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Generational and occupational differences in human factors knowledge and awareness: a comparison study
Conclusion Non-training grade doctors are less likely to seek HF training. Military doctors are more familiar with HF and have undertaken more training. Given the role of HF in communication, human error, potential litigation, stress, conflict and gross negligence manslaughter convictions, further education is vital. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Herron, J. B. T., Ferris, C., Gilliam, A. Tags: Original research Source Type: research

A critical appraisal of impact of compounding factors in limb salvage decision making in combat extremity vascular trauma
Conclusions Multiple factors affect limb viability following compromised distal circulation and our data show a trend towards various subsets of limbs that are more vulnerable due to inherent or acquired paucity of collateral circulation. Early identification and prioritisation of these limbs could achieve functional limb salvage if recognised. Further prospective research should look into the clinical, biochemical and morphological markers to facilitate selection and prioritisation of limb revascularisation. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Ratnayake, A. S., Bala, M., Fox, C. J., Jayatilleke, A. U., Thalgaspitiya, S. P. B., Worlton, T. J. Tags: Original research Source Type: research

Effects of synbiotic supplementation on the components of metabolic syndrome in military personnel: a double-blind randomised controlled trial
Conclusion Findings of the study revealed that synbiotic supplementation may lead to a significant improvement in the BMI, triglyceride and FBG levels in the military personnel. Thus, consumption of synbiotic supplements is recommended as an adjuvant therapy in the military personnel with metabolic syndrome. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Parastouei, K., Saeidipoor, S., Sepandi, M., Abbaszadeh, S., Taghdir, M. Tags: Original research Source Type: research

Association between traumatic brain injuries and ketamine infusion side effects following combat injury
Conclusion In this small sample of combat-injured service members, we were unable to detect a difference in ketamine-related side effects by documented TBI status. These hypothesis-generating findings support the need for future studies to examine the use of intravenous ketamine infusions for pain management, and subsequent care outcomes in patients who experience polytraumatic trauma inclusive of TBI. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Kane, A. V., Giordano, N. A., Tran, J., Kent, M. L., Highland, K. B. Tags: Original research Source Type: research

Microscopic and macroscopic comparisons of 0.223 soft point and full metal jacket ammunition with bos taurus scapulae as a proxy to human flat bones
Conclusion Gunshot flat bone wound morphology is distinctively different between SP and FMJ rounds. Circumferential delamination is only seen with FMJ due to the hardness of the round. Lead staining is only seen with SP rounds due to bullet composition. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Taylor, S. C., Kieser, D. C., Hammer, N., Pullen, A., Hooper, G. Tags: Original research Source Type: research

Postdeployment reintegration attitude of injured Dutch service members: a longitudinal study
Conclusions The results showed that for the BCs the personal attitude becomes more negative in time. However, the negative attitude towards work decreases in time after deployment. Particular attention should be paid to traumatic stress and aftercare. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: de Kruijff, L. G. M., Plat, M.-C., van Dongen, T., Hoencamp, R., van der Wurff, P. Tags: Original research Source Type: research

Distance travelled by military recruits during basic training is a significant risk factor for lower limb overuse injury
Conclusion Recruits travel long distances during basic training, particularly in the first few weeks when they are not yet conditioned. This distance travelled is likely a contributing risk factor to the high incidence of overuse injuries seen during training, and strategies to reduce this distance should be explored. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Whittle, R. S. Tags: Original research Source Type: research

Changes in physical fitness and anthropometrics differ between female and male recruits during the Finnish military service
Conclusions The study revealed sex differences in adaptations to the standardised military training. Both male and female recruits improved their physical fitness, but smaller gains were observed in women using the same training programme. The mechanisms explaining sex differences in adaptations to military training, and whether tailored training programmes are needed specifically for female recruits to reduce sex differences during military service, warrants further studies. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Santtila, M., Pihlainen, K., Vaara, J., Tokola, K., Kyröläinen, H. Tags: Original research Source Type: research

