Importance of awareness in improving performance of emergency medical services (EMS) systems in enhancing traffic safety: A lesson from India

<p><b>Objective</b>: India has been slow in implementing a central emergency medical services (EMS) system across the country. “108 services” is one of the most popular services that is functional under the public–private partnership model. Limited available literature shows that despite access to services, many traffic crash victims are transported using private vehicles. The objective of this study is to understand the effectiveness of 108 services from a traffic safety perspective.</p> <p><b>Method</b>: A questionnaire survey is conducted to understand the awareness of EMS and their function. Using traffic-related fatalities as the dependent variable, a fixed effect panel data model is developed to analyze the effectiveness of the 108 services in improving the traffic safety.</p> <p><b>Results</b>: The results from the survey show that, in general, people are not aware of the 108 services. A majority of the population prefers taking victims to the hospital using their personal vehicles or any other vehicles available compared to calling an ambulance. Results from panel data analysis show that despite having an efficient system, these services failed to make significant improvement in the safety of road users in the states in which their services were subscribed.</p> <p><b>Discussion</b>: The lack of awareness of an important safety service is alarming. This could be a major reason for lower utilization of 108 services for transporting victims of traffic crashes. This article shows the importance of having efficient awareness campaigns to improve the efficiency of any similar programs that are aimed to enhance the safety of a region.</p

MOESM1 of SIRT1 ameliorates oxidative stress induced neural cell death and is down-regulated in Parkinson’s disease

Additional file 1: Figure S1. Expression of SIRT1 in toxin treated SH-SY5Y cells. SIRT1WT and SIRT1H363Y were over-expressed in SH-SY5Y cells and control cells were transfected with empty vector following which cells were treated with diquat (20 or 10 μM) or rotenone (20 or 0.5 μM) for 20 h. Cells were harvested and the samples were probed for SIRT1. Data are presented as fold- untreated (+SD) from three independent assays (n = 3) with comparison to GAPDH as a housekeeping control protein. ***p < 0.001 when compared to 0.2% PBS, one-way ANOVA (Bonferroni corrected), ###p < 0.001 when compared to empty vector treatment, two-way ANOVA (Bonferroni corrected). Images are representative blot of SIRT1 and GAPDH

Expression level of genes involved in GPCR-mediated platelet activation.

<p>Expression level of genes involved in GPCR-mediated platelet activation.</p

Gene Ontology Mining Tool functional analysis.

<p>Gene list created using genes FC>1.5 and p-values≤0.05 relative to saline-infused MK pop.</p

Hierarchical clustering analysis of genes differentially expressed under elevated 5-HT conditions in MK cells.

<p>The expression pattern of 233 genes whose expression was changed significantly (FC>2, p<0.001) in saline (n = 3, denoted as C1–C3) and 5-HT-treated (n = 4, denoted as T1–T4) samples are shown. The data were clustered using the standard hierarchical method with average linkage and using the Pearson correlation to determine the distance function. The normalized expression index for each gene (rows) in each sample (columns) is indicated by a color code (see Expression index bar at top left of figure). The genes shown represent the genes that were up-regulated (red) and down-regulated (green) in the sample sets. Samples with similar patterns of expression of the genes studied will cluster together, as indicated by the dendogram.</p

Cell-surface expression of surrogate markers of platelet activation.

<p>(<b>A</b>) FITC-labeled P-selectin (CD62P) and (<b>B</b>) Alexa Fluor 448-labeled Gp1b show increased and decreased mean fluorescence intensity (unshaded area), respectively, following <i>in vivo</i> 5-HT treatment in contrast to saline-infused littermates (gray shaded area); n = 5–6. Increased staining indicates active exocytosis of alpha-granules in platelet membranes whereas decreased expression of Gp1b is consistent with enhanced platelet-platelet binding in the presence of high 5-HT. The assay was performed in triplicate.</p

Functional classification of differentially expressed genes.

<p>Genes (FC>1.5, p<0.05) are broadly grouped into selected functional categories: (<b>A</b>) cytoskeletal remodeling, (<b>B</b>) G-protein signaling, (<b>C</b>) vesicular transport, and (<b>D</b>) apoptosis and survival. The abscissa refers to the signal log ratio (SLR), representing the log₂ of the average change between transcript expression in saline- and 5-HT-infused megakaryocyte populations (SLR = 1 or log₂ of 1  =  FC of 2).</p

Dense-granule secretion assay.

