Integrated model for providing tactical emergency medicine support (TEMS): analysis of 120 tactical situations.

BACKGROUND: Various models for organising tactical emergency medicine support (TEMS) in law enforcement operations exist. In Helsinki, TEMS is organised as an integral part of emergency medical service (EMS) and applied in hostage, siege, bomb threat and crowd control situations and in other tactical situations after police request. Our aim was to analyse TEMS operations, patient profile, and the level of on-site care provided. METHODS: We conducted a retrospective cohort study of TEMS operations in Helsinki from 2004 to 2009. Data were retrieved from EMS, hospital and dispatching centre files and from TEMS reports. RESULTS: One hundred twenty TEMS operations were analysed. Median time from dispatching to arrival on scene was 10 min [Interquartile Range (IQR) 7-14]. Median duration of operations was 41 min (IQR 19-63). Standby was the only activity in 72 operations, four patients were dead on arrival, 16 requests were called off en route and patient examination or care was needed in 28 operations. Twenty-eight patients (records retrieved) were alive on arrival and were classified as trauma (n = 12) or medical (n = 16). Of traumas, two sustained a gunshot wound, one sustained a penetrating abdominal wound, three sustained medium severity injuries and nine sustained minor injuries. There was neither on-scene nor in-hospital mortality among patients who were alive on arrival. The level of on-site care performed was basic life support in all cases. CONCLUSIONS: The results showed that TEMS integrated to daily EMS services including safe zone working only was a feasible, rapid and efficient way to provide medical support to law enforcement operations.

Developing an independent, generic, phosphorus modelling component for use with grid-oriented, physically based distributed catchment models.

Grid-oriented, physically based catchment models calculate fields of various hydrological variables relevant to phosphorus detachment and transport. These include (i) for surface transport: overland flow depth and flow in the coordinate directions, sediment load, and sediment concentration and (ii) for subsurface transport: soil moisture and hydraulic head at various depths in the soil. These variables can be considered as decoupled from any chemical phosphorus model since phosphorus concentrations, either as dissolved or particulate, do not influence the model calculations of the hydrological fields. Thus the phosphorus concentration calculations can be carried out independently from and after the hydrological calculations. This makes it possible to produce a separate phosphorus modelling component which takes as input the hydrological fields produced by the catchment model and which calculates, at each simulation time step, the phosphorus concentrations in the flows. This paper summarises the equations and structure of such a Grid Oriented Phosphorus Component (GOPC) developed by the authors for simulating phosphorus concentrations and loads using the outputs of a fully distributed physical based hydrological model. The GOPC performance is illustrated by an example of a simplified hypothetical catchment subjected to some ideal conditions.

Targeting of biotinylated compounds to its target tissue using a low-density lipoprotein receptor-avidin fusion protein.

The very high binding affinity of avidin to biotin is one of the highest to occur in nature. We constructed a fusion protein composed of avidin and the endocytotic LDL receptor in order to target biotinylated molecules to cells of the desired tissues. In addition to the native avidin, charge-mutated and nonglycosylated avidins were utilized as part of the fusion proteins, in order to modify its properties. All of the fusion protein versions retained the biotin-binding capacity. Although the specificity was not increased, however, fusion proteins composed of natural avidin and nonglycosylated avidin bound most efficiently to the biotinylated ligands. Fluorescence microscopy and atomic force microscopy studies revealed the expression of the fusion protein on cell membranes, and demonstrated specific and high-affinity binding of biotin to the low-density lipoprotein receptor (LDLR)-avidin fusion protein in vitro. Additionally, systemically administered biotinylated ligand targeted with high specificity the intracerebral tumors of rats that were expressing fusion protein after the virus-mediated gene transfer. These results suggest that local gene transfer of the fusion protein to target tissues may offer a novel tool for the delivery of biotinylated molecules in vitro and in vivo for therapeutic and imaging purposes.