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Vol. 32, No. 9

May 1, 2015

Soldiers Train and Compete for Expert Field Medical Badge ELLEN CROWN

USAMRMC PUBLIC AFFAIRS

DAVID MOORE

U.S. ARMY SUPPORTACTIVITY-FORT DIX

Forty-six Soldiers received the Expert Field Medical Badge at Joint Base McGuireDix-Lakehurst in New Jersey April 27, culminating the one-week competition organized by the U.S. Army Medical Research and Materiel Command in collaboration with the Public Health Command and the Northern Regional Medical Command.

More than 230 candidates participated in the Northeastern Regional EFMB competition, which is one of more than a dozen EFMB competitions organized worldwide each year. EFMB awardees must pass a comprehensive written exam and complete a series of training lanes where they are tested on combat care and other military survival skills.

Competitors must also complete day and night land navigation and then, if they make it that far, a final 12-mile road march on the last day that must be completed within three hours. Typically, only about 15-20 percent of those who go out for the badge earn it each competition, making the EFMB one the most coveted honors in Army medicine.

However, it’s not all about competition. The EFMB competition also provides an opportunity for Service Members of all branches to train together and develop competence and confidence with field and medical tasks.

“It’s not about a badge that you put on your chest; it’s about treating Soldiers who are wounded on the battlefield,” said Maj. Gen. Brian C. Lein, commanding general, U.S. Army Medical Research and Materiel Command and Fort Detrick, Maryland, and Deputy for Medical Systems to the Assistant Secretary of the Army for Acquisition.

Preparing for the EFMB competition takes months, both for the competitors and for the 208 cadre who organized and supported the event. The USAMRMC’s 6th Medical Logistics Management Center took the lead for the second year in a row at organizing the Northeastern Regional EFMB competition.

“We learned a lot of lessons from last year that we were able to use this year to make the process more efficient,” said Capt. Walter Walsh, assigned to the 6th MLMC, referring to the coordination it takes to acquire, transport and set up all of the materiel for the tactical lanes, such as various up-armored vehicles, litters, ra-

Expert Field Medical Badge candidate Capt. Lindsey Nielsen (right), assigned to Walter Reed Army Institute of Research, navigates combat tactical lane 3 as she stabilizes a “patient” injured in a vehicle accident. Nielsen was one of three Soldiers from the WRAIR to earn the badge this year.

Photo by Ellen Crown, USAMRMC Public Affairs

Photo by Ellen Crown, USAMRMC Public Affairs

For many of the candidates, such as Cpl. Micah Alden-Danforth, a 28-year-old senior line medic assigned to the 371 Calvary 1st Brigade Combat Team, 10th Mountain Division, this year’s EFMB competition is not the first attempt at the badge.

“This year is about redemption for me,” said Alden-Danforth, who was one of the candidates to earn his badge this year. “Getting this badge is not only prestigious, but also a sign that you’re good at your job.”

Sgt. Lewis Williford, a lab technician assigned to the Walter Reed Army Institute of Research, earned his badge at last year’s EFMB competition and served as an evaluator this year.

“Preparation is the key,” said Williford.

“Train-up programs really make the difference.”

Train-up programs are coordinated at the local level, often by Soldiers that have already achieved the EFMB and now want to pass their skills on to the next generation.

The WRAIR has a robust train-up program

that began readying candidates four months prior to the competition with four hours of training twice each week.

“The concept is to ‘see one, do one and teach one,’” said Staff Sgt. Kelly McWhirter, assigned to the WRAIR. “If you get the badge and that is the last thing that you do with it, you have failed. You have to bring others along with you.”

McWhirter and Capt. Matthew LoPresti, the officer in charge of EFMB Combat Training Lane 3, organized the WRAIR train-up program, of which this year they now have three new badge recipients, including Capt.

Lindsey Nielsen, Capt. Sean Marcsisin and Sgt. Erik Bigham.

“I truly believe we have the best train-up program in the Army,” said Nielson, who added, “and if I can do this with a 7-monthold baby at home, anyone can do it if they really set their mind to it.”

dios and other medical gear typically in a field environment.

The tactical lanes are set up to be both physically and mentally challenging.

“You want medics to be on point when it comes to evaluating a casualty or treating someone wounded. There is no wiggle room. You need attention to detail to get it right to save someone’s life,” explained Sgt. 1st Class Richard Pina, non-commissioned officer in charge of EFMB Combat Training Lane 1, who is currently assigned to Fort Belvoir Community Hospital in Virginia.

Piña earned his badge in 2010.

Maj. Clem Bermudes, officer in charge of the Land Navigation portion of the EFMB competition, said the program places many stressors on candidates, including the often cold and rainy weather this season can bring on the upper east coast. This can include nights with no moonlight or stars. Bermudes said, in some cases, more than half the team will receive a “no go” from land or night navigation.

