To determine the relationship between PhoB and the general stress

To determine the relationship between PhoB and the general stress response in V. cholerae, we compared the ability of isogenic wild type, ΔphoB and ΔrpoS mutants to withstand environmental stresses. In Fig. 5 we show that, while strain SZS007 (wild type) and its isogenic ΔrpoS were similarly sensitive to 0.5 mM hydrogen peroxide, the ΔphoB was significantly more sensitive to this level of oxidative stress. The ΔrpoS mutant was more sensitive

than the wild type to higher hydrogen peroxide concentrations (data not shown). This result indicates that expression of PhoB provides protection to oxidative stress by a mechanism different from RpoS. As expected from previous studies (Yildiz & Schoolnik, BMS907351 1998; Jahid et al., 2006), the ΔrpoS mutant was more sensitive than the wild type to 1.2 M NaCl, while the ΔphoB mutant was more resistant (Fig. 5). The ΔphoB mutant was also more resistant than the wild-type strain and the ΔrpoS mutant to pH 4.5. Finally, the ΔrpoS mutant was more sensitive Caspase inhibitor to carbon starvation

compared with wild type and ΔphoB that behaved similarly with regard to this stress. Taken together, the above data are consistent with PhoB modulating environmental stress in a manner independent of the general stress response regulator RpoS. The finding that V. cholerae builds large poly-P stores and our previous observation that a mutant impaired in poly-P biosynthesis was more sensitive to environmental stressors in low-phosphate medium (Ogawa et al., 2000; Jahid et al., 2006) points toward phosphate starvation as a critical environmental stress that could impact the survival of V. cholerae in its aquatic Mannose-binding protein-associated serine protease habitat. Unfortunately, very little is known about how phosphate starvation affects V. cholerae behavior and life style. Extracellular orthophosphate is the major source of

high-energy phosphate for biosynthesis and many signal transduction pathways such as quorum sensing. Therefore, it was not surprising that phosphate limitation enhanced HapR expression, which is repressed when high-energy phosphate is transferred to LuxO. Phosphate starvation is known to activate PhoB and induce the transcription of the PhoB regulon (Lamarche et al., 2008). The fact that HapR represses biofilm formation (Waters et al., 2008) and PhoB has been shown to negatively affect biofilm formation in other Gram-negative bacteria (Monds et al., 2001, 2007) prompted us to examine the relationship between HapR, PhoB and biofilm formation. To this end, we constructed a ΔphoB mutant of strain SZS007. We did not observe any phenotype for this mutant in LB or high-phosphate medium (i.e. growth rate, motility, extracellular protease production). However, the mutant did exhibit reduced growth and alkaline phosphatase expression in low-phosphate medium containing the chromogenic substrate 5-bromo-4-chloro-3-indolyl phosphate (data not shown).

Governmental actions including increasing awareness of the import

Governmental actions including increasing awareness of the importance of vitamin D and guidelines on how to obtain it

are necessary. Creating areas where women, particularly those of lower socio-economic status, can enjoy sun exposure as well as fortifying more foods would go some way towards tackling this problem. “
“Behçet’s disease (BD) is a systemic vasculitis disease with oral and genital aphthous ulceration, uveitis, skin manifestations, arthritis and neurological involvement. Many investigators have published articles on BD in the last two decades since introduction of diagnosis criteria by the International Study Group for Behçet’s Disease in 1990. However, there is no scientometric analysis available for this increasing amount of literature. A scientometric analysis beta-catenin tumor method was used

to achieve a view of scientific articles about BD which were published between 1990 and 2010, by data retrieving from ISI Web of Science. The specific features such as publication year, language of article, geographical distribution, main journal in this field, institutional affiliation and citation characteristics were retrieved and analyzed. International collaboration was analyzed using Intcoll and Pajek softwares. There was a growing trend in the number of BD articles from 1990 to 2010. The number of citations to BD literature also increased around 5.5-fold in this period. The countries found to have the highest output were Turkey, Japan, the USA and England; the first two universities ITF2357 were from Turkey. Most of the top 10 journals publishing BD articles were in the field of rheumatology, consistent with the subject areas of the articles. There was a correlation between the citations per paper and the impact factor of the publishing journal. This

