Evaluación del control metabólico, resultados obstétricos y perinatales en mujeres con diabetes pregestacional

La diabetes es la complicación metabólica más frecuente durante el embarazo y con mayor impacto sobre la gestación y los resultados perinatales. La evolución de la diabetes tipo 1 durante el embarazo se asocia a importantes cambios de requerimientos de insulina y un control inadecuado se relaciona con el incremento de complicaciones maternofetales. El objetivo es describir el control glucémico y las complicaciones metabólicas, obstétricas y fetales asociadas a la diabetes tipo 1 pregestacional (DM1) en una cohorte de DM1 en seguimiento en la consulta pregestacional en tratamiento con múltiples dosis de insulina (MDI) o sistemas de infusión subcutánea de insulina (ISCI) y las modificaciones de los requerimientos de insulina durante el embarazo. Se ha realizado un estudio retrospectivo en todas las mujeres gestantes con DM1 atendidas durante el periodo 2010-2018 en consulta pregestacional en tratamiento con ISCI o MDI. Se recogieron datos del control glucémico, modificaciones de requerimientos de insulina y perinatales en la consulta pregestacional y de manera semanal a lo largo de la gestación. Se recogieron datos de los resultados perinatales al inicio, trimestralmente y tras el parto. Entre 2010-2018 fueron atendidas 39 gestantes con DM1. La HbA1c media previa al embarazo fue de 7,30% [DS 1,29], disminuyendo hasta HbA1c 6,30% [DS 0,65] previo al parto; (p<0,001). Ninguna paciente precisó ingreso por descompensaciones agudas glucémicas. Se evidenció polihidramnios en un 2,6 %, preeclampsia en el 20,5 % y el 29,2 % presentaron infecciones genitourinarias. En la descendencia un 33,3 % presentaron macrosomía, 10,3 % retraso del crecimiento intrauterino (CIR), 42,4 % hipoglucemia, y el 6,1 % hipocalcemia. Al comparar aquellas mujeres en tratamiento con MDI e ISCI se observó un mayor porcentaje de CIR (25% vs 0%, p<0,05) y preeclampsia (37,5 % vs 9,5%, p= 0,05) en aquellas tratadas con ISCI. También se observó una tendencia a presentar un menor nivel de HbA1c en el subgrupo en tratamiento con ISCI al inicio (7,0 DS 1,3 vs 7,5 DS 1,3; p =0,11) y durante el primer trimestre de gestación (6,6 DS 0,9 vs 7,2 DS 1,2; p= 0 ,09), y una posterior equiparación durante el segundo y tercer trimestre. De las 18 gestantes con DM1 en tratamiento con ISCI, el número de autocontroles capilares medio/día y el uso de bolus de rescate (bolus ayuda) fue de 7,1 [DS 1,3] y 5,2 [DS 0,9]/día durante la gestación frente a 4,1 [DS 1,1] y 3,5 [DS 1,1] durante el periodo pregestacional, respectivamente (p<0,05). En el análisis de los requerimientos durante el embarazo por periodos se observó un incremento de los requerimientos de insulina totales y por kilo de peso de la 1ª a 10ª semana (S) de gestación, posterior descenso de la semana 11ª a la 18ª, y un posterior incremento a partir de la semana 18ª hasta el parto (p<0,001) Al comparar los requerimientos de insulina durante las 37 semanas de gestación y pregestacional, aquellas mujeres con recién nacidos macrosómicos mostraban una tendencia a presentar mayores requerimientos de insulina totales y por kilo de peso durante toda la gestación de manera paralela, sin encontrarse diferencias en la glucemia media, desviación estándar, ni en porcentaje de glucemias por encima o por debajo del objetivo (70-140 mg/dl) o en la programación ISCI. Como conclusión, la tasa de complicaciones materno-fetales sigue siendo elevada en la población evaluada a pesar de un buen control metabólico global; si bien los resultados son semejantes a otras series publicadas. Existe una correlación entre el control metabólico y la disminución de eventos perinatales, por lo que es preciso una intervención multidisciplinar en el manejo de la Diabetes mellitus tipo 1. En la comparación del tratamiento de ISCI frente a MDI, en las gestantes tratadas con ISCI a pesar de una HbA1c mejor al inicio del embarazo, estas diferencias se van atenuando hasta igualarse a lo largo del segundo y tercer trimestre del embarazo. Los requerimientos de insulina durante la gestación en DM1 en tratamiento con ISCI se modifican de manera dinámica y paralela en tres periodos diferenciados, de manera independiente a los resultados neonatales posteriores.Grado en Medicin

