontamination

Lotion................................................2-21

Robotic Integration of HighIntensity Focused Ultrasound with

Life Support and Trauma and

Transport .........................................2-22

Robotic Laser Tissue Welding .........2-22

Severe Trauma Simulation...............2-23

Single-Litter Casualty Evacuation

Kit .....................................................2-23

Special Medical Emergency

Evacuation Device ...........................2-24

Special Operations Forces

Medical Handbook ...........................2-24

Steam Vacuum Pulse Sterilizer .......2-25

Stryker – Medical Evacuation

Vehicle..............................................2-25

Surgical Scrub Sink..........................2-26

Assessment of Learning with the

Mobile Telementoring Intubating

Video Laryngoscope in

Endotracheal Intubation Training.....2-27

Emergency Department SelfAssessment Survey and Incident 

Scenario Exercise Guidebook for 

Chemical, Biological, Radiological/

Nuclear, and Explosive Response 

Preparedness...................................2-28

Immersive Technologies Approach

to Medical Modeling and

Simulation ........................................2-29

SimSurgery: Development of a

Portable Simulator for Training

Robot-Assisted Surgery...................2-30

The Use of Cognitive Task Analysis

and Simulators for After-Action

Review of Medical Events in Iraq.....2-30

Dental Field Treatment and

Operating System ............................2-31

Dental Filmless Imaging System .....2-31

Field Dental Operating Unit .............2-32

Miniature Dental X-Ray System.......2-32

Blood Refrigerator............................2-33

Ceramic Oxygen Generator.............2-33

Clotting Agents.................................2-33

Fibrinogen Bandages.......................2-34

Junctional Hemostatic Device

(Combat Ready Clamp)....................2-34

Red Blood Cells, Extended Life.......2-34

Rotary Valve Pressure Swing

Oxygen Generator ...........................2-35

Transportable Pathogen Reduction 

Blood Safety System .......................2-36

Advanced Regenerative Medicine 

Technologies to Regenerate Lost 

Tissues.............................................2-37

Hyperbaric Oxygen Treatment of

Post-Concussion Syndrome ............2-38

Neuroprotective Drugs.....................2-39

Neurotriage Diagnostic Tools...........2-40

Active Thermal Resuscitation ..........2-41

Field Sterilizer Improvement

Device ..............................................2-41

Future Medical Shelter System........2-42

Ground Combat Vehicles – 

Medical Variants.............................. 2-43

Mine-Resistant AmbushProtected Ambulance...................... 2-44

Portable Noninvasive Shock

Monitor ............................................ 2-44

Replacement of the M113 Medical 

Ambulance/M577 Treatment

Variants in the Heavy Brigade

Combat Teams................................ 2-45

Stryker – Medical Treatment

Vehicle............................................. 2-46

Treatment Table .............................. 2-46

3DiMD: Gaming Environment for 

Training Team Coordination Skills ...2-47

Center for Advanced Surgical and 

Interventional Technology............... 2-48

Developing Generalized Algorithms

for Objectively Assessing Medical

and Surgical Skill with Various 

Modalities – Data .............................2-49

Dynamic Injury Creation

Simulator..........................................2-49

Medical Simulation Training

Initiative ............................................2-50

Mimic Technologies: Affordable

Haptics for Surgical Training............2-51

Part-Task Trainer Approach to

Medical Modeling and Simulation....2-52

PC-Based Interactive Multimedia ....2-53

Transurethral Resection of the

Prostate............................................2-53

VIRGILTM...........................................2-53

Virtual Reality Demo ........................2-54

Advanced Resuscitation Fluid .........2-55

Blood Product Shipping and

Transport Containers .......................2-55

Cryopreserved Platelets ..................2-56

Freeze-Dried Plasma.......................2-56

Pathogen Inactivation System.........2-57

Pharmacological Resuscitation

with Complement Inhibitor ...............2-58

Remote Acoustic Hemostasis

Device ..............................................2-58

Rapid Wound Cleansing System.....2-59

iii
Regenerative Medicine for

Wound Healing.................................2-59

Neuroprotective Drug Combination 

Therapy Strategy............................. 2-60

Automated Critical Care Life

Support System ...............................2-61

Medical Ultrasound, ThreeDimensional, Portable with

Advanced Communications .............2-62

Monitors ...........................................2-63

Pneumothorax Detector (Vital

Signs Monitor 2).............................. 2-64

Temporary Implantable Lactate

Sensor Biochip.................................2-65

Thirty-Minute Cold Sterilization

Solution ........................................... 2-66

Warfighter Remote Triage............... 2-66

Anticaries Components................... 2-66

Publications..................................... 2-68

Military Operational Medicine

Overview ............................................3-2

Advanced Blast Test Device ............. 3-6

Body Armor Blunt Trauma

Performance Testing Method.............3-7

Design Guidelines for Advanced 

Imaging and Display Technologies ....3-7

Effects of Prolonged Deployment 

on Physical Performance, Body 

Composition, and Injury Potential..... 3-8

Evaluation of Human Exposure to 

Whole-Body Vibration: Method for 

Evaluation of Vibration Containing 

Multiple Shocks................................. 3-9

INJURY-A.......................................... 3-9

INJURY 8.3 ......................................3-10

Injury Prevention and Restraint 

Technologies for Ground Vehicles 

and Helicopters (Inflatable Restraint 

Systems)...........................................3-10

Laser Exposure Standards to

Prevent Laser Eye Injury..................3-11

Ophthalmic Standards for Personal 

Protective Eyewear ..........................3-12

Reference Work on Sensory, 

Perceptual, and Cognitive

Aspects of Helmet-Mounted

Display Design .................................3-12

Total Army Injury Health and 

Occupational Database ...................3-13

Toxic Gas Assessment Software – 

Performance Evaluation ..................3-14

Warfighter Face and Eye Injury 

Protection.........................................3-15

Army Medical Department Suicide 

Event Report ...................................3-16

Pre/Post-Deployment Psychological 

Screening .........................................3-17

Resilience Training System..............3-18

Enhanced Fluid and Nutrition

Delivery System...............................3-19

Guidance on Using Modafinil and 

Dextroamphetamine as AlertnessPromoting Agents in Aviators 

Performing Extended Operations ....3-19

Nutritionally Optimized First Strike 

Ration...............................................3-20

On-the-Move Nutrient Delivery

System .............................................3-20

Probability of Survival Decision

Aid ....................................................3-21

Cold Weather Operations: Cold 

Injury Prevention and Performance 

Optimization .....................................3-22

Environmental Strain Prediction

Models..............................................3-22

High-Altitude Operations:

Management and Performance 

Optimization .....................................3-23

Hot Weather Operations: Heat

Illness Management and

Performance Optimization...............3-24

Intelligent Aquatic Biomonitor

System .............................................3-25

Rapid Analysis of Water for Select 

Chemical Contamination..................3-25

Automated Binocular Vision

Tester................................................3-26

Aviation Tactile Situation

Awareness System ..........................3-26

Biomechanical Design Guidelines

for Personal Equipment....................3-27

Blast Dosimeter................................3-27

Customized Functional Hearing 

Evaluation for Military Occupational 

Specialties........................................3-28

Design Guidelines for HeadSupported Devices...........................3-28

Epidemiology and Protection from

Injury in Combat...............................3-29

Injury Prevention and Restraint 

Technologies for Ground Vehicles

and Helicopters (Conventional

Restraint Systems).......................... 3-30

Physiological and Operational

Effects of Extended Mission

Duration and Seat Design................3-31

Return-to-Duty Vision Standards

After Traumatic Brain Injury ............ 3-32

Strategies to Optimize Bone

Health and Eliminate Stress

Fractures in New Recruits............... 3-33

Tactile Balance Assessment

Device ............................................. 3-33

Tinnitus Treatment Strategies......... 3-34

Traumatic Brain Injury Sensory 

Assessment Battery........................ 3-34

Mental Health Advisory Teams....... 3-35

Millennium Cohort and

Deployment Health.......................... 3-36

Operational and Strategic Studies

of Service Member and Spouse 

Behavioral Health............................ 3-38

Research on Behavioral Health

Practice .......................................... 3-38

iv

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Safe and Effective Treatment of 

Depression and Anxiety Disorders

in Warfighters.................................. 3-39

Design Guidelines for Effective 

Microclimate Cooling Systems........ 3-40

Effective Army Weight

Management Strategies.................. 3-40

Model for Fatigue Management.......3-41

Motion Sickness Countermeasures

in Army Aircraft ............................... 3-42

Nutritional Products for Digestive

Health and Immune Function.......... 3-43

Operational Ration Sustainment

Testing............................................. 3-43

Prevention and Treatment of Iron 

Deficiency Anemia in Female

Soldiers ........................................... 3-44

Sleep Watch.................................... 3-45

Altitude Sickness, Acclimatization,

and Performance Prediction

Models............................................. 3-46

Arm Immersion Cooling System..... 3-47

Biological Markers of Toxic

Exposures and Effects for

Deployment Health Surveillance .... 3-48

Rapid Analysis of Water for

Microbial Contamination ................. 3-49

Skin Temperature Feedback 

Microclimate Cooling....................... 3-50

Sweat Prediction Models .................3-51

Test System for Evaluating 

Environmental EndocrineDisrupting Chemicals and

Developing Candidate Biological 

Markers for Deployment Health 

Surveillance .................................... 3-52

Thermal Models on a Personal

Digital Assistant Format.................. 3-53

Thermal Warning Algorithm............ 3-53

Blast Standards for Neurosensory 

Personal Protective Equipment....... 3-54

Bone Image Analysis ...................... 3-54

Eye Injury Field Therapy Kit............ 3-55

Physical Activity Data Logger......... 3-55

Repeated Shock and Vibration

Limits for Trauma Patients .............. 3-56

Training, Overuse Injury, and 

Performance Modeling.................... 3-56

Warrior Injury Assessment

Manikin............................................ 3-57

Determinants of Soldier Risky

Behavior Post-Deployment ............. 3-58

Genetic, Proteomic, and 

Neurobehavioral Determinants of 

Deployment-Related Psychological 

Health Disorders and Traumatic

Brain Injury...................................... 3-59

Assessment of Mild Traumatic Brain 

Injury Through Modeling of Central 

Nervous System Indices ................. 3-60

Cognitive Readiness/Fatigue

Modeling.......................................... 3-61

Dietary Supplement Research........ 3-61

Finite Element Thermoregulatory

Model............................................... 3-62

Guidance on Using Stimulant and 

Sleep-Inducing Agents Under 

Operational Conditions ................... 3-63

PDA-Based Psychomotor

Vigilance Task ................................ 3-64

Remote Physiological Status

Monitor ............................................ 3-65

SPARNET – Spartan Network........ 3-65

Diagnosing and Preventing NonFreezing Cold Injury........................ 3-66

Environmental Sentinel Biomonitor 

System ............................................ 3-67

Heat Injury/Stroke Treatment and 

Return to Duty ................................. 3-68

Hydration Status Monitoring ........... 3-69

Pathology of Heat and Cold Injury...3-70

Publications......................................3-72

Clinical and Rehabilitative Medicine

Overview ............................................4-2

C-Leg® (Second Generation) 

Microprocessor Knee Prosthesis...... 4-6

iWalk Microprocessor-Controlled 

Prosthetic Ankle System................... 4-6

Allogeneic Engineered Skin/

StrataGraft®........................................4-7

Autologous Engineered Skin/Lonza 

Permaderm ........................................4-7

Autologous Skin Expander Device ....4-7

ReCell®/Partial Thickness Burn........ 4-8

Autologous Fat Transfer

Procedure.......................................... 4-8

Neodyne Mechanical Scar

Reduction Device.............................. 4-9

Biologic Extracellular Matrix

Scaffold for Functional Muscle 

Replacement....................................4-10

C-Leg (Third Generation) 

Microprocessor Knee Prosthesis..... 4-11

DEKA/APL Arms.............................. 4-11

Powered Knee-Ankle-Foot

System .............................................4-12

Socket Technologies........................4-13

Spring Ankle with Regenerative

Kinetics.............................................4-13

Fraxelated Carbon Dioxide Laser

for Treatment of Scar Contracture ...4-14

Riluzole Spinal Cord Injury

Treatment .........................................4-14

Treatment of Tinnitus .......................4-15

Formable, Nanostructured Ca PO4 

(NanoCaPS) Scaffolds.....................4-16

Peripheral Nerve Scaffolds..............4-17

PlexurLV Injectable Allograft BoneComposite Scaffold..........................4-17

Protocol for Immunomodulation

for Composite Tissue 

Allotransplantation – Hand and

Face Transplants..............................4-18

Molecular Signatures of Chronic

Pain Subtypes ..................................4-19

v
Pain Center of Excellence and

Chronic Pain Impact Network ..........4-20

Wearable Visual Aid as Treatment

for TBI-Associated Visual

Dysfunction ......................................4-21

Rehabilitation of Balance .................4-22 Publications......................................4-24

Medical Chemical and Biological Defense

Overview ............................................5-2

Skin Exposure Reduction Paste

Against Chemical Warfare Agents.... 5-6

Soman Nerve Agent Pretreatment 

Pyridostigmine ................................. 5-6

Antidote Treatment Nerve Agent 

Autoinjector ....................................... 5-6

Convulsant Antidote for Nerve

Agents ................................................5-7

M291 Skin Decontamination Kit.........5-7

Mark I Nerve Agent Antidote Kit ....... 5-8

Medical Aerosolized Nerve Agent 

Antidote ............................................. 5-8

Test-Mate Cholinesterase Kit............ 5-8

Anthrax Vaccine Adsorbed

(BiothraxTM) ....................................... 5-9

Smallpox Vaccine System................5-10

Comprehensive Educational Tools

and Resources.................................5-11

Computer-Based Training................5-11

Field Identification of Biological

Warfare Agents Course ...................5-12

Field Management of Chemical

and Biological Casualties Course....5-12

Hospital Management of Chemical, 

Biological, Radiological/Nuclear,

and Explosive Incident Course ........5-13

Medical Management of Chemical

and Biological Casualties Course....5-13

Nerve Agent Bioscavenger..............5-14

Advanced Anticonvulsant System ...5-15

Improved Nerve Agent Treatment 

System .............................................5-15

Next-Generation Anthrax Vaccine...5-16

Plague Vaccine (Recombinant

Plague Vaccine) ...............................5-17

Project Argus: A National 

Biosurveillance Priming System .....5-18

Recombinant Botulinum Toxin A/B 

Vaccine.............................................5-19

Trivalent Filovirus Vaccine ..............5-20

Tularemia Vaccine............................5-20

Venezuelan Equine Encephalitis 

Infectious Clone Vaccine .................5-21

Continuous Product Improvement

to the Joint Biological Agent 

Identification and Diagnostic

System .............................................5-22

Field-Deployable Ultra-Sensitive

Assay System for Biological

Toxins ...............................................5-23

Chemical Diagnostics ......................5-24

Cyanide Medical

Countermeasures ............................5-24

Cutaneous and Ocular

Therapeutics ....................................5-25

Skin and Wound

Decontamination..............................5-26

Recombinant Ricin Vaccine

Candidate.........................................5-27

Staphylococcal Enterotoxin A/B 

Multivalent Vaccine Candidate.........5-28

Vaccine Constructs for a

Combined Equine Encephalitis

Vaccine.............................................5-29

Virus-Like Particles......................... 5-30

Therapeutic Strategies for

Botulinum Neurotoxins.....................5-31

Therapeutic Strategies for

Treating Filovirus Infection.............. 5-32

Therapeutics for Smallpox and

Other Orthopoxviruses ................... 5-33

Publications..................................... 5-34

Advanced Technologies

Overview ............................................6-2

Clinical Looking Glass, “A

Revolutionary Clinical Intelligence

Tool” .................................................. 6-4

Departments of Combat Medical 

Training – Technology

Enhancement .................................... 6-4

Digital Imaging Network-Picture 

Archiving and Communications

System .............................................. 6-5

Digital Information and

Communications System.................. 6-5

Teleconsultation/Teledermatology.... 6-6

Video Laryngoscope ........................ 6-6

Web-Enabled Refractive Surgery 

Information System........................... 6-8

Advanced Surgical Technologies ..... 6-9

AHLTA-Mobile..................................6-10

Center for Military Biomaterials 

Research..........................................6-11

Common Development

Environment Initiative.......................6-12

Copper Antimicrobial Program ........6-13

Development of an Over-Ground, 

Pneumatically Actuated BodyWeight Support System...................6-13

Handwashing Compliance Reminder 

and Documentation System.............6-14

High-Altitude Platforms Mobile

Robotic Telesurgery.........................6-14

vi

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Joslin Comprehensive Diabetes 

Management Project........................6-15

Medical Surveillance Network .........6-16

Microencapsulation and Vaccine 

Delivery ............................................6-16

Nanofabricated Bioartificial

Kidney ..............................................6-17

New Clinical Data Mart Prototype

and Research Data Cube

Initiatives ..........................................6-18

New Sprayable Liquid Wound

Dressing ...........................................6-19

Next-Generation Portable X-Ray 

System .............................................6-20

Novel, Noninvasive, PatientSpecific Electrographic Seizure

Warning System...............................6-21

OASIS .............................................6-22

Periscopic Spine: Georgetown 

University .........................................6-23

Proton Beam Therapy – Loma

Linda University Medical Center......6-24

Proton Beam Therapy – The

Hospital of the University of 

Pennsylvania....................................6-24

Rugged Mobile Logistics System.....6-25

Troop Recruitment Improvement .....6-26

Wear-and-Forget Physiological

Sensing System for Combat

Casualty Care ..................................6-27

Wireless Electronic Information

Carrier/Personal Information

Carrier ..............................................6-28

Alliance for NanoHealth...................6-29

A Standards-Based Tool for 

Pharmacovigilance.......................... 6-30

Center for Research on Integrative 

Medicine in the Military ....................6-31

Clinical Breast Care Project at

Walter Reed Army Medical

Center.............................................. 6-32

Comfortable Socket ........................ 6-32

Digital Emergency Medical

Services .......................................... 6-33

Facilitating Cell Transplantation 

Research......................................... 6-33

Hibernation Genomics: 

Mechanisms for Metabolic

Suppression and Neural

Protection........................................ 6-34

Military Foot..................................... 6-35

National Eye Evaluation Research 

Network for Clinical Trials in

Retinal Degenerative Diseases

by the National Neurovision

Research Institute ........................... 6-36

National Functional Genomics

Center...............................................6-37

Personal Area Network for

Remote Physiological Monitoring ... 6-38

Robotic Medic Assistant, Patient 

Evacuator ........................................ 6-38

Robotic Telepresence for

Subspecialty Care........................... 6-39

Serpentine Robotic Manipulator

Arm.................................................. 6-39

Simulation-Based Open Surgery 

Training System............................... 6-40

Soldier Health Promotion to

Examine and Reduce Health

Disparities ........................................6-41

Speech-Capable Personal Digital 

Assistant.......................................... 6-42

Treatment of Peripheral Vascular 

Disease by Adipose-Derived

Stromal Cell Injection...................... 6-42

Virtual Humans ............................... 6-43

Virtual Retinal Laser Display........... 6-43

Virtual Therapies for Psychological 

Trauma: Virtual Iraq ........................ 6-44

Publications..................................... 6-46

Logistics

Overview ............................................7-2

Apheresis System..............................7-4

Cold Chain Management ...................7-4

Equipment Maintenance and

Repair.................................................7-5

Equipment Publications .....................7-5

Technology Assessment and 

Requirements Analysis ......................7-6

USAMMA Revolution in Logistics ......7-6

Medical Materiel Readiness

Program..............................................7-7

Appendices

Licensed Technologies

and Patents ....................................... A-2

Patents Issued to USAMRMC 

Laboratories ......................................A-8

Acronym List...................................... B-1

Index.................................................. C-1

vii
Mention of any specific commercial products, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, 

recommendation, or favoring by the United States Government. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States 

Government and shall not be used for advertising or product endorsement purposes. The mention of companies by name is solely for the purpose of representing Command collaborations and should not be implied as endorsement.
Introduction

Military 

Operational 

Medicine

Clinical and 

Rehabilitative 

Medicine

Medical Chemical 

and Biological 

Defense

Advanced 

Technologies

Logistics

Appendices

Military Infectious 

Diseases

Combat 

Casualty Care
USAMRMC

The nation’s military forces may be called to serve anywhere in the world 

during times of conflict or in peacetime. Among the threats our forces face are 

injury from combat operations, exposure to chemical or biological warfare agents, environmental extremes, and endemic diseases not common in the United States. To provide 

Warfighters defenses against these hazards and sustain their health is the goal of the 

U.S. Army Medical Research and Materiel Command (USAMRMC). 

A complex and diverse organization, the Command sustains the health and fighting ability 

of Soldiers, Sailors, Airmen, and Marines through its programs in medical research, medical 

materiel development, medical logistics, and development of new technologies to improve 

military health care on the battlefield. The Command is engaged in a broad spectrum of 

activity, from basic research in the laboratory to innovative product acquisition and the fielding and life-cycle management of medical equipment and supplies for deploying units.

Six laboratories make up the Command’s core science and technology capability. They are 

centers of excellence in specific areas of biomedical research, staffed by highly qualified 

military and civilian scientists and support personnel. A large extramural contract research 

program and numerous Cooperative Research and Development Agreements (CRADAs) 

with leading research and development organizations in the civilian sector complement the 

Command’s in-house science and technology capabilities. 

Five additional USAMRMC subordinate commands focus on Command requirements, 

such as medical materiel development, logistics, and contracting, to complete the life-cycle 

management of medical materiel.

x

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
This portfolio provides a comprehensive listing of the products USAMRMC provides or plans to 

deliver to protect and treat Warfighters who serve the nation. Products the Command develops 

fall into the following groups in this portfolio: Military Infectious Diseases, Combat Casualty 

Care, Military Operational Medicine, Clinical and Rehabilitative Medicine, Medical Chemical and 

Biological Defense, Advanced Technologies, and Logistics. An overview of each group’s mission 

and challenges precedes the group’s current product listing.

The section that begins on page xiv entitled “Work With Us” offers additional insight on how 

researchers and businesses can develop working relationships with the Command. For exam-

ple, one product may take the Small Business Innovation Research (SBIR) route, another may 

be the result of a CRADA.

Products are described as completed, promising, or future. Completed products in the 

portfolio are examples of the Command’s success stories. They have made it through the 

advanced development process and into the procurement system and can be purchased 

by units. Promising products are those closest to being put in a service member’s hands. 

These are products that have crossed the boundary from the laboratory to advanced devel-

opment. For example, vaccines and drugs in clinical trials and devices that are being evalu-

ated and modified to fit users’ needs are considered promising. One caveat is necessary 

here: When a vaccine or drug moves to the different phases of clinical trials, planners expect 

certain fail rates. For example, half of the drugs in Phase 1 trials do not make it to Phase 2, 

and a third do not make it from Phase 2 to Phase 3. Future products are in basic research in 

the laboratories. Some are in their early stages; some are awaiting funding to make the leap 

into advanced development. 

Appendix A also provides valuable information on the Command’s products. To give the 

reader an appreciation of advances the Command’s scientists have made over the years, it 

lists licensed technologies from USAMRMC laboratories and the patents the Command holds 

or held before they expired. Appendix B provides a list of acronyms that are used throughout 

the book.

xi
USAMRMC WORLDWIDE PRESENCE

USAMRMC Headquarters

6th Medical Logistics Management Center

Congressionally Directed Medical Research Programs

Telemedicine and Advanced Technology Research Center

U.S. Army Center for Environmental Health Research

U.S. Army Medical Materiel Agency

U.S. Army Medical Materiel Development Activity

U.S. Army Medical Research Acquisition Activity

U.S. Army Medical Research Institute of Infectious Diseases

U.S. Army Dental and Trauma Research Detachment

U.S. Army Research Institute of Environmental Medicine

U.S. Army Medical Research Institute of Chemical Defense

U.S. Army Institute of Surgical Research

U.S. Army Medical Research Detachment

U.S. Army Aeromedical Research Laboratory

National Museum of Health and Medicine

Armed Forces Medical Examiners

Walter Reed Army Institute of Research

xii

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
U.S. Army Medical Materiel Center, Europe

U.S. Army Medical Research Unit - Europe

U.S. Army Medical Materiel Center - Korea

Armed Forces Research Institute of Medical Sciences

U.S. Army Medical Research Unit - Kenya

xiii
WORK WITH US

Research Opportunities 

USAMRMC funds a broad range of extramural research programs. 

Submit a Proposal

Awards are usually contracts, grants, or cooperative agreements. Research proposals can be submitted to the Command through the 

USAMRMC Broad Agency Announcement (BAA), which is continuously open, or through special USAMRMC BAAs, which are open for limited 

time frames. 

BAAs and additional information can be viewed at www.usamraa.army.mil by selecting the “BAA” button. 

USAMRMC currently has the following research funding opportunities: 

y The Army SBIR program is a contract program for small businesses supporting defense and commercial applications. 

y The Small Business Technology Transfer Research program is a companion program to the SBIR program. It differs only in the requirement 

that work must be performed by small businesses in collaboration with nonprofit research organizations. 

y The Office of the Secretary of Defense SBIR program is a contract program for small businesses supporting defense and commercial 

applications. 

y The Chemical–Biological SBIR program is limited to chemical and biological defense topics. 

y The Defense Experimental Program to Stimulate Competitive Research promotes defense-related research and development in states not 

traditionally receiving significant amounts of federal support for science and engineering. 

y The Soldier Enhancement Program identifies and evaluates commercially available items to increase the effectiveness of individual 

Warfighters. 

For questions about these funding programs, call the USAMRMC Plans and Programs Office at 301-619-3354 or visit

https://mrmc.amedd.army.mil. 

xiv

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Business Opportunities

Businesses have several ways of pitching products to USAMRMC. 

New Products and Ideas Web Site

The Command recognizes that unsolicited proposals with unique and innovative products or 

ideas that have been developed outside of the government can help it accomplish its mission. 

To submit a new product or idea for consideration, visit www.usamraa.army.mil and click the 

“New Products and Ideas Submission” button. 

Small Business Programs

The Command makes a concerted effort to forge strategic alliances with various small 

businesses that offer innovative products, quality services, and dynamic business solutions in 

support of many Department of Defense initiatives. 

Visit the Office of Small Business Programs at www.mrmc.smallbusopps.army.mil to learn 

more about how small businesses can work with the Command. 

Vendor Days

The U.S. Army Medical Materiel Agency, along with other medical 

professionals at Fort Detrick, Maryland, routinely schedules Vendor Days 

for medical equipment and supply vendors to display products to multiple 

organizations at one time. For more information on Vendor Days, visit

http://www.detrick.army.mil/services/vendorday.cfm. 

Technology Transfer 

The Command’s Technology Transfer Office coordinates all intellectual 

property licensing from the federal sector to nonfederal parties on behalf of 

all the Command’s subordinate laboratories. 

Visit https://technologytransfer.amedd.army.mil to discover technology available for licensing 

through issued patents and published pending patents. 

xv

Military 

Operational 

Medicine

Clinical and 

Rehabilitative 

Medicine

Medical Chemical 

and Biological 

Defense

Advanced 

Technologies

Logistics

Appendices

Military Infectious 

Diseases

Combat 

Casualty Care
OVERVIEW

Infectious diseases debilitate service members and can influence 

battle outcome. Infectious diseases in the military cause lost duty 

time; increase the medical logistical burden for diagnosis, treatment, and evacuation; and decrease combat effectiveness. 

Many hospital admissions among U.S. service members in 

Vietnam were attributed to infectious diseases, including malaria, 

dengue, scrub typhus, and Japanese encephalitis. Dengue and 

malaria caused hospitalizations in Somalia, and dengue and diarrhea afflicted troops in Haiti. Diarrhea remains a major cause of 

illness among deployed service members supporting Operation 

Enduring Freedom in Afghanistan and Operation Iraqi Freedom in 

the Persian Gulf. Additional infectious disease threats to service 

members include hepatitis, leishmaniasis, meningococcal disease, 

human immunodeficiency virus (HIV), hantavirus infections, and 

other hemorrhagic fever viruses. Many environments to which service members deploy harbor specific infectious disease hazards. 

The Military Infectious Diseases Research Program (MIDRP) 

focuses on prevention, diagnosis, and treatment of naturally occurring disease-causing microorganisms with major impact on mission 

effectiveness. Research emphasis includes the following:

y Developing vaccines against infectious diseases important to the 

U.S. military

y Discovering and developing drugs to prevent and treat militarily 

relevant infections

y Creating techniques to identify disease-causing microorganisms 

and diagnose infections rapidly

y Collecting and analyzing epidemiological data to optimize infectious disease control strategy

y Evaluating methods to control vectors (insects and arthropods 

that carry disease-producing microorganisms) of relevant infectious diseases

The program is enhanced by numerous facilities, including eight 

infectious disease research laboratories around the world, accredited animal and biosafety level 4 containment laboratories, a pilot 

vaccine facility, and clinical trials units. Most of the associated 330 

scientists employed by the military, civil service, or contracting companies have advanced degrees. The program maximizes research 

dollars by collaborating with industry and universities through more 

than 100 cooperative research and development agreements.

1-2

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Vaccines

The discovery and development of vaccines to protect the 

Warfighter are priorities for the MIDRP. Vaccines can be adminis-

tered prior to deployment and provide long-term protection thereby 

reducing disease incidence and the associated medical logistics 

burden (which includes transportation of preventive countermea-

sures to prevent illnesses for which no vaccines are available as 

well as medical equipment for ill Warfighters). The U.S. military’s 

infectious diseases program has played a significant role in the 

development of 11 licensed vaccines: y Rubella (1969) y Adenovirus 4 and 7 vaccines (1980, 2011) y Tetravalent meningococcal vaccine (1981) y Hepatitis B vaccine (1981) y Oral typhoid vaccine (1989) y Japanese encephalitis vaccine (1992, 2009) y Hepatitis A vaccine (1995)

More than half of the vaccines routinely given to service members 

were codeveloped by the military. Development of other vac-

cines was supervised by investigators who began their careers 

at military research centers (e.g., yellow fever vaccine by former 

Army Surgeon General William Gorgas; mumps, measles, and 

varicella vaccines by Maurice Hilleman; and oral polio vaccine by 

Albert Sabin). Vaccines currently in advanced development stages 

include new adenovirus vaccines as well as vaccines for dengue 

and hepatitis E.

1-3
Drugs

The MIDRP has contributed to the development of most of the 

synthetic drugs licensed in the United States for the prevention and 

treatment of malaria, including:

y Chloroquine (1949)

y Primaquine (1952)

y Chloroquine-primaquine (combined drug, 1969)

y Sulfadoxine-pyrimethamine (1983)

y Mefloquine (1989)

y Doxycycline (1992)

y Halofantrine (1992) 

y Atovaquone-proguanil (2000)

y Intravenous artesunate (U.S. Food and Drug Administration [FDA] 

approved investigational new drug protocol #76,725 in 2010)

MIDRP researchers also developed the current dosing regimen 

for treating cutaneous leishmaniasis with the drug pentostam. 

Other antileishmanial drugs discovered and developed by MIDRP 

scientists are WR6026 (sitamaquine) for the treatment of visceral 

leishmaniasis and a third-generation topical formulation of two 

aminoglycosides (paromomycin and gentamicin) in a hydrophilic 

carrier (WR279,396) for the treatment of cutaneous leishmaniasis. 

WR279,396 is presently in Phase 3 studies. Equally important is 

the use of WR6026 as prophylaxis against transfusion-transmitted 

American trypanosomiasis also called Chagas disease.

Diagnostics and Vector Control

MIDRP products include fieldworthy devices to diagnose human 

infections rapidly (such as leishmaniasis and malaria) and to 

determine if insects are carrying infectious agents transmissible 

to humans (such as malaria parasites and dengue virus). Nucleic 

acid-based, polymerase chain reaction assays developed on 

multiple platforms allow infectious agents carried by ticks, sandflies, 

and mosquitoes to be detected at a deployed area medical laboratory. Additional products include insect repellents, a camouflage 

face paint/insect repellent, and computer-based systems to identify 

insects capable of transmitting human diseases. 

Other Contributions

Licensed products reflect only a small portion of the contributions 

of the U.S. military to infectious diseases research. Contributions 

range from the demonstration that yellow fever was transmitted by 

a virus by Major Walter Reed in 1900 to the treatment of cholera 

by Captain R.A. Phillips in the 1940s (which led to the development of oral rehydration solution) to the publication of the complete 

malaria genome in 2000. U.S. military physicians have authored 

and coauthored thousands of research publications elucidating 

the etiology, ecology, epidemiology, and pathophysiology of many 

infectious diseases, leading to effective treatment and control 

measures. Additionally, long-term deployment of military scientists to Department of Defense (DoD) laboratories in the tropics 

over the past 100 years has accelerated scientific discoveries and 

product development and assisted technology transfer of research 

techniques and tropical disease control measures to developing 

countries. 

1-4

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Diarrheal Diseases

Diarrhea afflicts up to 50 percent of troops deployed to high-risk 

areas. Currently, no guaranteed protective measures exist, and the 

global problem of antimicrobial-resistant, diarrhea-causing microorganisms may limit treatment options. Candidate vaccines for major 

causes of bacterial diarrhea, including enterotoxigenic Escherichia 

coli (ETEC), Shigella, and Campylobacter, are being developed and 

evaluated by the MIDRP.

Drugs to Prevent and Treat Malaria

Malaria is rated the most important infectious disease threat facing 

U.S. troops worldwide. Malaria may cause severe illness and death 

among U.S. service members sent to tropical and some subtropical 

regions. The malaria threat is exemplified by the experience of 225 

Marines briefly deployed to Liberia in 2003. Falciparum malaria 

was identified in 80 Marines, and 5 persons were noted to have 

severe and complicated infections. The MIDRP is developing new 

drugs to prevent infection and accelerate recovery from severe and 

multidrug-resistant infections. Because malaria parasites eventu-

ally develop mechanisms to resist the effect of antimalarial drugs, 

each drug is only useful for approximately 10–15 years, necessitat-

ing continuous replacement drug development efforts.

Malaria Vaccines

The MIDRP is developing vaccines to protect against Plasmodium 

falciparum and P. vivax as a long-term solution for the most 

significant infectious disease threat to U.S. forces. A vaccine with 

approximately 80 percent efficacy will improve operational capa-

bilities by minimizing malaria casualties and potentially decreas-

1-5
ing the need to use malaria drugs thus avoiding drug-associated 

side effects and compliance issues. The most advanced malaria 

vaccine, RTS,S/AS01, undergoing licensure trials in pediatric populations in sub-Saharan Africa today, was codeveloped 

by GlaxoSmithKline (GSK) and Walter Reed Army Institute of 

Research (WRAIR) scientists. Extensive efforts are under way to 

improve the efficacy of this vaccine from 50 percent to a target goal 

of 80 percent. The medical logistic burden associated with the need 

for administration of drug prophylaxis and medical diagnosis, evacuation, hospitalization, and intensive treatment will be reduced. 

Dengue Fever Vaccine

Dengue fever is a painful viral disease caused by a bite from an 

infected mosquito. Dengue is a leading cause of hospital admission 

in units operating in the tropics. There is currently no vaccine or 

drug to prevent or treat the disease. The MIDRP manages a program focusing on pathogenesis studies, diagnostics, and vaccine 

development to protect against the four types of dengue virus.

Leishmaniasis 

Leishmaniasis is a disease caused by protozoan parasites of the 

genus Leishmania transmitted by phlebotomine sandflies that 

has afflicted more than 1,500 U.S. service members stationed in 

Iraq. Leishmaniasis includes a wide spectrum of illnesses ranging 

from the self-healing cutaneous form to a life-threatening visceral 

disease. This program is focused on diagnostic assays to detect 

active Leishmania infection in theater, diagnostic assays to detect 

latent Leishmania infection in troops deployed in the endemic area 

(with concern for blood supply), and licensing an FDA-approved, 

systemic, nonparenteral treatment for cutaneous leishmaniasis.

Scrub Typhus Vaccine

Scrub typhus is caused by a bite from an infected mite or chigger and can cause fever and rash with a long convalescence or 

death. The disease is prevalent in Asia, Australia, and many Pacific 

Islands. Outbreaks occurred in the U.S. military in 2001. The 

MIDRP is developing diagnostic tools to detect infections in humans 

and a vaccine that can protect individuals from multiple strains of 

scrub typhus.

Meningococcus Type B Vaccine

Meningitis is a bacterial disease transmitted by human aerosol and 

is potentially life threatening or permanently debilitating. The threat 

to service members primarily occurs during basic training but is also 

prevalent in sub-Saharan Africa, South America, and Asia. Even 

a single case can be disruptive to troops. The DoD successfully 

developed meningococcal vaccines for types A, C, Y, and W-135. 

The MIDRP effort is now focused on type B.

Lethal Virus Countermeasures

Hantaviruses are usually transmitted to humans via aerosols created by infected rodent excreta. The four distinct hantaviruses that 

cause hemorrhagic fever with renal syndrome (HFRS) are endemic 

throughout Asia and Europe. There have been thousands of occurrences of HFRS causing illness (often necessitating evacuation and 

extensive long-term care) and death in U.S. troops. The MIDRP is 

pursuing DNA vaccines to prevent HFRS. 

1-6

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Diagnostic Systems

There is an urgent demand for fieldworthy methods to rapidly 

diagnose infectious diseases. This is particularly relevant given 

concerns about biological warfare. Timely and accurate diagnosis 

will permit appropriate medical treatments and other protective 

measures. MIDRP scientists are developing scientific assay sets 

suitable for a variety of assay platforms. 

Identification and Control of Insect Vectors

Seventy percent of deployed military personnel experience prob-

lems related to biting insects. The current military repellent is a 

greasy compound that dissolves plastic, is removed by abrasion or 

wetting, and is not popular with U.S. service members. The MIDRP 

is developing a new standard military insect repellent that is effec-

tive and has improved acceptability.

Military HIV Research Program

Military personnel can become infected by HIV via blood transfu-

sions, accidental blood exposure while providing humanitarian 

assistance, or sexual exposure. HIV impacts troop strength of 

U.S. and allied forces and the political and economic stability of 

developing nations. Research focuses on the development of a 

global HIV-1 vaccine. Field sites have been established in Uganda, 

Kenya, Tanzania, and Thailand. Research management is shared 

by the MIDRP, advanced development programs of the U.S. Army 

Medical Research and Materiel Command (USAMRMC), and 

the National Institutes of Health’s National Institute of Allergy and 

Infectious Diseases (NIAID).

1-7
COMPLETED | PROMISING | FUTURE

Adenovirus Vaccine, Types 4 and 7

Description

Adenovirus Vaccine is an orally administered, enteric-coated tablet containing live adenovirus serotypes 4 or 7 and is used almost exclusively by the military. It will prevent acute respiratory disease 

(ARD) caused by adenovirus (types 4 and 7) that frequently occurs in Soldiers, Sailors, Airmen, and 

Marines living in barrack-type environments during basic training. Prevention of adenovirus-related 

ARD will result in decreased recycling of recruits, due to missed training or hospitalization, and considerable cost savings.

The symptoms of ARD are pharyngitis, rhinitis, and pneumonia, and the illness often leads to lost 

training time. In the absence of vaccine, about 60 percent of ARD cases are due to adenovirus infection. Scientists at the National Institutes of Health and WRAIR developed an Adenovirus Vaccine, 

oral tablets containing live virus types 4 and 7, which were used for more than two decades. Millions 

of recruits received the vaccine, and it was shown to be both safe and effective. Failure to upgrade 

the production facility led to the termination of vaccine production in the 1996. A project to restore 

the vaccine is currently under way. A new facility has been built to produce types 4 and 7 vaccine in 

compliance with current FDA standards. Test and evaluation of the new vaccine was completed at 

Army and Navy basic training commands. The Biological License Agreement was approved by the 

FDA in March 2011.

Partners

y WRAIR

y USAMMDA

y NHRC

y Teva Women’s Health, Inc. USA (A subsidiary of Teva Pharmaceuticals)

PREVENTION

Aerosol Generator, Ultra-Low 

Volume, Electric

Description

The Aerosol Generator, Ultra-Low Volume, 

Electric (AGULVE) is used for dispensing 

pesticides in the form of fog. It is a lightweight unit for pesticide fogging operations 

composed of a spray head and pump that is 

powered from a vehicle’s electric power supply. Completed in 1993, AGULVE improves 

the sustainability of U.S. forces in regions 

of the world where disease-carrying insects 

reside.

Partners

y USAMMDA

y Beecomist

1-8

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Camouflaged Bednet Shelter

Description

The Camouflaged Bednet Shelter is used 

to protect service members from insects. It 

is a self-supporting, low-profile shelter that 

contains a collapsible support structure and 

is impregnated with a quick-acting insecticide 

for knock-down effect. Completed in 2004, 

it provides improved protection against biting 

insects and improves service member survivability and sustainability in regions of the 

world with insect-transmitted diseases.

Partners

y WRAIR

Combined Camouflage Face Paint

Description

Combined Camouflage Face Paint (CCFP) with DEET insect repellent improves U.S. troop survivability and sustainability in regions of the world where diseases are transmitted by biting insects. 

Inclusion of insect repellent protection reduces nuisance factors by repelling insects near the face, 

helping to reduce diseases (e.g., malaria and dengue fever) transmitted by biting insects. CCFP 

blends face paint with DEET to provide a minimum of 8 hours of protection against biting insects. 

CCFP was completed in 2003 and is packaged in a compact container with a mirror on top and 

compartments on the bottom providing 20 applications of the loam, green, and sand colors and 

10 applications of the black and white colors. A product improvement effort to reformulate and package CCFP in stick-type dispensers is projected to be complete in 2011. All CCFP formulations will be 

used by individual service members for protection against biting insects. In addition, the face paint 

reduces a service member’s near-infrared signature providing protection against detection by night 

vision goggles and allowing for assimilation into the military theater environment. 

Partners

y WRAIR

y USAMMDA

y NSRDEC

y Iguana LLC

1-9
Doxycycline (Vibramycin)

Description

Doxycycline (Vibramycin) is a drug used to 

treat malaria. It was developed originally as 

an antibacterial agent with useful antimalarial 

properties against tissue malaria parasite 

forms. It is effective against chloroquineresistant malaria parasite strains with fewer 

adverse effects than mefloquine; however, it 

requires daily administration, is slow-acting, 

and is associated with adverse effects that 

may impact daily compliance. This drug 

should not be administered to pregnant 

women or children. A new indication was 

completed in 1992.

Partners

y WRAIR

Electronic Surveillance System 

for the Early Notification of 

Community-Based Epidemics

Description

The Electronic Surveillance System for 

the Early Notification of Community-based 

Epidemics (ESSENCE) is a system proposed 

for the early detection of infectious disease 

outbreaks at military treatment facilities. Data 

from patient symptoms are instantaneously 

recorded at a patient’s visit and uploaded into 

ESSENCE, which also contains Ambulatory 

Data System diagnoses from 104 primary 

care and emergency clinics within a 50-mile 

radius of Washington, DC. Diagnostic 

codes are grouped into “syndromic clusters” 

consistent with emerging infections, including 

bioterrorism. Once an outbreak is suspected, 

the system dispatches an epidemic control 

team that may include epidemiologists, statisticians, and laboratory personnel.

Partners

y WRAIR 

y DoD GEIS

Global Emerging Infections System

Description

The Global Emerging Infections System 

(GEIS) is a communications system supporting medical surveillance activities. In 

the United States, GEIS units are located in 

California, Texas, Virginia, and Washington, 

DC. Overseas they are located in Peru, 

Egypt, Thailand, Indonesia, and Kenya. 

Together, these assets represent a global 

health care system, connected by a worldwide, state-of-the-art communication system 

using a relatively standardized information 

technology infrastructure for supporting medical surveillance activities. GEIS facilitates 

early recognition and control of new disease 

problems that threaten national security.

Partners

y WRAIR

COMPLETED | PROMISING | FUTURE

1-10 PREVENTION

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Hepatitis A Vaccine (Havrix®)

Description

The Hepatitis A Vaccine (Havrix) is an 

inactivated viral vaccine for the prevention of 

hepatitis A infection. It prevents epidemics 

during deployments to endemic regions and 

areas with suboptimal sanitation, water, and 

waste systems, as well as at military posts. 

Havrix replaced the use of immune serum 

globulin that required repeated injections, was 

not readily available, and was impractical to 

distribute during large deployments. Havrix 

was completed in 1995.

Partners

y WRAIR

y USAMMDA

y GSK

Hepatitis B Vaccine

Description

The Hepatitis B Vaccine (Heptavax B) is used 

to prevent hepatitis B infection. It was previously produced by using plasma from infected 

individuals and is now produced by recombinant methods in yeast cells. It prevents 

hepatitis B infection transmitted by blood and 

body fluid exposure. Completed in 1981, the 

Army contributed to the epidemiology and 

hepatitis B vaccine subtyping efforts.

The use of Heptavax was discontinued in 

1990, and currently two recombinant hepatitis 

B vaccines are available for use (Engerix-B®

[GSK] and Recombivax HB® [Merck].

Partners

y WRAIR

COMPLETED | PROMISING | FUTURE

Influenza Virus Vaccine

Description

The Influenza Virus Vaccine is used to 

prevent influenza infection. The U.S. military 

helped develop one of the first FDA-licensed 

vaccines for the prevention of influenza infection composed of inactivated whole influenza virus. The vaccine prevents influenza 

infection and its rapid epidemic spread in 

close quarters and contact that otherwise 

can significantly impact military readiness 

and civilian productivity and potentially lead 

to death in the very young and old. It was 

completed in 1945. The U.S. military does 

not currently manufacture influenza vaccines, 

but GEIS contributes pertinent epidemiologic 

data regarding current influenza vaccine 

preparation.

Partners

y WRAIR

1-11
Japanese Encephalitis Vaccine (IXIAROR)

Description

Japanese Encephalitis Vaccine is used to protect against Japanese encephalitis. It affords U.S. 

forces the ability to deploy to Asia without the risk of contracting the severe Japanese encephalitis 

disease. Japanese encephalitis is a potential threat to U.S. forces throughout Asia. Mosquitoes 

that breed in rice fields transmit the virus to susceptible people. The virus can cause brain infection 

(encephalitis), which requires intensive medical treatment and evacuation. Outbreaks occur in Asia, 

the Pacific Islands, northern Australia, and Russia. Japanese Encephalitis Vaccine was licensed in 

1992 and is used to immunize approximately 80,000 troops each year. In 2005, the U.S. distributor 

of the vaccine notified the DoD that manufacturing of the vaccine in Japan would stop while a new 

vaccine was developed. 

Korean and Army scientists working at WRAIR succeeded in inventing and patenting a new Japanese 

Encephalitis Vaccine made from virus grown in cell culture, purified, and inactivated with formalin. 

The vaccine eventually was developed by Intercell and Vienna, Austria. Clinical trials were conducted in many locations, including WRAIR. In 2009, the new vaccine was licensed by the FDA. 

The Defense Supply Center awarded Intercell a contract to supply the DoD with the new Japanese 

Encephalitis Vaccine. The Centers for Disease Control and Prevention Advisory Committee on 

Immunization Practices published guidelines for vaccine use.

Partners

y WRAIR

y USAMMDA

y Intercell Biomedical

Meningococcal Vaccine 

(Menomune)

Description

The Meningococcal Vaccine, Menomune, is 

used to prevent meningococcal infection. It 

is a tetravalent vaccine, composed of purified 

components from the polysaccharide coating 

(A, C, Y, and W-135 but not B), used against 

the Neisseria meningitidis bacteria that is 

transmitted by respiratory droplets under 

close person-to-person contact. The vaccine 

prevents meningococcal infections that, if 

invasive, can lead to meningitis and sepsis 

with a 10–30 percent fatality rate. In addition, 

it reduces the risk of meningococcal disease 

outbreaks among military recruits and service 

members. Menomune was completed in 

1981.

Partners

y WRAIR

y Sanofi Pasteur

COMPLETED | PROMISING | FUTURE

1-12 PREVENTION

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Oral Live Typhoid Vaccine (Vivotif)

Description

Oral Live Typhoid Vaccine (Vivotif) is a 

live, attenuated oral vaccine used to protect against Salmonella typhi bacterium 

infection that is caused by the ingestion of 

contaminated food or contact with contaminated feces and can be spread by a healthy 

carrier of the bacterium. This vaccine 

prevents typhoid fever, an acute generalized illness with fever, headache, abdominal 

pain, mild rash, and bowel movement and 

mental changes. In combination with hygiene 

control, the vaccine reduces the likelihood of 

epidemic spread of the disease, particularly 

in areas that lack clean water and effective 

sanitation systems. Vivotif was completed in 

1989.

Partners

y NMRC

y Berna Biotech Ltd.

Pesticide Dispersal Unit, 

Multicapability, Helicopter Slung

Description

The Pesticide Dispersal Unit, Multicapability, 

Helicopter Slung is a multimode (solid/liquid) 

pesticide sprayer used for insect control that 

is powered by a hydraulic motor and attached 

beneath a helicopter via a sling with a cargo 

hook and controlled within the helicopter. 

This unit will improve the sustainability of U.S. 

forces in disease-carrying, insect-infested 

regions of the world. Completed in 1993, 

it was used successfully after Hurricane 

Andrew hit southern Florida in 1992.

Partners

y USAMMDA

Rubella Vaccine 

(Meruvax, now Meruvax II)

Description

Rubella Vaccine (Meruvax II) is a live, attenuated viral vaccine for the prevention of rubella 

(German measles), which spreads person-toperson via respiratory droplets, causes fever 

and rash, and can lead to serious fetal malformations in pregnant women. Completed 

in 1969, the introduction of the vaccine to the 

United States during the same year resulted 

in a drop from 47,745 cases (for the 3 years 

prior) to 345 cases in 1998. As of 2005, 

rubella virus infection has been eliminated in 

the United States.

Partners

y WRAIR

y Merck

COMPLETED | PROMISING | FUTURE

1-13
PREVENTION/THERAPEUTICS

COMPLETED | PROMISING | FUTURE

Chloroquine (Aralen)

Description

Chloroquine (Aralen) is an antimalarial drug 

for both the treatment and prevention of

P. falciparum and P. vivax malaria. It has 

rapidly controlled the clinical symptoms of 

susceptible malarias and is useful in prevention when taken once a week. Completed in 

1949, the emergence of chloroquine-resistant 

malaria parasites has limited the use of this 

drug.

Partners

y WRAIR

y Abbott

y Eli Lilly and Company

y E.R. Squibb and Sons

y Sanofi-Synthelabo

y Sharp and Dohme, Inc.

y Winthrop

Primaquine

Description

Primaquine is an antimalarial drug used 

for the treatment and prevention of relapsing malaria following P. vivax and P. ovale

infections. It attacks the liver stage of malaria 

parasites and reduces recurrent malaria 

caused by latent forms of the malaria parasites present in the liver after cessation of a 

prior preventive such as chloroquine. It also 

prevents malaria infection. Primaquine was 

completed in 1952.

Partners

y WRAIR

y University of Chicago

y Winthrop-Stearns, Inc.

Sulfadoxine-Pyrimethamine 

(Fansidar)

Description

Sulfadoxine-Pyrimethamine (Fansidar) is a 

drug used for the treatment and prevention of 

malaria, particularly chloroquine-primaquineresistant types, which acts by blocking folic 

acid to prevent replication of the malaria 

parasites. The occurrence of infrequent, but 

serious, adverse allergic reactions limits its 

use except in countries where chloroquineresistant malaria is widespread and other 

drugs are not available. SulfadoxinePyrimethamine (Fansidar) was completed in 

1983.

Partners

y WRAIR

y Hoffmann LaRoche, Inc.

1-14

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
DIAGNOSTICS

COMPLETED | PROMISING | FUTURE

Malaria Rapid Diagnostic Device

Description

Malaria constitutes a serious infectious disease threat to U.S. forces in times of war and peace in 

most tropical and some subtropical regions of the world. The Malaria Rapid Diagnostic Device 

(MRDD) permits field diagnosis of malaria infection and early intervention. Malaria is a potentially 

fatal illness with the ability to quickly incapacitate large numbers of personnel. Diagnosis must be 

rapid to initiate proper therapy in infected persons and prevent infection in others. 

The MRDD is a field-deployable, handheld, disposable, point-of-care test to detect the presence of 

malaria parasites in blood samples of persons with symptoms compatible with malaria. The MRDD 

test follows a simple procedure where a whole blood finger-stick sample is added to a sample pad. 

After 15 minutes, the results are displayed in a small window on the device. The speed and simplicity 

allow diagnosis and targeted treatment to occur in the same patient visit, allowing for improved patient 

outcomes. The MRDD kits were completed and FDA cleared in September 2009. The MRDD kits 

are marketed worldwide.

Partners

y WRAIR 

y USAMMDA

y Binax, Inc.

1-15
TREATMENT

COMPLETED | PROMISING | FUTURE

Chloroquine-Primaquine

Description

Chloroquine-Primaquine is a combination of 

two antimalarial drugs used in the treatment 

of P. vivax infection (see also Chloroquine 

and Primaquine). Combining the two drugs 

into a single treatment yields improved 

compliance with the two-drug treatment for 

relapsing . Chloroquine-Primaquine was 

completed in 1969.

Partners

y WRAIR

y Sanofi-Synthelabo

Atovaquone-Proguanil (Malarone)

Description

Atovaquone-Proguanil (Malarone) is a combination of two existing drugs for the treatment 

of P. falciparum malaria that acts on the 

malaria parasite by inhibiting essential synthesis pathways. The combination of drugs 

has an enhanced effectiveness over singledrug treatments for malaria and reduced 

side effects compared to other antimalarial 

drugs. Atovaquone-Proguanil (Malarone) was 

completed in 2000.

Partners

y WRAIR

y USAMRU-K

y GSK

1-16

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Diarrheal Disease Supplement

Description

Rehydration and antimicrobial treatment are the cornerstones of disease management, but even with 

early institution of appropriate therapy, diarrheal diseases exact a cost in terms of lost duty and effectiveness. An effective supplement that will aid in the treatment of diarrheal disease will enhance the 

sustainability of troops in regions of the world where diarrheal illnesses and dysentery are endemic.

There is no licensed drug or biologic that provides a safe, effective mode of prevention against 

diarrheal diseases, leaving an important deficiency in military and travel medicine. This project is 

developing bovine milk immunoglobulins as a supplement with activity against ETEC, the predominant 

cause of traveler’s diarrhea. The first of two clinical trials was completed in 2006. The trial showed 

that anti-adhesin BlgG antibodies afford significant protection against ETEC. Three additional clinical 

trials to be conducted during 2007–2008 are expected to solidify the foundation for future development of a product suitable for field testing.

Partners

y CDMRP

y NMRC

THERAPEUTICS 1-17
Intravenous Artesunate for Treatment of Severe Malaria

Description

Malaria constitutes a serious infectious disease threat to U.S. forces in times of war and peace in 

most tropical and some subtropical regions of the world. Even with the most sophisticated preventive 

drugs and strategies, there will still be cases of malaria. Because of this, our troops will be at risk of 

dying from severe malaria when a patient is comatose or cannot take oral drugs.

Quinidine gluconate has been the only parenteral drug available in the United States to treat U.S. 

military and civilian personnel who may get severe malaria. Unfortunately, quinidine has significant 

cardiotoxic activity and can induce heart failure. Therefore, the use of quinidine requires constant 

monitoring in an intensive care setting. A safer treatment for severe malaria is needed. 

Intravenous Artesunate will be used to treat severe malaria. Artesunate in an intravenous form is 

being developed as a replacement for quinidine. Artesunate is a derivation of the compound artemisinin, an antimalarial drug extracted from the Chinese herb Artemisia annua. The safety profile of 

artesunate is well established because it is used as a non-GMP (good manufacturing practice) drug 

in many parts of the world. The MIDRP is developing an FDA, GMP version of the drug for use in the 

United States and by U.S. troops.

Partners

y WRAIR

y USAMMDA

y Sigma-Tau Industrie Farmaceutiche Riunite S.p.A.

THERAPEUTICS

COMPLETED | PROMISING | FUTURE

1-18

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Topical Antileishmanial Treatment Drug (Paromomycin)

Description

The topical antileishmanial cream will enhance the survivability and sustainability of U.S. forces in endemic regions by allowing for local early lesion treatment. Additionally, it will prevent morale and personnel problems in a unit due to the loss of affected personnel for treatment. Currently, affected personnel 

are evacuated out of the theater of operations for daily intravenous injections with highly toxic investigational pentavalent antimony drugs. 

Cutaneous leishmaniasis is a potentially disfiguring and serious parasitic disease. Leishmaniasis is one of several names for various tropical diseases that 

are caused by protozoa of the genus Leishmania. The parasites are transmitted by sandflies in tropical and subtropical zones. The manifestations of this 

disease may be visceral, mucocutaneous, or cutaneous. This illness is predominantly found in tropical and subtropical areas in the Middle East, southwest 

Asia, the Mediterranean coast, sub-Saharan Africa, Mexico, and Central and South America. In addition, there have been confirmed reports of canine leishmaniasis cases in 21 states across the United States. Current therapy for cutaneous leishmaniasis requires intravenous administration of toxic, metal-based 

drugs (antimonials) that have undesirable side effects and toxicities including vomiting, diarrhea, pancreatitis, elevated liver enzymes, and at higher doses, 

pulmonary edema.

Paromomycin, a topical cream made from two aminoglycoside antibiotics (15 percent paromomycin, kills the Leishmania parasite, and .5 percent gentamicin, 

to prevent or limit secondary bacterial infections) formulated in an aquaphilic base, will allow for local early lesion treatment of simple and uncomplicated 

cutaneous leishmaniasis.

Partners

y WRAIR

y USAMMDA

y Pasteur Institute (Tunisia)

y Teva Pharmaceuticals USA

1-19
Leishmania PCR Diagnostic Device

Description

The Leishmania PCR Diagnostic Device is a 

SmartCycler-based qualitative detection of 

leishmaniasis spp. 16S rDNA and for the differentiation of L. major DNA from skin lesion 

scrapings and punch biopsies in individuals 

suspected of having cutaneous leishmaniasis. 

The device will take approximately 45 minutes 

to run and is highly specific and sensitive to 

both leishmaniasis genus and L. major. It is 

intended to be deployed worldwide at medical centers and at the WRAIR Leishmania

Diagnostics Laboratory.

Partners

y WRAIR

y USAMMDA

y Cepheid

Leishmania Rapid Diagnostic 

Device

Description

The Leishmania Rapid Diagnostic Device 

(LRDD) is a disposable, point-of-care test that 

will rapidly detect the presence of Leishmania

parasites in samples taken directly from skin 

lesions. It will take approximately 15 minutes 

to run and requires no special training to 

use. There are five sampling methods under 

evaluation to detect L. major and L. tropica. 

The LRDD will be able to be deployed as 

far forward as combat support hospitals, 

the threshold, and battalion aid stations, the 

objective location.

Partners

y WRAIR

y USAMMDA

y InBios International Inc.

Leishmania Skin Test

Description

The Leishmania Skin Test (LST) will be an 

FDA-approved intradermal test to screen 

U.S. service members who have been 

exposed to L. tropica parasites during deployment to leishmaniasis-endemic areas. The 

current diagnosis of leishmaniasis requires a 

microscopic exam of stained lesion smears or 

culture of parasites, capabilities not available 

to medical units.

The LST screening tool will take 48 hours and 

does not require an expert to read smears or 

culturing and indentifying parasites. The LST 

is currently in clinical trials with the industry 

partner sponsoring the Investigational New 

Drug and filing the ensuing license application 

with the FDA.

Partners

y WRAIR

y USAMMDA

y Allermed Laboratories, Inc.

DIAGNOSTICS

COMPLETED | PROMISING | FUTURE

1-20

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Rapid Human Diagnostic Assays

Description

Arthropod-borne pathogens constitute a serious infectious disease threat to U.S. forces in times of war and peace in most tropical and some subtropical 

regions of the world. Rapid Human Diagnostic (RHD) and Rapid Vector Diagnostic (RVD) tests permit field diagnosis of many different disease infections and 

increase the chances for early intervention. 

Many arthropod-borne pathogens cause serious illness with the ability to quickly incapacitate large numbers of personnel. Diagnosis must be rapid to initiate 

proper therapy in infected persons and prevent infection in others. 

RHDs and RVDs are field-deployable, handheld, disposable, rapid tests to detect the presence of medically important pathogens (Rift Valley fever virus, 

Chikungunya, Japanese encephalitis, and others) in blood samples of persons with fevers of unknown origin compatible with the diseases. The RVDs detect 

the presence of medically important pathogens from the vector itself (e.g., mosquitoes, ticks, and sandflies). The RHD tests follow a simple procedure where 

a whole blood finger-stick sample is added to a sample pad. After just 15 minutes, the result can be read. This speed and simplicity allows diagnosis and 

targeted treatment to occur in the same patient visit, allowing for improved patient outcomes. The RVD tests follow a simple procedure where insects are 

ground in solution and a “dipstick” is added to the solution. Results are seen as bands on the sample pad. RHD kits are to be FDA approved whereas the 

RVD kits do not have the same requirements.

Partners

y WRAIR

y USAMRIID

y InBIOS

y Panbio

y VecTOR Systems

1-21
PREVENTION

COMPLETED | PROMISING | FUTURE

Alternate Insect Repellent

Description

This new repellent will offer the greatest tactical flexibility of any arthropod-borne disease prevention strategy. Repellents can be applied effectively to prevent most arthropod-borne disease even if 

surveillance has not identified the pathogen. Repellents are often the only means of protection from 

arthropod-borne diseases in combat environments when vector control measures are not possible, 

when no vaccines exist for diseases in the deployment area of operations, or when the speed of 

military developments prevents the use of chemoprophylaxis or vaccines.

The current military insect repellent is ineffective against some disease vectors and has a very low 

service member acceptance rate. Because no commercially available repellents meet Army requirements, new effective repellent compounds and leading-edge formulation technologies are being 

explored and prioritized. A new military insect repellent that is completely acceptable to the user and 

maintains effectiveness under combat conditions is desired.

Partners

y WRAIR

1-22

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

y WRAIR

y USAMMDA

y NMRC

y USAMC-AFRIMS

y GSK Biologicals

y Hawaii Biotech Inc.

y Sanofi Pasteur (vaccines division of sanofiaventis Group)

y Vical Inc.

Dengue Fever Vaccine

Description

Dengue Tetravalent Vaccine will prevent mission-degrading, potentially lethal occurrences of dengue fever and dengue hemorrhagic fever in service members who are deployed to tropical and subtropical regions of the world, increasing the survivability and sustainability of U.S. forces.

There are four serotypes of dengue virus. Each serotype causes an acute, incapacitating illness characterized by severe head, muscle, joint, and eye pain 

with fever lasting 4 to 7 days. Subsequent infection with a different dengue virus can occur and may result in the more severe often fatal hemorrhagic form of 

the disease. Because of this, a dengue vaccine must be protective against all four dengue virus serotypes (provide “tetravalent immunity”). Dengue fever is 

a leading cause of hospital admissions in units operating in the tropics. There are currently no licensed vaccines or drugs to prevent or treat dengue fever or 

the often fatal dengue hemorrhagic fever.

Numerous approaches are being considered to develop a dengue vaccine. The WRAIR/GSK Biologicals dengue vaccine is a tetravalent, classically attenuated live virus vaccine that currently is being evaluated in clinical studies. WRAIR and GSK also are collaborating on the early phase development of a 

purified inactivated virus (PIV) dengue vaccine; the PIV is in preclinical development. The NMRC is developing a DNA-based vaccine. Numerous variations 

on the DNA theme are being attempted but, to date, only one monovalent candidate has been tested in a Phase 1 clinical trial. Both WRAIR and NMRC have 

collaborated with Hawaii Biotech in evaluations of their recombinant protein vaccine candidates; Hawaii Biotech has completed a Phase 1 monovalent study 

and is positioning to execute a tetravalent Phase 1 study. Several of those above under development are candidates for “prime-boost” strategies of immunization. Preliminary results suggest that prime-boost immunization strategies may provide tetravalent immunity. Priming with DNA or live, attenuated followed 

by boosting with purified inactivated or subunit vaccines are promising candidates.

Dengue Tetravalent Vaccine ChimeriVaxTM is a candidate chimeric vaccine constructed using the dengue virus components inserted into a yellow fever virus 

backbone. The ChimeriVax proprietary process was developed by Acambis, Inc. USAMRMC currently is assisting Sanofi Pasteur, owner of Acambis Inc., in 

the clinical development of this vaccine.

Partners

1-23
PREVENTION

COMPLETED | PROMISING | FUTURE

Diarrheal Disease Vaccines

 Campylobacter Vaccine

 ETEC Vaccine

 Shigella Vaccine

Description

Vaccines against Campylobacter, ETEC, and Shigella will enhance the sustainability of U.S. forces. Diarrheal diseases affect up to 50 percent of U.S. service 

members early and continuously in deployments to disease-endemic areas. Currently, there are no totally effective preventive medicine measures or vaccines to protect troops against these threats.

Campylobacter Vaccine: Campylobacter infections are sometimes complicated by a usually temporary but potentially serious inflammatory neurological 

disorder called Guillain-Barre Syndrome. The association of an oral whole-cell-killed Campylobacter vaccine approach with Guillain-Barre Syndrome has 

precluded any additional whole-cell-killed or attenuated vaccine efforts. A second-generation, potentially improved, recombinant protein-based vaccine is 

nearing the clinical testing phase. Results of a new vaccine approach using capsule conjugates will be compared with the protein subunit results.

ETEC Vaccine: ETEC is a common etiologic agent of diarrhea in the Middle East irrespective of combat phase or operational tempo. Current research is 

focused on developing a purified protein subunit vaccine against ETEC. The target antigens in this vaccine strategy are the major ETEC colonization factor 

antigens and nontoxic derivatives of heat-labile enterotoxin.

Shigella Vaccine: Shigella is the most common pathogen during combat phases in U.S. operations in the Middle East. Vaccines against Shigella flexneri, 

S. sonnei, and S. dysenteriae are under development. Two promising approaches are being evaluated: Invaplex extracts of Shigella bacteria that induce 

immunity when sprayed into the nose and live Shigella vaccines that are genetically modified and safely induce immunity following ingestion.

Partners

y WRAIR

y NMRC

1-24

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Drug for Malaria Prophylaxis

Description

New drug prophylactics and therapies used for the treatment of malaria will increase the survivability and sustainability of U.S. forces deployed in highly 

endemic areas. 

The malaria parasite, transmitted by infected mosquitoes, is developing resistance to current antimalarial prophylactic drugs, and resistance is now widespread in Africa and Asia. Symptoms can be fever and flu-like including shaking, chills, headache, muscle aches, and tiredness. If not treated promptly, one 

type of malaria, P. falciparum, may cause kidney failure, seizures, mental confusion, coma, and death. Two other types, P. vivax and P. ovale, concentrate in 

the liver cells, eventually emerging into the blood and causing disease. The most dangerous species, P. falciparum, moves out of the liver and into the blood 

in just a few days. 

Studies suggest that Tafenoquine suppresses both the liver and blood stages of the malaria parasite and their effects and also may block transmission from 

already infected individuals. Currently, Tafenoquine is under development as a radical cure and potential postexposure prophylaxis against P. vivax malaria 

as a replacement for Primaquine. Future studies will focus on Tafenoquine for prophylaxis against P. falciparum.

Partners

y WRAIR

y USAMMDA

y GSK

1-25
y WRAIR

y USAMRIID (Lethal Viruses)

y CDMRP (Adenovirus)

y USAMMDA (Prime-Boost: RTS,S/

Adjuvant + Adeno35CS)

y Army and Navy OCONUS Laboratories

y NMRC (Technology Base R&D)

y GSK (RTS,S + Adjuvant)

PREVENTION

COMPLETED | PROMISING | FUTURE

Malaria Vaccines

 Recombinant Vaccine (RTS,S + Adjuvant)

 P. falciparum RTS,S + MSP-1

 Malaria DNA Vaccine and Prime-Boost Approaches

 Adenovirus Vaccine Against P. falciparum

Description

A safe, well-tolerated malaria vaccine will provide protection against disease and prevent blood-stage infection. P. falciparum is the most immediately lifethreatening type of malaria, causing massive destruction of the body’s red blood cells. Currently, there are no licensed vaccines, and the malaria parasite 

continues to develop resistance to new drugs used for treatment or prevention. Initially, P. falciparum malaria vaccines were being developed, but a combined 

vaccine to protect against all types of malaria is the long-term goal.

Recombinant Vaccine (RTS,S + Adjuvant): One P. falciparum malaria vaccine candidate consists of the RTS,S recombinant malaria protein antigen combined with a proprietary adjuvant from industry partner GSK.

P. falciparum RTS,S + MSP-1: This vaccine consists of the RTS,S recombinant protein antigen combined with an additional malaria antigen component.

Malaria DNA Vaccine and Prime-Boost Approaches: Investigators have demonstrated substantial protection using a combination of malaria DNA and pox 

virus. Another approach has been to combine RTS,S with adenovirus 35 (an uncommon adenovirus serotype against which little natural immunity exists). 

The prime-boost combination will consist of RTS,S/Adjuvant + Adeno35CS vaccines. 

Adenovirus Vaccine Against P. falciparum: A multicomponent adenovirus vaccine containing five promising antigens of P. falciparum will be used as a 

boost in combination with a DNA priming vaccine.

Partners

1-26

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Meningococcal Type B Vaccine

Description

Meningococcal meningitis is fortunately uncommon but causes a devastating illness, and a single case of meningitis can result in major disruptions of military 

operations and training because of the need for preventive and assessment measures. Five types of meningococcus (A, C, Y, W-135, and B) cause 80 percent of meningococcal meningitis. DoD researchers have contributed to the development of a licensed tetravalent vaccine protecting against types A, C, Y, 

and W-135. Development of a vaccine protective against type B meningococcus is under way; the ultimate goal is a pentavalent vaccine. Candidate monovalent meningococcal Group B vaccines have been shown to provide protection against strains of the same subtype in 50 to 80 percent of vaccinated subjects, 

and work is continuing to develop a polyvalent vaccine to provide wider protection against Group B meningococcus.

Meningococcal meningitis is an acute bacterial disease that occurs commonly in young adults, in males more than females, and particularly in newly aggregated adults under crowded living conditions such as barracks. It is a threat to service members in basic and advanced training, especially during major 

military mobilizations. The disease is prevalent in sub-Saharan Africa and South America and is potentially life threatening or permanently debilitating. New, 

virulent Group B clones have caused prolonged epidemics in at least five countries during the past 20 years.

Monovalent Group B vaccines are effective in protecting against disease only if they are made from the specific strain of the organism causing the outbreak. 

A polyvalent vaccine derived from three different strains is being developed to provide broad coverage against Group B organisms. Both intranasal and 

intramuscular routes of administration are being examined.

Partners

y WRAIR

1-27
PREVENTION

COMPLETED | PROMISING | FUTURE

Military HIV Research Program

 HIV Vaccine

 HIV Research Program

Description

An HIV vaccine will enhance survivability and sustainability of U.S. forces worldwide. Furthermore, an HIV vaccine will promote political, social, and economic stability, thereby deterring conflict and the need for U.S. intervention in areas where HIV is causing significant morbidity and mortality.

HIV poses a threat to U.S. military forces and is a national and global security issue. The magnitude of this disease is so great that it could destabilize 

foreign governments and slow economic growth worldwide. About 300 new cases of HIV occur annually among U.S. Army personnel, and it is estimated that 

30 percent of these HIV infections are acquired during overseas deployments, predominantly from the less developed countries of sub-Saharan Africa, Asia, 

and South America. According to the Central Intelligence Agency, HIV/AIDS will probably cause more deaths than any other single infectious disease and 

account for at least half of infectious disease deaths worldwide by 2020. 

HIV Vaccine: Currently, there is no effective vaccine to prevent HIV infections. A potential HIV vaccine candidate was evaluated in HIV-naïve volunteers 

using a prime-boost strategy. The HIV prime-boost vaccine consists of a prime with a recombinant canarypox virus expressing the products of three HIV-1 

genes and a boost with a recombinant vaccine containing the envelope proteins for HIV types E and B. The prime-boost vaccine approach is being used to 

induce both cellular and humoral immunity to HIV. A clinical trial conducted by WRAIR in collaboration with NIAID/Thai Ministry of Public Health using this 

candidate demonstrated the first-ever success in preventing HIV infection. While this vaccine gave modest protection, the Military HIV Research Program 

(MHRP) is evaluating novel vaccination strategies using modified vaccinia Ankara as a delivery vehicle. Initial Phase 1 clinical trials conducted in the United 

States and overseas showed that these vaccines are safe and immunogenic.

HIV Research Program: The HIV Research Program is mandated to develop a safe and effective HIV-1 vaccine against all HIV-1 subtypes (A, B, C, D, and 

E). Regional overseas laboratories, along with additional research sites, play a key role in this effort to test candidate vaccines for global protection. The 

MHRP collaborates with many U.S. and international agencies and research institutes, including close collaboration with NIAID. Its successful partnerships 

with host country governments, universities, and community organizations help leverage research dollars and expertise, accelerating the progress toward a 

globally effective vaccine. 

1-28

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Partners

y WRAIR

y USAMMDA

y AFRIMS

y NIAID (prime-boost)

y Sanofi Pasteur

y VaxGen

COMPLETED | PROMISING | FUTURE

Vaccines to Prevent Hemorrhagic Fever with Renal Syndrome

Description

Vaccine products are designed to provide protection against all four hantaviruses and enhance the 

sustainability of U.S. forces in regions of the world where hantaviruses are endemic.

HFRS is a problem throughout Asia and Europe that has caused life-threatening illness in thousands 

of service members. The virus is usually transmitted to humans via exposure to aerosols created 

when infected rodents’ urine, feces, or saliva is released onto environmental surfaces. After an incubation period of approximately 1–4 weeks, a patient may develop fever, kidney dysfunction, alterations 

of blood pressure, accumulation of fluid in the lungs, and blood-clotting problems.

Two vaccine approaches are under evaluation. The first is a DNA vaccine expressing Hantaan 

virus M segment expected to protect humans from HFRS caused by Hantaan virus, Seoul virus, 

and Dobrava virus but not Puumala virus. The second is a Puumala virus DNA vaccine expected to 

protect humans from HFRS caused by Puumala virus.

Partners

y USAMRIID

1-29
Antimalarial Drugs

Description

Development of a new drug for the chemoprophylaxis of malaria will increase the survivability and sustainability of U.S. forces deployed in highly endemic 

areas. A safe, effective, and well-tolerated drug that will prevent malaria infection is required to replace current antimalarial drugs in use for which compliance 

is poor and parasite resistance is increasing.

The malaria parasite, transmitted by infected mosquitoes, is developing resistance to current antimalarial prophylactic drugs, and resistance is now widespread in Africa and Asia. Symptoms can be fever and flu like, including shaking, chills, headache, muscle aches, and tiredness. If not treated promptly, one 

type of malaria, P. falciparum, may cause kidney failure, seizures, mental confusion, coma, and death. Two other types, P. vivax and P. ovale, concentrate in 

the liver cells, eventually emerging into the blood and causing disease. The most dangerous species, P. falciparum, moves out of the liver and into the blood 

in just a few days.

No effective malaria vaccine yet exists, and currently employed personal protective measures are ineffective in the prevention of malaria. There are compliance issues, side effects, and potential resistance problems with currently used antimalarial drugs.

Efforts are now focusing on the development of a drug that will be administered orally with no more than a weekly dosing. Several candidates have been 

identified and are in early clinical trials for safety, efficacy, and proof-of-concept testing.

Partners

y WRAIR

y USAMMDA

y AFRIMS

y World Health Organization Medicines for Malaria Venture

THERAPEUTICS

COMPLETED | PROMISING | FUTURE

1-30

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
1-31
PUBLICATIONS

1. Al Awaidy SA, Bawikar S, Al Busaidy S, 

Baqiani S, Al Abedani I, Varghese R, Abdoan 

HS, Al Abdoon H, Bhatnagar S, Al Hasini KS, 

Mohan P, Shah S, Elamir E, Klena J, Ahmed 

SF, Teleb N, Parashar U, and Patel MM. 

Considerations for introduction of a rotavirus 

vaccine in Oman: Rotavirus disease and 

economic burden. J Infect Dis, 2009, 200 

Suppl 1: S248-53.

2. A new Japanese encephalitis vaccine 

(Ixiaro). Med Lett Drugs Ther, 2009 Aug 24, 

51(1319): 66-7. PubMed PMID: 19696707.

3. Arroyo M, Sateren WB, Foglia G, Kibaya R, 

Langa L, Wassuna M, Bautista CT, Scott PT, 

Shaffer DN, Robb ML, Michael NL, Birx DL, 

and McCutchan FE. HIV-1 genetic diversity 

among tea plantation workers in Kericho, 

Kenya. AIDS and Human Retroviruses, 2009 

Nov, 25(11): 1061-4.

4. Arroyo MA, Phanuphak N, Krasaesub 

S, Sirivichayakul S, Assawadarachai V, 

Poltavee K, Pankam T, Ananworanich J, 

Paris R, Tovanabutra S, Kijak G, McCutchan 

FE, Phanuphak P, Kim JH, and de Souza 

M. Increased prevalence of non-CRF01_AE 

HIV-1 strains among high-risk clients 

attending the Thai red cross anonymous 

clinic in Bangkok, Thailand. AIDS Res Hum

Retroviruses, 2010, 26: 5-12.

5. Baqar S, Applebee LA, Gilliland TC 

Jr, Lee LH, Porter CK, and Guerry P. 

Immunogenicity and protective efficacy of 

recombinant Campylobacter jejuni flagellumsecreted proteins in mice. Infect Immun, 

2008, 76: 3170-5.

6. Baqar S, Tribble DR, Carmolli M, Sadigh K, 

Poly F, Porter C, Larsson CJ, Pierce KK, 

Guerry P, Darsley M, and Kirkpatrick B. 

Recrudescent Campylobacter jejuni infection 

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SD, Rockabrand DM, Frenck RW, Rozmajzl 

P, Kilbane E, Fox A, Ruck R, Lim M, 

Johnston J, Murphy E, and Sanders JW. The 

epidemiology of travelers’ diarrhea in Incirlik, 

Turkey: A region with a predominance of 

heat-stabile toxin producing enterotoxigenic 

Escherichia coli. Diagn Microbiol Infect Dis, 

2010, 66: 241-7.

90. Porter CK, Tribble DR, Aliaga PA, Halvorson 

HA, and Riddle MS. Infectious gastroenteritis 

and risk of developing inflammatory bowel 

disease. Gastroenterology, 2008, 135: 781-6.

91. Porter CK, Tribble DR, Halvorson H, Putnam 

SD, Sanders JW, and Riddle MS. Crosssectional survey of anthrax vaccine coverage 

and KAP among deployed U.S. military. Hum 

Vaccin, 2009, 5: 765-9.

92. Ranallo RT, Kaminski RW, George T, Kordis 

AA, Chen Q, Szabo K, and Venkatesan 

MM. Virulence, inflammatory potential, 

and adaptive immunity induced by Shigella 

flexneri msbB mutants. Infect Immun, 2010, 

78: 400-12.

93. Raviprakash K, Wang D, Ewing D, Holman 

DH, Block K, Woraratanadharm J, Chen L, 

Hayes C, Dong JY, and Porter K. A tetravalent dengue vaccine based on a complex 

adenovirus vector provides significant 

protection in rhesus monkeys against all four 

serotypes of dengue virus. J Virol, 2008, 

82(14): 6927-6934.

94. Rerks-Ngarm S, Pitisuttithum P, Nitayaphan 

S, Kaewkungwal J, Chiu J, Paris R, Premsri 

N, Namwat C, de Souza M, Adams E, 

Benenson M, Gurunathan S, Tartaglia J, 

McNeil JG, Francis DP, Stablein D, Birx DL, 

Chunsuttiwat S, Chirasak Khamboonruang 

C, Thongcharoen P, Robb ML, Michael NL, 

Kunasol P, and Kim JH, for the MOPH–

TAVEG Investigators*. Vaccination with 

ALVAC and AIDSVAX to Prevent HIV-1 

Infection in Thailand. NEJM, 2009, 361. 

http://content.nejm.org/cgi/content/full/

NEJMoa0908492.

95. Riddle MS. There is more to the story. 

J Travel Med, 2008, 15: 281-2.

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96. Riddle MS, Arnold S, and Tribble DR. Effect 

of adjunctive loperamide in combination 

with antibiotics on treatment outcomes in 

traveler’s diarrhea: A systematic review 

and meta-analysis. Clin Infect Dis, 2008, 

47: 1007-14.

97. Riddle MS, Patel SS, Sanders JW, 

Armstrong AW, Putnam SD, Schlett CD, and 

Tribble DR. Attitudes toward predeployment 

and experimental vaccinations among troops 

deployed to operation Iraqi freedom and 

operation enduring freedom. J Travel Med,

2008, 15: 68-76.

98. Riddle MS, Sanders JW, Jones JJ, and 

Webb SC. Self-reported combat stress 

indicators among troops deployed to Iraq 

and Afghanistan: An epidemiological study. 

Compr Psychiatry, 2008, 49: 340-5.

99. Riddle MS and Tribble DR. Reaching a 

consensus on management practices and 

vaccine development targets for mitigation 

of infectious diarrhea among deployed U.S. 

military forces. J Eval Clin Pract, 2008, 

14: 266-74.

100. Riddle MS, Tribble DR, Cachafiero SP, 

Putnam SD, and Hooper TI. Development of 

a travelers’ diarrhea vaccine for the military: 

How much is an ounce of prevention really 

worth? Vaccine, 2008, 26: 2490-502.

101. Riddle MS, Tribble DR, Putnam SD, Mostafa 

M, Brown TR, Letizia A, Armstrong AW, and 

Sanders JW. Past trends and current status 

of self-reported incidence and impact of disease and nonbattle injury in military operations in Southwest Asia and the Middle East. 

Am J Public Health, 2008, 98: 2199-206.

102. Saathoff E, Pritsch M, Geldmacher C, 

Koehler RN, Maboko L, Maganga L, Geis 

S, McCutchan FE, Kijak GH, Kim J, Arroyo 

MA, Gerhardt M, Tovanabutra S, Robb M, 

Williamson C, Michael N, and Hoelscher 

M. Viral and host factors associated with 

the HIV-1 viral load setpoint in adults from 

Mbeya Region, Tanzania. J Acquir Immune 

Deficiency Syn, 2010, 54: 324-331.

103. Sabra AH, Araj GF, Kattar MM, Abi-Rached 

RY, Khairallah MT, Klena JD, and Matar 

GM. Molecular characterization of ESBLproducing Shigella sonnei isolates from 

patients with bacilliary dysentery in Lebanon. 

J Infect Dev Ctries, 2009, 3: 300-5.

104. Sanders JW, Frenck RW, Putnam SD, Riddle 

MS, Johnston JR, Ulukan S, Rockabrand 

DM, Monteville MR, and Tribble DR. 

Azithromycin and loperamide are comparable to levofloxacin and loperamide for the 

treatment of traveler’s diarrhea in United 

States military personnel in Turkey. Clin 

Infect Dis, 2007, 45: 294-301.

105. Sanders JW, Fuhrer GS, Johnson MD, and 

Riddle MS. The epidemiological transition: 

The current status of infectious diseases in 

the developed world versus the developing 

world. Sci Prog, 2008, 91: 1-37.

106. Sandström E, Nilsson C, Hejdeman B, 

Bråve A, Bratt G, Robb M, Cox J, VanCott 

T, Marovich M, Stout R, Aboud S, Bakari M, 

Pallangyo K, Moss B, Earl P, Michael N, Birx 

D, Mhalu F, Wahren B, Biberfeld G, et al. for 

the HIVIS study group. Broad immunogenicity of a multigene, multiclade HIV-1 DNA 

vaccine boosted with heterologous HIV-1 

recombinant modified vaccinia virus Ankara. 

Journal of Infectious Disease, 2008 Nov 15, 

198(10): 1482-90.

107. Shaffer DN, Ngetich IK, Bautista CT, Sawe 

FK, Renzullo PO, Scott PT, Kibaya RM, 

Imbuki KO, Michael NL, Birx DL, Wasunna 

MK, and Robb ML. HIV-1 incidence rates 

and risk factors in agricultural workers and 

dependents in rural Kenya: 36-month followup of the Kericho HIV cohort study. J Acquir 

Immune Defic Synd, 2009, In press.

108. Shaheen HI, Abdel Messih IA, Klena JD, 

Mansour A, El-Wakkeel Z, Wierzba TF, 

Sanders JW, Khalil SB, Rockabrand DM, 

Monteville MR, Rozmajzl PJ, Svennerholm 

AM and Frenck RW. Phenotypic and genotypic analysis of enterotoxigenic Escherichia 

coli in samples obtained from Egyptian children presenting to referral hospitals. J Clin 

Microbiol, 2009, 47: 189-97.

109. Simasathien S, Thomas SJ, Watanaveeradej 

V, Nisalak A, Barberousse C, Innis BL, 

Sun W, Putnak JR, Eckels KH, Hutagalung 

Y, Gibbons RV, Zhang C, De La Barrera 

R, Jarman RG, Chawachalasai W, and 

Mammen MP Jr. Safety and Immunogenicity 

of a Tetravalent Live-attenuated Dengue 

Vaccine in Flavivirus Naive Children. Am J 

Trop Med Hyg, 2008, 78(3): 426-433.

110. Simmons M, Burgess T, Lynch J, and Putnak 

R. 2010. Protection against dengue virus by 

non-replicating and live attenuated vaccines 

used together in a prime boost vaccination 

strategy. Virology, 396(2): 280-288.

111. Skeehan CD, Tribble DR, Sanders JW, 

Putnam SD, Armstrong AW and Riddle MS. 

Nonbattle injury among deployed troops: 

an epidemiologic study. Mil Med, 2009, 

174: 1256-62.

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112. Smith DR, Lee JS, Jahrling J, Kulesh DA, 

Turell MJ, Groebner JL, and O’Guinn ML. 

Development of field-based real-time reverse 

transcription-polymerase chain reaction 

assays for detection of Chikungunya and 

O’nyong-nyong viruses in mosquitoes. Am J 

Trop Med Hyg, 2009 Oct, 81(4): 679-84.

113. Soltis BW, Sanders JW, Putnam SD, Tribble 

DR and Riddle MS. Self reported incidence 

and morbidity of acute respiratory illness 

among deployed U.S. military in Iraq and 

Afghanistan. PLoS One, 2009, 4: e6177.

114. Tate JE, Bunning ML, Lott L, Lu X, Su J, 

Metzgar D, Brosch L, Panozzo CA, Marconi 

VC, Faix DJ, Prill M, Johnson B, Erdman DD, 

Fonseca V, Anderson LJ, and Widdowson 

MA. Outbreak of severe respiratory disease 

associated with emergent human adenovirus 

serotype 14 at a U.S. air force training facility 

in 2007. J Infect Dis, 2009, May 15, 199(10): 

1419-26. PubMed PMID: 19351260.

115. Tauber E, Kollaritsch H, von Sonnenburg 

F, Lademann M, Jilma B, Firbas C, Jelinek 

T, Beckett C, Knobloch J, McBride WJ, 

Schuller E, Kaltenböck A, Sun W, Lyons 

A. Randomized, double-blind, placebocontrolled phase 3 trial of the safety and 

tolerability of IC51, an inactivated Japanese 

encephalitis vaccine. J Infect Dis, 2008 Aug 

15, 198(4): 493-9. Erratum in: J Infect Dis, 

2010 Apr 15, 201(8): 1278. PubMed PMID: 

18588481.

116. Tchesnokova V, McVeigh AL, Kidd B, 

Yakovenko O, Thomas WE, Sokurenko EV, 

and Savarino SJ. Shear-enhanced binding 

of intestinal colonization factor antigen I 

of enterotoxigenic Escherichia coli. Mol 

Microbiol, 2010, 76: 489-502.

117. Teague NS, Srijan A, Wongstitwilairoong B, 

Poramathikul K, Champathai T, Ruksasiri S, 

Pavlin J, and Mason CJ. Enteric pathogen 

sampling of tourist restaurants in Bangkok, 

Thailand. J Travel Med, 17: 118-23.

118. Thomas SJ, Hombach J, and Barrett A. 

Scientific consultation on cell mediated 

immunity (CMI) in dengue and dengue 

vaccine development. Vaccine, 2009, 27(3): 

355-368.

119. Tribble DR, Baqar S, Carmolli MP, Porter C, 

Pierce KK, Sadigh K, Guerry P, Larsson CJ, 

Rockabrand D, Ventone CH, Poly F, Lyon CE, 

Dakdouk S, Fingar A, Gilliland T, Daunais P, 

Jones E, Rymarchyk S, Huston C, Darsley 

M, and Kirkpatrick BD. Campylobacter jejuni

strain CG8421: A refined model for the study 

of Campylobacteriosis and evaluation of 

Campylobacter vaccines in human subjects. 

Clin Infect Dis, 2009, 49: 1512-9.

120. Tribble DR, Baqar S, Pang LW, Mason 

C, Houng HS, Pitarangsi C, Lebron C, 

Armstrong A, Sethabutr O, and Sanders 

JW. Diagnostic approach to acute diarrheal 

illness in a military population on training 

exercises in Thailand, a region of campylobacter hyperendemicity. J Clin Microbiol, 

2008, 46: 1418-25.

121. Tribble DR, Baqar S, Scott DA, Oplinger 

ML, Trespalacios F, Rollins D, Walker RI, 

Clements JD, Walz S, Gibbs P, Burg EF III, 

Moran AP, Applebee L, and Bourgeois AL. 

Assessment of the duration of protection in 

Campylobacter jejuni experimental infection 

in humans. Infect Immun, 2010, 78: 1750-9.

122. Turbyfill KR, Kaminski RW, and Oaks EV. 

Immunogenicity and efficacy of highly purified invasin complex vaccine from Shigella 

flexneri 2a. Vaccine, 2008, 26: 1353-64.

123. Turell MJ, Linthicum KJ, Patrican LA, Davies 

FG, Kairo A, and Bailey CL. Vector competence of selected African mosquito (Diptera: 

Culicidae) species for Rift Valley fever virus. 

J Med Entomol, 2008, 45: 102-108.

124. Turell MJ, O’Guinn ML, Dohm D, Zyzak M, 

Watts D, Fernandez R, Calampa C, Klein 

TA, and Jones JW. Susceptibility of Peruvian 

mosquitoes to eastern equine encephalitis 

virus. J Med Entomol, 2008 Jul, 45(4): 720-5.

125. Turell MJ, Sardelis MR, Jones JW, Watts 

DM, Fernandez R, Carbajal F, Pecor JE, and 

Klein TA. Seasonal distribution, biology, and 

human attraction patterns of mosquitoes 

(Diptera: Culicidae) in a rural village and 

adjacent forested site near Iquitos, Peru. 

J Med Entomol, 2008 Nov, 45(6): 1165-72.

126. Turell MJ, Sardelis MR, Jones JW, Watts 

DM, Fernandez R, Carbajal F, Wooster M, 

Pecor J, Calampa C, and Klein TA. Seasonal 

distribution, biology, and human attraction 

patterns of mosquitoes (Diptera: Culicidae) 

in a rural village and adjacent forested area 

near Iquitos, Peru. J Med Entomol, 2008, 

45: 1165-1172.

127. Vigil A, Ortega R, Nakajima-Sasaki R, Pablo 

J, Molina DM, Chao CC, Chen HW, Ching 

WM, and Felgner PL. Genome-wide profiling 

of humoral immune response to Coxiella 

burnetii infection by protein microarray. 

Proteomics, 2010 Jun, 10(12): 2259-69.

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128. Wierzba TF, Abdel-Messih IA, Gharib B, 

Baqar S, Hendaui A, Khalil I, Omar TA, 

Khayat HE, Putnam SD, Sanders JW, Ng 

LK, Price LJ, Scott DA, and Frenck RR. 

Campylobacter infection as a trigger for 

Guillain-Barre syndrome in Egypt. PLoS 

One, 2008, 3: e3674.

129. Wu S-J, Pal P, Ekanayake SE, Greenwald D, 

Lara S, Raviprakash K, Kochel T, Porter K, 

Hayes C, Nelson W, and Callahan J. A dryformat field-deployable quantitative reverse 

transcriptase-PCR assay for diagnosis of 

dengue infections. Am J Trop Med Hyg, 

2008, 79: 505–510.

130. Wulan WN, Listiyaningsih E, Samsi KM, 

Agtini MD, Kasper MR, and Putnam SD. 

Identification of a rotavirus G12 strain, 

Indonesia. Emerg Infect Dis, 2010, 

16: 159-61.

131. Yokoyama T, Paek S, Ewing CP, Guerry 

P, and Yeo HJ. Structure of a sigma28-

regulated nonflagellar virulence protein 

from Campylobacter jejuni. J Mol Biol, 2008, 

384: 364-76.

132. Youssef FG, Adib I, Riddle MS, and Schlett 

CD. A review of cryptosporidiosis in Egypt. 

J Egypt Soc Parasitol, 2008, 38: 9-28.

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Military 

Operational 

Medicine

Clinical and 

Rehabilitative 

Medicine

Medical Chemical 

and Biological 

Defense

Advanced 

Technologies

Logistics

Appendices

Military Infectious 

Diseases

Combat 

Casualty Care
Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

OVERVIEW

Caring for combat casualties is constrained by logistics, manpower, 

and the hostile operational environment. Eighty-six percent of all 

battlefield deaths occur within the first 30 minutes after wounding, 

making the ability to rapidly locate, diagnose, and treat injuries 

vital to reversing the historical outcomes of battlefield injuries. The 

Combat Casualty Care Research Program’s goals are to reduce the 

killed-in-action rate of American troops by 25 percent, reduce the 

morbidity of combat injuries, and reduce the medical footprint on 

the battlefield. 

Several factors complicate providing combat casualty care. Military 

casualties may wait for hours before definitive health care can be 

provided. Initial treatment and subsequent evacuation occur in 

austere environments characterized by limited supplies and limited 

diagnostic and life-support equipment. Further, providing acute 

and critical care is labor intensive and must frequently be provided 

by non-physician medical personnel. The primary challenge for 

combat casualty care research is overcoming these limitations by 

providing biologics, pharmaceuticals, and devices that enhance the 

capability of first responders to effectively treat casualties as close 

as possible to the location and time of injury.

Minimizing Blood Loss and Optimizing Fluid 

Resuscitation

Since mid-World War II, nearly 50 percent of combat deaths have 

been due to exsanguinating hemorrhage. Of those, about half 

could have been saved if timely, appropriate care had been available. Postmortem study of casualties in Operation Iraqi Freedom 

suggests that up to 18 percent of all battlefield deaths can be 

prevented with improved measures to stop and treat severe hemorrhage associated with combat injury. The Army and Department 

of Defense (DoD) seek new technologies and products that can 

reduce morbidity and mortality of severe battlefield hemorrhage. 

The Army’s research and product development efforts focus on discovery and development of technologies and products that enhance 

far-forward capabilities for control, resuscitation, and stabilization of 

casualties with severe hemorrhage and technologies that enhance 

capabilities for the preservation of vital tissues and reduction of 

morbidity and mortality as a consequence of severe hemorrhage.

