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The development, use, and timely promotion of Open Education (OE) has been effective in addressing myriad educational concerns, including inclusivity, accessibility and learning achievement, among many others. However, limited information exists in the literature concerning how OE could enhance Generative Artificial Intelligence (GenAI), which is receiving extensive interest and criticism at this time. To address this research gap, this study relies on the Open Educational Practices (OEP) framework of Huang et al. (2020) to provide various OEP scenarios that could help to promote and facilitate the effective and safe adoption of GenAI in education. The findings of this study could provide guidelines on how relying on OEP when adopting GenAI could help in ensuring quality education which is the sustainable development goal (SDG 4) of the United Nations (UN).

Background and Purpose The management of acute ischemic stroke (AIS) due to distal medium vessel occlusion (DMVO) remains uncertain, particularly in comparing the effectiveness of intravenous thrombolysis (IVT) plus mechanical thrombectomy (MT) versus IVT alone. This study aimed to evaluate the safety and efficacy in DMVO patients treated with either MT-IVT or IVT alone. Methods This multinational study analyzed data from 37 centers across North America, Asia, and Europe. Patients with AIS due to DMVO were included, with data collected from September 2017 to July 2023. The primary outcome was functional independence, with secondary outcomes including mortality and safety measures such as types of intracerebral hemorrhage. Results The study involved 1,057 patients before matching, and 640 patients post-matching. Functional outcomes at 90 days showed no significant difference between groups in achieving good functional recovery (modified Rankin Scale 0–1 and 0–2), with adjusted odds ratios (OR) of 1.21 (95% confidence interval [CI] 0.81 to 1.79; P=0.35) and 1.00 (95% CI 0.66 to 1.51; P>0.99), respectively. Mortality rates at 90 days were similar between the two groups (OR 0.75, 95% CI 0.44 to 1.29; P=0.30). The incidence of symptomatic intracerebral hemorrhage was comparable, but any type of intracranial hemorrhage was significantly higher in the MT-IVT group (OR 0.43, 95% CI 0.29 to 0.63; P

This manifesto critically examines the unfolding integration of Generative AI (GenAI), chatbots, and algorithms into higher education, using a collective and thoughtful approach to navigate the future of teaching and learning. GenAI, while celebrated for its potential to personalize learning, enhance efficiency, and expand educational accessibility, is far from a neutral tool. Algorithms now shape human interaction, communication, and content creation, raising profound questions about human agency and biases and values embedded in their designs. As GenAI continues to evolve, we face critical challenges in maintaining human oversight, safeguarding equity, and facilitating meaningful, authentic learning experiences. This manifesto emphasizes that GenAI is not ideologically and culturally neutral. Instead, it reflects worldviews that can reinforce existing biases and marginalize diverse voices. Furthermore, as the use of GenAI reshapes education, it risks eroding essential human elements—creativity, critical thinking, and empathy—and could displace meaningful human interactions with algorithmic solutions. This manifesto calls for robust, evidence-based research and conscious decision-making to ensure that GenAI enhances, rather than diminishes, human agency and ethical responsibility in education.

Background Acute ischemic stroke arising from medium vessel occlusions (MeVO) poses substantial challenges in treatment and management. This study aims to elucidate the outcomes and factors contributing to achieving excellent recanalization (modified Thrombolysis in Cerebral Infarction [mTICI] 2c–3) versus successful recanalization (mTICI 2b) in patients with MeVO stroke undergoing mechanical thrombectomy (MT). Methods We conducted a multinational study analyzing data from the MAD‐MT (Multicenter Analysis of Distal Medium Vessel Occlusions: Effect of Mechanical Thrombectomy) registry, encompassing 37 centers across North America, Asia, and Europe, collected between September 2017 and July 2023. The study included acute ischemic stroke patients with MeVO treated with MT, with or without intravenous thrombolysis, who achieved mTICI 2b–3 post‐MT. Results Among 1463 patients with successful recanalization (mTICI 2b–3), 523 achieved mTICI 2b recanalization, and 940 achieved mTICI 2c–3. Distal occlusions exhibited higher odds of excellent recanalization compared with proximal MeVO vessel occlusions (odds ratio, 1.58; 95% CI, 1.17–2.15; P = 0.003). Cardioembolic stroke pathogenesis was associated with a higher likelihood of excellent recanalization (1.67; 95% CI, 1.07–2.59; P = 0.018). Patients achieving mTICI 2c–3 recanalization demonstrated lower initial National Institutes of Health Stroke Scale scores, significant improvements in postprocedural National Institutes of Health Stroke Scale shift, and a higher percentage of favorable 90‐day outcomes compared with those with mTICI 2b. However, no significant difference in 90‐day mortality rates was observed. Conclusion This study underscores that among patients with MeVO stroke with successful recanalization (mTICI 2b–3) there is higher likelihood of achieving excellent recanalization (mTICI 2c–3) in distal occlusions and cardioembolic pathogenesis. mTICI 2c–3 scores post‐MT correlate with improved clinical outcomes compared with mTICI 2b, affirming the superiority of excellent recanalization over successful recanalization in patients with MeVO stroke. Further prospective studies and randomized controlled trials are warranted for validation.

