Episode 73: Targeting TBI

Lisa Peña (LP): Traumatic Brain Injury, or TBI, is a major cause of death and disability, according to the US Centers for Disease Control and Prevention. TBI affects people of all ages. SwRI is tackling this public health threat with cutting edge solutions that prevent and screen for brain injuries, how a simple smell test and specialized helmet pads are taking on TBI. That's next on this episode of Technology Today.

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Hello, and welcome to Technology Today. I'm Lisa Peña. A traumatic brain injury, or TBI, can happen to anyone. According to the CDC, people over 75, military service members and veterans and people who live in rural areas with less access to trauma care are some of the groups most at risk for death and disability associated with TBI.

SwRI is researching and developing solutions to address traumatic brain injuries. Our guests today are senior research engineer Kreg Zimmern, who is leading the development of the Advanced Military Measure of Olfaction, or AMMO, a TBI screening test. And research engineer Dr. Daniel Portillo, leading SwRI research and development for innovative helmet pads to prevent TBI. The project is part of a collaboration with The University of Texas at San Antonio. Thank you for being here, Kreg and Daniel.

SwRI Senior Research Engineer Kreg Zimmern demonstrates the Advanced Military Measure of Olfaction (AMMO) kit, a smell loss screening test. Loss of smell is an indicator of traumatic brain injury that signals to healthcare providers that diagnostic tests are required.

Kreg Zimmern (KZ): Thanks for having us.

Daniel Portillo (DP): Yes, thank you.

LP: So let's start with understanding the problem, this challenge you're tackling. So what is a traumatic brain injury or TBI? What classifies a head injury as a TBI?

KZ: So, generally, a TBI is a disruption of the normal function of the brain caused by some external force. So, a blow to the head, a pressure wave from a blast, things like that cause a disruption to the normal biological function of the brain.

DP: Yeah. And I think it's important to note, there's different severities of TBIs. Maybe it's just a concussion, but they could be more severe where you have skull damage or internal bleeding. No matter the severity, they can all lead to long-term complications.

KZ: Well-- and symptoms can also be very different. So you can have physical symptoms, you can have cognitive or emotional symptoms and sometimes they're delayed. So sometimes they come on right as the TBI happens and you can tell, hey, something happened. And now this is a result of that. But sometimes those results can be delayed by days, months, possibly years. And so you don't necessarily always know what the cause is. It makes it really hard to diagnose and follow.

LP: So how does someone end up with a TBI? Can you give us some of the causes.

KZ: So for civilians, it's generally falls or bumping your head on something or something falling on you in your home or in the workplace. For the military population, blasts are the big ones. So IEDs, explosions from artillery, things like that are generally the largest cause of TBI.

DP: Yeah and to add in to that, specifically to the military, yes, there the blast threats, but there's also the ballistic threats, which can be bullets, or shrapnel, or fragments or things flying really fast that could hit somebody's head. In both of those, no matter whether it's a fall or a ballistic event or a blast event, they can all lead to a wide range of TBIs with different severities.

KZ: Sports and not the ones that you obviously think of-- football and things like that-- have large amounts of TBI but also sports like soccer, sports like basketball, where you're running in and you don't necessarily have protection.

DP: Yeah, obviously, boxing, that's the main goal, I think. So, yeah, I agree, there's lots of sports and lots of ways that people can get these head injuries.

LP: Yeah, again, so many ways to end up with a TBI. It's not uncommon and it can happen to anyone. So why is this an important health issue to tackle with multiple solutions?

DP: There's-- well, the reason that it's an important issue is there's lots of effects of this. It can cause lots of problems. It can be either immediate or long-term health problems. It can be-- it can lead to certain mental health issues. It can lead to, obviously, there's health care costs. And then, on top of that, it can make people less productive and it can even be a burden to the people that are trying to provide care for the person that has the injury-- family, friends, you name it. There's-- the TBIs really influence a lot of things in a person's life.

KZ: Well, it can sometimes fundamentally change somebody's personality that happens sometimes pretty frequently with severe TBI. I think the other thing that's important to note is TBI is one of those things that if caught early and treated early can be minor, it can be solved, it can be healed from, and people's lives can go on as normal, almost as if it never happened.

