16 research outputs found
Modelling biospheric control of carbon fluxes between atmosphere, ocean and land in view of climatic change.
Life-threatening infections in children in Europe (the EUCLIDS Project): a prospective cohort study
Background: Sepsis and severe focal infections represent a substantial disease burden in children admitted to hospital. We aimed to understand the burden of disease and outcomes in children with life-threatening bacterial infections in Europe.
Methods: The European Union Childhood Life-threatening Infectious Disease Study (EUCLIDS) was a prospective, multicentre, cohort study done in six countries in Europe. Patients aged 1 month to 18 years with sepsis (or suspected sepsis) or severe focal infections, admitted to 98 participating hospitals in the UK, Austria, Germany, Lithuania, Spain, and the Netherlands were prospectively recruited between July 1, 2012, and Dec 31, 2015. To assess disease burden and outcomes, we collected demographic and clinical data using a secured web-based platform and obtained microbiological data using locally available clinical diagnostic procedures.
Findings: 2844 patients were recruited and included in the analysis. 1512 (53·2%) of 2841 patients were male and median age was 39·1 months (IQR 12·4–93·9). 1229 (43·2%) patients had sepsis and 1615 (56·8%) had severe focal infections. Patients diagnosed with sepsis had a median age of 27·6 months (IQR 9·0–80·2), whereas those diagnosed with severe focal infections had a median age of 46·5 months (15·8–100·4; p<0·0001). Of 2844 patients in the entire cohort, the main clinical syndromes were pneumonia (511 [18·0%] patients), CNS infection (469 [16·5%]), and skin and soft tissue infection (247 [8·7%]). The causal microorganism was identified in 1359 (47·8%) children, with the most prevalent ones being Neisseria meningitidis (in 259 [9·1%] patients), followed by Staphylococcus aureus (in 222 [7·8%]), Streptococcus pneumoniae (in 219 [7·7%]), and group A streptococcus (in 162 [5·7%]). 1070 (37·6%) patients required admission to a paediatric intensive care unit. Of 2469 patients with outcome data, 57 (2·2%) deaths occurred: seven were in patients with severe focal infections and 50 in those with sepsis.
Interpretation: Mortality in children admitted to hospital for sepsis or severe focal infections is low in Europe. The disease burden is mainly in children younger than 5 years and is largely due to vaccine-preventable meningococcal and pneumococcal infections. Despite the availability and application of clinical procedures for microbiological diagnosis, the causative organism remained unidentified in approximately 50% of patients
Plasma lipid profiles discriminate bacterial from viral infection in febrile children
Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics
Model estimates of CO2 emissions from soil in response to global warming
One effect of global warming will be to accelerate the decomposition of soil organic matter, thereby releasing CO2 to the atmosphere, which will further enhance the warming trend 1-7. Such a feedback mechanism could be quantitatively important, because CO2 is thought to be responsible for approximately 55% of the increase in radiative forcing arising from anthropogenic emissions of gases to the atmosphere 8, and there is about twice as much carbon in the top metre of soil as in the atmosphere 9. Here we use the Rothamsted model for the turnover of organic matter in soil 3 to calculate the amount of CO2 that would be released from the world stock of soil organic matter if temperatures increase as predicted, the annual return of plant debris to the soil being held constant. If world temperatures rise by 0.03-degrees-C yr-1 (the increase considered as most likely by the Intergovernmental Panel on Climate Change 8), we estimate that the additional release of CO2 from soil organic matter over the next 60 years will be 61 x 10(15) gC. This is approximately 19% of the CO2 that will be released by combustion of fossil fuel during the next 60 years if present use of fuel continues unabated. 
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Committed terrestrial ecosystem changes due to climate change
Targets for stabilizing climate change are often based on considerations of the impacts of different levels of global warming, usually assessing the time of reaching a particular level of warming. However, some aspects of the Earth system, such as global mean temperatures1 and sea level rise due to thermal expansion2 or the melting of large ice sheets3, continue to respond long after the stabilization of radiative forcing. Here we use a coupled climate–vegetation model to show that in turn the terrestrial biosphere shows significant inertia in its response to climate change. We demonstrate that the global terrestrial biosphere can continue to change for decades after climate stabilization. We suggest that ecosystems can be committed to long-term change long before any response is observable: for example, we find that the risk of significant loss of forest cover in Amazonia rises rapidly for a global mean temperature rise above 2 °C. We conclude that such committed ecosystem changes must be considered in the definition of dangerous climate change, and subsequent policy development to avoid it