Explore the vast range of titles available.

Existing approaches for the screening and treatment of asymptomatic bacteriuria in pregnancy are based on trials that were done more than 30 years ago. In this study, we reassessed the consequences of treated and untreated asymptomatic bacteriuria in pregnancy. In this multicentre prospective cohort study with an embedded randomised controlled trial, we screened women (aged ≥18 years) at eight hospitals and five ultrasound centres in the Netherlands with a singleton pregnancy between 16 and 22 weeks' gestation for asymptomatic bacteriuria. Screening was done with a single dipslide and two culture media. Dipslides were judged positive when the colony concentration was at least 1×105 colony-forming units (CFU) per mL of a single microorganism or when two different colony types were present but one had a concentration of at least 1×105 CFU per mL. Asymptomatic bacteriuria-positive women were eligible to participate in the randomised controlled trial comparing nitrofurantoin with placebo treatment. In this trial, participants were randomly assigned 1:1 to receive either nitrofurantoin 100 mg or identical placebo tablets, and were instructed to self-administer these tablets twice daily for 5 consecutive days. Randomisation was done by a web-based application with a computer-generated list with random block sizes of two, four, or six participants rendered by an independent data manager. 1 week after the end of treatment, they provided us with a follow-up dipslide. Women, treating physicians, and researchers all remained unaware of the bacteriuria status and treatment allocation. Women who refused to participate in the randomised controlled trial did not receive any antibiotics, but their outcomes were collected for analysis in the cohort study. We compared untreated and placebo-treated asymptomatic bacteriuria-positive women with asymptomatic bacteriuria-negative women and nitrofurantoin-treated asymptomatic bacteriuria-positive women. The primary endpoint was a composite of pyelonephritis with or without preterm birth at less than 34 weeks, analysed by intention to treat at 6 weeks post-partum. This trial is registered with the Dutch Trial Registry, number NTR3068. Between Oct 11, 2011, and June 10, 2013, we enrolled 5621 women into our screening cohort, of whom 5132 were eligible for screening. After exclusions for contaminated dipslides and patients lost to follow-up, in our final cohort of 4283 women, 248 were asymptomatic bacteriuria positive, of whom 40 were randomly assigned to nitrofurantoin and 45 to placebo for the randomised controlled trial, whereas the other 163 asymptomatic bacteriuria-positive women were followed without treatment. The proportion of women with pyelonephritis, preterm birth, or both did not differ between untreated or placebo-treated asymptomatic bacteriuria-positive women and asymptomatic bacteriuria-negative women (6 [2·9%] of 208 vs 77 [1·9%] of 4035; adjusted odds ratio [OR] 1·5, 95% CI 0·6–3·5) nor between asymptomatic bacteriuria-positive women treated with nitrofurantoin versus those who were untreated or received placebo (1 [2·5%] of 40 vs 6 [2·9%] of 208; risk difference −0·4, 95% CI −3·6 to 9·4). Untreated or placebo-treated asymptomatic bacteriuria-positive women developed pyelonephritis in five [2·4%] of 208 cases, compared with 24 [0·6%] of 4035 asymptomatic bacteriuria-negative women (adjusted OR 3·9, 95% CI 1·4–11·4). In women with an uncomplicated singleton pregnancy, asymptomatic bacteriuria is not associated with preterm birth. Asymptomatic bacteriuria showed a significant association with pyelonephritis, but the absolute risk of pyelonephritis in untreated asymptomatic bacteriuria is low. These findings question a routine screen-treat-policy for asymptomatic bacteriuria in pregnancy. ZonMw (the Netherlands Organisation for Health Research and Development).

Urinary tract infections (UTIs) are among the most common bacterial infections globally, with significant morbidity and rising antimicrobial resistance (AMR). This study aimed to investigate the prevalence of uropathogens and their antimicrobial resistance patterns at Mbarara Regional Referral Hospital (MRRH) in Uganda. A retrospective analysis of 939 urine culture- positive records from January 2019 to December 2024 was conducted. Isolates were identified, and antimicrobial susceptibility testing was performed using the disc diffusion method. Data on patient demographics, uropathogen distribution, and resistance trends of organisms with greater than or equal to 25 isolates were analyzed using Python-based statistical methods, including Chi-square and Mann-Kendall trend analysis. was the most isolated pathogen, accounting for 428 isolates (45.6%), followed by spp. with 385 isolates (41.0%) while spp. and spp. contributed 42 (4.5%) and 26 (2.8%) isolates, respectively. The cases were dominated by females (69.0%). There was an extremely high resistance to commonly prescribed antibiotics such as ampicillin (91.3%) and sulfamethoxazole (91.6%). Carbapenem resistance was overall low (≤10.3%) but also had a statistically significant rising trend in spp. (p = 0.0415). Multidrug resistance (MDR) was present in 56.9% of the isolates, predominantly in and spp. and 70% of the MDR isolates were ESBL producers. This study underscores the urgent need for routine culture and sensitivity, and updated treatment guidelines to address the rising AMR among uropathogens in Uganda.