Social Media

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A candidate is tested on tactical medical skills at the Northeastern Regional Expert Field Medical Badge competition at Joint Base McGuire-Dix-Lakehurst in New Jersey April 17 - 27.

What’s Inside

Fort Detrick Volunteers Honored at Recognition Ceremony, p.3

BAHC Donates to Local Shelter, p. 5

MSS PMO Personnel Attract Mosquitoes in Thailand, p. 6

Commentary: Military Spouse Appreciation Day Military Spouse Appreciation Day is observed each year as a way to honor the contributions, strength and resilience of military spouses who selflessly serve alongside their Army, Navy, Marines, Air Force or Coast Guard Service Member. I might be the one wearing the uniform, but my wife serves right alongside of me.

President Ronald Reagan recognized the profound importance of spousal commitment to the readiness and well being of military members. He created Proclamation 5184 on April 17, 1984. Congress officially made the day part of National Military Appreciation Month in 1999 and standardized the date declaring the Friday before Mother’s Day every year as Military Spouse Appreciation Day. This year’s theme, “Military Spouses - The Strength of Our Service Members,” recognizes the

significant impact spouses have on the strength of our Service Members and the Nation.

I am proud that this year my wife, Terry, will be speaking at the Fort Detrick celebration May 8 from 1-3 p.m.; where the U.S. Army Garrison Fort Detrick will honor military spouses with a funfilled event in the Community Activities Center, Building 1529.

Throughout the course of my military career, Terry has supported my endeavors while being an amazing mom to our three children. If it weren’t for her support, both at home and abroad, I wouldn’t be where I am right now.

Take some time this May to also thank the spouses for their great sacrifices and achievements in support of our Armed Forces. Our military force would not be what it is today, the strongest in the world, without our military spouses.

Maj. Gen. Brian C. Lein USAMRMC and Fort Detrick Commanding General

TRICARE Beneficiaries Being Targeted

by Call Centers and Others for Unsolicited Medical Prescriptions The Defense Health Agency, Office of Program Integrity has received a significant number of concerns from our TRICARE beneficiaries regarding unsolicited attempts by “call centers” to encourage them to provide personal identifying information and health information so that they can allegedly provide prescribed cream medications to the TRICARE beneficiary.

TRICARE and its contractors never call and ask for personal identifying information or health information.

Beneficiaries should be wary of unsolicited attempts by any entity asking them for personal or health information, either by phone or in person.

The “call center” will normally cold call and say, “I am a representative calling from XYZ, we are calling to tell you about a benefit TRICARE will cover for you for a prescription pain cream you are eligible for. Do you have any of the following medical issues (list of issues) or pain? If so, TRICARE wants to get you taken care of, all we need are your doctor’s name and your TRICARE

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information and we will contact your doctor and get these medications or supplies out to you immediately and submit a claim.”

DHA PI strongly advises you to give NO information to these types of unsolicited requests for your personal health information and personal identifying information. Often these “call centers” have identified what limited information they have through “Google” searches or through individuals who have approached you independently and obtained information directly from you.

Should you receive a phone call for this information, provide NO information. Also, please immediately submit a Fraudline report to our Pharmacy Benefits contractor ESI. You can report the issue to Express Scripts, Inc. Express Scripts Fraud Tip Hotline: 1-866-759-6139 Email: TRICAREfraudtip@express-scripts.com ESI can also flag your profile and reject attempts to bill for these medications. If you do receive unsolicited medication in the mail, you can refuse delivery.

The STANDARD is an authorized unofficial newspaper, published every two weeks under the provisions of AR 360-1 for the military and civilians at Fort Detrick. Circulation is 7,000. The STANDARD is a commercial enterprise newspaper printed by Comprint Military Publications, 9030 Comprint Court, Gaithersburg, Md., 20877, a private firm, in no way connected with the United States Government or Department of Defense. The contents of the STANDARD do not necessarily reflect the official views or endorsement of the U.S. Government, the Department of Defense or the U.S. Army. The appearance of advertising in this publication, including inserts and supplements, do not constitute endorse-

Fort Detrick Standard May 1, 2015

Fire and Emergency Services (301) 619-2528 Near Miss Hotline (301) 619-3164 USAG Network Enterprise Help Desk (301) 619-2049 Balfour Beatty (240) 379-6518 Directorate of Public Works Trouble Desk (301) 619-2726 Barquist Army Health Clinic (866) 379-3981

ment of DoD. Everything advertised in this publication shall be made available for purchase, use or patronage without regard to race, color, religion, sex, national origin, age, marital status, physical handicap, political affiliation, or any other nonmerit characteristic of the purchaser, user or patron.

