2023 MHSRS Abstract-driven Breakout Sessions and Description

MHSRS 2023 Focus Area
Warfighter Medical Readiness
Breakout Session Topic Area Session Description
Medical Countermeasure Assessment for Flaviviruses and other Vector-borne Viral Pathogens of Military Importance Infectious Disease Prevention and Treatment Abstracts should address: 1. Research efforts specific to vector-borne viral pathogens that impact either SOUTHCOM, INDOPACOM or AFRICOM, 2. Research focus areas limited to surveillance, prevention, and treatment of vector-borne viral pathogens. 3. Potential strategies and approaches to translate clinical research into data-driven solutions during theater operations.
How SARS-CoV-2 Investments have Improved Medical Readiness for other Emerging Infectious Diseases Infectious Disease Prevention and Treatment Discuss how specific investments in SARS-CoV-2 diagnostics, preventive measures, and therapeutics have transitioned into technologies that have been used to create medical countermeasures for other (non-SARS-CoV-2) infectious diseases threats.
Addressing Military Vaccine Hesitancy: A Crucial Barrier to Force Health Protection and Pandemic Preparedness Infectious Disease Prevention and Treatment The SARS-CoV-2 pandemic uncovered widespread vaccine hesitancy among military servicemembers and the broader military community that poses a significant barrier to Force Health Protection and Pandemic Preparedness. Abstracts should address one or more of the following vaccine hesitancy topics: 1) prevalence; 2) characteristics of servicemembers with vaccine hesitancy; 3) factors associated with vaccine hesitancy; 4) Mitigation strategies to include applying best practices from other populations
Microbiome and Pathogenesis: Implications for Systemic Immunity and Wound Healing Infectious Disease Prevention and Treatment Abstracts should address either 1) Microbial consortia during systemic infections or wound healing and treatment, 2) utility of microbiome augmentation for immune fortification and wound treatment, and 3) potential applications of probiotic microbiota and products in disease and wound therapeutics.
Tissue Wound Management for Prolonged Care Environments Infectious Disease Prevention and Treatment Combat wound infections due to drug-resistant are on the rise in deployed military personnel. The focus of this session is on research leading to the development of (1) Novel treatment and optimized healing strategies for combat wound care and (2) Strategies and technologies to predict and provide advanced wound care in a prolonged field care environment, and (3) Novel approaches and concepts to counter the threat of wound infection to maintain tissue viability through alternative treatment strategies.
Innovative Technologies to Optimize Warfighters' Performance, and Return to Duty: Individual Wearables, and Neuromodulation Brain Health This session will present research related to advanced innovative non-invasive technologies that are related to optimization of Warfighters' brain health performance and environmental threat response(s). Technologies that optimize human performance, physiological status monitoring, and increase leadership decision capability will be included.
Comprehensive Strategy and Action Plan for Warfighter Brain Health - Way Forward LOI4 (Late/Long Term Effects) Brain Health Line of Inquiry (LOI) 4 from Comprehensive Strategy and Action Plan for Warfighter Brain Health set out understand, predict, and reduce the influence of factors that contribute to long term and late effects following repetitive or cumulative brain exposures or injuries. The development of medical countermeasures to reduce long term and late effects will be tied to predictive models and algorithms to forecast outcomes, which will allow for the development of focused treatment strategies and follow-up clinical activities. Abstracts submitted to this session should describe predictive modeling approaches that can facilitate the identification and forecasting of long-term or late effects associated with hazardous exposures and/or injuries.
Mental Health and Traumatic Brain Injury TBI/Brain Health Abstracts should address: 1. Comorbidity of mental health conditions and TBI 2. The impact of mental health and/or TBI on medically ready force including treatment responders and non-responders, duty status, and medical separation 3. Long-term impact of comorbid conditions in TBI 4. Access to treatment including availability of mental health providers and standard of care practices.
Impact and Assessment of Blast Exposure on Psychiatric Symptoms Blast Traumatic brain injury has been shown to trigger both trigger new or exacerbate existing psychiatric symptoms. Although combat deployment has been demonstrated to be a strong risk factor for psychiatric symptoms, less is known about the impact of blast exposure on psychological health. Moreover, blast exposure has been found to affect psychiatric symptoms independent of mild traumatic brain injury among combat veterans. Abstracts submitted to this session should address one or more of the following topics: 1) evaluation of blast exposure severity on psychiatric symptoms; 2) evaluation of types of blast exposure that may lead to or exacerbate psychiatric symptoms; 3) longitudinal assessment of the long-term impact of blast on psychiatric symptoms; and 4) evaluation of the impact of blast exposure on psychiatric symptoms at different levels of head injury, from subclinical to severe. Psychiatric outcomes can include, but are not limited to 1) PTSD, 2), depression, 3) alcohol consumption, 4) sleep, 5) pain, and 6) quality of life. Populations may be either active-duty service members or veterans.
