Diabetes gestacional : el rol del ejercicio físico en su prevención

Introducción. La prevalencia de la Diabetes Gestacional (DG) varía en todo el mundo, así como entre los grupos raciales y étnicos del mismo país. Hasta la fecha actual, no se ha llegado a un consenso en el criterio diagnóstico, y eso dificulta una estimación veraz de prevalencia entre países. A pesar de ello, es ineludible obviar el incremento en la incidencia de esta complicación en todo el mundo, y la trascendencia de sus riesgos a la salud pública. En España, según los criterios clásicos –del National Diabetes Data Group- existe una alta prevalencia en un 8,8 % de DG en gestantes. Es importante encontrar la mejor vía para la prevención de la DG y, uno de los factores de riesgo parece ser el aumento excesivo de peso durante el embarazo. El ejercicio es un elemento fundamental para el control del metabolismo de la glucosa y para reducir los niveles de hiperlipidemia. Sin embargo, existe controversia para definir el tipo de sesiones, duración e intensidad que puedan contribuir a su prevención. Objetivo. Conocer en qué medida el ejercicio físico programado durante el embarazo, combinado en agua y tierra, con ejercicios aeróbicos y de tonificación muscular, puede actuar como un factor de prevención de la DG. Al mismo tiempo, valorar si exceder las recomendaciones de peso puede influir el diagnóstico de la DG. Material y Métodos. Este estudio se desarrolló mediante una colaboración entre la Universidad Politécnica de Madrid y los Servicios de Ginecología y Obstetricia del Hospital Universitario de Puerta de Hierro, el Hospital Universitario de Torrelodones y el Centro de Salud de Torrelodones. Se obtuvo la aprobación del Comité Ético de Investigación Clínica (CEIC). Se realizó un ensayo clínico, aleatorizado, controlado, no enmascarado. 272 mujeres gestantes sanas dieron su consentimiento informado para la inclusión en el estudio. De las cuáles, finalmente 257 (edad= 33,2±4,4 años) fueron analizadas, 101 de ellas correspondientes al grupo intervención (GI, n=101) y 156 al grupo control (GC, n=156). El inicio del programa correspondió a la semana 10-14 del embarazo hasta el final, la 38-40. Con una frecuencia de 3 sesiones semanales y una duración de 60 y 50 minutos, en tierra y agua, respectivamente. Resultados. Se halló diferencias significativas en los valores en los 180 min del test de tolerancia oral a la glucosa [GI: 98,00±29,48 mg/dl vs. GC: 116,25±29,90 mg/dl (t64= 2,37; p= 0,021)] y, de igual modo, el GI mostró menor prevalencia de la DG [GI: 1 %, Ejercicio y DG n= 1 vs. GC: 8,8 %, n= 13 (2 1= 6,84; p= 0,009)] y una estimación de riesgo significativa (OR= 9,604; 95 % CI: 1,23-74,66). La excesiva ganancia de peso fue menor en el GI [GI: 22,8 %, n= 23 vs. GC: 34,9 %, n= 53 (2 1= 4,22; p= 0,040)], pero no existió una correlación con la incidencia de DG (ϕ= -0,007; p= 