Operational Medicine Applications of Bioengineering

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomedical Engineering and Biomaterials".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 8253

Special Issue Editors

F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
Interests: bioengineering; technology; innovation; health; human performance; operational medicine; military medicine; biologics; therapeutics; diagnostics; imaging

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Guest Editor
Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 722 West 168th St., New York, NY 10032, USA
Interests: diagnostics; biometric data; pathogens; public health; readiness; next generation sequencing

Special Issue Information

Dear Colleagues,

Operational medicine refers collectively to the delivery of healthcare under a wide range of challenging conditions including austere environments, conflict or war zones, climate change-forced migrations, extreme weather conditions such as arctic freeze and oppressive heat waves, and natural disasters such as hurricanes and earthquakes. Operational medicine is a concern for military medicine, rural medicine, disaster medicine, or any field which includes the delivery of health care under potentially extreme conditions with limited resources. Medical conditions such as trauma, environmental exposures, the exhaustion of healthcare workers, and the depletion of medical supplies become critical and challenges the provision of healthcare. Advances in bioengineering promise to solve the various issues encountered in operational medicine, enabling the proper monitoring of human health, the detection of environmental exposures, providing novel therapies, or even preventing injury.    

This Special Issue invites papers that show advances in bioengineering that can benefit operational medicine by improving the prevention, delivery, detection, and/or treatment of injuries common to austere conditions.

This Special Issue invites contributions of original research papers and review articles dealing with the adaptation of bioengineering for operational readiness, resilience, and medical care. The topics of biotechnologies can include, but are not limited to, austere manufacturing, tissue engineering, organ-on-chip models, organoid platforms, cell therapies, biosurveillance, predictive algorithms and tools, advanced diagnostics, and point-of-care medical devices.

Dr. Vincent B. Ho
Dr. J. Kenneth Wickiser
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • operational medicine
  • austere medicine
  • disaster medicine
  • biotechnology
  • additive manufacturing
  • austere manufacturing
  • 3D printing
  • organ-on-chip
  • organoid
  • bioprinting
  • cell therapy
  • biosurveillance
  • medical devices

Published Papers (6 papers)

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Research

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10 pages, 2251 KiB  
Article
Point-of-Need Additive Manufacturing in Austere Arctic Environments: An Evaluation of Medical Logistics Requirements and Capabilities Demonstration
by Cate Wisdom, Nicholas Chartrain, Kelli Blaize-Wise, George J. Klarmann, Kristin H. Gilchrist and Vincent B. Ho
Bioengineering 2024, 11(3), 232; https://doi.org/10.3390/bioengineering11030232 - 28 Feb 2024
Viewed by 982
Abstract
Medical response to military conflicts, natural disasters, and humanitarian crises are challenged by operational logistics with unreliable supply chains, delayed medical evacuation, and compatibility of the disparate medical equipment and consumables. In these environments, stocks of supplies will become more quickly depleted and [...] Read more.
Medical response to military conflicts, natural disasters, and humanitarian crises are challenged by operational logistics with unreliable supply chains, delayed medical evacuation, and compatibility of the disparate medical equipment and consumables. In these environments, stocks of supplies will become more quickly depleted and the need for equipment parts increases secondary to their higher likelihood for failure from overuse. Additive Manufacturing (AM), or 3D printing, at or closer to the point-of-need provides potential solutions to mitigate these logistics challenges. AM’s ability to tailor the resultant product through computer design enables real-time modification of a product to meet a specific situation. In this study, we deployed two different 3D printers to an arctic locale to demonstrate the utility of 3D printing and bioprinting in austere environments. Deployment of AM solutions in austere environments will likely impact medical care following natural disasters and conflicts with contested logistics. The work presented here furthers the readiness status of AM for use in austere environments to manufacture medical equipment parts and demonstrates its potential use for tissue engineering and advanced medical treatments in remote environments. Full article
(This article belongs to the Special Issue Operational Medicine Applications of Bioengineering)
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20 pages, 101764 KiB  
Article
Simultaneous High-Frame-Rate Acoustic Plane-Wave and Optical Imaging of Intracranial Cavitation in Polyacrylamide Brain Phantoms during Blunt Force Impact
by Eric J. Galindo, Riley R. Flores, Ricardo Mejia-Alvarez, Adam M. Willis and Michaelann S. Tartis
Bioengineering 2024, 11(2), 132; https://doi.org/10.3390/bioengineering11020132 - 29 Jan 2024
Viewed by 1287
Abstract
Blunt and blast impacts occur in civilian and military personnel, resulting in traumatic brain injuries necessitating a complete understanding of damage mechanisms and protective equipment design. However, the inability to monitor in vivo brain deformation and potential harmful cavitation events during collisions limits [...] Read more.
Blunt and blast impacts occur in civilian and military personnel, resulting in traumatic brain injuries necessitating a complete understanding of damage mechanisms and protective equipment design. However, the inability to monitor in vivo brain deformation and potential harmful cavitation events during collisions limits the investigation of injury mechanisms. To study the cavitation potential, we developed a full-scale human head phantom with features that allow a direct optical and acoustic observation at high frame rates during blunt impacts. The phantom consists of a transparent polyacrylamide material sealed with fluid in a 3D-printed skull where windows are integrated for data acquisition. The model has similar mechanical properties to brain tissue and includes simplified yet key anatomical features. Optical imaging indicated reproducible cavitation events above a threshold impact energy and localized cavitation to the fluid of the central sulcus, which appeared as high-intensity regions in acoustic images. An acoustic spectral analysis detected cavitation as harmonic and broadband signals that were mapped onto a reconstructed acoustic frame. Small bubbles trapped during phantom fabrication resulted in cavitation artifacts, which remain the largest challenge of the study. Ultimately, acoustic imaging demonstrated the potential to be a stand-alone tool, allowing observations at depth, where optical techniques are limited. Full article
(This article belongs to the Special Issue Operational Medicine Applications of Bioengineering)
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Review

