Majority of Brits want a soft Brexit compromise, but leave voters don’t

With the battle over Brexit returning to the House of Commons with the Internal Market Bill, it is easy to lose sight of the bigger picture: what the British public wants in terms of a longer-term relationship with the European Union. To try to find out, Simon Hix (LSE), Clifton van der Linden (McMaster University) and Mark Pickup (Simon Fraser University) conducted a survey experiment with a random sample of British voters, where they asked them to choose between hypothetical “package deals”. This forced voters to have to make trade-offs across key issues. When faced with such choices, British voters overall prefer a “softer” form of Brexit: where the UK applies EU regulatory standards in return for quota-free and tariff-free access to the EU’s single market. However, a majority of Leave voters prefer a much “harder” trade-off: of regulatory sovereignty but restrictions on UK exports. Reconciling this difference will continue to plague British politics

Temporal Variations among Invasive Pneumococcal Disease Serotypes in Children and Adults in Germany (1992–2008)

Nationwide surveillance of invasive pneumococcal disease has been conducted in Germany since 1992. From 1992 to 2008, a total of 12,137 isolates from invasive pneumococcal disease were collected. Data on serotypes were available for 9,394 invasive isolates. The leading serotypes were serotypes 14 (16.5%), 3 (8.0%), 7F (7.6%), 1 (7.3%), and 23F (6.0%). Variations in serotype distribution over the years are particularly extensive, especially concerning serotype 14 (min 7.4%, max 33.5%) with the highest percentages among the isolates serotyped from around 1997 to 2006. Serotypes 1 and 7F increased over the last decade. No increase was observed concerning serotype 19A. Higher pneumococcal conjugate vaccine coverages were observed among children (7v, 57.3%; 10v, 72.8%; 13v, 83.5%) than among adults (7v, 39.9%; 10v, 55.5%; 13v, 73.5%). The temporal variations in serotype distribution have to be kept in mind when interpreting vaccine coverages reported in epidemiological studies

Transplant Coronary Artery Disease

Since the fIrst successful orthotopic cardiac transplantation in 1967. the survival after transplantation has gradually been improved due to the introduction of cyclosporin-A, the monitoring of acute rejection by cndomyocardial biopsies and optimized patient carel, In the last decade, clinical studies indicate that coronary artcry disease ill the graft is the most common cause of death in the first postoperative years. The earliest change consist of concentric fibrosis and smooth muscle cell proliferation with collagen accumulation creating diffuse intimal thickening. Tills process involves not only the large epicardial vessels but also the intramyocardial branches. The specific fillgiographic morphology of the lesions found after transplantation was described by the group of Stanford, distinguishing 3 categories: type A, discrete or short tubular stenosis in the proximal, middle or distal segments of major coronary arteries or their branches, type B; diffuse concentric luminal narrowing in the middle to distal segment branches; and type C, diffusely narrowed irregular distal branches that are squared of and end abruptly, the latter two groups both unique to the post-transplant patients • Despite this clear categorization, pathological examinations showed that the process of accelerated

Macrolide susceptibility and serotype specific macrolide resistance of invasive isolates of Streptococcus pneumoniae in Germany from 1992 to 2008

<p>Abstract</p> <p>Background</p> <p>Macrolide resistant <it>Streptococcus pneumoniae </it>has been on a gradual increase in Germany for over a decade. The current study was undertaken against the background of the recent observation of declining macrolide resistance rates especially among German children. Nationwide surveillance of invasive pneumococcal disease has been conducted in Germany since 1992. A population- and laboratory-based approach was used to collect data on invasive pneumococcal disease, and isolates sent to the National Reference Center for Streptococci by diagnostic microbiological laboratories from 1992 to 2008 were included in this study.</p> <p>Results</p> <p>From 1992 to 2008, data on macrolide susceptibility were available for 11,807 invasive isolates. 8,834 isolates (74.8%) were from adults (≥ 16 years), and 2,973 isolates (25.2%) from children (< 16 years). The overall nonsusceptibility rate of all isolates was 16.2% (intermediate, 0.2%; resistant, 16.0%). Higher resistance rates were observed among children (intermediate, 0.2%; resistant, 23.8%) than among adults (intermediate, 0.3%; resistant 13.4%). Maximum nonsusceptibility rates during the period under study were observed in 2005 (children: intermediate, 0.3%; resistant, 32.3%; adults: intermediate, 0.0%; resistant, 18.6%), while nonsusceptibility rates in 2008 were considerably lower, especially for children (children: intermediate, 0.0%; resistant, 15.2%; adults: intermediate, 0.1%; resistant, 12.9%). The rate of resistance was higher among the vaccine serotypes (7-valent, 36.6%; 10-valent, 28.2%; 13-valent, 24.3%) than among the non vaccine serotypes (non 7-valent, 6.5%; non 10-valent, 7.4%; non 13-valent, 6.3%). Serotype 14 (69.6% nonsusceptibility) proved to be the most resistant serotype.</p> <p>Conclusions</p> <p>There has been a considerable and statistically significant decrease in macrolide nonsusceptibility in Germany since 2005, especially among children.</p

Streptococcus pneumoniae carriage, resistance and serotypes among Jordanian children from Wadi Al Seer District, Jordan

Objectives: Isolation of Streptococcus pneumoniae from healthy children in Wadi Al Seer, Jordan before vaccination with prevenar.  Methods: Nasopharyngeal and throat swabs were colloected from 118 healthy children with age range from one to 50 months and mean age 13.4 months. Isolates were analysed for antimicrobial susceptibility, serotyping and macrolide resistant genotypes and phenotypes.Results: The overall nasopharyngeal carriage rate was 55.1% (n= 65/118). The percentage of resistance was as follows: Penicillin (80%), erythromycin (61.5%), clindamycin (33.8%), trimethoprim-sulfamethoxazole (73.8%), and tetracycline (53.8%). Vancomycin, Amoxicillin, cefotaxime, levofloxacin and telithromycin showed no resistance. 37/ 65 isolates (56.9%) were multiresistant. (MIC50, MIC90) were as follows (µg/ml): Penicillin (0.5, 2),  erythromycin (2, &gt;=32), clindamycin (0.06, &gt;=32), trimethoprim-sulfamethoxazole (4, &gt;=32), tetracycline (16, 32), and and levofloxacin (0.5, 1). Among macrolide resistant isolates 40 (61.5%), macrolide resistant phenotypes indicated were (n, %): M-Phenotypes (18, 45%), iMLSB (1, 2.5%) and cMLSB (21, 52.5%) with genotypes erm(B) 55%, and mef(A) 45%. The most common serotypes indicated were: 19F (18.5%), 6B (16.9%), 23F (12.3%), 35B (6.2%), 11A, NT and 15A (4.6%) each, and 14, 34, 23A, 6A, and 19A (3.1%) each. Coverage of PCV7, PCV10 and PCV13 was 52.3%, 52.3% and 58.5%, respectively.Conclusions: Carriage of pneumococci in Jordan is relatively high with high resistance rate which is a serious risk of future invasive and non invasive pneumococcal infections, and their spread is worrisome