0,910). Conclusiones. El programa de ejercicio desarrollado durante el embarazo mostró efectividad en la reducción de la prevalencia de la DG, preservó la tolerancia a la glucosa y redujo la excesiva ganancia de peso materno. Background. The prevalence of Gestational Diabetes (GD) varies around the world, as well as between racial and ethnic groups within the same country. Currently, there is not a consensus about the diagnostic criteria, and that makes it difficult to obtain accurate estimates of prevalence between countries. The increased trend in the prevalence across the globe and the risks for public health cannot be ignored. In Spain, according to the diagnostic criteria of National Diabetes Data Group, there is a prevalence of 8.8 % for GD in pregnant women. It is important to look for the best way to prevent GD and one of the risk factors seems to be excessive weight gained during pregnancy. Exercise is an essential element for glucose metabolic control and reducing hyperlipidemia levels. However, there is controversy to define the type of activity, duration and intensity to prevent GD. Objective. To assess the effectiveness of an exercise programme carried out during pregnancy (land/aquatic activities), both aerobic and muscular conditioning can help to the prevent GD. Also, to assess if excessive maternal weight gain influences the GD diagnosis. Material and methods. Collaboration between the Technical University of Madrid and the Gynecology and Obstetrics Department of Puerta de Hierro University Hospital, Torrelodones University Hospital and Health Center of Torrelodones supported the study. It was approved by the Clinical Research Ethics Committee (CEIC). A clinical, randomized controlled trial recruited 272 pregnant women without obstetric contraindications and gave informed consent for inclusion in the study. Of these women, 257 were studied (age= 33,2±4,4 years), 101 in intervention group (IG, n= 101) and 156 in control group (CG, n= 156). A physical exercise program three times per week during pregnancy was developed. The duration of the sessions was 60 minutes and 50 minutes in land and water, respectively. Results. The IG showed lower maternal values in the Oral Glucose Tolerance Test (OGTT) at 180 minutes [IG: 98,00±29,48 mg/dl vs. CG: 116,25±29,90 mg/dl (t64= 2,37; p= 0,021)] and the IG reduced the prevalence of GD [IG: 1%, n= 1 vs. CG: 8,8 %, n= 13 (2 1= 6,84; p= 0,009)] with a significance risk estimate (OR= 9,604; 95 % CI: 1,23- 74,66). Excessive maternal weight gain was less in the IG [IG: 22,8 %, n= 23 vs. CG: Exercise and GD 34,9 %, n= 53 (2 1= 4,22; p= 0,040)] but there was no correlation with the prevalence of GD (ϕ= -0,007; p= 0,910). Conclusions. The exercise programme performed during pregnancy reduced the prevalence of GD, preserved glucose tolerance and reduced excessive maternal weight gain.

