Random Generation of Arbitrary Waveforms for Emulating Three-Phase Systems

This paper describes an apparatus for generating a signal representative of steady-state and transient disturbances in three-phase waveforms of an ac electrical system as described in IEEE Std 1159-09. It can be configured as a synthesizer of randomly distorted signals for different applications: for testing the effects of disturbed grid on equipment and to generate patterns of electrical disturbances for the training of artificial neural networks, which are used for measuring power quality tasks. For the first purpose, voltage and current amplifiers are added in the output stage, which allows the generation of disturbed signals at grid level.Comisión Interministerial de Ciencia y Tecnología DPI2006-15467-C02-01Comisión Interministerial de Ciencia y Tecnología DPI2006-15467-C02-0

Electricity clustering framework for automatic classification of customer loads

Clustering in energy markets is a top topic with high significance on expert and intelligent systems. The main impact of is paper is the proposal of a new clustering framework for the automatic classification of electricity customers’ loads. An automatic selection of the clustering classification algorithm is also highlighted. Finally, new customers can be assigned to a predefined set of clusters in the classificationphase. The computation time of the proposed framework is less than that of previous classification tech- niques, which enables the processing of a complete electric company sample in a matter of minutes on a personal computer. The high accuracy of the predicted classification results verifies the performance of the clustering technique. This classification phase is of significant assistance in interpreting the results, and the simplicity of the clustering phase is sufficient to demonstrate the quality of the complete mining framework.Ministerio de Economía y Competitividad TEC2013-40767-RMinisterio de Economía y Competitividad IDI- 2015004

Indicaciones Límite de las Fracturas de Húmero con Clavo Endomedular Cerrojado

El tratamiento de las fracturas diafisarias del húmero ha entrado en controversia en los últimos años, como lo refleja la literatura internacional. La problemática aumenta cuando se trata de fracturas diafisarias límites que alcanzan la zona metafisaria superior e inferior. En un intento de mejora terapéutica este grupo de autores ha testado un clavo cerrojado para el húmero diseñado por Seidel. El promedio de seguimiento ha sido de 12 meses con un mínimo de 6 meses. El número de casos evaluados ha sido 6. Siguiendo la cotación de Stewart, 4 de los seis pacientes obtuvieron resultados buenos o excelentes. Todos los pacientes consolidaron sus fracturas en un período de tiempo normal, entre 3 y 5 meses, con una media de 4 meses, 4 de los seis pacientes no se inmovilizaron con yeso en ningún momento. La bondad y sencillez del método hace augurar buenos resultados en otros grupos ampliando sus indicaciones.Treatment of dyaphyseal fractures of the humerus has been the source of considerable controversy in recent years. The problem increases in dimension when one is dealing with limiting diaphyseal fractures that invole the upper and lower metaphyseal zone. In an attempt to improve the therapy of this circunstance, the members of this research team have tested a locking nail for the humerus designed by Seidel. The mean follow-up time has been 12 months, with a minimum of six months. The number of cases evaluated was 6. According to the scale of Stewart, four of the cases obtained good or excellent results. All the patients consolidated their fractures within a normal period of time -between 3 and 5 months-, with a mean of 4 months. Four of the 6 patients wer e not immobilized with paster at any time. The goodness and simplicity of the method are suggestive of promising results in other groups by broadening its indications

Dictamen sobre la constitucionalidad de la pena de prisión permanente revisable

En este Dictamen se examina si resulta conforme a la Constitución española la pena de prisión permanente revisable introducida en el Código penal español por la LO 1/2015 (en concreto, en los artículos 33.2.a, 35, 36, 76.1.e, 78 bis, 92, 140, 485.1, 605.1, 607.1.1º, 607.1.2º y 607 bis 2.1º, todos ellos en la redacción que les dio la LO 1/2015). Y se concluye que no es así, porque la regulación de dicha pena vulnera la prohibición de penas inhumanas (art. 15.1 CE), el derecho a la libertad, porque prevé una privación de la misma desproporcionada y ajena a criterios de culpabilidad (art. 17.1 CE), el mandato de determinación derivado del principio de legalidad penal (art. 25.1 CE), y el mandato de resocialización (art. 25.2 CE), por cuanto prácticamente restringe toda posibilidad de resocialización del condenado