Editorial content is prepared and edited by the Fort Detrick Public Affairs Office, 810 Schreider Street, Fort Detrick, Md. 21702-5000. Editorial Offices are in Bldg. 810, Suite 004, telephone 301-619-2018; e-mail: usarmy.detrick.usag.mbx. pao@mail.mil.

Visit our Web site at: www.detrick.army.mil

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Provost Marshal Office (301) 619-2652

Sustaining a community of excellence through restoration, environmental stewardship and workforce development

Post Operator (301) 619-8000

Command Staff Maj. Gen. Brian C. Lein

Commanding General, U.S. Army Medical Research and Materiel Command and Fort Detrick

Col. Steven P. Middlecamp U.S. Army Garrison Commander

Editorial Staff Melissa Myers

USAMRMC/Fort Detrick PAO

Fort Detrick Volunteers Honored at Recognition Ceremony NICK MINECCI

The Day President Nixon Visited NICK MINECCI

USAG PUBLIC AFFAIRS

USAG PUBLIC AFFAIRS

The Fort Detrick Volunteer Awards Ceremony was held April 20 at the Community Activities Center, honoring the members of the Fort Detrick community who volunteered approximately 10,000 hours of their time, representing a labor savings for our community of over $208,000.

More than 50 volunteers received Certificates of Appreciation signed by U.S. Army Medical Research and Materiel Command and Fort Detrick Commanding General Maj. Gen. Brian C. Lein and acting Commander of U.S. Army Garrison Fort Detrick Col. Perry Clark.

Individual President’s Service Awards and Group President’s Service Awards were presented to those volunteering between 100 to more than 1,000 hours in 2014, and some volunteers also received Governor’s Office on Volunteerism Certificates of Appreciation for their continued volunteer work in support of their community and Maryland.

“Our volunteers are Soldiers, spouses, kids, retirees, members of the community, civilian employees, contractors, etc. They range in age from 4 - 80 plus years young. They are a vital part of many of our organizations on post and in the community,” said Clark. “Volunteering not only supports the Fort Detrick community, but helps develop lasting relationships and links our hearts toward a common goal. When someone donates a handful of time, the difference made is tremendous and it shapes a community for the better while the experience improves the person who donated the time.”

The 2014 Fort Detrick Volunteer of the Year, Joan Derk, was honored for not only displaying enthusiasm, commitment and selfless service, but for many years of continuously volunteering. Derk also received the Governor’s Volunteer Service Certificate, signed by Governor Larry Hogan, in appreciation for her efforts, “to ensure the vitality of the community in which you volunteer, your contribution to the citizens of Maryland and your support of Maryland’s longstanding tradition of community involvement.”

Starting in March 1943, Detrick Field became shrouded in mystery after years of use as an encampment of the 104th Aero Squadron of the 29th Division of the Maryland National Guard then later a Cadet Pilot Training Center until the Japanese bombed Pearl Harbor and the U.S. entered World War II. In March 1943, the federal government purchased additional land, renaming the area Camp Detrick, and making it home to the U.S. Army Biological Warfare Laboratories. The USBWL was responsible for researching biocontainment, decontamination, gaseous sterilization, agent purification and was the lead U.S. Army agency dedicated to biological warfare research efforts during World War II. For almost three decades, Camp Detrick, later designated as Fort Detrick, continued with the mission of continuing biological research; recognized as one of the leading research institutions for biological agents requiring special containment. On Nov. 25, 1969, President Richard M. Nixon outlawed offensive biological research in the United States, with the research at Fort Detrick becoming solely focused on defensive measures.

On Oct. 19, 1971, Nixon traveled from Washington, Distict of Columbia, to Fort Detrick to announce he was creating the Frederick Cancer Research Facility of the National Cancer Insti-

Individuals recognized for their volunteer activities were: Alton Bennett John Wagner Dennis Helmstetter Dolores Christie Vernon Kephart Forest Whiting Katherine Suarez Cameron Thoma Brittany Branch-smith Benjamin Rubio Thomas Starkoski David Handwerker Jermaine Thomas Sara Handworker Jean Gonzalez Cynthia Gervasi Jonelle Boye Sarah Vaughn Willetta Christian Maria Vaughn Lorenzo Nichols Lisa Weed Nancy Sanchez De Arriaga Chris Cason Debbie Skvorak Howard James Andrea Rander Lakeisha Mulheron Denis Garcia Parag Apte Adaliza Pantoja-Bobe Stuti Ganatra Jessy Donaho Sagar Matharu Sheila Chestnut Joshua Evans Gabriella Cantoni Karl Busch James Frye Mildred Busch Charles Chipley Michele Thomas Michael Caselle Belinda Afi Carolyn Whittenburg Garrett Grim Anthony Malavenda Sheila Brown Allan Phillips Terrence Gibson Miae Martinez Jason Sepanic Higinio Martinez Jacob Sepanic Anna Sepanic

Fort Detrick Volunteer of the Year Joan Derk

President Richard M. Nixon on Fort Detrick, Oct. 19, 1971, to announce the biological warfare facility would be converting into the Frederick Cancer Research Facility of the National Cancer Institute at Fort Detrick. Today the organization is called the Frederick National Laboratory for Cancer Research.

