Research on Papua, a digital tool with artificial intelligence in favor of learning and linguistic attitudes towards the learning of the English language in students of Spanish language as L1.

This study examines learners' perceptions of the linguistic and learning potential of an AI-based English language learning app called Papua. The study took a quasi-experimental approach in which 128 students of the degree in Primary Education at the University of Huelva, Spain, gained experience of using the app over a six-week period, and then answered a questionnaire. This was of a quantitative design, and included the following components: attitudes towards learning English; attitudes towards learning oral and written skills, and towards opportunities for interacting in English; and attitudes towards the motivation provided by the app. These attitudes were contrasted according to the variables memory and self-evaluation. The results of the study showed that oral skills were perceived as the most improved skill. Participants also foregrounded the enhancement of memorization of vocabulary, and positively evaluated the self-evaluation feature included in the app.

Usefulness of Self-Expanding Drainage Cannula in Venovenous Extracorporeal Membrane Oxygenation: Tips, Tricks, and Results of an Early Experience.

Inadequate venous drainage decreases the efficiency of extracorporeal membrane oxygenation (ECMO). Pump augmentation may even make it worse due to collapse of the venous system under negative pressures. Furthermore, recirculation is a phenomenon that occurs when oxygenated blood supplied through the infusion cannula is withdrawn directly through the drainage cannula without contributing to the oxygenation of the patient and also compromises the efficacy of the therapy. Large drainage cannulas allow for similar flow rates at lower pump speed. But percutaneous insertion of these larger cannulas could be challenging. When using a self-expandable cannula, the diameter of the cannula for the insertion can be reduced, and once inserted, its intravascular diameter maximized, resulting in a large venous cannula due to in situ expansion after mandrel removal (up to 36F). We present a retrospective series of selfexpanding venous cannula 430 or 530 mm in length in six consecutive patients undergoing venovenous (VV) ECMO. No vascular or cardiac iatrogenic injury was caused during implantation. Target flows were reached, and no clinically significant recirculation was described in any case. The use of selfexpanding drainage cannulas was safe, and efficient drainage was achieved with easy and definitive unique positioning during cannulation.

Frailty, disability and comorbidity: different domains lead to different effects after surgical aortic valve replacement in elderly patients.

OBJECTIVES: Frailty syndrome predicts adverse outcomes after surgical aortic valve replacement. However, disability or comorbidity is frequently associated with preoperative frailty evaluation. The effects of these domains on early and late outcomes were analysed. METHODS: A prospective study including patients aged ≥75 years with symptomatic severe aortic stenosis who received aortic valve replacement with or without coronary artery bypass grafting was conducted. We used the Cardiovascular Health Study Frailty Phenotype to assess frailty, the Lawton-Brody index to define disability and the Charlson comorbidity index (CCI) to evaluate comorbidity. RESULTS: Frailty was identified in 57 (31%), dependence in 18 (9.9%) and advanced comorbidity (CCI ≥ 4) in 67 (36.6%) of the 183 enrolled patients. Operative mortality (1.6%), transfusion rate and duration of stay increased in patients with CCI ≥4 (P < 0.005). There was a non-significant trend for these adverse outcomes among the frail patients. Follow-up was achieved in all patients (median/interquartile range 869/699-1099 days). Kaplan-Meier univariable analysis showed a reduced survival rate for frail and dependent patients and for those with multiple comorbidities (P < 0.05). According to multivariable analysis, frailty and comorbidity were independent risk factors for 1-year mortality, while disability and comorbidity, but not frailty, were risk factors for 3-year mortality (P < 0.05). CONCLUSIONS: Surgical aortic valve replacement in patients aged ≥75 years is a safe procedure with low mortality rates. Operative outcomes are mainly affected by comorbidities. The main influence of survival occurs throughout the first year, and an improved functional status prevents any progression towards disabilities, which could potentially benefit long-term outcomes. CLINICAL TRIAL REGISTRATION NUMBER: NCT02745314.

Quick spontaneous remodelling of thrombosed false lumen in acute type-A aortic dissection.

Natural history of acute Stanford type A aortic dissection (AAAD) implies the need of emergent surgical treatment in the vast majority of cases. Nevertheless, conservative treatment has been described to yield acceptable outcomes, when compared to surgery, in selected high risk cases of thrombosed false lumen. We report a significant quick remodelling of the false lumen occurred in an 85-year-old female 6 days after conservative treatment.