is the first scientometric analysis of BD, showing the scientometric characteristics of ISI publications on BD. “
“The historical significance Thymidylate synthase of the Medici family of Florence is widely recognised, but the diseases which afflicted leading members of this family have only been scientifically studied in recent decades. Paleopathological findings on exhumed skeletons, supplemented by medical descriptions in historical documents, have permitted a retrospective diagnosis of a triple pathological syndrome in the senior branch of the Medici family. Peripheral joint and spinal conditions, with the presence of skin disease, are identified in several generations of the family in the 15th century and are presented as the ‘Medici syndrome’. Radiological findings are compared with macro- and microscopical descriptions in the diagnosis of the peripheral joint disease and spinal ankylosis/stenosis within the syndrome. “
“Objective:  To investigate the effect of Kashin-Beck disease (KBD)-affected feed and T-2 toxin on the bone development of Wistar rats.

Governmental actions including increasing awareness of the import

Governmental actions including increasing awareness of the importance of vitamin D and guidelines on how to obtain it

are necessary. Creating areas where women, particularly those of lower socio-economic status, can enjoy sun exposure as well as fortifying more foods would go some way towards tackling this problem. “
“Behçet’s disease (BD) is a systemic vasculitis disease with oral and genital aphthous ulceration, uveitis, skin manifestations, arthritis and neurological involvement. Many investigators have published articles on BD in the last two decades since introduction of diagnosis criteria by the International Study Group for Behçet’s Disease in 1990. However, there is no scientometric analysis available for this increasing amount of literature. A scientometric analysis learn more method was used

to achieve a view of scientific articles about BD which were published between 1990 and 2010, by data retrieving from ISI Web of Science. The specific features such as publication year, language of article, geographical distribution, main journal in this field, institutional affiliation and citation characteristics were retrieved and analyzed. International collaboration was analyzed using Intcoll and Pajek softwares. There was a growing trend in the number of BD articles from 1990 to 2010. The number of citations to BD literature also increased around 5.5-fold in this period. The countries found to have the highest output were Turkey, Japan, the USA and England; the first two universities selleck products were from Turkey. Most of the top 10 journals publishing BD articles were in the field of rheumatology, consistent with the subject areas of the articles. There was a correlation between the citations per paper and the impact factor of the publishing journal. This

is the first scientometric analysis of BD, showing the scientometric characteristics of ISI publications on BD. “
“The historical significance this website of the Medici family of Florence is widely recognised, but the diseases which afflicted leading members of this family have only been scientifically studied in recent decades. Paleopathological findings on exhumed skeletons, supplemented by medical descriptions in historical documents, have permitted a retrospective diagnosis of a triple pathological syndrome in the senior branch of the Medici family. Peripheral joint and spinal conditions, with the presence of skin disease, are identified in several generations of the family in the 15th century and are presented as the ‘Medici syndrome’. Radiological findings are compared with macro- and microscopical descriptions in the diagnosis of the peripheral joint disease and spinal ankylosis/stenosis within the syndrome. “
“Objective:  To investigate the effect of Kashin-Beck disease (KBD)-affected feed and T-2 toxin on the bone development of Wistar rats.

05) This prospective multicenter study showed that KABISA TRAVEL

05). This prospective multicenter study showed that KABISA TRAVEL performed as well as travel physicians in diagnosing febrile illnesses in returning travelers. Its diagnostic accuracy reached almost 90% of the challenged cases when considering the top five ranking list. In addition, KABISA TRAVEL was perceived as helpful in suggesting further investigations and final diagnoses in a sizeable

proportion of the cases, in particular when the diagnosis was not immediately clear. Also, in the majority of the cases, the tutor asked for additional information before providing a final ranking with sufficient probability. The high number of malaria cases in our study might be explained by the high proportion of hospitalized patients. Even if no single clinical C59 wnt molecular weight or biological feature has good sensitivity and specificity to predict malaria in febrile patients,13,14 malaria was rarely missed both by clinicians and KABISA AT9283 TRAVEL in our study. Comparison of the most frequent diagnosis with other published studies is biased by the definition of diagnoses and by the selection criteria: O’Brien studied only hospitalized patients, Ansart only outpatients, Bottieaux and Wilson mixed populations (27 and

