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

Effectiveness of Mechanical Horse-Riding Simulators on Postural Balance in Neurological Rehabilitation: Systematic Review and Meta-Analysis

Mechanical horse-riding simulators consist of a device that mimics the movement of a real horse, generating between 50 and 100 three-dimensional physical movements (forward and back, left and right, up and down). The main objective of this study is to analyze the effectiveness of mechanical horse-riding simulators to improve postural balance in subjects with neurological disorders. The search was conducted during January-March 2019 in PubMed, Physiotherapy Evidence Database (PEDro), Cochrane, Web of Science, CINAHL, and Scopus. The methodological quality of the studies was evaluated through the PEDro scale. A total of seven articles were included in this systematic review, of which four contributed information to the meta-analysis. Statistical analysis showed favorable results for balance in stroke patients, measured by the Berg Balance Scale (standardized mean difference (SMD) = 3.24; 95%; confidence interval (CI): 1.66-4.83). Not conclusive results were found in sitting postural balance, measured using the Gross Motor Function Measure-66 (GMFM-66) Sitting Dimension, in patients with cerebral palsy. Most studies have shown beneficial effects on postural balance compared with conventional physical therapy. However, due to the limited number of articles and their low methodological quality, no solid conclusions can be drawn about the effectiveness of this therapy

Effectiveness of Mechanical Horse-Riding Simulators on Postural Balance in Neurological Rehabilitation: Systematic Review and Meta-Analysis

Mechanical horse-riding simulators consist of a device that mimics the movement of a real horse, generating between 50 and 100 three-dimensional physical movements (forward and back, left and right, up and down). The main objective of this study is to analyze the effectiveness of mechanical horse-riding simulators to improve postural balance in subjects with neurological disorders. The search was conducted during January-March 2019 in PubMed, Physiotherapy Evidence Database (PEDro), Cochrane, Web of Science, CINAHL, and Scopus. The methodological quality of the studies was evaluated through the PEDro scale. A total of seven articles were included in this systematic review, of which four contributed information to the meta-analysis. Statistical analysis showed favorable results for balance in stroke patients, measured by the Berg Balance Scale (standardized mean difference (SMD) = 3.24; 95%; confidence interval (CI): 1.66-4.83). Not conclusive results were found in sitting postural balance, measured using the Gross Motor Function Measure-66 (GMFM-66) Sitting Dimension, in patients with cerebral palsy. Most studies have shown beneficial effects on postural balance compared with conventional physical therapy. However, due to the limited number of articles and their low methodological quality, no solid conclusions can be drawn about the effectiveness of this therapy

Lesson from the habitat suitability models to evaluate the environmental of Pinus nigra Arnold and Pinus sylvesris L. in the Iberian Peninsula

PREDICT POTENTIAL DISTRIBUTION. Spatial and temporal evolution of the species under different climate scenarios. Generation of habitat suitability models (HSM) high degree of uncertainty and limitations. The importance of their validation has been stressed. In this work we discuss the present potential distribution of P. sylvestris and P. nigra in the Iberian Peninsula by using MaxEnt, and evaluate the influence of the different environmental variables. Our intention is to select a set of environmental variables that explains better their current distribution, to achieve the most accurate and reliable models. Then we project them to the past climatic conditions (21 to 0 kyrs BP), to evaluate the outputs with existing palaeo-ecological data

Time dependence of breakdown in a global fiber-bundle model with continuous damage

A time-dependent global fiber-bundle model of fracture with continuous damage is formulated in terms of a set of coupled non-linear differential equations. A first integral of this set is analytically obtained. The time evolution of the system is studied by applying a discrete probabilistic method. Several results are discussed emphasizing their differences with the standard time-dependent model. The results obtained show that with this simple model a variety of experimental observations can be qualitatively reproduced.Comment: APS style, two columns, 4 figures. To appear in Phys. Rev.

Time evolution of damage under variable ranges of load transfer

We study the time evolution of damage in a fiber bundle model in which the range of interaction of fibers varies through an adjustable stress transfer function recently introduced. We find that the lifetime of the material exhibits a crossover from mean field to short range behavior as in the static case. Numerical calculations showed that the value at which the transition takes place depends on the system's disorder. Finally, we have performed a microscopic analysis of the failure process. Our results confirm that the growth dynamics of the largest crack is radically different in the two limiting regimes of load transfer during the first stages of breaking.Comment: 8 pages, 7 figures, revtex4 styl

Assessing the effects of complexity in cross-temporal transferability of species distribution modelling predictions using palaeobotanical data

Valoración de la transferencia temporal de los modelos de distribución de especies para su aplicación en nuestros días utilizando datos paleobotánicos Corilus avellana y Alnus glutinosa

Bursts in a fiber bundle model with continuous damage

We study the constitutive behaviour, the damage process, and the properties of bursts in the continuous damage fiber bundle model introduced recently. Depending on its two parameters, the model provides various types of constitutive behaviours including also macroscopic plasticity. Analytic results are obtained to characterize the damage process along the plastic plateau under strain controlled loading, furthermore, for stress controlled experiments we develop a simulation technique and explore numerically the distribution of bursts of fiber breaks assuming infinite range of interaction. Simulations revealed that under certain conditions power law distribution of bursts arises with an exponent significantly different from the mean field exponent 5/2. A phase diagram of the model characterizing the possible burst distributions is constructed.Comment: 9 pages, 11 figures, APS style, submitted for publicatio