Supra-aortic extra-anatomic debranch (SAD) are prosthetic surgical grafts used to revascularize head and neck arteries that would be blocked during a surgical or hybrid procedure used in treating ascending and arch of the aorta pathologies. However, bypassing the supra-aortic arteries but not occluding their orifice might introduce potential for competitive flow that reduces bypass patency. Competitive flow within the bypasses across the supra-aortic arteries has not previously been identified. This research identified haemodynamics due to prophylactic inclusion of bypasses from the brachiocephalic artery (BCA) to the left common carotid artery (LCCA), and from the LCCA to left subclavian artery (LSA). Four model configurations investigated the risk of competitive flow and the necessity of intentionally blocking the proximal LSA and/or LCCA. Particle image velocimetry (PIV) was used to assess haemodynamics in each model configuration. We found potential for competitive flow in the BCA-LCCA bypass when the LSA was blocked, in the LSA-LCCA bypass, when the LCCA alone or LCCA and LSA were blocked. Flow stagnated at the start of systole within the RCCA-LCCA bypass, along with notable recirculation zones and reciprocating flow occurring throughout systolic flow. Flow also stagnated in the LCCA-LSA bypass when the LCCA was blocked. There was a large recirculation in the LCCA-LSA bypass when both the LCCA and LSA were blocked. The presence of competitive flow in all other configurations indicated that it is necessary to block or ligate the native LCCA and LSA once the debranch is made and the thoracic endovascular aortic repair (TEVAR) completed.

Cardiovascular diseases (CVDs) are one of the leading causes of death globally. In-vitro measurement of blood flow in compliant arterial phantoms can provide better insight into haemodynamic states and therapeutic procedures. However, current fabrication techniques are not capable of producing thin-walled compliant phantoms of complex shapes. This study presents a new approach for the fabrication of compliant phantoms suitable for optical measurement. Two 1.5× scaled models of the ascending aorta, including the brachiocephalic artery (BCA), were fabricated from silicone elastomer Sylgard-184. The initial phantom used the existing state of the art lost core manufacturing technique with simple end supports, an acrylonitrile butadiene styrene (ABS) additive manufactured male mould and Ebalta-milled female mould. The second phantom was produced with the same method but used more rigid end supports and ABS male and female moulds. The wall thickness consistency and quality of resulting stereoscopic particle image velocimetry (SPIV) were used to verify the fidelity of the phantom for optical measurement and investigation of physiological flow fields. However, the initial phantom had a rough surface that obscured SPIV analysis and had a variable wall thickness (range = 0.815 mm). The second phantom provided clear particle images and had a less variable wall thickness (range = 0.317 mm). The manufacturing method developed is suitable for fast and cost-effective fabrication of different compliant arterial phantom geometries.

Globally, 10.8 million people were diagnosed with tuberculosis during 2023 causing approximately 1.3 million deaths. This study aimed to assess the prevalence and characterization of pyrazinamide resistance by detecting the gene among newly diagnosed patients attending Bombo General Military Hospital, Central Uganda. Cross-sectional study looking at newly diagnosed TB patients in Bombo General Military Hospital. The sputum samples were confirmed TB positive using GeneXpert PCR technology, DNA extraction using the CTAB method, DNA amplification, and finally gel electrophoresis for gene detection. A total of 166 sputum-positive tuberculosis samples were analyzed. Males were 91/166 (55%), while 115 (70%) of the positive sputum samples were positive HIV status. The majority (96%) of the newly diagnosed patients showed no detection of rifampicin resistance, while the rest 6/160 (4%) showed indeterminate rifampicin resistance. Of the 52 (31%) patients with positive gene, 29 (56%) had HIV positive status 18 (34%) had unknown HIV status and 5 (10%) had negative HIV status. It was observed that only one patient 1 (2%) showed both rifampicin and pyrazinamide resistance and was a female patient aged 42 years of age with positive HIV status and positive gene status. This study reveals the important trends regarding drug resistance and its relationship with HIV status. The majority of patients (96%) did not exhibit rifampicin resistance, suggesting that multi-drug-resistant tuberculosis is not widespread among the newly diagnosed cases. The majority (56%) of the patients with the gene mutation, were HIV-positive. This highlights the potential vulnerability of HIV-positive TB patients to multidrug resistance though the overall pyrazinamide resistance rate remains low.

Background: Facebook has become one of the most popular advertising platforms on social media. It is therefore important for social media marketers and researchers to have an understanding of the predictors of Facebook users’ engagement with Facebook advertising across all brands and Facebook advertising types. Objectives: This study aimed to determine whether the theory of planned behaviour could be applied to understand and predict engagement with Facebook advertising. Method: Non-probability convenience sampling resulted in a sample size of 656 Facebook users above the age of 18 who resided in South Africa. The data collected by means of an online survey were analysed using regression analyses. Results: The findings indicated that attitude was the strongest predictor of behavioural intention to engage with Facebook advertising, followed by subjective norms. However, perceived behavioural control was found not to be a significant predictor of behavioural intention to engage with Facebook advertising. Furthermore, behavioural intention to engage with Facebook advertising was found to predict actual engagement. Conclusion: Social media marketers need to focus on influencing attitudes and subjective norms to increase engagement with their Facebook advertisements. Furthermore, the theory of reasoned action was found to be more appropriate to predict engagement with Facebook advertising, as it excludes perceived behavioural control.