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14 pages, 1351 KiB  
Review
Modern In Vitro Techniques for Modeling Hearing Loss
by Jamie J. Shah, Couger A. Jimenez-Jaramillo, Zane R. Lybrand, Tony T. Yuan and Isaac D. Erbele
Bioengineering 2024, 11(5), 425; https://doi.org/10.3390/bioengineering11050425 - 26 Apr 2024
Viewed by 1078
Abstract
Sensorineural hearing loss (SNHL) is a prevalent and growing global health concern, especially within operational medicine, with limited therapeutic options available. This review article explores the emerging field of in vitro otic organoids as a promising platform for modeling hearing loss and developing [...] Read more.
Sensorineural hearing loss (SNHL) is a prevalent and growing global health concern, especially within operational medicine, with limited therapeutic options available. This review article explores the emerging field of in vitro otic organoids as a promising platform for modeling hearing loss and developing novel therapeutic strategies. SNHL primarily results from the irreversible loss or dysfunction of cochlear mechanosensory hair cells (HCs) and spiral ganglion neurons (SGNs), emphasizing the need for innovative solutions. Current interventions offer symptomatic relief but do not address the root causes. Otic organoids, three-dimensional multicellular constructs that mimic the inner ear’s architecture, have shown immense potential in several critical areas. They enable the testing of gene therapies, drug discovery for sensory cell regeneration, and the study of inner ear development and pathology. Unlike traditional animal models, otic organoids closely replicate human inner ear pathophysiology, making them invaluable for translational research. This review discusses methodological advances in otic organoid generation, emphasizing the use of human pluripotent stem cells (hPSCs) to replicate inner ear development. Cellular and molecular characterization efforts have identified key markers and pathways essential for otic organoid development, shedding light on their potential in modeling inner ear disorders. Technological innovations, such as 3D bioprinting and microfluidics, have further enhanced the fidelity of these models. Despite challenges and limitations, including the need for standardized protocols and ethical considerations, otic organoids offer a transformative approach to understanding and treating auditory dysfunctions. As this field matures, it holds the potential to revolutionize the treatment landscape for hearing and balance disorders, moving us closer to personalized medicine for inner ear conditions. Full article
(This article belongs to the Special Issue Operational Medicine Applications of Bioengineering)
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17 pages, 1211 KiB  
Review
Knee Joint Preservation in Tactical Athletes: A Comprehensive Approach Based upon Lesion Location and Restoration of the Osteochondral Unit
by Daniel J. Cognetti, Mikalyn T. Defoor, Tony T. Yuan and Andrew J. Sheean
Bioengineering 2024, 11(3), 246; https://doi.org/10.3390/bioengineering11030246 - 1 Mar 2024
Viewed by 1210
Abstract
The unique physical demands of tactical athletes put immense stress on the knee joint, making these individuals susceptible to injury. In order to ensure operational readiness, management options must restore and preserve the native architecture and minimize downtime, while optimizing functionality. Osteochondral lesions [...] Read more.
The unique physical demands of tactical athletes put immense stress on the knee joint, making these individuals susceptible to injury. In order to ensure operational readiness, management options must restore and preserve the native architecture and minimize downtime, while optimizing functionality. Osteochondral lesions (OCL) of the knee have long been acknowledged as significant sources of knee pain and functional deficits. The management of OCL is predicated on certain injury characteristics, including lesion location and the extent of subchondral disease. Techniques such as marrow stimulation, allograft and autologous chondrocyte implantation are examined in detail, with a focus on their application and suitability in tactical athlete populations. Moreover, the restoration of the osteochondral unit (OCU) is highlighted as a central aspect of knee joint preservation. The discussion encompasses the biomechanical considerations and outcomes associated with various cartilage restoration techniques. Factors influencing procedure selection, including lesion size, location, and patient-specific variables, are thoroughly examined. Additionally, the review underscores the critical role of post-operative rehabilitation and conditioning programs in optimizing outcomes. Strengthening the surrounding musculature, enhancing joint stability, and refining movement patterns are paramount in facilitating the successful integration of preservation procedures. This narrative review aims to provide a comprehensive resource for surgeons, engineers, and sports medicine practitioners engaged in the care of tactical athletes and the field of cartilage restoration. The integration of advanced preservation techniques and tailored rehabilitation protocols offers a promising avenue for sustaining knee joint health and function in this demanding population. Full article