Integral field optical spectroscopy of a representative sample of ULIRGs: II. Two-dimensional kpc-scale extinction structure

We investigate the two-dimensional kpc-scale structure of the extinction in a representative sample of local ULIRGs using the Halpha/Hbeta line ratio.We use optical integral field spectroscopy obtained with the INTEGRAL instrument at the William Herschel Telescope. Complementary optical and near-IR high angular resolution HST images have also been used. The extinction exhibits a very complex and patchy structure in ULIRGs on kpc scales, from basically transparent regions to others deeply embedded in dust (Av~0.0 to Av~8.0 mag). Nuclear extinction covers a broad range in Av from 0.6 to 6 mag, 69% of the nuclei having Av>2.0 mag. Extinction in the external regions is substantially lower than in the nuclei with 64% of the ULIRGs in the sample having median Av of less than 2 mag for the entire galaxy. While post-coalescence nuclei tend to cluster around Av values of 2 to 3 mag, pre-coalescence nuclei appear more homogeneously distributed over the entire 0.4 mag <Av< 7.7 mag range. For the average extinction (Av~2.0 derived for the ULIRGs of the sample, the ratio of the de-reddened to observed SFR values is 6. The extinction-corrected, Halpha-based SFR ranges from 10 to 300 Msun/yr. For only 28% of the cases the de-reddened SFR is <20 Msun/yr, whereas for the observed SFR this percentage increases to 72%. The IR-based SFR is always higher than the optical-based one, with differences ranging from about 2 to up to 30. The nuclear observed SFR has an average contribution to the total one of 16% for the entire sample. Once corrected for extinction, the average value becomes 31%. Because of mostly extinction effects, the optical (I-band) half-light radius in the sample galaxies is on average a factor 2.3 larger than the corresponding near-IR (H-band) value.Comment: To appear in A&

The Performance of the Magneto-Impedance Effect for the Detection of Superparamagnetic Particles

The performance of magneto-impedance sensors to detect the presence and concentration of magnetic nanoparticles is investigated, using finite element calculations to directly solve Maxwell&rsquo;s equations. In the case of superparamagnetic particles that are not sufficiently magnetized by an external field, it is assumed that the sensitivity of the magneto-impedance sensor to the presence of magnetic nanoparticles comes from the influence of their magnetic permeability on the sensor impedance, and not from the stray magnetic field that the particles produce. The results obtained not only justify this hypothesis, but also provide an explanation for the discrepancies found in the literature about the response of magneto-impedance sensors to the presence of magnetic nanoparticles, where some authors report an increasing magneto-impedance signal when the concentration of magnetic nanoparticles is increased, while others report a decreasing tendency. Additionally, it is demonstrated that sensors with lower magneto-impedance response display larger sensitivities to the presence of magnetic nanoparticles, indicating that the use of plain, nonmagnetic conductors as sensing materials can be beneficial, at least in the case of superparamagnetic particles insufficiently magnetized in an external magnetic field.This work is supported by the Spanish government (Project: MAT2017-83632-C3) and by the Basque government under grants KK-2019/00101 and IT1245-19

Asymmetrical structure of ionization and kinematics in the Seyfert galaxy NGC 5033

We present integral field spectroscopy of NGC 5033, a low luminosity Seyfert galaxy. The observations were made with INTEGRAL, a fiber based system operating at the WHT. The intensity map of the H$\beta$ emission line represents a spiral or ring-like pattern of HII regions. On the contrary, the [OIII] intensity map morphology is markedly anisotropic. The strong morphological differences imply that the [OIII] emitters represent highly ionized gas illuminated by the central source. The [OIII] map morphology is compatible with a biconical structure of ionization induced by strong extinction in the galaxy disc that also obscures half of the spheroidal stellar bulge. We identify the spectrum corresponding to the Seyfert 1 nucleus from the presence of H$\beta$ broad emission lines. This spectrum is located in a region where strong extinction is expected but exhibits the bluest spectral energy distribution. The Seyfert 1 nucleus seems to be offcenter with respect to the stellar rotation center. This result has been also found in other Seyfert galaxies and interpreted in terms of a past merger. The offcentering could indicate the presence of nonsymmetric departures in the gravitational potential which could be fueling the active nucleus. The kinematics of the [OIII] emitters show important deviations at a kpc scale with respect to the stellar velocity field and show features related to the asymmetrical morphology of the high ionization region.Comment: 9 pages, accepted for publication in Astronomy and Astrophysics. Figures 1 and 7 are attached as .gif file