26% hospitalized, respectively).3,9,13,15 Malaria was the most common diagnosis (resp. 27, 19.9, 27, and 21%), followed by respiratory track infection (24, 7.4, 10.5, and 14%), and gastroenteritis (14, 18.4, 7.1, and 15%). The results of our study are not really different for the latter two, except for the high prevalence of malaria which is uncommon, especially the high proportion of nonfalciparum malaria. The high proportion of dengue might be because of the worldwide increase over the last decade.16,17 Most missed diagnoses were because of nonspecific case presentation. KABISA was less well performing Fludarabine than clinicians. Although the numbers are equal, the balance of suggested serious and treatable diseases seems rather favorable for clinicians. Also here, we should state that KABISA only gives hints, during the initial workup, and is not a final

decider. Every session ends with this warning. Several limitations must be mentioned. First, no public call was made for this study; only the institution where the system has been developed and other centers with formerly existing links took part in this investigation. Second, we cannot be sure that all cases were prospectively entered in the KABISA TRAVEL within 36 hours after the first clinical contact. As the electronic report files were not locked, also some modifications might have been made a posteriori by the physicians before sending them. Third, it is also possible that not all eligible cases who presented in each center during the study period have been actually included, and it is possible as well that some selection of cases had occurred, favoring, for example, unusual cases or typical tropical cases. To which extent it has impacted on the performances of both competitors is however difficult to quantify.

The software flags sequences that have uncertain assignments or i

The software flags sequences that have uncertain assignments or in which no HMM regions could be detected in either orientation, suggesting the presence of sequence anomalies. We evaluated the reliability of the software by screening all bacterial (387 520) and archaeal (19 261) 16S sequences deposited in the SILVA database release 102 (Fig. 1a); mitochondrial and chloroplast sequences were excluded beforehand. Because the SILVA database stores all entries in a well-curated

multiple sequence find protocol alignment, all these entries should be present in the 5′–3′ orientation. On a 3 GHz dual-core computer, v-revcomp processed the bacterial and archaeal datasets in 252 and 8 min, respectively. All sequences except one bacterial entry were assigned as being in the 5′–3′ orientation, representing a detection accuracy of virtually 100%. The software Selleck GSK269962 flagged 40 (0.01%) sequences that showed the detection of either one HMM (37 cases), two HMMs (two cases) or three HMMs (one case) in the reverse complementary orientation; however, the majority of HMMs (i.e. 9–16) were detected in the input orientation. We studied these 40 uncertain sequences in more detail using blast against

NCBI GenBank (Benson et al., 2010) as well as through pairwise sequence alignments against an Escherichia coli reference rRNA operon (GenBank accession J01695, Prestle et al., 1992) where necessary. Fifteen cases (37.5%) were reverse complementary chimeras, i.e. sequences erroneously assembled to contain one segment in the reverse complementary orientation as compared with the remainder of the sequence (see representative example in Supporting Information, Fig. S1a). This reverse-complemented segment led to the detection of one or more HMMs in the opposite orientation compared with the rest of the sequence. In

PLEK2 12 cases (30%), the HMMs detected a segment at either the 5′ or the 3′ end of the reverse complementary sequence that did not match any entry in GenBank; such sequences are very likely to represent chimeric unions or other sequence artefacts (see representative example in Fig. S1b). The remaining 13 cases (32.5%) contained no obvious anomaly and might represent occasional false-positive detections by individual HMMs. Importantly, though, the average HMM detection ratio between the original and the reverse complementary sequence in these 13 cases was 16 : 1, which leaves no doubt about the true orientation of the query. Considering that any 500-bp segment of a 16S sequence should have approximately 4–6 HMM detections (Hartmann et al., 2010), some sequences had lower HMM detection counts than would have been expected based on the sequence length.

The supernatant and pellet samples were kept at −25 °C until furt

The supernatant and pellet samples were kept at −25 °C until further use. Enzymatic activity was assayed in triplicate using the dinitrosalicylic acid (DNS) method (Sumner & Howell, 1935). One unit of dextransucrase activity is defined as the amount of enzyme that catalyzes the formation of 1 μmol fructose min−1 at 30 °C in 20 mM sodium acetate buffer (pH 5.4) with 292 mM sucrose. Supernatant and cell-associated fractions find more from Weissella cultures were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Each sample (30 μL) was mixed with NuPAGE® LDS sample buffer 4 × (10 μL) (Invitrogen, France) and incubated at 70 °C for 10 min to denature the

