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Fish larvae in aquaculture have high mortality rates due to pathogenic bacteria, especially the Vibrio species, and ineffective prophylactic strategies. Vaccination is not feasible in larvae and antibiotics have reduced efficacy against multidrug resistant bacteria. A novel approach to controlling Vibrio infections in aquaculture is needed. The potential of phage therapy to combat vibriosis in fish larvae production has not yet been examined. We describe the isolation and characterization of two bacteriophages capable of infecting pathogenic Vibrio and their application to prevent bacterial infection in fish larvae. Two groups of zebrafish larvae were infected with V. anguillarum (∼106 CFU mL-1) and one was later treated with a phage lysate (∼108 PFU mL-1). A third group was only added with phages. A fourth group received neither bacteria nor phages (fish control). Larvae mortality, after 72 h, in the infected and treated group was similar to normal levels and significantly lower than that of the infected but not treated group, indicating that phage treatment was effective. Thus, directly supplying phages to the culture water could be an effective and inexpensive approach toward reducing the negative impact of vibriosis in larviculture.

In patients with intracerebral haemorrhage (ICH), early haemorrhage expansion affects clinical outcome. Haemostatic treatment reduces haematoma expansion, but fails to improve clinical outcomes in many patients. Proper selection of patients at high risk for haematoma expansion seems crucial to improve outcomes. In this study, we aimed to prospectively validate the CT-angiography (CTA) spot sign for prediction of haematoma expansion. PREDICT (predicting haematoma growth and outcome in intracerebral haemorrhage using contrast bolus CT) was a multicentre prospective observational cohort study. We recruited patients aged 18 years or older, with ICH smaller than 100 mL, and presenting at less than 6 h from symptom onset. Using two independent core laboratories, one neuroradiologist determined CTA spot-sign status, whereas another neurologist masked for clinical outcomes and imaging measured haematoma volumes by computerised planimetry. The primary outcome was haematoma expansion defined as absolute growth greater than 6 mL or a relative growth of more than 33% from initial CT to follow-up CT. We reported data using standard descriptive statistics stratified by the CTA spot sign. Mortality was assessed with Kaplan-Meier survival analysis. We enrolled 268 patients. Median time from symptom onset to baseline CT was 135 min (range 22–470), and time from onset to CTA was 159 min (32–475). 81 (30%) patients were spot-sign positive. The primary analysis included 228 patients, who had a follow-up CT before surgery or death. Median baseline ICH volume was 19·9 mL (1·5–80·9) in spot-sign-positive patients versus 10·0 mL (0·1–102·7) in spot-sign negative patients (p<0·001). Median ICH expansion was 8·6 mL (−9·3 to 121·7) for spot-sign positive patients and 0·4 mL (−11·7 to 98·3) for spot-negative patients (p<0·001). In those with haematoma expansion, the positive predictive value for the spot sign was 73%; the negative predictive value was 84%, sensitivity was 63%, and specificity was 90%. Median 3-month modified Rankin Scale (mRS) was 5 in CTA spot-sign-positive patients, and 3 in spot-sign-negative patients (p<0·001). Mortality at 3 months was 43·4% (23 of 53) in CTA spot-sign positive versus 19·6% (31 of 158) in CTA spot-sign-negative patients (HR 2·4, 95% CI 1·4–4·0, p=0·002). These findings confirm previous single-centre studies showing that the CTA spot sign is a predictor of haematoma expansion. The spot sign is recommended as an entry criterion for future trials of haemostatic therapy in patients with acute ICH. Canadian Stroke Consortium and NovoNordisk Canada.

(1) Background: Consumer smartwatches may be a helpful tool to screen for atrial fibrillation (AF). However, validation studies on older stroke patients remain scarce. The aim of this pilot study from RCT NCT05565781 was to validate the resting heart rate (HR) measurement and the irregular rhythm notification (IRN) feature in stroke patients in sinus rhythm (SR) and AF. (2) Methods: Resting clinical HR measurements (every 5 min) were assessed using continuous bedside ECG monitoring (CEM) and the Fitbit Charge 5 (FC5). IRNs were gathered after at least 4 h of CEM. Lin’s concordance correlation coefficient (CCC), Bland-Altman analysis, and mean absolute percentage error (MAPE) were used for agreement and accuracy assessment. (3) Results: In all, 526 individual pairs of measurements were obtained from 70 stroke patients—age 79.4 years (SD ± 10.2), 63% females, BMI 26.3 (IQ 22.2–30.5), and NIHSS score 8 (IQR 1.5–20). The agreement between the FC5 and CEM was good (CCC 0.791) when evaluating paired HR measurements in SR. Meanwhile, the FC5 provided weak agreement (CCC 0.211) and low accuracy (MAPE 16.48%) when compared to CEM recordings in AF. Regarding the accuracy of the IRN feature, analysis found a low sensitivity (34%) and high specificity (100%) for detecting AF. (4) Conclusion: The FC5 was accurate at assessing the HR during SR, but the accuracy during AF was poor. In contrast, the IRN feature was acceptable for guiding decisions regarding AF screening in stroke patients.

