Search

We report the comparative investigation of Mo and Ni incorporation effects on the electrochemical behavior, DC conductivity and optical transmittance of PEG/β-V2O5 thin films. Mo doping, changed the preferred orientation of tetragonal structure from (241) to (200) direction, while Ni doping had no considerable effect on the texture coefficient of pristine V2O5. Moreover, the highest electrical conductivity observed in PEG/V2O5:Mo sample could be related to the substitution of V5+ by Mo6+. This substitution increased electrical carrier concentration (3.7E19 cm−3) which led to the enhancement of electrical conductivity. Because of that, a significant improvement has been occurred in the electrochemical behavior of PEG/V2O5:Mo film. According to the results, the specific capacitance and the charge transfer resistance of PEG/V2O5:Mo thin films were found to be almost 5 times higher and less than half of pure V2O5 film, respectively. In addition, FESEM images showed that PEG/V2O5:Ni sample had nanoflaked surface morphology with dispersed nanograins, whereas the PEG/V2O5:Mo sample exhibited a special porous morphology with stacked nanograins distributed on striped sheets. Based on optical measurements, Mo doping also boosts the average transmittance of the PEG/V2O5 sample. Besides, the observed blue shift in the absorption edge of the doped samples could be attributed to the Burstein-Moss effect. [ABSTRACT FROM AUTHOR]

Nanocrystalline vanadium oxide thin films were prepared using sol-gel dip-coating technique. The effect of heat treatment in different environment including air, N, Ar, and O gas on the structural, optical, electrical, and electrochemical properties of nanocrystalline vanadium oxide thin films were investigated. The results indicated that the calculated average crystallite size was reduced by annealing in Ar environment. Scanning electron microscopy (SEM) images showed layered morphology on the surface of the film annealed in air atmosphere, whereas the film annealed under Ar and N ambient revealed granular and wrinkle morphology, respectively. This morphology altered to rather smooth surface by annealing in O environment. The optical bandgap of the films were found to be 1.75, 1.84, 2.08, and 2.10 eV annealed in air, O, N, and Ar environment, respectively. It was observed that the films annealed under Ar and N ambient had low resistivity (~ 0.2 Ω cm) and high carrier concentration, while the film annealed in nitrogen environment showed higher mobility of charge carrier. The electrochemical measurements showed that annealing under N ambient improved the intercalation of Li ions, leading a higher interfacial capacitance of 19.18 mF Cm, and decreased the charge transfer resistance due to surface defects created by heat treatment in nitrogen environment. [ABSTRACT FROM AUTHOR]

In modern burn care, the focus extends beyond mere patient survival to encompass long-term functional and cosmetic outcomes. Research suggests that the technique and manner of suturing during skin grafting play a significant role in scar formation. This study aimed to explore the effectiveness of wound edge approximation with skin grafting compared to the conventional approach, where the graft edge exclusively interacts with the wound edge, in reducing hypertrophic scar development. Seventy-four burn unit patients eligible for grafting were randomly allocated into 2 groups: those receiving grafts with overlapping edges (Group A) and those receiving grafts with edges tailored to the burn wound (Group B). Evaluation of graft sites occurred immediately post-surgery and at 1 and 6 months post-operatively using the standardized Vancouver Scar Scale (VSS) administered by trained surgeons. The findings of this study revealed that there was no statistically significant difference between the 2 examined groups regarding the average duration of hospitalization and the mean thickness of wounds (P > 0.05). Similarly, the mean scores for pain, vascular index, and pigmentation index immediately post-surgery, at 1 month, and 6 months later, as well as the scar height index and flexibility immediately and at 1-month post-surgery, and the VSS index at the study's conclusion, showed no significant variation between the 2 groups (P > 0.05). However, at the 6-month follow-up, the mean scar height score (P = 0.004) in the overlapping group and the mean flexibility score (P = 0.017) in the non-overlapping group were significantly lower compared to the respective alternative group. This indicates a notable improvement in scar height and wound flexibility in the overlapping group over the non-overlapping group after 6 months., (Published by Oxford University Press on behalf of the American Burn Association 2024.)

