algorithms are the first medication-specific, patient-centric deprescribing guidelines developed and validated for patients on HD.

Nine medication-specific deprescribing algorithms for patients on HD were developed and validated by clinician review. Our algorithms are the first medication-specific, patient-centric deprescribing guidelines developed and validated for patients on HD.

Pragmatic cluster randomized trials (CRTs) offer an opportunity to improve health care by answering important questions about the comparative effectiveness of treatments using a trial design that can be embedded in routine care. There is a lack of empirical research that addresses ethical issues generated by pragmatic CRTs in hemodialysis.

To identify stakeholder perceptions of ethical issues in pragmatic CRTs conducted in hemodialysis.

Qualitative study using semi-structured interviews.

In-person or telephone interviews with an international group of stakeholders.

Stakeholders (clinical investigators, methodologists, ethicists and research ethics committee members, and other knowledge users) who had been involved in the design or conduct of a pragmatic individual patient or cluster randomized trial in hemodialysis, or their role would require them to review and evaluate pragmatic CRTs in hemodialysis.

Interviews were conducted in-person or over the telephone and were audio-recorded with consent. find more ave received less coverage than other, well-known, issues such as consent. Pragmatic CRTs offer a potential approach to address equity concerns and we suggest future ethical analyses and guidance for pragmatic CRTs in hemodialysis embed equity considerations within them. We further note the potential for the co-creation of health data infrastructure with patients which would aid care but also facilitate patient-centered research. These present results will inform planned future guidance in relation to the ethical design and conduct of pragmatic CRTs in hemodialysis.

Registration is not applicable as this is a qualitative study.

Registration is not applicable as this is a qualitative study.

This study explored the combined use of fever detection and thoracic ultrasonography to identify calves with early onset bovine respiratory disease (BRD). Thoracic ultrasonography was then used to assess the efficacy of antimicrobial and non-steroidal anti-inflammatory drug (NSAID) treatment for early onset BRD through a randomised study design.

Calves were recruited from a single dairy farm in the UK, and fitted with a TempVerified FeverTag, which was activated when a calf developed fever (a temperature of 39.7°C for six hours). On identification of fever, a Wisconsin calf score was used to provide a diagnosis of BRD by exclusion of other causes. Calves were randomly assigned to experimental groups; group 1 (NSAID) received flunixin meglumine, group 2 (antimicrobial) received florfenicol, group 3 (both) received both drugs. A thoracic ultrasound was conducted within 48 hours of fever detection, and again 14 days later to assess lung pathology.

A total of 152 calves were recruited, with a relative BRD p pathology.Staphylococcus aureus is a versatile pathogen that can cause a variety of diseases, ranging from mild to fatal infection. This study aimed to detect the virulence genes (cna, ica, hlg and sdrE) in S. aureus isolated from different types of infections in Sudanese patients admitted to different hospital in Khartoum state. This is a descriptive cross-sectional study conducted over a period of 4 months from 1 April to 30 July 2017 in Khartoum. Overall, 65 S. aureus isolates were identified using standard biochemical and microbiologic tests. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Nucleic acid was extracted using the guanidine hydrochloride method, and all the genes except for sdrE were detected by multiplex PCR. The ica gene was the predominant one, found in 73.85% of the isolates, with sdrE found in 38.46%, cna in 29.25% and hlg in 7.69%. The relationship between the virulence genes and resistance to antibiotics showed that the highest resistance was observed in isolates with ica and sdrE, followed by cna and hlg. There were significant relationships between methicillin resistance and the presence of sdrE and ica genes (p 0.01 for both) and between ciprofloxacin resistance and the presence of sdrE gene (p 0.03).Acinetobacter baumannii is one of the most important opportunistic challenging pathogens as a result of its ability to acquire resistance to broad range of antibiotics and cause a variety of severe nosocomial infections. We investigated the frequency of the aminoglycoside-modifying enzymes (AMEs) and oxacillinase genes among clinical isolates of A. baumannii collected from hospitalized patients in Imam Khomeini Hospital, Ahvaz city, Iran. This prospective cross-sectional study was performed on 80 clinical isolates of A. baumannii collected from patients referred to Imam Khomeini Hospital in Ahvaz, Iran. Initial identification of isolates as A. baumannii was performed using conventional bacteriologic tests, and final confirmation was carried out by PCR of blaOXA-51-like gene and multiplex PCR of gyrB locus. MICs of different classes of antibiotics against these strains was measured by using VITEK 2 system. After extraction of genomic DNA, two groups of multidrug-resistant A. baumannii genes including AME (aadAbial agents usually prescribed for severe infections caused by A. baumannii. Therefore, because of rapid emergence of resistance even for colistin or tigecycline, monotherapy should be avoided. These results show the importance of providing antibiotics correctly in intensive care units and following antibiotic stewardship protocols as the only effective strategies to attempt to control antibiotic resistance in healthcare settings.Today an alternative approach to control bacterial infections is the use of natural and traditional plant compounds to interfere with their quorum-sensing (QS) systems. In this study, antibacterial and anti-QS sensing activity of Syzygium aromaticum, Dionysia revoluta Boiss. and Eucalyptus camaldulensis Dehnh. were evaluated. These plants are local to the Middle East region and have since ancient times been used for their antibacterial activity. Plant compounds were extracted with n-hexane, methanol and 96% ethanol mixed solvent. Antibacterial activity of this herbal extracts against five Gram-negative and Gram-positive bacteria were assessed. The effective sub-minimum inhibitory concentration (MIC) of this extract on bacterial QS systems were investigated by a violacein quantification assay in the Chromobacterium violaceum CV026 biosensor strain, inhibition of exogenously QS signal molecules in Aeromonas veronii bv. Sobria strain BC88 and Pseudomonas aeruginosa isolated from a patient with cystic fibrosis in vitro.