Current technologies and products under investigation or in development include:

y Lyophilized plasma and platelets

y Cryopreserved (frozen) platelets

y Extended shelf-life (8 weeks) red blood cells

y Recombinant, activated factor VII and other blood clotting factors 

for treatment of clotting abnormalities associated with severe 

hemorrhage

y New bandages and other agents that may be applied to stop 

external bleeding

y Simple fluid warming and administration devices

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

2-2
y Treatments to enhance blood flow and oxygen delivery to vital 

tissues that can:

» Prevent cell death or organ failure

» Reduce or eliminate oxygen starvation and tissue injury associated with resupply of fluids during resuscitation

» Prevent secondary brain or spinal cord injury

» Prevent reduction of immune system protection and serious 

infection associated with shock and resuscitation

» Reduce injury to vital tissues by reducing demand for oxygen 

and other vital nutrients during shock

» Prevent bacteria from crossing the bowel wall into the blood 

stream as a consequence of shock

y Fieldable rapid test kits for testing walking blood donors for 

blood-borne pathogens and for blood typing

y Fundamental investigations of vascular and tissue responses to 

fluid resuscitation

Treatments for Battle and Non-Battle Injuries

This science and technology effort includes:

y Refining of closed-loop control algorithms for automated delivery 

of oxygen, ventilation, and fluids

y Development of noninvasive sensors to determine tissue viability 

and perfusion

y Identification and testing of techniques, drugs, and treatments to 

enhance vascular repair

y Techniques and assessments for commercial materiel developments applicable to surgical management of primary ballistics 

and thermal burn injuries

y Techniques for management of primary blast, crush, and chemical burn injuries

y Defining predictive vital signs for use in tools that assist in deciding to implement life-saving interventions

y Development of simulators for use in training caregivers on 

trauma treatment techniques

Examples of specific products or efforts that may be addressed 

include materiel for the pharmacological or surgical management 

of high-velocity ballistics, fragment, and blast injuries. Materiel 

of interest also includes agents, including autologous stem cells, 

which promote neuronal regeneration, bone repair and regeneration, and vascular healing and regeneration; treatment of chemical 

burns; and equipment and procedures for emergency airway management and mechanical ventilation of severely injured casualties.

2-3
Meeting Program Goals

Battlefield conditions impose severe constraints on available 

manpower, equipment, and medical supplies for casualty care. A 

premium is placed on medical interventions that can be used on 

the battlefield or as close to it as possible, before or during medical 

evacuation, preferably by medical corpsmen. Medical materiel must 

be easily transportable (i.e., small, lightweight, and durable); devices 

must be easy to use, low maintenance, with self-contained power 

sources as necessary; and drugs and biologics, ideally, should not 

require refrigeration or other special handling.

More specifically, the program’s efforts address:

y Products and methods that reduce the number of battlefield 

deaths due to hemorrhage

y Pathogen inactivation in blood products to reduce transfusioninduced morbidity and mortality

y Techniques and technologies that improve the acquisition and 

availability of blood products and reduce the medical and logistical requirements to care for battlefield casualties

y The best fluids and strategies for resuscitation to improve survival when evacuation is delayed and resources are limited

y Advanced, noninvasive physiologic sensors and diagnostics 

for detecting penetrating or blunt trauma wounding events and 

remote triage of visible wounds and traumatic brain injury

y Automated critical care life support

y Tissue regeneration

y Prevention and treatment of dental disease

y Neuroprotective treatment strategies that significantly improve 

the prognosis for a service member’s functional recovery from 

brain and spinal cord injuries

y Technology and training aids to render self-aid and buddy aid

The resulting combat casualty care products listed in this section 

are divided into the following subcategories:

y Hemorrhage Control/Resuscitation Strategies 

y Hard and Soft Tissue Injury 

y Neuroprotective Treatment Strategies 

y Trauma Management Systems

y Training

y Dental

Training

Two compelling needs underpin the Command’s simulation and 

training technology research portfolio: (1) The DoD’s requirement to train 100,000 military health care personnel annually 

and (2) increasing national interest in reducing medical errors. 

This spans from point of wounding, to combat casualty care, to 

surgical care given in fully equipped fixed medical facilities. An 

integrated research team, convened in February 2000, developed 

an integrated strategic plan. Research is being conducted in four 

general categories: (1) Personal Computer (PC)-based Interactive 

Multimedia, (2) Digitally Enhanced Mannequins, (3) Part-Task 

Trainers, and (4) Total Immersion Virtual Reality. Several funding sources are being invested: congressionally sponsored, Small 

Business Innovation Research (SBIR), innovation, and dual-use 

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Casualty

Care
funds. More than 150 separate projects—some small, some 

large—have been conducted with a cumulative investment of more 

than $60 million since 1999, making it the DoD’s largest investor 

in science and technology research. The strategy is to identify 

enabling technologies, mature them into components, integrate 

those components into simulation-based training systems, and 

validate them to determine the degree to which they transfer skills 

learned via simulation to the practice of actual patient care. The 

future plan is to (1) continue identifying and developing enabling 

technologies; (2) continue training transfer studies; (3) support 

open source and architecture standards; (4) facilitate convergences between science and technology research areas and surgical 

robotics, education and entertainment, and virtual reality applied 

to behavioral health; and (5) emphasize transition of products to 

relevant military and private sector end-user communities.

2-5
COMPLETED | PROMISING | FUTURE

HEMORRHAGE CONTROL/

RESUSCITATION STRATEGIES

Chitosan Hemorrhage Control Dressing (HemCon Bandage)

Description

The Chitosan Hemorrhage Control Dressing adheres to an injury site to form a clot and stop severe 

bleeding. This dressing is manufactured from chitosan, a natural biomaterial obtained from shellfish. 

Once applied, the Chitosan Hemorrhage Control Dressing tightly adheres to an injury site forming a 

durable clot. The dressing will stop severe external arterial and venous bleeding. The U.S. Food and 

Drug Administration cleared the dressing for external use in November 2002 and later expanded the 

dressing’s indication to include use as an antibacterial barrier in June 2005. Named one of the Army’s 

10 Greatest Inventions for 2004, the development of a chitosan dressing for internal surgical use is 

currently under way. While effective, it has been replaced by a more flexible kaolin-treated gauze that 

performs better.

Partners

y USAISR

y USAMMA

y HemCon, Inc.

Combat Application Tourniquet

Description

The Combat Application Tourniquet (CAT) is a 

lightweight, easy-to-use tourniquet for hemorrhage control in severely bleeding extremities. The CAT is a strap-type tourniquet with 

a built-in stick or windlass for tightening. It 

allows rapid, effective control of extremity 

hemorrhage for self, buddy, or medic application in far-forward locations and is included 

as a component of the Improved First Aid 

Kit. The CAT was named one of the Army’s 

10 Greatest Inventions for 2005.

Partners

y USAISR

y USAMMA

y USAMMDA

y Program Executive Office Soldier

y North American Rescue

2-6

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Combat Gauze

Description

Combat Gauze is a simple 3 inch x 4 yard 

sterile strip of gauze impregnated with kaolin. 

When used with direct pressure, the dressing 

is intended to stop or greatly reduce severe 

arterial, venous, or mixed bleeding in less 

than 4 minutes. Medics, combat lifesavers, 

and other military personnel will use Combat 

Gauze as the primary hemostatic dressing on 

the battlefield to aid in the control of severe 

hemorrhage in injured service members.

Partners

y USAISR

y USAMMA

y University of California, Santa Barbara

y Z-Medica

Demand Oxygen Controller

Description

The Demand Oxygen Controller senses 

breathing and oxygen rates and reduces the 

required amount of oxygen to one-third the 

usual amount needed for standard ventilation. 

It was completed in 1989.

Partners

y USAMMDA

Field Medical Oxygen-Generating 

and Distribution System

Description

The Field Medical Oxygen-Generating and 

Distribution System (FMOGDS) provides 

oxygen refill capabilities. The FMOGDS is a 

lightweight system that provides bedside and 

cylinder-refill oxygen capabilities. Completed 

in 1993, it provides greater mobility and flexibility with reduced logistics dependence on 

medical-grade oxygen resupply.

Partners

y USAMMDA

2-7
Golden Hour Blood Container

Description

The Golden Hour Blood Container can hold 

red blood cells and needs no power source 

to maintain its internal temperature. It holds 

4 units of red blood cells and uses a combination of vacuum-insulated panels and an 

internal container that has a liquid phasechange material like reusable freezer packs. 

At room temperature, units of blood cells can 

last 121 hours at well below freezing (-9°F) for 

more than 97 hours, and at 105°F, they are 

good for more than 78 hours. It extends the 

amount of time a medic can transport blood 

products and allows for extended evacuation times necessary for far-forward combat 

units. The Golden Hour Blood Container was 

named one of the Army’s Greatest Inventions 

for 2003.

Partners

y WRAIR

y Minnesota Thermal Sciences

Hypothermia Prevention and 

Management Kit

Description

The Hypothermia Prevention and 

Management Kit consists of a water-resistant 

reflective blanket, a heat-reflective skull cap, 

and a Ready-Heat blanket. The Ready-Heat 

blanket has built-in chemical heating elements that can achieve 100°F–110°F in about 

30 minutes and can sustain this temperature for more than 8 hours. The kit weighs 

3 pounds and is disposable.

Partners

y USAISR

y North American Rescue

y Tech-Trade

Impedance Threshold Device

Description

The Impedance Threshold Device (ITD) is a 

small, lightweight plastic valve that attaches 

to a standard facemask or mouthpiece and 

acts as a temporary resuscitation device that 

requires no power. Use of the ITD results 

in a vacuum within the thorax during each 

inspiration to increase central blood volume 

and cerebral blood flow, reducing the risk of 

hemorrhagic shock. Completed in 2005, the 

ITD is used in Operation Iraqi Freedom.

Partners

y USAISR

COMPLETED | PROMISING | FUTURE

HEMORRHAGE CONTROL/ 2-8 RESUSCITATION STRATEGIES

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Improved First Aid Kit

Description

The Improved First Aid Kit (IFAK) was 

developed in response to the Tactical Combat 

Casualty Care Doctrine. The IFAK increases 

an individual service member’s capabilities 

to provide self-aid/buddy aid and provides 

interventions for two leading causes of death 

on the battlefield—severe hemorrhage and 

inadequate airway. An IFAK is issued to 

every deploying service member via the rapid 

fielding initiative. The IFAK was completed 

in 2005. A new IFAK resupply kit is now 

available, and a second CAT will be added to 

the IFAK.

Partners

y USAMRMC

y USAMMDA

y Directorate of Combat and Doctrine 

Development

y Program Executive Office Soldier

y U.S. Marine Corps

COMPLETED | PROMISING | FUTURE

Individual Chemical Resuscitation 

Device

Description

The Individual Chemical Resuscitation Device 

restores normal breathing to a battlefield 

casualty. This device provides manually 

operated, positive-pressure respiratory resuscitation to assist in the restoration of normal 

breathing of a battlefield casualty. It also 

filters chemical warfare agents from ambient 

air and can be used with an oropharyngeal 

mask or cricothyroid cannula. The Individual 

Chemical Resuscitation Device was completed in 1987.

Partners

y USAMMDA

Low-Power Blood Cooling and 

Storage Device

Description

The Low-Power Blood Cooling and Storage 

Device extends the capability of the current 

blood refrigerator and cools fresh whole 

blood using very low power requirements. It 

provides greater flexibility and reduces the 

logistical strain of storage at all levels of medical care from field hospitals to the battlefield. 

Completed in 2002, this device is being used 

in Operation Iraqi Freedom.

Partners

y USAMMDA

y Accutemp

2-9
Optimal Fluid Resuscitation 

Guidelines

Description

Guidelines for the administration of resuscitative fluids by medics and forward-deployed 

medical personnel will provide optimal fluid 

resuscitation for wounded service members. 

Using current understanding, a set of guidelines was developed regarding optimal fluid 

resuscitation in injured Warfighters who have 

experienced substantial blood loss and may 

experience long delays in evacuation.

The guidelines will reduce or eliminate consequences frequently associated with fluid 

replacement after severe blood loss.

Partners

y USAISR

y WRAIR

Rapid Blood Sterilization System

Description

The Rapid Blood Sterilization System allows 

whole blood collection and use within a short 

time frame. This purification system allows 

medics to collect whole blood from a donor, 

sterilize it, and place it into a recipient in 

a matter of only a few hours. This system 

enables the rapid sterilization of blood products for use on the battlefield as well as for 

blood banks.

Partners

y USAMMDA

Rapid Intravenous Infusion Pump

Description

The Rapid Intravenous Infusion Pump is 

a portable, electronic infusion pump that 

delivers intravenous fluids to restore blood 

pressure and intravascular volume. It is battery operated and about the size of a deck of 

playing cards. It can be used far forward on 

the battlefield or in the transport of patients 

and is being used in the global war on terror.

Partners

y WRAIR

COMPLETED | PROMISING | FUTURE

HEMORRHAGE CONTROL/ 2-10 RESUSCITATION STRATEGIES

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Spray-On Protective Bandage

Description

The Spray-On Protective Bandage is an 

antimicrobial, flexible bandage that will reduce 

or eliminate blood and fluid loss, reduce 

or eliminate pain associated with motion, 

and protect wounds from environmental 

contamination. The bandage is capable of 

reducing or stopping blood and fluid losses, 

including compressible hemorrhage and 

amputation stumps after minimal tourniquet 

control. Wound stabilization is provided for 

2 or more days after injury. It may be used 

in conjunction with enzymatic and chemical 

debridement.

This product is easily applied on the battlefield and allows mobility for the Warfighter 

with small wounds. Large wounds can be 

stabilized following initial treatment with 

compression-style and hemostatic dressings 

or minimal tourniquet use. 

Partners

y USAISR

Thermal Infusion System (formerly 

Cartledge Infuser)

Description

The Thermal Infusion System is a portable, 

rugged, easy-to-use, state-of-the-art fluid 

infusion device capable of warming and infusing fluids at rapid rates to treat and sustain 

hypovolemic trauma patients. It can infuse 

normothermic blood or fluids at rates as low 

as 10 milliliters per hour up to 1,200 milliliters 

per minute. The system weighs 22 pounds. 

The U.S. Food and Drug Administration 

cleared this product for marketing in October 

2006.

Partners

y USAMMDA

Ventilatory Assist Device for 

Anesthesia Machine

Description

The Ventilatory Assist Device for Anesthesia 

Machine is an integrated ventilator and 

anesthesia machine that ensures proper 

ventilation of patients during surgery and is 

compatible with low-pressure oxygen sources 

such as oxygen generators and concentrators. It provides forward surgical teams with 

the ability to properly ventilate a wounded 

service member while replacing the more 

labor-intensive system of an anesthetist handbagging a patient and reduces equipment 

load. Completed in 2005, the Ventilatory 

Assist Device for Anesthesia Machine is 

being used in Operation Iraqi Freedom.

Partners

y USAMMDA

2-11
HARD AND

SOFT TISSUE INJURY

COMPLETED | PROMISING | FUTURE

Antimicrobials for Orthopedic Injuries

 Antimicrobial Bone Replacement Material

 Antimicrobial External Fixator Pins

Description

Through the use of Antimicrobial Bone Replacement Material and External Fixator Pins, the risk of 

infection from bone fractures will be reduced. Treatment of casualties in austere environments necessitates extra precautions be taken to minimize the risk of surgical wound infection. Antimicrobial bone 

repair and stabilization items are impregnated with antibiotics to reduce or eliminate the occurrence of 

infection associated with bone fracture injuries.

Antimicrobial Bone Replacement Material. This device will replace lost bone and help stabilize 

bone fractures. 

Antimicrobial External Fixator Pins. Surgical pins and screws will be used to stabilize bone 

fractures.

Partners

y USAISR

2-12

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Splints, Extremity and Pelvic

 Lightweight Extremity Splint

 Pelvic Fracture Stabilizer

Description

The Lightweight Extremity Splint. Replacing the current board splints, this is a spray-on contractible or pneumatic expandable splint fabricated from new, lightweight material(s) and deployable far 

forward in the battle area. Service members with immobilized and nondisplaced fractures may be 

able to continue their missions, and service members with serious open fractures may be stabilized 

and transportable for several days under battle conditions. The splint will enable a service member 

with a single upper extremity fracture to remain functional, perhaps even operating a weapon until 

evacuation. A service member with a lower extremity fracture may be able to evacuate with crutches 

or one other person instead of needing a stretcher evacuation team. 

The Pelvic Fracture Stabilizer. This splint system will stabilize a fractured pelvis to facilitate movement of injured patients without risk of further pelvic organ damage due to pelvic instability. Pelvic 

fractures are very difficult to immobilize and stabilize especially during evacuation from the battlefield 

via carried litter or ambulance.

Partners

y USAISR

2-13
TRAUMA MANAGEMENT 

SYSTEMS

COMPLETED | PROMISING | FUTURE

Advanced Medic Training Technologies

Description

The Advanced Medic Training Technologies effort has successfully developed the first wireless, fieldcapable patient simulator and a game-based simulation with courseware to train life-saving skills to 

combat medics, combat lifesavers, and Warfighters in realistic environments and while deployed.

The Advanced Medical Training Technologies effort was part of a 3-year Army Technology Objective 

that yielded two products for combat medics, combat lifesavers, and Warfighters to address these 

concerns. The first is the Stand Alone Patient Simulator (SAPS), the first completely wireless, 

physiologically based, deployable, and rugged patient simulator that allows training in a field environment. The second is the TC3 (Tactical Combat Casualty Care) simulation, a low-cost, game-based 

simulation that was developed to meet Army TC3 learning objectives. SAPS is gaining congressional 

and high-level Army support to be fielded as a rapid-fielding initiative to speed up the fiscal year 

2010 transition to the Medical Simulation Training Center. The onboard bleeding capability developed for SAPS already has been transitioned to the Army’s standard patient simulator in the Medical 

Simulation Training Center. The TC3 simulation transitioned to the Department of Combat Medic 

Training in May 2007.

Partners

y USAMRMC

y U.S. Army Research, Development and Engineering Command, Simulation and Training 

Technology Center

Army Medical Department Interim 

Tent System

Description

The Army Medical Department Interim Tent 

System provides lighter, brighter, and more 

environmentally resistant patient areas. 

Future plans call for air beam technology to 

reduce the weight by two-thirds and setup 

time by half; this will become the Future Force 

Tent System. The Army Medical Department 

Interim Tent System was completed in 2004.

Partners

y USAMMDA

2-14

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Chemical Warfare Agent Protective 

Patient Wrap

Description

The Chemical Warfare Agent Protective 

Patient Wrap system is made up of a breathable laminate material for the top layer, a 

three-layer laminate for the ground cloth, 

a flexible plastic film for the window, and a 

coated and laminated chemical and protective 

cover. 

The second-generation Chemical Agent 

Wrap provides respiration and percutaneous 

protection for unmasked, uncontaminated 

patients for at least 6 hours after initial exposure to all known potential chemical warfare 

agents in vapor, aerosol, liquid, or thickened 

liquid form.

The wrap is manufactured in one size and 

is large enough to completely encapsulate 

military personnel.

Partners

y USAMMDA

y M-C Industries,Inc.

y SafetyTech International, Inc.

Emergency Hypothermia and

Smart Aortic Catheter

Description

The Emergency Hypothermia and Smart 

Aortic Catheter induces hypothermia to slow 

down metabolism. This device is particularly 

useful in slowing trauma casualty deterioration during evacuation and surgery. This 

catheter will help stabilize a casualty’s 

temperature to slow down metabolism during 

emergency transport to a medical facility.

Partners

y TATRC

y IIRTI

Field Computed Tomography 

Scanner

Description

The Field Computed Tomography Scanner 

is a commercial x-ray computed tomography 

system that is shock mounted and installed in 

an International Standard Organization (ISO) 

shelter. This device was completed in 1993.

Partners

y USAMMDA

y USAMMA

y Philips

2-15
Field Operating Table Improvement

Description

The Field Operating Table Improvement fixes 

problems with the rigidity and elevation gearing of the past version. Completed in 2004, 

the weight and size are significantly reduced 

from the deployable medical system table that 

is currently in use.

Partners

y USAMMA

Field Optometry Set

Description

The Field Optometry Set contains field 

operational optometric equipment, including 

examining chair, instrument pole, supporting 

accessories, optometric instrumentation, and 

field chests. The set was completed in 1988.

Partners

y USAMMDA

Fluid Warming System

Description

The Fluid Warming System is a small, lightweight system for warming blood, lactated 

Ringer’s solution, Hextend, and other fluids to 

be used in far-forward areas. It extends quality care further in the battle area and allows 

for extended evacuation times.

Partners

y USAMMA

y USAMMDA

y Vital Signs, Inc.

TRAUMA MANAGEMENT 

SYSTEMS

COMPLETED | PROMISING | FUTURE

2-16

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Folding Decontaminable Litter

Description

The Folding Decontaminable Litter consists 

of aluminum poles and spreader bars, a 

polypropylene mesh fabric, and retractable 

nylon handles. Modifications were made to 

the litter handles to allow the litter to collapse 

to 78 inches in length. All components are 

resistant to chemical agents and decontaminating solutions. The litter is a critical component of the M1114/M1151 Casualty Evacuation 

(CASEVAC) Kit, MRAP CASEVAC Kits, and 

the MRAP Ambulance Medical Equipment 

Set.

Partners

y USAMMDA

y North American Rescue

High-Speed Mini-Sterilizer

Description

The High-Speed Mini-Sterilizer is a tabletop 

device with an inner chamber approximately 

10 inches wide by 12 inches deep that 

sterilizes with bursts of steam on a cycle of 

approximately 1 minute. Completed in 1986, 

the High-Speed Mini-Sterilizer was later 

replaced with a commercial item.

Partners

y USAMMDA

COMPLETED | PROMISING | FUTURE

2-17
Life Support for Trauma and Transport System

Description

The Life Support for Trauma and Transport (LSTAT) System is a portable, single-patient, trauma 

casualty care, surgical support, and evacuation platform. The LSTAT System incorporates a 

mechanical ventilator with a built-in compressor, vital signs monitor, intravenous infusion pump, 

suction apparatus, defibrillator, self-contained oxygen supply, and onboard computer for recording 

patient diagnostic and treatment data. The U.S. Food and Drug Administration cleared the LSTAT for 

marketing in June 1998, and it has been used in Operations Enduring and Iraqi Freedom. The LSTAT 

is being modified to meet Critical Care System for Trauma and Transport requirements. In addition, 

USAMMDA, in collaboration with the Defense Advanced Research Projects Agency, is currently 

developing the LSTAT-Lite, which will be a lightweight, litter-mountable trauma casualty care system 

incorporating a ventilator with a built-in compressor, vital signs monitor, intravenous infusion pumps, 

and integrated display and control with patient data recording.

Partners

y WRAIR

y USAMMDA

Medical Supply Envelope

Description

The Medical Supply Envelope is a fabric container with pockets for the storage, transportation, and disbursement of medical supplies 

required at a triage site. It is prepackaged 

with critical supplies, will fit into a medical 

chest, and can be retrieved for immediate 

use. The Medical Supply Envelope was 

completed in 1992.

Partners

y USAMMDA

TRAUMA MANAGEMENT 

SYSTEMS

COMPLETED | PROMISING | FUTURE

2-18

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Military Transportable Field 

Radiographic and Fluoroscopic 

System

Description

The Military Transportable Field Radiographic 

and Fluoroscopic System provides radiographic and fluoroscopic capabilities. This 

system incorporates solid-state electronics, 

composite materials for lightweight construction, and military-specific components for 

system reliability. Completed in 1987, it also 

is referred to as the High-Capacity X-ray 

System.

Partners

y USAMMDA

y USAMMA

y Philips

Mine-Resistant Ambush-Protected Ambulance

Description

The Mine-Resistant Ambush-Protected (MRAP) Ambulance provides up-armored forward support 

for medical evacuation in theater operations. USAMRMC helped to develop, produce, train, and 

field MRAP CAT I (Category I) and CAT II ambulances to evacuate patients while protecting forces in 

theater defending against threats. Before MRAP vehicles, most light tactical vehicles did not have the 

necessary armor protection for current threats.

With support from BAE and Navistar, the MRAP Ambulance Program Office, the Directorate of 

Combat and Doctrine Development, and USAMMDA delivered three-litter and two-litter ambulances 

to Operation Iraqi Freedom and Operation Enduring Freedom.

Partners

y USAMMDA

y MRAP JPO

y NAVISTAR

y BAE

y Milton Engineering

COMPLETED | PROMISING | FUTURE

2-19
Operating Room Table

Description

The Maquet Table is a manually operated, pedestal-style operating table. It has 

an articulating top section and adjustable 

foot and head sections for superior patient 

positioning with maximum convenience for 

the surgical team, setting the standard for 

operating efficiency, ergonomics, and safety. 

It was designed to accommodate patients 

weighing up to 300 pounds and includes foot 

pedal-operated, conductive casters and locks 

designed to compensate for uneven floor 

surfaces.

Partners

y USAMMA

y Getinge USA, Inc.

Pain Control Pump

Description

The AmbIT® PCA (patient-controlled analgesia) Infusion Pump is a battery-operated, 

intravenous pump for administration of medications for pain management. It provides a 

simple yet sophisticated solution for many 

types of postoperative local pain management 

and traditional intravenous delivery of PCA 

narcotics and regional nerve blocks. The 

programmable operation delivers technology that is easy to use for clinicians, reduces 

patient training time, and adds versatility to 

meet a patient’s pain management needs. It 

is currently being used with great success 

and is working to relieve patients’ pain on 

long air evacuation flights to Europe and the 

United States.

Partners

y USAMMA

y Sorenson

Patient Holding and Evacuation 

Heater Unit

Description

The Patient Holding and Evacuation Heater 

Unit protects service members from cold 

conditions during evacuation when used 

with existing evacuation bags. The unit was 

completed in 1987.

Partners

y USAMMDA

TRAUMA MANAGEMENT 

SYSTEMS

COMPLETED | PROMISING | FUTURE

2-20

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Portable Field X-Ray Table

Description

The Portable Field X-Ray Table is a lightweight platform for positioning patients for 

medical imaging in the field. It weighs less 

than 100 pounds and has a “bucky system” to 

allow patient imaging in either the horizontal 

or vertical position. The table was completed 

in 1999.

Partners

y USAMMDA

Reactive Skin Decontamination 

Lotion

Description

The Reactive Skin Decontamination Lotion 

(RSDL) neutralizes chemical agents by 

rapidly breaking them down to nontoxic or 

less toxic forms that can then be removed 

with water. The RSDL can be used on skin or 

equipment.

Partners

y Chemical-Biological Medical Systems

y USAMMDA

COMPLETED | PROMISING | FUTURE

2-21
Robotic Integration of High-Intensity Focused Ultrasound with Life Support 

and Trauma and Transport 

Description

The High-Intensity Focused Ultrasound (HIFU) system is integrated with the LSTAT System. The 

main advantages of HIFU are its noninvasive nature and that therapy occurs deep within a patient’s 

body without affecting the intervening tissue. The objective of this project is to create a revolutionary 

teleoperated HIFU system that is robust and at least as effective as a local, non-telerobotic system. 

To do this, a telerobotic system will be developed that employs a master-slave design, an innovative 

control system that is stable even in the presence of data latency and bandwidth constraints, a unique 

series-elastic actuation system for arm flexibility, new methods of detecting and controlling hemorrhaging through HIFU, and an intuitive human interface—all seamlessly integrated with the LSTAT 

System. This will allow a trauma surgeon or a trained operator to remotely perform noninvasive HIFU 

surgery on a casualty in the field.

Partners

y TATRC

Robotic Laser Tissue Welding

Description

Incorporating laser tissue welding into a 

surgical robotic platform provides greater 

control over some of the parameters that 

are critical for a successful outcome of the 

bonds. The synergy between laser tissue 

welding and robotic surgery has the potential 

to improve the state of the art of microsurgical 

procedures and robotic minimally invasive 

surgery. High precision and lack of tremor of 

the manipulator, together with the increased 

uniformity of solder and power delivery, 

should result in higher quality bonds.

Partners

y TATRC

TRAUMA MANAGEMENT 

SYSTEMS

COMPLETED | PROMISING | FUTURE

2-22

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Severe Trauma Simulation

Description

The Severe Trauma Simulation (STS) effort developed simulated skin, flesh, blood, and smells to 

realistically simulate severe trauma for training combat medics, combat lifesavers, and Warfighters. 

Blast injuries from roadside and car bombs, rocket-propelled grenades, and mortars account for more 

than half of U.S. combat deaths in Iraq and Afghanistan. The objective of this effort was to research 

STS technologies to prepare the Army’s Warfighters to deal with severe injuries encountered on 

the battlefield. Medical personnel are not always prepared to treat such injuries and are thus less 

effective in the use of their medical skills. Additionally, battlefield conditions are vastly different from 

traditional training in sterile environments. Lessons learned from Iraq and Afghanistan show that 

traditional techniques and procedures for treating injuries can be improved. 

The STS effort was part of a 3-year Army Technology Objective starting in fiscal year 2007 that 

produced STSs with skin, flesh, blood, and smells that integrate with patient simulators or actors. 

Research was conducted to identify trade-offs between cost and realism for training efficacy with 

such simulations. Training scenarios more appropriate for the current operational tempo in the global 

war on terror also were developed under this effort.

Partners

y USAMRMC

y U.S. Army Research, Development and Engineering Command, Simulation and Training 

Technology Center

Single-Litter Casualty Evacuation 

Kit

Description

The Single-Litter CASEVAC Kit allows service 

members to be evacuated from the theater 

of operations quickly using an up-armored 

asset. The M1114, M1151, five MRAP variants, and MRAP All-Terrain Vehicle (M-ATV)

transform into CASEVAC vehicles.

USAMMDA and the Directorate of Combat 

and Doctrine Development developed a safer 

version of this kit. Kits have been produced 

and shipped to theater for evaluation by 

users.

Partners

y USAMMDA

y Directorate of Combat and Doctrine 

Development

y MRAP JPO

y Space and Naval Warfare Systems 

Command

COMPLETED | PROMISING | FUTURE

2-23
Special Medical Emergency 

Evacuation Device

Description

The Special Medical Emergency Evacuation 

Device (SMEED) is a platform used to hold 

medical monitoring equipment in the evacuation of service members. The platform has 

modular flexibility and significantly improves 

the ability to evacuate ventilated patients 

with multiple IVs and monitors. Completed 

in 2004, the SMEED has been used in 

Operation Iraqi Freedom.

Partners

y USAISR

Special Operations Forces Medical Handbook

Description

The Special Operations Forces Medical Handbook (SOFMH) provides an up-to-date, portable field 

medical reference for Special Operations Forces medics and other first responders working in austere 

environments. The SOFMH was developed through a collaboration between USAMRMC and the 

Headquarters, U.S. Special Operations Command to make available comprehensive military medical 

reference materials, including pictures where appropriate, for first responders. The SOFMH is available in printed format or electronic format and has an established online authoring and editing tool to 

assist in updating and providing the most relevant military medical materials. In the electronic format, 

the SOFMH is a standard reference provided with Armed Forces Health Longitudinal Technology 

Application-Mobile (AHLTA-Mobile), a wireless handheld device that is in place throughout the DoD. 

The SOFMH helps improve military health care by enhancing training and assisting in effective decision making by providing a quick reference tool. Since its publication, the SOFMH has been used 

extensively in Operation Enduring Freedom and Operation Iraqi Freedom by all levels of U.S. and 

allied military health care personnel. 

Partners

y TATRC

TRAUMA MANAGEMENT 

SYSTEMS

COMPLETED | PROMISING | FUTURE

2-24

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Steam Vacuum Pulse Sterilizer

Description

The Steam Vacuum Pulse Sterilizer is a 

ruggedized, highly reliable sterilizer for field 

hospital use with large throughput. It employs 

a pressure and vacuum pulsing-conditioning 

principle for air removal and is designed to 

sterilize instruments, linens, and solutions. 

This sterilizer was completed in 1991.

Partners

y USAMMDA

Stryker – Medical Evacuation 

Vehicle

Description

The Stryker – Medical Evacuation Vehicle is 

the medical evacuation variant of the Stryker 

Armored Vehicle platform for the Stryker 

Brigade Combat Team. Capabilities of the 

Stryker – Medical Evacuation Vehicle include 

an automated litter lift system, onboard 

oxygen, suction, storage space for essential 

medical items and equipment, and the capacity to carry four litter patients or six ambulatory patients and a crew of three. Completed 

in 2003, this vehicle has been used in 

Operation Iraqi Freedom.

This vehicle has been fielded with continued 

product improvement ongoing. A treatment 

variant is in development.

Partners

y USAMMDA

y Stryker Brigade Combat Team

y Directorate of Combat and Doctrine 

Development

2-25
TRAUMA MANAGEMENT 

SYSTEMS

COMPLETED | PROMISING | FUTURE

Surgical Scrub Sink

Description

The Surgical Scrub Sink replaced a product that has been used in combat support hospitals for more 

than 12 years. When it was determined that the fielded model was no longer commercially available, 

the Army Medical Department required that a new product be procured. USAMMA determined the 

availability of potential vendors, conducted a market analysis, and identified three manufacturers 

ready to address military requirements for a field scrub sink meeting both sustainability requirements 

and current hand hygiene principles. The review and selection process as well as contract award and 

production was completed in less than a 10-month time period.

Clinical evaluations of all three products were conducted by a panel of tri-service operating room 

nurses at Fort Detrick, Maryland. Further analysis regarding life cycle logistics and maintenance 

was conducted as well as altitude, high/low temperature, humidity, dust, shock, and vibration testing. 

Though multiple products passed environmental and operational testing, USAMMA’s source selection 

board chose the product meeting both clinical and supportability requirements.

Partners

y USAMMA

y Aseptico, Inc.

2-26

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Assessment of Learning with the Mobile Telementoring Intubating Video 

Laryngoscope in Endotracheal Intubation Training

Description

During a mass casualty scenario (whether man made or a natural disaster), health care providers 

could be overwhelmed by patients, many of whom would need airway support. The study will evaluate the efficacy of the Berci Video Macintosh Intubating Laryngoscope System, which has a camera 

incorporated into its handle with a short image and light bundle, allowing video projection to a monitor 

screen. Specific research objectives are to: (1) measure the efficacy of the video laryngoscope for 

airway training compared to the standard laryngoscope, (2) measure the performance of students 

using the video laryngoscope compared to the standard laryngoscope, and (3) develop a curriculum 

for the use of the video laryngoscope in airway training to support anesthesia training programs, 

advanced cardiac life support airway training, the far-forward battlefield medic, and the conscious 

sedation training program.

Partners

y TATRC

y University of Nebraska Medical Center

COMPLETED | PROMISING | FUTURE

TRAINING 2-27
TRAINING

Emergency Department Self-Assessment Survey and Incident Scenario 

Exercise Guidebook for Chemical, Biological, Radiological/Nuclear, and 

Explosive Response Preparedness

Description

This guidebook promotes the development of an effective response by the civilian medical community 

to chemical, biological, radiological/nuclear, and explosive (CBRNE) terrorist attacks through the use 

of online tools and advanced distributed learning. A hospital self-assessment survey for emergency 

department preparedness was developed by the National Bioterrorism Civilian Medical Response 

Center (CiMeRC) at Drexel University as a deliverable under a government contract funded by congressional appropriation. Based largely on the Soldier and Biological/Chemical Command Domestic 

Preparedness Training Manual and input from an expert consensus panel, the survey was designed 

to determine emergency department readiness to generate a minimal level of reasonable response to 

a chemical or biological mass casualty event, regardless of population base or surge capacity. The 

self-assessment survey contained 14 questions and was accessed online. References and expert 

opinions were also available. The survey was used to provide a snapshot of regional readiness as 

well as to support targeted allocation of health care resources. Also developed by CiMeRC is a 

guidebook entitled Strategies for Incident Preparedness: A National Model. The disaster preparedness training handbook contained 20 different CBRNE disaster scenarios. Both the self-assessment 

survey and guidebook were translated into Spanish and were evaluated in Latin America.

Partners

y TATRC

y CiMeRC

COMPLETED | PROMISING | FUTURE

2-28

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Immersive Technologies Approach to Medical Modeling and Simulation

Description

Immersive technologies offer promise to improve medical training in the area of reinforcing cognitive skills for individuals and small units. Forterra Systems, Inc., in collaboration with the Stanford 

University Medical Media and Information Technologies group, is developing an avatar-based system 

to train medical first responders for CBRNE events. The avatars can be manipulated in a persistent 

virtual environment equipped with the features and facilities required to “play the game.” CBRNE scenarios can be practiced by multiple players at various locations who are connected over the Internet. 

Taking a different approach, SIMmersion LLC, in collaboration with the Uniformed Services University 

of the Health Sciences, is developing a virtual reality (movie-based) training system to teach differential diagnosis skills, such as smallpox versus chicken pox, required by health care providers in 

response to CBRNE events. This has the potential to augment today’s use of standardized patients. 

Specific to military combat medic training, the Virtual Reality Medical Center is developing a low-cost, 

interactive virtual reality video game trainer that is hypothesized to improve combat medic skills. The 

trainer is based on the Army’s Combat Medic Advanced Skills Training curriculum. The purpose is 

to determine the degree to which lower cost, lower fidelity training platforms have a positive “training 

transfer” from the simulation experience into the delivery of real health care.

Partners

y TATRC

y SIMmersion LLC, collaborating with the Uniformed Services University of the Health Sciences

y Forterra Systems, Inc., collaborating with Stanford University Medical Media and Information 

Technologies

y Virtual Reality Medical Center

COMPLETED | PROMISING | FUTURE

2-29
TRAINING

COMPLETED | PROMISING | FUTURE

SimSurgery: Development of a 

Portable Simulator for Training 

Robot-Assisted Surgery

Description

SimSurgery has developed technology for 

virtual reality simulation with special focus 

on surgical suturing and soft tissue deformation such as tissue dissection. SimSurgery’s 

vision is to increase clinical performance and 

reduce health care costs by offering solutions 

for better training and computer-assisted 

tools in surgery. This project will produce a 

portable device that resembles the surgeon 

console in a surgical robot system as well 

as surgical simulator software that replaces 

the need for biological tissue (animals or 

patients) and equipment. Once this has been 

accomplished, the performance of surgical 

robotics versus traditional laparoscopy by use 

of simulators will be compared.

Partners

y TATRC

y SimSurgery

The Use of Cognitive Task Analysis and Simulators for After-Action Review of 

Medical Events in Iraq

Description

Researchers are developing an innovative protocol for streamlining expert medical knowledge into 

simulation development and enhancing learning for hands-on clinical skills. This project attempts to 

improve medical after-action review with a novel combination of cognitive task analysis conducted 

while interviewees moulage simulators. Three medical experts who have experienced and solved 

the same type of important medical problem in Iraq will be interviewed separately and together. It is 

hypothesized that interview protocols employing a novel combination of medical cognitive task analysis combined with the moulage of simulators will more accurately capture the mix of automated and 

conscious decisions used to solve critical medical problems on the battlefield in Iraq. Each expert 

will be interviewed separately and, after reviewing the results, the other two experts will be asked to 

correct and improve on the information gathered from the “other” experts. This process has been 

found to identify and eliminate errors as well as provide accurate and efficient descriptions of medical 

decisions and actions that solved battlefield problems.

Partners

y TATRC

y University of Southern California

2-30

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

DENTAL

Dental Field Treatment and 

Operating System

Description

The Dental Field Treatment and Operating 

System (DEFTOS) is a dental operating 

system to be used in the field. DEFTOS is 

a small, lightweight, mobile dental operating 

system for dental officers in the field that uses 

the latest electric motor-driven handpiece 

technology and can be quickly assembled or 

disassembled and packed into one molded 

shipping container, reducing the footprint of 

the field dental operating unit. The system 

includes both a high-speed and low-speed 

handpiece, air and water supply, air and water 

syringe, high-volume evacuator, saliva ejector, 

variable-speed foot switch, and oil-less air 

compressor. Completed in 2003, DEFTOS 

has been used in Operation Iraqi Freedom.

Partners

y U.S. Army Dental Research Detachment

Dental Filmless Imaging System

Description

The Dental Filmless Imaging System 

provides digitized dental images to forwarddeployed service members. The Dental 

Filmless Imaging System consists of an x-ray 

detector and image acquisition and storage 

components to digitize images for storage 

and viewing. It is compatible with currently 

fielded x-ray sources. Images are available 

immediately for the treating dentist. It is 

used by forward-deployed dental technicians 

and officers and replaces conventional x-ray 

film, film processors, and the associated 

chemicals, eliminating the logistical burden 

of temperature- and time-sensitive components. Also, volume, weight, and power 

requirements are reduced. This system was 

completed in 2002.

Partners

y TATRC

y USAMMA

y Dexis

2-31
Miniature Dental X-Ray System

Description

The Miniature Dental X-Ray System is used 

to provide dental x-rays in the field. The 

Miniature Dental X-Ray System is a small, 

lightweight, handheld dental x-ray system for 

field use. It is battery operated and suitable 

for use with self-developing film or a digital 

imager. The system was completed in 1993.

Partners

y USAMMA

y USAMMDA

y Aribex

Field Dental Operating Unit

Description

The Field Dental Operating Unit is a small, 

lightweight, mobile dental unit used to provide 

emergency and limited preventive and 

sustaining dental care in the field. It consists 

of a light source, suction apparatus, water 

reservoir, and high- and low-speed drills. The 

unit was completed in 1990.

Partners

y USAMMDA

DENTAL

COMPLETED | PROMISING | FUTURE

2-32

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

HEMORRHAGE CONTROL/

RESUSCITATION STRATEGIES

Blood Refrigerator

Description

A blood refrigerator could store blood and 

plasma products in the HBCT Treatment 

Variant Vehicle. A refrigerator for medical 

treatment vehicles takes blood supplies 

closer to the point of injury. The refrigerator 

holds 10 units, opens in the front, has an LCD 

display, and has communications capabilities. 

The device has a 72-hour mission to store 

blood and plasma products, which are the 

best resuscitative fluids for patients who have 

lost significant amounts. Funding is being 

used to modify a commercial off-the-shelf 

item.

Partners

y USAMMDA

y Thomas EMS

Ceramic Oxygen Generator

Description

The Ceramic Oxygen Generator uses a metal 

reinforced composite, thin-film ceramic membrane to generate oxygen. Producing 1 liter 

of oxygen requires 30 watts of electricity. The 

device will be battery powered and weigh only 

10 pounds.

Existing oxygen production technology uses 

techniques, such as pressure swing adsorption or cryogenics, to separate oxygen from 

air. The Ceramic Oxygen Generator uses no 

major moving parts; instead it uses a thin, hot 

ceramic membrane that has a voltage applied 

to it. The applied voltage drives atmospheric 

oxygen and only oxygen through the membrane to a collection chamber. The mechanical simplicity and high efficiency make this a 

promising technology. 

Partners

y USAMMA

y USAMMDA

y IGR Enterprises, Inc.

Clotting Agents

 Intravenous Hemostatic Drugs

Description

Clotting agents are drugs or other formulations that act to control bleeding that is not 

accessible for compression, such as an 

intra-abdominal hemorrhage. There are no 

equivalent products currently, and treatment 

requires immediate surgery. The products 

will prolong the lives of service members 

awaiting evacuation. 

Intravenous Hemostatic Drugs are administered via intravascular, oral, or other novel 

routes to enhance natural clot formation. 

Examples of such drugs are NovoSeven®

(recombinant human factor VIIa), which is currently in limited clinical use in trauma patients, 

and fibrinogen, which is used prehospital for 

trauma in Europe.

Partners

y USAISR

2-33
Fibrinogen Bandages

Description

Medics, combat lifesavers, and other medical 

personnel will use the Fibrinogen Bandage on 

the battlefield to aid in the control of severe 

hemorrhage in injured service members. The 

Fibrinogen Bandage will be composed of 

human fibrinogen and thrombin. When used 

with direct pressure, the dressing is intended 

to stop severe arterial, venous, or mixed 

bleeding in 2 to 4 minutes. 

Partners

y USAISR

y USAMMDA

Junctional Hemostatic Device 

(Combat Ready Clamp)

Description

This device is a disposable clamp that is 

designed to control difficult bleeding in 

the pelvic region, provide compression of 

large vessels in the inguinal and abdominal 

regions, and supply additional pressure 

to a current pressure dressing. It can be 

fitted with pressure discs of varying sizes to 

address the bleeding situation. It is easy to 

assemble and to use.

This device would be used by medics and 

higher trained medical personnel to provide 

hemorrhage control at compressible sites not 

conducive to placement of currently available 

tourniquets. 

Partners

y USAISR

y Combat Medical Systems

COMPLETED | PROMISING | FUTURE

HEMORRHAGE CONTROL/

RESUSCITATION STRATEGIES

Red Blood Cells, Extended Life

Description

Red Blood Cells, Extended Life (RBCXL) 

consist of a new additive solution that extends 

the total shelf-life of packed red blood cells 

from 6 weeks to at least 8 weeks and extends 

the deployed shelf-life from approximately 

3 weeks to at least 5 weeks—an increase 

of approximately 60 percent. Enhanced 

shelf-life not only reduces the expiration of 

packed red blood cells but also improves the 

quality of red blood cells at every time point 

of measurement compared to current red 

blood cells. RBCXL also may mitigate the 

degradation of packed red blood cells, which 

may have a negative impact in casualties 

who receive more than 10 units of packed red 

blood cells in a single transfusion.

Partners

y USAMMDA

y Hemerus Medical, LLC

2-34

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Rotary Valve Pressure Swing Oxygen Generator

Description

The Rotary Valve Pressure Swing Oxygen Generator (RVPSOG) is a smaller, more efficient product 

and will reduce the logistical burden of the oxygen generator for forward-deployed medical assets 

for use in single-patient care and transport. Existing pressure swing adsorption oxygen generator 

technology is being miniaturized into a portable device. Miniaturization requires the development of 

a small but reliable compressor. A rotary valve driven directly by a small motor will eliminate complex 

valve and control systems used in conventional oxygen generators. 

The logistical burden of resupply and refill of oxygen cylinders will be eliminated. The RVPSOG 

replaces the standard “D” cylinder for patient care and transport and yields increased efficiency and 

reduced size and weight. 

Partners

y USAMMA

y USAMMDA

y Chart Industries

y SeQual

2-35
Transportable Pathogen Reduction Blood Safety System 

Description

The possibility of transmitting disease by the transfusion of blood or blood components to a patient is 

a longstanding problem in transfusion medicine. Currently, donors are asked about their medical and 

behavioral history, and samples of their blood are tested for the presence of several viruses. While 

this approach provides a high level of safety, it has limitations. If an infected person donates blood 

with virus levels below the detection limit of the screening tests, the test will not detect virus, but the 

blood could still transmit disease. Another limitation of current practice is that testing is only done for 

a limited number of viruses; a number of well-known viruses, as well as emerging viruses, will not be 

detected. Also, testing is not done for parasites and is not routinely done for bacteria.

The proposed approach to pathogen reduction uses light and riboflavin to inactivate pathogens in 

blood components. This technology is currently in development for application to red blood cells and 

platelet and plasma products. Treatment of platelet and plasma products is in a later stage of development than that of red blood cells; it has been used in clinical studies in the United States and South 

Africa with platelet products. The technology requires the addition of a riboflavin solution to plasma 

or platelets followed by exposure to ultraviolet light. Red blood cells are treated with the addition of 

a riboflavin solution and exposure to visible light. With the riboflavin-and-light technology, pathogen 

nucleic acids are damaged, preventing their replication and hence disease transmission in recipients 

of blood products.

Partners

y TATRC

y CDMRP

y USAMMDA

y CaridianBCT

COMPLETED | PROMISING | FUTURE

HEMORRHAGE CONTROL/ 2-36 RESUSCITATION STRATEGIES

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

HARD AND SOFT

TISSUE INJURY

Advanced Regenerative Medicine Technologies to Regenerate Lost Tissues

Description

This effort focuses on developing advanced regenerative medicine technologies to restore functional 

tissues using the latest advances in stem cell research combined with tissue engineering technologies to produce new cells and tissues to replace damaged cells resulting from combat injuries. 

Researchers seek to develop novel therapies to regenerate fingertips using extracellular matrix material, to repair and reconstruct injured or missing soft tissues using extracellular matrix as a bioscaffold, 

and to treat severe skin burns via extraction, expansion, and cell support technologies of autologous 

skin cells from a healthy area of a patient’s skin to enable skin cell tissue engineering in the wound of 

a patient. Skin regeneration takes place directly in the wound of a patient by using a cell spray device 

followed by placing a temporary artificial capillary bed to support cell proliferation and cell migration in 

the wound thereby reducing in vitro culture time (i.e., no in vitro expansion). 

Partners

y USAISR 

y TATRC

y University of Pittsburgh

y Pittsburgh Tissue Engineering Initiative

2-37
Hyperbaric Oxygen Treatment of Post-Concussion Syndrome

Description

USAMMDA is leading a government and academic partnership to determine if hyperbaric oxygen 

(HBO2) is of benefit in the treatment of chronic symptoms of mild traumatic brain injury (TBI) or postconcussion syndrome (PCS).

HBO2 is defined as the administration of oxygen in a chamber at greater than atmospheric pressure 

in which oxygen becomes increasingly dissolved in the blood and body tissues. There is anecdotal 

evidence to suggest that HBO2 may be beneficial in the treatment of acute and chronic symptoms 

associated with TBI. Better quality evidence, including sham-controlled, randomized trials, must be 

obtained prior to determining if HBO2 should be used as a standard treatment for TBI or PCS.

Both TBI and PCS adversely impact military operational readiness and effectiveness. Currently there 

is insufficient evidence to recommend HBO2 to treat PCS; however, the DoD is conducting clinical 

trials to generate the scientific evidence to guide therapy.

Partners

y USAMMDA

y MIRECC 19, Denver Veterans Affairs Medical Center

y Naval Health Research Center

y Intermountain Healthcare

y OxyHeal Health Group

y Henry M. Jackson Foundation

COMPLETED | PROMISING | FUTURE

NEUROPROTECTIVE 2-38 TREATMENT STRATEGIES

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Neuroprotective Drugs

Description

Neuroprotective drugs will improve the outcome following acute brain trauma. A new drug, NNZ2566, was examined by WRAIR through collaboration with an industry partner for the treatment of 

brain injury in a penetrating ballistic-like brain injury model. NNZ-2566 demonstrated efficacy in this 

animal model as well as various other brain injury models. This promising candidate drug treatment 

currently is being examined for safety and efficacy in a 260-patient Phase 2 clinical trial. NNZ-2256 is 

an analog of Glypromate® (or glycine-proline-glutamate), a naturally occurring small-molecule neuroprotectant derived from IGF-1 (insulin-like growth factor 1), which is produced in the brain but does not 

bind to IGF-1 receptors. 

Neurological trauma is the number one cause of traumatic mortality on the battlefield and often is 

associated with significant morbidity, disability, and delayed mortality in those who survive the initial 

injury. A neuroprotective drug used to preserve or protect otherwise uninjured neurological tissue in 

the face of direct head trauma will reduce residual disability and subsequent long-term care demands. 

The capability to stimulate or enhance neuronal healing and repair as well as functional recovery will 

further reduce residual disability.

Partners

y WRAIR 

y CDMRP

y Neuren Pharmaceuticals Limited

COMPLETED | PROMISING | FUTURE

2-39
COMPLETED | PROMISING | FUTURE

NEUROPROTECTIVE 

TREATMENT STRATEGIES

Neurotriage Diagnostic Tools

Description

A rapid, field-implementable, diagnostic device is in development for the objective assessment of 

neurological trauma—the number one cause of mortality on the battlefield. A small volume of blood 

is analyzed to determine the levels of brain-specific biomarkers. Clinical trials are currently being 

conducted to determine the utility of the biomarkers to diagnose brain injury in severe, moderate, 

and mild traumatic brain injury (TBI) patients. A 1,200-patient clinical trial is being planned for final 

U.S. Food and Drug Administration approval of a biomarker diagnostic device for TBI. In the field, 

the results of this bioassay will be combined with a medical evaluation to provide a diagnosis of injury 

magnitude, ascertain casualty triage status, and provide treatment recommendations specific to the 

casualty’s condition. 

The diagnostic tools being developed will help manage the injury and may reduce subsequent 

residual disability and associated long-term care demands.

Partners

y WRAIR

y USAMMA

y Banyan Biomarkers, Inc.

2-40

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Field Sterilizer Improvement Device

Description

This newly improved sterilizer will reduce the 

water consumption of the device currently 

used by forward-deployed medical facilities. 

While the current field sterilizer is a wellproven piece of equipment, one shortcoming 

has been its high water consumption; it uses 

2 1⁄2 gallons of water every time it sterilizes a 

load of materials. A water recovery module 

will be added to the sterilizer to condense the 

exhaust steam and return it to the sterilizer’s 

boiler. The design of the water recovery 

module has been updated to use currently 

available components and improve the 

access for maintenance and repair. This 

effort is intended to fully field a water recovery 

system.

Partners

y USAMMDA

TRAUMA MANAGEMENT 

SYSTEMS

Active Thermal Resuscitation

Description

Active Thermal Resuscitation is a methodology that uses a prototype portable warming system that 

can heat fluid or blood to prevent the onset of hypothermia. Hypothermia is common and increases 

mortality in wounded personnel. Forward surgical teams currently use standard civilian fluid warmers 

and forced-air warming blankets to help prevent the onset of hypothermia. These systems, however, are not portable and do not effectively treat established hypothermia. Also, they require large 

amounts of generated electrical power and have a sizable transport footprint. Researchers have 

demonstrated a prototype portable warming system that can address this need while improving the 

mobility of a forward surgical team. The system uses the most favorable thermodynamic and physiologic methods to achieve rewarming of the hypothermic service member.

Partners

y TATRC

y University of Texas Health Science Center at Houston

2-41
COMPLETED | PROMISING | FUTURE

TRAUMA MANAGEMENT 

SYSTEMS

Future Medical Shelter System

Description

The Future Medical Shelter System program uses congressional funding to explore rigid and softwalled shelters for forward-deployed health care providers. The Future Medical Shelter System 

consists of chemically and biologically hardened ISO containers with quick erect and strike times and 

integrated electrical, water, and medical packages. Currently, one- and two-sided ISO aluminum rigid 

wall shelters serve as an interim solution.

A Request for Proposals has been released seeking commercial off-the-shelf products that will 

reduce the weight of comparable systems, enhance transportability and deployability, and be stronger 

and less expensive.

The Army Medical Department is working to transition to Force Provider in fiscal year 2014.

Partners

y USAMMDA

y U.S. Army Natick Soldier Research, Development and Engineering Center

y U.S. Air Force

y U.S. Navy

y Mobile Medical International

y EADS North American

2-42

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Ground Combat Vehicles – Medical Variants

Description

Medical variants of the Ground Combat Vehicles (GCV) platform will serve as the ground medical 

evacuation and treatment assets for heavy brigade combat teams. This program replaces the Future 

Combat System program and should be ready in fiscal year 2017. Two medical variants of the GCV 

are planned: Medical Evacuation and Medical Treatment. Medical capabilities will include onboard 

oxygen generation, suction, storage space for essential medical items and equipment, and automated 

data management. The Medical Evacuation variant will carry four litter patients on an automated litter 

lift system or six ambulatory patients and a crew of three. The Medical Treatment variant will provide 

interior space for treatment (surgery) of one patient and a crew of four.

GCV medical variants will provide the capability for medical response assets to move with the farforward and mobile Units of Action. Additionally, use of the GCV platform yields the same mobility, 

transportability, and supportability as the supported force.

Partners

y USAMMDA – Medical

y Program Manager, Future Combat Systems, Brigade Combat Team - Vehicle

2-43
TRAUMA MANAGEMENT 

SYSTEMS

COMPLETED | PROMISING | FUTURE

Mine-Resistant Ambush-Protected 

Ambulance

Description

The Mine-Resistant Ambush-Protected 

Ambulance provides up-armored forward 

support for medical and area support missions to do evacuation in theater operations. 

There is a requirement for an MRAP Caiman 

four-litter ambulance and an M-ATV two-litter 

ambulance in Operation Enduring Freedom. 

The AMEDD is helping the MRAP JPO to 

meet the Joint Urgent Operational Needs 

Statement for an M-ATV Ambulance. The 

first unit equipped will be September of fiscal 

year 2011.

Partners

y USAMMDA

y Directorate of Combat and Doctrine 

Development

y MRAP JPO

Portable Noninvasive Shock Monitor

Description

The Portable Noninvasive Shock Monitor will assist military medical personnel in preventing mortality 

and morbidity associated with shock. Trauma and hemorrhage are leading causes of death in the 

United States and a major concern of the military. Significant loss of blood leads to shock, a condition of inadequate organ perfusion and tissue oxygenation. There is the need for intelligent medical 

systems to guide corpsmen and combat medics in triage and resuscitation of severely injured combatants. A prototype, portable sensor system based on near infrared spectroscopy to noninvasively measure tissue perfusion has been developed and tested. This system quickly and accurately measures 

muscle pH, muscle oxygen tension, and hematocrit from light reflected off the palm of the hand and 

will guide combat medical personnel in resuscitation care and evacuation. The noninvasive, continuous process provides earlier indication of life-threatening medical problems and a means of rapidly 

triaging casualties; medical information to guide treatment where none currently exists; and advanced 

medical capability not previously available near the battlefield and during transport. Prototype development was completed in 2005 and capability was demonstrated in 2006. Evaluations are planned at 

Brooke Army Medical Center’s Burn Unit and Beth Israel Deaconess Hospital Emergency Department 

in 2007.

Partners

y USAISR

y CDMRP

y University of Massachusetts Medical School

y Luxtec Corporation

2-44

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Replacement of the M113 Medical Ambulance/M577 Treatment Variants in the 

Heavy Brigade Combat Teams

Description

Work is currently under way among the U.S. Army Medical Department Center and School, Project 

Management Office Heavy Brigade Combat Team (PM HBCT), and the Office of the Surgeon General 

to determine a replacement ambulance for the aging M113/M577 ambulance. Since the M113 program has been terminated, an interim armored ambulance and treatment variant is needed. Current 

plans are to replace the M113/M577 in the fiscal year 2018 time frame with 7 BCTs per year, which is 

210 evacuation and 56 treatment variants. USAMRMC is working with PM HBCT to ensure that the 

medical requirements for these vehicles are being met. This includes development of the treatment 

table, blood refrigerator, and shelter that spiraled from the FCS program. The Army Capabilities 

Integration Center is now supporting this initiative.

Partners

y USAMMDA

y Program Executive Office, Ground Combat and Support Systems

y Directorate of Combat and Doctrine Development

y OTSG

2-45
COMPLETED | PROMISING | FUTURE

TRAUMA MANAGEMENT 

SYSTEMS

Treatment Table

Description

Treatment tables and surgical lights provide 

required capability to battalion aid stations, 

and they will transition into Stryker or Bradley 

variants. Because commercial tables did not 

meet the requirements, USAMRMC designed 

and built a prototype table to be tested and 

then transitioned to the commercial sector.

Partners

y USAMMDA

y Tank and Automotive Research, 

Development, and Engineering Center 

Project Management Heavy Brigade 

Combat Team

Stryker – Medical Treatment

Vehicle

Description

The Stryker – Medical Treatment Vehicle is 

the treatment variant of the Stryker Armored 

Vehicle platform for the Stryker Brigade 

Combat Team. Capabilities of the Stryker – 

Medical Treatment Vehicle include a treatment table, onboard oxygen, suction, storage 

space for essential medical items and equipment, remote weapon station, and the ability 

to provide forward critical care to the injured. 

The vehicle variant is in development.

Partners

y USAMMDA

y Stryker Brigade Combat Team

y Directorate of Combat and Doctrine 

Development

2-46

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

TRAINING

3DiMD: Gaming Environment for Training Team Coordination Skills

Description

A three-dimensional, interactive, networked system assists in training military health care team coordination skills. 3DiMD will provide an effective solution to the problem of expanding the scope of team 

coordination skill training in military health care environments. In addition, the software platform to 

be developed will allow for the integration of multiple scenarios and work environments (e.g., training 

modules) to allow expansion into public health care environments. The main objective is to develop 

an immersive three-dimensional environment to train and assess military health care team coordination skills. Because this is a development project, there is no formal experimental hypothesis to test. 

However, the design specification and prototype will be evaluated qualitatively. Ease of use, practicality, scope, and effectiveness of the training system will be assessed through heuristic analysis by 

experts in team training. Future work will assess the impact of the prototype training environment 

on the team coordination skills of military health care providers. Future efforts also will evaluate the 

efficacy of the prototyped interactive team coordination assessment tools.

Partners

y TATRC

y Duke University Medical Center

2-47
COMPLETED | PROMISING | FUTURE

TRAINING

Center for Advanced Surgical and Interventional Technology

Description

The Center for Advanced Surgical and Interventional Technology (CASIT) of the David Geffen School of Medicine at the University of California, Los Angeles, 

is working on the TATRC-supported project, “The Application of Novel Technologies in Computer-Mediated Medicine.” CASIT uses the resources of the 

School of Medicine, the Biomedical Engineering Department, the California Nano-Systems Institute, and industry to advance the technology of interventional 

medicine; to improve telementoring, telesurgery, and telepresence; and to facilitate on-site diagnosis and treatment. The project has seven interrelated subprojects. CASIT is uniquely suited to develop technologies that will enhance the care of the Warfighter as well as provide new and sophisticated simulators 

for education, training, telementoring, and telesurgery. The close proximity of engineers and scientists to physicians, investigators, surgical robots, and other 

instruments provides a unique opportunity for interaction resulting in greater potential for innovation, rapid transition of technology into useful medical applications, and effective coordination with TATRC and DoD experts.

Project 1 is a haptic-guided telementoring system that will improve expert surgeon telepresence at remote surgical sites. Project 2 will develop a haptic 

feedback system for minimally invasive surgery, which also will be applicable to extremity prosthesis. Project 3 is developing a wireless, implantable, cathetermounted sensor for physiologic monitoring. Project 4 involves a telepresent application using a robotic wireless system that is integrated with a system that 

delivers relevant and real-time patient information directly to a caregiver’s computer. Project 5 is a PC-based multimodal procedure trainer. Project 6 will use 

flexible, three-dimensional ultrasound technology to enhance diagnosis of injuries and facilitate interoperative guidance. Project 7 takes advantage of the 

development of thin film nickel titanium for an intravascular prosthesis. 

Partners

y TATRC 

2-48

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Developing Generalized Algorithms for Objectively Assessing Medical and 

Surgical Skill with Various Modalities – Data

Description

New simulators being developed will produce large amounts of data that will provide insight into 

human performance. Inherent difficulties in evaluating clinical competence for physicians have 

spawned the wide use of various subjective assessment techniques. Inspired by objective methodology, algorithms are based on a mathematical finite-state model. Statistical distances measured 

between models representing subjects with various skill levels are sensitive enough to provide an 

objective measure of medical or surgical skill level. The goal of the proposed research project is to 

develop a generalized methodology based on Markov models independent of the modality being used 

and to test it using data acquired from three different modalities including: (1) An instrumented surgical 

tool, (2) a physical simulator (e-pelvis), and (3) a robotic system (DeVinci by Intuitive Surgical). The 

type and severity of the injuries that military medical personnel will have to cope with in the battlefield may exceed the nature and complexity of the injuries that a civilian clinician has to treat. These 

circumstances make simulators, along with software for assessing skill level, critical elements for 

military medical training. The proposed methodology could one day be extended to other nonmedical 

military simulators.

Partners

y TATRC

y University of Washington

Dynamic Injury Creation Simulator

Description

The Virtual Reality Medical Center is producing a functional, medically and militarily tested 

prototype of the injury creation simulator to 

provide a realistic training experience at two 

levels. For corpsmen embedded with their 

squads, the goal is rapid initial assessment 

and stabilization. Medical scenarios will 

include only wounds that corpsmen address in 

the field. The medical scenarios for Echelon 

II will be selected from a broader choice of 

procedures while still focusing on the treatment of injuries for which corpsmen have 

existing equipment. These scenarios will 

provide medics and corpsmen with the actual 

experience in the field that they must master. 

The training exercises take place under live or 

simulated fire complete with “enemy” actors 

and combatants, explosions, and other special 

effects. The investigators will bring all the tools 

of Hollywood special effects to live training, culminating in a near-real battlefield experience.

Partners

y TATRC

2-49
TRAINING

Medical Simulation Training Initiative

Description

Looking into the future, the Medical Simulation Training Initiative (MSTI) is a long-term research effort 

to identify, develop, and integrate fundamental “enabling technologies” into medical simulation devices 

and even entire medical training systems. The Center for Integration of Medicine and Innovative 

Technology (CIMIT) Simulation Group is executing the MSTI program. Examples of enabling technologies are tissue properties measurement, tool-tissue interactions, haptics, virtual reality graphics 

and visualization, learning, and open systems architecture. Under the auspices of this technology 

development initiative, concepts have been prototyped into products related to computer-based simulation training systems, for example, VIRGIL and Smallpox Inoculation Training, also called SITU. 

TATRC is leading two significant initiatives to pave the way for widespread adoption: validation and 

open standards development leading to interoperability. TATRC has funded more than a dozen studies to validate the degree to which skills developed via simulation transfer to the delivery of health 

care. To enhance interoperability among medical simulation systems, TATRC is now facilitating 

informal discussions to spur the development of “open source standards” for medical modeling and 

simulation.

Partners

y TATRC

COMPLETED | PROMISING | FUTURE

2-50

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Mimic Technologies: Affordable Haptics for Surgical Training

Description

Mimic Technologies will use advanced technologies in haptics and simulation to improve proficiency 

and safety in surgical training. Wound trauma care is a culmination of many basic skills (regulation 

of bleeders, wound debridement, suturing, etc.). A basic skills trainer, such as the Wound Trauma 

Simulator, would not only be appropriate for teaching surgeons but would also be appropriate for training paramedics, emergency medical technicians, and nurses.

Mimic Technologies has developed an affordable two-handed haptic system that can be used for 

open surgery simulation. The system includes a stereoscopic display that will colocate virtual images 

with the surgical tools held by the user. To demonstrate this platform, the development of a Wound 

Trauma Simulator will be initiated, which has the potential to help train medical personnel to treat 

projectile wounds to the pelvis. 

Partners

y TATRC

COMPLETED | PROMISING | FUTURE

2-51
COMPLETED | PROMISING | FUTURE

TRAINING

Part-Task Trainer Approach to Medical Modeling and Simulation

Description

Health care personnel can improve their cognitive and psychomotor skills with “part-task” trainers. Aviation crews simulate portions of missions that are high 

risk, high consequence rather than an entire mission from start to finish. This has led to the term “part-task trainer.” In medical modeling and simulation, 

many “part-task” efforts are under way to support physician, nursing, and allied health care personnel training. End user input has formed the foundation for 

current efforts to develop part-task simulators for specific procedures. In addition, platforms are being developed for the purpose of training specific skill sets 

or hosting different surgical simulators, such as the haptics-optional surgical training system, simulation-based open surgery training system, affordable haptics for surgical training, deployable simulation workstation (Sim-Pod), and portable simulator for training robot-assisted surgery. In addition to training, these 

simulation platforms have the potential to host the development of new clinical procedures and testing of new medical devices during development.

Partners

y TATRC

y Affordable Haptics for Surgical Training – Mimic Technologies

y Chest Trauma Training System – CIMIT Simulation Group

y Compartment Syndrome – Touch of Life

y Cricothyroidotomy – National Capital Area Medical Simulation Center

y Exsanguinating Hemorrhage – SimQuest LLC

y Fractured Femur – Simulution, Touch of Life

y Haptics-Optional Surgical Training System – Energid Technologies, SimQuest LLC

y Intracranial Hematoma/Burr Hole and Trauma Flap – SimQuest LLC, Verefi Technologies, Inc.

y Portable Simulator for Training Robot-Assisted Surgery – SimSurgery

y Regional Anesthesia – Energid Technologies, Touch of Life

y Simulation-Based Open Surgery Training System – SimQuest LLC, Touch of Life

2-52

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
PC-Based Interactive Multimedia

Description

Simulation Technologies for Advanced 

Trauma Care (STATCare) by RTI International 

is a trauma patient simulator that gives 

sustainment training for emergency medical technicians on a PC-based interactive 

multimedia “virtual patient.” The patient 

responds physiologically and pharmacokinetically to user diagnosis and treatment. User 

interaction is recorded for after-action review. 

With additional funding directed through 

another agency (the Office of the Secretary 

of Defense for Health Affairs is expanding 

STATCare’s capabilities into Sim-PatientTM, 

also developed by RTI International), it will 

have the capability to simulate multiple 

patients and provide training beyond the 

emergency medical technician level. TATRC 

also has begun work to develop PC-based 

“sim games” for CBRNE training.

Partners

y TATRC

Transurethral Resection of the 

Prostate

Description

Under SBIR Phase II funding, validation, 

software, and force feedback research is 

being conducted to increase training effectiveness. The National Capital Area Medical 

Simulation Center, together with Emory 

University, is conducting a comprehensive 

“virtual reality to operating room” validation 

study on the URO MentorTM simulator. The 

main components of the software module and 

also external software and hardware modules 

as well as their relations to each other were 

designed. The haptic device was adapted to 

laser transurethral resection of the prostate. 

The interface with the force feedback device 

was designed at high frequency to maintain a 

smooth response.

Partners

y TATRC

VIRGILTM

Description

The CIMIT Simulation Group is developing 

this prototype chest trauma training system, 

which teaches trainees how to diagnose 

and treat a chest trauma victim in a combat 

situation. It integrates a hybrid manikin, 

virtual reality tools, and a computer-based 

system and offers several levels of difficulty. 

In April 2004, VIRGIL was selected as one of 

the Army’s 10 Greatest Inventions for 2003. 

Initial validation studies at the National Capital 

Area Medical Simulation Center have shown 

that VIRGIL trains third-year medical students 

as effectively as pig training.

Partners

y TATRC

COMPLETED | PROMISING | FUTURE

2-53
TRAINING

Virtual Reality Demo

Description

Skills degrade over time, may be lost at a 

moment of need, and are needed for the 

unexpected. The Virtual Reality Demo 

psychomotor skills trainer/tester is a portable, 

flexible, self-contained haptics-based simulator. It allows training to be moved from the 

laboratory to the workplace or to field conditions for just-in-time training.

Partners

y TATRC

COMPLETED | PROMISING | FUTURE

2-54

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Blood Product Shipping and Transport Containers

Description

Researchers are finding ways to deliver viable blood products from blood banks in the United States 

to hospitals in the combat theater. The shipping and transportation containers for blood products are 

boxes that need no power source to maintain an internal temperature within the ranges required for 

blood product shipping (i.e., 4oC, 20oC–24oC, or -20oC). These boxes are the next generation of the 

“Golden Hour Blood Container,” an award-winning, fielded USAMRMC product, which uses a combination of vacuum-insulated panels with an internal container that has a liquid phase-change material 

similar to that in reusable freezer packs. The internal portion of the container is cooled to below the 

phase-change temperature (effectively frozen) then returned to the container along with the units of 

blood product. Different internal containers allow the shipping and transport containers to transport 

packed red blood cells, fresh frozen plasma, or liquid platelets in their appropriate temperature ranges 

without the use of wet or dry ice. 

Blood products will break down and can significantly harm a recipient if not stored at the right temperature. These containers will replace the StyrofoamTM and wet or dry ice currently used to ship 

blood products. They will allow movement of blood products to and storage of blood products at 

locations much further forward than the current system allows thus getting the much needed product 

to a combat casualty sooner. The product is not blood specific and could be used for transporting any 

temperature-sensitive products, such as biologicals, vaccines, or reagents. Future versions of the 

container may incorporate constant monitoring of the internal temperature.

Partners

y WRAIR

Advanced Resuscitation Fluid

Description

Advanced Resuscitation Fluid will help to 

maintain critical levels of blood pressure and 

tissue perfusion to preserve organ integrity and function. The fluid is designed for 

small-volume resuscitation for trauma and 

blood loss with delayed evacuation for up to 

72 hours. 

This product will support the continuing effort 

to extend the “golden hour” for far-forward 

treatment to improve survival and minimize 

morbidity after life-threatening injuries. 

Specifically, the product will counter vascular 

injury and immune system activation caused 

by decreased perfusion and oxygen radical 

generation during tissue re-oxygenation. The 

product also will not interfere with the ability 

of the blood to coagulate or form clots.

Partners

y USAISR

HEMORRHAGE CONTROL/

RESUSCITATION STRATEGIES 2-55
COMPLETED | PROMISING | FUTURE

HEMORRHAGE CONTROL/

RESUSCITATION STRATEGIES

Cryopreserved Platelets

Description

Cryopreserved Platelets (CPP) will fill the gap so state-of-the-art care can be provided to combat 

casualties for the control of hemorrhage far forward on the battlefield at combat support hospitals. 

CPP are human platelets collected, processed, and frozen at -80°C. CPP may be stored for up to 

2 years before use. The platelets can be thawed within 5 minutes and reconstituted for administration with normal saline. The functional activity of this blood product is similar to native platelets with 

regard to the clotting function. Key attributes of this product are battlefield availability and prolonged 

shelf-life.

Platelets are a key element in normal blood clotting after injury or surgical incision. The current 

blood-banked platelet product can be stored for only 5 days and is generally not available on the 

battlefield. Platelets continue to be absent in Operation Enduring Freedom, but fresh whole blood and 

deployment of platelet apheresis have been used to fill the gap in Operation Iraqi Freedom. CPP will 

fill the current gap in effective medical management of hemorrhage at the combat support hospital.

Partners

y WRAIR

y USAMMDA

y University of Cincinnati

y Dartmouth-Hitchcock Medical Center

y Fast-Track Biologics

y Puget Sound Blood Center

Freeze-Dried Plasma

Description

Freeze-dried plasma is lyophilized human 

plasma packaged for rapid reconstitution 

and administration. The functional activity 

of this blood product is equivalent to fresh 

frozen plasma including clotting function. 

Key attributes of freeze-dried plasma include 

extended shelf-life and temperature stability.

Freeze-dried plasma will reduce the logistical 

footprint by reducing refrigeration requirements associated with fresh frozen plasma 

and can be used in far-forward medical treatment facilities for casualty management. 

Partners

y WRAIR

y USAMMDA

y HemCon Medical Technologies, Inc.

2-56

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Pathogen Inactivation System

Description

CaridianBCT has developed a way to reduce disease-causing agents and inactivate white blood cells 

that can contaminate blood products intended for transfusion. The sooner safe blood can be provided 

and the safer that blood is, the better the chances of survival on the battlefield. 

TATRC is working with CaridianBCT to ensure the safety of blood products used in transfusions for 

military personnel injured in combat. Research has shown that for trauma cases in the field—where 

the use of fresh whole blood is often put into practice—transfusion of whole blood has a significant 

positive impact on patient outcomes, including survival. 

TATRC is assisting CaridianBCT’s development of the Mirasol® Pathogen Reduction Technology 

(PRT) system as a transportable system to treat whole blood thereby reducing the risks associated 

with blood-borne pathogens and donor white cells. As a lightweight, portable device, the Mirasol PRT 

system has the potential to introduce safer blood with fewer complications, providing a new way for 

military and civilian surgeons and transfusion medicine specialists to aid patients with life-threatening 

blood loss. 

Partners

y TATRC

y USAMMDA

y CaridianBCT

2-57
Pharmacological Resuscitation with Complement Inhibitor

Description

Hemorrhage and the resuscitation fluids used to treat it cause excessive activation of the complement system, a natural body defense mechanism consisting of a system of proteins meant to protect 

against infection. However, excessive complement activation will cause tissue damage. Complement 

activation inhibitors greatly reduce tissue and organ injury as well as the requirement for resuscitation 

fluid in animal models of hemorrhagic shock. 

Currently, there are a few complement inhibitors already approved by the U.S. Food and Drug 

Administration for the treatment of lupus, paroxysmal nocturnal hemoglobinuria, and hereditary 

angioneurotic edema. These commercially produced complement inhibitors currently are being investigated in military-relevant animal models for efficacy testing for a new indication to treat hyperactivation of the complement system during hemorrhagic shock and trauma.

Partners

y USAISR/BHT-2

y Harvard Medical School

COMPLETED | PROMISING | FUTURE

HEMORRHAGE CONTROL/

RESUSCITATION STRATEGIES

Remote Acoustic Hemostasis 

Device

Description

Control of internal hemorrhage by the Remote 

Acoustic Hemostasis Device will stabilize 

bleeding. This high-intensity focused ultrasound device functions by focusing ultrasonic 

waves to cause cauterization of both internal 

and external bleeding structures without 

damaging overlying or surrounding tissues. 

The Remote Acoustic Hemostasis Device 

will feature a computerized Doppler guidance system designed to locate and focus on 

hemorrhaging structures.

Partners

y USAISR 

y Defense Advanced Research Projects 

Agency

2-58

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Regenerative Medicine for Wound Healing

Description

Wound injury treatments for military personnel are being developed using combinations of products 

containing hydrogel biomaterials, tunable topical release of antimicrobial/antibiotics, and autologous 

stem cells for inducing active tissue regeneration. This combination strategy will not only enhance 

healing through promoting blood vessel growth and granulation but also will limit the onset of opportunistic wound infections. Preventing infection once a wound is inflicted provides the best platform for 

accelerating wound healing. Developing a fibrin-based scaffold capable of delivering silver sulfadiazine provides the necessary environment for a wound to heal without any further complications. This 

strategy has advantages over topical delivery by providing release of antibiotic in a controlled fashion. 

The use of the pegylated fibrin wound dressing provides a convenient delivery format as well as a 

hydrated, degradable scaffold to manage the wound environment prior to debridement.

Partners

y USAISR 

y TATRC

y University of Texas at Austin

Rapid Wound Cleansing System

Description

Rapid wound cleaning is necessary to avoid 

wound sepsis and achieve optimal healing. 

This wound cleansing system will replace 

the current heavier system. Reducing the 

amount of fluid and the weight a medic carries without compromising care is important 

for the medic’s mobility on the battlefield. The 

product will be a small-volume wound cleaning device. Replacing the current system will 

reduce the required volume from 12 liters to 

less than 2 liters.

Partners

y USAISR

HARD AND SOFT TISSUE 

INJURY 2-59
COMPLETED | PROMISING | FUTURE

NEUROPROTECTIVE 

TREATMENT STRATEGIES

Neuroprotective Drug Combination Therapy Strategy

Description

Neuroprotective drugs will improve the outcome following acute brain trauma. TBI is a complex 

problem not likely to be healed with just one type of treatment. Drugs that show promise in the treatment of one area of TBI sequelae (e.g., antiepileptic drugs) will be examined in combination therapy 

via isobolic analysis. The goal will be to identify possible combinations of drugs that work together to 

show efficacy in the treatment of TBI.

Neurological trauma is the number one cause of traumatic mortality on the battlefield and often is 

associated with significant morbidity, disability, and delayed mortality in those who survive the initial 

injury. A neuroprotective drug used to preserve or protect otherwise uninjured neurological tissue in 

the face of direct penetrating head trauma will reduce residual disability and subsequent long-term 

care demands. The capability to stimulate or enhance neuronal healing and repair as well as functional recovery will further reduce residual disability.

Partners

y WRAIR

2-60

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

TRAUMA MANAGEMENT 

SYSTEMS

Automated Critical Care Life Support System

Description

The Automated Critical Care Life Support (ACCLS) System will provide automated life support 

capability up to 72 hours on the battlefield for surgical and postsurgical environments including the 

en route care transport of patients during recovery and evacuation. The system is a portable, selfcontained, lightweight (less than 40 pounds), protected environment for one casualty. Life support 

functions are automated including computer-driven, closed-loop control of ventilation, fluid, drug, and 

oxygen administration. It also incorporates data logging and telecommunication capabilities to facilitate record keeping and to enable real-time communication of patient data to the receiving hospital for 

assistance with monitoring and decision assistance from a remote location.

The ACCLS System automatically optimizes the patient’s treatment while freeing the medical staff 

to care for other casualties once a seriously injured casualty has been stabilized. The system will 

provide increased and improved holding capability at the forward surgical team as well as extended 

critical care capability within the ground and air ambulance platforms.

Partners

y WRAIR

2-61
COMPLETED | PROMISING | FUTURE

TRAUMA MANAGEMENT 

SYSTEMS

Medical Ultrasound, Three-Dimensional, Portable with Advanced 

Communications

Description

The Medical Ultrasound, Three-Dimensional, Portable with Advanced Communications (MUSTPAC 3) 

device allows a user to capture ultrasonic information from a conventional ultrasound unit in the form 

of a three-dimensional databank. The device maps standard two-dimensional volume by coupling 

the ultrasound machine to a mechanical arm providing six degrees of freedom information. The 

three-dimensional data are forwarded to a radiologist who then uses the virtual probe to “scan” the 

imaginary patient in any directional plane and make a diagnosis. 

The benefits of the MUSTPAC 3 device are that data are digitized for storage and transmission and 

reconstructed into three-dimensional images, images are rendered in color, a layperson can operate 

the ultrasound unit, and distant review and diagnosis can occur.

Partners

y TATRC

2-62

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Monitors

 Non-Contact Heart Monitor (Vital Signs Monitor 1)

 Non-Contact Respiration Monitor

Description

These devices allow for the monitoring of casualties enclosed in chemical protective overgarments 

without exposing either the patient or medical personnel to a contaminated environment. Mass casualty triage and high noise and vibration evacuation environments are situations where these monitors 

will be useful. 

Non-Contact Heart Rate Monitor. This is a handheld diagnostic attachment to the Warrior Medic 

System or a stand-alone system that will measure life signs in wounded service members. Sensors 

measure heart rate and possibly cardiac stroke volume to assess the injury status of a patient, and 

artificial intelligence coding provides treatment suggestions. 

Non-Contact Respiration Monitor. This is a small, self-contained monitor that attaches to a gas 

mask filter canister or is incorporated in the gas mask that will sense the flow of air entering the gas 

mask and indicate the state of breathing audibly and visually. 

Partners

y WRAIR

y USAMMDA

2-63
Pneumothorax Detector (Vital Signs Monitor 2)

Description

The Pneumothorax Detector indicates the presence of a collapsed lung in patients with chest wounds. 

Measurements are made noninvasively using either breath sounds or microwaves.

Penetrating wounds of the chest can result in a collapsed lung that if not readily identified can further 

complicate treatment. The Pneumothorax Detector replaces radiography for diagnosis and will help 

guide the rapid, appropriate management of a collapsed lung.

Early detection of a collapsed lung (pneumothorax) will help avoid later complications in treatment. 

With this device, medics and forward-deployed medical personnel can diagnose a collapsed lung in a 

patient with a chest wound.

Partners

y WRAIR

COMPLETED | PROMISING | FUTURE

TRAUMA MANAGEMENT 2-64 SYSTEMS

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Temporary Implantable Lactate Sensor Biochip

Description

The goal of this project is to develop an implantable lactate-sensing biochip for temporary implantation that is capable of telemetered reporting of local lactate levels that can indicate level of injury and 

hemorrhage risk. Following injury that results in tissue hypoxia, interstitial lactate levels increase and 

are the main source of metabolically produced acid responsible for tissue acidosis. Lactate levels 

also have been found to correlate with the severity of injury, including hemorrhage. In preliminary 

development studies, these biochips are temporarily implanted into a skeletal muscle bed of animals. Lactate levels are continuously monitored for implantation periods varying from several hours 

to 3 months and include testing in a model of severe hemorrhagic shock. A hemorrhage rat model 

has been developed, and lactate- and glucose-specific biosensors have been fabricated, packaged, 

and implanted into hemorrhaged rats. Preliminary results obtained using an implanted but tethered 

biochip and portable potentiostats have produced good correlations between blood lactate and tissue 

lactate levels. Design considerations for the technical performance and the desired “footprint” for 

an implantable biochip have produced a comprehensive set of technical specifications. A prototype 

device is pending further in vivo studies on biocompatibility and analysis in another hemorrhage rat 

model of trauma.

Partners

y CDMRP

y Virginia Commonwealth University 

2-65
Warfighter Remote Triage

Description

Remote monitoring of wounding and vital 

signs capability via the Land Warrior Suit 

will enable a combat medic to attend to the 

most critically injured first. A minimal set 

of sensors to detect wounding and monitor 

vital signs will be embedded in the Future 

Force Warrior Suit to diagnose and evaluate 

a casualty’s physiological status and triage 

priority from a remote location to focus and 

optimally direct the medic’s lifesaving skills 

to the appropriate casualty. Future Force 

medics will have a small and wearable PC 

capable of interfacing with physiological sensors and of hosting diagnostic algorithms that 

will provide medical decision assistance and 

the capability to send information through the 

medical alert system. 

Warfighter Remote Triage aids in a medic’s 

diagnosis and treatment of casualties thereby 

enhancing survivability. 

Partners

y USAISR

DENTAL

Anticaries Components

Description

The Anticaries Components constitute a 

system of simple, safe, U.S. Food and Drug 

Administration-approved chemical additives, 

including antimicrobial peptides, to field 

rations.

Dental problems cause a significant percentage of lost duty time, and in the austere environment of lengthy deployments and combat, 

lack of good dental hygiene practice is commonplace. The Anticaries Components will 

help prevent the occurrence of dental plaquerelated emergencies in deployed forces.

Partners

y WRAIR

y USAISR

Thirty-Minute Cold Sterilization 

Solution

Description

The Thirty-Minute Cold Sterilization Solution 

is produced by reconstituting a dry chemical 

compound with water. Following mechanical 

cleaning, instruments are soaked in the solution for 30 minutes to sterilize them. 

Medical and dental care requires sterilization of instruments that is typically done with 

steam, heat, or chemicals, alone or in combination, using relatively large equipment. Field 

medical and dental personnel carry a limited 

number of presterilized instrument packs, and 

once used, the instruments must be resterilized prior to reuse. The Thirty-Minute Cold 

Sterilization Solution will reduce the logistical 

burden associated with maintaining a supply 

of sterilized instruments. 

Partners

y WRAIR

y USAMMA

COMPLETED | PROMISING | FUTURE

TRAUMA MANAGEMENT 2-66 SYSTEMS

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
2-67
PUBLICATIONS

1. Ahmed A, Bodo M, and Armonda RA. Effect 

of metal fragments in brain on electrical 

monitoring: In vitro and in vivo rat studies. 

Journal of Physics: Conference Series, 

2010, 224(1): 012132.

2. Allan PF, Hollingsworth MJ, Maniere GC, 

Rakofsky AK, Chung KK, Naworol GA, 

Ward JA, Perello M, and Morris MJ. Airway 

humidification during high-frequency percussive ventilation. Respir Care, 2009 Mar, 

54(3): 350-8.

3. Allan PF, Osborn EC, Chung KK, and 

Wanek SM. High-frequency percussive 

ventilation revisited. J Burn Care Res, 2010, 

31: 510-520.

4. Allen D. The Institute of Surgical Research: 

Setting the Standard. BAMC, 25 May 2010, 

presentation.

5. Allen D, Mitchell C, and Greeley HL. A 

Multi-Track Preceptorship Program in a Burn 

Intensive Care Unit. AMSUS, 2 Nov 2010, 

poster.

6. Allen DA, Mann EA, and Serio-Melvin 

ML. Clinician Satisfaction with Computer 

Decision Support in the Burn ICU. AMSUS, 

2 Nov 2010, poster.

7. Allen DA, Mann EA, and Serio-Melvin 

ML. Clinician Satisfaction with Computer 

Decision Support in the Burn ICU. ATACCC, 

16-19 Aug 2010, poster.

8. Allen DA, Mann EA, and Serio-Melvin 

ML. Clinician Satisfaction with Computer 

Decision Support in the Burn ICU. PJV, 

26-29 Apr 2010, poster.

9. Allen PB, Dubick MA, Salyer SW, Holcomb 

JB, and Blackbourne LH. Preventing 

Hypothermia: An Evaluation Comparing 

Current Devices Used by the U.S. Army, 

Utilizing an In Vitro Warmed Saline Model. 

Committee on Tactical Combat Casualty 

Care, 3 Aug 2010, presentation.

10. Allen PB, Salyer SW, Dubick MA, Holcomb 

JB, and Blackbourne LH. Preventing 

hypothermia: Comparison of current devices 

used by the U.S. Army in an in vitro warmed 

fluid model. J Trauma, 2010 Jul, 69 Supp 1: 

S154-61.

11. Allen PB, Salyer SW, Dubick MA, Holcomb 

JB, and Blackbourne LH. Preventing 

Hypothermia: An Evaluation Comparing 

Current Devices Used by the U.S. Army, 

Utilizing an In Vitro Warmed Saline Model. 

NATO, 19-21 April 2010, presentation.

12. Allen PB, Salyer SW, Dubick MA, Holcomb 

JB, and Blackbourne LH. Preventing 

hypothermia: Comparison of current devices 

used by the U.S. Army with an in vitro 

warmed crystalloid fluid model. Proc of 

NATO RTO Symposium on Use of Advanced 

Technologies and New Procedures in 

Medical Field Operations, 182: 1-22.

13. Alvarado R, Chung KK, Cancio LC, and Wolf 

SE. Burn resuscitation. Burns, 2009 Feb, 

35(1): 4‐14. Epub 2008 Jun 9.

14. Anthony L, Gerhardt RT, Sharma K, et al. 

Enabling pre-hospital documentation via 

spoken language understanding on the 

modern battlefield. In press, Proceedings of 

the 3rd International Conference on Applied 

Human Factors and Ergonomics, 2010.

15. Ashley JS. The Army Nurse Corps 

Population and Practices. Recruiting 

Commands Educators Tour for Deans of 

Schools of Nursing, May 2010, presentation.

16. Atkins JL. Overview of the Planned Studies 

of Therapeutic Interventions for ClosedHead Injury Associated with Significant 

Trauma and Hemorrhage. ATACCC 2009, 

presentation.

17. Atkins JL. Hyperkalemia after packed red 

blood cell transfusion in trauma patients – 

discussion. J Trauma, 2008, 64(2): S90-S91.

18. Atkins JL, Gorbunov NV, and Komarov 

A. The Role of Iron in Lung Inflammation 

Following Blast Exposure or Hemorrhage 

Resuscitation. Military Health Research 

Forum 2009, presentation.

19. Atkins JL, Gorbunov NV, Komarov A, and 

Kiang J. Increase in intercellular iron causes 

extracellular release of asymmetric dimethyl 

arginine (ADMA). ATACCC 2009, poster.

2-68

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
20. Atkins JL, Gorbounov NV, Trabosh V, Van 

Duyne R, Kashanchi F, and Komarov AM. 

Ferrous iron is found in mesenteric lymph 

bound to TIMP-2 following hemorrhage/

resuscitation. Biometals, In press, 2010, 

DOI: 10.1007/s10534-010-9394-1.

21. Atkins JL, Gorbounov NV, Van Duyne 

R, Kashanchi F, and Komarov AM. Fe(II) 

complexes increase in mesenteric lymph 

after resuscitation from hemorrhage. Shock 

Congress 2008. Shock, June 2008, 29: 7, 

P122.

22. Atkins JL, Hammamieh R, Jett M, Gorbunov 

NV, Asher LV, and Kiang JG. Alphadefensin-like product and asymmetric 

dimethylarginine increase in mesenteric 

lymph after hemorrhage in anesthetized rat. 

Shock, 2008, 30(4): 411-6.

23. Atkins JL, Kagan V, Byzek S, Keesee J, 

Gist I, and Lu X. Enhanced Survival in 

Hemorrhagic Shock Through Changes in 

Dietary Nitrite. ATACCC 2009, presentation.

24. Atkins JL, Lee C-H, Barrows E, Quinn P, 

Gonzales R, and Oliver JD. Dual lumen 

catheter for heparin-free hemorrhage in rats: 

Design, construction and use. FASEB J, 

2008, 22: 1227.13.

25. Atkins JL and Long JB. Loss of 

Ceruloplasmin Ferroxidase Activity 

Contributes to Neuronal Injury After Blast 

Exposure. Military Health Research Forum 

2009, presentation.

26. Austin TJ, Brown Baer P, Christy R, Thomas 

S, and Hale R. Soft Tissue Constructs 

Using Regenerative Medicine Technology 

to Reconstruct Orofacial Wounds After Burn 

Scar Excision. NATO, 19-21 April 2010, 

poster.

27. Bacomo FK, Lundy JB, and Chung KK. 

Concomitant Drotrecogin Alfa Use and Renal 

Replacement Therapy in Severely Ill Septic 

Patients in the Burn Unit. Society of Critical 

Care Medicine, 9-13 Jan 2010, poster.

28. Bauman RA, Ling G, Tong L, Januszkiewicz 

A, Agoston D, Delanerolle N, Kim Y, Ritzel D, 

Bell R, Ecklund J, Armonda R, Bandak F, and 

Parks S. An introductory characterization 

of a combat-casualty-care relevant swine 

model of closed head injury resulting from 

exposure to explosive blast. J Neurotrauma, 

2009, 26: 841-860.

29. Baer DG, Dubick MA, Wenke JC, McGhee 

LL, Convertino VA, Cancio LC, Wolf SE, 

and Blackbourne LH. Advanced Product 

Development for Combat Casualty Care at 

the U.S. Army Institute of Surgical Research. 

NATO, 19-21 April 2010, presentation

30. Baer DG, Dubick MA, Wenke JC, McGhee 

LL, Convertino VA, Cancio LC, Wolf SE, and 

Blackbourne LH. Advanced product development for combat casualty care at the U.S. 

Army Institute of Surgical Research. Proc of 

NATO RTO Symposium on Use of Advanced 

Technologies and New Procedures in 

Medical Field Operations, 182: 02-1-11.

31. Baer LA, Burns JW, Jordan BS, Sondeen 

JL, Dubick MA, Chaudry IH, and Wade CE. 

Resuscitation of hemorrhaged sedated 

mature male miniature swine with 17-β estradiol. Shock, 2008 June, 29(Supp 1): 11.

32. Baer LA, McCue R, Hsu O, and Wade 

CE. Effects of Disuse and Controlled 

Hemorrhage on Liver Function in Rats. 

Shock Society, 12-15 Jun 2010, poster.

33. Baer LA, Pidcoke HF, Wu X, Silliman DT, 

Walters T, Tou J, Wolf SE, and Wade CE. 

Effects of Daily Insulin Treatment on Bone in 

Rats Following Severe Burn and Disuse. EB 

(FASEB), 24-28 Apr 2010, poster.

34. Baer LA, Wade CE, Silliman DT, Walters T, 

Wolf SE, and Wu X. Severe burn and disuse 

independently contribute to reduction in bone 

density in rats. FASEB J, 2008 April, 22: 

1205.1.

35. Bailey JR, Stinner DJ, Backbourne LH, Hsu 

JR, and Mazurek MT, STReC. CombatRelated Pelvis Fractures in Non-Survivors. 

ATACCC, 16-19 Aug 2010, presentation.

36. Barillo DJ, Cancio LC, Stack RS, Carr 

SR, Broger KP, Crews DM, Renz EM, and 

Blackbourne LH. Deployment and operation 

of a transportable burn intensive care unit in 

response to a burn multiple casualty incident. 

Am J Disaster Med, 2010 Jan-Feb, 5(1): 5-13.

37. Barillo DJ, Renz E, Broger K, Moak B, Wright 

G, and Holcomb JB. An emergency medical 

bag set for long-range aeromedical transportation. Am J Disaster Med, 2008 Mar-Apr, 

3(2): 79-86.

38. Barr JL, Mase VJ, Grubbs DL, Roe JL, 

Walters TJ, and Dubick MA. Effect of 

Skeletal Muscle Ischemia-Reperfusion (I/R) 

Post-Conditioning (Post C) on Antioxidant 

Status in Rats. ATACCC, 16-19 Aug 2010, 

poster.

2-69
39. Batchinsky A, Kuusela T, Salinas J, Jones 

J, Convertino V, Baer D, Wade C, Holcomb 

J, and Cancio L. Clinical and methodological impact of data set length reduction on 

measures of R-to-R interval complexity in 

prehospital trauma patients. J Crit Care, 

2007 Dec, 22(4): 339.

40. Batchinsky A, Salinas J, Holcomb J, 

and Cancio L. Assessment of the Need 

to Perform Life-Saving Interventions 

Using Comprehensive Analysis of the 

Electrocardiogram and Artificial Neural 

Networks. NATO, 19-21 April 2010, 

presentation.

41. Batchinsky AI. The Patient as a Complex 

System. Assessment of System Level 

Complexity: Practicality at the Bedside. 

Complexity and Variability at the Bedside, 

28 Sep-1 Oct 2010, presentation.

42. Batchinsky AI. Tapering off Mechanical 

Ventilation: Objective Criteria for Weaning. 

