Analysis of maturation features in fetal brain ultrasound via artificial intelligence for the estimation of gestational age

Background: Optimal prenatal care relies on accurate gestational age dating. After the first trimester, the accuracy of current gestational age estimation methods diminishes with increasing gestational age. Considering that, in many countries, access to first trimester crown rump length is still difficult owing to late booking, infrequent access to prenatal care, and unavailability of early ultrasound examination, the development of accurate methods for gestational age estimation in the second and third trimester of pregnancy remains an unsolved challenge in fetal medicine. Objective. This study aimed to evaluate the performance of an artificial intelligence method based on automated analysis of fetal brain morphology on standard cranial ultrasound sections to estimate the gestational age in second and third trimester fetuses compared with the current formulas using standard fetal biometry. Study Design: Standard transthalamic axial plane images from a total of 1394 patients undergoing routine fetal ultrasound were used to develop an artificial intelligence method to automatically estimate gestational age from the analysis of fetal brain information. We compared its performance—as stand alone or in combination with fetal biometric parameters—against 4 currently used fetal biometry formulas on a series of 3065 scans from 1992 patients undergoing second (n=1761) or third trimester (n=1298) routine ultrasound, with known gestational age estimated from crown rump length in the first trimester. Results: Overall, 95% confidence interval of the error in gestational age estimation was 14.2 days for the artificial intelligence method alone and 11.0 when used in combination with fetal biometric parameters, compared with 12.9 days of the best method using standard biometrics alone. In the third trimester, the lower 95% confidence interval errors were 14.3 days for artificial intelligence in combination with biometric parameters and 17 days for fetal biometrics, whereas in the second trimester, the 95% confidence interval error was 6.7 and 7, respectively. The performance differences were even larger in the small-for-gestational-age fetuses group (14.8 and 18.5, respectively). Conclusion: An automated artificial intelligence method using standard sonographic fetal planes yielded similar or lower error in gestational age estimation compared with fetal biometric parameters, especially in the third trimester. These results support further research to improve the performance of these methods in larger studies.The research leading to these results was partially funded by Transmural Biotech S.L. In addition, the research has received funding from “la Caixa” Foundation under grant agreements LCF/PR/GN14/10270005 and LCF/PR/GN18/10310003, the Instituto de Salud Carlos III (PI16/00861, PI17/00675) within the Plan Nacional de I+D+I and cofinanced by Instituto de Salud Carlos III— Subdirección General de Evaluación together with the Fondo Europeo de Desarrollo Regional (FEDER) “Una manera de hacer Europa,” Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, United Kingdom), Cellex Foundation, ASISA Foundation, and Agency for Management of University and Research Grants under grant 2017 SGR number 1531. In addition, E.E. has received funding from the Departament de Salut under grant number SLT008/18/00156.Peer ReviewedPostprint (published version

Docentes por un Mundo Mejor : Fomentando espacios escolares libres de discriminación por diversidad sexual

