Circulating and Endometrial Profiles of miR-145, miR-155-5p, miR-224, MPP-5, and PECAM-1 Expression in Patients with Repeated Implantation Failure: A Case Control Study

Objective: An association between microRNAs (miRNAs) and adhesion proteins expression with repeated implantationfailure (RIF) has been recently reported; however, these findings are controversial. This study aims to evaluatethe endometrial and circulating expressions of miR-145, miR-155-5p, and miR-224 in addition to the endometrialexpressions of membrane protein palmitoylated-5 (MPP-5) and endothelial cell adhesion molecule-1 (PECAM-1) inpatients with RIF compared to control subjects.Materials and Methods: This case-control study was carried out between June 2021-July 2022. Subjects included 17patients with RIF and 17 control subjects, who had previous spontaneous term pregnancy with a live birth, who referredto the Medical Centre of Arash Hospital, Tehran, Iran. Endometrial tissue samples were obtained via hysteroscopyand Pipelle catheter in the RIF and control subjects, respectively. Plasma samples were collected after ovulationin all subjects. The expression levels of MPP5, PECAM-1, miR-224, miR-145, and miR-155-5p were evaluated byquantitative real-time polymerase chain reaction (qRT-PCR). The student’s t test, chi-square, Mann-Whitney U, andanalysis of covariance (ANCOVA) were used for data analyses.Results: RIF patients had less endometrial miR-155-5p expression, and higher endometrial and circulating expressions ofmiR-145 and miR-224 compared to control subjects. Endometrial PECAM-1 and MPP5 expression significantly decreased inpatients with RIF compared to the control group. There was a positive correlation between circulating miR-224 and endometrialmiR-155-5p, and between circulating miR-155-5p and endometrial PECAM-1 expression levels in patients with RIF.Conclusion: The present study suggests that circulating miR-224, endometrial miR-145, and PECAM-1 can bereliable, novel biomarkers for diagnosis of RIF

The comparison of gains prescribed for digital behind-the-ear hearing aids using the manufacturer-specific and conventional prescriptive formulas

Background and Aim: There are several prescriptive formulas for covering a variety of hearing loss, each of which applies relatively different amplifications at different frequencies. This study aims to compare the gains prescribed for digital behind-the-ear (BTE) hearing aids by the Desired Sensation Level Multi-Stage [Input/Output] (DSLm[I/O]), National Acoustic Laboratories-non linear2 (NAL-NL2) and manufacturer-specific formulas at different levels of input intensity. Methods: The gain values in 12-channel BTE hearing aids prepared from four companies (Oticon, Phonak, ReSound and Siemens) were measured at three levels of input intensity (45, 65, and 85 dB SPL) and at a frequency range of 250−8000 Hz for two moderately severe flat and mild sloping to severe hearing losses by using the DSLm[I/O], NAL-NL2 and manufacturer-specific formulas in the Frye FP35 test box. Results: There was no significant difference between the four selected hearing aids in terms of prescribed gain values using the prescriptive formulas (p > 0.05). Conclusion: The DSLm[I/O] formula prescribes higher gain in the 12-channel BTE hearing aids from Oticon, Phonak and Siemens companies at all input intensities and frequencies for moderately severe flat and mild sloping to severe hearing losses compared to the NAL-NL2 formula and manufacturer-specific formulas (Voice Ali­gned Compression (VAC), Adaptive Phonak, Connexx Fit and audiogram+)

High Flow Nasal Cannulae versus Nasal Continuous Positive Airway Pressure in Neonates with Respiratory Distress Syndrome Managed with INSURE Method: A Randomized Clinical Trial

Background: In recent years, various noninvasive respiratory support (NRS) of ventilation has been provided more in neonates. The aim of this study was to compare the effect of HFNC with NCPAP in post-extubation of preterm infants with RDS after INSURE method (intubation, surfactant, extubation). Methods: A total of 54 preterm infants with RDS (respiratory distress syndrome) were enrolled in this study. Using a randomized sequence, they were assigned into two groups after INSURE method. The first group received HFNC while the second group received NCPAP for respiratory support after extubation. A comparison was made between these two groups by the rate of reintubation, air leak syndrome, duration of oxygen therapy, hospitalization, the rate of bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and mortality. Data were analyzed by using the SPSS version 18 software. The statistical analyses included Student’s t-test for continuous data and compared proportions using Chi-squared test and Fisher‘s exact test for categorical data. Result: The rate of reintubation was higher in the HFNC compared with the NCPAP group. The rate of either IVH or ROP had no significant differences between the two groups. In addition, duration of oxygen requirement and hospitalization were not statistically different. There was no case of BPD or mortality among these patients. Conclusion: This study showed that preterm infants with RDS could manage post-extubation after INSURE method with either NCPAP or HFNC. However, in this single-center study, the rate of reintubation was higher in the HFNC group while further multicenter study might be assigned. Trial Registration Number: IRCT201201228800N