Pelvic Floor Morbidity Following Vaginal Delivery versus Cesarean Delivery: Systematic Review and Meta-Analysis

Objective: To compare pelvic floor disorders between vaginal delivery (VD) and cesarean delivery (CD). Methods: For this study, a PUBMED database search was used, utilizing a combination of relevant medical subjects’ headings (MeSH) terms, with the following keywords: “Pelvic floor disorders” or “Pelvic floor morbidity” and “Delivery”. Search limits were articles in English or Spanish, about women, published from December 2009 to December 2019. The STATA 16 package was used for meta-analysis and data heterogeneity assessment. Results: Thirteen studies meeting eligibility criteria were identified comprising 1,597,303 participants. Abstract: Pelvic floor morbidity prevalence was Urinary Incontinence (UI) 27.9% (5411 patients in 7 studies with reported cases), Pelvic Organ Prolapse (POP) 14.2% (6019 patients in 8 studies with reported cases), and Anal Incontinence (AI) 0.4% (1,589,740 patients in 5 studies with reported cases). Our meta-analyses revealed significantly higher rates of all three morbidities and overall morbidity in the VD versus CD group: UI OR = 2.17, 95% CI 1.64–2.87, p for heterogeneity ≤ 0.0001, I2 = 84%; POP OR = 3.28, 95% CI 1.91–5.63, p for heterogenicity ≤ 0.043, I2 = 63%; AI OR = 1.53, 95% CI 1.32–1.77; p for heterogeneity ≤ 0.291, I2 = 20%; and overall morbidity (OR = 2.17, 95% CI 1.64–2.87; p for heterogeneity ≤ 0.0001, I2 = 84%). Conclusion: Vaginal delivery is directly related to the appearance of pelvic floor disorders, mainly UI, POP, and AI. The risk of POP should be taken into higher consideration after vaginal delivery and postpartum follow-up should be performed, to identify and/or treat it at the earliest stages

Brain-Derived Neurotrophic Factor Levels in Cord Blood from Growth Restricted Fetuses with Doppler Alteration Compared to Adequate for Gestational Age Fetuses

Background and Objectives: Fetal growth restriction (FGR) is a severe obstetric disease characterized by a low fetal size entailing a set of undesired consequences. For instance, previous studies have noticed a worrisome association between FGR with an abnormal neurodevelopment. However, the precise link between FGR and neurodevelopmental alterations are not yet fully understood yet. Brain-derived neurotrophic factor (BDNF) is a critical neurotrophin strongly implicated in neurodevelopmental and other neurological processes. In addition, serum levels of BDNF appears to be an interesting indicator of pathological pregnancies, being correlated with the neonatal brain levels. Therefore, the aim of this study is to analyze the blood levels of BDNF in the cord blood from fetuses with FGR in comparison to those with weight appropriate for gestational age (AGA). Materials and Methods: In this study, 130 subjects were recruited: 91 in group A (AGA fetuses); 39 in group B (16 FGR fetuses with exclusively middle cerebral artery (MCA) pulsatility index (PI) 95th percentile). Serum levels of BDNF were determined through ELISA reactions in these groups. Results: Our results show a significant decrease in cord blood levels of BDNF in FGR and more prominently in those with UA PI >95th percentile in comparison to AGA. FGR fetuses with exclusively decreased MCA PI below the 5th percentile also show reduced levels of BDNF than AGA, although this difference was not statistically significant. Conclusions: Overall, our study reports a potential pathophysiological link between reduced levels of BDNF and neurodevelopmental alterations in fetuses with FGR. However, further studies should be conducted in those FGR subjects with MCA PI < 5th percentile in order to understand the possible implications of BDNF in this group.Depto. de Salud Pública y Materno - InfantilFac. de MedicinaTRUEUnión EuropeaComunidad de MadridInstituto de Salud Carlos IIIHalekulani S.LFundación Santiago Dexeus Fontpu

Effects of Sex, Age and Height on Symphysis–Ischial Spine Distance Measured on a Pelvic CT

