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Separation and identification of molecules and biomolecules such as nucleic acids, proteins, and polysaccharides from complex fluids are known to be important due to unmet needs in various applications. Generally, many different separation techniques, including chromatography, electrophoresis, and magnetophoresis, have been developed to identify the target molecules precisely. However, these techniques are expensive and time consuming. "Lab‐on‐a‐chip" systems with low cost per device, quick analysis capabilities, and minimal sample consumption seem to be ideal candidates for separating particles, cells, blood samples, and molecules. From this perspective, different microfluidic‐based techniques have been extensively developed in the past two decades to separate samples with different origins. In this review, "lab‐on‐a‐chip" methods by passive, active, and hybrid approaches for the separation of biomolecules developed in the past decade are comprehensively discussed. Due to the wide variety in the field, it will be impossible to cover every facet of the subject. Therefore, this review paper covers passive and active methods generally used for biomolecule separation. Then, an investigation of the combined sophisticated methods is highlighted. The spotlight also will be shined on the elegance of separation successes in recent years, and the remainder of the article explores how these permit the development of novel techniques. [ABSTRACT FROM AUTHOR]

Information technologies give patients the opportunity to communicate with medical professionals remotely. Telemedicine uses these technologies to provide advanced healthcare and medical services. We present a medical online consultation application based on Web Real-Time Communications (WebRTC) technology enabling chat, audio, and video calls. Communication architecture and protocols of the application are explained in detail. Additionally, the user interface of the application is shown via performed calls. The application is tested and evaluated on different network connections (3G, 4G, local, and DSL) and different browsers and mobile operating systems (Android, Chrome, Firefox, Internet Explorer, iOS, Opera, Safari). During calls, communication quality parameters such as round-trip time (RTT) and packet loss, obtained via the WebRTC application programming interface, are analyzed. 3G, 4G, and local connections show low packet losses (<1%). Packet losses are high (>1%) in Android, Chrome, iOS, Opera, and Safari for DSL connection, but RTT values are low (<100 ms) in all different conditions excluding iOS. In the presented application, RTT and packet loss remain lower than 100 ms and 1%, respectively, in various scenarios, indicating good communication quality. RTT and packet loss are related to total time and hang time parameters, which describe the necessary time to establish and to end a call. It is shown that communication quality of the application can simply be measured by analyzing the total time parameter. This enables predictable information for communication quality for WebRTC-based applications without continuously monitoring RTT and packet loss for the first time. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare women with spontaneous preterm delivery before 37 weeks and women who delivered at term with respect to amniotic fluid C-reactive protein (CRP), glucose levels, and white blood cell counts at the time of genetic amniocentesis. STUDY DESIGN: The study was conducted on 216 pregnant women who underwent genetic amniocentesis between the 15th and 18th weeks of gestation at Baskent University Obstetrics and Gynecology Department. All patients were followed until delivery for the occurrence of pregnancy complication. Indications for amniocentesis included abnormal triple test results showing increased risk for Down's syndrome, advanced maternal age and sonographic findings indicative for chromosomal abnormalities. The samples were carried immediately to the laboratory for cytogenetic and biochemical examination. Women with spontaneous preterm delivery before 37 weeks (n = 20) and those who delivered at term (n = 196) were compared with respect to some maternal and infant characteristics, amniotic fluid C-reactive protein, glucose levels, and amniotic fluid white blood cell counts. RESULTS: During the study period 244 patients underwent amniocentesis. A chromosomal abnormality was present in 11 patients. 1 patient had a spontaneous pregnancy loss within 3 weeks after the procedure and 16 patients were delivered for fetal or maternal indications (preeclampsia, fetal growth restriction, placenta previa). The remaining 216 women were included in the study and investigated for the risk of preterm delivery. The prevalence of spontaneous preterm delivery before 37 weeks was 9.3% (20/216). There were no significant differences between the preterm delivery and the term delivery groups with respect to C-reactive protein levels and white blood cell counts. Mean amniotic glucose levels were significantly lower in the preterm delivery group (P<0.05). Amniotic fluid glucose levels of < or = 46 mg/dL had a sensitivity of 100% and NPV of 100%. CONCLUSION: Amniotic fluid glucose levels at the time of genetic amniocentesis are lower in women with spontaneous preterm delivery before 37 weeks compared to those who delivered at term. Amniotic fluid glucose levels of < or = 46 mg/dL at the time of genetic amniocentesis may be more sensitive, cheaper and have higher negative predictive value than C-reactive protein levels and white blood cell counts for the prediction of patients in spontaneous preterm labor. The greatest benefit of amniotic fluid glucose testing might be when the physician judges the patient to be at low risk for preterm delivery. [ABSTRACT FROM AUTHOR]

