CASA Medevac Operations Proof of Concept in the Southern Indian Ocean Zone.

BACKGROUND: Air medical evacuations by tactical aircraft are mandatory in every country, particularly in deployments abroad where hospital resources are limited. In the overseas French departments, it can be particularly useful for military and civilian scientists stationed on the very remote islands of the French Southern and Antarctic Lands. This priority medical support mission uses fixed wing CASA CN235 aircraft and is led by the French Air Force and the French Military Medical Service, in cooperation with the civilian health service.CASE REPORT: The authors present the case of a French soldier with chest trauma on an isolated island who benefited from continuum of care during his air evacuation to Reunion Island.DISCUSSION: This case illustrates that the "CASA Medevac" concept has become a crucial link in the French medical evacuation chain in remote areas. The complex organization, the human material resources, and, finally, the training program are briefly presented.Guénot P, Dubecq C, Colleu F, Dubourg O, Lec C, Bertran P-E. CASA Medevac operations proof of concept in the southern Indian Ocean zone. Aerosp Med Hum Perform. 2022; 93(6):536-539.

Helicopter Rescue Missions for Emergency Medical Aid at Sea: A New Assignment for the French Military Medical Service?

Historically in charge of the search and rescue of aircraft in distress alongside military aeronautical crews, the doctors and nurses of the French Military Medical Service (FMMS) also participate in helicopter rescue missions for emergency medical aid at sea off the French metropolitan coast. This public service mission is placed at the heart of force medicine because it can be transposed to external theaters of operations (OPEX). Recent changes in the regulation of medical aid at sea, in particular the creation in 2013 of maritime emergency mobile resuscitation services, initially weakened the role of the teams of the FMMS. However, their 2018 and 2019 activity report reflects the persistence of strong involvement. The "FMMS 2020" model, especially through its "openness" aspect, allows the FMMS the optimal conditions to maintain its position as a key player in this field, particularly through the development of institutional partnerships with the public health service. Associated with their mastery of the air-maritime environment, strengthening the skills in emergency medicine of the military medical teams in charge of this mission appears to be 1 of the main measures ensuring the achievement of this objective and a high quality of care for patients.

Fixed Wing Tactical Aircraft for Air Medical Evacuation in Sahel.

OBJECTIVE: The medical support of military operations over a 5 million km2 area in the Sahel-Saharan strip has justified the use of a medical fixed wing aircraft. Two CASA CN 235 aircraft currently perform medical evacuation (medevac) from the point of injury to forward surgical structures and then to the international airport before strategic medevac to France. METHODS: A retrospective observational study including all flights performed from January 2013 to December 2017 by the medical CASA located in Mali. RESULTS: Three thousand three flight hours were achieved. Four hundred twenty-four medevacs were performed for 898 patients. Seventy-five percent were evacuated from forward surgical structures. Their initial categorization included 10% Alpha, 23% Bravo, and 67% Charlie. Mechanical ventilation was performed for 5%; 34.5% had common medical or surgical pathologies, 34.2% were combat casualties mostly by explosion, and 18.7% were nonbattle injuries. No difficulties related to the aeronautical environment were reported by the teams. CONCLUSION: Tactical medevac with fixed wing aircraft has become a crucial link in the French medical evacuation chain in remote areas. Military emergency medical teams were able to provide in-flight intensive care before and after damage control surgery. Discussions are underway to consider possible doctrinal and logistical evolutions.

[Army nurse in French Guiana, nursing practice in exceptional circumstances]. / Infirmier militaire en Guyane.

French Guiana is the site of intensive and illegal gold mining which French military forces from the Harpie mission are engaged in combating. This gold washing is particularly harmful to the fauna and flora in the tropical rainforest. The army nurse provides the healthcare support for this mission, which is carried out in the rainforest, in an isolated location and with restricted resources.

Methylidynearsine (HC[triple bond]As): synthesis and direct characterization by UV-photoelectron spectroscopy and mass spectrometry.

The dehydrohalogenation of gaseous dichloromethylarsine on solid base led to chloromethylidenearsine and, at higher temperature of the base, to methylidynearsine, the third unsubstituted heteroalkyne unambiguously synthesized up to now.

Mass spectrometry investigations on electrolyte degradation products for the development of nanocomposite electrodes in lithium ion batteries.

