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Classical works on troubadour texts focus on Platonic and Aristotelian influences. In contrast, this article considers the relationship between troubadour texts and Nietzsche's philosophy, suggesting that Nietzsche's understanding of troubadour art underlines both the radical specificity of troubadour songs and their innovative epistemology. Engaging with three songs, 'Be·m cuidei de chantar sofrir' by Bernart de Ventadorn, 'Era·m platz' by Guiraut de Borneil, and Guilhem IX's 'Farai un vers de dreit nien,' the author reads the display of binary figures to define the main characteristics of a new epistemology far from Platonism and Aristotelianism. Nietzsche's account of the concept of 'gay science' helps us to understand the figure of contradiction fostered by troubadours. Methodologically, this critical reading complements a philological approach. Instead of looking for a feature of the text that might be related to an existing philosophy, thus going from medieval texts toward an earlier philosophy, this methodology proceeds from Nietzsche's philosophy toward medieval texts, making the troubadour songs a terminus ad quo (rather than a terminus ad quem) so as to outline the specificity of their own art - the gay science. [ABSTRACT FROM AUTHOR]

Objectives: To study the diagnostic performance of an ultrasound-based algorithm that includes the deceleration time (DT) of early mitral filling to establish a diagnosis of acute heart failure (AHF) in patients who come to an emergency department because of dyspnea., Material and Methods: Prospective analysis in a convenience sample of patients who came to a hospital emergency department with acute dyspnea. The algorithm included ultrasound findings and 4 echocardiographic findings as follows: mitral annular plane systolic excursion, Doppler mitral flow velocity, tissue Doppler imaging measure of the lateral annulus, and the DT of early mitral filling. The definitive diagnosis was made by 2 physicians blinded to each other's diagnosis and the ultrasound findings., Results: A total of 166 adult patients with a mean (SD) age of 76 (13) years were included; 79 (48%) were women. AHF was the definitive diagnosis in 62 patients (37%). Diagnostic agreement was good between the 2 physicians (κ = 0.71). The algorithm classified all the patients, and there were no undetermined diagnoses. Diagnostic performance indicators for the ultrasound-based algorithm integrating early DT findings were as follows: area under the receiver operating characteristic curve, 0.91 (95% CI, 0.86-0.96); sensitivity, 87% (95% CI, 76%-94%); specificity, 95% (95% CI, 89%-98%); positive likelihood ratio, 18.1 (95% CI, 7.7-42.8); and negative likelihood ratio, 0.14 (95% CI, 0.07-0.26)., Conclusion: The ultrasound-based algorithm integrating the DT of early mitral filling performs well for diagnosing AHF in emergency patients with dyspnea. The inclusion of early DT allows all patients to be diagnosed.