1,548 results match your criteria: "Royal Centre for Defence Medicine Research & Academia[Affiliation]"

While there are women represented in some notable positions within the UK Defence Medical Services (DMS), the challenges and barriers to successful female progression have not disappeared. The DMS needs highly talented, motivated doctors working to support operations, yet we struggle to recruit and retain female personnel. This is in clear contrast to the increased proportion of female personnel working within the civilian medical workforce.

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Article Synopsis
  • Researchers studied strokes from 1990 to 2021 to understand how many people get them and how they are affected around the world.
  • In 2021, strokes caused about 7.3 million deaths and were a major cause of health problems, especially in specific regions like Southeast Asia and Oceania.
  • There are differences in stroke risks based on where people live and their age, and some areas actually saw more strokes happening since 2015.
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The differential diagnosis of suspected multiple sclerosis has been developed using data from North America, northern Europe, and Australasia, with a focus on White populations. People from minority ethnic and racial backgrounds in regions where prevalence of multiple sclerosis is high are more often negatively affected by social determinants of health, compared with White people in these regions. A better understanding of changing demographics, the clinical characteristics of people from minority ethnic or racial backgrounds, and the social challenges they face might facilitate equitable clinical approaches when considering a diagnosis of multiple sclerosis.

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Social support is a key determinant of mental health across multiple populations and contexts. Little is known about social support among UK (ex-)military personnel, especially those with combat injuries following deployment to Afghanistan. This study aimed to investigate the level of perceived social support and its associations with mental health among injured and uninjured UK (ex-)military personnel.

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WONOEP appraisal: Genetic insights into early onset epilepsies.

Epilepsia

November 2024

Saul R. Korey Department of Neurology, Isabelle Rapin Division of Child Neurology, Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA.

Early onset epilepsies occur in newborns and infants, and to date, genetic aberrations and variants have been identified in approximately one quarter of all patients. With technological sequencing advances and ongoing research, the genetic diagnostic yield for specific seizure disorders and epilepsies is expected to increase. Genetic variants associated with epilepsy include chromosomal abnormalities and rearrangements of various sizes as well as single gene variants.

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Oxidative stress-induced neuronal apoptosis is primarily involved in brain aging and impaired hippocampal neurogenesis. Long-term D-galactose administration increases oxidative stress related to brain aging. Chrysin, a subtype of flavonoids, exhibits neuroprotective effects, particularly its antioxidant properties.

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Definitions of adverse events associated with extracorporeal membrane oxygenation in children: results of an international Delphi process from the ECMO-CENTRAL ARC.

Lancet Child Adolesc Health

October 2024

Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA; Susan B Meister Child Health Evaluation and Research Center, Division of General Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA. Electronic address:

Article Synopsis
  • ECMO is a complex and risky life support system that lacks standardized definitions for adverse outcomes, which hinders effective research and practices.
  • The ECMO-CENTRAL ARC was formed to create clear definitions for pediatric ECMO adverse events, using input from literature and a diverse expert panel.
  • After three rounds of surveys, 13 key adverse event definitions were established and unanimously agreed upon by the voting experts.
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  • Antimicrobial resistance (AMR) is a significant global health issue in the 21st century, affecting the burden of disease and mortality linked to bacterial infections across various regions.
  • A comprehensive study was conducted to assess the impact of AMR from 1990 to 2021, analyzing data from 204 countries on deaths and disability-adjusted life years (DALYs) related to 22 pathogens and 84 pathogen-drug combinations.
  • The researchers employed statistical modeling and extensive datasets to estimate AMR's burden, even in areas lacking direct data, considering multiple factors such as sepsis-related deaths and antibiotic resistance rates.
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Sequential [Lu]Lu-PSMA-617 and docetaxel versus docetaxel in patients with metastatic hormone-sensitive prostate cancer (UpFrontPSMA): a multicentre, open-label, randomised, phase 2 study.

Lancet Oncol

October 2024

Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.