Adaptaciones cardiacas hemodinámicas, estructurales y funcionales a un programa de ejercicio físico supervisado durante el embarazo: ensayo clínico aleatorizado = Hemodynamic, structural and functional cardiac adaptations in a supervised physical exercise program during pregnancy: a randomized controlled trial

Introducción: Diversos cambios ocurren en el sistema cardiovascular materno durante el embarazo, lo que genera un gran estrés sobre este sistema especialmente durante el tercer trimestre, pudiendo acentuarse en presencia de determinados factores de riesgo. Los objetivos de este estudio fueron, valorar las adaptaciones cardiovasculares producidas por un programa específico de ejercicio físico; su seguridad sobre el sistema cardiovascular materno y los resultados del embarazo; y su eficacia en el control de los factores de riesgo cardiovascular. Material y métodos: El diseño del estudio fue un ensayo clínico aleatorizado. 151 gestantes sanas fueron evaluadas mediante un ecocardiograma y un electrocardiograma en la semana 20 y 34 de gestación. Un total de 89 gestantes participaron en un programa de ejercicio físico (GE) desde el primer hasta el tercer trimestre de embarazo, constituido principalmente por 25-30 minutos de trabajo aeróbico (55-60% de la frecuencia cardiaca de reserva), trabajo de fortalecimiento general y específico, y un trabajo de tonificación del suelo pélvico; desarrollado 3 días a la semana con una duración de 55-60 minutos cada sesión. Las gestantes aleatoriamente asignadas al grupo de control (GC; n=62) permanecieron sedentarias durante el embarazo. El estudio fue aprobado por el Comité Ético de investigación clínica del Hospital Universitario de Fuenlabrada. Resultados: Las características basales fueron similares entre ambos grupos. A diferencia del GC, las gestantes del GE evitaron el descenso significativo del gasto cardiaco indexado, entre el 2º y 3ºT de embarazo, y conservaron el patrón geométrico normal del ventrículo izquierdo; mientras que en el GC cambió hacia un patrón de remodelado concéntrico. En la semana 20, las gestantes del GE presentaron valores significativamente menores de frecuencia cardiaca (GC: 79,56±10,76 vs. GE: 76,05±9,34; p=0,04), tensión arterial sistólica (GC: 110,19±10,23 vs. GE: 106,04±12,06; p=0,03); tensión arterial diastólica (GC: 64,56±7,88 vs. GE: 61,81±7,15; p=0,03); tiempo de relajación isovolumétrica (GC: 72,94±14,71 vs. GE: 67,05±16,48; p=0,04); y un mayor tiempo de deceleración de la onda E (GC: 142,09±39,11 vs. GE: 162,10±48,59; p=0,01). En la semana 34, el GE presentó valores significativamente superiores de volumen sistólico (GC: 51,13±11,85 vs. GE: 56,21±12,79 p=0,04), de llenado temprano del ventrículo izquierdo (E) (GC: 78,38±14,07 vs. GE: 85,30±16,62; p=0,02) y de tiempo de deceleración de la onda E (GC: 130,35±37,11 vs. GE: 146,61±43,40; p=0,04). Conclusión: La práctica regular de ejercicio físico durante el embarazo puede producir adaptaciones positivas sobre el sistema cardiovascular materno durante el tercer trimestre de embarazo, además de ayudar en el control de sus factores de riesgo, sin alterar la salud materno-fetal. ABSTRACT Background: Several changes occur in the maternal cardiovascular system during pregnancy. These changes produce a considerable stress in this system, especially during the third trimester, which can be increased in presence of some risk factors. The aims of this study were, to assess the maternal cardiac adaptations in a specific exercise program; its safety on the maternal cardiovascular system and pregnancy outcomes; and its effectiveness in the control of cardiovascular risk factors. Material and methods: A randomized controlled trial was designed. 151 healthy pregnant women were assessed by an echocardiography and electrocardiography at 20 and 34 weeks of gestation. A total of 89 pregnant women participated in a physical exercise program (EG) from the first to the third trimester of pregnancy. It consisted of 25-30 minutes of aerobic conditioning (55-60% of their heart rate reserve), general and specific strength exercises, and a pelvic floor muscles training; 3 times per weeks during 55-60 minutes per session. Pregnant women randomized allocated to the control group (CG) remained sedentary during pregnancy. The study was approved by the Research Ethics Committee of Hospital Universitario de Fuenlabrada. Results: Baseline characteristics were similar between groups. Difference from the CG, pregnant women from the EG prevented the significant decrease of the cardiac output index, between the 2nd and 3rd trimester of pregnancy, and preserved the normal left ventricular pattern; whereas in the CG shifted to concentric remodeling pattern. At 20 weeks, women in the EG had significant lower heart rate (CG: 79,56±10,76 vs. EG: 76,05±9,34; p=0,04), systolic blood pressure (CG: 110,19±10,23 vs. EG: 106,04±12,06; p=0,03); diastolic blood pressure (CG: 64,56±7,88 vs. EG: 61,81±7,15; p=0,03); isovolumetric relaxation time (GC: 72,94±14,71 vs. GE: 67,05±16,48; p=0,04); and a higher deceleration time of E Wave (GC: 142,09±39,11 vs. GE: 162,10±48,59; p=0,01). At 34 weeks, the EG had a significant higher stroke volume (CG: 51,13±11,85 vs. EG: 56,21±12,79 p=0,04), early filling of left ventricular (E) (CG: 78,38±14,07 vs. EG: 85,30±16,62; p=0,02) and deceleration time of E wave (CG: 130,35±37,11 vs. EG:146,61±43,40; p=0,04). Conclusion: Physical regular exercise program during pregnancy may produce positive maternal cardiovascular adaptations during the third trimester of pregnancy. In addition, it helps to control the cardiovascular risk factors without altering maternal and fetus health.