Getting a compound TBI-- it can be devastating. So having a traumatic brain injury and then getting another one before it's healed is not an additive effect. It is a multiplicative or synergistic effect, which means it doesn't just get worse by a little bit, it gets worse by a lot so being able to have multiple methods to prevent TBI. But then looking at different ways to measure it are really important because that way you have a larger coverage and you are able to catch more people early so we don't get into a situation where somebody is getting a compound TBI.

LP: So everyday activities can cause a TBI-- a fall, a car accident, playing sports-- so this really is a topic that can effect anyone, everybody, anywhere. So let's talk about the solutions under development at SwRI right now. Kreg, let's start with you. Tell us about SwRI's new screening tool for TBI, the Advanced Military Measure of Olfaction, or AMMO. What is it? How does it work? Who can use it?

KZ: So, yeah-- so olfaction is smell. So olfaction is being able to sense and describe smell. And so the AMMO kit is a medical device that we've designed to identify smell loss or anosmia, the inability to identify correctly-- correctly identify smells. And so there's lots of early evidence that shows it can be a very useful screen for traumatic brain injury.

This isn't a diagnostic by any means. This is a tool that can be used to look for an objective data point. So one of the big issues with traumatic brain injury diagnosis and just identification is a lot of the data is subjective. So what is the baseline behavior for somebody and how is that changed or is this due to other things that are going on like-- so if somebody has had an injury, say, a blast injury, they may also be having blood loss or are they confused because they had a traumatic brain injury or because they're low on blood. So there's all kinds of very complicated reasons why TBI is very hard to detect and to classify.

So smell loss is something that is a very objective measure of, hey, there's something going on with the brain. And so we designed this kit to diagnose that symptom to then screen for TBI. So it's an indirect way to get to TBI, but it's something that's highly sensitive. So it means it's got a low false negative. Yeah, that's right. It has false negatives for the test, is actually more sensitive than CT.

So generally the gold standard for TBI diagnosis is a doctor or a provider would notice somebody is having symptoms, so either they're complaining about headaches, or they're being confused or they've had personality changes. They'll notice those symptoms, they'll send them for a CT and then if the CT shows that there's something going on, they'll send them for an MRI. So the MRI is the gold standard for the diagnosis of TBI.

The olfaction or anosmia, so the loss of sense of smell is actually more sensitive than CT. So we think it can be used as a screening tool to say, hey, we need to investigate this further and it can be useful in a non-clinical setting.

DP: Yeah, I actually spent a decent amount of time designing medical devices as my graduate research and the doctors were always looking for solutions. And it was like, how can we detect anything with the least amount of invasiveness as possible? Can we get away-- can we find a way to do it without taking blood samples or having to do these complex scans where you have to go to specific facilities--

KZ: Or exposure to radiation.

DP: --or exposure to radiation, right. So the fact that this is basically completely noninvasive is-- I mean, that's awesome. I think it's really, really neat.

KZ: Yeah, I think the powerful thing about it is it can be done anywhere. So it can be done in the field, it can be done in the clinic. It doesn't take a lot of training to have the physician or whoever the provider is going to be administer it.

And, again, it's just looking for one symptom that is fairly objective. So in a sea of subjective data points that we're trying to put together, an objective data point is pretty powerful, according to the providers we've talked to.

 

SwRI’s Dr. Daniel Portillo (right) and UTSA’s Dr. Morteza Seidi (left) are creating innovative military helmet pads designed to prevent traumatic brain injury (TBI). The project is supported by a $125,000 grant from the Connecting through Research Partnerships (Connect) program.

LP: So I find it interesting that you said, this is a little bit more telling than even a CT scan.

KZ: Anosmia and the early data that we have shows that it's more sensitive. So there's fewer false negatives with a-- with this screening kit than there are with CT. CT is extremely useful for lots of other things, but CTs aren't always available. Especially-- like you talked about, this happens a lot in rural communities. Rural communities are well-known to be underserved in medical facilities, so not having a CT or MRI available means that, I think, a lot of people probably go undiagnosed.

