1. Stephen Cohn, MD, FACS, UTHSC-SA

2. NTI Science Committee  Subject matter experts  Senior leadership  In-depth knowledge/awareness of prior and current trauma research  Members: Peggy Knudson, MD, ChairEllen J. MacKenzie, PhD David B. Hoyt, MD, Vice-ChairAndrew B. Peitzman, MD Timothy C. Fabian, MDBasil A. Pruitt, Jr., MD Donald H. Jenkins, MDRonald M. Stewart, MD Gregory J. Jurkovich, MD

3. Science Committee Role  Determines priorities for each RFP, which is then broadly distributed  Reviews pre-proposals and issues invitations for full proposals  Evaluates proposals, makes proposal selections, and recommends awards and funding decisions to the Board  The Board, which includes representatives of Army, Air Force, and Navy, considers recommendations for full approval 3

4. Review Criteria  Scientific merit  Clinical relevance  Clinical impact  Innovation  Feasibility of completing study on time  Military relevance  Appropriate budget  Potential for follow-on studies  Multicenter involvement

5. Proposals and Awards  April, 2010  85 pre-proposals from 25 states plus DC  15 invitations for full proposals  7 awarded studies, with 22 participating sites  January, 2011  92 pre-proposals from 25 states  21 invitations for full proposals  8 awarded studies, with 20 participating sites 5

6. Pre-proposal Response

7. Award Distribution 16 Lead Sites42 Participating Sites

8. NTI Awarded Studies $3.8 million  Mycoplasma Pneumoniae in the ICU  Dr. Joel Baseman, University of Texas Health Science Center at San Antonio  Timing and Mechanism of Traumatic Coagulopathy  Dr. Mitchell Cohen, University of California at San Francisco  Evaluation of Ventilator Bundle in Injured Patients  Dr. Martin Croce, University of Tennessee Health Science Center at Memphis  Comparative Effectiveness of Clinical Care Processes in Resuscitation and Management of Moderate to Severe Traumatic Injuries  Dr. Shahid Shafi, Baylor Research Institute  Comparison of IV Iron Supplementation to both Enteral Supplementation and Placebo for the Anemia of Traumatic Critical Illness  Dr. Fred Pieracci, University of Colorado at Denver 8

9.  Vasopressin Supplementation during Resuscitation of Hemorrhagic Shock  Dr. Carrie Sims, University of Pennsylvania  Characterization of the effects of the early Sex-Hormone Environment Following Injury  Dr. Jason Sperry, University of Pittsburgh  The Safety and Efficacy of Platelet Transfusion in Patients Receiving Antiplatelet Therapy that Sustain Intracranial Hemorrhage  Mark Cipolle, Christiana Health Care System, Newark DE  Effect of Antioxidant Vitamins on Coagulopathy and Nosocomial Pneumonia after Severe Trauma  Jean-Francois Pittet, University of Alabama at Birmingham  Detection and Management of Non-Compressible Hemorrhage by Vena Cava Ultrasonography  Jay J Doucet, University of California San Diego 9

10.  Splenic Injury Prospective Outcomes Trial  Ben Zarzaur, AAST/ PI: University of Tennessee Health Science Center, Memphis TN  Transfusion of Stored Fresh Whole Blood in a Civilian Trauma Center: A Prospective Evaluation of Feasibility and Outcomes  Gill Cryer, UCLA Dept of Surgery, Los Angeles, CA  Acute Lung Injury Ventilation Evaluation (ALIVE) Trial  Suresh Agarwal, Boston Medical Center, Boston, MA  Methicillin-Resistant Staphylococcus aureus in a Trauma Population: Does Decolonization Prevent Infection?  Robert Maxwell, Univ. of Tenn. HSC, Chattanooga, TN  Thrombelastography (TEG®) based dosing of enoxaparin for thromboprophylaxis: a prospective randomized trial  Martin A Schreiber, Oregon Health & Science University, Portland, OR  Hepcidin and Anemia in Trauma  Lena M. Napolitano, Univ. of Michigan Health System, Ann Arbor MI

11. Research Project Awards: NTI Role/Responsibilities  Manages RFP and review process  Manages regulatory compliance through TATRC, HRPO, and USAMRMC  Manages contracts  Monitors scientific progress and prepares reports  Holds annual investigator meeting  Sponsors annual trauma conference to disseminate results, encourage investigators, and support military/civilian exchange 11

12.  Timing and Mechanism of Traumatic Coagulopathy  Wireless Vital Sign Monitor Project  Mycoplasma Pneumoniae in the ICU

13. Stephen Cohn, MD, FACS, UTHSC-SA

14. Mycoplasma Pneumoniae in the ICU  Preliminary data showed M. pneumoniae  common in ICU patients with suspected VAP  associated with prolonged ventilator course  associated with poor oxygenation in subjects with ARDS 14

15. Mycoplasma Pneumoniae in the ICU  Multicenter, prospective, observational study  Investigating the role of Mycoplasma pneumoniae in ICU patients with suspected ventilator-associated pneumonia (VAP)  Objectives are to:  determine the incidence of M. pneumoniae infection among critically ill ventilator-dependent subjects  evaluate the impact of this pathogen on ICU outcomes 15

16. Mycoplasma Pneumoniae in the ICU  Apply novel diagnostic assays targeting the Community Acquired Respiratory Distress Syndrome (CARDS) toxin  Subjects undergo routine bronchoscopy with bronchoalveolar lavage (BAL) for the diagnosis of VAP  Samples of BAL fluid and serum collected  Polymerase chain reaction (PCR) assessment for CARDS toxin gene sequences  BAL tested for CARDS toxin protein  Serum assayed for anti-CARDS toxin antibodies  Additional serum samples collected to test for seroconversion 16

17. Mycoplasma Pneumoniae in the ICU  Research will:  Determine the incidence of M. pneumoniae  Determine the ventilator course and ICU outcomes  Determine the physiologic implications of M. pneumoniae in this setting  Expand upon preliminary findings from a single hospital 17

18. Mycoplasma Pneumoniae in the ICU  First study to employ these novel assays for the rapid detection of M. pneumoniae infection in the ICU  First study to systematically evaluate the contribution of this pathogen to pulmonary dysfunction in critically ill subjects. 18