Society for Complexity in Acute Illness, 

10-12 Sep 2010, presentation.

43. Batchinsky AI. Toward a Complex Systems 

Approach in Bedside Monitoring. ATACCC, 

16-19 Aug 2010, presentation.

44. Batchinsky AI, Cancio LC, and Buchman TG. 

Half empty or half full? Crit Care Med, 2010 

Aug, 38(8): 1747-8.

45. Batchinsky AI, Cooke WH, Kuusela TA, 

Jordan BS, and Cancio LC. Sympathetic 

nerve activity and heart rate variability during 

severe hemorrhagic shock in sheep. Auton 

Neurosci, 2007 Oct 30, 136(1-2): 43-51.

46. Batchinsky AI, Jordan BS, Necsoiu C, 

Dubick M, and Cancio LC. Dynamic changes 

in shunt and ventilation-perfusion mismatch 

following experimental pulmonary contusion. 

Shock, 2010 March, 33(4): 419-425.

47. Batchinsky AI, Jordan BS, Regn D, Necsoiu 

C, Federspiel W, Morris MJ, and Cancio LC. 

Veno-Venous Extracorporeal CO2 Removal: 

Can We Reduce Dependence on Mechanical 

Ventilation During En-Route Care? NATO, 

19-21 April 2010, poster.

48. Batchinsky AI, Jordan BS, Regn D, Necsoiu 

C, Morley S, Federspiel W, Hattler BG, 

Morris MJ, Blackbourne L, and Cancio LC. 

Veno-Venous Extracorporeal CO2 Removal: 

Reduction in Dependence on Mechanical 

Ventilation via the Hemolung Artificial Lung 

System. ATACCC, 16-19 Aug 2010, poster.

49. Batchinsky AI, Liu NT, Baker WL, Walker 

K, Salinas J, and Cancio LC. Real-Time 

Calculation of Heart Rate Complexity 

in Trauma Patients Following Automatic 

R-Wave Detection via the Automated 

Electrocardiogram Selection of Peaks 

(AESOP) Algorithm. ATACCC, 16-19 Aug 

2010, poster.

50. Batchinsky AI, McManus JG, Ryan KL, 

Rickards CA, and Convertino VA. Changes 

in pulse character and mental status are late 

responses to central hypovolemia. Prehosp 

Emerg Care, 2008 Apr-Jun, 12(2): 192-8.

51. Batchinsky AI, Necsoiu C, Jordan B, Burns 

J, Wade C, and Cancio LC. Effects of 

Selective Autonomic Blockade on HeartRate Complexity and Survival Time During 

Lethal Hemorrhagic Shock. ATACCC, 16-19 

Aug 2010, poster.

52. Batchinsky AI, Necsoiu C, Jordan B, Burns J, 

Wade C, and Cancio LC. Effects of Selective 

Autonomic Blockade on Heart-Rate 

Complexity and Survival Time During Lethal 

Hemorrhagic Shock. Shock Society, 12-15 

Jun 2010, poster.

53. Batchinsky AI, Salinas J, and Cancio LC. 

Managing Information Flow for Decision 

Support at the Bedside. International 

Workshop on Complexity and Real World 

Applications, 21-23 Jul 2010, presentation.

54. Batchinsky AI, Salinas J, Jones JA, Necsoiu 

C, and Cancio LC. Predicting the Need to 

Perform Life-Saving Interventions in Trauma 

Patients Using New Vital Signs and Artificial 

Neural Networks. ATACCC, 16-19 Aug 2010, 

poster.

55. Batchinsky AI, Skinner JE, Necsoiu C, 

Jordan BS, Weiss D, and Cancio LC. New 

measures of heart-rate complexity: Effect of 

chest trauma and hemorrhage. J Trauma, 

2010 Feb 18.

56. Batchinsky AI, Terrazas IB, Shah S, Bevis 

ZJ, Scherer MA, Dubick MA, Holcomb JB, 

and Cancio LC. Immediate effects of chest 

trauma on coagulation status in swine. 

Shock, 2008 June, 29(Supp 1): 119.

57. Batchinsky AI, Ward JA, Baker WL, 

Walker K, Salinas J, and Cancio LC. 

Lyaponov Exponent Calculations as Indices 

of Cardiovascular Regulation During 

Hemorrhage with Autonomic Blockade. 

Society for Complexity in Acute Illness, 10-12 

Sep 2010, poster.

58. Batchinsky AI, Wolf SE, Molter N, Kuusela T, 

Jones JA, Moraru C, Boehme M, Williams K, 

2-70

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Bielke P, Wade C, Holcomb JB, and Cancio 

LC. Assessment of cardiovascular regulation after burns by nonlinear analysis of the 

electrocardiogram. J Burn Care Res, 2008 

Jan/Feb, 29(1): 56‐63. 

59. Bauman RA, Ling G, Tong L, Januszkiewicz 

A, Agoston D, Delanerolle N, Kim Y, Ritzel D, 

Bell R, Ecklund J, Armonda R, Bandak F, and 

Parks S. An introductory characterization 

of a combat-casualty-care relevant swine 

model of closed head injury resulting from 

exposure to explosive blast. J Neurotrauma, 

2009, 26(6): 841-60.

60. Bedno SA, Li Y, Han W, Cowan DN, Scott 

CT, Cavicchia MA, and Niebuhr DW. 

Exertional heat illness among overweight 

U.S. Army recruits in basic training. Aviation, 

Space, and Environmental Medicine, 2010, 

81(2): 107-11.

61. Beekley AC, Blackbourne LH, Sebesta JA, 

McMullin NR, Mullenix PS, Holcomb JB, 

and Members of the 31st Combat Support 

Hospital Research Group. Selective nonoperative management of penetrating torso 

injury from combat fragmentation wounds. 

J Trauma, 2008 Feb, 64(2 Supp): S108-S117.

62. Beekley AC, Sebesta JA, Blackbourne LH, 

Herbert GS, Kauvar DS, Baer DG, Walters 

TJ, Mullenix PS, Holcomb JB, and Members 

of the 31st Combat Support Hospital 

Research Group. Prehospital tourniquet use 

in operation Iraqi freedom: Effect on hemorrhage control and outcomes. J Trauma, 2008 

Feb, 64(2 Supp): S-28-S37.

63. Beltran MJ, Burns TC, Eckel TT, Potter BK, 

Wenke JC, and Hsu JR, STReC. Peripheral 

Nerve Recovery Following Combat-Related 

Type III Open Tibia Fractures. Limb 

Lengthening and Reconstruction Society, 

16-17 Jul 2010, presentation.

64. Beltran MJ and Collinge CA. Effects of 

Computerized Physician Order Entry (CPOE) 

on Perioperative Antibiotic Administration 

Errors in Patients with High-Energy Open 

and Closed Fractures. Orthopaedic Trauma 

Association, 13-16 Oct 2010, poster.

65. Beltran MJ, Kirk KL, and Hsu JR. Minimally 

invasive shortening humeral osteotomy to 

salvage a through-elbow amputation. Mil 

Med, 2010 Sep, 175(9): 693-6.

66. Beltran MJ, Ochoa LM, Graves RM, and Hsu 

JR. Composite bone and soft tissue loss 

treated with distraction histiogenesis. J Surg 

Orthop Adv, 2010 Spring, 19(1): 23-8.

67. Bennett JW, Robertson JL, Hospenthal DR, 

Wolf SE, Chung KK, Mende K, and Murray 

CK. Impact of extended spectrum betalactamase producing Klebsiella pneumoniae

infections in severely burned patients. J Am 

Coll Surg, 2010 Sep, 211(3): 391-9. 

68. Bentley TB and Long JB. Blast Injury 

Decreases Hemorrhage Tolerance in Rats. 

Advanced Technology Applications for 

Combat Casualty Care (ATACCC) Meeting, 

St. Pete’s Beach, FL, August, 2009.

69. Blackbourne LH. Combat Blood Transfusion. 

France-U.S. Blood Products and Cellular 

Therapy Workshop 2010, 15-16 Apr 2010, 

presentation.

70. Blackbourne LH. Combat Damage Control 

Resuscitation No. 1. NATO, 19-21 April 2010, 

presentation.

71. Blackbourne LH. Combat Damage Control 

Resuscitation No. 2. NATO, 19-21 April 2010, 

presentation.

72. Blackbourne LH. Combat Prehospital 

Resuscitation. Prehospital Resuscitation 

Conference, 26-27 Feb 2010, presentation.

73. Blackbourne LH. Blood Ratios – Yes. 

Eastern Association for the Surgery of 

Trauma, 19-23 Jan 2010, presentation.

74. Blackbourne LH. The next generation of 

combat casualty care. J Trauma, 2009 Apr, 

66(4 Supp): S27-8.

75. Blackbourne LH. Combat damage control 

surgery. Crit Care Med, 2008 Jul, 36(7 

Supp): S304-10.

76. Blackbourne LH, Czarnik J, Mabry R, 

Eastridge B, Baer D, Butler F, and Pruitt B 

Jr. Decreasing killed in action and died of 

wounds rates in combat wounded. J Trauma, 

2010 Jul, 69(Supp 1): S1-4.

77. Blackbourne LH and Pruitt B Jr. The warrior’s combat surgeon: COL (ret.) John B. 

Holcomb, MD, FACS—U.S. Army 1985-

2008. J Trauma, 2009 Apr, 66(4 Supp): 

S29-30.

78. Blair JA, Owens J, and Hsu JR, STReC. 

Functional Capabilities of Lower Extremity 

Limb Salvage Patients Using a Circular 

External Fixator with a Foot Plate 

Modification. Limb Lengthening and 

Reconstruction Society, 16-17 Jul 2010, 

presentation.

2-71
79. Blair JA, Stinner DJ, Kirby JM, Gerlinger 

TL, and Hsu JR, Skeletal Trauma Research 

Consortium (STReC). Quantification of 

femoral neck exposure through a minimally 

invasive Smith-Petersen approach. J Orthop 

Trauma, 2010 Jun, 24(6): 355-8.

80. Bluman EM, Hills C, Keeling JJ, and Hsu JR. 

Augmented subatmospheric wound dressings (SAWDA): Technique tip. Foot Ankle Int, 

2009 Jan, 30(1): 62-4. 

81. Bodo M, Garcia A, Pearce F, Van Albert S, 

and Armonda R. Influence of volume and 

flow change on the electrical impedance signal (in vitro). Journal of Physics: Conference 

Series, 2010, 224(1): 012111.

82. Bodo M, Pearce F, Garcia A, Van Albert S, 

Settle T, Szebeni J, Baranyi L, Hartings J, 

and Armonda R. In vivo cerebral blood flow 

autoregulation studies using rheoencephalography. Journal of Physics: Conference 

Series, 2010, 224(1): 012088.

83. Bolenbaucher R. Development of 

Performance Improvement Knowledge for 

Deployed Trauma Nurse Coordinators. STN 

Conference, 7-9 Apr 2010, presentation.

84. Bolenbaucher R, Compton L, Molter N, 

Moore J, Cotner-Pouncy T, West S, and 

Spott MA. Caring for Wounded Warriors: 

Development of Performance Improvement 

Knowledge for Deployed Trauma Nurse 

Coordinators. STN Conference, 7-9 Apr 

2010, poster.

85. Bommineni YR, Dick EJ Jr, Estep JS, Van 

de Berg JL, and Hubbard GB. Fatal acute 

chagas disease in a chimpanzee. J Med 

Primatol, 2009 Mar 5.

86. Borgman MA, Spinella PC, Perkins JG, 

Grathwohl KW, Repine T, Beekley AC, 

Sebesta J, Jenkins D, Wade CE, and 

Holcomb JB. The ratio of blood products 

transfused affects mortality in patients 

receiving massive transfusions at a combat 

support hospital. J Trauma, 2007 Oct, 63(4): 

805-13.

87. Bowman PD, Bynum JA, and Klemcke HG. 

Gene expression analysis of circulating 

leukocytes of rat strains exhibiting long and 

short survival times following severe hemorrhage. FASEB J, 2008 April, 22: 1255.16.

88. Bowman PD, Sondeen JL, Prince MD, and 

Bynum JA. The genetic response of human 

umbilical vein endothelial cells (HUVEC) to 

laminar shear stress. FASEB J, 2008 April, 

22: 964.22.

89. Boyer JM, Blatz PJ, Akers KS, Okulicz JF, 

Chung KK, Renz EM, Hospenthal DR, and 

Murray CK. Nontuberculous mycobacterium 

infection in a burn ICU patient. Burns, 2010 

Jun 29. 

90. Brady KM, Mytar JO, Kibler KK, Easley RB, 

Koehler RC, Czosnyka M, Smielewski P, 

Zweifel C, Bodo M, Pearce FJ, and Armonda 

RA. Monitoring cerebrovascular pressure 

reactivity with rheoencephalography. Journal 

of Physics: Conference Series, 2010, 224(1): 

012089.

91. Branstetter JG, Jackson SR, Haggard WO, 

Richelsoph KC, and Wenke JC. Locallyadministered antibiotics in wounds in a 

limb. J Bone Joint Surg Br, 2009 Aug, 91(8): 

1106-9.

92. Bray AB, Foy KJ, and Castillo MA. Value of 

Oral Care in the Reduction of VAP in Burn 

ICU Patients. AMSUS, 2 Nov 2010, poster.

93. Bray AB, Foy KJ, and Castillo MA. Value of 

Oral Care in the Reduction of VAP in Burn 

ICU Patients. Summer Institute on Evidence 

Based Practice, 8-10 Jul 2010, poster.

94. Brenner M, Kreuter K, Ju J, Mahon S, Tseng 

L, Mukai D, Burney T, Guo S, Su J, Tran A, 

Batchinsky A, Cancio LC, Narula N, and 

Chen Z. In vivo optical coherence tomography detection of differences in regional 

large airway smoke inhalation induced injury 

in a rabbit model. J Biomed Opt, 2008 May/

Jun, 13(3): 034001.

95. Bridges E. Evidence Based Practice Update 

from the Frontlines. PJV, 26-29 Apr 2010, 

presentation.

96. Bridges E. Evidence Based Practice Update 

from the Frontlines. University of Washington 

Critical Care Nursing Conference, 23 Mar 

2010, presentation.

97. Bridges E, Evers K, and Kirkness C. Wartime 

Critical Care Air Transport. AMSUS, 2 Nov 

2010, poster.

98. Brosch LR, Holcomb JB, Thompson JC, 

and Cordts PR. Establishing a human 

research protection program in a combatant 

command. J Trauma, 2008 Feb, 64(2 Supp): 

S9-S13.

99. Brown Baer P, Ioppolo RB, Wenke J, and 

Hale R. Report of Injuries, Treatments 

and Surgical Outcomes of Soldiers with 

Complex Craniomaxillofacial Battle Injuries: 

A Case Series. Armed Forces Institute of 

Regenerative Medicine, 11-15 Jan 2010, 

poster.

2-72

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
100. Brown Baer PR, Wenke JC, Guelcher SA, 

Dumas J, and Hale RG. Fracture of Calcium 

Phosphate Bone Substitute in the Rabbit 

Cranial Critical Size Defect Model. ATACCC, 

16-19 Aug 2010, poster.

101. Brown K, Walker JA, Cortez DS, Murray 

CK, and Wenke JC. Earlier Debridement 

and Antibiotic Administration Decreases 

Infection. AAOS, 9-13 March 2010, 

presentation.

102. Brown KV, Dharm-Datta S, Potter BK, 

Etherington J, Mistlin A, Hsu JR, and 

Clasper JC. Comparison of development of 

heterotopic ossification in injured U.S. and 

U.K. armed services personnel with combatrelated amputations: Preliminary findings and 

hypotheses regarding causality. J Trauma, 

2010 Jul, 69 Supp 1: S116-22.

103. Brown KV, Li B, Guda T, Perrien D, 

Guelcher SA, and Wenke JC. Decreasing 

Complications in Open Fractures with a 

Novel Bone Graft. Orthopaedic Research 

Society, 6-9 Mar 2010, poster.

104. Brown KV, Walker JA, Cortez DS, Murray 

CK, and Wenke JC. Earlier debridement and 

antibiotic administration decrease infection. J Surg Orthop Adv, 2010 Spring, 19(1): 

18-22.

105. Burkett SE, Zanders TB, Batchinsky A, 

Chung KK, Jordan BS, Regn D, Nguyen 

R, Necsoiu C, Morris M, and Cancio LC. 

Comparison of Airway Pressure Release 

Ventilation to Conventional Ventilation in a 

Porcine Model of Severe Inhalation Injury. 

Society of Critical Care Medicine, 9-13 Jan 

2010, poster.

106. Burns J, Baer L, Dubick M, and Wade C. 

Controlled 60% hemorrhage with small 

volume P188 in miniature swine. Shock, 33 

(Supp 1): 37-38 (abst P83), 2010.

107. Burns JW, Baer LA, Hagerman EJ, Jordan 

BS, Nelson JJ Jr, Batchinsky AI, Cancio 

LC, Jones JA, Dubick MA, and Wade CE. 

Development and resuscitation of a sedated, 

mature male miniature swine severe hemorrhage model. J Trauma, 2010 Nov 4.

108. Burns JW, Baer LA, Meyers BL, Nelson JJ, 

Fedyk CG, Scherer MR, Jones JA, Dubick 

MA, and Wade CE. Severe Controlled 

Hemorrhage Resuscitation with Small 

Volume Poloxamer 188 in Sedated Miniature 

Swine. Shock Society, 12-15 Jun 2010, 

poster.

109. Burns JW, Kruyer WB, Celio PV, Deering 

J, Loecker TH, Richardson LA, Fanton JW, 

Davis H, and Dick EJ Jr. Cardiac ischemia 

model for +Gz using miniature swine and 

baboons. Aviat Space Environ Med, 2008 

Apr, 79(4): 374-83.

110. Burns TC, Stinner DJ, Possley DR, Mack 

AW, Eckel TT, Potter BK, Wenke JC, 

and Hsu JR. Skeletal Trauma Research 

Consortium (STReC). Does the zone of 

injury in combat-related type III open tibia 

fractures preclude the use of local soft tissue 

coverage? J Orthop Trauma, 2010 Nov, 

24(11): 697-703.

111. Burns TC, Stinner DJ, Possley DR, Mack 

AW, Eckel TT, Potter BK, Wenke JC, 

and Hsu JR. Does the Zone of Injury 

in Combat Related Type III Open Tibia 

Fractures Preclude the Use of Local Soft 

Tissue Coverage? American Orthopaedic 

Association, 9-12 Jun 2010, poster.

112. Butler FK Jr, Holcomb JB, Giebner SD, 

McSwain NE, and Bagian J. Tactical combat 

casualty care 2007: Evolving concepts and 

battlefield experience. Mil Med, 2007 Nov, 

172(11 Supp): 1‐19. 

113. Calderon M, Ryan KL, Kheirabadi BS, and 

Klemck HG. Differences among inbred rat 

strains in hematoligical and coagulation measures. FASEB J, 2008 April, 22: 1227.3.

114. Calvano TP, Hospenthal DR, Renz EM, Wolf 

SE, and Murray CK. Central nervous system 

infections in patients with severe burns. 

Burns, 2010 Aug, 36(5): 688-91. Epub 2009 

Oct 12.

115. Cancio LC. Invited critique: Bridging the gap 

between disaster plan and execution. J Burn 

Care Res, 2008 Jan-Feb, 29(1): 166-7.

116. Cancio LC, Batchinsky AI, Salinas J, Kuusela 

T, Convertino VA, Wade CE, and Holcomb 

JB. Heart rate complexity for prediction of 

prehospital lifesaving interventions in trauma 

patients. J Trauma, 2008.

117. Cancio LC, Kuwa T, Matsui K, Drew GA, 

Galvez E Jr, Sandoval LL, and Jordan BS. 

Intestinal and gastric tonometry during 

experimental burn shock. Burns, 2007 Nov, 

33(7): 879-84. 

118. Cancio LC, Wade CE, West SA, and 

Holcomb JB. Prediction of mortality and of 

the need for massive transfusion in casualties arriving at combat support hospitals 

in Iraq. J Trauma, 2008 Feb, 64(2 Supp): 

S51-S56.

119. Cannon JW, Eastridge B, Holcomb JB, and 

Blackbourne LH. Incidence and Mortality of 

ARDS in Combat Casualty Care. ATACCC, 

16-19 Aug 2010, presentation.

2-73
120. Cardo LJ, Hmel P, and Wilder D. Stored 

packed red blood cells contain a procoagulant phospholipid reducible by leukodepletion filters and washing. Transfusion and 

Apheresis Science, 2008, 38(2): 141-7.

121. Cardo LJ, Salata J, and Wilder D. Removal 

of Plasmodium falciparum-infected red blood 

cells from whole blood by leukoreduction 

filters. Transfusion, 2009, 49(2): 337-46.

122. Cardo LJ, Wilder D, and Salata J. Neutrophil 

priming, caused by cell membranes and 

microvesicles in packed red blood cell units, 

is abrogated by leukocyte depletion at collection. Transfusion and Apheresis Science, 

2008, 38(2): 117-25.

123. Champion HR, Holcomb JB, Lawnick MM, 

Kelliher T, Spott MA, Galarneau MR, Jenkins 

DH, West SA, Dye J, Wade CE, Eastridge 

BJ, Blackbourne LH, and Shair EK. Improved 

characterization of combat injury. J Trauma, 

2010 May, 68(5): 1139-50.

124. Champion HR, Holcomb JB, and Young LA. 

Injuries from explosions: Physics, biophysics, 

pathology, and required research focus. J 

Trauma, 2009 May, 66(5): 1468-77; discussion 1477. Review.

125. Chapman TT, Richard RL, Hedman TL, 

Chisholm GB, Quick CD, Baer DG, Dewey 

WS, Jones JS, Renz EM, Barillo DJ, Cancio 

LC, Chung KK, Holcomb JB, and Wolf SE. 

Military return to duty and civilian return to 

work factors following burns with focus on 

the hand and literature review. J Burn Care 

Res, 2008 Sep-Oct, 29(5): 756-62.

126. Chapman TT, Richard RL, Hedman TL, Renz 

EM, Wolf SE, and Holcomb JB. Combat 

casualty hand burns: Evaluating impairment 

and disability during recovery. J Hand Ther, 

2008 Apr-Jun, 21(2): 150-9.

127. Chen J, Crispin JC, Tedder TF, Dalle Lucca 

J, and Tsokos GC. B cells contribute to 

ischemia/reperfusion-mediated tissue injury. 

J Autoimmunity, 2009, 32(3-4): 195-200.

128. Chen X, Roe J, Sanchez ME, Wu X, 

Rathbone CR, Yoo JJ, and Walters TJ. 

Treatment of Tourniquet-Induced Ischemia/

Reperfusion Injury with Muscle Progenitor 

Cells. Translational Regenerative Medicine 

Forum, 6-8 Apr 2010, poster.

129. Chen X, Roe J, Sanchez ME, Wu X, 

Rathbone CR, Yoo JJ, and Walters TJ. 

Treatment of Tourniquet-Induced Ischemia/

Reperfusion Injury with Muscle Progenitor 

Cells. WFIRM Retreat, 8-9 Mar 2010, poster.

130. Chen Z, Tortella FC, Dave JR, Marshall VS, 

Clarke DL, Sing G, Du F, and Lu XC. Human 

amnion-derived multipotent progenitor cell 

treatment alleviates traumatic brain injuryinduced axonal degeneration. Journal of 

Neurotrauma, 2009, 26(11): 1987-97.

131. Chik PP, Ho CS, Yeung PS, Wong YK, Chan 

DW, Chung KK, and Lo LY. Contribution of 

discourse and morphosyntax skills to reading 

comprehension in Chinese dyslexic and typically developing children. Ann Dyslexia, 2010 

Sep 11. [Epub ahead of print].

132. Cho SE, Holcomb JB, Tieu BH, Englehart 

MS, Morris MS, Karahan ZA, Underwood 

SA, Muller PJ, PrinceMD, Medina L, 

Sondeen J, Shults C, Duggan M, Tabbara M, 

Alam HB, and Schreiber MA. Reproducibility 

of an animal model simulating complex 

combat related injury in a multiple institution 

format. Shock, 2009 Jan, (31)1: 87-96.

133. Christy R. Adipose Derived Stem Cells 

for Tissue Engineered Therapies. 

Johns Hopkins University, 22 Mar 2010, 

presentation.

134. Christy R, Natesan S, Walters T, and Baer 

DG. Delivery of Adipose Derived Stem Cells 

into Collagen Based Hydrogels. Armed 

Forces Institute of Regenerative Medicine, 

11-15 Jan 2010, poster.

135. Christy R, Seetharaman S, Stowers R, 

Natesan S, and Suggs L. Preparation and 

Characterization of Silver Sulfadiazine 

Loaded Chitosan Microspheres for 

Infected Wounds. Armed Forces Institute 

of Regenerative Medicine, 11-15 Jan 2010, 

poster.

136. Christy RJ. Extremity Trauma Research 

& Regenerative Medicine. Centre de 

Transfusion Sanguine Des Armees, 16 Apr 

2010, presentation.

137. Christy RJ, Natesan S, Seetharaman M, 

Zamora D, Hardy S, and Wrice N. Stem Cells 

for the Treatment of Soft Tissue Trauma and 

Burns. San Antonio Stem Cell Conference, 

18-20 Oct 2010, presentation.

138. Chung K, Renz EM, Cancio LC, and Wolf S. 

Regarding critical care of the burn patient: 

The first 48 hours. Crit Care Med, 2010 Apr, 

38(4): 1225. 

139. Chung KK. Emergency Burn Care. WBAMC 

Grand Rounds, 12 Oct 2010, presentation.

140. Chung KK. Urine Output Is the Best Monitor 

of Burn Resuscitation. National Trauma 

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Medical Chemical 

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Infectious 

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Care
Institute Conference, 30 Aug-1 Sep 2010, 

presentation.

141. Chung KK. Telemedicine the Military 

Perspective. Remote Presence Clinical 

Innovator’s Forum, 22-24 Jul 2010, 

presentation.

142. Chung KK. Renal Replacement Therapy in 

the Burn ICU: Issues and Controversies. 

ABA, 9-12 Mar 2010, presentation.

143. Chung KK. Military Telemedicine Past, 

Present, and Future. Battlefield Healthcare 

Summit, 29 Mar 2010, presentation.

144. Chung KK. BEST Ventilator Mode Study: A 

Prospective Randomized Controlled Trial. 

Society of Critical Care Medicine, 9-13 Jan 

2010, presentation.

145. Chung KK, Blackbourne LH, Renz EM, 

Cancio LC, Wang J, Park MS, Horvath EE, 

Albrecht MC, White CE, Wanek SM, Barillo 

DJ, Wolf SE, and Holcomb JB. Global evacuation of burn patients does not increase the 

incidence of venous thromboembolic complications. J Trauma, 2008 Jul, 65(1): 19-24.

146. Chung KK, Dennis CJ, Yoon BS, Milligan 

DJ, and Holland SR. Risk Factors for 

Hypotension Following Urgent Intubation in 

a Burn Intensive Care Unit. Army/AF ACP, 

17-19 Nov 2010, poster.

147. Chung KK, Grathwohl KW, Barrigan C, 

Poropatich RK, Renz EM, and Blackbourne 

LH. Robotic Tele-Presence in a Military ICU: 

A Prospective Observational Study. Society 

of Critical Care Medicine, 9-13 Jan 2010, 

poster.

148. Chung KK, Juncos LA, Wolf SE, Mann 

EE, Renz EM, White CE, Barillo DJ, Clark 

RA, Jones JA, Edgecombe HP, Park MS, 

Albrecht MC, Cancio LC, Wade CE, and 

Holcomb JB. Continuous renal replacement 

therapy improves survival in severely burned 

military casualties with acute kidney injury. 

J Trauma, 2008 Feb, 64(2 Supp): S179-S187.

149. Chung KK, Lundy JB, Matson JJ, Renz EM, 

White CE, King BT, Barillo DJ, Jones JA, 

Cancio LC, Blackbourne LH, and Wolf SE. 

Continuous venovenous hemofiltration in 

severely burned patients with acute kidney 

injury: A cohort study. Crit Care, 2009 May 1, 

13(3): R62.

150. Chung KK, Perkins RM, and Oliver JD III. 

Renal replacement therapy in support of 

combat operations. Crit Care Med, 2008 Jul, 

36(7 Supp): S365-9.

151. Chung KK, Salinas J, Renz EM, Alvarado 

RA, King BT, Barillo DJ, Cancio LC, Wolf 

SE, and Blackbourne LH. Simple derivation 

of the initial fluid rate for the resuscitation of 

severely burned adult combat casualties: In 

silico validation of the rule of 10. J Trauma, 

2010 Jul, 69 Supp 1: S49-54.

152. Chung KK, Shelhamer M, Aden JK, Merill 

GA, Wolf SE, Renz EM, Schwacha MG, 

Holcomb JB, Blackbourne LH, and Cancio 

LC. Prognostic Value of Serum Cytokines 

in Severely Burned Patients on Mechanical 

Ventilation. Chest, 30 Oct-4 Nov 2010, 

presentation.

153. Chung KK, Shelhamer MC, Aden JA, Merrill 

GA, Schwacha MG, Cancio LC, Renz EM, 

Wade CE, Blackbourne LH, and Wolf SE. 

Inflammatory Response to High Frequency 

Percussive Ventilation. Shock Society, 12-15 

Jun 2010, poster.

154. Chung KK, Wolf SE, Cancio LC, Alvarado 

R, Jones JA, McCorcle J, King BT, Barillo 

DJ, Renz EM, and Blackbourne LH. 

Resuscitation of severely burned military 

casualties: Fluid begets more fluid. J Trauma, 

2009 Aug, (67)2: 231-237.

155. Chung KK, Wolf SE, Renz EM, Allan PF, 

Aden JK, Merrill GA, Shelhamer MC, 

King BT, White CE, Bell DG, Schwacha 

MG, Wanek SM, Wade CE, Holcomb JB, 

Blackbourne LH, and Cancio LC. Highfrequency percussive ventilation and low 

tidal volume ventilation in burns: A randomized controlled trial. Crit Care Med, 2010, 38: 

000–000.

156. Cohn SM, Blackbourne LH, Landry DW, 

Proctor KG, Walley KR, and Wenzel V. San 

Antonio vasopressin in shock symposium 

report. Resuscitation, 2010 Jul 22.

157. Convertino V, Thomas SJ, Soller BR, 

and Scott P. Investigating Non-Invasive 

Monitoring Devices Using Severe Dengue 

as a Surrogate for Trauma-Induced Shock. 

ATACCC, 16-19 Aug 2010, poster.

158. Convertino VA. Responses of Sympathetic 

Nerve Activity to Presyncope: New Insights 

About Autonomic Mechanisms of Fainting. 

International Society of Gravitational 

Physiology, 14-18 Jun 2010, presentation.

159. Convertino VA. Use of Advanced MachineLearning Techniques for Non-Invasive 

Monitoring of Hemorrhage. NATO, 19-21 

April 2010, presentation.

2-75
160. Convertino VA and Cap AP. Should patients 

with haemorrhage be kept warm? J Physiol, 

2010 Sep 1, 588(17): 3135.

161. Convertino VA, Hurst GM, Ryan KL, Vyas 

N, and Rickards CA. Bleeding or Active? 

Validation of a Machine-Learning Algorithm 

for Remote Determination of Blood Volume 

Status. American College of Sports 

Medicine, 2-5 Jun 2010, poster.

162. Convertino VA, Hurst GM, Ryan KL, Vyas 

N, Ward KR, and Rickards CA. Bleeding or 

Active? Validation of a Machine-Learning 

Algorithm for Remote Determination of Blood 

Volume Status. ATACCC, 16-19 Aug 2010, 

poster.

163. Convertino VA, Rickards CA, HinojosaLaborde C, Glorsky SL, Gerhardt RT, 

McManus JG, and Ryan KL. Advanced 

Capabilities for Emergency Medical 

Monitoring: A Strategy for Combat Casualty 

Triage Decision Support on the Battlefield. 

ATACCC, 16-19 Aug 2010, poster.

164. Convertino VA, Rickards CA, Ryan KL, and 

Cooke WH. Autonomic compensation to central hypovolemia monitored with heart period 

variability. FASEB J, 2008 April, 22: 1229.2.

165. Convertino VA, Ryan KL, Rickards CA, 

Salinas J, McManus JG, Cooke WH, and 

Holcomb JB. Physiological and medical 

monitoring for en route care of combat 

casualties. J Trauma, 2008 Apr, 64(4 Supp): 

S342-53.

166. Cooke WH, Rickards CA, Ryan KL, and 

Convertino VA. Autonomic compensation to 

simulated hemorrhage monitored with heart 

period variability. Crit Care Med, 2008 Jun, 

36(6): 1892-9.

167. Cooke WH, Rickards CA, Ryan KL, Kuusela 

TA, and Convertino VA. Muscle sympathetic 

nerve activity during intense lower body 

negative pressure to presyncope in humans. 

J Physiol, 2009 Aug 24. [Epub ahead of 

print].

168. Cooper DB, Mercado-Couch JM, Critchfield 

E, Kennedy J, Vanderploeg RD, DeVillibis 

C, and Gaylord KM. Factors influencing 

cognitive functioning following mild traumatic 

brain injury in OIF/OEF burn patients. 

NeuroRehabilitation, 2010 Jan 1, 26(3): 

233-8.

169. Cordts PR, Brosch LA, and Holcomb JB. 

Now and then: Combat casualty care policies 

for operation Iraqi freedom and operation 

enduring freedom compared with those of 

Vietnam. J Trauma, 2008 Feb, 64(2 Supp): 

S14-S20.

170. Costache MC, Qu H, Ducheyne P, and 

Devore D. Polymer-Xerogel Composites 

for Controlled Release Wound Dressings. 

Society for Biomaterials, 21-24 Apr 2010, 

poster.

171. Costache MC, Qu H, Ducheyne P, and 

Devore DI. Polymer-xerogel composites 

for controlled release wound dressings. 

Biomaterials, 2010 Aug, 31(24): 6336-43.

172. Covey DC, Aaron RK, Born CT, Calhoun JH, 

Einhorn TA, Hayda RA, Levin LS, Mazurek 

MT, Murray CK, Powell ET, Schwarz EM, and 

Wenke JC. Orthopaedic war injuries: From 

combat casualty care to definitive treatment: 

A current review of clinical advances, basic 

science, and research opportunities. Instr 

Course Lect, 2008, 57: 65-86.

173. Crabtree SJ, Robertson JL, Chung KK, Renz 

EM, Wolf SE, Hospenthal DR, and Murray 

CK. Clostridium difficile infections in patients 

with severe burns. Burns, 2010 Nov 1.

174. Cross JD, Ficke JR, Hsu JR, Masini BD, and 

Wenke JC. Female Casualties of Operations 

Enduring Freedom and Iraqi Freedom. 

SOMOS, 13-17 Dec 2010, presentation.

175. Cross JD, Ficke JR, Hsu JR, Masini BD, and 

Wenke JC. Battlefield Orthopaedic Injuries 

Cause the Majority of Long Term Disabilities. 

Orthopaedic Trauma Association, 13-16 Oct 

2010, poster.

176. Cross JD, Ficke JR, Hsu JR, Masini BD, and 

Wenke JC. Battlefield Orthopaedic Injuries 

Cause the Majority of Long Term Disabilities. 

Southern Orthopaedic Association, 16-19 

Jun 2010, poster.

177. Cross JD, Ficke JR, Hsu JR, Masini BD, and 

Wenke JC. Battlefield Orthopaedic Injuries 

Cause the Majority of Long Term Disabilities. 

Extremity War Injury Symposium, 27-29 Jan 

2010, presentation.

178. Cross JD, Johnson AE, Wenke JC, and 

Ficke JR. Battlefield Orthopaedic Injuries 

Cause the Majority of Long Term Disabilities. 

SOMOS, 13-17 Dec 2010, presentation.

179. Cross JD, Rathbone CR, and Wenke JC. 

Bone Morphogenetic Proteins: Comparison 

of Osteogenic, Antiogenic and Migratory 

Potentials. Orthopaedic Trauma Association, 

13-16 Oct 2010, presentation.

180. Cross JD, Stinner DJ, Burns TC, Wenke JC, 

and Hsu JR, STReC. Return to Duty After 

Type III Open Tibia Fracture. SOMOS, 13-17 

Dec 2010, presentation.

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Medical Chemical 

and Biological 

Defense

Clinical and 

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Medicine

Advanced 

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Military

Infectious 

Diseases

Combat 

Casualty

Care
181. Cross JD, Stinner DJ, Burns TC, Wenke JC, 

and Hsu JR, STReC. Return to Duty After 

Type III Open Tibia Fracture. ATACCC, 16-19 

Aug 2010, presentation.

182. Cross JD, Stinner DJ, Burns TC, Wenke 

JC, and Hsu JR. Return to Duty After Type 

III Open Tibia Fracture. Limb Lengthening 

and Reconstruction Society, 16-17 Jul 2010, 

presentation.

183. Cross JD, Stinner DJ, Burns TC, Wenke JC, 

and Hsu JR, STReC. Return to Active Duty 

Following Type III Open Tibia Fracture. Roy 

Davis Research Competition, 3 May 2010, 

presentation.

184. D’Avignon LC, Hogan BK, Murray CK, Loo 

FL, Hospenthal DR, Cancio LC, Kim SH, 

Renz EM, Barillo D, Holcomb JB, Wade 

CE, and Wolf SE. Contribution of bacterial 

and viral infections to attributable mortality 

in patients with severe burns: An autopsy 

series. Burns, 2010 Jan 12. 

185. D’Avignon LC, Saffle JR, Chung KK, and 

Cancio LC. Prevention and management 

of infections associated with burns in the 

combat casualty. J Trauma, 2008 Feb, 

64(3 Supp): S277-S286.

186. Dalle Lucca JJ, Bedocs P, Dymond M, 

Baranyi L, Szebeni J, and Bunger R. 

Survival of Hemorrhagic Shock Is Improved 

by Complement Blockade and Metabolic 

Support: A Pilot Study in a Rat Model of 

Permissive Hypotension. ATACCC, 16-19 

Aug 2010, poster.

187. Danks R and Lairet K. Innovations in caring 

for a large burn in the Iraq war zone. J Burn 

Care Res, 2010, 31: 665-669.

188. Darlington D. Control of Non-Compressible 

External Bleeding. CIMIT, 26 Oct 2010, 

presentation.

189. Darlington DN, Fedyk CG, Scherer MR, 

Delgado AV, Kheirabadi BS, Pusateri AE, 

Wade CE, Cap AP, and Dubick MA. Effect 

of Hemodilution on Coagulation of Human 

Blood In Vitro. ATACCC, 16-19 Aug 2010, 

poster.

190. Darlington DN, Kheirabadi BS, Martini WZ, 

and Dubick MA. Hemorrhage-Induced 

Acidosis Does Not Affect Activated 

Recombinant Factor VII Function in Swine. 

EB (FASEB), 24-28 Apr 2010, poster.

191. Darlington DN, Kheirabadi BS, Martini WZ, 

and Dubick MA. Hemorrhagic-induced 

acidosis does not affect recombinant factor 

VIIa (rFVIIa) function in swine. FASEB J, 

2010, 24: 788.8.

192. Dave JR, Williams AJ, Yao C, Lu XC, and 

Tortella FC. Modeling cerebral ischemia 

in neuroproteomics. Methods in Molecular 

Biology, 2009, 566: 25-40.

193. Davis AR, Shear DA, Chen Z, Lu XC, and 

Tortella FC. A comparison of two cognitive 

test paradigms in a penetrating brain injury 

model. Journal of Neuroscience Methods, 

2010, 189(1): 84-7.

194. Dawson C, Shields B, Aden J, Wolf S, 

Chung KK, Hurley RK, and Wade C. Blood 

Coagulation and Vitamin K Status in Burns. 

Society of Critical Care Medicine, 9-13 Jan 

2010, poster.

195. Delgado AV, Kheirabadi BS, Fruchterman 

TM, Scherer M, Cortez D, Wade CE, Dubick 

MA, and Holcomb JB. A novel biologic hemostatic dressing (fibrin patch) reduces blood 

loss and resuscitation volume and improves 

survival in hypothermic, coagulopathic swine 

with grade V liver injury. J Trauma, 2008 Jan, 

64(1): 75-80.

196. DeSocio P. Immersive Virtual Reality 

Analgesia for Combat Related Burn Injuries. 

American Academy of Pain Medicine 

Meeting, 3-6 Feb 2010, presentation.

197. DeSocio PA and Maani CV. Military anesthesiology: Treating the severely burned 

wounded warrior. ASA Newsletter, 2008 Mar, 

72(3): 9-11.

198. Devore D, Tarte N, and Archer C. 

Nanoparticle Drug Delivery for the Treatment 

of Biofilm Infections. PTEI, 6 Aug 2010, 

poster.

199. Dewey WS, Richard RL, Hedman 

TL, Chapman TT, Quick C, Renz EM, 

Blackbourne LH, Wolf SE, and Holcomb JB. 

Opposition splint for partial thumb amputation: A case study measuring disability before 

and after splint use. J Hand Ther, 2009 JanMar, 22(1): 79-87.

200. Dewey WS, Richard RL, Hedman TL, 

Chapman TT, Quick CD, Holcomb JB, and 

Wolf SE. A review of compression glove 

modifications to enhance functional grip: A 

case series. J Burn Care Res, 2007 NovDec, 28(6): 888-91.

201. Dixon DR, Jeffrey NR, Dubey VS, and 

Leung KP. Antimicrobial peptide inhibition of 

Porphyromonas gingivalis 381-induced hemagglutination is improved with a synthetic 

decapeptide. Peptides, 2009, 30(12): 2161-7.

2-77
202. Dixon DR, Karimi-Naser L, Darveau RP, 

and Leung KP. The anti-endotoxic effects 

of the KSL-W decapeptide on Escherichia 

coli O55:B5 and various oral lipopolysaccharides. Journal of Periodontal Research, 

2008, 43(4): 422-30.

203. Dubick M. History of Animal Models at 

USAISR. French Military Blood Bank, 15-17 

Apr 2010, presentation.

204. Dubick M, Baer L, Barr J, Wu X, Grubbs D, 

Pidcoke H, and Wade C. Antioxidant status in 

tissues from rats subjected to thermal injury, 

hindlimb uploading and insulin therapy. 

Shock, 33 (Supp 1): 19 (abst P19), 2010.

205. Dubick MA. Hemostasis Research Program 

at ISR. Ludwig Boltzmann Institute for 

Experimental and Clinical Traumatology 

Grand Rounds, 9 Nov 2010, presentation.

206. Dubick MA. Hemostyptic Wound Bandages: 

Are There Any Differences. Innsbruck Winter 

Coagulation Symposium, 4-7 Nov 2010, 

presentation.

207. Dubick MA. The Future of Hemostasis: 

Research to Improve Field Hemorrhage 

Control. SHORESH, 24-29 Oct 2010, 

presentation.

208. Dubick MA. Overview of Hypertonic Saline 

Resuscitation in the Pre-Hospital Setting. 

Toronto Resuscitation Meeting, 7-8 Oct 2010, 

presentation.

209. Dubick MA. A treatment worth its salt? Crit 

Care Med, 2008 Jun, 36(6): 1978-9. 

210. Dubick MA, Baer L, Barr J, Wu X, Grubbs D, 

Pidcoke H, and Wade C. Antioxidant Status 

in Tissues from Rats Subjected to Thermal 

Injury, Hindlimb Uploading and Insulin 

Therapy. Shock Society, 12-15 Jun 2010, 

poster.

211. Dubick MA, Barr JL, Christy RJ, Roe JL, 

and Walters TJ. Effects of Poloxamer-188 

on antioxidant status in rat skeletal muscle 

subjected to tourniquet-induced ischemia/

reperfusion injury. FASEB J, 2008 May, 

22: 1121.6.

212. Dubick MA, Batchinsky AI, Barr JL, and 

Cancio LC. Evidence of oxidative stress in 

lung, liver and heart from sheep exposed to 

chlorine (Cl2) Gas. Toxicologist, 2008 March, 

102(1): 404.

213. Dubick MA, Dorfman R, Klemcke HG, 

Kheirabadi BS, and Holcomb JB. Stability 

of activated recombinant human factor VII 

(rFVIIa) after 28 days storage at 24°C and 

43°C. Blood, 2008 Nov, 112:4074.

214. Dubick MA and Kheirabadi BS. New 

Technologies for Treating Severe Bleeding 

in Far-Forward Combat Areas. NATO, 19-21 

April 2010, presentation.

215. Dubick MA and Kheirabadi BS. New 

technologies for treating severe bleeding 

in far-forward combat areas. Proc of NATO 

RTO Symposium on Use of Advanced 

Technologies and New Procedures in 

Medical Field Operations, 182: 21-1-12.

216. Dubick MA and Kragh JF. Battle Casualty 

Survival with Emergency Tourniquet Use to 

Stop Limb Bleeding. SHORESH, 24-29 Oct 

2010, presentation.

217. Dubick MA, Mase VJ, Barr JL, Grubbs DL, 

Roe JL, and Walters TJ. Effect of Skeletal 

Muscle Ischemia-Reperfusion (I/R) PostConditioning (Post C) on Antioxidant Status 

in Rats. EB (FASEB), 24-28 Apr 2010, poster.

218. Dubick MA, Mase VJ, Barr JL, Grubbs DL, 

Roe JL, and Walters TJ. Effect of skeletal 

muscle ischemia-reperfusion (I/R) postconditioning (Post C) on antioxidant status in 

rats. FASEB J, 2010, 24: 591.3.

219. Dubick MA, Park MS, Barr JL, and Atkins 

JL. Ceruloplasmin Oxidase (CPO) Activity 

in Plasma from Burn and Non-Burn Trauma 

Patients. TSIS, 9-13 Mar 2010, poster.

220. Dubick MA, Park MS, Barr JL, and Atkins 

JL. Ceruloplasmin oxidase (CPO) activity 

in plasma from burn and non-burn trauma 

patients. Inflamm Res, 2010, 59 (Supp 1): 

S125.

221. Dubick MA, Scherer MR, Darlington DN, 

Delgado AV, Martini WZ, and Kheirabadi BS. 

Hemostatic effects of recombinant activated factor VII (rFVIIa) in acidotic and pH 

corrected swine. Crit Care Med, 2008 Dec, 

36(12 Supp): A110 (abst 445), 2008.

222. Dubick MA, Scherer MR, Darlington DN, 

and Kheirabadi BS. Effects of Acidosis and 

pH Correction on Thrombin Generation in a 

Swine Hemorrhage Model. Society of Critical 

Care Medicine, 9-13 Jan 2010, poster.

223. Dubick MA, Scherer MR, Terrazas I, and 

Blackbourne LH. Differential Effects of 

Resuscitation Fluids Coagulation Profiles 

in Human Blood, Ex Vivo, as Determined 

by Thrombelastography. International 

Symposium on Critical Bleeding, 6-7 Sep 

2010, poster.

224. Dubick MA, Scherer MR, Terrazas I, and 

Blackbourne LH. Differential Effects of 

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Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Resuscitation Fluids Coagulation Profiles in 

Human Blood, Ex Vivo, as Determined by 

Thrombelastography. ATACCC, 16-19 Aug 

2010, poster.

225. Dubick MA, Sondeen JL, Medina L, Prince 

MD, Yoshimaru E, and Kameneva M. 

Resuscitation with hextend alone or with 

a drag-reducing polymer (DRP) in a swine 

hemorrhage (HEM) model. Shock, 2008 

June, 29(Supp 1): 9.

226. Dunne JR, Lee TH, Burns C, Cardo LJ, Curry 

K, and Busch MP. Transfusion-associated 

microchimerism in combat casualties. 

J Trauma, 2008, 64(2 Supp): S92-7.

227. Eastridge B. Benchmarking Injury Care on 

the Battlefield Using Lessons from Civilian 

Trauma Systems. Pakistan Military Briefing, 

presentation.

228. Eastridge B. Damage Control Resuscitation. 

Pakistan Military Briefing, presentation.

229. Eastridge B. Translating Military Trauma 

System Concepts into Civilian Mass Casualty 

and Disaster Planning. Pakistan Military 

Briefing, presentation.

230. Eastridge B, Wade C, Spott M, Costanzo G, 

Dunne J, Flaherty S, West S, Apodaca A, 

Holcomb J, Blackbourne LH, and Casscells 

SW. Utilizing a Trauma Systems Approach to 

Benchmark and Improve Combat Casualty 

Care. Pakistan Military Briefing, presentation.

231. Eastridge BJ, Hardin M, Cantrell J, OetjenGerdes L, Williams J, Mazuchowski E, 

Mallak C, Wade CE, Simmons J, Mace J, 

Mabry R, Bolenbaucher R, and Blackbourne 

LH. Died of Wounds: Cause of Death After 

Battlefield Injury. ATACCC, 16-19 Aug 2010, 

presentation.

232. Eastridge BJ, Stansbury LG, Stinger H, 

Blackbourne L, and Holcomb JB. Forward 

surgical teams provide comparable outcomes to combat support hospitals during 

support and stabilization operations on the 

battlefield. J Trauma, 2009 Apr, 66(4 Supp): 

S48-50.

233. Eastridge BJ, Wade CE, Spott MA, Costanzo 

G, Dunne J, Flaherty S, Holcomb JB, West 

S, Apodaca A, Blackbourne L, and Casscells 

SW. Utilizing a trauma systems approach to 

benchmark and improve combat casualty 

care. J Trauma, 2010 Jul, 69 Supp 1: S5-9.

234. Edens JW, Chung KK, Pamplin JC, Allan 

PF, Jones JA, King BT, Cancio LC, Renz 

EM, Wolf SE, Wade CE, Holcomb JB, and 

Blackbourne LH. Predictors of early acute 

lung injury at a combat support hospital: A 

prospective observational study. J Trauma, 

2010 Jul, 69 Supp 1: S81-6.

235. Edgerton C, Crispin JC, Moratz CM, Bettelli 

E, Oukka M, Simovic M, Zacharia A, Egan 

R, Chen J, Dalle Lucca JJ, Juang YT, and 

Tsokos GC. IL-17 producing CD4+ T cells 

mediate accelerated ischemia/reperfusioninduced injury in autoimmunity-prone mice. 

Clinical Immunology, 2009, 130(3): 313-21.

236. Elsayed N and Atkins JL eds. Explosion and 

Blast Related Injuries. Elsevier, Academic 

Press, New York, 2008.

237. Endorf FW, Cancio LC, and Gibran NS. Toxic 

epidermal necrolysis clinical guidelines. 

J Burn Care Res, 2008 Sep/Oct, 29(5): 

706-712.

238. Ennis JL, Chung KK, Renz EM, Barillo 

DJ, Albrecht MC, Jones JA, Blackbourne 

JL, Cancio LC, Eastridge BJ, Flaherty SF, 

Dorlac WC, Kelleher KS, Wade CE, Wolf SE, 

Jenkins DH, and Holcomb JB. Joint theater 

trauma system implementation of burn 

resuscitation guidelines improves outcomes 

in severely burned military casualties. J 

Trauma, 2008 Feb, 64(2 Supp): S146-S152.

239. Fedyk CG, Darlington DN, Kheirabadi BS, 

Scherer MR, Delgado AV, Pusateri AE, and 

Dubick MA. The Effect of rFVIIa on PT, aPTT 

and TEG in Hemodiluted and Hypothermic 

Blood. ATACCC, 16-19 Aug 2010, poster.

240. Fortner PA. ISR Burn Operating Room 

Prevention of Corneal Abrasions 

Performance Improvement Initiative. 

AMSUS, 2 Nov 2010, poster.

241. Fowler M, Garza T, Slater T, Maani C, and 

McGhee L. The Effect of Gabapentin on 

Posttraumatic Stress Disorder in Burned 

Soldiers. ATACCC, 16-19 Aug 2010, poster.

242. Fox CJ, Gillespie DL, Cox ED, Kragh JF 

Jr, Mehta SG, Salinas J, and Holcomb JB. 

Damage control resuscitation for vascular surgery in a combat support hospital. 

J Trauma. 2008 Jul, 65(1): 1-9. 

243. Fox CJ, Gillespie DL, Cox ED, Mehta SG, 

Kragh JF, Salinas J, and Holcomb JB. The 

effectiveness of a damage control resuscitation strategy for vascular injury in a combat 

support hospital: Results of a case control 

study. J Trauma, 2008 Feb, 64(2 Supp): 

S99-S107.

244. Fox CJ, Mehta SG, Cox ED, Kragh JF Jr, 

Salinas J, and Holcomb JB. Effect of recombinant factor VIIa as an adjunctive therapy in 

damage control for wartime vascular injuries: 

A case control study. J Trauma, 2009 Apr, 

66(4 Supp): S112-9.

2-79
245. Fox CJ, Perkins JG, Kragh JF, Singh NN, 

Patel B, and Ficke JR. Popliteal Artery 

Repair in Massively Transfused Military 

Trauma Patients: A Pursuit for Life and Limb. 

Association of Surgeons of Great Britain and 

Ireland, 14-16 Apr 2010, poster.

246. Fox CJ, Perkins JG, Kragh JF, Singh NN, 

Patel B, and Ficke JR. Popliteal artery repair 

in massively transfused military trauma 

casualties: A pursuit to save life and limb. 

J Trauma, 2010, 69(Supp. 1): S123-34.

247. Fox CJ, Perkins JG, Kragh JF Jr, Singh NN, 

Patel B, and Ficke JR. Popliteal artery repair 

in massively transfused military trauma 

casualties: A pursuit to save life and limb. 

J Trauma, 2010 Jul, 69 Supp 1: S123-34.

248. Fries D and Martini WZ. Role of fibrinogen in 

trauma-induced coagulopathy. Br J Anaesth, 

2010 Aug, 105(2): 116-21. Review.

249. Garman R, Jenkins LW, Bauman R, Swauger 

P, Parks S, Switzer R, Dixon CE, Clark 

RSB, Bayir H, Kagan V, Jackson EK, and 

Kochanek PM. Blast Overpressure Injury 

in Rats with Body Protection Produces 

Acute and Sub-Acute Axonal, Dendritic 

and Synaptic Neuropathology. Journal of 

Neurotrauma. Meeting Abstract from the 

2nd Joint Symposium of the National and 

International Neurotrauma Societies, Santa 

Barbara, CA, Sep 7-11, 2009.

250. Gaylord K, Zolezzi ME, and Blackbourne 

LH. Developing a Medication Profile of Burn 

Patients with and without Post-Traumatic 

Stress Disorder (PTSD). ABA, 9-12 Mar 

2010, presentation.

251. Gaylord KM, Arzola S, and Blackbourne LH. 

Impact of a Provider Resiliency Program in 

an Army Burn Center. ABA, 9-12 Mar 2010, 

poster.

252. Gaylord KM, Cooper DB, Mercado JM, 

Kennedy JE, Yoder LH, and Holcomb JB. 

Incidence of posttraumatic stress disorder 

and mild traumatic brain injury in burned service members: Preliminary report. J Trauma, 

2008 Feb, 64(2 Supp): S200-S206.

253. Gaylord KM, Holcomb JB, and Zolezzi ME. A 

comparison of posttraumatic stress disorder 

between combat casualties and civilians 

treated at a military burn center. J Trauma, 

2009 Apr, 66(4 Supp): S191-5.

254. Gentry C, Frazier L, Ketz A, Abel L, Castro 

M, Steele N, and Bridges E. Preflight/

Enroute Pain Management of Trauma 

Victims Transported by USAF AE from 

Operation Enduring Freedom. AMSUS, 

2 Nov 2010, poster.

255. Gerhardt R. Remote Damage Control 

Resuscitation: Concepts, Challenges 

and Research Opportunities as Trauma 

Resuscitation Moves into the Out-of-Hospital 

Arena. Society for Academic Emergency 

Medicine, 3-6 Jun 2010, presentation.

256. Gerhardt R, Berry J, and Blackbourne 

LH. Analysis of Life-Saving Interventions 

Performed by Out-of-Hospital Combat 

Medical Personnel. Society for Academic 

Emergency Medicine, 3-6 Jun 2010, poster.

257. Gerhardt RT and Barry JA. Logistical 

Requirements in Out-of-Hospital Combat 

Casualty Care: Patient Movement Items 

Should Be Issued at Role-I. American 

College of Emergency Physicians, 11-15 Apr 

2010, poster.

258. Gerhardt RT, Barry JA, and Blackbourne LH. 

Medical Evacuations Originating from Role-1 

Combat Casualty Care: A Capability Gap 

Analysis. American College of Emergency 

Physicians, 11-15 Apr 2010, poster.

259. Gerhardt RT, Berry J, and Blackbourne 

LH. Analysis of Medical Evacuations and 

Life-Saving Interventions Performed by 

Out-of-Hospital Combat Medical Personnel. 

Society for Academic Emergency Medicine, 

3-6 Jun 2010, oral.

260. Gerhardt RT, Berry J, and Blackbourne 

LH. Analysis of Life-Saving Interventions 

Performed by Out-of-Hospital Combat 

Medical Personnel. American College of 

Emergency Physicians, 11-15 Apr 2010, 

poster.

261. Gerhardt RT, Berry J, and Blackbourne 

LH. Analysis of life-saving interventions 

performed by out-of-hospital combat medical 

personnel. Academic Emergency Medicine, 

17 (5), S1-205, 2010.

262. Gerhardt RT, Berry JA, and Blackbourne 

LH. Analysis of Life-Saving Interventions 

Performed by Out-of-Hospital. ATACCC, 

16-19 Aug 2010, poster.

263. Gerhardt RT, Hermstad EL, Crawford DM, 

Rayfield JR, Pfaff JA, and Hunter CH. 

Addition of post-discharge oral secobarbital 

to standard emergency department treatment of migraine headache improves pain 

relief and patient perception of headache 

resolution. In press, American Journal of 

Emergency Medicine.

264. Gerhardt RT, Mabry RL, De Lorenzo RA, and 

Butler FK. Fundamentals of combat casualty 

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and Biological 

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Care
care. Combat Casualty Care: Lessons 

Learned from OEF & OIF. DVD. Los Angeles, 

CA: Pelagique, LLC, 2010.

265. Gerhardt RT, Shaffer BM, Dixon P, Pfaff 

JA, Liker J, and Ward J. Assessment of the 

Diagnostic and Predictive Values of Thirst 

Perception, Plasma Angiotensin-2 and 

Arginine Vasopressin During Initial Trauma 

Resuscitation. ATACCC, 16-19 Aug 2010, 

poster.

266. Gerhardt RT, Shaffer BM, Dixon P, Pfaff JA, 

Liker J, Ward J, and Mueller GM. Diagnostic 

and predictive values of thirst, angiotensin-2 

and vasopressin during trauma resuscitation. 

Prehospital Emergency Care, 2010 Jul/Sep, 

14(3): 317-323.

267. Gharavi RB, Shoge RO, Long JB, and 

Bentley TB. Characterization of an AirDriven Shock Tube Used to Recreate 

Battlefield Traumatic Brain Injuries. National 

Neurotrauma Symposium, June 2010.

268. Gilmore K, Chen P, and Leung KP. Antimicrobial peptides for plaque control and 

beyond. Journal of the California Dental 

Association, 2009, 37(11): 779-88.

269. Glasser JS, Guymon CH, Mende K, Wolf 

SE, Hospenthal DR, and Murray CK. Activity 

of topical antimicrobial agents against 

multidrug-resistant bacteria recovered from 

burn patients. Burns, 2010 Jun 7.

270. Glasser JS, Landrum ML, Chung KK, 

Hospenthal DR, Renz EM, Wolf SE, and 

Murray CK. Description of Streptococcus 

pneumoniae infections in burn patients. 

Burns, 2010 Jun, 36(4): 528-32. Epub 2009 

Sep 18.

271. Goebel P, Williams J, and Gerhardt RT. Pilot 

study of the performance characteristics of 

the d‐dimer in presumed sepsis. Western 

Journal of Emergency Medicine, 2010, 11(2): 

173-9. 

272. Gomez R, Murray CK, Hospenthal DR, 

Cancio LC, Renz EM, Holcomb JB, Wade 

CE, and Wolf SE. Causes of mortality by 

autopsy findings of combat casualties and 

civilian patients admitted to a burn unit. J Am 

Coll Surg, 2009 Mar, 208(3): 348-54. Epub 

2009 Jan 21.

273. Gorbunov NV, Asher LV, Elsayed N, and 

Atkins JL. Inflammatory response in primary 

blast injury. In: Explosion and Blast Related 

Injuries (eds. Elsayed N and Atkins JL), 

Elsevier Butterworth-Heinemann, Oxford, 

UK, 2008.

274. Gore DC, Hawkins HK, Chinkes DL, Chung 

DH, Sanford AP, Herndon DN, and Wolf SE. 

Assessment of adverse events in the demise 

of pediatric burn patients. J Trauma, 2007 

Oct, 63(4): 814-8.

275. Grathwohl KW, Black IH, Spinella PC, 

Sweeney J, Robalino J, Helminiak J, Grimes 

J, Gullick R, and Wade CE. Total intravenous 

anesthesia including ketamine versus volatile 

gas anesthesia for combat-related operative 

traumatic brain injury. Anesthesiology, 2008 

Jul, 109(1): 44-53.

276. Grathwohl KW, Venticinque SG, Blackbourne 

LH, and Jenkins DH. The evolution of 

military trauma and critical care medicine: 

Applications for civilian medical care systems. Crit Care Med, 2008 Jul, 36(7 Supp): 

S253-4.

277. Greeley H. Duty, honor and country. Nursing 

care of the seriously burned: An exercise in 

teamwork. Advance for Nurses, 2007 Nov, 

5(24): 12.

278. Greenhalgh DG, Saffle JR, Holmes JH 

IV, Gamelli RL, Palmieri TL, Horton JW, 

Tompkins RG, Traber DL, Mozingo DW, 

Deitch EA, Goodwin CW, Herndon DN, 

Gallagher JJ, Sanford AP, Jeng JC, 

Ahrenholz DH, Neely AN, O’Mara MS, 

Wolf SE, Purdue GF, Garner WL, Yowler 

CJ, and Latenser BA; The American Burn 

Association Consensus Conference on 

Burn Sepsis and Infection Group. American 

Burn Association Consensus Conference to 

Define Sepsis and Infection in Burns. J Burn 

Care Res, 2007 Nov-Dec, 28(6): 776-790.

279. Guda T, Hernandez JW, Singleton B, 

Appleford M, Walker J, Pilia M, Son JS, Oh 

S, Ong J, and Wenke J. Histomorphometry 

of Varying Hydroxyapatite Scaffold 

Architectures In Vivo. Biomedical 

Engineering Society, 6-9 Oct 2010, poster.

280. Guda T, Walker J, Kim SG, Oh S, 

Appleford M, Ong J, and Wenke J. 

Guiding Hydroxypatite Scaffold Based 

Bone Regeneration in Vivo with Collagen 

Membranes. Society for Biomaterials, 21-24 

Apr 2010, presentation.

281. Guda T, Walker J, Oh S, Appleford M, Ong 

J, and Wenke J. Bone Defect Regeneration 

In Vivo Using Hydroxyapatite Scaffolds: A 

Biomechanical Perspective. Armed Forces 

Institute of Regenerative Medicine, 11-15 Jan 

2010, presentation.

2-81
282. Guda T, Walker JA, Oh S, Appleford MR, 

Ong JL, and Wenke JC. Bone Defect 

Regeneration In Vivo Using Hydroxyapatite 

Scaffolds: A Biomechanical Perspective. 

Armed Forces Institute of Regenerative 

Medicine, 11-15 Jan 2010, poster.

283. Hafeman AE, Zienkiewicz KJ, Carney 

E, Litzner B, Stratton C, Wenke JC, and 

Guelcher SA. Local delivery of tobramycin 

from injectable biodegradable polyurethane 

scaffolds. J Biomater Sci Polym Ed, 2010, 

21(1): 95-112.

284. Haik KL, Shear DA, Hargrove C, Patton 

J, Mazei-Robison M, Sandstrom MI, and 

Dunbar GL. 7-nitroindazole attenuates 

6-hydroxydopamine-induced spatial learning deficits and dopamine neuron loss in a 

presymptomatic animal model of Parkinson’s 

disease. Experimental and Clinical 

Psychopharmacology, 2008, 16(2): 178-89.

285. Hale DF, Chung KK, Simmons JW, Ritchie 

JD, Aden JK, White CE, Cancio LC, Renz 

EM, and Blackbourne LH. Prone Positioning 

in Adult Burn Patients with Refractory 

Hypoxemia Is Associated with Improved 

Oxygenation. ACS Surgical Forum, 3-7 Oct 

2010, poster.

286. Hale RG. The Lateral Mandibular Body 

Defect: A Target of Opportunity for 

Regenerative Medicine Technology. 

ATACCC, 16-19 Aug 2010, presentation.

287. Hammers DW, Merritt EK, Matheny W, 

Adamo ML, Walters TJ, Estep JS, and Farrar 

RP. Functional deficits and insulin-like growth 

factor-i gene expression following tourniquetinduced injury of skeletal muscle in young 

and old rats. J Appl Physiol, 2008 Oct, 

105(4): 1274-81.

288. Hansen JJ, Hardin M, Simmons DP, 

DeSocio PA, King BT, White CE, Ritchie 

JD, Chung KK, Blackbourne LH, and Maani 

CV. Treatment of Refractory Fever in the 

Burn ICU with an Intravascular Temperature 

Management Catheter. American Society of 

Anesthesiologists, 9-12 Sep 2010, poster.

289. Hansen JJ, Hardin M, Simmons DP, 

DeSocio PA, King BT, White CE, Ritchie 

JD, Chung KK, Blackbourne LH, and Maani 

CV. Treatment of Refractory Fever in the 

Burn ICU with an Intravascular Temperature 

Management Catheter. NATO, 19-21 April 

2010, presentation.

290. Hardin M, Oh JS, White CE, and Cohn SM. 

Effect of stitch length on complications. Arch 

Surg, 2010 Jun, 145(6): 600; author reply 

600-1.

291. Hardin MO, Larson CR, Ritchie JD, Hetz KM, 

Freemyer JD, Chung KK, Blackbourne LH, 

Renz EM, and White CE. Mucormycosis in a 

Burn Intensive Care Unit. Surgical Infection 

Society, 17-20 Apr 2010, poster.

292. Hardin MO, Rich N, Wade C, Champion 

H, White C, Martin M, Rasmussen T, 

Pruitt B, Blackbourne LH, and Eastridge 

B. Rediscovering Lessons of Wars Past: 

Massive Transfusion in Vietnam and Current 

Conflicts. ATACCC, 16-19 Aug 2010, poster.

293. Hardin MO, Ritchie JD, Chung KK, White 

CE, Cancio LC, Wolf SE, Renz EM, and 

Blackbourne LH. Outcomes After Cardiac 

Arrest in an Adult Burn ICU. ISBI, 15-21 Jun 

2010, presentation.

294. Hardin MO, Spinella PC, Ritchie JD, White 

CE, Wade CE, and Blackbourne LH. The 

Effect of Plasma: RBC Ratio in U.S. Military 

Casualties Receiving a Massive Transfusion 

with Component Therapy. ATACCC, 16-19 

Aug 2010, poster.

295. Hardy S, Seetharaman S, Natesan S, 

Stowers RS, Mullens C, Baer DG, Suggs 

LJ, and Christy RJ. An Antibacterial 

Fibrin-Based Wound Dressing to Induce 

Angiogenesis in Wound Repair. ATACCC, 

16-19 Aug 2010, poster.

296. Hartings JA, Gugliotta M, Gilman C, Strong 

AJ, Tortella FC, and Bullock MR. Repetitive 

cortical spreading depolarizations in a 

case of severe brain trauma. Neurological 

Research, 2008, 30(8): 876-82.

297. Hartings JA, Strong AJ, Fabricius M, 

Manning A, Bhatia R, Dreier JP, Mazzeo 

AT, Tortella FC, and Bullock MR. Spreading 

depolarizations and late secondary insults 

after traumatic brain injury. Journal of 

Neurotrauma, 2009, 26(11): 1857-66.

298. Hawley JS, Murray CK, and Jorgensen JH. 

Colistin heteroresistance in Acinetobacter

and its association with previous colistin 

therapy. Antimicrob Agents Chemother, 2008 

Jan, 52(1): 351-2.

299. Hedman TL, Renz EM, Richard RL, Quick 

CK, Dewey WS, Barillo DJ, Cancio LC, Baer 

DG, Wolf SE, and Holcomb JB. Incidence 

and severity of combat hand burns after all 

army activity message. J Trauma, 2008 Feb, 

64(2 Supp): S169-S173.

300. Hess JR, Brohi K, Dutton RP, Hauser CJ, 

Holcomb JB, Kluger Y, Mackway-Jones K, 

Parr MJ, Rizoli SB, Yukioka T, Hoyt DB, and 

Bouillon B. The coagulopathy of trauma: A 

review of mechanisms. J Trauma, 2008 Oct, 

65(4): 748-54.

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Medical Chemical 

and Biological 

Defense

Clinical and 

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Advanced 

Technologies Logistics Appendices

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Infectious 

Diseases

Combat 

Casualty

Care
301. Hess JR and Holcomb JB. Transfusion practice in military trauma. Transfus Med, 2008 

Jun, 18(3): 143-50.

302. Hilton W, Serkin F, Walter J, Oh J, and 

Blackbourne LH. Clinical Outcomes of 

Management of Battlefield Posterior Urethral 

Trauma of U.S. Service Members from 

2003-2009. Society of Government Service 

Urologists, 18 Jan 2010, presentation.

303. Holcomb JB. Clinical outcomes from the 

war: Introduction. J Trauma, 2008 Feb, 

64(2 Supp): S1.

304. Holcomb JB, McManus JG, Kerr ST, and 

Pusateri AE. Needle versus tube thorascostomy in a swine model of traumatic tension 

hemopheumothorax. Prehosp Emerg Care, 

2009 Jan-Mar, 13(1): 18-27.

305. Holcomb JB, Wade CE, Michalek JE, 

Chisholm GB, Zarzabal LA, Schreiber MA, 

Gonzalez EA, Pomper GJ, Perkins JG, 

Spinella PC, Williams KL, and Park MS. 

Increased plasma and platelet to red blood 

cell ratios improves outcome in 466 massively transfused civilian trauma patients. 

Ann Surg, 2008 Sep, 248(3): 447-58.

306. Hospenthal DR, Murray CK, Andersen RC, 

Blice JP, Calhoun JH, Cancio LC, Chung 

KK, Conger NG, Crouch HK, D’Avignon LC, 

Dunne JR, Ficke JR, Hale RG, Hayes DK, 

Hirsch EF, Hsu JR, Jenkins DH, Keeling JJ, 

Martin RR, Moores LE, Petersen K, Saffle 

JR, Solomkin JS, Tasker SA, Valadka AB, 

Wiesen AR, Wortmann GW, and Holcomb 

JB. Guidelines for the prevention of infection 

after combat-related injuries. J Trauma, 2008 

Feb, 64(3 Supp): S211-S220.

307. Hoyt DB, Dutton RP, Hauser CJ, Hess JR, 

Holcomb JB, Kluger Y, Mackway-Jones K, 

Parr MJ, Rizoli SB, Yukioka T, and Bouillon 

B. Management of coagulopathy in the 

patients with multiple injuries: Results from 

an international survey of clinical practice. 

J Trauma, 2008 Oct, 65(4): 755-64; discussion 764-5.

308. Hsu JR. Bone Defects. National Trauma 

Institute Conference, 30 Aug-1 Sep 2010, 

presentation.

309. Hsu JR, Stinner DJ, and Brown DA, Skeletal 

Trauma Research Consortium (STReC). 

Splitting of the proximal femur with a new 

femoral nail. J Orthop Trauma, 2010 Apr, 

24(4): e40-3.

310. Hsu JR, Stinner DJ, Rosenzweig SD, Salinas 

J, and Dickson KF. Is there a benefit to drains 

with a Kocher-Langenbeck approach? A prospective randomized pilot study. J Trauma, 

2010 Apr 6.

311. Hurley RK, Shields B, Wolf S, Aden J, 

Dawson C, and Wade C. Evaluation of 

Urinary Nitrogen Loss in Modern Burn 

Patients. Society of Critical Care Medicine, 

9-13 Jan 2010, poster.

312. Huzar T, Renz E, King B, Chung KK, White 

CE, Malin E, Lundy J, Aden J, Wolf SE, 

Blackbourne LH, and Cancio L. Pneumatosis 

Intestinalis in Patients with Burns. ABA, 9-12 

Mar 2010, poster.

313. Inaba K, Branco BC, Rhee P, Blackbourne 

LH, Holcomb JB, Teixeira PG, Shulman I, 

Nelson J, and Demetriades D. Impact of 

plasma transfusion in trauma patients who 

do not require massive transfusion. J Am 

Coll Surg, 2010 Jun, 210(6): 957-65. Epub 

2010 Apr 28.

314. Inaba K, Branco BC, Rhee P, Holcomb JB, 

Blackbourne LH, Shulman I, Nelson J, and 

Demetriades D. Impact of ABO-identical vs 

ABO-compatible nonidentical plasma transfusion in trauma patients. Arch Surg, 2010 

Sep, 145(9): 899-906.

315. Inaba K, Lustenberger T, Rhee P, Holcomb 

JB, Blackbourne LH, Shulman I, Nelson J, 

Talving P, and Demetriades D. The impact of 

platelet transfusion in massively transfused 

trauma patients. J Am Coll Surg, 2010 Sep 

14. [Epub ahead of print].

316. Jackson SR, Richelsoph KC, Courtney HS, 

Wenke JC, Branstetter JG, Bumgardner JD, 

and Haggard WO. Preliminary in vitro evaluation of an adjunctive therapy for extremity 

wound infection reduction: Rapidly resorbing 

local antibiotic delivery. J Orthop Res, 2009 

Jul, 27(7): 903-8.

317. Johnson AE, Cross JD, Wenke JC, and 

Ficke JR. Female Casualties of Operations 

Enduring and Iraqi Freedom. ATACCC, 16-19 

Aug 2010, poster.

318. Juang YT, Wang Y, Jiang G, Peng HB, Ergin 

S, Finnell M, Magilavy A, Kyttaris VC, and 

Tsokos GC. PP2A dephosphorylates Elf-1 

and determines the expression of CD3zeta 

and FcRgamma in human systemic lupus 

erythematosus T cells. J Immunol, 2008, 

181(5): 3658-64.

319. Judd DB, Warme W, and White CE. The 

“Bluie,” a simplified method for applying a 

vacuum-assisted closure dressing in residual 

limbs and complex war wounds. Am J Ortho, 

2009 Apr, 38(4): 199-200.

2-83
320. Kauvar DS and Baer DG. Effect of a targeted 

education intervention on the incidence of 

waste-burning injuries in a military population. J Burn Care Res, 2009 Jul-Aug, 30(4): 

700-4.

321. Kauvar DS, Baer DG, and Walters TJ. 

Influence of systemic hypotension on skeletal 

muscle ischemia-reperfusion injury after 

4-hour tourniquet application. J Surg Educ, 

2007 Sep-Oct, 64(5): 273-7.

322. Kealey GP, Barillo DJ, and Wells SM. Study 

proposals for inhaled gases. J Burn Care 

Res, 2009 Jan-Feb, 30(1): 154-5.

323. Keeling JJ, Hsu JR, Shawen SB, and 

Andersen RC. Strategies for managing 

massive defects of the foot in high-energy 

combat injuries of the lower extremity. Foot 

Ankle Clin, 2010 Mar, 15(1): 139-49.

324. Keen EF III, Robinson BJ, Hospenthal DR, 

Aldous WK, Wolf SE, Chung KK, and Murray 

CK. Prevalence of multidrug-resistant organisms recovered at a military burn center. 

Burns, 2010 Jan 15.

325. Keen EF III, Robinson BJ, Hospenthal DR, 

Aldous WK, Wolf SE, Chung KK, and Murray 

CK. Incidence and bacteriology of burn infections at a military burn center. Burns, 2010 

Jun, 36(4): 461-8. Epub 2009 Dec 31.

326. Kelly JF, Ritenour AE, McLaughlin DF, Bagg 

KA, Apodaca AN, Mallak CT, Pearse L, 

Lawnick MM, Champion HR, Wade CE, and 

Holcomb JB. Injury severity and causes 

of death from operation Iraqi freedom and 

operation enduring freedom: 2003-2004 versus 2006. J Trauma, 2008 Feb, 64(2 Supp): 

S21-S27.

327. Kheirabadi BS, Crissey JM, DeGuzman R, 

Perez MR, Cox AB, Dubick MA, and 

Holcomb JB. Effects of synthetic versus 

natural colloid resuscitation on inducing 

dilutional coagulopathy and increasing 

hemorrhage in rabbits. J Trauma, 2008 May, 

64(5): 1218-28.

328. Kheirabadi BS, Delgado AV, Dubick MA, 

Scherer MR, Fedyk CG, Holcomb JB, and 

Pusateri AE. In vitro effect of activated 

recombinant factor VII (rFVIIa) on coagulation properties of human blood at hypothermic temperatures. J Trauma, 2007 Nov, 

63(5): 1079-1086.

329. Kheirabadi BS, Edens JW, Terrazas IB, 

Estep JS, Klemcke HG, Dubick MA, and 

Holcomb JB. Comparison of new hemostatic 

granules/powders with currently deployed 

hemostatic products in a lethal model of 

extremity arterial hemorrhage in swine. 

J Trauma, 2009 Feb, 66(2): 316-26; discussion 327-8.

330. Kheirabadi BS, Mace JE, Terrazas IB, Fedyk 

CG, Estep JS, Dubick MA, and Blackbourne 

LH. Safety evaluation of new hemostatic 

agents, smectite granules, and kaolin-coated 

gauze in a vascular injury wound model in 

swine. J Trauma, 2010 Feb, 68(2): 269-78.

331. Kheirabadi BS, Mace JE, Terrazas IB, 

Fedyk CG, Valdez KK, Estep S, Dubick 

MA, and Blackbourne LH. Clot-Inducing 

Minerals Versus Plasma Protein Dressing 

for Topical Treatment of External Bleeding 

in the Presence of Coagulopathy. Eastern 

Association for the Surgery of Trauma, 19-23 

Jan 2010, presentation.

332. Kheirabadi BS, Mace JE, Terrazas IB, Fedyk 

CG, Valdez KK, Macphee MJ, Beall D, 

Estep JS, Dubick MA, and Blackbourne LH. 

Clot-inducing minerals versus plasma protein 

dressing for topical treatment of external 

bleeding in the presence of coagulopathy. 

J Trauma, 2010 Nov, 69(5): 1062-73.

333. Kheirabadi BS, Perez MR, Cox A, Miranda 

N, Dubick MA, and Holcomb JB. Prophylactic 

recombinant factor VIIa (rFVIIa) treatment 

prevented coagulopathy and reduced bleeding in rabbits subjected to vascular injuries. 

Shock, 2008 June, 29(Supp 1): 119.

334. Kheirabadi BS, Sieber J, Bukhari T, Rudnicka 

K, Murcin LA, and Tuthill D. High-pressure 

fibrin sealant foam: An effective hemostatic 

agent for treating severe parenchymal 

hemorrhage. J Surg Res, 2008 Jan, 144(1): 

145-50. 

335. Kheirabadi BS, Terrazas IB, Hardin MO, 

Valdez KK, Gallego HL, Prince MD, 

Estep JS, Hanson MA, Dubick MA, and 

Blackbourne LH. Preliminary Safety 

Assessment of the Intracorporeal Use of 

Combat Gauze to Control Parenchymal 

Hemorrhage in Swine. ATACCC, 16-19 Aug 

2010, poster.

336. Kheirabadi BS, Wang X, Meledeo MA, 

Dubick MA, and Bowman PD. Toxicity of 

Silicate Minerals Used as Active Agent in 

Hemostatic Products Toward Vascular and 

Inflammatory Cells In Vitro. ATACCC, 16-19 

Aug 2010, poster.

337. Kiang JG, Krishnan S, Lu X, and Li Y. 

Inhibition of inducible nitric-oxide synthase 

protects human T cells from hypoxia-induced 

apoptosis. Molecular Pharmacology, 2008, 

73(3): 738-47.

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Combat 

Casualty

Care
338. Kim JG, Lee J, Roe J, Tromberg BJ, Brenner 

M, and Walters TJ. Hemodynamic changes 

in rat leg muscles during tourniquet-induced 

ischemia-reperfusion injury observed by 

near-infrared spectroscopy. Physiol Meas, 

2009 Jul, 30(7): 529-40.

339. King BT. Current Status of Burn Disaster 

Management in the U.S. Role of the Military. 

ABA, 9-12 Mar 2010, presentation.

340. King BT, Chung KK, Renz EM, Barillo DJ, 

Lundy JB, Huzar TF, Kauvar DS, Jones JA, 

Cancio LC, Wolf SE, and Blackbourne LH. 

Complications in the Burn Intensive Care 

Unit: Civilian vs. Combat Casualties. Society 

of Critical Care Medicine, 9-13 Jan 2010, 

poster.

341. Klemcke HG, Baer DG, Pankratz VS, Cox A, 

Cortez DS, Garrett MR, Joe B, and Ryan KL. 

Is survival time after hemorrhage a heritable, 

quantitative trait: An initial assessment. 

Shock, 2008 Jun, 29(6): 748-53.

342. Klemcke HG, Calderon ML, Rose R, and 

Oh T. Survival Time After Hemorrhage in 

Inbred Rats with Known Blood Volumes. 

EB (FASEB), 24-28 Apr 2010, poster.

343. Klemcke HG, Kheirabadi BS, and Ryan 

KL. Plasma potassium concentrations after 

severe controlled hemorrhage in inbred rat 

strains. FASEB J, 2008 April, 22: 1227.4.

344. Kochanek PM, Bauman RA, Long J, Dixon 

CE, and Jenkins LW. Blast-induced traumatic 

brain injury and polytrauma—A critical 

problem begging for new insight and new 

therapies. J Neurotrauma, 2009.

345. Kochanek PM, Bauman RA, Long JB, Dixon 

CR, and Jenkins LW. A critical problem 

begging for new insight and new therapies. 

J Neurotrauma, 2009, 26(6): 813-4.

346. Komarov AM, Gorbunov NV, Van Duyne R, 

Kashanchi F, and Atkins JL. Iron Carrying 

Proteins in the Mesenteric Lymph of Rats. 

Free Radical Biology and Medicine Annual 

Meeting, 2009.

347. Kragh J. Use of tourniquets and their effects 

on limb function in modern combat environment. Foot & Ankle Clinics of North America, 

2010 Feb.

348. Kragh J, Wade CE, Baer DG, Jones JA, 

Walters TJ, Hsu JR, Wenke JC, Ficke 

JR, Blackbourne LH, and Holcomb JB. 

Orthopaedic Trauma in the Current War: 

Casualty Rates, Injury Severity, Fasciotomy 

Rates, and Tourniquet Use. AAOS, 9-13 Mar 

2010, presentation.

349. Kragh JF. Tourniquet Update: Q & A. 

Committee on Tactical Combat Casualty 

Care, 3 Aug 2010, presentation.

350. Kragh JF. Tourniquet Use, in: War Surgery 

in Afghanistan and Iraq: A Series of Cases, 

2003-2007. Borden Institute, Washington 

DC, 2008.

351. Kragh JF, Littrel ML, Jones JA, Walters 

TJ, Naer DG, Wade CE, and Holcomb JB. 

Battle Casualty Survival with Emergency 

Tourniquet Use to Stop Limb Bleeding. 

Orthopaedic Research Society, 6-9 Mar 

2010, presentation.

352. Kragh JF, O’Neill ML, Walters TJ, Baer DG, 

Wade CE, Holcomb JB, and Blackbourne 

LH. The Military Emergency Tourniquet 

Program’s Lessons Learned with Devices 

and Designs. Western Orthopedic 

Association, 4-7 Aug 2010, poster.

353. Kragh JF, Walters TJ, Baer DG, Fox CJ, 

Wade CE, Salinas J, and Holcomb JB. 

Practical use of emergency tourniquets 

to stop bleeding in major limb trauma. 

J Trauma, 2008 Feb, 64(2 Supp): S38-S50.

354. Kragh JF Jr. Letters to the editor. Ann 

Surg, 2009 Jul 30. [Epub ahead of print] 

No abstract available.

355. Kragh JF Jr, Kirby JM, and Ficke JR. 

Extremity Trauma. Combat Casualty Care: 

Lessons Learned from OEF & OIF. DVD. Los 

Angeles, CA: Pelagique, LLC, 2010.

356. Kragh JF Jr, Robbins J, and Ward JA. 

Faculty turnover and resident in-training 

examination and board scores. Am J Orthop, 

2007 Dec, 36(12): E180-4.

357. Kragh JF Jr, Walters TJ, Baer DG, Fox CJ, 

Wade CE, Salinas J, and Holcomb JB. 

Survival with emergency tourniquet use to 

stop bleeding in major limb trauma. Ann 

Surg, 2009 Jan, 249(1): 1-7.

358. Kramer GC, Kinsky MP, Prough DS, Salinas 

J, Sondeen JL, Hazel-Scerbo ML, and 

Mitchell CE. Closed-loop control of fluid therapy for treatment of hypovolemia. J Trauma, 

2008 Apr, 64(4 Supp): S333-41. 

359. Krishnan S, Juang YT, Chowdhury B, 

Magilavy A, Fisher CU, Nguyen H, Nambiar 

MP, Kyttaris V, Weinstein A, Bahjat R, 

Pine P, Rus V, and Tsokos GC. Differential 

expression and molecular associations of 

Syk in systemic lupus erythematosus T cells. 

J Immunol, 2008, 181(11): 8145-52.

2-85
360. Krueger CA, Murray CK, Mende K, Guymon 

CH, and Gerlinger T. Bacterial Contamination 

of Surgical Scrubs: A Nosocomial 

Infection Risk? SOMOS, 13-17 Dec 2010, 

presentation.

361. Krueger CA, Murray CK, Mende K, Guymon 

CH, and Gerlinger T. Bacterial Contamination 

of Surgical Scrubs: A Nosocomial Infection 

Risk? Infectious Disease Society of North 

America, 21-24 Oct 2010, poster.

362. Krueger CA, Murray CK, Mende K, Guymon 

CH, and Gerlinger T. Bacterial Contamination 

of Surgical Scrubs: A Nosocomial Infection 

Risk. Clinical Orthopaedic Society, 23-25 

Sep 2010, presentation.

363. Krueger CA, Stinner DJ, Masini BD, Wenke 

JC, and Hsu JR. What Do I Do Now with 

Drop-Contaminated Bone? SOMOS, 13-17 

Dec 2010, presentation.

364. Kulik L, Fleming SD, Moratz C, Reuter JW, 

Novikov A, Chen K, Andrews KA, Markaryan 

A, Quigg RJ, Silverman GJ, Tsokos GC, and 

Holers VM. Pathogenic natural antibodies recognizing annexin IV are required to 

develop intestinal ischemia-reperfusion 

injury. J Immunology, 2009, 182(9): 5363-73.

365. Lalliss SJ, Stinner DJ, Waterman SM, 

Branstetter JG, Masini BD, and Wenke JC. 

Negative pressure wound therapy reduces 

pseudomonas wound contamination more 

than Staphylococcus aureus. J Orthop 

Trauma, 2010 Sep, 24(9): 598-602.

366. Larson C. Burns, Transfusion, and 

Coagulation. University of Texas, 7 May 

2010, presentation.

367. Larson C, Wade C, Wolf S, Aden J, Park 

M, and White C. Preoperative Clotting 

Association with Perioperative Transfusion 

in Burns. ACS South Texas, 27 Feb 2010, 

presentation.

368. Larson C, Wade CE, White CE, Park MS, 

and Wolf SE. Measuring Blood Volume and 

Blood Loss During Excision and Grafting in 

the Severely Burned. Shock Society, 12-15 

Jun 2010, poster.

369. Larson CR, Wade CE, Wolf SE, Aden 

J, Maani CV, Park MS, and White CE. 

Perioperative Clotting Ability and Association 

of Transfusion in the Severely Burned. AWS, 

3 Oct 2010, poster.

370. Larson CR, Wade CE, Wolf SE, Aden 

J, Maani CV, Park MS, and White CE. 

Perioperative Clotting Ability and Association 

of Transfusion in the Severely Burned. AAST, 

22-25 Sep 2010, poster.

371. Larson CR, Wade CE, Wolf S, Aden 

J, Maani CV, Park MS, and White CE. 

Perioperative Clotting Ability and Association 

of Transfusion in the Severely Burned. 

ATACCC, 16-19 Aug 2010, poster.

372. Larson CR, White CE, Spinella PC, Jones 

JA, Holcomb JB, Blackbourne LH, and Wade 

CE. Association of shock, coagulopathy, and 

initial vital signs with massive transfusion in 

combat casualties. J Trauma, 2010 Jul, 69 

Supp 1: S26-32.

373. Latenser BA and Wolf SE. Proposed 

multicenter studies. J Burn Care Res, 2009 

Jan-Feb, 30(1): 188-9.

374. Lester M. Heterotopic Ossification in the 

Burn Patient: Experience at the U.S. Army 

Burn Center. University of Utah Burn Center, 

11 Nov 2010, presentation.

375. Lester M. Rehabilitation Following Burn 

Injury and Associated Trauma. Moldova Burn 

Seminar, 24-26 Aug 2010, presentation.

376. Lester M, Richard R, Oh J, Oswald D, 

King BT, Renz EM, and Blackbourne LH. 

Escharotomy and Fasciotomy Influence on 

Limb Function. ATACCC, 16-19 Aug 2010, 

poster.

377. Leung KP, Abercrombie JJ, Campbell TM, 

Gilmore KD, Bell CA, Faraj JA, and DeLuca 

PP. Antimicrobial peptides for plaque control. 

Advances in Dental Research, 2009, 21(1): 

57-62.

378. Levy JH, Dutton RP, Hemphill JC, 

Shander A, Cooper D, Paidas MJ, Kessler 

CM, Holcomb JB, and Lawson JH. 

Multidisciplinary approach to the challenge 

of hemostasis. International Anesthesia 

Research Society, 2010 Feb, 110(2): 354-64.

379. Lew TA, Walker JA, Wenke JC, Blackbourne 

LH, and Hale RG. Characterization of 

craniomaxillofacial battle injuries sustained 

by United States service members in the current conflicts of Iraq and Afghanistan. J Oral 

Maxillofac Surg, 2010 Jan, 68(1): 3-7.

380. Li B, Brown KV, Wenke JC, and Guelcher 

SA. Sustained release of vancomycin from 

polyurethane scaffolds inhibits infection of 

bone wounds in a rat femoral segmental 

defect model. J Control Release, 2010 Apr 9.

381. Liu MC, Akinyi L, Scharf D, Mo JX, Larner 

SF, Muller U, Oli MW, Zheng WR, Kobeissy 

F, Papa L, Lu XC, Dave JR, Tortella FC, 

Hayes RL, and Wang KKW. Ubiquitin 

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C-terminal hydrolase-L1 as a biomarker for 

ischemic and traumatic brain injury in rats. 

European Journal of Neuroscience, 2010, 

31(4): 722-32.

382. Liu NT, Baker WL, Batchinsky AI, Salinas J, 

and Cancio LC. Enhancing QRS Detection 

Using the Automated Electrocardiogram 

Selection of Peaks (AESOP) Algorithm. 

American Heart Association Resuscitation 

Science Symposium, 13-14 Nov 10, poster.

383. Lofgren AL, Wenke JC, and Rathbone CR. 

The Effect of Lovastatin on Cell Migration. 

ATACCC, 16-19 Aug 2010, poster.

384. Long J, Bentley T, Atkins J, Januszkiewicz 

A, and Bauman R. Kevlar Vest Protection 

Against Blast Overpressure Brain Injury: 

Systemic Contributions to Injury Etiology. 

Military Health Research Forum, Kansas 

City, MO, August 31-September 3, 2009, 

presentation.

385. Long J, Bentley T, Atkins J, Januszkiewicz 

A, and Bauman R. Brain Vulnerability to 

Repeated Blast Overpressure. Military 

Health Research Forum, Kansas City, MO, 

August 31-September 3, 2009, presentation.

386. Long JB, Bentley TB, Atkins JL, 

Januszkiewicz A, Parks S, Ritzel D, and 

Bauman RA. Blast-Induced Traumatic Brain 

Injury: Recreating a Battlefield Injury in the 

Laboratory. IFMBE Proceedings 30, 2010.

387. Long JB, Bentley TB, Atkins JL, 

Januszkiewicz A, Parks S, Ritzel D, and 

Bauman RA. Blast-Induced Traumatic Brain 

Injury: Recreating a Battlefield Injury in 

the Laboratory. 26th Southern Biomedical 

Engineering Conference, 2010.

388. Long JB, Bentley TL, Wessner KA, Cerone 

C, Sweeney S, and Bauman RA. Blast 

overpressure in rats: Recreating a battlefield 

injury in the laboratory. J Neurotrauma, 

2009, 26(6): 827-40.

389. Longfield JN, Morris MJ, Moran KA, Kragh 

JF Jr, Wolf R, and Baskin TW. Community 

meetings for emergency research community 

consultation. Crit Care Med, 2008 Mar, 36(3): 

731-6. 

390. Lu XC, Chen RW, Yao C, Wei H, Yang X, 

Liao Z, Dave JR, and Tortella FC. NNZ-2566, 

a glypromate analog, improves functional 

recovery and attenuates apoptosis and 

inflammation in a rat model of penetrating ballistic-type brain injury. Journal of 

Neurotrauma, 2009, 26(1): 141-54.

391. Lu XC, Si Y, Williams AJ, Hartings JA, 

Gryder D, and Tortella FC. NNZ-2566, 

a glypromate analog, attenuates brain 

ischemia-induced non-convulsive seizures 

in rats. Journal of Cerebral Blood Flow and 

Metabolism, 2009, 29(12): 1924-32.

392. Lundy JB, Hetz K, Chung KK, Renz EM, 

White CE, King BT, Huzar T, Wolf SE, and 

Blackbourne LH. Outcomes with the use of 

recombinant human erythropoietin in critically ill burn patients. Am Surg, 2010 Sep, 

76(9): 951-6.

393. Maani CV. Pain Control for Combat Casualty 

Care and Translational Advances in Pain. 

Battlefield Healthcare Summit, 6-8 Dec 

2010, presentation.

394. Maani CV. Burn Pain and Virtual Reality 

Analgesia. AMSC Management of Burns and 

Multiple Trauma Course, 30 Aug-3 Sep 2010, 

presentation.

395. Maani CV. Pain and Trauma Anesthesia: U.S. 

Army ISR Research Initiatives. ATACCC, 

16-19 Aug 2010, presentation.

396. Maani CV, DeSocio PA, and Holcomb JB. 

Coagulopathy in trauma patients: What 

are the main influence factors? Opinion in 

Anesthesiology, 2009 Apr, 22(2): 255-260.

397. Maani CV, Hoffman HG, DeSocio PA, 

Morrow M, Galin C, et al. Pain control during 

wound care for combat-related burn injuries 

using custom articulated arm mounted virtual 

reality goggles. Journal of CyberTherapy & 

Rehabilitation, 2008 Summer 1(2): 193-198.

398. Mabry R and McManus JG. Prehospital 

advances in the management of severe 

penetrating trauma. Crit Care Med, 2008 Jul, 

36(7 Supp): S258-66.

399. Mabry RL, Cuniowski P, Frankfurt A, and 

Adams B. Advanced Airway Management 

in Combat Casualties at the Point of Injury. 

NATO, 19-21 April 2010, poster.

400. Manley GT, Diaz-Arrastia R, Brophy M, Engel 

D, Goodman C, Gwinn K, Veenstra TD, Ling 

G, Ottens AK, Tortella F, and Hayes RL. 