In a battlefield-- so this was developed for the battlefield itself-- there's no CT or MRI in role 1 care, so being able to use something like this gives some-- gives a commander an objective data point when he's trying to make a decision if somebody can stay in theater or if they need to be evac back to a role 2 or role 3 care, where right now it's just, what do I think and how am I feeling about this guy? What's he acting like? This is more something objective. You could say, hey, he's failed his AMMO test. We might need to get him looked at.

DP: Right. This is an actual data point as opposed to concussion protocol, where it's like, what's your name? What's your address? You let me track your eyes in front of you. This is an actual--

KZ: What you're talking about is the MACE test is what they use in the field, which is complicated actually. It's a bunch of questions that they ask you. One of those is can you smell things. And I don't know if you've ever noticed this, but we don't notice when we don't smell things. We notice when we smell good things or bad things. But the lack of smell is not something that we just innately notice.

But with a kit like this, where you're supposed to be smelling something, we've confirmed it and we've got the medical device history to show that people can identify these smells. Now we can say objectively they're not being able to identify smells.

LP: So, again, this is a screening tool--

KZ: Yes.

LP: --a very useful screening tool, but you still have to follow up with those big scans.

KZ: Oh, absolutely. This is by no means a diagnosis. We are not pretending it is in any way. You still need to go talk to your doctor. This is a way to say, maybe I need to elevate care, maybe I need to go have something looked at instead of I'm a-- my head hurts and I'm a little sleepy. Maybe I'll just sleep this off and see. This gives you that data point to say, hey, maybe this is something I should take care of.

LP: So you've given us a few examples already, but who would be most likely to use AMMO.

KZ: So this was designed for the military. So we think that it would be super useful to be able to put on military medics packs. It's lightweight, it's low volume, so it's not going to take up a lot of room. It's not going to make them remove a lot of other life saving equipment from their pack, which is always a big deal when you're talking about adding something to a medics pack.

And then we think that it can be used clinically here in emergency services, so putting it on the backs of ambulances, putting it in clinicians offices. So if somebody is presenting with symptoms that they're not really sure about but they could be indicative of TBI, especially if they've come in with something that is like, oh, yeah, you were exposed to something that might cause that. So I fell and now I have this symptom. Even if they didn't say they hit their head, maybe we should test for it.

This-- one of the other parts about this is it's very low cost. We think it can be produced for under $10 or so a kit. And it's got a long shelf life. So we've already done a year of stability. We're looking at a second year with no special storage conditions, no need for cold chain. So it can be done cheaply, quickly and effectively. And it's a really good way to screen for something to say maybe we should elevate care. MRIs are expensive, CTs are expensive. This is a way to say maybe justify that cost and say they failed this test, let's justify the next steps.

LP: Do you see this in medicine cabinets at homes in the future?

KZ: So right now we're developing this for prescription only. We do see that-- so this is a medical device. But the medical devices in this category are class II exempt. So that means the FDA has said that olfaction test doesn't pose a safety risk, so it can be marketed without going to the FDA. We are wanting to do clinical trials to get the data collected to make sure that it does what we think is we think is going to do.

So, yes, at some point we think it might be available over the counter. That would be further down the road. Right now, we are looking at it as prescription only, but that would be where we'd like to get is it's in the every football coaches sideline bag, those kinds of things.

LP: So let's get a little bit more into the science of it. How is scent identification linked to TBI?

KZ: So there's a couple different ways that this can happen. So the main thing is if you have damage to your olfactory nerve-- so your olfactory nerves go straight into your brain from your nose.

So you have your sensory organ in your nostrils and there's a direct line into your brain. You don't have to go through the rest of the nervous system. And so it's a really good way to get a direct take on what's happening in the brain.

So damage to olfactory nerves can be a cause and the olfactory bulb, which is in your brain, and processes scent information is another way can be caused. Frontal lobe and temporal lobe injuries can also effect the way that you interpret smell and the way you identify smell. And then shearing forces-- so if there's rapid acceleration or deceleration, it can cause shearing forces that damage brain tissue. And so those are the ways that smell-- that's why smell is effected by injury to the brain.

LP: When you get to the level of traumatic brain injury, is it possible to have that type of injury but it not affect your sense of smell?