In the continuing challenge to find new routes to improve the performance of commercial lithium ion batteries cycling in alkyl carbonate-based electrolyte solutions, original designs, and new electrode materials are under active worldwide investigation. Our group has focused on the electrochemical behavior of a new generation of nanocomposite electrodes showing improved capacities (up to 3 times the capacity of conventional electrode materials). However, moving down to "nanometric-scale" active materials leads to a significant increase in electrolyte degradation, compared to that taking place within commercial batteries. Postmortem electrolyte studies on experimental coin cells were conducted to understand the degradation mechanisms. Structural analysis of the organic degradation products were investigated using a combination of complementary high-resolution mass spectrometry techniques: desorption under electron impact, electrospray ionization, and gas chromatography coupled to a mass spectrometer equipped with electron impact and chemical ionization ion sources. Numerous organic degradation products such as ethylene oxide oligomers (with methyl, hydroxyl, phosphate, and methyl carbonate endings) have been characterized. In light of our findings, possible chemical or electrochemical pathways are proposed to account for their formation. A thorough knowledge of these degradation mechanisms will enable us to propose new electrolyte formulations to optimize nanocomposite-based lithium ion battery performance.

Controlled synthesis and inclusion ability of a hyaluronic acid derivative bearing beta-cyclodextrin molecules.

A new synthetic route to beta-cyclodextrin-linked hyaluronic acid (HA-CD) was developed. This was based on the preparation of a HA derivative selectively modified with adipic dihydrazide (HA-ADH) and a beta-cyclodextrin derivative possessing an aldehyde function on the primary face, followed by their coupling by a reductive amination-type reaction. The CD-polysaccharide was fully characterized in terms of chemical integrity and purity by high-resolution NMR spectroscopy. The complexation ability of the grafted CD was further demonstrated by isothermal titration calorimetry using sodium adamantane acetate (ADAc) and Ibuprofen as model guest molecules. The thermodynamic parameters for the complexation of these negatively charged guest molecules by the beta-CD grafted on negatively charged HA were shown to be largely influenced by the ionic strength of the aqueous medium.

Synthesis and antiviral activity of novel acyclic nucleosides in the 5-alkynyl- and 6-alkylfuro[2,3-d]pyrimidine series.

The synthesis of novel acyclic nucleosides in the 5-alkynyl and 6-alkylfuro[2,3-d]pyrimidine series is described. These compounds were evaluated against HIV and HSV in order to determine their spectrum of antiviral activity. Their cytotoxicities against PBM, CEM and VERO cells were also determined. Compounds 21d and 24b displayed moderate EC50s of 2.7 and 4.9 microM, respectively, against HIV-1 and of 6.3 and 4.8 microM, respectively, against HSV. Nevertheless, these compounds also showed cellular toxicity, suggesting that the antiviral effects are secondary to the toxic effects.

Palladium-catalyzed synthesis of uridines on polystyrene-based solid supports.

In this paper, the solid-phase synthesis of various substituted pyrimidine nucleosides is described starting from 2'-deoxyuridine, which has been attached through a base labile linker to polystyrene resins. The utility of the Pd(0) cross-coupling to functionalized pyrimidine nucleosides is expanded herein to include reactions of resin-supported 5-iodo-2'-deoxyuridine under Sonogashira, Stille, Heck, and Suzuki conditions. Upon cleavage with MeONa, a library of 5-substituted pyrimidine nucleosides was obtained in good (under Sonogashira and Stille conditions) to moderate (under Heck or Suzuki conditions) yields and high purity. Except the Suzuki-type reactions, the presented methods exhibit a significant improvement and facilitate the synthetic procedure with respect to purification and yields (determined after filtration over silica gel).

Dehydrochlorination of alpha-Chlorophosphines, a Simple and General Route to Phosphaalkenes.

Primary and secondary alpha-chlorophosphines 2a-g are prepared in ca. 70% yield by chemoselective reduction of the corresponding phosphonic and phosphinic esters with AlHCl(2) and are characterized by (31)P, (13)C, and (1)H NMR and by HMRS. They can be kept several weeks in the refrigerator after purification. They lead then to the corresponding phosphaalkenes 3a-g by HCl elimination. For the volatile alpha-chlorophosphines 2a-e HCl elimination occurs in the gas phase on solid potassium carbonate under VGSR conditions (vacuum gas-solid reactions); the corresponding phosphaalkenes 3a-e are characterized by real time HRMS analysis of the gaseous flow (VGSR/HRMS coupling) and by solid-phase IR spectroscopy after condensation of the gaseous flow on a KBr window cooled to 77 K. The decomposition of phosphaalkenes at this temperature is monitored by IR spectroscopy. The alpha-chlorophosphines 2a-g undergo a HCl elimination in the liquid phase in the presence of a Lewis base; the formation of the transient phosphaalkenes is monitored by (31)P FT-NMR. The temperature of HCl elimination is dependent both upon the P-H acidity of the phosphine precursors and the nature of the base. The (31)P NMR data of the simple phosphaalkenes 3a-g are for the first time reported. They are consistent with the proposed structure. The stereochemistry of the (Z)- and (E)-isomers is established according to the "cis-rule". Phosphaalkenes 3a-g are also characterized by chemical trapping in solution with various dienes, dipoles, or thiols. All of these experiments confirm the transient character of these species. The synthetic potential of this route is evaluated.