Integral field optical spectroscopy of a representative sample of ULIRGs: I. The Data

We present a project aimed at studying the structure, dust distribution, ionization state, and kinematics of a representative sample of 22 ULIRGs. The galaxies in the sample undergo different merger phases (they are evenly divided between pre- and post-coalescence systems) and ionization stages (27% HII, 32% LINER, 18% Seyfert, and 23% mixed classifications) over a wide infrared luminosity range (11.8<Lir/Lsun<12.6), which also includes some galaxies of low luminosity. The main aims of this paper are to present the sample and discuss the structure of the stellar and ionized gas components. Our results imply that evolution caused by a merger is occurring in the ionized gas structure of ULIRGs. The present study relies on the use of integral field optical spectroscopy data obtained with the INTEGRAL instrument at the 4.2 m William Herschel Telescope.Comment: To appear in A&A. Paper with higher quality images can be found at http://hera.ph1.uni-koeln.de/ftpspace/maca/Catalog

Non-circular motion evidences in the circumnuclear region of M100 (NGC 4321)

We analyse new integral field spectroscopy of the inner region (central 2.5 kpc) of the spiral galaxy NGC 4321 to study the peculiar kinematics of this region. Fourier analysis of the velocity residuals obtained by subtracting an axisymmetric rotation model from the $\rm H\alpha$ velocity field, indicates that the distortions are {\em global} features generated by an $m=2$ perturbation of the gravitational potential which can be explained by the nuclear bar. This bar has been previously observed in the near-infrared but not in the optical continuum dominated by star formation. We detect the optical counterpart of this bar in the 2D distribution of the old stellar population (inferred from the equivalent width map of the stellar absorption lines). We apply the Tremaine--Weinberg method to the stellar velocity field to calculate the pattern speed of the inner bar, obtaining a value of $\Omega_b$=160$\pm70\rm km s^{-1} kpc^{-1}$. This value is considerably la rger than the one obtained when a simple bar model is considered. However the uncertainties in the pattern speed determination prevent us to give support to alternative scenarios.Comment: 11 pages, 11 figures, accepted for publication in MNRA

The benefits of CLIL instruction in Spanish students’ productive vocabulary knowledge

Este artículo pretende (i) analizar el vocabulario productivo de 101 estudiantes españoles de inglés como lengua extranjera de 4º de ESO en dos centros de educación secundaria situados en el norte de España en dos tipos de instrucción AICLE y no-AICLE y (ii) comparar los resultados obtenidos por los participantes de acuerdo con su sexo. Para medir el vocabulario productivo de los estudiantes se utilizó la versión paralela del Productive Vocabulary Levels Test (PVLT) (Laufer & Nation, 1995, 1999). Los resultados muestran que los alumnos AICLE obtienen puntuaciones significativamente mejores que sus compañeros no-AICLE siendo el tamaño del vocabulario productivo en ambos grupos inferior a 1000 palabras. En lo que respecta a las diferencias en cuanto al sexo no se constatan diferencias significativas entre los chicos y las chicas. Estos resultados parecen indicar que el enfoque AICLE resulta beneficioso para el aprendizaje del vocabulario productivo en una lengua extranjera.This paper aims at (i) investigating the productive vocabulary knowledge of 101 10th grade (4 th ESO) EFL Spanish students in two different types of instruction CLIL and non-CLIL, and (ii) analysing the results obtained according to sex-based differences among the participants. We used the parallel version of the Productive Vocabulary Levels Test (PVLT) (Laufer & Nation, 1995, 1999) to measure students’ productive vocabulary knowledge. Our results reveal that our CLIL sample obtained significantly better results than their non-CLIL partners, and the students’ productive vocabulary size ranks below 1,000 words. As for sex-based differences, CLIL boys’ mean scores are the highest, but the differences between both sexes, regardless of their type of instruction, are not statistically significant. These findings led us to belie

Diseño y acondicionamiento acústico y electroacústico de una sala de proyecciones en 3D