Common data elements for traumatic brain 

injury: Recommendations from the biospecimens and biomarkers working group. Arch 

Phys Med Rehabil, 2010, 91(11): 1667-72.

401. Mann E, Pidcoke HF, Salinas J, Holcomb JB, 

Wolf SE, and Wade CE. The impact of intensive insulin protocols and restrictive blood 

transfusion strategies on glucose measurement in American Burn Association (ABA) 

verified burn centers. J Burn Care Res, 2008 

Sep-Oct, 29(5): 718-23. 

2-87
402. Mann EA, Jones JA, Wolf SE, and Wade 

CE. Computer Decision Support Software 

(Endotool) Safely Improves Glycemic Control 

in the Burn Intensive Care Unit. Society 

of Critical Care Medicine, 9-13 Jan 2010, 

poster.

403. Mann EA, Pidcoke HF, Salinas J, Wade CE, 

Holcomb JB, Wolf SE, Lacara T, Domagtoy 

C, Lickliter D, Quattrocchi K, Snipes L, 

Kuszaj J, and Prasnikar M. Accuracy of 

glucometers should not be assumed. 

Am J Crit Care, 2007 Nov, 16(6): 531-2.

404. Mann EA, Pidcoke HF, Salinas J, Wolf SE, 

Wade CE, and Holcomb JB. Hematocrit 

causes the most significant error in point of 

care glucometers. Crit Care Med, 2009 Apr, 

37(4): 1530; author reply 1530-1. 

405. Mann EA, Pidcoke HF, Wade CE, Salinas 

J, Michalek JE, Holcomb JB, and Wolf SE. 

Impact of intensive insulin protocols and 

restrictive blood transfusion strategies on 

glucose measurement in ABA verified burn 

centers. J Burn Care Res, 2007 Nov-Dec, 

28(Supp 2): S54.

406. Mann EA and Salinas J. The use of computer 

decision support systems for the critical care 

environment. AACN Adv Crit Care, 2009 JulSep, 20(3): 216-9. No abstract available.

407. Mann EA, Salinas J, Pidcoke HF, Wolf SE, 

Holcomb JB, and Wade CE. Error rates 

resulting from anemia can be corrected in 

multiple commonly used point-of-care glucometers. J Trauma, 2008 Jan, 64(1): 15-21.

408. Mann EA, Wood GL, and Wade CE. Use of 

procalcitonin for the detection of sepsis in the 

critically ill burn patient: A systematic review 

of the literature. Burns, 2010 May 26.

409. Markell KW, Renz EM, White CE, Albrecht 

ME, Blackbourne LH, Park MS, Barillo DA, 

Chung KK, Kozar RA, Minei JP, Cohn SM, 

Herndon DN, Cancio LC, Holcomb JB, and 

Wolf SE. Abdominal complications after 

severe burns. J Am Coll Surg, 2009 May, 

208(5): 940-7; discussion 947-9. 

410. Martini W. Fibrinogen Regulation on 

Coagulation Function After Hemorrhagic 

Shock in Pigs. International Fibrinogen 

Meeting, 23-25 Aug 2010, poster.

411. Martini W. Fibrinogen Metabolic Responses 

After Hemorrhagic Shock. TSIS, 9-13 Mar 

2010, presentation.

412. Martini W, Chinkes D, Colvin S, Rodriguez 

A, and Dubick M. Dynamics of fibrinogen 

metabolism for 5 days following hemorrhagic 

shock and lactated Ringer’s (LR) resuscitation in pigs. Inflamm Res, 2010, 59 (Supp 1): 

S25-26.

413. Martini WZ. Trauma Associated Coagulation 

Disorders. Innsbruck Winter Coagulation 

Symposium, 4-7 Nov 2010, presentation.

414. Martini WZ. Fibrinogen Regulation on 

Coagulation Function After Hemorrhagic 

Shock in Pigs. ATACCC, 16-19 Aug 2010, 

poster.

415. Martini WZ. Coagulopathy by hypothermia 

and acidosis: Mechanisms of thrombin generation and fibrinogen availability. J Trauma, 

2009 Jul, 67(1): 202-8; discussion 208-9. 

Review.

416. Martini WZ. Fibrinogen metabolic responses 

to trauma. Scand J Trauma Resusc Emerg 

Med, 2009 Jan 13, 17(1): 2.

417. Martini WZ, Chung KK, Colvin S, Cortez 

D, and Dubick MA. Long Term Effects of 

Hemorrhagic Shock on Coagulation Function 

in Pigs. ATACCC, 16-19 Aug 2010, poster.

418. Martini WZ, Chung KK, Colvin S, Cortez 

D, and Dubick MA. Long Term Effects of 

Hemorrhagic Shock on Coagulation Function 

in Pigs. Shock Society, 12-15 Jun 2010, 

poster.

419. Martini WZ, Cortez DS, Dubick MA, Park 

MS, and Holcomb JB. Thrombelastography 

is better than PT, aPTT, and activated 

clotting time in detecting clinically relevant 

clotting abnormalities after hypothermia, 

hemorrhagic shock and resuscitation in pigs. 

J Trauma. 2008 Sep, 65(3): 535‐43.

420. Martini WZ and Holcomb JB. Acidosis and 

Coagulopathy: The differential effects on 

fibrinogen synthesis and breakdown in pigs. 

Ann Surg, 2007 Nov, 246(5): 831-5. 

421. Martini WZ, Wolf SE, Chinkes DL, Chung 

KK, Dubick MA, Blackbourne L, and Yu YM. 

Enhanced albumin synthesis in severely 

burned adults. Shock, 2010 Feb 10.

422. Mase VJ, Wade CE, Eastridge BJ, Walters 

TJ, and Baer DG. Admission Physiology 

Criteria Upon Presentation to Combat 

Support Hospitals: Are Current Critical Vital 

Signs Effective? ACS Surgical Forum 3-7 

Oct 2010, presentation.

423. Mase VJ, Wade CE, Eastridge BJ, Walters 

TJ, and Baer DG. Admission Physiology 

Criteria Upon Presentation to Combat 

Support Hospitals: Are Current Critical Vital 

Signs Effective? ACS Regional Meeting, 27 

May 2010, presentation.

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424. Mase VJ Jr, Hsu JR, Wolf SE, Wenke JC, 

Baer DG, Owens J, Badylak SF, and Walters 

TJ. Clinical application of an acellular 

biologic scaffold for surgical repair of a 

large, traumatic quadriceps femoris muscle 

defect. Orthopedics, 2010 Jul 13, 33(7). 

doi: 10.3928/01477447-20100526-24.

425. Masini B, Stinner D, Waterman S, and 

Wenke J. Bacterial Adherence to High 

Tensile-Strength Suture: A Bioluminescent 

In-Vitro Analysis. AAOS, 9-13 Mar 2010, 

poster.

426. Masini B, Stinner DJ, Waterman SM, Wenke 

JP, and Gerlinger TL. Bacterial Adherence to 

Titanium Versus Bioabsorbable Interference 

Screws. AAOS, 9-13 Mar 2010, presentation.

427. Masini BD, Murray CK, Wenke JC, and Hsu 

JR. Prevention and treatment of infected foot 

and ankle wounds sustained in the combat 

environment. Foot Ankle Clin, 2010 Mar, 

15(1): 91-112.

428. Masini BD, Owens BD, Hsu JR, and Wenke 

JC. Rehospitalization After Combat Trauma. 

SOMOS, 13-17 Dec 2010, presentation.

429. Masini BD, Ritenour AE, Racusin AW, 

Wenke JC, Gerlinger TL, and Hsu JR. Acute 

Compartment Syndrome of the Thigh in 

Combat Casualties. ATACCC, 16-19 Aug 

2010, poster.

430. Masini BD, Stinner DJ, Waterman SM, and 

Wenke JC. Bacterial Adherence to High 

Tensile-Strength Suture: A Bioluminescent 

In Vitro Analysis. Arthroscopy Association of 

North America, 20-23 May 2010, poster.

431. Masini BD, Stinner DJ, Waterman 

SM, Wenke JC, and Gerlinger TL. 

Bacterial Adherence to Titanium Versus 

Bioabsorbable Interference Screws. 

Arthroscopy Association of North America, 

20-23 May 2010, poster.

432. Masini BD, Waterman SM, Wenke JC, 

Owens BD, Hsu JR, and Ficke JR. Resource 

utilization and disability outcome assessment 

of combat casualties from operation Iraqi 

freedom and operation enduring freedom. 

J Orthop Trauma, 2009 Apr, 23(4): 261-6.

433. Matheu FA and McFaul SJ. Supernates from 

stored red blood cells inhibit platelet aggregation. Transfusion, 2010, 50(6): 1196-202.

434. Matos RI, Holcomb JB, Callahan C, and 

Spinella PC. Increased mortality rates of 

young children with traumatic injuries at 

a U.S. army combat support hospital in 

Baghdad, Iraq, 2004. Pediatrics, 2008 Nov, 

122(5): e959-66.

435. McFaul SJ, Corley JB, Mester CW, and Nath 

J. Packed blood cells stored in AS-5 become 

proinflammatory during storage. Transfusion, 

2009, 49(7): 1451-60.

436. McFaul SJ, Desmond DE, and Matheu 

FA. Inhibition of Platelet Aggregation by 

Supernates from Stored Red Blood Cells. 

AABB, 9-12 Oct 2010, poster.

437. McFaul SJ, Desmond DE, and Matheu 

FA. Inhibition of Platelet Aggregation by 

Supernates from Stored Red Blood Cells. 

ATACCC, 16-19 Aug 2010, poster.

438. McGhee L. DoD Pain Management 

Research. World Congress on Pain, 4 Sep 

2010, presentation.

439. McGhee L. Early Pain Management and 

Long Term Outcome – An Update. ATACCC, 

16-19 Aug 2010, presentation.

440. McGhee L. Early Pain Management and 

Long Term Outcome – An Update. TTCP, 

4 May 2010, presentation.

441. McGhee L, Slater TM, Garza TH, Fowler 

M, DeSocio PA, and Maani CV. The 

Relationship of Early Acute Pain in Theater 

and Injury Severity in Injured Soldiers. 

American Academy of Pain Medicine 

Meeting, 3-6 Feb 2010, poster.

442. McGhee LL. The Relationship of Early Pain 

Scores and Post Traumatic Stress Disorder 

in Burned Soldiers. ABA, 9-12 Mar 2010, 

presentation.

443. McGhee LL, Garza TH, Slater TM, Fowler 

M, DeSocio PA, and Maani CV. The 

Relationship of Early Pain Scores and 

Post-Traumatic Stress Disorder in Burned 

Soldiers. ATACCC, 16-19 Aug 2010, poster.

444. McGhee LL, Maani CV, Garza TH, DeSocio 

PA, Gaylord KM, and Black IH. The relationship of intravenous midazolam and posttraumatic stress disorder development in burned 

soldiers. J Trauma, 2009 Apr, 66(4 Supp): 

S186-90.

445. McGhee LL, Maani CV, Garza TH, Desocio 

PA, Gaylord KM, and Black IH. The effect of 

propranolol on posttraumatic stress disorder 

in burned service members. J Burn Care 

Res, 2009 Jan/Feb, 30(1): 92-97.

446. McGhee LL, Maani CV, Garza TH, Gaylord 

KM, and Black IH. The correlation between 

ketamine and posttraumatic stress disorder 

in burned service members. J Trauma, 2008 

Feb, 64(2 Supp): S195-S199.

2-89
447. McGrath SP, Ryan KL, Wendelken SM, 

Rickards CA, and Convertino VA. Pulse 

oximeter plethysmographic waveform 

changes in awake, spontaneously breathing, 

hypovolemic volunteers. Anesth Analg, 2010 

Jan 26. 

448. McLaughlin DF, Niles SE, Salinas J, Perkins 

JG, Cox ED, Wade CE, and Holcomb JB. A 

predictive model for massive transfusion in 

combat casualty patients. J Trauma, 2008 

Feb, 64(2 Supp): S57-S63.

449. McManus J, Salinas J, Morton M, Lappan C, 

and Poropatich R. Teleconsultation program 

for deployed soldiers and healthcare professionals in remote and austere environments. 

Prehosp Disaster Med, 2008 May-Jun, 23(3): 

210-6; discussion 217.

450. McManus JG, McClinton A, and Morton MJ. 

Ethical issues in conduct of research in combat and disaster operations. Am J Disaster 

Med, 2009 Mar-Apr, 4(2): 87-93.

451. McManus JG, Ryan KL, Morton MJ, Rickards 

CA, Cooke WH, and Convertino VA. 

Limitations of end-tidal CO(2) as an early 

indicator of central hypovolemia in humans. 

Prehosp Emerg Care, 2008 Apr-Jun, 12(2): 

199-205.

452. McMullin NR, Hedner U, Ezban M, Lauritzen 

B, Prince MD, Holcomb JB, and Sondeen 

JL. Recombinant factor VIIa reduces rebleed 

hemorrhage volume in a swine aortotomy 

model: A randomized double-blinded study. 

Shock, 2008 Jun, 29(6): 703-708.

453. McMullin NR, Wade CE, Holcomb JB, 

Nielsen TG, Rossaint R, Riou B, Rizoli SB, 

Kluger Y, Choong PI, Warren B, Tortella BJ, 

and Boffard KD; NovoSeven Trauma Study 

Group. Prolonged prothrombin time after 

recombinant activated factor VII therapy in 

critically bleeding trauma patients is associated with adverse outcomes. J Trauma, 2010 

Jul, 69(1): 60-9.

454. Merritt EK, Cannon MV, Hammers DW, Le 

LN, Gokhale R, Sarathy A, Song TJ, Tierney 

MT, Suggs LJ, Walters TJ, and Farrar RP. 

Repair of traumatic skeletal muscle injury 

with bone-marrow-derived mesenchymal 

stem cells seeded on extracellular matrix. 

Tissue Eng Part A, 2010 Jun 7.

455. Merritt EK, Hammers DW, Tierney M, Suggs 

LJ, Walters TJ, and Farrar RP. Functional 

assessment of skeletal muscle regeneration 

utilizing homologous extracellular matrix as 

scaffolding. Tissue Eng Part A, 2010 Apr, 

16(4): 1395-405.

456. Miclau T, Schmidt AH, Wenke JC, Webb LX, 

Harro JM, Prabhakara R, and Shirtliff ME. 

Infection. J Orthop Trauma, 2010 Sep, 24(9): 

583-6.

457. Moore EE, Knudson MM, Schwab CW, 

Trunkey DD, Johannigman JA, and Holcomb 

JB. Military-civilian collaboration in trauma 

care and the senior visiting surgeon program. 

N Engl J Med, 2007 Dec 27, 357(26): 2723-7.

458. Mora AG, Ritenour AE, Wade CE, Holcomb 

JB, Blackbourne LH, and Gaylord KM. 

Posttraumatic stress disorder in combat 

casualties with burns sustaining primary 

blast and concussive injuries. J Trauma, 

2009 Apr, 66(4 Supp): S178-85.

459. Mora AG, Schwacha MG, Pidcoke HF, Chung 

KK, Aden JK, Park MO, Wolf SE, and Wade 

CE. An Inflammatory Response to High Risk 

Glycemic Variability in Patients with Burns. 

Shock Society, 12-15 Jun 2010, poster.

460. Mountcastle SB, Posner M, Kragh JF Jr, and 

Taylor DC. Gender differences in anterior 

cruciate ligament injury vary with activity: 

Epidemiology of anterior cruciate ligament injuries in a young, athletic population. Am J Sports Med, 2007 Oct, 35(10): 

1635-42. 

461. Murray CK, Griffith ME, Mende K, Guymon 

CH, Ellis MW, Beckius M, Zera WC, Yu X, 

Co EA, Aldous W, and Hospenthal DR. 

Methicillin-resistant Staphylococcus aureus

in wound cultures recovered from a combat 

support hospital in Iraq. J Trauma, 2010 Jul, 

69(1): S1-S7 (Supplement).

462. Murray CK, Hsu JR, Solomkin JS, Keeling 

JJ, Andersen RC, Ficke JR, and Calhoun JH. 

Prevention and management of infections 

associated with combat-related extremity 

injuries. J Trauma, 2008 Feb, 4(3 Supp): 

S239-S251.

463. Murray CK, Loo FL, Hospenthal DR, Cancio 

LC, Jones JA, Kim SH, Holcomb JB, Wade 

CE, and Wolf SE. Incidence of systemic 

fungal infection and related mortality following severe burns. Burns, 2008 Dec, 34(8): 

1108-12.

464. Murray CK, Wilkins K, Molter NC, Yun HC, 

Dubick MA, Spott MA, Jenkins D, Eastridge 

B, Holcomb JB, Blackbourne LH, and 

Hospenthal DR. Infections in combat casualties during operations Iraqi and enduring 

freedom. J Trauma, 2009 Apr, 66(4 Supp): 

S138-44.

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465. Muschler GF, Raut VP, Patterson TE, Wenke 

JC, and Hollinger JO. The design and use 

of animal models for translational research 

in bone tissue engineering and regenerative 

medicine. Tissue Eng Part B Rev, 2010 Feb, 

16(1): 123-45. Review.

466. Natesan S, Baer D, Walters TJ, Suggs L, 

and Christy RJ. Autologous Adipose Derived 

Stem Cells Differentiate into Epithelial and 

Vascular Cells. Wound Healing Society, 

17-20 Apr 2010, poster.

467. Natesan S, Baer DG, Walters TJ, Babu M, 

and Christy RJ. Adipose-derived stem cell 

delivery into collagen gels using chitosan 

microspheres. Tissue Eng Part A, 2010 Apr, 

16(4): 1369-84.

468. Natesan S, Baer DG, Walters TJ, Suggs L, 

and Christy RJ. Autologous Adipose Derived 

Stem Cells Differentiate into Epithelial and 

Vascular Cells. Wound Healing Society, 

17-20 Apr 2010, presentation.

469. Natesan S, Seetharaman S, Wrice NL, 

Zamora D, Baer DG, and Christy RJ. 

Promoting Vasculogenesis of Human 

Derived Adipose Stem Cells. ATACCC, 

16-19 Aug 2010, poster.

470. Natesan S, Wrice NL, Seetharaman S, Baer 

DG, and Christy RJ. Epidermal-substitute 

developed from human adipose derived stem 

cells. TERMIS, 5-8 Dec 2010, poster.

471. Natesan S, Zhang G, Seetharaman S, 

Walters TJ, Baer DG, Suggs L, and Christy 

R. Vasculo-genesis in PEGylated Fibrin 

Hydrogel. McGowan Institute Retreat, 7-10 

Mar 2010, poster.

472. Natesan S, Zhang G, Walters TJ, Christy RJ, 

and Suggs LJ. A Bilayer Construct Controls 

Adipose Derived Stem Cell Differentiation. 

Society for Biomaterials, 21-24 Apr 2010, 

presentation.

473. Nateson S, Zhang G, Walters TJ, Suggs 

LJ, and Christy RJ. Development of a 

Vascularized Dermal Equivalent Adipose 

Derived Stem Cell. Biomedical Engineering 

Society, 6-9 Oct 2010, poster.

474. Nesbitt M, Allen P, Beekley A, Butler F, 

Eastridge B, and Blackbourne L. Current 

Practice of Thermoregulation During the 

Transport of Combat Wounded. NATO, 

19-21 April 2010, poster.

475. Nessen SC, Cronk DR, Edens J, Eastridge 

BJ, Little TR, Windsor J, Blackbourne LH, 

and Holcomb JB. U.S. army two-surgeon 

teams operating in remote Afghanistan—An 

evaluation of split-based forward surgical team operations. J Trauma, 2009 Apr, 

66(4 Supp): S37-47.

476. Niles SE, McLaughlin DF, Perkins JG, Wade 

CE, Li Y, Spinella PC, and Holcomb JB. 

Increased mortality associated with the early 

coagulopathy of trauma in combat casualties. J Trauma, 2008 Jun, 64(6): 1459-63; 

discussion 1463-5.

477. Nylund CM, Borgman MA, Holcomb 

JB, Jenkins D, and Spinella PC. 

Thromboelastography to direct the administration of recombinant activated factor VII in 

a child with traumatic injury requiring massive transfusion. Pediatr Crit Care Med, 2009 

Mar, 10(2): e22-6.

478. Ochoa LM, Dawson L, Patzkowski JC, 

and Hsu JR. Radiographic prevalence of 

femoroacetabular impingement in a young 

population with hip complaints is high. Clin 

Orthop Relat Res, 2010 Jan 27.

479. Oh J, Huzar T, Kragh J, Cancio L, Renz E, 

Chung K, Jones J, Wolf SE, and King B. 

Extremity Fasciotomy in Burns Increases 

Amputation Rates. ABA, 9-12 Mar 2010, 

poster.

480. Oh T, Calderon ML, and Klemcke HG. Brain 

Stem Oxygenase (HO) mRNA Expression in 

Inbred Rat Strains After Severe Hemorrhage. 

EB (FASEB), 24-28 Apr 2010, poster.

481. Ottens AK, Bustamante L, Golden EC, Yao 

C, Hayes RL, Wang KK, Tortella FC, and 

Dave JR. Neuroproteomics: A biochemical 

means to discriminate the extent and modality of brain injury. Journal of Neurotrauma, 

2010, 27(10): 1837-52.

482. Owens BD, Kragh JF, Wenke JC, Macaitis J, 

Wade CE, and Holcomb JB. Combat wounds 

in operation Iraqi freedom and operation 

enduring freedom. J Trauma, 2008 Feb, 

64(2): 295-299.

483. Owens BD, White DW, and Wenke JC. 

Comparison of irrigation solutions and 

devices in a contaminated musculoskeletal 

wound survival model. J Bone Joint Surg 

Am, 2009 Jan, 91(1): 92-8.

484. Owens JG, Hsu JR, and Blair JA. The 

Ability to Return to Running and Sports 

Participation After Limb Salvage: A 

Case Series. SOMOS, 13-17 Dec 2010, 

presentation.

2-91
485. Pamuk ON, Lapchak PH, Rani P, Pine P, 

Dalle Lucca JJ, and Tsokos GC. Spleen tyrosine kinase inhibition prevents tissue damage after ischemia-reperfusion. American 

Journal of Physiology. Gastrointestinal and 

Liver Physiology, 2010, 299(2): G391-9.

486. Park MS, Salinas J, Wade CE, Wang JJ, 

Martini WZ, Pusateri AE, Merrill GA, Chung 

KK, Wolf SE, and Holcomb JB. Combining 

early coagulation and inflammatory status 

improves prediction of mortality in burned 

and nonburned trauma patients. J Trauma, 

2008 Feb, 4(2 Supp): S188-S194.

487. Parr MJ, Bouillon B, Brohi K, Dutton RP, 

Hauser CJ, Hess JR, Holcomb JB, Kluger 

Y, Mackway-Jones K, Rizoli SB, Yukioka 

T, and Hoyt DB. Traumatic coagulopathy: 

Where are the good experimental models? 

J Trauma, 2008 Oct, 65(4): 766-71.

488. Patel OV, Zakrzewska E, Maple RL, Baer 

LA, Ronca AE, Wade CE, and Plaut K. 

Lipogenesis impaired in periparturient rats 

exposed to altered gravity is independent of 

prolactin and glucocorticoid secretion. Eur J 

Appl Physiol, 2008 Nov, 104(5): 847-58. 

489. Patel S, White CE, Batchinsky AI, Burns 

JW, Wade CE, and Cancio L. Heart Rate 

Complexity Correlates with Lactate and Base 

Excess During Lethal Hemorrhagic Shock. 

AAST, 22-25 Sep 2010, poster.

490. Patel S, White CE, Batchinsky AI, Burns 

JW, Wade CE, and Cancio L. Heart Rate 

Complexity Correlates with Lactate and Base 

Excess During Lethal Hemorrhagic Shock. 

ATACCC, 16-19 Aug 2010, poster.

491. Patzkowski JC, Kirk Kl, Orr JD, Waterman 

BR, Kirby JM, and Hsu JR, STReC. 

Quantification of Posterior Ankle Exposure 

Through an Achilles Tendon-Splitting vs. 

Posterolateral Approach. SOMOS, 13-17 Dec 

2010, presentation.

492. Pauldine R, Beck G, Salinas J, and Kaczka 

DW. Closed-loop strategies for patient care 

systems. J Trauma, 2008 Apr, 64(4 Supp): 

S289-94. Review.

493. Perkins JG, Andrew CP, Spinella PC, 

Blackbourne LH, Grathwohl KW, Repine TB, 

Ketchum L, Waterman P, Lee RE, Beekley 

AC, Sebesta JA, Shorr AF, Wade CE, and 

Holcomb JB. An evaluation of the impact 

of apheresis platelets used in the setting 

of massively transfused trauma patients. 

J Trauma, 2009 Apr, 66(4 Supp): S77-84; 

discussion S84-5.

494. Perkins JG, Cap AP, Spinella PC, Shorr 

AF, Beekley AC, Grathwohl KW, Rentas 

FJ, Wade CE, and Holcomb JB; the 31st 

Combat Support Hospital Research Group. 

Comparison of platelet transfusion as fresh 

whole blood versus apheresis platelets 

for massively transfused combat trauma 

patients. Transfusion, 2010 Aug 26. [Epub 

ahead of print].

495. Pham TN, Cancio LC, and Gibran NS. 

American Burn Association practice guidelines burn shock resuscitation. J Burn Care 

Res, 2008 Jan/Feb, 29(1): 257-266.

496. Pidcoke HF, Salinas J, Wanek SM, 

Concannon M, Loo F, Wirfel KL, Holcomb 

JB, Wolf SE, and Wade CE. Patterns of 

exogenous insulin requirement reflect insulin 

sensitivity changes in trauma. Am J Surg, 

2007 Dec, 194(6): 798-803; discussion 803.

497. Pidcoke HF, Wade CE, Mann EA, Salinas 

J, Cohee BM, Holcomb JB, and Wolf SE. 

Anemia causes hypoglycemia in intensive 

care unit patients due to error in single-channel glucometers: Methods of reducing patient 

risk. Crit Care Med, 2010 Feb, 38(2): 471-6.

498. Pidcoke HF, Wade CE, Mann EA, Salinas 

J, Michalek JE, Cohee BM, Holcomb JB, 

and Wolf SE. Occult hypoglycemia in a burn 

ICU unmasked with correction of hematocrit 

effect in point-of-care glucometers. J Burn 

Care Res, 2007 Nov-Dec, 28(Supp 2): S92.

499. Pidcoke HF, Wolf SE, Jones JA, Holcomb 

JB, and Wade CE. Diurnal pattern in insulin 

secretion persists in severely injured patients. FASEB J, 2008 April, 22: 1205.7.

500. Platteborze L. FDA-Regulated Clinical Trials 

at USAISR. MRMC Intramural Lab, 14-16 

Jun 2010, presentation.

501. Platteborze L. U.S. Army Institute of Surgical 

Research. MRMC Intramural Lab, 14-16 Jun 

2010, presentation.

502. Platteborze L. U.S. Army Brief. MRMC, Apr 

2010, presentation.

503. Platteborze LS, Young-McCaughan S, 

King-Letzkus I, McClinton A, Halliday A, 

and Jefferson T. Performance improvement/

research advisory panel: A model for determining whether a project is performance or 

quality improvement activity or research. Mil 

Med, 2010 Apr, 175(4): 289-291.

504. Plotkin AJ, Wade CE, Jenkins DH, Smith KA, 

Noe JC, Park MS, Perkins JG, and Holcomb 

JB. A reduction in clot formation rate and 

strength assessed by thrombelastography 

is indicative of transfusion requirements in 

2-92

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
patients with penetrating injuries. J Trauma, 

2008 Feb, 64(2 Supp): S64-S78.

505. Plueger M, Chung KK, Peterson CD, SerioMelvin M, Durning R, and Renz EM. A MultiService Approach to Delivering Combat 

Casualty Care Training Utilizing Robotic 

Telepresence. AMSUS, 2 Nov 2010, poster.

506. Plueger M, Rainwater B, Chung KK, Salinas 

R, Serio-Melvin M, Durning R, and Renz E. 

Remote Robotic Telepresence for PreDeployment Burn Care-Training. Summer 

Institute on Evidence Based Practice, 8-10 

Jul 2010, poster.

507. Polykratis IA, Rubal BJ, Sondeen JL, 

DeLorenzo RA, and Dubick MA. The hypercoagulability of initial intraosseous aspirates. 

FASEB J, 2010, 24: 788.3.

508. Possley DR, Burns TC, Stinner DJ, Murray 

CK, Wenke JC, and Hsu JR, Skeletal Trauma 

Research Consortium. Temporary external 

fixation is safe in a combat environment. 

J Trauma, 2010 Jul, 69 Supp 1: S135-9.

509. Possley DR, Burns TC, Stinner DJ, Murray 

Ck, Wenke JC, and Hsu JR, STReC. 

External Fixation Is Safe for Damage Control 

Orthopaedics in a Combat Environment. 

AAOS, 9-13 Mar 2010, poster.

510. Prince MD, Sondeen JL, Kheirabadi BS, 

Wade CE, Polykratis IA, DeGuzman R, and 

Dubick MA. Initial Resuscitation with Plasma 

and Blood Components Reduced Bleeding 

Compared to Hextend in Anesthetized Swine 

with Uncontrolled Splenic Hemorrhage. 

ATACCC, 16-19 Aug 2010, poster.

511. Radek KA, Baer LA, Eckhardt J, Dipietro LA, 

and Wade CE. Mechanical unloading impairs 

keratinocyte migration and angiogenesis during cutaneous wound healing. J Appl Physiol, 

2008 May, 104(5): 1295-303.

512. Rainwater B, Chung KK, Peterson CD, 

Salinas R, Serio-Melvin M, Durning R, and 

Renz E. Remote Robotic Telepresence for 

Pre-Deployment Burn Care Training. ABA, 

9-12 Mar 2010, presentation.

513. Rainwater B, Chung KK, Peterson CD, 

Salinas R, Serio-Melvin M, Durning R, and 

Renz EM. Remote Robotic Tele-Presence for 

Pre Deployment Burn Care Training. Remote 

Presence Clinical Innovator’s Forum, 22-24 

Jul 2010, poster.

514. Rainwater B, Chung KK, Peterson CD, 

Salinas R, Serio-Melvin M, Durning R, and 

Renz EM. Remote Robotic Tele-Presence 

for Pre-Deployment Burn Care Training. 

American Telemedicine Association, 16-18 

May 2010, poster.

515. Rastogi A, Luo Z, Wu Z, Ho PS, Bowman 

PD, and Stavchansky S. Development and 

characterization of a scalable microperforated device capable of long-term zero order 

drug release. Biomed Microdevices, 2010 

Jun 29.

516. Rastogi A, Yang J, Wang X, Bynum J, 

Stavchansky S, and Bowman P. Induction 

of Hypoxia Inducible Factor 1 Alpha (HIF1a) 

by Caffeic Acid Phenethyl Ester (CAPE) and 

Caffeic Acid Phenethyl Amide (CAPA) in 

Mouse Skin Fibroblasts. EB (FASEB), 24-28 

Apr 2010, poster.

517. Rathbone CR, Rice JW, and Walters TJ. 

Comparison of Human Bone Marrow Derived 

and Adipose Derived Stem Cells in Their 

Resistance to Oxidative Stress and Hypoxia. 

PTEI, 6 Aug 2010, poster.

518. Rayburn D, Byzek S, Gist I, and Atkins 

J. Effect of Changes in Dietary Nitrite on 

Ventilation. 33rd Annual Conference on 

Shock, 2010.

519. Regules JA, Glasser JS, Wolf SE, 

Hospenthal DR, and Murray CK. 

Endocarditis in burn patients: Clinical and 

diagnostic considerations. Burns, 2008 Aug, 

34(5): 610-6.

520. Regules JA, Horvath LL, and Chung KK. 

Invasive Vibrio cholerae infection following 

burn injury. J Burn Care Res, 2008 May-Jun, 

29(3): 551-4. 

521. Reisner AT, Xu D, Ryan KL, Convertino VA, 

Rickards CA, and Mukkamala R. Monitoring 

non-invasive cardiac output and stroke 

volume during experimental human hypovolaemia and resuscitation. Br J Anaesth, 2010 

Nov 4.

522. Renz E. Care of Combat Related 

Burn Casualties. ABA, 9-12 Mar 2010, 

presentation.

523. Renz EM. Moldova Burn Seminar 2010 No. 

1. Moldova Burn Seminar, 24-26 Aug 2010, 

presentation.

524. Renz EM. Moldova Burn Seminar 2010 No. 

3. Moldova Burn Seminar, 24-26 Aug 2010, 

presentation.

525. Renz EM. Moldova Burn Seminar 2010 No. 

4. Moldova Burn Seminar, 24-26 Aug 2010, 

presentation.

2-93
526. Renz EM. Moldova Burn Seminar 2010 No. 

5. Moldova Burn Seminar, 24-26 Aug 2010, 

presentation.

527. Renz EM. Moldova Burn Seminar. Moldova 

Burn Seminar, 24-26 Aug 2010, presentation.

528. Renz EM. Use of High Frequency 

Ventilation to Care for Military Casualties. 

High Frequency Conference, Mar 2010, 

presentation.

529. Renz EM, Cancio LC, Barillo DJ, White 

CE, Albrecht MC, Thompson CK, Ennis JL, 

Wanek SM, King JA, Chung KK, Wolf SE, 

and Holcomb JB. Long range transport of 

war-related burn casualties. J Trauma, 2008 

Feb, 64(2 Supp): S136-S145.

530. Renz EM, Rivera MA, and Lester ME. 

Moldova Burn Seminar 2010 No. 2. Moldova 

Burn Seminar, 24-26 Aug 2010, presentation.

531. Ressner RA, Murray CK, Griffith ME, 

Rasnake MS, Hospenthal DR, and Wolf SE. 

Outcomes of bacteremia in burn patients 

involved in combat operations overseas. 

J Am Coll Surg, 2008 Mar, 206(3): 439-44. 

532. Riccio C, Bentley TB, and Long JB. Blast 

Overpressure Injury in Rats Produces 

Widespread Fiber Degeneration. ATACCC, 

August 2010.

533. Richard R. Great Fires of the Northeast. 

ABA, 9-12 Mar 2010, poster.

534. Richard R, Hedman TL, Quick CD, Renz EM, 

Cancio LC, Chung KK, Dewey WS, Barillo 

DJ, and Holcomb JB. Burns. Burns, 2008 

Mar, 34(2): 295-6. 

535. Richard RL, Hedman TL, Quick CD, Barillo 

DJ, Cancio LC, Renz EM, Chapman TT, 

Dewey WS, Dougherty M, Esselman P, 

Forbes-Duchart L, Franzen BJ, Hunter 

H, Kowalske K, Moore M, Nakamura DY, 

Nedelec B, Niszczak J, Parry I, Serghiou 

M, Ward RS, Holcomb JB, and Wolf SE. A 

clarion to recommit and reaffirm burn rehabilitation. J Burn Care Res, 2008 May-Jun, 

29(3): 425-32. 

536. Rickards CA. Re: Heart period variability 

monitoring in trauma and hemorrhage. 

J Trauma, 2010 Aug, 69(2): 479-80. No 

abstract available.

537. Rickards CA, Cohen KD, Bergeron LL, 

Burton L, Khatri PJ, Lee CT, Ryan KL, Cooke 

WH, Doerr DF, Lurie KG, and Convertino VA. 

Inspiratory resistance, cerebral blood flow 

velocity, and symptoms of acute hypotension. Aviat Space Environ Med, 2008 Jun, 

79(6): 557-64.

538. Rickards CA, Ryan KL, and Convertino VA. 

Characterization of common measures of 

heart period variability in healthy human 

subjects: Implications for patient monitoring. 

J Clin Monit Comput, 2010 Feb, 24(1): 61-70. 

Epub 2009 Nov 22.

539. Rickards CA, Ryan KL, Cooke WH, Romero 

SA, and Convertino VA. Combat stress or 

hemorrhage? Evidence for a decision-assist 

algorithm for remote triage. Aviat Space 

Environ Med, 2008 Jul, 79(7): 670-6.

540. Rickards CA, Ryan KL, Hinojosa-Laborde C, 

Cooke WH, and Convertino VA. What Is the 

Stimulus for Oscillations in Arterial Pressure 

and Cerebral Blood Velocity? American 

Autonomic Society, 3-6 Nov 2010, poster.

541. Rickards CA, Ryan KL, Ludwig DA, and 

Convertino VA. Is heart period variability 

associated with the administration of lifesaving interventions in individual prehospital 

trauma patients with normal standard vital 

signs? Crit Care Med, 2010 Jun 18.

542. Rickards CA, Ryan KL, Muniz GW, Moralez 

G, and Convertino VA. How many heart 

beats are enough? A systematic assessment 

of data length reduction on measures of 

heart rate variability and complexity. FASEB 

J, 2008 April, 22: 1229.1.

543. Ritchie JD, Hardin MO, White CE, and 

Blackbourne LH. Utilization of Echelon II 

Military Treatment Facilities Associated with 

Decreased Mortality. NATO, 19-21 April 

2010, presentation.

544. Ritenour AE and Baskin TW. Primary blast 

injury: Update on diagnosis and treatment. 

Crit Care Med, 2008 Jul, 36(7 Supp): S311-7.

545. Ritenour AE, Blackbourne LH, Kelly JF, 

McLaughlin DF, Pearse LA, Holcomb JB, 

and Wade CE. Incidence of primary blast 

injury in U.S. military overseas contingency 

operations: A retrospective study. Ann Surg, 

2010 Jun, 251(6): 1140-4.

546. Ritenour AE, Christy RJ, Roe JL, Baer 

DG, Dubick MA, Wade CE, Holcomb JB, 

and Walters TJ. The effect of a hypobaric, 

hypoxic environment on acute skeletal 

muscle edema after ischemia-reperfusion 

injury in rats. J Surg Res, 2010 May 15, 

160(2): 253-9. Epub 2009 May 3.

547. Ritenour AE, Dorlac WC, Fang R, Woods 

T, Jenkins DH, Flaherty SF, Wade CE, and 

Holcomb JB. Complications after fasciotomy 

revision and delayed compartment release in 

combat patients. J Trauma, 2008 Feb, 64(2 

Supp): S153-S162.

2-94

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
548. Ritenour AE, Morton MJ, McManus JG, 

Barillo DJ, and Cancio LC. Lightning injury: A 

review. Burns, 2008 Aug, 34(5): 585-94. 

549. Ritenour AE, Wickley A, Ritenour JS, Kriete 

BR, Blackbourne LH, Holcomb JB, and 

Wade CE. Tympanic membrane perforation 

and hearing loss from blast overpressure in 

operation enduring freedom and operation 

Iraqi freedom wounded. J Trauma, 2008 Feb, 

64(2 Supp): S174-S178.

550. Rivera M. Principles of Burn Wound 

Management. Moldova Burn Seminar, 24-26 

Aug 2010, presentation.

551. Roback JD, Caldwell S, Carson J, Davenport 

R, Drew MJ, Eder A, Fung M, Hamilton M, 

Hess JR, Luban N, Perkins JG, Sachais BS, 

Shander A, Silverman T, Snyder E, Tormey 

C, Waters J, and Djulbegovic B. Evidencebased practice guidelines for plasma transfusion. Transfusion, 2010, 50(6): 1227-39.

552. Rose R, Oh T, Calderon ML, and Klemcke 

HG. Inter- and Intra-Strain Variability for 

Survival Time After Hemorrhage in Inbred 

Rats. ATACCC, 16-19 Aug 2010, poster.

553. Rose R, Oh T, Calderon ML, and Klemcke 

HG. Inter- and Intra-Strain Variability for 

Survival Time After Hemorrhage in Inbred 

Rats. EB (FASEB), 24-28 Apr 2010, poster.

554. Rothwell SW, Sawyer E, Dorsey J, Flournoy 

WS, Settle T, Simpson D, Cadd G, Janmey P, 

White C, and Szabo KA. Wound healing and 

the immune response in swine treated with 

a hemostatic bandage composed of salmon 

thrombin and fibrinogen. Journal of Materials 

Science-Materials in Medicine, 2009, 20(10): 

2155-66.

555. Rothwell SW, Settle T, Wallace S, Dorsey 

J, Simpson D, Bowman JR, Janmey P, and 

Sawyer E. The long term immunological 

response of swine after two exposures to a 

salmon thrombin and fibrinogen hemostatic 

bandage. Biologicals, 2010, 38(6): 619-28.

556. Roy D, Arason GA, Chowdhury B, Mitra A, 

and Calaf GM. Profiling of cell cycle genes of 

breast cells exposed to etodolac. Oncology 

Reports, 2010, 23(5): 1383-91.

557. Rubal B, Neal C, Sartin C, Dubick M, and 

DeLorenzo R. The potential for improved 

intraosseous flow at low infusion pressures. 

Shock, 2010, 33 (Supp 1): 39 (abst P88).

558. Rubal BJ, Gerhardt RT, Sartin CW, Neal 

CL, and DeLorenzo RA. Medullary shear 

and pressure changes associated with high 

intraosseous infusion rates in an isolated 

hind limb preparation. In Press, Annals of 

Emergency Medicine, 56 (3 Supp), 2010.

559. Ryan K, Rickards CA, Hinojosa-Laborde 

C, and Convertino VA. Association of 

Arterial Pressure Oscillations with Direct 

Measurement of Sympathetic Outflow in 

Subjects with Differing Tolerances to Central 

Hypovolemia. American Autonomic Society, 

3-6 Nov 2010, presentation.

560. Ryan KL. Being A Physiologist in a Military 

Lab or “How I Found My Ideal Job in the 

Most Unlikely of Places.” EB (FASEB), 24-28 

Apr 2010, presentation.

561. Ryan KL, Batchinsky A, McManus JG, 

Rickards CA, and Convertino VA. Changes 

in pulse character and mental status are late 

responses to central hypovolemia. Prehosp 

Emerg Care, 2008 Apr-Jun, 12(2): 192-8.

562. Ryan KL, Cooke WH, Rickards CA, Lurie 

KG, and Convertino VA. Breathing through 

an inspiratory threshold device improves 

stroke volume during central hypovolemia in 

humans. J Appl Physiol, 2008 May, 104(5): 

1402-9. 

563. Ryan KL, Rickards CA, Ludwig DA, and 

Convertino VA. Tracking central hypovolemia 

with ECG in humans: Cautions for the use of 

heart period variability in patient monitoring. 

Shock, 2010 Jun, 33(6): 583-9.

564. Ryan KL, Rickards CA, Muniz GW, Moralez 

G, and Convertino VA. Individual variability 

in heart rate variability (HRV) and complexity 

(HRC) measurements. FASEB J, 2008 April, 

22: 1229.3.

565. Salas MA, Pierce A, and Madinneni J. In 

Vitro Hemostatic Potential of Freeze-Dried 

Platelets (FDP). ATACCC, 16-19 Aug 2010, 

poster.

566. Salinas J. Interconnectivity and 

Interoperability. The ISR IDEA System. 

Society for Complexity in Acute Illness, 10-12 

Sep 2010, presentation.

567. Salinas J. Analysis, Classification, and 

Complexity of Physiologic Signals to Support 

Medical Decision Support: Why Is My 

Computer Smarter Than Me??? Israel, 14-18 

Jun 2010, presentation.

568. Salinas J. Maximum Fluid Needs for Burn 

Resuscitation Occur at 9 Hours Post Burn. 

ABA, 9-12 Mar 2010, presentation.

569. Salinas J, Baker WL, Batchinsky AI, Cancio 

LC, and Clayton NJ. Integrated Data 

Exchange and Archival (IDEA) System. 

ATACCC, 16-19 Aug 2010, poster.

2-95
570. Salinas J, Baker WL, Batchinsky AI, Cancio 

LC, Clayton NJ, Salinas J, Baker WL, 

Batchinsky AI, Cancio LC, and Clayton NJ. 

Integrated Data Exchange and Archival 

(IDEA) System. Society for Complexity in 

Acute Illness, 10-12 Sep 2010, poster.

571. Salinas J, Chung K, Serio-Melvin M, Kramer 

G, Cancio L, Wade C, McIvor P, Miller 

KJ, and Wolf SE. Computerized Decision 

Support System for Burn Resuscitation 

Improves Outcomes in Burn Patients. NATO, 

19-21 April 2010, poster.

572. Salinas J, Chung KK, Serio-Melvin ML, 

Kramer GC, Cancio LC, Wade CE, McIvor 

PD, Miller KJ, and Wolf SE. Computerized 

Decision Support System for Burn 

Resuscitation Improves Outcomes in Burn 

Patients. ATACCC, 16-19 Aug 2010, poster.

573. Salinas J, Doderer M, Liu N, Batchinsky A, 

Holcomb J, Blackbourne LH, and Cancio LC. 

Machine Learning Techniques Effectively 

Predict Need for Life Saving Interventions in 

Trauma Patients. NATO, 19-21 April 2010, 

poster.

574. Salinas J, Doderer M, Liu N, Batchinsky AI, 

Holcomb JB, Blackbourne LH, and Cancio 

LC. Use of Machine Learning Technologies 

to Predict Life Saving Interventions in the 

Prehospital Environment and Emergency 

Department. Eastern Association for the 

Surgery of Trauma, 19-23 Jan 2010, poster.

575. Salinas J, Drew G, Gallagher J, Cancio LC, 

Wolf SE, Wade CE, Holcomb JB, Herndon 

DN, and Kramer GC. Closed-loop and 

decision-assist resuscitation of burn patients. 

J Trauma, 2008 Apr, 64(4 Supp): S321-32.

576. Salinas J, Kramer G, Chung KK, SerioMelvin M, Wade C, Renz E, Wolf S, and 

Cancio L. The Death of the Resuscitation 

Formulas as We Know Them. ABA, 9-12 Mar 

2010, presentation.

577. Salinas J, McIvor PD, Clayton MJ, SerioMelvin ML, Shields BA, Miller KJ, Wade 

CE, Renz EM, Cancio LC, and Wolf SE. 

Computerized Mapping and Tracking of 

Burns. ABA, 9-12 Mar 2010, poster.

578. Salinas J, McIvor PD, Clayton NJ, SerioMelvin ML, Shields BA, Miller KJ, Wade 

CE, Renz EM, Cancio LC, and Wolf SE. 

Computerized Mapping and Tracking of 

Burns. ATACCC, 16-19 Aug 2010, poster.

579. Scherer MR, Darlington DN, Kheirabadi 

BS, Fedyk CG, Kremenevskiy I, Delgado 

AV, Pusateri AE, and Dubick MA. The 

Effect of rFVIIa on Thrombin Generation 

of Hemodiluted and Hypothermic Blood. 

ATACCC, 16-19 Aug 2010, poster.

580. Schmidt P, Moore C, Scuba S, King BT, 

Chung KK, Pamplin JC, Renz EM, and 

Cancio LC. Care of Pediatric Burn Patients 

During Wartime in Iraq: Baghdad to Boston 

and Back. Pacific Institute of Nursing 

Advancing Practice Education and Research 

Conference, 29-30 Mar 2010, presentation.

581. Schmidt PM, Moore CL, Scuba SC, King 

BT, Chung KK, Pamplin JC, Renz EM, and 

Cancio LC. From Baghdad to Boston and 

Back: Care of Iraqi Children with Major Burns 

Transferred to U.S. Burn Centers During 

Wartime. AMSUS, 2 Nov 2010, poster.

582. Schmidt PM, Moore CL, Scuba SC, King 

BT, Chung KK, Pamplin JC, Renz EM, and 

Cancio LC. From Baghdad to Boston and 

Back: Care of Iraqi Children with Major Burns 

Transferred to U.S. Burn Centers During 

Wartime. Karen A Rieder Poster Session, 

2 Nov 2010, poster.

583. Schmidt PM, Moore CL, Scuba SC, King 

BT, Chung KK, Pamplin JC, Renz EM, 

and Cancio LC. Care of Pediatric Burn 

Patients During Wartime in Iraq: Baghdad 

to Boston and Back. National Trauma 

Institute Conference, 30 Aug-1 Sep 2010, 

presentation.

584. Schreiber MA, Perkins J, Kiraly L, 

Underwood S, Wade C, and Holcomb JB. 

Early predictors of massive transfusion in 

combat casualties. J Am Coll Surg, 2007 

Oct, 205(4): 541-545. 

585. Schreiber MA, Zink K, Underwood S, 

Sullenberger L, Kelly M, and Holcomb JB. 

A comparison between patients treated 

at a combat support hospital in Iraq and a 

level I trauma center in the United States. 

J Trauma, 2008 Feb, 64(2 Supp): S118-S121; 

discussion S121-2.

586. Seetharaman S, Stowers RS, Natesan 

S, Mullens C, Suggs LJ, and Christy RJ. 

Fibrin Based Hydrogels for Infected Wound 

Therapy. TERMIS, 5-8 Dec 2010, poster.

587. Selvapandiyan A, Duncan R, Mendez J, 

Kumar R, Salotra P, Cardo LJ, and Nakhasi 

HL. A Leishmania minicircle DNA footprint 

assay for sensitive detection and rapid speciation of clinical isolates. Transfusion, 2008, 

48(9): 1787-98.

588. Sengupta R, Billiar TR, Atkins JL, Kagan 

VE, and Stoyanovsky DA. Nitric oxide and 

2-96

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dihydrolipoic acid modulate the activity of 

caspase 3 in HepG2 cells. FEBS Letters, 

2009, 583(21): 3525-30.

589. Serio-Melvin M. Burn Resuscitation Decision 

Support System (BRDSS). National Trauma 

Institute Conference, 30 Aug-1 Sep 2010, 

presentation.

590. Serio-Melvin M. Computer Assisted Decision 

Support in a Burn Intensive Care Unit. 

BDE Nurse Symposium, 25-26 May 2010, 

presentation.

591. Serio-Melvin M, Yoder LH, and Gaylord KM. 

Caring for burn patients at the United States 

institute of surgical research: The nurses’ 

multifaceted roles. Nurs Clin North Am, 2010 

Jun, 45(2): 233-48.

592. Serio-Melvin ML. Advances in Burn Wound 

Mapping. ATACCC, 16-19 Aug 2010, 

presentation.

593. Serio-Melvin ML. Burn Resuscitation 

Decision Support: The Nurse’s Role. 

ATACCC, 16-19 Aug 2010, presentation.

594. Serkin FB, Soderdahl DW, Hernandez J, 

Patterson M, Blackbourne L, and Wade 

CE. Combat urologic trauma in U.S. military 

overseas contingency operations. J Trauma, 

2010 Jul, 69 Supp 1: S175-8.

595. Sethuraman G, Ryan KL, Rickards CA, and 

Convertino VA. Ectopy in trauma patients: 

Cautions for use of heart period variability 

in medical monitoring. Aviat Space Environ 

Med, 2010 Feb, 81(2): 125-9.

596. Shear DA, Lu XC, Bombard MC, Pedersen 

R, Chen Z, Davis A, and Tortella FC. 

Longitudinal characterization of motor and 

cognitive deficits in a model of penetrating ballistic-like brain injury. Journal of 

Neurotrauma, 2010, 27(10): 1911-23.

597. Shear DA, Williams AJ, Sharrow K, Lu XC, 

and Tortella FC. Neuroprotective profile of 

dextromethorphan in an experimental model 

of penetrating ballistic-like brain injury. 

Pharmacology, Biochemistry, and Behavior, 

2009, 94(1): 56-62.

598. Shere JL. Ocular Trauma Classification. 4th 

Military Vision Symposium on Ocular and 

Brain Injury, presentation.

599. Shi T, Moulton VR, Lapchak PH, Deng GM, 

Dalle Lucca JJ, and Tsokos GC. Ischemiamediated aggregation of the actin cytoskeleton is one of the major initial events resulting 

in ischemia-reperfusion injury. American 

Journal of Physiology-Gastrointestinal and 

Liver Physiology, 2009, 296(2): G339-47.

600. Shields BA, Chung KK, Gibson DD, 

Salinas J, Serio-Melvin ML, and Wolf SE. 

Interruptions in the Provision of Enteral 

Nutrition Leads to Severe Weight Loss. 

American Society for Parenteral and Enteral 

Nutrition Clinical Nutrition Week, 9-12 Feb 

2010, poster.

601. Shields BA, Pidcoke HF, Wade CE, Jones 

JA, Brown AE, and Wolf SE. Using Visceral 

Proteins as Markers for Nutritional Status 

in Hypercalorically Fed Critically Ill Burn 

Patients. American Society for Parenteral 

and Enteral Nutrition Clinical Nutrition Week, 

9-12 Feb 2010, poster.

602. Siller-Jackson A, Bowman P, Wenke J, 

Bynum J, and Hammamieh R. Temporal 

Gene Expression Associated with Healing 

and Non-Healing Bone During the 

Repair Process in Rat Calvarial Defects. 

Orthopaedic Research Society, 6-9 Mar 

2010, poster.

603. Siller-Jackson A, Bowman P, Wenke J, 

Bynum J, and Hammamieh R. Temporal 

Gene Expression Associated with Healing 

and Non-Healing Bone During the 

Repair Process in Rat Calvarial Defects. 

Orthopaedic Research Society, 6-9 Mar 

2010, presentation.

604. Siller-Jackson A, Bowman P, Wenke JC, 

Bynum JA, and Hammamieh R. Temporal 

Gene Expression Profiling of Bone Repair in 

a Rat Calvarial Defect. EB (FASEB), 24-28 

Apr 2010, poster.

605. Silliman DT, Dumas JE, Guelcher SA, Wenke 

JC, Hale RG, and Brown Baer PR. Dose and 

Delivery Kinetic Effects of rhBMP-2 on Post 

Operative Swelling in New Zealand White 

Rabbit Critical Size Defect Cranial Surgery. 

ATACCC, 16-19 Aug 2010, poster.

606. Simmons D and Desocio P. Virtual Reality 

Pain Control During Wound Debridement of 

Combat-Related Burn Injures. ABA, 9-12 Mar 

2010, presentation.

607. Simmons JW, Chung KK, Renz EM, White 

CE, Cotant CL, Tilley MA, Hardin MO, 

Jones JA, Blackbourne LH, and Wolf SE. 

Fenoldopam use in a burn intensive care 

unit: A retrospective study. BMC Anesthesiol, 

2010 Jun 24, 10(1): 9. 

608. Simmons JW, Chung KK, White CE, Cancio 

LC, Hardin MO, Ritchie JD, Jones JA, Renz 

EM, Wolf SE, Wade CE, and Blackbourne 

LH. RIFLE vs AKIN Classification in a Burn 

ICU. ATACCC, 16-19 Aug 2010, poster.

2-97
609. Simmons JW, Chung KK, White CE, Mace 

JE, Jones JA, Wolf SE, Wade CE, and 

Blackbourne LH. AKIN Stage Associated 

with Mortality in a Burn ICU. Society of 

Critical Care Medicine, 9-13 Jan 2010, 

poster.

610. Simmons JW, Chung KK, White CE, Renz 

EM, Lundy JB, Hardin MO, Jones JA, Wolf 

SE, and Blackbourne LH. Fenoldopam 

Use in a Burn ICU. Society of Critical Care 

Medicine, 9-13 Jan 2010, poster.

611. Simmons JW, Hardin M, White CE, Ritchie 

JD, Eastridge B, Perkins J, Wade C, and 

Blackbourne LH. Minimizing Impact of 

Survival Bias on Massive Transfusion 

Plasma:RBC Ratio. Eastern Association 

for the Surgery of Trauma, 19-23 Jan 2010, 

poster.

612. Simmons JW, White CE, Eastridge BJ, Mace 

JE, Wade CE, and Blackbourne LH. Impact 

of policy change on U.S. Army combat 

transfusion practices. J Trauma, 2010 Jul, 

69 Supp 1: S75-80.

613. Sjulin T. Characterization of Inhalation Injury 

with Computerized Tomography of the Chest: 

A Retrospective Review. Army/AF ACP, 17-19 

Nov 2010, presentation.

614. Sjulin T, Renz E, Cancio L, White C, King BT, 

Blackbourne LH, Allen A, Chung KK, and Oh 

J. Characterization of Inhalation Injury with 

Computerized Tomography of the Chest: A 

Retrospective Review. South West Texas 

ACP Competition, 21 May 2010, poster.

615. Slater TM, Garza TH, Fowler M, McGhee L, 

Desocio PA, and Maani CV. The Relationship 

of Early Acute Pain in Theater and Injury 

Severity in Injured Soldiers. ATACCC, 16-19 

Aug 2010, poster.

616. Smith KK, Gilcreast D, and Pierce K. 

Evaluation of staff’s retention of ACLS and 

BLS skills. Resuscitation, 2008 Feb, 78: 

59-65.

617. Soller BR, Ryan KL, Rickards CA, Cooke 

WH, Yang Y, Soyemi OO, Crookes BA, 

Heard SO, and Convertino VA. Oxygen 

saturation determined from deep muscle, not 

thenar tissue, is an early indicator of central 

hypovolemia in humans. Crit Care Med, 2008 

Jan, 36(1): 176-82. 

618. Soller BR, Yang Y, Soyemi OO, Heard SO, 

Ryan KL, Rickards CA, Convertino VA, 

Cooke WH, and Crookes BA. Near infrared 

spectroscopy. Crit Care Med, 2009 Jan, 

37(1): 385. 

619. Soller BR, Yang Y, Soyemi OO, Ryan KL, 

Rickards CA, Walz JM, Heard SO, and 

Convertino VA. Noninvasively determined 

muscle oxygen saturation is an early indicator of central hypovolemia in humans. J Appl 

Physiol, 2008 Feb, 104(2): 475-81. 

620. Sondeen J. Blood Components Reduced 

Bleeding Compared to Hextend in 

Anesthetized Swine with Uncontrolled 

Splenic Hemorrhage. ATACCC, 16-19 Aug 

2010, presentation.

621. Sondeen J. USSOCOM Bio-Medical 

Research & Development Project Update 

Briefing. ATACCC, 16-19 Aug 2010, 

presentation.

622. Sondeen J, Prince D, Kheirabadi B, Wade C, 

Polykratis A, deGuzman R, and Dubick M. 

Initial resuscitation with plasma and blood 

components reduced bleeding compared to 

Hextend in anesthetized swine with uncontrolled splenic hemorrhage. Shock, 2010, 

33 (Supp 1): 39 (abst P87).

623. Sondeen J, Prince MD, Kheirabadi BS, 

Wade CE, Polykratis IA, DeGuzman R, and 

Dubick MA. Initial Resuscitation with Plasma 

and Blood Components Reduced Bleeding 

Compared to Hextend in Anesthetized Swine 

with Uncontrolled Splenic Hemorrhage. 

Shock Society, 12-15 Jun 2010, poster.

624. Sondeen JL, De Guzman R, Cap 

Ap, Polykratis IA, and Dubick MA. 

Characterization of Thromboelastogram 

Parameters in Response to Ex Vivo Changes 

to Blood Component Concentrations. 

ATACCC, 16-19 Aug 2010, poster.

625. Sondeen JL, Dubick MA, Holcomb JB, and 

Wade CE. Uncontrolled hemorrhage differs 

from volume or pressure-matched controlled 

hemorrhage in swine. Shock, 2007 Oct, 

28(4): 426-433.

626. Sondeen JL, Prince MD, Medina L, 

Polykratis IA, Dubick MA, and Holcomb JB. 

Comparison of lyophilized swine plasma 

(LSP) to fresh frozen plasma (FFP) plus two 

ratios of packed red blood cells (RBC) in 

a cold, coagulopathic, poly trauma severe 

hemorrhagic shock swine model. Shock, 

2008 June, 29(Supp 1): 13-14.

627. Song J, Wolf SE, Wu XW, Finnerty CC, 

Gauglitz GG, Herndon DN, and Jeschke MG. 

Starvation-induced proximal gut mucosal 

atrophy diminished with aging. JPEN J 

Parenter Enteral Nutr, 2009 Jan 6. 

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628. Song J, Wolf SE, Wu XW, Finnerty CC, 

Herndon DN, and Jeschke MG. Proximal gut 

mucosal epithelial homeostasis in aged IL-1 

Type I receptor knockout mice after starvation. J Surg Res, 2010 Apr 21.

629. Spadafora C, Awandare GA, Kopydlowski 

KM, Czege J, Moch JK, Finberg RW, Tsokos 

GC, and Stoute JA. Complement receptor 

1 is a sialic acid-independent erythrocyte 

receptor of Plasmodium falciparum. PLoS 

Pathogens, 2010, 6(6): e1000968.

630. Spinella PC, Carroll CL, Staff I, Gross R, Mc 

Quay J, Keibel L, Wade CE, and Holcomb 

JB. Duration of red blood cell storage is 

associated with increased incidence of deep 

vein thrombosis and in-hospital mortality in 

patients with traumatic injuries. Crit Care, 

2009 Sep 22, 13(5): R151. [Epub ahead of 

print].

631. Spinella PC, Perkins JG, Grathwohl KW, 

Beekley AC, and Holcomb JB. Warm fresh 

whole blood is independently associated with 

improved survival for patients with combatrelated traumatic injuries. J Trauma, 2009 

Apr, 66(4 Supp): S69-76.

632. Spinella PC, Perkins JG, Grathwohl KW, 

Beekley AC, Niles SE, McLaughlin DF, Wade 

CE, and Holcomb JB. Effect of plasma and 

red blood cell transfusions on survival in 

patients with combat related traumatic injuries. J Trauma, 2008 Feb, 64(2): S69-S78.

633. Spinella PC, Perkins JG, Grathwohl KW, 

Repine T, Beekley AC, Sebesta J, Jenkins 

D, Azarow K, and Holcomb JB, the 31st CST 

Research Working Group. Fresh whole blood 

transfusions in coalition military, foreign 

national, and enemy combatant patients during operation Iraqi freedom at a U.S. combat 

support hospital. World J Surg, 2008 Jan, 

32(1): 2-6. 

634. Spinella PC, Perkins JG, Grathwohl KW, 

Repine T, Beekley AC, Sebesta J, Jenkins 

D, Azarow K, and Holcomb JB, 31st Combat 

Support Hospital Research Working Group. 

Risks associated with fresh whole blood 

and red blood cell transfusions in a combat 

support hospital. Crit Care Med, 2007 Nov, 

35(11): 2576-81.

635. Spinella PC, Perkins JG, McLaughlin DF, 

Niles SE, Grathwohl KW, Beekley AC, 

Salinas J, Mehta S, Wade CE, and Holcomb 

JB. The effect of recombinant activated 

factor VII on mortality in combat-related 

casualties with severe trauma and massive 

transfusion. J Trauma, 2008 Feb, 64(2): 286-

93; discussion 293-4.

636. Spoerke NJ, Van PY, Differding JA, Zink KA, 

Cho SD, Muller PJ, Karahan ZA, Sondeen 

JL, Holcomb JB, and Schreiber MA. Red 

blood cells accelerate the onset of clot 

formation in polytrauma and hemorrhagic 

shock. J Trauma, 2010 Nov, 69(5): 1054-61.

637. Spott MA and West S. Injury Trends of 

Mounted Warriors from Surface Wound 

Mapping. Injury and Injury Trends, 13 May 

2010, presentation.

638. Stansbury LG, Branstetter JG, and Lalliss 

SJ. Amputation in military trauma surgery. 

J Trauma, 2007 Oct, 63(4): 940-944.

639. Stansbury LG, Lalliss SJ, Branstetter JG, 

Bagg MR, and Holcomb JB. Amputations 

in U.S. military personnel in the current 

conflicts in Afghanistan and Iraq. J Orthop 

Trauma, 2008 Jan, 22(1): 1-4.

640. Sterner JB, Zanders TB, Morris MJ, and 

Cancio LC. Inflammatory mediators in smoke 

inhalation injury. Inflamm Allergy Drug 

Targets, 2009 Mar, 8(1): 63-9.

641. Stinger HK, Spinella PC, Perkins JG, 

Grathwohl KW, Salinas J, Martini WZ, Hess 

JR, Dubick MA, Simon CD, Beekley AC, Wolf 

SE, Wade CE, and Holcomb JB. The ratio 

of fibrinogen to red cells transfused affects 

survival in casualties receiving massive 

transfusions at an army combat support 

hospital. J Trauma, 2008 Feb, 64(2 Supp): 

S79-S85.

642. Stinner D, Noel S, Haggard W, Watson JT, 

and Wenke J. Local Antibiotic Delivery Using 

Tailorable Chitosan Sponges: The Future 

of Infection Control? AAOS, 9-13 Mar 2010, 

poster.

643. Stinner D, Waterman S, and Wenke J. 

Negative Pressure Wound Therapy in a 

Contaminated Musculoskeletal Wound 

Survival Model: Is NPWT Effective on S. 

aureus Too? AAOS, 9-13 Mar 2010, poster.

644. Stinner DJ, Beltran MJ, Masini BD, Wenke 

JC, and Hsu JR. Bacteria on External 

Fixators: Which Prep Is Best? SOMOS, 

13-17 Dec 2010, poster.

645. Stinner DJ, Keeney JA, Hsu JR, Rush 

JK, Cho MS, Wenke JC, and Ficke JR. 

Outcomes of internal fixation in a combat 

environment. J Surg Orthop Adv, 2010 

Spring, 19(1): 49-53.

646. Stinner DJ, Noel SP, Haggard WO, Watson 

JT, and Wenke JC. Local antibiotic delivery 

using tailorable chitosan sponges: The future 

of infection control? J Orthop Trauma, 2010 

Sep, 24(9): 592-7.

2-99
647. Stinner DJ, Orr JD, and Hsu JR. 

Fluoroquinolone-associated bilateral patellar 

tendon rupture: A case report and review 

of the literature. Mil Med, 2010 Jun, 175(6): 

457-9.

648. Stout LR, Jezior JR, Melton LP, Walker JA, 

Brengman ML, Neumeier ST, Smith RL, 

Vanfosson CA, Knuth TE, Holcomb JB, and 

Cancio LC. Wartime burn care in Iraq: 28th 

combat support hospital, 2003. Mil Med, 

2007 Nov, 172(11): 1148-53.

649. Suggs L, Natesan S, Zhang G, Baer DG, 

Walters TJ, and Christy RJ. A bilayer 

construct controls adipose derived stem 

cell differentiation into endothelial cells and 

pericytes without growth factor stimulation. 

Tissue Eng Part A, 2010 Nov 17. 

650. Svoboda SJ, Owens BD, Gooden HA, Melvin 

ML, Baer DG, and Wenke JC. Irrigation 

with potable water versus normal saline in a 

contaminated musculoskeletal wound model. 

J Trauma, 2008 May, 64(5): 1357-9.

651. Therien SP, Duran-Stanton AM, Nesbitt 

ME, and Gerhardt RT. Pre-Hospital Medical 

Documentation in the Joint Theater Trauma 

Registry: A Retrospective Study. Doctoral 

Defense to Baylor University, 16 Nov 2010, 

poster.

652. Theriern SP, Gerhardt RT, Nesbitt ME, and 

Duran-Stanton AM. The Availability of PreHospital Medical Documentation in the Joint 

Theater Trauma Registry. ATACCC, 16-19 

Aug 2010, poster.

653. Thomas R, McManus JG, Johnson A, Mayer 

P, Wade C, and Holcomb JB. Ocular injury 

reduction from ocular protection use in current combat operations. J Trauma, 2009 Apr, 

66(4 Supp): S99-103.

654. Thompson C, Chung KK, Huzar T, McCorcle 

J, Tyrell K, Aden JK, King BT, Renz E, Wolf 

SE, and Blackbourne LH. Burns to the 

Perineum Among Military Casualties: An 

Independent Predictor of Mortality? ABA, 

9-12 Mar 2010, presentation.

655. Torres A, Bentley T, Bartels J, Sarkar 

J, Barclay D, Namas R, Constantine G, 

Zamora R, Puyana JC, and Vodovotz Y. 

Mathematical modeling of posthemorrhage 

inflammation in mice: Studies using a novel, 

computer-controlled, closed-loop hemorrhage apparatus. Shock, 2009, 32(2): 172-8.

656. Tou JC, Foley A, Yuan YV, Arnaud S, Wade 

CE, and Brown M. The effect of ovariectomy combined with hindlimb unloading 

and reloading on the long bones of mature 

sprague-dawley rats. Menopause, 2008 

May-Jun, 15(3): 494-502.

657. Trabosh V, Tong L, Steinbach T, Du F, Long 

J, and Atkins J. Does Iron Accumulate 

in the Brain Following Exposure to Blast 

Overpressure? 28th Annual National 

Neurotrauma Symposium, 2010.

658. Trunkey DD, Johannigman JA, and Holcomb 

JB. Lessons relearned. Arch Surg, 2008 Feb, 

143(2): 112-4. 

659. Tyler J. Current U.S. Military Operations 

and Implications for Military Surgical 

Training. ACS Surgical Forum, 3-7 Oct 2010, 

presentation.

660. Tyler J. Current U.S. Military Operations and 

Implications for Military Surgical Training. 

Gary Wratten Surgical Symposium, 26-28 

May 10, presentation.

661. Tyler J, Clive K, White C, Beekley A, and 

Blackbourne LH. Current U.S. Military 

Operations and Implications for Military 

Surgical Training. ATACCC, 16-19 Aug 2010, 

poster.

662. Tyler J, Clive K, White C, Beekley A, and 

Blackbourne LH. Current U.S. Military 

Operations and Implications for Military 

Surgical Training NATO, 19-21 April 2010, 

poster.

663. Tyler JA, Clive KS, White CE, Beekley AC, 

and Blackbourne LH. Current U.S. military 

operations and implications for military surgical training. J Am Coll Surg, 2010 Sep 22. 

[Epub ahead of print].

664. Van PY, Sambasivan CN, Wade CE, 

Jones JA, Holcomb JB, Schreiber MA, and 

Blackbourne LH. High transfusion ratios are 

not associated with increased complication 

rates in patients with severe extremity injuries. J Trauma, 2010 Jul, 69 Supp 1: S64-8.

665. Voelckel WG, Convertino VA, Lurie KG, 

Karlbauer A, Schöchl H, Lindner KH, and 

Trimmel H. Vasopressin for hemorrhagic 

shock management: Revisiting the potential 

value in civilian and combat casualty care. 

J Trauma. 2010 Jul, 69 Supp 1: S69-74. 

Review.

666. Wade C, Wolf SE, Salinas R, Jones JA, 

Rivera R, Hourigan L, Baskin T, Linfoot J, 

Mann EA, Chung K, and Dubick M. Loss of 

protein, immunoglobulins, and electrolytes 

in exudates from negative pressure wound 

therapy. Nutr Clin Pract, 2010 Oct, 25(5): 

510-6.

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667. Wade CE. Prior exercise alters responses to 

hemorrhage. Shock, 2010 Jul, 34(1): 68-74.

668. Wade CE. Hyperglycemia may alter cytokine 

production and phagocytosis by means other 

than hyperosmotic stress. Crit Care, 2008 

Oct 9, 12(5): 182. 

669. Wade CE, Dubick MA, Blackbourne LH, and 

Holcomb JB. It is time to assess the utility of 

thrombelastography in the administration of 

blood products to the patient with traumatic 

injuries. J Trauma, 2009 Apr, 66(4): 1258. 

670. Wade CE, Eastridge BJ, Jones JA, West 

SA, Spinella PC, Perkins JG, Dubick MA, 

Blackbourne LH, and Holcomb JB. Use 

of recombinant factor VIIa in U.S. military 

casualties for a five-year period. J Trauma, 

2010 Aug, 69(2): 353-9.

671. Wagner SJ, Skripchenko A, Salata J, 

O’Sullivan AM, and Cardo LJ. Inactivation 

of Leishmania donovani infantum and 

Trypanosoma cruzi in red cell suspensions 

with thiazole orange. Transfusion, 2008, 

48(7): 1363-7.

672. Wait E, Mora A, Aden J, Salinas J, Wolf S, 

and Wade C. Temperature Variability in the 

Severely Burned. Society of Critical Care 

Medicine, 9-13 Jan 2010, poster.

673. Walters SM, Dubey VS, Jeffrey NR, 

and Dixon DR. Antibiotic-induced 

Porphyromonas gingivalis LPS release and 

inhibition of LPS-stimulated cytokines by 

antimicrobial peptides. Peptides, 2010, 31(9): 

1649-53.

674. Walters TJ, Chen X, Roe J, Sanchez M, Wu 

X, Rathbone CR, and Yoo JJ. Treatment of 

Tourniquet-Induced Ischemia/Reperfusion 

Injury with Muscle Stem Cells. Armed Forces 

Institute of Regenerative Medicine, 11-15 Jan 

2010, poster.

675. Walters TJ, Christy RJ, and Wu X. Rat Model 

for Traumatic Volumetric Muscle Loss: A 

Platform for Testing Engineered Skeletal 

Muscle. Society for Biomaterials, 21-24 Apr 

2010, poster.

676. Walters TJ, Kragh JF, and Baer DG. 

Influence of fiber-type composition on recovery from tourniquet-induced skeletal muscle 

ischemia-reperfusion injury. Appl Physiol 

Nutr Metab, 2008 Apr, 33(2): 272-81.

677. Walters TJ, Kragh JF, Kauvar DS, and Baer 

DG. The combined influence of hemorrhage 

and tourniquet application on the recovery 

of muscle function in rats. J Orthop Trauma, 

2008 Jan, 22(1): 47-51.

678. Wang H. Intravitreal Injection of Bone 

Marrow-Derived Stem Cells in a Laser 

Retinal Injury Model Results in Cell 

Migration. UTHSCSA, 7 Jun 2010, 

presentation.

679. Wang X, Bynum J, Stavchansky S, and 

Bowman P. Network Analysis of the 

Cytoprotective Effect of CDDO-IM Against 

Oxidant Stress in Human Umbilical Vein 

Endothelial Cells (HUVEC). EB (FASEB), 

24-28 Apr 2010, poster.

680. Wang X, Bynum J, Stavchansky S, Dubick 

M, Hackman R, Keen C, and Bowman P. 

Cytoprotection of Human Endothelial Cells 

from Oxidative Stress by Polyphenols: The 

Role of Gene Expression Versus Direct 

Antioxidant Effect. EB (FASEB), 24-28 Apr 

2010, poster.

681. Wang X, Bynum J, Stavchansky S, Dubick 

M, Hackman R, Keen C, and Bowman P. 

Cytoprotection of human endothelial cells 

from oxidative stress by polyphenols: The 

role of gene expression versus direct antioxidant effect. FASEB J, 2010 24: 760.3.

682. Wang X, Pang J, Maffucci JA, Pade DS, 

Newman RA, Kerwin SM, Bowman PD, and 

Stavchansky S. Pharmacokinetics of caffeic 

acid phenethyl ester and its catechol-ring 

fluorinated derivative following intravenous 

administration to rats. Biopharm Drug 

Dispos, 2009 Jul, 30(5): 221-8.

683. Wang X, Pang J, Newman RA, Kerwin 

SM, Bowman PD, and Stavchansky S. 

Quantitative determination of fluorinated caffeic acid phenethyl ester derivative from rat 

blood plasma by liquid chromatography-electrospray ionization tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed 

Life Sci, 2008 May 1, 867(1): 138-43. 

684. Wang X, Stavchansky S, Kerwin SM, and 

Bowman PD. Structure-activity relationships in the cytoprotective effect of caffeic 

acid phenethyl ester (CAPE) and fluorinated 

derivatives: Effects on heme oxygenase-1 

induction and antioxidant activities. Eur J 

Pharmacol, 2010 Mar 9.

685. Wang X, Stavchansky S, Zhao B, Bynum JA, 

Kerwin SM, and Bowman PD. Cytoprotection 

of human endothelial cells from menadione cytotoxicity by caffeic acid phenethyl 

ester: The role of heme oxygenase-1. Eur J 

Pharmacol, 2008 Sep 4, 591(1-3): 28-35. 

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686. Wang Y, Li Y, Dalle Lucca SL, Simovic M, 

Tsokos GC, and Dalle Lucca JJ. Decay 

accelerating factor (CD55) protects neuronal 

cells from chemical hypoxia-induced injury. 

J Neuroinflammation, 2010, 7: 24.

687. Ward JA, Cancio LC, Batchinsky AE, 

Newman PR, Convertino VA, and Holcomb 

JB. Hemorrhagic shock data mining project: 

Poincare plot analysis. FASEB J, 2008 April, 

22: 1227.2.

688. Ward KR, Tiba MH, Ryan KL, Filho IP, 

Rickards CA, Witten T, Soller BR, Ludwig 

DA, and Convertino VA. Oxygen transport 

characterization of a human model of progressive hemorrhage. Resuscitation, 2010 

Apr 23.

689. Wei G, Hartings JA, Yang X, Tortella FC, 

and Lu XC. Extraluminal cooling of bilateral 

common carotid arteries as a method to 

achieve selective brain cooling for neuroprotection. Journal of Neurotrauma, 2008, 25(5): 

549-59.

690. Wei G, Lu XC, Yang X, and Tortella FC. 

Intracranial pressure following penetrating 

ballistic-like brain injury in rats. Journal of 

Neurotrauma, 2010, 27(9): 1635-41.

691. Wei HH, Lu XC, Shear DA, Waghray A, 

Yao C, Tortella FC, and Dave JR. NNZ2566 treatment inhibits neuroinflammation 

and pro-inflammatory cytokine expression induced by experimental penetrating 

ballistic-like brain injury in rats. Journal of 

Neuroinflammation, 2009, 6: 19.

692. Wenke JC, Warren GL, Rathbone CR, and 

Armstrong RB. Mouse plantar flexor muscle 

size and strength after inactivity and training. 

Aviat Space Environ Med, 2010 Jul, 81(7): 

632-8.

693. White CE, Batchinsky AI, Necsoiu C, Nguyen 

R, Walker KP III, Chung KK, Wolf SE, and 

Cancio LC. Lower interbreath interval complexity is associated with extubation failure 

in mechanically ventilated patients during 

spontaneous breathing trials. J Trauma, 2010 

Jun, 68(6): 1310-6.

694. White CE, Park MS, Renz EM, Kim SH, 

Schrank AE, Wolf SE, and Cancio LC. Burn 

center treatment of patients with severe 

anhydrous ammonia injury: Case reports 

and literature review. J Burn Care Res, 2007 

Nov-Dec, 28(6): 922-8. 

695. White CE and Renz EM. Advances in 

surgical care: Management of severe burn 

injury. Crit Care Med, 2008 Jul, 36(7 Supp): 

S318-24.

696. White CE, Simmons JW, Holcomb JB, 

Aydelotte JD, Eastridge BJ, and Blackbourne 

LH. Impact of extremity amputation on 

combat wounded undergoing exploratory 

laparotomy. J Trauma, 2009 April, 66(4): 

S86-S92.

697. Williams AJ, Tortella FC, Gryder D, and 

Hartings JA. Topiramate reduces non-convulsive seizures after focal brain ischemia in 

the rat. Neuroscience Letters, 2008, 430(1): 

7-12.

698. Wolf SE. Vitamin C and smoke inhalation 

injury. J Burn Care Res, 2009 Jan/Feb, 30(1): 

184-186.

699. Wolf SE. The year in burns 2007. Burns, 

2008 Dec, 34(8): 1059-71.

700. Wolf SE, Shields BA, and Wade CE. 

Substrate utilization in the critically ill. JPEN 

J Parenter Enteral Nutr, 2009 Jan-Feb, 33(1): 

111; author reply 112. 

701. Wu X, Baer LA, Wolf SE, Wade CE, and 

Walters TJ. The impact of muscle disuse 

on muscle atrophy in severely burned rats. 

J Surg Res, 2010 Sep 15.

702. Wu X, Wolf SE, and Walters TJ. Muscle 

contractile properties in severely burned rats. 

Burns, 2010 Apr 7.

703. Wu X, Xiao Y, Baer LA, Chen Y, Wold SE, 

Walters TJ, and Wade CE. The Gene Profile 

of the Skeletal Muscle in Response to Burn 

and Hindlimb Unloading. EB (FASEB), 24-28 

Apr 2010, poster.

704. Wu X, Xiao Y, Chen Y, Pidcoke H, and Wolf 

S. Effect of High Dose Insulin Treatment 

on Skeletal Muscle Gene Expression 

After Severe Burn. ABA, 9-12 Mar 2010, 

presentation.

705. Yamanaka T, Furukawa T, MatsumotoMashimo C, Yamane K, Sugimori C, Nambu 

T, Mori N, Nishikawa H, Walker CB, Leung 

KP, and Fukushima H. Gene expression 

profile and patho-genicity of biofilm-forming 

Prevotella intermedia strain 17. BMC 

Microbiology, 2009, 9: 11.

706. Yamane K, Ogawa K, Yoshida M, Hayashi H, 

Nakamura T, Yamanaka T, Tamaki T, Hojoh 

H, Leung KP, and Fukushima H. Identification 

and characterization of clinically isolated 

biofilm-forming gram-positive rods from teeth 

associated with persistent apical periodontitis. J Endodontics, 2009, 35(3): 347-52.

2-102

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Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
707. Yang J, Marriner GA, Wang X, Bowman PD, 

Kerwin SM, and Stavchansky S. Synthesis 

of a series of caffeic acid phenethyl amide 

(CAPA) fluorinated derivatives: Comparison 

of cytoprotective effects to caffeic acid 

phenethyl ester (CAPE). Bioorg Med Chem, 

2010 Jun 11.

708. Yao C, Williams AJ, Ottens A, Lu XC, Liu 

MC, Hayes RL, Wang KK, Tortella FC, 

and Dave JR. P43/pro-EMAPII: A poten-

tial biomarker for discriminating traumatic 

versus ischemic brain injury. Journal of 

Neurotrauma, 2009, 26(8): 1295-305.

709. Yao C, Williams AJ, Ottens AK, May Lu XC, 

Chen R, Wang KK, Hayes RL, Tortella FC, 

and Dave JR. Detection of protein biomark-

ers using high-throughput immunoblotting 

following focal ischemic or penetrating 

ballistic-like brain injuries in rats. Brain Injury, 

2008, 22(10): 723-32.

710. Yoder LH, Nayback AM, and Gaylord K. 

The evolution and utility of the burn specific 

health scale: A systematic review. Burns, 

2010.

711. Young-McCaughan S, Menetrez J, Bingham 

M, Gaylord K, Vriend C, Inman A, Garcia 

C, Garre M, Eagy J, and Miaskowski C. 

Pain and sleep disturbance in soldiers with 

extremity trauma. The Army Nurse Corps 

Newsletter, 2008 Apr, 8(4): 8.

712. Yun HC, Blackbourne LH, Jones JA, 

Holcomb JB, Hospenthal DR, Wolf SE, Renz 

EM, and Murray CK. Infectious complications 

of noncombat trauma patients provided care 

at a military trauma center. Mil Med, 2010 

May, 175(5): 317-23.

713. Yun HC, Branstetter JG, and Murray CK. 

Osteomyelitis in military personnel wounded 

in Iraq and Afghanistan. J Trauma, 2008 Feb, 

64(2 Supp): S163-S168.

714. Zamora DO, Natesan S, Suggs LJ, and 

Christy RJ. Promoting Vasculogenesis 

of Human Derived Adipose Stem Cells. 

International Vascular Biology, 20-24 Jun 

2010, poster.

715. Zanders TB, Burkett SE, Batchinsky AI, 

Chung KK, Jordan BS, Regn DD, Nguyen 

R, Necsoiu C, Morris MJ, and Cancio LC. 

Comparison of Airway Pressure Release 

Ventilation to Conventional Ventilation in a 

Porcine Model of Severe Smoke Inhalation 

Injury. ATACCC, 16-19 Aug 2010, poster.

716. Zink KA, Sambasivan CN, Holcomb JB, 

Chisholm G, and Schreiber MA. A high ratio 

of plasma and platelets to packed red blood 

cells in the first 6 hours of massive transfu-

sion improves outcomes in a large multi-

center study. Am J Surg, 2009 May, 197(5): 

565-70; discussion 570.

717. Zolezzi M and Gaylord KM. Developing a 

Medication Profile of Burn Patients with and 

Without Post Traumatic Stress Disorder. PJV, 

26-29 Apr 2010, poster.

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Clinical and 

Rehabilitative 

Medicine

Medical Chemical 

and Biological 

Defense

Advanced 

Technologies

Logistics

Appendices

Military Infectious 

Diseases

Combat 

Casualty Care

Military 

Operational 

Medicine
The mission of the Military Operational Medicine Research 

Program (MOMRP) is to develop effective countermeasures against 

stressors and to maximize health, performance, and fitness. Our 

mission is protecting the whole Soldier from head to toe, inside and 

out, at home, and on the battlefield. Science to Soldier is indeed 

our focus.

MOMRP, U.S. Army Medical Research and Materiel Command 

(USAMRMC), conducts biomedical research to deliver products and 

solutions to the Warrior that address health and fitness throughout 

the deployment cycle. MOMRP is centered on cutting-edge scientific research and bringing science to the Soldier on the battlefield 

in a relevant, timely manner. MOMRP depends on a phenomenal 

cadre of dedicated scientists and engineers who continuously and 

tirelessly work to protect the nation’s most valuable asset—the 

Warrior. MOMRP is divided into four research focus areas: Injury 

Prevention and Reduction, Psychological Health and Resilience, 

Physiological Health, and Environmental Health and Protection.

Injury Prevention and Reduction

Biomedical basis for countermeasures that prevent and mitigate 

Warrior injury

Warriors are susceptible to physical, sometimes debilitating injuries. 

Head and neck injuries, including severe brain trauma, have been 

reported in one-quarter of evacuated service members. In the past 

5 years, the Walter Reed Army Medical Center alone has surgically 

treated approximately 700 Warriors with moderate to severe visual 

injuries. Nearly 70,000 combat troops are collecting disability for 

tinnitus and more than 58,000 for hearing loss. Medical disability 

discharge rates have increased with 78 percent due to musculoskeletal injury. MOMRP research helps prevent physical injuries 

through development of injury prediction models, equipment design 

specifications and guidelines, health hazard assessment criteria, 

and strategies to reduce musculoskeletal injuries.

MOMRP Injury Prevention and Reduction research develops 

models to predict the degree of injury from known threats, develops 

design guidelines and performance specifications for protective 

equipment, and identifies countermeasures to prevent or mitigate 

injury to the Warrior. Key threats addressed by this research 

area include blast overpressure, blunt and penetrating trauma, 

musculoskeletal and training injuries, and neurosensory injury. 

This program addresses thoracic and pulmonary injury protection 

OVERVIEW

On the battlefield and at home, service members’ physical and mental health, performance, and fitness require 

state-of-the-science, evidence-based strategies, interventions, and countermeasures.

3-2

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
through modeling blast and blunt trauma, protection that prevents or 

reduces neurosensory injury, validated standards for performance 

to assess return to duty, and training doctrine based on physiologi-

cal mechanisms that underlie musculoskeletal injury that identify 

and mitigate injury risks.

Psychological Health and Resilience

Strategies and interventions that build psychological resilience and 

optimize psychological health and emotional fitness among Soldiers 

and families

Psychological health problems are the second leading cause of 

evacuation during prolonged and/or repeated deployments. Of 

returning Warriors, 20–40 percent have behavioral health problems 

post-deployment, mostly related to post-traumatic stress disorder 

(PTSD), depression, and interpersonal conflict. MOMRP research-

ers develop strategies and advise policy makers to enhance and 

sustain mental fitness throughout service members’ careers. 

These include validated prevention and treatment interventions 

that address psychological health issues, enhanced screening and 

identification of concussion-related health concerns, and improved 

clinical guidelines for health care providers.

MOMRP Psychological Health and Resilience research is focused 

on prevention, treatment, and recovery of Soldiers’ and families’ 

behavioral health, which are critical to force health and readiness. 

Research is necessary to guide policy and ensure optimal delivery 

of behavioral health training and services across the continuum of 

care and deployment cycle. Threats addressed by this research 

component include PTSD, suicide, family separation, and family 

violence. 

3-3
Current Psychological Health research topic areas include:

y Universal and selective behavioral health prevention and 

resiliency building

y Case identification, treatment, and clinical management of 

individuals with mental disorders

y Suicide prevention

y Neurocognitive assessment and clinical management of

post-concussion-related challenges

y Substance use-related problems

y Ongoing epidemiological and preclinical research to identify 

vulnerability, protective, and risk factor interactions associated 

with mental disorders and negative risk-taking behaviors

y Family and community wellness capacity building

y Bereavement interventions

y Prospective epidemiological, intervention, and surveillance 

research designed to address neurological health, fitness and 

readiness, longer-term physical and mental health, disease, and 

performance outcomes over the deployment cycle

Physiological Health 

Biomedical countermeasures to sustain Warrior health and operational effectiveness

The rapid pace of operations and the need for repeated deployments have a profound effect on the physiological health and 

performance of Warriors. MOMRP develops novel nutritional 

strategies that maintain and sustain optimal health and readiness, 

a comprehensive sleep and performance management system that 

predicts Warrior physiological degradation, and a real-time medical 

status monitoring and situational awareness informational system 

enabling commanders to ensure mission success. 

MOMRP Physiological Health research focuses on developing 

medical standards, predictive models, and countermeasures to 

prevent or mitigate the effects of physiological stressors on the 

performance and fitness of Warriors. These stressors include 

inappropriate nutrition, poor physical fitness, sleep loss, sleep 

deprivation, fatigue, and burn out. The focus is on threats and 

stressors in both the garrison and operational environments. 

Current research addresses advanced biomedical modeling 

and networked physiological status monitoring capabilities, a 

comprehensive sleep and performance management system 

based on effects of chronic sleep restriction and acute total sleep 

deprivation, individual physiological differences in sleep loss 

resilience, nutritional health surveillance and dietary supplement 

use, and interventions to mitigate threats to operational health.

Environmental Health and Protection

Assess and sustain Warrior health and performance in extreme 

environments

Warriors train and fight while exposed to a range of harsh 

environmental conditions, such as extreme heat and cold 

temperatures and high terrestrial altitude. These harsh 

environmental conditions, alone or combined with other operational 

stressors, degrade military physical and cognitive performance. 

MOMRP provides guidelines to mitigate performance degradation 

from these environmental extremes. Warriors are also susceptible 

to exposure to toxic chemicals and materials in the operational 

environment. MOMRP develops biomarkers to detect toxic 

exposures and methods to assess their impact on health risk. 

3-4

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
MOMRP Environmental Health and Protection research develops medical standards, predictive models, and countermeasures 

to prevent or mitigate the effects of extreme environments and 

toxic material exposure in the military. Threats addressed by this 

program include extremes of heat/cold and hydration, high altitude, 

and toxic industrial chemicals and materials. Current research 

projects focus on methods that sustain operational performance in 

extreme heat and cold and at high altitudes to prevent and manage 

heat, cold, altitude sickness, and hydration-related injuries. This 

research also includes detecting, monitoring, and assessing the risk 

of the Warrior’s exposure to toxic chemicals and materials during 

operations.

MOMRP conducts medical research to deliver products and solutions for the Warrior that address health and fitness throughout the 

deployment cycle. The focus is on life cycle solutions that maximize the effectiveness of taxpayer dollars and minimize the health 

effects of operational and environmental stressors on the Warrior. 

MOMRP leverages its Department of the Army funds and congressionally directed funds for research not only at Department of 

Defense (DoD) laboratories but also at myriad extramural research 

organizations from small colleges to multinational corporations in 

the development of cutting-edge technology. The research products are directly applicable to today’s battlefield and the anticipated 

problems of tomorrow’s war. 

“

”

There is nothing more important than the 

safety of our Soldiers, their confidence in 

their equipment, and America’s confidence in 

their Army.

– Former Secretary of the Army

Pete Geren

“

”

That this nation, in order to continue to field 

the best, most effective military and Army 

the world has ever seen, we have to take care 

of the Soldier and his and her family as well.

– Secretary of the Army John McHugh

3-5
INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

Advanced Blast Test Device

Description

The Advanced Blast Test Device (ABTD) provides a versatile, biofidelic method to collect blast 

overpressure and impulse noise data for assessment of blast overpressure hazards to prevent 

occupational injuries for military personnel during weapon firing exercises. The ABTD is a developmental device to collect blast overpressure and noise data for occupational blast hazard assessment 

to meet four requirements requested by field testers. First, it is lightweight, approximately 50 pounds, 

to enable easy handling in tight spaces such as inside a vehicle. Second, it is anthropometrically 

shaped so that sound data can be measured at the ear location satisfying MIL-STD-1474D specifications with the blast overpressure measured at the correct chest and thorax locations. Third, it is 

configurable with a suite of accessories provided to allow the user to place the ABTD at standing, 

sitting, kneeling, and crouching positions. Fourth, it is adaptable with various attachments provided 

for mounting impulse sound gauges or acoustical headform. Nonauditory hazard is predicted using 

INJURY 8.3 with the overpressure data as input. Auditory hazard is assessed using MIL-STD-1474D. 

The ABTD has been field tested for functionality, and a series of field tests is being planned to provide 

benchmark evaluation data to support the development of a test operational plan for blast testing.

Partners

y MOMRP

y L-3 Communications/Jaycor

3-6

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Body Armor Blunt Trauma Performance Testing Method

Description

A biomedically valid body armor blunt trauma performance testing method consisting of two components: (1) a physical model known as the “Anthropomorphic Test Module” that measures the distribution of forces and motions behind body armor systems during a ballistic impact and (2) a biomedically 

valid, human blunt trauma injury prediction model packaged in a user-friendly, web-based software 

application known as Behind Armor Blunt Trauma Assessment. The human injury prediction model 

is the product of carefully controlled animal tests that included advanced medical imaging techniques 

and the latest mathematical modeling methods. The model’s predictions were validated with extensive injury data from the animal tests.

Partners

y MOMRP

y University of California, San Diego

y L-3 Communications/Jaycor

Design Guidelines for Advanced 

Imaging and Display Technologies

Description

Design criteria and test methods for imaging and display systems based on visual 

performance capabilities were developed. 

This includes predictive models of visual performance with sensor and display systems in 

operational environments. These criteria and 

methods provide the means for evaluating 

new system designs and give developers the 

information necessary to develop effective 

imaging and display systems for rotary-wing 

aircraft and other military vehicles.

Partners

y USAARL

3-7
Effects of Prolonged Deployment on Physical Performance,

Body Composition, and Injury Potential

Description

Anecdotal reports have raised concerns that prolonged deployment to Iraq and Afghanistan may be 

associated with significant loss of body weight and muscle mass and a reduced capability to carry 

out physical tasks such as load carriage. If these changes are occurring, there is also the possibility 

that these service members may be at greater risk for musculoskeletal injury. A series of studies has 

been conducted involving a complete assessment of body composition, strength, and metabolic aerobic capacity in several hundred service members before and immediately after approximately 1 year 

of deployment to Iraq and Afghanistan. In addition, information was obtained to determine the relative 

importance or impact of nutritional factors, energy expenditure related to mission demands, and the 

ability of service members to continue their physical training on these physiological measures. The 

results demonstrated that changes in maximal aerobic or endurance capacity were reduced by less 

than 5 percent, there were minimal changes in body composition in terms of lean body mass or fat, 

and no significant or consistent changes in strength or power. A key factor impacting changes in body 

composition and/or physical performance was the fact that Soldiers noted that their ability to physically train was decreased while being deployed. 

Partners

y USARIEM

y Public Health Command (Provisional)

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

3-8

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Evaluation of Human Exposure to 

Whole-Body Vibration: Method for 

Evaluation of Vibration Containing 

Multiple Shocks

Description

The Method for Evaluation of Vibration 

Containing Multiple Shocks is used to predict 

injuries sustained by service members who 

ride in Army tactical ground vehicles at high 

speeds over rough terrain.

This standardized method for health hazard 

assessment of whole-body vibration and 

repeated jolt in vehicles is based on laboratory studies of human responses to repeated 

jolts and a neural network of the lower spine. 

The method was published as an international 

standard (ISO 2631-5) and transitioned to the 

U.S. Army Center for Health Promotion and 

Preventive Medicine.

