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Este artículo explora el impacto de la inteligencia artificial (IA) en el aprendizaje del idioma inglés para estudiantes de nivel pre-intermedio (B1) en una universidad ecuatoriana. A través de un enfoque cualitativo, se analizaron las percepciones de estudiantes y docentes sobre el uso de herramientas de IA, como aplicaciones de reconocimiento de voz, plataformas de aprendizaje adaptativo y programas de retroalimentación instantánea. Los hallazgos indican que la IA facilita la personalización del aprendizaje, mejora la precisión en la pronunciación y fomenta el desarrollo de habilidades comunicativas. Sin embargo, se identificaron barreras significativas, tales como la falta de acceso tecnológico y la necesidad de capacitación docente para maximizar el uso de estas herramientas. Este estudio sugiere que la IA no solo motiva a los estudiantes, sino que también permite un aprendizaje autónomo y personalizado, aunque enfrenta desafíos relacionados con la equidad en el acceso y la integración en las prácticas pedagógicas.

Abstract Objective Rare and complex epilepsies encompass a diverse range of disorders characterized by seizures. We aimed to establish a consensus on key issues related to these conditions through collaboration among experienced neurologists, neuropediatricians, and patient advocacy representatives. Methods Employing a modified Delphi method, a scientific board comprising 20 physicians and 4 patient advocacy representatives synthesized existing literature with their expertise to formulate statements on contentious topics. A final 32‐member expert panel, representing diverse regions of Italy, validated these statements through a two‐round voting process, with consensus defined as an average score ≥7. Results Sixteen statements reached a consensus, emphasizing the necessity for epidemiological studies to ascertain the true prevalence of rare epilepsies. Etiology emerged as a crucial factor influencing therapeutic strategies and outcome prediction, with particular concern regarding prolonged and tonic–clonic seizures. The importance of early implementation of specific drugs and non‐pharmacological interventions in the treatment algorithm for developmental and epileptic encephalopathies (DEEs) was underscored. Multidisciplinary care involving experts with diverse skills was deemed essential, emphasizing non‐seizure outcomes in adolescence and adulthood. Significance This national consensus underscores the imperative for personalized, comprehensive, and multidisciplinary management of rare epilepsies/DEEs. It advocates for increased research, particularly in epidemiology and therapeutic approaches, to inform clinical decision‐making and healthcare policies, ultimately enhancing patients' outcomes. Plain Language Summary The modified Delphi method is broadly used to evaluate debated topics. In this work, we sought the consensus on integrated and social care in epilepsy management. Both representatives of high‐level epilepsy centers and patients' caregivers were directly involved.

According to evolutionary psychologists, an individual—consciously or not—who allocates resources for somatic effort focuses on homeostasis and the protection of themselves and others. During health crises, patients must choose between mobilizing their remaining resources to either recover or accepting the disease as inevitable. When patients choose to be proactive in terms of protecting their health, are conscientious, and compliant in the recovery process, a high level of patient activation is achieved. Therefore, we examined (N = 252) whether the patients’ K fitness strategies are predictors for engagement in patient activation-type behavior. In addition, we tested the mediating effect of pain catastrophizing and the moderating effect of romantic satisfaction. We found that people with a medical diagnosis, who were in a romantic relationship, and had high-K fitness were much more likely to be activated patients. Moreover, pain catastrophizing mediated the relationship between high-K fitness strategy and patient activation, while romantic satisfaction moderated this relationship, amplifying its intensity. The findings highlight the importance of identifying patients’ psychological resources (e.g., high-K strategy, romantic satisfaction, or pain perception) to keep them engaged in the health recovery process.

BackgroundBrain arteriovenous malformations (AVMs) are challenging vascular lesions. Extensive follow-up studies are necessary to refine the therapeutic algorithm, and to improve long-term survival in these patients. The aim of the study was to assess surgical outcomes, and to evaluate overall long-term mortality in patients treated for brain AVMs.MethodsThis retrospective single-center study included 191 patients with brain AVMs, admitted between 2012 and 2022. Clinical and angiographical particularities have been analyzed, to identify factors that might influence early outcome and overall long-term mortality.ResultsOut of 79 patients undergoing surgery, 51 had ruptured AVMs with total resection achieved in 68 cases (86.1%). Deep venous drainage was associated with incomplete resection. Female sex, admission modified Rankin Scale (mRS) > 2, and eloquent location were independent predictors of poor outcomes. Multiple venous drainage was associated with a higher risk of worsened early outcome. Eloquent brain region involvement, conservative treatment, increasing age, admission mRS > 2, and comorbidities significantly decrease survival in brain AVM patients. Patients treated with interventional treatments had significantly better survival than the conservatively managed ones, when adjusting for age and admission mRS.ConclusionThe study identified female sex, poor neurologic status on admission and eloquence as independent prognostic factors for a negative outcome after surgery. Patients who received interventional treatment had significantly better survival than patients managed conservatively. We recommend employing tailored, proactive management strategies as they significantly enhance long-term survival in brain AVM patients.

