Shaping Research Programs to Fill Knowledge Gaps

Call for Abstracts for the 2020 Military Health System Research Symposium (MHSRS)

The DoD Blast Injury Research Coordinating Office (BIRCO) actively contributes and participates in the annual MHSRS, the DoD's premier scientific meeting. Visit the MHSRS homepage and consider submitting an abstract.

Select Blast-related MHSRS 2020 Abstract Topics for Consideration:

• Computational Modeling of Human Effects due to Low- Level Blast Exposure:
  Abstracts submitted to this session should address any of the following topics: (1) Computational methods to capture low level blast shockwave interaction with the human body & military environments, (2) Computational modeling of injury prediction related to low-level exposure of blast, or (3) Computational modeling of how mitigation strategies reduce exposure & potential injuries.
• Sensory Combat Injuries: Innovative Diagnostic & Treatment Strategies for Hearing & Vision:
  The session will focus on research that addresses: (1) Epidemiology of military-related sensory (hearing or vision) loss/dysfunction, (2) Preclinical & clinical research advancing sensory diagnostics & treatments to preserve or restore function, (3) Medical treatment of tinnitus & hearing loss (e.g., cell regeneration & pharmacological interventions), (4) Preclinical & clinical research advancing sensory trauma treatment feasible in operational environments & perspectives that address: a) Current & anticipated sensory systems injuries epidemiology, b) Current & anticipated impact on readiness, performance & return to duty, c) treatment needs, research opportunities, & strategies to prepare for the future war, or d) resource constraints both of supplies & medical expertise.
• Brain Health & Cognitive Performance Effects Resulting from Blast Exposures in the Training Environment:
  Abstracts submitted to this session should address any of the following topics: (1) Investigation of single & repetitive, low-level, sub-concussive blast exposure effects (acute, sub-acute, & long term) on Warfighter brain health performance as measured by cognitive, psychological, &/or functional factors, (2) Delineation of the potential acute, sub-acute, & long-term health effects Warfighters may experience as a result of repetitive, low-level, sub-concussive blast exposure in terms of self-reported health problems, medical diagnoses, & healthcare utilization, or (3) Identification of biological correlates such as blood-based biomarkers, neuroimaging, & neurosensory functioning that may be associated with health effects resulting from repetitive, low-level, sub-concussive blast overpressure exposure in the training environment.
• Caring for Traumatic Soft Tissue & Orthopedic Injury Austere Environments:
  This session will focus on innovative technologies to treat traumatic soft tissue & orthopedic injuries related to extremity trauma injuries. Areas of interest include novel technologies & therapeutic solutions to stabilize soft tissue & orthopedic injuries, prevent secondary injuries, & maintain tissue viability in austere environments, particularly when evacuation to higher levels of care is delayed or unavailable.

Visit the MHSRS Breakout Session page for a full list of topics.

Abstract Submission Instructions:

• Submit abstracts through the MHSRS website (https://mhsrs.health.mil/). You must be a registered member of the MHSRS website.
• MEDCOM and DHA CAC Users: Signing in with a CAC is the most secure/desirable method since it uses two-factor authentication. For these individuals, your DoD CAC should allow access and you therefore should not have to register for a member account.
• All others (non MEDCOM and DHA military and civilian) must register for a new member account: Visit the Website Registration page for a username and password for access the abstract submission site.

Please note: The location and date of the 2020 MHSRS are still to be determined. This information will be posted on the MHSRS website when it is available.

March 5, 2020

Call for Abstracts for the 2019 Military Health System Research Symposium (MHSRS)

On behalf of the Executive Agent for Medical Research for the Prevention, Mitigation, and Treatment of Blast Related Injuries and the Department of Defense (DoD) Blast Injury Research Program Coordinating Office (PCO), the PCO Director is pleased to announce that the Call for Abstracts is now open for the 2019 Military Health System Research Symposium (MHSRS).

The Blast Injury Research PCO actively contributes and participates in the annual MHSRS, the DoD's premier scientific meeting. This year, the PCO is sponsoring two breakout sessions that may be of interest.

Please consider submitting an abstract for an oral or poster presentation during one of these sessions (see topics below). The MHSRS provides a collaborative environment for military medical care providers with deployment experience, DoD scientists, academia, and industry to meet and exchange information on the unique medical needs of the Warfighter.

The theme for the 2019 MHSRS is "Research for Readiness" and the abstract submission deadline is March 15, 2019.

