Análisis del infrarregistro de la mortalidad perinatal y sus factores asociados en una región sanitaria de Cataluña

ResumenObjetivosEvaluar la magnitud del infrarregistro de las muertes perinatales de la Región Sanitaria «Centre» (RSC) (Cataluña). Estimar las tasas de mortalidad reales y analizar los factores asociados al infrarregistro.MétodosEstudio observacional retrospectivo del infrarregistro de la mortalidad perinatal durante el período 1991–1992 en la RSC. Mediante una recogida activa se han identificado las muertes perinatales de peso igual o superior a 500 gr o de 22 semanas o más, ocurridas en los hospitales del RSC, comparándolas, mediante un apareamiento informático, con las muertes perinatales del registro oficial de mortalidad. Las variables de apareamiento utilizadas han sido: nombre y apellidos del recién nacido, sexo, municipio y fecha de la defunción. Se ha aplicado el análisis de regresión logística para detectar los factores asociados al infrarregistro.ResultadosLa mortalidad perinatal en la RSC en el período 1991–92 se ha infraestimado en un 34% (IC 95%: 26%–42%). La mayor parte de las muertes no declaradas corresponde a muertes fetales y/o recién nacidos de muy bajo peso o de gran prematuridad que mueren a las pocas horas de vida. Durante el fin de semana el infrarregistro es unas cuatro veces mayor. Una vez recogida, la tasa de mortalidad perinatal en la RSC para los años 1991–1992 pasa de 6,3 por 1.000 nacimientos a 9,6 por 1.000 nacimientos.ConclusionesPara disponer de una información precisa de las necesidades de salud de las mujeres en edad fértil y de los recién nacidos de la RSC, y de cada uno de sus sectores, debe mejorarse la declaración de las muertes perinatales.SummaryObjectivesTo assess the degree of undereporting of perinatal deaths in the «Centre» Region (CR) during 1991 and 1992.MethodsObservational retrospective study of the undereporting of perinatal deaths in the CR during 1991 and 1992. Perinatal deaths above 499 grams or 21 weeks of gestation which occurred in the hospitals of the CR were identified by reviewing hospital records, and then compared through linkage with perinatal deaths recorded in vital statistics. The following variables were used for the matching: name and surname, sex, county and date of death. Logistic regression was used to identify factors associated with undereporting.ResultsThe degree of undereporting of perinatal deaths in the CR during 1991–1992 was 34% [95% CI: (26%–42%)]. Most undereported perinatal deaths corresponded to fetal deaths, or very low birthweight or preterm livebirths that died shortly after birth. Over the weekend, undereporting increases by four-fold. The official perinatal mortality rate for the CR, 6.3 per 1,000 births, increased to 9.6 per 1,000 births, after taking into account undereporting.ConclusionsIn order to have valid information of the health needs of mothers and newborns reporting of perinatal deaths must be improved

The Cluster of Galaxies Abell 970

We present a dynamical analysis of the galaxy cluster Abell 970 based on a new set of radial velocities measured at ESO, Pic du Midi and Haute-Provence observatories. Our analysis indicates that this cluster has a substructure and is out of dynamical equilibrium. This conclusion is also supported by differences in the positions of the peaks of the surface density distribution and X-ray emission, as well as by the evidence of a large scale velocity gradient in the cluster. We also found a discrepancy between the masses inferred with the virial theorem and with the X-ray emission, what is expected if the galaxies and the gas inside the cluster are not in hydrostatic equilibrium. Abell 970 has a modest cooling flow, as is expected if it is out of equilibrium as suggested by Allen (1998). We propose that cooling flows may have an intermittent behavior, with phases of massive cooling flows being followed by phases without significant cooling flows after the acretion of a galaxy group massive enough to disrupt the dynamical equilibrium in the center of the clusters. A massive cooling flow will be established again, after a new equilibrium is achieved.Comment: 24 pages, 9 figures, submitted to A&