<p>(<b>A</b>) Platelets isolated from mice after 24 hours of 5-HT infusion exhibit increased dense-granule exocytosis, as indicated by increased levels of secreted 5-HT. Dense granule secretion was monitored by measuring the level of fluorescent material which was created by OPT as described in the Materials and Method section. The measurements were done at excitation wavelength 355 nm and emission wavelength 475 nm. Data represent mean ± SD; Asterisk (*) indicates statistical significance compared to Saline+SLO by Student’s <i>t</i>-test, <i>p<0.05</i>. (<b>B</b>) Dense-granule secretion was monitored following plasma membrane staining for granulophysin (CD63), a surrogate marker of exocytosis. FACS analysis demonstrates increased mean fluorescence intensity following 5-HT infusion compared to saline-infused littermates.</p

Effects of low-dose rate γ-irradiation combined with simulated microgravity on markers of oxidative stress, DNA methylation potential, and remodeling in the mouse heart

<div><p>Purpose</p><p>Space travel is associated with an exposure to low-dose rate ionizing radiation and the microgravity environment, both of which may lead to impairments in cardiac function. We used a mouse model to determine short- and long-term cardiac effects to simulated microgravity (hindlimb unloading; HU), continuous low-dose rate γ-irradiation, or a combination of HU and low-dose rate γ-irradiation.</p><p>Methods</p><p>Cardiac tissue was obtained from female, C57BL/6J mice 7 days, 1 month, 4 months, and 9 months following the completion of a 21 day exposure to HU or a 21 day exposure to low-dose rate γ-irradiation (average dose rate of 0.01 cGy/h to a total of 0.04 Gy), or a 21 day simultaneous exposure to HU and low-dose rate γ-irradiation. Immunoblot analysis, rt-PCR, high-performance liquid chromatography, and histology were used to assess inflammatory cell infiltration, cardiac remodeling, oxidative stress, and the methylation potential of cardiac tissue in 3 to 6 animals per group.</p><p>Results</p><p>The combination of HU and γ-irradiation demonstrated the strongest increase in reduced to oxidized glutathione ratios 7 days and 1 month after treatment, but a difference was no longer apparent after 9 months. On the other hand, no significant changes in 4-hydroxynonenal adducts was seen in any of the groups, at the measured endpoints. While manganese superoxide dismutase protein levels decreased 9 months after low-dose γ-radiation, no changes were observed in expression of catalase or Nrf2, a transcription factor that determines the expression of several antioxidant enzymes, at the measured endpoints. Inflammatory marker, CD-2 protein content was significantly decreased in all groups 4 months after treatment. No significant differences were observed in α-smooth muscle cell actin protein content, collagen type III protein content or % total collagen.</p><p>Conclusions</p><p>This study has provided the first and relatively broad analysis of small molecule and protein markers of oxidative stress, T-lymphocyte infiltration, and cardiac remodeling in response to HU with simultaneous exposure to low-dose rate γ-radiation. Results from the late observation time points suggest that the hearts had mostly recovered from these two experimental conditions. However, further research is needed with larger numbers of animals for a more robust statistical power to fully characterize the early and late effects of simulated microgravity combined with exposure to low-dose rate ionizing radiation on the heart.</p></div

SAM:SAH ratios in mouse heart following HU, γ irradiation or combined HU + γ irradiation.

<p>HPLC was utilized to determine SAM:SAH ratios a.) 7 days, b.) 1 month, or c.) 9 months after a 21 day exposure to HU, γ irradiation (⁵⁷Co: 0.01 cGy/h; 0.04 Gy total), or a combined HU + γ irradiation. Sample sizes: CTL for all time points, n = 6; HU for 7 day time-point, n = 4; HU for 1 month time-point, n = 5; HU for 9 month time-point, n = 6; ⁵⁷Co for 7 day and 9 month time-points, n = 5; ⁵⁷Co for 1 month time-point, n = 6; HU+⁵⁷Co for 7 day time-point, n = 6; HU+⁵⁷Co for 1 and 9 month time-points, n = 5. Values are means ± SEM. * Significantly different than CTL, p < 0.05; t Significantly different than HU, p < 0.05; # Significantly different than ⁵⁷Co, p < 0.05; $ Significantly different than HU+⁵⁷Co, p < 0.05.</p