Photo courtesy of National Archives

tute at Fort Detrick. The Department of Health, Education, and Welfare (later renamed the Department of Health and Human Services) was afforded approximately 68 acres and 70 buildings on Fort Detrick for this mission.

“In November of 1969, I made a decision that the United States would take the leadership in discontinuing research in the development of weapons for biological warfare. As a result of that decision, this facility, therefore, no longer could be used in that way.

But it was one of the finest facilities in the world, and consequently, we found that, in January of this year when I made an announcement with regard to a new initiative for conquest of cancer, we needed just what this facility had to offer,” said Nixon during his remarks at the event.

“Consequently, today we are making an announcement that, where we have previously had scientists--some of the best people that we could possibly find in the United States--working on weapons of war, we now have scientists devoting their efforts toward saving life, rather than destroying life. So I think all Americans are very appreciative of the fact that, in terms of our conquest of cancer program, we have one of the best facilities in the world right here which will be used for the purpose of making progress in that area. I think all of us, too, are very happy that we have here an indication of how the genius of man, which could be used to destroy life-that same genius can better be used to save life,” said Nixon.

In a statement released the same day Nixon said, “Today, we mark another chapter in the realization of that dream as we announce that one of our largest facilities for research on bacteriological warfare is being converted into a leading center for cancer research.”

In 1973, as a result of the 1969 law signed by Nixon and the Oct. 19, 1971 visit to Fort Detrick, the National Cancer Institute, also called NCI-Frederick, opened at Fort Detrick.

Fort Detrick Hosts Days of Remembrance Observance JENNI BENSON

USAG PUBLIC AFFAIRS

“In their uniqueness, stories of rescue remind us all of the wide range of choices that we are capable of making as individuals. Our actions in the face of injustice of hatred always matter.”

-The United States Holocaust Memorial Museum The U.S. Army Medical Research and Materiel Command Headquarters and Headquarters Detachment hosted a Days of Remembrance Ceremony April 17 at the Community Activities Center on Fort Detrick.

Dignitaries and local elected officials participated in a remembrance ceremony where Mr. Emanuel “Manny” Mandel served as the guest speaker. Mandel is a survivor-volunteer at the United States Holocaust Memorial Museum. Manny shared his story as a Holocaust survivor and challenged the audience to never forget.

“During these weeks each year, many of us, the survivors, are in fact

involved in these kinds of talks to familiarize the world with that which we can familiarize them with and with which they cannot be familiarized with, once we are gone,” said Mandel.

“I am one of the youngest survivors you will ever meet. I was born in 1936 which makes me close to 80, but I’m 79. Most of us will not be around much longer to talk about our experiences; we must never forget.”

According to his bio, Manny was 7 when the Germans occupied Budapest in March 1944. Manny and his family were among a group of Jews whom Adolf Eichmann offered to trade for Allied material. In exchange for trucks and other goods, some 1,600 Hungarian Jews left Hungary by train, with the promise that they would be permitted to enter Switzerland. After difficulties in the negotiations, Manny and his family were diverted to Bergen-Belsen camp. They were taken to Switzerland

by Nazi transport in late 1944, first to a Red Cross hotel near Montreux and then to a children’s home in Heiden.

Sustaining a community of excellence through restoration, environmental stewardship and workforce development

In 1945, Manny and his mother immigrated on a British troop ship to Palestine. He moved to the United States in 1949.

During the observance, 7 candles were lit to remember the six million Jews murdered in the Holocaust, as well as the millions of non-Jewish victims of Nazi persecution, in a candlelighting ceremony.

Each candle was dedicated to an important group of witnesses to the Holocaust. Ending with the lighting of one yellow candle, dedicated to us, the next generation, to remind us to carry on the flames of remembrance.

The United States Congress established the Days of Remembrance as the Nation’s annual commemoration of the Holocaust. Each year, the United States Holocaust Memorial Museum leads the Nation in commemorating the Days of Remembrance.

This year’s theme is “Learning from the Holocaust: Choosing to Act.” Fort Detrick Standard May 1, 2015

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Defense Science Study Group Visits USAMRMC LISA MORRIS

USAMRMC PUBLIC AFFAIRS

A select group of academics from the top universities in the country visited the U.S. Army Medical Research and Materiel Command April 16.