Development and Validation of Sensors and PPE for Blast Polytrauma Blast Abstracts should address: 1) Development and validation of sensors for performance and accuracy in different environmental conditions including but not limited to: altitude, temperature, humidity, underwater effects on exposure; 2) Understanding effectiveness of PPE for blast polytrauma; 3) Sensors to detect blast exposure related polytrauma and physiological changes; 4) PPE effectiveness for blast polytrauma; 5) Validation techniques of sensors and PPE with military standards.
Computational Modeling of Human Lethality, Injury, and Impairment from Blast Threats in All Environments Blast Abstracts should address Computational models and tools of blast wave gas dynamics, human body biodynamics, injury biomechanics, and trauma pathophysiology, as well as a range of spatial and temporal scales. Explosive weapons (EWs) are a continuing and significant source of casualties in military operations. The spectrum of operational scenarios involving these blast threats is broad and includes both mounted and dismounted operations. As EWs technology and deployment methods become more complex, so too are the resultant injuries, which now require increasingly sophisticated protective countermeasures and medical interventions. A novel approach is required to rapidly design and test protection systems that can mitigate or prevent the spectrum of the resulting blast injuries. Abstracts should address computational models and tools of blast wave-induced traumatic brain injury, lung injury, hearing loss, extremity injury, and protection.
Implementation of Interventions for Prevention of Suicide and Other Harmful Behaviors Psychological Health and Resilience Abstracts should address any of the following topics: (1) Studies that examine the efficacy and implementation of integrated prevention interventions for suicide and/or other harmful behaviors (including but not limited to, sexual assault and harassment, violence, alcohol/substance misuse, and non-suicidal self-injury, (2) Barriers and challenges, and/or facilitating factors for implementation of interventions within the Military Health System (MHS) or within non-medical military installations, (3) Solutions or recommendations for developing or adapting existing interventions for implementation feasibility.
Military-Centric Interventions for Battlefield Psychological Injuries Psychological Health and Resilience The purpose of this session is to highlight novel assessment, including pharmacological or non-pharmacological countermeasures, for psychological health conditions in far forward environments. Specifically, the abstracts submitted should describe one of the following capabilities: (1) identify, prevent, or mitigate the progression of psychological injury, including conditions such as acute stress reactions and adjustment disorders (2) stabilize acute casualties, (3) improve the capability of first responders to perform triage and initiate treatment on injured Service members, and (4) improve outcomes.
Interrupting Behavioral Health Trajectories to Sustain the Force Psychological Health and Resilience Abstracts should address research advances in monitoring, screening, diagnostic, prognostic, and predictive strategies related to early identification, triage, and/or prevention of behavioral health (BH) issues in Service Members. Tools and strategies could include: (1) Models for monitoring and predicting risk of BH disorders/resilience; (2) Objective markers of psychological health status or symptom trajectories (e.g., PTSD, Acute Stress Disorder, Adjustment Disorders); (3) Specialized assessments for military populations; (4) Pharmacologic or devices that can prevent early BH issues such as acute stress reactions from becoming chronic. Research that has developed, validated, and/or field tested these tools/strategies will be considered. All submissions should describe Knowledge and/or Technology Readiness Level (KRL/TRL) of existing data/technology used, methods of data analysis, populations assessed/monitored/treated, and results of any supporting data analyses that are available. (Definitions of Biomedical KRLs & TRLs: https://www.rand.org/content/dam/rand/pubs/research_reports/RR2100/RR2127/RAND_RR2127.pdf; https://www.ncbi.nlm.nih.gov/books/NBK201356/)
Military Transitions - Advances in Early Interventions for Promoting and Strengthening Psychological Readiness of Service Members Psychological Health and Resilience The purpose of this session is to present innovative preclinical and clinical research that addresses: (1) assistance in primary and secondary interventions to promote psychological health issues relevant to transitions across the military lifecycle, (2) strengthening of service member and family psychological readiness undergoing various types of military (e.g., accession, deployment, PCS) and psychological health care (step-ups/downs in care) transitions, and/or (3) identification of supports, including policies and protocols, necessary to promote successful coping of SM and family with specific transitional stressors.