KZ: So it's possible, but unlikely. So all those things are possible. But they're-- one of the things that we're looking at is we don't want-- we want to err on the side of caution, so we want to make sure that we're telling people that, yeah, go get checked instead of being like, no, you're fine. So it's really designed that way to make sure that if there's any kind of olfaction issue, we can detect it. And that's an indication that you need to go get checked.

False negatives and false positives happen with any test like that needs to-- we always need to be cognizant of that fact. But the underlying data shows and the early data shows that it's very accurate as far as being able to detect, smell loss and that smell loss is highly correlated with being MRI-positive for TBI.

LP: Yeah, so that was my next question. How accurate is AMMO? What are you looking at that makes you feel like, yeah, this is definitely a useful tool?

KZ: So when we talk about accuracy, what we need to specify what we're being accurate for. So AMMO is designed to identify smell loss. It's not ident-- we're not identifying a traumatic brain injury. We're identifying the symptom of smell loss and it's highly accurate for that. We've established good accuracy there.

And then the background research that's gone on with connecting olfaction to TBI shows that loss of sense of smell is highly correlated with being MRI-positive for traumatic brain injury and that-- like I said earlier, that it's very sensitive. It's a good screening tool. It wouldn't necessarily be a good off the shelf diagnostic because it's not necessarily super specific. So the specificity is low, but the sensitivity being high means that it's a good screening tool and it's a good way to make-- of how are we going to elevate care decisions?

DP: Does it look for whether or not you can smell or whether or not your smell has changed or both?

KZ: Its identification of smell.

DP: Oh, OK--

KZ: So there are--

DP: --so whether you're getting your smells right.

KZ: Exactly. So whether your brain is processing it correctly.

DP: Got you.

KZ: We have six different odors in the kit that are we've established through the background research. And the way that this question is presented is here's the smell, smell it and now here's a card with four answers. Which one is it? So you don't have to just come out with it, which is a more difficult cognitive task. You just have to look at the four and then pick the one that's right. And so if you're unable to do that, that shows that your brain is not able to correctly identify the smells that are we know that are present.

DP: So I don't know if you're allowed to disclose what those specific odors are, but are they stuff that normal people would easily be able to identify--

LP: Coffee, grass--

DP: Yeah.

KZ: So, yes, they are things like that. We're not publicizing exactly which smells they are, but they are very common smells. And this isn't a miss one and you're done type thing. So we are saying that you need to evaluate it like how well you're doing. People interpret smells a little bit differently all the time. People think-- some people think things smell bad and smell-- those other people think those same things smell good.

DP: I know exact-- yes.

KZ: There are cultural smells. So there are some smells that people are not exposed to because of cultural reasons. And so there's-- we had to be careful about that. And we are looking-- as we are doing this, we're always looking to improve this. So we are looking at making improvements by adding smells and by doing things like that to make it a more comprehensive test. But we do want to keep it short and we want to keep it simple because that makes it easy to use.

This is a screening tool. We are not telling anyone if you don't identify these smells, you have a TBI because there's lots of other things that it could be. Famously, COVID knocks your smell out. So we're also looking into that.

DP: Or changes it. Yeah.

KZ: Yeah, or changes it. But there are other confounding factors. But what we're wanting to do with this is be able to pick up a lot of these people that have TBIs that are going undetected because that's really important in being able to heal and to prevent compound TBI and then also to make decisions about every day-- how they're functioning right then.

LP: So let's get into ease of use. If you've never seen this kit before, can it be used anywhere? Are directions easy to follow? Can anyone administer this test?

KZ: Yes. So we designed it to be as easy as possible to administer and as quick as possible to administer. So the test consists of six odors that are in little vials. If you've ever seen smelling salts-- they look a lot like smelling salts. They're little vials that are glass wrapped in plastic. You crush them with your finger, you turn it over, and then you smell it, and then you identify that-- you pick the choice from the card. That's it. You throw it away.

The person who's giving the test has an answer card that has the multiple choice like you would see on a test. They bubble in which you answer. And then when you're done. There's the answers are under a sticker. So you can't see them at first. So you don't give away the answers on accident. But then that person scores it. Did they get it right or not. And so if you perform poorly on the test, we're like the-- we're-- it is suggested that then, hey, you need to go see a doctor about this and maybe get a CT or MRI.

