Objectives: Of all strokes, 85% are ischemic and intracranial artery occlusion accounts for 80% of these ischemic strokes. Endovascular therapy for acute ischemic stroke was a new modality aiming at resolution of clots in occluded cerebral arteries. The platelet-to-lymphocyte ratio (PLR) was introduced as a potential marker to determine increased inflammation, which is a result of releasing many mediators from the platelets. In this study we aimed to evaluate whether the PLR had a prognostic role in stroke patients undergoing thrombectomy and attempted to determine the effect that this ratio had on their survival. Methods: Over a three-year period, demographic, clinical, and angiographic findings of 57 consecutive patients with acute ischemic stroke who underwent mechanical thrombectomy were evaluated. Results: The patients were divided into two groups on the basis of a PLR level cut-off value of 145 based on receiver operating characteristic (ROC) curve. Successful revascularization (mTICI 2b and 3) was achieved in 42 of 57 (73.7%) patients; a mTICI 3 state was observed in 21 of 23 patients with low-PLR values (p = .015). Patients with higher PLR values had significantly a score of less than six on the ASPECT scale compared to patients with lower PLR values (p = .005). The patients with low-PLR values had better functional outcomes (mRS ≤ 2) compared with the patients with high-PLR values [respectively, p = .004 (at first month) and p = .014 (at third month)]. Discussion: The platelet-to-lymphocyte ratio could represent pro-thrombotic inflammatory state in acute ischemic stroke patients because having a high-PLR values increased the poor prognosis, the rate of insufficient recanalization, and the size of infarcted area.

Objectives: In this study, we aimed to evaluate the effect of the Ischemic preconditioning (IPreC) on the expression profile of cerebral miRNAs against stroke by induced transient middle cerebral artery occlusion (MCAo) in diabetic rats. Methods: Eighty male Spraque Dawley rats were allocated to eight groups. In order to evaluate the expression profile of miRNAs, we induced transient MCAo seven days after STZ-induced diabetes (DM). Also we performed IPreC 72 h before transient MCAo to assess whether IPreC could have a neuroprotective effect against ischemia-reperfusion injury. Results: The general characteristics of STZ-treated rats included reduced body weight and elevated blood glucose levels compared to non-diabetic ones. We demonstrated that miRNA expression profiles, which are determined for biological functions such as aquaporin 4 formation (miR-29b-2, miR-124a-3p, miR-130a, miR-223 and miR-320a), glutamate toxicity (miR107, miR-145, miR-223), salvageable ischemic area (miR-9a, miR-19b, miR-29b-2, miR-341, miR-339–5p, miR-15–5p, miR-99b-5p), and neoangiogenesis (let-7f-5p, miR-126a and miR-322–3p), were regulated following IPreC. Ischemic preconditioning before cerebral ischemia significantly reduced infarction size compared with the other groups [IPreC + MCAo (27 ± 11 mm³) vs. MCAo (109 ± 15 mm³) p < 0.001; DM + IPreC + MCAo (38 ± 9 mm³) vs. DM + MCAo (165 ± 41 mm³) p < 0.001, respectively]. Discussion: The study results revealed the neuroprotective effects of ischemic preconditioning, supported with the upregulated pro-survival miRNAs in MCA infarcts.

Spinal fusion cages play a crucial role in stabilizing the spine and promoting bone growth in degenerative spine disorders. Recent advancements in biodegradable polymer‐based cages have introduced materials with shape memory properties, enabling minimally invasive implantation and improved adaptability. This study focuses on the development of 4D‐printed PLA/PCL blend spinal cages, investigating their thermal, mechanical, biodegradation, and shape memory properties, alongside surface wettability through contact angle measurements. The novelty of this study lies in identifying the optimal PLA/PCL ratio, balancing mechanical strength, biodegradability, and shape memory behavior for spinal fusion applications. The findings highlight PLA/PCL (80:20) as the most suitable composition, offering a well‐balanced combination of properties. Differential scanning calorimetry (DSC) analysis revealed that 20 wt% PCL enhances toughness, flexibility, and crystallinity while slightly reducing the glass transition temperature. Mechanical testing showed improved fracture behavior and elongation at this ratio, with tensile stress peaking before decreasing at higher PCL concentrations due to increased ductility. Biodegradation studies confirmed an increasing degradation rate with higher PCL content, while contact angle measurements indicated greater hydrophilicity, though this trend reversed at higher concentrations. Shape memory analysis demonstrated that as PCL content increased from 10 to 60 wt%, shape recovery decreased from 76.07% to 61.28%, while high shape fixity (96.42%–99.80%) was maintained. The PLA/PCL20 blend exhibited a 74.5% shape memory effect and a 68.75% recovery rate in the spinal cage design, making it a promising material for minimally invasive spinal fusion applications.