Partners

y USAARL

INJURY-A

Description

INJURY-A is a software tool for material developers to assess the effects of armor materials on blast 

lung injury so that protection concepts can be developed to mitigate blast overpressure injuries for 

Warfighters. Based on the normalized work methodology, INJURY-A predicts the risk of lung injury 

by coupling the material effects with the thorax motion to calculate the total irreversible work done to 

the lung as a result of a blast insult. Field tests are performed using the Modified Blast Test Device 

(MBTD) that is instrumented with distributed pressure sensors to measure the under-armor blast loading. The MBTD data are used to construct the material model for coupling with the thorax response 

to calculate normalized work. Predictions have been validated against animal tests with more than 

200 subjects involving a range of material concepts. The software is packaged with a GUI (graphical 

user interface) for managing and analyzing field data, building material models, predicting outcomes, 

and generating test reports.

Partners

y MOMRP

y U.S. Army Natick Soldier Research, Development and Engineering Center

y L-3 Communications/Jaycor

COMPLETED | PROMISING | FUTURE

3-9
INJURY 8.3

Description

Based on INJURY 8.2 and continuing with 

the normalized work methodology, INJURY 

8.3 software has been upgraded to include 

validation against thermobaric blast data and 

lethality predictions. Software architecture 

has been rebuilt on a SimuLink platform 

to better accommodate future upgrades 

to include predictions of injury patterns 

where applications also can be packaged 

for more seamless linking to support other 

software applications such as the Toxic Gas 

Assessment Software. The Blast Test Device 

is used to collect blast overpressure data as 

inputs as before. Documentation is being 

updated in preparation for a verification, 

validation, and accreditation effort.

Partners

y MOMRP

y L-3 Communications/Jaycor

Injury Prevention and Restraint Technologies for Ground Vehicles and 

Helicopters (Inflatable Restraint Systems)

Description

Inflatable restraint technologies are being developed and integrated into Army aviation platforms. 

While these technologies have inherent crash protection capabilities, they also introduce novel injury 

hazards. USAMRMC testing revealed hazards to the upper extremities and ocular regions when the 

systems are not properly designed or the occupant is not in the design eye position. The prototype 

lateral bag design was found to present a greater than 90 percent risk of upper extremity injury, 

prompting a system redesign. The redesign eliminated 99 percent of the hazard. More than 300 

UH-60L helicopters have been modified with the air bag system. Surveillance of injury resulting from 

crashes of these air bag-equipped vehicles is ongoing and will reveal the injury mitigation capabilities 

and new hazards associated with these protective systems. Expanded research and modeling efforts 

will provide guidelines to assist in the design of future inflatable restraint systems that reduce the risk 

of these inherent hazards.

Partners

y USAARL

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

3-10

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Laser Exposure Standards to Prevent Laser Eye Injury

Description

Laser exposure standards were developed to prevent laser eye injuries. These standards impact deployment of each military laser system, the design of new 

military laser systems, and the development of protective eyewear for Soldiers. The understanding of the biomedical thresholds and laser-tissue interaction 

mechanisms for laser exposure conditions inherent to military laser systems facilitates triage of overexposure to laser radiation. The maximum permissible 

exposure limits for laser exposure conditions to prevent eye injury during the design, testing, and deployment of advanced military laser systems were updated 

and incorporated in the Army Radiation Safety Program described in Army Regulation 11-9 for laser radiation. The following key points were determined and 

published:

 Ocular injury thresholds for wavelengths in the 1–2 micrometer range resulted in the update of exposure guidelines impacting the Airborne Laser, the 

Airborne Tactical Laser, and other high-energy laser systems.

 Retinal injury thresholds as a function of retinal irradiance diameter were used to assess the hazards of particle cell suspension switches for military optical 

sites and for the update of exposure guidelines.

 Ocular aversion response (eye movement) impact on retinal injury risk assessments and exposure guidelines for long duration exposures were determined. 

 The understanding of the visual effect of visible laser, the ocular aversion response, and the laser-induced retinal injury threshold impacted the safe deployment of laser illuminators (dazzlers). While exposure to safe levels can be perceived as extremely bright, the biomedical data obtained to establish safe 

exposure limits also facilitated triage of suspected and actual injury from such illuminations.

These standards impact the design of new military laser systems and protective equipment and provide the Army Medical Department with the tools necessary to assess field laser hazard when laser systems are used in testing, training, and operational environments.

Partners

y USAISR 

3-11
Ophthalmic Standards for

Personal Protective Eyewear

Description

Personal Protective Eyewear design concepts 

have radically changed over the past few 

years. These changes have greatly improved 

the protection of Soldiers but have required 

the development of new or revised ophthalmic standards for vendor guidance. The 

wraparound polycarbonate shield design and 

ophthalmic correction lens carrier approach 

to Personal Protective Eyewear has required 

the development of new ophthalmic tests to 

evaluate face form angle and procedures 

to adjust ophthalmic prescription to accommodate the effect of large face form angles. 

These measurements and procedures have 

been adapted and are currently in use by 

military ophthalmic fabrication facilities 

worldwide.

Partners

y USAARL

y Program Executive Office Soldier

y Product Manager Air Warrior

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

Reference Work on Sensory, Perceptual, and Cognitive Aspects of HelmetMounted Display Design

Description

Helmet-Mounted Displays: Sensation, Perception and Cognition Issues provides insights into the 

effects of helmet-mounted displays (HMDs) for pilots, educators, academics, and the general public 

who are interested in the field of human factors engineering, military night flight operations, and the 

visual and auditory science behind improvements in advanced aviation (and other Warfighter) sensor 

systems.

This is the second in a series of books on HMDs published by USAARL. The first book, HelmetMounted Displays: Design Issues for Rotary-Wing Aircraft, focused on engineering design issues 

whereas this book fills the gap identified by the National Research Council related to the relationship 

between the HMD hardware design and user perception/cognition of visual and auditory displays. 

From the explanation of the human machine interaction dilemma, through the detailing of visual and 

auditory display systems, this book provides the reader with a thorough understanding of the issues 

related to military operations with respect to our senses, how we perceive what is represented, and 

ultimately how we assimilate and react to this information.

Partners

y USAARL

3-12

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Total Army Injury Health and Occupational Database

Description

The Total Army Injury Health and Occupational Database (TAIHOD) is used to track and store the 

demographic, occupational, and health information of Army members over the course of their active 

duty careers. It is a major research capability used by the Military Performance, Thermal Mountain 

Medicine, and Nutrition Divisions at USARIEM.

TAIHOD is a database for answering epidemiological questions of injury and health outcomes relevant 

to the Army. It contains information on individual service member demographic and occupational 

characteristics, health outcomes, and health behaviors collected over the course of an Army member’s active duty career for all Army members who have served on active duty since 1971—approximately 5 million individuals. TAIHOD provides the data necessary for the development of military 

health and safety policies.

Partners

y USARIEM

3-13
Toxic Gas Assessment Software – Performance Evaluation

Description

Toxic Gas Assessment Software – Performance Evaluation (TGAS-PE) predicts impairment, incapacitation, and lethality following exposure to toxic gases. TGAS-PE is a tool that predicts probability 

of total incapacitation, immediate lethality, and delayed lethality from inhalation of a mixture of seven 

common fire gases (i.e., low O2, CO, CO2, NO2, HCN, HC1, and Acrolein). For exposures to gases 

that interfere with oxygen delivery, such as hypoxia or altitude or atmospheres with carbon monoxide, 

the software predicts decrements in physical performance for an arbitrary work profile. The software 

is based on a comprehensive mathematical model of human physiology, including pulmonary, cardiovascular, humeral, and neural control systems. The model has been validated against physiological 

and performance data for small and large animal tests and human exposures under normal and altitude conditions. Several forms of the application are available for use in human hazard assessment 

for occupational exposure at low levels to those for use in survivability and lethality assessment.

Partners

y MOMRP

y L-3 Communications/Jaycor

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

3-14

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Warfighter Face and Eye Injury Protection

Description

Operationally focused face and eye injury research conducted under the USAARL Cockpit Air Bag 

research program illustrated the need for biomedically relevant facial and ocular injury criteria as 

well as a timely, low-cost alternative to cadaver-based testing. The primary research thrusts in this 

program include the development of the Facial and Ocular Countermeasure Safety (FOCUS), a 

biofidelic test headform capable of measuring blunt impact forces acting on the face and eye and the 

promulgation of biomedically based facial and ocular injury criteria. Together, these tools will provide 

Army materiel developers an efficient, cost-effective means of evaluating the efficacy of novel face 

and eye protection devices. This research effort will lead to improved protective devices, enhancing 

the survivability and sustainability of the Warfighter. 

Partners

y USAARL

COMPLETED | PROMISING | FUTURE

3-15
Army Medical Department Suicide Event Report 

Description

The Army Medical Department Suicide Event Report (ASER) is a data system that captures information on suicide. ASER is a reporting instrument with both quantitative and qualitative information to 

better understand and summarize suicides in real time. It uses a web-based electronic data system 

containing information on all suicides and all hospitalized attempted suicides. Enhanced Army suicide 

surveillance will allow better targeting of current and future suicide prevention programs.

Partners

y WRAIR

y USAMRU-E

y U.S. Army Europe

y Europe Regional Medical Command

PSYCHOLOGICAL HEALTH AND 

RESILIENCE

COMPLETED | PROMISING | FUTURE

3-16

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Pre/Post-Deployment Psychological Screening

Description

Individual and unit functioning are improved through the early identification of service members with potential behavioral health issues using a simple, easily 

administered, valid, and cost-effective screening procedure. Prior to and returning from deployments, behavioral health providers are tasked with identifying service members who may benefit from behavioral health services. Through the use of survey instruments and brief structured clinical interviews, large 

groups of service members can be rapidly screened, and those with behavioral health care issues can be identified and referred for follow-up care.

In 2004, two blind-validation screening studies produced a short screen fielded in U.S. Army Europe. The research demonstrated that behavioral health 

concerns become more evident several months following return from combat. This screening research influenced the development of the DoD’s PostDeployment Health Reassessment program per policy guidance from the Assistant Secretary of Defense for Health Affairs. A third blind-validation study 

conducted by USAMRU-E in 2005 provided scoring guidelines for the mental health component of the Post-Deployment Health Reassessment (DD Form 

2900) and developed a structured interview guide to help triage service members.

By establishing a short and valid screening procedure and determining the optimal time to conduct screening, mental health support can be streamlined and 

brought forward to meet the needs of a deploying force.

Partners

y WRAIR

y USAMRU-E

y U.S. Army Europe

y Europe Regional Medical Command

COMPLETED | PROMISING | FUTURE

3-17
Resilience Training System

Description

WRAIR developed and tested Battlemind Training, the Army’s first integrated mental health training system, which was mandated Army-wide in 2007. Since 

that time, the Army initiated Comprehensive Soldier Fitness, a large-scale program designed to increase resilience and enhance performance through unitlevel master resilience trainers, the Army’s professional military education system, and mandated deployment cycle training. Battlemind was integrated into 

this larger effort, and WRAIR has served as the lead in adapting the material as well as creating and piloting a component of the Master Resilience Trainer 

course. All of the training modules address Soldier and family strengths and include actions Soldiers can take to care for themselves, their buddies, and 

those they lead. 

Throughout this transition period, WRAIR continues to test the efficacy of resilience training. WRAIR has integrated resilience training and programmatic 

research efforts by incorporating Land Combat Study and Mental Health Advisory Team findings into resilience training modules. In 2010, WRAIR conducted 

a program evaluation to assess the Training and Doctrine Command’s pilot efforts to integrate Master Resilience Trainer course concepts into the Army’s 

Basic Officer Leadership Course. The study resulted in a policy decision to create a 10-hour resilience training course for the Basic Officer Leadership 

Course. Additional modules are being developed, and follow-on research is assessing methods for increasing resilience training efficacy.

Partners

y WRAIR 

y USAMRU-E

y Training and Doctrine Command

y Comprehensive Soldier Fitness

y Army Center for Enhanced Performance

PSYCHOLOGICAL HEALTH AND 

RESILIENCE

COMPLETED | PROMISING | FUTURE

3-18

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Enhanced Fluid and Nutrition 

Delivery System

Description

This research effort exploits new knowledge 

on water needs and adverse performance 

consequences from dehydration. New 

doctrine and sweat prediction software will 

improve the prediction of water needs while 

the Enhanced Fluid and Nutrition Delivery 

System will optimize fluid intakes. Both will 

reduce hydration-related heat injury incidence 

while also sustaining performance. The logistical water supply burden will be minimized 

by reducing water procurement error and 

increasing potable water consumption due to 

the presence of a flavoring agent but without 

water hygiene concerns. Nutritional supplements will minimize adverse performance 

outcomes of dehydration.

Partners

y USARIEM

Guidance on Using Modafinil and Dextroamphetamine as Alertness-Promoting 

Agents in Aviators Performing Extended Operations

Description

Research was conducted on the use of prescription-only pharmacologic products to enhance 

performance and alertness during unavoidable sleep loss in aviators. Two stimulants were tested: 

dextroamphetamine (Dexedrine®) and modafinil (Provigil®). Eighteen pilots each completed 15 helicopter flights and other evaluations during two 40-hour periods of sustained wakefulness during 

which they received two of three experimental conditions: 3 doses at 4-hour intervals of modafinil 

(100 milligrams), dextroamphetamine (5 milligrams), or placebo. Statistical results showed that the 

stimulants maintained alertness, feelings of well-being, cognitive function, judgment, risk perception, 

and situation awareness of sleep-deprived aviators consistently better than placebo and without side 

effects of aeromedical concern. Like previous research, this study strongly suggests that these drugs 

can maintain acceptable levels of mood and performance during sleep deprivation. The results also 

confirm that modafinil is well tolerated and appears to be a good alternative to dextroamphetamine for 

countering the debilitating mood and cognitive effects of sleep loss during sustained operations.

The findings of this study resulted in a change to the Aviation Policy Letter by the U.S. Army 

Aeromedical Consultant Advisory Panel approving the use of modafinil by U.S. Army aviation forces. 

The U.S. Navy is using the results to affect an equivalent action.

Partners

y USAARL

PHYSIOLOGICAL HEALTH 3-19
Nutritionally Optimized First Strike 

Ration

Description

The First Strike Ration is a lighter weight, 

shelf-stable, appealing, and nutritious individual ration that increases mental awareness 

and stamina for use during high-tempo operations in logistically austere conditions.

Together with the Combat Feeding Directorate, 

a lightweight, low-volume, 100 percent 

eat-on-the-move ration was developed and 

tested. The newly developed ration includes 

components that have been shown to preserve 

cognitive and physical performance during 

demanding mission conditions. The First 

Strike Ration is now available for procurement. 

Partners

y USARIEM

y Combat Feeding Directorate, U.S. Army 

Natick Soldier Research, Development 

and Engineering Center, Army Materiel 

Command

PHYSIOLOGICAL HEALTH

COMPLETED | PROMISING | FUTURE

On-the-Move Nutrient Delivery 

System

Description

The Nutrient Delivery System is a simple 

add-on to the Personal Hydration System that 

enables the user to receive nutrition on the 

move. The patented device enables Soldiers 

to have on-demand access to a beverage 

mixed to their current personal taste. It eliminates cumbersome mixing. Moreover, the 

Nutrient Delivery System is designed to keep 

the water reservoir free of mold or bacterial 

contamination over periods of prolonged use. 

Product acceptability studies demonstrate 

that the Nutrient Delivery System is a desired 

product. Sixty-eight percent of Soldiers rate the 

device as “moderately” to “extremely valuable” 

with 83 percent saying they would recommend 

the system to their peers and 76 percent recommending that the Army invest in the technology.

The Nutrient Delivery System is expected to 

be available for commercial purchase in 2011.

Partners

y USARIEM

3-20

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Probability of Survival Decision Aid

Description

The purpose of this research effort was to develop a Probability of Survival Decision Aid (PSDA) that 

predicts hypothermia, dehydration, and survival time during prolonged exposure to a wide range of air 

and water conditions at sea.

Estimates of survival time are required to optimize planning and execution of search and rescue 

operations and to improve the likelihood of a successful outcome. For accidental immersion, survival 

times are often represented in tables or curves as a function of water temperature. Such onedimensional representations can be misleading as tables and plots are often over simplified requiring 

interpolation between discrete values to fit a given set of conditions. Curves provide a continuous 

analog representation of survival information but require a graphic interpretation. A better alternative 

is to use a mathematical model of human thermoregulation. The PSDA mathematical model allows 

the input of more specific information and more complex analysis relative to a given incident and thus 

predicts survival times that more accurately reflect the physiological state of victims.

This project has been transitioned to the U.S. Coast Guard and integrated into its Search and Rescue 

Optimal Planning System.

Partners

y USARIEM

y U.S. Coast Guard

3-21
Cold Weather Operations: Cold Injury Prevention and Performance 

Optimization

Description

Cold exposure guidelines were developed to prevent and reduce hypothermia, frostbite, and nonfreezing cold injuries to service members. To alleviate the psychomotor and cognitive deficits associated with cold exposure, nutritional supplements were evaluated for their efficacy in prevention during 

hypothermia.

Policy memoranda, field manuals, and training aids regarding hypothermia and other cold injuries 

were produced in conjunction with the U.S. Army Public Health Command and the Office of the 

Surgeon General. A comprehensive Technical Bulletin guidance document for health care providers 

entitled “Prevention and Management of Cold Weather Injuries” (TB MED 508) has been published. 

In addition, NATO STANAG 2539, “Prevention and Management of Cold Weather Injuries,” has been 

adopted. Tyrosine, an amino acid supplement, has been shown to improve marksmanship and cognitive performance in hypothermic Soldiers. 

Partners

y USARIEM

Environmental Strain Prediction 

Models

Description

Environmental Strain Prediction Models 

are biomedically valid tools for predicting individual and unit-level performance 

outcomes based on environmental and 

operational variables. Given particular terrain 

characteristics, environmental temperature, 

and clothing requirements, these tools will 

provide accurate predictions of thermal strain 

with recommendations for fluid replacement 

and work/rest schedules. These prediction 

models provide mission planners and leaders 

the ability to simulate missions using accurate 

predictions regarding service member performance in environmental extremes.

Partners

y USARIEM

ENVIRONMENTAL HEALTH AND 

PROTECTION

COMPLETED | PROMISING | FUTURE

3-22

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
High-Altitude Operations: Management and Performance Optimization

Description

High-altitude (terrestrial) exposure guidelines were developed to prevent and reduce hypobaric 

hypoxia-related illnesses and performance impairments to service members. Nutritional supplements 

were evaluated for their efficacy in improving exercise performance at high altitude, and the effect of 

dehydration on performance at high altitude was quantified.

Policy memoranda, field manuals, and training aids regarding management of high-altitude acclimatization and altitude sickness were produced in conjunction with the U.S. Army Public Health 

Command and the Office of the Surgeon General. A comprehensive Technical Bulletin guidance 

document for health care providers entitled “Altitude Acclimatization and Illness Management” (TB 

MED 505) and a deployment health guide, “A Soldier’s Guide to Staying Healthy at High Elevations,” 

have been published and adopted as NATO (North Atlantic Treaty Organization) Standardization 

Agreements. These state-of-the-art guidelines are used for training and operational planning and 

serve to prevent and reduce altitude-related injuries to service members. 

Carbohydrate supplementation improved exercise performance at high altitude and is a key component of a new Modular Operational Ration Enhancement High-Altitude Pack. Dehydration reduces 

exercise performance at high altitude and increases severity of acute mountain sickness symptoms.

Partners

y USARIEM

COMPLETED | PROMISING | FUTURE

3-23
Hot Weather Operations: Heat Illness Management and Performance 

Optimization

Description

Heat exposure guidelines were developed to prevent and reduce heat-related injuries to service members. Nutritional supplements were evaluated for their efficacy in improving exercise performance in 

the heat, and the effect of dehydration on performance in the heat was quantified.

Policy memoranda, field manuals, and training aids regarding heat injury were produced in conjunction with the U.S. Army Public Health Command and the Training and Doctrine Command Surgeon’s 

Office. Examples include the “Heat Injury Protection Guide,” the “Heat Acclimatization Guide,” the 

Technical Bulletin guidance document for health care providers entitled “Heat Stress Control and 

Heat Casualty Management” (TB MED 507), the NATO STANAG 2981, “Prevention of Heat Injury,” 

and heat injury/heat stroke return-to-duty guidelines for AR 40-501, “Standards of Medical Fitness.” 

In addition, there was a recent update (June 2010) to AR 40-501 for “Heat Illness Medical Evaluation 

Board and Profile Policy.” These state-of-the-art guidelines for training and operational practice serve 

to prevent and reduce heat-related injuries to service members.

Supplementation with branched chain amino acids, quercetin, and caffeine showed no improvement 

in exercise performance in the heat. Dehydration reduces exercise performance in the heat with the 

performance decrement becoming progressively greater as the air temperature increases.

Partners

y USARIEM

ENVIRONMENTAL HEALTH AND 

PROTECTION

COMPLETED | PROMISING | FUTURE

3-24

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Intelligent Aquatic Biomonitor 

System

Description

The Intelligent Aquatic Biomonitor System 

(iABS) monitors fish behavior as a way to 

detect toxic chemicals in water. The iABS 

rapidly detects a wide range of toxic chemicals or chemical mixtures in water sources by 

measuring changes in fish behavior. Fish are 

natural integrators of water quality conditions 

and respond to a wide range of chemicals 

and mixtures. The system can be used at 

water treatment plants or other water production facilities, and water can be monitored 

after it is dechlorinated. The system protects 

drinking water supplies by continuously 

monitoring water. The biomonitor responds 

within an hour to most chemicals at acutely 

toxic levels and is in use at military facilities 

and major metropolitan areas. The iABS is 

available through a commercial partner.

Partners

y USACEHR

Rapid Analysis of Water for Select 

Chemical Contamination

Description

Rapid Analysis of Water for Select Chemical 

Contamination is a solid-phase microextraction and gas chromatography-mass 

spectrometry sampling and analysis method 

developed for two insecticides, carbaryl and 

lindane. Minimum levels of detection in environmental water sources are 10 microgram/

liter and 1.0 microgram/liter for carbaryl and 

lindane, respectively. The total analysis time 

using field-portable equipment is 30 minutes. This method avoids the use of complex 

sample preparation steps and enhances 

analyst safety by the elimination of handling 

solvents in field environments.

Partners

y USACEHR

COMPLETED | PROMISING | FUTURE

3-25
Automated Binocular Vision Tester

Description

This project will develop an Automated 

Binocular Vision Tester (ABVT) that can rapidly assess oculomotor functions in traumatic 

brain injury (TBI) patients. An ABVT will 

serve as an alternative to the time-consuming 

conventional oculomotor examination that 

currently must be performed by an optometrist or ophthalmologist.

Even though oculomotor dysfunction is common in military personnel after TBI, the ability 

to conduct a complete oculomotor evaluation 

on every deploying/redeploying Warfighter is 

currently not possible. This limitation can be 

overcome by employing an easy-to-use ABVT 

that can rapidly assess a significant number 

of oculomotor functions. In addition, an ABVT 

will provide a standardized assessment tool 

that will reduce the amount of chair time per 

patient and increase test–retest repeatability.

Partners

y USAARL

y WRAMC

Aviation Tactile Situation 

Awareness System

Description

The Aviation Tactile Situation Awareness 

System (TSAS) provides intuitive orientation 

cues to reduce pilot workload and permits 

pilots to maintain control of a helicopter under 

conditions of degraded visual environments. 

The Aviation TSAS consists of tactile stimulators embedded into a belt, seat, and shoulder 

straps, which provide information tactually 

from aircraft sensors concerning drift, velocity, 

and altitude changes. The information from 

platform sensors is converted into vibrotactile 

“taps” applied to the pilot’s body intuitively and 

unobtrusively permitting the pilot to attend to 

other mission-essential tasks visually. In addition to flight parameters, the Aviation TSAS 

provides navigation and threat information.

Partners

y USAARL

y Chesapeake Technologies, Inc.

y Defence Research and Development 

Canada – Toronto

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

3-26

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Biomechanical Design Guidelines 

for Personal Equipment

Description

Biomechanical analyses involving load 

carriage are made in conjunction with the 

determination of metabolic rate or energy 

cost. This includes evaluation of prototype 

military load carriage systems and footwear 

to assist in making equipment development 

and procurement decisions. Physical training 

programs are being evaluated for improving 

service member physical performance and 

quantification of the effects of load carried on 

the speed of over ground foot travel and the 

negotiation of obstacles on the battlefield. 

Partners

y USARIEM

Blast Dosimeter

Description

The Blast Dosimeter is a small (1” diameter, 0.45” thickness), lightweight (0.2 ounce), battery-powered 

device that contains a thin-film, piezoresistive sensor integrated with a microprocessor-driven 

electronics board that computes the dose and Work using the INJURY algorithm in real time. The 

date, time, and Work value are stored in flash memory for later download by two-way radio frequency 

communications. The INJURY model has been extensively validated against conventional and novel 

explosives, in free field and enclosure environments, and from blast levels from occupationally safe to 

lethal.

The Blast Dosimeter is constructed to operate in harsh environments and designed to function as 

a passive device for up to 2 years of continuous use or 1 year (after 1 year on the shelf-life) of use 

on a single coin cell battery. The onboard flash memory can store permanent values (Dosimeter 

Serial No.), temporary values (i.e., calibration data, Battle Roster Number, and Start Date/Time), 

and replaceable values (Blast Date/Time and Work values). The thin-film, piezoresistive sensor was 

selected because of low power requirements in standby mode and very rapid response to shock 

loading. 

The Blast Dosimeter can replace the subjective self-reporting by individuals with an objective 

measure that can distinguish “safe” and potentially injurious exposures, objectively flag a Soldier to a 

serious or life-threatening exposure, and supplement acceleration-based sensors to understand the 

pattern of exposure in combat and that could put emerging TBI models into perspective.

Partners

y MOMRP

y L-3 Communications/Jaycor

3-27
Customized Functional Hearing 

Evaluation for Military

Occupational Specialties

Description

This program will develop, implement, 

and demonstrate a Functional Hearing 

Assessment System (FHAS). Hearing tests 

and standards will be developed based on 

the hearing-critical activities necessary to 

perform Military Occupational Specialty 

(MOS)-specific duties safely and effectively. 

The FHAS will evaluate speech intelligibility, sound detection, and localization using 

the recorded background noise and relevant 

phrases for MOS-specific, hearing-critical 

tasks.

Partners

y USAARL

y Creare, Inc.

Design Guidelines for Head-Supported Devices

Description

Developing head-supported devices (HSDs) requires design guidelines and health hazard assessment methods to enhance service member performance and provide protection from neck injury. 

Biomedically based design guidelines and assessment methods for HSDs, such as protective 

helmets, weapon sighting, and communication and night vision goggle systems, are being developed. 

The development process uses epidemiological studies, biomechanical engineering analysis, injury 

studies with human cadavers and manikins, and advanced biofidelic neck models to develop and 

validate neck injury criteria. The health risk assessment method includes the neck injury prediction 

model and algorithms that produce a risk assessment code based on the predicted injury severity and 

the probability of occurrence. 

HSDs are critical components; however, they increase the amount of weight supported by the head 

and neck and may place service members at risk of degraded performance or neck injury. This 

project will provide guidelines and assessment methods for the assessment of HSDs used in current 

operations and the future development of safe and effective helmet-mounted systems, including 

enhanced combat helmet design.

Partners

y USAARL

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

3-28

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Epidemiology and Protection from Injury in Combat

Description

There is an urgent need to assess the performance of personal protective equipment (PPE) in current 

combat operations. Current trauma databases lack exposure and PPE data necessary for reliable 

analyses. USAMRMC has a long-standing capability to analyze damaged protective equipment, 

correlate the analysis with scenario and injury data, and produce recommendations for improved 

equipment, tactics, procedures, and requirements. In the future, this capability, historically based 

in aviation, will expand to include mounted Army service members who are injured in combat. This 

initiative will allow Army decision makers to assess the performance of current combat protective 

equipment. 

A multidisciplinary team of physicians, engineers, safety experts, and operational service members 

will conduct analyses of damaged protective equipment, correlate those analyses with scenario and 

injury data, and make recommendations regarding deficiencies, improvements, and future equipment 

requirements. Specific analyses of protective helmets from aviation and ground service members will 

allow determination of impact forces and system performance. The result will be a seamless record 

of a service member’s wounding event, risk factors, diagnoses, treatment, and outcome and will lead 

to enhanced Warfighter survivability through wound pattern detection and optimized PPE.

Partners

y USAARL

3-29
Injury Prevention and Restraint Technologies for Ground Vehicles and 

Helicopters (Conventional Restraint Systems)

Description

Biomedically based injury criteria and test methods for improved helicopter and ground vehicle occupant protection systems will provide system developers with the tools they need to design, develop, 

and field safer and more survivable air and ground vehicles for service members.

Many injuries that routinely occur in tactical vehicle operations and mishaps are preventable through 

the use of improved occupant restraint systems. Traditionally, military ground vehicles have not been 

equipped with state-of-the-art safety equipment, but significant improvement in occupant safety in 

tracked and wheeled tactical vehicles can be realized through the integration of commercial automotive technology and current military aviation restraint systems. Contact injuries account for more than 

80 percent of injuries received in Army vehicle mishaps. Biomedically based performance criteria and 

flail trajectories are needed during the design and development of occupant restraint systems. New 

generic test methods are being developed to ease comparative performance assessments among 

candidate restraint systems. Special considerations in the military platform environment include the 

need for rapid and unhindered egress following enemy contact and survival in the post-crash (e.g., 

rollover) environment.

Partners

y USAARL

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

3-30

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Physiological and Operational Effects of Extended Mission Duration and Seat 

Design

Description

Reports from the Center for Army Lessons Learned and operational experience confirm that many 

deployed service members experience significant back pain due to long mission duration and uncomfortable seating. These symptoms could affect mission accomplishment. In some cases, unauthorized seat cushions have been introduced into the field as a countermeasure; the effects of these 

cushions on crash survival are largely unknown. 

The purpose of this research program is to develop a methodology to quantify seat cushion effects 

on seated endurance and pain and to develop a cost-effective methodology to assess seat cushion 

energy attenuation. The product will be a standardized evaluation methodology and performance 

requirements of seat cushions, increasing service member endurance.

Partners

y USAARL

3-31
Return-to-Duty Vision Standards After Traumatic Brain Injury

Description

Determining when a Soldier with a history of TBI is ready to return to duty is problematic. The goal of 

this project is to provide tests to the clinician that will assist the evaluation of these Soldiers. Visual 

dysfunctions that can occur with TBI include: visual acuity loss, visual field loss, oculomotor dysfunctions, extra-ocular motility impairment and loss of binocular vision, cranial nerve palsies including lid 

paralysis, corneal involvement, pupillary involvement, sensory and/or spatial misperceptions, nystagmus, and visual midline shift syndrome. Unfortunately, there is currently no supportive scientific 

evidence to: (1) establish pre-deployment visual evaluation requirements, (2) develop clinical guidelines for the diagnosis and future management of TBI-induced visual dysfunctions, and (3) establish 

fitness-for-duty and return-to-duty ocular/visual standards after TBI. USAARL continues its role of 

providing testing and guidance to the medical standards community. This project will evaluate the 

new vision tests and develop recommendations for vision testing after TBI.

Partners

y USAARL

y Warrior Resiliency and Recovery Center, Fort Campbell, Kentucky

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

3-32

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Strategies to Optimize Bone Health and Eliminate Stress Fractures in New 

Recruits

Description

Current research, supported in part through special congressional funding, includes nearly 60 major 

studies centered on physical training and other factors that influence the normal bone remodeling and 

repair process. In addition to identification of modifiable risk factors for stress fractures that result 

from changes in physical training load, these studies seek to identify interventions that may improve 

bone quality through biomechanical forces (including vibration and exercise), nutrition (including protein, vitamin D, and calcium intake), and hormonal influences (including low-dose estrogens, DHEA, 

and androgens). Combined with the results of additional studies investigating the role of genetics and 

personal health, dietary, and fitness habits, this bone health research program will lead to innovative 

approaches to prevent stress fracture injury in new recruits, provide early diagnosis and treatment of 

stress fractures, and favorably affect disability discharge rates. The ultimate goal of this program is to 

eliminate stress fracture injuries, improve overall bone health of the Warfighter, and ensure continued 

quality of life beyond a service member’s military career. 

Partners

y USARIEM

Tactile Balance Assessment Device

Description

The Tactile Balance Assessment Device 

(TBAD) provides physiotherapists with a tool 

to evaluate balance-compromised patients. 

The TBAD utilizes a balance board to provide 

center of gravity and stability of stance information to clinical evaluators while subjects 

are engaged in tasks that challenge the 

balance system. The center of gravity information from the balance board is provided 

as a tactile biofeedback cue to a collection 

of tactile stimulators on the torso-worn belt 

permitting the patient to correct for any deviations from optimal balance.

Partners

y USAARL

y Engineering Acoustics, Inc.

y Balance Sense

3-33
Tinnitus Treatment Strategies

Description

This project will identify active duty Soldiers with uncompensated tinnitus to objectively measure 

their audiometric function (including tinnitus pitch and loudness matching), to subjectively measure 

the effect of tinnitus on quality of life, and to determine the best treatment strategies compatible with 

continued military service and return to duty.

Warfighters’ survivability depends on accurate sensory perception of the environment. Despite 

technological advances in hearing protective devices, the likelihood of exposure to continuous and 

impulse noise on the modern battlefield remains high. As a result, the prevalence of tinnitus in returning Operation Iraqi Freedom and Operating Enduring Freedom Soldiers is at an all-time high. The 

goal of this project is to evaluate promising tinnitus treatment programs for active duty Soldiers with 

debilitating tinnitus.

Partners

y USAARL

y Neuromonics

Traumatic Brain Injury Sensory 

Assessment Battery

Description

The purpose of the TBI Sensory Assessment 

Battery is to evaluate and characterize the 

vestibular, auditory, and oculomotor sequelae 

in Warfighters diagnosed with TBI.

Sensory deficits secondary to TBI will be 

measured and compared to normal sensory 

function to determine which of these tests 

are sensitive to the sensory effects of TBI in 

an effort to refine immediate and long-term 

fitness-for-duty and return-to-duty standards.

Partners

y USAARL

y Warrior Resiliency and Recovery Center, 

Fort Campbell, Kentucky

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

3-34

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Mental Health Advisory Teams

Description

The WRAIR Psychological Health and Resilience Program is the lead proponent for Mental Health 

Advisory Teams (MHATs). Since 2003, WRAIR has led MHATs into Iraq and Afghanistan. The 

MHATs deliver rapid behavioral health research findings directly to senior leaders within the U.S. 

Army Central Command, U.S. Army Medical Command, and DoD. MHAT recommendations have 

informed policy regarding deployment length, dwell time, behavioral health delivery, and other aspects 

of deployment-related behavioral health. MHATs provide objective data using scientifically validated 

research and sampling methods to inform policy and best clinical practice for taking care of the 

Warfighter.

Partners

y USAMRMC

y WRAIR

y DoD-Health Affairs

y Navy Bureau of Medicine and Surgery

y Office of the Army Surgeon General

y U.S. Air Force

y U.S. Army Central Command

y U.S. Marine Corps

y U.S. Navy

PSYCHOLOGICAL HEALTH AND 

RESILIENCE 3-35
Millennium Cohort and Deployment Health

Description

Launched in 2001 prior to the start of the operations in Iraq and Afghanistan, the Millennium Cohort Study has enrolled more than 150,000 service members 

from all components (active duty, Reserve, National Guard) and all services (Army, Air Force, Navy, Marine Corps, and Coast Guard). This large populationbased study requests cohort members to complete a questionnaire every 3 years regardless of military status at the time of follow-up. These data are linked 

to other electronic DoD data sources such as electronic medical records, pharmaceuticals, deployment, and occupational exposure data. Findings indicate 

that combat-related stressors, rather than deployment itself, are associated with increased risk for alcohol misuse, smoking, depression, PTSD, sleep problems, hypertension, respiratory symptoms, and eating disorders in women. Furthermore, certain subpopulations have been shown to be at increased risk 

for post-deployment health issues, including Reserve/National Guard, those who report low pre-deployment physical or mental health, and individuals who 

report prior assault. Studies also have highlighted possible ways to mitigate mental health symptoms, such as increasing physical activity levels and avoiding 

excess weight gain. Finally, immunization research has demonstrated that the anthrax and smallpox vaccinations are not associated with increased symptom 

reporting or health outcomes. 

Current studies are investigating transient symptoms and progression of symptoms to chronic illness, attempting to further understand the relation of possible stress and chronic health conditions, such as hypertension, diabetes, and heart disease. Factors related to common conditions present in the military, 

such as migraines, hearing loss, and back pain, also are being examined. Ongoing strategic studies are focusing on participants’ use of complementary and 

alternative therapies and factors that may predict wellness. As this study follows service members after separation from the military, strategic research also 

will be examining separation as it relates to employment, weight change, physical activity, and reasons for leaving military service.

Established at the Marine Corps Recruit Depot in San Diego, California, the Recruit Assessment Program (RAP) was launched in 2001 to collect baseline 

health data on Marine recruits. Main functions of the RAP include understanding health risks at entrance to the military, understanding how service-related 

exposures including deployments affect health, and developing early intervention and prevention programs. Strategic studies using RAP data have identified 

specific risk factors among male Marines for PTSD.

PSYCHOLOGICAL HEALTH AND 

RESILIENCE

COMPLETED | PROMISING | FUTURE

3-36

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Strategic studies using electronic data from 

the Military Health System have been conducted to quantify the impact of deployment 

on post-deployment health care utilization 

and vaccination status on health care utilization by including inpatient and outpatient 

encounters. Findings have indicated that 

deployers are healthier than the regular active 

duty force prior to deployment and return from 

deployment with higher hospitalization rates 

than nondeployed personnel, but these levels 

regress back to being consistent with the rest 

of the active duty military. Future studies will 

aim to assess the spectrum of morbidities 

related to deployment exposures and injuries.

Partners

y MOMRP

y Naval Health Research Center

COMPLETED | PROMISING | FUTURE

3-37
Operational and Strategic Studies of Service Member and Spouse Behavioral 

Health

Description

Since 2003, the Military Psychiatry Branch from WRAIR has collected pre- and post-deployment 

behavioral health data at U.S. military installations. These studies have included surveys of active 

duty Soldiers and their spouses as well as National Guard Soldiers. To date, data have been collected on more than 70,000 Soldiers and spouses. Results have informed Army leaders on policy 

issues related to behavioral health. Products include key publications documenting the effects of 

combat operations in both Afghanistan and Iraq on service member mental health and the factors that 

promote access to behavioral health care as well as policy recommendations regarding behavioral 

health care. 

Partners

y WRAIR

y U.S. Army Forces Command

y Clemson University

y Texas Women’s University

y University of Maryland

y University of South Carolina

Research on Behavioral Health 

Practice 

Description

In 2010, WRAIR surveyed behavioral health 

providers in a study designed in collaboration 

with the American Psychiatric Association. The 

survey addressed caseload characteristics, the 

degree to which evidence-based treatments are 

used for mental health issues such as PTSD 

and suicidal behavior, and provider job satisfaction. This study is the first time data of this type 

have been collected in the Army. Results will 

lead to recommendations for improving behavioral health care delivery for Soldiers. 

Partners

y WRAIR

y U.S. Army Medical Command

y American Psychiatric Association

PSYCHOLOGICAL HEALTH AND 

RESILIENCE

COMPLETED | PROMISING | FUTURE

3-38

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Safe and Effective Treatment of Depression and Anxiety Disorders in 

Warfighters

Description

Research is planned to determine any effects, beneficial or detrimental, of administration of selected 

serotonin reuptake inhibitor substances on subsequent aviator flight performance and cognition. In 

the United States, about 10 percent of the population (7 percent women and 3 percent men) meet 

criteria for major depression, and another 4 or 5 percent undergo a depressive experience that is 

not sufficient to be officially classified as clinical depression. In the 1998 Department of Defense 

Survey of Health Related Behaviors Among Military Personnel, 18.9 percent of the surveyed Army 

members screened positive for depressive symptoms. The aviator community is not immune to these 

psychiatric problems. One commonly prescribed treatment for mild depression is selective serotonin 

reuptake inhibitors. The effects of these medications on service member performance and cognition 

are unknown. 

Partners

y USAARL

COMPLETED | PROMISING | FUTURE

3-39
Design Guidelines for Effective Microclimate Cooling Systems

Description

Improvements in the design and implementation of microclimate cooling (MCC) systems will enhance 

service member performance and reduce both heat strain and injury. The efficacy of MCC systems 

will improve through the implementation of physiologically driven designs. Engineering attempts to 

enhance liquid MCC capabilities include reducing the coolant temperature and increasing flow, both of 

which increase power requirements. However, over cooling the skin produces skin vasoconstriction, 

increases thermal resistance, and decreases conductive heat transfer. As the skin-to-MCC garment 

interface gradient narrows, the amount of cooling per unit of power consumed declines and cooling 

efficiency decreases. This project examines the use of intermittent MCC to reduce vasoconstriction, 

maximize heat flux, and conserve battery power requirements.

Future Force operational requirements will accentuate heat strain, increase the incidence of heat 

casualties, and reduce work performance by demanding sustained work rates and rapid deployment 

with minimal time for heat acclimatization. Traditional MCC technologies have been successfully used 

to alleviate heat strain in mounted service members, but cooling limitations and power and weight 

restrictions do not currently make this technology applicable to dismounted individuals. 

This project will maintain performance capabilities of a service member by improving heat flux thus 

reducing heat strain and water requirements. Intermittent MCC also will decrease cooling power 

requirements by 45 percent.

Partners

y USARIEM

y U.S. Army Natick Soldier Research, Development and Engineering Center

Effective Army Weight

Management Strategies

Description

Biomedical research is being conducted to 

identify effective strategies for healthy body 

weight maintenance. Weight loss strategies being evaluated for efficacy among 

military personnel include meal replacement 

diets, use of over-the-counter weight loss 

pharmaceuticals, subsistence on structured 

energy-restricted meals served in garrison 

dining facilities, and Internet or personal 

digital assistant (PDA)-based weight loss and 

maintenance interventions applicable to Army 

Reserve and National Guard personnel as 

well as active duty personnel. Biological factors that influence eating behavior are being 

examined to identify effective behavioral 

strategies for modulating food intake. Finally, 

interactions between nutrients, biology, and 

eating behavior are being investigated to 

determine optimal food product formulations 

for promoting or deterring food intake. 

Partners

y USARIEM

PHYSIOLOGICAL HEALTH

COMPLETED | PROMISING | FUTURE

3-40

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Model for Fatigue Management

Description

Acute or chronic sleep loss is a common problem encountered by the armed forces, especially during 

continuous and sustained military operations. The ability to gauge and predict an individual’s cognitive performance impairment due to sleep loss can significantly impact the success and safety of a 

mission. In particular, due to individual physiological differences, this predictive capability needs to 

be customized to each individual Soldier. Accordingly, the individualized model for fatigue management combines the physiology and neurobiology underlying sleep loss of a Soldier with key concepts 

in the field of system identification to model and predict performance impairment hours in advance 

(approximately 24 hours) for an individual subjected to sleep loss. The model uses past performance impairment measurements of the individual to customize the model parameters, predict future 

performance impairment levels, and provide the corresponding statistically based measures of model 

reliability for that individual. An important feature of this model is the ability to adapt its parameters to 

an individual as new performance measurements of that individual become available thereby improving its prediction accuracy with time. The current model for individualized fatigue management can be 

augmented with physiologically based models of the effects of caffeine in restoring alertness levels to 

yield an integrated biomathematical model for quantifying the effects of sleep loss and caffeine dosing 

on performance impairment levels at an individual level.

Partners

y WRAIR

y DoD Biotechnology High Performance Computing Software Applications Institute/TATRC

3-41
Motion Sickness Countermeasures in Army Aircraft

Description

This series of studies investigates the use of stroboscopic illumination as a nonpharmacologic 

countermeasure to motion sickness related to retinal slip. Airsickness remains an important problem for today’s Army. Soldiers must be ready to execute missions at any time during or following 

transportation so minimizing the symptoms of motion sickness is critical. A preliminary assessment 

of stroboscopic shutter glasses (n = 8) in USAARL’s research helicopter indicated that stroboscopic 

technologies are a promising nonpharmacological motion sickness prevention strategy. A second 

study examined the idea of applying stroboscopic illumination to the passenger area of moving 

military vehicles as a countermeasure for motion sickness. This study used a multi-axis ride simulator 

to reproduce the motion profiles of airborne and amphibious vehicles to examine the effectiveness of 

a 4 and 8 hertz stroboscopic environment and found evidence of effectiveness in subjects’ subjective 

reports. A third study is in preparation that will utilize 20 subjects and 8 hertz stroboscopic illumination in the cabin area of USAARL’s research helicopter. The development of a nonpharmacologic 

motion sickness remedy would be of great benefit to the operational military community.

Partners

y USAARL

y TATRC

PHYSIOLOGICAL HEALTH

COMPLETED | PROMISING | FUTURE

3-42

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Nutritional Products for Digestive Health and Immune Function

Description

Respiratory infections are the leading cause of outpatient illness in U.S. military personnel. Acute 

gastrointestinal infections are also common. Soldiers appear to be more susceptible to these illnesses during intense physical training particularly when coupled with sleep deprivation, inadequate 

food intake, and psychological stressors. Thus, there is interest in strategies that can reduce illness 

rates. 

Probiotics are safe, healthy bacteria that live in the human digestive system and can be found in 

common foods such as yogurt. Daily administration of certain types of probiotics have been shown to 

positively influence markers of immune function and prevent and/or treat respiratory and gastrointestinal infections in non-military populations. Research is under way to study the impact of a multistrain 

combination of probiotics on immunocompetence and the incidence, duration, and severity of respiratory and gastrointestinal infections in military personnel. Positive results may lead to improved quality 

of life for military personnel and potential cost savings due to reduced reliance on the health care 

system and preserved training/working days. 

Micro-mineral elements such as zinc are important for digestive health and immune competence. 

Research with adult Kenyans frequently afflicted with diarrhea recently was conducted to determine 

the effectiveness of zinc supplementation for prevention of diarrhea. While environmental conditions prevented general conclusions for the overall population, zinc supplementation was effective for 

reducing diarrhea incidence and severity in those adults afflicted with HIV and/or malaria. 

Partners

y USARIEM

y WRAIR

y The Kenya Medical Research Institute

Operational Ration Sustainment 

Testing

Description

A systematic chemical analysis of all food 

components in the Meals, Ready-to-Eat 

and the First Strike Ration is under way to 

define the chemical composition of the ration 

menus. The database produced by this effort 

will assist the ration developer in producing 

menus that meet the Nutritional Standards for 

Operational Rations, enable the Contracting 

Officer to evaluate whether the contractor is 

building the desired product, and determine 

whether standard storage conditions for 

operational rations affect nutrient quality. 

Equally important, the database will enable 

investigators to determine if Warfighters are 

consuming diets that achieve the Military 

Dietary Recommended Intakes, and if not, to 

devise strategies to achieve this desired goal. 

Partners

y USARIEM

y Combat Feeding Directorate, U.S. Army 

Natick Soldier Research, Development and 

Engineering Center, Army Materiel Command

3-43
Prevention and Treatment of Iron Deficiency Anemia in Female Soldiers

Description

USARIEM has tested both iron supplements and iron-containing food products for the maintenance 

of iron status in female Soldiers during basic combat training. Once daily supplementation with iron 

in capsule form prevented declines in iron status during basic combat training. Consumption of the 

iron supplement resulted in improvements in measures of mood following basic combat training and 

improved running time in Soldiers reporting to basic combat training with iron deficiency anemia. 

Twice-daily consumption of an iron-fortified food product improved iron status in female Soldiers with 

iron deficiency anemia.

Current efforts are under way to elucidate rapid, cost-effective methodologies for the screening of 

Soldiers for iron status at the start of military training such that intervention strategies may be delivered to appropriate target populations. 

Partners

y USARIEM

PHYSIOLOGICAL HEALTH

COMPLETED | PROMISING | FUTURE

3-44

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Sleep Watch

Description

The Sleep Watch is a wrist-worn, wear-and-forget device that provides real-time quantitative estimates of the wearer’s cognitive readiness based on sleep/wake history derived from wrist movements. The Sleep Watch generates online, real-time cognitive readiness estimates using the onboard 

WRAIR Sleep Performance Model. These estimates are available to the individual service member 

on the face of the Sleep Watch and can be wirelessly transmitted to a PDA, laptop, etc., allowing commanders to use individual Warfighter cognitive readiness estimates for mission planning via Alertness 

Management for Military Operations (AMMO) system tools. 

An application-specific, integrated circuit for micro-electro-mechanical system activity sensor, the 

onboard sleep-scoring algorithm, and Sleep Performance Model form an “intelligent sensor” that 

can be implemented as stand-alone or integrated into other systems such as WPSM (Warfighter 

Physiological Status Monitoring) and Future Force Warrior.

The Sleep Watch provides remote monitoring capabilities needed to predict service member cognitive 

readiness and does so at a low cost in terms of power, weight, volume, and computational capacity.

Partners

y WRAIR

y Air National Guard

y Defense Safety Oversight Council

COMPLETED | PROMISING | FUTURE

3-45
Altitude Sickness, Acclimatization, and Performance Prediction Models

Description

Altitude Sickness, Acclimatization, and Work Performance Prediction Models are being developed 

to provide mission-specific estimates of the impact of high terrestrial altitude on Warfighter health 

and performance. The first comprehensive predictive models of altitude sickness risk, performance 

capabilities, and acclimatization strategies for moderate- to high-altitude operations are being developed. These prediction models will provide mission planners and leaders the ability to evaluate risk 

mitigation controls, estimate altitude sickness incidence and severity, and accurately predict service 

member performance in high terrestrial regions. Moreover, this work is developing a prototype 

Personal Altitude Acclimatization Monitor that will provide automatic assessment of individual altitude 

acclimatization status and a mountain medicine enhancement to personal physiological status 

monitoring systems to provide real-time assessment of mountain sickness and performance capabilities. The predictive models are being incorporated into an advanced prototype Altitude Readiness 

Management System software application that can run on multiple platforms including handheld 

personal digital devices.

Partners

y USARIEM

ENVIRONMENTAL HEALTH AND 

PROTECTION

COMPLETED | PROMISING | FUTURE

3-46

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Arm Immersion Cooling System

Description

The Arm Immersion Cooling System (AICS) provides an efficient, rapid method of cooling to Soldiers 

in the training environment, requiring minimal logistical and personnel support to transport, set up, 

use, and maintain the system. Avoidance of exertional heat injury (EHI) has long been a challenge in 

the training environment, and a number of heat stress mitigation strategies and methods have been 

employed over the years. Examples include moving to shady areas, removal or loosening of clothing, 

providing water misters, and modifying the time of day and order of training events. In spite of these 

efforts, EHI continues to be a problem. The AICS provides a simple, efficient method for facilitating 

body core temperature cooling and reducing the risk of EHI. Immersion of the hands and forearms 

for 10 minutes in cool water decreases the body’s core temperature substantially. Phase 2 prototypes 

are being developed. Phase 1 prototypes have been fielded at Fort Benning and Camp Mackall, been 

accepted by the Ranger and Special Forces community, and have been successful in mitigating heat 

stress.

Partners

y USARIEM

y U.S. Army Natick Soldier Research, Development and Engineering Center

COMPLETED | PROMISING | FUTURE

3-47
Biological Markers of Toxic Exposures and Effects for Deployment Health 

Surveillance

Description

Biological markers, or biomarkers, are measurable molecular, biochemical, or cellular alterations in 

biological matrices, such as fluids, cells, or tissues, which occur in response to hazardous chemical 

exposure. Since individuals may vary in the extent of exposure, uptake, and response to chemicals, 

biological measures of toxicant exposure and effect—biomarkers—are needed for operational risk 

management. Since biomarkers can indicate the degree of exposure, biological effects, and susceptibility to disease from hazards that personnel may encounter, they have many potential applications in 

force health protection and health surveillance of DoD personnel. 

This research program is identifying key biomarkers associated with hazardous chemicals encountered by military personnel. Taking advantage of genomic technologies and bioinformatics, experiments are being conducted using genome-sequenced animal models to identify novel biomarkers that 

are also highly conserved (homologous) in humans. Along with microarrays for gene expression, a 

proteomics approach (analysis of an organism’s proteins or its proteome) also is being used to screen 

for biomarkers. The products of this effort include validated and measurable sets of biomarkers that 

can be used to evaluate the toxic exposures encountered by military personnel.

Partners

y USACEHR

ENVIRONMENTAL HEALTH AND 

PROTECTION

COMPLETED | PROMISING | FUTURE

3-48

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Rapid Analysis of Water for Microbial Contamination

Description

The assurance of safe water is paramount to the health and performance of the Warfighter. Any 

technology to assess the microbial purity of water under field conditions must meet rigorous criteria. 

It must be readily portable, provide timely results, have adequate sensitivity (1 colony forming unit 

per 100 milliliters), be compatible with military power sources, and be of a complexity appropriate for 

operation by a preventive medicine specialist.

Researchers will provide rapid identification and semiquantification of Escherichia coli and total 

coliform bacteria in 8 hours or less instead of the current 18–24 hours. Pacific Technologies developed the “Coliform Analyzer” that combines classical membrane filtration with innovative computer 

electronics for the selective growth and semiquantification of both total coliform bacteria and E. coli in 

the presence of other water heterotrophic bacteria.

Pacific Technologies has been awarded another contract to continue development and commercialize the “Coliform Analyzer” with the purpose that this detector will replace the coliform tests currently 

used by the Army.

Partners

y USACEHR

y USAMMA

y Pacific Technologies

COMPLETED | PROMISING | FUTURE

3-49
Skin Temperature Feedback Microclimate Cooling

Description

Future Force operational requirements will accentuate heat strain, increase the incidence of heat 

casualties, and reduce work performance by demanding sustained work rates and rapid deployment 

with minimal time for heat acclimatization. Improvements in the design and implementation of MCC 

systems will enhance service member performance and reduce both heat strain and injury.

MCC technologies have been successfully used to alleviate heat strain in mounted service members, but cooling limitations and power and weight restrictions do not currently make this technology 

applicable to dismounted individuals. Traditional MCC approaches involve constant skin cooling with 

liquids at low temperatures and high flow rates. As a result, MCC power, size, and weight requirements increase. Because overly cold skin reduces heat flux, the amount of cooling per unit of power 

is reduced. This project examines the use of skin temperature feedback MCC to maximize heat flux 

and conserve battery power. The skin temperature feedback MCC methodology has been patented, 

and prototype systems demonstrate a 45 percent reduction in required power. Skin temperature 

feedback MCC will decrease the size and weight of MCC systems and make possible effective MCC 

for dismounted individuals. 

Partners

y USARIEM

ENVIRONMENTAL HEALTH AND 

PROTECTION

COMPLETED | PROMISING | FUTURE

3-50

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Sweat Prediction Models

Description

An improved, comprehensive sweat prediction equation was developed that incorporates a wider 

range of operational work rates, work durations, and modern clothing/equipment (such as body armor) 

to better predict modern operational water needs. The improved sweat prediction equation has 

undergone extensive validity testing (i.e., cross-validity, generalized validity, and extension validity) 

and demonstrates 65 percent greater accuracy than progenitor equations. The improved sweat prediction equation will provide mission planners the ability to accurately estimate water needs for groups 

thus improving the efficiency of water procurement. Moreover, it will provide leaders with the ability to 

predict water needs of individuals in real time thus enhancing the safety and sustainability of service 

members. Work is ongoing to incorporate the improved sweat prediction equation into a user-friendly 

software application platform.

Partners

y USARIEM

COMPLETED | PROMISING | FUTURE

3-51
Test System for Evaluating Environmental Endocrine-Disrupting Chemicals

and Developing Candidate Biological Markers for Deployment Health 

Surveillance

Description

Biomarkers (i.e., molecular, biochemical, or cellular alterations) can provide valuable information on 

exposure of troops to hazardous chemicals. The western clawed frog (Xenopus tropicalis) shows 

promise as a nonmammalian model organism for efficiently identifying candidate human biomarkers. The same frog model is being considered for use by the U.S. Environmental Protection Agency 

(EPA) to screen for endocrine-disrupting chemicals in the environment. This EPA-funded project will 

provide EPA with an amphibian growth and reproduction test protocol while refining methods that will 

facilitate the use of X. tropicalis for the development of biomarkers for use in evaluating toxic chemical 

exposures encountered by military personnel.

Partners

y USACEHR

ENVIRONMENTAL HEALTH AND 

PROTECTION

COMPLETED | PROMISING | FUTURE

3-52

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Thermal Models on a Personal 

Digital Assistant Format

Description

USARIEM has developed a Heat Strain 

Decision Aid model that runs on a PDA for 

predicting the risk of heat casualties. This 

model is the best available, user-friendly 

predictor of endurance times in thermally 

challenging environments within the DoD. It 

is especially well adapted to military and first 

responders performing military or paramilitary 

activities in nuclear, biological, and chemical 

protective ensembles with or without body 

armor. 

At present, the model requires separate input 

of clothing, work activity level, and environmental conditions; calculates maximum work 

time to 300 minutes; recommends work and 

rest cycles for sustained operations; and 

estimates water consumption requirements.

Partners

y USARIEM

COMPLETED | PROMISING | FUTURE

Thermal Warning Algorithm

Description

Heat injury is a serious problem for the armed forces especially during deployments to localities 

with very hot climates. An early warning of the likelihood of a person’s body core temperature rising 

beyond healthy limits is paramount to alleviating or avoiding different heat-related illnesses. The early 

warning algorithm combines recent advances in core temperature telemetry with data-driven prediction techniques to forecast an individual’s core temperature for up to 20 minutes ahead of current 

time. The algorithm is based on linear predictive techniques, which make it very stable and easy to 

implement in real time. Although temperature prediction is based on an individual’s recently collected 

temperature data, the algorithm is robust enough that it is “portable” from person to person. The 

algorithm requires only modest memory and processing power and can be incorporated into systems 

that will be used to provide real-time physiological status monitoring of personnel.

Partners

y DoD Biotechnology High Performance Computing Software Applications Institute/TATRC

3-53
INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

Blast Standards for Neurosensory 

Personal Protective Equipment

Description

Currently, military-authorized PPE is evaluated against the same protective ophthalmic 

ANSI (American National Standards Institute) 

standards created for civilian industry but are 

not evaluated against blast mechanisms to 

which Warfighters are exposed during combat. USAARL continues its role of providing 

PPE testing and guidance to project managers and interacting with vendors to facilitate 

the development and implementation of PPE. 

This project will develop recommendations 

that will improve protection against primary 

neurosensory blast injury. 

Partners

y USAARL

y Program Executive Office Soldier

y Alabama National Guard EOD Unit

y Fort Rucker Range Control

Bone Image Analysis

Description

BAMPack is a novel software tool that integrates bone image analysis with database storage of 

results. Instead of reducing bone density to a single number, BAMPack allows for a detailed regional 

analysis of images, revealing the subtle changes that otherwise would have gone unnoticed. The 

changes in the architecture of the cortical bone can have profound implications for bone strength and 

injury potential. BAMPack can also efficiently handle batch analysis of the many images that are generated by protocols with large cohorts such as those involving military recruits. Its uniform and robust 

algorithm for segmentation, alignment, and rotation means it can be used to pool data from images 

collected from various Bone Health and Military Medical Readiness Program-sponsored research 

protocols. It is the ideal tool for analysis of images, such as those from the tibia bone, and retrieval of 

results arising from cross-sectional and longitudinal studies involving noninvasive imaging.

Partners

y USARIEM

y L-3 Communications/Jaycor

3-54

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Eye Injury Field Therapy Kit

Description

The Eye Injury Field Therapy Kit will contain comprehensive diagnostic tools and treatment strategies for laser-induced eye injury. Military lasers can produce eye injuries at tactical ranges resulting 

in immediate visual impairment or blindness. Diagnosis of visual dysfunction from blast or mild TBI 

in the absence of observable ocular injury (lacerations and fragment injury) often is delayed due to 

triage of urgent wounds. The Eye Injury Field Therapy Kit will provide the combat medic with the tools 

to rapidly diagnose and treat laser eye injuries to minimize vision loss.

Current research evaluates enhancements to the high-contrast, achromatic Aidman Vision Screener 

by utilizing contrast and chromatic targets to characterize visual dysfunction. Research has characterized the relative efficacy of selected steroids and nonsteroidal anti-inflammatory drugs for specific 

retinal injury taxonomies for both highly localized thermal and thermal-mechanical injury to the retina 

from laser radiation. Other neuroprotective agents are being investigated to minimize secondary 

effects of laser-induced retinal trauma. Advanced ocular imaging technologies and assessments 

of visual function (such as the multifocal electroretinogram and spectral domain ocular coherence 

tomography) are used to characterize the efficacy of the intervention. 

Depending on the taxonomy of the injury (visual dysfunction, laser dose, location within the retina, 

proximity to other lesions, etc.), primary and secondary effects include retinal burn, retinal and vitreous hemorrhage, retinal hole formation, inter-retinal scar formation, choroidal neovascularization, 

retinal nerve fiber degeneration remote from the lesion site, retinal traction, and proliferative vitreoretinopathy. Treatment strategies based on the injury taxonomy provided by the Eye Injury Field 

Therapy Kit will minimize visual impairment from battlefield eye injury. 

Partners

y USAISR

Physical Activity Data Logger

Description

An alpha-version of PATracker, which is a 

smartphone application running on Android 

OS, has been developed to allow researchers 

to log physical and other activities performed 

by recruits during basic combat training. 

It can track the type, intensity, and other 

parameters associated with all resting and 

exercise-related activities over the course of 

an entire day. The desktop application allows 

the user to store, view, and analyze data. 

The alpha-version has been field tested and 

will be used in prospective studies to collect 

quality training data. Future versions of the 

software will improve software functions per 

user feedback and explore the integration 

with ambulatory sensor systems to record 

high-resolution activity data. 

Partners

y USARIEM

y L-3 Communications/Jaycor

3-55
Training, Overuse Injury, and Performance Modeling

Description

The physical demands of basic training, while designed to enable recruits to pass the Army fitness 

and body composition standards, are associated with a high prevalence of musculoskeletal injury. 

These injuries result in lost duty time, medical costs, loss of manpower, and even separation from the 

service. A large number of empirical studies have been conducted to evaluate the effects of various 

physical training programs, as well as other factors, on the development of fitness and the occurrence 

of musculoskeletal injury. The goal is to develop a statistical mathematical “computational” model 

that can be used to predict the physical performance capabilities and the potential for musculoskeletal injury for a given individual based on medical history and the physical training program being 

applied.

The first version of Training, Overuse Injury, and Performance (TOP) computational models have 

been developed based on statistical and biomechanical analysis of performance and injury data from 

standardized Army training programs. The TOP models have the potential to identify individuals who 

either are at extreme risk for musculoskeletal injury or unlikely to pass the Army fitness standards. 

The models also can allow elements of the physical training program, such as running mileage, to be 

varied to minimize injury while at the same time enable an individual to attain the required performance standards. The models are implemented in both a web-based application and a client application to help Soldiers succeed in finishing by providing software solutions during the recruitment phase 

and at the beginning of and during basic combat training. The models also are being improved by 

further data collection and analysis and will be validated by prospective studies.

Partners

y USARIEM

INJURY PREVENTION AND 

REDUCTION

COMPLETED | PROMISING | FUTURE

Repeated Shock and Vibration 

Limits for Trauma Patients

Description

This project will characterize shock and vibration in common medical transport vehicles 

using simulated patients, determine doseresponse relationships, develop transmissivity functions in healthy humans, and then 

develop shock and vibration standards for 

trauma patients. These outcomes will provide 

combat medical system designers with 

necessary criteria to ensure safe transport for 

wounded Warfighters.

Partners

y USAARL

3-56

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Warrior Injury Assessment Manikin

Description

This product will develop a new Anthropomorphic Test Device (ATD) that will assess injury probability 

in the current military-unique combat environment. ATDs currently used in military vehicle tests were 

designed for civilian automotive crash tests and are not specific or relevant to the common injuryproducing mechanisms encountered in current combat operations. Automotive ATDs were designed 

for frontal, rearward, and side impacts not to provide valid biomechanical responses to the primarily 

vertical loading events found in current threat scenarios. This effort will develop operationally specific 

vertical impact response corridors, mathematical models, and mechanical surrogates suitable for 

performing injury risk assessment in military environments.

Partners

y USAARL 

y Army Research Laboratory

y Tank and Automotive Command

y Denton ATD

COMPLETED | PROMISING | FUTURE

3-57
Determinants of Soldier Risky Behavior Post-Deployment

Description

Anecdotally reported cases have suggested an increase in risky behaviors exhibited by Soldiers following deployment. It is unknown if these changes are real or if the changes are due to factors such 

as combat experiences, demographic variables, cognitive abilities, or experiencing mild TBI or PTSD 

during deployment.

Operation Iraqi Freedom and Operation Enduring Freedom have been supported by more than 1 million deployed U.S. Soldiers in recent years. Often, the conditions under which these Soldiers carry 

out their missions are of high stress both physically and psychologically. Soldiers will be surveyed 

both before and after deployment to determine if any of the previously discussed factors influence 

increases in risk propensity following deployment. Results may suggest better post-deployment training for Soldiers to decrease risk-taking behavior.

Partners

y USAARL

PSYCHOLOGICAL HEALTH AND 

RESILIENCE

COMPLETED | PROMISING | FUTURE

3-58

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Genetic, Proteomic, and Neurobehavioral Determinants of Deployment-Related 

Psychological Health Disorders and Traumatic Brain Injury

Description

With the increase of reported TBI and PTSD cases found in Soldiers following deployment, it is important to determine a neurobiological basis for these conditions. To this end, it is necessary to identify 

biomarkers that predict neurocognitive deficits as a result of combat experience.

Changes in plasma proteomic profiles in Soldiers will be compared to cognitive control and mood 

scores at both pre- and post-deployment stages. In addition, pre-deployment cognitive control will be 

correlated with post-deployment psychological health outcomes. Finally, variability at genetic loci will 

be associated with both the development of PTSD and post-concussive syndrome symptom severity 

following mild TBI.

Partners

y USAARL 

COMPLETED | PROMISING | FUTURE

3-59
Assessment of Mild Traumatic Brain Injury Through Modeling of Central 

Nervous System Indices

Description

The goal of this project is to develop models to predict the occurrence and persistence of mild TBI 

using data collected with field-expedient methodologies. Models will be developed to predict the 

occurrence and persistence of mild TBI from data using relatively simple methods that can be used 

in the field. Event-related potentials of electroencephalogram and functional near-infrared spectroscopy will be used to train mild TBI diagnostic models. The research will initially determine subclinical 

consequences of head trauma experienced during military duty under controlled laboratory conditions. Models will be developed and validated using laboratory data. Training of the model will be 

done using the data collected during the initial study phases. The final model will consist of the fully 

trained classification algorithm. The intention will be to produce a streamlined product that enables 

the individual and test administrator to quickly make a diagnosis while minimizing error.

Partners

y USARIEM

y WRAIR

PHYSIOLOGICAL HEALTH

COMPLETED | PROMISING | FUTURE

3-60

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Cognitive Readiness/Fatigue Modeling

Description

The Walter Reed Sleep Performance Model (WRAIR SPM) predicts cognitive effectiveness based on 

the two factors exerting the greatest impact on cognitive effectiveness: sleep/wake history and time 

of day. Refinements are currently under development to (1) individualize model predictions based 

on obtained sleep/wake amounts (measured using the Sleep Watch) and actual cognitive readiness 

(measured using the PDA Psychomotor Vigilance Task) and (2) optimize predictions to account for 

use of psychoactive compounds (e.g., caffeine). The WRAIR SPM is integrated into the Sleep Watch 

for online, real-time cognitive effectiveness estimation and is being integrated into the Defense Safety 

Oversight Council-sponsored AMMO system for mission planning and fatigue risk management.

The AMMO system is a flexible, laptop-based software program that allows the user to (1) prospectively forecast cognitive readiness based on a given mission schedule (from which sleep/wake is 

then estimated), (2) generate real-time optimizations of personnel work/sleep scheduling to support a 

given mission, and (3) retrospectively reconstruct cognitive effectiveness level based on a known or 

estimated sleep/wake schedule associated with an event (e.g., accident reconstruction).

Partners

y WRAIR

y TATRC

y Air National Guard

y Defense Safety Oversight Council

COMPLETED | PROMISING | FUTURE

Dietary Supplement Research

Description

More than one-half of military personnel regularly use dietary supplements. The safety and 

efficacy of dietary supplements are not adequately assessed by any government agency. 

No DoD process exists to identify potential 

adverse health events associated with dietary 

supplement use by military personnel and to 

evaluate health risks and benefits of dietary 

supplements. This new program will develop 

standardized, evidence-based processes for 

evaluating health risk and safety of dietary 

supplements and for rapidly evaluating 

efficacy of dietary supplements for enhancing 

operational readiness.

Partners

y USARIEM

y Office of the Secretary of Defense for 

Health Affairs

y Uniformed Services University of the Health 

Sciences

3-61
Finite Element Thermoregulatory Model

Description

The Finite Element Thermoregulatory Model (FETM) will serve as a foundation to inform future 

development of textiles, clothing ensemble, and architectures for individual protection as well as 

enabling other complex analyses. Magnetic resonance imaging and computed tomography data 

of the human body, obtained from the National Library of Medicine’s Visible Human Project, will be 

coupled with three-dimensional body surface scans to create a general model. This general model 

will be morphed to individual anthropometrics and imbued with thermoregulatory characteristics, such 

as metabolic heat production, circulation, and sweating. The final model will be a tool to analyze and 

predict individual thermoregulatory responses to novel protective clothing designs, physical activity, 

and harsh and asymmetric environmental conditions, such as those found in extreme mountainous 

terrain or in hot military vehicles. This FETM will improve the ability to predict individual responses 

to military missions and support the development of clothing and individual protective equipment that 

has a minimal thermal impact on Warfighters.

Partners

y USARIEM

PHYSIOLOGICAL HEALTH

COMPLETED | PROMISING | FUTURE

3-62

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Guidance on Using Stimulant and Sleep-Inducing Agents Under Operational Conditions

Description

Guidance is needed regarding the “what/when/how much/how long” for safe and appropriate use of (1) prescription (modafinil – Provigil®) and over-the-counter (caffeine – Stay-Alert® gum) stimulants to sustain cognitive readiness during unavoidable sleep loss associated with continuous and sustained operations 

and (2) prescription sleep-inducing agents (zolpidem – Ambien®; zaleplon – Sonata®) to induce restorative sleep under operational conditions—requirements 

unique to the military.

Stimulants. Results of research indicate no advantage to dextroamphetamine (a Schedule II compound) over modafinil (a Schedule IV compound) and suggest that modafinil should replace dextroamphetamine as the prescription stimulant of choice for operational use. Ongoing research is focused on determining whether modafinil possesses any advantage over nonprescription caffeine. Of specific interest is the extent to which modafinil and caffeine restore sleep 

loss-induced impairments in judgment, decision making, appropriate risk taking, planning, and other operationally relevant cognitive capabilities. Other issues 

addressed include potential development of tolerance and operationally relevant side effects (to include impairment of subsequent sleep). 

Sleep-inducing agents. Research results indicate that, with the exception of possessing shorter half-lives, there is no advantage of non-benzodiazepine 

compounds, such as zolpidem, zaleplon, and eszopiclone, over traditional benzodiazepines, such as temazepam, in terms of risk of operationally relevant 

impairment upon abrupt awakening from drug-induced sleep. Ongoing and future research will address whether newly available compounds possessing 

novel mechanisms of action (e.g., hypocretin/orexin antagonist, 5-HT2A receptor antagonists, and GABAergic agonists) possess advantages over currently 

available benzodiazepine receptor agonists (i.e., zolpidem, zaleplon, eszopiclone, and temazepam). 

Partners

y WRAIR

y University of California, San Francisco

y SRI International

3-63
PDA-Based Psychomotor Vigilance Task 

Description

The PDA-Based Psychomotor Vigilance Task (PVT) is a fieldable implementation of the gold standard 

10-minute PVT, a simple one-choice reaction time task that is easily administered and sensitive to 

even small amounts of sleep restriction. The PDA PVT allows for noninvasive, rapid, and relatively 

unobtrusive assessment of cognitive readiness. The results of this rapid assessment of each individual service member’s extant cognitive readiness level can be used by commanders to gauge the 

extent of cognitive restoration following short sleep opportunities or stimulant administration. Results 

show that the PVT is the most sensitive and reliable metric for detecting and quantifying impairments 

due to even mild amounts of sleep restriction—and in advance of frank errors and accidents. PVT 

output can be input to the WRAIR SPM to individualize the model thus yielding highly accurate, 

real-time estimates of individual cognitive readiness status. Ongoing work links PVT metrics to the 

capacity for rapid, correct decision making and other mental operations that enable a service member 

to recognize and capitalize on emergent battlefield opportunities. 

Partners

y WRAIR 

PHYSIOLOGICAL HEALTH

COMPLETED | PROMISING | FUTURE

3-64

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

SPARNET – Spartan Network

Description

The purpose of the SPARNET system is to increase medical awareness and situational awareness 

during training. USARIEM, in partnership with MOMRP and TATRC, is guiding the development of 

personal and squad-area data network technologies to improve remote medical and situational awareness during higher risk training activities. To meet this objective, integrated systems are being developed that will capture, analyze, communicate, display, and archive geo-location and physiological 

sensor data. The main system elements are a Warfighter-worn Spartan Network (SPARNET), which 

includes a squad-area network radio for student-to-instructor data communication, and a Personal 

Area Network (PAN) for on-body data communication. The PAN radio is inductively linked, minimalist, and modular with processing capabilities for use with sensor systems such as the Physiological 

Status Monitor. The use of inductive data transmission minimizes cross-talk and detectability due to 

the rapid attenuation of the modulated magnetic field that carries data. SPARNET enables continuous monitoring of a Warfighter trainee’s geo-location and health status during field training to improve 

force health protection.

Partners

y MOMRP

y TATRC

y USARIEM

Remote Physiological Status Monitor

Description

The Remote Physiological Status Monitor 

(RPSM) is a Soldier-worn device that 

integrates physiological status monitoring 

with situational awareness to enable remote 

monitoring of enabled Soldiers. Product fielding is managed and funded by PEO Soldier 

with assistance from PM, Medical Support 

Systems. RPSM is a Nett Warrior additional 

attribute, which is planned to be fielded with 

Nett Warrior Increment 2 requirements in 

2017. It communicates occurrence, location, 

activity, and limited physiologic data. The 

RPSM improves commander/medic response 

time and helps limit medics’ exposure time to 

reach Soldiers who demonstrate absence of 

life signs. Immediate detection of injuries with 

the initiation of first aid measures will improve 

the likelihood of Soldier survival after injury.

Partners

y USARIEM

y Welch Allyn

y QinetiQ

y Zephyr

3-65
ENVIRONMENTAL HEALTH AND 

PROTECTION

COMPLETED | PROMISING | FUTURE

Diagnosing and Preventing Non-Freezing Cold Injury

Description

Medical diagnostic tests, biomarkers for susceptibility, and focused microclimate heating will be developed to identify cases of non-freezing cold injury (NFCI), prevent NFCI, and maintain manual dexterity 

during cold weather operations.

The Afghanistan theater is the first U.S. military extreme cold weather operation since World War II 

and Korea, and it is anticipated that NFCIs again will become a significant U.S. military medical problem. Current medical diagnosis of NFCI is based on medical history with no validated, quantitative 

clinical test available. Even with sophisticated cold weather clothing systems, susceptible Soldiers 

still suffer from debilitating NFCIs. Identifying those Soldiers most at risk of NFCI before training and 

deployment will decrease the number of injuries sustained. Finally, with Soldiers fighting on a digital 

battlefield, sustainment of manual dexterity will be critical to maintaining combat effectiveness. The 

deployability, readiness, and sustainability of operations under cold weather conditions will increase 

with the products from this effort. These research products will include a quantitative medical test for 

differentially diagnosing NFCI, identification of sensitive biomarkers that predict those Soldier’s most 

susceptible to NFCI, and development of focused microclimate heating strategies to improve manual 

dexterity and protect Soldiers from NFCI.

Partners

y USARIEM

y Massachusetts Institute of Technology

y United Kingdom Ministry of Defence

3-66

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Environmental Sentinel Biomonitor System

Description

Providing drinking water to deployed troops can use a large fraction of available transportation assets. 

Although decentralized water production could reduce the transportation burden, it will be difficult to 

ensure that water produced in many diverse locations is safe to drink in view of the many toxic industrial contaminants that may be present in water and the limited number of such chemicals that can be 

rapidly detected in the field.

Evaluating the overall toxicity of a water sample provides an alternative to identifying a large number 

of individual chemicals. The Environmental Sentinel Biomonitor (ESB) system uses biologically based 

sensors to rapidly identify the toxicity associated with many different classes of chemicals thus providing a warning of potential harm that can trigger appropriate risk management actions.

Potential ESB system applications include in rear areas and at garrison facilities, such as water treatment 

plants, at field water production facilities that use equipment including the Tactical Water Purification 

System, in Future Combat Systems manned ground vehicles to evaluate water produced by onboard 

water generation equipment, and by individual service members in the field (e.g., Special Forces).

A prototype ESB system for use in rear areas and at garrison facilities was delivered in 2008. 

Increment 2 of the ESB reached Milestone A in March 2009 and is scheduled for completion in 2014. 

Partners

y USACEHR

y USAMMDA

y Directorate of Combat and Doctrine 

Development

y Edgewood Chemical Biological Center

y USACHPPM

y OTSG

y Agaue Biosystems

y ANP Technologies

3-67
Heat Injury/Stroke Treatment and Return to Duty

Description

Heat injury/stroke (HIS) is a significant challenge for the U.S. Armed Forces. There are currently no 

validated pharmacologic treatments to mitigate the adverse consequences of HIS and ensure recovery. Criteria for return-to-duty guidelines lack sound scientific evidence.

Using rodent models of HIS, alternative therapies and pharmacological treatments will be studied to 

address these gaps in knowledge. The rodent models to be used accurately simulate human HIS 

responses and allow for determination of the efficacy of current over-the-counter medications as well 

as novel drugs in clinical trials. Determining the effectiveness of these HIS therapeutics will help 

mitigate the acute and long-term effects from HIS, including disturbances in thermoregulatory, cardiovascular, and immune system physiology. In-depth, molecular-level analyses of HIS tissues will allow 

for the identification of characteristic gene expression patterns that provide insight into molecular-level 

markers that can be tested for their ability to monitor HIS recovery. Collectively, advances in the field 

of HIS will improve Warfighter performance, long-term health, and provide sound scientific data for 

establishing return-to-duty criteria.

Partners

y USARIEM

ENVIRONMENTAL HEALTH AND 

PROTECTION

COMPLETED | PROMISING | FUTURE

3-68

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Hydration Status Monitoring

Description

This research effort began with definitive laboratory work to understand biological variation in hydration assessment measures and to establish a gold standard marker against which future technologies 

could be evaluated. USARIEM is now in the process of developing, testing, and comparing three 

prototype noninvasive human hydration sensors designed to be simple, field portable, use little power, 

and provide a valid measure of body hydration levels when compared to the gold standard. The 

technology will allow hydration status assessment across all roles of military care and will distinguish 

between fluid and fluid-electrolyte losses. The prevention and proper treatment of hydration problems 

would be improved in many medical military scenarios. The insertion of a noninvasive hydration 

sensor into existing medical equipment sets would improve hydration management by squad leaders 

during pre-combat checks (prevention), by medics in theater (point of care), and by medical personnel 

in the rear roles of care (treatment and return to duty).

Partners

y USARIEM

3-69
Pathology of Heat and Cold Injury

Description

Rapid deployment and sustained operations of the Warfighter at thermal extremes can compromise 

performance, prevent mission goals, and increase non-combat casualties. Prevention of non-combat 

casualties only can be realized with knowledge-based enhancement of the complex mechanisms that 

mediate thermal injury. During the past 20 years, the U.S. Army has seen an eightfold increase in 

heat stroke hospitalization rates while the hospitalization rate for heat illness has decreased markedly. 

The development of cellular and animal models of heat injury and exertional hypothermia permits the 

study of militarily relevant issues associated with environmental extremes under thermal conditions 

that are too dangerous to study in human volunteers. Elucidation of the mechanisms of thermal injury 

will lead to novel strategies to enhance and sustain Warfighter performance and health in hot and cold 

environments. 

Partners

y USARIEM

ENVIRONMENTAL HEALTH AND 

PROTECTION

COMPLETED | PROMISING | FUTURE

3-70

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
3-71
1. Adam GE, Carter R, et al. Hydration effects 

on cognitive performance during military 

tasks in temperate and cold environments. 

Physiol Behav, 2008.

2. Adam GE, Cheuvront SN, Merullo D, 

Castellani JW, Lieberman HR, and Sawka 

MN. Hydration effects on cognitive performance in cold and temperate environments. 

Physiol Behav, 93, 748-756, 2008.

3. Adam GE, Fulco CF, et al. Multi-task 

performance at sea-level and high altitude. 

Proceedings of the 26th Army Science 

Conference, 2008.

4. Adler AB, Bliese PB, McGurk D, Hoge 

CW, and Castro CA. Battlemind debriefing 

and battlemind training as early interventions with soldiers returning from Iraq: 

Randomization by platoon. J Consult Clin 

Psychol, 2009.

5. Adler AB, Castro CA, and McGurk D. Timedriven battlemind psychological debriefing: A 

group-level early intervention in combat. Mil 

Med, 2009.

6. Adler AB, Cawkill P, van den Berg C, Arvers 

P, Puente J, and Cuvelier Y. International 

military leader’s survey on operational 

stress. Mil Med, 2008.

7. Adler AB, Litz BT, Castro CA, Suvak M, 

Thomas JL, Burrell L, McGurk D, Wright KM, 

and Bliese PD. Group randomized trial of 

critical incident stress debriefing provided to 

US peacekeepers. J Traumatic Stress, 2008.

PUBLICATIONS

8. Adler AB, Wright KM, Bliese PD, Eckford R, 

and Hoge CW. A2 diagnostic criterion for 

combat-related posttraumatic stress disorder. 

J Traumatic Stress, 2008.

9. Alemany JA, Nindl BC, et al. Effects of 

dietary protein content on IGF-I, testosterone, and body composition during 8 days of 

severe energy deficit and arduous physical 

activity. J Appl Physiol, 2008.

10. Antczak AJ and Brininger TL. Diagnosed 

eating disorders in the U.S. Military: A nine 

year review. Eating Disorders: The Journal of 

Treatment and Prevention, 2008.

11. Antczak AJ, Evans RK, et al. Relationship 

between vitamin A consumption and stress 

fracture risk in female military recruits. 

NEACSM, 2009.

12. Antczak AJ, Evans RK, et al. Relationships 

between vitamin A consumption and stress 

fracture risk in female military recruits. 

NEACSM, 2008.

13. Arbel Y, Yanovich R, et al. Lifestyle before 

recruitment and stress fracture occurrence 

during 12 months of strenuous training. 

ICEE, 2009.

14. Arciero PJ, Gentile CL, et al. Increased 

dietary protein improves total and regional 

body composition and insulin sensitivity in 

overweight adults. Metabolism, 2008.

15. Baggish A, Fulco CS, Muza SR, Rock PB, 

Beidleman BA, Cymerman A, Yared K, 

Fagenholz P, Systrom D, Wood MJ, Weyman 

AE, Picard MH, and Harris NS. The impact 

of moderate altitude staging on pulmonary 

arterial hemodynamics after ascent to high 

altitude. High Altitude Medicine and Biology,

In Press, 2010.

16. Baggish AL, Yared K, Weiner RB, Francis 

W, Demes R, Pickard MH, Hagerman F, and 

Wood MJ. Differences in cardiac parameters 

among elite rowers and sub-elite rowers. 

Med Sci Sports Exerc, 42, 1215-1220, 2010.

17. Bannon DI, Parsons PJ, Centeno JA, Lal 

S, Xu H, Rosencrance AB, Dennis WE, 

and Johnson MS. Lead and copper in 

pigeons (Columia livia) exposed to a small 

arms—range soil. Arch Environ Contam 

Toxicol, 10:1007, 2010. DOI: 10:1007/

s00244-010-9540-3.

18. Bedekar A. A Microfluidic System for Affinity 

Reagent Generation and Assay Development 

for High-Throughput Biomarker Validation. 

USAMRMC Technical Report W81XWH08-C-0019, Fort Detrick, MD, June 2008, 

ADB343507.

19. Beidleman BA, Fulco CS, Muza SR, Rock 

PB, Staab JE, Forte VA, Brothers MD, and 

Cymerman A. Effect of six days of staging on 

physiologic adjustments and acute mountain 

sickness during ascent to 4300 M. High 

Altitude Medicine & Biology, 10, 253-260, 

2009.

3-72

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
20. Beidleman BA, Muza SR, Fulco CS, 

Cymerman A, Sawka MN, Lewis SF and 

Skrinar GS. Seven intermittent exposures 

to altitude in nine days improves time-trial 

exercise performance at 4300 M. Med Sci 

Sports Exerc, 40, 141-148, 2008.

21. Beidleman BA, Muza SR, Fulco CS, Jones 

J, Lammi E, Staab JE, and Cymerman A. 

Intermittent hypoxic exposure does not 

improve endurance performance at altitude. 

Med Sci Sports Exerc, 41, 1317-1325, 2009.

22. Bell NS, Schwartz CE, et al. The changing 

profile of disability in the U.S. Army. Disability 

and Health Journal, 2008.

23. Berglund L and Yokota M. Real-time noninvasive heat strain prediction model. SAE 

Transactions, 2008.

24. Berglund LG, Endrusick T, Yokota M, 

and Santee W. Portable Protective Dog 

Enclosure and Its Thermal Effects on the 

Animal. Proceedings of the 13th International 

Conference on Environmental Ergonomics 

(ICEE) meeting in Boston 2009. 

25. Blaha MD and Leon LR. Effects of indomethacin and buprenorphine analgesia on 

the postoperative recovery of mice. Journal 

of the American Association for Laboratory 

Animal Science, 47, 8-19, 2008.

26. Blanchard LA and Santee WR. Comparison 

of USARIEM Heat Strain Decision Aid to 

Mobile Decision Aid and Standard Army 

Guidelines for Warm Weather Training. 

USARIEM Technical Report No. T08/07, 

2008.

27. Bliese PD, Wright KM, Adler AB, Cabrera 

O, Castro CA, and Hoge CW. Validating 

the PC-PTSD and the PTSD checklist with 

soldiers returning from combat. Journal of 

Consulting and Clinical Psychology, 2008.

28. Bliese PD, Wright KM, Adler AB, Cabrera 

O, Castro CA, and Hoge, CW. Validating the 

primary care posttraumatic stress disorder 

screen and the posttraumatic stress disorder 

checklist with Soldiers returning from 

combat. Journal of Consulting and Clinical 

Psychology, 76(2), 272-281, 2008.

29. Bliese PD, Wright KM, and Hoge CW. 

Screening for mental health problems as a 

preventive mental health program. In press. 

In AB Adler, PD Bliese, and CA Castro 

(Eds.). Deployment Psychology: The Impact 

of Combat on Mental Health. Washington, 

DC: American Psychological Association, 

2010.

30. Boye M. Rapid assessment of eye injuries on 

the battlefield. National Defense University 

Press, 2010.

31. Boyko EJ, Jacobson IG, Smith B, Ryan 

MAK, Hooper TI, Amoroso PJ, Gackstetter 

GD, Barrett-Connor E, and Smith TC for 

the Millennium Cohort Study Team. Risk of 

diabetes in U.S. military service members in 

relation to combat deployment and mental 

health. Diabetes Care, 2010.

32. Brestoff JR, Clippinger B, et al. An acute 

bout of endurance exercise but not sprint 

interval exercise enhances insulin sensitivity. 

Appl Physiol Nutr Metab, 2009.

33. Brininger TL, Antczak AJ, et al. Upper 

extremity injuries in the U.S. military during 

peacetime years and wartime years. J Hand 

Ther, 2008.

34. Britt TW, Greene-Shortridge TM, Brink S, 

Nguyen QB, Rath J, Cox AL, Hoge CW, and 

Castro CA. Perceived stigma and barriers to care for psychological treatment: 

Implications for reactions to stressors in different contexts. Journal of Social and Clinical 

Psychology, 2008.

35. Brunye TT, Lieberman HR, et al. Caffeine 

modulates attention network function. Brain 

Cogn, 2009.

36. Buehler SS and Gregg AM. Comparative 

Analysis of Enzymatic Test Kits for Detecting 

Pesticides in Drinking Water—Methods 

Modification Testing. USAMRMC Technical 

Report W81XWH-05-D-0001, Fort Detrick, 

MD, June 2009, ADB350851.

37. Buller MJ. Chapter 2 – Systems Architecture. 

NATO HFM-132-RTG Technical Report, 

2008.

38. Buller MJ, Latzka WA, Yokota M, Tharion 

WJ, and Moran DS. A real-time heat strain 

risk classifier using heart rate and skin 

temperature. Physiological Measurement 

Journal, 2008.

39. Buller MJ, Tatbul N, Tharion WJ, Karis AJ, 

Herbert NJ, Mullen S, Zdonik S, and Hoyt 

RW. A confidence-based body-sensor 

network information management strategy 

for ambulatory health state monitoring 

applications. IEEE Transactions. Information 

Technology in Biomedicine, 2009.

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40. Buller MJ, Tharion WJ, Hoyt RW, and 

Jenkins OC. Estimation of Human Internal 

Temperature from Wearable Physiological 

Sensors. Proceedings of the TwentySecond Innovative Applications of Artificial 

Intelligence Conference (IAAI-10), Atlanta, 

GA, 2010.

41. Buller MJ, Wallis DC, Karis AJ, Herbert NJ, 

Cadarette BS, Blanchard LA, Amin MM, 

DiFilippo JL, Economos D, Hoyt RW, and 

Richter MW. Thermal-Work Strain During 

Marine Rifle Squad Operations in Iraq 

(Summer 2008). USARIEM Technical Report 

No. T09/01, 2008.

42. Cabrera OA, Bliese PD, Hoge CW, Castro 

CA, and Messer SC. Aggressiveness and 

perceived marital quality: The moderating 

role of a family-supportive work climate. 

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43. Cadarette BS, Chinevere TD, Ely B, 

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Sawka MN. Physiological Responses to 

Exercise-Heat Stress with Prototype Pulsed 

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Report T08-12, U.S. Army Research Institute 

of Environmental Medicine, Natick, MA, 

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44. Carlson LA, Headley S, DeBruin J, Tuckow 

AP, Marelli BS, Koch AJ, and Kenefick RW. 

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45. Carter R. Exertional heat illness and hyponatremia: An epidemiological prospective. Curr 

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46. Carter R and Watenpaugh DE. Obesity and 

obstructive sleep apnea: Or is it OSA and 

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47. Castellani JW, Carter R, Adam G, and 

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48. Castellani JW, Carter R, et al. Hypohydration 

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49. Castellani JW, Mahoney C, and O’Brien 

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50. Castellani JW, Sawka MN, DeGroot DW, and 

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51. Chan P, MacFadden L, Dang X, Ho K, 

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Study of Material Effects on Blast Lung Injury 

Using Normalized Work Method. Presented 

at the PASS 2010, Quebec City, Canada, 

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52. Cheatham RA, Lieberman HR, et al. 

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glycemic load energy diets on mood and 

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53. Cheuvront SN, Bearden SE, Kenefick RW, 

Ely BR, DeGroot DW, Sawka MN, and 

Montain SJ. A simple and valid method 

to determine thermoregulatory sweating 

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54. Cheuvront SN, Chinevere TD, Ely BR, 

Kenefick RW, Goodman DA, McClung JP, 

and Sawka MN. Serum S100 response to 

moderate exercise-heat strain before and 

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55. Cheuvront SN, Ely BR, Kenefick RW, 

Michniak-Kohn BB, Rood JC, and Sawka 

MN. No effect of nutritional adenosine receptor antagonists on exercise performance in 

the heat. American Journal of Physiology,

296, R394-R401, 2009.

56. Cheuvront SN, Goodman DA, Kenefick 

RW, Montain SJ, Blanchard L, and Sawka 

MN. Impact of a protective vest and spacer 

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57. Cheuvront SN, Kenefick RW, Ely BR, 

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Nindl BC, and Sawka MN. Hypohydration 

reduces vertical ground reaction impulse but 

not jump performance. European Journal of 

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58. Cheuvront SN, Kenefick RW, et al. Negative 

effects of dehydration on vertical jump are 

masked by a lower body mass. European 

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59. Cheuvront SN, Montain S, Stephenson LA, 

and Sawka MN. Skin Temperature Feedback 

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and Decreases Required Microclimate 

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Advanced 

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Infectious 

Diseases

Combat 

Casualty

Care
Enhancement for NATO Military Operations 

(Science, Technology, and Ethics) HFM-181 

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60. Cheuvront SN, Montain SJ, Stephenson 

LA, and Sawka MN. Optimization of Liquid 

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of Skin Temperature. Proceedings of the 13th 

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61. Chinevere TD, Cadarette BS, Goodman 

DA, Ely BR, Cheuvront SN, and Sawka 

MN. Efficacy of body ventilation system for 

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62. Chinevere TD, Kenefick RW, Cheuvront SN, 

Lukaski HC, and Sawka MN. Effect of heat 

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63. Costanzo DL, Pfluger PT, Dougherty MK, 

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65. Crocker GH, Hayes MV, Jones EM, Nye 

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66. Crocker GH, Hayes MV, Weems RE, and 

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Jaycor.

67. Cuddy JS, Rudy BC, Santee WR, and 

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68. Curtis TM, Tabb J, Romeo L, Schwager 

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73. Edwards DG, Mastin CR, and Kenefick RW. 

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79. Erlich T, Sawka M, Hadid A, Ben-Ari O, 

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85. Evans RK, Negus CH, Antczak AJ, Spiering 

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96. Goldman SB, Brininger TL, et al. Clinical 

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140. Kenefick RW, Cheuvront SN, Palombo LJ, 

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143. Killgore WD, Cotting DI, Thomas JL, Cox 

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152. LeardMann CL, Smith B, and Ryan MAK. 

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to hot and cold environments. Physiological 

Basis of Human Performance During Work 

and Exercise. N Taylor, H Groeller, and 

S McLennan, eds. Elsevier Ltd.: Oxford, 

Chapter 21, pp. 379-400, 2008.

295. Toxicology Excellence for Risk Assessment 

(TERA). Derivation of Human Lethal Doses. 

USACEHR Technical Report 0802, Fort 

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296. Trader DE. The Effects of Dechlorination 

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Pentachlorophenol and Copper Sulfate on 

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Report. Hood College, MD, 2008.

297. Trader DE, Gargan TP II, and van der 

Schalie WH. An Evaluation of the Abraxis 

Organophosphate/Carbamate Screen Test. 

USACEHR Technical Report 0901, Fort 

Detrick, MD, June 2009, ADB351100.

298. Trader DE and van der Schalie 

WH. An Evaluation of the ECLOX 

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299. Tucker JS, Sinclair RR, Mohr CD, Adler AB, 

Thomas JL, and Salvi AD. Stress and counterproductive behavior: Multiple relationships 

between demands, control, and soldier indiscipline over time. Journal of Occupational 

Health Psychology, 2009.

300. Tucker JS, Sinclair RR, Mohr CD, Adler AB, 

Thomas JL, and Salvi AD. A temporal investigation of the direct, interactive, and reverse 

relations between demand and control and 

affective strain. Work & Stress, 2008.

301. Urso ML and Pierce JR. Chronic exercise 

training alaters the matrix metalloprotease 

response to an acute bout of high intensity 

exercise. European Journal of Applied 

Physiology, 2009.

302. van der Schalie WH, Brennan LM, Gargan 

TP II, Shedd TR, Trader DE, Vallejo Y, 

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2008, ADB345562.