Directed by the non-profit Institute for Defense Analyses and sponsored by the Defense Advanced Research Projects Agency, the Defense Science Study Group comprises 15 of the most outstanding science and engineering professors from academic institutions like Stanford University, Cornell University and the Massachusetts Institute of Technology, among other esteemed schools.

Members of this prestigious group have the unique opportunity to learn about the U.S.’ security challenges through the interaction with top-level officials from the Department of Defense and other government organizations, various intelligence agencies, the White House and Congress.

In the two years of the program, the group visits military bases throughout the country, gaining a unique perspective of operating forces and meeting with senior commanders responsible for the Nation’s defense.

Tours of defense laboratories and industrial facilities provide further insight for members into the technical dimensions of national security.

Selection for the DSSG is competitive. The IDA solicits more than 150 nominations of extremely well qualified scientists and engineers from senior leaders within major universities, and only selects about 5 percent.

Leaders from the IDA hope that once they graduate from the program, these academics can use their unique perspectives to integrate their exposure of the inner workings of the government into their research to help develop solutions to some of the country’s greater capability gaps.

“When I started the program about 30 years ago, the idea was we need bright people to get educated with national defense,”

Members of the Defense Science Study Group tour the U.S. Army Medical Research Institute of Infectious Diseases as a part of a visit to the U.S. Army Medical Research and Materiel Command April 16.

Photo by Adam Wyatt, TATRC

said DSSG Director Robert E. Roberts.

“When they graduate from the program, they want to get involved.”

With several seasoned experts guiding the program, the group receives a well-

rounded picture of the government’s operations and requirements.

“Visits of this character are vital to the success of the program. These senior university professors have expressed deep interest in solving difficult defense problems,” said retired Air Force Gen. Michael P.C. Carns, one of the mentors to the DSSG. “They’re here to understand what the needs are, and the hope is that one of these professors will adopt something they learn about here for their study.”

The group’s visit to the USAMRMC began with an overview briefing of the command from Chief of Staff Col. Richard Starrs.

Members showed particular interest in the command’s relationship with the U.S. Food and Drug Administration, emerging threats and challenges, how the health of the Soldier impacts the health of the unit and many more diverse topics.

Interspersed with presentations about See USAMRMC, continued on page 6

Local Clinic Celebrates 15 Years Since Opening SHANNON BISHOP

USAG PUBLIC AFFAIRS

Named after the former U.S. Army Medical Research Institute of Infectious Diseases Commander Col. Richard Barquist, the Fort Detrick Barquist Army Health Clinic opened its doors 15 years ago to serve local Service Members and their families.

Barquist, the USAMRIID commander in 1977, was known as a gentle, caring individual whose knowledge of medicine, infectious disease and the potential of biological warfare made him a valuable asset to national defense, according to Fort Detrick records from 1994.

Barquist passed away in 1994 and the clinic was dedicated to him just five years later before opening in 2000.

Though the Walter Reed National Military Medical Center is just a few miles down the road in Bethesda, Maryland, the clinic at Fort Detrick offers health care to beneficiaries who seek care in a more local setting.

“The clinic has grown so much from just a few doctors in the USAMRIID years ago,” said BAHC Commander Lt. Col. Jason Sepanic. “We’re still expanding and trying to get more space.”

When the clinic opened, the space featured 25,000 square feet

that consolidated primary care, radiology, occupational health, dental, pharmacy and alcohol and drug rehabilitation into one building. Since the opening, the clinic has expanded its services within the space to include psychology, social work and primary care for family members.

The clinic has also moved the occupational health division into a separate building to accommodate behavioral health and physical therapy services, which were not part of the original design, according to Anna Walsh, deputy commander for administration at the BAHC. Additionally, according to Walsh, total enrollment has in-

creased from approximately 2,000 to 6,400 patients.

“We are much busier than we were years ago,” said Joann Claybon, medical support assistant at the BAHC. “We still have more changes coming, like the new pharmacy, but these are all good changes.”

Claybon jokingly shared that with more space, more doctors and more patients she has a lot more scanning to do.

“I want to continue to improve upon the great care here so we can support the community,” said Sepanic. “We are trying to expand upon the current partnership we have with the Veterans Affairs Clinic.

We also want to continue to increase

the overall health of the community through the triad initiative.”

In the last year, the BAHC has made efforts to make the clinic experience a more pleasant and efficient one through changes to the phone system, patient care systems, the Nurse Advice Line and emphasizing programs such as the Performance Triad.

Additionally, in line with the U.S. Army Medical Command values, the BAHC is also committed to synchronizing military health care efforts; redefining the patient care experience and continuing to create a health system built on quality care and patient safety.

For more information about the BAHC, call (301) 619-7175.