Objectives: To establish a relationship between hyperemesis gravidarum (HG) and Helicobacter pylori (H. Pylori) infection by histologic testing. Methods: Twenty patients with severe HG (Group I) and 10 volunteer pregnant women without gastric complaints (Group II) were included in the study. Endoscopic evaluations were done in both groups and biopsies were obtained from the antrum and corpus for the histopathologic diagnosis of H. pylori. The groups were compared with the χ2-test and Fisher''s exact test where appropriate. Results: H. pylori was diagnosed in 19 (95%) of 20 patients in Group I and 5 (50%) of 10 patients in group II. H. pylori densities in the antrum and corpus were higher in Group I and the differences between the two groups were statistically significant. The biopsy specimens revealed significant inflammation and H. pylori activation processes in patients with HG, and in 18 of 19 patients inflammation scores were greater than +2 on the scale. Pangastritis was demonstrated by endoscopic examination in 17 of 20 patients with HG. Enterogastric reflux was also diagnosed in 10 patients. In the control group, three patients had antral gastritis. Conclusions: We suggest that in patients with intractable nausea and vomiting during pregnancy, pangastritis and enterogastric reflux are the main endoscopic findings and that these findings are closely associated with H. pylori infection, which can be diagnosed histologically. The degree of gastric complaints may be associated with the density of H. pylori infection. [Copyright &y& Elsevier]

An abstract of the article "Does multi-fetal pregnancy reduction influence perinatal results in twin pregnancies?," by F. F. Yanik and colleagues is presented.

The article presents several case studies involving limb body wall defects of the fetus during the first trimester of pregnancy. One showed a large abdominal wall defect with scoliosis, and the stomach, liver and bowel were all outside the abdomen. Another had a large abdominal defect with severe scoliosis and anencephaly with a suspicion of cleft lip and palate. The last demonstrated Turner's syndrome, had a large abdominal wall defect, and the bowel and liver outside were outside the abdomen.

An abstract of the article "Can bleeding affect fetal Doppler parameters during genetic amniocentesis?." by E. Tarim, T. Cok, C. Iskender is presented.

An abstract of the article "Abdominal wall defects: evaluation of 20 cases at a tertiary care center," by E. Simsek and colleagues are presented.

An abstract of the article "Prenatal diagnosis of right diaphragmatic eventration associated with fetal hydrops," by C. Iskender and colleagues is presented.

An abstract of the article "Can LMWHs affect uterine artery Doppler in patients with trombophilia?," by T. Cok, E. Tarim and C. Iskender is presented.

An abstract of the conference paper "Glucose challenge test between 130-140 mg/dl; adding abdominal circumference measurement difference between 29-33 weeks may predict macrosomia," by E. Tarim and colleagues is presented.

An abstract of the conference paper "Limb body wall defect: three different presentations with abdominal wall defects," by S. Hacivelioglu and colleagues is presented.

An abstract of the conference paper "Low molecular weight heparins and first trimester maternal PAPP-A and hCG levels, fetal nuchal translucency in the first trimester of pregnancy," by E. Tarim and colleagues is presented.

An abstract of the conference paper "First trimester maternal serum PAPP-A levels and macrosomia," by E. Tarim and colleagues is presented.

