Military Medicine and Medical Research as a Source of Inspiration and Innovation to Solve National Security and Health Challenges in the 21st Century

Abstract

The history of military medicine and research is rife with examples of novel treatments and new approaches to heal and cure soldiers and others impacted by war's devastation. In the 21st century, new threats, like climate change, are combined with traditional threats, like geopolitical conflict, to create novel challenges for our strategic interests. Extreme and inaccessible environments provide heightened risks for warfighter exposure to dangerous bacteria, viruses, and fungi, as well as exposure to toxic substances and extremes of temperature, pressure, or both providing threats to performance and eroding resilience. Back home, caring for our veterans is also a health-care priority, and the diseases of veterans increasingly overlap with the health needs of an aging society. These trends of climate change, politics, and demographics suggest performance evaluation and resilience planning and response are critical to assuring both warfighter performance and societal health. The Cleveland ecosystem, comprising several hospitals, a leading University, and one of the nation's larger Veteran's Health Administration systems, is ideal for incubating and understanding the response to these challenges. In this review, we explore the interconnections of collaborations between Defense agencies, particularly Air Force and Army and academic medical center-based investigators to drive responses to the national health security challenges facing the United States and the world.

Keywords: Health research; fatigue and stress; human performance and resilience; sensors.

Figure 1.

Components of an electrochemical biosensor. Electrochemical biosensors must be specific to their target to accurately characterize amidst signal noise as well as highly sensitive to precisely quantify the µM level concentrations found in biological samples. The necessary specificity and sensitivity are achieved by careful selection of surface molecular receptors and adjustment of enzymatic activity. Carbon-based electrodes offer high surface area to volume ratio, as well as rapid electron transfer capability, making them suitable for achieving miniaturization and real-time data output. [29]. Image Source: Cho IH, Kim DH, Park S. In Biomaterials Research. Springer Nature. Feb 4, 2020. CC BY 4.0.

Figure 2.

SynthoPlate mechanism of hemostatic activity. Platelets are cells that facilitate stoppage of bleeding (hemostasis) from injured blood vessels by forming a plug at the injury site via binding to specific proteins like Von Willebrand Factor (VWF) and collagen exposed at the site as well as by aggregating among each other via cross-linking of their surface integrin GPIIb-IIIa by fibrinogen (Fg). Synthetic Platelet (SP) systems are nanoparticles that mimic these platelet mechanisms and thus facilitate hemostasis by virtue of VWF-binding peptides (VBP), collagen-binding peptides (CBP), and Fg-mimetic peptides (FMP) combinatorially decorated on the particle surface.