(This article belongs to the Special Issue Operational Medicine Applications of Bioengineering)
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22 pages, 2308 KiB  
Review
Treatment of Tendon Injuries in the Servicemember Population across the Spectrum of Pathology: From Exosomes to Bioinductive Scaffolds
by Mikalyn T. DeFoor, Daniel J. Cognetti, Tony T. Yuan and Andrew J. Sheean
Bioengineering 2024, 11(2), 158; https://doi.org/10.3390/bioengineering11020158 - 5 Feb 2024
Viewed by 1218
Abstract
Tendon injuries in military servicemembers are one of the most commonly treated nonbattle musculoskeletal injuries (NBMSKIs). Commonly the result of demanding physical training, repetitive loading, and frequent exposures to austere conditions, tendon injuries represent a conspicuous threat to operational readiness. Tendon healing involves [...] Read more.
Tendon injuries in military servicemembers are one of the most commonly treated nonbattle musculoskeletal injuries (NBMSKIs). Commonly the result of demanding physical training, repetitive loading, and frequent exposures to austere conditions, tendon injuries represent a conspicuous threat to operational readiness. Tendon healing involves a complex sequence between stages of inflammation, proliferation, and remodeling cycles, but the regenerated tissue can be biomechanically inferior to the native tendon. Chemical and mechanical signaling pathways aid tendon healing by employing growth factors, cytokines, and inflammatory responses. Exosome-based therapy, particularly using adipose-derived stem cells (ASCs), offers a prominent cell-free treatment, promoting tendon repair and altering mRNA expression. However, each of these approaches is not without limitations. Future advances in tendon tissue engineering involving magnetic stimulation and gene therapy offer non-invasive, targeted approaches for improved tissue engineering. Ongoing research aims to translate these therapies into effective clinical solutions capable of maximizing operational readiness and warfighter lethality. Full article
(This article belongs to the Special Issue Operational Medicine Applications of Bioengineering)
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14 pages, 458 KiB  
Review
Leveraging Technology for Vestibular Assessment and Rehabilitation in the Operational Environment: A Scoping Review
by Carrie W. Hoppes, Karen H. Lambert, Susan L. Whitney, Isaac D. Erbele, Carlos R. Esquivel and Tony T. Yuan
Bioengineering 2024, 11(2), 117; https://doi.org/10.3390/bioengineering11020117 - 25 Jan 2024
Viewed by 1882
Abstract
Introduction: The vestibular system, essential for gaze and postural stability, can be damaged by threats on the battlefield. Technology can aid in vestibular assessment and rehabilitation; however, not all devices are conducive to the delivery of healthcare in an austere setting. This scoping [...] Read more.
Introduction: The vestibular system, essential for gaze and postural stability, can be damaged by threats on the battlefield. Technology can aid in vestibular assessment and rehabilitation; however, not all devices are conducive to the delivery of healthcare in an austere setting. This scoping review aimed to examine the literature for technologies that can be utilized for vestibular assessment and rehabilitation in operational environments. Materials and Methods: A comprehensive search of PubMed was performed. Articles were included if they related to central or peripheral vestibular disorders, addressed assessment or rehabilitation, leveraged technology, and were written in English. Articles were excluded if they discussed health conditions other than vestibular disorders, focused on devices or techniques not conducive to the operational environment, or were written in a language other than English. Results: Our search strategy yielded 32 articles: 8 articles met our inclusion and exclusion criteria whereas the other 24 articles were rejected. Discussion: There is untapped potential for leveraging technology for vestibular assessment and rehabilitation in the operational environment. Few studies were found in the peer-reviewed literature that described the application of technology to improve the identification of central and/or peripheral vestibular system impairments; triage of acutely injured patients; diagnosis; delivery and monitoring of rehabilitation; and determination of readiness for return to duty. Conclusions: This scoping review highlighted technology for vestibular assessment and rehabilitation feasible for use in an austere setting. Such technology may be leveraged for prevention; monitoring exposure to mechanisms of injury; vestibular-ocular motor evaluation; assessment, treatment, and monitoring of rehabilitation progress; and return-to-duty determination after vestibular injury. Future Directions: The future of vestibular assessment and rehabilitation may be shaped by austere manufacturing and 3D printing; artificial intelligence; drug delivery in combination with vestibular implantation; organ-on-chip and organoids; cell and gene therapy; and bioprinting. Full article
(This article belongs to the Special Issue Operational Medicine Applications of Bioengineering)
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