Military Prototype Advancement Initiative (MPAI)

In multi-domain operations, today’s operating force will be overwhelmed with casualties, the ability to evacuate will be limited, first responders and medics will struggle with limited resources and ability to achieve the “Golden Day,” resulting in operational units and commanders rapidly losing freedom of maneuver and combat effectiveness. Therefore, medical assets must be highly mobile and more dispersed (e.g., smaller, more modular medical units), Warfighters will require greater self-sufficiency and autonomy (e.g., may have more limited medical-related communications and re-supply), and there will be an increased cognitive and physical stress on Warfighters (they will need ways to maximize lethality and return to the fight quickly). The purpose of this RPP was to solicit current MTEC members for a broad range of medical prototype technological and knowledge solutions related to the Focus Areas of Interest which include:

FOCUS AREA #1: Prolonged Field Care (PFC): A primary emphasis in 2021 is to identify and develop medical techniques, knowledge products, and materiel (medical devices, drugs, and biologics) for early intervention in life-threatening battle injuries and prolonged field care (PFC). Because battlefield conditions impose severe constraints on

available manpower, equipment, and medical supplies available for casualty care, there is a need for medical interventions that can be used within the battle area or as close to it as possible, before or during medical evacuation. Preferred medical techniques and materiel that can be used by combat medics must be easily transportable (i.e., small,

lightweight, and durable in extreme environments and handling); devices must be easy to use and require low maintenance, with self-contained power sources, as necessary. This focus area is also interested in solutions that include artificial intelligence (AI), with a focus on the employment of AI to support providing care at the point of need in remote and austere environments.

FOCUS AREA #2: Medical Readiness: This area focuses on developing technologies that maximize medical readiness and provide mobile health solution sets for the modern Warfighter. Efforts may include diagnostics, treatments, AI-based advanced telehealth technologies, and training solutions to prevent or reduce injury and improve physiological

and psychological health and resilience. This objective includes environmental health and protection including the assessment and sustainment of health and the operational effectiveness of Service members exposed to harsh operational environments including altitude, cold, heat, and exposure to environmental health. This focus area also includes medical readiness in response to infectious diseases encountered by service members during deployment and those that can significantly impact performance.

FOCUS AREA #3: Emerging Technologies: This area is focused on the Multi-Domain Battle, an operational environment involving greater dispersion and near isolation over great distances, which is likely to cause severe restrictions on mobility for medical missions and shortfalls in both human and materiel human resources due to area denial challenges. Combat units will need to be more self-sufficient and less dependent on logistical support. Combatant commanders with increased sick or wounded Soldiers will face degradation of medical resources and encumbered combat effectiveness without new combat casualty management and Force multiplication strategies. This focus area is searching for emerging technologies that will increase medical mobility while ensuring access to essential medical expertise and support regardless of the operating environment.

FOCUS AREA #4: Maximizing Human Potential: This area aims to develop effective countermeasures against military-relevant stressors and to prevent physical and psychological injuries during training and operations in order to maximize the human potential, in support of the Army Human Performance Optimization and Enhancement, Human Dimension, Multi-Domain Battle, and the DoD Total Force Fitness concepts.

FOCUS AREA #5: Applied Medical Robotics and Machine Perception and Intelligence Systems: This area focuses on investigation of novel technologies and methods of applying robotics to augment medical capability and capacity in forward care settings. The specific technologies include machine perception and intelligence systems, and advanced motion planning and control of semi-autonomous robotics. The target applications include the use of tele-surgical robotics to extend the reach of remote surgeons, and robotic-assisted casualty monitoring, diagnostics, and intervention to assist local care providers in combat casualty care situations. This area also focuses on leveraging unmanned air and ground systems to provide standoff detection and remote assessment of combat causalities to facilitate rapid casualty extraction, and to provide emergency medical resupply to support field care when evacuation is not possible. The research project award recipients were selected from the Offerors who responded to MTEC’s Request for Project Proposals (21-06-MPAI).

