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[Resumen]: Dentro de la normativa laboral, se contempla la posibilidad para los trabajadores de poner fin a su relación laboral de manera indemnizada, con derecho, en su caso, a la prestación por desempleo, cuando la empresa incurre en incumplimientos graves y culpables de sus obligaciones. No obstante, el artículo 50 del Estatuto de los Trabajadores, encargado de regular esta opción, menciona de manera explícita solo algunos de los incumplimientos que habilitan el uso de este recurso, dejando en manos de los juzgados y tribunales la tarea de ampliar dicha lista. El propósito de este trabajo es explorar en qué medida, bajo qué circunstancias y de qué manera los incumplimientos empresariales, con un enfoque particular en los riesgos psicosociales y el acoso laboral, pueden ser considerados en virtud de dicho artículo.

Objective To determine if the addition of the assessment of levator ani muscle (LAM) avulsion to the measurement of the difference in the pubis-uterine fundus distance between rest and with the Valsalva maneuver could increase the diagnostic capacity of ultrasound for uterine prolapse (UP). Methods This multicenter, observational and prospective study included 145 patients. Ultrasound assessment was performed, establishing the diagnosis of UP as a difference between the pubic-uterine fundus distance at rest and during the Valsalva maneuver ≥15 mm (standard technique), while LAM avulsion was defined as an abnormal LAM insertion in three central slices using multislice ultrasound. A binary multivariate logistic regression model was made using nonautomated methods to predict surgical UP (general population, premenopausal, and postmenopausal patients), including the difference between the pubis-uterine fundus distance at rest and with the Valsalva maneuver as well as LAM avulsion. Results A total of 143 patients completed the study. The addition of LAM avulsion criteria to the standard dynamic distance-based protocol for the diagnosis of UP resulted in a higher sensitivity for the general population (79.7 vs 68.1%) as well as for premenopausal (89.3 vs 79.9%) and postmenopausal patients (76 vs 66.1%). In contrast, the standard technique showed a higher specificity than the model based on the standard technique associated with LAM avulsion for the general population (89.2 vs 74.3%) and premenopausal women (91.7 vs 63.2%). For postmenopausal patients, the model based on the standard technique associated with LAM avulsion had a higher sensitivity (76 vs 66.1%) and specificity (91.7 vs 86.8%) than the ultrasound diagnosis of UP. Conclusion The implementation of the assessment of LAM avulsion in the ultrasound diagnosis of UP is useful in postmenopausal patients, increasing sensitivity and specificity relative to the ultrasound assessment based only on the difference between

Objectives—It is unknown whether diagnosing uterine prolapse (UP) via ultrasound or surgical criteria is superior. Our objective is to determine whether the diagnostic capacity of ultrasound with surgical criteria differs from that of surgical criteria only. Methods—This was a multicenter prospective observational study with 54 premenopausal patients with surgical criteria for a dysfunctional pelvic floor pathology who were consecutively recruited for 1 year. Clinical UP with surgical criteria was defined when UP stage II–IV was identified (during pelvic floor consultation), and UP diagnosed by ultrasound with surgical criteria was established when a difference ≥15 mm was found between rest and Valsalva applied to the pubis-uterine fundus. The sensitivity, specificity and positive and negative predictive values were determined to evaluate clinical and ultrasound methodologies as diagnostic tests. Results—UP diagnosed by ultrasound with surgical criteria presented better sensitivity (78.57 vs 35.71%), specificity (92.11 vs 81.58%), positive predictive value (61.83 vs 23.99%), and negative predictive value (96.35 vs 11.37%) than UP diagnosed by surgical criteria only. Conclusion—Ultrasound with surgical criteria is superior to surgical criteria alone when diagnosing UP.