Article Synopsis
  • Lutetium-177 [Lu]Lu-PSMA-617 is being studied for its effectiveness in improving survival and quality of life for patients with metastatic castration-resistant prostate cancer, but its benefits for hormone-sensitive prostate cancer are still unclear.
  • The UpFrontPSMA trial involved patients with high-volume metastatic hormone-sensitive prostate cancer, who were randomly assigned to receive either [Lu]Lu-PSMA-617 followed by docetaxel or docetaxel alone as standard care.
  • The primary goal of the trial was to determine if patients treated with [Lu]Lu-PSMA-617 could achieve undetectable levels of prostate-specific antigen (PSA) after 48 weeks.
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  • The global sports medicine community is interested in understanding if repetitive head impacts (RHI) lead to chronic traumatic encephalopathy (CTE) and its related clinical syndromes.
  • A 2022 article claimed to provide definitive proof of causality between RHI and CTE using the Bradford Hill criteria, sparking significant media attention.
  • However, the authors of this counterpoint argue that the evidence is insufficient to support those claims and stress the need for precise definitions, consistent measurements, and well-designed studies before establishing any causal links.
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N. gonorrhoeae, which causes the sexually transmissible infection gonorrhoea, remains a significant public health threat globally, with challenges posed by increasing transmission and antimicrobial resistance (AMR). The COVID-19 pandemic introduced exceptional circumstances into communicable disease control, impacting the transmission of gonorrhoea and other infectious diseases.

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Outcomes of non-surgical management of non-condylar mandibular fractures: a systematic review and meta-analysis.

Br J Oral Maxillofac Surg

November 2024

Department of Oral & Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham B15 2GW, United Kingdom; Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Mindelsohn Way, Birmingham B15 2TH, United Kingdom. Electronic address:

Surgical intervention utilising open and (less commonly) closed reduction, are the main methods for the management of fractures of the mandible that do not involve the condyle or coronoid. Non-surgical management of these fracture patterns is rare. This systematic review aimed to collate current evidence surrounding this topic.

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Antimicrobial spectrum against wound pathogens and cytotoxicity of star-arranged poly-l-lysine-based antimicrobial peptide polymers.

J Med Microbiol

September 2024

Department of Clinical Microbiology, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland.

Article Synopsis
  • - The text discusses the urgent need for new topical antimicrobials to manage wound infections as infection risks rise, emphasizing the lack of solid research on the cytotoxicity and effectiveness of antimicrobial peptides (AMPs) in current literature.
  • - The study focuses on a specific AMP polymer called 16-PLL, investigating its bactericidal activity against ESKAPE pathogens and its cytotoxic effects on human cells, finding it effective but also toxic at certain concentrations.
  • - Modifications to 16-PLL were made to reduce toxicity, but these did not significantly improve its safety profiles, indicating that while further development may be necessary, prioritizing the safety and selectivity of such antimicrobials is crucial for future research.
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Background: Transcranial temporal interference stimulation (tTIS) is a new, emerging neurostimulation technology that utilizes two or more electric fields at specific frequencies to modulate the oscillations of neurons at a desired spatial location in the brain. The physics of tTIS offers the advantage of modulating deep brain structures in a non-invasive fashion and with minimal stimulation of the overlying cortex outside of a selected target. As such, tTIS can be effectively employed in the context of therapeutics for the psychiatric disease of disrupted brain connectivity, such as major depressive disorder (MDD).

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To investigate if retinal thickness has predictive utility in COVID-19 outcomes by evaluating the statistical association between retinal thickness using OCT and of COVID-19-related mortality. Secondary outcomes included associations between retinal thickness and length of stay (LoS) in hospital. In this retrospective cohort study, OCT scans from 230 COVID-19 patients admitted to the Intensive Care Unit (ITU) were compared with age and gender-matched patients with pneumonia from before March 2020.