BHSAI Develops System to Identify Patients with Severe Bleeding During Transport LORI A. DEBERNARDIS AND ANNA K. APPLEGATE TATRC

Did you know that the majority of casualties that die on the battlefield die from uncontrolled bleeding? Analysis of data from conflicts in Iraq and Afghanistan indicates that approximately 22 percent of Service Members who died following severe bleeding after injury could have potentially been saved had their hemorrhaging been controlled early on.

Experts in the combat casualty care community believe that the opportunity to save casualties is in the pre-hospital environment. Saving a life does not just happen once you get to the hospital, it happens when you can manage hemorrhage at the point of injury or in transit to a medical treatment facility.

Given this information, how would one go about handling, or even recognizing the need for administering a blood transfusion?

The Biotechnology High Performance Computing Software Applications Institute, one of the Telemedicine & Advanced Technology Research Center’s key labs, is addressing this issue with development of the Automated Processing of the Physiologic Registry for As-

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Fort Detrick Standard May 1, 2015

sessment of Injury Severity system, or APPRAISE. The APPRAISE is an artificial intelligence-based system that can alert medics when trauma patients are in need of massive blood transfusions without any human intervention. It collects and analyzes, in real time, vital sign information from the patient during pre-hospital transport. It then uses the results of that analysis to determine if the patient will need a massive blood transfusion before the patient arrives at the hospital.

The system consists of an offthe-shelf vital signs monitor connected to a ruggedized PC running Microsoft Windows. Dr. Jaques Reifman, Ph.D., the BHSAI director, members of his team, Maxim Khitrov and Jianbo Liu, Ph.D., and Andrew T. Reisner, M.D., an investigator with BHSAI at the time of development and an emergency room doctor at Massachusetts General Hospital, collaborated to develop the APPRAISE system.

“A benefit of the system is that it uses standard vital signs, such as EKG, heart rate and blood pressure, which caregivers are already familiar with,” said Reifman. “There is no need for training caregivers to new sensor modalities, so APPRAISE can

be easily disseminated throughout the health care system.”

The team worked with Boston MedFlight, a not-for-profit organization operating in Boston and New England that served as the equivalent to a shock trauma medevac, to test and validate the BHSAI-developed mathematical models and algorithms in a prospective study.

For nearly two years, the APPRAISE system was used in Boston MedFlight helicopters to monitor trauma patients during emergency transports. Patients were then transported to one of three hospital partners: Massachusetts General Hospital, Brigham and Women’s Hospital or Beth Israel Deaconess Medical Center.

By comparing clinical and trauma registry data with computer predictions, BHSAI scientists found that the APPRAISE system was able to automatically identify casualties in need of massive blood transfusions with 78 percent sensitivity and 90 percent specificity within 10 minutes of the start of transport to the trauma center.

This was the first time that anyone, not just the Army, had been able to collect and analyze data in real time as patients were being transported. The BHSAI team

Maxim Khitrov, a software developer and HJF contractor (left), and Jaques Reifman, Ph.D., a senior research scientist and director at the Biotechnology High Performance Computing Software Applications Institute (right), demonstrate the APPRAISE system.

APPRAISE is a clinically validated platform for the automated, pre-hospital, real-time collection and analysis of vital sign data.

Photo by Adam Wyatt, TATRC

has received two U.S. patents for the APPRAISE system and is currently pursuing FDA approval and a licensing agreement with a commercial partner.

Excited about the results and what this technology could mean for Warfighters in the future, Reifman said, “[The] bottom line is that the majority of the casualties on the battlefield are due to un-

Sustaining a community of excellence through restoration, environmental stewardship and workforce development

controllable bleeding. Here, we deployed in the civilian setting a technology that demonstrates how we can identify bleeding patients pre-hospital, in real time, and in a fully automated fashion in a prospective trial.”

More information about the APPRAISE system trial will be documented in the May 2015 issue of the journal Shock.

Ebola Vaccine Appears BAHC Donates Effective, WRAIR Publishes to Local Shelter Findings in NEJM As the U.S. Department of Defense’s largest biomedical research facility, the Walter Reed Army Institute of Research has once again demonstrated the U.S. military’s expertise in responding to outbreaks of infectious diseases with its successful completion of a phase 1 clinical trial for an Ebola vaccine candidate, the recombinant vesicular stomatitis virus for the Zaire strain of Ebola.

Together with researchers from the National Institute of Allergy and Infectious Diseases, who completed their own phase 1 clinical trial, researchers at the WRAIR and NIAID published their findings from the trials in the New England Journal of Medicine April 1.

The trials, conducted independently but collaboratively, explored the safety and immunogenicity of the investigational vaccine when administered at different dosages.

The Public Health Agency of Canada developed the rVSV-ZEBOV and licensed the candidate to NewLink Genetics Corporation who, in turn, sublicensed to Merck Sharp & Dohme Corporation. The vaccine’s intent for both pre- and post-exposure prophylaxis would allow both those exposed and those not yet exposed to Ebola to avoid developing Ebola virus disease.