Length of labor is one of the factors contributing to maternal and neonatal childbirth outcomes. Auriculotherapy is a potential therapeutic intervention for reducing labor duration. This systematic review aims to evaluate the efficacy of auriculotherapy in shortening labor time.This systematic review and meta-analysis included randomized controlled trials published from inception until July 2024. Scopus, Cochrane Library, Web of Science, Embase, and PubMed were searched for eligible studies. Article screening was performed using Endnote X8. Data analysis and assessment of the risk of bias were performed by Review Manager 5.3. Analysis of pooled data was performed using fixed and random effect models. Five studies ( n  = 433 participants) were included in the meta-analysis from an initial pool of 150 articles. The participants' mean age was 25.07 ± 4.52. Auriculotherapy reduced the length of the active and second phases of labor by approximately sixty (MD = -63.54; 95 percent CI: -84.47, -42.62; p  < .00001) and seven minutes (MD = -7.67; 95 percent CI: -13.46, -1.89, p  = .009), respectively. Auriculotherapy was found to significantly decrease the duration of the active and second phases of labor. However, it is not possible to generalize the results and further high-quality studies involving more individuals from various socioeconomic backgrounds are needed to provide support for these findings.

Introduction and Hypothesis: The high prevalence of pelvic organ prolapse (POP) and related complications shows the necessity of early identification of risk factors. It is considered that striae and POP share a similar physiopathology. However, the link between the two is still inconclusive and requires further investigation. We conducted this study to evaluate the association between striae and POP., Methods: Databases such as PubMed, Embase, Cochrane Library, Scopus, Web of Science, and Google Scholar were searched to find relevant literature from inception up to May 2023. Full-text articles published in English or other languages and observational studies were included. The statistical analysis was performed using STATA 14.2. The random effects model was performed and heterogeneity was ≥ 50%. Statistical tools such as the Chi-squared test and the I 2 index were used to calculate the level of heterogeneity among studies. Additionally, we utilized Funnel plots and Egger tests to assess the presence of publication bias., Results: Seven studies were selected for meta-analysis, yielding a total of 605 patients and 660 control subjects, to assess the link between striae and POP. The overall pooled odds ratio (OR) was 2.08 (95% confidence interval 1.04-4.19, I 2  = 80.40%). Our analysis revealed a strong relationship between POP and striae (p < 0.001)., Conclusions: This study recommends that stretch marks may be used as a helpful indicator of the risk for POP. Evaluation of striae as a risk factor and screening tool for detecting women at risk for the development of POP should be addressed in future well-designed studies. However, there is a need for high-quality studies in this field owing to the low quality of evidence., (© 2024. The International Urogynecological Association.)

Background: Endometriosis is a chronic and debilitating disease that can affect the entire reproductive life course of women, with potential adverse effects on pregnancy. The aim of the present study is to investigate the association between hypertensive disorders in pregnancy and endometriosis., Method: Relevant articles were searched from the Cochrane Library, PubMed, Scopus and Web of Science from inception up to December 2023. The full-text observational studies published in English that had a confirmed diagnosis of endometriosis were included. The case group included pregnant women diagnosed with endometriosis at any stage, while the control group consisted of pregnant women who had not been previously diagnosed with endometriosis. Two authors extracted and analyzed the data independently. Disagreements were reconciled by reviewing the full text by a third author. Endnote X9 was used for screening and data extraction. We used fixed and random effects models in Review Manager 5.3 to analyze the pooled data. The quality of the included studies was assessed using the Downs and Black checklist., Results: Out of the 9863 articles reviewed, 23 were selected for meta-analysis. According to the results of this study, there was an association between endometriosis and gestational hypertension (OR = 1.11, 95% CI: 1.06, 1.16; I 2  = 45%, P < 0.00001; N = 8), pre-eclampsia (OR = 1.26, 95% CI: 1.18, 1.36; I 2  = 37%, P < 0.00001; N = 12), and hypertensive disorders in pregnancy (OR = 1.13, 95% CI: 1.06, 1.21; I 2  = 8%, P = 0.0001; N = 8)., Conclusions: This study confirmed that endometriosis may elevate the risk of developing gestational hypertensive disorders. Raising awareness of this issue will help to identify effective strategies for screening and early diagnosis of hypertensive disorders in pregnancy., (© 2024. The Author(s).)

Background: Dysmenorrhea and premenstrual syndrome (PMS) are common periodic and frequent complications in women of reproductive age that can negatively affect health and quality of life. The present study examined the effects of curcumin on the severity of dysmenorrhea and PMS symptoms., Methods: A systematic review and meta-analysis of randomized controlled trials was conducted by searching databases such as the Cochrane Library, EMBASE, Scopus, PubMed, and Web of Science from inception to January 2023. Article screening was performed using Endnote ver. X8 (Clarivate). Review Manager (RevMan ver. 5.3; Cochrane) was used for the quality assessment and meta-analysis. A total of 147 studies were screened, of which five were finally selected for quantitative and qualitative analyses. The studies were conducted between 2015 and 2021, and a total of 379 participants with a mean age of 23.33±5.54 years had been recruited in these studies., Results: The meta-analysis showed that curcumin consumption could significantly reduce the severity of dysmenorrhea (mean difference, -1.25; 95% confidence interval [CI], -1.52 to -0.98; three studies; I2=31%) and the overall score of PMS (standardized mean difference, -1.41; 95% CI, -1.81 to -1.02; two studies; I2=0%)., Conclusion: The reduction in the severity of PMS and dysmenorrhea has been attributed to curcumin's anti-inflammatory and antidepressant activities. Although the findings suggest that curcumin may be an effective treatment for reducing the severity of PMS and dysmenorrhea, further research with a larger number of participants from various socioeconomic levels and a longer duration of treatment is needed to evaluate the effective dose of curcumin.