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  • The study examined how health facility staff in Karonga, Malawi perceive barriers to accessing injury care, focusing on three types of delays: seeking care, reaching care, and receiving care.
  • A survey of 228 staff revealed that the most critical barrier overall is the lack of reliable physical resources at health facilities, particularly affecting the final phase of care.
  • Key barriers identified include high financial costs for seeking care, inadequate emergency transport, and insufficient medical resources, highlighting significant areas for improvement in the healthcare system.
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Effects of ECM protein-coated surfaces on the generation of retinal pigment epithelium cells differentiated from human pluripotent stem cells.

Regen Biomater

August 2024

State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China.

Retinal degeneration diseases, such as age-related macular degeneration (AMD) and retinitis pigmentosa (RP), initially manifest as dysfunction or death of the retinal pigment epithelium (RPE). Subretinal transplantation of human pluripotent stem cell (hPSC)-derived RPE cells has emerged as a potential therapy for retinal degeneration. However, RPE cells differentiated from hPSCs using current protocols are xeno-containing and are rarely applied in clinical trials.

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Early versus Delayed Timing of Primary Repair after Open-Globe Injury: A Systematic Review and Meta-analysis.

Ophthalmology

August 2024

Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom; Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, United Kingdom. Electronic address:

Article Synopsis
  • * Timely surgical intervention is crucial to reduce the risk of serious complications like endophthalmitis, which can affect visual outcomes.
  • * A review of 15 studies showed that repairs done within 24 hours significantly lowered the odds of endophthalmitis, but visual outcomes were similar regardless of repair timing.
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Background: Heart rate variability (HRV) is a marker of autonomic function. However, the reliability of short-term HRV measurement in individuals with combat-related traumatic injury (CRTI) remains undetermined.

Methods: An intra- and inter-rater reliability study was conducted using a subsample (n = 35) of British servicemen with CRTI enrolled in the ongoing ADVANCE study.

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A broadly cross-reactive i-body to AMA1 potently inhibits blood and liver stages of Plasmodium parasites.

Nat Commun

August 2024

Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Sciences, La Trobe University, Victoria, 3086, Australia.

Apical membrane antigen-1 (AMA1) is a conserved malarial vaccine candidate essential for the formation of tight junctions with the rhoptry neck protein (RON) complex, enabling Plasmodium parasites to invade human erythrocytes, hepatocytes, and mosquito salivary glands. Despite its critical role, extensive surface polymorphisms in AMA1 have led to strain-specific protection, limiting the success of AMA1-based interventions beyond initial clinical trials. Here, we identify an i-body, a humanised single-domain antibody-like molecule that recognises a conserved pan-species conformational epitope in AMA1 with low nanomolar affinity and inhibits the binding of the RON2 ligand to AMA1.

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Background: Helicopter Emergency Medical Services (HEMS) in the United Kingdom (UK) are provided in a mixed funding model, with the majority of services funded by charities alongside a small number of government-funded operations. More socially-deprived communities are known to have greater need for critical care, such as that provided by HEMS in the UK. Equity of access is an important pillar of medical care, describing how resource should be allocated on the basis of need; a concept that is particularly relevant to resource-intensive services such as HEMS.

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Article Synopsis
  • - The study focuses on the relationship between ionised hypocalcaemia (iHypoCa) and early hypotension in pediatric trauma patients, emphasizing the potential consequences of iHypoCa on cardiovascular stability and coagulopathy.
  • - Conducted as a retrospective analysis from 2016 to 2022, the research included patients under 16 and aimed to identify the incidence of iHypoCa and its correlation with treatment measures and adverse outcomes.
  • - Findings indicated that 17.8% of patients showed iHypoCa on admission, with those affected having nearly three times the risk of hypotension, highlighting the need for further research despite the pilot study's limitations.
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Introduction: Traumatic brain injury (TBI) is a major cause of disability, with annual global incidence estimated as 69 million people. Survivors can experience long-term visual changes, altered mental state, neurological deficits and long-term effects that may be associated with mental illness. TBI is prevalent in military personnel due to gunshot wounds, and blast injury.

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