Coverage based empirical modelling for EMS rescue system of Karachi (Pakistan)

Hitne slučajeve uglavnom rješava služba hitne pomoći (EMS). U većini se slučajeva radi o jednom pacijentu. Osnovni sustavi nisu u stanju reagirati kod hitnih slučajeva s više unesrećenih. EMS je u zadnje dvije godine morao prilagoditi svoje planove takvim slučajevima zbog sve većeg broja nesreća i terorističkih napada. Ali takvi bi se planovi mogli osujetiti smanjenim proračunom i izvorima financiranja, a i brojem ambulantnih kola i njihovim položajem/lokacijom, te strategijom njihova slanja, što sve utječe na EMS. Dodatni faktor je promjenljivost u broju slobodnih ambulantnih kola u različito vrijeme tijekom dana. U svrhu održavanja pokrivenosti potrebno je pripaziti i da su ambulantna kola uvijek u stanju pripravnosti. U radu predlažemo model optimalizacije u EMS-u koji će pomoći kod medicinskih postupaka u regiji Karachi, Pakistan (uporabom podataka iz dvije godine, 2010. i 2011.). Također smo proveli i empirijsku analizu vremena reagiranja ambulantnih kola, njihovo vrijeme dolaska u bolnicu i vrijeme provedeno u bolnici. Korištene su Google mape kako bi se olakšalo praćenje i analiziranje mjesta nesreće uz pomoć GPSa ili nekog drugog izvora informacija. Fizikalna simulacija i rezultati su korišteni kao dio procesa planiranja što pokazuje integritet i učinkovitost vremenske granice temeljene na hitnosti pacijenta u vrijeme poziva (Spasilačka ekipa 15).Emergency Medical Services (EMS) is a major source of handling emergencies. Most of the emergencies have one patient. The routine systems are not able to respond to emergencies in which there are many casualties. The mass-casualty disaster response and EMS services plans have become more popular in case of ordinary disasters and terrorist attacks over the past decades. But it might not be possible to construct such plans due to limited resources and budget. There may be such more factors including the number of ambulances deployed, their position/location, and dispatching strategies that affect the EMS system. One more factor is the variation in number of vacant ambulances at different time of the day. In order to sustain coverage, it is necessary to locate ambulances at the station in functional states. In this paper we proposed an optimization model dealing with EMS to assist the medical treatment in the region of Karachi, Pakistan (by using two years data from the year 2010 to 2011). We also conducted and estimated an empirical analysis of ambulance response times, travel times to a hospital and the time spent at the hospital. Google maps are used to facilitate EMS’s provider to view and analyse the entire scene of the accident with the help of GPS or other sources of information. Physical simulation and results are used as part of the planning process, which shows the integrity and efficiency of the time threshold based on the acuity of the patient at the time when the 15 call is made (Rescue 15)

RTA Analysis & Existing Modelling for Emergency Medical Service

Prevention of accidents is extremely difficult in absence of present situation analysis, as the aim to identify the incident locations and safety deficiency area is the key to work out the effective solution. To access the feasibility of using Geographic Information System (GIS) for mapping of incident locations with an existing data source is vital to estimate variation of RTAs (Road Traffic Accidents) pattern by interpolating. Generally, accident particulars like location, date, time, sex and suspect are included in GIS database. Here, Arc GIS (10.2.1) software is applied to identify incident locations in Karachi district. To reduce the accidents in particular area/study area and in order to sustain coverage for emergency response, there may be such more factors including the number of ambulances deployed, their position/location, and dispatching strategies that affect the EMS system, authors strictly recommended covering based probabilistic model for (Rescue-15) solving the problem of ambulance locations. GIS facilitates the respective authority to do assessment and to analyze the entire position of the accident with the help of GPS or additional sources of information while consequences are utilized as part of the preparation progression is based on the acuity of the patient in time

The use of Panax notoginseng saponins injections after intravenous thrombolysis in acute ischemic stroke: a systematic review and meta-analysis

BackgroundAs a bioactive metabolite preparation widely used in acute ischemic stroke (AIS), the efficacy and safety of Panax notoginseng saponins injections (PNSI) in patients with AIS after intravenous thrombolysis remain to be evaluated.MethodsThis study included randomized controlled trials published before 26 April 2024 in 8 databases. AIS patients who received intravenous thrombolysis were included. The control group receiving conventional treatment and the treatment group receiving additional PNSI. Primary outcomes were selected as mortality, disability, and adverse events. Secondary outcomes were selected as all-cause mortality, improvement of neurological deficit, quality of life, and cerebral injury indicators. The revised Cochrane Risk of Bias tool was used to assess risk of bias. Risk ratio (RR) and mean differences (MD) were calculated for binary variables and continuous variables, respectively, based on a 95% confidence interval (CI).ResultsA total of 20 trials involving 1,856 participants were included. None of them reported mortality or disability. There was no significant difference in the adverse events [RR: 1.04; 95% CI: 0.60 to 1.81] and hemorrhagic transformation [RR: 0.99; 95% CI: 0.36 to 2.70] between the two groups. Compared to the control group, the treatment group had a better effect in neurological improvement assessed by National Institutes of Health Stroke Scale [MD: −2.91; 95% CI: −4.76 to −1.06], a better effect in activities of daily living changes in Barthel Index [MD: 9.37; 95% CI: 1.86 to 16.88], and a lower serum neuron-specific enolase level [MD: −2.08; 95% CI: −2.67 to −1.49].ConclusionFor AIS patients undergoing intravenous thrombolysis, the use of PNSI improved neurological deficits and enhanced activity of daily living in the short term without increasing the occurrence rate of adverse events. However, due to the moderate to very low certainty of evidence, it is advisable to conduct high-quality clinical trials to validate the findings of this study.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=466851, Identifier CRD4202346685

Clathrin Facilitates the Morphogenesis of Retrovirus Particles

The morphogenesis of retroviral particles is driven by Gag and GagPol proteins that provide the major structural component and enzymatic activities required for particle assembly and maturation. In addition, a number of cellular proteins are found in retrovirus particles; some of these are important for viral replication, but many lack a known functional role. One such protein is clathrin, which is assumed to be passively incorporated into virions due to its abundance at the plasma membrane. We found that clathrin is not only exceptionally abundant in highly purified HIV-1 particles but is recruited with high specificity. In particular, the HIV-1 Pol protein was absolutely required for clathrin incorporation and point mutations in reverse transcriptase or integrase domains of Pol could abolish incorporation. Clathrin was also specifically incorporated into other retrovirus particles, including members of the lentivirus (simian immunodeficiency virus, SIVmac), gammaretrovirus (murine leukemia virus, MLV) and betaretrovirus (Mason-Pfizer monkey virus, M-PMV) genera. However, unlike HIV-1, these other retroviruses recruited clathrin primarily using peptide motifs in their respective Gag proteins that mimicked motifs found in cellular clathrin adaptors. Perturbation of clathrin incorporation into these retroviruses, via mutagenesis of viral proteins, siRNA based clathrin depletion or adaptor protein (AP180) induced clathrin sequestration, had a range of effects on the accuracy of particle morphogenesis. These effects varied according to which retrovirus was examined, and included Gag and/or Pol protein destabilization, inhibition of particle assembly and reduction in virion infectivity. For each retrovirus examined, clathrin incorporation appeared to be important for optimal replication. These data indicate that a number of retroviruses employ clathrin to facilitate the accurate morphogenesis of infectious particles. We propose a model in which clathrin contributes to the spatial organization of Gag and Pol proteins, and thereby regulates proteolytic processing of virion components during particle assembly