Objectives: In this study, we aimed to evaluate whether the inflammation as measured by increased platelet to lymphocyte ratio (PLR) predispose to silent infarcts in patients with paroxysmal atrial fibrillation (PAF). Methods: The present study investigated a total of 48 new diagnosed patients with PAF who had no signs of stroke. PLR, which was calculated as the ratio of the platelet count to the lymphocyte count, C-reactive protein and erythrocyte sedimentation rate were measured due to evaluate inflammatory state. Magnetic resonance imaging (MRI) was performed to evaluate the presence of silent brain infarcts (SBIs) in patients. We calculated CHA₂DS₂–VASc scores for stratifying the stroke risk of patients. Results: Among our study population, the mean age was 56.40 ± 8.99; 36 patients were female. The leading vascular risk factor was hypertension (45.8%). SBI was determined in 16 patients (33.3%) on MRI. It was found that a higher PLR is significantly associated with the presence of SBIs in patients with PAF (P = .001). High PLR group showed silent lesions predominantly multiple, greater than 5 mm, bilateral and in the subcortical region; though no statistically significant differences were found in each lesion areas (P = .214; P = .509; P = .746; P = .059, respectively). Of 16 patients who showed SBI, 1 (6.3%) patient had CHA₂DS₂–Vasc scores of 0; 7 (43.8%) patients had CHA₂DS₂–Vasc scores of 1; 6 (37.5%) patients had CHA₂DS₂ -Vasc scores of 2 and 2 (12.5%) patients had CHA₂DS₂–Vasc scores of 3. We did not find any significant relationship between CHA₂DS₂–Vasc scores and presence of SBI in the study patients (P = .850). Discussion: High PLR might be a factor to induce inflammatory process on SBIs even with low CHA₂DS₂–VASc scores.

Introduction: More than half of all worldwide deaths and disabilities were caused by stroke. Large artery atherosclerosis is identified as a high etiological risk factor because it accounts for 20% of ischemic stroke.Objectives: To identify the significance of TRAIL and adropin release and the relative changes related to S100B levels, as well as the relationship between these biomarkers and the final infarct core, the clinical outcome, and the presence of large artery atherosclerosis in acute stroke patients.Materials and methods: Over a one-year period, demographic, clinical, and neuroimaging findings of 90 consecutive patients with acute ischemic stroke were evaluated.Results: The mean age of participants was 69.28 ± 10 and 39 patients were female. The increased level of S100B and the decreased levels of sTRAIL with adropin were significantly associated with moderate to severe neurologic presentation (p=0.0001, p=0.002, p=0.002, respectively). On the control CT, a large infarct core was significantly associated with decreased serum levels of sTRAIL and adropin (p=0.001 and p=0.000, respectively); however, the levels of S100B were not significantly associated with good ASPECTS score (p=0.684). Disability and an unfavorable outcome were significantly related to the decreased level of sTRAIL and adropin (p=0.001 and p=0.000 for THRIVE score>5, respectively). Decreased sTRAIL and adropin levels and an increased S100B level were correlated with the presence of large artery atherosclerotic etiologic factors (p=0.000, p=0.000, p=0.036, respectively).Conclusion: TRAIL and adropin serum levels were associated with poor clinical outcomes and greater infarcted area in acute ischemic stroke patients.