Clinical Competence and Its Related Factors of Nurses in Neonatal Intensive Care Units

Introduction: Clinical competence of nurses working in the neonatal intensive care units together with advancements in medical science and technology increased the survival rate of newborns that need specialized care. To ensure the quality of care and provide the safety of patients, evaluating the clinical competence of nurses seems necessary. This study aimed to evaluate the clinical competence of nurses in the neonatal intensive care units. Methods: In this cross-sectional study, 117 nurses working in the neonatal intensive care units of the hospitals affiliated to Tehran University of Medical Sciences were selected by census method. The research tool was Development of Competency Inventory for Registered Nurses questionnaire which completed by self-assessment. The mean clinical competence scores of participants categorized into 3 levels: weak: 273. Data were analyzed by SPSS version 13 using the Pearson correlation coefficient, t-test and Chi-square test. Results: The highest levels of competence were related to critical thinking and research attitude and interpersonal relationships, and the lowest level was related to training and mentoring. There was a direct statistically significant relationship between marital status, employment status, level of interest in working in the neonatal intensive-care units and the clinical competence of nurses. Conclusion: Since the clinical competence of nurses in the Neonatal Intensive Care Units is vital, some variables such as interest in the nursing profession, employment status, the neonatal intensive theoretical and practical training courses and the amount of overtime working hours should be taken into consideration

‘Elective caesarean section at 38–39 weeks gestation compared to > 39 weeks on neonatal outcomes: a prospective cohort study

Abstract Background This study was conducted to compare neonatal complications in scheduled cesarean sections (CS) between 38 and 39 gestational weeks with CS performed after 39 gestational weeks in Iranian low -risk pregnant women. Methods In this cohort study, 2086 patients were enrolled based on the inclusion and exclusion criteria. The neonates were evaluated in terms of the following items: transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), sepsis, need for NICU hospitalization, birth weight, birth height, head circumference, and the first minute and fifth minute Apgar score. Several multiple logistic regression models were performed for each response variable (adverse outcome) separately. Results The incidence of NICU admission was significantly higher in neonates born at 38–39 gestational weeks than those who were born after 39 gestational weeks. No significant differences were found in the incidence of neonatal sepsis, TTN, and RDS between the two groups. Conclusion According to our study results, elective CS at 38–9 weeks’ gestation is associated with a higher rate of TTN and NICU admission in comparison with elective CS performed after 39 completed gestational weeks

Factors influencing the attendance of preterm infants to neonatal follow up and early intervention services following discharge from NICU during first year of life in Iran

AbstractPurpose:  Determining maternal and infantile factors associated with the number of attending times of preterm infants to Neonatal Follow up and Early Intervention services during one year after discharge from neonatal intensive care unit.Method: This study used data from a cohort of preterm infants born in Arash Women’s Hospital and consecutively admitted to the NICU at the same hospital from April 2014 to February 2015.Data was gathered by completing a questionnaire administered via phone. Data included mother’s age, education, type of pregnancy, history of abortion, history of premature birth, self-reported post-partum depression and the number of children, as well as infant’s gender, birth weight, gestational age, length of stay in the NICU, living area, twin or triplet birth, number of siblings, and the child rank. Number of attending times to services was recorded. Result: After multivariate analysis, shorter length of stay in the NICU, lower maternal education, more number of children, self-declared lack of awareness about Neonatal Follow up and Early Intervention services, and self-reported lack of referral by a physician were the only factors that continued to be significantly correlated, and in fact, the truly influential ones associated with number of attending times.Conclusion: Results of this study have defined some predictors of poor follow up and early intervention service utilization in a high-risk group of infants following NICU discharge, which is suggested to be addressed by policymakers to overcome possible barriers to attendance.