This is the first Canadian study to examine practice patterns and perceptions of central retinal artery occlusion (CRAO) management among neurologists. An online survey was distributed nationwide to neurologists practicing in hyperacute stroke in Canada. Of 64 respondents, over half reported never having provided thrombolysis, although there was willingness to provide it if patients met the criteria. Ophthalmology support was deemed necessary in most cases of suspected CRAO to facilitate thrombolysis; however, virtual consultation would always be accepted by 41% of providers. These survey findings help to understand multidisciplinary practice patterns to develop educational strategies and inform future frameworks to guide care for patients with CRAO.

Dynapenic abdominal obesity (DAO), characterised by the combination of low muscle strength and abdominal fat accumulation, is an emerging health risk phenotype. Its association with incident stroke remains inadequately explored. This prospective cohort study investigated the relationship between DAO and new-onset stroke in middle-aged and older adults. We analysed data from the China Health and Retirement Longitudinal Study (CHARLS, n 10 153) and used the English Longitudinal Study of Ageing (ELSA, n 5421) for external validation, over a seven-year follow-up. Participants were categorised into four groups: no dynapenia or abdominal obesity (ND/NAO), isolated abdominal obesity, isolated dynapenia and DAO. After adjusting for socio-demographic, lifestyle and comorbidity factors, multivariable logistic regression revealed that DAO was significantly associated with a higher risk of stroke in both CHARLS (OR = 1·96, 95 % CI: 1·37–2·76, P < 0·001) and ELSA (OR = 2·38, 95 % CI: 1·11–5·10, P = 0·025) compared with the ND/NAO group. The risk conferred by DAO exceeded that of either condition in isolation. Stratified analysis suggested a potentially stronger association in urban Chinese men; however, effect modification was not statistically significant. We conclude that DAO is a significant, independent risk factor for stroke in both populations, with combined effects exceeding isolated conditions. This phenotype represents a practical, cross-population marker for clinicians and nutritionists to identify individuals at elevated stroke risk warranting targeted intervention, with potentially important implications for urban Chinese men.

This study aims to systematically identify and describe all randomized controlled trials (RCTs) evaluating post-stroke motor and cognitive rehabilitation conducted in Canada, within the broader context of global post-stroke rehabilitation research. The present secondary descriptive/bibliometric analysis used data derived from five integrated systematic reviews conducted by the same research group, from inception to 2024. A subset of data was examined in Canadian trials, including number of RCTs, sample size, participant sex, time post-stroke, methodological quality, intervention types and outcome measures. In total, 106 out of 3602 global RCTs were conducted in Canada. Canadian RCT relative contribution to global research has slowed down over time. Sample size was significantly smaller in the chronic post-stroke phase compared to acute and subacute phases in both Canadian (p = 0.013) and global trials (p < 0.001). Compared to global trials, Canadian RCTs had comparable sample size (p = 0.72) and methodological quality (p = 0.94) but were more likely to be conducted in the chronic phase (p = 0.001), evaluate exercise-based and rehabilitation-oriented interventions and assess activity and participation outcome measures. Chronic trials were more likely to be led by academic therapists (p = 0.031), while the acute and subacute trials were more likely to be led by academic physicians (p = 0.003). Canadian RCTs have made important contributions to stroke rehabilitation research. However, expanding research into earlier recovery phases, integrating technology-driven interventions and incorporating outcome measures across all three International Classification of Functioning, Disability and Health domains will be important to strengthening Canada’s impact and advancing stroke rehabilitation evidence.

Little is known about the combined association of physical activity (PA) and dietary quality (DQ) with stroke and its mortality outcomes. This study aims to investigate the individual and combined association of PA and DQ on odds of prevalent stroke and mortality among stroke survivors. We analysed data from 20 225 adults participating in the 2007–2018 National Health and Nutrition Examination Survey, including 838 stroke survivors. PA was measured by the self-reported metabolic equivalent to task (MET) minutes per week and DQ by Healthy Eating Index 2020 (HEI-2020). Logistic regression models evaluated associations with the odds of prevalent stroke, and Cox proportional hazards regression models assessed mortality risks among stroke survivors. Compared with no PA–lower DQ (reference), low PA–lower DQ (adjusted OR 0·49, 95 % CI 0·32–0·75), low PA–higher DQ (adjusted OR 0·56, 95 % CI 0·34–0·92), high PA–lower DQ (adjusted OR 0·66, 95 % CI 0·44–0·99) and high PA–higher DQ (adjusted OR 0·50, 95 % CI 0·34–0·73) were significantly associated with lower odds of stroke. Among stroke survivors, reduced mortality was observed for low PA–higher DQ (adjusted hazard ratio (HR) 0·43; 95 % CI 0·19–0·95), high PA–lower DQ (HR 0·36; 95 % CI 0·17–0·75) and high PA–higher DQ (HR 0·47; 95 % CI 0·27–0·83). This large observational study showed that a combination of appropriate PA and higher DQ is associated with reduced odds of stroke and mortality among stroke survivors. These findings support lifestyle modification as a strategy for stroke prevention and survivor care.