Objective: The purposes of this study were to evaluate and compare the maxillary sinus volume (MSV) of patients with a unilateral cleft lip and palate (UCLP) between the cleft side and noncleft side and between adolescent patients with UCLP and a control (noncleft) group using cone beam computed tomography (CBCT)., Methods: CBCT images of 44 UCLP patients (29 males and 15 females, with a mean [SD] age of 13.5 [5.0] years) and 44 (22 males and 22 females, with a mean [SD] age 14.9 [4.2] years) age- and sex-matched controls were evaluated in this study. Each maxillary sinus was assessed 3-dimensionally, segmented, and its volume was calculated., Results: There were no statistically significant differences between the age and gender distributions of the groups. There was a statistically significant difference in the MSVs of the cleft (10996.78±3522.89 mm 3 ) versus the noncleft side (10382.3±3416.2 mm3; P < .05)] but no significant difference between the MSVs of the right and left sides ( P > .05). In the intergroup comparison, the mean MSVs of the UCLP patients (10701.52±3369.33 mm 3 ) were significantly smaller than those of the control group (16054.08 ± 5293.96 mm 3 ; P < .001)., Conclusions: The MSVs of the UCLP patients showed a statistically significant decrease compared to those of the controls ( P < .001). There was also a significant difference in the MSVs of the cleft and noncleft sides of the UCLP patients ( P < .05).

Objective: Currently, more women are delaying childbearing until their 40s.This study compared the pregnancy and maternal features, pregnancy and foetal outcomes between multiparous and primiparous patients. We compared the same factors between assisted reproductive technology (ART) and non-ART primiparous patients because of the high proportion of ART used in the primiparous patients., Methods: The study retrospectively examined 1680 patients, 35 years of age and older, between March 2008 and February 2015., Results: Comparing the features of these two groups, there was an increased incidence of employment and the use of ART in primiparous patients, while birthweight tended to be higher in the multiparous group. There were no significant differences in pregnancy complications other than hypertension disorders, such as pre-eclampsia and HELLP syndrome, which were significantly more frequent in primiparous patients. The rates of foetal growth retardation and perinatal death were significantly higher in primiparous women. Comparison of the data between ART and non-ART primiparous patients indicated that the ART group had a higher initial body mass index and a lower smoking rate. No significant differences in pregnancy complications or foetal outcome were observed between these two groups., Conclusion: Primiparity is associated with increased pregnancy and foetal complications in advanced age pregnancies. However, the use of ART in this age group does not seem to be an additional risk factor.

Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy, which occurs in previous cesarean section scar tissue, with an incidence of 1 in 1800-3000 pregnancies. Transvaginal ultrasound-guided local methotrexate (MTX) administration presents as a non-systemic option with possible better penetration to the pregnancy site. We present the management of 18 patients with CSP solely by transvaginal ultrasound-guided local MTX administration. All patients were treated with local MTX with a dose of 50 mg/m(2) . Eleven (61.1%) of the patients did not need any further intervention. Four patients (22.2%) were treated with additional single-dose systemic MTX due to inadequate alteration in blood β-human chorionic gonadotrophin levels. Three patients (16.7%) required hysteroscopy and/or laparotomy. We suggest that transvaginal ultrasound-guided local MTX treatment may be considered as a first-line treatment for CSP., (© 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.)

Objectives: The aim of the study was to investigate to what extent sweeping of the membranes contributes to cervical shortening and if cervical shortening is related to the time to onset of labor and duration of the active phase of labor, Methods: This prospective randomized clinical trial was performed at Baskent University between February and March 2011. Women were randomly assigned to receive membrane sweeping (Sweeping Group) (n = 69) or no membrane sweeping (Control Group) (n = 71). Cervical length was measured (cervix1) in both groups by examiner 1 and the Bishop Score was determined in the control group and sweeping was performed in the sweeping group by examiner 2. Two days later the patients had another cervical length measurement (cervix 2) by examiner 1, blinded to the group and results of the examiner 2. t test, Mann-Whitney U test and Chi-square test were used for statistical analyses., Results: Cervix 1 was 27.4 +/- 8.4 mm and 29.6 +/- 8.9 mm (p = 0.14), cervix 2 was 23.3 +/- 8.8 mm and 23.8 +/- 8.5 mm (p = 0.28) and cervical shortening was 5 +/- 4 mm and 5 +/-4 mm (p = 0.446), time to onset of labor was 6.3 +/- 4.6 and 5.7 +/- 4.7 (p = 0.38) and duration of labor was 5.8 +/- 2.89 and 5.7 +/- 2.4 (p = 0.82) for the sweeping and the control groups, respectively, Conclusions: Sweeping of the membranes does not reduce cervical length and does not shorten time to onset of labor and duration of the active phase of labor NCT 1309308: Sweeping the Membranes, Cervical Length and Duration of Labor