In situ acoustic methods to estimate the physical and mechanical aging of oriented strand board

Following the success achieved in previous research projects usin non-destructive methods to estimate the physical and mechanical aging of particle and fibre boards, this paper studies the relationships between aging, physical and mechanical changes, using non-destructive measurements of oriented strand board (OSB). 184 pieces of OSB board from a French source were tested to analyze its actual physical and mechanical properties. The same properties were estimated using acoustic non-destructive methods (ultrasound and stress wave velocity) during a physical laboratory aging test. Measurements were recorded of propagation wave velocity with the sensors aligned, edge to edge, and forming an angle of 45 degrees, with both sensors on the same face of the board. This is because aligned measures are not possible on site. The velocity results are always higher in 45 degree measurements. Given the results of statistical analysis, it can be concluded that there is a strong relationship between acoustic measurements and the decline in physical and mechanical properties of the panels due to aging. The authors propose several models to estimate the physical and mechanical properties of board, as well as their degree of aging. The best results are obtained using ultrasound, although the difference in comparison with the stress wave method is not very significant. A reliable prediction of the degree of deterioration (aging) of board is presented.

Energy/power consumption model for an embedded processor board

This dissertation, whose research has been conducted at the Group of Electronic and Microelectronic Design (GDEM) within the framework of the project Power Consumption Control in Multimedia Terminals (PCCMUTE), focuses on the development of an energy estimation model for the battery-powered embedded processor board. The main objectives and contributions of the work are summarized as follows: A model is proposed to obtain the accurate energy estimation results based on the linear correlation between the performance monitoring counters (PMCs) and energy consumption. the uniqueness of the appropriate PMCs for each different system, the modeling methodology is improved to obtain stable accuracies with slight variations among multiple scenarios and to be repeatable in other systems. It includes two steps: the former, the PMC-filter, to identify the most proper set among the available PMCs of a system and the latter, the k-fold cross validation method, to avoid the bias during the model training stage. The methodology is implemented on a commercial embedded board running the 2.6.34 Linux kernel and the PAPI, a cross-platform interface to configure and access PMCs. The results show that the methodology is able to keep a good stability in different scenarios and provide robust estimation results with the average relative error being less than 5%. Este trabajo fin de máster, cuya investigación se ha desarrollado en el Grupo de Diseño Electrónico y Microelectrónico (GDEM) en el marco del proyecto PccMuTe, se centra en el desarrollo de un modelo de estimación de energía para un sistema empotrado alimentado por batería. Los objetivos principales y las contribuciones de esta tesis se resumen como sigue: Se propone un modelo para obtener estimaciones precisas del consumo de energía de un sistema empotrado. El modelo se basa en la correlación lineal entre los valores de los contadores de prestaciones y el consumo de energía. Considerando la particularidad de los contadores de prestaciones en cada sistema, la metodología de modelado se ha mejorado para obtener precisiones estables, con ligeras variaciones entre escenarios múltiples y para replicar los resultados en diferentes sistemas. La metodología incluye dos etapas: la primera, filtrado-PMC, que consiste en identificar el conjunto más apropiado de contadores de prestaciones de entre los disponibles en un sistema y la segunda, el método de validación cruzada de K iteraciones, cuyo fin es evitar los sesgos durante la fase de entrenamiento. La metodología se implementa en un sistema empotrado que ejecuta el kernel 2.6.34 de Linux y PAPI, un interfaz multiplataforma para configurar y acceder a los contadores. Los resultados muestran que esta metodología consigue una buena estabilidad en diferentes escenarios y proporciona unos resultados robustos de estimación con un error medio relativo inferior al 5%.

Integration of research advances in modelling and monitoring in support of WFD river basin management planning in the context of climate change

The integration of scientific knowledge about possible climate change impacts on water resources has a direct implication on the way water policies are being implemented and evolving. This is particularly true regarding various technical steps embedded into the EU Water Framework Directive river basin management planning, such as risk characterisation, monitoring, design and implementation of action programmes and evaluation of the "good status" objective achievements (in 2015). The need to incorporate climate change considerations into the implementation of EU water policy is currently discussed with a wide range of experts and stakeholders at EU level. Research trends are also on-going, striving to support policy developments and examining how scientific findings and recommendations could be best taken on board by policy-makers and water managers within the forthcoming years. This paper provides a snapshot of policy discussions about climate change in the context of the WFD river basin management planning and specific advancements of related EU-funded research projects. Perspectives for strengthening links among the scientific and policy-making communities in this area are also highlighted.

