A new sentinel surveillance system for severe influenza in England shows a shift in age distribution of hospitalised cases in the post-pandemic period

Background

The World Health Organization and European Centre for Disease Prevention and Control have highlighted the importance of establishing systems to monitor severe influenza. Following the H1N1 (2009) influenza pandemic, a sentinel network of 23 Trusts, the UK Severe Influenza Surveillance System (USISS), was established to monitor hospitalisations due to confirmed seasonal influenza in England. This article presents the results of the first season of operation of USISS in 2010/11.

Methodology/Principal Findings

A case was defined as a person hospitalised with confirmed influenza of any type. Weekly aggregate numbers of hospitalised influenza cases, broken down by flu type and level of care, were submitted by participating Trusts. Cases in 2010/11 were compared to cases during the 2009 pandemic in hospitals with available surveillance data for both time periods (n = 19). An unexpected resurgence in seasonal A/H1N1 (2009) influenza activity in England was observed in December 2010 with reports of severe disease. Reported cases over the period of 4 October 2010 to 13 February 2011 were mostly due to influenza A/H1N1 (2009). One thousand and seventy-one cases of influenza A/H1N1 (2009) occurred over this period compared to 409 at the same Trusts over the 2009/10 pandemic period (1 April 2009 to 6 January 2010). Median age of influenza A/H1N1 (2009) cases in 2010/11 was 35 years, compared with 20 years during the pandemic (p = <0.0001).

Conclusions/Significance

The Health Protection Agency successfully established a sentinel surveillance system for severe influenza in 2010/11, detecting a rise in influenza cases mirroring other surveillance indicators. The data indicate an upward shift in the age-distribution of influenza A/H1N1 (2009) during the 2010/11 influenza season as compared to the 2009/10 pandemic. Systems to enable the ongoing surveillance of severe influenza will be a key component in understanding and responding to the evolving epidemiology of influenza in the post-pandemic era.     

The effects of centralised and specialised intervention in the early course of severe unipolar depressive disorder: a randomised clinical trial

Background

Little is known on whether centralised and specialised combined pharmacological and psychological intervention in the early phase of severe unipolar depression improve prognosis. The aim of the present study was to assess the benefits and harms of centralised and specialised secondary care intervention in the early course of severe unipolar depression.

Methods

A randomised multicentre trial with central randomisation and blinding in relation to the primary outcome comparing a centralised and specialised outpatient intervention program with standard decentralised psychiatric treatment. The interventions were offered at discharge from first, second, or third hospitalisation due to a single depressive episode or recurrent depressive disorder. The primary outcome was time to readmission to psychiatric hospital. The data on re-hospitalisation was obtained from the Danish Psychiatric Central Register. The secondary and tertiary outcomes were severity of depressive symptoms according to the Major Depression Inventory, adherence to medical treatment, and satisfaction with treatment according to the total score on the Verona Service Satisfaction Scale-Affective Disorder (VSSS-A). These outcomes were assessed using questionnaires one year after discharge from hospital.

Results

A total of 268 patients with unipolar depression were included. There was no significant difference in the time to readmission (unadjusted hazard ratio 0.89, 95% confidence interval 0.60 to 1.32; log rank: χ² = 0.3, d.f. = 1, p = 0.6); severity of depressive symptoms (mood disorder clinic: median 21.6, quartiles 9.7–31.2 versus standard treatment: median 20.2, quartiles 10.0–29.8; p = 0.7); or the prevalence of patients in antidepressant treatment (73.9% versus 80.0%, p = 0.2). Centralised and specialised secondary care intervention resulted in significantly higher satisfaction with treatment (131 (SD 31.8) versus 107 (SD 25.6); p<0.001).

Conclusions

Centralised and specialised secondary care intervention in the early course of severe unipolar depression resulted in no significant effects on time to rehospitalisation, severity of symptoms, or use of antidepressants, but increased patient satisfaction.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00253071","term_id":"NCT00253071"}}NCT00253071     

四种杂交组合奥尼罗非鱼及其亲本的生长对比研究

通过RFID电子标记注射、跟踪和生长性状测量,对2个奥利亚罗非鱼品系(ZZ、AA)、2个尼罗罗非鱼品系(XX、EE)自交群体及其杂交奥尼罗非鱼4个群体(XZ、XA、EZ、EA)进行生长对比研究,罗非鱼亲本来自国家罗非鱼产业技术体系研发中心。结果表明:XZ、XA、EZ、EA四个奥尼罗非鱼群体雄性率均达94%以上,全长、体长、头长、体高等性状特征值显著高于亲本品系(P<0.05),奥尼罗非鱼的生长速率相对其亲本品系具有一定的优势,同时4个奥尼群体间生长性状特征值也存在显著差异(P<0.05);生长性状相关分析显示罗非鱼各配组群体的体质量与尾柄长相关性较低(0.690—0.846),与全长、体长、体高、体厚相关性较高;对罗非鱼各配组群体的比例性状进行主成分分析,第1主成分主要代表BS、HS、CDS、BWS性状特征,第2主成分主要代表TS、HS、CLS性状特征,通过第1、第2主成分作图可将AA与其他6个罗非鱼配组群体有效区分。     

改良型抗菌肽的研究进展

长期滥用抗生素导致了耐药菌株“超级细菌”的出现,增加了动物、人类健康和环境污染风险．寻找抗生素替代品正成为全球研究热点,抗菌肽因其高效抗菌效果和不同于抗生素的独特作用机制引起了各国研究者的关注,并进行了相关研究．然而抗菌肽的安全性、稳定性、生产成本等问题限制了其生产与应用．为了克服这些不利因素,研究者们对抗菌肽进行了多种方式的改造,产生了模拟型、同源型、杂合型、轭合型、稳定型和固位型等改良型抗菌肽,并有望在畜牧业、食品业、医药业等领域得到广泛的应用．本文主要综述了这些改良型抗菌肽近年来的研究进展．