The inaugural European emergency medical dispatch conference – a synopsis of proceedings

The inaugural European Emergency Medical Dispatch conference was held in Stockholm, Sweden, in May 2013. We provide a synopsis of the conference proceedings, highlight key topic areas of emergency medical dispatch and suggest future research priorities

Do male and female trauma patients receive the same prehospital care? : An observational follow-up study

Background: Trauma-related mortality can be lowered by efficient prehospital care. Less is known about whether gender influences the prehospital trauma care provided. The aim of this study was to explore gender-related differences in prehospital trauma care of severely injured trauma patients, with a special focus on triage, transportation, and interventions. Methods: We performed a retrospective observational study based on local trauma registries and hospital and ambulance records in Stockholm County, Sweden. A total of 383 trauma patients (279 males and 104 females) > 15years of age with an Injury Severity Score (ISS) of > 15 transported to emergency care hospitals in the Stockholm area were included. Results: Male patients had a 2.75 higher odds ratio (95% CI, 1.2-6.2) for receiving the highest prehospital priority compared to females on controlling for injury mechanism and vital signs on scene. No significant difference between genders was detected regarding other aspects of the prehospital care provided. Conclusions: This study indicated that prehospital prioritization among severely injured late adolescent and adult trauma patients differs between genders. Knowledge of a more diffuse presentation of symptoms in female trauma patients despite severe injury may help to adapt and improve prehospital trauma care for this group.Peer reviewe

Soluble Urokinase Plasminogen Activator Receptor (suPAR) in the Emergency Department (Ed): A Tool for the Assessment of Elderly Patients

Emergency department (ED) overcrowding is a global issue setting challenges to all care providers. Elderly patients are frequent visitors of the ED and their risk stratification is demanding due to insufficient assessment methods. A prospective cohort study was conducted to determine the risk-predicting value of a prognostic biomarker, soluble urokinase plasminogen activator receptor (suPAR), in the ED, concentrating on elderly patients. SuPAR levels were determined as part of standard blood sampling of 1858 ED patients. The outcomes were assessed in the group o

Antidepressant-like effect of losartan involves TRKB transactivation from angiotensin receptor type 2 (AGTR2) and recruitment of FYN

The renin-angiotensin system (RAS) is associated with peripheral fluid homeostasis and cardiovascular function, but recent evidence also suggests a functional role in the brain. RAS regulates physiological and behavioral parameters related to the stress response, including depressive symptoms. Apparently, RAS can modulate levels of brain-derived neurotrophic factor (BDNF) and TRKB, which are important in the neurobiology of depression and antidepressant action. However, the interaction between the BDNF/TRKB system and RAS in depression has not been investigated before. Accordingly, in the forced swimming test, we observed an antidepressant-like effect of systemic losartan but not with captopril or enalapril treatment. Moreover, infusion of losartan into the ventral hippocampus (vHC) and prelimbic prefrontal cortex (PL) mimicked the consequences of systemically injected losartan, whereas K252a (a blocker of TRK) infused into these brain areas impaired such effect. PD123319, an antagonist of AT2 receptor (AGTR2), also prevented the systemic losartan effect when infused into PL but not into vHC. Cultured cortical cells of rat embryos revealed that angiotensin II (ANG2), possibly through AGTR2, increased the surface levels of TRKB and its coupling to FYN, a SRC family kinase. Higher Agtr2 levels in cortical cells were reduced after stimulation with glutamate, and only under this condition an interaction between losartan and ANG2 was achieved. TRKB/AGTR2 heterodimers were also observed, in MG87 cells GFP-tagged AGTR2 co-immunoprecipitated with TRKB. Therefore, the antidepressant-like effect of losartan is proposed to occur through a shift of ANG2 towards AGTR2, followed by coupling of TRK/FYN and putative TRIG transactivation. Thus, the blockade of AGTR1 has therapeutic potential as a novel antidepressant therapy. (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe

TrkB-ICD Fragment, Originating From BDNF Receptor Cleavage, Is Translocated to Cell Nucleus and Phosphorylates Nuclear and Axonal Proteins

The signaling of brain-derived neurotrophic factor (BDNF) has been suggested to be impaired in Alzheimer's disease (AD), which may compromise the function of BDNF upon neuronal activity and survival. Accordingly, decreased levels of BDNF and its tropomyosin-receptor kinase B-full-length (TrkB-FL) have been detected in human brain samples of AD patients. We have previously found that neuronal exposure to amyloid-beta (A beta) peptide, a hallmark of AD, leads to calpain overactivation and subsequent TrkB-FL cleavage leading to decreased levels of TrkB-FL and the generation of two new fragments: a membrane-bound truncated receptor (TrkB-T') and an intracellular fragment (TrkB-ICD). Importantly, we identified this TrkB-FL cleavage and TrkB-ICD presence in human brain samples, which indicates that this molecular mechanism contributes to the loss of BDNF signaling in humans. The exact role of this TrkB-ICD fragment is, however, unknown. Here, we used a human neuroglioma cell line and rat cortical primary neuronal cultures to track TrkB-ICD intracellularly. Our data show that TrkB-ICD is a relatively stable fragment that accumulates in the nucleus over time, through a phosphorylation-dependent process. We also found that TrkB-ICD has tyrosine kinase activity, inducing the phosphorylation of nuclear and axonal proteins. These findings suggest that TrkB-ICD may lead to a dysregulation of the activity of several proteins, including proteins in the nucleus, to where TrkB-ICD migrates. Since TrkB-ICD is formed by A beta peptide-induced cleavage of TrkB-FL, the present data highlights a new mechanism that may have a role in AD pathophysiology.Peer reviewe

