True first-pass effect in basilar artery occlusions: First-pass complete reperfusion improves clinical outcome in stroke thrombectomy patients

Background: Complete reperfusion (mTICI 3) in anterior circulation ischemic stroke patients after a single mechanical thrombectomy (MT) pass has been identified as a predictor of favorable outcome (modified Rankin Score 0-2) and defined as true first-pass effect recently. This effect has not yet been demonstrated in posterior circulation ischemic stroke. We hypothesized a true first-pass effect for the subgroup of acute basilar artery occlusions (BAO). Methods: Consecutive patients with acute thromboembolic occlusions in the posterior circulation, treated between 2010 and 2017, were screened and all BAO patients with complete angiographic reperfusion and known symptom onset included for unmatched and matched analysis after adjustment for multiple confounding factors (demographics, time intervals, stroke severity, posterior circulation Alberta Stroke Program early computed tomography Score and comorbidity. The primary objective was outcome at 90 days between matched cohorts of single pass vs. multi pass complete reperfusion patients. Results: 90 MTs in BAO were analyzed, yielding 56 patients with known symptom onset, in whom we achieved complete reperfusion (mTICI 3), depending on whether complete reperfusion was achieved after a single pass (n = 28) or multiple passes (n = 28). Multivariable analysis of 56 non-matched patients revealed a significant association between first-pass complete reperfusion and favorable outcome (p < 0.01). In matched cohorts (n = 7 vs. n = 7), favorable outcome was only seen if complete reperfusion was achieved after a single pass (86% vs. 0%). Conclusion: Single pass complete reperfusion in acute basilar artery occlusion is an independent predictor of favorable outcome. Achieving complete reperfusion after multiple passes might impair favorable patient recovery. (c) 2021 Elsevier Ltd. All rights reserved

Articulating Design Principles for Productive Use of Video in Preservice Education

Despite the potential of video for professional learning, the field lacks an integrated framework to inform teacher educators’ pedagogical decision making, particularly in the context of preservice teacher education. This article aims to make a conceptual argument about productive ways of using video in preservice education contexts. Drawing on situative and sociocultural perspectives, we theorize how and under what conditions video can be used productively. We discuss existing frameworks and tools that guide the design of video-embedded learning environments. We then present an integrated framework, the principled use of video (PUV) to specify principles, processes, and key considerations for creating a system of video-embedded activities. The merits and potential pitfalls of the PUV framework are discussed using an illustrative case. We argue that productive use of video that facilitates the desired learning of preservice teachers involves attention to both the learning ecology and underlying theories of preservice teacher learning