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8 Xenon is neuroprotective, improves outcome and promotes beneficial early neuroinflammation in a rat model of severe traumatic brain injury
Conclusion We show xenon is neuroprotective after severe TBI in rats. Functional improvement and neuronal preservation was associated with a xenon-induced enhancement of resting microglial cell numbers and astrocyte activation. These findings are consistent with a role for early beneficial neuroinflammation in xenon’s neuroprotective effect. Xenon may be of benefit in the treatment of clinical brain trauma. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - March 23, 2023 Category: General Medicine Authors: Campos-Pires, R., Onggradito, H., Ujvari, E., Karimi, S., Valeo, F., Aldhoun, J., Edge, C. J., Franks, N. P., Dickinson, R. Tags: Electronic page Source Type: research

7 Towards 3D printed medical devices in vivo
Conclusion Facile printing of devices for electronic characterisation, or optical components for characterisation with a conventional camera paves the way for a next generation of embedded bioelectronics that we foresee revolutionizing healthcare via personalised telemedicine. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - March 23, 2023 Category: General Medicine Authors: James Fong, M., Baldock, S. J., Cheneler, D., Appleby, J. B., Hardy, J. G. Tags: Electronic page Source Type: research

6 Analysis of 983 civilian blast and ballistic casualties and the generation of a predictive model of injury burden
Conclusion This evidenced based, predictive model of the immediate response required to manage civilians injured by blast and ballistic mechanism can be applied to the conflict in Ukraine and to prepare for terror attacks on mass urban populations where blast and ballistic injuries are commonplace. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - March 23, 2023 Category: General Medicine Authors: Maitland, L., Veen, H., Harrison, D., Baden, J., Hettiaratchy, S. Tags: Electronic page Source Type: research

5 Association between combat-related traumatic injury and skeletal health: bone mineral density loss is localised and correlates with altered loading in amputees - the ADVANCE study
Conclusion Changes in bone health in CRTI appear to be mechanically driven rather than systemic. This may arise from altered joint and muscle loading creating a reduced mechanical stimulus to the femur. These findings support a lexicon change to unloading osteopenia and should not be associated with a diagnosis of systemic osteoporosis nor systemic treatments. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - March 23, 2023 Category: General Medicine Authors: McMenemy, L., Behan, F., Kaufmann, J., Cain, D., Bennett, A., Boos, C., Fear, N., Cullinan, P., Bull, A., Phillips, A., McGregor, A. Tags: Electronic page Source Type: research

4 Using virtual reality to deliver essential neurosurgery in austere and low-resource settings
Conclusion We demonstrate proof-of-principle for bi-directional surgical skills assessment using a remote proctorship interface combining live-streaming, 2D and 360-degree videos, and access via the VRIMS telesurgical platform. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - March 23, 2023 Category: General Medicine Authors: Please, H., Edemaga, D., Bolton, W., Nagadya, C., Obiga, O., Kiryabwire, J., Smith, C., Khan, M., Dhanda, J., Ekanayake, J. Tags: Electronic page Source Type: research

3 Imaging of high activity radioactive fragments with mobile digital radiography equipment
Conclusion Even for fragment activities below the MDA, surgical teams are likely to approach occupational dose limits within an hour, and in some cases, minutes. Patient images could appear normal, with the injury site still receiving several hundred Grays, having severe impacts on patient outcomes and clinical decision making, such as amputation. This work has contributed to surgical and CBRN medical training, planning recommendations in NHS Emergency Preparedness procedures, and will support further work to develop UK and international clinical guidelines, refine dose thresholds, and investigate other imaging modalities....
Source: Journal of the Royal Army Medical Corps - March 23, 2023 Category: General Medicine Authors: May, E., Melley, T., Bland, S., Gibb, I., Napier, I. Tags: Electronic page Source Type: research

2 Developing a new model to investigate the mechanobiology of primary blast in soft tissue
Conclusion This work outlines the design and development of a mechanosensitive apparatus for probing the cellular effects of blast shock wave on biomimetic tissue culture models. Metabolic data up to one week after exposure gives new and detailed insight into the cellular signalling after blast in skeletal muscle. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - March 23, 2023 Category: General Medicine Authors: Staruch, R., Sedman, A., Macildowie, S., Cork, L., Cleveland, R., Snelling, S., Thompson, M., Rickard, R., Spear, A. Tags: Electronic page Source Type: research