That's not saying you have a TBI that's saying that you can't process smells. For whatever reason, you're poorly identifying smells. And if you just fell off a ladder, there's a good chance that that's the reason. So that-- it's very simple, very easy. It's a one-time use test. You don't have to keep it and put it away. You can throw it all away at the end. It's a disposable test. And so, yeah, we've designed it to be easy to use-- as easy to use as possible.

LP: All right. So since it was developed for military use and can be used out in the field, can it be used in all weather conditions? What happens if it gets wet or is exposed to extreme temperatures?

KZ: Right. So part of what we did at Southwest Research Institute was made this into a device. So we got the under-- we-- the-- our client brought us the underlying research that they had done and we helped them make this into a device. And part of that was our requirements where it needed to be able to be used in the field. So it is packaged in a way that's waterproof and is it can be stored anywhere from below 0 degrees Celsius to 50, 55 degrees Celsius and it can be used in any of those kinds of climates.

Using it when it's actively raining and it's getting wet may make it where it's not going to work as well because it's going to reduce the odors because they're wet now and they're in solution instead of in the air. But just putting it under a hood or putting it under-- just covering up while you're using it would solve that problem. But it is packaged in such a way that it's robust to weather and to mechanical insult-- so crush, drop, all those things. It's not going to break just from dropping it.

LP: So is AMMO a first of its kind technology?

KZ: So there are other tests that identify smell loss and poor smell identification. They've been used in the past for things like trying to figure out somebody's got TBI or other cognitive issues-- so Alzheimer's, those kinds of things. They're generally pretty long. A lot of times they take 30 minutes. They take a trained person to give the test.

All the other ones that are out there right now are pretty complicated and they're expensive. When you're doing something that takes a lot longer, they have sometimes upwards of 50 different scents. That's a lot more expensive to make. And so it's not really useful in the field and it's not really useful for the layperson.

LP: All right. It's exciting to see what's next for AMMO. Again, AMMO is a screening tool-- fast and accurate-- that checks for smell loss, which can be associated with TBI. So thank you so much, Kreg, for telling us about AMMO. We'll come back to you in a bit.

I did want to go over to Daniel now talk about these innovative helmet pads. SwRI and The University of Texas at San Antonio are developing these military helmet pads designed to prevent TBI. So tell us about the specialized padding. What's it made of? How does it work?

DP: So there are obviously pads currently in military helmets. And the question that we started to ask ourselves is, are those pads the most effective solution at reducing the risk of getting a brain injury in a military environment?

So the military environment is a little bit different than, say, a football environment, where they still wear helmets. A football environment you would expect to see a lot of what we call blunt impacts and those are impacts where guys are hitting their heads together, maybe falling on the ground. You expect to see those in the military world too, right-- somebody falls, runs into a wall, something like that. But there are also ballistic and blast threats that military personnel are exposed to that we would not expect, hopefully, a football player to be exposed to.

And so we started to ask ourselves, OK, these pads that are in there, we know that there are existing materials and technologies to manufacture really unique structures now that may not have been available a decade, two decades ago. So can we try to leverage the new materials that have come out, the new manufacturing technologies that have come out and try to improve the existing military helmet pads.

So the thing that might be special about them is we are actually trying to design them in a way where the pad itself will perform differently depending on the speed of the impact. So to give you a rough idea of impact speeds, blunt impacts are typically 10 to 20 meter per second. Again, that's somebody kind of falling on the ground.

Ballistic impact speeds can be 1,000 meters per second. or in some cases. And that's really fast. But that's the magnitude of difference that we're looking at. And so we are hoping to design the pad to perform one way at the lower speed impacts. But then at the higher speed impacts, we hope that pad performs differently as a means of trying to reduce the amount of energy that is actually administered to the person's head.

LP: OK, I want to get into that a little bit in a bit. But-- so we're talking about padding for military helmets. You think helmets, you think athletics, football-- is this technology that can be transferred over to sports?