When the 2014 Ebola epidemic occurred, it became clear to the U.S. government and the global community that they needed to quickly advance the development of a vaccine.

In response to this need, the Defense Threat Reduction Agency requested support from the WRAIR to prepare and execute a human clinical trial and develop a lab test to support the assessment of the vaccine’s safety.

“When DTRA approached us, we redirected our personnel, mission and resources to meet the global need,” said Col. Stephen Thomas, deputy commander of the WRAIR and senior author of the NEJM publication. “The WRAIR lab enterprise, which is both domestic and international, may look like a number of individual programs, but really we are a collection of science and science support professionals with expertise in infectious diseases. We have a number of platforms, capabilities and competencies that are generally applicable to whatever the DOD determines to be a threat.”

With its adaptable platforms and capabilities, the military can direct and redirect its resources as the needs and requirements arise.

Past efforts include supporting vaccines licensed against Hepatitis A, Adenovirus Types 4 and 7 and Japanese encephalitis, not to mention major accomplishments like the HIV vaccine efficacy trial in Thailand and participation in Sanofi Pasteur’s Dengue vaccine phase 3 trial in Asia. Notably, the WRAIR investigated every current malaria drug in the world and supported their clinical use, including the RTS,S that first demonstrated efficacy through studies at the WRAIR. “Ebola was just the next thing in line. It’s an exemplar of what we do on a day-to-day basis and what we have been doing since 1893,” said Lt. Col. Jason Regules, deputy director of the Translational Medicine Branch within the WRAIR and co-lead author of the NEJM publication.

The WRAIR worked with NewLink, Merck and the DTRA to prepare for the clinical trial, execute the trial and analyze the data.

Preparation included working to meet the regulatory requirements, establishing logistical processes, helping design the study and the scientific activities that would characterize the vaccine’s performance, writing the protocol and submitting the plans for an independent ethical review.

Researchers had no difficulty in recruiting the 52 volunteers they enrolled.

“I think the scale of the human crisis that was occurring in Africa was such that really motivated people to step forward,” said Regules. “This one caught everyone by surprise

through its magnitude.”

Combining both centers, 40 volunteers received a single dose of the vaccine candidate and 12 received a placebo.

Researchers periodically assessed the volunteers for safety and collected blood samples to determine who developed antibodies.

Thirty-seven of 40 volunteers in the vaccine group showed the intended Ebola glycoprotein antibody response within two weeks of vaccination, and all of the volunteers had antibodies within 28 days of receiving the vaccine, with no significant side effects.

The vaccine intends to make the recipient’s immune system react as if it has been exposed to the Ebola virus. If the vaccine recipient were ever naturally exposed to Ebola, the immune system would respond and protect the individual from developing the Ebola virus disease.

Scientists developed the vaccine by replacing a small portion of the VSV virus with a small, but important, component of the Ebola virus. By doing this, they can stimulate the desired anti-Ebola immune response without actually exposing the recipient to any risk of developing Ebola.

“It tricks the body’s immune system into thinking you’ve been exposed to Ebola and prepares a protective response in the event you ever are actually exposed to the virus,” said Thomas.

Researchers assessed the antibody response using two different methods, a quantitative assay that examined the total amount of antibodies in the subject, and a qualitative assay that evaluated the antibodies’ function.

“We saw a robust immune response following a single dose of the vaccine, which could be particularly useful in outbreak interventions,” said Thomas.

The study’s mission was to produce results that would help determine the design of the studies in West Africa, for which the rVSV-ZEBOV is one of two Ebola vaccines being tested.

“These pivotal early studies helped inform dose selection for testing of rVSV-ZEBOV vaccine in a large-scale clinical trial in West Africa,” said Regules. “We were gratified to see that the vaccine was not associated with significant adverse effects in this very carefully monitored study.”

Staff members of the Fort Detrick Barquist Army Health Clinic donate items to a local shelter, Heartly House, in recognition of the Sexual Assault Awareness and Prevention Month during April. Heartly House serves Frederick County residents who have been impacted by domestic violence, sexual assault and child abuse. For more information about Heartly House, call (301) 662-8800.

Photo by Shannon Bishop, USAG Public Affairs

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MSS PMO Personnel Attract Mosquitos in Thailand DORA M. SEARS, SENIOR TECHNICAL WRITER

USAMMDA MEDICAL SUPPORT SYSTEMS PROJECT MANAGEMENT OFFICE

Representatives for the Medical Systems Support Project Management Office traveled to Kamphaeng Phet in Thailand on Nov. 3-14 to evaluate the efficacy of Carbon Dioxide Generator technologies in attracting dengue-vector mosquitos.