303. Vasterling JJ, Proctor SP, et al. PTSD symptom increases in Iraq-deployed soldiers: 

Comparison with non-deployed soldiers 

and associations with baseline symptoms, 

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304. Vasterling JJ, Schumm J, et al. PTSD and 

health functioning in a non-treatment seeking 

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analysis. J Rehab Res Develop, 2008.

305. Vincellette RL, Rockwell BA, Thomas RJ, 

Lund DJ, and Welsch AJ. Thermal lensing in 

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Optics, 2008.

306. Vogt DS, Proctor SP, et al. Validation 

of scales from the deployment risk and 

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Assessment, 2008.

307. Wang F. Highly Sensitive Hand-Held Device 

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Technical Report W81XWH-09-C-0037, 

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308. Wang HC, Brown J, Alayon H, and Stuck BE. 

Transplantation of quantum dot-labeled bone 

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Vision Research, 2009.

309. Wang HC, Muniz A, Clarkson DR, Alayon 

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Stuck BE. In vivo imaging of retinal structure 

with spectral domain optical coherence 

tomography in a mouse model of n-methyln-nitrosourea-induced retinal degeneration. Investigative Ophthalmology & Visual 

Science (Abstract), 2010.

310. Wang HCH, Yarbrough H, Clarkson DR, 

Schuschereba ST, and Stuck BE. NF-B 

activation in laser-induced retinal injury in 

rabbits. Investigative Ophthalmology & Visual 

Science (Abstract), 2008.

311. Wang HCH, Yarbrough HD, Golden DJ, 

Alayon H, Brown J Jr, and Stuck BE. 

Transplantation of quantum dot-labeled bone 

marrow-derived stem cells in a mouse model 

of laser-induced retinal trauma. Investigative 

Ophthalmology & Visual Science (Abstract), 

2009.

312. Wang S, Ramachandran A, and Ja S. 

Integrated microring resonator biosensors for 

monitoring cell growth and detection of toxic 

chemicals in water. Biosens Bioelectron,

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313. Wang Z, Yang H, Zhang F, Pan Z, CapóAponte JE, and Reinach PS. Dependence of 

EGF-induced increases in corneal epithelial 

proliferation and migration on GSK-3 inactivation. Investigative Ophthalmology and 

Vision Sciences, 2009.

314. Welch KE, LeardMann CA, Jacobson IG, 

Speigle SJ, Smith B, Smith TC, and Ryan 

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Epidemiology, 2009.

315. Wells TS, Jacobson IG, Smith TC, Spooner 

CN, Smith B, Reed RJ, Amoroso PJ, and 

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Journal of Epidemiology, 2008.

316. Wells TS, LeardMann CA, Fortuna SO, Smith 

B, Smith TC, Ryan MAK, Boyko EJ, and 

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Team. A prospective study of depression 

following combat deployment in support of 

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Journal of Public Health, 2010.

317. Wells TS, LeardMann CA, Smith TC, Smith 

B, Jacobson IG, Reed RJ, and Ryan MAK 

for the Millennium Cohort Study Team. Selfreported adverse health events following 

smallpox vaccination in a large prospective 

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Human Vaccines, 2008.

318. Welsh TT, Alemany JA, et al. Effects of 

intensified military field training on jump 

performance. Int J Sports Med, 2008.

319. Whitmer DL, Lund DJ, Hacker HD, Brown J, 

Pitman M, Palmer F, Jenkins K, and Stuck 

BE. Topical drug therapies for laser-induced 

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Visual Science (Abstract), 2008.

320. Whitmer DL and Stuck BE. Directed energy 

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Journal of US Army Veterinary Corps, 2009.

321. Widder MW, Brennan LM, Shedd TR, Trader 

DE, van der Schalie WH, Salazar N, Lerner 

E, and Iuga A. Unique Cell Characteristics 

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322. Widder MW, Brennan LM, and van der 

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2010.

323. Widder MW, Trader DE, Brennan LM, Shedd 

TR, Gargan TP II, van der Schalie WH, 

Salazar N, and Vallejo YR. An Environmental 

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324. Wilk JE, Bliese PD, Kim PY, Thomas JL, 

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325. Wilk JE, Thomas JL, McGurk D, Riviere LA, 

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326. Williamson DA, Young AJ, et al. Military 

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328. Wright KM, Adler AB, Bliese PD, and Eckford 

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programs. Military Medicine, 173(5), 411-421, 

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329. Wright KM, Cabrera OA, Bliese PD, Adler 

AB, Hoge CW, and Castro CA. Stigma and 

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330. Xu X, Amin M, and Santee WR. Probability 

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334. Yanovich R, Evans RK, et al. Hematological 

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341. Yu X, Ivanic J, Wallqvist A, and Reifman 

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Operational 

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Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

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Medicine

Medical Chemical 

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Rehabilitative 

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Military

Infectious 

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Combat 

Casualty

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Medical Chemical 

and Biological 

Defense

Advanced 

Technologies

Logistics

Appendices

Military Infectious 

Diseases

Combat 

Casualty Care

Military 

Operational 

Medicine

Clinical and 

Rehabilitative 

Medicine
The injuries of Operations Enduring and Iraqi Freedom are shaped 

by the widespread use of improvised explosive devices (IEDs). 

IEDs increase the likelihood that active-duty service members will 

be exposed to incidents such as blasts that can cause traumatic 

brain injuries (TBIs) and other debilitating injuries. Since 2001, 

there have been more than 30,000 battlefield injuries with most 

receiving more than 1 injury. Current war casualties are driving 

changes in health care needs and, therefore, changes in research 

and development.

The U.S. Army Medical Research and Materiel Command’s 

establishment of the Clinical and Rehabilitative Medicine Research 

Program (CRMRP) will enable active planning and coordination of 

an area of military research that has grown in importance during 

the current conflicts. The CRMRP focuses on definitive and rehabilitative care innovations required to reset our wounded Warriors in 

terms of duty, performance, and quality of life.

The CRMRP has six primary focus areas of research:

y Regenerative Medicine – includes the Armed Forces Institute of 

Regenerative Medicine (AFIRM)

y Rehabilitation of Neuromusculoskeletal Injuries

y Advanced Prosthetics/Amputee Care

y Vision Restoration and Rehabilitation

y Pain Management

y Hearing and Balance

The portfolios for each of the CRMRP’s six primary research 

focus areas are defined as follows:

The Regenerative Medicine portfolio exploits stem cell and biomaterials research to:

y Improve the speed of healing and decrease scarring

y Regenerate missing tissue, such as bone, cartilage, nerve, and 

muscle 

y Improve functionality and appearance following craniofacial 

reconstruction

y Develop scaffolds to integrate created tissue

y Reduce the need for tissue rejection therapy

y Improve surgical approaches and limb/tissue function

The Rehabilitation of Neuromusculoskeletal Injuries portfolio 

includes research that focuses on the following aims:

y Neuromuscular:

» Improve rehabilitation

» Strategies for limb salvage patients and limb health

» Fitness in amputees

» Spine rehabilitation and research strategies

» Minimize deleterious effects of contracture on function

» Bone loss and heterotopic ossification

OVERVIEW

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Military

Operational 

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Medical Chemical 

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Clinical and 

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Infectious 

Diseases

Combat 

Casualty

Care
» Psychosocial aspects

» Strategies that consider complicating factors

y Identify upper extremity kinematics and kinetic variables following 

injury that negatively influence locomotor and dynamic stability 

tasks

The Advanced Prosthetics/Amputee Care portfolio focuses on 

research to:

y Address psychosocial recovery aspects

y Improve rehabilitation for limb salvage and spinal injury patients

y Exercise and fitness systems and strategies (amputees)

y Improved orthotics, prosthetics, and robotics to improve extremity 

function

y Incorporate neural interface/feedback

The Vision Restoration and Rehabilitation portfolio includes 

research for:

y Acute treatment of ocular injury

y Restoration and rehabilitation of ocular injury, including artificial 

vision

y Ocular drug delivery

4-3
The Pain Management portfolio (including acute, chronic, and 

battlefield pain) supports both product development and knowledge 

research with aims to:

y Improve management of chronic and acute pain

y Establish safety margins for individual prescriptions

y Identify and treat pain generators

y Develop strategies to empower patients in managing pain

The Hearing and Balance portfolio focuses on the development 

of products and strategies for the restoration and rehabilitation of 

hearing and balance including:

y Restorative treatments and rehabilitation of hearing loss and 

auditory function due to traumatic injury (including TBI) and noise 

exposure

y Treatment and rehabilitation of auditory processing disorders and 

tinnitus

y Restorative treatments and rehabilitation of vestibular dysfunction 

and balance disorders due to traumatic injury (including TBI)

y Capabilities supporting assessments and evaluations conducted 

during diagnosis, treatment, and rehabilitation

Regenerative Medicine Overview

The burgeoning field of regenerative medicine provides hope for 

restoring the structure and function of damaged tissues and organs 

and curing previously untreatable injuries and diseases. The concept of regenerative medicine—in its simplest form—is to replace 

or regenerate human cells, tissues, or organs to restore or establish 

normal function. Advanced technologies, such as tissue regeneration, bone scaffolding, and stem cell-enabled treatments, are 

needed to revolutionize the clinical rehabilitation of severely injured 

service members.

The Department of Defense established the AFIRM in 2008 with 

the mission of developing new products and therapies to treat 

severe injuries suffered by U.S. service members. This multi-institutional, interdisciplinary network of scientists has been designed 

to accelerate the delivery of regenerative medicine therapies for 

severely injured service members. Centered around well-established, proven research investigators, the AFIRM has been able 

to expand the rehabilitative medicine knowledge base, develop 

models of injury, and test advanced technology products.

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Operational 

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Medical Chemical 

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Clinical and 

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Advanced 

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Military

Infectious 

Diseases

Combat 

Casualty

Care
4-5
PROSTHETICS/AMPUTEE CARE

COMPLETED | PROMISING | FUTURE

C-Leg® (Second Generation) 

Microprocessor Knee Prosthesis

Description

The prosthesis is based on the Otto Bock 

C-Leg design but has additional enhanced 

properties and functionality that make it 

suitable for use by military personnel who 

wish to remain on active duty subsequent 

to undergoing transfemoral amputation. It 

provides improved gait support, the ability for 

the user to walk backward and ascend stairs, 

an enhanced battery life between charging, 

and the ability to be charged while in use.

Partners

y USAISR

y TATRC

y Military Amputee Research Program

y BAMC

y Center for the Intrepid

y MATC

y Otto Bock Healthcare Products

iWalk Microprocessor-Controlled Prosthetic Ankle System

Description

The new microprocessor-controlled prosthetic ankle system, which is the first to provide powered 

plantarflexion, is clinically feasible in terms of hardware and software difficulties, patient and prosthetist satisfaction, and yields significant functional improvement in service members who have sustained 

transtibial amputation.

As the first commercially available device that provides active plantarflexion push-off, the PowerFoot 

prosthetic device manufactured by iWalk holds great potential to significantly reduce detrimental 

compensations, functional limitations, and long-term morbidity association with lower extremity amputation. It is expected to provide the greatest benefit during performance of challenging and militarily 

relevant tasks, such as walking over rocky terrain and on stairs and slopes where the demand for 

push-off power is significantly increased.

Partners

y USAISR

y TATRC

y Military Amputee Research Program

y WRAMC

y BAMC

y MIT

y iWalk

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Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Allogeneic Engineered Skin/

StrataGraft®

Description

The goal of this project is to develop a universal skin graft as a “ready to use” alternative 

to cadaveric skin for a period of time until an 

injured patient’s own skin can be used for 

grafting.

StrataGraft skin tissue is provided as a 

suturable circular patch of stratified epithelial 

tissue composed of a living dermal matrix 

(containing dermal fibroblasts) overlaid with 

human epidermal cells (NIKSTM cells).

Partners

y AFIRM – Wake Forest-Pittsburgh 

Consortium

y DHP

y University of Wisconsin–Madison

y Stratatech Corporation

Autologous Engineered Skin/Lonza 

Permaderm

Description

The goal of this project is to reduce the 

requirement for harvested skin autographs for 

the treatment of burn injuries by developing 

an engineered skin substitute (ESS) product. 

This technology uses a small sample of the 

patient’s healthy skin as the basis for growing a larger sheet of engineered skin over a 

30-day period. ESS products may be used to 

close burn wounds of greater than 40 percent 

at a single operation using autologous skin, 

and they heal in place.

Partners

y USAISR

y AFIRM – Rutgers-Cleveland Clinic 

Consortium

y JIEDDO

y Lonza Walkersville, Inc.

Autologous Skin Expander Device

Description

The goal of this program is the development 

of a device that enables the expansion of skin 

area by two- to fourfold to cover a greater surface area when treating burn patients. The 

Autologous Skin Expander Device enables 

covering burn injuries involving greater than 

40 percent total body surface area. A small 

sample of a patient’s healthy skin is subjected 

to a process that stretches it in a bioreactor 

over several days. The expanded skin then is 

reimplanted over the burn injury.

Partners

y AFIRM – Wake Forest-Pittsburgh 

Consortium

REGENERATIVE MEDICINE – 

BURNS/SCAR REDUCTION 4-7
ReCell®/Partial Thickness Burn

Description

This technology is utilized for the treatment 

of partial thickness burns, resulting in less 

scarring. It also is under investigation for 

scarless healing of resected hypertrophic 

scars. ReCell is a stand-alone, rapid, autologous cell-harvesting, processing, and delivery 

technology that enables surgeons and clinicians to treat skin defects using the patient’s 

own cells in a regenerative process, accelerating healing, minimizing scar formation, 

eliminating tissue rejection, and reintroducing 

pigmentation to the skin. ReCell has been 

designed for use in a wide variety of wound, 

plastic, reconstructive, burn, and cosmetic 

procedures. This product has point of care 

capability with an approximate 30-minute 

preparation time.

Partners

y USAISR

y AFIRM – Wake Forest-Pittsburgh 

Consortium

y DHP

y Avita Medical Limited

REGENERATIVE MEDICINE – 

BURNS/SCAR REDUCTION

REGENERATIVE MEDICINE – 

CRANIOFACIAL

COMPLETED | PROMISING | FUTURE

Autologous Fat Transfer Procedure

Description

The goal of this project is to develop autologous, cell-based therapies and constructs that repair, 

replace, regenerate, or supplement missing, damaged, or inadequate soft tissue and/or that reduce 

the aesthetic and functional deficits associated with soft tissue scarring and contracture.

There are few if any technologies at present that are known to positively impact the remodeling of 

established scar tissue. Essentially, all battlefield wounds involve some component of skin and/or 

soft-tissue injury, and in many cases the tissue loss/damage can be quite extensive. Autologous, 

adipose, and adipose-derived stem cells offer potential advantages over existing treatment options for 

remodeling existing scar tissue to improve functionality and esthetics of facial skin.

Partners

y USAISR

y AFIRM – Rutgers-Cleveland Clinic Consortium

4-8

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Neodyne Mechanical Scar Reduction Device

Description

The goal of this project is to reduce scarring following trauma by addressing the mechanical stress 

state of the healing wound through the use of region-specific devices capable of stress-shielding the 

healing wound.

Scar formation following trauma can lead to severe functional disability and disfigurement. 

Mechanical force has been recognized to influence cellular behavior and wound healing. Currently 

there are no commercially available wound care products that can specifically address the mechanical stress state of healing wounds to reduce scarring. The Neodyne Mechanical Scar Reduction 

Device is intended to stress-shield wounds by off-loading mechanical forces thereby reducing fibrosis 

(scar formation). The device would be applied following surgical closure of cutaneous wounds.

Partners

y AFIRM – Wake Forest-Pittsburgh Consortium

y NeoDyne Biosciences, Inc.

4-9
REGENERATIVE MEDICINE – 

EXTREMITY TRAUMA/LIMB SALVAGE

COMPLETED | PROMISING | FUTURE

Biologic Extracellular Matrix Scaffold for Functional Muscle Replacement

Description

The goal of this project is to develop an off-the-shelf biologic extracellular matrix scaffold capable of 

promoting clinically relevant muscle regeneration and function for the repair and reconstruction of 

complex extremity injuries suffered by Warfighters.

The current management of tissue coverage and augmentation for extremity reconstruction is 

minimal, allowing the body to heal by fibrosis (scarring). In many instances, this approach delays the 

rehabilitation process and rarely regains normal tissue function. The approach taken in this project 

is to produce an off-the-shelf scaffold implant to address missing soft tissue. The scaffold implant 

would initiate a stem/progenitor cell recruitment process and facilitate site-appropriate functional tissue restoration.

Partners

y USAISR

y AFIRM – Wake Forest-Pittsburgh Consortium

y JIEDDO

y DePuy, Inc.

4-10

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
PROSTHETICS/AMPUTEE CARE

COMPLETED | PROMISING | FUTURE

C-Leg (Third Generation) 

Microprocessor Knee Prosthesis

Description

The prosthesis is based on the Otto Bock 

C-Leg design but has additional enhanced 

properties and functionality that make it 

suitable for use by military personnel who 

wish to remain on active duty subsequent to 

undergoing transfemoral amputation. This 

version of the Otto Bock C-Leg microprocessor knee prosthesis is salt water resistant and 

watertight, and has increased static and cyclic 

strength and durability, a nonreflective coating, and a concept for hydraulic unit cooling.

Partners

y USAISR

y TATRC

y Military Amputee Research Program

y BAMC

y Center for the Intrepid

y MATC

y Otto Bock Healthcare Products

DEKA/APL Arms

Description

The overall objective is to develop a neurally controlled arm and hand prosthesis that will perform, 

look, and feel like a natural limb.

The DEKA arm is a strap-and-go technology. Inertial measurement units, in lieu of the prosthetic’s 

footpad myo-switch on the shoulder, allows the amputee to move from gross arm movements to hand 

movements. Additionally, the switch is adaptable so the system leads the amputee through a pressure system and myo-sites even if the amputee is a lower amputee as well. The APL arm intends to 

provide improved functionality through neural control (i.e., targeted neural motor reinnervation).

Partners

y USAMRMC

y USAISR

y DARPA

y Department of Veterans Affairs

y CFI

y DEKA

y APL

4-11
Powered Knee-Ankle-Foot System

Description

This is a prosthetic knee-ankle-foot system that improves mobility with computer-controlled components that have minimal energy requirements but are able to provide greater assistance than existing 

devices.

The prosthetic knee is being developed to generate its own electricity and uses it to control braking and swinging of the knee and leg. The prosthetic ankle uses active control to capture the user’s 

energy in a spring and release at the appropriate time to push off. Sensing technology is being developed to detect motion and muscle activity and to record daily living activities. The long-term objective 

of this project is to develop a prosthetic knee-ankle-foot system that actively coordinates the joints 

using multimodal biomechantronic sensory data for detection of user intent and control as well as for 

data logging as a functional outcome measure.

Partners

y USAISR

y CDMRP

y VA Medical Center

y MIT

y Seattle Institute for Biomedical and Clinical Research

PROSTHETICS/AMPUTEE CARE

COMPLETED | PROMISING | FUTURE

4-12

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Spring Ankle with Regenerative 

Kinetics

Description

The Spring Ankle with Regenerative Kinetics 

(SPARKy) seeks to develop a new generation of powered prosthetic devices based 

on the robotic tendon actuator. The robotic 

tendon is a lightweight actuator that has 

kinetic advantages and stores and releases 

energy to provide users with 100 percent of 

required push-off power and ankle range 

of motion comparable to able-bodied ankle 

motion while maintaining a form factor that is 

portable to the wearer. Additionally, this prosthesis will support continuous unstructured 

walking for up to 2.8 hours.

Partners

y TATRC

y Military Amputee Research Program

y United States Military Academy 

y Arizona State University 

COMPLETED | PROMISING | FUTURE

Socket Technologies

Description

These socket technologies were designed to maintain an appropriate prosthetic fit and residual limb 

volume. They measure shear and normal pressures, can be adjusted in real time as limb volume 

changes, improve coupling between the limb and the socket, and increase comfort during daily activity.

Partners

y USAMRMC

y USAISR

y WRAMC

y Center for the Intrepid

y Department of Veterans Affairs

y VA Puget Sound Healthcare System

y Providence VA

y Henry Jackson Foundation

y Texas Scottish Rite Hospital

y Liberating Technologies, Inc.

y Foster Miller, Inc.

y Next Step Orthotics and Prosthetics 

y D.E. Hokanson, Inc.

y Buster Greene and Associates

y Spencer Technologies

y Infoscitex Corporation

y Physical Optics Corporation

 

4-13
NEUROMUSCULOSKELETAL INJURY 

REHABILITATION

COMPLETED | PROMISING | FUTURE

Fraxelated Carbon Dioxide Laser 

for Treatment of Scar Contracture

Description

The Fraxelated Carbon Dioxide Laser will 

improve range of motion, scar compliance, 

and aesthetics of erythema and pigmentation 

while decreasing scar thickness and minimizing side effects and the potential complications of treatment.

The laser will be assessed on its ability to 

improve range of motion, thickness, compliance, and aesthetics in patients with burn 

scar contractures in the perioral and axillary 

regions.

Partners

y USAMRMC

y U.S. Air Force

Riluzole Spinal Cord Injury 

Treatment

Description

The North American Clinical Trials Network 

will carry out an acute safety and pharmacokinetic clinical trial of riluzole, a benzothiazole 

anticonvulsant NA+ channel-blocking agent 

with anti-glutamatergic activity that exerts a 

neuroprotective effect in patients who have 

sustained an acute spinal cord injury.

Partners

y USAISR

y TATRC

y The University of Toronto

y The University of Texas Medical School 

y The University of Texas School of Public 

Health

y The University of Virginia Hospital

y The Methodist Hospital, Houston 

y The Rehab Institute of Chicago

y Christopher Reeves Foundation

4-14

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
HEARING AND BALANCE 

RESTORATION/REHABILITATION

COMPLETED | PROMISING | FUTURE

Treatment of Tinnitus

Description

Tinnitus is the perception of sound by the auditory system in the absence of an actual external sound; 

typically, a ringing or buzzing is heard. In many individuals this is merely an occasional annoyance, 

but for others this can be significant enough to interfere with hearing, sleep, and/or cause emotional distress. Tinnitus has been reported in noise and blast-exposed patients and in patients with 

TBI. Tinnitus and hearing loss are the top service-connected disabilities for compensation by the 

Department of Veterans Affairs. Existing therapies include noise-masking devices, counseling, and 

brain/auditory system retraining tools and techniques, but effectiveness varies. Efforts are under way 

to evaluate the Neuromonics Tinnitus Treatment Program (NTTP), a commercially available tool for 

retraining the brain’s perception of tinnitus. Studies are being done using military patients to evaluate 

the effectiveness of the NTTP for tinnitus resulting from military-relevant exposures to noise and blast. 

Additionally, the device and treatment program are being enhanced to enable telemedicine capabilities and optimize the hardware and software. As opposed to strategies that provide masking noise or 

coping skills, the NTTP has the advantage of potentially treating tinnitus.

Partners

y Neuromonics, Inc.

4-15
REGENERATIVE MEDICINE – 

CRANIOFACIAL

COMPLETED | PROMISING | FUTURE

Formable, Nanostructured Ca PO4 (NanoCaPS) Scaffolds

Description

The goal of this project is to develop novel bioactive bone cements and scaffolds based on natural 

polymers that incorporate nanostructured calcium phosphate to address craniofacial reconstruction.

This project focuses on developing novel bone regeneration strategies for craniofacial reconstruction by exploiting the combined attributes of nanoscale inorganic bioactive cements and naturally 

derived polymer hybrid materials that possess excellent bioreactivity, biocompatibility, safety, and 

regenerative capability. This combination of materials would result in the development of structurally 

and functionally normal bone for injured military personnel. The proposed technologies also will be 

investigated for regenerating large osseous defects in the extremities where bone fracture is a major 

clinical problem contributing to nearly 50 percent of all armed forces personnel injuries.

Partners

y AFIRM – Wake Forest-Pittsburgh Consortium

y JIEDDO

4-16

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
REGENERATIVE MEDICINE – 

EXTREMITY TRAUMA

COMPLETED | PROMISING | FUTURE

Peripheral Nerve Scaffolds

Description

This represents two projects with the goal to develop nerve conduits that have the capacity to repair 

the type of large defects in mixed nerves that will be needed for limb salvage procedures or for repair 

of small motor nerves.

The contemporary standards of care for treatment of peripheral nerve lacerations or segmental 

defects include primary repair or nerve grafting. When direct repair is not possible, currently the most 

effective method to reestablish functional nerve continuity is the use of an autologous nerve graft. 

However, autologous nerve grafts have several drawbacks, including loss of function at the donor site, 

size mismatch, and limited availability. An alternative to nerve autografts would enhance the current 

standard of care and lead to better outcomes and capabilities. NeuraLum is a surgically implanted 

polycaprolactone fumarate scaffold, and KeraGen is a surgically implanted keratin-derived polymer 

scaffold. These materials are absorbed by the body over time and may be delivered with adipose- or 

mesenchymal-derived stem cells or growth factors.

Partners

y TATRC

y AFIRM – Rutgers-Cleveland Clinic Consortium

PlexurLV Injectable Allograft BoneComposite Scaffold

Description

This goal of this project is to develop an 

injectable bone void filler for use in extremity 

long bone defects and craniofacial surgical 

repair that would alleviate the need for autografts as a bone grafting material.

Extremity injuries are common battle injuries 

with current treatment options incorporating the use of bone allo- or autografts. Due 

to the size and geometry of many of these 

injuries, surgery involving the harvest of bone 

allo- or autografts has limited application. 

An injectable nanoporous bone void filler 

composed of an allograft bone-biodegradable 

polyurethane composite may provide significant advantages over current treatment 

options. The material is designed to promote 

faster cellular infiltration and remodeling leading to better outcomes.

Partners

y AFIRM – Rutgers-Cleveland Clinic 

Consortium

4-17
REGENERATIVE MEDICINE – 

TRANSPLANTATION

COMPLETED | PROMISING | FUTURE

Protocol for Immunomodulation for Composite Tissue Allotransplantation – 

Hand and Face Transplants

Description

The goal of this project is to develop a novel immunosuppressive/immunomodulative protocol for 

composite tissue allotransplantation (CTA) to mitigate the inherent risks associated with current immunosuppressive protocols.

Composite tissue allografts (e.g., hand and face transplants) are now a clinical reality. Apart from 

excellent and highly encouraging functional results, CTA has not reached widespread clinical use 

because recipients currently require lifelong, high-dose, multidrug immunosuppression to prevent 

graft rejection. These regimes carry a high risk for serious side effects. Using a minimization 

strategy, various protocols consisting of recipient conditioning, donor bone marrow infusion, and 

monotherapy maintenance immunosuppression have been defined and currently are being tested in a 

clinical setting.

Partners

y TATRC

y AFIRM – Wake Forest-Pittsburgh Consortium

y AFIRM – Rutgers-Cleveland Clinic Consortium

4-18

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
PAIN MANAGEMENT

COMPLETED | PROMISING | FUTURE

Molecular Signatures of Chronic Pain Subtypes

Description

Knowledge of why different chronic pain syndromes develop after a seemingly identical injury would 

enhance the understanding of pain biology in general; allow military and civilian physicians to provide 

earlier, more targeted interventions; and permit a more sophisticated approach to novel analgesic 

discovery and development.

The project will collect data and specimens from approximately 350 existing and 100 prospective 

subjects who will represent discovery and validation populations, respectively. From the discovery 

population, mechanistically relevant biomarkers capable of discerning subtypes of chronic pain will be 

identified, the validity of which will be confirmed in the prospective population as they receive treatment at WRAMC, BAMC, and the Durham VAMC.

Partners

y DVPMI

y WRNMMC

y BAMC

y Durham VAMC

4-19
Pain Center of Excellence and Chronic Pain Impact Network

Description

Established in 2003, the Defense & Veterans Pain Management Initiative (DVPMI), also known as the DoD Pain Center of Excellence located at WRNMMC, 

seeks to improve the management of pain in military and civilian medicine. Through clinical research efforts, it has become a model for effective integration 

of acute and chronic pain medicine.

Currently, there is a large number of Soldiers in the Army’s Warrior Transition Units (WTUs) with chronic pain. Physicians have been reluctant to prescribe 

opioids for the treatment of chronic non-cancer-related pain, which has resulted in pervasive undertreatment of this disabling condition. Although the importance of the role of opioids in the treatment of chronic non-cancer-related pain was finally recognized in the 1990s, a lack of confidence persists among health 

care providers in their ability to manage chronic pain patients, in particular among primary care physicians.

To address these and other concerns, the Army Surgeon General chartered the Pain Management Task Force in August 2009. In its Final Report of May 

2010 was a recommendation to implement a comprehensive electronic patient assessment screening tool and outcomes registry that could be standardized 

across DoD and VHA clinics.

The Chronic Pain Impact Network (CPAIN) will be an electronic assessment screening tool and outcomes registry. A similar tool has been built previously 

and validated at a leading academic pain treatment center (University of Washington). The research will evaluate the use of the CPAIN tool to assist in the 

clinical management of Soldiers with chronic pain at two different WTUs. The research is expected to determine whether using CPAIN will help decrease the 

average daily dose of opioids, number of patients on large doses of opioids, and/or the duration of opioid use for patients in the WTU; decrease the number of 

unscheduled visits for opioid medication refills; facilitate the identification of patients at risk for opioid misuse and for linking therapeutic outcomes to medication dosage; and increase the level of physician confidence in managing opioid therapy in WTU pain patients.

Partners

PAIN MANAGEMENT

COMPLETED | PROMISING | FUTURE

y WRNMMC

y Madigan Army Medical Center

y Department of Veterans Affairs

y DVPMI

y University of Washington

y Conemaugh Health System

4-20

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

VISION RESTORATION AND 

REHABILITATION

Wearable Visual Aid as Treatment for TBI-Associated Visual Dysfunction

Description

To develop and refine the BrainPort vision device to enable blinded veteran testing and evaluation 

in normal operational settings, at home, occupationally, and in other activities of daily living. To 

implement and test hardware and software device enhancements through an iterative process using 

feedback and performance measures from users who are blind. This work will lead directly to a 

proven assistive technology ready for rapid deployment to wounded Warriors, veterans, and civilians 

who are blind.

The BrainPort visual prosthetic enables perception of visual information using the tongue and camera 

system as a paired substitute for the eye. Visual information is collected from a video camera and 

translated into gentle electrical stimulation patterns on the surface of the tongue. With training, users 

perceive shape, size, location, and motion of objects in their environment. It is a functional, nonsurgical device developed as an aid to the visually impaired.

Partners

y TATRC

y University of Southern California

4-21
HEARING AND BALANCE 

RESTORATION/REHABILITATION

COMPLETED | PROMISING | FUTURE

Rehabilitation of Balance

Description

Dizziness and balance are common outcomes of head injury and blast-related TBI. Optimized 

balance rehabilitation devices and treatment protocols are needed to retrain the brain and balancesensing systems of the body. These devices and protocols are expected to provide more rapid and/or 

complete recovery with good retention and reduced patient workload for therapists. Various technology approaches are being employed. Generally, balance instability (sway) is detected by having 

the patient stand on a motion-sensing platform with feedback provided to the patient visually (video 

screen) or tactually (e.g., vibration). Treatment involves having the patient practice with the device; 

thus, portable, low-cost solutions are being developed. Studies are under way to evaluate existing 

commercial-off-the-shelf and research and development phase technologies along with treatment 

protocols to assess the approach with the best effectiveness and stability over time. The technologies 

being researched also may support the development of tools for the diagnosis of balance disorders 

and evaluations/guidelines for return to duty including in the forward deployed setting.

Partners

y USAARL

y Naval Medical Center, San Diego

y Office of the Secretary of Defense, SBIR Program

y Headley Court (UK)

4-22

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
4-23
PUBLICATIONS

1. Agrawal V, et al. Epimorphic regeneration 

approach to tissue replacement in adult 

mammals. Proc Natl Acad Sci USA, 2009, 

107(8): 3351-5.

2. Amos PJ, Kapur SK, Stapor BS, Shang H, 

Bekiranov S, Khurgel M, Rodeheaver GT, 

Peirce S, and Katz AJ. Human adiposederived stromal cells accelerate diabetic 

wound healing: Impact of cell formulation and 

delivery. Tissue Engineering: Part A, v16, 

No. 5, 2010, pp 1595-1606.

3. Bailey AM, Lawrence MB, Shang H, Katz 

AJ, and Peirce SM. Agent-based model of 

therapeutic adipose-derived stromal cell trafficking during ischemia predicts ability to roll 

on P-selectin. PLoS Computational Biology, 

2009, Vol. 5, No.2.

4. Bettinger C, Bruggeman J, Borenstein J, and 

Langer R. In vitro and in vivo degradation 

of poly (1,3-diamino-2-hydroxypropaneco-polyol sebacate) elastomers. Journal 

of Biomedical Materials Research, 2009, 

91: 1077-1088, PMID: 19107786.

5. Bettinger C, Bruggeman J, Misra A, 

Borenstein J, and Langer R. Biocompatibility 

of biodegradable semiconducting melanin films for nerve tissue engineering. 

Biomaterials, 2009, 30: 3050-3057, 

PMID: 19286252.

6. Bettinger C, Kulig K, Vacanti J, Borenstein 

J, and Langer R. Nanofabricated collageninspired synthetic elastomers for primary 

rat hepatocyte culture. Tissue Engineering, 

2009, 15: 1321-1329, PMID: 18847357, 

PMCID: PMC2789736.

7. Bettinger C, Langer R, and Borenstein J. 

Engineering substrate topography at the 

micro- and nanoscale to control cell function. 

Angewandte Chemie, 2009, 48: 5406-5415, 

PMID: 19492373, NIHMSID: NIHMS148783.

8. Bhang S, Cho S, Lim J, Kang J, Lee T, 

Yang H, Song Y, Park M, Kim H, Langer R, 

Anderson D, and Kim B. Locally delivered 

growth factor enhances the angiogenic 

efficacy of adipose derived stromal cells 

transplanted to ischemic limbs. Stem Cells, 

2009, 27: 1976-1986, PMID: 19544425.

9. Boerckel JD, Dupont KM, Kolambkar YM, 

Lin ASP, and Guldberg RE. In vivo model 

for evaluating the effects of mechanical 

stimulation on tissue-engineered bone repair. 

Journal of Biomechanical Engineering, 2009, 

131(8): 084502.

10. Brayfield CA, Marra KG, and Rubin JP. 

Adipose stem cells for soft tissue regeneration. Handchirurgie, Mikrochirurgie, 

Plastische Chirurgie, 2010, 42(2): 124-128.

11. Brown KV, Walker J, Cortez D, and Wenke 

J. Delay in debridement and antibiotics 

increases infection. J Surg Orth Adv, 2010 

19(1): 18-22.

12. Chan J, Zhang L, Tong R, Ghosh D, 

Gao W, Liao G, Yuet K, Gray D, Rhee J, 

Cheng J, Golomb G, Libby P, Langer R, 

and Farokhzad O. Spatiotemporal controlled delivery of nanoparticles to injured 

vasculature. Proceedings of the National 

Academy of Sciences, 2010, 107: 2213-2218, 

PMID: 20133865.

13. Cho S, Goldberg M, Son S, Xu Q, Yang 

F, Mei Y, Bogatyrev S, Langer R, and 

Anderson D. Lipid-like nanoparticles for 

small interfering RNA delivery to endothelial 

cells. Advanced Functional Materials, 2010, 

19: 3112-3118.

14. Choi JH, Bellas E, Glettig DL, and Kaplan 

DL. Adipogenic differentiation of human 

adipose-derived stem cells on 3D silk fibroin 

scaffolds. Methods in Molecular Biology. 

Eds. Jeffrey M. Gimble and Bruce Bunnell, 

Humana Press, in press.

15. Choi JH, Gimble JM, Lee K, Marra K, Rubin 

PJ, Yoo JJ, Vunjak-Novakovic G, and Kaplan 

DL. Adipose tissue engineering for soft tissue regeneration. Tissue Engineering Part B: 

Reviews, 2010 March 24.

16. Clements IP, Kim YT, English AW, Lu X, 

Chung A, and Bellamkonda, RV. Thin-film 

enhanced nerve guidance channels for 

peripheral nerve repair. Biomaterials, 2009, 

30(23-24): 3834-46.

17. Costache D, Sheihet L, Zaveri K, Knight 

DD, and Kohn J. Polymer-drug interactions in tyrosine-derived triblock copolymer 

nanospheres: A computational modeling 

approach. Mol Pharm, 2009, Sep-Oct, 

6(5): 1620-7.

4-24

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
18. Dang T, Xu Q, Bratlie K, O’Sullivan E, 

Chen X, Langer R, and Anderson D. 

Microfabrication of homogenous, asymmetric 

cell-laden hydrogel capsules. Biomaterials, 

2009, 30: 6896-6902, PMID: 19800116, 

NIHMSID147749.

19. Dumas JE, Zienkiewicz K, Tanner SA, Prieto 

EM, Bhattacharyya S, and Guelcher SA. 

Synthesis and characterization of injectable 

allograft bone/polymer composite scaffolds. 

Tissue Engineering, in press.

20. Dupont KM, Sharma K, Stevens HY, 

Boerckel JD, Garcia AJ, and Guldberg RE. 

Human stem cell delivery for large segmental bone defect repair. Proceedings of the 

National Academy of Sciences USA, 2010, 

107(8): 3305-10.

21. Fisher O, Khademhosseini A, Langer R, 

and Peppas N. Bioinspired materials for 

controlling stem cell fate. Accounts of 

Chemical Research, in press (advance web 

pub: 10.1021/ar900226q), PMID: 20043634, 

NIHMSID: NIHMS168065.

22. George P, Saigal R, Lawlor M, Moore 

M, LaVan D, Marini R, Selig M, Makhni 

M, Burdick J, Langer R, and Kohane D. 

Three-dimensional conductive constructs for 

nerve regeneration. Journal of Biomedical 

Materials Research, 2009, 91: 519-527, 

PMID: 18985787.

23. Gerecht S, Ferreira LS, and Langer R. 

Vascular differentiation of human embryonic 

stem cells in bioactive hydrogel-based scaffolds. Methods in Molecular Biology, 2010, 

584:333-354, PMID: 19907986.

24. Ghaznavi M, Kokai LE, Tuffaha SH, Lovett 

ML, Kaplan DL, and Marra KG. Silk fibroin 

conduits in a rat model: A cellular and functional assessment of peripheral nerve repair. 

Annals of Plastic Surgery, 2010, in press.

25. Golub J, Kim YT, Duvall CL, Bellamkonda 

RV, Gupta D, Lin ASP, Weiss D, Taylor WR, 

and Guldberg RE. Sustained VEGF delivery 

via PLGA nanoparticles promotes vascular 

growth. American Journal of Physiology. 

Heart and Circulatory Physiology, 2010, 

298(6): H1959-65.

26. Guldberg RE. Spatiotemporal delivery strategies for promoting musculoskeletal tissue 

regeneration. Journal of Bone and Mineral 

Research, 2009, 24(9): 1507-11.

27. Harris T, Green J, Fung P, Langer R, 

Anderson D, and Bhatia S. Tissue-specific 

gene delivery via nanoparticle coating. 

Biomaterials, 2009, 30: 3926-3933, PMID: 

19850333, PMCID: PMC2796451.

28. Hashizume R, Fujimoto KL, Hong Y, 

Amoroso NJ, Tobita K, Miki T, Keller BB, 

Sacks MS, and Wagner WR. Morphological 

and mechanical characteristics of the reconstructed rat abdominal wall following use of a 

wet electrospun biodegradable polyurethane 

elastomer scaffold. Biomaterials, 2010, 

31: 3253-3265.

29. Hoffman-Kim D, Mitchel JA, and 

Bellamkonda RV. Topography, cell response, 

and nerve regeneration. Annu Rev Biomed 

Eng, in press.

30. Hook A, Williams P, Anderson D, and Langer 

R. High throughput methods applied in 

biomaterial development and discovery. 

Biomaterials, 2010, 31: 187-198, PMID: 

19815273.

31. Johnson MR, Lee HJ, Bellamkonda RV, and 

Guldberg RE. Sustained release of BMP-2 

in a lipid-based microtube vehicle. Acta 

Biomaterialia, 2009, 5(1): 23-28.

32. Jun Y, Li J, Runge MB, Dadsetan M, Chen 

Q, Lu L, and Yaszemski MJ. Crosslinking 

characteristics and mechanical properties of 

an injectable biomaterial composed of polypropylene fumarate and polycaprolactone 

copolymer. Journal of Biomaterials Science: 

Polymer Edition, in press.

33. Kang JH, Gimble JM, and Kaplan DL. 

In vitro 3D model for human vascularized 

adipose tissue. Tissue Eng Part A, 2009, 

15: 2227-2236.

34. Khademhosseini A and Langer R. 

Nanotechnologies: Emerging applications 

in biomedicine. BBA General Subjects, in 

press.

35. Khademhosseini A, Rajalingam B, Jinno S, 

and Langer R. Nanoengineered systems 

for tissue engineering and regeneration, in 

Nanotechnology, 2009, 361-384. Ed, Vogel 

V, Wiley-Vch Verlag GmbH and Co, KGaA, 

Weinheim, Germany.

36. Kim J, Dadsetan M, Ameenuddin S, 

Windebank AJ, and Yaszemski MJ. In vivo 

biodegradation and biocompatibility of PEG/

sebacic acid-based hydrogels using a cage 

implant system. Journal of Biomedical 

Material Research, Part A, 2010, in press.

37. Kim U and Soh HT. Simultaneous sorting of 

multiple bacterial targets using integrated 

dielectrophoretic magnetic activated cell 

sorter. Lab on a Chip, 2009, (9): 2313-2318.

4-25
38. Kokai LE, Ghaznavi AM, and Marra KG. 

Incorporation of double-walled microspheres 

into polymer nerve guides for the sustained 

delivery of glial cell line-derived neurotrophic 

factor. Biomaterials, 2010, 31(8): 2313-2322.

39. Kokai LE, Tan H, Jhunjhunwala S, Little SR, 

Frank J, and Marra KG. Protein bioactivity and polymer orientation is affected by 

stabilizer incorporation in double-walled 

microspheres. Journal of Controlled Release, 

2010, 141: 168-176.

40. Kolambkar Y and Guldberg RE. Colonization 

and osteogenic differentiation of different 

stem cell sources on electrospun nanofiber 

meshes. Tissue Engineering, in press.

41. Kraehenbuehl T, Ferreira L, Zammaretti P, 

Hubbell J, and Langer R. Cell-responsive 

hydrogel for encapsulation of vascular cells. 

Biomaterials, 2009, 30: 4318-4324, PMID: 

19500842.

42. Kretlow JD, Shi M, Young S, Spicer PP, 

Demien N, Jansen JA, Wong ME, Kasper 

FK, and Mikos AG. Porous polymethylmethacrylate space maintainers promote 

soft tissue coverage of clean/contaminated 

alveolar bone defects. Tissue Eng Part C 

Methods, 2010, in press, DOI: 10.1089/ten.

tec.2010.0046.

43. Lahann J and Langer R. Nanobiomaterials: 

The interface of nanotechnology and biomaterials. IQT Quarterly, 2010, 1: 11-15.

44. Lee H, McKeon RJ, and Bellamkonda RV. 

Sustained delivery of thermostabilized 

chABC enhances axonal sprouting and 

functional recovery after spinal cord injury. 

Proceedings of National Academies of 

Sciences USA, 2010, 107(8): 3340-5.

45. Lee KW, Wang S, Dadsetan M, Yaszemski 

MJ, and Lu L. Enhanced cell ingrowth and 

proliferation through three-dimensional nanocomposite scaffolds with controlled pore 

structures. Biomacromolecules, 2010 Mar 8, 

11(3): 682-9.

46. Levenberg S, Ferreira L, Chen-Konak L, 

Kraehenbuehl T, and Langer R. Isolation, differentiation and characterization of vascular 

cells derived from human embryonic stem 

cells. Nature Protocols, in press.

47. Li B, Brown KV, Wenke JC, and Guelcher 

SA. Sustained release of vancomycin from 

polyurethane scaffolds inhibits infection of 

bone wounds in a rat femoral segmental 

defect model. Journal of Controlled Release, 

2010 Aug 3, 145(3): 221-30.

48. Li B, Yoshii T, Hafeman AE, Nyman JS, 

Wenke JC, and Guelcher SA. The effects 

of rhBMP-2 released from biodegradable 

polyurethane/microsphere composite scaffolds on new bone formation in rat femora. 

Biomaterials, 2009 Dec, 30(35): 6768-79, 

Epub 2009 Sep 17.

49. Lou XH, Qian J, Xiao Y, Viel L, Gerdon 

AE, Lagally ET, Atzberger P, Tarasow TM, 

Heeger AJ, and Soh HT. Micromagnetic 

selection of aptamers in microfluidic channels. Proceedings of the National Academy 

of Sciences, USA, 2009, 106(9): 2989-2994.

50. Magno MH, Kim J, Srinivasan A, McBride S, 

Darr A, Bolikal D, Darr A, Hollinger JO, and 

Kohn J. Synthesis, degradation and biocompatibility of tyrosine-derived polycarbonate 

scaffolds for use in bone tissue engineering. Journal of Materials Chemistry, 2010, 

accepted.

51. Markert CD, et al. Immunofluorescence 

microscopy for imaging of nuclear p63 in 

human primary keratinocytes: A comparison 

of antibodies and fixation methods. Journal 

of Immunological Methods, 2010, 352: 

174-177.

52. Muschler GF, Raut VP, Patterson TE, Wenke 

JC, and Hollinger JO. The design and use 

of animal models for translational research 

in bone tissue engineering and regenerative 

medicine. Tissue Eng Part B Rev, 2010 Feb, 

16(1): 123-45.

53. Nguyen D, Green J, Chan J, Anderson D, 

and Langer, R. Polymeric materials for gene 

delivery and DNA vaccination. Advanced 

Materials, 2009, 21: 847-867.

54. Park H, Karajanagi S, Wolak K, Aanestad 

J, Deheron L, Kobler J, Lopez-Guerra G, 

Heaton J, Langer R, and Zeitels S. 3D 

hydrogel model using adipose-derived stem 

cells for vocal fold augmentation. Tissue 

Engineering Part A, 2010, 16: 535-543, 

PMID: 19728785.

55. Park H, Yip M, Kost J, Kobler J, Langer R, 

Zeitels S, and Chertok B. Indirect lowintensity ultrasonic stimulation for tissue 

engineering. Journal of Tissue Engineering, 

in press.

56. Raut VP, Patterson TE, Wenke JC, Hollinger 

JO, and Muschler GF. Assessment of 

biomaterials: Standardized in vivo testing. An Introduction to Biomaterials, 2010, 

SA Guelcher, JO Hollinger (eds), CRC Press, 

in print.

57. Runge MB, Dadsetan M, Baltrusaitis J, 

Knight AM, Ruesink T, Lazcano E, Lu L, 

4-26

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Medicine

Medical Chemical 

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Medicine

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Care
Windebank AJ, and Yaszemski MJ. The 

development of electrically conductive 

polycaprolactone fumarate-polypyrrole 

composite materials for nerve regeneration. 

Biomaterials, in press.

58. Santiago LY, Clavijo-Alvarez J, Brayfield 

C, Rubin JP, and Marra KG. Delivery of 

adipose-derived precursor cells for peripheral nerve repair. Cell Transplantation, 2009, 

18(2): 145-158.

59. Satish L, Johnson S, Abdulally A, Post 

JC, Ehrlich GD, and Kathju S. Cloning and 

expression of rabbit CCT subunits eta and 

beta in healing cutaneous wounds. Cell 

Stress Chaperones, 2010 Apr 15 [Epub 

ahead of print].

60. Satish L, Johnson S, Wang JH, Post JC, 

Ehrlich GD, and Kathju S. Chaperonin containing T-complex polypeptide subunit eta 

(CCT-eta) is a specific regulator of fibroblast 

motility and contractility. PLoS One, 2010 

Apr 30, 5(4): e10063.

61. Shi M, Kretlow JD, Nguyen A, Young S, 

Baggett LS, Wong ME, Kasper FK, and 

Mikos AG. Antibiotic-releasing porous polymethylmethacrylate constructs for osseous 

space maintenance and infection control. 

Biomaterials, 2010 May, 31(14): 4146-56.

62. Singer AJ, Taira BR, Lin F, Lim T, Anderson 

R, and Clark RAF. Curcumin reduces injury 

progression in a rat comb burn model. J Burn 

Care Res, in press, 2010.

63. Sorrell JM, Baber MA, and Caplan AI. 

Influence of adult mesenchymal stem cells 

on in vitro vascular formation. Tissue Engr A, 

2009, 15: 1751-1761.

64. Suh WH and Tirrell M. Surface engineering 

using peptide amphiphiles. Comprehensive 

Biomaterials, 2010, in press.

65. Tan H, Ramirez CM, Miljkovic ND, Li H, 

Rubin JP, and Marra KG. Thermosensitive 

injectable hyaluronic acid hydrogel for adipose tissue engineering. Biomaterials, 2009, 

30(36): 6844-6853.

66. Tan H, Rubin JP, and Marra KG. Injectable 

in situ forming biodegradable chitosan-hyaluronic acid based hydrogels for adipose tissue regeneration. Organogenesis, in press.

67. Taylor M, Urquhart A, Anderson D, Langer 

R, Davies M, and Alexander M. Partial least 

squares regression as a powerful tool for 

investigating large combinatorial polymer 

libraries. Surface and Interface Analysis 

(Spec. Iss.), 2009, 41: 127-135.

68. Tholpady SS, Ogle RC, and Katz AJ. 

Adipose stem cells and solid organ 

transplantation. Current Opinion in Organ 

Transplantation, 2009, 14: 51-55.

69. Wojtowicz AM, Oest ME, Dupont KM, 

Templeman KL, Hutmacher DW, Guldberg 

RE, and García AJ. Collagen-mimetic peptide coating of biomaterial scaffolds for bone 

defect repair. Biomaterials, in press.

70. Yang F, Cho S, Son S, Bogatyrev S, Singh 

D, Green J, Mei Y, Park S, Bhang S, Kim B, 

Langer R, and Anderson D. Genetic engineering of human stem cells for enhanced 

angiogenesis using biodegradable polymeric 

nanoparticles. Proceedings of the National 

Academy of Sciences, 2010, 107: 3317-3322.

71. Yang F, Green J, Dinio T, Keung L, Cho S, 

Park H, Langer R. and Anderson D. Gene 

delivery to human adult and embryonic 

cell-derived stem cells using biodegradable nanoparticulate polymeric vectors. 

Gene Therapy, 2009, 16: 533-546, PMID: 

19129861, PMCID: PMC2688702.

72. Yang F, Mei Y, Langer R, and Anderson D. 

High-throughput optimization of stem cell 

microenvironments. Combinatorial Chemistry 

and High Throughput Screening, 2009, 

12: 554-561, PMID: 19601753, PMCID: 

PMC2748120.

73. Yao L, de Ruiter GC, Wang H, Knight AM, 

Spinner RJ, Yaszemski MJ, Windebank 

AJ, and Pandit A. Controlling dispersion of 

axonal regeneration using a multichannel 

collagen nerve conduit. Biomaterials, 2010 

Apr 27 [Epub ahead of print].

4-27

Advanced 

Technologies

Logistics

Appendices

Military Infectious 

Diseases

Combat 

Casualty Care

Military 

Operational 

Medicine

Clinical and 

Rehabilitative 

Medicine

Medical Chemical 

and Biological 

Defense
Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

OVERVIEW

Future battlefields are expected to be at least as dangerous as 

any of the past or any that were anticipated during the Cold War. 

Although treaties and agreements forbidding the use of chemical 

and biological weapons were milestones in arms control, such 

weapons remain significant threats to U.S. and allied forces. 

Stockpiles of chemical weapons found in Iraq after the 1990–1991 

Gulf War, the use of these weapons in the Iran–Iraq War, the 

1995 nerve gas attack in the Tokyo subway, and the anthrax letter 

attacks of 2001 are vivid reminders of the potential risk and threat 

to both service members and civilians from these weapons.

Medical Chemical Defense Research

The mission of the Medical Chemical Defense Research Program 

is to preserve combat effectiveness by timely provision of medical countermeasures in response to joint chemical warfare (CW) 

defense requirements. This program executes Department of 

Defense (DoD) medical chemical defense science and technology research programs assigned to U.S. Army Medical Research 

and Materiel Command (USAMRMC) laboratories by the Defense 

Threat Reduction Agency’s Joint Science and Technology Office for 

Chemical and Biological Defense.

Nerve agents can be fatal to the unprotected Warfighter. Survivors 

may have recurring seizures and long-term brain damage. Through 

joint research and development, the nerve agent threat has been 

substantially reduced by the fielding of numerous products:

y Soman Nerve Agent Pretreatment Pyridostigmine (SNAPP), a 

pretreatment drug, can be administered orally to troops under risk 

of CW attack without degrading their performance.

y Mark I Nerve Agent Antidote Kit (NAAK) provides a service 

member with the nerve agent antidote atropine and an oxime, 

2-pralidoxime chloride (2-PAM).

y Antidote Treatment Nerve Agent Autoinjector (ATNAA) is an 

improvement over the Mark I NAAK.

y Convulsant Antidote for Nerve Agent (CANA), diazepam in 

an autoinjector, is used as an adjunct therapy for nerve agent 

poisoning to protect against seizure-induced brain injury and to 

enhance survival.

y Medical Aerosolized Nerve Agent Antidote (MANAA) is an aerosolized atropine that can be rapidly administered far-forward to 

casualties for the control of respiratory effects of nerve agents.

y Skin Exposure Reduction Paste Against Chemical Warfare 

Agents (SERPACWA) is a topical pretreatment that forms a film 

barrier on the skin and augments Mission-Oriented Protective 

Posture gear by preventing or delaying the penetration of a 

wide variety of CW agents including the blistering agent sulfur 

mustard. 

Reactive Skin Decontamination Lotion (RSDL) is a U.S. Food 

and Drug Administration (FDA)-cleared, individually carried skin 

decontamination kit. RSDL provides the Warfighter with the ability 

to decontaminate the skin after exposure to CW and biological warfare (BW) agents in support of immediate and thorough 

personnel decontamination operations. RSDL also provides the 

Warfighter with improved capability over the existing M291 Skin 

Decontamination Kit to reduce lethal and performance-degrading 

effects of CW agents. RSDL neutralizes, as opposed to removing, 

the agent. Additionally, it can be used to decontaminate individual 

equipment, weapons, and casualties (unbroken skin only).

5-2

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Research and product development supporting pretreatment, 

treatment, diagnostics, and clinical management of the chemi-

cal casualty are the keys to continuing discovery and fielding of 

medical countermeasures to CW agents. Successful technology 

base programs that have transitioned to advanced development 

and that have received acquisition program status include the 

Advanced Anticonvulsant System Program, the Improved Nerve 

Agent Treatment System (INATS) Program, and the Bioscavenger 

Program. Bioscavenger Increment II is a recombinant protein that 

is produced from an engineered expression system, giving it a sig-

nificant manufacturing advantage over Bioscavenger I, which was a 

plasma-derived human butyrylcholinesterase. 

 Active programs in the USAMRMC technology base include 

research to develop medical countermeasures against vesicants 

and nontraditional chemical agents, research to identify and 

develop neurological therapeutics (i.e., neuroprotection), research 

to develop a catalytic nerve agent bioscavenger pretreatment 

(Bioscavenger III) that enhances efficacy by degrading multiple 

molecules of nerve agents in vivo, and research to identify and 

develop therapeutics to treat the respiratory and systemic effects of 

CW agents. 

The Medical Chemical Defense Research Program also provides 

education and training to officers and enlisted persons from all of 

the services who will be the doctors, nurses, and medics who will 

treat a Warfighter exposed to CW agents. Depending on the avail-

ability of funding, the capability exists to broadcast this information 

around the world via satellite to first responders who would likely 

be tending to casualties exposed to CW agents in the event of a 

terrorist action.

5-3
Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

Medical Biological Defense Research

The mission of the Medical Biological Defense Research Program 

is to ensure the sustained effectiveness of U.S. forces in a BW 

environment and to deter the use of these weapons by maintaining a strong medical defensive posture. This USAMRMC program 

executes DoD medical biological defense science and technology 

research programs assigned to USAMRMC laboratories by the 

Defense Threat Reduction Agency’s Joint Science and Technology 

Office for Chemical and Biological Defense. 

Vaccines and drugs for biological threat agents and toxins are 

designed to prevent casualties in a BW attack. Diagnostic tests 

and reagents are developed to diagnose disease in the event of 

actual exposure to biological agents. Antitoxins and drugs are 

designed to treat casualties, prevent deaths, and expedite return to 

duty after exposure.

Technologies that have transitioned to Medical Chemical and 

Biological Defense Program advanced development include a 

recombinant plague vaccine (Plague Vaccine Program), a vaccine 

against botulinum toxin subtypes A and B (Recombinant Botulinum 

A/B Vaccine Program), and a vaccine against Venezuelan equine 

encephalitis (VEE) virus (VEE Vaccine Program). The VEE 

Vaccine Program has been put on hold after adverse reactogenicity was observed in a Phase 1 clinical trial. An improved 

anthrax vaccine (recombinant protective antigen vaccine), the 

outcome of research at the U.S. Army Medical Research Institute 

of Infectious Diseases (USAMRIID), was being developed by the 

U.S. Department of Health and Human Services (HHS) under 

Project BioShield; however, the contract with the performer was 

terminated when problems with the vaccine’s stability caused 

the company to miss a deadline for starting a clinical trial. HHS, 

through the Biomedical Advanced Research and Development 

Authority, has established a contract with PharmAthene for 

advanced development of its second-generation recombinant 

protective antigen vaccine targeted for future procurement in the 

U.S. Strategic National Stockpile. Diagnostic assays developed in 

the technology base that meet requirements for application to the 

currently fielded Joint Biological Agent Identification and Diagnostic 

System (JBAIDS) have also transitioned to Medical Chemical and 

Biological Defense Program advanced development. In addition, 

recombinant human monoclonal antibodies for therapeutic treatment of exposure to staphylococcal enterotoxins A and B were 

transitioned to advanced development supported by the National 

Institute of Allergy and Infectious Diseases (NIAID).

Technologies in the technology base that are maturing to eventually transition to advanced development include diagnostic assays 

and protocols for incorporation into the fielded JBAIDS, a combined 

VEE, eastern equine encephalitis (EEE), and western equine 

encephalitis vaccine (WEE), and vaccines against staphylococcal 

enterotoxin and ricin toxin exposure.

 Research efforts supported by the Joint Science and Technology 

Office for Chemical and Biological Defense (JSTO-CBD) at 

USAMRMC laboratories continue to focus on the development of 

multiagent vaccines against viral, bacterial, and toxin agents that 

will afford recipients protection against unique combinations of 

biological threat agents. JSTO-CBD-directed research efforts in 

biological therapeutics leverage cutting-edge technologies, such as 

nanotechnology and small-molecule application, which will intervene in post-exposure effects of biological threat agents. 

The most likely route of dissemination of a BW agent on the 

battlefield is through small-particle aerosols; therefore, researchers 

continue to develop, refine, and validate experimental models used 

to study airborne infection and disease prevention. If exposure and 

illness occur, rapid diagnosis is essential for proper treatment and 

medical management. Field-deployable, rapid assays are being 

developed for diagnosis of BW agent exposure.

5-4

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
In addition to research and development, training military and 

civilian health care professionals in the diagnosis and treatment of 

BW agent exposure is a Command priority. USAMRMC experts 

also provide technical support to law enforcement agencies and 

counterterrorism initiatives. 

The products in this section are divided into medical chemical 

defense products and medical biological defense products, and 

then subcategorized appropriately.

5-5
Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

COMPLETED | PROMISING | FUTURE

Medical Chemical Defense:

PREVENTION

Medical Chemical Defense:

THERAPEUTICS

Skin Exposure Reduction Paste 

Against Chemical Warfare Agents

Description

SERPACWA is an FDA-approved paste 

containing chemically inert perfluorinated 

polymers that delay or prevent penetration of 

nerve agents and sulfur mustard. Completed 

in 2003, it is used as a pretreatment in 

conjunction with Mission-Oriented Protective 

Posture gear to prevent or reduce the toxicity 

resulting from CW agents on the skin. 

Partners

y USAMRICD

y USAMMDA

Soman Nerve Agent Pretreatment 

Pyridostigmine 

Description

SNAPP is a drug that was previously used 

to treat a chronic neuromuscular disease 

known as myasthenia gravis. It is now FDA 

approved as a prophylaxis against the lethal 

effects of the nerve agent soman. It is the 

first such drug to be approved under the 

FDA’s Animal Efficacy Rule. Completed in 

2003, SNAPP is used in conjunction with 

current antidotes.

Partners

y USAMRICD

y USAMMDA

Antidote Treatment Nerve Agent 

Autoinjector

Description

ATNAA provides treatment for nerve agent 

exposure of U.S. forces. The FDA-approved 

ATNAA is a two-chambered autoinjector used 

for the intramuscular injection of the nerve 

agent antidotes atropine and 2-PAM through 

the same needle. The ATNAA is administered after onset of symptoms to treat nerve 

agent toxicity. The ATNAA is a replacement 

for the currently fielded Mark I NAAK that 

delivers the same two drugs but requires two 

separate autoinjectors.

Partners

y USAMRICD

y USAMMDA

5-6

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Convulsant Antidote for Nerve 

Agents

Description

CANA offers U.S. forces additional protection from nerve agent poisoning. CANA is 

a diazepam 10 milligram autoinjector used 

for the prevention or abatement of convulsions and the prevention or reduction of brain 

injury associated with nerve agent poisoning. 

Completed in 1991, CANA is an FDAapproved, service member-carried item used 

with the Mark I NAAK. 

Partners

y USAMRICD

y USAMMDA

M291 Skin Decontamination Kit

Description

Emergency decontamination products are 

intended to remove and neutralize potentially 

lethal CW and BW agents following agent 

exposure. The M291 Skin Decontamination 

Kit is a superior, safe, and effective system 

for use against multiple percutaneous CW 

agents. The wallet-like, flexible pouch contains six individually sealed foil packets and is 

carried in the pocket of protective suits. This 

kit was completed in 1990.

Partners

y USAMRICD

y USAMMDA

COMPLETED | PROMISING | FUTURE

5-7
Medical Aerosolized Nerve Agent 

Antidote

Description

MANAA increases the survival and sustainability of U.S. forces by supplying treatment 

for nerve agent exposure. MANAA is packaged as a pressurized inhaler device containing aerosolized atropine to counteract the 

effects of nerve agents, such as tabun, sarin, 

soman, cyclosarin, and VX. This antidote 

was completed in 1994.

Partners

y USAMRICD

y USAMMDA

Test-Mate Cholinesterase Kit

Description

The Test-Mate Cholinesterase Kit measures 

blood enzyme erythrocyte AChE and plasma 

cholinesterase, providing detection of nerve 

agent exposure in less than 4 minutes. The 

kit contains a battery-operated colorimeter, 

a photometric analyzer, and all equipment 

and reagents necessary for performing up 

to 96 tests. Blood for each test is easily 

obtained from a finger stick. This kit was 

completed in 1997.

Partners

y USAMRICD

y USAMMDA

Medical Chemical Defense:

THERAPEUTICS

COMPLETED | PROMISING | FUTURE

Mark I Nerve Agent Antidote Kit

Description

The Mark I NAAK is administered when personnel are exposed to nerve agents, such as 

sarin, soman, tabun, and VX, and have signs 

and symptoms of exposure. The kit contains 

two multichamber autoinjectors containing 

2 milligrams of atropine and 600 milligrams 

of 2-PAM each. The Mark I NAAK was completed in 1983 and replaced by the ATNAA.

Partners

y USAMRICD

y USAMMDA

5-8

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Medical Biological Defense:

PREVENTION

Anthrax Vaccine Adsorbed (BiothraxTM)

Description

Anthrax Vaccine Adsorbed (Biothrax) protects U.S. forces against all forms of anthrax, decreases the 

threat of a biological attack, and enhances strategic mobility. Anthrax Vaccine Adsorbed (Biothrax) is 

a sterile, cell-free filtrate containing proteins made from an avirulent strain of Bacillus anthracis. This 

FDA-licensed vaccine meets requirements for safety, efficacy, purity, and potency. 

The Anthrax Vaccine Program provides the DoD with the Biothrax used to vaccinate and protect the 

Warfighter from potential exposure to B. anthracis. Biothrax is produced by Emergent BioSolutions 

and is FDA approved. The vaccine is administered in a 5-dose regimen over an 18-month period with 

an annual booster dose. 

Partners

y Joint Program Executive Office for Chemical and Biological Defense

y Emergent BioSolutions

COMPLETED | PROMISING | FUTURE

5-9
Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

1-5-10

Military Operational 

Medicine

Medical Chemical and 

Biological Defense Logistics COTS 

and Enhancements

COTS 

and Enhancements

Military Infectious 

Diseases

Combat 

Casualty Care

4-5-10

Smallpox Vaccine System

Description

Smallpox is a viral disease that was declared eradicated by the World Health Organization. 

Consequently, the general public is no longer routinely vaccinated. This leaves a highly vulnerable 

population, especially when smallpox is considered to be a prime candidate for use as a biological weapon. The case fatality rate of smallpox disease among unvaccinated individuals is between 

15 percent and 40 percent. The disease can be transmitted through casual contact.

An improved vaccine to protect against this BW threat is highly desirable. Only limited doses of the 

currently licensed smallpox vaccine (DryVax) are available, and there are significant reservations 

about mass inoculation due to its known side effects. The Joint Vaccine Acquisition Program (JVAP) 

Prime Systems Contractor, DynPort Vaccine Company, obtained FDA licensure in February 2005 for 

a new Vaccine Immune Globulin (VIG) product for intravenous administration instead of intramuscular 

(i.e., Vaccine Immune Globulin Intravenous [VIGIV]). 

The Smallpox Vaccine System Program provides both the ACAM2000TM smallpox vaccine and the 

VIGIV to vaccinate and protect the Warfighter from potential exposure to smallpox. Both products are 

FDA approved. The DoD’s ACAM2000 requirement is being met through an Inter-agency Agreement 

with HHS under which the DoD draws upon supplies held within the U.S. Strategic National Stockpile. 

VIGIV is used to treat rare but serious adverse reactions associated with vaccination with ACAM2000, 

and the DoD maintains its own supply of VIGIV through a direct contract with the manufacturer, 

Cangene Corporation.

Partners

y HHS

y CBMS JVAP

y Cangene Corporation

Medical Biological Defense:

PREVENTION

COMPLETED | PROMISING | FUTURE

5-10

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
4-5-11 1

Comprehensive Educational Tools 

and Resources

Description

Comprehensive educational tools and 

resources provide additional learning materials to service members to enrich the overall 

learning experience of managing chemical 

agent casualties. 

An example of a comprehensive educational 

tool is the Medical Management of Chemical 

Casualties Supplemental Training Materials 

V. 4.00 CD-ROM. In addition, the Chemical 

Casualty Care Division web site at

https://ccc.apgea.army.mil provides access to 

educational videos, an article database, a student tracking database, and a chemical agent 

symptoms and treatments bookmark.

Partners

y USAMRICD

Computer-Based Training

Description

Computer-Based Training (CBT) offers service members a variety of interactive, multimedia learning 

courses both online and in compact disk format. Many of the CBT modules listed below are accredited for continuing medical education and continuing education unit credits for physicians, nurses, and 

paramedics.

y Medical Management of Nerve Agent Casualties

y Medical Management of Chemical Casualties Course

y Triage of Chemical Agent Casualties Course

y Virtual Field Training Exercise Course

y Patient Decontamination Station Small Group Exercise

y M40A1 Chemical-Biological Mask Function and Operation

y Nerve Agent Virtual Casualty Assessment

Partners

y USAMRICD

Medical Chemical and Biological Defense:

TRAINING

COMPLETED | PROMISING | FUTURE

5-11
Field Identification of Biological 

Warfare Agents Course

Description

The Field Identification of Biological Warfare 

Agents (FIBWA) course was designed to 

allow students to set up, maintain, and operate a deployable laboratory under field conditions. The 4-week FIBWA course includes 

classroom instruction, extensive hands-on 

laboratory training in diagnostic techniques, 

and a field exercise that integrates course 

material with real-world scenarios. Concepts 

of operations and diagnostic materials, 

equipment, and technology are continually 

evaluated and transitioned into the field to 

ensure that training is cutting edge. Six 

student courses and three manager courses 

for laboratory officers and commanders are 

offered each year. While FIBWA is designed 

for organizations within the DoD, course 

material can be tailored to meet the specific 

needs of other government agencies.

Partners

y USAMRICD

Field Management of Chemical and 

Biological Casualties Course

Description

The Field Management of Chemical and 

Biological Casualties course is designed for 

medical and chemical noncommissioned 

officers, Chemical and Medical Service Corps 

officers, and civilian first responders. Course 

instruction focuses on emergency treatment, 

triage, decontamination, and evacuation 

of casualties. Pre- and postcourse tests 

are administered to each class to evaluate 

student learning progress.

Partners

y USAMRICD

y USAMRIIID

Medical Chemical and Biological Defense:

TRAINING

COMPLETED | PROMISING | FUTURE

5-12

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Hospital Management of Chemical, Biological, Radiological/Nuclear, and 

Explosive Incident Course

Description

The Hospital Management of Chemical, Biological, Radiological/Nuclear, and Explosive (CBRNE) 

Incident course is designed to equip military and civilian hospital-based medical and management 

professionals with skills, knowledge, and information resources to carry out the full spectrum of health 

care facility responsibilities required by a CBRNE incident or mass casualty event. 

Classroom and practical application instruction focuses on diagnosis, treatment, and incident management in response to mass casualty events of all types, including incidents involving weapons of mass 

destruction. The course also is offered as a modified, exportable 2- to 5-day course to meet specific 

audience needs. Pre- and postcourse tests are administered to evaluate student progress. 

Partners

y USAMRICD

y USAMRIID

Medical Management of Chemical 

and Biological Casualties Course

Description

The Medical Management of Chemical and 

Biological Casualties course is designed for 

medical professionals. Instruction focuses 

on pathophysiology, diagnosis, and treatment 

of chemical and biological casualties. The 

course also is offered as an exportable 2-day 

course to meet specific audience needs. The 

exportable 2-day version does not include 

laboratory and field instruction.

Partners

y USAMRICD

y USAMRIID

COMPLETED | PROMISING | FUTURE

5-13
COMPLETED | PROMISING | FUTURE

Nerve Agent Bioscavenger

Description

Nerve agents (e.g., soman, sarin, and VX) are fast acting and lethal at low doses. The DoD is developing a bioscavenger medical countermeasure, a prophylactic regimen intended to prevent incapacitation and death from exposure to a broad spectrum of nerve agents. Bioscavenger is a recombinant 

form of human butyrylcholinesterase produced in the milk of transgenic goats. FDA approval for the 

recombinant bioscavenger product (Bioscavenger Increment II) is planned for 2017. The DoD also 

is exploring more efficient and cost-effective alternative technologies for production of bioscavenger. 

The technology base is performing research to develop a catalytic bioscavenger (Bioscavenger 

Increment III) that will actively degrade nerve agents without losing its own activity. The technology is 

immature, and a candidate will not be ready for transition to advanced development until late 2020.

Partners

y USAMRICD

y WRAIR

y CBMS MITS

Medical Chemical Defense: 5-14 PREVENTION

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Medical Chemical Defense:

THERAPEUTICS

Advanced Anticonvulsant System

Description

Nerve agent exposure can cause seizures 

and convulsions in Warfighters. The use 

of an anticonvulsant provides an effective 

treatment for service members against nerve 

agent-induced seizures and subsequent brain 

damage caused by nerve agent exposure. 

The Advanced Anticonvulsant System (AAS) 

will treat seizures and prevent subsequent 

neurological damage caused by exposure to 

nerve agents. The AAS, injected intramus-

cularly, will consist of the drug midazolam 

in an autoinjector. Midazolam will replace 

diazepam in the fielded CANA. Midazolam 

is more water soluble than diazepam and terminates nerve agent-induced seizures more 

quickly than diazepam. AAS will not eliminate 

the need for other protective and therapeutic 

systems. FDA approval is planned for 2012.

Partners y USAMRICD y CBMS MITS

Improved Nerve Agent Treatment 

System

Description

Provide protection against nerve agentinduced symptoms of toxicity, such as breath

-

ing difficulties, hypersecretions, and muscle 

tremors. The INATS is an enhanced treat-

ment regimen designed to provide protection 

against a broad spectrum of nerve agents. 

The components of INATS include (1) replac-

ing the currently fielded oxime (2-PAM) with a 

new oxime and (2) obtaining FDA approval for 

use of pyridostigmine bromide, the compo-

nent of SNAPP, for use against additional 

nerve agents. The current pretreatment 

indication for SNAPP is limited to soman. 

The new oxime is intended to replace 2-PAM 

in the currently fielded ATNAA or similar 

device. The INATS will not eliminate the need 

for other protective and therapeutic systems. 

The INATS is intended for self-administration. 

FDA approval is planned for 2017. 

Partners y USAMRICD y CBMS MITS

5-15
Medical Biological Defense:

PREVENTION

Next-Generation Anthrax Vaccine

Description

Anthrax is caused by spores and most commonly occurs in wild and domestic mammals, although 

it has been manufactured as a BW agent. Symptoms vary depending on the route of exposure; 

however, sore throat, mild fever, and muscle aches usually begin within 7 days of exposure. Severe 

breathing difficulty, shock, and meningitis follow, and as the bacteria multiply in the lymph nodes, 

toxemia progresses and the potential for widespread tissue destruction and organ failure increases. 

Up to 90 percent of untreated cases result in death. Currently, ciprofloxacin is the only antibiotic 

approved by the FDA to treat anthrax exposure.

Obtaining an alternative for the currently licensed anthrax vaccine would provide the DoD with 

additional options in protecting the force against this serious BW threat. HHS, through the Biomedical 

Advanced Research and Development Authority, has established a contract with PharmAthene for 

advanced development of its second-generation recombinant protective antigen vaccine targeted for 

future procurement in the U.S. Strategic National Stockpile.

Partners

y USAMRIID

y HHS

y PharmAthene

COMPLETED | PROMISING | FUTURE

5-16

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Plague Vaccine (Recombinant Plague Vaccine)

Description

An effective FDA-licensed vaccine against aerosolized plague will enhance force protection and 

strategic mobility. Infection induced by inhalation of Yersinia pestis represents a serious BW threat. 

The resultant disease, pneumonic plague, has an incubation period of 2 to 5 days and an untreated 

mortality rate of nearly 100 percent within 1 to 3 days after the onset of illness. The disease can be 

transmitted through flea bites and is characterized by high fever, chills, headache, malaise, myalgias, 

cough with blood-tinged sputum, and tender, swollen lymph nodes. The disease progresses rapidly, 

resulting in epigastric discomfort, noisy respiration, and a bluish discoloration of the skin followed 

rapidly by respiratory failure, circulatory collapse, and bleeding tendencies if left untreated. 

CBMS JVAP is developing a new vaccine intended to protect Warfighters against pneumonic plague 

as a result of aerosolized exposure to Y. pestis. The Recombinant Plague Vaccine (rF1V) candidate 

is composed of the F1V fusion protein formulated with an aluminum hydroxide adjuvant and delivered 

intramuscularly as a 3-dose series prior to potential aerosol exposure to Y. pestis. Initial development 

of this vaccine candidate was pioneered at USAMRIID. FDA approval is planned for 2015.

Partners

y USAMRIID

y CBMS JVAP

5-17
Project Argus: A National Biosurveillance Priming System 

Description

For the United States to meet present and future biothreats that span agricultural, animal, and human 

considerations, an integrative strategy for information discovery, exploitation, and effective proactive 

use by the response community is critical. Indications and Warnings (I&Ws) provide a key component 

for integration within the U.S. biosurveillance portfolio, enabling earlier warning potential. Project 

Argus is the first attempt to integrate I&Ws in an effort to detect catastrophic bioevents on an international scale.

I&Ws alert U.S. responders of an imminent bioevent weeks to months in advance. I&Ws are markers occurring globally, outside of U.S. borders, before an outbreak can affect U.S. interests, forces, 

citizens, or territory, thus allowing the United States time to respond. In effect, I&Ws can prime the 

national response infrastructure by alerting agencies of an evolving threat that could ultimately be 

catastrophic. Retrospective analyses of major bioevents have demonstrated the presence of multiple 

I&Ws present in multiple data sources weeks to months in advance, which were not recognized and 

used properly by the national response community. In addition to funding provided by USAMRMC’s 

Telemedicine and Advanced Technology Research Center, the project also has benefited from financial support from the Intelligence Technology Innovation Center and the Department of Homeland 

Security National Biodefense Analysis and Countermeasures Center.

Partners

y TATRC

y Imaging Science and Information Systems Center-Georgetown University in partnership with the 

MITRE Corporation

Medical Biological Defense:

PREVENTION

COMPLETED | PROMISING | FUTURE

5-18

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Recombinant Botulinum Toxin A/B Vaccine

Description

An effective FDA-licensed vaccine against aerosolized botulinum toxins A and B will enhance force 

protection and strategic mobility. The paralytic neurotoxins elaborated by Clostridium botulinum are 

the most potent, naturally occurring toxins known. Botulism is acquired naturally by oral ingestion of 

the organism or infection of a preexisting wound. Direct intoxication of humans can be accomplished 

by aerosolizing the toxin, leading to intoxication by inhalation. Botulism symptoms appear within 

hours to days following exposure to botulinum toxin. All symptoms are the result of irreversible binding of the toxin to neurons. Typical symptoms include nausea, vomiting, headache, dry mouth, urinary 

retention, intestinal obstruction, and general neurologic disorder characterized by weakness and dizziness. Eventually, the illness results in weakness in descending extremities and respiratory muscles. 

Respiratory paralysis is most often the immediate cause of death.

CBMS JVAP is developing a new vaccine intended to protect Warfighters against aerosolized 

exposure to botulinum toxins. The Recombinant Botulinum Toxin A/B Vaccine (rBV A/B) candidate is 

composed of nontoxic but immunogenic fragments of the botulinum toxin heavy chains of serotypes 

A and B. Initial development of this vaccine candidate was pioneered at USAMRIID. FDA approval 

is planned for 2016. The vaccine is intended for use in an active vaccination program and will be 

administered intramuscularly as a 3-dose primary series prior to deployment of Warfighters into possible threat areas.

Partners

y USAMRIID

y CBMS JVAP

5-19
Medical Biological Defense:

PREVENTION

Trivalent Filovirus Vaccine 

Description

USAMRIID scientists have made and patented several potential vaccines against Ebola and Marburg 

viruses using different vaccine strategies, including gene based (DNA), replication-defective viral vectors (alphavirus replicons), and virus-like particles using two filovirus proteins. These have all been 

tested successfully in rodents, and some have demonstrated efficacy in nonhuman primates. In addition, USAMRIID investigators are collaborating with scientists in other government agencies, industry, 

and academia to test experimental adenovirus-vectored and rhabdovirus-vectored vaccines for Ebola 

and Marburg viruses. At least one of these candidate vaccines successfully protected nonhuman 

primates from Ebola virus. 

CBMS JVAP is developing a new trivalent vaccine for the DoD intended to protect against aerosolized 

exposure to filoviruses. The CBMS JVAP will develop a trivalent vaccine system to protect against 

Ebola Sudan, Ebola Zaire, and Marburg viruses. The objective end product would contain all three 

vaccine components in a single vaccine formulation. CBMS JVAP will serve as the integrator for 

the technology development phase by managing and coordinating the various vaccine development 

contracts and intergovernmental efforts from Milestone A to B. Anticipated fielding is fiscal year 2024. 

Partners

y USAMRIID

y CBMS JVAP

COMPLETED | PROMISING | FUTURE

Tularemia Vaccine

Description

Tularemia is an incapacitating and occasionally fatal infection transmitted to humans by 

fly and tick bites. Clinical symptoms are often 

confused with those of plague; therefore, 

tularemia can be very difficult to diagnose. 

Infection induced by inhalation or ingestion of 

Francisella tularensis organisms represents 

a serious BW threat because only a small 

amount is necessary to cause infection. 

Antibiotics may not be a viable option in the 

theater of operations, and there is no U.S.-

licensed tularemia vaccine.

The DoD’s advanced development program 

for a tularemia vaccine was terminated due to 

removal of funding; however, HHS continues 

tularemia vaccine development through 

submission of an Investigational New Drug 

application to the FDA.

Partners

y USAMRIID

y HHS/NIAID

5-20

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

Venezuelan Equine Encephalitis Infectious Clone Vaccine

Description

The VEE virus is a highly infectious agent that is easily manufactured in large quantities, stable in 

storage, and efficiently transmitted by aerosol. The alpha viruses are amenable to genetic manipulations, thereby increasing their potential as BW weapons. 

Clinical manifestations include a sudden onset of a nonspecific febrile illness that consists of malaise, 

fever, chills, headache, retro-orbital pain, nausea, vomiting, and sore throat. The acute phase of the 

illness lasts 4–6 days with total recovery taking 2–3 weeks. There is no antiviral with recognized 

efficacy against VEE infection, and medical intervention remains limited to supportive care.

The VEE Infectious Clone Vaccine, designated V3526, is a genetically engineered, live, attenuated virus that will be administered subcutaneously. Because this is a live viral product, only one 

vaccination will be required. The vaccine will elicit an immune response within 30 days, provide 

80 percent protection for 1 year, and have a shelf-life of at least 3 years. The advanced development 

program for VEE vaccine was terminated in 2006 due to reallocation of program funding to the DoD’s 

Transformational Medical Technologies Initiative program.

Partners

y USAMRIID

y CBMS JVAP

5-21
Continuous Product Improvement to the Joint Biological Agent Identification 

and Diagnostic System

Description

The JBAIDS is a reusable, portable, modifiable biological agent identification and diagnostic system 

capable of rapid, reliable, and simultaneous identification of multiple biological agents and other 

pathogens of operational concern. The JBAIDS Anthrax, Tularemia, and Plague Detection Systems 

are FDA cleared for diagnostic use. On 24 August 2009, the FDA granted an Emergency Use 

Authorization for the swine influenza (2009H1N1) diagnostic capability on JBAIDS. CBMS through 

the Office of the Surgeon General, submitted the JBAIDS H5 avian influenza in vitro diagnostic kit to 

the FDA on 29 January 2009; the FDA approved the H5 in vitro diagnostic kit 510(k) submission on 

6 July 2010. In addition to these two influenza detection assays, the Office of the Assistant Secretary 

of Defense for Health Affairs has released funding for expanded infectious disease detection capability on the JBAIDS; this additional infectious disease detection capability is projected to be available 

to deployed military forces in 18 to 24 months. CBMS will submit the Q-Fever in vitro diagnostic kit to 

the FDA for clearance by the fourth quarter of fiscal year 2010.

USAMRIID develops state-of-the-art technologies, critical diagnostic reagents, and protocols to support rapid and confirmatory identification of biological threat agents. Diagnostic assays developed at 

USAMRIID are standardized, optimized, and transitioned to the advanced developer for application 

with the JBAIDS.

Partners

y USAMRIID

y CBMS MITS 

Medical Biological Defense:

DIAGNOSTICS

COMPLETED | PROMISING | FUTURE

5-22

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Field-Deployable Ultra-Sensitive Assay System for Biological Toxins

Description

The early and rapid detection of biological toxins is critically important to the protection of military 

personnel deployed in combat situations. However, current methods for detecting biotoxins are 

not well suited to the development of highly specific assay systems for detecting biotoxins down to 

the level of 1 attomolar (10–18 M) in combat deployment situations. Investigators have developed 

assays to detect cholera toxin B subunit in deionized water, human urine, and farm run-off water. The 

detection limits achieved with this immunoassay were all well below 1 attomolar. Assays also have 

been developed for botulinum neurotoxin serotype A and tetanus toxoid using trisialoganglioside 

GT1b-labeled immunoliposomes. The detection limits of these assays were also well below 1 attomolar. A prototype field-deployable version of the assays has been developed based on the Roche 

LightCycler®. These efforts have resulted in the development of a simple immunoassay system that 

is easily field deployable but is also more sensitive than any previous technology for the detection of 

biological toxins. Efforts are under way to develop a more portable “lab-chip” format for the assay 

and assays for the detection of human diseases, such as HIV, amyloid disorders (prion disease), and 

cancer. A patent covering this technology is pending.

Partners

y CDMRP 

y AFIP

COMPLETED | PROMISING | FUTURE

5-23
COMPLETED | PROMISING | FUTURE

Chemical Diagnostics

Description

The Chemical Diagnostics area seeks to 

develop screening procedures and definitive analytical methods for testing biomedical samples for individual exposure to CW 

agents.

Chemical Diagnostics research focuses on 

developing state-of-the-art laboratory/fieldable methods that detect exposure to CW 

agents (e.g., nerve agents and vesicants) in 

clinical samples. It also targets identifying 

biomolecular targets that can be leveraged 

as analytical methodologies as well as in vitro 

and in vivo studies characterizing the time 

course and longevity of a particular analyte/

biomarker.

Partners

y USAMRICD

Medical Chemical Defense:

DIAGNOSTICS

Medical Chemical Defense:

PREVENTION

Cyanide Medical Countermeasures

Description

Medical countermeasures against cyanide intoxication and the development of more accurate and 

reliable methodologies to assay for cyanide from biological samples will provide additional protection 

to service members on the battlefield. Cyanide is a fast-acting inhibitor of cellular respiration. No pretreatment against cyanide is presently available, and modern cyanide treatments accessible to DoD 

personnel have serious limitations. Pharmaceutical countermeasures against cyanide (i.e., pretreatments and treatments) must act rapidly, have relatively long half- and shelf-lives, and present no or 

minimal side effects. Efforts are ongoing to identify pretreatment compounds that will protect service 

members from cyanide. In addition, scavengers for cyanide are being evaluated as treatments and 

pretreatments. 

Research toward medical countermeasures against cyanide is funded through the National Institutes 

of Health (NIH) Countermeasures Against Chemical Threats (CounterACT) Research Network 

program. This program seeks to enhance the current medical response capabilities of the nation in 

preparation for a chemical event emergency. To achieve this goal, NIH has developed a comprehensive cooperative research network composed of research centers of excellence, individual research 

projects, small business innovation research projects, and contracts and inter-agency agreements 

with other federal entities. 

Partners

y USAMRICD

y NIH CounterACT Research Network

5-24

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Cutaneous and Ocular Therapeutics

Description

This research area focuses on the development of therapeutic strategies to effectively minimize injuries to dermal and ocular tissues resulting from exposure to vesicant CW agents. Vesicant chemical 

agents such as sulfur mustard are a significant threat to U.S. forces, and there is currently no vesicant 

agent treatment available. This work will yield a vesicant agent countermeasure that will substantially 

reduce the number of casualties or degree of injury, reduce the medical logistical burden, deter use of 

sulfur mustard, and enhance the ability of U.S. forces to sustain operational tempo.

Research efforts validated countermeasure approaches using anti-inflammatories and chemical 

scavengers. Research efforts also are exploring the use of debridement techniques combined with 

treatment adjuncts, to include dressings, growth factors, and skin substitutes, to facilitate the healing 

of vesicant-induced skin injuries. In addition, the technologies of an injectable, FDA-approved fluorescence dye and a wearable, portable diagnostic instrument that uses night vision technology were 

combined to create a method for evaluating the depth of burn injuries caused by exposure to sulfur 

mustard.

Partners

y USAMRICD

Medical Chemical Defense:

THERAPEUTICS

COMPLETED | PROMISING | FUTURE

5-25
Skin and Wound Decontamination

Description

A method for skin and wound decontamination will enhance survival and sustainability of U.S. forces in need of emergency decontamination products following nerve agent exposure. Current techniques of decontamination include activated charcoal that is rubbed over the body to absorb the chemical agent. One 

technology being explored is a cotton sponge impregnated with enzymes, including acetylcholinesterase, which bind organophosphorus compounds or nerve 

agents and inactivate them before they can do harm. The additives in the sponge remove, contain, and destroy organophosphorus compounds and vesicants, preventing further contamination. The decontamination product also is being evaluated for decontamination and detoxification of biological agents and 

removal of radiologicals from skin.

The sponge reacts to a nerve agent by changing color. Because it is made of polyurethane, it is inexpensive and sturdy and should not require any special 

training for its use. It already has been shown to be stable when stored at 45°C. Decontamination currently is being tested in animals.

The FDA approved the RSDL as a medical device on 25 March 2003. Testing indicates that the lotion is superior to the currently fielded activated charcoal 

decontaminant, the M291 Skin Decontamination Kit, in the removal and neutralization of chemical agents. The RSDL is a component of the Joint Service 

Personnel/Skin Decontamination System (JSPDS), an FDA-cleared individually carried skin decontamination kit. The JSPDS provides the Warfighter with the 

ability to decontaminate the skin, after exposure to CW and BW agents, in support of immediate and thorough personnel decontamination operations. The 

M291 Kit will be replaced by the JSPDS.

Partners

y USAMRICD

y WRAIR

y Joint Program Executive Office for Chemical and Biological Defense Decontamination Program Manager

Medical Chemical Defense:

THERAPEUTICS

COMPLETED | PROMISING | FUTURE

5-26

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Recombinant Ricin Vaccine Candidate

Description

A ricin vaccine will decrease the threat of a biological attack and enhance strategic mobility of U.S. 

forces. Ricin is a toxin derived from the castor plant, which is grown throughout the world for commercial purposes. Approximately 1 million pounds of castor beans are used each year in the process 

of manufacturing castor oil. Given its ready availability and its high level of toxicity—particularly when 

delivered as an aerosol—ricin is a significant potential agent of BW or terrorism. Currently, there is no 

vaccine or therapy available for human use.

The new vaccine candidate, called RTA 1-33/44-198, is a fragment of the ricin toxin A-chain that 

has been modified to eliminate the toxic enzymatic property of RTA, increase protein stability, and 

maintain its ability to elicit a protective immune response. The vaccine fully protected mice from a 

whole-body aerosol challenge with lethal doses of ricin. 

Next steps include testing in nonhuman primates and refinement of a scaled-up production method 

that is robust and reproducible. 

Partners

y USAMRIID

Medical Biological Defense:

PREVENTION

COMPLETED | PROMISING | FUTURE

5-27
Staphylococcal Enterotoxin A/B Multivalent Vaccine Candidate

Description

Recombinant staphylococcal enterotoxin serotypes A and B (SEA/B) multivalent vaccines 

will decrease the threat of a biological attack and enhance strategic mobility of U.S. forces. 

Staphylococcus aureus produces a number of toxic proteins, including SEA/B. These are part of a 

larger group of superantigen toxins capable of directly stimulating a large population of immune cells 

and inducing an intense inflammatory response that injures host tissues. Symptoms begin approximately 3 to 12 hours after aerosol infection and include flu-like and respiratory signs, which may 

persist for weeks. Severe exposures can result in acute pulmonary edema and respiratory failure. 

These toxins are easily manufactured and very stable. There are currently no FDA-licensed vaccines 

or therapeutics for protection from SEA/B. 

The recombinant SEA and SEB vaccine components are expressed in Escherichia coli. Preclinical 

safety, efficacy, and long-term immunity have been demonstrated in rodents and nonhuman primates. 

Furthermore, scalable manufacturing and purification processes, formulation studies, and lot release 

criteria have been developed. These accomplishments serve as a basis for considering the SEA/SEB 

vaccine candidates of sufficient maturity to transition out of the technology base. 

Partners

y USAMRIID

Medical Biological Defense:

PREVENTION

COMPLETED | PROMISING | FUTURE

5-28

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Vaccine Constructs for a Combined Equine Encephalitis Vaccine

Description

A multivalent vaccine that protects against VEE, EEE, and WEE would decrease the threat of a biological attack and enhance strategic mobility of U.S. forces. In addition to developing a new candidate 

vaccine for VEE, USAMRIID research is focused on developing safe and efficacious vaccines for EEE 

and WEE. Like VEE, these viruses are highly infectious and easily transmitted by the aerosol route. 

Current vaccines for EEE and WEE are available for Investigational New Drug use only and have 

been found to be relatively ineffective in a significant portion of the recipients. Three approaches 

are being pursued: naked DNA vaccines; replicon-vectored vaccines; and live, attenuated vaccines 

derived by genetic engineering. 

USAMRIID scientists also are working to confirm cross-protection among various strains of VEE, 

EEE, and WEE with the ultimate goal of developing a multivalent vaccine that would protect against all 

three viruses.

Partners

y USAMRIID

COMPLETED | PROMISING | FUTURE

5-29
Medical Biological Defense:

PREVENTION

Virus-Like Particles

Description

The goal of this research effort is to develop a safe and efficacious subunit, vector-free filovirus vaccine consisting of multiple virus-like particles (VLPs) each expressing three antigens, glycoprotein 

(GP), VP40, and nucleoprotein (NP), of a filovirus strain. The VLPs are spontaneously produced in 

cells when the three genes are expressed ectopically. These VLPs have a morphology that is strikingly similar to the authentic filovirus with the GP expressed on the surface, traversing the envelope, a 

layer of matrix protein (VP40) underneath the envelope, as well as encapsidated NP. It is anticipated 

that the final product will be a trivalent vaccine consisting of VLPs for Ebola virus Zaire, Ebola virus 

Sudan, and Marburg Musoke, each produced separately in mammalian cells. This trivalent vaccine 

will provide immunity against multiple Ebola and Marburg viruses. To date, mono- and multivalent 

efficacy in nonhuman primates and a high degree of efficacy following 2 doses of the vaccine have 

been demonstrated.

Partners

y USAMRIID

COMPLETED | PROMISING | FUTURE

5-30

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Therapeutic Strategies for Botulinum Neurotoxins

Description

Botulinum neurotoxins are the most toxic biological substances known. These toxins bind to peripheral cholinergic nerve cells, rendering them inactive and causing neuromuscular paralysis, respiratory 

failure, and death. Current treatment for botulinum intoxication involves weeks of intensive care.

USAMRIID has worked closely with the University of California, San Francisco, to develop monoclonal 

antibodies to treat all seven serotypes of botulinum neurotoxin. These efforts resulted in a combination of three human-compatible monoclonal antibodies that bind to the toxin, rendering it harmless.

NIAID has awarded a contract to XOMA Ltd. and SRI International to produce three human monoclonal antibodies against botulinum neurotoxin A. 

Partners

y USAMRIID

y University of California, San Francisco

Medical Biological Defense:

THERAPEUTICS

COMPLETED | PROMISING | FUTURE

5-31
Therapeutic Strategies for Treating Filovirus Infection

Description

Drugs to treat infection with the filoviruses Ebola and Marburg would reduce Warfighter morbidity and 

mortality and also decrease the associated hazard to medical and laboratory personnel. USAMRIID 

scientists are identifying viral targets as well as strategies for the treatment of clinical symptoms 

and are evaluating an extensive array of drugs and antibodies for their potential in therapeutic and 

prophylactic treatments of filovirus infections. USAMRIID has identified new targets as well as lead 

compounds and small molecules for further exploration. One drug, recombinant nematode anticoagulant protein c2 (rNAPC2), successfully protected some monkeys from challenge with Ebola virus, 

apparently by blocking the abnormal blood clotting that is characteristic of Ebola infection. 

Monoclonal antibodies to Ebola virus isolated from vaccinated mice by USAMRIID protected mice 

from challenge when administered as late as 2 days after infection, and other monoclonal antibodies 

have protected guinea pigs from lethal Marburg virus infection. USAMRIID researchers are collaborating with Arizona State University, Biovation, and The Dow Chemical Company in evaluating these 

antibodies as potential treatments.