DP: In theory, yes. But, again, the fact that this pad-- the fact that we need this pad to perform differently depending on these different rates of impact-- you would never see those impact rates in sports just because of the amount of energy that needs to be given to the helmet. So it might be translatable. And what we come up with might work-- again, there is a range of impact speeds, it's just not the orders of magnitude that we're designing for. So I definitely think that what we hopefully come up with could be used in the sports world. But I think, by and large, we're designing specifically for these really drastic changes in speeds.

LP: OK, so you're at the beginning of this project and you are looking closely at these pads for military use. So you've discussed how the different rates of speeds of impact can change the padding. How does it respond to different types of impacts? Can you explain that--

DP: OK, so have you ever seen oobleck? It's like the cornstarch and water mixture.

KZ: So it's like a non-Newtonian--

DP: Correct. Yeah, so have you ever seen that--

KZ: Yeah, yeah, I have.

DP: --because it's like-- so you can slowly put your hand into it and your hand will just sink in there. But if you like punch it stops your hand. So it's a liquid. Now, we cannot use oobleck in these pads because, obviously, if you get a hole in it, your pad is leaks out and it's gone. So that'd be useless. But that's the same idea where if you basically apply different amounts of force to it, all of a sudden the performance and stiffness changes and that's what we're looking at trying to implement in our pad. But, like I said, we're not going to use liquids, but we hope to do that mechanically with solid structures in the pads.

LP: It's not like it's-- it's not like a smartphone or there's not like a chip in there causing-- it's literally just what the pads made out of.

DP: Correct, yeah, so we're exploring novelly architectured materials and that could be 3D printing. You can get some really cool, intricate structures by 3D printing now. There's also-- it seems like every day there's a new 3D printed material that comes out and could be used for something.

So we're looking at a variety of options when it comes to helmet pad designs. We're looking at a bunch of different materials, whether they're we can 3D print them or not because there are certain geometries that can be manufactured without 3D printing. And we don't want to just completely ignore those. We want to explore lots of different options. And the way that we plan to explore those is we plan to build computer simulations of those pads.

We have a long history here of simulating ballistic events. And so we want to build computer models. We want to try a few different pad designs out where we can tune the models to the specific material that we want to put in the pads and that geometry. And then once we feel confident that the pads are performing the way we want them to, we plan to experimentally test them.

KZ: I got a question. What's the advantage of having a material that reacts to different speeds or different forces or basically the rate of the force that's applied versus just designing for your worst case scenario-- so the worst-- the highest speed, highest impact?

DP: So it's all about the translation of energy from the impact through the helmet into the head. And so we want to essentially reduce that energy as much along the way as possible. There-- and the reason that we want to change the stiffness is because at different speeds that energy moves differently to the head.

So if you have a slow speed impact and you have a really big piece of foam, you have a long time to decelerate it. If it's a high speed impact, it's the opposite. And so that's essentially the core of what we want to do is we want to design this pad so that maybe it's squishier for in the blunt impact regime and maybe it's a lot stiffer in the faster impact speed regime.

KZ: And so does it change fast-- does the material stiffness change fast enough so that where a projectile would come and it hits fast first so it's stiff and then as it slows down, it becomes less rigid? So you get that whole--

DP: So that's--

KZ: --that's really cool. Awesome.

DP: --what we're exploring. And the fundamental concept of what we want to design is, how can we design a pad that's-- obviously, there's the liquid example that I gave, but how can we design a physical solid structure that will behave differently? And that's where the intricacies come with designing specific structures within the pad or printing complex geometries that will behave differently.

LP: It's really fun to hear you guys learning about each other's projects and chiming in with your own knowledge of what about TBI research and asking really-- asking smart questions that those of us on the outside might not think of. So how are you-- Daniel, how are you using computer analysis of human brain response to develop the pads? What does that entail?

DP: That's a great question and I think it's a really important part of our research because, like I was telling Kreg, nobody's going to volunteer for a clinical trial for ballistic impact. Nobody's going to want to do that.

LP: Yeah, no.