Acetylsalicylic acid (ASA) and statins have been identified as potentially reducing the risk of intracranial aneurysms (IA) rupture. We aim to determine the effect of this drugs on the risk of rupture of IA. We performed a retrospective cohort study from a prospective database of patients with IA treated in our institution between January 2013 and December 2018. Demographics, previous oral treatments, presence of multiple aneurysms, size of aneurysm, lobulation, location and morphology of the aneurysms were recorded. Patients were dichotomized as ruptured and unruptured IA. A total of 408 IA were treated, of which 283 (68.6%) were in women. The median age was 53, 194 (47.5%) were ruptured IA. 38 patients (9.3%) were receiving ASA and 84 (20.6%) were receiving statins at the moment of the IA diagnosis. In the multivariable regression analysis, ASA plus statin use and multiple aneurysms were independently associated with unruptured IA (OR 5.01, 95% CI, 1.37-18.33, P = 0.015 and OR 2.72, 95% CI 1.68-4.27, P<0.001, respectively). Whereas, lobulated wall aneurysm and PComA/AComA location were inversely and independently associated with unruptured IA condition (OR 0.34, 95% CI 0.21-0.55, P<0.001 and OR 0.37, 95% CI 0.23-0.60, P<0.001, respectively). However, ASA and statins in monotherapy were not independently associated with unruptured IA condition. In our study population ASA plus statins treatment is independently associated with unruptured IA. Larger and prospective studies are required to explore this potential protective effect against IA rupture.

The Frank's sign is a diagonal earlobe crease running from the tragus to the edge of the auricle at an angle of 45°. Many studies have associated this sign with coronary artery disease and some with cerebrovascular disease. The objective of this study was to analyse the prevalence of the Frank's sign in patients suffering from acute stroke with a particular focus on its prevalence in each of the five aetiopathogenic stroke subtypes. Special interest is given to embolic stroke of undetermined source (ESUS), correlating the sign with clinical and radiological markers that support an underlying causal profile in this subgroup. Cross-sectional descriptive study including 124 patients admitted consecutively to a stroke unit after suffering an acute stroke. The Frank's sign was evaluated by the same blinded member of the research team from photographs taken of the patients. The stroke subtype was classified following SSS-TOAST criteria and the aetiological study was performed following the ESO guidelines. The Frank's sign was present in 75 patients and was more prevalent in patients with an ischaemic stroke in comparison with haemorrhagic stroke (63.9 vs. 37.5, p<0.05). A similar prevalence was found in the different ischaemic stroke subtypes. The Frank's sign was significantly associated with age, particularly in patients older than 70 who had vascular risk factors. Atherosclerotic plaques found in carotid ultrasonography were significantly more frequent in patients with the Frank's sign (63.6%, p<0.05). Analysing the ESUS, we also found an association with age and a higher prevalence of the Frank's sign in patients with vascular risk factors and a tendency to a high prevalence of atherosclerosis markers. The Frank's sign is prevalent in all aetiopathogenic ischaemic stroke subtypes, including ESUS, where it could be helpful in suspecting the underlying cardioembolic or atherothrombotic origin and guiding the investigation of atherosclerosis in patients with ESUS and the Frank's sign.

Probiotic foods offer many benefits to human health, causing increased interest in the development of new food products that exploit such benefits. However, traditional dairy foods are being replaced by other non-dairy foods to provide additional sources of benefits provided by bioactive molecules. Therefore, the objective of the present work was to study the production process of a probiotic fruit drink and then microencapsulate the probiotic pulp to stabilize the drink further. Passion fruit pulp (Passiflora edulis Sims f. flavicarpa Deg.) was fermented with Lactobacillus reuteri under different temperature conditions in combination with different pHs to find the best fermentation conditions. Different from dairy sources, the optimal conditions for the growth of Lactobacillus reuteri in the passion fruit pulp were found to be 30 °C at pH 3.18, where phenolic compounds could also be used as a secondary metabolic pathway. Spray-drying was performed using different conditions for microencapsulation. Process yields and Lactobacillus reuteri survival showed the dependency of droplet sizes, whereas phenolic compound retention was increased when higher amounts of gelatin were used. Therefore, the development of a new food product comprising a powdered fruit pulp rich in probiotic and phenolic compounds was possible.

