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PubMedDate not supplied

Web-based training for EMT continuing education.

OBJECTIVE: New Internet technologies offer the opportunity to delivery quality instruction to emergency medical technicians (EMTs) in a cost-effective manner. The purpose of this study was to determine whether web-based continuing education (CE) could be developed at a low cost and provide a high level of satisfaction and acceptance among EMTs. METHODS: EMTs completed web-based CE modules in place of traditional instructor-led instruction. The EMTs in the study completed a questionnaire that assessed acceptance and satisfaction. Expenses for producing and delivering web-based instruction and delivering instructor-led instruction were tracked for all aspects of the project. RESULTS: Seventy-four percent of the EMTs strongly preferred the web-based modules over instructor-led modules. Other survey items indicated a high level of acceptance of the format (87%). The web-based modules in this study were produced and delivered at a cost of dollar 3 per EMT/module, which is less than the costs of traditional instructor-led training, ranging from dollar 21 to dollar 82 per EMT/module. CONCLUSION: Although not a replacement for all instructor-led training, web-based training can be a cost-effective and acceptable alternative for achieving instructional objectives within the cognitive domain. It offers other benefits such as improved administration of training records and consistent delivery of content.

Attitude of Health Personnel↗
PubMedDate not supplied

A comparison of classroom and distance learning techniques for rural EMT-I instruction.

OBJECTIVES: To determine whether two different distance learning techniques are as effective as classroom teaching for training rural-based emergency medical technician-intermediate (EMT-I) students. METHODS: A prospective, nonrandomized comparison of three different instructional methods, with the outcome measurements being mean test scores and attrition rates, was devised. Fifty-seven EMT-I students from rural communities in central Texas were assigned to one of three groups. Each group received 50 hours of didactic instruction based on the U.S. Department of Transportation EMT-I curriculum. The same instructor taught all classes, and all groups used the same workbooks, syllabi, and computer-based tutorials. Group 1 (n = 25) received traditional classroom instruction. Group 2 (n = 18) received instruction using a two-way audio/graphic computer network. Group 3 (n = 14) received instruction using a satellite-based audio/video networks. All students then took a standardized multiple-choice examination. Attrition rates were based on the number of those who qualified for EMT-I certification. RESULTS: Mean test results for each group were as follows: group 1, 93 (95% CI = 91-95); group 2, 94 (95% CI = 93-96); group 3, 94 (95% CI = 92-96). No significant difference was noted in mean test scores between groups (p = 0.21). Attrition rates were as follows: group 1, 88% (95% CI = 69-97%); group 2, 100% (95% CI = 81-100%); group 3, 86% (95% CI = 57-98%). No significant difference was seen in attrition rates between groups (p = 0.24). CONCLUSIONS: No difference was found in mean test scores or attrition rates between traditional classroom and two distance learning methods for rural-based EMT-I students. Distance learning techniques may offer an effective alternative for providing educational opportunities to rural EMS providers.

Certification↗
PubMed2006

Histamine uptake by human endometrial cells expressing the organic cation transporter EMT and the vesicular monoamine transporter-2.

Cellular reuptake of monoamines, which is mediated by cell membrane transporters, is followed by accumulation in vesicles by vesicular monoamine transporters (VMAT). The aim of this study was to demonstrate the presence of functional monoamine transporters with high affinity for histamine in human endometrial tissue, since histamine has been implicated as a paracrine signal during endometrial decidualization and embryo implantation. In situ hybridization with (35)S-labelled cRNA probes was used for detection of the organic cationic transporter-2 (OCT-2), the extraneuronal monoamine transporter (EMT), and VMAT-2 in cryosections of normal human endometrial tissue. To identify functional transporters for histamine in endometrial cells, we incubated primary cultures of stromal cells and cultures of attached glands with (3)H-labelled histamine. Cultures were pretreated with either corticosterone, a specific inhibitor of EMT, or reserpine, a specific inhibitor of VMAT-2. EMT mRNA was localized in the stroma with peak expression in the secretory phase, whereas OCT-2 mRNA was expressed by few cells in the stroma throughout the cycle. VMAT-2 mRNA was localized in the stroma during the proliferative phase and in the epithelium during the secretory phase. Thus, EMT and VMAT-2, which both have high affinity for histamine, are strongly expressed in endometrial cells. Both corticosterone and reserpine significantly reduced the uptake of (3)H-histamine in stromal cells during the proliferative as well as the secretory phase. This indicates the presence of functional EMT and VMAT-2 transporter proteins throughout the cycle, even though their periods of maximal mRNA expression were limited. The results of uptake experiments with glandular epithelial cells confirmed not only the presence of functional VMAT-2 transporter protein in the secretory phase but also the absence of a histamine-specific plasma membrane transporter throughout the cycle. Thus, endometrial tissue contains both plasma membrane and vesicular membrane monoamine transporters with high affinity for histamine. They can potentially influence the reproductive process by the uptake of extracellular histamine and subsequent release on demand.

