COHA Translational Fellowship Opportunity for Residency-Trained Veterinary Specialists - One Health Alliance
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COHA Translational Fellowship Opportunity
for Residency-Trained Veterinary Specialists
Translational investigations of metabolomics for precision trauma medicine
Area of Research:
Trauma is the leading cause of death in people under the age of 45 and the third
leading cause of death for people of all ages (USA), as well as the second leading
cause of death in dogs (USA) and leading cause of death in cats (UK).
Understanding and defining the metabolomics of trauma patients across the
translational spectrum presents opportunity to further identify clinical biochemical
markers and lay the groundwork for future development of interventions for
improving outcome in veterinary and human trauma patients.
University/Department:
• Colorado State University
• University of Colorado Health Division of Trauma and Acute Care Surgery
• CBR Division, Defence Science and Technology Laboratory
• Imperial College London
Primary Mentor:
Elizabeth Ryan, PhD, Associate Professor, e.p.ryan@colostate.edu
Mentor Team:
The Translational Medicine Institute (TMI) at Colorado State University has
developed a trauma research working group that the identified fellow will join.
The mentorship team will include Elizabeth Ryan (CSU, Environmental and
Radiological Health Sciences, CVMBS), Kelly Hall (CSU, Clinical Sciences,
College of Veterinary Medicine and Biomedical Sciences (CVMBS)), Julie Dunn
(UCHealth Medical Center of the Rockies, Trauma surgeon), Heather Pidcoke
(CSU, Translational Medicine Institute, Chief Medical Officer), Tracy Webb
(CSU, Clinical Sciences and Research Integrity and Compliance Review Office,
CVMBS), Emrys Kirkman and Sara Watts (CBR, Defence Science and
Technology Laboratory) and Mansoor Khan (Imperial College London, Trauma
surgeon). This clinical and translational science team includes basic, pre-clinical
and clinical researchers, educators and administrators that have significant track
records in veterinary and human trauma patient care and share a passion for
improving trauma patient care and outcomes through research and education.
Julie Dunn, MD, MS, Director of Trauma and Acute Care Surgery Research.
Julie.dunn@uchealth.orgKelly Hall, DVM, MS, DACVECC, Associate Professor Critical Care Services
and Veterinary Committee on Trauma (VetCOT) co-founder, Chair.
khall.wilke@colostate.edu
Mansoor Khan MBBS PhD PGDip FRCS FEBS FACS CMgr FCMI, Honorary
Clinical Professor of Trauma Surgery, Brighton and Sussex University Hospitals,
UK. manskhan@icloud.com
Emrys Kirkman OBE PhD Joint academic lead Combat Casualty Care research
programme Dstl, UK. emrys.kirkman@talk21.com
Heather Pidcoke, MD, MSCI, PhD, Chief Medical Research Officer, OVPR;
Associate Director, Research, TMI. H.Pidcoke@Colostate.edu
Sarah Watts PhD, BETMED MRCVS, Veterinary Surgeon and Senior Principal
Scientist, joint academic lead Combat Casualty Care research programme Dstl,
UK. sawatts1@dstl.gov.uk
Tracy Webb, DVM, PhD, Research Scientist and Clinical Review Board
Coordinator.
tracy.webb@colostate.edu
Description of Potential Research Project(s):
The major objective of the overarching project is to examine a suite of small
molecules from a wide range of chemical classifications, also known as
metabolomics, within the blood, stool and bone marrow of human and veterinary
patients alongside experimental laboratory animal models. In this research, the
inflammatory cascade and metabolite signatures will be determined from:
• induced trauma models [sheep (fracture) and pig (combined soft tissue
injury, hemorrhagic shock and resuscitation)]
• naturally occurring trauma in dogs
• human trauma patients
In order to participate in patient recruitment, sample acquisition and analysis, the
fellow’s training will be divided across all clinical and translational research
dimensions from Dr. Elizabeth Ryan’s lab (Ryan/McGilvray, 25%), clinical time in
the CSU Veterinary Teaching Hospital (Hall, Guillaumin, 25%), UCHealth North
(Dunn, 25%) and Imperial College London (Khan, 25%).Additional Training Opportunities: The Colorado Clinical and Translational Sciences Institute (CCTSI), offers extensive resources for developing and enhancing skills regarding team research, statistical analysis, patient recruitment, etc. https://cctsi.cuanschutz.edu/cctsi *25% CSU Ryan laboratory Elizabeth Ryan has been working in human biospecimen metabolomics analysis for 10+years and will provide the non-targeted metabolomics and interdisciplinary training needs for protocol standardization of biospecimen collections and processing through to data acquisition by UPLC-MS/GC-MS and data analysis. Additional bioinformatics and computational needs for results interpretations with clinical markers will be supported with the goals for the fellow to complete 1-2 team/coauthored manuscripts and a review article. Ryan will also provide assistance with grant writing and extramural submissions for research project funding. Ryan and Dunn have history of successful collaboration in this area. *25% UCHealth North Medical Center of the Rockies During this portion of the experience the fellow will attend morning rounds during which all patient care is discussed among a multi-disciplinary team (physicians, students, pharmacists, nutritionists and therapy groups). The fellow will round with the trauma and acute care surgery hospital teams in the intensive care unit, the stepdown unit and the trauma ward. They will have the opportunity to observe surgeries with an emphasis on general trauma surgery, neurosurgery, and orthopedic surgery. Other observational experiences will be proffered as time allows. There will an on-call requirement during this rotation to allow the fellow to respond to acute trauma activations. Fellows will be allowed to audit the Advanced Trauma Life Support Course and participate in all skills sessions of this course. They will attend trauma grand rounds and may be asked to present a topic to grand rounds specific to the area of research. *25% Imperial College London, Kent Surrey Sussex Air Ambulance In the UK, the fellow will engage in a multi-disciplinary, multi-center research program. The primary placement will be at the Department of Surgery and Cancer, Imperial College London with Mr James Kinross, Senior Lecturer in Colorectal Surgery and an authority in Metabolomics. Here, samples derived from an in vivo model of trauma at Dstl Porton Down will be analyzed. This in vivo study focuses on pre-hospital management of military trauma during prolonged evacuation in austere circumstances. The metabolomic data will be integrated with concurrent information about hemodynamics, oxygen transport and immunology. The fellow will then be seconded to Kent Surrey Sussex Air Ambulance (Professor Richard Lyons) to see initial casualty management and undertake research analysis on pre- hospital data. This will be followed by a period at the South East Coast Major
Trauma Centre to observe continuation of care and further research with Dr Duncan Bootland (Trauma Director) and Professor Mansoor Khan (Trauma Surgeon). *25% CSU Veterinary Teaching Hospital (VTH) Critical Care Services In the Urgent Care and Critical Care Unit, the fellow will participate on the clinical floor providing primary patient care, teaching and supervision of veterinary students, interns and residents on service. Additionally, the fellow will participate in recruitment of clinical cases for active projects involving emergent and critical care patients. Fellowships are for 2 years and provide stipend and employee benefits at the NIH post-doctoral pay scale. Fellows may supplement their stipend with up to 25% effort towards clinical work, if such work is in alignment with the research and career development plan. All fellowships will have a start date of fall 2021. Biosketches of primary mentor and mentor team
OMB No. 0925-0001 and 0925-0002 (Rev. 09/17 Approved Through 03/31/2020)
BIOGRAPHICAL SKETCH
Provide the following information for the Senior/key personnel and other significant contributors.
Follow this format for each person. DO NOT EXCEED FIVE PAGES.
NAME: Ryan, Elizabeth P.
eRA COMMONS USER NAME (credential, e.g., agency login): EPRyan
POSITION TITLE: Associate Professor
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing,
include postdoctoral training and residency training if applicable. Add/delete rows as necessary.)