Psychological Health Research Translation - Current Status and Future Directions Psychological Health and Resilience The purpose of this session is to highlight processes, limitations, and strategies in dissemination practices for psychological health research which affect the fidelity of implemented policy or practice. Examples of such limitations include insufficiency in uniform or quality training for key personnel (e.g., leaders, resilience trainers, mental skills trainers, non-specialty personnel). To address these inadequacies, research efforts are encouraged that have bridge findings to policy and practice, including clinical interventions, education, training, and performance optimization. Relevant abstracts include: (1) implementation of community-based approaches, (2) strategies of optimizing the usage of specialty and non-specialty medical personnel and (3) best practices to overcome institutional or cultural barriers and deliver evidence-based care to SM within the military community.
Longitudinal Studies of Service Member, Veteran, and/or Military Family Member Health and Well-Being Psychological Health and Resilience Abstracts submitted to this session should address one or more of the following: (1) provide a high-level overview of a DoD or VA-affiliated longitudinal study of service members, veteran, and/or military family member health, (2) describe historical and/or current methodology used in such longitudinal studies, (3) summarize empirical findings garnered from such studies on relevant topics (e.g., occupational and environmental exposures, traumatic brain injury, psychological health, resilience).
Warfighter Operational Resilience: Current and Future Directions in the Development and Implementation of Programs to Maintain "Resilience Under Fire" Psychological Health and Resilience Operational resilience is critical to sustaining combat power and prevailing in future conflicts. Current resilience programs rely on a classroom education model that fails to address the acute stresses of combat and the need to develop warfighters who can maintain combat effectiveness under those conditions. Future resilience-focused training and education must be applicable to the operational environment and should include interventions that can be self-administered or administered by non-medical personnel while under fire. Competitive abstracts for this breakout session will (1) summarize novel approaches to developing operational resilience; (2) address challenges with implementing and sustaining the effectiveness of resilience programs; (3) describe resilience optimized for specialized Warfighter communities; and/or (4) showcase unique methodologies to measure, assess, and evaluate operational resilience.
Solutions to Optimize and Accelerate Recovery from Neuromusculoskeletal Injury Neuromusculoskeletal Injury Musculoskeletal injuries are highly prevalent among United States Service members, and particularly among those with extremity injuries. Abstracts should be focused on non-surgical interventions for the treatment and rehabilitation of neuromusculoskeletal injury with a focus on optimization of outcomes and return to duty. Abstracts may also include technologies to track or monitor the progress of recovery.
Multifactorial Problems Contributing of Musculoskeletal Injuries in the Military Neuromusculoskeletal Injury Musculoskeletal injuries (MSKI) in military personnel have been recognized for over a century and half; yet only modest gains have been made in prevention. One reason for the persistence of MSKI is the panoply of contributing factors, with the greatest predictor of future musculoskeletal injury being previous musculoskeletal injury. Categories of risk factors include demographics, lifestyle practices, physical fitness, medication usage, genetics, and medical history. Non-modifiable risk factors aid in risk stratification, and modifiable risk factors provide targets for intervention. Significant progress in prevention requires scientific evidence related to the most impactful risk factors to support risk stratification and development of successful intervention strategies. This session seeks abstracts that address novel: (1) Multifactorial risk factors for primary and secondary MSKI; (2) Evidence for modifiable risk factors to target for intervention, to include the effect of NSAIDs on musculoskeletal health; (3) Holistic interventions addressing multiple risk factors simultaneously for MSKI prevention.
Innovative Tools and Technologies for Predicting and Assessing Musculoskeletal Injuries of the Warfighter Neuromusculoskeletal Injury Abstracts should address one or more of the following: 1. Devices and technologies being utilized for predicting and monitoring musculoskeletal injuries (MSKIs) and risk of injury in military personnel; 2. Strategies being employed for screening personnel for MSKI risk based on demographic and military occupation data; 3. Analytical tools and MSK models for predicting and preventing sustained MSKIs, optimizing warfighter performance, and understanding MSKI risk; 4. Field studies and data collection for MSKIs in military populations; 5. Tools for assessing musculoskeletal injury; and 6. Emerging opportunities for analysis of large datasets of relevant health and performance data of individuals who sustained MSKIs using Artificial Intelligence (AI) and/or Machine Learning (ML).
From Sockets to Osseointegration: Human Interface Solutions for Assistive Device Technology Neuromusculoskeletal Injury Abstracts should address any of the following topics: (1) Advancements in osseointegration; (2) Advancements in socket design; (3) Technology(ies) to improve the interaction between the user and the assistive device.