Aim: There is mounting evidence that eating habits affect sleeping patterns and their quality. The goal of this study was to evaluate the associations between major dietary patterns, identified using principal component analysis (PCA) and insomnia in young women., Methods: The study subjects comprised 159 healthy young women aged 18-25 years. Neuropsychological assessment was performed using standard instruments, including a cognitive ability questionnaire (CAQ), depression and anxiety stress scales (DASS-21), insomnia severity index (ISI), Epworth sleepiness scale (ESS), and quality of life questionnaire (QLQ). Dietary patterns were obtained from a 65-item validated food frequency questionnaire (FFQ) in this study, using PCA., Results: Two major dietary patterns were identified that were termed: "Traditional" and "Western." The Western pattern was characterized by a high intake of snacks, nuts, dairy products, tea, fast foods, chicken, and vegetable oils. Subjects with moderate/severe insomnia were found to have lower scores for total cognitive ability task, nocturnal sleep hours, and physical and mental health, but higher scores for depression, anxiety, stress, and daytime sleepiness compared to those without insomnia (p < 0.05). After adjustment for potential confounders, high adherence to the Western dietary pattern was associated with higher odds of insomnia (OR = 5.9; 95% confidence intervals: 1.9-18.7; p = 0.003)., Conclusion: Our findings indicated adherence to Western pattern may increase the odds of insomnia. Prospective research is required to determine the feasibility of targeting dietary patterns to decrease the odds of insomnia., (© 2023 The Authors. Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Neuropsychopharmacology.)

Background: Involvement of women in the decision-making process during childbirth plays an important role in their physical and psychosocial preparation. A birth plan allows the woman to express her expectations and facilitates her participation in her own care. The present study is the first to assess the implementation of birth plans integrated into childbirth preparation classes in Tehran, Iran., Methods: This study is a randomized controlled clinical trial performed on 300 pregnant women at 32-33 weeks of gestation referring to four public health centers in Tehran, Iran. The participants were randomly allocated into intervention and control groups using block randomization method. A training session on the items of the birth plan checklist was held in the fifth session of childbirth preparation classes for the participants in the intervention group. Accordingly, a birth plan was prepared according to the requests of mothers. The birth plan was implemented after the women were admitted to the maternity ward. The primary outcomes were frequency of vaginal birth, mean duration of labor stages, and mean score of childbirth satisfaction. We used a checklist of maternal and neonatal outcomes, Mackey's childbirth satisfaction questionnaire, and a partogram form for data collection. Independent t -test, Mann-Whitney U -test, Chi-square test, Fisher's exact test, and logistic regression were used for data analysis., Results: Vaginal birth rates were significantly higher in women who had birth plans compared with those without (81.9% vs. 48.7%, p  < 0.001). Also, the lengths of the first and the second stages of labor were significantly shorter in women having a birth plan ( p  = 0.02). Women in the birth plan group were significantly more satisfied with the process of labor and childbearing ( p  < 0.001), and started breastfeeding after birth earlier than those in the control group ( p  < 0.001)., Conclusion: Having a birth plan and attending childbirth preparation classes can increase the rate of normal vaginal birth. Also, according to our results, women's participation in the decision- making process and fulfilling their preferences during birth can improve maternal and neonatal outcomes and childbirth satisfaction. Trial registration: IRCT20190415043283N2. 2020-12-07., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Mohaghegh, Javadnoori, Najafian, Abedi, Kazemnejad Leyli, Montazeri and Bakhtiari.)

