Differences in risk factors and outcome after acute stroke in patients with tandem occlusion and those with isolated intracranial occlusion after endovascular treatment.

OBJECTIVE: This study aimed to compare the clinical features, treatment, and clinical outcome of patients with tandem occlusion and isolated intracranial occlusion through endovascular treatment (EVT). METHODS: Patients with acute cerebral infarction who received EVT in two stroke centers were retrospectively included. According to MRI or CTA results, the patients were divided into tandem occlusion group or isolated intracranial occlusion group. The baseline data, etiological classification, treatment, post-stroke complications, image features, and clinical outcome were compared. Multivariate logistic regression analysis was used to evaluate the related factors affecting the prognosis of patients with EVT. RESULTS: Among 161 patients with acute cerebral infarction, there were 33 cases (20.5%) in the tandem occlusion group and 128 cases (79.5%) in the isolated intracranial occlusion group. Compared with isolated intracranial occlusion, the patients with tandem occlusion had higher rates of large artery atherosclerosis (P = 0.028), symptomatic intracerebral hemorrhage (sICH) (P = 0.023), bilateral infarction (P = 0.042), and longer time for endovascular procedure (P = 0.026). There was no significant statistical difference in 90-day mRS score between the two groups (P = 0.060). Multivariate logistic regression identified the following independent predictors of poor functional outcome: older age, high fasting blood glucose, infarction area > 1/3, and hemorrhagic transformation. CONCLUSIONS: Compared with isolated intracranial occlusion, there was not a worse prognosis among patients with tandem occlusion who received EVT.

Pigeon egg white protein-based transparent durable hydrogel via monodisperse ionic surfactant-mediated protein condensation.

The thermal gelation property of proteins is useful in creating protein-based materials. The gelation of protein solution often proceeds by the random aggregation of denatured proteins, and the protein-based gels are typically brittle or opaque, or both. Improvement in the mechanical and optical properties of protein-based materials are required for them to be practical and functional. This study investigated pigeon egg white, which is semitransparent in its thermally gelled state, as a protein source for creating hydrogel materials. The protein thermal gelation process was initiated from the orderly condensed state of proteins complexed with monodisperse ionic surfactants to suppress random aggregation. The resultant gel showed transparency in the visible light region and was not destroyed at 99% compression under 17.8 MPa compressive stress, 350-fold higher than the compressive fracture strength of typical boiled pigeon egg white. These results showed that durable transparent hydrogels could be fabricated by the rational combination of natural proteins and surfactants.

Mechanical Thrombectomy in Patients with Acute Ischemic Stroke and ASPECTS ≤5.

OBJECTIVE: This study examined the clinical features, functional outcomes, and prognostic indicators of acute ischemic stroke (AIS) patients who had an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) ≤ 5 and who underwent mechanical thrombectomy (MT). METHODS: We included consecutive AIS patients with ASPECTS ≤ 5 who had received MT at the same hospital. Demographic, clinical, and radiological data were collected and analyzed. Functional outcome at 90 days after treatment was classified as good or poor based on the modified Rankin Scale (mRS). RESULTS: Of the 152 included patients with ASPECTS ≤ 5 who received MT, 64 (42.11%) experienced poor functional outcomes and 32 (21.1%) experienced good functional outcomes. The independent predictors of poor functional outcomes were the presence of respiratory tract infections (OR 3.72, 95% CI 1.17-11.91), modified thrombolysis in cerebral infarction (OR 0.41, 95% CI 0.2-0.83), symptomatic intracerebral hemorrhage (sICH) (OR 4.96, 95% CI 1.36-18.13), and baseline score on the National Institute of Health Stroke Scale (NIHSS) (OR 1.18, 95% CI 1.03-1.36). Independent predictors of 90-day mortality included time from groin puncture to recanalization (OR 1.03, 95% CI 1.01-1.05), NIHSS scores (OR 1.28, 95% CI 1.12-1.47) and the occurrence of sICH (OR 1.81, 95% CI 1.25-5.75). CONCLUSION: AIS patients with ASPECTS ≤ 5 can experience good functional outcomes after MT. However, patients with sICH, respiratory infection, higher NIHSS score or failed recanalization are more likely to experience poor functional outcomes.

The Relationship Between Family Support and e-Learning Engagement in College Students: The Mediating Role of e-Learning Normative Consciousness and Behaviors and Self-Efficacy.

Due to the current COVID-19 pandemic, colleges and universities have implemented network teaching. E-learning engagement is the most important concern of educators and parents because this will directly affect student academic performance. Hence, this study focuses on students' perceived family support and their e-learning engagement and analyzes the effects of e-learning normative consciousness and behaviors and self-efficacy on the relationship between family support and e-learning engagement in college students. Prior to this study, the relationship between these variables was unknown. Four structural equation models revealed the multiple mediating roles of e-learning normative consciousness and behaviors and self-efficacy in the relationship between family support and e-learning engagement. A total of 1,317 college students (mean age=19.51; 52.2% freshman) voluntarily participated in our study. The results showed that e-learning normative consciousness and behaviors and self-efficacy played significant and mediating roles between students' perceived family support and e-learning engagement. Specifically, these two individual variables fully mediated the relationship between students' perceived family support and e-learning engagement. The multiple mediation model showed that family members can increase family support of their children by creating a household environment conducive to learning, displaying positive emotions, demonstrating the capability to assist their children, advocating the significance of learning normative consciousness and behaviors, and encouraging dedicated and efficient learning. The findings complement and extend the understanding of factors influencing student e-learning engagement.