DEGREE Completion
(if Date FIELD OF STUDY
INSTITUTION AND LOCATION
applicable) MM/YYYY
Bowling Green State University Bowling Green, OH B.S. 12/1996 Environmental Science,
Biology
University of Rochester School of Medicine and M.S. 05/2003 Molecular Toxicology
Dentistry, Rochester, NY
University of Rochester School of Medicine and Ph.D. 05/2006 Molecular Toxicology
Dentistry, Rochester, NY
University of Rochester School of Medicine and Postdoc 12/2008 Cancer Control and
Dentistry, Rochester, NY Prevention
A. Personal Statement
My translational, integrated Toxicology and Nutrition research training program has largely focused on the
synergistic activities between fiber rich foods and commensal gut microbial metabolism for the prevention and
control of gastrointestinal diseases across the lifespan. This research has strong implications for improving
diets and enhancing mucosal immune responses. My research training in molecular toxicology began with
small molecule modulators of immunity (e.g. nonsteroidal anti-inflammatory drugs), and led to postdoctoral
training in clinical and translational research with animal and human intervention trials. My collaborative
research team approaches involve identification of changes in small molecules using metabolomics. The utility
of this technology in health and disease contexts has been supported by competitive funding awards from the
NIH-NCI (R03, R21 and R01 mechanisms), NIFA-USDA, Bill and Melinda Gates Foundation (Phase I and II
Grand Challenges Explorations in Global Health) and USAID. M laborator utili es a multiplatform omics
strategy to study complex interactions between bioactive small molecules (chemicals, drugs, probiotics etc.)
with diverse faculty and human clinical collaborations for undergraduate/graduate training across the fields of
agriculture, nutritional sciences, pediatrics, and microbiology. This new area of evaluating trauma-immune
responses to injury with metabolomics is supported by animal models, as well as naturally occurring injuries in
companion animals and humans. Evaluating blood and bone marrow metabolites protect or disturb
inflammation has important implications for identification of novel therapeutic targets and has been a logical
point of integration to mechanisms involving nutritional support for bone injury healing. The integrated systems
approach to evaluate long bone injuries in sheep and dogs will be critical proof of concept data to support a
larger grant application to NIH, DOD or NASA. This new collaborative team has distinct and complementary
expertise in surgery, bone injury, immunity and metabolomics workflows alongside collaborations with UC-
Health. I have experience working across disciplines and have coauthored publications with members of this
Multi-PI team that show successful outcomes from working and training students together. My background
and expertise is available to support multiple aspects of this grant application.
B. Positions and Honors
Positions and Employment
1995 Research Assistant, Rocky Mountain Biological Laboratory, Gothic, Colorado1996 Birds of Prey Instructor, HawkWatch International, Inc., Salt Lake City, Utah
1997-1999 Community Forestry Extension, American Peace Corps Volunteer, Nepal
2000 Research Assistant, Harvard University, Organismic and Evolutionary Biology Department
2001 Management Support, Human Health Risk Assessment, Tetra Tech NUS, Pittsburgh, PA
2004 Graduate Teaching Assistant, Department of Environmental Medicine, University of Rochester
2006-2007 Postdoctoral Fellowship Training, NCI R25 Cancer Control, University of Rochester, NY
2008-2009 Research Assistant Professor, Cancer Prevention Laboratory, Colorado State University List in
2009-2012 Assistant Professor, Department of Clinical Sciences, Animal Cancer Center, CSU
2012-2016 Assistant Professor, Department of Environmental and Radiological Health Sciences, Colorado
State University, Fort Collins CO
2016- Associate Professor (tenured), Department of Environmental and Radiological Health Sciences,
Colorado State University, Fort Collins CO
Other Recent Experience and Professional Service
2019 The National Academies of Sciences, Engineering and Medicine. Committee to Review DoD's
Approach to Deriving an Occupational Exposure Limit for Trichloroethylene
2018-present: Committee on Toxicology (COT): The National Academies of Sciences, Engineering
and Medicine.
2019-present: Full member, NIH- study section: Integrated Nutrition, Metabolism and Physiology
(INMP)
2018 NIH- Integrated Nutrition, Metabolism and Physiology (INMP), Ad hoc member
2017 NIH- Endocrinology, Metabolism, Nutrition and Reproductive Sciences IRG Special
Emphasis Panel (SEP) ZRG1 EMNR A (07)
2017 NIH Special Emphasis Panel: Molecular Profiles and Biomarkers of Food and Nutrient Intake
Special Emphasis Panel (2018/01 ZRG1 EMNR-V (55) R
2016 NIH-NIEHS Special Emphasis Panel: ZES1 RAM-J (LP) 1 - NIH Loan Repayment Program
(Clinical and Pediatric Researchers)
Honors
2004 James P. Wilmot Cancer Center, Immunology Section Award-First Place
2004 Michael G. Buonocore Award, Department of Oral Biology, University of Rochester
2005 Bristol-Myers-Squibb Award, for meritorious research in toxicology.
2005 William F. Neuman Award, Department of Environmental Medicine, University of Rochester
2005 University of Rochester Graduate Student Society Merit Award-First Place
2006 Harold Hodge Award (Outstanding dissertation in toxicology).
2006 First Place Drug Discovery Specialty Section Award, Society of Toxicology Annual Meeting
2006-2008 NCI Cancer Control and Prevention Fellowship (R25 CA102618)
2008 Reproductive and Developmental Toxicology Specialty Section Award, Society of Toxicology
2011 American Society of Preventive Oncology Meeting-Overall First Place Abstract Award
2011 University of Colorado Comprehensive Cancer Center Annual Symposium Best Abstract Award
2014 Zoetis Animal Health Early Career Research Award
2015 Emerging Individual Interdisciplinary Scholarship Award, CSU Vice President for Research
C. Contributions to Science
A series of my scientific contributions are described below that reflect an innovative multi-platform strategy to
assess how metabolism of chemicals can produce diverse microbial metabolites in mice, dogs, pigs, and
humans that influence immunity across the lifespan. My translational research team labors at the nexus of
plant, microbial and mammalian kingdoms and spans both important chronic and infectious diseases with
underlying gut dysfunction. * Indicates corresponding author and underline are Multi-PI names for this grant.
1. Working across species has rigorous translational significance to scientific-biomedical research in humans
as animals represent innovative biosentinals. I have worked collaboratively for metabolomics studies in
various species (e.g. rodents, chicken, pig, dog, human) that prepares me to help with this project.
a. Rubinelli PM, Kim SA, Park SH, Roto SM, Nealon NJ, Ryan EP*, and Ricke SC. Differential Effects
of Rice Bran Cultivars to Limit Salmonella Typhimurium in Chicken Cecal In Vitro Incubations and
Impact on the Cecal Microbiome and Metabolome. PLoS One. 2017 Sep 22; 12. DOI:10.1371/journal.pone.0185002. PubMed PMID: 28937988; PMCID: PMC5609742.
b. Lei S, Ramesh A, Twitchell E, Wen K, Bui T, Weiss M, Yang X, Kocher J, Li G, Giri-Rachman E,
Trang NV, Jiang X, Ryan EP*, Yuan L. High Protective Efficacy of Probiotics and Rice Bran against
Human Norovirus Infection and Diarrhea in Gnotobiotic Pigs. Front Microbiol. 2016; 7: 1699. DOI:
10.3389/fmicb.2016.01699. PubMed PMID: 27853451; PMCID: PMC5090003.
c. Kumar A, Henderson A, Forster GM, Ryan EP*. Dietary rice bran promotes resistance to
Salmonella enterica serovar Typhimurium colonization in mice. BMC Microbiol. 2012;12: 71.