Objective: Perineal trauma is a serious and frequent problem after childbirth which is experienced by millions of women worldwide. The technique used for perineal repair may have an impact on pain and wound healing. The aim of the present study was to compare the continuous non-locking technique with interrupted suturing for the repair of episiotomy or second-degree perineal tears., Methods: A single-blind randomized-controlled trial was conducted from October 2021 to August 2022 in Sina Hospital, Ahvaz, Iran. Three hundred women were selected and randomly assigned into control and intervention groups using block randomization technique. The main outcomes included pain and wound healing that were assessed using visual analog scale (VAS), as well as redness, edema, ecchymosis/bruising, discharge, and approximation scale (REEDA). The secondary outcomes were the use of analgesics, duration of perineal repair, material used for suturing, pain during urination and defecation, and resumption of sexual intercourse. The participants were followed up on the first and seventh days and in the 6th week postpartum. Mann-Whitney, Chi-square, and Generalized Estimating Equations (GEE) model were used for data analysis., Results: Wound healing was significantly better in the continuous non-locking suture technique compared to the interrupted technique ( β  = -1.98; P  > 0.0001). Women also experienced less pain in the continuous non-locking suture technique ( β  = -2.46; P  > 0.0001). There was a reduction in the use of analgesics, the duration of perineal repair, and the material used for suturing in the continuous non-locking suturing technique as opposed to the interrupted method ( P  < 0.0001).The odds of pain during urination and defecation significantly reduced in women who underwent the continuous non-locking method ( P  < 0.001). Also, women in the continuous non-locking group resumed their sexual intercourse earlier ( P  < 0.0001)., Conclusion: The findings of this study revealed that use of continuous non-locking technique for suturing was associated with reduced perineal pain and improved wound healing. Furthermore, it was associated with a shorter duration of perineal repair, less suture material used, and less need for analgesics compared with the interrupted method. There is, however, need for more studies to confirm the results of the present study.Iranian registry for randomized controlled trials (Ref. ID: IRCT20190415043283N1)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Faal Siahkal, Abedi, Iravani, Esfandiarinezhad, Dastoorpoor, Bakhtiari, Najafian, Sharifipour and Mohaghegh.)

Background: Understanding women's experience of birth planning is necessary for introducing and implementing this process in the Iranian maternity services. This study aims to explore perceptions of birth plan implementation in Iran from the perspective of women, their husbands, and clinicians., Methods: This qualitative study was conducted in Iran. Qualitative data were collected from November 2020 to March 2021 by conducting semi-structured in-depth interviews with ten mothers who prepared a birth plan, and 15 key informants (obstetricians, midwives, and husbands) who were involved in the implementation process of birth plans. Data were analyzed using conventional qualitative content analysis., Results: Data reduction process resulted in 380 codes that were categorized in 16 subcategories and five main categories. The main categories were "Guide and pattern of preparing for childbirth pathway", "Maternal empowerment and sense of triumph", "Facilitating and enhancing communication", "Successful transition to parenthood and women's satisfaction", and "Challenges associated with implementation of the birth plan". The overarching theme "Birth plan: The missing link in promotion of vaginal birth in Iran" was constructed from these categories., Conclusion: Findings of this study highlight the effectiveness of the implementation of birth plan along with childbirth preparation classes for increasing the likelihood of a successful vaginal birth and promoting empowerment and satisfaction in women during the childbirth process. The findings of this study could pave the way for developing, introducing, and implementing of birth plan in Iran., (© 2022. The Author(s).)

Background: Episiotomy is one of the common procedures during childbirth in Iran, which causes pain, discomfort, and scar in the perineum. This study aimed to pursue the effect of Malva Sylvestris cream on episiotomy pain and healing., Methods: This study was a double-blinded randomized-controlled clinical trial that was conducted from April to December 2021 at the Sina hospital in Ahvaz, Iran. Sixty women were selected and randomly assigned to control and intervention groups using block randomization. The main outcomes included pain assessment and episiotomy wound healing that are assessed by the Visual analog scale (VAS), and perineal healing scale included redness, edema, ecchymosis/bruising, discharge, approximation (REEDA). The cream was used twice a day for up to 14 days. The participants were followed on the first, seventh, and fourteenth days postpartum. Independent T-test, Mann-Whitney, and Chi-square, and Generalized Estimating Equations (GEE) model were used by SPSS software version 22 for data analysis. Statistically significant level was considered less than 0.05., Results: There were no significant statistical differences between the two groups in demographic characteristics (P>0.05). No significant statistical differences were found in both groups in terms of perineal healing (B=-0.05; P=0.89) and pain scores (B=0.15; P=0.56). However, the chance of external dysuria in the intervention group decreased by 77% (P=0.01)., Conclusion: Despite showing the positive effect of Malva Sylvestris extract on wound healing in animal and in-vitro studies, this clinical study failed to show the positive effect of this extract on wound healing and pain relief of episiotomy. However, future clinical trials are needed to substantiate the above findings. Trial Registration Number: IRCT20190826044621N1., Competing Interests: None declared., (Copyright: © International Journal of Community Based Nursing and Midwifery.)

