The 2020 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for the Secondary Prevention of Stroke includes current evidence-based recommendations and expert opinions intended for use by clinicians across a broad range of settings. They provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations address triage, diagnostic testing, lifestyle behaviors, vaping, hypertension, hyperlipidemia, diabetes, atrial fibrillation, other cardiac conditions, antiplatelet and anticoagulant therapies, and carotid and vertebral artery disease. This update of the previous 2017 guideline contains several new or revised recommendations. Recommendations regarding triage and initial assessment of acute transient ischemic attack (TIA) and minor stroke have been simplified, and selected aspects of the etiological stroke workup are revised. Updated treatment recommendations based on new evidence have been made for dual antiplatelet therapy for TIA and minor stroke; anticoagulant therapy for atrial fibrillation; embolic strokes of undetermined source; low-density lipoprotein lowering; hypertriglyceridemia; diabetes treatment; and patent foramen ovale management. A new section has been added to provide practical guidance regarding temporary interruption of antithrombotic therapy for surgical procedures. Cancer-associated ischemic stroke is addressed. A section on virtual care delivery of secondary stroke prevention services in included to highlight a shifting paradigm of care delivery made more urgent by the global pandemic. In addition, where appropriate, sex differences as they pertain to treatments have been addressed. The CSBPR include supporting materials such as implementation resources to facilitate the adoption of evidence into practice and performance measures to enable monitoring of uptake and effectiveness of recommendations.

Bulk rock geochemistry and major- and trace-element compositions of clinopyroxene have been determined for three suites of peridotitic mantle xenoliths from the North Atlantic Craton (NAC) in northern Scotland, to establish the magmatic and metasomatic history of subcontinental lithospheric mantle (SCLM) below this region. Spinel lherzolites from the southernmost locality (Streap Com'laidh) have non-NAC mantle compositions, while the two northern xenolith suites (Loch Roag and Rinibar) are derived from the thinned NAC marginal keel. Clinopyroxene compositions have characteristic trace-element signatures which show both 'primary' and 'metasomatic' origins. We use Zr and Hf abundances to identify ancient cryptic refertilization in 'primary' clinopyroxenes. We suggest that Loch Roag and Rinibar peridotite xenoliths represent an ancient Archaean-Palaeoproterozoic SCLM with original depleted cratonic signatures which were overprinted by metasomatism around the time of intrusion of the Scourie Dyke Swarm (∼2.4 Ga). This SCLM keel was preserved during Caledonian orogenesis, although some addition of material and/or metasomatism probably also occurred, as recorded by Rinibar xenoliths. Rinibar and Streap xenoliths were entrained in Permo-Carboniferous magmas and thus were isolated from the SCLM ∼200 Ma before Loch Roag xenoliths (in an Eocene dyke). Crucially, despite their geographical location, lithospheric mantle peridotite samples from Loch Roag show no evidence of recent melting or refertilization during the Palaeogene opening of the Atlantic.

Dynamic ice-sheet models are used to assess the contribution of mass loss from the Greenland ice sheet to sea-level rise. Mass transfer from ice sheet to ocean is in a large part through outlet glaciers. Bed topography plays an important role in ice dynamics, since the acceleration from the slow-moving inland ice to an ice stream is in many cases caused by the existence of a subglacial trough or trough system. Problems are that most subglacial troughs are features of a scale not resolved in most ice-sheet models and that radar measurements of subglacial topography do not always reach the bottoms of narrow troughs. The trough-system algorithm introduced here employs mathematical morphology and algebraic topology to correctly represent subscale features in a topographic generalization, so the effects of troughs on ice flow are retained in ice-dynamic models. The algorithm is applied to derive a spatial elevation model of Greenland subglacial topography, integrating recently collected radar measurements (CReSIS data) of the Jakobshavn Isbræ, Helheim, Kangerdlussuaq and Petermann glacier regions. The resultant JakHelKanPet digital elevation model has been applied in dynamic ice-sheet modeling and sea-level-rise assessment.