Objective: To examine the influence of age, sex and height on the symphysis–ischial spine distance (SID) measured on pelvic Computed tomography (CT)images in subjects of reproductive age, and to determine the interobserver reproducibility. This measurement (SID) is of great importance because the use of intrapartum ultrasound is based on the assumption of a specific value (30 mm) of such a measurement. Methods: This was a cross-sectional descriptive study in which SID was measured in subjects aged 20 to 44 years who had been scheduled for pelvic CT at our centre from January 2018 to May 2021 for different reasons. Radiographic measurements of the pelvis were obtained through the multiplanar reconstruction of the CT image. The images obtained from all of the participants were independently assessed by three senior radiologists, and the SID measurements made by each one were blinded from those of the remaining observers. Correlations between the SID and patient age, height and sex were analyzed by univariate and multivariate linear regression. Results: The mean SID for 87 of the enrolled participants (45 women, 42 men) was 28.2 ± 6.25 mm. Among the observers, the mean difference in this distance was 1 to 2 mm, and was scarcely related to measurement size, with agreement being greater than 70%. The mean SID was significantly related to sex and height (SID = −24.9 − 6.51 × sex (0 or 1) + 0.34 × height (cm); p = 0.01; sex equals 1 for a man and 0 for a woman), such that it was a mean of 2.5 mm greater in women than men (29.50 mm vs. 26.99 mm). Conclusion: Measurements of SID on CT images show good interobserver reproducibility, and are related to sex and height.Depto. de Salud Pública y Materno - InfantilFac. de MedicinaTRUEUnión EuropeaComunidad de MadridInstituto de Salud Carlos IIIHalekulani S.L.pu

Risk Factors in Third and Fourth Degree Perineal Tears in Women in a Tertiary Centre: An Observational Ambispective Cohort Study

Objectives: To analyze the main risk factors associated with third and fourth degree postpartum perineal tears in women attended to in our obstetrics service. Methods: An observational, retrospective, hospital cohort study was carried out in women whose deliveries were attended to in the obstetrics service of the Hospital General Universitario Gregorio Marañón de Madrid (HGUGM), during the period from January 2010 to April 2017. Results: During the study period, a total of 33,026 patients were included in the study. For maternal variables, the associated increased risk of severe perineal tearing in nulliparous women is OR = 3.48, for induced labor OR = 1.29, and for instrumental delivery by forceps OR = 4.52 or spatulas OR = 4.35; for the obstetric variable of episiotomy, it is OR = 3.41. For the neonatal variables, the weight of the newborns has a directly proportional relationship with the risk of severe tears, and for birth weights of 3000 g (OR = 2.41), 3500 g (OR = 1.97), and 4000 g (OR = 2.17), statistically significant differences were found in each of the groups (p < 0.05). Conclusion: Primiparity, induction of labor, episiotomy, instrumental delivery with forceps or spatula, and a birth weight of 3000 g or more are significantly associated with an increased risk of third and fourth degree perineal tears

Factors Associated with Failure of Bakri Balloon Tamponade for the Management of Postpartum Haemorrhage. Case Series Study and Systematic Review

Background: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Bakri balloon tamponade (BBT) is recommended when PPH does not respond to medical treatment. Nowadays few published studies have performed a multivariate analysis to determine the variables independently associated with BBT failure. Methods: Our study purpose was to determine the variables independently associated with BBT failure: first, in a large single-centre cohort study between 2010 and 2020, and second, in a systematic literature review using Medline and the Cochrane Library. Maternal and perinatal variables, PPH characteristics, technique-related variables and complications were recorded in the case series study, comparing between successful and failed BBT patients. Study characteristic and variables significantly associated with BBT failure were recorded in the systematic review. All studies used a logistic regression test. Results: The case series included 123 patients. The profile of these patients were primiparous, with vaginal delivery and a full-term new-born. BBT was successful in 81.3% of cases. Five studies were included in the systematic review, providing data from 551 patients. BBT was successful in 79.5% of cases. Conclusions: Maternal age, caesarean delivery, ≥7 red blood cells units (RBCU) transfused and curettage before BBT insertion, history of caesarean section, pre-pregnancy obesity, anteriorly placed placenta, placenta accreta, caesarean delivery, estimated blood loss before insertion of BBT, long operation duration, and coagulopathy were independent factors for BBT failure