PCO Abstract Topics For Consideration:

• Approaches for Monitoring Warfighter Blast-Related Exposures in Training to Develop Effective Safety Standards:
  This session will explore methods for monitoring Service member exposures to blast-related health risks associated with weapons firing during training, for determining the potentially injurious effects of the exposures, and for using the acquired data and knowledge to establish effective training safety standards that protect Service member health while maximizing training effectiveness to enhance lethality on the battlefield. Potentially hazardous exposures include, but are not limited to, blast overpressure, impulse noise, and inhaled propellant combustion products. The research and concepts presented during this session address the key components of the FY18 NDAA Section 734 mandate for the DoD to monitor Service member blast exposures. Abstracts will focus on: (1) exposure monitoring methods such as wearable and environmental sensors; (2) studies that link exposure data to blast-related injuries such as auditory, lung, and brain injury; and (3) processes for developing safe exposure standards that enable effective training.
• Ocular Injuries Caused by Exposure to Blast Overpressure (co-sponsored with the DoD/VA Vision Center of Excellence):
  This session will examine the evidence and possible mechanisms of unique ocular injuries caused by exposure to the blast overpressure generated by explosive weapons, such as improvised explosive devices (IEDs), and explore potential strategies to prevent these injuries. Abstracts will focus on: (1) clinical evidence of primary blast-induced injuries to the eye and visual system observed in Service members who were exposed to explosive weapons; (2) the application of computational modeling tools, such as finite element modeling, to elucidate the fundamental mechanisms of blast-induced ocular injuries; (3) studies using animal models to establish a link between blast overpressure exposure and ocular and vision injury, and to support the validation of computational models; and (4) proposed strategies to protect against blast-induced ocular injuries.

Abstract Submission Instructions:

• Submit abstracts through the MHSRS website (https://mhsrs.health.mil/). You may be required to re-register for an account on the MHSRS website due to new requirements instituted by the USAMRDC Web Team.
• MEDCOM and DHA CAC Users: Signing in with a CAC is the most secure/desirable method since it uses two-factor authentication. For these individuals, your DoD CAC should allow access and you therefore should not have to register for a member account. Please try to go directly to the portal here: https://mhsrs.health.mil/conference/ (Choose -- AMED CAC --). If you have trouble accessing with CAC, please register for a member account.
• All others (non MEDCOM and DHA military and civilian) must register for a new member account: Go to https://mhsrs.health.mil/SitePages/Register.aspx for a username and password for access the abstract submission site.

Please note: The location and date of the 2019 MHSRS are still to be determined. This information will be posted on the MHSRS website and communicated via e-mail to those registered on the MHSRS website when it is available.

February 15, 2019

2018 MHSRS Scientific Tract: Advancing Blast Injury Research to Close Critical Knowledge Gaps: Update

At the recent 2018 Military Health System Research Symposium (MHSRS) in Kissimmee, FL, the Blast Injury Research Program Coordinating Office (PCO) supported a scientific tract entitled, "Advancing Blast Injury Research to Close Critical Knowledge Gaps." The tract featured four two-hour breakout sessions at which distinguished researchers with expertise in blast-related injury discussed their results and efforts to an audience of military medical experts, as well as many research poster presentations extending and deepening the themes of the breakout sessions. The posters and talks reached many hundreds of active members of the military health community. These sessions were a forum to discuss progress made to address the critical knowledge gaps and recommendations made during previous State of the Science (SoS) meetings. Sessions were heavily attended and gave an opportunity for experts in these fields to interact with each other and with the PCO.

Each breakout session explored an active area of blast injury research that had been previously characterized by a PCO "State of the Science" meeting. The topics of the breakouts and posters included:

1. Blast-induced Tinnitus: Tinnitus and hearing loss are highly prevalent service-connected disabilities and continue to represent significant medical and cost issues for both the DoD and VA. This session and associated posters detailed the progress made to address the knowledge gaps and expert panel recommendations from the International State-of-the-Science Meeting, "Blast-Induced Tinnitus." The session and posters focused on: (1) Operational readiness impacts of tinnitus in the military; (2) Mechanisms and contributing factors associated with tinnitus onset and progression; (3) Key markers for predicting an individual's susceptibility for developing tinnitus; (4) New or improved techniques to diagnose and characterize tinnitus; (5) Novel therapies for preventing and treating tinnitus.
2. Minimizing the Impact of Wound Infections Following Blast-related Injuries – Wound infection continues to be a significant source of morbidity and mortality in the modern era of military healthcare. Victims of blast injury often suffer from multiple traumatic injuries; the mechanism, severity, and complexity of these injuries contribute to the risk for wound infection. This session and associated posters described the progress made to address the knowledge gaps and expert panel recommendations from the International State-of-the-Science Meeting, "Minimizing the Impact of Wound Infections Following Blast-Related Injuries." The focus was on: (1) Theater-specific prevention and treatment of wound infections following blast injuries; (2) Real-time assessment of infection reduction strategies and clinical practice guideline compliance; (3) Wound infection surveillance and analytic epidemiology in theaters of operation; and (4) DoD Trauma Registry and related programs (e.g., Trauma Infectious Diseases Outcome Study and the Military Orthopedic Trauma Registry).
3. Environmental Blast and Impact Sensors in Training and Brain Health Sustaining – This session and associated posters focused on 1) the effective use of human mounted sensors that measure blast exposure or blunt impacts to the head and 2) the advancement of our current understanding of cognitive performance deficits and/or brain injury risk that result from cumulative hits to the head.
4. Does Repeated Blast-related Trauma Contribute to the Development of Chronic Traumatic Encephalopathy (CTE)? – Blast-related injury is a potential threat to the health and performance of Service members. Some research suggests that repeated exposure to blast-related traumatic brain injury could induce long-term neurodegeneration. This session and associated posters described the progress made to address the knowledge gaps and expert panel recommendations from the International State-of-the-Science Meeting, "Does Repeated Blast-Related Trauma Contribute to the Development of Chronic Traumatic Encephalopathy (CTE)?" The focus was on: (1) Standardized clinical diagnostic criteria for blast-related neurodegeneration; (2) Validated animal models clinically relevant to blast injury and chronic neurodegeneration; (3) Non-Invasive serial assessment strategies (e.g. biospecimen and imaging biomarkers); (4) Longitudinal and prospective studies to explore the spatiotemporal development of CTE and candidate risk factors; and (5) Coordinated brain bank/repository system accessible to the research community.