Adult↗
PubMed2003

New approach to generalized two-dimensional correlation spectroscopy. III: Eigenvalue manipulation transformation (EMT) for spectral selectivity enhancement.

This paper demonstrates the potential of eigenvalue manipulating transformation (EMT) of a data matrix for spectral selectivity enhancement, especially useful in 2D correlation analysis. The EMT operation aims at the accentuation of select features of the information content of the original data matrix. For example, by uniformly lowering the power of a set of eigenvalues associated with the original data, the smaller eigenvalues become more prominent and the contributions of secondary loadings become amplified. As a direct consequence of the minor factor accentuation by such EMT operations, 2D correlation spectra gain much stronger discriminating power. The selectivity enhancement effect of such manipulation of eigenvalues is much more noticeable on the synchronous 2D correlation spectrum. This improvement for the spectral selectivity of synchronous 2D correlation spectra is potentially very important, as we usually put more emphasis on the interpretation of asynchronous 2D spectra in 2D correlation analysis due to overlaps of synchronous peaks. Such EMT operations tend to exaggerate the information content of minor PCs and reduce that of major PCs. Thus, much more subtle difference of spectral behavior for each component is now highlighted. Surprisingly, asynchronous 2D correlation spectra are found to be much less sensitive to such EMT operations. The result indicates that the distinction of different band responses has already been accomplished effectively by the original asynchronous 2D correlation analysis.

Algorithms↗
PubMed1997

Analysis of CD28 cytoplasmic tail tyrosine residues as regulators and substrates for the protein tyrosine kinases, EMT and LCK.

The CD28 cell surface receptor provides an important costimulatory signal for T cells necessary for their response to Ag. Early events in CD28 signaling include recruitment and activation of phosphatidylinositol 3-kinase (PI3-kinase) and activation of the protein tyrosine kinases (PTKs), LCK and EMT. Recruitment and activation of PI3-kinase is known to be dependent upon phosphorylation of tyrosine 173 of the CD28 cytoplasmic tail contained within a YMNM motif. By contrast, little is known of which residues of the CD28 tail, including tyrosines, are required for the activation of PTKs. To address this we studied the ability of truncation mutants and tyrosine to phenylalanine substitution mutants of the CD28 cytoplasmic tail to activate LCK and EMT in Jurkat T leukemia cells. Our results indicate that 1) activation of EMT is partially dependent upon tyrosine 173 of the CD28 tail, although it does not require PI3-kinase activation; 2) activation of LCK is independent of CD28 cytoplasmic tail tyrosine residues; and 3) elements sufficient for the activation of both kinases are contained within the first half of the tail. In addition we studied the CD28 tail as a substrate for both PTKs in in vitro kinase assays. We demonstrate that EMT can phosphorylate all four tyrosines of the CD28 tail, in contrast to LCK, which phosphorylates only tyrosine 173. Together with evidence that in vivo, tyrosines other than tyrosine 173 become phosphorylated following CD28 stimulation, this finding suggests that, like LCK, one function of EMT during CD28 signaling is phosphorylation of the receptor.

CD28 Antigens↗
PubMed2025

Expression analysis of LINC00671 and LINC01913 long non-coding RNAs in gastric cancer patients and their correlation with EMT markers.