enzymes reversibly. Electrophoresis was performed on NuPAGE® 3–8% Tris-acetate gel with Selleckchem Ixazomib the XCell Surelock Minicell system (Invitrogen) at room temperature at constant voltage (150 V). After migration, proteins were stained with the Colloidal Blue Staining kit (Invitrogen). For in situ detection of dextransucrase activity, the gel was first washed three times with

sodium acetate buffer (20 mM sodium acetate, pH 5.4, 0.05 g L−1 CaCl2 and 0.1% v/v Triton X-100) for a total of 60 min to renaturate dextransucrase. It was then incubated overnight in the same buffer supplemented with sucrose (10% w/v). Thereafter, dextransucrase activity was revealed by periodic acid-Schiff staining (Schiff’s reagent, Sigma-Aldrich) of the polymer formed (Miller & Robyt, 1986). The molecular mass was estimated with the Precision Plus Protein Standards all blue purchased from BioRad Laboratories. The supernatant of W. cibaria K39 harvested from the glucose medium culture was concentrated up to fivefold with a Centricon (30 kDa cut-off, Millipore)

to reach a protein concentration around 1 g L−1, as determined by the Bradford method (Bradford, 1976), and subjected to SDS-PAGE. The proteins were stained with colloidal blue Coomassie and silver staining (ProteoSilver Plus Silver Stain kit, Sigma-Aldrich), which is more sensitive. however In addition, zymogram was performed to specifically detect dextransucrase activity. The unique band detected at 180 kDa was excised from the Coomassie blue-stained gel in sterile conditions and stored in ultrapure water at 4 °C. Protein sequencing was conducted by Eurogentec by the ESI-MS-MS analysis (Liege Science Park, Belgium). Weissella total DNA was prepared according to Robert et al. (2009) or using a DNA extraction kit (DNeasy Blood and Tissue kit, Qiagen) from overnight cultures grown in MRS medium. PCR amplifications were carried out using a Gradient Master Thermocycler (Eppendorf). Reactions were performed in a total volume of 20 μL containing 1 μL of template DNA (approximatively 5–10 ng), 1 × reaction buffer, 0.2 mM dNTP, 1.5 mM MgCl2, appropriate concentration of oligonucleotide primers (Sigma or Eurogentec) and 0.75 U RedGoldstar Taq polymerase (Eurogentec).

To explore this possibility, we studied patients with lengthy exp

To explore this possibility, we studied patients with lengthy exposure to the three main antiretroviral drug classes who had experienced multiple treatment failures. We compared the results of genotypic drug resistance assays on cellular DNA at the time of suppressed viraemia with those of resistance genotyping of plasma

HIV-1 RNA at the time of past treatment failures. The patients had been enrolled in the Agence Nationale de Recherche sur le SIDA (ANRS) 138-intEgrase inhibitor MK_0518 to Avoid Subcutaneous Injections of EnfuviRtide (EASIER) randomized trial, which was designed to assess the switch from enfuvirtide to raltegravir among highly treatment-experienced HIV-1-infected patients with good virological control [8]. The Akt inhibitor ANRS 138-EASIER study was a 48-week noninferiority randomized multicentre trial assessing the efficacy and safety of a switch from enfuvirtide to raltegravir in highly treatment-experienced patients receiving a suppressive enfuvirtide-containing regimen [8]. The main inclusion criteria were (i) HIV-1-infected patients with failure on, or intolerance to, triple drug classes [nucleoside reverse transcriptase inhibitor (NRTI), nonnucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI)]; (ii) a stable enfuvirtide-based regimen for 3 months or more; and (iii) plasma HIV-1 RNA levels < 400

copies/mL for at least the last 3 months. One hundred and sixty-nine patients were enrolled in this trial. The results of all available HIV-1 RNA resistance tests performed on plasma during previous episodes of virological failure were collected from French virology laboratories belonging to the ANRS network ICG-001 concentration and performing annual resistance genotyping quality controls [9]. Information on drug resistance mutations was analysed centrally. We constructed the ‘cumulative’ RNA genotype for each patient Terminal deoxynucleotidyl transferase by adding up all mutations found in previous genotypic tests for each drug class. HIV-1 DNA resistance genotyping was performed in a central laboratory prior to randomization. Viral DNA was extracted from 200 μL of frozen stored whole blood using an automatic nucleic

