: Introduction: Stroke etiology may affect the prognosis of acute basilar artery occlusion (BAO). This study aimed to estimate the efficacy and safety of endovascular treatment (EVT) in BAO strokes due to the underlying stroke etiologies of large artery atherosclerosis (LAA) and cardioembolism (CE). Patients and methods: Patients with LAA and CE subtypes from the registry EVT for Acute Basilar Artery Occlusion Study (BASILAR) were selected for this analysis. We estimated the EVT treatment effect relative to standard medical treatment (SMT) in these patients by using a propensity score approach with inverse probability of treatment weighted estimation. Outcomes included 90-day favorable functional outcomes (modified Rankin scale (mRS) 0–3), functional independence (mRS 0–2), all-cause mortality, and symptomatic intracranial hemorrhage (sICH). Results: A total of 744 patients were included in the final analysis. After weighting with inverse probability of treatment estimation, the patients who, based on their characteristics, were treated with EVT rather than SMT, demonstrated higher rates of favorable functional outcomes in both the LAA (29.2% vs 11.7%, adjusted OR with 95% CI: 4.34 [2.15–8.78], p < 0.001) and the CE subtype (36.0% vs 8.1%, adjusted OR with 95% CI: 9.14 [1.96–42.55], p = 0.005). A similar finding was also observed for functional independence. EVT patients also demonstrated lower rates of mortality than SMT. Among EVT patients, no significant difference was observed in mortality or sICH between LAA and CE groups, but LAA patients had lower rates of favorable functional outcome and functional independence (29.2% vs 37% and 24.2% vs 32.9%, respectively), where the latter remained significant after adjustment for imbalances in baseline data (p = 0.04). Conclusions: In acute BAO strokes, both LAA and CE patients who, based on their characteristics, were treated with EVT rather than SMT, demonstrated better outcomes. Among EVT patients, LAA and CE subtypes displayed important baseline and treatment differences, and LAA patients were less likely to achieve functional independence at 3 months, but mortality and sICH were similar between LAA or CE subtypes. These results need to be confirmed in future clinical trials.

Cardiopulmonary resuscitation (CPR) is vital for saving patients experiencing cardiac arrest. Teaching CPR skills through short videos offers numerous advantages. However, potential inaccuracies or misinformation could mislead the public and impact the effectiveness of CPR education. This study aims to evaluate the quality and accuracy of CPR instructional videos shared on three major short video platforms in China (TikTok, Bilibili, and REDnote), analyze common irregular or erroneous practices, and provide valuable suggestions for content optimization. The collected videos were evaluated using a five-point scoring criterion based on 2020 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). The videos were categorized into three levels: excellent, moderate, and poor, based on their video quality scores for CPR procedures and non-procedural content. Further categorization was made by video duration (≤5 min as short; >5 min as long). Additionally, the most critical and prevalent irregularities or errors were documented, and a detailed analysis of the most popular video from each platform was carried out. The relationship between video quality and popularity, and video duration and popularity were examined separately. A total of 100 CPR instructional videos were analyzed. While 86% of the videos were produced by healthcare professionals, substantial errors were identified in critical areas such as the extra time spent removing foreign body airway obstruction (67%), and incorrect hand position during compression (62%). Other issues with non-procedural content were identified, including video acceleration (13%), lack of step-by-step explanations (61%), etc. Statistical analysis revealed no significant differences in popularity across videos of different quality or duration (p = 0.876 among video quality groups for CPR procedures, p = 0.988 among video quality groups for non-procedural content, p = 0.260 between video duration groups). This study identified the necessity for improvements in CPR procedures and non-procedural content of CPR instructional videos. To enhance video quality, measures such as rigorous review mechanisms, public feedback and promotion of certified high-quality videos are recommended.