ESO Imaging Survey: Optical follow-up of 12 selected XMM-Newton fields

(Abridged) This paper presents the data recently released for the XMM-Newton/WFI survey carried out as part of the ESO Imaging Survey (EIS) project. The aim of this survey is to provide optical imaging follow-up data in BVRI for identification of serendipitously detected X-ray sources in selected XMM-Newton fields. In this paper, fully calibrated individual and stacked images of 12 fields as well as science-grade catalogs for the 8 fields located at high-galactic latitude are presented. The data covers an area of \sim 3 square degrees for each of the four passbands. The median limiting magnitudes (AB system, 2" aperture, 5\sigma detection limit) are 25.20, 24.92, 24.66, and 24.39 mag for B-, V-, R-, and I-band, respectively. These survey products, together with their logs, are available to the community for science exploitation in conjunction with their X-ray counterparts. Preliminary results from the X-ray/optical cross-correlation analysis show that about 61% of the detected X-ray point sources in deep XMM-Newton exposures have at least one optical counterpart within 2" radius down to R \simeq 25 mag, 50% of which are so faint as to require VLT observations thereby meeting one of the top requirements of the survey, namely to produce large samples for spectroscopic follow-up with the VLT, whereas only 15% of the objects have counterparts down to the DSS limiting magnitude.Comment: 24 pages, 10 figures, accepted for publication in Astronomy and Astrophysics. Accompanying data releases available at http://archive.eso.org/archive/public_datasets.html (WFI images), http://www.eso.org/science/eis/surveys/release_65000025_XMM.html (optical catalogs), http://www.aip.de/groups/xray/XMM_EIS/ (X-ray data). Full resolution version available at http://www.astro.uni-bonn.de/~dietrich/publications/3785.ps.g

The NGC4839 group falling into the Coma cluster observed by XMM-Newton

We present here the first analysis of the XMM Newton EPIC-MOS data of the galaxy group around NGC4839, which lies at a projected distance to the Coma cluster center of 1.6Mpc. In our analysis, which includes imaging, spectro-imaging and spectroscopy we find compelling evidence for the sub group being on its first infall onto the Coma cluster. The complex temperature structure around NGC 4839 is consistent with simulations of galaxies falling into a cluster environment. We see indications of a bow shock and of ram pressure stripping around NGC4839. Furthermore our data reveal a displacement between NGC4839 and the center of the hot gas in the group of about 300kpc. With a simple approximation we can explain this displacement by the pressure force originating from the infall, which acts much stronger on the group gas than on the galaxies.Comment: 6 pages, Accepted for publication in the special A&A Letters issue for XMM-Newto

Quality of life in patients with hereditary haemorrhagic telangiectasia (HHT)

Background: There are very few studies about general quality of life parameters, standards for the description of health status and comparison with general population data on patients with Hereditary hemorrhagic telangiectasia (HHT), a rare disease in which epistaxis is a cardinal symptom. Purpose: To assess the quality of life in a population of Spanish patients with HHT and compare it with the general population. Design and methods: Between January 1st 2005 and December 31st 2013, 187 adult patients diagnosed with HHT who were admitted to the HHT Unit of the Hospital Sierrallana, completed on their first visit, the EuroQol 5D-3L (five dimensions and three levels) quality of life descriptive test and the visual analog scale (VAS). The numerical social index value was also determined and the subjective effect of the nasal epistaxis on their quality of life was estimated classified as mild, moderate or severe. Results: Patients with HHT had greater problems than the general population in the five dimensions of the EuroQol 5D-3L, particularly considering pain/discomfort and anxiety/depression. In the VAS and the social index value, patients with HHT also scored lower than the general population, particularly older patients, males, and patients with HHT2. They also had values similar to those of populations with chronic illnesses. The subjective perception of the severity of epistaxis correlated strongly with the VAS and social index values. Conclusions: The quality of life of patients with HHT, estimated using the EuroQol 5D-3L scale, is affected across all dimensions. The scores are similar to those seen in cases of other chronic diseases. Older patients, males and the carriers of the ACVRL1 mutation generally have worse scores on these scales. The VAS and the social index value are index that correlate well with the severity of the clinical symptoms associated mainly with epistaxis

Emergency hospital services utilization in Lleida (Spain): A cross-sectional study of immigrant and Spanish-born populations