Objectives The objective of this study is to investigate a multicenter study to establish if differences exist in the levator ani muscle avulsion (LAM) rates between deliveries performed with Malmstrom's vacuum and the Kiwi vacuum. Study design A prospective, multicenter observational study with 199 primiparous subjects was performed. All patients had undergone vaginal delivery by vacuum (Malmstrom's or Kiwi). Avulsion was defined as an abnormal insertion of LAM in the lower pubic branch in the multiplanar mode, as identified in the three central sections by transperineal 3/4D echography 6 months after delivery. The area of ​​the levator hiatus was measured in the plane of minimum dimensions at rest, during the Valsalva maneuver and during contraction. Results LAM avulsion occurred in 33.1% of cases in which Malmstrom's vacuum was used and in 29.4% of cases in which the Kiwi vacuum was used (the difference was not statistically significant), which resulted in a crude odds ratio (OR) of 0.977 (0.426, 2.241; P = .957) and an adjusted OR of 2.90 (0.691; 12.20; P = .146). Women in the Malmstrom's vacuum group had a larger LHA at rest 14.77 vs 12.64 cm2; P = .001) and at maximum contraction (13.41 vs 10.83 cm2; P < 0.001) in comparison with the Kiwi group, although the difference did not reach statistical significance under Valsalva maneuver (18.71 vs 17.21 cm2; P = .051).Differences between both groups were detected in the measurements of the hiatus area levator at rest (14.77 vs 12.64 cm2), during the Valsalva maneuver (18.71 vs 17.21 cm2) and during maximum contraction (13.41 vs 10.83 cm2). Conclusions In the present study, Malmstrom's vacuum was not associated with a higher risk of LAM in comparison with Kiwi's Omnicup.

The coupling of biological and thermal technologies allows for the complete conversion of wastes into energy and biochar eliminating the problem of sludge disposal. The valorisation of fatty residues as co-substrate in a mesophilic digester of a wastewater treatment plant was studied considering an integrated approach of co-digestion and pyrolysis. Four digested samples obtained from co-digestion of sewage sludge and butcher’s fat waste were studied by thermogravimetric analysis. The activation energy corresponding to the sludge pyrolysis was calculated by a non-isothermal kinetic. Arrhenius activation energy was lower for the pyrolysis of a digested grease sample (92 kJ mol obtained by OFW and 86 kJ mol obtained by Vyazovkin) than for the pyrolysis of sewage sludge and its blends (164–190 kJ mol obtained by OFW and 162–190 kJ mol obtained by Vyazovkin). The analysis of the integrated approach of anaerobic co-digestion and pyrolysis of digestates demonstrated that the addition of 3% (w/v) of fat to the feeding sludge results in a 25% increase in the electricity obtained from biogas (if a combined heat and power unit is considered for biogas valorisation) and increasing the fat content to 15% allows for covering all thermal needs for drying of digestate and more than doubles (2.4 times) the electricity production when the scenario of digestion and pyrolysis is contemplated.

Introduction: Forceps use is the main risk factor for levator ani muscle (LAM) injuries. We believe that the disengagement of the forceps branches before delivery of the fetal head could influence LAM injuries, so we aimed to determine the influence of the disengagement of the forceps on the occurrence of LAM avulsion during forceps delivery. Material and methods: A prospective, observational, multicenter study was conducted with 261 women who underwent forceps delivery. The women were classified according to whether the branches of the forceps had been disengaged before delivery of the fetal head. LAM avulsion was defined using a multislice mode (3 central slices). Results: In all, 255 women completed the study (160 without disengagement and 95 with disengagement). LAM avulsions were observed in 37.9% of women in the group with disengagement and in 41.9% of women in the group without disengagement. The crude OR (without disengagement vs with disengagement) for avulsion was 0.90 (95% CI 0.49-1.67, P = 0.757) and an adjusted OR of 0.82 (95% CI 0.40-1.69, P = 0.603). Conclusions: We did not observe a statistically significant reduction in the LAM avulsion rate with disengagement of the forceps branches before delivery of the fetal head.

[ES] España ha intensificado la aplicación de políticas encaminadas a la reducción del número de accidentes y de víctimas, durante la última década, y ha alcanzado un elevado nivel de éxito en esta tarea, situando a nuestro país en un puesto muy destacado entre los países de Europa y del mundo en relación a la seguridad vial. En el año 2013, España ocupó el quinto puesto en el grupo de países de la UE-28 en el indicador muertos por millón de habitante. Un indicador análogo con datos de exposición no existe a nivel europeo, en tanto el denominador (la exposición) es una magnitud de difícil obtención. El logro de nuevas metas exige medidas específicas dirigidas a ámbitos y colectivos con características diferentes, y para ello es necesario un mejor conocimiento de los verdaderos niveles de riesgo de determinados grupos de usuarios, definidos por criterios de género, o edad, o de tipos de vehículos y características constructivas, prestaciones o eficacia de sistemas de seguridad, entre otros factores. En el caso de los vehículos, existen datos de distancias recorridas en diferentes periodos, recogidos en las fichas de inspección técnica, e incorporados, desde hace unos años, en bases de datos gestionadas por las comunidades autónomas y por la DGT, pero estos datos están siendo escasamente explotados.En el presente trabajo se presenta una metodología de análisis de los datos obtenidos en las inspecciones técnicas de los vehículos, y de estimación de la exposición (veh-km anual) de diferentes grupos de vehículos (según tipo, edad y potencia, entre otras variables determinantes) que pueden presentar diferencias significativas en sus niveles de exposición. La metodología, que incluye la creación de bases limpias y la formación de conglomerados de vehículos con elevada homogeneidad en el valor de su movilidad, se ha aplicado a una muestra de autobuses articulados a modo de estudio piloto. Con este trabajo se pretende contribuir a un mejor conocimiento de los verdaderos nive