PubMed PMID: 22583915; PubMed Central PMCID: PMC3390288. PubMed PMID: 22916814.
d. Forster, G. M., Stockman, J., Noyes, N., Heuberger, A. L., Broeckling, C. D., Bantle, C. M., & Ryan,
EP*. (2018) A Comparative Study of Serum Biochemistry, Metabolome and Microbiome Parameters
of Clinically Healthy, Normal Weight, Overweight, and Obese Companion Dogs. Topics in
Companion Animal Medicine. 2018. 33(4): 126-135. DOI: 10.1053/j.tcam.2018.08.003. PMID
30502863
2. I have a strong background of testing various environmental exposures and conditions (e.g. chemicals,
oxygen, nutrients and probiotics) as modulators of immunity.
a. Abdo Z, LeCureux J, LaVoy A, Eklund B, Ryan EP, Dean GA (2019) Impact of oral
probiotic Lactobacillus acidophilus vaccine strains on the immune response and gut microbiome of
mice. PLoS ONE 14(12): e0225842. https://doi.org/10.1371/journal.pone.0225842
b. Luis E. Zambrana, Starin McKeen, Hend Ibrahim, Iman Zarei, Erica C. Borresen, Lassina Doumbia,
Abdoulaye Bore, Alima Cissoko, Seydou Douyon, Karim Kone, Johann Perez, Claudia Perez, Ann
Hess, Zaid Abdo, Lansana Sangare, Ababacar Maiga, Sylvia Becker-Dreps, Lijuan Yuan, Ousmane
Koita, Samuel Vilchez & Elizabeth P. Ryan*. (2019). Rice bran supplementation modulates growth,
microbiota and metabolome in weaning infants: a clinical trial in Nicaragua and Mali. Scientific
Reports. 9, Article 13919.
c. Nealon, NJ., Parker, KP., Lahaie, P., Ibrahim, H. Maurya, A., Komal, R., and E.P.Ryan*. (2019)
Health implications for dietary supplementation with Bifidobacterium longum-fermented rice bran
and rice bran supplementation affects the gut microbiome and metabolome. Beneficial Microbes. In
press. https://doi.org/10.3920/BM2019.0017
d. Schwerdtfeger LA, Nealon NJ, Ryan EP, Tobet SA (2019) Human colon function ex vivo:
Dependence on oxygen and sensitivity to antibiotic. PLoS ONE 14(5): e0217170.
https://doi.org/10.1371/journal.pone.0217170
3. Evaluating probiotic- prebiotic interactions for immunity and protection against enteric pathogens. Emerging
evidence from our group supports use of metabolomics to inform us about the phytochemical
diversity/small molecule profiles of synbiotics associated with intestinal health and immune modulatory
properties. Publications regarding the role for synbiotics are provided below.
a. Nealon NJ, Yuan L, Yang X, Ryan EP*. Rice Bran and Probiotics Alter the Porcine Large Intestine
and Serum Metabolomes for Protection against Human Rotavirus Diarrhea. Frontiers in
Microbiology. 2017; 8. PubMed PMID: 28484432; PMCID: PMC5399067.
b. Nealon NJ, Worcester CR, Ryan EP*. Lactobacillus paracasei metabolism of rice bran reveals
metabolome associated with Salmonella Typhimurium growth reduction. Journal of Applied
Microbiology. 2017; 122: 1639-1656. PubMed PMID: 28371001; PMCID: PMC5518229.
c. Goodyear A, Kumar A, Ehrhart E, Swanson KS, Grusak MA, Leach JE, Dow SW, McClung A, and
Ryan EP*. Dietary rice bran supplementation prevents Salmonella colonization differentially across
varieties and by priming intestinal immunity. Journal of Functional Foods. 2015 October; 18 Part A:
653-664.
d. Ryan EP*. Heuberger, A., Prenni, J., Broekling, C., & Weir, T. (2011) Rice bran fermented with
Saccharomyces boulardii generates novel metabolite profiles with bioactivity. Journal of Agriculture
and Food Chemistry. 59(5):1862-1870 DOI: 10.1021/jf1038103. PubMed PMID: 21306106
4. A growing understanding of the relationships between gut microbiota metabolism and mucosal immune
regulation with relevance to enteric diseases will enhance our knowledge of gut dysfunction. Ryan has 10+
years of expertise evaluating immune responses that is a unique combination with direct applications to the
studies proposed in this R01 application. Note: gnotobiotic pig study was a sub-award to Yuan.
a. Yang X, Twitchell E, Li G, Wen K, Weiss M, Kocher J, Lei S, Ramesh A, Ryan EP*, Yuan L. High
protective efficacy of rice bran against human rotavirus diarrhea via enhancing probiotic growth, gut
barrier function, and innate immunity. Sci Rep. 2015; 5: 15004. PubMed PMID: 26459937; PubMedCentral PMCID: PMC4602212.
b. Schwerdtfeger LA, Ryan EP, Tobet SA. An organotypic slice model for ex vivo study of neural,
immune, and microbial interactions of mouse intestine. Am J Physiol Gastrointest Liver Physiol.
2016; 310: G240-248. PubMed PMID: 26680736; PMCID: PMC4754739
c. Boehle KE, Gilliand J, Wheeldon CR, Holder A, Adkins JA, Geiss BJ, Ryan EP, Henry
CS. Utilizing Paper-Based Devices for Antimicrobial Resistant Bacteria Detection.
Angewandte Chemie International Edition. 2017; 56. DOI: 10.1002/anie.201702776.
PubMed PMID: 28474847.
d. Yang, X, Tin C, Li G, Wang H, Kocher J, Pelzer K, Ryan E, Yuan L. Dietary Rice Bran protects
against rotavirus diarrhea and promotes Th-1 type immune responses to human rotavirus vaccine in
gnotobiotic pigs. Clinical and Vaccine Immunology. 2014, 21(10): 1396-403. Pubmed PMID:
25080551. DOI: 10.1128\CVI.00210--14.
5. A number of chemical and microbial factors contribute to the gut dysfunction of children and a number of
efforts are needed to promote healthy barrier functions early in life and across the lifespan. Below are
international efforts that are highly relevant to the need for a strong mechanistic understanding of
microbiota function.
a. Mapesa JO, Maxwell AL, Ryan EP*. An Exposome Perspective on Environmental Enteric
Dysfunction. Environ Health Perspective. 2016; 124: 1121-1126. DOI:10.1289/ehp.1510459
PubMed PMID: 26713888; PMCID: PMC4977058.
b. Kinyuru JN, Borresen EC, Ryan EP* (2015). Nutritional and Safety Evaluation of Heat-Stabilized
Rice Bran for Supplementary Feeding of Malnourished Children in Kenya. International Journal of
Food Science Nutrition and Dietetics. 04(6), 226-232. DOI: 10.19070/2326-3350-150004
c. Mirassou-Wolf T, Chantou V, Grossman KG, DeCoursey M, and Ryan EP*. Baseline Assessment
of Water, Sanitation, and Hygiene (WaSH) Infrastructure and Practices in Government Schools of
the Trapeang Chour Commune, Cambodia. Journal of Environmental Health Sciences. 2017; 3: 1-
8. https://doi.org/10.15436/2378-6841.17.1168
d. Borresen EC, Zhang L, Trehan I, Nealon NJ, Maleta KM, Manary MJ, & Ryan EP*. The nutrient and
metabolite profile of three complementary legume foods with potential to improve gut health in rural
Malawian children. 2017; 1:2. Current Developments in Nutrition 2017; 1:e001610.