Objective: The purpose of this study was to explore the effectiveness of aromatherapy with Citrus aurantium Lavender on the sexual function of postmenopausal women. Materials and methods : A randomized controlled trial with single-blind design was conducted on eighty postmenopausal women in Ahvaz, Iran from January to December 2019. The women were randomly assigned to the Citrus aurantium group (n=40) and placebo group (n=40). The intervention group received two drops of Citrus aurantium essential oil twice a day, for four consecutive days a week, for four weeks as inhalation. Similarly, placebo was received by the control group. Results: The results of this study revealed that in the intervention group, the FSFI total score and all of its dimensions were significantly improved compared to the control group. Conclusion: Aromatherapy using Citrus aurantium can be used as an alternative or complementary method for improvement of sexual function in postmenopausal women. It is recommended that the postmenopausal women suffering from sexual dysfunction be informed on the aromatherapy by Citrus aurantium essential oil., (Copyright © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.)

Background: One of the most common problems in menopausal women is sleep disturbance. Citrus aurantium has sedative, hypnotic, and anti-anxiety effects. The aim of this study was to investigate the effect of Citrus aurantium aroma on the sleep quality of postmenopausal women., Methods: This was a double-blind randomized controlled trial that was conducted from Feb to Dec 2019 on 80 postmenopausal women who suffered from sleep disturbances. The participants were assigned into two groups randomly. Women in the intervention group were requested to use 2 drops of essential oil of Citrus aurantium, twice a day, for 4 consecutive days in a week, for 4 weeks as inhalation. The control group received almond oil in the same way. The quality of sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI) before the intervention and 4 weeks after the intervention started. The data were analyzed using the SPSS statistical software, version 21, and P<0.05 was considered statistically significant., Results: After 4-weeks of intervention, the mean score of sleep quality was significantly lower in the Citrus aurantium group compared to the control group (5.75±1.33 vs 13±1.59, P<0.001). In the intervention group, all dimensions of PSQI were improved significantly (P<0.001)., Conclusion: The results of this study showed that the aroma of Citrus aurantium essence could significantly improve the sleep quality of postmenopausal women. Therefore, it is recommended that health care providers should inform the postmenopausal women and advise them to use this intervention for reduction of sleep disorders., Trial Registration Number: IRCT20160427027633N7., (Copyright: © International Journal of Community Based Nursing and Midwifery.)

Background: E-learning is web-based learning for education and training. The current global pandemic crisis created due to COVID-19 has made worldwide online learning. This study aimed to investigate the level of satisfaction and quality of E-learning in medical universities from the students' point of view during the epidemic of COVID-19 and assessing the obstacles and solutions proposed to improve the quality of E-learning., Materials and Methods: A cross-sectional, web-based study was conducted among 400 medical university students of Iran during the epidemic of COVID-19. After getting written consent, three parts questionnaire contains demographic, user satisfaction, quality questionnaire, and three open-ended questions were distributed randomly using social media. Descriptive analysis, t -test, Chi-square, and Pearson correlation coefficient were used to achieve the objective of this study, with significance set to P < 0.05. Furthermore, three open-ended questions were reviewed qualitatively and the problems and solutions suggested by the students were reported., Results: Based on the findings of the descriptive section, 277 of the respondents were girls (69%) with a mean age of 21 ± 2 years. Sixty-nine percent of students were studying in medical sciences universities and 31% were studying in Islamic Azad University. The level of satisfaction was in the upper range of low (34.0 ± 10.0); P < 0.001, and intention to reuse was moderate (23.06 ± 6.0); P = 0.064. Student's perception of quality in most domains was in the upper range of low to medium. User satisfaction, intention to reuse, the quality of knowledge, and participatory quality for evaluating online courses were significantly higher in the Azad University group than in medical universities., Conclusion: Given that this is the first experience in the use of E-learning in Iran, both universities have not yet fully succeeded in satisfying students and it is necessary to increase the quality of E-learning based on student suggestions., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

Background: In 2013, there was an estimation of greater than 4.5 million Afghan refugees who had migrated to the least developed countries. Over one million are legally registered in Iran. We assessed the heart health status as described by the American Heart Association (AHA) in the Afghan refugee populace., Methods: This cross-sectional survey was carried out on 1,634 Afghan refugees, including 746 males (45.7%) and 888 females (54.3%), selected through a convenience sampling method in 2016. The American Heart Association's seven cardiovascular health metrics were evaluated to specify the status of heart health in Afghan refugees. Differences with age and sex were analyzed using the χ 2 test., Results: Only one (0.1%) participant met the ideal for all seven cardiovascular health metrics. No significant differences were found between women and men in meeting the ideal criteria for more than five cardiovascular health metrics. As age increased, the proportion of refugees who met the ideal for more than five cardiovascular health metrics declined., Conclusions: Refugees were not meeting the ideal cardiovascular health for some of the assessed metrics. Intervention to improve and monitor heart health in Afghan refugees is needed., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© Springer Nature Switzerland AG 2021.)