acid extractor (MagnaPure; Roche, Meylan, France). Reverse transcriptase–polymerase chain reaction (RT-PCR) and then nested PCR were used to amplify the reverse transcriptase (RT) and protease (PR) genes according to ANRS consensus methods (www.hivfrenchresistance.org). Population sequencing was performed on purified amplicons with the Taq Dye Deoxy Terminator cycle sequencing kits (Applied Biosytems, Courtaboeuf, France) and resolved on an ABI 3700 automated DNA sequencer (Applied Biosytems, Courtaboeuf, France). Sequences were aligned with the HIV-1 subtype B HXB2 reference strain, and RT and PR mutations were identified from the 2008 International Antiviral Society (IAS)-USA resistance list (www.iasusa.org) and the 2009 ANRS v18 algorithm (www.hivfrenchresistance.org).

Initiation of HAART was defined as the first time the children to

Initiation of HAART was defined as the first time the children took a PI with two or more additional antiretrovirals. Subsequent changes of HAART were ignored in the statistical analysis as long as the HAART regimen still included a PI. Height and weight were used to calculate the body mass index (BMI). For classification by BMI category, overweight and low weight were defined according to the World Health Organization (WHO) Expert Committee [19]. The degree of insulin resistance (IR) was estimated by the homeostatic model assessment method

(HOMA) from samples acquired from fasting patients via the formula: plasma glucose (mmol/L) × serum insulin (mU/L)/22.5. Lipodystrophy diagnoses were based on the clinical examination at the last visit according to Hartman et al. [20]. The degree of lipoatrophy or lipohypertrophy in every part of the body was measured as absent www.selleckchem.com/products/pd-166866.html (score of 0), mild (score of 1), moderate (score of 2), or severe (score of 3). Patients with scores ≥2 were classified in the lipodystrophy (LD) group and patients with scores <2 were classified find more in the nonlipodystrophy (NLD) group. Multiplex suspension bead array immunoassays were performed using the Luminex 100™ analyser (Luminex Corporation, Austin, TX, USA) and Multiplex kits (LINCOplex™; LINCO Research, St Charles, MO, USA) to determine protein levels in plasma according to the user manual. The statistical analysis

was performed with the Statistical Package for the Social Sciences (SPSS) (v.12) (SPSS, Chicago, IL, USA). All P-values were two-tailed. Statistical significance was defined as P<0.05. Continuous variables were compared longitudinally either within groups or against baseline data (Wilcoxon's test). Table 1 shows the demographic and clinical baseline characteristics of the 27 vertically HIV-infected children during 48 months on HAART. Most of the study population were female, Benzatropine were in Centers for Disease Control and Prevention (CDC) category C and had

previously been treated with combined therapy. Table 2 shows details of the ART received by the children. The most frequently prescribed HAART protocol at baseline was two NRTIs+one PI. The NRTI most frequently in use was lamivudine (3TC) and the most common PI was nelfinavir (NFV). After 2 years on HAART, 13 children remained on their initial HAART regimen, but by 4 years only seven children remained on their initial regimen. Figure 1 shows the medians for peripheral T-cell subset percentages, plasma viral load, and lipid and adipokine concentrations during follow-up of the study subjects. The median CD4 percentage increased to >25% at 12 months of HAART (Fig. 1a), and the median CD8 percentage was >30% at HAART initiation and throughout the entire follow-up period (Fig. 1b). The median viral load decreased during follow-up (Fig. 1c), but HAART reduced the viral load to ≤400 HIV-1 RNA copies/mL in <50% of children (37, 40.


“The peptide cholecystokinin (CCK) is a short-term satiety


“The peptide cholecystokinin (CCK) is a short-term satiety signal released from the gastrointestinal tract during food intake. From the periphery, CCK signalling travels via the vagus nerve to reach the brainstem from which it is relayed higher into the brain. The hypothalamus is a key integrator of appetite-related stimuli and the ventromedial nucleus of the hypothalamus (VMN) is thought to have an important role in the regulation of satiety. We investigated Crizotinib datasheet the effect of intravenous injections of CCK on the spontaneous firing activity of single VMN neurons in urethane-anaesthetised rats in vivo. We found that the predominant effect of CCK on the electrical activity