Health and Readiness Unique to the Female Active Duty Service Woman Women’s Health Abstracts should address the following key areas of interest: 1) Convenient and timely reproductive health care for Active-Duty Service Women (ADSW), particularly in deployed and training environments, 2) optimizing return to duty post pregnancy (including following abortion, miscarriage, and obstetric delivery) for Active Duty women, or 3) optimization of fertility services in times of essential military readiness.
Female Warfighter Health & Performance Women’s Health This session will focus on latest efforts focused on physiological considerations, physical performance, injury risk, and environmental stress in military women. Abstracts should address any of the following topics: (1) Military relevant exercise/ task performance in women and risk of injury, (2) Influence of anthropometrics/body composition in military specific tasks/physical performance in women, (3) Physiological responses to environmental or training extremes in women.
Force Health Protection: Operational Exposure Research and Predictive Risk Methods Occupational and Environmental Exposures Service Members are frequently exposed to unique, complex, and potentially hazardous operational environments. The abstract should address research dealing with occupational and operational threats to Service Member health protection using toxicology, exposure science and applied scientific approaches by focusing on 1) determining molecular and cellular responses associated with operational exposures; 2) assessing occupational and environmental exposures using novel approaches; 3) computational modeling of biologic systems to further risk prediction and chemical risk assessment tools.
Military Exposures and Subsequent Long-term Outcomes Occupational and Environmental Exposures Abstracts submitted to this session should address one or more of the following topics: 1) logistical challenges to the consolidation of DoD and VA data sources for studying long-term outcomes after military exposures. 2) Studies examining the impact of military exposures on chronic medical conditions (including, but not limited to, heart disease, hypertension, diabetes, and cancer). 3) Studies of military exposures and mental health outcomes.
Advances in Data Science, Machine Learning, and Artificial Intelligence to Provide Actionable Medical Information in Support of Medical Readiness, Disease Prevention or Treatment, and Return to Duty Medical Artificial Intelligence, Automation, and Decision Support / Predictive Analytics This session will focus on the latest efforts, accomplishments, and challenges to utilizing and integrating Artificial Intelligence and Machine Learning into healthcare applications across the Military Health System. Abstracts should include the use of AI/ML in support of (I) Medical conditions and risk factors that impact return to duty (RTD) status; (II) Variables that improved RTD outcomes following injury or disease; and (III) Key factors impacting medical readiness and disease prevention. Focused topics may include, but not limited to: (1) Diagnostic or decision support clinical workflows, (2) Emerging trends in AI software, (3) Regulatory considerations, (4) Ethical, Legal, Security and Societal implications, (5) Autonomous AI-enabled healthcare, (6) AI-guided Image Acquisition, and (7) Next steps in product development.
Leveraging Big Data/Predictive Analytics for Military Health System Decision Making: Considerations for Assessment, Treatment, and Policy Medical Artificial Intelligence, Automation, and Decision Support / Predictive Analytics Abstracts should address the use of big data/predictive analytics for 1) clinical treatment and assessment, 2) operational/field decision making, 3) health outcomes prediction, and 4) policy determination and implementation.
Update on Wearables in the Deployed Environment Physiological Status Abstracts submitted to this session should address any of the following topics that are related to physiological monitoring algorithms or novel body-worn sensors to measure/quantify: 1) Cold Strain 2) Fluid intake - Underhydration or overdrinking/ hyponatremia risk 3) Low blood oxygen - Acute Mountain sickness or respiratory compromise 4) Gait abnormality - Overloading, musculoskeletal overuse 5) cognitive degradation.
Undersea Operational Research Panel Physiological Status The cognitive/physical mission readiness, safety, and health of DoD Divers, SEALs, and submariners are critical to National Defense Strategy. We will discuss recent findings from several laboratories conducting assessment/mitigation RDT&E on important undersea medical and operational risks/challenges associated with diving or distressed submarine escape/rescue, such as: 1) Undersea-specific effects/considerations of Arctic/Cold-water exposure; 2) Gas/atmospheric effects (e.g., excess O2/CO2); 3) Pressure effects (e.g., compression/decompression; diving at altitude); 4) Exertion effects (e.g., cognitive effects during strenuous diving); 5) Other effects revealed by studies of diver health risks/outcomes. Empirical and epidemiological findings will be presented concerning effects, readiness measures, predictive models, countermeasures, and technologies.