Background: To evaluate the effect of dexamethasone administration on the interval between initiation of labor induction and active phase of labor., Methods: The databases including PubMed, Cochrane Library, Embase, Scopus and Web of Science were searched for studies published up to June 27, 2021. Two types of articles were included: a) full-text articles published in English or any other languages, and b) Randomized Controlled Trials (RCTs). Participants were primi- or multigravida women with term or post-term pregnancy. The intervention group received parenteral or extra-amniotic dexamethasone whereas the control group received normal saline or no treatment before initiation of labor induction. All data were analyzed using Review Manager 5.3., Results: Seventeen studies involving 1879 patients were included in the meta-analysis. Administration of dexamethasone reduced the interval between the initiation of labor induction and the beginning of active phase by about 70 min [MD: - 1.17 (- 1.37, - 1.00); P < 0.00001]. Duration of the first stage of labor in the dexamethasone group was about 88 min shorter than that in the control. There were no maternal and fetal adverse effects., Conclusions: Dexamethasone could significantly reduce the length of induction-active phase interval, and length of the first stage of labor, with no difference in maternal or fetal adverse effects., (© 2021. The Author(s).)

Background: This systematic review aimed to investigate the reliability of ultrasound method compared with digital vaginal examinations in detecting cervical dilation., Methods: We searched Cochrane (CENTRAL), MEDLINE, EMBASE, CINAHL, ISI Web of Science Core Collection, Trip Database, PubMed, DARE and NHS EED, HTA, and PROSPERO. Ten observational studies with a total sample size of 856 were included in the meta-analysis., Results: The intraclass correlation coefficient (ICC) values ranged between 0.21 and 0.69. The fixed-effect models for the ultrasound test showed an average of ICC (r = 0.32 (95% CI 0.26-0.38). Correlation between two methods was poor (r = 0.359, 95% CI 0.26-0.44). In nulliparous and multigravida participants the correlation between ultrasound measurements and digital examinations was (r = 0.349, 95% CI 0.25-0.43) and ICC (r = 0.676, 95% CI 0.419-0.833), respectively., Conclusion: Trans-perineal ultrasonography seems to be a reliable method for assessing labor progression in multigravida women, but its usage in nulliparous women needs further studies., (© 2021. The Author(s).)

Background and Hypothesis: Pelvic organ prolapse (POP) is a very common and distressing problem that affects women's quality of life. This systematic review aimed to investigate the association of the dimensions of the genital hiatus and levator hiatus at rest and Valsalva with POP., Methods: The Cochrane Library, PubMed, Scopus, Embase and Web of Science were searched on 25 April 2020. All data were analyzed using Review Manager 5.3., Results: Of the 1288 papers reviewed, 21 (n = 5145: 2909 women with POP and 2236 controls) were considered for meta-analysis. Compared with the normal pelvic floor group, the urogenital hiatus size in the POP group was significantly higher at rest (mean difference: 0.49; 95% CI: [0.43, 0.55], P < 0.00001) and at Valsalva (mean difference: 0.79; 95% CI: [0.70, 0.89], P < 0.00001). Also, the levator ani hiatus size in the POP group was significantly higher at rest (mean difference: 0.52, 95% CI: [0.25, 0.78], P < 0.0001) and at Valsalva (mean difference: 1.01; 95% CI: [0.73,1.28], P < 0.00001) compared with that in the normal pelvic floor group., Conclusion: This systematic review showed that the sizes of the urogenital hiatus and levator ani hiatus and area of the levator hiatus in the POP group were significantly higher than those in the normal pelvic floor groups in both positions (rest or Valsalva maneuver). Also, in the POP group, the levator hiatus length at rest was significantly lower than that in the Valsalva maneuver., (© 2021. The International Urogynecological Association.)