Abstract Background Pallister-Killian syndrome (PKS) is a rare genetic disorder caused by mosaic tetrasomy of 12p with wide neurological involvement. Intellectual disability, developmental delay, behavioral problems, epilepsy, sleep disturbances, and brain malformations have been described in most individuals, with a broad phenotypic spectrum. This observational study, conducted through brain MRI scan analysis on a cohort of patients with genetically confirmed PKS, aims to systematically investigate the neuroradiological features of this syndrome and identify the possible existence of a typical pattern. Moreover, a literature review differentiating the different types of neuroimaging data was conducted for comparison with our population. Results Thirty-one individuals were enrolled (17 females/14 males; age range 0.1–17.5 years old at first MRI). An experienced pediatric neuroradiologist reviewed brain MRIs, blindly to clinical data. Brain abnormalities were observed in all but one individual (compared to the 34% frequency found in the literature review). Corpus callosum abnormalities were found in 20/30 (67%) patients: 6 had callosal hypoplasia; 8 had global hypoplasia with hypoplastic splenium; 4 had only hypoplastic splenium; and 2 had a thin corpus callosum. Cerebral hypoplasia/atrophy was found in 23/31 (74%) and ventriculomegaly in 20/31 (65%). Other frequent features were the enlargement of the cisterna magna in 15/30 (50%) and polymicrogyria in 14/29 (48%). Conversely, the frequency of the latter was found to be 4% from the literature review. Notably, in our population, polymicrogyria was in the perisylvian area in all 14 cases, and it was bilateral in 10/14. Conclusions Brain abnormalities are very common in PKS and occur much more frequently than previously reported. Bilateral perisylvian polymicrogyria was a main aspect of our population. Our findings provide an additional tool for early diagnosis.Further studies to investigate the possible correlations with both genotype and phenotype may help to define the etiopathogenesis of the neurologic phenotype of this syndrome.

The purpose of coatings is to protect or enhance the functionality of the substrate material, irrespective of the field in which the material was designed. The use of coatings in medicine is rapidly expanding with the objective of enhancing the osseointegration ability of metallic materials such as titanium. The aim of this study was to obtain biomimetic hydroxyapatite (HAp)-based coatings on titanium by using the pulsed galvanostatic method. The morphology of the HAp-based coatings revealed the presence of very thin and wide plate-like crystals, grown perpendicular to the Ti substrate, while the chemical composition highlighted a Ca/P ratio of 1.66, which is close to that of stoichiometric HAp (1.67). The main phases and chemical bonds identified confirmed the presence of the HAp phase in the developed coatings. A roughness of 228 nm and a contact angle of approx. 17° were obtained for the HAp coatings, highlighting a hydrophilic character. In terms of biomineralization and electrochemical behavior, it was shown that the HAp coatings have significantly enhanced the titanium properties. Finally, the in vitro cell tests carried out with human mesenchymal stem cells showed that the Ti samples coated with HAp have increased cell viability, extracellular matrix, and Ca intracellular deposition when compared with the uncoated Ti, indicating the beneficial effect.

Background: Type A aortic dissection (TAAD) is a life-threatening condition which requires prompt diagnosis and surgical treatment. When TAAD involves the aortic root, aortic valve-sparing or Bentall procedures are the main surgical treatment options. Method: The subjects of this analysis were 3735 patients included in the European Registry of Type A Aortic Dissection (ERTAAD). Propensity score matching was performed by estimating a propensity score from being treated with the Bentall or the David procedure using multilevel mixed-effects logistics, considering the cluster effect of the participating hospitals. Results: A Bentall procedure was performed in 862 patients, while a David operation was performed in 139 patients. The proportion of aortic root replacement, as well as the different techniques of aortic root replacement, varied significantly between the participating hospitals (p < 0.001). After propensity score matching, we obtained two groups of 115 patients each, and no statistical differences were reported in terms of postoperative outcomes, except for the rate of dialysis, which was higher in the patients requiring a Bentall procedure (17.4% vs. 7.0%, p-value 0.016). In the unmatched cohorts, the David procedure was associated with a lower 10-year mortality rate compared to the Bentall procedure (30.1% vs. 45.6%, p-value 0.004), but no difference was observed after matching (30.0% vs. 43.9%, p-value 0.082). After 10 years, no differences were observed in terms of proximal aortic reoperation (3.9% vs. 4.1%, p-value 0.954), even after propensity score matching (2.8% vs. 1.8%, p-value 0.994). Conclusions: The David and Bentall procedures are durable treatment methods for TAAD. When feasible, it is advisable that the David procedure is performed for acute TAAD by surgeons with experience with this demanding surgical technique.