1 Transfer of military surgical simulation developments to the civilian sphere
Conclusion These findings mirror the experience on the MOSTT course where 63% of participants indicated that their confidence had improved. These results demonstrate the value for high fidelity surgical simulation in civilian practice to help maintain currency in less frequently encountered injury patterns. The training includes the whole team in high fidelity DCS simulation without the need for live tissue or cadaveric material and shows that surgical mannequins developed for the military environment have utility on civilian trauma courses. Research by the authors about the effects of this model on surgical ability and pe...
Source: Journal of the Royal Army Medical Corps - March 23, 2023 Category: General Medicine Authors: Cohen, H., Swain, C., Stannard, A., Faulconer, E., Parker, P., Hand, C., Pallister, I. Tags: Electronic page Source Type: research

Correction: Using CT scans to determine the optimal sizes of hard armour plates to protect the torso for UK female Armed Forces personnel
(Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - January 23, 2023 Category: General Medicine Tags: Correction Source Type: research

Call of duty: the ethical imperative to increase the participation of women in UK military research
(Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - January 23, 2023 Category: General Medicine Authors: Kolstoe, S. E., Affleck, P., Cons, J., Davis, M. C. Tags: Letter Source Type: research

Sex differences in response to exercise heat stress in the context of the military environment
Women can now serve in ground close combat (GCC) roles, where they may be required to operate alongside men in hot environments. However, relative to the average male soldier, female soldiers are less aerobically fit, with a smaller surface area (A D), lower mass (m) with higher body fat and a larger A D/m ratio. This increases cardiovascular strain, reduces heat exchange with the environment and causes a greater body temperature increase for a given heat storage, although a large A D/m ratio can be advantageous. Physical employment standards for GCC roles might lessen the magnitude of fitness and anthropometric difference...
Source: Journal of the Royal Army Medical Corps - January 23, 2023 Category: General Medicine Authors: Corbett, J., Wright, J., Tipton, M. J. Tags: Invited review Source Type: research

Role of sex and stature on the biomechanics of normal and loaded walking: implications for injury risk in the military
Load carriage and marching ‘in-step’ are routine military activities associated with lower limb injury risk in service personnel. The fixed pace and stride length of marching typically vary from the preferred walking gait and may result in overstriding. Overstriding increases ground reaction forces and muscle forces. Women are more likely to overstride than men due to their shorter stature. These biomechanical responses to overstriding may be most pronounced when marching close to the preferred walk-to-run transition speed. Load carriage also affects walking gait and increases ground reaction forces, joint mome...
Source: Journal of the Royal Army Medical Corps - January 23, 2023 Category: General Medicine Authors: Gill, N., Roberts, A., O'Leary, T. J., Liu, A., Hollands, K., Walker, D., Greeves, J. P., Jones, R. Tags: Invited review Source Type: research

Gender data gap in military research: a review of the participation of men and women in military musculoskeletal injury studies
Servicewomen are at increased risk of musculoskeletal injuries compared with their male counterparts, but women are under-represented in sports medicine research. The aim of this review was to assess the representation of women in military musculoskeletal injury studies. PubMed was searched for human original research studies using the terms Military OR Army OR Navy OR ‘Air Force’ AND ‘musculoskeletal injury’. Each study was categorised as epidemiology (basic training), epidemiology (trained personnel), risk factors, interventions and other. The number of male and female participants was retrieved f...
Source: Journal of the Royal Army Medical Corps - January 23, 2023 Category: General Medicine Authors: O'Leary, T. J., Young, C. D., Wardle, S. L., Greeves, J. P. Tags: Invited review Source Type: research

Personalised digital technology for mental health in the armed forces: the potential, the hype and the dangers
The COVID-19 pandemic has resulted in a digital technology revolution which included widespread use in remote healthcare settings, remote working and use of technology to support friends and family to stay in touch. The armed forces have also increased its use of digital technology, but not at the same rate, and it is important that they do not fall behind in the revolution. One area where digital technology could be helpful is the treatment and management of mental health conditions. In a civilian setting, digital technology adoption has been found to be acceptable and feasible yet there is little use in the armed forces....
Source: Journal of the Royal Army Medical Corps - January 23, 2023 Category: General Medicine Authors: Leightley, D., Murphy, D. Tags: Personal view Source Type: research

Integrating women into combat roles: comparing the UK Armed Forces and Israeli Defense Forces to understand where lessons can be learnt
In October 2018, women became eligible to serve in all roles in the UK Armed Forces. The Israeli Defense Forces (IDF) have employed women in limited ground close combat (GCC) roles since 1995. Integration of women into some IDF combat units has improved our understanding of injury risk for servicewomen. While the research findings from physiological studies on women in IDF GCC roles helped inform the integration of women into UK GCC roles, the applicability of the data is limited by the differences between Israeli and UK approaches to recruitment, training and operational deployability of servicewomen. Women in IDF combat ...
Source: Journal of the Royal Army Medical Corps - January 23, 2023 Category: General Medicine Authors: Fieldhouse, A., O'Leary, T. J. Tags: Personal view Source Type: research