Additional list of publications provided at:
https://www.ncbi.nlm.nih.gov/myncbi/elizabeth.ryan.1/bibliography/public/
D. Additional Information: Research Support and/or Scholastic Performance
Ongoing Research Support
1R01CA201112-01A1 Ryan (PI) 07/01/2019 06/30/2020
NIH Administrative Supplement Novel approaches to develop microbial consortia for use as oral dietary
supplements that advance colon health functions will include integrated functional profiles of species-
composition identity with gene expression, proteins and metabolite products included in the formulation.
004228-00002 Ryan (PI) 11/15/15 11/14/20
USDA-NIFA-National Institute of Food and Agriculture
Rice Bran and Bean Metabolomes for Human Dietary Exposure Biomarkers
This project will identify dietary biomarkers of rice bran and navy bean consumption using biological samples
collected from intervention trials conducted with these foods in children and adults.
Role: PI
1R01CA201112-01A1 Ryan (PI) 07/01/16 06/30/21
National Institutes of Health- National Cancer Institute
Rice Bran Microbial Metabolism for Colon Chemoprevention
This project involves transfaunation of microbiota from humans fed rice bran as a novel dietary colon cancer
chemoprevention strategy that will be evaluated using carcinogen induced colon cancer models.
Role: PIOMB No. 0925-0001/0002 (Rev. 08/12 Approved Through 8/31/2015)
BIOGRAPHICAL SKETCH
Provide the following information for the Senior/key personnel and other significant contributors.
Follow this format for each person. DO NOT EXCEED FIVE PAGES.
NAME: Dunn, Julie A., M. D., M. S.
eRA COMMONS USER NAME (credential, e.g., agency login): julie.dunn
POSITION TITLE: Medical Director of Trauma Research, UCHealth North, Medical Center of the Rockies
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing,
include postdoctoral training and residency training if applicable. Add/delete rows as necessary.)
DEGREE Completion
(if Date FIELD OF STUDY
INSTITUTION AND LOCATION
applicable) MM/YYYY
University of California, Davis, CA BS June 1984 Nutrition Science
University of Tennessee, Knoxville, TN MS Dec 1987 Physiology
East Tennessee State University, Johnson City, TN MD June 1991 Medical Doctor
A. Personal Statement
I am a board-certified surgeon with specialization in trauma care and am uniquely qualified to serve as co-investigator on
this project. Since the outset of my career over twenty-five years ago, I have witnessed first-hand the morbidity associated
with long bone fractures and the often-subtle detrimental physiologic impact. Trauma results in over 2 million hospital
admissions per year. It accounts for 30% of all life years lost in the United States, more than cancer and heart disease
combined, and remains the number one cause of death between the ages of 1 and 46. Better diagnostic and therapeutic
markers are needed to assess adequacy of interventions, monitor responses at the cellular level and inform clinical
decision making. Systems biology in the form of metabolomics research holds promise in dissecting the complex processes
of traumatic injury and resuscitation. I am particularly interested in long bone fractures and the role that bone marrow
plays in cell signaling, inflammation, the immune response and healing. There is compelling evidence that bone injury
and bone marrow products play a prominent role in the response to trauma. Long bone injury results in embolization of
marrow that can complicate patient care and there is newer evidence to suggest that there are also inflammatory pro-
resolving compounds released. The balance between pro-inflammatory and pro-resolving compounds is a novel area of
study. Our recent human pilot study confirms that there is an identifiable metabolite signature as a result of fracture
reaming in humans after injury, but controlled studies are needed to further clarify this phenomenon. Injury results in a
complex array of simultaneous physiologic and biochemical changes and I am enthusiastic about the application of
systems biology to this problem, particularly in the area of long bone injury. I have an interest in the long bone fracture
as an inflammatory insult in multisystem trauma and feel this project will add a meaningful dimension to the care of our
trauma patients and serve as a fruitful translational project for a post-doctoral student.
B. Positions and Honors
Positions and Employment
1998-2002 Asst. Professor, Dept. of Surgery, Quillen COM, East TN State University, Johnson City, TN
2000-2009 Director of Trauma Services (Level I) Quillen COM, East TN State University, Johnson City, TN
2000-2002 Medical Advisor to Wound Care, Johnson City Medical Center, Johnson City, Tennessee
2000-2006 Medical Director, Washington County Emergency Medical Services, Johnson City, TN
2002-2010 Associate Professor, Dept. of Surgery, Quillen COM, East TN State University, Johnson City, TN
2010-2011 Professor, Department of Surgery, Quillen College of Medicine, Johnson City, TN2011-2016 American College of Surgeons National Committee on Trauma
2015-2018 Colorado State Chair for Trauma American College of Surgeons Committee on Trauma
2011- Trauma and General Surgery, UC Health North, Medical Center of the Rockies, Loveland, CO
2011- Director Trauma Research, UCHealth, Medical Center of the Rockies, Loveland, CO
2012- Affiliate Faculty School of Biomedical Engineering, Colorado State University, Fort Collins, CO
2015- Adjunct Clinical Faculty School of Medicine, Dept. of Surgery, University of Colorado, Denver, CO
2015- Chair, Industry Advisory Board School of Biomed Engineering, Colorado State University, Fort Collins, CO
2016- Chief Medical Officer, LifeBoard Medical, LLC, Denver, CO
2018- Region 8 Chief for Trauma American College of Surgeons Committee on Trauma
Other Experience and Professional Memberships
1991- American Medical Association
1998- American College of Surgeons
1998- Association of Women Surgeons
1999- American Association for the Surgery of Trauma
2001-2004 Vice Chair for Trauma for Tennessee
2005- Member, Advanced Trauma Life Support Committee
2002- Eastern Association for the Surgery of Trauma
2005-2011 Chair for Trauma, State of Tennessee
2005-2011 Tennessee Ambulance Board
2008-2009 Vice President, Tennessee Chapter, American College of Surgeons
2009-2010 President-Elect, Tennessee Chapter, American College of Surgeons
2010-2011 President, Tennessee Chapter, American College of Surgeons
2011-2018 Tennessee Trauma Center Inspection Team, Out-of-State Site Reviewer (Lead Reviewer)
2014- Western Trauma Association
2017 Associate Examiner, American Board of Surgery
Honors
1998 Chief Resident of the Year. Conferred by the James H. Quillen Medical School Class of 1999
1998 Upjohn Resident of the Year
2002 Alpha Omega Alpha Honor Society
2008 ACS/AAST Health Policy Scholarship
2008 Tennessee Hospital Association Award for Meritorious Service
2009 Tennessee Emergency Medical Services for Children Advocate Award
2011 Service Award Trauma Care Advisory Council - Tennessee
2016 American College of Surgeons Committee on Trauma ATLS Styner Meritorious Service Award
2018 Positively Collaborative Award Colorado Dept of Public Health Trauma Section
C. Contribution to Science
1. My early work addre ed he ran i ional circ la ion of he ne born and a he ba i for m Ma er The i
a. Dunn JA, Lorch V, Sinha SN. 1989. Responses of small intrapulmonary arteries to vasoactive compounds in
the fetal and neonatal lamb: Norepinephrine, epinephrine, serotonin and potassium chloride. Pediatric
Research 25:360-363.
2. During my research years as a resident, I focused on issues that pertained to critically ill patients in the ICU, on
such diverse issues as acute pancreatitis, hypoxia/reperfusion injury, radiation-related arterial disease,
trauma-related issues.
a. Dunn JA, Williams M. 1996. Ascending aortic rupture in the presence of an airbag. Annals of Thoracic
Surgery. 62:577-578.
b. Dunn JA, Li C, Ha T, Williams DL, Browder W, Kao R. 1996. Hypoxia/reperfusion induces transcription factor
NF-kB binding activity in human endothelial cells. Surgical Forum 82:379-382.c. Dunn JA, Li C, Ha T, Kao RL, Browder W. 1997. Therapeutic modification of NF-kB binding activity and TNF-a
gene expression during acute biliary pancreatitis. The American Surgeon. 63:1036 1044.