Aeromedical Aspects of the Army's Future Vertical Lift Program Physiological Status The Army's Future Vertical Lift program is developing a series of new aircraft with expanded mission and flight characteristics, featuring new technologies and physiological challenges that will test the limits of human performance, and present new physical challenges to aircrew health and survival. This session will review the major characteristics of the developing FVL aircraft family, describe the aeromedical and performance challenges presented by these advanced aircraft, and present the comprehensive ongoing research program aimed at preserving FVL aircrew health, performance, occupant protection, and enroute casualty care. Major elements include aircrew health and medical standards, performance maintenance and enhancement, operator state monitoring and scalable autonomy, advanced occupant crash protection, head / spine protection, post-crash survival, enroute casualty care, and flight medic performance. Topics will range from visual problems (helmet-mounted displays) to real time monitoring of aircrew for fatigue, workload, hypoxia, etc., to new crashworthy seats that prevent spine fractures, to an 'elite athlete' model of holistic health, to the effects of sleep deprivation on flight medic performance.
Precision Medicine Research: Optimizing Warfighter Healthcare, Readiness, and Return to Duty Physiological Status Submissions for this session will address large scale genomic, proteomic, and transcriptomic data in day-to-day military medical practice and precision medicine research (consent, sample collection, sequencing, interpretation, report generation, report disclosure, follow up care, and research and education opportunities).
MHSRS 2023 Focus Area
Expeditionary Medicine
Breakout Session Topic Area Session Description
Battlefield Biomarkers for TBI: Diagnostic and Prognostic Indicators Traumatic Brain Injury Diagnosis and Treatment The purpose of this session is to describe research on promising biomarkers for TBI with near-term potential for application in austere and/or deployed environments. The abstracts submitted should: (1) describe promising biomarker candidates that can be utilized for either diagnosis, prognosis, or return to duty decision making following TBI; (2) describe any related technologies required for assessment of biomarker candidates; (3) discuss the ability of identified biomarker candidates to sub phenotype different TBI injuries. The usability and clinical interpretation of either novel devices that can be used to track biomarkers or technology-based performance assessments for TBI may also be discussed. Biomarker candidates at a nascent stage of development with less direct potential for application to the deployed and/or austere environment will not be discussed.
Traumatic Brain Injury Treatment for Early Combat, In-theater Administration Traumatic Brain Injury Diagnosis and Treatment Abstracts for this session will address severe Traumatic Brain Injury (TBI) treatment materiel and knowledge research, development and outcomes directed at Role 1 and Role 2 combat environment that is advanced through TRL-4 to TRL-6 with a clinical pipeline and regulatory pathway. Abstracts should address if the treatment can support prolonged care in combat where evacuation is not possible or delayed, and how early treatment lessens the burden of severe TBI. For materiel-directed research the abstract must address the regulatory pathway; and for knowledge, the abstract must address the clinical pipeline, through planned Clinical Practice Guidelines and clinical adoption, or other knowledge dissemination for instance.
Novel Strategies for Treatment of Shock or Blood Failure: Blood and Blood Products Hemorrhage Control/Blood Products Abstracts should address: (1) Shock mitigation strategies, (2) Hemostasis and Coagulopathy, (3) Current and new directions of blood and blood products for treatment of shock-related trauma.
Emerging Technologies for Treatment of Non-compressible Torso Hemorrhage Hemorrhage Control/Blood Products The purpose of this session is to present innovative preclinical and clinical research to enable critical care and casualty management capabilities for the treatment of non-compressible torso hemorrhage (NCTH). Areas of interest include simulation technologies (e.g., mixed, virtual, blended realities and holographic patient representation), autonomous technologies, and novel technologies for damage control and combat surgical care in a forward environment and for prolonged casualty management. Submissions can also address ways to minimize the logistical burden associated with NCTH capabilities to enable their use far forward. Abstracts should articulate how research outcomes would improve casualty care, specifically when hemorrhage control cannot easily be obtained in the torso region.
Cellular Therapeutics for Treatment of Shock and Trauma Hemorrhage Control/Blood Products Abstracts should address: (1) Cellular therapeutics for use in trauma indications, (2) Biology and mechanism of cellular therapeutics, (3) Current and new directions in cellular therapeutics, and (4) Cellular therapeutic processing, manufacturing, storage, and delivery.
Hemorrhage Control and Vascular Dysfunction Hemorrhage Control/Blood Products Abstracts should focus on hemorrhage control using hemostatic dressings, to include drugs that protect from the onset of vascular dysfunction. Specifically, they should (1) Define the need for hemostatic products in a military-relevant setting (i.e., epidemiological data, justification for use in prolonged field care settings), (2) show the safety & effectiveness for hemostatic products in controlling blood loss (i.e., preclinical, clinical data, and real world evidence important for the development of clinical practice guidelines), (3) Define current and novel hemostatic products that take advantage of physiological factors to direct and optimize their use in combat casualty care, (4) Define mechanism and novel drugs that target components of the vascular and lymphatics to mitigate the onset of vascular dysfunction and tissue edema.