in the VMN is inhibitory. We analysed the responses to CCK according to electrophysiologically distinct subpopulations of VMN neurons and found that four of these VMN subpopulations

were inhibited by CCK, while five were not significantly affected. Finally, CCK-induced inhibitory response in VMN neurons was not altered by pre-administration of intravenous leptin. “
“Converging lines of evidence suggest that synaptic plasticity at auditory inputs to the lateral amygdala (LA) is critical for the formation and storage of auditory fear memories. Auditory information reaches the LA from both thalamic and cortical areas, raising the question of whether they make distinct contributions to fear memory storage. Here we address this by comparing the induction of long-term potentation (LTP) at the CP-868596 datasheet two inputs in vivo in anesthetized rats. We first show, using field potential measurements, that different patterns and frequencies of high-frequency stimulation (HFS) consistently elicit stronger LTP at cortical inputs than at thalamic inputs.

Field potential responses elicited during HFS of thalamic inputs were also smaller than responses during HFS of cortical inputs, suggesting less effective postsynaptic depolarization. Pronounced differences in the short-term plasticity profiles of the two inputs were also observed: Glycogen branching enzyme whereas cortical inputs displayed paired-pulse facilitation, thalamic inputs displayed paired-pulse depression. These differences in short- and long-term plasticity were not due to stronger inhibition at thalamic inputs: although removal of inhibition enhanced responses to HFS, it did not enhance thalamic LTP and left paired-pulse depression unaffected. These results highlight the divergent nature of short- and long-term plasticity at thalamic and cortical sensory inputs to the LA, pointing to their different roles in the fear learning system. “
“The H+ hypothesis of lateral feedback inhibition in the outer retina predicts that depolarizing agents should increase H+ release from horizontal cells. To test this hypothesis, self-referencing H+-selective microelectrodes were used to measure extracellular H+ fluxes from isolated goldfish horizontal cells.

A self-administered questionnaire-based study was performed among

A self-administered questionnaire-based study was performed among secondary school girls (n = 589) who participated in professional education provided by a pediatric and adolescent gynecologist. The questionnaire comprised sociodemographic

characteristics, sexual activity, knowledge on contraceptive methods, cervical screening and sources of their knowledge. Simple descriptive statistics, χ2 and one-way-anova tests, multivariate logistic regression analysis and Pearson correlation were applied. All statistical analyses were carried out using spss 17.0 for Windows. A total of 50.3% of adolescent girls had already had a sexual contact. Half of the sexually active participants had already visited a gynecologist, and most of them did so due to some kind of complaint. The overall knowledge about cervical screening was quite low;

higher knowledge was found among those having visited a gynecologist. Adolescent girls’ knowledge on cervical screening Metformin datasheet was improved by previous visits to a gynecologist. The participation of an expert – a gynecologist – in a comprehensive sexual education program of teenage girls is of high importance in Hungary. “
“This cross-sectional study was carried out to determine physical and emotional discomforts experienced before and after a gynecologic examination by women who presented to the outpatient clinic of the gynecology and obstetrics department at a university PI3K phosphorylation hospital. The sample of study was composed of 248 women. Data were collected with a survey form developed by researchers. T-test and variance analysis were used in statistical analysis. Emotional discomfort before the examination was felt by 80.2% of the women, while 80.6% stated they felt emotional discomfort after the examination. Physical discomfort before the examination was experienced by 67.3% of the women, while 76.6% stated that they felt physical discomfort after the PTK6 examination. The emotional discomfort mean score was 5.02 ± 3.24 before examination and 4.62 ± 3.23 after examination (P > 0.05). The physical discomfort mean score was 3.38 ± 3.12 before examination and 3.94 ± 3.02

after examination and the difference between mean scores was statistically significant (P < 0.05). The women felt more physical discomfort during the examination than they anticipated beforehand. The emotional discomfort in women who preferred a female physician was significantly higher than in those who preferred a male physician or who had no preference on the sex of their physician. "
“The rate of cesarean section (CS) has been reported to be as high as 40% among Iranian women in the year 2009. The aim of this study was to determine the rate of cesarean delivery on mother’s request (CDMR) and to determine maternal attitude and knowledge about various modes of delivery in private and public (university) hospitals in Tehran. All primiparous mothers delivering in six selected hospitals between April 2010 and March 2011 were included.