Background: Parkinson's disease (PD), a prevalent and progressive neurodegenerative disorder, currently lacks effective and satisfactory pharmacological treatments. Computational drug repurposing represents a promising and efficient strategy for drug discovery, aiming to identify new therapeutic indications for existing pharmaceuticals.Methods: We employed a drug-target network approach to computationally repurpose FDA-approved drugs from databases such as DrugBank. A literature review was conducted to select candidates not previously reported as pharmacoprotective against PD. Subsequent in vitro evaluation utilized Cell Counting Kit-8 (CCK8) assays to assess the neuroprotective effects of the selected compounds in the SH-SY5Y cell model of Parkinson's disease induced by 1-methyl-4-phenylpyridinium (MPP+). Furthermore, an in vivo mouse model of Parkinson's disease induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) was developed to investigate the mechanisms of action and therapeutic potential of the identified drug candidates.Results: Our approach identified 176 drug candidates, with 28 selected for their potential anti-Parkinsonian effects and lack of prior PD-related reporting. CCK8 assays showed significant neuroprotection in SH-SY5Y cells for Omaveloxolone and Cyproheptadine. In the MPTP-induced mouse model, Cyproheptadine inhibited interleukin-6 (IL-6) expression and prevented Tyrosine Hydroxylase (TH) downregulation via the MAPK/NFκB pathway, while Omaveloxolone alleviated TH downregulation, potentially through the Kelch-like ECH-associated protein 1 (KEAP1)-NF-E2-related factor 2 (Nrf2)/antioxidant response element (ARE) pathway. Both drugs preserved dopaminergic neurons and improved neurological deficits in the PD model.Conclusion: This study elucidates potential drug candidates for the treatment of Parkinson's disease through the application of computational repurposing, thereby underscoring its efficacy as a drug discovery strategy.

Background The triglyceride-glucose (TyG) index, a simple and reliable surrogate marker of insulin resistance, has been shown to correlate with adverse stroke outcomes. This study aims to evaluate the association between TyG index and outcomes in patients undergoing endovascular treatment (EVT) for large vessel occlusion (LVO) due to different etiologies. Methods A total of 702 patients with acute anterior-circulation LVO due to large artery atherosclerosis (LAA) and cardioembolism (CE), who underwent EVT, were retrospectively included in this study between September 2018 and January 2024. The TyG index was categorized into tertiles: T1 (TyG ≤ 6.92), T2 (6.92 < TyG ≤ 7.60), and T3 (TyG > 7.60). The primary outcome was a shift toward worse outcome on the modified Rankin Scale (mRS). Secondary outcomes included 3-month poor outcome (mRS ≥ 3), successful recanalization, symptomatic intracranial hemorrhage (sICH), and 3-month mortality. Results Among EVT patients (median age 69 years, 55.1% male), the median TyG index was 7.43 (6.93-8.00) for LAA and 7.05 (6.65–7.71) for CE ( p < 0.001). In LAA patients, an elevated TyG index was associated with mRS shift (adjusted odds ratio [OR] = 1.79; 95% CI = 1.34–2.41; p < 0.001), 3-month poor outcome ( OR = 1.61; 95% CI = 1.13–2.34; p = 0.009), and mortality (OR = 1.77; 95% CI = 1.12–2.82; p = 0.015), but not with successful recanalization or sICH. Similar association was also oberved in CE or all patients. However, there was no significant CE/LAA and TyG index interaction on any outcome. Conclusion This study found that while the TyG index differed between LAA and CE patients with LVO undergoing EVT, elevated TyG index was associated with worse clinical outcomes in both groups.

Background: Both the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and collateral status are well-established predictors of clinical outcomes in patients with large ischemic stroke undergoing endovascular therapy (EVT); however, they have traditionally been assessed independently. This study aimed to evaluate the prognostic value of a combined imaging score, the AS-TCIS score, which integrates ASPECTS and collateral status into a unified framework. Methods: This study is a subanalysis of a prospective multicenter cohort including patients with ASPECTS ≤5 enrolled between November 2021 and February 2023. The AS-TCIS score was constructed by integrating the 5-point ASPECTS with collateral status, including the 3-point Tan score and the 8-point comprehensive venous outflow (CVO) score, yielding a 16-point composite scale. The primary outcomes were 90-day functional outcome (modified Rankin Scale [mRS] 0–3) and mortality. Results: Of 750 patients, 287 were eligible (median age 67 years; 58.5% male; median AS-TCIS score 8). In multivariable models, each 1-point increase in AS-TCIS was associated with higher odds of mRS 0–3 (OR 1.38; 95% CI 1.24–1.56) and mRS 0–2 (OR 1.30; 95% CI 1.17–1.47), and lower odds of mortality (OR 0.74; 95% CI 0.66–0.82), with no significant association with symptomatic intracranial hemorrhage (OR 0.92; 95% CI 0.82–1.03). AS-TCIS also demonstrated a linear association with functional outcome and mortality. Compared with ASPECTS, Tan score, and their combination, AS-TCIS showed consistently higher AUCs and improved model fit across all outcomes. Conclusion: The AS-TCIS score, a composite of ASPECTS and collateral status, was independently associated with 90-day outcomes in patients with large ischemic stroke undergoing EVT. It may provide incremental value for risk stratification and outcome prediction in acute stroke imaging assessment.