Jake Fox, MSS PMO product manager for the CDG program, and Dr. Kendra Lawrence, senior scientific consultant for the U.S. Army Medical Materiel Development Activity, spent two weeks evaluating the efficacy and functionality of the CDG systems in partnership with the Armed Forces Research Institute of Medical Sciences unit in Thailand.

The team evaluated four CDG systems in combination with the Centers for Disease Control miniature light trap against the light trap alone and against the light trap with dry ice - the form of carbon dioxide currently used with the vector traps.

Results showed the CDG systems were unable to surpass the dry ice, which Lawrence calls the “gold standard” for vector attractants, in terms of the number of mosquitos attracted to the traps. “To beat dry ice, or even to be as good as dry ice, is pretty hard,” said Lawrence.

Despite its high efficacy status, however, dry ice has its drawbacks. “In most contingency operations you’re going to places where they don’t make dry ice,” said Lawrence. CDG systems solve this problem by producing a more portable and accessible source of CO2 gas.

Of the CDG systems tested in Kamphaeng Phet, Fox said only one proved effective in a real-world environment, based not only on standards of efficacy in capturing the dengue-vector mosquitos, but also operability and reliability. Lawrence notes, however, that in terms of the number of mosquitos attracted, “most of them did better than the light trap alone.”

According to Lawrence, malaria, dengue fever and leishmaniasis, which top the USAMRMC, continued from page 4

specific focuses within the command, including Ebola research, the Chemical Biological Defense Program and prosthetics research, the day also included a briefing from Maj. Gen. Brian C. Lein, commanding general of the USAMRMC and Fort Detrick.

Lein answered the group’s questions in both an informal and formal structure, inviting their approaches before, during and after lunch.

“The effects of sequestration could have a negative impact on the young people coming into the science and technology field,” said Lein in response to a question about retention at the USAMRMC. After a morning of comprehensive presentations providing the group with their first look into the USAMRMC, members toured the U.S. Army Medical Research Institute of Infectious Diseases and received an overview of both the USAMRIID and the U.S. Army Center for Environmental Health Research.

Members remained engaged and interested throughout the day, constantly thinking about how they could apply what they were learning to their own research.

“I do healthcare-related robotics research.

This kind of exposure allows us to hear about the real problems and see how our research fits,” said DSSG member Ayanna Howard, professor at the School of Electrical and Computer Engineering within the Georgia Insti-

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Sustaining a community of excellence through restoration, environmental stewardship and workforce development

Jake Fox, MSS PMO product manager for the CDG program at the U.S. Army Medical Materiel Development Activity, and Dr. Thanyalak with the Armed Forces Research Institute of Medical Sciences unit in Thailand, prep the CUBE CDG generators at the field lab in Kamphaeng Phet.

Photo courtesy of Dr. Kendra Lawrence

military’s list of vector-borne diseases, are transmitted by mosquitoes and sand flies attracted to CO2. Preventive medicine units deployed to areas that present a significant risk of these diseases use vector traps to define appropriate protective measures for vector control. The CO2 attractant increases their effectiveness.

Fox expects data from the recent Thailand trip, as well as from trials conducted last May against malaria vectors in Mae Sot, Thailand, to support the decision to continue development of the CDG systems. “We expect Milestone B and permission to enter the Engineering and Manufacturing Development [phase] in the third quarter of fiscal year 2015,” said Fox. The team hopes to travel to Greece this July to conduct evaluations against leishmaniasis vectors. “The plan is to test them against sand flies in collaboration with the USDA lab that is there,” said Lawrence.

According to Fox, if evaluation trials continue to go well, the CDG system could be ready for initial operational capability in fiscal year 2016. tute of Technology. “We each look at all of this from different perspectives.”

Members felt privileged they could participate in such a high-level program of education and study, drawing a connection between their contributions and the contributions of Service Members.

“Being a part of this group is an honor.

It gives me an outlet to serve my country in a different way, like our men and women in combat,” said DSSG member John Dabiri, professor in the Division of Engineering and Applied Science at the California Institute of Technology. “It’s interesting to think that we as scientists can contribute in some of the same ways.”

Everyone involved in the DSSG’s visit from the USAMRMC received thoughtprovoking inquiries, a promising forecast of the support and solutions to come from the group.

“The DSSG is a distinguished assemblage of some of the greatest minds in science and technology in the country. The fact that they come from outside the DOD gives them fresh perspectives that they can offer us,” said Col. Erin Edgar, commander of the USAMRIID. “I was impressed by the multitude of high-level questions they asked.

Their intellectual curiosity surpassed that of all other groups I’ve hosted here. A few members mentioned that they would be interested in returning for a ‘deeper dive.’ I’d wholeheartedly welcome that.”

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