BACKGROUND: Long-chain non-coding RNAs (lncRNAs) play various roles in the regulation of gene expression at the levels of transcription and translation, and epigenetic modification. Dysregulation of lncRNAs is associated with various malignancies, including cancer. lncRNAs have been demonstrated to regulate critical biological processes in cancer cells, such as apoptosis, proliferation, migration, and invasion. They also play essential roles in the development of gastric cancer (GC). However, the clinical significance and biological function of many lncRNAs remain unexplored in GC progression. This study aimed to evaluate the expression profiles of LINC00671 and LINC01913 in GC patients and investigate their correlation with epithelial-to-mesenchymal transition (EMT) markers. METHOD: The real-time PCR technique was applied to measure the expression levels of the selected lncRNAs (LINC01913 and LINC00671) and EMT-related mRNAs (MAMLs and MMP-13) in 83 tumor and adjacent normal tissues obtained from GC patients. RESULT: A significant reduction in LINC00671 expression was observed in 55.4% of tumor tissues, while elevated expression of LINC01913 (41%), MMP13 (56.6%), and MAML1 (44.6%) was detected, representing the proportion of samples with dysregulated expression relative to matched normal tissues. Dysregulation of these genes was significantly associated with various clinicopathological features (P&#x2009;<&#x2009;0.05), supporting a potential link between these lncRNAs and EMT processes in GC. CONCLUSION: The observed associations between LINC00671, LINC01913, and EMT-related genes suggest their potential as prognostic biomarkers for treatment response in GC patients.

Humans↗
PubMed2006

MEKK4 regulates developmental EMT in the embryonic heart.

Congenital heart malformations occur at a rate of one per one hundred births and are considered the most frequent birth defects. This high incidence of cardiac defects underscores the complex developmental processes required to form the first functioning organ in mammals. The molecular cues which govern heart development are poorly defined and require an improved understanding in order to advance repair strategies for heart defects. The cytoplasmic MAP kinase kinase kinase, MEKK4, is a critical effector in cellular stress responses; however, the function of MEKK4 during embryonic development and cardiogenesis is not well understood. We have identified MEKK4 as a critical signaling molecule during cardiovascular development. We report the detection of MEKK4 transcripts to early myocardium, endocardium and to cardiac cushion cells that have executed epithelial to mesenchymal transformation (EMT). These observations suggest that MEKK4 may function during production of the cushion mesenchyme as required to create valves and the septated heart. We used a kinase inactive form of MEKK4(MEKK4(KI)) in an in vitro assay that recapitulates in vivo EMT, and show that MEKK4(KI) attenuates mesenchyme production. However, addition of a constitutively active MEKK4 into ventricular explants, a system that does not normally undergo EMT, is not able to cause mesenchymal cell outgrowth. Thus, the kinase activity of MEKK4 is essential, but not sufficient, to support developmental EMT. This knowledge provides a basis to understand how MEKK4 may integrate signaling cascades controlling heart development.

Animals↗
PubMed1993

Structure and expression of novel protein-tyrosine kinases, Emb and Emt, in hematopoietic cells.

Two novel tyrosine kinase cDNAs were obtained from murine mast cells. These kinases, Emb and Emt, constitute a novel tyrosine kinase subfamily which may also include Tec, a kinase preferentially expressed in liver, and Dsrc28, a fruit fly kinase. Both lack hydrophobic stretches characteristic of the transmembrane domains found in growth factor receptor tyrosine kinases and carboxyl-terminal, negative regulatory tyrosine residue found in Src family kinases. In addition to the Src homology region 2 (SH2) and SH3 domains characteristic of the Src family kinases and other signaling molecules, Emb and Emt share a similar amino-terminal domain comprised mainly of two repeat segments. The emb 2.7-kb transcript was expressed in mast cells, myeloid cells and B lymphocytes while the emt 4.6-kb mRNA in mast cells, myeloid cells and T lymphocytes. The evidence for in vitro tyrosine kinase activity of Emb and Emt proteins is also provided.

Amino Acid Sequence↗
PubMedDate not supplied

Do pulse checks delay semiautomatic defibrillation by EMT-defibrillators?