Advances in Prolonged Care Forward Surgical Care/Prolonged Care The purpose of this session is to present innovative research on materiel solutions to enable critical care and casualty management capabilities to be moved closer to the point of need to decrease mortality and morbidity during prolonged care scenarios. Prolonged care is inclusive of prehospital field care, austere/resource limited environments, and in theatre hospital environments due to delayed evacuation. Areas of interest include novel technologies for damage control and combat surgical care in a forward environment, solutions to prevent and treat secondary injury and acute treatment sequelae, and prolonged casualty management. Abstracts should articulate how solutions would improve casualty care outcomes, specifically when evacuation is delayed or unavailable, or in resource limited environments.
Clinical Studies to Advance Combat Casualty Care Forward Surgical Care/Prolonged Care The purpose of this session is to provide latest information on currently ongoing clinical studies and trials that will provide knowledge or a materiel product that will advance the field of combat casualty care. Abstracts should address: 1. The area of combat casualty care that will be improved by the study. 2. The research strategy of the clinical study or clinical trial to include discussion of the intervention, if applicable. 3. How the study population relates to military cohorts. 4. Next steps to advance the results from the study.
Polytrauma and Multi-Organ Dysfunction Forward Surgical Care/Prolonged Care Combat scenarios spanning multi domain operations (MDO) will result in a multifaceted future battlefield resulting in complex injury patterns. Exacerbated by evacuation delays, multi-organ dysfunction (MOD) is likely to follow the combination of mechanical trauma, thermal injury, and/or CBRN. There is limited information on these injury patterns and the novel strategies to treat them. Abstracts submitted to this session should highlight existing studies on the pathophysiology of polytrauma to inform both Clinical Practice Guidelines and knowledge/materiel gaps pertinent to combined injury. Both animal and human research aimed at diagnosing, preventing, mitigating, or treating MOD (e.g., acute kidney injury, acute respiratory distress syndrome) following polytrauma across roles of care.
Advanced Battlefield Care of Severe Burn Casualties at the Point of Need: Prehospital to Definitive Care Burn Management Session presents preclinical/clinical research aimed at near-term delivery of innovative, acute/sub-acute therapies for prehospital management of severe burn injuries by non-burn specialist personnel (e.g., medics, buddy aid) to improve recovery outcomes. Focus areas: (1) Advanced burn fluid resuscitation. (2) Viable tissue preservation post-burn to reduce the treatment required to restore skin structure/function. (3) Accelerate burn wound healing. (4) Provide definitive burn wound treatment closer to point of injury. (5) Develop models for burns resulting from emerging weapons threats; identify/test treatment candidates. (6) Develop animal models, agnostic of mechanism of burn, in context of polytrauma and/or combined with chemical or radiological burns; evaluate potential treatment interactions. (7) Develop decision support tools to expand provider capability and capacity to concurrently treat large numbers of burn casualties.
Battlefield Analgesia Pipeline: Novel Therapeutics from the Benchtop to the Battlefield Pain Management Acute pain negatively impacts Warfighter performance. There is a critical need for improved pain management on the battlefield and under prolonged care conditions when access to skilled providers and resources are limited. Better analgesics and local anesthetics are desperately needed to keep Warfighters in the fight and enhance return to duty status. Abstracts should include one or more of the following: (1) Therapeutic agents for inflammatory, neuropathic, and other types of pain tested in battlefield-relevant models which assess cognitive or motor function. (2) Novel pain management agents tested clinically or pre-clinically that assess sedation or impact on cardiorespiratory function or coagulation. (3) Novel delivery of analgesic and anesthetic agents to improve pain management along the echelons of medical care for battlefield injuries.
Enabling Medical Mobility and CASEVAC during Future Large Scale Combat Operations En Route Care Abstracts should focus on optimizing CASEVAC mobility to enhance agility and prolong survivability. Specifically, they should (1) Define the indications for CASEVAC critical intervention (e.g. critical use cases), (2) Define the needed support and associated requirements (e.g. materiel or supplies) for critical use cases, (3) Define platform limitations and environment characteristics (i.e. temperature, pressure, vibration, etc.) which would hinder agility and survivability, (4) Technology and knowledge solutions that can facilitate overcoming platform limitations, (5) Emerging solutions that enhance CASEVAC capabilities and/or optimize en route provider task performance.