El estudio de sensibilidad de problemas físicos, tradicionalmente se ha llevado a cabo analíticamente mediante la resolución de derivadas parciales de la función objeto de estudio. Los resultados obtenidos expresan la relación entre las variables de entrada de un sistema y la respuesta del mismo. Sin embargo, el enfrentamiento a problemas de cálculo complejos de resolver analíticamente, ha llevado a desarrollar técnicas numéricas que sirvan para aproximar los valores teóricos mediante procedimientos numéricos. En este trabajo, se han analizado técnicas como el Análisis de la Varianza, la Regresión y Dynamic Trees, sobre un problema sencillo cuya solución analítica es conocida, y se han comprobado los resultados obtenidos con la solución exacta del problema. La elección correcta del método estadístico, permitirá posteriormente utilizarlo para resolver problemas de mayor envergadura, cuyo desarrollo no sea viable por métodos analíticos. El problema tratado en este trabajo, ha sido el expuesto en el artículo de A. Tortorelli y P. Michaleris cuyo estudio de sensibilidad matemático queda reflejado a través de las derivadas parciales de las funciones que se estudian. Se evaluará la respuesta de las frecuencias de vibración del sistema y sus correspondientes modos (vectores propios), al variar los parámetros. Cada una de las técnicas estadísticas empleadas, con sus correspondientes fundamentos teóricos y particularidades, utilizan diferentes maneras de medir la relación de las variables de entrada y las de salida. Los resultados de todas ellas, extraídas a partir del Software R, permiten estimar las medidas de importancia de las variables de entrada sobre la salida.

The degree of development and operability of the indicators for the Marine Strategy Framework Directive (MSFD) using Descriptor 1 (D1) Biological Diversity was assessed. To this end, an overview of the relevance and degree of operability of the underlying parameters across 20 European countries was compiled by analysing national directives, legislation, regulations, and publicly available reports. Marked differences were found between countries in the degree of ecological relevance as well as in the degree of implementation and operability of the parameters chosen to indicate biological diversity. The best scoring EU countries were France, Germany, Greece and Spain, while the worst scoring countries were Italy and Slovenia. No country achieved maximum scores for the implementation of MSFD D1. The non-EU countries Norway and Turkey score as highly as the top-scoring EU countries. On the positive side, the chosen parameters for D1 indicators were generally identified as being an ecologically relevant reflection of Biological Diversity. On the negative side however, less than half of the chosen parameters are currently operational. It appears that at a pan-European level, no consistent and harmonized approach currently exists for the description and assessment of marine biological diversity. The implementation of the MSFD Descriptor 1 for Europe as a whole can therefore at best be marked as moderately successful.

[EN] Background: Caesarean section is necessary to save the lives of mothers and newborns at times, but it is important to perform it only when it is essential due to all the risks involved. This study aimed to examine the rate of caesarean sections performed at a tertiary hospital using the Robson classification to detect methods for the detection of and/or reduction in these caesarean section rates. Methods: A descriptive, cross-sectional study of a retrospective database was carried out. Results: A total of 10,317 births were assessed. The Robson classification was used to assess these interventions and verify whether the indication for performed caesarean sections was appropriate. In total, 2036 births by caesarean section were performed in the whole sample. The annual caesarean section rate varied between 18.67% and 21.18%. Conclusions: Caesarean sections increased by about 20% in 2021 compared to 2020 even though the trend over the years of study was decreasing. Vaginal delivery after caesarean section is a reasonable and safe option. Caesarean section rates could be improved, mostly in Robson’s Group 2. The Robson classification facilitated progress in the implementation of measures aimed at improving care and adjusting caesarean section rates.