Background Data on impact of COVID‐19 vaccination and outcomes of patients with COVID‐19 and acute ischemic stroke undergoing mechanical thrombectomy are scarce. Addressing this subject, we report our multicenter experience. Methods and Results This was a retrospective analysis of patients with COVID‐19 and known vaccination status treated with mechanical thrombectomy for acute ischemic stroke at 20 tertiary care centers between January 2020 and January 2023. Baseline demographics, angiographic outcome, and clinical outcome evaluated by the modified Rankin Scale score at discharge were noted. A multivariate analysis was conducted to test whether these variables were associated with an unfavorable outcome, defined as modified Rankin Scale score >3. A total of 137 patients with acute ischemic stroke (48 vaccinated and 89 unvaccinated) with acute or subsided COVID‐19 infection who underwent mechanical thrombectomy attributable to vessel occlusion were included in the study. Angiographic outcomes between vaccinated and unvaccinated patients were similar (modified Thrombolysis in Cerebral Infarction ≥2b: 85.4% in vaccinated patients versus 86.5% in unvaccinated patients; P=0.859). The rate of functional independence (modified Rankin Scale score, ≤2) was 23.3% in the vaccinated group and 20.9% in the unvaccinated group (P=0.763). The mortality rate was 30% in both groups. In the multivariable analysis, vaccination status was not a significant predictor for an unfavorable outcome (P=0.957). However, acute COVID‐19 infection remained significant (odds ratio, 1.197 [95% CI, 1.007–1.417]; P=0.041). Conclusions Our study demonstrated no impact of COVID‐19 vaccination on angiographic or clinical outcome of COVID‐19–positive patients with acute ischemic stroke undergoing mechanical thrombectomy, whereas worsening attributable to COVID‐19 was confirmed.

ObjectiveMechanical thrombectomy (MT) has become the standard treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO). First-pass (FP) reperfusion of the occluded vessel and fewer passes with stent retrievers show improvement in functional outcomes in stroke patients, while higher numbers of passes are associated with higher complication rates and worse outcomes. Studies indicate that a larger size of the stent-retriever is associated with a higher rate of first-pass reperfusion and improved clinical outcomes. In this retrospective study, we investigated the clinical performance of a recently developed and one of the largest stent-retrievers available in the treatment of LVO (pRESET 6-50, phenox GmbH, Bochum).Materials and methodsAll consecutive patients with ischemic stroke due to proximal large vessel occlusion treated with MT using the pRESET 6-50 stent-retriever in two tertiary stroke centers between 09/2021 and 07/2022 were included in this study. The reperfusion rate after MT was quantified by the modified thrombolysis in cerebral infarction (mTICI) score, and functional neurological outcome was evaluated with the National Institutes of Health Stroke Scale (NIHSS) score and the major early neurological recovery (mENR) rate after 24 h. Successful FP reperfusion was defined as mTICI ≥ 2b. Successful and complete reperfusion were defined as mTICI ≥ 2b and mTICI ≥ 2c, respectively.ResultsIn total, 98 patients (52 men and 46 women) with a median age of 75 (range 25–95 years) were included. A total of 70 (72%) patients presented with an occlusion of the middle cerebral artery (MCA) in the M1 segment, 6 (6%) patients with an occlusion of the M2 segment, 17 (17%) patients with an occlusion of the internal carotid artery (ICA), and 5 (5%) patients with an occlusion of the obstructed basilar artery (BA). Successful FP reperfusion was achieved in 58 patients (62%). Successful and complete reperfusion were achieved in 95 (97%) and 82 (83%) patients, respectively. The median National Institutes of Health Stroke Scale (NIHSS) in all treated patients improved from 17 to 7.5. Major early neurological recovery (mENR) was observed in 34 patients (35.1%).ConclusionMT with the pRESET 6-50 stent-retriever achieves high successful first-pass and final reperfusion rates in patients with AIS and LVO. The results of this study support the thesis to use large-format stent-retriever in proximal vessel occlusion MT whenever feasible in order to improve high FP and final reperfusion rate, which are known predictors of good clinical outcome.

The emergence of open educational resources (OER) represents one of the most significant educational developments in the 21st century. Given their capacity to be freely adapted, re-used, and shared in different contexts, OER expand the options for educators. This paper reports on an initial study concerning such choices in which educators’ personalities are investigated in relation to the OER adoption. Choosing open approaches has been shown to correlate with personal attitudes and several studies have highlighted the potential and need for investigating how personality might affect OER adoption. To address this gap, this study investigates the impact of educators’ personality differences in relation to OER adoption. The analysis focuses specifically on the perception towards OER and the intention to use OER using the Five-Factor Model (FFM) to identify educators’ personalities. Following a mixed methods approach, data collected from university educators using questionnaires (57 respondents) and interviews (15 respondents) are discussed in a two-stage hierarchical regression analysis. Demographic variables (age and gender) do not show any significant relationship. Findings reveal that while the explored five personality dimensions do not have an impact on the educator attitudes towards OER, they seem to have a significant impact on their intention to use OER. Specifically, only three personality dimensions – namely, extraversion, agreeableness, and openness – have a significant impact on the intention to use OER. This shows that ‘open attitude’ (mixing extraversion, and agreeableness, and openness) may be a fundamental prerequisite for educators to engage in open teaching practices, including the use of OER.