Objective: To investigate if first trimester lipids, sonographic parameters and serum markers are related to small- and large-for-gestational age (SGA, LGA) infants., Methods: This study was conducted at Baskent University Adana Research Center between December 2009 and July 2011 and enrolled 433 women. Blood samples were drawn to measure fasting blood glucose, serum triglycerides, cholesterol, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein, fβ-hCG and pregnancy associated protein-A (PAPP-A) at the first trimester. Crown rump length and nuchal translucency were measured as suggested by the fetal medicine foundation., Results: LGA group was significantly taller (p = 0.016) and SGA group had significantly greater BMI (0.025). SGA fetuses were born at a significantly earlier gestational age (p = 0.001). Univariate analysis revealed that LGA group had significantly lower cholesterol (p = 0.038) and LDL levels (p = 0.041). PAPP-A was significantly lower in SGA Group compared with LGA Group (0.027). After controlling for age, parity, height, pre-pregnant BMI, weight gain during pregnancy and fasting blood sugar, none of the lipids, serum markers or sonographic parameters was related to LGA. PAPP-A was the only parameter significantly associated with SGA after multivariate analysis (p = 0.008)., Conclusion: PAPP-A was significantly associated with SGA after controlling for confounders.

Background: The addition of opioids to local anesthetics contributes to the quality of spinal anesthesia and postoperative analgesia., Objective: In our prospective, randomized, double-blind, controlled study, our aim was to compare the effect of low-dose sufentanil plus levobupivacaine or a fentanyl plus levobupivacaine mixture on anesthesia quality, block characteristics, newborn and mother well-being, surgeon satisfaction, and duration of postoperative analgesia., Methods: Ninety-three patients were randomized into 3 groups (n = 31). Patients in Group C received 0.5% levobupivacaine (2.2 ± 0.2 mL), Group S received 2.5 µg sufentanil plus 0.5% levobupivacaine (2.2 ± 0.2 mL), and Group F received 10 µg fentanyl plus 0.5% levobupivacaine (2.2 ± 0.2 mL) intrathecally completed to a volume of 3 mL with the addition of saline in all groups. Patients' demographics, sensory and motor block characteristics, hemodynamics, Apgar scores, umbilical blood gas values, maternal side effects, surgeon satisfaction score, time to first analgesia requirement, and additional analgesic use within 24 hours were recorded., Results: In Group S and Group F, target levels of sensory and motor block were achieved more rapidly (P < 0.001). The hemodynamic values were lower (P < 0.05), and the duration of sensory blockade and the time of first analgesic requirement were longer (P < 0.001) in Group S. Additional analgesic requirement during first 24-hour period was lowest in Group S, and highest in Group C (P < 0.001). Apgar scores and umbilical blood gas samples were similar between groups. Postoperative pruritus was more frequent in Group S (P < 0.001) and surgeon satisfaction score was significantly lower in Group C (P = 0.003)., Conclusions: We suggest that the addition of sufentanil and fentanyl to intrathecal levobupivacaine during caesarean section surgery is more effective than the administration of levobupivacaine alone. The addition of sufentanil to levobupivacaine allowed rapid onset time for sensory and motor block levels. It also extended the duration of postoperative analgesia and led to a decrease in total analgesic requirement. ClinicalTrials.gov identifier: NCT01858090.