Este proyecto está orientado al diseño y el acondicionamiento de una sala de cine siguiendo las normas establecidas por el SMPTE. El primer paso a realizar será el diseño de la sala en el cual habrá que tener en cuenta la distribución de los asientos dentro de la misma, el dimensionado de la pantalla que servirá para establecer la forma y dimensiones del recinto, así como la correcta ubicación del proyector. Posteriormente se realizará el acondicionamiento acústico del cine, con la elección de los diferentes materiales que permitan la obtención de un tiempo de reverberación óptimo. A continuación se procederá a la selección de los equipos electroacústicos más adecuados y a su colocación a lo largo de la sala para posteriormente realizar un estudio de todos los parámetros de esta para garantizar la perfecta escucha dentro de la misma. Se elegirán, al igual que se ha hecho con los elementos electroacústicos, los equipos de video específicos, teniendo en cuenta el sistema de proyección 3D utilizado y se procederá a su instalación dentro de la sala. Se indicará de forma independiente cual será el esquema de conexionado correspondiente a cada una de las partes, tanto de audio como de video. Todos los equipos y parámetros ajustables de la sala, tanto de audio como de video, se realizaran siguiendo las recomendaciones establecidas por el SMPTE para una correcta visión y escucha, así como también el diseño de la sala. Para llevar a cabo todo lo anteriormente descrito se utilizara el programa de simulación EASE 4.3 con él que se ajustaran los parámetros más significativos para verificar que la sala cumple con las condiciones de escucha que determina la norma. Todo esto irá acompañado de un presupuesto detallado de cada uno de los equipos y materiales utilizados, así como de los costes derivados de la mano de obra. Se adjuntarán también los planos de la sala donde se indicarán todas las medidas establecidas a lo largo del proyecto. Para la realización de estos se utilizara el programa de diseño Google SkechUp. Por último se facilitarán las hojas de características de cada uno de los equipos instalados en la sala para conocer sus especificaciones y modo de funcionamiento. Abstract This project is orientated at designing and conditioning a cinema according to standards set by the SMPTE. First of all, the cinema hall needs to be designed, taking into consideration seat distribution and screen dimension, in order to establish the shape and dimensions of the room and the correct location for the projector. Later the acoustic conditioning of the cinema is covered, with the choice of appropriate materials in order to permit an optimum reverberation time. The next step is the selection of the most appropriate electro-acoustic equipment and its positioning throughout the room. A study is then carried out of all the parameters to ensure perfect hearing in the cinema. Then the specific video equipment is chosen, bearing in mind the 3D projection system used and is installed in the theatre. A wiring diagram is indicated for each element used, for both audio and video. All equipment and adjustable parameters of the room, both audio and video, are made according to the recommendations established by the SMPTE for correct viewing and listening, as is the design of the cinema. To carry out the steps described above the EASE 4.3 simulation program is used. This program adjusts all significant parameters to verify that the room complies with the listening conditions determined by the standard. A detailed budget is included for all equipment and materials used, as well as the labour costs. Plans of the room, showing all measurements taken during the project are indicated. This is done using the Google SkechUp program. Finally data sheets are provided for each piece of equipment installed in the room detailing specifications and operating mode

Adaptation of the Electric Machines Learning Process to the European Higher, Education Area

In this paper the basic lines of a complete teaching methodology that has been developed to adaptthe electric machines learning process to the European Higher Education Area (EHEA) arepresented. New teaching materials that are specific to Electric Machines have been created(textbooks, self-learning e-books, guidelines for achieving teamwork research, etc.). Working ingroups has been promoted, as well as problem solving and self-learning exercises, all of which areevaluated in a way that encourages students' participation. Finally, the students' learning process inthe lab has been improved by the development both of a new methodology to follow in the lab andnew workbenches with industrial machines that are easier to use and also enable the labexperiments to be automated. Finally, the first results obtained as a result of applying the proposedmethodology are presented

The determinants of international financial integration revisited: the role of networks and geographic neutrality

Over the last two decades, the degree of international financial integration has increased substantially, becoming an important area of research for many financial economists. This paper explores the determinants of the asymmetries in the international integration of banking systems. We consider an approach based on both network analysis and the concept of geographic neutrality. Our analysis focuses on the banking systems of 18 advanced economies from 1999 to 2005. Results indicate that banking integration should be assessed from the perspective of both inflows and outflows, given that they show different patterns for different countries. The parametric techniques point out the remarkable role of both geographic distance and trade integration. However, the most relevant results are yielded by nonparametric techniques, which we use due to the lack of well-established results on the determinants of trade in assets. These techniques reveal that the effect of the covariates on banking integration is not constant over the conditional distribution which (in practical terms) implies that the sign of the relationship varies across countries