SuPer++: Surgical Perception Framework for Surgical Robotic Tactical Combat Casualty Care

Project Team: University of California, San Diego

Award Amount: $0.59M

Project Duration: 13 months

Project Objective: To address the requirements of this RFP, we propose Super++, the Surgical Perception Framework++, a prototype perception engine for understanding, labeling, and reconstructing surgical trauma scenes from camera. With integrated tissue recognition, 3D reconstruction, and fluid tracking, Super++ is an integrated solution comprising several demonstrated computer vision technologies developed over the past few years at UCSD, namely leveraging the original SuPer framework that is the state-of-the-art in 3D reconstruction and tracking of tissues in cameras. Our proposed solution, Super++ achieves higher-level image understanding by combining the best in 3D reconstruction and tracking of tissues using deep learning, with pixel-level labeling of anatomical features, methods for handling occlusions from foreign bodies and instruments, dense tracking of blood, and finally a pipeline for converting images to 3D physics simulation of the tissues.

Maritime Casualty and Supply Tracking (MCAST)

Project Team: Applied Research Associates

Award Amount: $3.47M

Project Duration: 12 months

Project Objective: MCAST is a decision support toolset to address this complexity and the requirement for speed of planning to enable planners to quickly and accurately develop COAs that involve lifesaving patient movement and medical logistic resupply actions. MCAST also will assist planners in analyzing and comparing COAs through integration with existing tools that overlay COAs directly on a “live” common operating picture (COP) and show the effects of each COA using symbology that moves as the COA progresses over time. This bridges the human user’s mental model of the operation with computational and information resources that streamline tedious, error-prone planning tasks. Patient movement and medical logistics resupply are some of the most important actions to sustain unit performance and improve the psychological well-being of all hands involved. Medical, Logistics, and Operational stakeholders have expressed the need for MCAST capabilities and have supported preliminary descriptions of the MCAST toolset.

Management of Post-Traumatic Stress Disorder Using Novel Audio-Visual Stimulation Device

Project Team: Sana Health

Award Amount: $0.51M (additional cost share = $192K)

Project Duration: 12 months

Project Objective: Treatment and management of PTSD symptoms and its comorbidities with a portable, wearable neuromodulation device that delivers low intensity, coordinated pulses of light (through closed eyelids) and sound. This is a Phase 1 randomized, sham-controlled trial of 40 individuals drawn from U.S. active-duty military and veteran populations. The Sana device mode of action is to restore hemispheric balance, through entrainment, in which audio-visual stimulation triggers a frequency following response. Sana is the first company to bring all the applications from these fields into one, portable device with the promise of providing a widely available, effective, and safer alternative to pharmacological agents. Studies in patients with non-PTSD conditions, (e.g., pain, TBI and anxiety) have confirmed Sana device efficacy for PTSD comorbidities including depression and insomnia (sleep onset & quality).

Investigation of the Safety & Efficacy of a Portable Medical Device to Provide Point-of-Injury, Non-pharmaceutical Regional Analgesia

Project Team: Cornerstone Research Group

Award Amount: $1.05M

Project Duration: 37 months

Project Objective: Cornerstone Research Group, Inc. (CRG) is developing the Quick Magnetic Analgesia Cuff (QMAC). The QMAC uses magnetic coils (MCs) to noninvasively transmit analgesic stimulation (AS) & block peripheral nerve conduction. When the QMAC is worn proximal to a limb injury, pain from that injury will be blocked. The QMAC will enable portable, simple, on-demand analgesia, facilitating pain management & minimizing challenges associated with drugs. This kind of AS is currently applied via invasive electrodes unsuitable for portable pain relief. CRG’s DHA Phase I SBIR demonstrated transmission of AS via noninvasive MCs. Our Phase II (in progress) is focusing on further development of the MCs & support hardware optimized for transmitting AS. Georgia Institute of Technology is contributing small animal in vivo electrophysiology. The overarching goal of this proposed work is to refine the QMAC for use in pigs, & to conduct initial evaluations of QMAC safety and efficacy in providing pain relief in a porcine model.