September 19, 2018

Building the Diagnostic Cockpit of the Future

On September 18-19, 2017, the Brain Health Research Program Coordinator, COL Sidney Hinds II, participated in the Academy for Radiology and Biomedical Imaging Research Symposium: "Building the Diagnostic Cockpit of the Future," in Rockville, Maryland. The cockpit metaphor refers to diagnostic tools that have multiple data feeds, process quantitative data, and present data to human operators in an easy to consume format, enabling them to make informed decisions. Throughout the working meeting, all aspects of medical imaging were discussed via didactic or small-group exercises, including: quality, value(s), effectiveness, cost, integration with other specialties, diagnostic tools (imaging plus all medical data), machine learning, precision medicine, performance improvement, research, and information technology.

The Academy sponsors the Interagency Working Group on Medical Imaging (IWGMI), which is a chartered entity that continues to work on a Federal medical imaging research roadmap. COL Hinds is the DoD representative to the IWGMI and presented a lecture on military aspects of emergency medicine/trauma needs in diagnostic imaging.

September 20, 2017

The Director of the DoD Blast Injury Research Program Coordinating Office Chairs Breakout Session on Computational Modeling at 2017 Military Health System Research Symposium (MHSRS)

The Military Health System Research Symposium (MHSRS) is the Department of Defense's (DoD) premier scientific meeting, and provides a collaborative environment for military medical care providers with deployment experience, military scientists, academia, and industry to exchange information on research and health care advancements. The 2017 MHSRS was held in Kissimmee, Florida on August 27-30, 2017. On August 29 the DoD Blast Injury Research Program Coordinating Office (PCO) director, Mr. Leggieri, chaired a breakout session entitled, "Computational Modeling of Human Lethality, Injury, and Impairment from Blast Threats in All Environments". This was the second year that the PCO chaired an MHSRS breakout session specifically focused on blast injury.

The breakout session featured talks by experts who presented their work on computational modeling of occupational blast exposure, hull designs, head impacts, and weapons effects and blast loads. In addition, several experts presented their biomedical research on developing predictive injury risk curves and the functional, behavioral, and neuropathological effects following blast exposure in rodent models. Biomedical research informs computational modeling efforts and is critical for validation of models. Following the scientific presentations, Mr. Leggieri moderated a panel discussion between the speakers and audience. One key theme that emerged from the discussion was the importance of understanding the timeline and relative contribution and of primary and secondary injuries in traumatic brain injury (TBI).

Through the breakout session at MHSRS, the PCO highlights the critical role that medical research plays in the development of blast injury protection systems for explosive weapons and provides a forum for the medical and non-medical communities to exchange information and explore potential collaborative opportunities. This supports the responsibilities of the Executive Agent (EA) for the DoD Blast Injury Research Program, to share knowledge and create partnerships that further blast injury research.

Read more about 2017 MHSRS

August 30, 2017

NJIT President's Forum Keynote Lecture

The Brain Health Research Program Coordinator and well known US Army neurologist, COL Sidney Hinds II, was invited to give the President's Forum Keynote Lecture at the inauguration of the New Jersey Institute of Technology's (NJIT) Institute of Brain and Neuroscience Research (IBNR) at the NJIT Campus, Newark, New Jersey on March 6, 2017. COL Hinds presented an overview of combat-related TBI challenges, highlighting the current state of the science of combat-related TBI, ongoing longitudinal studies to address knowledge gaps, and provided insights into ongoing collaborations supported by the DoD Blast Injury Research Program Coordinating Office (PCO), US Army Medical Research and Development Command and their DoD, Federal agency, academic and industry partners.