Stroke is a leading cause of death and a major contributor to long-term disability worldwide. Accurate stroke assessment is critical for both research and clinical care. In vivo neuroimaging modalities, particularly CT and MRI, are widely used and increasingly coupled with deep learning (DL) to improve stroke assessment. These approaches have matured rapidly and benefit from harmonized imaging protocols and growing multi-center datasets, but they remain limited in sensitivity to microinfarcts, subtle early ischemic changes, and cellular-level pathology. Digital pathology, through whole-slide imaging, offers unmatched tissue-level resolution and biological ground truth for validating imaging biomarkers, yet DL applications for infarct analysis in histopathology remain comparatively underdeveloped and data-limited, with most existing work focused on vascular morphometry or neurodegenerative pathology rather than infarct analysis. This review aims to provide insights from pathology, radiology, and computational sciences. We summarize dominant architectural trends in in vivo imaging, review emerging computational pathology approaches, and describe MRI-pathology correlation and ex vivo validation workflows. We further examine key translational challenges, including dataset scarcity, scanner and staining variability, demographic bias, computational feasibility, and limited external validation. Finally, we outline future directions emphasizing harmonized data infrastructure, multimodal integration, and emerging foundation models to enable scalable, biologically grounded, and equitable infarct assessment across clinical and research settings.

Neuropsychiatric disorders (NPDs) are a leading cause of disability worldwide. The predominantly plant-based EAT–Lancet diet has been proposed to confer neuropsychiatric benefits, yet evidence remains limited. This study synthesized associations between adherence to the EAT–Lancet diet and neuropsychiatric outcomes. We searched PubMed, Web of Science, Embase, Scopus, and ProQuest Dissertations and Theses Global through September 4, 2025. Observational studies reporting associations between EAT–Lancet adherence and NPDs were included. Binary outcomes were pooled as hazard ratios (HRs) or odds ratios (ORs), and continuous outcomes as regression coefficients (β). Subgroup, sensitivity, and publication-bias analyses were performed. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework (GRADE). Twenty-two cohort and six cross-sectional studies were included. Higher adherence to the EAT–Lancet diet was associated with lower risks of depression (OR 0.76; 95% CI 0.71–0.81), anxiety (OR 0.82; 0.76–0.89), stroke (HR 0.84; 0.76–0.92), and dementia (HR 0.96; 0.93–1.00), whereas no significant association was observed for global cognitive function (β 0.02; −0.01 to 0.06). Sensitivity analyses supported robustness. Certainty of evidence was very low for anxiety, depression, and cognition, and low for stroke and dementia. Greater adherence to the EAT–Lancet diet was associated with lower risks of depression, anxiety, stroke, and dementia. However, given the low certainty of evidence, findings should be interpreted cautiously. Further large prospective studies and randomized controlled trials are warranted to improve evidence quality and clarify the potential role of the EAT–Lancet diet in neuropsychiatric disease prevention.