Behind Armor Blunt Trauma Consortium: Injuries, Mechanisms, and Biomedical Injury Criteria

Project Team: The Medical College of Wisconsin

Award Amount: $2.32M

Project Duration: 13 months

Project Objective: The objectives of this study are to develop thoracoabdominal region-specific injury criteria resulting from energy/momentum transferred from the armor while successfully defeating ballistic threats. We will conduct tests with whole body post-mortem human subjects (PMHS) representative of Behind Armor Blunt Trauma (BABT) events. The product/outcomes include thoracoabdominal region-specific structural responses of PMHS and porcine cadaver, scaling relationships between species, region-specific injury criteria ranging from incapacitation to death and deep tissue contusion, and hierarchical injury risk curves (IRCs).

Skills Determination, Decay and Delay Study (SD3)

Project Team: University of Pittsburgh

Award Amount: $4.42M

Project Duration: 24 months

Project Objective: This study plans to establish a methodology for skills determination, decay, and delay by addressing 20 carefully chosen critical medical skills serving as pilots. The skills were identified by the tri-service Defense Medical Modeling and Simulation Office (DMMSO) and provide an evidence-based understanding of proficiency criteria as a framework for future work in skill education and skills decay evaluation.

Translational Technologies for Detection and Restoration of Glymphatic Flow

Project Team: Rice University

Award Amount: $2.84M

Project Duration: 13 months

Project Objective: The project proposes the development of a closed-loop system which, through the indirect measurement of CSF flow, will improve glymphatic flow drainage and amplify restorative sleep by non-invasive neuromodulation. The modulation parameters will be optimized through feedback between the CSF flow measurement and the modulator, based purely on data. Our project goal hinges on three inter-related hypotheses: (1) measurement of several physiological parameters integrated by the use of contemporary mathematical approaches will allow indirect non-invasive evaluation of the CSF flow, (2) transcranial/transcutaneous stimulation will facilitate CSF outflow and improve restorative sleep and, (3) introduction of the feedback between sensors and modulators will improve effect of stimulation on the CSF flow.

Sustaining and Enhancing Post Mission Analysis of Side-Scan Sonar Data

Project Team: Washington State University

Award Amount: $0.78M

Project Duration: 35 months

Project Objective: We propose to conduct an in-laboratory, sleep deprivation study at the WSU Sleep and Performance Research Center over a 3y period of performance to examine the impact of fatigue and task factors on performance of a UUV side-scan sonar PMA-like surrogate task. The surrogate task has been developed specifically for use in the proposed study by NHRC and will be made available to WSU. N=36 healthy adult subjects (males and females, aged 18-35) will be recruited. The laboratory study will be 4 days/3 nights: following a baseline night with a 10h sleep opportunity, subjects will undergo 38h of total sleep deprivation, followed by a recovery night with a 10h sleep opportunity. Throughout the study, we will administer several variations of the NHRC-developed PMA surrogate task, which will be parametrically manipulated to investigate the role of task features (pacing, automation, target density, environmental complexity, etc.) and fatigue on PMA performance.

Augmented Neurophysiology of Sleep and Performance Readiness

Project Team: University of North Carolina

Award Amount: $4.25M

Project Duration: 37 months

Project Objective: The proposed technology, Augmented Neural Oscillation Driver or ‘AugNOD’, is an easily-applied, wireless, combined electroencephalography (EEG)/transcranial electrical stimulation (TES) headband that can be applied before sleep to monitor and improve slow wave sleep and glymphatic clearance. The AugNOD system utilizes two complimentary protocols to support glymphatic function: 1) the integrated TES Slow Oscillation (TES SO) promotes slow wave sleep, engaging sleep-active glymphatic clearance; 2) the Direct Current Glymphatic Clearance (DCGC) protocol directly improves glymphatic function through enhancement of brain extracellular diffusion.