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The “Shoresh” meeting is a bilateral Israel-United States meeting on military medicine, jointly led by the
IDF Medical Corps and the US Army Medical Research and Development Command )MRDC(. It is part of the cooperation agreement for military R&D. The first meeting took place in 1980 and revolved around the medical response to the threat of chemical warfare agents. Over the years, the meeting was gradually expanded to other areas of the Medical Corps’ work. During the CBRN sessions at the current meeting, comprehensive scientific reviews were provided, the core issues of preparedness against threats were discussed, and professional tours were held at the US Army, USAMRIID, and AFRRI research centers. The meeting included a special session on synthetic biology, both as the source of an emerging threat and as an innovative tool that enables the development of new and advanced technologies, aiming to formulate common topics of interest for dialogue in future meetings. After a timeout due to the COVID-19 pandemic, the conference served as a basis for the renewal of communication and cooperation in the field of R&D of CBRN medicine. The next “Shoresh” meeting is scheduled to take place in Israel in 2024. As a lesson from the current meeting, preparatory meetings between the parties ought to be scheduled in order to focus the expected discussion topics and monitor the implementation of the defined promotion topics.

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The “Shoresh” conference, a joint working conference of the US and Israeli military medical corps, has been taking place for several decades in order to create opportunities for setting up clinical and research collaborations. This year, the conference comprised nine working groups, including CBRN defense, emergency medicine, physiology, public health, and mental health. In this article, the authors summarize impressions of the mental health working group that is concerned with human behavior issues and stressful environments. The topics discussed included performance improvement, health promotion, sleep problems, stress reactivity, mental distress, suicidal behavior, resilience, and unit cohesion. The participants agreed to strengthen the exchange of information and research findings in these areas.

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In this article, we present the highlights and insights from the Victim Identification Forensic Pathology Session )Identification of Victims of Mass Casualty Events ]IVMCE[ Working Group( of the US/Israel Shoresh Data Exchange Conference, September 1822, 2022, Rockville, Maryland. Topics included novel techniques in DNA processing and data analysis. A joint session with the Combat Casualty Care Group dealt with the important role of forensic pathology in determining causes and mechanisms of death in the military, injury patterns that affect future outcomes, preventable deaths and mitigation strategies, and the status of the IDF pre-hospital, interactive, wearable medical record. Forensic investigations of spaceflight mishaps were presented, as were techniques for identifying challenging remains, including novel fingerprinting techniques. The usefulness of UAV’s for vitality determination and victim identification at sites of limited access and mass casualty events was discussed, with emphasis on the role of thermal imaging. Toxicological findings in military personnel were presented, including effects on soldier performance and suicide rates. Both sides presented advanced measures to protect chain-of-custody of remains from the field. The forensic approach to COVID-19, including pathologic findings and mitigation strategies, was presented, as were lessons from the IDF-MC DNA-laboratory. The US-Defense POW/ MIA Accounting Agency )DPAA( presented progress in identifying historical remains. Special topics included sudden cardiac death associated with exercise in service members and forensic pathologic findings in cases where restraining devices and tasers were used. The session concluded with a discussion about how to expand the exchange of students, residents, officers, forensic specialists, and researchers.

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The Israel Naval Medical Institute )INMI( of the Israeli Navy, based in Haifa, provides specialized routine and emergency medical services to Navy personnel serving in above or underwater capacities. The INMI has years of experience in medical and physiological aspects of diving and naval medicine, including hyperbaric oxygen therapy, fitness to dive/sail, approving diving profiles, medical screening, audiological testing, investigation of diving accidents, personalized treatment for motion sickness and disabled submarine medical standby. The INMI conducts original research to advance these topics for the benefit of the Israeli Navy. INMI and the Israeli Navy Medical Branch participated in the 2022 Shoresh conference with the US Navy, furthering the bilateral sharing of data and research results. The following are the topics that were presented at the conference.

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The Combat Casualty Care Working Group )CCC-WG( within the 2022 Shoresh meeting brought together experts from Israel and the United States to address critical challenges in combat casualty care. This article provides an overview of the CCC-WG sessions, summarizing several presentation topics, the future outlook on battlefield care, and key action items discussed during the meeting. With 16 presentations by representatives from each of the countries, the CCC-WG covered a wide range of topics, including trauma and brain health, medical evacuation of casualties in the f ield, combined injuries, postmortem investigations, trauma registries, prolonged f ield care, blood products, and various aspects of combat casualty care. The CCCWG identified specific action items to improve interoperability, define parameters for combined injury, compare and analyze trauma care guidelines and data sharing platforms, collaborate with military training schools, and establish quality indices for trauma care. This focused group effort reflects the dedication of both countries to advancing combat casualty care and improving outcomes for military personnel.