Purpose: To investigate if normotensive and hypertensive patients with intrauterine growth restricted (IUGR) fetuses were different with respect to maternal and fetal characteristics and Doppler flow., Methods: The records of patients with IUGR fetuses who had to be delivered before 34th gestational week because of fetal distress were examined. Early Doppler abnormalities were defined as increased umbilical artery resistance and redistribution of blood flow in the middle cerebral artery while late Doppler abnormalities were defined as the absence or reversal of umbilical artery blood flow and Doppler flow changes in venous Doppler. t Test, Chi-square test and Mann-Whitney U test were used for the comparison of data as appropriate. p < 0.05 was considered statistically significant., Results: Thirty-six patients were hypertensive while 42 were normotensive. Gestational week at admission for hypertensive and normotensive groups (30.8 ± 3.6 vs. 32.3 ± 3.1) (p = 0.057), time to delivery (7.1 ± 12.6 vs. 4.3 ± 9.1 days) (p = 0.267) and gestational week at delivery (31.8 ± 3.1 vs. 32.9 ± 2.9) (p = 0.117) were similar. Birth weight was significantly lower (1242 ± 534 vs. 1516 ± 504 g) (p = 0.02) in the normotensive group. The frequency of having oligohydramnios (64.2 % for normotensive and 44.4 % for hypertensive patients) (p = 0.079) was similar in both groups. Early Doppler abnormalities were more common in hypertensive group (75 vs. 40.5 %) (p = 0.001) while late Doppler abnormalities were more common in normotensive group (25 vs. 59.5 %) (p = 0.001)., Conclusion: Birth weight was lower and late Doppler abnormalities were more common in the normotensive group while early Doppler abnormalities were more common in hypertensive group.

Numerical abnormalities of sex chromosomes are seen approximately 1 in 400 live births. Pentasomy X is a very rare chromosomal abnormality and it is defined as presence of five X chromosomes instead of two. Prenatal sonographic features have rarely been described in the literature before. Here we present a non-immune fetal hydrops diagnosed during the 17th week of gestation. Ultrasonographic examination revealed subcutaneous edema, pleural effusion and ascites, and also clinodactyly of the fifth fingers of both hands. The fetal karyotype was assessed as 49,XXXXX (pentasomy X) in two different culture flasks. Hydropic signs regressed at 21 weeks' gestation. Prenatal diagnosis may not be possible usually for this rare chromosomal abnormality. Every anomaly detected prenatally, such as transient hydrops, may help us to diagnose pentasomy X., (© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.)

Objective: The aim of this study was to use uterine artery Doppler ultrasonography to investigate the cases of women with thrombophilia who used LMWH during the 18-22-week period of gestation., Methods: This retrospective study was conducted at our university between January 2005 and July 2010. 64 patients were treated with low-dose LMWHs (enoxaparine 40 mg) from the beginning of pregnancy until 36 weeks of gestation. Fifty control subjects were also included in this study. Transabdominal ultrasound examination and bilateral uterine artery Doppler measurements pulsatility index (PI), resistive index (RI), and systole/diastole measurement (S/D) were performed during the 18-22-weeks period of gestation., Results: No significant differences were found between the groups with respect to maternal age or gestational age at the time of uterine artery Doppler. However, the mean PI (1.07 ± 0.46 for LMWH group and 0.91 ± 0.31 for control, p = 0.036) and the mean RI (0.59 ± 0.12 for LMWH group and 0.54 ± 0.10 for control, p = 0.021) were significantly higher in the trombophilia group., Conclusion: Women with trombophilia still have an increased mean PI and RI, as determined by uterine artery Doppler ultrasonography during the 18-22-week period of gestation, even if they use LMWH.

Aim: Our aim in this study was to examine the risk factors associated with gestational diabetes mellitus (GDM) in women who did not have GDM during a previous pregnancy., Materials and Methods: In this retrospective cohort study, we reviewed the charts of all pregnant women who delivered two pregnancies between January 2000 and June 2010. Group 1 consisted of patients with gestational diabetes and Group 2 served as the control., Results: There were 743 women who underwent GDM screening by means of the 50-g glucose challenge test (GCT). Thirty-eight women (5.1%) were excluded because of a previous history of GDM. The recurrence of GDM was 42.1% in this group (16 of the 38). The remaining 705 patients were divided into the GDM group (n = 38) and the control group (n = 667). Undergoing a 50-g GCT during the previous pregnancy (p = 0.000, 95% CI +0.01 to +0.002), age (p = 0.009, 95% CI +0.001 to +0.009), and weight differences between the pregnancies at the first trimester (p = 0.005, 95% CI +0.001 to +0.007) were independent parameters related to GDM., Conclusion: The 50-g GCT during the previous pregnancy was, interestingly, increased in the GDM group. It was also an independent risk factor for women without a history of GDM.

