Search Results (4)

Background and Objectives: PoCUS ultrasound applications are widely used in everyday work, especially in the field of emergency medicine. The main goal of this research was to create a diagnostic and therapeutic protocol that will integrate ultrasound examination of the lungs, ultrasound measurements of the inferior vena cava (assessment of central venous pressure) and BREST scores (risk stratification for heart failure), with the aim of establishing a more effective differential diagnostic approach for dyspneic patients. Materials and Methods: A cross-sectional study was conducted in the emergency medicine department with the educational center of the community health center of Banja Luka. Eighty patients of both sexes were included and divided into experimental and control groups based on the presence or absence of dyspnea as a dominant subjective complaint. Based on the abovementioned variables, the LUSBI protocol (lung ultrasound/BREST score/inferior vena cava) was created, including profiles to determine the nature of the origin of complaints. The biochemical marker of heart failure NT pro-BNP served as a laboratory confirmation of the cardiac origin of the complaints. Results: The distribution of NT pro BNP values in the experimental group showed statistically significant differences between individual profiles of the LUSBI protocol (p < 0.001). Patients assigned to group B PLAPS 2 had significantly higher average values of NT pro-BNP (20159.00 ± 3114.02 pg/mL) compared to other LUSBI profiles. Patients from the experimental group who had a high risk of heart failure according to their BREST scores also had a significantly higher average maximum expiratory diameter compared to those without heart failure (p = 0.004). A statistically significant difference (p = 0.001) in LUSBI profiles was observed between the groups of patients divided according to CVP categories. Conclusion: The integration of the LUSBI protocol into the differential diagnosis of dyspnea has been shown to be very effective in confirming or excluding a cardiac cause of the disease in patients. Full article

The reliability of AI-based object detection models has gained interest with their increasing use in safety-critical systems and the development of new regulations on artificial intelligence. To meet the need for robustness evaluation, several authors have proposed methods for testing these models. However, applying these methods in industrial settings can be difficult, and several challenges have been identified in practice in the design and execution of tests. There is, therefore, a need for clear guidelines for practitioners. In this paper, we propose a method and guidelines for assessing the robustness of AI-based 2D object detection systems, based on the Goal Question Metric approach. The method defines the overall robustness testing process and a set of recommended metrics to be used at each stage of the process. We developed and evaluated the method through action research cycles, based on two industrial cases and feedback from practitioners. Thus, the resulting method addresses issues encountered in practice. A qualitative evaluation of the method by practitioners was also conducted to provide insights that can guide future research on the subject. Full article

The warming and acidification of surface waters as predicted by the IPCC leads aquatic species to face major multifaceted changes in their environment. Although teleosts have efficient regulatory systems to cope with these changes, such changes clearly have the potential to impact their physiological functions. Hence, it is crucial to estimate the ability of teleost fishes to cope with multi-stresses to predict how they will deal with future environments. In this context, we investigated the joint effect of warming and acidification on three-spined stickleback (Gasterosteus aculeatus) from the juvenile stage to adulthood, focusing on parameters linked to growth, sexual maturation, and reproduction. Juvenile sticklebacks were split in 2 climate scenarios: a “Current” scenario corresponding to the current seasonal physico-chemical parameters of the water of the “Rade de Brest” in France, and a “RCP8.5” scenario with a warming of 3 °C and an acidification of 0.4 pH units. After 7 months, fish in the RCP8.5 scenario reached the same size and mass as those in the Current scenario, but they needed greater amounts of food to reach satiety. Furthermore, the mortality rate over the experiment was higher in the RCP8.5 scenario. Muscle lipid content, an indicator of energy reserves, was lower in females in the RCP8.5 scenario, suggesting an increased need for energy to maintain homeostasis and other physiological functions or a divergence in energy allocation strategy. Moreover, females exhibited lower sexual maturation and egg quality under the RCP8.5 scenario, which could have contributed to the lower fertilisation rate observed. Males were more resilient to the RCP8.5 scenario, exhibiting only a trend for lower kidney somatic index scores. Altogether, these results suggest a delay and/or an inhibition of gametogenesis and maturation in fish in warmed and acidified waters. The analysis of blood sex steroid concentrations, brain gene expression profiles, and physiological indexes did not allow us to discriminate between a delay and an inhibition of maturation in the RCP8.5 scenario. Overall, these findings clearly indicate that there is a long-term global impact of combined acidification and warming on the mortality and reproductive performance of three-spined stickleback. Full article

Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity worldwide. This study aimed to develop and validate a predictive model for PPH after vaginal deliveries, based on routinely available clinical and biological data. The derivation monocentric cohort included pregnant women with vaginal delivery at Brest University Hospital (France) between April 2013 and May 2015. Immediate PPH was defined as a blood loss of ≥500 mL in the first 24 h after delivery and measured with a graduated collector bag. A logistic model, using a combination of multiple imputation and variable selection with bootstrap, was used to construct a predictive model and a score for PPH. An external validation was performed on a prospective cohort of women who delivered between 2015 and 2019 at Brest University Hospital. Among 2742 deliveries, PPH occurred in 141 (5.1%) women. Eight factors were independently associated with PPH: pre-eclampsia (aOR 6.25, 95% CI 2.35–16.65), antepartum bleeding (aOR 2.36, 95% CI 1.43–3.91), multiple pregnancy (aOR 3.24, 95% CI 1.52–6.92), labor duration ≥ 8 h (aOR 1.81, 95% CI 1.20–2.73), macrosomia (aOR 2.33, 95% CI 1.36–4.00), episiotomy (aOR 2.02, 95% CI 1.40–2.93), platelet count < 150 Giga/L (aOR 2.59, 95% CI 1.47–4.55) and aPTT ratio ≥ 1.1 (aOR 2.01, 95% CI 1.25–3.23). The derived predictive score, ranging from 0 to 10 (woman at risk if score ≥ 1), demonstrated a good discriminant power (AUROC 0.69; 95% CI 0.65–0.74) and calibration. The external validation cohort was composed of 3061 vaginal deliveries. The predictive score on this independent cohort showed an acceptable ability to discriminate (AUROC 0.66; 95% CI 0.62–0.70). We derived and validated a robust predictive model identifying women at risk for PPH using in-depth statistical methodology. This score has the potential to improve the care of pregnant women and to take preventive actions on them. Full article