DP: Never signed me up for that. So the best we can do is have these computer models to try and understand how the brain is, in fact, behaving inside of the skull during these different events. And so Dr. Memar at UTSA has a really nice model of the human brain. And so what Dr. Seidi and I will-- are planning to do is use our-- so Dr. Seidi has-- at UTSA has good experience in the blunt impact testing. He does a lot of football helmet research and stuff like that. So he's got a lot of experience and a nice computational model of those blunt impacts, whereas here we have a lot of experience in the ballistic impact. So we plan to work together to simulate both of those events.

And the things that we're looking for in terms of the measurements we're taking during the simulations are going to be the head acceleration speeds and rotation speeds. Then once we know what those accelerations and rotations are, we can give that information to Dr. Memar, and she can then apply that to her brain model where she can then see, OK, based on the data that you just gave me from your simulation, what damage would be done to the brain.

Now, the reason that we can't do all of that in one is simply because there are different simulation softwares that better predict how things perform. The simulation software that she use is not the same software that we're going to use to just give her that data. And so that's the plan of how we want to basically characterize the performance of these pads. That's the path forward for us.

LP: How will you use 3D printing technology to build these helmet pads?

DP: That's a good question. And so I hinted at it, but-- and there are just more and more 3D printers and more and more materials all of the time. And so, one, it's hard to know everything that exists out there. Now, we, especially Dr. Seidi has spent a lot of time looking into different materials and 3D printing technologies for his football helmet pads.

And so we plan to explore those and to see what is available to us. And that's going to be some of the attempt that we make when we're designing these pads. Again, we're looking at exploring some 3D printed options as well as some more traditional manufacturing methods to make them.

LP: So let's talk about the collaboration with The University of Texas at San Antonio that's making this research possible. This project is supported by a $125,000 grant from the Connecting through Research Partnerships or Connect program. So tell us about this program.

DP: I think it's a great program. Obviously, UTSA is the largest university here in San Antonio. I would argue we're probably one of the largest research institutions here in San Antonio. And so the fact that both institutions came to the understanding that if we both chip in a little bit of money for our research teams to work together and to develop these really unique ideas and projects, that makes all of the research in San Antonio better in a sense and allows us-- now that we've started on some of these projects, now that opens the door to bigger funding opportunities to be able to really take the initial ideas and concepts we come up with to a bigger scale and make them more applicable. And then we just have the ability to learn more.

KZ: Well-- and that's is really true to the core concept of Southwest Research Institute of taking something that's academic and the people who are looking at the pure science and the original science and making it something applied. So I think-- my-- at least my experience with the Connect programs is it really is purely what Southwest Research does is take things from we have a really good idea and we have this data behind it to how do we apply that in the real world.

DP: And specifically for this project, it compliments both of our strengths. So, like I said, Dr. Seidi has really nice equipment and experience doing these blunt impact tests and we have the same-- or the equivalent experience doing ballistic testing. And so they're not able to do the ballistic testing, we don't have the equipment to do the blunt testing, so us working together is almost one of the easiest ways to actually get started on this work is because our collaboration is just so complementary.

LP: It's going to give you that full picture that's so important in this kind of research.

DP: Absolutely. And I am sort of biased. I'm an alumni from UTSA, so it's always fun to work.

LP: Perfect. This is a great project for you.

DP: It's always fun to work with your alma mater. So.

LP: Yeah, I wanted to add the Connect program was established in 2010 to explore a collaborative approach between SwRI and UTSA in a few areas, including biomedicine and biotechnology, the data sciences, smart and secure manufacturing, space sciences and technology. So this really is an important partnership. And it's great that your research is part of it.

DP: Absolutely.

LP: So at the beginning of the school football season this year, we heard about two players in the news, a high schooler and middle schooler, who died of football-related brain injuries. So athletes involved in sports like boxing and football, as we mentioned, are vulnerable to TBI. And Dr. Portillo, you played football in school, so how does your personal experience impact your research.

DP: Yes, so I did play football at UTSA. Fortunately, I was a kicker, so I never was really exposed to some of the head threats that other players might experience. I was in on very few tackles, which is fine with me.

But, yeah, I knew a few guys whose careers were basically ended from head injuries and it was really sad to see because they were great football players, they were great people, and they had so much great football left to play and they just weren't able to do that. And so it was a bummer to see that because those are your friends. And I know-- and I still have lots of friends that were in the military in the past and they sustained head injuries.