<p>Abstract</p> <p>Background</p> <p>The use of emergency hospital services (EHS) has increased steadily in Spain in the last decade while the number of immigrants has increased dramatically. Studies show that immigrants use EHS differently than native-born individuals, and this work investigates demographics, diagnoses and utilization rates of EHS in Lleida (Spain).</p> <p>Methods</p> <p>Cross-sectional study of all the 96,916 EHS visits by patients 15 to 64 years old, attended during the years 2004 and 2005 in a public teaching hospital. Demographic data, diagnoses of the EHS visits, frequency of hospital admissions, mortality and diagnoses at hospital discharge were obtained. Utilization rates were estimated by group of origin. Poisson regression was used to estimate the rate ratios of being visited in the EHS with respect to the Spanish-born population.</p> <p>Results</p> <p>Immigrants from low-income countries use EHS services more than the Spanish-born population. Differences in utilization patterns are particularly marked for Maghrebi men and women and sub-Saharan women. Immigrant males are at lower risk of being admitted to the hospital, as compared with Spanish-born males. On the other hand, immigrant women are at higher risk of being admitted. After excluding the visits with gynecologic and obstetric diagnoses, women from sub-Saharan Africa and the Maghreb are still at a higher risk of being admitted than their Spanish-born counterparts.</p> <p>Conclusion</p> <p>In Lleida (Spain), immigrants use more EHS than the Spanish born population. Future research should indicate whether the same pattern is found in other areas of Spain and whether EHS use is attributable to health needs, barriers to access to the primary care services or similarities in the way immigrants access health care in their countries of origin.</p

An assessment of existing models for individualized breast cancer risk estimation in a screening program in Spain

Background: The aim of this study was to evaluate the calibration and discriminatory power of three predictive models of breast cancer risk. Methods: We included 13,760 women who were first-time participants in the Sabadell-Cerdanyola Breast Cancer Screening Program, in Catalonia, Spain. Projections of risk were obtained at three and five years for invasive cancer using the Gail, Chen and Barlow models. Incidence and mortality data were obtained from the Catalan registries. The calibration and discrimination of the models were assessed using the Hosmer-Lemeshow C statistic, the area under the receiver operating characteristic curve (AUC) and the Harrell’s C statistic. Results: The Gail and Chen models showed good calibration while the Barlow model overestimated the number of cases: the ratio between estimated and observed values at 5 years ranged from 0.86 to 1.55 for the first two models and from 1.82 to 3.44 for the Barlow model. The 5-year projection for the Chen and Barlow models had the highest discrimination, with an AUC around 0.58. The Harrell’s C statistic showed very similar values in the 5-year projection for each of the models. Although they passed the calibration test, the Gail and Chen models overestimated the number of cases in some breast density categories. Conclusions: These models cannot be used as a measure of individual risk in early detection programs to customize screening strategies. The inclusion of longitudinal measures of breast density or other risk factors in joint models of survival and longitudinal data may be a step towards personalized early detection of BC.This study was funded by grant PS09/01340 and The Spanish Network on Chronic Diseases REDISSEC (RD12/0001/0007) from the Health Research Fund (Fondo de Investigación Sanitaria) of the Spanish Ministry of Health

Intracluster light in clusters of galaxies at redshifts 0.4<z<0.8

The study of intracluster light can help us to understand the mechanisms taking place in galaxy clusters, and to place constraints on the cluster formation history and physical properties. However, owing to the intrinsic faintness of ICL emission, most searches and detailed studies of ICL have been limited to redshifts z<0.4.We search for ICL in a subsample of ten clusters detected by the ESO Distant Cluster Survey (EDisCS), at redshifts 0.4<z<0.8, that are also part of our DAFT/FADA Survey. We analyze the ICL by applying the OV WAV package, a wavelet-based technique, to deep HST ACS images in the F814W filter and to V-band VLT/FORS2 images of three clusters. Detection levels are assessed as a function of the diffuse light source surface brightness using simulations. In the F814W filter images, we detect diffuse light sources in all the clusters, with typical sizes of a few tens of kpc (assuming that they are at the cluster redshifts). The ICL detected by stacking the ten F814W images shows an 8sigma detection in the source center extending over a ~50x50kpc2 area, with a total absolute magnitude of -21.6 in the F814W filter, equivalent to about two L* galaxies per cluster. We find a weak correlation between the total F814W absolute magnitude of the ICL and the cluster velocity dispersion and mass. There is no apparent correlation between the cluster mass-to-light ratio (M/L) and the amount of ICL, and no evidence for any preferential orientation in the ICL source distribution. We find no strong variation in the amount of ICL between z=0 and z=0.8. In addition, we find wavelet-detected compact objects (WDCOs) in the three clusters for which data in two bands are available; these objects are probably very faint compact galaxies that in some cases are members of the respective clusters. We have shown that ICL is important in clusters at least up to z=0.8.Comment: Accepted in A&A. Six figures in jpg format. Paper still to be improved by A&A english correcto

