Paper Session I-A - Titan IV Integrate. Test and Launch Facility System Improvements

In order to sustain our quest for new frontiers, we must first appreciate how we attained our present accomplishments. We are transitioning from the research and development phase into the operational phase of accessing space. Three decades ago we struggled with the idea of placing a basketball sized satellite into space and today the Titan IV system is installing school bus size payloads in Earth orbit and beyond. The scope of this paper is to briefly describe the Titan IV system, including the flight hardware, facilities and ground equipment, and explain how this system is improving at the Eastern Launch Site (ELS) to assure reliable, cost effective access to space for the Department of Defense (DoD) larger payloads

Care of victims of suicide bombing

history of suicide bombingSuicide bombers often target crowds. This commentary discusses the additional features required in a medical response beyond conventional mass casualty care, including forensic documentation, preservation of evidence, suspect tissue identification and viral status, victim counselling and postexposure prophylaxis. We propose a pathway for care of victims of a suicide bomb, adapting elements from protocols for child abuse, sexual assault and needle-stick exposure

Utilization profile of the Canadian-led coalition Role 2 Medical Treatment Facility in Iraq: the growing requirement for multinational interoperability.

Background: The Canadian Armed Forces deployed a Role 2 Medical Treatment Facility (R2MTF) to Iraq in November 2016 as part of Operation IMPACT. We compared the multinational interoperability required of this R2MTF with that of similar facilities previously deployed by Canada or other nations. Methods: We reviewed data (Nov. 4, 2016, to Oct. 3, 2017) from the electronic Disease and Injury Surveillance Report and the Daily Medical Situation Report. Clinical activity was stratified by Global Burden of Diseases category, ICD-10 code, mechanism of injury, services used, encounter type, nationality and blood product usage. We reviewed the literature to identify utilization profiles for other MTFs over the last 20 years. Results: In total, 1487 patients were assessed. Of these, 5.0% had battle injuries requiring damage-control resuscitation and/or damage-control surgery, with 55 casualties requiring medical evacuation after stabilization. Trauma and disease non-battle injuries accounted for 44% and 51% of patient encounters, respectively. Other than dental conditions, musculoskeletal disorders accounted for most presentations. Fifty-seven units of fresh frozen plasma and 64 units of packed red blood cells were used, and the walking blood bank was activated 7 times. Mass casualty activations involved coordination of health care and logistical resources from more than 12 countries. In addition to host nation military and civilian casualties, patients from 15 different countries were treated with similar frequency. Conclusion: The experience of the Canadian R2MTF in Iraq demonstrates the importance of multinational interoperability in providing cohesive medical care in coalition surgical facilities. Multinational interoperability derives from a unique relationship between higher medical command collaboration, international training and adherence to common standards for equipment and clinical practice

Deciphering the Link between Doubly Uniparental Inheritance of mtDNA and Sex Determination in Bivalves: Clues from Comparative Transcriptomics

Bivalves exhibit an astonishing diversity of sexual systems and sex-determining mechanisms. They can be gonochoric, hermaphroditic or androgenetic, with both genetic and environmental factors known to determine or influence sex. One unique sex-determining system involving the mitochondrial genome has also been hypothesized to exist in bivalves with doubly uniparental inheritance (DUI) of mtDNA. However, the link between DUI and sex determination remains obscure. In this study, we performed a comparative gonad transcriptomics analysis for two DUI-possessing freshwater mussel species to better understand the mechanisms underlying sex determination and DUI in these bivalves. We used a BLAST reciprocal analysis to identify orthologs between Venustaconcha ellipsiformis and Utterbackia peninsularis and compared our results with previously published sex-specific bivalve transcriptomes to identify conserved sex-determining genes. We also compared our data with other DUI species to identify candidate genes possibly involved in the regulation of DUI. A total of 3c12,000 orthologous relationships were found, with 2,583 genes differentially expressed in both species. Among these genes, key sex-determining factors previously reported in vertebrates and in bivalves (e.g., Sry, Dmrt1, Foxl2) were identified, suggesting that some steps of the sex-determination pathway may be deeply conserved in metazoans. Our results also support the hypothesis that a modified ubiquitination mechanism could be responsible for the retention of the paternal mtDNA in male bivalves, and revealed that DNA methylation could also be involved in the regulation of DUI. Globally, our results suggest that sets of genes associated with sex determination and DUI are similar in distantly-related DUI species

Proposed specifications of a mobile operating room for far-forward surgery

Provision of initial surgery to casualties within one hour of injury is associated with better survival. Where evacuation options are limited, surgery within the “golden hour” may have to occur close to the point of injury. Interventions close to the point of injury are limited by the adverse environment. Far-forward surgery has a long history going back to Dominique Larrey of the Napoleonic Army. We reviewed previous reports and used our own experience of far- forward surgery to describe the specifications of the ideal mobile operating room that would address some of these environmental barriers

Decadal evolution of a very small heavily debris-covered glacier in an Alpine permafrost environment

Glacier response to climate forcing can be heterogeneous and complex, depending on glacier system characteristics. This article presents the decadal evolution of the Tsarmine Glacier (Swiss Alps), a very small and heavily debris-covered cirque glacier located in the Alpine periglacial belt. Archival aerial photogrammetry and autocorrelation of orthophotos were used to compute surface elevation, volume and geodetic mass changes, as well as horizontal displacement rates for several periods between 1967 and 2012. A GPR survey allowed us to investigate glacier thickness (15 m mean) and volume (4 × 106 m3) in 2015 and to anticipate its future evolution. Different dynamics occurred in recent decades because of the heterogeneous surface characteristics. The climate-sensitive upper debris-free zone contrasts with the progressively stagnant heavily debris-covered glacier tongue. Between 1967 and 2012, the glacier lost 1/3 of its initial volume (2 × 106 m3). The average mass balance stabilised at ~−0.3 m w.e. a −1 since 1999. Compared with other local glaciers, the Tsarmine Glacier shows a particular decadal behaviour both in time (divergence of mass balance since the 2000s) and space (inverted ablation pattern). This might be explained by the combined influence of debris cover, shadow, snow redistribution and permafrost conditions on this very small glacier

Epidermolysa bullosa in Danish Hereford calves is caused by a deletion in LAMC2 gene

BACKGROUND Heritable forms of epidermolysis bullosa (EB) constitute a heterogeneous group of skin disorders of genetic aetiology that are characterised by skin and mucous membrane blistering and ulceration in response to even minor trauma. Here we report the occurrence of EB in three Danish Hereford cattle from one herd. RESULTS Two of the animals were necropsied and showed oral mucosal blistering, skin ulcerations and partly loss of horn on the claws. Lesions were histologically characterized by subepidermal blisters and ulcers. Analysis of the family tree indicated that inbreeding and the transmission of a single recessive mutation from a common ancestor could be causative. We performed whole genome sequencing of one affected calf and searched all coding DNA variants. Thereby, we detected a homozygous 2.4 kb deletion encompassing the first exon of the LAMC2 gene, encoding for laminin gamma 2 protein. This loss of function mutation completely removes the start codon of this gene and is therefore predicted to be completely disruptive. The deletion co-segregates with the EB phenotype in the family and absent in normal cattle of various breeds. Verifying the homozygous private variants present in candidate genes allowed us to quickly identify the causative mutation and contribute to the final diagnosis of junctional EB in Hereford cattle. CONCLUSIONS Our investigation confirms the known role of laminin gamma 2 in EB aetiology and shows the importance of whole genome sequencing in the analysis of rare diseases in livestock