3. As a practicing acute care surgeon, I remain interested in critical illness and injury. I have participated in a host
of multi-institutional trauma trials, published educational articles, and am a contributor to the American College
of Surgeons Committee on Trauma Advanced Trauma Life Support Course.
a. Karmy-Jones R, Jurkovich GJ, Velmahos GC et al. Practice Patterns and Outcomes of Retrievable Vena
Cava Filters in Trauma Patients: An AAST Multicenter Study. J Trauma 2007;62:17-25.
b. Ali J, Dunn JA, Eason MP, Drumm JL. Comparing the Simulator with the Live Patient Model in the ATLS
Initial Assessment Station. J Surg Res 2010;162: 7-10.
c. Bernard, A. and the Polyheme Workgroup. Postinjury Resuscitation with Human Polymerized
Hemoglobin Prolongs Early Survival: A Post Hoc Analysis The Journal of Trauma, Injury, Infection and Critical
Care. J Trauma. 2011 May; 70(5 Suppl):S34-7.
d. Advanced trauma life support (ATLS®): the ninth edition. ATLS Subcommittee.; American College of
Surgeons Committee on Trauma. International ATLS working group. J Trauma Acute Care Surg. 2013
May;74(5):1363-6.
e. Inaba K, Byerly S, Bush LD, et al.; WTA C-Spine Study Group. Cervical spinal clearance: A prospective
Western Trauma Association Multi-institutional Trial. J Trauma Acute Care Surg. 2016;81(6):1122-1130.
f. Tapson VF, Hazelton JP, Myers J, Robertson C, Gilani R, Dunn JA, et al. Evaluation of a Device Combining an
Inferior Vena Cava Filter and Central Venous Catheter for Preventing Pulmonary Embolism Among Critically
Ill Trauma Patients. J Vasc Intervent Radiol 2017;28(9):1248-1254.
g. Dunn JA, et al. 2017. ATLS 10th Edition. American College of Surgeons, Committee on Trauma.
Shackford SR, Dunne CE, Karmy-Jones R, Long W, Teso D, Schreiber MA, Watson J, Watson C BS; McIntyre
RC, Ferrigno L, Shapiro M, Southerland K, Dunn JA, et al. The Evolution of Care Improves Outcome in Blunt
Thoracic Aortic Injury: A Western Trauma Association Multicenter Study. J Trauma Acute Care Surg. 2017;
83(6):1006-1013.
h. Zarzaur BL, Dunn JA, Leininger B, et al. Natural history of splenic vascular abnormalities after blunt injury: A
Western Trauma Association multicenter trial. J Trauma Acute Care Surg. 2017; 83(6):999-1005.
i. Callcut R, Kornblith L, Conroy A, et al. The Why and How Our Trauma Patients Die: A Prospective Multicenter
Western Trauma Association Study. J Trauma Acute Care Surg. 2019 May; 86(5):864-870.
j. Ley EJ, Leonard SD, Barmparas G, et al. Beta blockers in Critically Ill Patients with Traumatic Brain Injury:
Results from a multi-center, Prospective, Observational AAST Study. J Trauma Acute Care Surg.
2018;84(2):234-244.
k. Holzmacher JL, Reynolds C, Patel M, et al. Platelet Transfusion Does Not Improve Outcomes in Brain Injured
Patients on Antiplatelet Therapy. Brain Injury 2018;32:3,325-330.
l. Yuma P, Orsi R, Dunn JA, et al. Traumatic injury and access to care in rural areas: leveraging linked data and
geographic information systems for planning and advocacy. Rural Remote Health. 2019 Sep; 19 (3):5089.m. Hend Ibrahim, Omar Alnachoukati, Bridget A. Baxter, Trinette Chapin, Thomas Schroeppel, Julie Dunn and
Elizabeth P. Ryan. Non-Targeted Metabolomics Signature in the Plasma and Bone Marrow of Patients with
Long Bone Injuries. Curr Metab Systems Biol. In Press.
D. Research Support
Ongoing Research Support
NIH/NIBIB 1R25EB025791-01 Brennan-Pierce (PI) 2018-2022
Clinical Immersion Program for Engineers. Co-PI de minimus 1% effort
$125,000
Eastern Association for the Surgery of Trauma Trials Group Dunn (Sub-PI) 2019-Present
Brain versus bone: Does fracture fixation technique influence outcomes in
Patients with traumatic injury.
NIH/NIBIB R21EB024683 Mueller (PI) 9/01/2017 5/31/2020
An integrated electrical impedance/ultrasound tomography system for
pulmonary monitoring and Diagnosis. Co-PI $558,604
Phase II, multicenter, double-blind, placebo-controlled study to assess 2017- Present
Efficacy, safety and tolerability of AVP-786 for the treatment of
Neurobehavioral Disinhibition including aggression, agitation, and irritability in patients with
Traumatic brain injury (Sub-PI). Industry Sponsored
A prospective multi-center evaluation of geriatric patients with traumatic 2017- Present
Brain injury. AAST Multi-Institutional Trials Network (Sub-PI)
Completed Research Support
NIH/NLM 1 R43 LM012959-01 Dunn (PI) 2018
Automated Real-Time Trauma Resuscitation Communication System for
Clinical Decision Support. PI $150,000
Lifeboard Proof-of-Concept Grant. Dunn (PI) Colorado Office of 2015- 2017
Economic Development and International Trade $150,000
Colorado State University Co-Pilot Dunn (Co-PI) 2015- 2017
Novel anti-infective meshes for complex hernia repair: in vitro and in vivo
modeling. $60,000
Industry-Sponsored Dunn (PI) 2015-2016
Phase III case series clinical study of the reversal of the anticoagulant
effects of dabigatran by IV administration of idarucizumab in patients
treated with dabigatran who have uncontrolled bleeding or require
surgery or procedures.
PVHS Foundation Grant Dunn (PI) 2012-2014
Fat Emboli: The Role of Fat Emboli in the Trauma Inflammatory Response.
Industry-Sponsored Dunn (PI) 2014-2016
Angel Catheter Clinical Trial: Prevention of pulmonary embolism in high
risk subjects.OMB No. 0925-0001 and 0925-0002 (Rev. 03/2020 Approved Through 02/28/2023)
BIOGRAPHICAL SKETCH
Provide the following information for the Senior/key personnel and other significant contributors.
Follow this format for each person. DO NOT EXCEED FIVE PAGES.
NAME: Mansoor Ali Khan
eRA COMMONS USER NAME (credential, e.g., agency login):
POSITION TITLE: Honorary Clinical Professor of Trauma Surgery, Brighton and Sussex Medical School
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing,
include postdoctoral training and residency training if applicable. Add/delete rows as necessary.)
DEGREE Completion
(if Date FIELD OF STUDY
INSTITUTION AND LOCATION
applicable) MM/YYYY
Kings College London, UK AKC 2000 Theology/Philosophy
Kings College London, UK MB 2000 Bachelor of Surgery
Kings College London, UK BS 2000 Bachelor of Medicine
Royal College of Surgeons of England, UK MRCS(Eng) 2005 Membership (Surgery)
Royal College of Surgeons of England, UK FRCS(Gen) 2010 Fellowship (Surgery)
European Board of Surgery, Belgium FEBS(Gen) 2016 Fellowship (Surgery)
American College of Surgeons, USA FACS 2016 Fellowship (Surgery)
University of Warwick, UK PhD 2016 Medicine
Pearson BTEC, UK PGDip 2019 Strategic Management
Chartered Management Institute, UK CMgr 2020 Management
Chartered Management Institure, UK FCMI 2020 Management
A. Personal Statement
Mansoor Khan MBBS(Lond) PhD PGDip FRCS(GenSurg) FEBS(GenSurg) FACS AKC is a Consultant
Oesophagogastric, Trauma and General as well as Honorary Clinical Professor of Trauma Surgery at Brighton
and Sussex University Hospitals. He has recently retired from the Royal Navy, at the rank of Surgeon
Commander after completing o er t o decades of militar ser ice ith distinction. After grad ation from King s
College London in 2000, he undertook his House Officer training in Plymouth and Portsmouth, followed by
three years of military posts. In November 2001 he graduated from Britannia Royal Naval College in Dartmouth
and was deployed in the Northern Arabian Gulf on military operations upon completion. The remainder of his
General D ties sa deplo ments in the Baltic and North Sea on NATO s Immediate Reaction Force of
Minehunters, the 2003 Gulf War and Counter narcotics deployment in the Caribbean.