Advanced cardiac life support (ACLS) guidelines from the American Heart Association (AHA) now recommend not checking for a pulse between the initial three defibrillations for pulseless patients in ventricular tachycardia or fibrillation. The AHA asserts that checking for a pulse needlessly delays defibrillation. This study was undertaken to determine if pulse checks delay defibrillation by EMT-Defibrillators (EMT-Ds) using a semiautomatic defibrillator (SAED). Twenty-seven EMT-Ds demonstrated delivery of three successive defibrillations during two test scenarios: once with and once without pulse checks after the first and second defibrillations. The time from the first to third defibrillation was recorded. The mean time to deliver the defibrillations was 60.2 +/- 6.2 seconds with pulse checks and 57.5 +/- 4.6 seconds without pulse checks. The difference, 2.7 +/- 5.9 seconds, was statistically significant (P = 0.026). Pulse checks by EMT-Ds do delay administration of defibrillations, but consideration should be given to reinstating pulse checks as a part of the AHA guidelines, since this delay is of questionable clinical significance.

Electric Countershock↗
PubMed1988

A comparison of an innovative four-hour EMT-D course with a 'standard' ten-hour course.

A study was conducted to determine if a four-hour emergency medical technician-defibrillation (EMT-D) course could produce student skills equivalent to a "standard" ten-hour EMT-D course. Two matched groups of EMTs were established, one of which was instructed by a four-hour course (study group) while the other (control group) entered a "standard" ten-hour course. On both written and practical testing, one week and 18 months after the completion of the course, the study group was comparable to the control group. These results indicate that the more cost-effective four-hour course can be used, thus encouraging the widespread availability of cardiac defibrillation by EMTs.

Adult↗
PubMed1997

Expression of c-ets-1 mRNA is associated with an invasive, EMT-derived phenotype in breast carcinoma cell lines.

We have previously observed in vitro that some stromal proteinases (MMP-2, MT1-MMP) were expressed or activated by invasive carcinoma cell lines exhibiting mesenchymal features, presumably acquired through an epithelial to mesenchymal transition (EMT). To examine the potential contribution of c-ets-1 to this phenotype, we have compared here the expression of c-ets-1 with invasiveness in vitro and expression of vimentin, E-cadherin, uPA, MMP-1 and MMP-3 in a panel of human breast cancer cell lines. Our results clearly demonstrate an association between c-ets-1 expression and the invasive, EMT-derived phenotype, which is typified by the expression of vimentin and the lack of E-cadherin. While absent from the two non-invasive, vimentin-negative cell lines, c-ets-1 was abundantly expressed in all the four vimentin-positive lines. However, we could not find a clear quantitative or qualitative relationship between the expression of c-ets-1 and the three proteinases known to be regulated by c-ets-1, except that when they were expressed, it was only in the invasive c-ets-1-positive lines. UPA mRNAs were found in three of the four vimentin-positive lines, MMP-1 in two of the four, and MMP-3 could not be detected in any of the cell lines. Intriguingly, MDA-MB-435 cells, which exhibit the highest metastatic potential of these cell lines in nude mice, expressed vimentin and c-ets-1, but lacked expression of these three proteinases, at least under the culture conditions employed. Taken together, our results show that c-ets-1 expression is associated with an invasive, EMT-derived phenotype in breast cancer cells, although it is apparently not sufficient to ensure the expression of uPA, MMP-1 or MMP-3, in the vimentin-positive cells. Such proteases regulation is undoubtedly qualified by the cellular context. This study therefore advances our understanding of the molecular regulation of invasiveness in EMT-associated carcinoma progression, and suggests that c-ets-1 may contribute to the invasive phenotype in carcinoma cells.

Breast Neoplasms↗
PubMed2006

Reciprocal regulation of RhoA and RhoC characterizes the EMT and identifies RhoC as a prognostic marker of colon carcinoma.

Understanding how RhoC expression and activation are regulated is essential for deciphering its contribution to tumorigenesis. Here, we report that RhoC expression and activation are induced by the epithelial to mesenchymal transition (EMT) of colon carcinoma. Using LIM 1863 colon cancer cells, RhoC protein expression and subsequent activation were detected coincident with the loss of E-cadherin and acquisition of mesenchymal characteristics. Several Ets-1 binding sites were identified in the RhoC promoter, and evidence was obtained using chromatin immunoprecipitation that Ets-1 can regulate RhoC expression during the EMT. Interestingly, a marked decrease in RhoA activation associated with the EMT was observed that corresponds to the increase in RhoC expression. Use of shRNA established that RhoA inhibits and RhoC promotes post-EMT cell migration, demonstrating functional significance for their coordinate regulation. To assess the importance of RhoC expression in colon cancer, immunohistochemistry was performed on 566 colorectal tumors with known clinical outcome. The level of RhoC ranged from no expression to high expression, and statistical analysis revealed that elevated RhoC expression correlates with poor outcome as well as aberrant expression and localization of E-cadherin. These data provide one mechanism for how RhoC expression is regulated in colon carcinoma and substantiate its utility as a prognostic marker.