Expeditionary Diagnostics and Treatment of Vision Injury Sensory Systems Abstracts should address: 1) Epidemiology of military-related visual loss/dysfunction; 2) Preclinical & clinical research advancing vision injury diagnostics in the battlefield setting; 3) Preclinical & clinical research advancing battlefield and en route care of vision injury to preserve eyesight; 4) Preclinical & clinical research advancing acute definitive treatment of vision injury.
Advanced Decision Support and Automation Technologies to Support Combat Casualty Care During Multi-Domain Operations, Large Scale Combat Operations, and Prolonged Care Advanced Decision Support and Automation Technologies Abstracts should address topics related to advanced medical technologies (decision support, automation, robotics, artificial intelligence, machine learning, etc.) for assisting medical personnel operating in current and future multi-domain battlefields, during large scale combat operations, or in prolonged care settings. Topics should focus on the use of these technologies to address capability gaps for management and care of trauma/critical care casualties in these environments including mass casualty situations, dense urban environments, austere and resource constrained environments, advanced/intelligent casualty triage, and advanced patient evacuation and movement. Topics include the use of decision support and artificial intelligence technologies to assist providers in better diagnosis and management of critical care patients, advanced automated systems (open and closed loop) to deliver medical care, medical robotic technologies to support damage control surgical interventions, unmanned systems for casualty care management and evacuation, and technologies to optimize medical logistics associated with combat casualty care in the battlefield. Topics can also include technologies that provide for better interactions between users and computers/robots (man-machine teaming), advanced machine-vision technologies for the critical care environment, and use of virtual and/or augmented reality technologies for improved clinical decision support at the point of need.
Medicine and Performance Optimization in the Arctic Forward Surgical Care/Prolonged Care and Warfighter Performance Response to medical considerations in extreme cold environments is a critical knowledge gap when considering medical and operational effectiveness. Warfighters exposed to cold environments are susceptible to performance decrements and cold-weather injuries that may compromise warfighter readiness. This session focuses on warfighter performance, injury prevention, and treatment when conducting training and operations in extreme cold. Abstracts submitted to this session should address any of the following topics: (1) Sustaining physical and cognitive performance in cold environments; (2) Extreme cold injury prevention including physiological countermeasures, current cold weather gear, and human factors limitations; and (3) Medical treatment in the extreme cold, including cold-weather injuries, combat casualty care, pharmacological interventions, and monitoring.
Responding to a Nuclear Event and CBRN Exposure with Resource Limitations Forward Surgical Care/Prolonged Care and Warfighter Performance As stated in the 2022 National Defense Strategy, U.S. competitors are building larger and more diverse nuclear arsenals. A wide range of technologies and applications are complicating escalation dynamics and creating new challenges for strategic stability; these include advanced chemical and biological weapons and emerging payload and delivery systems for both conventional and non-strategic nuclear weapons. How the MHS cares for complex injuries after a nuclear event requires planning. Abstracts should utilize pre-clinical, clinical, or computational models aimed at highlighting advancements in radiation science to address the response to radiation exposure, and present state-of-the-art developments for factors such as acute radiation syndrome and its protection (prophylactic strategies), treatment (marrow transplantation, other therapeutics), medical triage, health physics, biodosimetry, or internal contamination (decorporation agents). Historically, combat injuries are clinically complex with ~70% of injuries categorized as polytrauma. The complexities of combined injuries, including chemical and/or radiation exposure, plus trauma, severe burns or other injuries expected in operational environments may also be addressed.
Surviving and Thriving in a Distributed Operations Environment: Military Health Challenges and Solutions Forward Surgical Care/Prolonged Care This session will explore operational challenges and research solutions when caring for injured warfighters as part of the Distributed Operations (DO) warfighting concept. While each Service has adopted a version of DO to its own capabilities, the challenges imposed by DO on stabilizing, sustaining and caring for wounded warfighters are common across those frameworks: land, air, sea and communication superiority are challenged, logistics are contested, and forces are distributed over large distances with limited assets. These constraints impose unique challenges across the continuum of care. Abstracts submitted to this session should address one or more of these topics: (1) DO-focused Military Health threats and challenges; (2) Point of Injury Management in DO– land, air and sea; (3) Managing across the Continuum of Care in DO.