In this paper we propose a new algorithm for real-time filtering of video sequences corrupted by Poisson noise. The algorithm provides effective denoising (in some cases overcoming the filtering performances of state-of-the-art techniques), is ideally suited for hardware implementation, and can be implemented on a small field-programmable gate array using limited hardware resources. The paper describes the proposed algorithm, using X-ray fluoroscopy as a case study. We use IIR filters for time filtering, which largely simplifies hardware cost with respect to previous FIR filter-based implementations. A conditional reset is implemented in the IIR filter, to minimize motion blur, with the help of an adaptive thresholding approach. Spatial filtering performs a conditional mean to further reduce noise and to remove isolated noisy pixels. IIR filter hardware implementation is optimized by using a novel technique, based on Steiglitz–McBride iterative method, to calculate fixed-point filter coefficients with minimal number of nonzero elements. Implementation results using the smallest StratixIV FPGA show that the system uses only, at most, the 22% of the resources of the device, while performing real-time filtering of 1024 × 1024@49fps video stream. For comparison, a previous FIR filter-based implementation, on the same FPGA, in the same conditions and constraints (1024 × 1024@49fps), requires the 80% of the logic resources of the FPGA.

\"The need for sedation can be decreased greatly by adequate preparation and by creating a less threatening, child friendly environment in which to perform the study\" (Olson et al. 2001). In 2006, Bild encouraged the avoidance of sedation during EEG and provided several helpful ideas in his ASET News article \"Alternatives to Sedation in the EEG Lab\" (Bild 2006). In this article Bild states, \"We recently discontinued the use of sedation in our lab and we were probably one of the last holdouts using chloral hydrate\" (Bild 2006). Several years later, chloral hydrate is still a common method of sedating children for EEG studies. This article will encourage exploration and utilization of sedation alternatives, and discourage the use of sedatives for neurophysiological testing. This article is based on a review of EEG lab websites, a literature review, and over a decade of experience as a neurophysiology technologist at multiple institutions.

We consider the problem of inferring the basal sliding coefficient field for an uncertain Stokes ice sheet forward model from synthetic surface velocity measurements. The uncertainty in the forward model stems from unknown (or uncertain) auxiliary parameters (e.g., rheology parameters). This inverse problem is posed within the Bayesian framework, which provides a systematic means of quantifying uncertainty in the solution. To account for the associated model uncertainty (error), we employ the Bayesian approximation error (BAE) approach to approximately premarginalize simultaneously over both the noise in measurements and uncertainty in the forward model. We also carry out approximative posterior uncertainty quantification based on a linearization of the parameter-to-observable map centered at the maximum a posteriori (MAP) basal sliding coefficient estimate, i.e., by taking the Laplace approximation. The MAP estimate is found by minimizing the negative log posterior using an inexact Newton conjugate gradient method. The gradient and Hessian actions to vectors are efficiently computed using adjoints. Sampling from the approximate covariance is made tractable by invoking a low-rank approximation of the data misfit component of the Hessian. We study the performance of the BAE approach in the context of three numerical examples in two and three dimensions. For each example, the basal sliding coefficient field is the parameter of primary interest which we seek to infer, and the rheology parameters (e.g., the flow rate factor or the Glen's flow law exponent coefficient field) represent so-called nuisance (secondary uncertain) parameters. Our results indicate that accounting for model uncertainty stemming from the presence of nuisance parameters is crucial. Namely our findings suggest that using nominal values for these parameters, as is often done in practice, without taking into account the resulting modeling error, can lead to overconfident and heavily biased results. We also show that the BAE approach can be used to account for the additional model uncertainty at no additional cost at the online stage.

Background The prevalence of asymptomatic bacteriuria (ASB) in pregnancy is 2-10% and is associated with both maternal and neonatal adverse outcomes as pyelonephritis and preterm delivery. Antibiotic treatment is reported to decrease these adverse outcomes although the existing evidence is of poor quality. Methods/Design We plan a combined screen and treat study in women with a singleton pregnancy. We will screen women between 16 and 22 weeks of gestation for ASB using the urine dipslide technique. The dipslide is considered positive when colony concentration ≥10 5 colony forming units (CFU)/mL of a single microorganism or two different colonies but one ≥10 5  CFU/mL is found, or when Group B Streptococcus bacteriuria is found in any colony concentration. Women with a positive dipslide will be randomly allocated to receive nitrofurantoin or placebo 100 mg twice a day for 5 consecutive days (double blind). Primary outcomes of this trial are maternal pyelonephritis and/or preterm delivery before 34 weeks. Secondary outcomes are neonatal and maternal morbidity, neonatal weight, time to delivery, preterm delivery rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal admission days and costs. Discussion This trial will provide evidence for the benefit and cost-effectiveness of dipslide screening for ASB among low risk women at 16–22 weeks of pregnancy and subsequent nitrofurantoin treatment. Trial registration Dutch trial registry: NTR-3068