Developing criteria for Cesarean Section using the RAND appropriateness method

<p>Abstract</p> <p>Background</p> <p>Cesarean section rates are increasing worldwide, and a rapid increase has been observed in Iran. Disagreement exists between clinicians about when to use cesarean section. We aimed to identify the appropriateness criteria for the use of cesarean section in Iran.</p> <p>Method</p> <p>A consensus development study using a modified version of the RAND Appropriateness Method (RAM). We generated scenarios from valid clinical guidelines and expert opinions. A panel of experts participated in consensus development: first round via mail (12 members), second round face-to-face (9 members). We followed the RAM recommendations for the development of the scenario lists, rating scales, and statistical analyses.</p> <p>Results</p> <p>294 scenarios relevant to cesarean section were identified. 191 scenarios were considered appropriate, of which 125 scenarios were agreed upon. The panel found cesarean inappropriate for 21% of scenarios, and 'equivocal' for 14% of scenarios.</p> <p>Conclusion</p> <p>RAM is useful for identifying stakeholder views in settings with limited resources. The participants' views on appropriateness of certain indications differed with available evidence. A large number of scenarios without agreement may partly explain why it has been difficult to curb the growth in cesarean section rate.</p

Optimizing Carbonaceous Nanostructure Composition as a Substrate to Grow Co Electrocatalysts

Global warming and other adverse environmental effects of fossil fuels have forced humans to consider clean and renewable energy resources. In this context, hydrogen production from water splitting reaction is a key approach. In order to reduce required overpotential for water oxidation reaction, it is necessary to use low cost and earth abundant electrocatalysts like Co, Cu, Fe, Mn, Ni and Zn nanostructures. Herein, cobalt nanostructures on steel-mesh substrate were applied. Electrochemical method was used for growth of Co nanoflakes because of its simplicity and scalability for commercial approach. On the other hand, using carbonaceous support layers including nanomaterials such as graphene and carbon nanotubes, can reduce overpotential and increase efficiency of the electrocatalyst.&nbsp; According to the results, 40 wt% of graphene oxide and 60 wt% of carbon nanotubes in prepared carbon paste led to better growth for cobalt oxide nanoflakes. For the mentioned layer, cobalt was detected in metallic crystalline phase and the overpotential and electrical resistance measured 305 mV and 20 &Omega;, respectively

A new pillared Cd-organic framework as adsorbent of organic dyes and as precursor of CdO nanoparticles

A new neutral cadmium-organic framework with a pillared layer structure, [Cd3(BTC)2(4-bpdb)2] (H3BTC = benzene-1,3,5-tricarboxylic acid; 4-bpdb = 1,4-bis(4-pyridyl)-2,3-diaza-1,3-butadiene), has been synthesized via solvothermal reaction of cadmium nitrate with the tricarboxylic acid H3BTC and the linear bispyridyl linker 4-bpdb. The complex has been characterized by single crystal X-ray diffraction, showing to possess a 3D porous network of jcr7 topology. The capability of the prepared MOF in adsorbing the organic dyes Congo Red (CR) and Neutral Red (NR), together with kinetics and thermodynamics of their adsorption, have been investigated in detail. The adsorption process was well described by pseudo-first order and pseudo-second order kinetics for CR and NR, respectively. In addition, conversion of the MOF 3D architecture into nano-sized cadmium oxide particles has also been studied

Job Satisfaction on Primary Health Care Providers in the Rural Settings

&quot;nBackground: Job satisfaction remains as an important concern for both employer and employee. The leaving of work&amp;shy;place and migration to city centers is one of the main results of Job dissatisfaction among the primary health care (PHC) provid&amp;shy;ers in rural setting of Iran, Behvarzes. Determining the predictor&apos;s factors of the PHC providers&apos; job dissatisfac&amp;shy;tion and provid&amp;shy;ing appropriate strategies to address these factors can most likely improve their performance and dimin&amp;shy;ish the prob&amp;shy;lem.&quot;nMethods: Data were collected from 290 of the PHC providers worked full-time in Kurdistan rural health-house by a sur&amp;shy;vey for identifying the individual, environmental, and work factors that influence job satisfaction.&quot;nResults: Only 17% of the participants&apos; overall job satisfaction was high. Furthermore, the developed model presented sta&amp;shy;tistically significant differences between job satisfaction and village population size, satellite villages covered, and dis&amp;shy;tance between health-house and city center.&quot;nConclusion: It is expected that the finding of the study can help Iran health system policymakers and managers for plan&amp;shy;ning and implementing effective policies in order to meet the PHC providers&apos; needs and so improve quality of pri&amp;shy;mary health care in the rural areas

Next-generation sequencing reveals a novel pathological mutation in the TMC1 gene causing autosomal recessive non-syndromic hearing loss in an Iranian kindred

OBJECTIVES: Hearing loss (HL) is the most common sensory-neural disorder with excessive clinical and genetic heterogeneity, which negatively affects life quality. Autosomal recessive non-syndromic hearing loss (ARNSHL) is the most common form of the disease with no specific genotype-phenotype correlation in most of the cases. Whole exome sequencing (WES) is a powerful tool to overcome the problem of finding mutations in heterogeneous disorders. METHODS: A comprehensive clinical and pedigree examination was performed on a multiplex family from Khuzestan province suffering from hereditary HL. Direct sequencing of GJB2 and genetic linkage analysis of DFNB1A/B was accomplished. WES was utilized to find possible genetic etiology of the disease. Co-segregation analysis of the candidate variant was done. High resolution melting analysis was applied to detect variant status in 50 healthy matched controls. RESULTS: Clinical investigations suggested ARNSHL in the pedigree. The family was negative for DFNB1A/B. WES revealed a novel nonsense mutation, c.256G > T (p.Glu86*), in TMC1 segregating with the phenotype in the pedigree. The variant was absent in the controls. CONCLUSION: Here, we report successful application of WES to identify the molecular pathogenesis of ARNSHL in a large family. The novel nonsense TMC1 variant meets the criteria of being pathogenic according to the ACMG-AMP variant interpretation guidelin