Upon completion of three years of Military General Duties, he commenced surgical training completing his
rotations in Peterborough, Birmingham and South Yorkshire. Having successfully obtained his FRCS in
General Surgery in 2010, he subsequently got deployed on a busy tour at Camp Bastion in Afghanistan,
followed directly by a 1-year Trauma Critical Care Fellowship at the world-renowned R Adams Cowley Shock
Trauma Center in Baltimore, USA. He was appointed a Consultant General Surgeon in the Defence Medical
Services of the UK, and subsequently was awarded a Fellowship of the European Board of Surgery and
Fellowship of the American College of Surgeons. Since appointment as a Consultant Trauma Surgeon he has
undertaken multiple operational tours and was the Lead Clinician for the Military Team that was awarded the
Military Civilian Health Partnership Award in 2014 for Team of the Year, for work in Afghanistan. More recently,
he has just returned from a 4-month tour of South Sudan on a United Nations deployment.Military positions have included being the Consultant Advisor in General Surgery (Head of General Surgery) to Medical Director General Royal Navy, and the Senior Lecturer in Military Surgery at the Royal Centre for Defence Medicine. Current positions include Visiting Professor of Physics at Imperial College London and a number of international Adjunct Professor of Surgery (USUHS, Bethesda and Shock Trauma, Baltimore, NIHR positions, overseas Academic positions, Editor/Associate Editor and Reviewer for multiple journals, undergraduate and postgraduate examiner, Co- Director of the Definitive Surgical Trauma Skills course at the Royal College of Surgeons of England, a member of multiple international surgical organisations as well as being faculty on multiple international surgical training courses. He is keen on research and has published extensively with over 200 publications, book chapters and conference papers and secured in excess of £3 Million in research grants. His interests include research into Primary Injury Prevention, Blast Mitigation strategies, Haemorrhage control, Trauma education, Physiological monitoring, studying the gut microbiome in relation to trauma and hypoperfusion and research into Oesophagogastric and General Surgical techniques and advances. B. Positions and Honors RESEARCH/ACADEMIC APPOINTMENTS 2020 Present: Honorary Clinical Professor of Trauma Surgery, Brighton and Sussex University Hospital, Brighton, UK 2019 Present: Visiting Professor in Plasma Physics, Imperial College London, London, UK 2018 Present: Adjunct Professor of Surgery, Uniformed Services University Health Sciences, Bethesda, USA 2018 Present: Adjunct Professor of Surgery, R Adams Cowley Shock Trauma Center, Baltimore, USA 2016 Present: Clinical Lead for ED, Acute Care and Trauma. London NIHR DEC, Imperial College London 2016 Present: NIHR NWL Plastics and Hand Lead, NIHR NWL CRN, London 2016 Present: NIHR NWL Trauma Lead, NIHR NWL CRN, London 2013 Present: Senior Researcher at the Motor Knowledge Institute Automobile and Touring Club of the United Arab Emirates, United Arab Emirates 2014 2019: Honorary Senior Clinical Lecturer, Department of Surgery and Cancer, Imperial College London 2016 2019: Senior Lecturer in Military Surgery, Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine. JOURNAL AFFILIATIONS 2020 Present: Editorial Board for Journal of Endovascular Trauma Management 2018 Present: Reviewer The Lancet 2018 Present: Editorial Board for Journal of the Royal Naval Medical Service 2018 Present: Editor for Journal of Abdominal Wall Reconstruction 2017 Present: Reviewer BMJ Open 2017 Present: Reviewer European Journal of Trauma and Emergency Surgery 2017 Present: Reviewer Journal of Patient Experience 2016 Present: Associate Editor for Trauma (SagePub) 2016 Present: Editorial Board for Trauma (SagePub) 2014 Present: Reviewer Journal of Trauma and Acute Care Surgery 2014 Present: Reviewer Emergency Medicine Journal 2013 Present: Reviewer for Scandanavian Journal of Gastroenterology 2013 Present: Reviewer RAMC (Now Military Health) Journal
MEMBERSHIP OF INTERNATIONAL ORGANISATIONS
2020 Present: Association of Upper GI Surgeons
2019 Present: International Surgical Society
2019 Present: International Association for Trauma Surgery and Intensive Care
2018 Present: Damage Control Resuscitation Society
2018 Present: Motorsport UK
2018 Present: Ambroise Pare International Military Surgery Forum
2018 Present: American Association for the Surgery of Trauma
2016 Present: American College of Surgeons
2016 Present: European Society of Emergency and Trauma Surgery
2013 Present: Eastern Association for the Surgery of Trauma
2013 Present: Association of Trauma and Military Surgeons
2012 Present: Association of Military Surgeons of the United States
C. Contributions to Science
PhD THESIS
OUTCOMES OF LAPAROSCOPIC FUNDOPLICATION
University of Warwick Medical School. M Khan. Awarded: October 2016
SUPERVISION
3 x PhD Candidates Supervised
14 x MSc Students Supervised
PROJECTS COMPLETED
EXERCISE ICE MAIDEN
ADMST/ADGPPC/Imperial College London
This is multicentre collaboration to monitor 6 female soldiers as they try and reach the South Pole. We will be
developing and utilising Physiological Sensors that are miniaturised and can record physiological data for the
3-month trek. This will allow us to develop arduous monitoring equipment which can potentially be utilised to
provide real time data in soldiers.
SPINAL INJURY PREVENTION
Motor Knowledge Institute of the Automobile and Touring club of the UAE/FIA/Imperial College London
There is a high incidence of spinal cord injury and vertebral column fractures in Motorsport. This study is
utilising accelerometers to determine the forces transmitted through the spine and development of mitigating
strategies i.e. adapted seats, within the confines of Motorsport regulation.