With the creation of the IBNR, NJIT is bringing together basic, applied and translational neuroscience research from several NJIT departments to unify and integrate neuroscience research. In addition, the IBNR has already made plans to consolidate its relationship with Rutgers and other external partners, as well as, expand its scope of collaboration with new partners.

Following the Keynote lecture, attendees participated in a poster walk-through session and tours of the IBNR research centers and laboratories.

Read more...

March 6, 2017

Quantifying the Physiological Effects of Blast Loads

The PCO took part in a science and technology program review titled, "Blast Load Assessment: Sense and Test (BLAST) for Navy corpsmen and other medical providers." This program, which is under the Office of Naval Research (ONR) Force Health Protection Future Naval Capabilities Pillar, develops technologies to quantify the physiological effects of blast loads on Service Members in the field environment. Technologies under development include:

It is envisioned that miniature dosimeter technology will indicate if a given exposure presents a likelihood of injury and will be readable by corpsmen and other medical providers. ONR is developing all three products in parallel and plans to transition the products to the Bureau of Medicine and Surgery (BUMED) by 2018.

March 1, 2017

National Football League Scientific Advisory Board

On March 1, 2017, the Brain Health Research Program Coordinator, COL Sidney Hinds II, attended the inaugural meeting of the National Football League (NFL) Scientific Advisory Board. The NFL assembled this Scientific Advisory Board consisting of independent experts, scientists, and clinicians in December 2016 to develop a process to solicit, review, and evaluate research proposals to fund neuroscience research as part of the NFL's new Play Smart. Play Safe. Initiative. In addition to COL Hinds, the Scientific Advisory Board includes members from industry, academia, and the Department of Veteran Affairs. The purpose of this first meeting was to define the NFL requirements for research; meet with the NFL Head, Neck, and Spine Committee; set priorities for research; and brainstorm the methodologies to be used to provide impactful research, which will lead to knowledge products that help players and patients. Next, members of the Scientific Advisory Board will collate the data presented and synthesize a cogent strategy that will fulfill the NFL's needs and move the science forward. COL Hinds' participation in this meeting is in keeping with the mission of the DoD Blast Injury Research Program Coordinating Office and is instrumental in promoting information sharing of brain health-related research between DoD and private partners.

March 1, 2017

Scientists Use Fluorescent Gels to Study Blast Pressure on the Brain

Scientists at the Army Research Laboratory (ARL), in partnership with the DoD Blast Injury Research Program Coordinating Office (PCO), are developing nanomaterials to help understand the mechanism of brain injuries when Soldiers are exposed to explosions. They have developed a gel material with fluorescent properties that mimics the texture and mass of the human brain. Their goal is to show the scale of damage to the brain under blast pressure exposures that Soldiers encounter in combat or training.

This partnership includes medical researchers from the Japanese Ministry of Defense, whose recent visit to the US was coordinated by the PCO. The Japanese team will test the Army's samples with a laser-induced shockwave.

• Read more at Army.mil
  
• Read more at Armed With Science

February 13, 2017

PCO chairs breakout session on blast injury prevention at 2016 Military Health System Research Symposium (MHSRS)

Department of Defense (DoD) Blast Injury Research Program Coordinating Office (PCO) director, Mr. Michael Leggieri chaired a breakout session entitled, "The Role of Medical Research in Blast Injury Prevention," at the 2016 Military Health System Research Symposium (MHSRS) in Kissimmee, Florida, on August 17, 2016. As the DoD's premier scientific meeting, the MHSRS provides a collaborative environment for military medical care providers with deployment experience, military scientists, academia, and industry to exchange information on research and health care advancements. The session chaired by the PCO was the first time that a MHSRS breakout session was specifically focused on blast injury prevention.

The breakout session, "The Role of Medical Research in Blast Injury Prevention," featured talks by six blast injury experts who presented their work on biomechanical standards and modeling for ear injury; laboratory guidelines for reproducing blast exposure; human-centered design approaches for blast injury protection systems; effects of primary blast waves on head acceleration; and the pathophysiology of experimental primary blast-induced traumatic brain injury (TBI). Following the scientific presentations, Mr. Leggieri moderated a panel discussion between the speakers and audience.

The PCO's participation in the annual MHSRS supports the responsibilities of the Executive Agent (EA) for the DoD Blast Injury Research Program, to share knowledge and create partnerships that further blast injury research. By developing and chairing a breakout session at MHSRS, the PCO highlights the critical role that medical research plays in the development of blast injury protection systems for explosive weapons and provides a forum for the medical and non-medical communities to exchange information and explore potential collaborative opportunities.

Read more about 2016 MHSRS.

February 1, 2017