Attitudes and perceived barriers to mental healthcare in the Peoples Liberation Army Navy: study from a navy base
Conclusions Extensive efforts to decrease organisational barriers and stigma towards mental healthcare should be a priority for researchers and policymakers to improve the usage of mental health services. Psychoeducation aimed at de-stigmatising mental health problems should be delivered and the accessibility and availability of mental health services should be increased. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Gu, R.-P., Liu, X. R., Ye, X. F. Tags: Open access Original research Source Type: research

Royal Society of Medicine, Colt Foundation Research & Clinical Innovation Meeting 2021
(Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Barnard, E., Breeze, J. Tags: Editorial Source Type: research

6 Cortical hypoperfusion on intensive care unit admission identifies the development of acute kidney injury. The microshock renal study
Conclusion Cortical hypoperfusion is detectable on admission to ICU using CEUS and identifies patients who will develop severe AKI. This paves the way for interventional study, individualizing renal resuscitation with vasoactive therapies. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Watchorn, J., Huang, D., Bramham, K., Hutchings, S. Tags: Royal Society of Medicine, Colt Foundation Research Prize Finalists Source Type: research

5 Rifaximin prophylaxis against travellers diarrhoea does nor increase acquisition of extended-spectrum ss - lactamase producing enterobacteriaceae (ESBL-E) in a UK military population travelling to Kenya
Conclusions While ESBL acquisition rate was relatively high (26.5%), rifaximin was not associated with an increase in ESBL acquisition. Further work will be performed to investigate acquisition of rifaximin resistance among commensal Enterobacteriaceae during the trial. Further Bioinformatic work is ongoing looking at acquisition of resistance genes. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Troth, T., Burns, D., Porter, C., Rimmer, J., Fraser, J., Lalani, T., Tribble, D., Schaik, W. V., Gutierrez, R. Tags: Royal Society of Medicine, Colt Foundation Research Prize Finalists Source Type: research

4 Early identification of high-risk individuals for combination monoclonal antibody therapy is feasible by SARS-CoV-2 anti-spike antibody specific lateral flow assay
Conclusions POC assays were found to be reliable predictors of both antibody status and broadly of neutralising antibody titre. Anti-S POC assays have potential to act as suitable alternatives for rapid identification of community patient immune status at presentation. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Pallett, S. J., Rayment, M., Randell, P., Davies, G. W., Moore, L. S. Tags: Royal Society of Medicine, Colt Foundation Research Prize Finalists Source Type: research

3* Evaluation of an Artificial Intelligence (AI) system to augment clinical risk prediction of Trauma Induced Coagulopathy in the pre-hospital setting: a prospective observational study
Conclusions AI systems can improve human risk prediction in the pre-hospital setting. In the military environment, where austerity and lack of senior clinical expertise may affect outcomes, the benefit of implementing predictive AI should be substantial. (*awarded First Place) (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Marsden, M., Perkins, Z., Marsh, W., Christian, M., Lyon, R., Davenport, R., Tai, N. Tags: Royal Society of Medicine, Colt Foundation Research Prize Finalists Source Type: research

2 Cardiopulmonary exercise testing excludes clinically significant disease in military patients recovering from COVID-19
Conclusion UK Armed Forces personnel with persistent symptoms post SARS-CoV-2 infection demonstrate reassuringly little organ pathology. CPET and functional capacity testing, but not reported symptoms, allow the exclusion of clinically significant disease. (Source: Journal of the Royal Army Medical Corps)
Source: Journal of the Royal Army Medical Corps - September 26, 2022 Category: General Medicine Authors: Chamley, R., Holdsworth, D., Barker-Davies, R., Bennett, A., OSullivan, O., Ladlow, P., Houston, A., May, S., Mulae, J., Xie, C., Cranley, M., Sellon, E., Naylor, J., Halle, M., Parati, G., Davos, C., Nicol, E. Tags: Royal Society of Medicine, Colt Foundation Research Prize Finalists Source Type: research