Índice de pulsatilidad de arteria cerebral media como predictor para desenlaces desfavorables en fetos pequeños para la edad gestacional

Introducción: La aparición de vasodilatación aislada de la arteria cerebral media en fetos pequeños para la edad gestacional sin otros cambios en el doppler puede interpretarse como fisiológica o podría ser la manifestación inicial de una restricción de crecimiento intrauterino de inicio tardío. Se pretende evaluar la asociación de la disminución del índice de pulsatibilidad de la arteria cerebral media, como predictor de desenlaces perinatales adversos, en fetos con bajo peso para edad gestacional. Metodología: Se realizó un estudio de cohorte analítica de temporalidad histórica para determinar si el hallazgo de disminución de la pulsatibilidad en el doppler de arteria cerebral media se asocia con el pronóstico perinatal adverso, en fetos pequeños para edad gestacional mediante un muestreo no probabilístico. Resultados: Se recolectaron un total de 325 flujometría doppler de fetos pequeños para edad gestacional. El riesgo de parto pretérmino fue RR 2.6 IC95% 1.6-4.1, de hospitalización fue RR 1.4 IC95%1.1-1.9 y de muerte fue 2.1 IC95%1.5-3.2 cuando hay índice de pulsatilidad alterada en la arteria cerebral media. La regresión logística mostró que el riesgo de desenlaces desfavorables con alteraciones en la arteria cerebral media fue de RR 4.2 IC95% 2.5-7.1 ajustado por edad materna, edad gestacional y bajo peso al nacer. Discusión Los pacientes expuestos presentan mayor riesgo de desenlaces desfavorables con diferencias significativas, no así en otros estudios publicados. El presente estudio muestra asociaciones significativas que debe ser evaluada con estudios más amplios.

Psychometric properties of the scale NBAS applied to preterm or low birth weight

Objective: to assess, in a randomized sample of measurements made with the NBAS scale, in preterm and / or low birth weight babies, some psychometric characteristics of the same as her construct validity and internal consistency. Materials and methods: we designed a study of assessment of Psychometric properties. From a study of cross-sectional measurements, there were made assessment of the statistic behavior of the items, individually and in their internal consistency, then, there were carried out, type exploratory and confirmatory factor analysis. Results: we find that, in the analysis of preterm or low birth weight babies, the scale remains largely, the overall structure of factors proposed since 1982, in relation to the dimensions of habituation, social interactive and complementary. The items that make up the dimensions of SNA and motor systems are integrated. Also, we found Cronbach alpha values for internal consistency, which reflects higher to medium correlation levels in the behavioral and reflex items. Conclusion: the NBAS scale reflects characteristics of construct validity and internal consistency, which credits it as a useful tool in clinical assessment of neurodevelopmental effects of preterm or low birth weight babies. It is necessary to analyze the structure of the scale when used for purposes of scientific research.

Health insurance as a strategy for access : Streamlined facts of the Colombian Health Care Reform

La reforma colombiana al sistema de salud (Ley 100 de 1993) estableció, como estrategia para facilitar el acceso, la universalidad de un seguro de salud que se adquiere mediante la cotización en el régimen contributivo o mediante la afiliación gratuita al régimen subsidiado, con la meta de cubrir a toda la población con un plan de beneficios único que comprende servicios de todos los niveles de atención. En el documento se analizan los principales hechos estilizados de la reforma en cuanto a cobertura del seguro y acceso y, mediante modelos logit, se estiman los determinantes de la afiliación y del acceso, con datos de las encuestas de calidad de vida de 1997 y 2003. Se destaca que la cobertura pasó del 20% de la población en 1993 al 60% en 2004, aunque parece imposible alcanzar la universalidad; la estructura y evolución de la cobertura muestran que los dos regímenes son complementarios, de modo que mientras el contributivo tiene mayor presencia en las ciudades y entre la población con empleo formal, el subsidiado tiene mayor peso entre la población rural y con bajos niveles de ingresos; por otra parte, el seguro tiene ventajas para la población subsidiada, con una mayor probabilidad de utilización de servicios, aunque el plan es inferior al del contributivo y existen barreras para el acceso.