Objective: Ectopic decidual reaction (deciduosis) can be seen rarely on the peritoneum during laparotomy for a cesarean section for pregnancy, in addition to the ovary and cervix. The aim of this study was to evaluate the clinical, histopathological, immunohistochemical characteristics of ectopic decidua cases that were incidentally found in the peritoneum during a cesarean section., Material and Method: A total of seven cases where decidualization was found in the peritoneal biopsy taken during pregnancy at the Baskent University Medical Faculty Adana Teaching and Training Hospital Department of Pathology were included in this study. The clinical features of the cases were obtained from their clinical folders. The morphological findings were recorded and the peritoneal biopsies were analyzed with keratin Pan Ab-1, calretinin, vimentin, HMB-45 and progesterone receptor antibody for immunohistochemical analysis., Results: The mean age for the seven cases was 36±4.16. The gestational age was 33 to 39 (mean 37.2) weeks. Microscopic evaluation revealed decidualized cells that were large polygonal and eosinophilic, some with vacuolated cytoplasm, that formed small nodules under the mesothelium of the peritoneum in all cases. Immunohistochemical staining showed positive staining of the cell cytoplasm with vimentin and positive staining of the cell nucleus with the progesterone receptor antibody in the decidual cells. Calretinin, keratin and HMB-45 stains were negative., Conclusion: Pregnancy-related peritoneal deciduosis develops with the effect of progesterone in pregnancy. It disappears without complication in the postpartum period. Immunohistochemistry may help the differential diagnosis of peritoneal deciduosis where problems are experienced differentiating the case from malignant mesothelioma or metastatic tumor.

Objective: Our aim in this study was to investigate the association between 1-h glucose challenge test (GCT) of 130-140 mg/dl and the development of macrosomia., Methods: In this retrospective cohort study, patients with GCT between 130 and 140 mg/dl were divided into two groups. Macrosomic and appropriate-for-gestational-age (AGA) term neonates were compared for the presence of maternal risk factors and fetal abdominal circumference between 29 and 34 weeks., Results: There were no significant differences between the groups with respect to maternal age, parity, BMI at the first trimester and at the time of GCT, gestational weeks at delivery. However; history of a macrosomic baby delivery was significantly higher in macrosomic group (33.3% for group 1, 11.3% for group 2, p = 0.001). Abdominal circumference at 29-34 weeks of gestations was significantly higher in macrosomic group (32.46 ± 1.97 for group 1 vs. 31.06 ± 2.46 for group 2, p = 0.002)., Conclusion: History of a macrosomic baby delivery and abdominal measurement at 29-34 weeks was important predictors of macrosomia in patients with GCT between 130 and 140 mg/dl.

A cardiac hydatid cyst in pregnancy is a very rare condition. Surgical intervention followed by medical therapy is the treatment of choice. A hydatid disease in pregnancy is challenging with a varied presentation and manifestation. A pregnant woman presented with a ruptured pericardial cyst diagnosed by echocardiography, magnetic resonance and serology. Finally, she received medical treatment and no surgical intervention.

Purpose of Investigation: We studied the relation of first trimester nuchal translucency and first trimester biochemical markers using low molecular weight heparin (LMWH) at 11-14 weeks of gestation., Methods: This retrospective study was conducted at our university between January 2007 and July 2009. Ninety-six patients were treated with low-dose LMWHs (enoxaparine 40 mg) from the beginning of pregnancy to 36 weeks of gestation and low-dose aspirin (100 mg) to 32 weeks (group 1) and 100 control subjects (group 2) were included in the study. Transabdominal ultrasound examination was performed to diagnose any major fetal defects and for measurement of crown rump length (CRL) and fetal nuchal translucency (NT) thickness. Blood samples were drawn from each women PAPP-A and free beta hCG levels., Results: There were no significant differences with respect to age, gestational age at the first trimester, and gestational age at birth between the groups. The mean birth weight of babies in the LMWH group was lower than the control (p = 0.026). There were also no significant differences with respect to CRL, serum PAPP-A and hCG at 11-14 weeks of gestation. However, NT of group 1 was significantly lower than group 2 (p = 0.000). In the Spearman correlation, LMWH was negatively correlated with only NT (r = -0.298, p = 0.000). NT in the first trimester (95% CI -0.632-0.230, p = 0.000) was an independent parameter related to using LMWH., Conclusion: Women who used LMWH during pregnancy had decreased NT compared with unaffected women.