Palaeogenomics of Upper Palaeolithic to Neolithic European hunter-gatherers

Modern humans have populated Europe for more than 45,000 years1,2. Our knowledge of the genetic relatedness and structure of ancient hunter-gatherers is however limited, owing to the scarceness and poor molecular preservation of human remains from that period3. Here we analyse 356 ancient hunter-gatherer genomes, including new genomic data for 116 individuals from 14 countries in western and central Eurasia, spanning between 35,000 and 5,000 years ago. We identify a genetic ancestry profile in individuals associated with Upper Palaeolithic Gravettian assemblages from western Europe that is distinct from contemporaneous groups related to this archaeological culture in central and southern Europe4, but resembles that of preceding individuals associated with the Aurignacian culture. This ancestry profile survived during the Last Glacial Maximum (25,000 to 19,000 years ago) in human populations from southwestern Europe associated with the Solutrean culture, and with the following Magdalenian culture that re-expanded northeastward after the Last Glacial Maximum. Conversely, we reveal a genetic turnover in southern Europe suggesting a local replacement of human groups around the time of the Last Glacial Maximum, accompanied by a north-to-south dispersal of populations associated with the Epigravettian culture. From at least 14,000 years ago, an ancestry related to this culture spread from the south across the rest of Europe, largely replacing the Magdalenian-associated gene pool. After a period of limited admixture that spanned the beginning of the Mesolithic, we find genetic interactions between western and eastern European hunter-gatherers, who were also characterized by marked differences in phenotypically relevant variants

Palaeogenomics of Upper Palaeolithic to Neolithic European hunter-gatherers

Modern humans have populated Europe for more than 45,000 years. Our knowledge of the genetic relatedness and structure of ancient hunter-gatherers is however limited, owing to the scarceness and poor molecular preservation of human remains from that period. Here we analyse 356 ancient hunter-gatherer genomes, including new genomic data for 116 individuals from 14 countries in western and central Eurasia, spanning between 35,000 and 5,000 years ago. We identify a genetic ancestry profile in individuals associated with Upper Palaeolithic Gravettian assemblages from western Europe that is distinct from contemporaneous groups related to this archaeological culture in central and southern Europe, but resembles that of preceding individuals associated with the Aurignacian culture. This ancestry profile survived during the Last Glacial Maximum (25,000 to 19,000 years ago) in human populations from southwestern Europe associated with the Solutrean culture, and with the following Magdalenian culture that re-expanded northeastward after the Last Glacial Maximum. Conversely, we reveal a genetic turnover in southern Europe suggesting a local replacement of human groups around the time of the Last Glacial Maximum, accompanied by a north-to-south dispersal of populations associated with the Epigravettian culture. From at least 14,000 years ago, an ancestry related to this culture spread from the south across the rest of Europe, largely replacing the Magdalenian-associated gene pool. After a period of limited admixture that spanned the beginning of the Mesolithic, we find genetic interactions between western and eastern European hunter-gatherers, who were also characterized by marked differences in phenotypically relevant variants.Open access funding provided by Max Planck Society. This project has received funding by the European Research Council under the European Union’s Horizon 2020 research and innovation programme under grant agreements no. 803147-RESOLUTION (to S.T.), no. 771234-PALEoRIDER (to W.H.), no. 864358 (to K.M.), no. 724703 and no. 101019659 (to K.H.). K.H. is also supported by the Deutsche Forschungsgemeinschaft (DFG FOR 2237). E.A. has received funding from the Van de Kamp fonds. PACEA co-authors of this research benefited from the scientific framework of the University of Bordeaux’s IdEx Investments for the Future programme/GPR Human Past. A.G.-O. is supported by a Ramón y Cajal fellowship (RYC-2017-22558). L. Sineo, M.L. and D.C. have received funding from the Italian Ministry of University and Research (MUR) PRIN 2017 grants 20177PJ9XF and 20174BTC4R_002. H. Rougier received support from the College of Social and Behavioral Sciences of CSUN and the CSUN Competition for RSCA Awards. C.L.S. and T. Saupe received support from the European Union through the European Regional Development Fund (project no. 2014-2020.4.01.16-0030) and C.L.S. received support from the Estonian Research Council grant PUT (PRG243). S. Shnaider received support from the Russian Science Foundation (no. 19-78-10053).Peer reviewe