The language used in early mother-child interaction by very-low-birth-weight children, with a focus on the emergence of grammar. 'El lenguaje utilizado por niños con muy bajo peso al nacer en la interacción temprana entre madre e hijo, con atención especial a la aparición de la gramática'.

Resumen basado en el de la publicación. Resumen en español

Multiple perspectives on the concept of conditional probability. 'Perspectivas múltiples sobre el concepto del probabilidad condicional'

Resumen en portugués, español y francés. Resumen basado en el de la publicación

Congestion probability routing in virtual path ATM network

This dissertation focuses on the problem of providing mechanisms for routing point to point and multipoint connections in ATM networks. In general the notion of multipoint connection refers to connections that involve a group of users with more than two members. The main objective of this dissertation is to contribute to design efficient routing protocols with alterative routes in fully connected VP-based ATM Networks for call establishment of point to point and multipoint VC connections. An efficient route should be computed during this connection establishment phase.

ABR as a predictor of neurodevelopment in very low birth weight neonates

This paper discusses a study to determine whether the neonatal ABR predicts neurodevelopmental delays in low birth weight infants.

Quantification of the probability of containment failure caused by an in-vessel steam explosion for the Sizewell B PWR

AEA Technology has provided an assessment of the probability of α-mode containment failure for the Sizewell B PWR. After a preliminary review of the methodologies available it was decided to use the probabilistic approach described in the paper, based on an extension of the methodology developed by Theofanous et al. (Nucl. Sci. Eng. 97 (1987) 259–325). The input to the assessment is 12 probability distributions; the bases for the quantification of these distributions are discussed. The α-mode assessment performed for the Sizewell B PWR has demonstrated the practicality of the event-tree method with input data represented by probability distributions. The assessment itself has drawn attention to a number of topics, which may be plant and sequence dependent, and has indicated the importance of melt relocation scenarios. The α-mode failure probability following an accident that leads to core melt relocation to the lower head for the Sizewell B PWR has been assessed as a few parts in 10 000, on the basis of current information. This assessment has been the first to consider elevated pressures (6 MPa and 15 MPa) besides atmospheric pressure, but the results suggest only a modest sensitivity to system pressure.

General relationships between pressure, weight, and mass of a hydrostatic fluid

In curved geometries the hydrostatic pressure in a fluid does not equal the weight per unit area of the fluid above it. General weight–pressure and mass–pressure relationships for hydrostatic fluids in any geometry are derived. As an example of the mass–pressure relationship, we find a geometric reduction in surface pressure as large as 5 mbar on Earth and 39 mbar on Titan. We also present a thermodynamic interpretation of the geometric correction which, as a corollary, provides an independent proof of the hydrostatic relationship for general geometries.

Understanding the processes governing climate variability and change, climate predictability and the probability of extreme events

The purpose of Research Theme 4 (RT4) was to advance understanding of the basic science issues at the heart of the ENSEMBLES project, focusing on the key processes that govern climate variability and change, and that determine the predictability of climate. Particular attention was given to understanding linear and non-linear feedbacks that may lead to climate surprises,and to understanding the factors that govern the probability of extreme events. Improved understanding of these issues will contribute significantly to the quantification and reduction of uncertainty in seasonal to decadal predictions and projections of climate change. RT4 exploited the ENSEMBLES integrations (stream 1) performed in RT2A as well as undertaking its own experimentation to explore key processes within the climate system. It was working at the cutting edge of problems related to climate feedbacks, the interaction between climate variability and climate change � especially how climate change pertains to extreme events, and the predictability of the climate system on a range of time-scales. The statisticalmethodologies developed for extreme event analysis are new and state-of-the-art. The RT4-coordinated experiments, which have been conducted with six different atmospheric GCMs forced by common timeinvariant sea surface temperature (SST) and sea-ice fields (removing some sources of inter-model variability), are designed to help to understand model uncertainty (rather than scenario or initial condition uncertainty) in predictions of the response to greenhouse-gas-induced warming. RT4 links strongly with RT5 on the evaluation of the ENSEMBLES prediction system and feeds back its results to RT1 to guide improvements in the Earth system models and, through its research on predictability, to steer the development of methods for initialising the ensembles