Biomarkers, Tumor↗
PubMed2005

Disabled-2 (Dab2) is required for transforming growth factor beta-induced epithelial to mesenchymal transition (EMT).

Transforming growth factor beta (TGFbeta) induces an epithelial to mesenchymal transition (EMT) during both physiological and pathological processes; however, the mechanism underlying this transition is not fully elucidated. Here, we have demonstrated that TGFbeta induces the expression of the adaptor molecule disabled-2 (Dab2) concomitant with the promotion of EMT. We show that TGFbeta induces a transient accumulation of Dab2 to the membrane and increases Dab2 binding to beta1 integrin. Furthermore, small interfering RNA (siRNA)-mediated silencing of Dab2 expression in mouse mammary gland epithelial cells results in inhibition of integrin activation, shown by a decrease of both TGFbeta-induced focal adhesion kinase phosphorylation and cellular adherence, leading to apoptosis and inhibition of EMT. Forced re-expression of human Dab2, not targeted by the mouse siRNA sequence, rescues cells from apoptosis and restores TGFbeta-mediated integrin activation and EMT. These results are confirmed in the F9 teratocarcinoma cell line, a model for retinoic acid-induced visceral endoderm differentiation in which we demonstrate that ablation of retinoic acid-induced Dab2 expression levels, by stable siRNA silencing of Dab2, blocks visceral endoderm differentiation. Our findings indicate that Dab2 plays an important regulatory role during cellular differentiation and that induction of differentiation in the absence of Dab2 expression commits the cell to apoptosis.

Adaptor Proteins, Signal Transducing↗
PubMed2006

The evaluation of two death education programs for EMTs using the theory of planned behavior.

The goal of this study was to evaluate the effectiveness of two death education programs by comparing pretest and posttest scores of behavioral intentions and (reported) behavior of EMTs when at the scene of a death. After the interventions, the majority of EMTs intended to change their behavior at the scene of a death when compared to the control group. In a three-month follow-up study, the majority of EMTs who received the intervention (and made a death notification) changed their behavior. In this sample, these programs were effective in changing the behavioral intentions of EMTs.

Attitude of Health Personnel↗
PubMedDate not supplied

The in-hospital interval: a description of EMT time spent in the emergency department.

OBJECTIVE: We conducted a time-motion study of emergency medical technician (EMT) flow in an urban, academic emergency department (ED). Our objective was to describe the activity of the EMTs during their time in the ED. Secondary objectives included the association of time of day, age, and triage code with the various time intervals. METHODS: In this descriptive study, we combined information from two databases: prospectively collected time-motion data of EMTs presenting to one ED and an electronically collected prehospital call database of time data. The pretriage, triage, and posttriage time intervals were calculated, as well as total time spent in the ED as a proportion of total call time. Mean times with 95% confidence intervals (CIs) were reported. Analysis of variance was performed to examine the associations of time of day, age, and triage code with time intervals. RESULTS: Data were available for 152 calls. The mean pretriage interval was 8.79 (95% CI, 7.55-10.04) minutes, the mean triage interval was 5.14 (95% CI, 4.49-5.79) minutes, and the mean posttriage interval was 31.33 (95% CI, 29.08-33.58) minutes. The proportion of the total call time that was spent in the ED was 45%. Subgroup analysis showed significant differences only between total time spent in the ED in the 7:30-10:00 AM period as compared with the other periods. CONCLUSIONS: More time was spent in the pretriage and posttriage intervals as compared with the triage interval. Further time-motion studies in the ED will be necessary to plan interventions aimed at decreasing the time spent in-hospital by EMTs.

Aged↗
PubMed2003

Agmatine is efficiently transported by non-neuronal monoamine transporters extraneuronal monoamine transporter (EMT) and organic cation transporter 2 (OCT2).