Reduced LYNX1 expression in transcriptome of human iPSC-derived neural progenitors modeling fragile X syndrome

Lack of FMR1 protein results in fragile X syndrome (FXS), which is the most common inherited intellectual disability syndrome and serves as an excellent model disease to study molecular mechanisms resulting in neuropsychiatric comorbidities. We compared the transcriptomes of human neural progenitors (NPCs) generated from patient-derived induced pluripotent stem cells (iPSCs) of three FXS and three control male donors. Altered expression of RAD51C, PPIL3, GUCY1A2, MYD88, TRAPPC4, LYNX1, and GTF2A1L in FXS NPCs suggested changes related to triplet repeat instability, RNA splicing, testes development, and pathways previously shown to be affected in FXS. LYNX1 is a cholinergic brake of tissue plasminogen activator (tPA)-dependent plasticity, and its reduced expression was consistent with augmented tPA-dependent radial glial process growth in NPCs derived from FXS iPSC lines. There was evidence of human iPSC line donor-dependent variation reflecting potentially phenotypic variation. NPCs derived from an FXS male with concomitant epilepsy expressed differently several epilepsy-related genes, including genes shown to cause the auditory epilepsy phenotype in the murine model of FXS. Functional enrichment analysis highlighted regulation of insulin-like growth factor pathway in NPCs modeling FXS with epilepsy. Our results demonstrated potential of human iPSCs in disease modeling for discovery and development of therapeutic interventions by showing early gene expression changes in FXS iPSC-derived NPCs consistent with the known pathophysiological changes in FXS and by revealing disturbed FXS progenitor growth linked to reduced expression of LYNX1, suggesting dysregulated cholinergic system.Peer reviewe

Sääntelyyn perustuvat rahapelihaittojen ehkäisytoimet ja niiden soveltuvuus Suomen rahapelijärjestelmään : Tutkimustietoon ja asiantuntija-arvioihin perustuva selvitys 1.6.2017

Sosiaali- ja terveysministeriö antoi 16.2.2017 Terveyden ja hyvinvoinnin laitoksen (THL) rahapeli- ja päihdeasiantuntijoista muodostetulle työryhmälle toimeksiannon selvittää tutkimusnäytön valossa vaikuttavimpia rahapelihaittojen ehkäisytoimia, sekä niiden soveltuvuutta Suomeen. Työryhmä esittää tutkimusnäytön ja asiantuntijatiedon pohjalta kuutta vaikuttavaksi katsomaansa sääntelytoimenpidettä rahapelihaittojen ehkäisemiseksi Suomessa. Esitettävät toimenpiteet ovat: rahapelejä tarjoavien toimipisteiden maantieteellisen keskittymisen ja sijaintipaikkojen rajoittaminen, pelipisteiden määrän rajoittaminen (erityisesti rahapeliautomaattien osalta), pelaamisen rajoittaminen anniskelupaikoissa, pakollinen pelaajan tunnistautuminen, pakolliset pelaajan itse asettamat rajat pelikulutukselle, sekä pelaajan itselleen hakema pelikielto. Työryhmä pitää vaikuttavuuden kannalta tärkeänä toimenpiteiden huolellista toimeenpanoa ja vaikutusten arviointia

Sääntelyyn perustuvat rahapelihaittojen ehkäisytoimet ja niiden soveltuvuus Suomen rahapelijärjestelmään : Tutkimustietoon ja asiantuntija-arvioihin perustuva selvitys 1.6.2017

Sosiaali- ja terveysministeriö antoi 16.2.2017 Terveyden ja hyvinvoinnin laitoksen (THL) rahapeli- ja päihdeasiantuntijoista muodostetulle työryhmälle toimeksiannon selvittää tutkimusnäytön valossa vaikuttavimpia rahapelihaittojen ehkäisytoimia, sekä niiden soveltuvuutta Suomeen. Työryhmä esittää tutkimusnäytön ja asiantuntijatiedon pohjalta kuutta vaikuttavaksi katsomaansa sääntelytoimenpidettä rahapelihaittojen ehkäisemiseksi Suomessa. Esitettävät toimenpiteet ovat: rahapelejä tarjoavien toimipisteiden maantieteellisen keskittymisen ja sijaintipaikkojen rajoittaminen, pelipisteiden määrän rajoittaminen (erityisesti rahapeliautomaattien osalta), pelaamisen rajoittaminen anniskelupaikoissa, pakollinen pelaajan tunnistautuminen, pakolliset pelaajan itse asettamat rajat pelikulutukselle, sekä pelaajan itselleen hakema pelikielto. Työryhmä pitää vaikuttavuuden kannalta tärkeänä toimenpiteiden huolellista toimeenpanoa ja vaikutusten arviointia