Partners

y USAMRIID

y Arizona Sate University

y The Dow Chemical Company

y Biovation

Medical Biological Defense:

THERAPEUTICS

COMPLETED | PROMISING | FUTURE

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Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Therapeutics for Smallpox and Other Orthopoxviruses

Description

Smallpox was eradicated in 1979 through the efforts of the World Health Organization. Currently, the 

virus is known to exist only in two World Health Organization-sanctioned repositories. However, there 

is concern that undisclosed reference stocks may exist, and the U.S. population is no longer routinely 

immunized against smallpox. Due to the potential for the virus to be used as a BW agent or for bioterrorism, antiviral drugs are urgently needed. 

Because smallpox no longer occurs naturally, vaccine and drug candidates cannot be tested for their 

ability to prevent or treat the disease in humans. Licensing of future medical countermeasures for 

smallpox will depend on animal studies. The FDA has established an Animal Efficacy Rule to facilitate the approval of vaccines and drugs for biological agents in cases where efficacy data in humans 

cannot be obtained. 

Tecovirimat (ST-246) inhibits orthopoxvirus egress from infected cells and therefore prevents it from 

causing disease. Research at USAMRIID has established that oral ST-246 is able to stop the spread 

and disease progression of both smallpox and monkeypox in nonhuman primate models. Additional 

studies are aimed at refining the therapeutic window and the dose-route schedule.

Partners

y USAMRIID 

y HHS/NIAID

COMPLETED | PROMISING | FUTURE

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1. Adler M and Nicholson JD. Evaluation of 

toosendanin as a botulinum neurotoxin 

antagonist. The Botulinum Journal, 1(2), 208-

218, 2008.

2. Adler M, Oyler G, Apland JP, Deshpande SS, 

Nicholson JD, Anderson J, Millard CB, and 

Lebeda FJ. Mechanism of action of botulinum 

neurotoxin and overview of medical countermeasures for intoxication. In: Chemical 

Warfare Agents: Chemistry, Pharmacology, 

Toxicology, and Therapeutics (eds. JA 

Romano Jr, BJ Lukey, H Salem), 2nd ed. 

CRC Press: Boca Raton, FL, pp. 389-422, 

2008.

3. Adler M and Sweeney RE. Computerassisted communication device for botulinum-intoxicated patients. The Botulinum 

Journal, 1(2), 170-182, 2008.

4. Ahmed S, Olson MA, Ludivico ML, Gilsdorf 

J, and Smith LA. Identification of residues surrounding the active site of type A 

botulinum neurotoxin important for substrate 

recognition and catalytic activity. Protein 

Journal, Apr 2008, 27(3): 151-62.

5. Ahmed SA, Smith L, and Toth S. Issues in 

therapeutic development against botulinum 

neurotoxins (BONT). Toxicon, 2008 Jun 1, 

51(Suppl. 1): 8.

6. Alkhalil A, Strand S, Mucker E, Huggins JW, 

Jahrling PB, and Ibrahim SM. Inhibition of 

monkeypox virus replication by RNA interference. Virology Journal, 2009, 6: 188.

7. Aman MJ, Kinch MS, Warfield K, Warren T, 

Yunus A, Enterlein S, Stavale E, Wang P, 

Chang S, Tang Q, Porter K, Goldblatt M, and 

Bavari S. Development of a broad-spectrum 

antiviral with activity against Ebola virus. 

Antiviral Research, 2009 Sep, 83(3): 245-51.

8. Amemiya K, Meyers JL, Rogers TE, Fast RL, 

Bassett AD, Worsham PL, Powell BS, Norris 

SL, Krieg AM, and Adamovicz JJ. CpG 

oligodeoxynucleotides augment the murine 

immune response to the Yersinia pestis F1-V 

vaccine in bubonic and pneumonic models of 

plague. Vaccine, 2009 Apr 6, 27(16): 2220-9.

9. Anderson DR, Taylor SL, Fetterer DP, 

and Holmes WW. Evaluation of protease 

inhibitors and an antioxidant for treatment 

of sulfur mustard-induced toxic lung injury. 

Toxicology, 263(1), 41-46, 2009.

10. Anderson J, Williams PT, Katos AM, Krasna 

M, Burrows W, and Hilmas CJ. Botulinum 

toxin. In Handbook of Toxicology of Chemical 

Warfare Agents (ed. RC Gupta), 407-432, 

Academic Press: London, 2009.

11. Apland JP, Aroniadou-Anderjaska V, and 

Braga MFM. Soman induces ictogenesis 

in the amygdala and interictal activity in 

the hippocampus that are blocked by a 

GluR5 kainate receptor antagonist in vitro. 

Neuroscience, 159(1), 380-389, 2009.

12. Apland JP, Figueiredo TH, Qashu F, 

Aroniadou-Anderjaska V, Souza AP, and 

Braga MF. Higher susceptibility of the 

ventralver susthedorsal hippocampus and 

the posteroventral versus anterodorsal 

amygdala to soman-induced neuropathology. 

NeuroToxicology, July 2010. [Epub ahead of 

print].

13. Aracava Y, Pereira EFR, Akkerman M, 

Adler Michael, and Albuquerque EX. 

Effectiveness of donepezil, rivastigmine, 

and (+/-)huperzine A in counteracting the 

acute toxicity of organophosphorus nerve 

agents: Comparison with galantamine. 

Journal of Pharmacology and Experimental 

Therapeutics, 331(3), 1014-1024, 2009.

14. Aroniadou-Anderjaska V, Figueiredo TH, 

Apland JP, Qashu F, and Braga MFM. 

Primary brain targets of nerve agents: The 

role of the amygdala in comparison to the 

hippocampus. NeuroToxicology, 30, 772-776, 

2009.

15. Asher LVSU, Wahl-Jensen V, Zimmerman 

M, Larsen T, and Hooper JW. Ultrastructural 

Pathology in Syrian Hamsters Experimentally 

Infected with Andes Hantavirus. Abstracts of 

the General Meeting of the American Society 

for Microbiology, 2008 108 p. 667.

16. Baldwin CD, Howe GB, Sampath R, Blyn 

LB, Matthews H, Harpin V, Hall TA, Drader 

JJ, Hofstadler SA, Eshoo MW, Rudnick K, 

Studarus K, Moore D, Abbott S, Janda J, and 

Whitehouse CA. Usefulness of multilocus 

polymerase chain reaction followed by 

electrospray ionization mass spectrometry to 

identify a diverse panel of bacterial isolates. 

PUBLICATIONS

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Diagnostic Microbiology and Infectious 

Disease, 2009 Apr, 63(4): 403-8.

17. Ballough GPH, Kan RK, Nicholson JD, Fath 

DM, Tompkins CP, Moffa GM, and Filbert 

MG. Brain damage from soman-induced 

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JH. Effects of 4-pyridine aldoxime on nerve 

agent-inhibited acetylcholinesterase activity in guinea pigs. Archives of Toxicology, 

83(12), 1083-1089, 2009.

206. Shih T-M, Skovira JW, O’Donnell JC, and 

McDonough JH. Treatment with tertiary 

oximes prevents seizures and improves 

survival following sarin intoxication. Journal 

of Molecular Neuroscience, 40(1-2), 63-69, 

2010.

207. Shih T-M, Skovira JW, O’Donnell JC, and 

McDonough JH. In vivo reactivation by 

oximes of inhibited blood, brain and peripheral tissue cholinesterase activity following 

exposure to nerve agents in guinea pigs. 

Chemico-Biological Interactions, 2010 Mar 9. 

[Epub ahead of print].

208. Shih T-M, Skovira JW, O’Donnell JC, and 

McDonough JH. Central acetylcholinesterase reactivation by oximes improves survival 

and terminates seizures following nerve 

agent intoxication. Advanced Studies in 

Biology, 1(3), 155-196, 2009.

209. Shih T-M, Skovira JW, O’Donnell JC, and 

McDonough JH. Evaluation of nine oximes 

on in vivo reactivation of blood, brain and 

tissue cholinesterase activity inhibited by 

organophosphorus nerve agents at lethal 

dose. Toxicology Mechanisms and Methods, 

19(607), 379-385, 2009.

210. Shipley MA and Minogue TD. Evaluation of 

the Fujifilm QuickGene-Mini80 for Nucleic 

Acid Extraction and Subsequent Detection 

of Select Biothreat Agents. Abstracts of the 

General Meeting of the American Society for 

Microbiology, 2008, 108 p. 150.

211. Sidell FR, Newmark J, and McDonough 

JH. Nerve agents. In Textbook of Military 

Medicine: Medical Aspects of Chemical 

Warfare (ed. SD Tuorinsky), Department of 

the Army, Office of The Surgeon General 

and Borden Institute: Washington, DC, pp. 

155-219, 2008.

212. Skovira JW, McDonough JH, and Shih T-M. 

Protection against sarin-induced seizures 

in rats by direct brain microinjection of 

scopolamine, midazolam or MK-801. Journal 

of Molecular Neuroscience, 40(1-2), 56-62, 

2010.

213. Skovira JW, O’Donnell JC, Koplovitz I, 

Kan RK, McDonough JH, and Shih T-M. 

Reactivation of brain acetylcholinesterase 

by monoisonitrosoacetone increases the 

therapeutic efficacy against nerve agents in 

guinea pigs. Chemico-Biological Interactions, 

2010 Mar 15. [Epub ahead of print].

214. Smart JK, Mauroni Al, Hill BA Jr, and Kok 

AB. History the chemical threat, chemical 

terrorism, and its implications for military 

medicine. In Textbook of Military Medicine: 

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SD Tuorinsky), Department of the Army, 

Office of The Surgeon General and Borden 

Institute: Washington, DC, pp. 115-153, 2008.

215. Smith DR, Lee JS, Jahrling J, Kulesh DA, 

Turell MJ, Groebner JL, and O’Guinn ML. 

Development of field-based real-time reverse 

transcription-polymerase chain reaction 

assays for detection of Chikungunya and 

O’nyong-nyong viruses in mosquitoes. 

American Journal of Tropical Medicine and 

Hygiene, 2009 Oct, 81(4): 679-84.

216. Smith LA. Botulism and vaccines for its 

prevention. Vaccine, 2009 Nov 5, 27

(Suppl 4): D33-9.

217. Smith JR, Capacio BR, Korte WD, Woolfitt 

AR, and Barr JR. Analysis for plasma protein 

biomarkers following an accidental human 

exposure to sulfur mustard. Journal of 

Analytical Toxicology, 32(1), 17-24, 2008.

218. Smith WJ. Therapeutic options to treat 

sulfur mustard poisoning. The road ahead. 

Toxicology, 263(1), 70-73, 2009.

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219. Smith WJ, Clark MG, Talbot TB, Caple 

PA, Sidell FR, and Hurst CG. Long-term 

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Tuorinsky), Department of the Army, Office of 

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220. Solano MI, Thomas J, Taylor JT, McGuire 

JM, Jakubowski EM, Thomson SA, 

Maggio VL, Holland KE, Smith JR, 

Capacio B, Woolfitt AR, Ashley DL, and 

Barr JR. Quantification of nerve agent 

VX-butyrylcholinesterase adduct biomarker 

from an accidental exposure. Journal of 

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221. Spik KW, Badger C, Mathiessen I, Tjelle T, 

Hooper JW, and Schmaljohn C. Mixing of M 

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Puumala virus reduces their immunogenicity 

in hamsters. Vaccine, Sep 19, 2008, 26(40): 

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222. Spurgers KB, Sharkey CM, Warfield KL, and 

Bavari S. Oligonucleotide antiviral therapeutics: Antisense and RNA interference 

for highly pathogenic RNA viruses. Antiviral 

Research, Apr 2008, 78(1): 26-36.

223. Stahl AM, Adler M, Millard CB, and Gilfillan 

L. Accelerating botulism therapeutic product 

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Drug Development Research, 2009 June, 70 

(4, Sp. Iss.): 303-326.

224. Stahl AM, Adler M, Millard CB, and Gilfillan 

L. Product development tools to enhance 

drug discovery. The Botulinum Journal, 1(1), 

7-13, 2008.

225. Sun W, Doctor BP, Lenz DE, and Saxena 

A. Long-term effects of human butyrylcholinesterase pretreatment followed by acute 

soman challenge in cynomolgus monkeys. 

Chemico-Biological Interactions, 175(1-3), 

428-430, 2008.

226. Swenson DL, Wang D, Luo Min, Warfield 

KL, Woraratanadharm J, Holman DH, Dong 

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nonhuman primates complete protection 

against multistrain Ebola and Marburg virus 

infections. Clinical and Vaccine Immunology, 

Mar 2008, 15(3): 460-7.

227. Swenson DL, Warfield KL, Warren TK, 

Lovejoy C, Hassinger JN, Ruthel G, Blouch 

RE, Moulton HM, Weller DD, Iversen PL, 

and Bavari S. Chemical modifications of 

antisense morpholino oligomers enhance 

their efficacy against Ebola virus infection. 

Antimicrobial Agents and Chemotherapy, 

2009 May, 53(5): 2089-99.

228. Talbot TB, Lukey B, and Platoff GE Jr. 

Introduction to the chemical threat. In 

Textbook of Military Medicine: Medical 

Aspects of Chemical Warfare (ed. SD 

Tuorinsky), Department of the Army, Office of 

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229. Taylor BJ, Orr SA, Chapman JL, and Fisher 

DE. Beyond-use dating of extemporaneously 

compounded ketamine, acepromazine, and 

xylazine: Safety, stability, and efficacy over 

time. Journal of the American Association for 

Laboratory Animal Science, 2009 Nov, 48(6): 

718-26.

230. Taylor SL, Frias-Staheli N, Garcia-Sastre 

A, and Schmaljohn CS. Hantaan virus 

nucleocapsid protein binds to importin alpha 

proteins and inhibits tumor necrosis factor 

alpha-induced activation of nuclear factor 

kappa B. Journal of Virology, 2009 Feb, 

83(3): 1271-9.

231. Taylor SL, Krempel RL, and Schmaljohn CS. 

Inhibition of TNF-alpha-induced activation 

of NF-kappaB by hantavirus nucleocapsid 

proteins. Annals of the New York Academy of 

Sciences, 2009 Sep, 1171 (Suppl 1): E86-93.

232. Torres-Escobar A, Juárez-Rodríguez 

MD, Gunn BM, Branger CG, Tinge SA, 

and Curtiss R III. Fine-tuning synthesis 

of Yersinia pestis LcrV from runaway-like 

replication balanced-lethal plasmid in a 

Salmonella enterica serovar typhimurium 

vaccine induces protection against a lethal

Y. pestis challenge in mice. Infect Immun, 

Jun 2010, 78(6):2529-43.

233. Toth SI, Smith LA, and Ahmed SA. 

Extreme sensitivity of botulinum neurotoxin 

domains towards mild agitation. Journal of 

Pharmaceutical Sciences, 2009 Sep, 98(9): 

3302-11.

234. Trombley AR, Wachter L, Garrison J, 

Buckley-Beason VA, Jahrling J, Hensley LE, 

Schoepp RJ, Norwood DA, Goba A, Fair JN, 

and Kulesh DA. Comprehensive panel of 

real-time TaqMan polymerase chain reaction 

assays for detection and absolute quantification of filoviruses, arenaviruses, and New 

World hantaviruses. Am J Trop Med Hyg, 

May 2010, 82(5):954-60.

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Triage of chemical casualties. In Textbook 

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Chemical Warfare (ed. SD Tuorinsky), 

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Washington, DC, pp. 511-525, 2008.

236. Tuorinsky SD and Sciuto AM. Toxicinhalational injury and toxic industrial 

chemicals. In Textbook of Military Medicine: 

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SD Tuorinsky), Department of the Army, 

Office of The Surgeon General and Borden 

Institute: Washington, DC, pp. 339-370, 2008.

237. Turell MJ, Dohm DJ, Mores CN, Terracina L, 

Wallette DL, Hribar LJ, Pecor JE, and Blow 

JA. Potential for North American mosquitoes 

to transmit Rift Valley fever virus. Journal of 

the American Mosquito Control Association, 

Dec 2008, 24(4): 502-7.

238. Turell MJ, Linthicum KJ, Patrican LA, Davies 

FG, Kairo A, and Bailey CL. Vector competence of selected African mosquito (Diptera: 

Culicidae) species for Rift Valley fever virus. 

Journal of Medical Entomology, Jan 2008, 

45(1) 102-8.

239. Turell MJ, O’Guinn ML, Dohm D, Zyzak M, 

Watts D, Fernandez R, Calampa C, Klein 

TA, and Jones JW. Susceptibility of Peruvian 

mosquitoes to eastern equine encephalitis 

virus. Journal of Medical Entomology, Jul 

2008, 45(4): 720-5.

240. Turell MJ and Parker MD. Protection of 

hamsters by Venezuelan equine encephalitis virus candidate vaccine V3526 against 

lethal challenge by mosquito bite and 

intraperitoneal injection. American Journal of 

Tropical Medicine and Hygiene, Feb 2008, 

78(2):328-32.

241. Turell MJ, Sardelis MR, Jones JW, Watts 

DM, Fernandez R, Carbajal F, Pecor JE, and 

Klein TA. Seasonal distribution, biology, and 

human attraction patterns of mosquitoes 

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242. Turell MJ, Whitehouse CA, Butler A, Baldwin 

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Journal of Tropical Medicine and Hygiene, 

Feb 2008, 78(2): 344-7.

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BK. Pathology of inhalational Francisella 

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Simulation models examining the effect of 

Brugian filariasis on dengue epidemics. 

American Journal of Tropical Medicine and 

Hygiene, 2009 Jan, 80(1): 44-50.

246. Waag DM, England MJ, Bolt CR, and 

Williams JC. Low-dose priming before vaccination with the phase I chloroform-methanol 

residue vaccine against Q fever enhances 

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247. Walters MS and Mobley HL. Bacterial 

proteomics and identification of potential 

vaccine targets. Expert Rev Proteomics, Apr 

2010, 7(2):181-4.

248. Warfield KL, Bradfute SB, Wells J, Lofts 

L, Cooper MT, Alves DA, Reed DK, 

VanTongeren SA, Mech CA, and Bavari 

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a mouse model for Marburg hemorrhagic 

fever. Journal of Virology, 2009 July, 83(13): 

6404-15.

249. Webb RP, Smith TJ, Wright P, Brown J, and 

Smith LA. Production of catalytically inactive 

BoNT/A1 holoprotein and comparison with 

BoNT/A1 subunit vaccines against toxin 

subtypes A1, A2, and A3. Vaccine, 2009 July 

16, 27(33): 4490-4497.

250. Welkos S, Norris S, and Adamovicz J. 

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Hilmas CJ. A new device for the capture and 

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Microbiology, 2008, 108 p. 114.

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261. Zottola MA. A partial exploration of the 

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Lawrence R. Disulfides as cyanide anti-

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Research in Toxicology, 22, 1948–1953, 

2009.

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Logistics

Appendices

Military Infectious 

Diseases

Combat 

Casualty Care

Military 

Operational 

Medicine

Clinical and 

Rehabilitative 

Medicine

Medical Chemical 

and Biological 

Defense

Advanced 

Technologies
OVERVIEW

Advanced Medical Technologies

The U.S. Army Medical Research and Materiel Command’s 

(USAMRMC’s) Telemedicine and Advanced Technology Research 

Center (TATRC) manages congressionally mandated advanced 

technology projects, including identification, exploration, and 

demonstration of key technologies that will reduce the medical 

“footprint” and increase medical mobility while ensuring Warfighters 

have access to essential medical expertise and support wherever 

they deploy. Through partnerships with industry and academia, 

resulting products help make medical care and services more 

accessible to Warfighters, reduce costs, and enhance the overall 

quality of health care in wartime and peacetime. Current projects 

focus on:

y Advanced prosthetics, orthotics, and other orthopedic assistive 

devices, treatments, and interventions for patients with major limb 

amputations, fractures, and other orthopedic-related injuries 

y Chronic disease management that highlights the use of telemedicine, home care monitoring, evolving biosensor development, 

and advanced immunologic testing in vulnerable populations 

y Computational biology or bioinformatics, which involves the 

development and application of methods for analysis, interpretation, prediction, and modeling of biological data

y Health information technologies

y Advanced medical imaging technologies, which is divided into 

four distinct research areas: portable imaging and image-guided 

therapeutics, advanced high-performance imaging, computational methods and decision support in imaging, and optical/paraoptical imaging techniques 

y Medical logistics of state-of-the-art prototype devices 

y Robotic technologies to locate, identify, assess, treat, and rescue 

battlefield casualties 

y Mobile computing and remote monitoring that focus on identifying 

and developing point-of-care medical technologies and support 

architectures to improve military health care 

y Nanotechnology and biomaterials to improve drugs and devices 

for diagnosis and therapy 

y Neuroscience projects that leverage the latest technologies in 

prevention, diagnosis, treatment, and therapy to prevent injury or 

improve Warfighter outcomes from traumatic brain, spinal cord, 

and peripheral nerve injuries as well as the neuropsychologic 

effects of war

y Regenerative medicine, created in response to the current military medical needs to treat traumatically injured tissues resulting 

from combat or battlefield wounds

6-2

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Care
6-3
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

COMPLETED | PROMISING | FUTURE

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

Clinical Looking Glass, “A Revolutionary Clinical Intelligence Tool”

Description

TATRC is working with Emerging Health IT, Inc. (Montefiore Medical Center, New York) to pilot a 

revolutionary clinical intelligence tool known as the Clinical Looking Glass. The Clinical Looking Glass 

currently is used by clinicians at Montefiore Medical Center to perform quality assurance studies and 

health research studies. It is a data warehouse with an easy-to-use front end that allows clinicians 

to build study and control cohorts at their desktops, using data from the electronic health record, and 

make comparisons between these groups as to differences in health outcomes. Cohorts can be 

compared easily with statistical measures and graphical outputs ready for use in quality assurance 

meeting and publications. All of this is done automatically, in a matter of minutes, with no need for 

chart abstracts, or statisticians. All cohorts and results can be saved as objects for reuse and sharing 

with colleagues. By default, all studies are done with de-identified data; however, identified data are 

available to those with permission to support patient remediation at the point of care.

Between 2006 and 2008, TATRC established the Clinical Looking Glass with de-identified data from 

the National Capital Area. In 2009, TATRC began establishing a pilot of the Clinical Looking Glass at 

the U.S. Air Force Population Health Center, Brooks City, Texas. The plan for 2010 is to enhance the 

Clinical Looking Glass with Military Health System (MHS) data from the Air Force Corporate Health 

Information Processing Service warehouse and then make the Clinical Looking Glass available for 

further evaluation by select clinicians at the National Naval Medical Center in Bethesda and Walter 

Reed over the Internet. Given a successful pilot at Brooks City Base, clinician support, and funding, 

the plan is to move the Clinical Looking Glass to production as a system of record for the MHS.

Partners

y TATRC

y Emerging Health IT, Inc. (Montefiore Medical Center, New York)

Departments of Combat 

Medical Training – Technology 

Enhancement

Description

To reduce the number of persons needed 

to conduct the All Skills Practical Exam and 

reduce the amount of time candidates must 

wait to receive the results of their skills evaluation. This is a significant challenge to both 

military and civilian training departments. 

Deloitte Consulting LLP has completed the 

research, design, and development of a technical solution: to digitize and integrate formsbased testing and training documents into the 

68W training program to improve the quality 

of combat medic training. This includes the 

digital conversion of paper to electronic forms, 

processing of radio frequency identification 

signals using passive tag technology, two-way 

secure wireless synchronization of the tablet, 

and central servers managing the data.

Partners

y TATRC

y Deloitte Consulting LLP (formally 

BearingPoint, Inc.)

6-4
COMPLETED | PROMISING | FUTURE

Digital Imaging Network-Picture Archiving and Communications System

Description

The Digital Imaging Network-Picture Archiving and Communications System (DIN-PACS) provides service members and their families with faster and better images to enhance quality of care. DIN-PACS 

is made up of several components, including reusable phosphorus plates that work with a normal x-ray 

machine, a computerized radiography scanner, and a workstation to view captured images. Images 

can be lightened or darkened, leveled to find the best quality, sent off-site to a radiologist for diagnostic 

reading, and archived immediately. DIN-PACS was completed in 1991.

Partners

y TATRC

y USAMMA

y Army PACS Program Management Office

y AGFA

y Fuji

y GE

y Philips

y Medweb

Digital Information and 

Communications System

Description

The Digital Information and Communications 

System (SMART/MC3T) enables service 

members to establish communications 

(e.g., self-sufficient Internet and telephone 

coverage) in remote areas and provides local 

authorities with medical situational awareness and telemedicine services. SMART/

MC3T implements commercially available 

technologies through a modular solution that 

is heterogenous, multiplatform, open standards based, and upward compatible in both 

capacity and technology. The system was 

completed in 2003.

Partners

y TATRC

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Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

Video Laryngoscope 

Description

TATRC has been supporting efforts led by Dr. Ben Boedeker to develop increasingly improved airway 

management tools for the far-forward battlefield. This effort has been centered on video laryngoscopy. With the advent of video laryngoscopy, a need for novel support devices was created. Two 

novel support devices, the Intubating Forceps and the suction Video Laryngoscope Blade were 

developed and fielded for military use.

The Video Laryngoscope Blade was evaluated in a simulated airway model with secretions. The 

hemorrhagic airway creates difficulty in airway visualization, impeding attempts to successfully 

perform intubation. Challenges in the development of a suction laryngoscope include insufficient suction rates and complicated methods of attaching catheters, making the device difficult to use. Video 

laryngoscopy requires optics free from distortion. This work compared a specially designed Video 

Laryngoscope Blade with an integrated suction capability and its comparison to, and support of, a 

standard suction system. The new system was comparable to and in many ways superior to older 

systems. The significant difference between each individual type of suction and the combination of 

the two indicate that using both during a procedure would increase the amount of blood and debris 

removed from a severely bleeding airway. The Laryngoscope Blade is present in almost every intubation so integrating suction provides an additional avenue for removal of liquid from the airway while 

freeing the practitioner’s hands for other tasks. 

The Boedeker (Curved) Intubating Forceps for Removal of a Foreign Body also have been evaluated in a manikin. Foreign body aspiration is a common clinical problem, especially in children. The 

foreign body is commonly removed using McGill forceps and direct laryngoscopy. While standard 

laryngoscopes provide a direct view along the line of sight (10 degree field of view), with video laryngoscopy a much wider (60 degree) field of view may be achieved. Conventional (straight shaft) McGill 

forceps are designed to operate in direct line of sight. However, when using video laryngoscopy, the 

COMPLETED | PROMISING | FUTURE

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

Teleconsultation/Teledermatology

Description

Facilitates readiness and promotes health 

protection of the force. Teleconsultation/

teledermatology facilitates delivery of medical 

treatment through information and telecommunication technologies and was completed 

in 2001.

Partners

y TATRC

6-6
working end of this instrument does not pass 

into the laryngoscopist’s field of view. The 

Boedeker Intubating Forceps were developed 

to allow the operator to reach into the full field 

of view offered by video laryngoscopy. In 

this testing, curved forceps, bent in an arc 

similar to the MacIntosh blade, were shown 

to offer advantages for retrieval of foreign 

objects passed beyond the field of view by 

straight line of sight. This study demonstrated 

that the successful removal of foreign bodies 

using forceps that are curved to match the 

shape of the MacIntosh laryngoscope blade is 

significantly more effective than using forceps 

with a noncurved shaft.

These two instruments, the novel suction 

blade and the novel laryngeal retrieval forceps, have been licensed and production has 

begun by medical manufacturers. 

Partners y TATRC y University of Nebraska Medical Center

COMPLETED | PROMISING | FUTURE

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Medical Chemical 

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Defense

Clinical and 

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Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

Web-Enabled Refractive Surgery Information System

Description

Collection and management of refractive surgery information will protect patients, improve care, and 

reduce costs by providing an electronic medical record that is accessible at any facility a patient visits. 

The Warfighter Refractive Eye Surgery Program (WRESP) provides service members with refractive 

eye surgery to increase their mobility in combat.

WRESP was initiated to support service members as well as track the long-term effects and benefits 

of refractive surgery. It was developed and adopted in cooperation with the ophthalmology consultant 

for the Surgeon General. 

The Web-Enabled Refractive Surgery Information System (WebRSIS) was developed to capture 

refractive surgery clinical data and to conduct outcome analysis. This program was developed by 

doctors for doctors to meet the business needs and clinical environment found at regional medical 

centers. 

Current technology provides audit trails, provider tracking, digital signatures, and privilege management; data consolidation, real-time and historical reporting, and a questionnaire; pre-operative exam, 

treatment plan, operation notes, and post-operative exam; and a deployment questionnaire.

To date, about 4,100 patients have been entered into the existing RSIS program with more than 3,900 

patients entered into the new WebRSIS. Next year, about 12,000 new records are anticipated. These 

numbers will be used in the Standard Refractive-Surgery Data Report, which automatically summarizes outcomes from multiple surgeries. The Standard Refractive-Surgery Data Report benefits the 

patient, surgeon, and the MHS by reporting data in a concise and meaningful way. 

Partners

y TATRC

COMPLETED | PROMISING | FUTURE

TELEMEDICINE AND ADVANCED 6-8 MEDICAL TECHNOLOGIES
TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Advanced Surgical Technologies

Description

Advanced Surgical Technologies (AST) will use progressive advanced technologies in communication and patient care to improve the efficiency and safety of military and civilian operating rooms. 

The operating room is a highly complex environment of startling isolation in real time. Staff teamwork is fragmented and requires an inordinate amount of voice communication resulting in negative 

unplanned events occurring frequently and in clusters. In addition, valuable time is wasted; quality 

indicators, including patient safety, are assessed only in retrospect; and too much energy is expended 

on making the operating room function instead of directing patient care.

AST will integrate existing pockets of research through collaboration to implement advanced medical technologies in both the federal and civilian health care systems and stimulate new research and 

development focused specifically within the following topical research areas: patient safety, advanced 

devices, medical informatics, telesurgery, and perioperative systems design.

Partners

y TATRC

6-9
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

AHLTA-Mobile

Description

On the battlefield, it is crucial for first responders to have current medical information at the point of 

care. AHLTA-Mobile (Armed Forces Health Longitudinal Technology Application-Mobile) is a diagnostic tool that provides useful medical informatics and telemedicine support across the spectrum of the 

military health care operations and continuum of support levels of care. 

AHLTA-Mobile, a wireless handheld device that is used throughout the Department of Defense (DoD) 

to capture electronic health records for more than 9 million U.S. service members, retirees, and their 

families, enables first responders and other health care staff to quickly and accurately capture, integrate, transmit, and display data from medical histories and physical examinations, medical reference 

libraries, diagnostic and treatment decision aids, medical sustainment training, and medical mission 

planning. The personal digital assistant (PDA) can be used by military health care providers at all 

levels of care from the foxhole to the medical center. AHLTA-Mobile, also called BMIST-J (Battlefield 

Medical Information System Tactical-Joint), supports a user interface that includes help windows and 

decision rationale. The system is easily adaptable to evolving medical procedures and protocols in 

addition to new medical databases and mission requirements. Under adequate conditions, AHLTAMobile is capable of supporting real-time “teleconsultation” between the first responder and expert 

medical staff in different locations. AHLTA-Mobile was named as one of the Army’s 10 Greatest 

Inventions for 2003 and 2004. 

Partners

y TATRC

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

6-10
COMPLETED | PROMISING | FUTURE

Center for Military Biomaterials Research

Description

The Center for Military Biomaterials Research (CeMBR), located at Rutgers University in Piscataway, 

New Jersey, will become the military’s scientific resource in the field of biomaterials science and 

engineering. CeMBR will facilitate the research and development of new biomaterial technologies 

and improve the control of cell-material interactions with applications for improving both preventive 

and combat casualty care.

CeMBR was specifically designed to address the shortcomings and needs of the military as outlined 

in a 2001 Board on Army Science and Technology Report, “Opportunities in Biotechnology for Future 

Army Applications.” CeMBR has implemented a roadmap process in which the military’s requirements for new biomaterials are delineated and targeted. Specifically, the center will address the 

process by which the military incorporates biotechnology developments and specific applications of 

biomaterials for improving both preventive and combat casualty care. 

CeMBR will create a unique industrial/academic/government network with a core faculty and a panel 

of nationally renowned scientific advisors for project selection and outcomes evaluation. The major 

focus of the center is to help the military negotiate an environment of rapidly changing science and 

assist in the translation of science from the bench to the field and bedside using the most efficient 

technology translation mechanisms available. Some of the scientific investigations supported at the 

center include sprayable wound dressings, scaffolds for bone regeneration, a model for a human skin 

equivalent, and stem cell technologies for tissue regeneration. New technologies are added to the 

center’s portfolio of projects as determined by a scientific advisory panel.

Partners

y TATRC

6-11
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Common Development Environment Initiative

Description

The Common Development Environment (CDE) Initiative will organize and facilitate local and regional 

innovations in health informatics and technology, as well as steer the IM/IT research agenda toward 

the rapid enhancement of the Enterprise-Wide Electronic Health Record solution, AHLTA. 

Promising health information technologies are being developed in military research settings and at 

local MTFs across the MHS. However, these efforts are not well coordinated and yield few benefits 

to mainstream military health information systems. The lack of an agile process or methodology for 

the coordinated development, testing, and hand off of health IT products to the enterprise has resulted 

in a failure to capitalize on emerging technology innovations and financial investments in information 

management/information technology (IM/IT). 

The CDE Initiative seeks to align IM/IT research and prototyping activities with mainstream IM/IT 

acquisition strategies and business processes to improve the quality and availability of candidate solutions for AHLTA. To achieve this goal, the CDE Initiative will design and test a management model 

that coordinates research and business practice, sets standards and guidelines, and offers a representative AHLTA development environment for government, academia, and industry partners to use 

when designing, developing, or testing IM/IT solutions.

Partners

y TATRC

6-12
COMPLETED | PROMISING | FUTURE

Copper Antimicrobial Program

Description 

The Copper Antimicrobial Program will determine the efficacy of copper touch surfaces to mitigate 

cross-contamination of infectious diseases. This project is conducting a multiyear study to determine 

the impact of copper touch surfaces on three organisms: methicillin-resistant Staphylococcus aureus,

vancomycin-resistant Enterococci, and Acinetobacter baumannii. This study includes multicenter 

clinical trials that focus on three different patient populations. The first trial was conducted in an 

intensive care unit at three hospital sites, the second clinical trial examined the effect of copper touch 

surfaces in cancer care units at two hospital sites, and the final trial examined whether the intervention also is efficacious for “routine” patients (i.e., those hospitalized on a gastrointestinal care unit 

[regular] medical ward at a single hospital site). 

Fabrication of the copper components and the installation of the objects in the intensive care units 

were completed. Preliminary results are encouraging. The microbial burden associated with the 

copper surfaces was substantially lower than the non-copper counterparts in the rooms studied. 

Sixty-seven percent of the copper objects were found to have fewer than 100 cfu/100 cm2 while an 

almost inverse relationship was observed for the non-copper objects where greater than 63 percent of 

the objects evaluated were found to have a microbial burden greater than 100 cfu/100 cm2.

Partners

y TATRC 

y Medical University of South Carolina

y Charleston Research Institute at the Ralph H. Johnson Veterans Affairs (VA) Medical Center

y Memorial Sloan-Kettering Cancer Center

Development of an Over-Ground, 

Pneumatically Actuated BodyWeight Support System

Description

Developed and patented, the ZeroG is a 

revolutionary over-ground gait training system 

that will enhance therapeutic outcomes in 

individuals following neurological injuries, 

such as stroke, spinal cord injury, and traumatic brain injury, as well as individuals with 

amputations of the lower extremities.

Partners

y TATRC

y ZeroG

6-13
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Handwashing Compliance Reminder and Documentation System

Description

To reduce the number of hospital-acquired infections by developing a “zone of protection” for the 

patient through a reminder system that emits a quiet beep to providers in the event they have not 

washed their hands prior to engagement with the patient. 

The Center for Integration of Medicine and Innovative Technology’s (CIMIT’s) system can be incorporated 

into a clinician’s or other caregiver’s badge to remind them, in real time, if proper hand cleansing has 

not occurred according to room-specific protocols. The unique features in this system are expected to 

minimize disruption of clinical efficiency and to facilitate compliance in a nonthreatening way yet still allow 

data logging to document compliance for quality assurance purposes. The system will be smart enough 

to “know” when proper cleansing has or has not occurred and to do so in a context-sensitive manner. 

Thus, it will be flexible enough to conform to different care practices in different units, be subtle enough 

to not embarrass the clinician in front of the patient, and finally be inexpensive enough to be used by 

every clinician. It will be designed for quick and easy installation at the local unit level, yet will be totally 

scalable, and hence does not require expensive or invasive infrastructure modification or installation.

To date, a prototype device has been developed, and preliminary testing has proven successful. The 

project was selected for funding from the DoD and VA Joint Incentive Fund to demonstrate how this 

system will work in a ward of the Boston VA Hospital and in a ward at the U.S. Army Institute of Surgical 

Research.

Partners

y TATRC

y CIMIT

High-Altitude Platforms Mobile 

Robotic Telesurgery

Description

The use of an unmanned aerial vehicle (UAV) 

containing communication platforms has the 

capability to address communication deficiencies for successful telesurgery. 

A surgeon from the University of Cincinnati 

operated the telerobotic surgical arm from the 

University of Washington by manipulating the 

master unit several miles from the simulated 

patient. Communication signals were provided 

to and from a master unit and a surgical arm 

by the Programmable Universal Manipulation 

Arm (PUMA) UAV on a wireless 802.11g 

system. The PUMA also was employed to 

establish a link between Simi Valley, California, 

and Seattle, Washington. This research 

demonstrated the potential of using UAVs for 

scalable wireless communication with reduced 

latency. Additional research is planned.

Partners

y TATRC

6-14
COMPLETED | PROMISING | FUTURE

Joslin Comprehensive Diabetes Management Project

Description

Providing state-of-the-art diabetes and endocrine medical care within a team setting, Joslin uses a 

telemedicine system for comprehensive diabetes management and the assessment of diabetic retinopathy that provides increased access for diabetic patients to appropriate care, centralizes patients 

in the care process, empowers patients to better manage their disease, can be performed in a costeffective manner, and maintains the high standard of care required for the appropriate management of 

diabetic patients.

The Comprehensive Diabetes Management Project is a web-based diabetes health care delivery 

system that provides connected care for patients and providers based on clinical guideline decision 

support and alerting. It was developed to provide an optimal design for needed comprehensive 

care. This is a patient-entered, care manager-driven, customizable program that interacts with the 

electronic medical record and other diverse clinical data sources, such as laboratory systems, to 

aggregate data and present them in a medically appropriate manner to increase the efficiency of 

the physician–patient encounter. The system is built on available technologies and tools, uses open 

source tools when appropriate, and has a Health Insurance Portability and Accountability Actcompliant, secure Internet patient portal component for patients to access their results, participate 

in educational modules, and observe trends in their own illnesses. In addition, the system facilitates 

more continuous communication between patients and their care teams. This diabetes-specific 

patient information system stratifies patients into risk categories that include systemic and comorbid 

risks as well as behavioral risks, tracks outcomes, and stimulates physicians to improve care. 

Partners

y TATRC

6-15
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Medical Surveillance Network

Description

The Medical Surveillance Network will facilitate data exchange and support all levels of 

care with an integrated joint medical information system thereby linking system communications and promoting situational awareness.

The Medical Communications for Combat 

Casualty Care (MC4)/Theater Medical 

Information Program (TMIP) is a defense 

medical surveillance system. The MC4/

TMIP conducts medical trend analyses 

based on data from multiple sources (i.e., 

environmental survey data; nuclear, biological, and chemical data; patient encounter 

data; and medical sensor data). This system 

links to worldwide surveillance resources to 

include the command and control system for 

Warfighter situational understanding updates.

Partners

y TATRC

y MC4

y TMIP

Microencapsulation and Vaccine 

Delivery

Description

The goal of this effort is to produce a more 

effective vaccine delivery method. More 

effective and easily stored vaccines are a 

critical tool in the military’s defense against 

possible viral warfare or terrorist attacks. 

Investigators at Texas A&M University are 

engaged in promising research in microencapsulation of vaccines, entrapping them 

within micro- or nanoparticles, as a way to 

enhance their effectiveness. These encapsulated vaccines could have the capability to be 

shipped at room temperature and taken orally 

in a single dose.

TATRC is supporting the group’s efforts to 

develop prototype controlled-release vaccines for animal testing with the ultimate goal 

of improving the delivery of a number of vital 

vaccines.

Partners

y TATRC

y Texas A&M University

6-16
COMPLETED | PROMISING | FUTURE

Nanofabricated Bioartificial Kidney

Description

Many combat casualties result in substantial blood loss and shock along with traumatic organ injury. 

When service members with such injuries are successfully resuscitated and transported to medical 

treatment facilities (MTFs), acute renal failure can develop secondary to shock and traumatic injury. 

In Operation Iraqi Freedom, in-hospital mortality from acute renal failure approaches 40 percent.

Advances in the treatment of renal failure will involve the tissue engineering of kidney nephronal units. 

For this technology to be generally applicable, devices must be compact, inexpensive, and self-monitoring. The advent of microelectromechanical systems technology has produced practical surface 

and bulk micromachining techniques with the ability to manufacture mechanical devices (pores, 

valves, gears, etc.) with feature sizes on the same order of magnitude as subcellular organelles in 

combination with on-chip electronics and sensors. This combination allows the development of 

microelectromechanical devices that can be engineered to interact intelligently with their environment. 

The current project will result in the development of a bioartificial kidney consisting of synthetic membranes and living cells that can be deployed quickly to the bedside of a wounded service member to 

treat acute renal failure and improve the unacceptably high mortality rates associated with it.

Partners

y TATRC

y University of Michigan

y Cleveland Clinic Foundation

y Innovative BioTherapies, Inc.

6-17
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

New Clinical Data Mart Prototype and Research Data Cube Initiatives

Description

The New Clinical Data Mart (CDM) Prototype and Research Data Cube will exploit cutting-edge data warehousing technologies to support improved clinical 

decision making, impacting the lives of 9.2 million military beneficiaries.

New CDM Prototype: This is a new data warehousing model that will receive feeds from the AHLTA Clinical Data Repository. The Clinical Data Repository 

contains detailed clinical encounter information that can be used to improve clinical decision making. Execution is through a Cooperative Research and 

Development Agreement (CRADA) that requires TATRC to collect metrics on the performance of the prototype and compare it to the existing CDM. The 

prototype will be designed to support queries by up to 50,000 users. 

Research Data Cube: This project will build a set of de-identified clinical encounters and other data that can be used to support Small Business Innovation 

Research and congressional initiatives aimed at improving access to care, health care delivery, and population health. The ultimate concept is to provide 

Health Insurance Portability and Accountability Act-compliant, public-use files containing large, longitudinal patient data sets to support random clinical trials 

and observational data studies. These data also can support a variety of specialized studies, such as post-marketing surveillance of the safety of drugs or 

cohort studies involving chronic disease conditions. The Research Data Cube also will support true data mining to discover relationships in clinical data 

through pattern recognition and clustering techniques. These techniques can help researchers and health care personnel better understand the disease 

causation process and can influence patient interventions. 

Partners

y CDM: Microsoft Corporation; Hewlett Packard, Inc.; Intel, Inc.; and Solid Quality Learning, Inc.

y Research Data Cube: Will leverage past work of KBSI, Inc.; Windber Research Institute; Emerging Health, Inc.; Montefiore Medical Center; and Lincoln 

Technologies. May be supported by a new CRADA with Oracle.

6-18
COMPLETED | PROMISING | FUTURE

New Sprayable Liquid Wound 

Dressing

Description

Researchers are developing a New, 

Sprayable Liquid Wound Dressing technology 

that an injured Warrior could apply onehanded in a combat setting. The GelSprayTM 

Liquid Bandage forms a tough hydrogel in 

seconds that conforms directly to a wound 

without sticking to it when removed. 

The GelSpray Liquid Bandage was approved 

by the U.S. Food and Drug Administration 

(FDA) for minor cuts and irritations in 2008. 

With TATRC’s assistance, its developers are 

preparing for a human clinical study required 

to extend the technology to battlefield care. 

The technology shows promise for quicker 

wound healing with less care needed.

Partners y TATRC y Rutgers University

6-19
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Next-Generation Portable X-Ray System

Description

Engineers at GE Global Research, collaborating with research scientists at Emory University and TATRC, are working to incorporate the advanced diagnostic 

image quality of GE flat panel digital detector technology in portable x-ray systems. GE researchers, along with TATRC personnel, spent several days at 

Fort Lewis working with military stakeholders to carry out the critical “customer input” phase of this process. Military participants included active and retired 

military personnel, the majority of whom had deployed and recently returned from the theater of operations on the battlefield. Included in this group are radiologists, staff sergeants, specialists, and physicists. All were willing and eager to frame requirements for a forward-deployed portable x-ray system. The key 

high-level system characteristics gathered in this exercise were classified in seven major categories: availability, transportability, durability, reliability, portability, flexibility, and simplicity.

These high-level customer requirements were transformed into concrete specifications and further characterized by the GE team into specific subsystem 

capabilities. It was clear from the resulting detector subsystem requirements that the digital detector with its glass panel and sensitive hardware required a 

significant development effort. Modeling of mechanical packaging options gives a design that will meet the rugged requirements, the addition of the wireless 

and battery operation will free the detector of its tether, and a custom positioned design will provide the flexibility required for tube positioning and imaging 

applications without the weight and space necessary for systems found in brick and mortar facilities.

Currently a prototype is being developed to demonstrate the design presented to and accepted by the military stakeholders. Key areas of focus of prototype 

development are the detector ruggedization, wireless integration, and development of a system that can be easily transported to combat support hospitals in 

theater and survive the environment there.

Partners

y TATRC

y USAMMA

y Emory University

y GE Global Research

6-20
COMPLETED | PROMISING | FUTURE

Novel, Noninvasive, Patient-Specific Electrographic Seizure Warning System

Description

CIMIT is building and evaluating a noninvasive, patient-specific system that accurately detects electrographic seizure onset sufficiently in advance of the onset of clinical symptoms to warn the patient of 

an impending seizure or to automatically trigger potentially abortive therapy. 

This detection system is capable of learning to recognize seizure onset patterns with high sensitivity and specificity. CIMIT aims to integrate this automated seizure detection system with an audible 

alarm and the Vagus Nerve Stimulatory (VNS) to trigger acute VNS stimulation as an abortive therapy 

upon seizure detection. The audible alarm could potentially ameliorate the consequences of seizures 

by giving patients and caregivers time to seek a safe position or to administer an acute pharmacological therapy. Results to date include the development and integration of the system with VNS as well 

as the successful demonstration in five patients in a clinical setting (VA hospital). 

Partners

y TATRC

y CIMIT

6-21
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

OASIS 

Description

OASIS provides an IM/IT environment for the developmental test and evaluation of patient health care hardware and software architectures thus replicating 

the flow of information from levels I–IV. The platform also serves to integrate emerging and innovative technologies that have yet to interface with MC4 equipment to ensure interoperability. 

OASIS, formerly known as the Forward Deployable Digital Medical Treatment Facility, was developed as a research, development, and testing platform. It 

provides a rapidly deployable MTF used for showcasing, evaluating, and training advanced medical technologies and information systems developed through 

collaborations with government, industry, and academia. OASIS also emphasizes modular configurations composed of lightweight and rugged equipment 

packages engineered to reduce weight, cube, and airframe requirements while providing essential care in theater and reach-back capabilities from any 

deployed location. Successful products that have transitioned through this platform include the BMIST-J (Battlefield Medical Information System TacticalJoint) and the Alaska Structure shelter system. 

Follow-on actions include the integration of medical programs of record into the architecture, such as the Joint Medical Workstation, Theater Medical 

Database System, and the Joint Patient Tracking System, and the formulation of a Joint Developmental Test Plan along with the associated program offices 

and service representatives outlining the acceleration of the test, evaluation, and acquisition of emerging technologies. To determine form, fit, and functionality, OASIS may be deployed in support of the Army Medical Department Board and its operational test and evaluation functions, the Stryker Brigade National 

Training Center rotations, the Uniformed Services University of the Health Sciences, Bushmaster field training exercise, or to support the Regional Training 

Site-Medical. 

Partners

y TATRC

6-22
COMPLETED | PROMISING | FUTURE

Periscopic Spine: Georgetown University

Description

Georgetown University’s Periscopic Spine project is aimed at improving the state of the art of imageguided and minimally invasive spine procedures by developing new clinical techniques along with the 

computer-based hardware and software needed for their use. The focus of the project is the development of new techniques for precision, minimally invasive procedures. While techniques for the spine 

will continue to be investigated, the focus has broadened into other anatomical regimes, in particular 

thoraco-abdominal procedures. On the scientific side, the characterization of respiratory motion 

and compensation for this motion has become one of the focal points of the work, including the use 

of electromagnetic tracking for this purpose. New initiatives in precision radiosurgery have been 

developed with Radiation Medicine, and there are two new collaborations, one with the University 

of Maryland in exoskeleton robotics and another with the Department of Physics at Georgetown 

University in nanotechnology. A new phase of the project, to develop an integrated interventional 

suite of the 21st century based on rotational angiography and electromagnetic tracking, is anticipated.

Partners

y TATRC

6-23
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Proton Beam Therapy – Loma Linda University Medical Center

Description

The goal is to develop the next generation of technologies that will ensure the availability of high-quality, noninvasive cancer therapy. The Loma Linda University Medical Center is the country’s first proton treatment center. The history of this center dates back as far as the 1960s; Dr. James Slater first 

conceived of a plan to develop the core technologies needed for such a clinic. The facility went online 

in the early 1990s. To revolutionize the current standard of care for proton beam therapy, Dr. Slater 

and his team partnered with TATRC to manage the resources needed to develop innovations in active 

beam scanning technologies. Previous efforts funded by TATRC completed the accelerator and 

beam transport system’s enhanced control system. This provided the foundation for delivering active 

beam scanning to the treatment rooms, increased dose monitoring sampling and accelerator cycle 

delivery, and decreased fluence variation. These are critical factors for targeting irregularly shaped 

volumes common in cancers and other diseases. 

Partners

y TATRC

y Loma Linda University Medical Center

Proton Beam Therapy – The 

Hospital of the University of 

Pennsylvania

Description

The goal is to develop the next generation of 

technologies that will ensure the availability 

of high-quality, noninvasive cancer therapy. 

The Hospital of the University of Pennsylvania 

has developed a comprehensive program 

to develop tools that will precisely modulate 

proton beams, control patient movement, 

monitor treatment in real time, and develop 

advances in three-dimensional treatment 

planning for proton beam therapy. The 

Principal Investigator, Dr. James McDonough, 

has engaged experts at the Walter Reed 

Army Medical Center for additional expertise 

in radiation oncology and treatment planning.

Partners

y TATRC

y Walter Reed Army Medical Center

y Hospital of the University of Pennsylvania

6-24
COMPLETED | PROMISING | FUTURE

Rugged Mobile Logistics System

Description

The Rugged Mobile Logistics System (RMLS) consists of a number of intelligent, rugged, portable 

hardware items, integrated by VerdaSee, to provide critical information at the local, regional, and 

global levels. The hardware components are a mixture of commercial off-the-shelf (COTS) and COTS 

products that have been modified and enhanced by VerdaSee to meet the project needs, and some 

of the hardware/software components are custom designed by VerdaSee specifically for the RMLS. 

RMLS nodes can support large and small, fixed and mobile warehouses, depots, and terminals.

The RMLS is an economical, innovative, and unique combination of COTS hardware and software 

elements. An example of the uniqueness is the ability to track supplies carried within containers 

down to a single item, such as a pill bottle. The GPS-enabled system provides near real-time data 

and information with graphic displays linked to standard enterprise systems to provide local, regional, 

and global visibility of assets at a granularity and in a presentation model needed by specific users 

accessing the system.

This design protects the end-user community from the issue of obsolescence that otherwise burdens 

the traditional approach to logistics management that is software or product driven. 

Partners

y TATRC

y VerdaSee

6-25
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Troop Recruitment Improvement

Description

The goal of Troop Recruitment Improvement (TRIM) is to provide definitive information on the factors 

that underlie the development of obesity in young persons. This knowledge will help ensure the availability of a large pool of youth who are fit and ready for military service. The proposed TRIM design is 

using state-of-the-art measures to characterize the range of factors influencing obesity in children and 

adolescents from early childhood to recruitment age in a comprehensive and coordinated manner. 

This project is to pilot test those measures and methods. 

Partners

y TATRC

y Clemson University

y Medical University of South Carolina

y University of Iowa

y University of South Carolina (including South Carolina State University)

y The Cooper Institute

y Pennington Biomedical Research Center

y South Carolina Research Authority

6-26
COMPLETED | PROMISING | FUTURE

Wear-and-Forget Physiological Sensing System for Combat Casualty Care

Description

Physiological monitoring of individual Warfighters would provide the Army with an unprecedented capability to assess the health state of Warfighters and 

rapidly identify and respond to critical cases. A uniquely qualified team from Foster-Miller and Malden Mills Industries, in continuing collaboration with 

USAMRMC and TATRC, proposes to apply electronic textile technologies to develop robust and reliable wear-and-forget physiological sensing platforms. 

These intelligent textile technologies would allow sensing systems to be manufactured as minimally constrictive garments. Furthermore, these systems must 

tolerate physical activity, minimize motion artifacts, and generate clinical quality data.

The ultimate objective of the program is a wearable physiological sensor platform that is comfortable enough to ensure the compliance of a service member 

while producing and reporting highly reliable vital sign data, including heart rate, respiration rate, and skin temperature, as well as the wearer’s activity level 

and body posture. These data will then be tied to algorithms that generate valuable information about the health status of a Warfighter to either a medic or a 

commander. A medic would use this information to assess and triage an injured person. Such information could allow for immediate notification of an injury 

or warn a medic not to risk his or her own life because the person is already dead. A commander who has knowledge about the physical state of multiple 

Warfighters or squads could choose those most fit for a mission.

Partners

y TATRC

y Combat Casualty Care Research Program

y Foster-Miller

y Malden Mills Industries

6-27
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Wireless Electronic Information Carrier/Personal Information Carrier

Description

The Electronic Information Carrier (EIC) is integral to “patient-centered” medical data flow on the 

battlefield. It is intended for issue to each service member prior to deployment and is preloaded with 

each individual’s medical history, master problem list, immunizations, etc. It will then serve as a personal medical data storage device for any care provided to the patient from point of injury to CONUS 

(continental United States)-based medical centers and beyond.

The EIC is a wireless data storage device the size of a dog tag that is capable of storing up to 

4 gigabytes of data; however, the real power of the EIC is its ability to securely and wirelessly read 

and write data within a range of 10 meters of a medical device such as the BMIST and the Composite 

Health Care System II-T. It also has a universal physical interface that ensures compatibility with any 

commercial or government off-the-shelf IT products and can be used when wireless communications 

are not available. 

The Personal Information Carrier is an earlier nonwireless version with storage capacities up to 

1 gigabyte. Like the EIC, it is a rugged, low-power consumption, flash memory device that is hardware and operating system independent. 

The EIC allows individual medical data to be accessed and updated by medical personnel when realtime connectivity to a database is unavailable. The EIC was chosen as one of the Army’s 10 Greatest 

Inventions for 2004.

Partners

y TATRC

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TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Alliance for NanoHealth

Description

The Alliance for NanoHealth (ANH) is collectively bridging the disciplines to develop nanotechnologybased solutions to unresolved problems in medicine. The principal goal is to provide new clinical 

approaches to saving lives through better diagnosis, treatment, and prevention. 

The ANH is a highly interdisciplinary consortium of several institutions. It was established to advance 

nanotechnology for a broad range of applications, including cancer therapy and drug delivery. The 

ANH is currently conducting research for imaging and hyperthermia treatment of inflamed endothelium, nanotechnology applications in vascular grafts, and targeted delivery of nanoparticles for 

antitumor therapies. 

In addition, the ANH is supporting 10 seed projects to evaluate application of nanotechnology for clinical proteomics, molecular imaging of neurological diseases, targeted RNA therapies for drug-resistant 

cancers including lung cancer, studying biological dynamics of solid cancers, prosthetic sensors for 

improved rehabilitation, central nervous system therapeutics and axon regenerative scaffolds, threedimensional sensors for neural recording, and multiplexing magnetic resonance imaging diagnostics. 

Partners

y TATRC

y University of Houston

6-29
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

A Standards-Based Tool for Pharmacovigilance

Description

The overall purpose of the U.S. Army Medical Department-FDA collaboration is to evaluate the safety 

of drugs. The focus is research into and development of enhancements to existing software in support of the FDA Sentinel Initiative using data derived from DoD medical records and medical insurance claims related to its population of active service personnel, dependents, and retirees, as well as 

the support of supplementary staff at the Office of the Surgeon General (OTSG) Pharmacovigilance 

Center (PVC) to carry out medical product safety research of interest to the collaborating parties. 

Initially the PVC succeeded in enhancing its signal detection software and in deploying that software 

in a server facility to support interactive use by staff at the PVC.

There remain several challenges in the evolution of the signal detection facility to full production status. The complete set of medical data resources useful in signal detection must be assembled from 

multiple systems within the DoD, and data elements outside the core data available from the Medical 

Data Repository (MDR) are still being assembled. Also, it has been difficult to provide rapid response 

times for some analysis tasks generated by the PVC on the large health care database. Further work 

in these areas, as well as work to improve the ease of use of the software, is continuing in the remainder of the year. Last, there is not enough flexibility in the software to answer the kinds of questions 

required for rapid analysis of signals. 

The PVC staff also found problems with the military’s data dictionaries. They noted that their 

pharmacy data transaction system had inaccurate dispense dates that linked to the claims processing 

and not the dispensing of the medication. The PVC took these findings and requested the data 

warehouse (MDR) data dictionary be updated, and it requested the requirements group for the new 

electronic medical record pull data from the “DRX key” from the Composite Health Care System 

for all dispensing of drugs, both new and refills. In addition, the PVC requested that the ALLERGY 

section be linked with the Computerized Physician Order Entry (CPOE) and that the CPOE document 

Process of Pharmacovigilance

Formulary: Safe, Effective, and Favorable 

Risk/Benefit Ratio

Signal Generation

• Clinical Trials: Premarket

• Passive Surveillance: 

AERS (FDA) and needed 

military reporting systems

• Active Surveillance: 

Pharmacovigilance 

Defense Application 

System

• Directed Surveillance: 

Monitor signal and 

risk/benefit ratio

Signal Verification

• Drill into medical details

• Develop case definitions 

for case series

• Comparative cohort 

analysis

• Verify among database

Risk Mitigation

• Formulary Decisions

• Education, Alerts

• IT Solutions

• Policies

• Guidelines

Hypothesis Testing

• Clinical Trials

• Regional Epidemiological 

Studies

• MHS Epidemiology 

Studies

Pharmacovigilance

Defense Application 

System

6-30
COMPLETED | PROMISING | FUTURE

reasons why drugs are stopped (e.g., 

intolerant, ineffective, allergy, complete 

treatment, or patient reason). In addition, the 

PVC documented the need for establishing 

an adverse drug event reporting tool and 

development of an enterprise database.

In several cases, the scientific research performed by the PVC staff helped identify gaps 

in the available data and software resources 

and led to improvements in these resources.

An extension of the collaboration for fiscal 

year 2010 is presently under discussion 

between the FDA and DoD.

Partners

y TATRC

y OTSG-MEDOM

y FDA Center for Drug Evaluation and 

Research

Center for Research on Integrative Medicine in the Military

Description

The objective of the Center for Research on Integrative Medicine in the Military (CRIMM) is to identify 

an integrative biopsychosocial program for the management of stress focused on skills training of 

combat troops and their families in four key areas: physical, social, mental, and spiritual. The specific 

aims of the CRIMM are to gather best evidence on the most reputable and scientifically advanced 

programs of biopsychosocial preset and reset training and rigorously assess the most promising ones 

for use in military populations; synthesize the evidence for the best programs and make a recommendation for program configuration and implementation; assess the needs of combat-exposed military 

personnel and their families at key military training sites and readiness of these environments to 

participate in such programs; develop a valid and reliable toolkit for assessing such programs; launch 

a pilot program incorporating the biopsychosocial model within an appropriate training and education 

environment; and evaluate the cost, timing, and outcomes of the training to provide military decision 

makers with the evidence to determine whether expansion of such training will effectively support the 

mind-body-spirit of our nation’s Warriors. 

Partners

y TATRC

y Samueli Institute

6-31
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Clinical Breast Care Project at 

Walter Reed Army Medical Center

Description

This multidisciplinary model integrates prevention, screening, diagnosis, treatment, and 

continuing care; however, the project is further 

unique in the incorporation of advances in risk 

reduction, informatics, tissue banking, and 

research. 

The goal of this project is to decrease the 

morbidity and mortality of breast cancer 

among American women, develop a comprehensive breast care center/system to enable 

health care providers with a multidisciplinary 

team approach that works toward the common goal, and empowering women with 

breast cancer and other breast disorders with 

the decision-making tools and environment to 

enhance quality of life and to meet psychosocial needs of the patients and their families.

Partners

y TATRC

y Walter Reed Army Medical Center

y Windber Medical Center

Comfortable Socket

Description

This research effort examines both active and passive methods of decreasing discomfort/increasing 

comfort, eliminating intra-socket moisture, and maintaining intra-socket vacuum. Amputees may use 

a variety of ways to wrap their residual limb within the socket to make themselves more comfortable. For a suction socket, the most common method is to wrap the residual limb in one or several 

socks. The limb is then compressed with a gel liner that provides cushioning between the limb and 

the hard-shell socket and enhances suction between the prosthesis and the residual limb. Once the 

limb is inside the liner and socket, a polymeric gel sleeve is placed over the socket, extending up onto 

the limb to secure the vacuum that holds the socket onto the limb. This configuration, even during 

low-intensity activities, can cause sweating. The sweating will lead to slipping between residual limb 

and the socket/sleeve. The increased movement in the socket could lead to rashes and blistering as 

well as loss of vacuum integrity.

There are a variety of ways to make the socket more comfortable. Improved gel liners and more padding within the socket are simple solutions. TATRC is working with several organizations to achieve 

this goal. Many of the organizations have novel ideas that could completely change the interface 

between a prosthetic device and the residual limb.

Partners

y TATRC

y University of Wisconsin, College of Health Sciences

y Infoscitex Corporation of Waltham, Massachusetts

y Ohio Willow Wood Company

y Physical Optics Corporation in Torrance, California

y Sandia National Laboratories

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COMPLETED | PROMISING | FUTURE

Digital Emergency Medical 

Services

Description

Telementoring and telemedicine capabilities 

will allow earlier interventions in recording patient data and give medics access to 

medical information. The digital emergency 

medical services (EMS) system, a component 

of the Disaster Relief and Emergency Medical 

Services project, integrates diagnostic medical equipment, medical informatics software 

systems, and communications systems. The 

digital EMS system provides a common user 

interface, integrated medical equipment, and 

remote video cameras. A unique and vital 

aspect is the system’s capability to provide 

real-time patient information, such as vital 

signs, to a remote physician and, in turn, 

communicate instructions back to personnel 

on-site. This also allows medics to refer to 

treatment protocols or refresher training for 

any situation. 

Partners

y TATRC

Facilitating Cell Transplantation 

Research

Description

This is a unique transplantation research 

project that investigates the role of facilitating 

cells in promoting immune tolerance. This 

research suggests that modulation of the 

immune response is possible and can be 

used to overcome problems of rejection and 

graft versus host disease that are common 

in complex tissue transplantations. Studies 

in patients with sickle cell disease have established that facilitating cell therapy can induce 

chimerism in these patients. The sickle cell 

trait is treated using donor bone marrow, 

which is tolerated by the recipient patient, 

dramatically treating the sickle cell disease.

The following figure illustrates the conditions 

and disorders that could benefit or be cured 

by bone marrow/facilitating cell transplants 

derived through this research.

Partners

y TATRC

y University of Louisville

Autoimmunity

• Diabetes

• Multiple Sclerosis

• Rheumatoid Arthritis

• Crohn’s Colitis

• Lupus

• Psoriasis

Hemoglobinopathies

• Sickle Cell Disease

• Thalassemia

Leukemia

Metabolic Disorders

• Chronic 

Granulomatous

• Hunters Syndrome

• Leukodystrophy

Rare Childhood 

Disorders

• ADA Deficiency

• Aplastic Anemia

• SCID

Regenerative Repair

• Macular 

Degeneration

• Myocardial Infarction

• Islet Regeneration

Transplants

• Heart

• Kidney

• Liver

• Pancreatic Islets

• Hand/Face

Conditions That Will Benefit from or Be 

Cured by a Bone Marrow/Facilitating 

Cell Transplant

6-33
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

Hibernation Genomics: Mechanisms for Metabolic Suppression and Neural 

Protection

Description

The overall goal of this research program is to understand the fundamental molecular and biological 

adaptations that create the animals’ (i.e., Arctic ground squirrel and black bear) unique capabilities. 

Understanding such mechanisms can identify unique solutions to the difficult medical problems 

that are associated with battlefield trauma, both acute survival following traumatic hemorrhage and 

improved recovery/rehabilitation.

Through basic studies on hibernating mammals, this research seeks novel therapies for use in the 

treatment of battlefield injuries in field-forward positions where Warfighters would benefit from stabilization before transport to advanced medical facilities. The proposed work will develop natural animal 

model systems of hibernators as genetic and physiological resources for use in determining the 

molecular basis of hibernation. The intent is to identify the biochemical pathways that are altered to 

regulate preparation for, entry into, and recovery from hibernation and to provide candidate pharmaceutical products that can induce and reverse similar states in humans. The results of these studies 

could translate to novel approaches to improve recovery from traumatic injury to muscle and bone. 

Partners

y TATRC

y University of Alaska Fairbanks

6-34
COMPLETED | PROMISING | FUTURE

Military Foot

Description

To return to the field on active duty or to an active civilian life, service members need a prosthetic leg 

that is able to perform during rigorous activities and under extreme conditions, such as swimming, 

climbing, or running on uneven, wet, or sandy terrain.

The ideal “military foot” is not a simple problem as every patient and his/her circumstances are unique 

and require what is essentially a custom solution. Lower limb amputations are generally categorized 

as transfemoral (above the knee) or transtibial (below the knee). Other levels of amputation include 

ankle, knee, and hip disarticulations. There are a variety of solutions that incorporate passive or 

active knee and ankle joints that can be controlled by an onboard computer or system of myoelectric 

devices.

TATRC is fostering a broad range of lower extremity-related projects to support service members as 

they strive to achieve their highest possible quality of life. 

Partners

y TATRC

y Arizona State University Human Machine Integration Laboratory

y The Massachusetts Institute of Technology Media Laboratory

y KCF Technologies of State College, Pennsylvania

y Otto Bock

y The Rehabilitation Institute of Chicago 

6-35
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

National Eye Evaluation Research Network for Clinical Trials in Retinal 

Degenerative Diseases by the National Neurovision Research Institute

Description

The focus of this research effort is to establish a network of five clinical treatment and evaluation centers to study retinal degenerative diseases. Retinal degenerative diseases are a family of inherited 

pathologies with the ultimate consequence of photoreceptor apoptosis and severe visual impairment 

usually ending in blindness. The National Eye Evaluation Research Network advances the science 

of therapeutic and preventive interventions for inherited orphan retinal degenerative diseases and dry 

age-related macular degeneration through the conduct of clinical trials.

Neurotech’s encapsulated cell technology uniquely enables the controlled, continuous delivery of biologics directly to the back of the eye, overcoming a major obstacle in the treatment of retinal disease. 

Partners

y TATRC

y University of California, San Diego

y University of Medicine and Dentistry of New Jersey

y University of Utah Moran Eye Center

y Children’s Hospital of Philadelphia

y Wilmer Eye Institute at Johns Hopkins University

6-36
COMPLETED | PROMISING | FUTURE

National Functional Genomics Center

Description

The status of oncology care in the United States can perhaps best be described as “experimental.” Even though there is a wide range of accuracy in the 

diagnosis of many cancers, reliability in the prediction of prognosis for patients is seriously lacking, resulting in variability of treatments rendered and subjecting patients to tremendous stress during the course of their disease, which can complicate treatment. The National Functional Genomics Center (NFGC) was 

established to address these issues and to provide cancer patients with accurate diagnosis, prognosis, and treatment.

The NFGC’s research focuses on three interconnected areas: microarray, proteomics, and drug discovery. These areas of research are tied together with 

bioinformatics and support by additional technologies and are used to discover molecular signatures for cancer, identify cancer markers for early detection 

and unique therapeutic targets, discover putative new drug therapy targets and develop innovative treatments, and ensure each of these areas of research 

provides solutions to enable “personalized” medicine. 

The NFGC also planned and designed new and expanded infrastructure at the Moffitt Cancer Center subsequently to pave the way for state-of-the-art 

genomics research. Investment in high-quality shared resources staffed with trained technical personnel has been shown to minimize the costs of equipment outlay for individual researchers and maximizes efficiency and reproducibility of research. Early funding efforts also helped to create NFGC’s External 

Advisory Board. This board consists of top, internationally recognized experts in various disciplines of genomics and is designed to oversee the activities of 

the NFGC and provide recommendations for its future growth.

Once the infrastructure was in place, the NFGC began to establish and maintain collaborations with other centers that have directly produced beneficial 

research to the military and to homeland security. Today, the collaborations through the NFGC keep expanding, and the NFGC continues its pursuit to study 

and validate molecular targets of cancer that predict cancer risk, diagnosis, prognosis, and response to treatment.

Partners

y TATRC

y Moffitt Cancer Center

y NFGC

6-37
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

Personal Area Network for Remote Physiological Monitoring

Description

Elintrix has been contracted to develop an integrated system that will capture, analyze, communicate, 

display, and archive geo-location and physiologic sensor data. The program consists of two projects 

to include Soldier-worn elements of the Spartan network (SPARNET), which includes a squad area 

network radio for Soldier-to-Soldier data communication, and a personal area network (known as 

BIONET) radio for on-body communication. The BIONET radio is a modifiable, integrated, inductively 

linked, minimalist, modular design with processing capability for use with sensor systems like the 

Warfighter Physiological Status Monitor. BIONET supports the transmission of data via a modulated 

magnetic field. Detection of the resulting short-range, bidirectional communications by hostile forces 

is made problematic due to the frequency and rapid attenuation of the magnetic field. SPARNET 

enables continuous monitoring of a Warfighter’s geo-location and health status in the field to improve 

force health protection.

Partners

y TATRC

y USARIEM

y Elintrix

Robotic Medic Assistant, Patient 

Evacuator

Description

The Robotic Medic Assistant is to be used 

by combat medics and Warfighter-buddy first 

responders to assist in combat casualty location, assessment, treatment, extraction, and 

evacuation.

This robotic device can be used in urban 

terrain and in hazardous or contaminated 

environments. The device supports Future 

Combat Systems concepts of mobility, agility, 

survivability, and sustainment. A vehicle crew 

can recover a casualty, either manually or 

mechanically, without the need to dismount 

and without driving to the casualty.

This robotic patient recovery technology performs multiple missions in hazardous areas 

thereby reducing risk to first responders. The 

greatest benefit of this technology is that it 

allows providers to focus on patients. 

Partners

y TATRC

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

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COMPLETED | PROMISING | FUTURE

Robotic Telepresence for 

Subspecialty Care

Description

This research effort will focus on developing 

a software application for remote wireless 

access in real time to a comprehensive 

set of medical data. A wireless, mobile 

pocket device will allow access to all data, 

including viewing radiographic imaging 

connected to the PACS (Picture Archiving 

and Communications System). The entire 

medical electronic record can be accessed 

remotely in real time. New high-speed cell 

phone networks are employed. This technology will be fused with the InTouch robot for 

virtual physician presence at the bedside, in 

the emergency room, or on the battlefield. It 

will allow for remote expert consultation with 

the ability to view the patient, interview the 

patient, and assess a complete set of medical 

data in real time.

Partners

y TATRC

y Center for Advanced Surgical and 

Interventional Technology

Serpentine Robotic Manipulator Arm

Description

The Serpentine Robotic Manipulator Arm 

could be used to perform more complex 

treatment tasks or could be attached to a 

small robot for conducting triage during mass 

casualty situations.

This project is intended to adapt Carnegie 

Mellon University’s serpentine manipulator 

arm and integrate it with the life support for 

trauma and transport (LSTAT) system as a 

remotely controlled casualty examination 

device that enables medics or surgeons to 

perform tele-examinations on a patient before 

or during evacuation. A set of noninvasive physiological monitors, developed by 

TeleMedic of Canada, has been integrated 

so that they can be robotically placed by 

remotely manipulating the serpentine arm and 

a movable gantry device on the LSTAT. 

Partners

y TATRC

y Carnegie Mellon University

6-39
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

Simulation-Based Open Surgery Training System

Description

The goal is to improve training so surgeons can obtain and maintain proficiency in the performance of 

open surgical procedures. A personal computer-based Simulation of Open Surgery Training System 

(SOSTS) is a developmental platform to obtain surgical metrics (of devices, instruments, and their 

use in procedures of surgical technique) and to develop and evaluate new open surgical procedures 

and advanced medical devices. TATRC envisions an open architecture surgical simulation platform 

that allows the rendering and use of virtual versions of actual instruments used in trauma surgery. A 

final goal is to enable novel surgical instruments to be “scanned” and “virtualized” or entered into the 

simulator before they reach the physical prototype stage and then are evaluated. The SOSTS has 

potential to reduce surgical errors, improve patient safety, reduce costs, improve access to care in 

fixed medical treatment facilities, and improve medical educational training programs. This technology also will allow the assessment of novel surgical instruments and techniques in silico, in turn 

limiting the use of animals and reducing development costs. Two examples are the Fractured Femur 

Simulator and Compartment Syndrome Simulation System. 

Partners

y TATRC

y Energid Technologies

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

6-40
COMPLETED | PROMISING | FUTURE

Soldier Health Promotion to Examine and Reduce Health Disparities

Description

This project examines the root causes of military attrition and many of the factors that contribute to Soldier health issues (e.g., diet, military environment, 

physical activity patterns, physical readiness, stressors, and anxiety) both pre- and post-deployment. Other key focuses are post-traumatic stress disorder 

(PTSD) and mental health. 

The efforts will provide a framework for understanding the historical and cultural backgrounds of Soldiers and how certain factors (e.g., poverty, educational 

history, inequities in health care access, diet, and mental health) contribute to health disparities. 

Project 1 is focused on obesity and nutrition issues. This will include evaluation of the physical training program, assessment of whether obesity demotivates 

Soldiers, and drill sergeant knowledge of nutrition/obesity issues. A primary interest will be the “life course perspective” (impact of Soldier entrance into the 

military environment) to better understand the transition.

Project 2 will assess baseline data for injury rates and examine the training regimen (load and progression) during basic combat training with the recommendation of Fort Jackson personnel. The Certified Athletic Trainer-Forward program collaborates with on-site, certified athletic trainers to analyze data related to 

lost hours from training, Troop Medical Center visits, heat-related injuries, and Army Physical Fitness Test scores.

Project 3 examines methods for screening recruits for mental health problems (e.g., PTSD) at point of intake, the stigma associated with seeking mental 

health services, the career paths of Soldiers, the small number of mental health referrals, and the impact of sleep deprivation on mental health (also a factor in 

Soldier injury). 

Partners

y TATRC

y The University of South Carolina – Institute for Partnerships to Eliminate Health Disparities

6-41
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

Speech-Capable Personal Digital 

Assistant

Description

The Speech-Capable PDA will allow military 

health care providers to enter data handsfree, allowing focus to be on the patient.

The PDA is equipped with a directional-array 

miniature microphone system and speech 

recognition software. Health care providers 

can perform hands-on medical and surgical 

procedures at all echelons of care, ranging 

from combat medic first responders to physicians in tertiary care medical centers. 

Partners

y TATRC

Treatment of Peripheral Vascular 

Disease by Adipose-Derived 

Stromal Cell Injection

Description

The focus of this research is to advance 

regenerative medicine to enhance recovery 

after battlefield injuries. 

This project is investigating whether adiposederived stromal cells can be delivered directly 

to ischemic tissue by intramuscular injection into ischemic tissues or through in situ 

vasculature and to increase distal circulation and relieve the symptoms of peripheral 

vascular disease. Tissue Genesis, Inc. has 

successfully developed a portable, automated 

cell separation system and patented process 

that isolates and sorts human fat tissue into 

therapeutic cells.

Partners

y TATRC

y Tissue Genesis, Inc. 

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

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COMPLETED | PROMISING | FUTURE

Virtual Humans

Description

The program SimCoach proposes to build on advances in “human-centered” computing to create a 

more personal, reassuring, and ultimately more effective interface for access and dissemination of 

medically relevant information. The Institute for Creative Technologies is developing an intelligent, 

interactive program called “SimCoach” to help Warfighters and their families initiate the medical treatment process and to learn about resources for psychological health and traumatic brain injury. 

Through SimCoach, Warfighters, spouses, or other family members will be able to initiate a dialogue 

about their medical concerns with an interactive Virtual Human. This intelligent graphical character will use speech, gesture, and emotion to introduce the capabilities of the system, solicit basic 

anonymous background questions about the user’s history and medical concerns, and direct them to 

appropriate medical information and medical professionals. 

The user will be given access to a variety of general relevant information on psychology, neurology, 

rehabilitation, the military health care system, and also to other service members. They can also 

be directed to experts on specific areas such as stress, brain injury, marriage counseling, suicide, 

rehabilitation, reintegration, and other relevant specialties. 

SimCoach is not conceived to deliver treatment or diagnosis or to replace human providers and 

experts or seen as a replacement for existing services. Instead, SimCoach will aim to start the 

process of engaging Warfighters and/or their families to become aware of and to seek out treatment 

programs, to give advice and encouragement, and act as a supplement that will allow individuals who 

may otherwise be initially uncomfortable talking to a “live” person to initiate treatment.

Partners

y TATRC

y Institute for Creative Technologies, University of Southern California

Virtual Retinal Laser Display

Description

An unobstructed full field of vision of the computer screen for health care providers while 

performing hands-on medical and surgical 

procedures is vital for patient treatment.

The Virtual Retinal Laser Display technology provides head-, helmet-, headgear-, or 

eyeglasses-mounted, hands-free, daylight 

readable computer color display by directing 

a laser beam containing a computer image 

directly onto the retina of the eye. This projects vital medical information on a health care 

provider’s retina while treating a patient. 

Partners

y TATRC

6-43
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

Virtual Therapies for Psychological Trauma: Virtual Iraq

Description

The rapidly growing field of clinical virtual reality holds promise for innovative treatments for PTSD. Exposure therapy is a well-researched, evidence-based 

treatment for PTSD that involves patients being gradually re-exposed to relevant traumatic events in a progressive and repetitive manner directed by a clinician. This often involves re-imagining the trauma through guided visualizations with a therapist. Exposure therapy helps to slowly desensitize the patient to 

the strong emotional and physiological responses triggered by memories of traumatic events and helps the patient to process these memories in an effort to 

increase adaptive coping. Using virtual reality exposure may enhance treatment by providing a more controlled method for prompting this re-imagining and 

may circumvent the patient’s natural (albeit counterproductive) tendencies to avoid painful memories during treatment sessions.

This project developed a series of virtual Iraq environments to be used for exposure therapy with Iraq combat veterans with PTSD. The virtual environment 

was initially designed from an Xbox game and U.S. Army-funded combat simulation trainer. Virtual Iraq consists of multiple combat environments (i.e., city 

and desert road) that were created to simulate common combat experiences in Iraq, including Humvee patrols, improvised explosive devices, and ground 

combat. Patients can use either a game controller or replica M4 to navigate the game environment. The virtual reality component uses a virtual reality helmet, three-dimensional audio, and vibrotactile and olfactory stimuli with physiological monitoring. The therapist is able to modify and change the experience 

in real time. The treatment consists of two weekly, 90–120-minute sessions over 5 weeks and is paced by the patient following parameters of general exposure therapy and includes outside education and homework around PTSD and exposure therapy. There are a number of research and clinical projects under 

way within the DoD utilizing Virtual Iraq. Preliminary analysis of the first 20 completers has shown significant reduction in pre- and post-PTSD symptoms with 

16 of 20 completers experiencing a 50 percent reduction in symptoms with high levels of patient and provider acceptance and satisfaction.

Partners

y TATRC

y U.S. Army Research, Development, and Engineering Command

y Defense Centers of Excellence

y Office of Naval Research

y U.S. Air Force

y Institute of Creative Technologies, University of Southern California

TELEMEDICINE AND ADVANCED 

MEDICAL TECHNOLOGIES

COMPLETED | PROMISING | FUTURE

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6-45
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

PUBLICATIONS

1. Ananth S. CAM: An increasing presence in 

U.S. hospitals. Hospitals & Health Networks, 

2009, http://www.hhnmag.com/hhnmag_app/

jsp/articledisplay.jsp?dcrpath=HHNMAG/

Article/data/01JAN2009/090120HHN_

Online_Ananth&domain=HHNMAG (January 

20, 2009).

2. Andy Kireta Sr, President, Copper 

Development Association. CNBC’s 

“Collaboration Now” Interview, November 

2008 (national television broadcast).

3. Armed with Copper, Researchers Attacking 

Hospital Infections. Newark Star Ledger, 

August 28, 2007.

4. Arney D, Fischmeister S, Goldman JM, Lee I, 

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Casualty

Care

38. Hsu JY, Bourguignon LY, Adams CM, 

Peyrollier K, Zhang H, Fandel T, Cun CL, 

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metalloproteinase-9 facilitates glial scar formation in the injured spinal cord. J Neurosci, 

2008, 28: 13467-77.

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AA. Evaluation of novice and expert interpersonal interaction skills and a virtual patient. 

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AA. Virtual humans for assisted health 

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St-George C, Sugar J, and Rizzo AA. Virtual 

Justina: A PTSD virtual patient for clinical 

classroom training. Ann Rev Cybertherapy 

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2008.

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Tactile feedback induces reduced grasping 

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outside of the PDGF family employ ROS/

SFKs to activate PDGF receptor alpha and 

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cells. J Biol Chem, 2009, 284: 6329.

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P, Lagali NS, Heyne B, Scaiano JC, Watsky 

MA, Kato Y, Munger R, Shinozaki N, Li F, 

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A, Nyati MK, Varambally S, Palanisamy N, 

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Seibyl J. Biomarkers for Parkinson’s 

disease: Tools to assess Parkinson’s 

disease onset and progression. Ann 

Neurol, 2008, 64 (Suppl 2): S111-21. [Grant 

W81XWH-06-1-0678: Establishing an 

“At Risk” Cohort for Parkinson Disease 

Neuroprevention Using Olfactory Testing and 

DAT Imaging].

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Life Sciences Innovation Day, June 3, 2009: 

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Documentation System.

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31, 2009.

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JP, Ku H, and Downs JH. In-helmet 

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Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care

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Appendices

Military Infectious 

Diseases

Combat 

Casualty Care

Military 

Operational 

Medicine

Clinical and 

Rehabilitative 

Medicine

Medical Chemical 

and Biological 

Defense

Advanced 

Technologies

Logistics
OVERVIEW

Medical Logistics

The U.S. Army Medical Research and Materiel Command’s 

(USAMRMC’s) responsibilities in the medical materiel arena include 

medical materiel acquisition and logistics functions, strategic 

medical logistics readiness, and critical health care programs. The 

U.S. Army Medical Materiel Agency (USAMMA) and the U.S. Army 

Medical Materiel Center, Europe (USAMMCE), the Command’s 

logistics organizations, provide direction and resources, acquire 

and manage assets, provide capabilities and distribute materiel, 

and support the national military strategy of power projection. Key 

programs include the acquisition, storage, distribution, and transfer 

of prepositioned stocks located ashore and afloat, medical chemical defense packages, short shelf-life pharmaceuticals, and other 

materiel. Integral to this support are partnerships with defense 

organizations and inventory-management contracts with industry. 

The Command also supports deployable medical logistics support 

teams.

Both USAMMA and USAMMCE explore and employ innovative 

methods to bring best business practices and new information 

technologies to the medical logistics system. Such focused logistics initiatives provide more efficient and accurate ways to deliver 

and manage precision packages and biomedical maintenance 

capabilities.

7-2

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
7-3
Apheresis System

Description

The treatment of hemorrhage in battlefield casualties requires the use of large amounts of blood 

products for transfusion to replace lost blood and to enable successful surgery. Delivery of adequate 

supplies of platelets, the crucial cellular component for the control of bleeding, poses significant 

logistical challenges because of their short shelf life, need for constant agitation, and delays that can 

occur during shipping, leading to a decrease in their viability and functionality.

The Haemonetics MCS 9000 mobile collection system is a multicomponent platform providing a 

complete portfolio of protocols for the collection of platelets, red cells, plasma, and combinations of 

these. Its versatility enables blood collection organizations throughout the world to implement a complete and economical solution for the automation of blood donation operations. For forward-deployed 

locations, the system provides the ability to collect platelets for immediate use or to store them until 

needed. The system addresses the traditional drawbacks of platelet therapy by automating the 

platelet collection process, which permits the collection of greater quantities of platelets from a single 

donor, and enabling on-site platelet collection, which eliminates the need for platelet shipping.

Partners

y Haemonetics

Cold Chain Management

Description

Cold Chain Management is a system that is 

used to distribute medical supplies to firstlevel users. It protects service members by 

managing and coordinating the distribution 

of temperature-sensitive medical products in 

critically short supply from manufacturers to 

first-level users. Supplies are shipped in validated containers, which include temperaturemonitoring devices, and are moved rapidly to 

users. Cold Chain Management is ongoing.

Partners

y USAMMA

COMPLETED | PROMISING | FUTURE

7-4 MEDICAL LOGISTICS

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Equipment Maintenance and

Repair

Description

The Medical Maintenance Management 

Directorate (M3D) has principal responsibility 

for and serves as the Army’s lead for Class 

VIII medical equipment maintenance. M3D 

manages the Army Medical Department’s 

National Maintenance Program, operates a 

National Maintenance Sustainment Program 

for medical materiel, and provides depot-level 

medical maintenance capability. It provides 

maintenance policy, initiatives, guidance, 

and assistance in the development, acquisition, and sustainment of medical equipment. 

MD3 also performs depot-level maintenance, 

major overhaul/maintenance, and sustainment maintenance on standard and selected 

nonstandard medical materiel to Active Army, 

U.S. Army Reserve, Army National Guard, 

authorized Department of Defense (DoD) 

activities, and other federal agencies. 

Partners

y USAMMA

COMPLETED | PROMISING | FUTURE

Equipment Publications

Description

USAMMA develops and publishes interactive electronic technical manuals, publishes electronic medical equipment operator and service literature, and develops and publishes electronic support and 

consumables handbooks to support field-deployable medical equipment.

Interactive electronic technical manuals are developed using SGML tagging and display software 

developed by the Missile Command at Redstone Arsenal. The software is Interactive Authoring and 

Display System. Tagging is consistent to the definition type document guidelines specified in military 

specifications. All manuals are published on CDs and mailed when requested.

Electronic medical equipment operator and service literature is groomed and bookmarked then published on the AKO (Army Knowledge Online) web site. All literature is also published on CDs. A table 

of contents on USAMMA’s web site lists available resources. Before operator and service literature 

was available on AKO, approximately 400 CDs per month were mailed in response to requests from 

the order form on the Medical Devices Program Management Office web page.

A Support and Consumable Handbook is developed for each unit assemblage set. The handbook 

contains inserts for each item of equipment within that set. It also lists all other unit assemblages 

that employ that equipment item. The insert provides detailed descriptions, characteristics, resupply 

items, start-up lists, and many times repair parts. The handbooks are updated promptly when items 

change. Handbooks remain available for retired unit assemblages and are labeled as Archived. All 

are available on USAMMA’s web site.

Partners

y USAMMA

7-5
Technology Assessment and Requirements Analysis

Description

The Technology Assessment and Requirements Analysis (TARA), a core capability of USAMMA’s 

Project Management Office for Integrated Clinical Systems, provides information and analyses to 

ensure that clinical outcomes for service members are optimized. It provides information via database 

analyses to senior decision makers at Army military treatment facilities and the Medical Command 

for accomplishing missions and developing acquisition strategies to optimize clinical outcomes. 

TARA allows 5-year budget requirements to be aggressively managed with front-loading of medical 

care support equipment and super capital expense equipment program requirements for the routine 

replacement of diagnostic, imaging, laboratory, and patient-monitoring systems. Resulting process 

improvements through the generation of requirements and delivery of services have generated a cost 

avoidance of $243 million to the AMEDD since 1994. TARA is ongoing.

Partners

y USAMMA

y MEDCOM

y OTSG

USAMMA Revolution in Logistics

Description

The USAMMA Revolution in Logistics (URL) 

supports the medical mission and enables 

the optimization of business practices. It 

improves business practices through employment of an enterprise resource planning system based on the same software product as 

the Army’s Logistics Modernization Program 

and DoD’s Business Systems Modernization 

Program. This system employs an integrated 

business information warehouse capability 

to provide USAMMA and stakeholders with 

highly detailed reports to support the dynamic 

changing medical mission. The system 

optimizes and modernizes medical logistics 

business practices. Employment of the URL 

has achieved a $13 million cost avoidance 

and reduced customer wait time for medical 

assemblages from 18 months to an average 

of 2 months. URL is ongoing.

Partners

y USAMMA

COMPLETED | PROMISING | FUTURE

7-6 MEDICAL LOGISTICS

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
COMPLETED | PROMISING | FUTURE

MEDICAL LOGISTICS

Medical Materiel Readiness Program

Description

The Medical Materiel Readiness Program (MMRP) will support medical units transitioning through 

their operational readiness cycles. This program will allow commanders to easily manage their training and maintenance requirements, which will prove to be a better solution for deployment.

USAMMA has developed the MMRP to support the Army Force Generation (ARFORGEN) model 

and the Army Campaign Plan, which are designed to improve Joint Force readiness. One tenant of 

the Army Medical Department’s transformation is to develop an equipping solution that supports units 

once they are designated Deployment, Ready, and Contingency Expeditionary Forces and transitioned to the Reset/Train, Ready, and Available force pools. The equipping solution must encompass 

the three ARFORGEN equipment sets: (1) Baseline Equipment Set, (2) Training Equipment Set, and 

(3) Deployment Equipment Set, which are designed to support training and mission requirements of 

units transitioning between the force pools. 

The goal of the program is to ensure that appropriate equipment items are ready for training and 

deployment to meet the requirements of the Joint Force. The MMRP serves as the umbrella program, 

encompassing equipment authorized by units and as part of other programs, such as the Reserve 

Component Hospital Decrement Program, Hospital Optimization Standardization Program, and the 

Army Pre-Positioned Stocks Program.

Partners

y USAMMA

7-7

Military Infectious 

Diseases

Combat 

Casualty Care

Military 

Operational 

Medicine

Clinical and 

Rehabilitative 

Medicine

Medical Chemical 

and Biological 

Defense

Advanced 

Technologies

Logistics

Appendices
Provided in this appendix are two lists regarding USAMRMC-developed technologies. The first is a summary of licensed technologies, and the 

second is a listing of patents issued to the laboratories. All expired licenses are indicated with an asterisk (*).

Licensed Technologies from USAMRMC Laboratories

The following list highlights technologies developed in USAMRMC laboratories that have been licensed to commercial entities for further development or production. 