La discriminación por orientación sexual en las escuelas es un problema que afecta la autoestima, el desarrollo integral y el proceso de aprendizaje, ya que no hay un ambiente de respeto ni de valoración. Es por eso que, se presenta el trabajo de investigación denominado “Docentes por un Mundo Mejor: Fomentando espacios escolares libres de discriminación por diversidad sexual”. Para este trabajo, se planteó la siguiente problemática comunicacional: el miedo de los docentes de secundaria del colegio Mundo Mejor de Chimbote a abordar temas relacionados a la diversidad sexual en las aulas, debido a que se sienten poco preparados para mediar espacios libres de violencia contra discriminación sexual en los que se pueda hablar con respeto, empatía y asertividad de estos temas. El objetivo principal fortalecer las competencias y seguridad de los docentes para propiciar y generar espacios respetuosos, empáticos, asertivos y libres de violencia contra la diversidad sexual. Asimismo, se propuso trabajar a través de dos enfoques: Género, que se basa en la necesidad de reflexionar sobre las identidades masculinas y femeninas como constructos sociales, y, Derechos Humanos, relacionado al reconocimiento de los estudiantes como sujetos de derechos y no como objetos de cuidado. El recojo de información utiliza una metodología cualitativa y cuantitativa, y se propone la ejecución de nueve actividades que cumplen con los objetivos específicos del proyecto. Por su parte, las estrategias utilizadas tienen una metodología dialógica y participativa, testimonial, edu-entretenimiento y comunicación comunitaria; por ello, el proyecto está diseñado para ser implementado de manera presencial. Finalmente, se rescata que la comunicación para el desarrollo es clave pues permite cambiar las actitudes y comportamientos de los docentes para convertirlos en agentes de cambio.Discrimination based on sexual orientation in schools affects self-esteem, integral development and, above all, the learning process of students, since there is no environment of respected or appreciation. For this reason, the research work called "Docentes por un Mundo Mejor: Fomentando espacios escolares libres de discriminación por diversidad sexual " is presented. For this work, the following communication problem was raised: the fear of secondary school teachers of the Mundo Mejor school in Chimbote to address issues related to sexual diversity in the classroom because they feel unprepared to mediate spaces free of violence against sexual discrimination in which they can talk about these issues with respect, empathy and assertiveness. The main objective is to strengthen the competencies and security of teachers to promote and generate respectful, empathetic, assertive and violence-free spaces against sexual diversity. It was also proposed to work through two approaches: Gender, which is based on the need to reflect on masculine and feminine identities as social constructs, and Human Rights, related to the recognition of students as subjects of rights and not as objects of care. The collection of information uses a qualitative and quantitative methodology, and nine activities are proposed that meet the specific objectives of the project . The strategies used have a dialogic and participatory methodology, testimonial, edutainment and community communication; therefore, the project is designed to be implemented in a face-to-face manner. Finally, it should be noted that communication for development is key because it allows us to change the attitudes and behaviors of teachers in order to turn them into agents of change

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

New coordination polymers based on a novel polynitrile ligand: Synthesis, structure and magnetic properties of the series [M(tcnoetOH)2(4,4′-bpy)(H2O)2] (tcnoetOH−=[(NC)2CC(OCH2CH2OH)C(CN)2]−; M=Fe, Co and Ni)

International audienceA novel polynitrile anionic ligand, tcnoetOH−(=[(NC)2CC(OCH2CH2OH)C(CN)2]−), has been synthesized by a one-pot reaction from a cyclic acetal and malononitrile. This ligand has been successfully used to prepare, with 4,4′-bpy as co-ligand, a novel series of coordination polymers formulated as [M(tcnoetOH)2(4,4′-bpy)(H2O)2] with M(II) = Fe (1), Co (2) and Ni (3). These isostructural compounds present a linear chain structure consisting of octahedrally coordinated metal ions bridged by trans 4,4′-bpy ligands. The coordination sphere of the metal ions is completed with two terminal tcnoetOH− ligand and two water molecules. The magnetic properties indicate that the three compounds are paramagnetic, as expected from the long 4,4′-bpy bridge connecting the metal atoms. Their magnetic properties have been fitted with a model of isolated ions including a zero field splitting for the Fe(II) and Ni(II) derivatives

A novel polynitrile ligand with different coordination modes: Synthesis, structure and magnetic properties of the series [M(tcnoprOH)2(H2O)2] (M=Mn, Co and Cu) (tcnoprOH−=[(NC)2CC(OCH2CH2CH2OH)C(CN)2]−)

International audienceA novel polynitrile ligand (tcnoprOH− = [(NC)2CC(OCH2CH2CH2OH)C(CN)2]−) with up to five potentially coordinating groups has been synthesized in a one-pot reaction from a cyclic acetal and malononitrile. The combination of this novel ligand with different transition metal ions has led to the synthesis of two different structural types with the same formula but with different coordination modes in the ligand. Mn(II) and Cu(II) lead to a μ2-N,O-coordinating mode in the series of compounds formulated as [M(N,O-tcnoprOH)2(H2O)2] (M = MnII (1) and CuII (2)), whereas Co(II) and, most probably Ni(II), lead to a μ2-N,N′-coordinating mode in [Co(N,N′-tcnoprOH)2(H2O)2] (3). Both structural types consist of linear chains of metal ions connected by a double tcnoprOH− bridge. These ligands are connected to the metal ions through one –CN and one –OH group in compounds 1 and 2 (N,O-coordinating mode) or through two –CN groups in compound 3. Magnetic measurements show that all compounds are paramagnetic with a low zero field splitting for the Mn derivative