Children at danger: injury fatalities among children in San Diego County

External causes of death are important in the pediatric population worldwide. We performed an analysis of all injury-fatalities in children between ages zero and 17 years, between January 2000 and December 2006, in San Diego County, California, United States of America. Information was obtained from the County of San Diego Medical Examiner’s database. External causes were selected and grouped by intent and mechanism. Demographics, location of death and relation between the injury mechanism and time of death were described. There were 884 medico-legal examinations, of which 480 deaths were due to external causes. There majority were males (328, 68.3%) and whites (190, 39.6%). The most prevalent mechanism of injury leading to death was road traffic accidents (40.2%), followed by asphyxia (22.7%) and penetrating trauma (17.7%). Unintentional injuries occurred in 65.8% and intentional injuries, including homicide and suicide, occurred in 24.2 and 9.4%, respectively. Death occurred at the scene in 196 cases (40.9%). Most deaths occurred in highways (35.3%) and at home (28%). One hundred forty-six patients (30.4%) died in the first 24 h. Seven percent died 1 week after the initial injury. Among the cases that died at the scene, 48.3% were motor vehicle accidents, 20.9% were victims of firearms, 6.5% died from poisoning, 5% from hanging, and 4% from drowning. External causes remain an important cause of death in children in San Diego County. Specific strategies to decrease road-traffic accidents and homicides must be developed and implemented to reduce the burden of injury-related deaths in children

Leptospira interrogans Stably Infects Zebrafish Embryos, Altering Phagocyte Behavior and Homing to Specific Tissues

Leptospirosis is an extremely widespread zoonotic infection with outcomes ranging from subclinical infection to fatal Weil's syndrome. Despite the global impact of the disease, key aspects of its pathogenesis remain unclear. To examine in detail the earliest steps in the host response to leptospires, we used fluorescently labelled Leptospira interrogans serovar Copenhageni to infect 30 hour post fertilization zebrafish embryos by either the caudal vein or hindbrain ventricle. These embryos have functional innate immunity but have not yet developed an adaptive immune system. Furthermore, they are optically transparent, allowing direct visualization of host–pathogen interactions from the moment of infection. We observed rapid uptake of leptospires by phagocytes, followed by persistent, intracellular infection over the first 48 hours. Phagocytosis of leptospires occasionally resulted in formation of large cellular vesicles consistent with apoptotic bodies. By 24 hours, clusters of infected phagocytes were accumulating lateral to the dorsal artery, presumably in early hematopoietic tissue. Our observations suggest that phagocytosis may be a key defense mechanism in the early stages of leptospirosis, and that phagocytic cells play roles in immunopathogenesis and likely in the dissemination of leptospires to specific target tissues

Isoprene suppression of new particle formation in a mixed deciduous forest

Production of new particles over forests is an important source of cloud condensation nuclei that can affect climate. While such particle formation events have been widely observed, their formation mechanisms over forests are poorly understood. Our observations made in a mixed deciduous forest with large isoprene emissions during the summer displayed a surprisingly rare occurrence of new particle formation (NPF). Typically, NPF events occur around noon but no NPF events were observed during the 5 weeks of measurements. The exceptions were two evening ultrafine particle events. During the day, sulfuric acid concentrations were in the 106 cm-3 range with very low preexisting aerosol particles, a favorable condition for NPF to occur even during the summer. The ratio of emitted isoprene carbon to monoterpene carbon at this site was similar to that in Amazon rainforests (ratio >10), where NPF events are also very rare, compared with a ratio <0.5 in Finland boreal forests, where NPF events are frequent. Our results suggest that large isoprene emissions can suppress NPF formation in forests although the underlying mechanism for the suppression is unclear. The two evening ultrafine particle events were associated with the transported anthropogenic sulfur plumes and ultrafine particles were likely formed via ion-induced nucleation. Changes in landcover and environmental conditions could modify the isoprene suppression of NPF in some forest regions resulting in a radiative forcing that could have influence on the climate. © 2011 Author(s)

Isoprene suppression of new particle formation in a mixed deciduous forest

Production of new particles over forests is an important source of cloud condensation nuclei that can affect climate. While such particle formation events have been widely observed, their formation mechanisms over forests are poorly understood. Our observations made in a mixed deciduous forest with large isoprene emissions during the summer displayed a surprisingly rare occurrence of new particle formation (NPF). Typically, NPF events occur around noon but no NPF events were observed during the 5 weeks of measurements. The exceptions were two evening ultrafine particle events. During the day, sulfuric acid concentrations were in the 106 cm-3 range with very low preexisting aerosol particles, a favorable condition for NPF to occur even during the summer. The ratio of emitted isoprene carbon to monoterpene carbon at this site was similar to that in Amazon rainforests (ratio >10), where NPF events are also very rare, compared with a ratio <0.5 in Finland boreal forests, where NPF events are frequent. Our results suggest that large isoprene emissions can suppress NPF formation in forests although the underlying mechanism for the suppression is unclear. The two evening ultrafine particle events were associated with the transported anthropogenic sulfur plumes and ultrafine particles were likely formed via ion-induced nucleation. Changes in landcover and environmental conditions could modify the isoprene suppression of NPF in some forest regions resulting in a radiative forcing that could have influence on the climate. © 2011 Author(s)

Modelling the transmission of healthcare associated infections: a systematic review.

BACKGROUND: Dynamic transmission models are increasingly being used to improve our understanding of the epidemiology of healthcare-associated infections (HCAI). However, there has been no recent comprehensive review of this emerging field. This paper summarises how mathematical models have informed the field of HCAI and how methods have developed over time. METHODS: MEDLINE, EMBASE, Scopus, CINAHL plus and Global Health databases were systematically searched for dynamic mathematical models of HCAI transmission and/or the dynamics of antimicrobial resistance in healthcare settings. RESULTS: In total, 96 papers met the eligibility criteria. The main research themes considered were evaluation of infection control effectiveness (64%), variability in transmission routes (7%), the impact of movement patterns between healthcare institutes (5%), the development of antimicrobial resistance (3%), and strain competitiveness or co-colonisation with different strains (3%). Methicillin-resistant Staphylococcus aureus was the most commonly modelled HCAI (34%), followed by vancomycin resistant enterococci (16%). Other common HCAIs, e.g. Clostridum difficile, were rarely investigated (3%). Very few models have been published on HCAI from low or middle-income countries.The first HCAI model has looked at antimicrobial resistance in hospital settings using compartmental deterministic approaches. Stochastic models (which include the role of chance in the transmission process) are becoming increasingly common. Model calibration (inference of unknown parameters by fitting models to data) and sensitivity analysis are comparatively uncommon, occurring in 35% and 36% of studies respectively, but their application is increasing. Only 5% of models compared their predictions to external data. CONCLUSIONS: Transmission models have been used to understand complex systems and to predict the impact of control policies. Methods have generally improved, with an increased use of stochastic models, and more advanced methods for formal model fitting and sensitivity analyses. Insights gained from these models could be broadened to a wider range of pathogens and settings. Improvements in the availability of data and statistical methods could enhance the predictive ability of models