Motivating young students to be part of the global research in nuclear through the Seminar of Nuclear Fusion

Jóvenes Nucleares (Spanish Young Generation in Nuclear, JJNN) is a non-profit organization that depends on the Spanish Nuclear Society (SNE). The Universidad Politécnica de Madrid (Technical University of Madrid, UPM) was chosen to host the Seminar as it is one of the most prestigious technical universities of Spain, and has a very strong curriculum in nuclear engineering training and research. Both, the UPM and the SNE, supported strongly the seminar: the opening session was conducted by the member of to board of directors of the Spanish Nuclear Society and Nuclear Engineering professor of the UPM, Emilio Mínguez and the closing session was conducted by the director of the Nuclear Fusion Institute (UPM).

Ethics and materials. Some Spanish Case Studies

In Navea, north of Spain, a medieval arch bridge shows a visible distortion (fig.1a). A stone falls down from the web of a gothic vault in a big parish church in Burgos (fig. 1b), and a voussoir falls down from the rib of another gothic vault in Oviedo (fig. 1c). An oval dome collapses in Zaragoza, though another four identical domes remain safe (fig. 1d). Sometimes the building has to support new, heavier loads. The ruin of the abandoned (since the 19th Century) monastery of Melón should be consolidated, some vaults are rebuilt and the visitors can walk over them. A Franciscan Convent is going to be turned into a Cultural Centre, the loads to be supported being multiplied by a factor of two. A little medieval bridge is asked to support the pass of heavy lorries. These are some of the cases I have studied in the last two decades, all of them referring to questions of structural safety. These are the kind of situations which often occurs in the field of Historic Structures. They require a study and an answer. This is no scholarly work (though in some cases new lines of future research will emerge). A judgement must be made by the expert and this judgement affects the safety and economy, in the last instance, of people. As there are rarely unique answers, the behaviour of the expert, then, can also be judged as "ethical", if he proposes an intervention that is necessary and adequate (or, recommends no intervention, judging the situation safe), or "non-ethical", if recommends an unnecessary or disproportionate intervention. In relation to the monument, also, the proposal can be judged ethically; any intervention damaging seriously the character of the monument may be labelled un-ethical.

Business ethics: a way to identify fraud from the basics

When we look to perform a work for developing a framework to create a business and take it correctly, there are always some persons looking as a challenge those bases and finding a mistake. The way to work in these situations is not a matter of law, is a matter of devoting time to identify these situations. It is always said that the evil goes a step ahead. The business ethics have been altered for quite time by some would-be entrepreneurs. These people have learned to play with business ethics to show your business as prosperous as something that is sought to highlight and adulterate their results quickly. Once the company reaches an international dimension, many companies take on global responsibility and, in these cases where you can see if the objective has been to obtain a rapid capital increase or growth is in line with its proportions. A business ethics is based on establishing a strong base so that interest is encouraged from an early time. Good staff, organizational level should be achieved and not only at the company but, out of the company too. Thus, you can create a secure base to convince potential investors and employees about the business. There are no freeways in business ethics and all fast track can be or a genius or leads to failure. We must find where these jumps are occurring, such errors or corrections to business ethics and their rules. Thus we can differentiate a company or an entrepreneur who is working correctly from the cloaking. Starting from the basics of business ethics and studying the different levels from the personal to the prospect that the company shows in the world. Lets see where these changes are occurring and how we can fight against them and anticipate the market to possible cases of fraud or strange movements seeking to attract the unwary

Experience in spacecraft on-board software development

This paper describes some important aspects of high- integrity software development based on the authors' work. Current group research is oriented towards mixed- criticality partitioned systems, development tools, real- time kernels, and language features. The UPMSat-2 satellite software is being used as technology demonstra- tor and a case study for the assessment of the research results. The flight software that will run on the satellite is based on proven technology, such as GNAT/ORK+ and LEON3. There is an experimental version that is being built using a partitioned approach, aiming at assessing a toolset targeting partitioned multi-core em- bedded systems. The singularities of both approaches are discussed, as well as some of the tools that are being used for developing the software.