NIHR DEC STUDY – POC TEG (Phase 1 Studies for CoaguScan)
Imperial College London/Highland BioSciences Ltd
Highland Bioscience Limited (HBL) have created a viscoelastic device, CoaguScan, which measures the ability
of a patient s blood to clot (i.e. their c rrent clotting stat s) sing portable and d rable technolog . It has been
created to improve upon current viscoelastic devices such as thromboelastography (TEG®) and rotationalthromboelastometry (ROTEM®). Unlike TEG and ROTEM, this HBL technology has the ability to deliver results to clinicians at the point of care (i.e. at the patient s bedside). Phase 1 trials are complete. ONGOING STUDIES/PhD/MSc Ethomics of Surgery Imperial College London Ethomics is the high-throughput machine measurement of animal behaviour, including human motor movements and skills. We propose a novel, ethomics-based surgical planning and training model, which harnesses the power of artificial intelligence to analyse the movements of skilled senior surgeons whilst performing surgery,and b ild a s rgical roadmap for said proced res. The AI-developed roadmap will be then used to plan neurosurgical procedures and train junior surgeons, giving them real-time feedback on their performance when practicing before they undertake the procedures on real patients, thereby optimising training and enhancing patient safety. MOTORSPORT IMPACT MITIGATION DEVICES McLaren/Mercedes Petronas/Institute of Shock Physics (Imperial College London)/Dyson School of Engineering (Imperial College London) There is a high incidence of spinal cord injury and vertebral column fractures in Motorsport. This subsequent study is utilising data obtained from accelerometers to develop adapted seats, seat mounts and mitigation devices working within the confines of Motorsport regulation MATERIALS FOR MITIGATION OF PRIMARY BLAST Imperial College London Two PhD students considering the visceral effects of the blast wave and developing body armour to mitigate against the primary blast insult. NIHR DEC STUDY – POC TEG (Phase 0, 1, 2 and 3 Studies for CoaguScan) Imperial College London/Highland BioSciences Ltd VENTILATORY STRATEGIES IN THE MANAGEMENT OF BLAST LUNG Imperial College London/New York University/University of Maryland/University of Nottingham The optimal strategy for managing casualties in suffering from Blast Lung is not known. Currently, the management is the same as for those patients who suffer from Acute Respiratory Distress Syndrome (ARDS), following the ARDSNet Protocol. The University of Nottingham in collaboration with Dr Habashi (UM and NYU) has developed a mathematical model to compare Airway Pressure Release Ventilation (APRV) and ARDSNet, with a view to undertaking further animal studies should the results demonstrate that APRV is superior to ARDSNet. METABOLIC PHENOTYPING OF THE GUT MICROBIOME IN MAJOR HAEMORRHAGE: A PILOT STUDY ADMST/Imperial College London/DSTL Porton Down To determine if patients subjected to major haemorrhage perturb the metabolic function of the gut microbiota and can gut microbial co-metabolism be used to predict survival or to stratify therapy? £3.5 Million successfully raised in NIHR and Innovate UK, amongst others in funds
D. Additional Information: Research Support and/or Scholastic Performance Recent Publications. Di Saverio S, Pata F, Khan M, Ietto G, Zani E, Carcano G. Convert to open: the new paradigm for surgery during COVID‐19? Br J Surg. 2020 May 05. Tatum D, Duchesne J, Pereira B, Cotton B, Khan M, Brenner M, et al. Time to Hemorrhage Control in a Hybrid ER System: Is it Time to Change? Shock (Augusta, Ga). 2020. Penn C, Khan M. Is laparoscopy still of value in managing the patient with abdominal trauma? Trauma. 2020;22(1):40-4. Ordoñez CA, Khan M, Cotton B, Perreira B, Brenner M, Ferrada P, et al. The Colombian Experience in Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): The Progression from a Large Caliber to a Low-Profile Device at a Level I Trauma Center. Shock (Augusta, Ga). 2020. Naumann DN, Pearce AP, Martin M, Khan MA. Should All Trauma Surgeons be Proficient in Laparoscopy? Surgical Laparoscopy Endoscopy & Percutaneous Techniques. 2020;30(1):91-2. Khan S, Elghazaly H, Mian A, Khan M. A meta-analysis on anticoagulation after vascular trauma. European Journal of Trauma and Emergency Surgery. 2020:1-9. Kauvar D, Cotton B, Khan M, Perreira B, Brenner M, Ferrada P, et al. Challenges and Opportunities for Endovascular Treatment of Hemorrhage in Combat Casualty Care. Shock. 2020. Kauvar D, Cotton B, Khan M, Perreira B, Brenner M, Ferrada P, et al. Circulatory Trauma: A Paradigm for Understanding the Role of Endovascular Therapy in Hemorrhage Control. Shock. 2020. Hörer TM, Pirouzram A, Khan M, Brenner M, Cotton B, Duchesne J, et al. Endovascular Resuscitation and Trauma Management (EVTM)-Practical Aspects and Implementation. Shock (Augusta, Ga). 2020. Goh E, Chidambaram S, Segaran E, Rey V, Khan M. A meta-analysis of the outcomes following enteral vs parenteral nutrition in the open abdomen in trauma patients. Journal of Critical Care. 2020;56(2):42-8. Duchesne J, Taghavi S, Houghton A, Khan M, Perreira B, Cotton B, et al. Prehospital Mortality Due to Hemorrhagic Shock Remains High and Unchanged: A Summary of Current Civilian EMS Practices and New Military Changes. Shock (Augusta, Ga). 2020. Di Saverio S, Khan M, Pata F, Ietto G, De Simone B, Zani E, et al. Laparoscopy at all costs? Not now during COVID-19 and not for acute care surgery and emergency colorectal surgery: a practical algorithm from a Hub Tertiary teaching hospital in Northern Lombardy, Italy. Journal of Trauma and Acute Care Surgery. 2020.
OMB No. 0925-0001 and 0925-0002 (Rev. 03/2020 Approved Through 02/28/2023)
BIOGRAPHICAL SKETCH
Provide the following information for the Senior/key personnel and other significant contributors.
Follow this format for each person. DO NOT EXCEED FIVE PAGES.
NAME: Emrys Kirkman
eRA COMMONS USER NAME (credential, e.g., agency login):
POSITION TITLE: Dstl Fellow in Combat Casualty Care (At D , Fe i a e i cie ific role rather than
a training position)
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing,
include postdoctoral training and residency training if applicable. Add/delete rows as necessary.)
DEGREE Completion
(if Date FIELD OF STUDY
INSTITUTION AND LOCATION
applicable) MM/YYYY
University of Manchester (UK) B.Sc. 06/1981 Physiology and
(Hons) Pharmacology
University of Manchester (UK) Ph.D. 10/1987 Physiology
A. Personal Statement
I am the Dstl Fellow for Combat Casualty Care working for the Defence Science and Technology Laboratory
(Dstl) at Porton Down. Dstl is an agency of the Ministry of Defence (MoD) and exists to supply the very best,
impartial, scientific and technical research advice to the MoD and Other Government Departments. I am one
of two academic leads for the Combat Casualty Care research program. My overall role is to ensure Dstl
delivers relevant clinical solutions and evidence base to support changes in clinical management strategies to
our stakeholders. A number of solutions have already become operational and have impacted on the care of
battlefield casualties which, based on published comments by senior members of DMS, has reduced mortality
and morbidity in wounded service men and women.
My interest in this fellowship stems from 33 years of trauma research. Trauma is the single biggest cause of
mortality in the first four decades of life in the developed countries, and is responsible for an even greater
amount of morbidity. There are enormous challenges in the management of trauma casualties, and a long
pathway from initial injury to eventual recovery. Physiological responses and treatments given early can have
long ranging effects on the recovery capacity of the casualty, which can only be understood and improved
upon based on multidisciplinary research. This is because trauma is a multisystem problem, and the
ca a i eg a ed e e he i i ia a a and subsequent treatment are key to survival and
recovery. The underlying signals are complex; the initial hemodynamic response and alteration in oxygen
transport, followed by reperfusion during resuscitation that impinges on the inflammatory and coagulation
systems and microvascular control. All of this causes profound changes in metabolism. We already have
established in vivo models of complex trauma, developed in collaboration with clinical colleagues, and a
capability to integrate physiology, immunology and vascular biology. Expanding this capability, by
collaboration with an established center of excellence, into metabolomics is the logical next step. The fellow
will join us at an exciting time as the link between us and Imperial College develops. The fellow will not only
gain experience of metabolomics in trauma, but also the development of research protocols and the integration
of scientific disciplines in the context of clinical practice.B. Positions and Honors
Positions and Employment (honorary appointments shown in italics)
1984-87 Research Fellow, Department of Physiology, Royal Free Hospital
School of Medicine, London, UK
1987-90 Post-Doctoral Research Fellow, North Western Injury Research
Centre, University of Manchester, UK
1989-97 Honorary Lecturer, Department of Physiological Sciences (then
School of Biological Sciences), University of Manchester, UK
1990-96 Member of MRC scientific (non-clinical) staff, North Western Injury
Research Centre, University of Manchester, UK
1996-2002 Lecturer, Department of Biological Sciences, University of Durham,
Durham, UK
2000-present Honorary Lecturer, Faculty of Medicine, Newcastle University, UK
2001-10 Honorary Senior Lecturer, Academic Division, James Cook
University Hospital, Cleveland, UK
2002-04 Senior Lecturer, School for Health, University of Durham, UK
2004-current Honorary Senior Lecturer, School for Health (now School of
Medicine, Pharmacy and Health), University of Durham, UK
2004-current Team Leader Surgical Science then, Principal Scientist and
Academic Lead for Combat Casualty Care Research Programme,
then Dstl Fellow in Combat Casualty Care and Academic Lead
for Combat Casualty Care Research Programme, Chemical
Biological and Radiological Division, Dstl Porton Down, UK
2018-current Honorary Senior Lecturer, Sunderland University, UK
Awards and Honors
1981 British Heart Foundation Research Scholarship
1989 Emergency Medicine Research Society Research Scholarship
2007 Ministry of Defence Chief Scientific Advisor Science Innovation
Tech g Ce ifica e f C e da i f e ce i a c ib i
to work, as a member of Factor VIIa team, for development of an
effective treatment to control haemorrhage the leading cause of
battlefie d dea h.
