Canadian Stroke Best Practice Recommendations: Telestroke Best Practice Guidelines Update 2017.

Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. The 2016 update of the Canadian Stroke Best Practice Recommendations Telestroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by all healthcare providers and system planners who organize and provide care to patients following stroke across a broad range of settings. These recommendations focus on the use of telemedicine technologies to rapidly identify and treat appropriate patients with acute thrombolytic therapies in hospitals without stroke specialized expertise; select patients who require to immediate transfer to stroke centers for Endovascular Therapy; and for the patients who remain in community hospitals to facilitate their care on a stroke unit and provide remote access to stroke prevention and rehabilitation services. While these latter areas of Telestroke application are newer, they are rapidly developing, with new opportunities that are yet unrealized. Virtual rehabilitation therapies offer patients the opportunity to participate in rehabilitation therapies, supervised by physical and occupational therapists. While not without its limitations (e.g., access to telecommunications in remote areas, fragmentation of care), the evidence-to-date sets the foundation for improving access to care and management for patients during both the acute phase and now through post stroke recovery.

ADVANCED IMAGING. Extended-resolution structured illumination imaging of endocytic and cytoskeletal dynamics.

Super-resolution fluorescence microscopy is distinct among nanoscale imaging tools in its ability to image protein dynamics in living cells. Structured illumination microscopy (SIM) stands out in this regard because of its high speed and low illumination intensities, but typically offers only a twofold resolution gain. We extended the resolution of live-cell SIM through two approaches: ultrahigh numerical aperture SIM at 84-nanometer lateral resolution for more than 100 multicolor frames, and nonlinear SIM with patterned activation at 45- to 62-nanometer resolution for approximately 20 to 40 frames. We applied these approaches to image dynamics near the plasma membrane of spatially resolved assemblies of clathrin and caveolin, Rab5a in early endosomes, and α-actinin, often in relationship to cortical actin. In addition, we examined mitochondria, actin, and the Golgi apparatus dynamics in three dimensions.

Canadian†Stroke†Best†Practice†Recommendations: Hyperacute Stroke Care Guidelines, Update 2015.

The 2015 update of the Canadian Stroke Best Practice Recommendations Hyperacute Stroke Care guideline highlights key elements involved in the initial assessment, stabilization, and treatment of patients with transient ischemic attack (TIA), ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and acute venous sinus thrombosis. The most notable change in this 5th edition is the addition of new recommendations for the use of endovascular therapy for patients with acute ischemic stroke and proximal intracranial arterial occlusion. This includes an overview of the infrastructure and resources required for stroke centers that will provide endovascular therapy as well as regional structures needed to ensure that all patients with acute ischemic stroke that are eligible for endovascular therapy will be able to access this newly approved therapy; recommendations for hyperacute brain and enhanced vascular imaging using computed tomography angiography and computed tomography perfusion; patient selection criteria based on the five trials of endovascular therapy published in early 2015, and performance metric targets for important time-points involved in endovascular therapy, including computed tomography-to-groin puncture and computed tomography-to-reperfusion times. Other updates in this guideline include recommendations for improved time efficiencies for all aspects of hyperacute stroke care with a movement toward a new median target door-to-needle time of 30 min, with the 90th percentile being 60 min. A stronger emphasis is placed on increasing public awareness of stroke with the recent launch of the Heart and Stroke Foundation of Canada FAST signs of stroke campaign; reinforcing the public need to seek immediate medical attention by calling 911; further engagement of paramedics in the prehospital phase with prehospital notification to the receiving emergency department, as well as the stroke team, including neuroradiology; updates to the triage and same-day assessment of patients with transient ischemic attack; updates to blood pressure recommendations for the hyperacute phase of care for ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. The goal of these recommendations and supporting materials is to improve efficiencies and minimize the absolute time lapse between stroke symptom onset and reperfusion therapy, which in turn leads to better outcomes and potentially shorter recovery times.

Carbon nanotube wires and cables: near-term applications and future perspectives.

Wires and cables are essential to modern society, and opportunities exist to develop new materials with reduced resistance, mass, and/or susceptibility to fatigue. This article describes how carbon nanotubes (CNTs) offer opportunities for integration into wires and cables for both power and data transmission due to their unique physical and electronic properties. Macroscopic CNT wires and ribbons are presently shown as viable replacements for metallic conductors in lab-scale demonstrations of coaxial, USB, and Ethernet cables. In certain applications, such as the outer conductor of a coaxial cable, CNT materials may be positioned to displace metals to achieve substantial benefits (e.g. reduction in cable mass per unit length (mass/length) up to 50% in some cases). Bulk CNT materials possess several unique properties which may offer advantages over metallic conductors, such as flexure tolerance and environmental stability. Specifically, CNT wires were observed to withstand greater than 200,000 bending cycles without increasing resistivity. Additionally, CNT wires exhibit no increase in resistivity after 80 days in a corrosive environment (1 M HCl), and little change in resistivity with temperature (<1% from 170-330 K). This performance is superior to conventional metal wires and truly novel for a wiring material. However, for CNTs to serve as a full replacement for metals, the electrical conductivity of CNT materials must be improved. Recently, the conductivity of a CNT wire prepared through simultaneous densification and doping has exceeded 1.3 × 10(6) S/m. This level of conductivity brings CNTs closer to copper (5.8 × 10(7) S/m) and competitive with some metals (e.g. gold) on a mass-normalized basis. Developments in manipulation of CNT materials (e.g. type enrichment, doping, alignment, and densification) have shown progress towards this goal. In parallel with efforts to improve bulk conductivity, integration of CNT materials into cabling architectures will require development in electrical contacting. Several methods for contacting bulk CNT materials to metals are demonstrated, including mechanical crimping and ultrasonic bonding, along with a method for reducing contact resistance by tailoring the CNT-metal interface via electroless plating. Collectively, these results summarize recent progress in CNT wiring technologies and illustrate that nanoscale conductors may become a disruptive technology in cabling designs.