The paper presents a set of equations that stands to the basis of a computer program and to the software themselves, that offers to the user the possibility to automatic draw the arcs used to approximate the representation of a chamfer hexagonal prism. Also, the authors present the way to use software that generates the arcs that approximate hyperbolas resulting on a chamfered hexagonal prism.

The present study explores how modern graphics technology and computer-generated imagery (CGI) are revolutionizing the field of civil engineering. With an emphasis on 3D modelling, the study investigates how virtual reality (VR), augmented reality (AR), and 3D modelling may transform project design and communication. The research explores how these graphic tools improve planning, analysis, and presentation in civil engineering projects through case studies and software innovations. The construction of safer, more creative, and visually striking infrastructure projects is aided by the integration of CGI, which also enhances visualization and makes decision-making more effective. The important developments at the junction of civil engineering and graphics are highlighted in this study.

Acute Type A aortic dissection (ATAAD) represents a life-threatening medical emergency that requires emergent surgical repair. Despite improvement in surgical techniques and perioperative management, ATAAD remains associated with high early mortality and postoperative complications. A structured and individualized postoperative surveillance program is essential, not only for improving survival rates but also for identifying risk factors necessitating reintervention and enhancing the quality of life. Comprehensive postoperative care should address both medical monitoring and psychological support to meet the holistic needs of ATAAD survivors. In real-world settings adherence to guideline-directed imaging surveillance (GDIS) is poor, leading to underestimation of reintervention rates. A comprehensive aortic service should include GDIS, clinical assessments, cardiovascular risk management, and psychological support. Since August 2022, a virtual ward has been implemented in our department to facilitate remote monitoring, ensuring tight blood pressure control and early detection of complications.

Mourad Ghrairi,1,2 Shaival Dalal,3 Esther Esteban-García,4 Philippe Chomier,5 Xavier Valle,2 Ricard Pruna2 1Department of Sports Medicine, FIFA Medical Centre of Excellence, Dubai, United Arab Emirates; 2Department of Sports Medicine, FIFA Medical Centre of Excellence FC Barcelona, Barcelona, Spain; 3Department of Orthopedics and Sports Medicine, Arthro One Sports Injuries and Rehabilitation Centre, Ahmedabad, Gujarat, India; 4Department of Physiotherapy, FIFA Medical Centre of Excellence, Dubai, United Arab Emirates; 5Department of Rehabilitation, FIFA Medical Centre of Excellence, Dubai, United Arab EmiratesCorrespondence: Shaival Dalal, Arthro One Orthopaedic Centre, 4th Floor, NIRAMYA, Near Rajpath Club, Bodakdev, Ahmedabad, 380054, India, Tel +91-9904915211, Email shaival_dalal@yahoo.co.inPurpose: The SpeedCourt system has been confirmed as an effective and dependable tool for evaluating multi-directional change-of-direction (COD) maneuvers. It has also been employed in the rehabilitation process following Anterior Cruciate Ligament (ACL) injuries and for multi-directional training purposes. This study investigated by means of the SpeedCourt system determines 1) whether there is any difference in COD parameters and countermovement jumps (CMJ) between United Arab Emirates (UAE) and non-UAE professional footballers 2) whether there is any difference between the two lower limbs during change-of-direction manoeuvres.Methodology: This analysis included 100 professional football players from UAE or Non-UAE football clubs who were tested at FIFA Medical Centre of Excellence. With the help of Speedcourt system, 6-s tapping, countermovement jump (CMJ) and chase 15-s tests were performed. Comparison was done between UAE and non-UAE footballers and also between the dominant and non-dominant sides.Results: Out of the 100 players, 83 players were right foot dominant. Apart from the countermovement jump test, there was no significant difference in results between UAE and non-UAE football players. Average time to turn for dominant and non-dominant sides did not show any significant difference, for either group.Conclusion: There is no difference in 6-s tapping, Chase 15-s tests or limb asymmetry amongst UAE and Non-UAE footballers. However, the non-UAE footballers showed significantly better performance in Countermovement Jump Test. The data provide baseline values for forthcoming sports medicine research, which can be taken into account when creating injury prevention or return-to-sport protocols, particularly with regard to change of direction parameters and countermovement jump.Keywords: Speedcourt, rehabilitation, prevention, countermovement