In North America, terrestrial records of biodiversity and climate change that span Marine Oxygen Isotope Stage (MIS) 5 are rare. Where found, they provide insight into how the coupling of the ocean–atmosphere system is manifested in biotic and environmental records and how the biosphere responds to climate change. In 2010–2011, construction at Ziegler Reservoir near Snowmass Village, Colorado (USA) revealed a nearly continuous, lacustrine/wetland sedimentary sequence that preserved evidence of past plant communities between ~140 and 55 ka, including all of MIS 5. At an elevation of 2705 m, the Ziegler Reservoir fossil site also contained thousands of well-preserved bones of late Pleistocene megafauna, including mastodons, mammoths, ground sloths, horses, camels, deer, bison, black bear, coyotes, and bighorn sheep. In addition, the site contained more than 26,000 bones from at least 30 species of small animals including salamanders, otters, muskrats, minks, rabbits, beavers, frogs, lizards, snakes, fish, and birds. The combination of macro- and micro-vertebrates, invertebrates, terrestrial and aquatic plant macrofossils, a detailed pollen record, and a robust, directly dated stratigraphic framework shows that high-elevation ecosystems in the Rocky Mountains of Colorado are climatically sensitive and varied dramatically throughout MIS 5.

Understanding the fundamental properties of macromolecules has enhanced the development of emerging technologies used to improve biomedical research. Currently, there is a critical need for innovative platforms that can illuminate the function of biomedical reagents in a native environment. To address this need, we have developed an in situ approach to visualize the dynamic behavior of biomedically relevant macromolecules at the nanoscale. Newly designed silicon nitride devices containing integrated “microwells” were used to enclose active macromolecular specimens in liquid for transmission electron microscopy imaging purposes.We were able to successfully examine novel magnetic resonance imaging contrast reagents, micelle suspensions, liposome carrier vehicles, and transcribing viral assemblies. With each specimen tested, the integrated microwells adequately maintained macromolecules in discrete local environments while enabling thin liquid layers to be produced.

Information processing speed and episodic memory are two commonly affected cognitive abilities in MS. Insights into the mechanisms of and relationships between these abilities have recently come from structural neuroimaging techniques, but few studies have used fluid-attenuated inversion recovery (FLAIR), a neuroimaging sequence known to be sensitive to cortical and juxtacortical lesions in MS. We hypothesized that a volumetric index of FLAIR total lesion volume (TLV) would be associated with slowed processing speed and verbal memory dysfunction in MS. Twenty MS patients underwent FLAIR imaging and were administered measures of verbal memory and processing speed. Correlational and regression analyses indicated that TLV was directly and independently related to measures of processing speed and verbal memory, and TLV accounted for 56% of the variance in cognitive performance. These findings, considered in the context of prior work, suggest that FLAIR TLV is a useful predictor of commonly impaired cognitive functions in MS, and shows promise as a functionally relevant biomarker for disease status. (JINS, 2005, 11, 205–209.)

Because it is difficult to distinguish differences in event-related potentials between psychopaths and nonpsychopaths in Figures 1, 2, and 3, replacement figures are available upon request from the corresponding authors, Kent A. Kiehl or Robert D. Hare, 2136 West Mall, Department of Psychology, University of British Columbia, Vancouver, B.C., Canada, V6T 1Z4. E-mail KAK kiehl@cs.ubc.ca, RDH rhare@unixg.ubc.ca.

We tested the hypothesis that psychopathy is associated with abnormal processing of semantic and affective verbal information. In Task 1, a lexical decision task, and in Task 2, a word identification task, participants responded faster to concrete than to abstract words. In Task 2, psychopaths made more errors identifying abstract words than concrete words. In Task 3, a word identification task, participants responded faster to positive than to negative words. In all three tasks, nonpsychopaths showed the expected event-related potential (ERP) differentiation between word stimuli, whereas psychopaths did not. In each task, the ERPs of the psychopaths included a large centrofrontal negative-going wave (N350); this wave was absent or very small in the nonpsychopaths. The interpretation and significance of these differences are discussed.

Low dielectric constant insulators offer the potential of improved interconnection delay and conductor packing density in advanced ICs, both with current metallization schemes and with future technologies such as copper. While polymer materials are very promising in such applications, significant issues must be addressed before oxide-based materials are replaced in mainstream applications. This invited paper reviews the directions of our program, which has emphasized the use of vapor deposited polymers compatible with uniform deposition over large diameter wafers and copper metallization. Therefore, emphasis is placed on polymer material characteristics compatible with inlaid metal (ie. Dual Damascene) patterning.