Why is Openness in Education important, and why is it critically needed at this moment? As manifested in our guiding question, the significance of Openness in Education and its immediate necessity form the heart of this collaborative editorial piece. This rather straightforward, yet nuanced query has sparked this collective endeavour by using individual testimonies, which may also be taken as living narratives, to reveal the value of Openness in Education as a praxis. Such testimonies serve as rich, personal narratives, critical introspections, and experience-based accounts that function as sources of data. The data gleaned from these narratives points to the understanding of Openness in Education as a complex, multilayered concept intricately woven into an array of values. These range from aspects such as sharing, access, flexibility, affordability, enlightenment, barrier-removal, empowerment, care, individual agency, trust, innovation, sustainability, collaboration, co-creation, social justice, equity, transparency, inclusivity, decolonization, democratisation, participation, liberty, and respect for diversity. This editorial, as a product of collective endeavour, invites its readers to independently engage with individual narratives, fostering the creation of unique interpretations. This call stems from the distinctive character of each narrative as they voice individual researchers’ perspectives from around the globe, articulating their insights within their unique situational contexts.

In terms of scale, shock, and disenfranchisement, the disruption to formal education arising from COVID-19 has been unprecedented. Anecdotally, responses from teachers and educators around the world range from heightened caution to being inspired by distance education as the “new normal.” Of all the challenges, face-to-face and formal teaching have been most heavily affected. Despite some education systems demonstrating resilience, a major challenge is sustaining quality and inclusiveness in formal education suddenly delivered at a distance. In probing these issues, this article profiles international perspectives on the role of open education in responding to the impact on formal school and higher education caused by the COVID-19 pandemic. We proceed by highlighting and analysing practices and case studies from 13 countries representing all global regions, identifying and discussing the challenges and opportunities that have presented themselves. Reports cover the period from the beginning of 2020 until 11 March 2021, the first anniversary of the COVID-19 outbreak as declared by the World Health Organization. In our comparative study, we identify seven key aspects of which three (missing infrastructure and sharing OER, open education and access to OER, and urgent need for professional development and training for teachers) are directly related to open education at a distance. After comparing examples of existing practice, we make recommendations and offer insights into how open education strategies can lead to interventions that are effective and innovative—to improve formal education at a distance in schools and universities in the future.

Objective: In rare cases, Lyme neuroborreliosis (LNB) can induce cerebral vasculitis leading to severe stenosis of the cerebral vasculature and consecutive ischemia. Therapy is based on anti-biotic treatment of the tick-borne disease, whereas interventional therapeutic options have not been assessed yet. Material and Methods: We report on a patient with LNB and concomitant stenoses and progressive and fatal vasculitis of the cerebral vessels despite all therapeutic efforts by the departments of neurology and interventional neuroradiology. In this context, we also conducted a literature review on endovascular treatment of LNB-associated cerebral ischemia. Results: A 52-year-old female presented with transient neglect and psychomotor slowdown (initial NIHSS = 0). MRI and serology led to the diagnosis of basal meningitis due to LNB with vasculitis of cerebral arteries. Despite immediate treatment with antibiotics and steroids, neurologic deterioration (NIHSS 8) led to an emergency angiography on day 2 after admission. Hemodynamically relevant stenoses of the MCA were treated via spasmolysis and PTA, leading to almost complete neurological recovery. Despite intensified medical treatment, the vasculitis progressed and could only be transiently ameliorated via repetitive spasmolysis. On day 19, she again presented with significant neurologic deterioration (NIHSS 9), and PTA and stenting of the nearly occluded MCA were performed with a patent vessel, initially without hemorrhagic complications. Despite all therapeutic efforts and preserved stent perfusion, vasculitis worsened and the concurrent occurrence of subdural hemorrhage led to the death of the patient. Conclusion: Neuroradiological interventions, i.e., spasmolysis, PTA, and, if necessary, stenting, can and should be considered in cases of LNB-induced vasculitis and stroke that are refractory to best medical treatment alone. Key point: Neuroradiological interventions can be considered in patients with vascular complications of Lyme neuroborreliosis as an additional extension of the primary drug therapy.

BackgroundNeonatal stroke remains a rare condition that has not yet been assessed in the field of endovascular treatment.CaseWe present the first case report of a successful mechanical thrombectomy in a newborn with a basilar occlusion the treatment was 14 hours after birth. Complete reperfusion of the basilar artery was achieved after the two thrombectomy maneuvers with stent retrievers. Imaging follow-up proved patency of the target vessel and at day 30, the patient showed no neurologic deficits.ConclusionsMechanical thrombectomy appears to be technically feasible and can be an individual option in selected cases to treat stroke in neonates with proven persistent proximal cerebral artery occlusion.