Use of detergents and cleaning products puts women at risk due to hazardous chemical substances. Education of all women, especially pregnant and high-risk women about the proper use of detergents, is a necessity., Competing Interests: None declared., (© 2020 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Introduction and Hypothesis: Urinary incontinence (UI) is one of the most serious problems during pregnancy and after delivery. It can influence the quality of life and cause psychological problems that lead to depression and decreased self-esteem. We aimed to investigate the maternal, obstetrical and neonatal risk factors of urinary incontinence 3 to 12 months after childbirth., Methods: The Cochrane Library, Medline, Science Direct and Web of Science were searched for studies published from the inception of the databases up to December 2019, including any observational full-text papers. All data were analyzed using Review Manager 5.3. Of 338 articles reviewed, 20 studies were considered for meta-analysis., Results: The results of our study showed that vaginal delivery in contrast to cesarean section (OR = 3.74, 95% CI: [2.71, 5.15], P < 0.00001), UI in pregnancy (OR = 5.27, 95% CI: [3.40, 8.17], P < 0.00001), episiotomy (OR = 1.23, 95% CI: [1.05, 1.45], P < 0.01), perineal tear > grade 2, instrumental delivery in contrast to cesarean section, epidural or spinal anesthesia, maternal age, pre-pregnancy BMI and neonatal birthweight have a direct relationship with UI., Conclusions: This study confirmed that urinary incontinence during pregnancy and vaginal births had the strongest relationship with postpartum urinary incontinence. Also, the maternal upright positions during labor did not reduce the likelihood of urinary incontinence. The awareness of this issue helps find effective strategies to reduce the likelihood of female urinary incontinence.

Purpose: Gestational diabetes mellitus (GDM) is one of the most common medical complications in pregnancy. This systematic review aimed to evaluate the association between vitamin E and GDM., Methods: Relevant articles from the Cochrane Library, PubMed, Scopus, Science Direct, Web of Science, and EMBASE databases up to December 2019 were searched. The inclusion criteria were observational full-text articles. The fixed and random effect models were used to analyze the pooled data using Review Manager 5.3., Results: Thirteen studies, including 596 participants, of whom 285 were diagnosed with GDM were included in the meta-analysis. The vitamin E level was significantly lower in women with GDM (MD: - 0.10; 95% CI: [-0.15, - 0.05]). The level of vitamin E was not different between overweight women with GDM and healthy pregnant women (MD: 0.03; 95% CI: [-0.08, 0.013]). The level of vitamin E was significantly lower in the third trimester of pregnancy in GDM women in comparison to the healthy pregnant women(MD: -0.09; 95% CI: [-0.12, -0.06])., Conclusion: This study showed that the level of vitamin E is significantly lower in GDM women compared to healthy pregnant women., Competing Interests: Conflict of interestThere is no competing interest for authors., (© Springer Nature Switzerland AG 2020.)

This article presents a discourse on the incorporation of organizational factors into probabilistic risk assessment (PRA)/probabilistic safety assessment (PSA), a topic of debate since the 1980s that has spurred discussions among industry, regulatory agencies, and the research community. The main contributions of this article include (1) identifying the four key open questions associated with this topic; (2) framing ongoing debates by considering differing perspectives around each question; (3) offering a categorical review of existing studies on this topic to justify the selection of each question and to analyze the challenges related to each perspective; and (4) highlighting the directions of research required to reach a final resolution for each question. The four key questions are: (I) How significant is the contribution of organizational factors to accidents and incidents? (II) How critical, with respect to improving risk assessment, is the explicit incorporation of organizational factors into PRA? (III) What theoretical bases are needed for explicit incorporation of organizational factors into PRA? (IV) What methodological bases are needed for the explicit incorporation of organizational factors into PRA? Questions I and II mainly analyze PRA literature from the nuclear domain. For Questions III and IV, a broader review and categorization is conducted of those existing cross-disciplinary studies that have evaluated the effects of organizational factors on safety (not solely PRA-based) to shed more light on future research needs., (© 2020 Society for Risk Analysis.)

Background: The objective of this systematic review and meta-analysis was to assess the effectiveness of hyoscine n-butylbromide in labor progress., Methods: The databases including PubMed, the Cochrane Library, Science-Direct, Scopus and Web of Science were searched for studies published up to December 2019. Articles that published as randomized controlled trials (RCTs), and full-text articles published in English or other languages were included and participants were primi or multigravida women who were in active phase of labor. The intervention included HBB compared to placebo (normal saline) that was used during active phase of labor. Pooled estimates were measured using the fixed or random effect model, while the overall effect was reported in a mean difference (MD). All data were analyzed using Review Manager 5.3., Results: Twenty studies involving 3108 women were included in meta-analysis. Based on subgroup analysis by parity, use of HBB significantly reduced the duration of the first stage of labor in primigravida women (MD = - 57.73; 95% CI: [- 61.48, - 53.60]) and in multigravida women (MD = - 90.74; 95% CI: [- 97.24, - 84.24]). Administering HBB could reduce the second stages of labor in primigravidas and multigravidas about 6 min and 4 min respectively. Also, HBB reduced the duration of the third stage of labor in multigravidas about 3 min. APGAR score at one and 5 min after birth was not affected. The main maternal adverse effect was tachycardia and dry mouth. Labor duration in studies in which the participants were primi-and multigravida was not presented based on separate parities except for four papers, and the route of HBB administration was not the same across all studies., Conclusions: Although, the effect of HBB was minimal when multigravidas and primigravidas women were considered together, the HBB was clinically effective in primigravida and multigravida women for shortening the first and the second stages of labor. Also, HBB could reduce the length of the third stage of labor in multigravidas.