Evidence on the association between chronic hepatitis B virus (HBV) infection and stroke is limited, inconsistent, and confined predominantly to endemic regions in Asia. This study investigated the association between chronic HBV infection and stroke using data from the largest healthcare provider in Israel. All individuals aged 20 and older who were tested for hepatitis B surface antigen (HBsAg) between 2005 and 2023 were identified. Newly diagnosed HBV patients (HBsAg-positive) were propensity scorematched to non-HBV subjects (HBsAg-negative) in a 1:4 ratio and followed for stroke occurrence through 2024. The study included 20 544 HBV patients and 82 176 matched controls. Overall stroke was diagnosed in 472 HBV patients and 1 717 controls (incidence rates: 2.13 vs. 1.94 per 1 000 person-years). Hazard ratios were 1.09 (95% CI, 0.98–1.22) for overall stroke, 1.01 (0.89–1.14) for ischemic stroke, and 1.82 (1.35–2.45) for intracerebral hemorrhage (ICH). Ischemic stroke risk was specifically increased in younger individuals and females (p-for-interaction = 0.006 and 0.079, respectively). Results remained consistent when excluding patients with prior stroke. Exploratory analysis suggested hepatitis D coinfection is associated with increased ICH risk. In conclusion, chronic HBV infection was associated with significantly increased ICH risk, with subgroup-specific increases in ischemic stroke risk.

Using National Health and Nutrition Examination Survey data (2011–2020), we assessed the association between the nutritional risk index (NRI) and stroke risk among 22 839 adults (mean age, 49·61 (sd 17·07) years), including 910 individuals (3·98 %) with stroke. Weighted multivariable logistic regression and restricted cubic spline (RCS) analysis were used to characterise the association, with subgroup analyses to examine consistency across populations and mediation analyses to investigate the roles of lipid and inflammatory biomarkers. Higher continuous NRI was inversely associated with stroke, with each 1-unit increase associated with 4 % lower odds (OR = 0·96, 95 % CI: 0·95, 0·97), and participants in the highest NRI quartile (Q4) had a significantly lower stroke risk than those in the lowest NRI quartile (Q1) (OR 0·60, 95 % CI 0·42, 0·85). RCS analysis indicated a linear relationship (P for nonlinearity > 0·05), and the protective effect of higher NRI remained robust across nearly all subgroups examined. Mediation analyses revealed that total cholesterol, systemic immune-inflammation index, product of platelet and neutrophil count, neutrophil:lymphocyte ratio and lymphocyte:monocyte ratio each partially mediated the NRI–stroke association, with mediation effects ranging from 1·71 % to 13·65 %. These findings suggest that favourable nutritional status, reflected by higher NRI, is linked to lower stroke risk, with lipid metabolism and inflammation playing mediating roles in this association. Further longitudinal and mechanistic studies are warranted.

Intravenous thrombolysis for ischemic stroke after recent direct oral anticoagulant (DOAC) ingestion remains controversial due to hemorrhagic risk, limited rapid testing and inconsistent reversal strategies. We conducted an invite-only, web-based cross-sectional survey of Canadian stroke centers using a structured questionnaire. DOAC level testing was inconsistently available, with 9/13 centers (69%) reporting access but 8/13 centers (61%) reporting turnaround times exceeding 30 minutes. Consequently, 9/13 centers (69%) did not routinely use DOAC levels to guide thrombolysis decisions. Current practice demonstrates substantial variability and uncertainty, highlighting important evidence gaps and the potential role of clinical trials and consensus guideline development.

This study is a prospective observational study to systematically compare the effects of intermittent tube feeding and thickened feeding on dehydration status, thirst degree and quality of life in patients with dysphagia after stroke. A total of forty-eight patients with dysphagia after stroke were selected and divided into intermittent tube feeding group (twenty-four cases) and thickened feeding group (twenty-four cases). The grouping was based on the nutritional intake mode after clinical decision-making. Participants were selected from the Affiliated Brain Hospital of Nanjing Medical University and the First Affiliated Hospital of Nanjing Medical University. All enrolled patients received conventional treatment and nursing measures and were treated for 2 weeks. The dehydration status was evaluated by plasma osmotic pressure. The degree of thirst is evaluated by the Numerical Rate Scale. Total protein and Hb are used to assess nutritional status; The Functional Oral Intake Scale (FOIS) assesses swallowing function. The Swallowing Quality of Life Scale (SWAL-QOL) was used to assess the quality of life. After 2 weeks of treatment, the improvement in dehydration and thirst in intermittent tube feeding group was better than that in thickened feeding group (P < 0·05). The FOIS and SWAL-QOL scores of both groups of patients improved compared with those before treatment (P < 0·05). Intermittent tube feeding can improve the dehydration status of patients with dysphagia after stroke, relieve thirst and enhance swallowing function and quality of life. The study may provide a more comprehensive basis for the selection of clinical nutritional support plans.