Aquaculture facilities worldwide continue to experience significant economic losses because of disease caused by pathogenic bacteria, including multidrug‐resistant strains. This scenario drives the search for alternative methods to inactivate pathogenic bacteria. Phage therapy is currently considered as a viable alternative to antibiotics for inactivation of bacterial pathogens in aquaculture systems. While phage therapy appears to represent a useful and flexible tool for microbiological decontamination of aquaculture effluents, the effect of physical and chemical properties of culture waters on the efficiency of this technology has never been reported. The present study aimed to evaluate the effect of physical and chemical properties of aquaculture waters (e.g. pH, temperature, salinity and organic matter content) on the efficiency of phage therapy under controlled experimental conditions in order to provide a basis for the selection of the most suitable protocol for subsequent experiments. A bioluminescent genetically transformed Escherichia coli was selected as a model microorganism to monitor real‐time phage therapy kinetics through the measurement of bioluminescence, thus avoiding the laborious and time‐consuming conventional method of counting colony‐forming units (CFU). For all experiments, a bacterial concentration of ≈ 105 CFU ml−1 and a phage concentration of ≈ 106–8 plaque forming unit ml−1 were used. Phage survival was not significantly affected by the natural variability of pH (6.5–7.4), temperature (10–25°C), salinity (0–30 g NaCl l−1) and organic matter concentration of aquaculture waters in a temperate climate. Nonetheless, the efficiency of phage therapy was mostly affected by the variation of salinity and organic matter content. As the effectiveness of phage therapy increases with water salt content, this approach appears to be a suitable choice for marine aquaculture systems. The success of phage therapy may also be enhanced in non‐marine systems through the addition of salt, whenever this option is feasible and does not affect the survival of aquatic species being cultured. The efficiency of phage therapy in aquaculture systems is mostly affected by the variation of salinity and organic matter content. As the effectiveness of phage therapy increases with water salt content, this approach appears to be a suitable choice for marine aquaculture systems.

Hematoma expansion (HE) occurs in 20% of patients with hemorrhagic stroke within 24 h of onset, and it is associated with a poorer patient outcome. From a clinical point of view, predicting HE from the initial patient computed tomography (CT) image is useful to improve therapeutic decisions and minimize prognosis errors. In this work, we propose an end-to-end deep learning framework for predicting the final hematoma expansion and its corresponding lesion mask. We also explore the problem of having limited data and propose to augment the available dataset with synthetic images. The obtained results show an improved HE prediction when incorporating the use of synthetic images into the model, with a mean Dice score of the HE growth area of 0.506 and an average prediction error in hematoma volume of −3.44 mL. The proposed approach achieved results in line with state-of-the-art methods with far fewer data by using synthetic image generation and without requiring the inclusion of patient clinical data.

Publications about COVID-19 have occurred practically since the first outbreak. Therefore, studying the evolution of the scientific publications on COVID-19 can provide us with information on current research trends and can help researchers and policymakers to form a structured view of the existing evidence base of COVID-19 and provide new research directions. This growth rate was so impressive that the need for updated information and research tools become essential to mitigate the spread of the virus. Therefore, traditional bibliographic research procedures, such as systematic reviews and meta-analyses, become time-consuming and limited in focus. This study aims to study the scientific literature on COVID-19 that has been published since its inception and to map the evolution of research in the time range between February 2020 and January 2022. The search was carried out in PubMed extracting topics using text mining and latent Dirichlet allocation modeling and a trend analysis was performed to analyze the temporal variations in research for each topic. We also study the distribution of these topics between countries and journals. 126,334 peerreviewed articles and 16 research topics were identified. The countries with the highest number of scientific publications were the United States of America, China, Italy, United Kingdom, and India, respectively. Regarding the distribution of the number of publications by journal, we found that of the 7040 sources Int. J. Environ. Res. Public Health, PLoS ONE, and Sci. Rep., were the ones that led the publications on COVID-19. We discovered a growing tendency for eight topics (Prevention, Telemedicine, Vaccine immunity, Machine learning, Academic parameters, Risk factors and morbidity and mortality, Information synthesis methods, and Mental health), a falling trend for five of them (Epidemiology, COVID-19 pathology complications, Diagnostic test, Etiopathogenesis, and Political and health factors), and the rest varied throughout time with no discernible patterns (Therapeutics, Pharmacological and therapeutic target, and Repercussion health services).

A role of iron as a target to prevent stroke-induced neurodegeneration has been recently revisited due to new evidence showing that ferroptosis inhibitors are protective in experimental ischemic stroke and might be therapeutic in other neurodegenerative brain pathologies. Ferroptosis is a new form of programmed cell death attributed to an overwhelming lipidic peroxidation due to excessive free iron and reactive oxygen species (ROS). This study aims to evaluate the safety and tolerability and to explore the therapeutic efficacy of the iron chelator and antioxidant deferoxamine mesylate (DFO) in ischemic stroke patients. Administration of placebo or a single DFO bolus followed by a 72 h continuous infusion of three escalating doses was initiated during the tPA infusion, and the impact on blood transferrin iron was determined. Primary endpoint was safety and tolerability, and secondary endpoint was good clinical outcome (clinicalTrials.gov NCT00777140). DFO was found safe as adverse effects were not different between placebo and DFO arms. DFO (40–60 mg/Kg/day) reduced the iron saturation of blood transferrin. A trend to efficacy was observed in patients with moderate-severe ischemic stroke (NIHSS > 7) treated with DFO 40–60 mg/Kg/day. A good outcome was observed at day 90 in 31% of placebo vs. 50–58% of the 40–60 mg/Kg/day DFO-treated patients.