2009 Royal College of Anaesthetists Macintosh Professorship
2010 Ministry of Defence Chief Scientific Adviser Certificate of
Commendation in recognition of exceptional contribution to Defence
Science and Technology
2016 Officer of the Most Excellent Order of the British Empire (OBE) for
services in support of military medical treatment
Professional Memberships
1988 European Shock Society
1990 British Pharmacological Society
2000 Physiological Society
2001 American Physiological Society
2014 Fellow of The Royal Society of Medicine
2015 Shock Society
C. Contributions to Science
Initial work focused on cardiovascular reflexes and their interactions.
1) Scott EM, Kirkman E. Resetting of the baroreceptors by atenolol in the anaesthetized cat. Eur J
Pharmacol. 1983 Oct 14;94(1-2):167-70. doi: 10.1016/0014-2999(83)90457-0. PMID: 6653657.2) Daly MD, Kirkman E. Cardiovascular responses to stimulation of pulmonary C fibres in the cat: their
modulation by changes in respiration. J Physiol. 1988 Aug;402:43-63. doi:
10.1113/jphysiol.1988.sp017193. PMID: 3070009; PMCID: PMC1191880.
3) Daly MB, Kirkman E. Differential modulation by pulmonary stretch afferents of some reflex cardioinhibitory
responses in the cat. J Physiol. 1989 Oct;417:323-41. doi: 10.1113/jphysiol.1989.sp017804. PMID:
2621597; PMCID: PMC1189269.
I then moved on to work in the field of trauma, initially focusing on reflexes, hemodynamic responses
and oxygen transport in in vivo models
4) Little RA, Marshall HW, Kirkman E. Attenuation of the acute cardiovascular responses to haemorrhage by
tissue injury in the conscious rat. Q J Exp Physiol. 1989 Nov;74(6):825-33. doi:
10.1113/expphysiol.1989.sp003352. PMID: 2594935.
5) Rady MY, Little RA, Edwards JD, Kirkman E, Faithful S. The effect of nociceptive stimulation on the
changes in hemodynamics and oxygen transport induced by hemorrhage in anesthetized pigs. J Trauma.
1991 May;31(5):617-21; discussion 621-2. doi: 10.1097/00005373-199105000-00004. PMID: 2030507.
6) Rady MY, Kirkman E, Cranley J, Little RA. A comparison of the effects of skeletal muscle injury and
somatic afferent nerve stimulation on the response to hemorrhage in anesthetized pigs. J Trauma. 1993
Nov;35(5):756-61. doi: 10.1097/00005373-199311000-00018. PMID: 8230342.
7) Kirkman E, Zhang H, Spapen H, Little RA, Vincent JL. Effects of afferent neural stimulation on critical
oxygen delivery: a hemodynamic explanation. Am J Physiol. 1995 Dec;269(6 Pt 2):R1448-54. doi:
10.1152/ajpregu.1995.269.6.R1448. PMID: 8594948.
I then became engaged in military trauma, with a substantial focus on blast (explosive) injuries
8) Ohnishi M, Kirkman E, Guy RJ, Watkins PE. Reflex nature of the cardiorespiratory response to primary
thoracic blast injury in the anaesthetised rat. Exp Physiol. 2001 May;86(3):357-64. doi:
10.1113/eph8602145. PMID: 11429653.
9) Sawdon M, Ohnishi M, Watkins PE, Kirkman E. The effects of primary thoracic blast injury and morphine
on the response to haemorrhage in the anaesthetised rat. Exp Physiol. 2002 Nov;87(6):683-9. doi:
10.1113/eph8702432. PMID: 12447448.
10) Garner JP, Watts S, Parry C, Bird J, Kirkman E. Development of a large animal model for investigating
resuscitation after blast and hemorrhage. World J Surg. 2009 Oct;33(10):2194-202. doi: 10.1007/s00268-
009-0105-4. PMID: 19653034.
11) Garner J, Watts S, Parry C, Bird J, Cooper G, Kirkman E. Prolonged permissive hypotensive resuscitation
is associated with poor outcome in primary blast injury with controlled hemorrhage. Ann Surg. 2010
Jun;251(6):1131-9. doi: 10.1097/SLA.0b013e3181e00fcb. PMID: 20485127.
Also, coagulopathy of trauma and treating severe bleeding in a military setting
12) Sapsford W, Watts S, Cooper G, Kirkman E. Recombinant activated factor VII increases survival time in a
model of incompressible arterial hemorrhage in the anesthetized pig. J Trauma. 2007 Apr;62(4):868-79.
doi: 10.1097/ta.0b013e318034204b. PMID: 17426541.
13) Hodgetts TJ, Mahoney PF, Kirkman E. Damage control resuscitation. J R Army Med Corps. 2007
Dec;153(4):299-300. doi: 10.1136/jramc-153-04-16. PMID: 18619167.
14) Kirkman E, Watts S, Hodgetts T, Mahoney P, Rawlinson S, Midwinter M. A proactive approach to the
coagulopathy of trauma: the rationale and guidelines for treatment. J R Army Med Corps. 2007
Dec;153(4):302-6. doi: 10.1136/jramc-153-04-17. PMID: 18619168.
15) Hodgetts TJ, Kirkman E, Mahoney PF, Russell R, Thomas R, Midwinter M. UK defence medical services
guidance for the use of recombinant factor VIIa (rFVIIa) in the deployed military setting. J R Army Med
Corps. 2007 Dec;153(4):307-9. doi: 10.1136/jramc-153-04-18. PMID: 18619169.
More recently the models and areas of interest have become more complicated, looking at
mechanisms of coagulopathy and inflammatory responses in addition to oxygen transport
16) 15: Doran CM, Doran CA, Woolley T, Carter A, Male K, Midwinter MJ, Mahoney PF, Watts S, Kirkman E.
Targeted resuscitation improves coagulation and outcome. J Trauma Acute Care Surg. 2012
Apr;72(4):835-43. doi: 10.1097/TA.0b013e318248347b. PMID: 22491594.
17) Watts S, Nordmann G, Brohi K, Midwinter M, Woolley T, Gwyther R, Wilson C, Poon H, Kirkman E.
Evaluation of Prehospital Blood Products to Attenuate Acute Coagulopathy of Trauma in a Model ofYou can also read