And so, for me, this-- as a research scientist and engineer, you look at it and you say, OK, well, obviously helmets are doing some amount of good. And the question is, can we make them even better?

And I don't want to discredit all of the effort that's gone into designing military and football helmets and the pads within them, because that's been going on for decades. And it's not that they don't do a good job, we're just trying to push the boundary even further and say, can we come up with an even more novel concept now that we have access to some of these newer materials and manufacturing processes? Can we try to implement those and continue to push the boundary of helmet pad performance?

LP: Evolve it to something new.

DP: Correct, yes. Can we take another step forward? Yes.

LP: OK. So when do you foresee this being ready for use? What is your long-term vision for this technology?

DP: So by the end of this project, I think we're really hoping to have a few good designs and candidates that we believe perform really well. Then, beyond that, there's still the aspect of blast testing. So that's not actually in our plans currently for this scope of work for this project, we plan to do the blunt and ballistic impacts.

As Kreg was saying, there's the need for blast testing. That's a huge thing that lots of people see. And so that's one of the next steps forward is we want to make sure that they perform well in blast cases.

And then after that, I think it's a matter of trying to find either companies or government agencies that want to continue to push this boundary, take the progress that we've made and say, OK, we see the pathway, we see that these pads perform very well, let's continue to develop this a little bit more.

And eventually, once they've gone through all of the rigorous testing and performance evaluation, then we can begin to translate that into let's do the military standardized testing-- high temperature, low temperature, vibration, all that kind of stuff that's required to use these in the military. And maybe even one day they could be applied and the technology, could be translated to other pads and other helmets or maybe for body armor. I mean, there's a lot of possibilities, I think.

LP: All right, such important research on these innovative new-- and this new vision, really, for helmet pads. So we will be watching.

A quick mention here on another SwRI and UTSA Connect program project, researchers are working on a test to detect TBI by analyzing breath samples for specific biomarkers associated with diseases and cognitive function. So another project to watch there, just a lot of research on TBI here at the institute.

And there are other projects that are just getting started. The seeds have been planted. So, Kreg, can you tell us a little bit about those?

KZ: Yeah, so we have a couple of different projects where-- looking at things like using machine learning to look at not only diagnostics but maybe prognostics. So how is somebody expected to perform if they in-- later in life if they've had a TBI? But there's a lot of things going on that are pretty early stage, but we're pretty heavily involved in this-- the brain health area. And so I think it's great for Southwest Research to be involved in that and I think it help.

LP: All right. Definitely an exciting and, again, important topic to be delving into right now. So our mission at SwRI is to conduct research and development to benefit humankind. Will you bring it all together for us? How are these new tools, AMMO, and these specialized military helmet pads contributing to that mission?

DP: So, yeah, our technology would provide increased protection for people in potentially a variety of cases. Hopefully it can be expanded beyond just the settings that we're looking at in the military. But, as a whole, I think any effort towards reducing the risk of TBIs is a good effort. If we do a good enough job at reducing all of the risks for that, then Kreg's AMMO project is useless.

KZ: Well, I would say too that--

DP: That would be the goal. Sorry, I don't want to put you out of business.

KZ: Hopefully we get there. But until we get there--

LP: Yes.

KZ: --in the probably medium and even long-term future, I would say that the biggest thing is being able to identify them and being able to treat them and not having people go untreated--

DP: Absolutely.

KZ: --which, right now, a lot of people go untreated with traumatic brain injury. The compound TBI is a really big problem and people who have a TBI but they feel OK-- I mean, you talk about our soldiers and athletes, those are guys who are wired-- guys and girls who are wired to get back in the fight or get back in the game. They don't want to come out. They want to perform. But being able to say to somebody, hey, this looks like that you may have something going on, you need to sit out or it could be catastrophic is a powerful tool.

LP: Thank you for helping us understand TBI and the SwRI solutions in development that are targeting this public health issue. As we said at the top, anyone can suffer from TBI. So this is important work that you are conducting for the health and safety of all. Thank you both.

KZ: Thank you.

DP: Thank you.
 

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Ian McKinney and Bryan Ortiz are the podcast audio engineers and editors. I am producer and host, Lisa Peña.

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