Title Patent No. Issue Date

Flavivirus Detection and Quantification Assay 6,793,488 9/21/04

Force Sensing Treadmill 6,878,100 4/12/05

Method for Interpreting Forces and Torques Exerted by a Left and Right Foot on a Dual-Plate Treadmill 7,455,620 11/25/08

Internal Positive Control for Probe-Based Nucleic Acid Molecule Assays and Methods of Making and Using Thereof 7,005,267 2/28/06

Internal Positive Control for Probe-Based Nucleic Acid Molecule Assays and Methods of Making and Using Thereof 7,052,848 5/30/06

Detoxification with Sponges or Foams Containing Plurality of Enzymes and Encapsulated Indicator 6,541,230 4/1/03

Immobilized Enzymes Biosensors for Chemical Toxins 6,406,876 6/18/02

Preparation of Enzymatically Active Sponges or Foams for Detoxification of Hazardous Compounds 6,642,037 11/4/03

Material Include the DNA Sequences for the Primers and Probes N/A N/A

Antibodies Against Type A Botulinum Neurotoxin 6,667,158 12/23/03

System and Method for Predicting Human Cognitive Performance Using Data from an Actigraph 6,241,686 6/5/01

Method for Predicting Human Cognitive Performance 6,419,629 3/4/03

System and Method for Predicting Human Cognitive Performance Using Data from an Actigraph 6,527,715 3/4/03

Method and System for Predicting Human Cognitive Performance 6,530,884 3/11/03

Method and System for Predicting Human Cognitive Performance 6,553,252 4/22/03

Method and System for Predicting Human Cognitive Performance 6,740,032 5/25/04

Method and System for Predicting Human Cognitive Performance Using Data from an Actigraph 6,743,167 6/1/04

Method and System for Predicting Human Cognitive Performance 7,766,827 8/3/10

Supplemented and Unsupplemented Tissue Sealants, Methods and Their Production and Use 6,054,122 4/25/00

Antibodies with Simultaneous Subsite Specificities to Protein and Lipid Epitopes N/A N/A

Automated Inhalation Toxicology Exposure System N/A N/A

Automated Inhalation Toxicology Exposure System 6,904,912 6/14/05

A-2

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Title Patent No. Issue Date

Automated Inhalation Toxicology Exposure System N/A N/A

Prophylactic and Therapeutic Monoclonal Antibodies 6,451,309 2/9/01

Prophylactic and Therapeutic Monoclonal Antibodies 6,620,412 9/16/02

Prophylactic and Therapeutic Monoclonal Antibodies 6,451,309 8/7/10

Prophylactic and Therapeutic Monoclonal Antibodies 6,620,412 9/16/03

Assay for Detecting, Measuring and Monitoring the Activities and Concentrations of Proteins and Methods of Use Thereof 6,746,850 5/4/01

Murine Hybridoma Producing Monoclonal Antibodies Against Neisseria meningitidis, Numbers 14-1-A, 4-2-C, 7-1-W, F-1-Y N/A N/A

Topical Skin Protectants 5,607,979 3/4/97

Practical Serological Assay for the Clinical Diagnosis of Leishmaniasis 7,452,721 11/18/08

Internal Positive Control for Probe-Based Nucleic Acid Molecule Assays and Methods of Making and Using Thereof 7,005,267 2/28/06

Leishmania Diagnostic Kit and Background Information Related to This Kit as well as the FDA 510(K) for Leishmania N/A N/A

Dengue Virus Monoclonal Antibodies Produced by Several Hybridoma Lines N/A N/A

Raman Spectra Database System N/A N/A

Attenuated Japanese Encephalitis Virus Adapted to Vero Cell and a Japanese Encephalitis Vaccine 6,309,650 10/30/01

Absorbable Tissue Adhesives 5,350,798 9/27/94

Personal Water and Additive Apparatus 7,533,786 5/19/09

Fish Hatching Method and Apparatus N/A N/A

Asporogenic B. anthracis Expression System 6,316,006 11/13/01

Method of Making a Vaccine for Anthrax 6,387,665 5/14/02

System and Method for Evaluating Task Effectiveness Based on Sleep Pattern 6,579,233 6/17/03

Copyrights, Data Architecture, Business Rules and Know How Related to Biosurety Program Management Software N/A N/A

Identification of Small Molecule Inhibitors of Filovirus Replication N/A N/A

Moes OB/GYN Training System N/A N/A

System and Method for Handling Medical Information (BMIST) N/A N/A

System and Method for Handling Medical Information (BMIST) N/A N/A

Collaborative Development of a Tetravalent Live-Attenuated Vaccine Against Dengue N/A N/A

Attenuated Dengue-2 Virus Vaccine 6,511,667 1/28/03

Attenuated Dengue-3 Virus Vaccine 6,528,065 3/4/03

Attenuated Dengue-4 Virus Vaccine 6,537,557 3/25/03

A-3
Title Patent No. Issue Date

Multivalent Dengue Virus Vaccine 6,638,514 10/28/03

Adaptation of Virus to Vertebrate Cells 6,613,556 9/2/03

Sitamiquine 4-Methyl 1-5 (unsubstituted and substituted phenoxy) 6-Methoxy-8-(aminoalkylaminio) Quinolines N/A N/A

Inactivated Dengue Virus Vaccine 6,254,873 7/3/01

Method and Kit for Detection of Dengue Virus 6,190,859 2/20/01

Apparatus and Method for Automated Biomonitoring of Water Quality 6,058,763 5/9/00

Apparatus and Method for Automated Biomonitoring of Water Quality 6,393,899 5/28/02

Automated Biomonitoring of Water Quality*

Vaccine Technology 

Vaccine Technology 

Oral or Intranasal Vaccines Using Hydrophobic Complexes Having Proteosomes and Lipopolysaccharides 7,112,332 9/26/06

Immuno-Potentiating Systems for Preparation of Immunogenic Materials 

Immuno-Potentiating Systems for Preparation of Immunogenic Materials 5,726,292 3/10/98

Multi-Purpose Self-Erecting Structure Having Advanced Insect Protection and Storage Characteristics 6,672,323 1/6/04

Critical Care Platform for Litters 6,493,890 12/17/02

Critical Care Platform for Litters* N/A N/A

Critical Care Platform for Litters* N/A N/A

Critical Care Platform for Litters* N/A N/A

Critical Care Platform for Litters* N/A N/A

S. flexneria Hybridoma 220-2E8 N/A N/A

Chikungunya Vaccine-Strain of Live, Attenuated Chikungunya Virus, TSI-GSD-218 (Strain Chik 181/Clone 25) N/A N/A

Vaccine Strains: (1) Chikungunya, 181/25, (2) Venezuelan Equine Encelphalitis Tc-83, (3) Junin, Candid #1, and (4) Rift Valley 

Fever Virus, MP12

N/A N/A

Bacterial Superantigen Vaccines 6,713,284 3/30/04

Bacterial Superantigen Vaccines 6,399,332 6/4/02

Transdermal Delivery System for Antigen 5,910,306 6/8/99

Hybridoma Cell Line 7H2 Against E Protein of West Nile Virus (WNV) N/A N/A

Enhanced Substrates for the Protease Activity of Serotype A Botulinum Neurotoxin* N/A N/A

System and Method of Handling Medical Info-BMIST* N/A N/A

System and Method of Handling Medical Info-BMIST N/A N/A

A-4

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Title Patent No. Issue Date

System and Method of Handling Medical Info-BMIST N/A N/A

System and Method of Handling Medical Info-BMIST N/A N/A

Monoclonal Antibodies to Ebola Glycoprotein 6,630,144 10/7/03

Monoclonal Antibodies and Complementarity-Determining Regions Binding to Ebola Glycoprotein 7,335,356 2/26/08

Vaccine Against Gram-Negative Bacterial Infections 7,025,963 4/11/06

Vaccine Against Gram-Negative Bacterial Infections 7,235,644 6/26/07

Vaccine Against Gram-Negative Bacterial Infections 7,018,636 3/28/06

Vaccine Against Gram Negative Bacteria 6,558,677 5/6/03

Meningococcal Multivalent Native Outer Membrane Vesicle Vaccine, Methods of Making and Use Thereof Pct/

Us2009/045818

6/1/09

Convulsant Antidote Nerve Agent (Cana) New Drug Application N/A N/A

Identification of Small Molecule Inhibitors of Anthrax Lethal Factor N/A N/A

Identification of Small Molecule Inhibitors of Anthrax Lethal Factor N/A N/A

Inhibition of Anthrax Lethal Factor Protease 7,781,183 8/24/10

Identification of Small Molecule Inhibitors of Anthrax Lethal Factor Pct/

Us2004/029112

9/8/04

Small Molecule Inhibitors of Botulinum Neurotoxins* N/A N/A

Small Molecule Inhibitors of Botulinum Neurotoxins 7,825,154 11/2/10

Broad Spectrum Antibacterial Compounds*

Broad Spectrum Antibacterial Compounds N/A N/A

Broad Spectrum Antibacterial Compounds

Broad Spectrum Antibacterial Compounds*

Multi-Purpose Self-Erecting Structure Having Advanced Insect Protection and Storage Characteristics 6,672,323 1/6/04

System and Method for the Deconvolution of Mixed DNA Profiles Using a Proportionately Shared Allele Approach N/A N/A

Master Virus Seed (Designated as RVF Master Seed Pass 1 Zh548-P-1) and Production Seed Used to Make Live Attenuated, 

MP-12, Rift Valley Fever Virus Vaccine, Designated TSI-GSD-223 Lot 7-2-88

N/A N/A

System and Method for Predicting Human Cognitive Performance Using Data from an Actigraph 6,241,686 6/5/01

Method for Predicting Human Cognitive Performance 6,419,629 7/16/02

System and Method for Predicting Human Cognitive Performance Using Data from an Actigraph 6,527,715 3/4/03

Method and System for Predicting Human Cognitive Performance 6,530,884 3/11/03

Method and System for Predicting Human Cognitive Performance 6,553,252 4/22/03

A-5
Title Patent No. Issue Date

Method and System for Predicting Human Cognitive Performance 6,740,032 5/25/04

Method and System for Predicting Human Cognitive Performance Using Data from an Actigraph 6,743,167 6/1/04

Compositions for Treatment of Hemorrhaging with Activated Factor VIIA in Combination with Fibrinogen and Methods of Using 

Same 

6,825,323 11/30/04

Clone BE2 Anti-Soman; Clone ID8.2 Anti-Sarin N/A N/A

Human Liver Cell Line 7,015,036 3/21/06

7G8 Isolate of P. falciparum N/A N/A

Composition and Method of Treating Hepatitis C N/A N/A

Composition and Method of Treating Hepatitis C 5,849,696 12/15/98

Composition and Method of Treating Hepatitis C N/A N/A

Screening Methods Using Normal Human Liver Cell Line 7,781,186 8/24/10

Trauma Training Mannequin* N/A N/A

Trauma Training Mannequin* N/A N/A

Trauma Training System* N/A N/A

Trauma Training System N/A N/A

Trauma Training Mannequin N/A N/A

Lethal Mosquito Breeding Container 5,983,557 11/16/99

Lethal Mosquito Breeding Container 6,185,861 2/13/01

Lethal Mosquito Breeding Container 6,389,740 5/21/02

Lethal Mosquito Breeding Container N/A N/A

Antibodies Against Type A Botulinum Neurotoxin 6,667,158 12/23/03

Antibodies Against Type A Botulinum Neurotoxin 7,049,085 5/23/06

Method of Lysing Thrombi 5,399,158 3/21/95

Prolonged Storage of Red Blood Cells and Composition 6,150,085 11/21/00

Prolonged Storage of Red Blood Cells 6,447,987 9/10/02

Method for the Production of Purified Invasin Protein and Use Thereof N/A N/A

Automated Neuropsychological Assessment Metrics (ANAM) N/A N/A

Automated Neuropsychological Assessment Metrics (ANAM)* N/A N/A

Automated Neuropsychological Assessment Metrics (ANAM) N/A N/A

Automated Neuropsychological Assessment Metrics (ANAM)* N/A N/A

A-6

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Title Patent No. Issue Date

Automated Neuropsychological Assessment Metrics (ANAM)* N/A N/A

Automated Neuropsychological Assessment Metrics (ANAM)* N/A N/A

Automated Neuropsychological Assessment Metrics (ANAM)* N/A N/A

Neurocognitive and Psychomotor Performance Assessment and Rehabilitation System* 7,837,472 11/23/10

Method of Prophylactically Treating Organophosphate Poisoning N/A N/A

Method of Prophylactically Treating Organophosphate Poisoning* N/A N/A

Method of Prophylactically Treating Organophosphate Poisoning* N/A N/A

Vaccine Against Gram-Negative Bacterial Infections 7,018,636 3/28/06

Vaccine Against Gram-Negative Bacterial Infections 7,235,644 6/26/07

Vaccine Against Gram-Negative Bacterial Infections 7,025,963 4/11/06

Alphavirus RNA Replicon System*

Alphavirus RNA Replicon Systems 5,792,462 8/11/98

Alphavirus RNA Replicon System 6,639,650 6/17/97

Method of Inducing an Immune Response with a Live Venezuelan Equine Encephalitis Virus Expressing a Heterologous 

Immunogen

5,643,576 7/1/97

Attenuating Mutations in Venezuelan Equine Encephalitis Virus 5,505,947 4/9/96

cDNA Clone Coding for Venezuelan Equine Encephalitis Virus and Attenuating Mutations Thereof 5,185,440 2/9/93

Master Virus Seed (Designated as RVF Master Seed Pass 1 ZH548-P-1) and Production Seed Used to Make Live Attenuated, 

MP-12, Rift Valley Fever Virus Vaccine, Designated TSI-GSD-223 Lot 7-2-88

N/A N/A

Burn Patient Resuscitation System and Method 7,857,803 12/28/10

Decision-Assist Method for Resuscitation of Patients N/A N/A

Use of Bilosomes for Oral Delivery of Subunit Vaccines for Diarrheal Diseases N/A N/A

Monoclonal Antibodies or Assay Test Kits Using Monoclonal Antibodies Derived from the Provided Hybridomas for the 

Detection of Dengue Virus or Diagnosis of Dengue Virus Infections 

N/A N/A

Battlefield Medical Information System-Telemedicine (BMIST) N/A N/A

Battlefield Medical Information System-Telemedicine (BMIST) N/A N/A

Battlefield Medical Information System-Telemedicine (BMIST) N/A N/A

Shigella flexneri Strain Designated 15G N/A N/A

A-7
Patents Issued to USAMRMC Laboratories

The following list is a summary of the patents issued to USAMRMC laboratories. An asterisk (*) after the patent number indicates that the patent 

has expired.

Patent No. Issued Title

Armed Forces Institute of Pathology

7,445,908 11/4/08 Detection of Oxidizing Agents in Urine

7,582,430 9/1/09 Immunoliposome-Nucleic Acid Amplification (ILNAA) Assay

7,662,568 2/16/10 Immunoliposome-Nucleic Acid Amplification (ILNAA) Assay

Brooke Army Medical Center

7,552,729 6/30/09 Intubation Device and Method

Letterman Army Institute of Research

4,461,284* 7/24/84 Surgical Retaining Device

4,473,494* 9/25/84 Preparation of Stroma-Free, Non-Heme Protein-Free Hemoglobin

4,473,496* 9/25/84 Intramolecularly Crosslinked Hemoglobin

Madigan Army Medical Center

6,876,780 4/5/05 Providing for Automated Note Completion

7,043,437 5/9/06 Standardized Inpatient-Outpatient Nomenclatures and Accepting Both Outpatient and Inpatient Data to Commonly Accessible 

Storage

7,291,016 11/6/07 Opthalmic Surgery Simulation Device

7,761,463 7/20/10 Self-Serve Patient Check-In and Preventative Services Kiosk

Telemedicine and Advanced Technology Research Center

7,779,025 8/17/10 System and Method for Evaluating Data Sets over a Communication Network

Tripler Army Medical Center

6,754,306 6/22/04 Portable Medical Digital Radiography Assembly

7,204,171 4/17/07 Apparatus for Fastening and Loosening a Lid from a Container

7,316,298 1/8/08 Wheelchair Safety Brake Assembly

7,437,972 10/21/08 Apparatus for Fastening and Loosening a Lid from a Container

A-8

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

U.S. Army Aeromedical Research Laboratory

5,022,306* 6/11/91 Method of Ejecting an Interceptor Missile from Its Silo

6,834,971 12/28/04 Low-Backscatter Aperture Structure

6,896,377 5/24/05 Interchangeable Low-Backscatter Aperture Structure

7,096,184 8/22/06 Calibrating Audiometry Stimuli

7,143,031 11/28/06 Determining Speech Intelligibility

7,149,684 12/12/06 Determining Speech Reception Threshold

7,557,734 7/7/09 Airborne Visibility Indicator System and Method

7,734,101 6/8/10 Apparatus and System for Testing an Image Produced by a Helmet-Mounted Display

7,779,359 8/17/10 Multifunction Display Design Tool

U.S. Army Biomedical Research and Development Laboratory

4,941,631* 7/17/90 Semi-Micro Manipulators

4,960,496* 10/2/90 Atmospheric HCL Monitor

U.S. Army Center for Environmental Health Research

4,453,768* 6/12/84 Portable Reclining Examination Chair

4,788,789* 12/6/88 Collapsible Insect Trap

5,224,148* 6/29/93 X-Ray Cassette Holder and Positioning Device

5,375,276* 12/27/94 Portable Surgical Table

6,058,763 5/9/00 Apparatus and Method for Automated Biomonitoring of Water Quality

6,393,899 5/28/02 Apparatus and Method for Automated Biomonitoring of Water Quality

6,988,394 1/24/06 Apparatus and Method of Portable Automated Biomonitoring of Water Quality

7,094,417 8/22/06 Fish Hatching Method and Apparatus

7,702,473 4/20/10 Submersible Portable In-Situ Automated Water Quality Biomonitoring Apparatus and Method

U.S. Army Center for Health Promotion and Preventive Medicine

6,875,602 4/5/05 Portable Thermocycler

6,905,454 6/14/05 Handheld and Hand-Powered Centrifuge Device

7,069,814 7/4/06 Apparatus for Fastening a Lid to a Container

7,627,434 12/1/09 Method for Field-Based Ecological Risk Assessment Using Rodent Sperm Analysis

A-9
Patent No. Issued Title

U.S. Army Institute of Dental Research

4,637,931* 1/20/87 Polyactic-Polyglycolic and Co-Polymer Combined with Decalcified Freeze-Dried Bone for Use as a Bone Repair

U.S. Army Institute of Surgical Research

4,391,799* 7/5/83 Protective Gel Composition for Treating White Phosphorus Burn Wounds

4,393,048* 7/12/83 Protective Gel Composition for Treating White Phosphorus Burn Wounds

5,200,402* 4/6/93 Anti-Microbial Mafenide-Phosphanilate Compound, Pharmaceutical Compositions and Method of Use Thereof

6,144,867 11/7/00 Self-Piercing Pulse Oximeter Assembly

6,253,098* 6/26/01 Disposable Pulse Oximeter Assembly and Protective Cover Therefor

6,256,524* 7/3/01 Pulse Oximeter Sensor Combined with a Combination Oropharyngeal Airway and Bite Block

6,263,223* 7/17/01 Method for Monitoring Arterial Oxygen Saturation

6,266,547* 7/24/01 Nasopharyngeal Airway with Reflectance Pulse Oximeter Sensor

6,470,200 10/22/02 Pacifer Pulse Oximeter Sensor

6,493,890 12/17/02 Critical Care Platform for Litters

6,514,208 2/4/03 Method and Apparatus for Power Doppler Ultrasound Image Analysis

6,533,761 3/18/03 Catheter Securing Device and Bite Block

6,565,054 5/20/03 Syringe Holder Attachment for Medication

6,610,045 8/26/03 Orthogonal Arterial Catheter

6,708,935 3/23/04 Device for Upper Extremity Elevation

6,755,191 6/29/04 Securing a Device for an Endotracheal Tube

6,842,922 1/18/05 Critical Care Platform for Litters

6,890,322 5/10/05 Catheter Securing Device 

6,981,969 1/3/06 Orthogonal Arterial Catheter

7,149,562 12/12/06 Needle with Fiberoptic Capability

7,198,620 4/3/07 One Stage Saline Lock and Intravenous Catheter Set and Method of Use

7,458,743 12/2/08 Critical Care Platform for Litters

7,857,803 12/28/10 Burn Patient Resuscitation System and Method

D439,388 3/20/01 Medical Monitor Chassis

D443,062 6/5/01 Biomedical Data Recorder Chassis

A-10

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

U.S. Army Medical Materiel Agency

6,418,932 7/16/02 Convertible Patient Isolation Pod

U.S. Army Medical Materiel Development Activity

7,169,112 1/30/07 Non-Contact Respiration Monitor

U.S. Army Medical Research and Materiel Command

4,706,676* 11/17/87 Dermal Substance Collection Device

4,819,645* 4/11/89 Dermal Substance Collection Device

4,960,467* 10/2/90 Dermal Substance Collection Device

6,669,481 12/30/03 Neurocognitive Assessment Apparatus and Method

7,498,331 3/3/09 Arthropod Repellent Pharmacophore Models, Compounds, Identified as Fitting the Pharmacophore Models, and Methods of 

Making and Using Thereof

7,837,472 11/23/10 Neurocognitive and Psychomotor Performance Assessment and Rehabilitation System

U.S. Army Medical Research Institute of Chemical Defense

5,607,979 3/4/97 Topical Skin Protectants

6,001,625 12/14/99 Site-Directed Mutagenesis of Esterases

6,211,230* 4/3/01 Method of Reducing Brain Damage Resulting from Seizures

6,403,653 6/11/02 Active Topical Skin Protectants Using Reactive Nanoparticles

6,410,603 6/25/02 Active Topical Skin Protectants Using Combinations of Reactive Nanoparticles and Polyoxometalates on Metal Salts

6,410,604 6/25/02 Active Topical Skin Protectants Containing OPAA Enzymes and Clecs

6,414,039 7/2/02 Active Topical Skin Protectants Containing Polyoxometalates and/or Coinage Metal Complexes

6,417,236 7/9/02 Active Topical Skin Protectants Using Hybrid Organic Polysilsesquioxane Materials

6,420,434 7/16/02 Active Topical Skin Protectants Using Polyoxometallates

6,437,005 8/20/02 Active Topical Skin Protectants Using Polymer Coated Metal Alloys

6,472,437 10/29/02 Active Topical Skin Protectants

6,472,438 10/29/02 Active Topical Skin Protectants Containing S-330

6,555,334 4/29/03 Free Floating Cryostat Sections for Use in Light and Electron Microscopy

6,637,885 10/28/03 Method for Self-Detection of Pupillary Response

6,871,147 3/22/05 Automated Method of Identifying and Archiving Nucleic Acid Sequences

A-11
Patent No. Issued Title

U.S. Army Medical Research Institute of Chemical Defense (cont.)

7,303,759 12/4/07 Compositions and Methods for Reducing Blood and Fluid Loss from Open Wounds

7,371,714 5/13/08 Chemical Agent Decontamination Composition Comprising a Perfluorinated Aalkyl Bromide

U.S. Army Medical Research Institute of Infectious Diseases

4,532,122* 7/30/85 Anti-Trypanosomal Activity Coordination Compounds

5,185,440 2/9/93 cDNA Clone Coding for Venezuelan Equine Encephalitis Virus and Attenuating Mutations Thereof

5,298,423 3/29/94 Nucleotide Sequences Encoding the Expression of a Hantaan Virus Nucleocapsid Protein and G1 and G2 Glycoproteins

5,320,069* 6/14/94 Small Animal Restraint Device

5,453,271 9/26/95 Vaccine Against Ricin Toxin

5,505,947 4/9/96 Attenuating Mutations in Venezuelan Equine Encephalitis Virus

5,614,193 3/25/97 Hantavirus Vaccine

5,626,844* 5/6/97 Monoclonal Antibody Against Ricin A Chain

5,643,576 7/1/97 Method of Inducing an Immune Response with a Live Venezuelan Equine Encephalitis Virus Expressing a Heterologous 

Immunogen

5,792,462 8/11/98 Alphavirus RNA Replicon Systems

5,807,741* 9/15/98 Protective Monoclonal Antibody Against Botulinum Neurotoxin Serotype F

5,965,699 10/12/99 Assay for the Proteolytic Activity of Serotype A from Clostridium Botulinum

6,008,329* 12/28/99 Method for Purifying Cholera Toxin

6,046,806 4/2/00 Flow-Through Cell Culture Chamber

6,156,558 12/5/00 Alphavirus RNA Replicon Systems

6,200,959 3/13/01 Genetic Induction of Anti-Viral Immune Response and Genetic Vaccine for Filovirus

6,258,788 7/10/01 DNA Vaccines Against Tick-Borne Flaviviruses

6,261,567 7/17/01 Overcoming Interference in Alphavirus Immune Individuals

6,261,570* 7/17/01 Live Attenuated Virus Vaccines for Western Equine Encephalitis Virus, Eastern Equine Encephalitis Virus, and Venezuelan 

Equine Encephalitis Virus IE and IIIA Variants

6,287,566* 9/11/01 Protective Peptides of Neurotoxin of C. botulinum

6,296,854* 10/2/01 Live Attenuated Venezuelan Equine Encephalitis Vaccine

6,316,006 11/13/01 Asporogenic B. anthracis Expression System

6,387,665 5/14/02 Method of Making a Vaccine for Anthrax

A-12

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

U.S. Army Medical Research Institute of Infectious Diseases (cont.)

6,399,332 6/4/02 Bacterial Superantigen Vaccines

6,406,862 6/18/02 Dip-Stick Assay for C-Reactive Protein

6,451,309 9/17/02 Prophylactic and Therapeutic Monoclonal Antibodies

6,495,143 12/17/02 Botulinum Neurotoxin Vaccine

6,517,842 2/11/03 Marburg Virus Vaccines

6,521,235 2/18/03 Alphavirus RNA Replicon Systems

6,531,135 3/11/03 Alphavirus RNA Replicon Systems

6,531,487 3/11/03 Indolo(2,1-b) Quinazole-6, 12-Dione Antimalarial Compounds and Methods of Treating Malaria Therewith

6,541,010 4/1/03 Alphavirus RNA Replicon Systems

6,562,376 5/13/03 DNA Vaccines Against Poxviruses

6,620,412 9/16/03 Prophylactic and Therapeutic Monoclonal Antibodies

6,630,144 10/7/03 Monoclonal Antibodies to Ebola Glycoprotein

6,632,640 10/14/03 Vaccine Against Staphylococcus Intoxication

6,667,158 12/23/03 Antibodies Against Type A Botulinum Neurotoxin

6,713,284 3/30/04 Bacterial Superantigen Vaccines

6,762,280 7/13/04 High Throughput Assays for the Proteolytic Activities of Clostridial Neurotoxins

6,770,479 8/3/04 Anthrax Vaccine

6,824,778 11/30/04 Prophylactic and Therapeutic Monoclonal Antibodies

6,869,787 3/22/05 Ricin Vaccine and Methods of Making and Using Thereof

6,875,433 4/5/05 Monoclonal Antibodies and Complementarity-Determining Regions Binding to Ebola Glycoprotein

6,904,912 6/14/05 Automated Inhalation Toxicology Exposure System

6,919,200 7/19/05 Purification Method and Apparatus

6,984,504 1/10/06 Ebola Virion Protein Expressed from Venezuelan Equine Encephalitis (VEE) Virus Replicons

7,005,267 2/28/06 Internal Positive Control for Probe-Based Nucleic Acid Molecule Assays and Methods of Making and Using Thereof

7,034,107 4/25/06 High-Throughput Assays for the Proteolytic Activities of Clostridial Neurotoxins

7,037,680 5/2/06 Recombinant Light Chains of Botulinum Neurotoxins and Light Chain Fusion Proteins for Use in Research and Clinical Therapy

7,049,085 5/23/06 Antibodies Against Type A Botulinum Neurotoxin

A-13
Patent No. Issued Title

U.S. Army Medical Research Institute of Infectious Diseases (cont.)

7,052,848 5/30/06 Internal Positive Control for Probe-Based Nucleic Acid Molecule Assays and Methods of Making and Using Thereof 

7,081,529 7/25/06 Recombinant Vaccine Against Botulinum Neurotoxin

7,087,235 8/8/06 Fusion Protein of Streptococcal Pyrogenic Exotoxins

7,090,852 8/15/06 VEE Virus Replicon Encoding Marburg Proteins

7,157,553 1/2/07 High Throughput Assays for the Proteolytic Activities of Clostridial Neurotoxins

7,175,845 2/13/07 Monoclonal Antibodies Against Ricin Toxin and Methods of Making and Using Thereof

7,214,787 5/8/07 Recombinant Vaccine Against Botulinum Neurotoxin

7,217,812 5/15/07 DNA Vaccines Against Hantavirus Infections

7,227,010 6/5/07 Recombinant Light Chains of Botulinum Neurotoxins and Light Chain Fusion Proteins for Use in Research and Clinical Therapy

7,235,235 6/26/07 Alphavirus RNA Replicon Systems

7,267,823 9/11/07 Ebola Peptides and Immunogenic Compositions Containing Same

7,297,785 11/20/07 Unique Chromosomal Sequence of Bacillus anthracis and Methods of Making and Using Thereof Including Real-Time PCR 

Assays

7,335,356 2/26/08 Monoclonal Antibodies and Complementarity-Determining Regions Binding to Ebola Glycoprotein

7,351,435 4/1/08 Deglycosylated Ricin Toxin A-Chain Vaccine

7,374,931 5/20/08 Vaccine Against Staphylococcus Intoxication

7,377,276 5/27/08 Automated Inhalation Toxicology Exposure System and Method

7,378,257 5/27/08 Bacterial Superantigen Vaccines

7,407,935 8/5/08 Ricin Toxin A-Chain Fragment for Use as a Vaccine

7,455,994 11/25/08 Methods for Producing Marburg Virus Proteins

7,563,875 7/21/09 Recombinant Chimeric Human Anti-Botulinum Antibodies

7,574,340 8/11/09 Small Molecules and a Pharmacophore Model for Inhibition of Botulinum Toxin and Methods of Making and Using Thereof

7,638,333 12/29/09 Anthrax Vaccine

7,666,404 2/23/10 Glanders/Meliodosis Vaccines

7,682,618 3/23/10 Generation of Virus-Like Particles and Use as Panfilovirus Vaccine

7,718,779 5/18/10 Prophylactic and Therapeutic Monoclonal Antibodies

7,731,975 6/8/10 Chimeric Filovirus Glycoprotein

A-14

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

U.S. Army Medical Research Institute of Infectious Diseases (cont.)

7,736,656 6/15/10 Immunogenic Compositions and Vaccines for Ebola

7,750,132 7/6/10 Altered Superantigen Toxins

7,781,183 8/24/10 Inhibition of Anthrax Lethal Factor Protease

7,786,285 8/31/10 Recombinant Vaccine Against Botulinum Neurotoxin

7,790,181 9/7/10 Live Attenuated Virus Vaccines for Eastern Equine Encephalitis Virus

7,790,182 9/7/10 Protein Vaccine Against Pox Viruses

7,795,015 9/14/10 Antibodies Expressed in Insect Cells

7,825,154 11/2/10 Small Molecule Inhibitors of Botulinum Neurotoxins

U.S. Army Research Institute of Environmental Medicine

5,206,652* 4/27/93 Dopler Radar/Ultrasonic Hybrid Height Sensing System

5,415,379* 5/16/95 Pneumatic Winch

5,682,882* 11/4/97 Vigilance Monitor System

5,739,119* 4/14/98 Antisense Oligonucleotides Specific for the Muscarinic Type 2 Acetylcholine Receptor MRNA

6,104,671* 8/15/00 Apparatus and Method for Measuring the Relative Velocity and True Distance Between Two Objects

6,488,267 12/3/02 Apparatus for Lifting or Pulling a Load

6,670,170 12/30/03 Temperature Required Cell Perfusion

6,878,100 4/12/05 Force Sensing Treadmill

7,455,620 11/25/08 Method for Interpreting Forces and Torques Exerted by a Left and Right Foot on a Dual-Plate Treadmill

7,533,786 5/19/09 Personal Water and Additive Apparatus

7,658,303 2/9/10 Personal Water and Additive Apparatus

7,837,723 11/23/10 Body Thermoregulation Using Skin Temperature Feedback

7,851,775 12/14/10 Gear-Type Drink-o-Meter to Monitor Fluid Consumption

Walter Reed Army Institute of Research

3,476,311* 11/4/69 Two Dimensional Structure Encoding Typewriter

3,595,899* 7/27/71 2-(Phenylalkylamino) Ethanethio-Sulfuric Acids as Antiradiation Agents

3,597,444* 8/3/71 Method of Synthesizing Selenoureas from Thioureas

A-15
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

3,600,396* 8/17/71 Alpha Dilower Alkyl Amind-2,6,-DI-[p-Chlorophenyl]-4-Pyridine Methanols and Derivatives Thereof

3,629,410* 12/21/71 Alpha-Adrenergic Blocking Agents

3,636,192* 1/18/72 Meningococcal Polysaccharide Vaccines

3,655,715* 4/11/72 Synthesis of N-Substituted 2-Amino-Ethanethiosulfuric Acids

3,667,471* 6/6/72 Surgical Clamp

3,753,997* 8/21/73 Trifluoromethyl Substituted-2, 6-Diphenyl-4-Pyridyl Carbinolamine Antimalarials

3,763,148* 10/2/73 2,6-Bis-Tricluoromethyl-Phenyl-4-Pyridinecarbolyic Acid and Derivatives Thereof

3,764,604* 10/9/73 4-Pyridylcarbinolamine Anti-Malarials

3,886,167* 5/27/75 2-Aryl-6-Trifluoromethyl-4-Pyridyl-Carbinolamines Antimalarials

3,940,404* 2/24/76 2-Substituted Phenyl-6-Trifluoromethyl-4-Pyridyl-Carbinolamines

3,953,463* 4/27/76 2-Aryl-6-Trifluoromethyl-4-Pyridyl-Carbinolamines Antimalarials

3,961,898* 6/8/76 Comparator Circuit for Automatic Analysis Apparatus

4,135,131* 1/16/79 Microwave Time Delay Spectroscopic Methods and Apparatus for Remote Interrogation of Biological Threats

4,148,005* 4/3/79 Thermometric Transducer Device

4,162,500* 7/24/79 Ridged Waveguide Antenna Submerged in Dielectric Liquid

4,186,183* 1/29/80 Liposome Carriers in Chemotherapy of Leishmaniasis

4,187,300* 2/5/80 Use of Phosphonium Salts in Treatment of African Trypanosomiasis

4,209,519* 6/24/80 Anti-Leishmanial Lepidine Derivatives

4,240,027* 12/16/80 Electromagnetic Method for the Noninvasive Analysis of Cell Membrane Physiology and Pharmacology

4,246,534* 1/20/81 Calibration Method for Lumped Capacitance Measurement of Complex Permittivity at HV, VHF and UHF Frequencies

4,247,815* 1/27/81 Method and Apparatus for Physiologic Facsimile Imaging of Biologic Targets Based on Complex Permittivity Measurements 

Using Remote Microwave

4,267,182* 5/15/81 Narcotic Antagonists in the Therapy of Shock

4,271,389* 6/2/81 Method and Apparatus for Physiologic Facsimile Imaging of Biologic Targets Based on Using Remote Microwave Interrogation 

4,282,253* 8/4/81 Topical Prophylaxis Against Schistosomiasis

4,285,936* 8/25/81 Method for Producing a Vaccine Against Bacterial Infections Caused by Pseudomonas aeruginosa

4,299,493* 11/10/81 Auto-Optical Centering Device for Photometers

A-16

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

4,302,459* 11/24/81 Liposome Carriers in Leishmaniasis Chemotherapy with 8-Aminoquinoline Derivatives

4,317,776* 3/2/82 2-Acetyl- and 2-Propionylpyridine Thiosemicarbazones

4,346,608* 8/31/82 Floating Device for Density Gradient Fractionation

4,368,959* 1/18/83 Apparatus for and Method of Testing Vision

4,384,117* 5/17/83 Silver Metachloridine 

4,385,055* 5/24/83 2-Acetyl- and 2-Propionylpyridine Thiosemicarbazones as Antimalarials

4,401,670* 8/30/83 Method of Treating Gonorrhea Infections with 2-Acetyl- and 2-Proprionylpyridine Thiosemicarbazones

4,415,565* 11/15/83 Silver Metachlorodine in Treatment of Infections

4,416,872* 11/22/83 Treatment of Malaria with Liposomes Containing 8-Aminoquinoline Derivatives and Glycoconjugates

4,426,378* 1/17/84 Thyrotropin Releasing Hormone in Therapy of Shock as a Central Nervous System Stimulant

4,431,807* 2/17/84 4-Methyl-5(Unsubstituted phenoxy)-6-Methoxy-8-[Aminoalkylamino]Quinolines(Sitamiquine)

4,434,168* 2/28/84 Narcotic Antagonists in the Therapy of Shock

4,440,771* 4/3/84 2-Acetyl Quinoline Thiosemicarbazones Useful in Treatment of Gonorrhea, Malaria or Bacterial Infections

4,443,431* 4/17/84 Neisseria gonorrhoeae Vaccine

4,447,395* 5/8/84 Sampling Device

4,447,427* 5/8/84 Method for Treating Bacterial Infections with 2-Acetyl- and 2-Propionylpyridine Thiosemicarbazones

4,453,546* 6/12/84 Scleral Depressor

4,488,043* 12/11/84 Topographic Marking Device

4,493,930* 1/15/85 Medical 2-Acetyl-and 2-Propionylpyridine Thiosemimcarbazones and Preparation Thereof

4,554,279* 11/19/85 5-(Straight Chain 3-12 Carbon Alkoly)8-Quinolinames and Their Use for Treatment of Malaria

4,580,567* 4/8/86 Suture Needle Holder

4,591,573* 5/27/86 Sensitive Radioimmunoassay Using Antibody to L-Hyoscyamine

4,596,798* 6/24/86 2-Acetylpyridine Thiosemicarbazones as Antiviral Agents

4,617,394* 10/14/86 4-Methyl-5(Unsubstituted and Substituted) Phenoxy-2, 6-Dimethoxy-8-(Aminoalkylamino)Quinolines (Tafenoquine)

4,632,830* 12/20/86 Oral Vaccine for Immunization Against Enteric Disease

4,657,903* 4/14/87 Transition of Metal Complexes of the Selenium Analogs of 2-Acetyl- and 2-Propionylpyrine Thiosemicarbazones Useful for 

Treating Malarial Infections and Leukemia

A-17
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

4,659,708* 4/21/87 Anti-Leishmanial Lepidine Derivatives

4,659,738* 4/21/87 Topical Prophylaxis Against Schistosomal Infections

4,665,173* 5/12/87 2-Acetyl- and 2-Propionylpyridine Selenosemicarbazones

4,707,357* 11/17/87 Immunologically Active Peptides Capable of Inducing Immunization Against Malaria and Genes Encoding Therefor

4,707,543* 11/17/87 Process for the Preparation of Detoxified Polysaccharide-Outer Membrane Protein Complexes, and Their Use as Antibacterial 

Vaccines

4,713,391* 12/15/87 Azabicyloalkane Phenyl Substituted Alkane Carboxylates, Their Preparation and Use as Anticholinergic Agents

4,717,115* 1/5/88 Adjustable Mold for Fabricating Bone Replacements

4,739,069* 4/19/88 2-Acety1- and 2-Proprionylpyridine Thiosemicarbazones

4,777,166* 10/11/88 2-Acetylpyridine Thiosemicarbazone Compositions as Antiviral Agents

4,791,135* 12/13/88 Novel Antimalarial Dihydroartemisinin Derivatives

4,794,549* 12/27/88 Excito-Repellency Test System

4,808,598* 2/28/89 Method for Producing Protection in an Animal Against Cyanide Poisoning Using 8-Aminoquinolines

4,863,874* 9/5/89 Method for Detecting Phosphatidylinositol Through Binding to Concanavalin A

4,883,890* 11/28/89 Unsymmetrical Organic Disulfide Compounds Useful as Antiradiation Agents

4,885,256* 12/5/89 Monoclonal Antibodies to Cholesterol and Methods

4,897,403* 1/30/90 Antimalarial Compositions and Methods

4,906,564* 3/6/90 Antigenic Determinants Recognized by Antidotes Obtained Using a Pathogenic Agent or Derivative Thereof That Presents a 

Restricted Set of Antigens

4,909,256* 3/20/90 Transdermal Vapor Collection Method and Apparatus

4,943,657* 7/24/90 Unsymmetrical Organic Disulfide Compounds Useful as Antiradiation Agents

4,944,449* 7/31/90 Oversize Laser Mailer and Return Envelope and Method 

4,973,734* 11/27/90 Carbaphens: Aprophen Analogs That Are Binary Antidotes for Organophosphate Poisoning

4,978,782* 12/18/90 Organic Disulfide Compound Useful as Antiradiation Agents

4,992,561* 2/12/91 Simple Conversion of Artemisinic Acid into Artemisinin

4,999,344* 3/12/91 Phospholipid Compositions and Their Effective Use as Anti-Tumor Agents

5,000,732* 3/19/91 Device and Method for Providing Doses of a Liquid Material over Time to a Gut Associated Lymphoid Tissue or a Test Animal

A-18

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

5,011,495* 4/30/91 Unique Bone Regeneration Tricalcium Phosphate

5,026,897* 6/25/91 Carbaphens: Apropen Analogs That Are Binary Antidotes for Organophosphate Poisoning

5,055,394* 10/8/91 Nucleic Acid Probe and Method for the Rapid Detection of Typhoid Fever Bacteria

5,071,759* 12/10/91 Mouse Hybridoma Cell Lines Producing Antibodies Specific for Clostridium difficile Toxins

5,074,247* 12/24/91 Insect Containing Test Apparatus

5,077,570* 12/31/91 Photo Processing Work Station

5,112,607* 5/12/92 Potentiation of Immunotoxin Action by Brefeldin A

5,130,438* 7/14/92 Bis-Methylene Ether Pyridinium Compounds

5,202,320 4/13/93 Method for Treating Leishmaniasis (NIH rights)

5,204,352* 4/20/93 Compounds Exhibiting Antiparasitic Activity and a Method for Their Use

5,206,236 4/27/93 Method for the Treatment of Malaria

5,229,376* 7/20/93 Encapsulated Plant-Derived Phosphatidylinositol (PI) Compositions for the Prevention of Mitrogenicity-Induced Cell Proliferation

5,238,927* 8/24/93 Hydrolytic Stabilizer for Unstable Organic Ions

5,243,540* 9/7/93 Computer-Driven Amino Acid Indexer for Peptide Synthesis

5,258,386* 11/2/93 Synthesis and Use of Novel [+] -3-Substituted-N-Alkylmorphinans as Anticonvulsants and/or Antiischemic Agents

5,281,597* 1/25/94 Heterocyclic and Aromatic Thiosemicarbazones Useful in the Treatment of Filariasis

5,290,553 3/1/94 Alkaloids of Picralima Nitide Used for Treatment of Protozoal Diseases

5,331,010* 7/19/94 1-Phenylakanecarboxylic Acid Derivatives as Anticonvulsant and Neuroprotective Agents

5,350,798 9/27/94 Absorbable Tissue Adhesives

5,399,158 3/21/95 Method of Lysing Thrombi

5,415,532* 5/16/95 High Efficiency Balanced Oscillating Shuttle Pump

5,417,986* 5/23/95 Vaccines Against Diseases Caused by Enteropathogenic Organisms Using Antigens Encapsulated Within BiodegradableBiocompatible Microspheres

5,470,311* 11/28/95 Microsphere Drug Application Device

5,476,771* 12/19/95 Test for Quantitative Thrombin Time

5,626,151 5/6/97 Transportable Life Support System

5,631,283* 5/20/97 Use of Sialidase Inhibitors in the Prevention and Treatment of Infectious and Inflammatory States

A-19
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

5,660,854 8/26/97 Drug Releasing Surgical Implant or Dressing Material

5,693,343 12/2/97 Microparticles of Maximal Uptake Capacity by Both M Cells and Non-M Cells

5,695,750* 12/9/97 Compositions for Use to Deactivate Organophosphates

5,698,416 12/16/97 Method for Production of Antigens Under Control of Temperature-Regulated Promotors in Enteric Bacteria

5,705,197* 1/16/98 Extraction Process for Producing PLGA Microspheres

5,711,966 1/27/98 Method of Treating Malaria with Desbutylhalofantane

5,716,637 2/10/98 Solid Fat Nanoemulsions as Vaccine Delivery Vehicles

5,726,292 3/10/98 Immuno-Potentiating Systems for Preparation of Immunogenic Materials

5,736,148* 4/7/98 Infectious Japanese Encephalitis Virus cDNA Clones That Produce Highly Attenuated Recombinant Japanese Encephalitis 

Virus and Vaccines Therefor

5,762,965 6/9/98 Vaccines Against Intracellular Pathogens Using Antigens Encapsulated Within Biodegradable Biocompatible Microspheres

5,820,880 10/13/98 Liposomal Formulation

5,824,538 10/20/98 Shigella Vector for Delivering DNA to a Mammalian Cell

5,888,519* 3/10/99 Encapsulated High-Concentration Lipid A Compositions as Immunogenic Agents to Produce Human Antibodies to Prevent or 

Treat Gram-Negative Bacterial Infections

5,910,306 6/8/99 Transdermal Delivery System for Antigen

5,914,114 6/22/99 Method of Raising Antibodies Against E. coli of the Family CS4-CFA/I

5,916,096* 6/29/99 Advanced Surgical Suite for Trauma Casualties

5,916,588 6/29/99 Peptide-Containing Liposomes Immunogenic Liposomes and Methods of Preparation and Use

5,919,129* 7/6/99 Fiber Optic Periodontal Endoscope

5,939,075* 8/17/99 Mutants of Brucella melitensis

5,958,686 9/28/99 Simple PCR Technique for Detecting and Differentiating Bacterial Pathogens

5,961,970 10/5/99 Submicron Emulsions as Vaccine Adjuvants

5,965,572* 10/12/99 Methods for Treating Antibiotic-Resistant Infections

5,972,366* 10/26/99 Drug Releasing Implant or Dressing Material

5,980,898 11/9/99 Adjuvant for Transcutaneous Immunization

5,983,557 11/16/99 Lethal Mosquito Breeding Container

A-20

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

5,985,284 11/16/99 Oral or Intranasal Vaccine Using Hydrophobic Complexes Having Proteosomes and Lipopolysaccharides

6,007,838 12/28/99 Process for Making Liposome Preparation

6,046,200 4/2/00 Compositions Having Neuroprotective and Analgesic Activity

6,066,323 5/23/00 Use of Antibodies to Sialidase as Anti-Infectious Agents and Anti-Inflammatory Agents

6,071,949 6/6/00 Use of Lipoxygenase Inhibitors as Anti-Cancer Therapeutic and Intervention Agents

6,074,865 6/13/00 Recombinant Dengue Virus DNA Fragment

6,090,614* 7/18/00 Method for Production of Plasmodium Causing Relapsing Malaria

6,093,406* 7/25/00 Vaccine for Induction of Immunity to Malaria

6,110,492 8/29/00 Immunogenic Compositions

6,110,671* 8/29/00 Method of Measuring Tumor Suppressor Gene P53

6,117,640 9/12/00 Recombinant Vaccine Made in E. coli Against Dengue Virus

6,124,108* 9/26/00 Protein Biomarker for Mustard Chemical Injury

6,150,085 11/21/00 Prolonged Storage of Red Blood Cells and Composition

6,159,958* 12/12/00 Treatment or Prophylaxis of Retinal Pathology and Spinal Cord Injury

6,185,861 2/13/01 Lethal Mosquito Breeding Container

6,190,859 2/20/01 Method and Kit for Detection of Dengue Virus

6,214,548* 4/10/01 Diagnostic Methods for Cyclospora

6,217,911* 4/17/01 Sustained-Release Non-Steroidal, Anti-Inflammatory and Lidocaine PLGA Microspheres

6,241,686 6/5/01 System and Method for Predicting Human Cognitive Performance Using Data from an Actigraph

6,245,892 6/12/01 Invaplex from Gram Negative Bacteria, Method of Purification and Methods of Use

6,248,574* 6/19/01 Polypeptides Selectively Reactive with Antibodies Against Human Immunodeficiency Virus and Vaccines Comprising the 

Polypeptides

6,254,873 7/3/01 Inactivated Dengue Virus Vaccine

6,268,383* 7/31/01 Substituted Aromatic Compounds for Treatment of Antibiotic-Resistant Infections

6,274,598* 8/14/01 Methods for Treating Antibiotic-Resistant Infections

6,277,379 8/21/01 Use of Purified Invaplex from Gram Negative Bacteria as a Vaccine

6,284,739 9/4/01 Antileishmanial Composition for Topical Application

A-21
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

6,284,772* 9/4/01 Indolo[2,1,B] Quinazole-6,12-Dione Antimalarial Compounds and Methods of Treating Malaria Therewith

6,309,650 10/30/01 Attenuated Japanese Encephalitis Virus Adapted to Vero Cell and a Japanese Encephalitis Vaccine

6,309,669 10/30/01 Therapeutic Treatment and Prevention of Infections with Materials Encapsulated Within a Biodegradable-Biocompatible 

Polymeric Matrix

6,310,046* 10/30/01 Sequestrin of Plasmodium falciparum

6,316,197 11/13/01 Method of Diagnosing of Exposure to Toxic Agents by Measuring Distinct Pattern in the Levels of Expression of Specific Genes

6,339,102* 1/15/02 Method and Compositions for Treating and Preventing Retinal Damage

6,389,740 5/21/02 Lethal Mosquito Breeding Container

6,403,576 6/11/02 Antifungal and Antiparasitic Compounds

6,406,876 6/18/02 Immobilized Enzymes Biosensors for Chemical Toxins

6,410,012 6/25/02 Antimicrobial Mediated Bacterial DNA Delivery

6,410,056 6/25/02 Chemotherapeutic Treatment of Bacterial Infections with an Antibiotic Encapsulated Within a Biodegradable Polymeric Matrix

6,410,537 6/25/02 Compositions Having Neuroprotective and Analgesic Activity

6,419,629 7/16/02 Method for Predicting Human Cognitive Performance

6,432,434 8/13/02 Treatment of and/or Prophylaxis Against Brain and Spinal Cord Injury

6,433,023 8/13/02 Compositions Having Anti-Leishmanial Activity

6,444,445 9/30/02 Live Vaccine Against Brucellosis

6,447,796 9/10/02 Sustained Release Hydrophobic Bioactive PLGA Microspheres

6,447,987 9/10/02 Prolonged Storage of Red Blood Cells

6,469,049 10/22/02 Method of Treating, Preventing or Inhibiting Central Nervous System Injuries and Diseases

6,476,201 11/5/02 Methods for Production of Non-Covalently Complexed and Multivalent Proteosome Sub-Unit Vaccines

6,511,667 1/28/03 Attenuated Dengue-2 Virus Vaccine

6,514,501 2/4/03 Recombinant Vaccine Against Dengue Virus

6,527,715 3/4/03 System and Method for Predicting Human Cognitive Performance Using Data from an Actigraph

6,528,065 3/4/03 Attenuated Dengue-3 Virus Vaccine

6,528,097 3/4/03 Sustained Release Non-Steroidal, Anti-Inflammatory and Lidocaine PLGA Microspheres

6,530,884 3/11/03 Method and System for Predicting Human Cognitive Performance

6,537,557 3/25/03 Attenuated Dengue-4 Virus Vaccine

A-22

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

6,541,230 4/1/03 Detoxification with Sponges or Foams Containing Plurality of Enzymes and Encapsulated Indicator

6,553,252 4/22/03 Method and System for Predicting Human Cognitive Performance

6,558,677 5/6/03 Vaccine Against Gram-Negative Bacteria

6,573,244 6/3/03 Previns as Specific Inhibitors and Therapeutic Agents for Botulinum Toxin B and Tetanus Neurotoxins

6,613,556 9/2/03 Adaptation of Virus to Vertebrate Cells

6,628,751 9/30/03 Digital Radiographic Sensor View Capture

6,638,514 10/28/03 Multivalent Dengue Virus Vaccine

6,641,815 11/4/03 Sequestrin of Plasmodium falciparum

6,642,037 11/4/03 Preparation of Enzymatically Active Sponges or Foams for Detoxification of Hazardous Compounds

6,654,736 11/25/03 Chemical Information Systems

6,664,280 12/16/03 Antivesicant Compounds and Methods of Making and Using Thereof

6,672,323 1/6/04 Multipurpose Self-Erecting Structure Having Advanced Insect Protection and Storage Characteristics

6,680,374 1/20/04 Invaplex from Gram Negative Bacteria, Method of Purification and Methods of Use

6,706,754 3/16/04 Reversed Amidines and Methods of Using for Treating, Preventing, or Inhibiting Leishmaniasis

6,713,444 3/30/04 Buforin I as a Specific Inhibitor and Therapeutic Agent for Botulinum Toxin B and Tetanus Neurotoxins

6,740,032 5/25/04 Method and System for Predicting Human Cognitive Performance

6,743,167 6/1/04 Method and System for Predicting Human Cognitive Performance Using Data from an Actigraph

6,746,850 6/8/04 Assay for Detecting, Measuring and Monitoring the Activities and Concentrations of Proteins and Methods of Use Thereof

6,753,155 6/22/04 Protein Biomarker for Mustard Chemical Injury

6,756,399 6/29/04 Use of Lipoxygenase Inhibitors and PPAR Ligands as Anticancer Therapeutic and Intervention Agents

6,793,488 9/21/04 Flavivirus Detection, and Quantification Assay

6,797,276 9/28/04 Use of Penetration Enhancers and Barrier Disruption Agents to Enhance the Transcutaneous Immune Response

6,797,485 10/13/04 Mass Spectrometry of Colonization Factors

6,800,618 10/5/04 Chemosensitizing Agents Against Chloroquine Resistant P. falciparum and Methods of Making and Using Thereof

6,803,042 10/12/04 Oral or Intranasal Vaccines Using Hydrophobic Complexes Having Proteosomes and Lipopolysaccharides

6,815,425 11/9/04 Pharmaceutical Composition Containing pGlu-Glu-Pro-NH2 and Method for Treating Diseases and Injuries to the Brain, Spinal 

Cord and Retina Using Same

A-23
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

6,825,323 11/30/04 Compositions for Treatment of Hemorrhaging with Activated Factor VIIA in Combination with Fibrinogen and Methods of Using 

Same

6,825,382 11/30/04 Trifluoromethylepinephrine Compounds and Methods of Making and Using Thereof

6,844,010 1/18/05 Therapeutic Treatment and Prevention of Infections with a Bioactive Materials Encapsulated Within a BiodegradableBiocompatible Polymeric Matrix

6,849,050 2/1/05 System and Method for Detecting Visual Alterness

6,855,322 2/15/05 Isolation and Purification of P. falciparum Merozoite Protein-142 Vaccine 

6,855,331 2/15/05 Sustained Release Hydrophobic Bioactive PLGA Microspheres

6,869,602 3/22/05 Methods for Treating or Inhibiting Enterotoxigenic Escherichia coli Infections with Bovine Red Blood Cells

6,872,398 3/29/05 A Conjugate Vaccine Against Gram-Negative Bacterial Infection

6,891,077 5/10/05 Fibrinogen Bandages and Arterial Bleeding Models and Methods of Making and Using Thereof

6,900,025 5/31/05 Detection of Antibodies to Squalene in Serum

6,902,743 6/7/05 Therapeutic Treatment and Prevention of Infections with a Bioactive Material(s) Encapsulated Within a Biodegradable BioCompatible Polymeric Matrix

6,906,098 6/14/05 Mixed Steroidal 1,2,4,5-Tetraoxane Compounds and Methods of Making and Using Thereof

6,939,546* 9/6/05 Model for Testing Immunogenicity of Peptides

6,951,846 10/4/05 Artemisinins with Improved Stability and Bioavailability for Therapeutic Drug Development and Applications

7,008,774 3/7/06 Practical Serological Assay for the Clinical Diagnosis of Leishmaniasis

7,010,089 3/7/06 Digital Radiographic Sensor View Capture

7,015,036 3/21/06 Human Liver Cell Line

7,018,636 3/28/06 Vaccine Against Gram-Negative Bacterial Infections

7,025,963 4/11/06 Vaccine Against Gram-Negative Bacterial Infections

7,029,685 4/18/06 Plasmodium falciparum AMA-1 Protein and Uses Thereof

7,033,608 4/25/06 Novel "Burst-Free" Sustained Release Poly(Lactide/Glycolide) Microspheres

7,037,499 5/2/06 Adjuvant for Transcutaneous Immunization

7,045,336 5/16/06 Bacterial Delivery System

7,060,276 6/13/06 Plasmodium falciparum AMA-1 Protein and Uses Thereof

7,084,132 8/1/06 Artemisinins with Improved Stability and Bioavailability for Therapeutic Drug Development and Applications

A-24

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

7,094,883 8/22/06 Monoclonal Antibody Which Agglutinates E. coli Having the CS4-CFA/I Family Protein

7,101,902 9/5/06 2-Guanidinylimidazolidine Dione Compounds and Methods of Making and Using Thereof

7,112,332 9/26/06 Oral or Intranasal Vaccines Using Hydrophobic Complexes Having Proteosomes and Lipopolysaccharides

7,118,758 10/10/06 Transformed Bacteria Producing CS6 Antigens as Vaccines

7,150,875 12/19/06 Recombinant P. vivax Merozoite Protein-1 p42 Vaccine

7,175,981 2/13/07 Method of Diagnosing Stage or Aggressiveness of Breast and Prostate Cancer Based on Levels of Fatty Acid Binding Proteins

7,217,418 5/15/07 Multivalent Dengue Virus Vaccine

7,217,541 5/15/07 Method of Making CS6 Antigen Vaccine for Treating, Preventing, or Inhibiting Enterotoxigenic Escherichia coli Infections

7,235,234 6/26/07 Bacterial Delivery System

7,235,521 6/26/07 Previns as Specific Inhibitors and Therapeutic Agents for Botulinum Toxin B and Tetanus Neurotoxins

7,235,644 6/26/07 Vaccine Against Gram-Negative Bacterial Infections

7,253,177 8/7/07 Synthesis and Antimalarial Activity of Pyrrolo[3,2-F]Quinazoline-1,3,-Diamine Derivatives

7,256,281 8/14/07 Recombinant P. falciparum Merozoite Protein-142 Vaccine

7,258,863 8/21/07 Heterologous Protection Induced by Immunization with Invaplex Vaccine

7,259,167 8/21/07 Antimalarial and Antiproliferative Pharmacophore Models, Novel Tryptanthrin Compounds Having Increased Solubility, and 

Methods of Making and Using Thereof

7,265,215 9/4/07 Recombinant Vaccine Against Dengue Virus

7,270,964 9/18/07 Detection of Antibodies to Squalene in Serum

7,283,962 10/16/07 Methods and Systems for Detecting, Measuring, or Monitoring Stress in Speech

7,306,806 12/11/07 Recombinant P. falciparum Merozoite Protein-142 Vaccine

7,332,172 2/19/08 Transformed Bacteria Producing CS6 Antigens as Vaccines

7,375,079 5/20/08 Previns as Specific Inhibitors and Therapeutic Agents for Botulinum Toxin B and Tetanus Neurotoxins

7,378,097 5/27/08 Use of Penetration Enhancers and Barrier Disruption Agents to Enhance the Transcutaneous Immune Response

7,404,961 7/29/08 Antibodies Against Consensus Peptide of the CS4-CFA/1 Family Proteins

7,416,878 8/26/08 Immunogenic Compositions Including Rough Phenotype Brucella Host Strains and Complementation DNA Fragments

7,419,683 9/2/08 Method of Inhibiting Side Effects of Pharmaceutical Compositions Containing Amphiphilic Vehicles or Drug Carrier Molecules

7,452,721 11/18/08 Practical Serological Assay for the Clinical Diagnosis of Leishmaniasis

A-25
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

7,494,980 2/24/09 Antimicrobial Peptide and Methods of Use Thereof

7,527,802 5/5/09 Vaccine for Transcutaneous Immunization

7,550,275 6/23/09 Expression, Purification and Uses of a Plasmodium falciparum Liver Stage Antigen 1 Peptide

7,563,883 7/21/09 Recombinant P. falciparum Merozoite Protein-142 Vaccine

7,566,465 7/28/09 Artemisinins in the Clinical and Veterinary Management of Kinetoplastid Infections

7,566,540 7/28/09 Monoclonal Antibody Which Agglutinates E. coli Having the CS4-CFA/I Family Protein

7,595,191 9/29/09 Isolation and Purification of P. falciparum Merozoite Protein-142 Vaccine 

7,604,811 10/20/09 Oral-Intestinal Vaccines Against Diseases Caused by Enteropathic Organisms Using Antigens Encapsulated Within 

Biodegradable-Biocompatible Microspheres

7,611,896 11/3/09 A Novel and Practical Serological Assay for the Clinical Diagnosis of Leishmaniasis

7,625,571 12/1/09 Transformed Bacteria Producing CS6 Antigens as Vaccines

7,632,659 12/15/09 Use of Shigella Invaplex to Transport Functional Proteins and Transcriptionally Active Nucleic Acids Across Mammalian Cell 

Membranes In Vitro and In Vivo

7,655,247 2/2/10 Malaria Vaccines

7,660,692 2/9/10 Ballistic Impact Detection System

7,678,828 3/16/10 Methods for the Formulation and Manufacture of Artesunic Acid for Injection

7,722,889 5/25/10 Plasmodium Liver Stage Antigens

7,741,431 6/22/10 Liposomes Containing Target and/or Fusogenic Peptides, Preparations Containing Them, and Therapeutic Use Thereof

7,754,461 7/13/10 Large-Scale Production of Human Serum Butyrylcholinesterase as a Bioscavenger

7,759,106 7/20/10 Construction of Live Attenuated Shigella Vaccine Strains That Express CFA/I Antigens (CfaB and CfaE) and the B Subunit of 

Heat-Labile Enterotoxin (LTB) from Enterotoxigenic E. coli

7,766,827 8/3/10 Method and System for Predicting Human Cognitive Performance

7,780,966 8/24/10 Artificial Invaplex

7,781,186 8/24/10 Screening Methods Using Normal Human Liver Cell Line

7,790,186 9/7/10 A Plasmodium vivax Hybrid Circumsporozoite Protein and Vaccine

7,799,536 9/21/10 Endothelial Monocyte Activating Polypeptide II, a Biomarker for Use in Diagnosis and Treatment of Brain Injury

7,824,864 11/2/10 Detection of Human Antibodies to Squalene in Serum

D454,140 3/5/02 ICON for a Portion of a Display Screen

A-26

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Patent No. Issued Title

Walter Reed Army Institute of Research (cont.)

D454,356 3/12/02 Toolbar for a Portion of a Display Screen

D463,445 9/24/02 ICON for a Portion of a Display Screen

D463,446 9/24/02 ICON for a Portion of a Display Screen

4,824,666* 4/28/89 Method of Large Scale Growth of Toxoplasmic Microorganisms

5,550,214 8/27/96 Isolated Antigenic Oncogene Peptide Fragments and Uses

5,916,224* 6/29/99 Tendon Repair Clip Implant

6,054,122 4/25/00 Supplemented and Unsupplemented Tissue Sealants, Methods of Their Production and Use

RE39,321 10/3/06 Supplemented and Unsupplemented Tissue Sealants, Methods of Their Production and Use

7,766,870 8/3/10 Foley Catheter Adaptor (Dabbs Adaptor)

Walter Reed Army Medical Center

4,824,666* 4/28/89 Method of Large Scale Growth of Toxoplasmic Microorganisms

5,550,214 8/27/96 Isolated Antigenic Oncogene Peptide Fragments and Uses

5,916,224* 6/29/99 Tendon Repair Clip Implant

6,054,122 4/25/00 Supplemented and Unsupplemented Tissue Sealants, Methods of Their Production and Use

RE39,321 10/3/06 Supplemented and Unsupplemented Tissue Sealants, Methods of Their Production and Use

7,766,870 8/3/10 Foley Catheter Adaptor (Dabbs Adaptor)

A-27
Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
ACRONYM LIST

2-PAM 2-Pralidoxime

AAS Advanced Anticonvulsant 

System

ABTD Advanced Blast Test Device

ABVT Automated Binocular Vision 

Tester

ACCLS Automated Critical Care Life 

Support

AFIRM Armed Forces Institute of 

Regenerative Medicine

AGULVE Aerosol Generator, Ultra-Low 

Volume, Electric

AHLTA-Mobile Armed Forces Health 

Longitudinal Technology 

Application-Mobile

AICS Arm Immersion Cooling 

System

AMMO Alertness Management for 

Military Operations

ANH Alliance for NanoHealth

ARD Acute Respiratory Disease

ARFORGEN Army Force Generation

ASER Army Medical Department 

Suicide Event Report

AST Advanced Surgical 

Technologies

ATD Anthropomorphic Test Device

ATNAA Antidote Treatment Nerve 

Agent Autoinjector

BAA Broad Agency Announcement

BAMC Brooke Army Medical Center

BW Biological Warfare

CANA Convulsant Antidote for Nerve 

Agent

CASEVAC Casualty Evacuation

CASIT Center for Advanced Surgical 

and Interventional Technology

CAT Combat Application Tourniquet

CBMS Chemical Biological Medical 

Systems

CBRNE Chemical, Biological, 

Radiological/Nuclear, and 

Explosive

CBT Computer-Based Training

CDE Common Development 

Environment

CDM Clinical Data Mart

CDMRP Congressionally Directed 

Medical Research Programs

CeMBR Center for Military Biomaterials 

Research

CiMeRC Civilian Medical Response 

Center

CIMIT Center for Integration of 

Medicine and Innovative 

Technology

COTS Commercial-off-the-Shelf

CounterACT Countermeasures Against 

Chemical Threats

CPAIN Chronic Pain Impact Network

CPOE Computerized Physician Order 

Entry

CPP Cryopreserved Platelets

CRADA Cooperative Research and 

Development Agreement

CRIMM Center for Research on 

Integrative Medicine in the 

Military

CRMRP Clinical and Rehabilitative 

Medicine Research Program

CTA Composite Tissue 

Allotransplantation

CW Chemical Warfare

DEFTOS Dental Field Treatment and 

Operating System

DHP Defense Health Program

B-1
DIN-PACS Digital Imaging NetworkPicture Archiving and 

Communications System

DoD Department of Defense

DVPMI Defense & Veterans Pain 

Management Initiative

EEE Eastern Equine Encephalitis

EHI Exertional Heat Injury

EIC Electronic Information Carrier

EMS Emergency Medical Services

EPA U.S. Environmental Protection 

Agency

ESB Environmental Sentinel 

Biomonitor

ESS Engineered Skin Substitute

ESSENCE Electronic Surveillance System 

for the Early Notification of 

Community-Based Epidemics

ETEC Enterotoxigenic Escherichia 

coli

FDA U.S. Food and Drug 

Administration

FETM Finite Element 

Thermoregulatory Model

FHAS Functional Hearing 

Assessment System

FIBWA Field Identification of Biological 

Warfare Agents

FMOGDS Field Medical OxygenGenerating and Distribution 

System

FOCUS Facial and Ocular 

Countermeasure Safety

GCV Ground Combat Vehicles

GEIS Global Emerging Infections 

System

GP Glycoprotein

GSK GlaxoSmithKline

HBCT Heavy Brigade Combat Team

HBO2 Hyperbaric Oxygen

HFRS Hemorrhagic Fever with Renal 

Syndrome

HHS U.S. Department of Health and 

Human Services

HIFU High-Intensity Focused 

Ultrasound

HIS Heat Injury/Stroke

HIV Human Immunodeficiency 

Virus

HMD Helmet-Mounted Display

HSDs Head-Supported Devices

iABS Intelligent Aquatic Biomonitor 

System

I&Ws Indications and Warnings

IEDs Improvised Explosive Devices

IFAK Improved First Aid Kit

IM/IT Information Management/

Information Technology

INATS Improved Nerve Agent 

Treatment System

ISO International Standard 

Organization

ITD Impedance Threshold Device

JBAIDS Joint Biological Agent 

Identification and Diagnostic 

System

JSPDS Joint Service Personnel/Skin 

Decontamination System

JSTO-CBD Joint Science and Technology 

Office for Chemical and 

Biological Defense

JVAP Joint Vaccine Acquisition 

Program

LRDD Leishmania Rapid Diagnostic 

Device

LST Leishmania Skin Test

LSTAT Life Support for Trauma and 

Transport

M3D Medical Maintenance 

Management Directorate

M-ATV MRAP All-Terrain Vehicle

MANAA Medical Aerosolized Nerve 

Agent Antidote

MC4 Medical Communications for 

Combat Casualty Care

MCC Microclimate Cooling

MDR Medical Data Repository

MHATs Mental Health Advisory Teams

MHS Military Health System

MIDRP Military Infectious Diseases 

Research Program

MMRP Medical Materiel Readiness 

Program

B-2

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
MOMRP Military Operational Medicine 

Research Program

MOS Military Occupational Specialty

MRAP Mine-Resistant 

Ambush-Protected

MRDD Malaria Rapid Diagnostic 

Device

MSTI Medical Simulation Training 

Initiative

MTFs Medical Treatment Facilities

MUSTPAC 3 Medical Ultrasound, ThreeDimensional, Portable with 

Advanced Communications

NAAK Nerve Agent Antidote Kit

NFCI Non-Freezing Cold Injury

NFGC National Functional Genomics 

Center

NIAID National Institute of Allergy and 

Infectious Diseases

NIH National Institutes of Health

NMRC Naval Medical Research 

Center

NP Nucleoprotein

NTTP Neuromonics Tinnitus 

Treatment Program

OTSG Office of the Surgeon General

PAN Personal Area Network

PC Personal Computer

PCS Post-Concussion Syndrome

PDA Personal Digital Assistant

PIV Purified Inactivated Virus

PPE Personal Protective Equipment

PRT Pathogen Reduction 

Technology

PSDA Probability of Survival Decision 

Aid

PTSD Post-Traumatic Stress Disorder

PUMA Programmable Universal 

Manipulation Arm

PVC Pharmacovigilance Center

PVT Psychomotor Vigilance Task

RAP Recruit Assessment Program

RBCXL Red Blood Cells, Extended Life

RHD Rapid Human Diagnostic

RMLS Rugged Mobile Logistics 

System

RPSM Remote Physiological Status 

Monitor

RSDL Reactive Skin Decontamination 

Lotion

RVD Rapid Vector Diagnostic

RVPSOG Rotary Valve Pressure Swing 

Oxygen Generator

SAPS Stand Alone Patient Simulator

SBIR Small Business Innovation 

Research

SEA Staphylococcal Enterotoxin A

SEB Staphylococcal Enterotoxin B

SERPACWA Skin Exposure Reduction 

Paste Against Chemical 

Warfare Agents

SMEED Special Medical Emergency 

Evacuation Device

SNAPP Soman Nerve Agent 

Pretreatment Pyridostigmine

SOFMH Special Operations Forces 

Medical Handbook

SOSTS Simulation of Open Surgery 

Training System

SPARKy Spring Ankle with 

Regenerative Kinetics

SPARNET Spartan Network

STATCare Simulation Technologies for 

Advanced Trauma Care

STS Severe Trauma Simulation

TAIHOD Total Army Injury Health and 

Occupational Database

TARA Technology Assessment and 

Requirements Analysis

TATRC Telemedicine and Advanced 

Technology Research Center

TBAD Tactile Balance Assessment 

Device

TBI Traumatic Brain Injury

TGAS-PE Toxic Gas Assessment 

Software – Performance 

Evaluation

TMIP Theater Medical Information 

Program

TOP Training, Overuse Injury, and 

Performance

TRIM Troop Recruitment 

Improvement

TSAS Tactile Situation Awareness 

System

UAV Unmanned Aerial Vehicle

B-3
URL USAMMA Revolution in 

Logistics

USAISR U.S. Army Institute of Surgical 

Research

USAMMA U.S. Army Medical Materiel 

Agency

USAMMCE U.S. Army Medical Materiel 

Center, Europe

USAMMDA U.S. Army Medical Materiel 

Development Activity

USAMRICD U.S. Army Medical Research 

Institute of Chemical Defense

USAMRIID U.S. Army Medical Research 

Institute of Infectious Diseases

USAMRMC U.S. Army Medical Research 

and Materiel Command

VA U.S. Department of Veterans 

Affairs

VAMC Veterans Affairs Medical 

Center

VEE Venezuelan Equine 

Encephalitis

VIG Vaccine Immune Globulin

VIGIV Vaccine Immune Globulin 

Intravenous

VLPs Virus-Like Particles

VNS Vagus Nerve Stimulatory

WebRSIS Web-Enabled Refractive 

Surgery Information System

WEE Western Equine Encephalitis

WPSM Warfighter Physiological Status 

Monitoring

WRAIR Walter Reed Army Institute of 

Research

WRAIR SPM Walter Reed Army Institute of 

Research Sleep Performance 

Model

WRESP Warfighter Refractive Eye 

Surgery Program

WRNMMC Walter Reed National Military 

Medical Center

WTUs Warrior Transition Units

B-4

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
3DiMD: Gaming Environment for Training

Team Coordination Skills..................................2-47

A

A Standards-Based Tool for

Pharmacovigilance ...........................................6-30

AAS ..................................................................5-15

ABTD..................................................................3-6

ABVT ................................................................3-26

ACCLS..............................................................2-61

Active Thermal Resuscitation...........................2-41

Adenovirus Vaccine Against P. falciparum........1-26

Adenovirus Vaccine, Types 4 and 7 ...................1-8

Advanced Anticonvulsant System ....................5-15

Advanced Blast Test Device...............................3-6

Advanced Medic Training Technologies ...........2-14

Advanced Regenerative Medicine

Technologies to Regenerate Lost Tissues........2-37

Advanced Resuscitation Fluid ..........................2-55

Advanced Surgical Technologies........................6-9

Aerosol Generator, Ultra-Low Volume,

Electric................................................................1-8

AGULVE .............................................................1-8

AHLTA-Mobile...................................................6-10

AICS .................................................................3-47

Alliance for NanoHealth....................................6-29

Allogeneic Engineered Skin/StrataGraft® ...........4-7

Alternate Insect Repellent ................................1-22

Altitude Sickness, Acclimatization,

and Performance Prediction Models ................3-46

AmbIT® PCA.....................................................2-20

ANH..................................................................6-29

Anthrax Vaccine Adsorbed (BiothraxTM) .............5-9

Anthropomorphic Test Device...........................3-57

Anticaries Components ....................................2-66

Antidote Treatment Nerve Agent Autoinjector.....5-6

Antimalarial Drugs ............................................1-30

Antimicrobial Bone Replacement Material........2-12

Antimicrobial External Fixator Pins...................2-12

Antimicrobials for Orthopedic Injuries...............2-12

Apheresis System...............................................7-4

Arm Immersion Cooling System.......................3-47

Armed Forces Health Longitudinal

Technology Application-Mobile .........................6-10

Army Medical Department Interim

Tent System......................................................2-14

Army Medical Department Suicide

Event Report ....................................................3-16

ASER................................................................3-16

Assessment of Learning with the Mobile

Telementoring Intubating Video Laryngoscope

in Endotracheal Intubation Training..................2-27

Assessment of Mild Traumatic Brain

Injury Through Modeling of Central Nervous

System Indices .................................................3-60

AST.....................................................................6-9

ATD...................................................................3-57

ATNAA................................................................5-6

Atovaquone-Proguanil (Malarone)....................1-16

Autologous Engineered Skin/Lonza

Permaderm.........................................................4-7

Autologous Fat Transfer Procedure....................4-8

Autologous Skin Expander Device .....................4-7

Automated Binocular Vision Tester...................3-26

Automated Critical Care Life Support

System..............................................................2-61

Aviation Tactile Situation Awareness

System..............................................................3-26

B

Biologic Extracellular Matrix Scaffold for

Functional Muscle Replacement ......................4-10

Biological Markers of Toxic Exposures and

Effects for Deployment Health Surveillance .....3-48

Biomechanical Design Guidelines for

Personal Equipment .........................................3-27

Blast Dosimeter ................................................3-27

Blast Standards for Neurosensory

Personal Protective Equipment ........................3-54

INDEX

C-1
Blood Product Shipping and

Transport Containers........................................2-55

Blood Refrigerator ............................................2-33

Body Armor Blunt Trauma Performance

Testing Method ...................................................3-7

Bone Image Analysis........................................3-54

C

C-Leg® (Second Generation) Microprocessor

Knee Prosthesis .................................................4-6

C-Leg (Third Generation) Microprocessor

Knee Prosthesis ...............................................4-11

Camouflaged Bednet Shelter .............................1-9

Campylobacter Vaccine....................................1-24

CANA..................................................................5-7

CASIT...............................................................2-48

CAT.....................................................................2-6

CBT ..................................................................5-11

CCFP..................................................................1-9

CDE..................................................................6-12

CDM .................................................................6-18

CeMBR.............................................................6-11

Center for Advanced Surgical and

Interventional Technology.................................2-48

Center for Military Biomaterials Research........6-11

Center for Research on Integrative Medicine

in the Military ....................................................6-31

Ceramic Oxygen Generator..............................2-33

Chemical Diagnostics.......................................5-24

Chemical Warfare Agent Protective

Patient Wrap.....................................................2-15

Chitosan Hemorrhage Control Dressing

(HemCon Bandage)............................................2-6

Chloroquine (Aralen) ........................................1-14

Chloroquine-Primaquine...................................1-16

Clinical Breast Care Project at Walter Reed

Army Medical Center........................................6-32

Clinical Looking Glass, “A Revolutionary

Clinical Intelligence Tool”....................................6-4

Clotting Agents .................................................2-33

Cognitive Readiness/Fatigue Modeling............3-61

Cold Chain Management....................................7-4

Cold Weather Operations: Cold Injury

Prevention and Performance Optimization.......3-22

Combat Application Tourniquet...........................2-6

Combat Gauze ...................................................2-7

Combined Camouflage Face Paint.....................1-9

Comfortable Socket..........................................6-32

Common Development Environment

Initiative ............................................................6-12

Comprehensive Educational Tools and

Resources ........................................................5-11

Computer-Based Training.................................5-11

Continuous Product Improvement to the

Joint Biological Agent Identification and

Diagnostic System............................................5-22

Convulsant Antidote for Nerve Agents................5-7

Copper Antimicrobial Program..........................6-13

CPAIN...............................................................4-20

CPP ..................................................................2-56

CRIMM .............................................................6-31

Cryopreserved Platelets ...................................2-56

Customized Functional Hearing Evaluation

for Military Occupational Specialties.................3-28

Cutaneous and Ocular Therapeutics................5-25

Cyanide Medical Countermeasures .................5-24

D

Defense & Veterans Pain Management

Initiative ............................................................4-20

DEFTOS...........................................................2-31

DEKA/APL Arms...............................................4-11

Demand Oxygen Controller................................2-7

Dengue Fever Vaccine .....................................1-23

Dental Field Treatment and Operating

System..............................................................2-31

Dental Filmless Imaging System......................2-31

Departments of Combat Medical Training – 

Technology Enhancement ..................................6-4

Design Guidelines for Advanced Imaging and 

Display Technologies..........................................3-7

Design Guidelines for Effective Microclimate

Cooling Systems...............................................3-40

Design Guidelines for Head-Supported

Devices.............................................................3-28

Determinants of Soldier Risky Behavior

Post-Deployment..............................................3-58

Developing Generalized Algorithms for

Objectively Assessing Medical and Surgical

Skill with Various Modalities – Data..................2-49

Development of an Over-Ground,

Pneumatically Actuated Body-Weight

Support System................................................6-13

C-2

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Diagnosing and Preventing Non-Freezing

Cold Injury ........................................................3-66

Diarrheal Disease Supplement.........................1-17

Diarrheal Disease Vaccines..............................1-24

Dietary Supplement Research..........................3-61

Digital Emergency Medical Services ................6-33

Digital Imaging Network-Picture Archiving

and Communications System.............................6-5

Digital Information and Communications

System................................................................6-5

DIN-PACS...........................................................6-5

Doxycycline (Vibramycin) .................................1-10

Drug for Malaria Prophylaxis ............................1-25

DVPMI ..............................................................4-20

Dynamic Injury Creation Simulator...................2-49

E

Effective Army Weight Management

Strategies .........................................................3-40

Effects of Prolonged Deployment on

Physical Performance, Body Composition,

and Injury Potential.............................................3-8

EIC....................................................................6-28

Electronic Surveillance System for the

Early Notification of Community-Based

Epidemics.........................................................1-10

Emergency Department Self-Assessment

Survey and Incident Scenario Exercise

Guidebook for Chemical, Biological,

Radiological/Nuclear, and Explosive

Response Preparedness..................................2-28

Emergency Hypothermia and Smart

Aortic Catheter..................................................2-15

EMS..................................................................6-33

Enhanced Fluid and Nutrition

Delivery System................................................3-19

Environmental Sentinel Biomonitor System .....3-67

Environmental Strain Prediction Models...........3-22

Epidemiology and Protection from Injury

in Combat .........................................................3-29

Equipment Maintenance and Repair ..................7-5

Equipment Publications......................................7-5

ESB ..................................................................3-67

ESSENCE ........................................................1-10

ETEC Vaccine ..................................................1-24

Evaluation of Human Exposure to Whole-Body 

Vibration: Method for Evaluation of Vibration 

Containing Multiple Shocks ................................3-9

Eye Injury Field Therapy Kit .............................3-55

F

Facilitating Cell Transplantation Research .......6-33

FETM................................................................3-62

FHAS................................................................3-28

Fibrinogen Bandages .......................................2-34

FIBWA ..............................................................5-12

Field Computed Tomography Scanner.............2-15

Field Dental Operating Unit ..............................2-32

Field-Deployable Ultra-Sensitive Assay

System for Biological Toxins.............................5-23

Field Identification of Biological Warfare

Agents Course..................................................5-12

Field Management of Chemical and Biological 

Casualties Course ............................................5-12

Field Medical Oxygen-Generating and

Distribution System.............................................2-7

Field Operating Table Improvement .................2-16

Field Optometry Set..........................................2-16

Field Sterilizer Improvement Device.................2-41

Finite Element Thermoregulatory Model ..........3-62

Fluid Warming System......................................2-16

FMOGDS............................................................2-7

Folding Decontaminable Litter..........................2-17

Formable, Nanostructured Ca PO4

(NanoCaPS) Scaffolds .....................................4-16

Fraxelated Carbon Dioxide Laser for

Treatment of Scar Contracture .........................4-14

Freeze-Dried Plasma........................................2-56

Functional Hearing Assessment System..........3-28

Future Medical Shelter System ........................2-42

G

GCV..................................................................2-43

GEIS.................................................................1-10

GelSprayTM Liquid Bandage.............................6-19

Genetic, Proteomic, and Neurobehavioral

Determinants of Deployment-Related

Psychological Health Disorders and

Traumatic Brain Injury.......................................3-59

Global Emerging Infections System .................1-10

Golden Hour Blood Container ............................2-8

Ground Combat Vehicles – Medical Variants ...2-43

Guidance on Using Modafinil and Dextroamphetamine as Alertness-Promoting Agents in Aviators 

Performing Extended Operations .....................3-19

C-3
Guidance on Using Stimulant and Sleep-Inducing 

Agents Under Operational Conditions..............3-63

H

Handwashing Compliance Reminder and

Documentation System ....................................6-14

Heat Injury/Stroke Treatment and

Return to Duty ..................................................3-68

Hepatitis A Vaccine (Havrix®)...........................1-11

Hepatitis B Vaccine...........................................1-11

Hibernation Genomics: Mechanisms for

Metabolic Suppression and Neural

Protection .........................................................6-34

HIFU.................................................................2-22

High-Altitude Operations: Management and 

Performance Optimization................................3-23

High-Altitude Platforms Mobile Robotic

Telesurgery.......................................................6-14

High-Speed Mini-Sterilizer................................2-17

HIV Research Program ....................................1-28

HIV Vaccine......................................................1-28

Hospital Management of Chemical,

Biological, Radiological/Nuclear, and

Explosive Incident Course................................5-13

Hot Weather Operations: Heat Illness

Management and Performance Optimization...3-24

Hydration Status Monitoring .............................3-69

Hyperbaric Oxygen Treatment of

Post-Concussion Syndrome.............................2-38

Hypothermia Prevention and Management Kit...2-8

I

iABS..................................................................3-25

IFAK....................................................................2-9

Immersive Technologies Approach to Medical 

Modeling and Simulation ..................................2-29

Impedance Threshold Device.............................2-8

Improved First Aid Kit .........................................2-9

Improved Nerve Agent Treatment System........5-15

INATS ...............................................................5-15

Individual Chemical Resuscitation Device..........2-9

Influenza Virus Vaccine ....................................1-11

INJURY 8.3.......................................................3-10

INJURY-A............................................................3-9

Injury Prevention and Restraint Technologies for 

Ground Vehicles and Helicopters (Conventional 

Restraint Systems) ...........................................3-30

Injury Prevention and Restraint Technologies 

for Ground Vehicles and Helicopters (Inflatable 

Restraint Systems) ...........................................3-10

Intelligent Aquatic Biomonitor System..............3-25

Intravenous Artesunate for Treatment of

Severe Malaria .................................................1-18

Intravenous Hemostatic Drugs .........................2-33

ITD......................................................................2-8

iWalk Microprocessor-Controlled Prosthetic

Ankle System......................................................4-6

J

Japanese Encephalitis Vaccine (IXIAROR).......1-12

JBAIDS.............................................................5-22

Joint Service Personnel/Skin

Decontamination System..................................5-26

Joslin Comprehensive Diabetes

Management Project ........................................6-15

JSPDS..............................................................5-26

Junctional Hemostatic Device (Combat Ready 

Clamp)..............................................................2-34

L

Laser Exposure Standards to Prevent

Laser Eye Injury................................................3-11

Leishmania PCR Diagnostic Device.................1-20

Leishmania Rapid Diagnostic Device...............1-20

Leishmania Skin Test........................................1-20

Life Support for Trauma and

Transport System .............................................2-18

Lightweight Extremity Splint .............................2-13

Low-Power Blood Cooling and

Storage Device...................................................2-9

LRDD................................................................1-20

LST...................................................................1-20

LSTAT...............................................................2-18

M

M291 Skin Decontamination Kit .........................5-7

M3D....................................................................7-5

Malaria DNA Vaccine and Prime-Boost

Approaches ......................................................1-26

Malaria Rapid Diagnostic Device......................1-15

Malaria Vaccines ..............................................1-26

MANAA...............................................................5-8

C-4

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
Mark I NAAK.......................................................5-8

Mark I Nerve Agent Antidote Kit..........................5-8

MC4/TMIP ........................................................6-16

MCC .................................................................3-40

Medical Aerosolized Nerve Agent Antidote.........5-8

Medical Management of Chemical and

Biological Casualties Course............................5-13

Medical Materiel Readiness Program.................7-7

Medical Simulation Training Initiative ...............2-50

Medical Supply Envelope .................................2-18

Medical Surveillance Network ..........................6-16

Medical Ultrasound, Three-Dimensional,

Portable with Advanced Communications ........2-62

Meningococcal Type B Vaccine........................1-27

Meningococcal Vaccine (Menomune)...............1-12

Mental Health Advisory Teams .........................3-35

MHATs ..............................................................3-35

Microencapsulation and Vaccine Delivery ........6-16

Military Foot......................................................6-35

Military HIV Research Program........................1-28

Military Transportable Field Radiographic and 

Fluoroscopic System........................................2-19

Millennium Cohort and Deployment Health......3-36

Mimic Technologies: Affordable Haptics for

Surgical Training...............................................2-51

Mine-Resistant Ambush-Protected

Ambulance........................................................2-19

Mine-Resistant Ambush-Protected

Ambulance........................................................2-44

Miniature Dental X-Ray System .......................2-32

MMRP.................................................................7-7

Model for Fatigue Management........................3-41

Molecular Signatures of Chronic Pain

Subtypes...........................................................4-19

Monitors............................................................2-63

Motion Sickness Countermeasures in

Army Aircraft.....................................................3-42

MRAP Ambulance ............................................2-19

MRAP Ambulance ............................................2-44

MRDD...............................................................1-15

MSTI.................................................................2-50

MUSTPAC 3 .....................................................2-62

N

Nanofabricated Bioartificial Kidney...................6-17

National Eye Evaluation Research Network

for Clinical Trials in Retinal Degenerative

Diseases by the National Neurovision

Research Institute.............................................6-36

National Functional Genomics Center..............6-37

Neodyne Mechanical Scar Reduction Device ....4-9

Nerve Agent Bioscavenger...............................5-14

Neuroprotective Drug Combination

Therapy Strategy..............................................2-60

Neuroprotective Drugs......................................2-39

Neurotriage Diagnostic Tools............................2-40

New Clinical Data Mart Prototype and

Research Data Cube Initiatives........................6-18

New Sprayable Liquid Wound Dressing ...........6-19

Next-Generation Anthrax Vaccine ....................5-16

Next-Generation Portable X-Ray System.........6-20

NFGC ...............................................................6-37

Non-Contact Heart Monitor (Vital Signs

Monitor 1) .........................................................2-63

Non-Contact Respiration Monitor .....................2-63

Novel, Noninvasive, Patient-Specific

Electrographic Seizure Warning System..........6-21

Nutritional Products for Digestive Health

and Immune Function.......................................3-43

Nutritionally Optimized First Strike Ration........3-20

O

OASIS ..............................................................6-22

On-the-Move Nutrient Delivery System............3-20

Operating Room Table......................................2-20

Operational and Strategic Studies of Service 

Member and Spouse Behavioral Health...........3-38

Operational Ration Sustainment Testing ..........3-43

Ophthalmic Standards for Personal

Protective Eyewear...........................................3-12

Optimal Fluid Resuscitation Guidelines............2-10

Oral Live Typhoid Vaccine (Vivotif)...................1-13

P

Pain Center of Excellence and Chronic Pain

Impact Network.................................................4-20

Pain Control Pump ...........................................2-20

Part-Task Trainer Approach to Medical

Modeling and Simulation ..................................2-52

Pathogen Inactivation System..........................2-57

Pathology of Heat and Cold Injury....................3-70

Patient Holding and Evacuation Heater Unit ....2-20

C-5
PC-Based Interactive Multimedia .....................2-53

PDA-Based Psychomotor Vigilance Task ........3-64

Pelvic Fracture Stabilizer..................................2-13

Peripheral Nerve Scaffolds...............................4-17

Periscopic Spine: Georgetown University .......6-23

Personal Area Network for Remote

Physiological Monitoring...................................6-38

Pesticide Dispersal Unit, Multicapability,

Helicopter Slung ...............................................1-13

Pharmacological Resuscitation with

Complement Inhibitor .......................................2-58

Physical Activity Data Logger ...........................3-55

Physiological and Operational Effects of

Extended Mission Duration and Seat Design...3-31

Plague Vaccine (Recombinant

Plague Vaccine)................................................5-17

P. falciparum RTS,S + MSP-1...........................1-26

PlexurLV Injectable Allograft Bone

Composite Scaffold ..........................................4-17

Pneumothorax Detector (Vital Signs

Monitor 2) .........................................................2-64

Portable Field X-Ray Table...............................2-21

Portable Noninvasive Shock Monitor................2-44

Powered Knee-Ankle-Foot System ..................4-12

Pre/Post-Deployment

Psychological Screening ..................................3-17

Prevention and Treatment of Iron Deficiency

Anemia in Female Soldiers...............................3-44

Primaquine .......................................................1-14

Probability of Survival Decision Aid ..................3-21

Project Argus: A National Biosurveillance

Priming System ...............................................5-18

Protocol for Immunomodulation for Composite

Tissue Allotransplantation – Hand and Face

Transplants.......................................................4-18

Proton Beam Therapy – Loma Linda

University Medical Center.................................6-24

Proton Beam Therapy – The Hospital of the

University of Pennsylvania ...............................6-24

PSDA................................................................3-21

PVT...................................................................3-64

R

RAP ..................................................................3-36

Rapid Analysis of Water for Microbial

Contamination ..................................................3-49

Rapid Analysis of Water for Select Chemical

Contamination ..................................................3-25

Rapid Blood Sterilization System .....................2-10

Rapid Human Diagnostic Assays .....................1-21

Rapid Intravenous Infusion Pump ....................2-10

Rapid Wound Cleansing System......................2-59

RBCXL..............................................................2-34

Reactive Skin Decontamination Lotion.............2-21

ReCell®/Partial Thickness Burn ..........................4-8

Recombinant Botulinum Toxin A/B Vaccine......5-19

Recombinant Ricin Vaccine Candidate ............5-27

Recombinant Vaccine (RTS,S + Adjuvant).......1-26

Recruit Assessment Program...........................3-36

Red Blood Cells, Extended Life........................2-34

Reference Work on Sensory, Perceptual,

and Cognitive Aspects of Helmet-Mounted

Display Design..................................................3-12

Regenerative Medicine for Wound Healing......2-59

Rehabilitation of Balance..................................4-22

Remote Acoustic Hemostasis Device...............2-58

Remote Physiological Status Monitor...............3-65

Repeated Shock and Vibration Limits for

Trauma Patients ...............................................3-56

Replacement of the M113 Medical

Ambulance/M577 Treatment Variants in the

Heavy Brigade Combat Teams.........................2-45

Research on Behavioral Health Practice .........3-38

Resilience Training System..............................3-18

Return-to-Duty Vision Standards After

Traumatic Brain Injury.......................................3-32

RHD..................................................................1-21

Riluzole Spinal Cord Injury Treatment..............4-14

RMLS................................................................6-25

Robotic Integration of High-Intensity

Focused Ultrasound with Life Support and

Trauma and Transport ....................................2-22

Robotic Laser Tissue Welding..........................2-22

Robotic Medic Assistant, Patient Evacuator.....6-38

Robotic Telepresence for Subspecialty Care....6-39

Rotary Valve Pressure Swing

Oxygen Generator............................................2-35

RPSM...............................................................3-65

RSDL................................................................2-21

Rubella Vaccine (Meruvax, now Meruvax II) ....1-13

Rugged Mobile Logistics System .....................6-25

C-6

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care
RVD..................................................................1-21

RVPSOG..........................................................2-35

S

Safe and Effective Treatment of Depression

and Anxiety Disorders in Warfighters................3-39

SAPS................................................................2-14

SEA...................................................................5-28

SEB ..................................................................5-28

SERPACWA........................................................5-6

Serpentine Robotic Manipulator Arm................6-39

Severe Trauma Simulation ...............................2-23

Shigella Vaccine ...............................................1-24

SimSurgery: Development of a Portable

Simulator for Training Robot-Assisted

Surgery.............................................................2-30

Simulation-Based Open Surgery

Training System................................................6-40

Single-Litter Casualty Evacuation Kit ...............2-23

Single-Litter CASEVAC Kit ...............................2-23

Skin and Wound Decontamination ...................5-26

Skin Exposure Reduction Paste Against

Chemical Warfare Agents...................................5-6

Skin Temperature Feedback

Microclimate Cooling ........................................3-50

Sleep Watch .....................................................3-45

Smallpox Vaccine System................................5-10

SMART/MC3T ....................................................6-5

SMEED.............................................................2-24

SNAPP ...............................................................5-6

Socket Technologies.........................................4-13

SOFMH.............................................................2-24

Soldier Health Promotion to Examine and

Reduce Health Disparities................................6-41

Soman Nerve Agent Pretreatment

Pyridostigmine ...................................................5-6

SOSTS .............................................................6-40

SPARKy............................................................4-13

SPARNET – Spartan Network ..........................3-65

Special Medical Emergency Evacuation

Device...............................................................2-24

Special Operations Forces Medical

Handbook .........................................................2-24

Speech-Capable Personal Digital Assistant .....6-42

Speech-Capable PDA.......................................6-42

Splints, Extremity and Pelvic ............................2-13

Spray-On Protective Bandage..........................2-11

Spring Ankle with Regenerative Kinetics..........4-13

Stand Alone Patient Simulator..........................2-14

Staphylococcal Enterotoxin A/B Multivalent

Vaccine Candidate............................................5-28

STATCare .........................................................2-53

Steam Vacuum Pulse Sterilizer ........................2-25

Strategies to Optimize Bone Health and

Eliminate Stress Fractures in New Recruits .....3-33

Stryker – Medical Evacuation Vehicle ..............2-25

Stryker – Medical Treatment Vehicle................2-46

STS...................................................................2-23

Sulfadoxine-Pyrimethamine (Fansidar) ............1-14

Surgical Scrub Sink ..........................................2-26

Sweat Prediction Models..................................3-51

T

Tactical Combat Casualty Care ........................2-14

Tactile Balance Assessment Device.................3-33

TAIHOD ............................................................3-13

TARA ..................................................................7-6

TBAD................................................................3-33

TC3...................................................................2-14

Technology Assessment and

Requirements Analysis.......................................7-6

Teleconsultation/Teledermatology ......................6-6

Temporary Implantable Lactate

Sensor Biochip .................................................2-65

Test-Mate Cholinesterase Kit..............................5-8

Test System for Evaluating Environmental 

Endocrine-Disrupting Chemicals and Developing 

Candidate Biological Markers for Deployment 

Health Surveillance...........................................3-52

TGAS-PE..........................................................3-14

The Use of Cognitive Task Analysis and

Simulators for After-Action Review of Medical 

Events in Iraq....................................................2-30

Therapeutic Strategies for

Botulinum Neurotoxins .....................................5-31

Therapeutic Strategies for Treating

Filovirus Infection..............................................5-32

Therapeutics for Smallpox and Other

Orthopoxviruses ...............................................5-33

Thermal Infusion System (formerly

Cartledge Infuser).............................................2-11

C-7
Thermal Models on a Personal Digital

Assistant Format...............................................3-53

Thermal Warning Algorithm..............................3-53

Thirty-Minute Cold Sterilization Solution...........2-66

Tinnitus Treatment Strategies...........................3-34

TOP ..................................................................3-56

Topical Antileishmanial Treatment Drug

(Paromomycin) .................................................1-19

Total Army Injury Health and Occupational

Database ..........................................................3-13

Toxic Gas Assessment Software –

Performance Evaluation ...................................3-14

Training, Overuse Injury, and Performance

Modeling...........................................................3-56

Transportable Pathogen Reduction Blood

Safety System ................................................2-36

Transurethral Resection of the Prostate...........2-53

Traumatic Brain Injury Sensory

Assessment Battery..........................................3-34

Treatment of Peripheral Vascular Disease by 

Adipose-Derived Stromal Cell Injection............6-42

Treatment of Tinnitus........................................4-15

Treatment Table................................................2-46

TRIM.................................................................6-26

Trivalent Filovirus Vaccine ...............................5-20

Troop Recruitment Improvement......................6-26

TSAS ................................................................3-26

Tularemia Vaccine ............................................5-20

U

URL ....................................................................7-6

USAMMA Revolution in Logistics .......................7-6

V

Vaccine Constructs for a Combined Equine

Encephalitis Vaccine.........................................5-29

Vaccines to Prevent Hemorrhagic Fever with

Renal Syndrome...............................................1-29

Venezuelan Equine Encephalitis Infectious

Clone Vaccine...................................................5-21

Ventilatory Assist Device for

Anesthesia Machine .........................................2-11

Video Laryngoscope ..........................................6-6

VIRGILTM ..........................................................2-53

Virtual Humans .................................................6-43

Virtual Reality Demo.........................................2-54

Virtual Retinal Laser Display ............................6-43

Virtual Therapies for Psychological Trauma:

Virtual Iraq ........................................................6-44

Virus-Like Particles...........................................5-30

VLPs.................................................................5-30

W

Walter Reed Sleep Performance Model ...........3-61

Warfighter Face and Eye Injury Protection.......3-15

Warfighter Remote Triage.................................2-66

Warrior Injury Assessment Manikin ..................3-57

Wearable Visual Aid as Treatment for TBIAssociated Visual Dysfunction .........................4-21

Wear-and-Forget Physiological Sensing

System for Combat Casualty Care...................6-27

Web-Enabled Refractive Surgery

Information System.............................................6-8

WebRSIS............................................................6-8

Wireless Electronic Information Carrier/

Personal Information Carrier ............................6-28

WRAIR SPM.....................................................3-61

C-8

Military

Operational 

Medicine

Medical Chemical 

and Biological 

Defense

Clinical and 

Rehabilitative 

Medicine

Advanced 

Technologies Logistics Appendices

Military

Infectious 

Diseases

Combat 

Casualty

Care



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