Agmatine has received considerable attention recently. Available evidence suggests that agmatine functions as a neurotransmitter and inhibits, via induction of antizyme, cellular proliferation. Because of its positive charge, agmatine will not appreciably cross cellular membranes by simple diffusion. Indeed, all physiological models require a channel or transporter protein in the plasma membrane to effect inactivation or nonexocytotic release of agmatine. However, a transport mechanism for agmatine has not been identified on a molecular level so far. In the present study, the non-neuronal monoamine transporters, organic cation transporter (OCT) 1, OCT2, and extraneuronal monoamine transporter (EMT) (gene symbols SLC22A1-A3), both from human and rat, were examined, stably expressed in 293 cells, for [(3)H]agmatine transport. Our results indicate that OCT2 and EMT, but not OCT1, efficiently translocate agmatine. The structural homolog putrescine was not accepted as substrate. Uptake of agmatine via EMT and OCT2 was saturable, with K(m) values of 1 to 2 mM. The affinity of OCT1 was 10-fold lower. Carrier-mediated efflux of agmatine was documented in a trans-stimulation experiment. Finally, uptake of agmatine increased dramatically with increasing pH. Thus, only the singly charged species of agmatine is accepted as substrate. In conclusion, both EMT and OCT2 must be considered for the control of agmatine levels in rat and human.

Agmatine↗
PubMed2006

EMTs and GPs: what do we think of each other?

BACKGROUND: Ireland's health services are undergoing dramatic reorganisation. The establishment of general practitioner (GP) out of hours cooperatives and the integration of current ambulance services into a national ambulance service are among the issues that will impact on prehospital care of emergencies. The study aimed to explore the perceptions of GPs and emergency medical technicians (EMTs) of their own and each other's roles in the context of such reforms. METHODS: A census of all GPs (511) and EMTs (301) in three of Ireland's eight health board regions was undertaken. A questionnaire containing 31 statements asked respondents to indicate their agreement (or lack of it) in areas such as general relationships, care, and training, roles in emergencies and future developments. RESULTS: Of the personnel contacted, 72% of GPs and 75% of EMTs responded. They report excellent working relationships, agree that the ambulance service is of high quality, and that GPs are willing to provide care in emergencies. However, working links are less satisfactory for EMTs, who report a far higher perception of GP use of emergency ambulances than reported by GPs. Both groups are interested in innovative future links. DISCUSSION: Convergence between the professional groups in different geographic areas and between the disciplines across the areas is striking. They include areas of satisfaction and dissatisfaction. The need for improved liaison between the disciplines is clear.

Attitude of Health Personnel↗
PubMed2005

Distribution of sigma receptors in EMT-6 cells: preliminary biological evaluation of PB167 and potential for in-vivo PET.

Sigma(1) and sigma(2) receptors have been detected in many tissues and are highly expressed in several tumour cell lines from various tissues. The high level of expression observed for sigma receptors and their involvement in cell proliferation and apoptosis has led to the development of several sigma ligands in order to obtain a molecular probe for in-vivo diagnostic imaging techniques such as positron emission tomography (PET) and single photon emission computerized tomography (SPECT). The EMT-6 cells implanted in mice were a good model for evaluating the proliferation of solid tumours by in-vivo PET. Moreover, we developed the sigma ligand PB167, a cyclohexylpiperazine derivative, previously evaluated for sigma(2) receptor affinity and activity in standard protocols. The related results encouraged us to verify if this compound could be developed as a radiotracer for in-vivo PET in order to visualize sigma(2) receptors expressed in EMT-6 cells when implanted in mice. This perspective was thought to be favourable because PB167 bears a methoxy substituent on the tetraline nucleus, an easy point for (11)C labelling. The aims of this preliminary study were both to assess the relative distribution of sigma(1) and sigma(2) receptors in EMT-6 cells and to verify if PB167 could be developed as a sigma(2) radiotracer for in-vivo PET. The results showed that both sigma(1) and sigma(2) receptors were overexpressed in EMT-6 cells and that the ligand PB167 can be positively considered for radiosynthesis preparation in order to suitably visualize sigma(2) receptors by the in-vivo PET technique and correlate their presence to tumour proliferation.

Animals↗