MHSRS 2023 Focus Area
Warfighter Performance
Breakout Session Topic Area Session Description
Role of Sleep in Performance and Recovery Human Performance Optimization Abstracts should address 1. Role of sleep-in increasing performance mental and physical in operational environments, to include changing leadership viewpoints of sleep and more objective metrics of performance, 2. Role of sleep in recovery from increased mental and physical performance, 3. Role of sleep in recovery from mental and physical injury.
Hearing Loss, Tinnitus, and Balance: Whole-Life Warfighter Performance Human Performance Optimization Service Members are frequently exposed to hazardous noise, leading to tinnitus, and hearing loss. These conditions, along with imbalance, are significant depreciators of warfighter performance and sources of disability claims. This session explores the relationship of hearing loss, imbalance, and tinnitus with declines in whole-life performance, as well as mental and cognitive health. Abstracts should address: (1) epidemiology of hearing loss, imbalance, and tinnitus in the military and veteran populations, (2) injury identification and prevention, (3) associations of hearing loss and tinnitus with declines in cognition and mental health, and (4) treatment of hearing loss, imbalance, and tinnitus as potential modifiers for the warfighter’s optimal whole-life performance.
Military Injury Biomechanics and Applications for Injury Prevention Injury Prevention Abstracts submitted to this session should address any of the following topics: (1) Vehicle crashworthiness, injury trends, and injury biomechanics of mounted occupants; (2) Injury biomechanics of the head, neck, and spine during military operational tasks; (3) Injury biomechanics and tolerances for military personnel protective equipment (e.g., helmet and body armor); or (4) Mechanisms and biomechanics of injury for Service Members.
MHSRS 2023 Focus Area
Breakout Session Topic Area Session Description
Antimicrobial Countermeasures for Wound Infections in Military Personnel Infectious Disease Prevention and Treatment Combat wound infections due to drug-resistant or multidrug-resistant organisms are on the rise in deployed military personnel. The focus of this session is on research leading to the development of (1) rapid diagnostics, novel preventive & treatment strategies for combat wound infections and complications with multidrug-resistant (MDR) bacterial pathogens; (2) Strategies and technologies to diagnose, predict & prevent sepsis in a prolonged field care environment & (3) novel approaches to counter the threat of antibiotic-resistance through alternative treatment strategies & development of novel therapeutics. (4) knowledge regarding how trauma and polytrauma effect drug PK/PD and dysregulation of the immune system.
Advances in Regenerative Medicine for the Treatment of Neuromusculoskeletal Injuries from Point of Injury to Definitive Care and Beyond Regenerative Medicine Abstracts should address regenerative medicine centric approaches and products that provide innovative and effective solutions to enhance functional outcomes following neuromusculoskeletal (NMS) injury, including but not limited to: (1) Development and/or evaluation of regenerative medicine therapies which aim to facilitate improved functional outcomes following NMS injuries; (2) Optimization of the wound microenvironment (e.g. vascularization, innervation, immune-modulation) to facilitate improved efficacy of regenerative medicine therapies; (3) Evaluation of regenerative rehabilitation strategies that might enhance the biological and/or functional efficacy of regenerative medicine interventions, or (4) Advances in clinical translation of regenerative medicine-based knowledge or materiel products.
From Laboratory to Clinic: Progress of Orthotic and Prosthetic Technologies and Outcomes Regenerative Medicine This session will discuss the development of novel prosthetic and orthotic technologies. Abstracts submitted should address any of the following topics: (1) recent prosthetic or orthotic technology advancements; (2) transfemoral prosthetics or advanced limb orthoses for patients with limb salvage and impairment; (3) emerging exoskeletal solutions.
Exertional Illness in the Warfighter: Return to Duty Considerations Physiological Status Abstracts should address1. the epidemiology of common causes of exertional collapse including exertional heat stroke, exertional rhabdomyolysis, exercise collapse associated with sickle cell trait, and sudden cardiac arrest; and 2. current evidence based approaches for warfighter risk stratification, and management to facilitate expeditious return to duty decisions.
Integrative Medicine Across Operational Environments: Getting Warriors Back to the Fight without Drugs Pain Management Provision of effective integrative treatments for pain and psycho-emotional trauma will enable faster return-to-duty, support long-term force retention, and reduce overall reliance on opioid analgesics. Abstracts submitted to this breakout session should address: (1) Novel non-pharmacological pain management and psychological treatment methods under evaluation within the MHS, (2) Integration of new interventions into existing pain management or psychological pathways, (3) Opportunities to augment and enhance MHS capability in providing comprehensive field medicine, (4) Implementation of modalities in garrison and deployed settings (5) Efforts to characterize and reduce long-term opioid therapy prescribing trends within the MHS and summary of associated health outcomes.