In the nuclear power industry, Level 3 probabilistic risk assessment (PRA) is used to estimate damage to public health and the environment if a severe accident leads to large radiological release. Current Level 3 PRA does not have an explicit inclusion of social factors and, therefore, it is not possible to perform importance ranking of social factors for risk-informing emergency preparedness, planning, and response (EPPR). This article offers a methodology for adapting the concept of social vulnerability, commonly used in natural hazard research, in the context of a severe nuclear power plant accident. The methodology has four steps: (1) calculating a hazard-independent social vulnerability index for the local population; (2) developing a location-specific representation of the maximum radiological hazard estimated from current Level 3 PRA, in a geographic information system (GIS) environment; (3) developing a GIS-based socio-technical risk map by combining the social vulnerability index and the location-specific radiological hazard; and (4) conducting a risk importance measure analysis to rank the criticality of social factors based on their contribution to the socio-technical risk. The methodology is applied using results from the 2012 Surry Power Station state-of-the-art reactor consequence analysis. A radiological hazard model is generated from MELCOR accident consequence code system, translated into a GIS environment, and combined with the Center for Disease Control social vulnerability index (SVI). This research creates an opportunity to explicitly consider and rank the criticality of location-specific SVI themes based on their influence on risk, providing input for EPPR., (© 2018 Society for Risk Analysis.)

Aim: The purpose of the present study was to assess the relationship of sex hormone binding globulin (SHBG) and gestational diabetes mellitus (GDM)., Methods: The Cochrane Library, Medline, ScienceDirect, and Web of Science were searched for studies published from the inception of the databases up to February 2019. Our inclusion criteria were published observational full-text articles. All data were analyzed using Review Manager 5.3. Of 208 papers reviewed, 26 studies (n = 6668) were considered for meta-analysis., Results: The SHBG level was significantly lower in women with GDM compared to healthy women (MD = -11.86; 95% CI: [-13.02, -10.71]). Also, SHBG in women with PCOS and GDM and obesity was significantly lower than women with PCOS without GDM (MD = -38.14; 95% CI: [-56.79, -19.48]) and normal weight women (MD: -58.96; 95% CI: [-79.32, -38.59]). SHBG in the second trimester was lower than that in the first trimester and pre-conception., Conclusions: This systematic review showed that the level of SHBG is significantly lower in GDM pregnant women than that in healthy women. The results of this systematic review about the relationship of GDM and SHBG and suggestion to assess this marker in early pregnancy should be considered with caution., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Vitamin D deficiency may be a risk factor for negative outcome in pregnancy, such as pre-term labour, low birthweight, intrauterine growth retardation and gestational diabetes. This study aimed to evaluate the relationship between vitamin D and pre-eclampsia. This was a case-control study of 59 pre-eclamptic women and 59 healthy pregnant women selected in two hospitals in Ahvaz, Iran. Women with term singleton pregnancy, nulliparous and of reproductive age were selected. Venous blood samples (2 mL) were taken and the level of 25-dihydroxy vitamin D (25-OH-D) was measured. If the levels of 25-OH-D were less than 10 ng mL(-1), between 10 ng mL(-1) and 29 ng mL(-1) and more than 30 ng mL(-1), they were considered as indicating deficient, insufficient and normal 25-OH-D concentrations, respectively. The independent t-test, Mann-Whitney U-test, chi-square and logistic regression were used for analysing the data. Vitamin D deficiency was significantly higher in the pre-eclampsia group [odds ratio (OR) = 24.04, confidence interval (CI) = 2.10-274.8, P = 0.01]. Older women (30-35 years) were more likely to develop pre-eclampsia compared with the control group (OR = 10.36, CI = 2.18-49.09, P = 0.003). The results showed that women with body mass index (BMI) <20 were more likely to develop pre-eclampsia. The ages between 20 years and 30 years and normal BMI were not the risk factors for pre-eclampsia. Vitamin D deficiency has a statistically significant relationship with pre-eclampsia. It seems that the serum vitamin D levels are low in Iranian women because of their particular lifestyle and they may need more than 400 IU day(-1) vitamin D supplement during pregnancy., (© 2013 John Wiley & Sons Ltd.)