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RATIONALE: Fatigue affects almost half of all people living with stroke. Stroke survivors rank understanding fatigue and how to reduce it as one of the highest research priorities. METHODS: We convened an interdisciplinary, international group of clinical and pre-clinical researchers and lived experience experts. We identified four priority areas: (1) best measurement tools for research, (2) clinical identification of fatigue and potentially modifiable causes, (3) promising interventions and recommendations for future trials, and (4) possible biological mechanisms of fatigue. Cross-cutting themes were aphasia and the voice of people with lived experience. Working parties were formed and structured consensus building processes were followed. RESULTS: We present 20 recommendations covering outcome measures for research, development, and testing of new interventions and priority areas for future research on the biology of post-stroke fatigue. We developed and recommend the use of the Stroke Fatigue Clinical Assessment Tool. CONCLUSIONS: By synthesizing current knowledge in post-stroke fatigue across clinical and pre-clinical fields, our work provides a roadmap for future research into post-stroke fatigue.

Coseismic slip on the Patton Bay splay fault system during the 1964 Mw 9.2 Great Alaska Earthquake contributed to local tsunami generation and vertically uplifted shorelines as much as 11 m on Montague Island in Prince William Sound (PWS). Sudden uplift of 3.7–4.3 m caused coastal lagoons along the island's northwestern coast to gradually drain. The resulting change in depositional environment from marine lagoon to freshwater muskeg created a sharp, laterally continuous stratigraphic contact between silt and overlying peat. Here, we characterize the geomorphology, sedimentology, and diatom ecology across the 1964 earthquake contact and three similar prehistoric contacts within the stratigraphy of the Hidden Lagoons locality.We find that the contacts signal instances of abrupt coastal uplift that, within error, overlap the timing of independently constrained megathrust earthquakes in PWS—1964 Common Era, 760–870 yr BP, 2500–2700 yr BP, and 4120– 4500 yr BP. Changes in fossil diatom assemblages across the inferred prehistoric earthquake contacts reflect ecological shifts consistent with repeated draining of a lagoon system caused by >3 m of coseismic uplift. Our observations provide evidence for four instances of combined megathrust‐splay fault ruptures that have occurred in the past ∼4,200 years in PWS. The possibility that 1964‐style combined megathrust‐splay fault ruptures may have repeated in the past warrants their consideration in future seismic and tsunami hazards assessments.

Current ichnofacies models for shelf environments are largely based on analysis of ancient sedimentary deposits and have rarely been applied to studies of modern siliciclastic shelves. Siliciclastic shelf margins are key components of source rocks and unconventional shale plays that can be used as modern analogs to ancient systems. This paper examines the sedimentology and ichnology of shelf margin cores of the Mississippi River Delta containing strata formed during the 2004 (Ivan) and 2005 (Katrina and Rita) hurricane events in the Gulf of Mexico, together with those from the Kikori-Fly-Purari rivers in the Gulf of Papua, New Guinea and the Tūranganui-a-Kiwa/Poverty Bay shelf deposits of the Waipaoa River basin, offshore New Zealand. The cores provide examples of modern-day traces created by marine organisms on muddy shelves and are used to evaluate ichnological models that have been applied to determine sedimentation rates and depositional processes in ancient settings. In total, six facies were recognised based on lithology and ichnological characteristics: (1) laminated very fine sand, produced by waxing and waning currents, displaying scarce to moderate bioturbation; (2) laminated silty mud, formed by waxing and waning currents, exhibiting scarce, very low to moderate bioturbation; (3) normally graded sand and silt, created by suspension settling following a wave-enhanced sediment-gravity flow (WESGF), which reveals low to moderate bioturbation; (4) fluid mudflow/suspension settling deposits, characterised by structureless mud with low to high bioturbation; (5) biogenically mottled silty mud deposited by suspension settling which show high bioturbation intensity; and, (6) storm-generated facies of laminated sand formed by rapid sediment accumulation on the shelf. The different study areas show remarkably similar traces with variable intensity, diversity, abundance and distribution. The Mississippi River Delta cores are typified by Helminthopsis, Chondrites, Sch

Building robust age–depth models to understand climatic and geologic histories from coastal sedimentary archives often requires composite chronologies consisting of multi-proxy age markers. Pollen chronohorizons derived from a known change in vegetation are important for age–depth models, especially those with other sparse or imprecise age markers. However, the accuracy of pollen chronohorizons compared to other age markers and the impact of pollen chronohorizons on the precision of age–depth models, particularly in salt marsh environments, is poorly understood. Here, we combine new and published pollen data from eight coastal wetlands (salt marshes and mangroves) along the Atlantic Coast of the United States (U.S.) from Florida to Connecticut to define the age and uncertainty of 17 pollen chronohorizons. We found that 13 out of 17 pollen chronohorizons were consistent when compared to other age markers (radiocarbon, radionuclide 137Cs and pollution markers). Inconsistencies were likely related to the hyperlocality of pollen chronohorizons, mixing of salt marsh sediment, reworking of pollen from nearby tidal flats, misidentification of pollen signals, and inaccuracies in or misinterpretation of other age markers. Additionally, in a total of 24 models, including one or more pollen chronohorizons, increased precision (up to 41 years) or no change was found in 18 models.

© The Author(s), 2021. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Christie, M. A., Bernhardt, C. E., Parnell, A. C., Shaw, T. A., Khan, N. S., Corbett, D. R., Garcia-Artola, A., Clear, J., Walker, J. S., Donnelly, J. P., Hasse, T. R., & Horton, B. P. Pollen geochronology from the Atlantic Coast of the United States during the last 500 years. Water, 13(3), (2021): 362, https://doi.org/10.3390/w13030362., Building robust age–depth models to understand climatic and geologic histories from coastal sedimentary archives often requires composite chronologies consisting of multi-proxy age markers. Pollen chronohorizons derived from a known change in vegetation are important for age–depth models, especially those with other sparse or imprecise age markers. However, the accuracy of pollen chronohorizons compared to other age markers and the impact of pollen chronohorizons on the precision of age–depth models, particularly in salt marsh environments, is poorly understood. Here, we combine new and published pollen data from eight coastal wetlands (salt marshes and mangroves) along the Atlantic Coast of the United States (U.S.) from Florida to Connecticut to define the age and uncertainty of 17 pollen chronohorizons. We found that 13 out of 17 pollen chronohorizons were consistent when compared to other age markers (radiocarbon, radionuclide 137Cs and pollution markers). Inconsistencies were likely related to the hyperlocality of pollen chronohorizons, mixing of salt marsh sediment, reworking of pollen from nearby tidal flats, misidentification of pollen signals, and inaccuracies in or misinterpretation of other age markers. Additionally, in a total of 24 models, including one or more pollen chronohorizons, increased precision (up to 41 years) or no change was found in 18 models., MC was funded by the National Science Foundation EAR 1624551. NSK, TS, and BPH were funded by the Ministry of Education Academic Research Fund MOE2018-T2-1-030 and MOE2019-T3-1-004, the National Research Foundation Singapore, and the Singapore Ministry of Education, under the Research Centres of Excellence initiative. This article is a contribution to International Geoscience Program (IGCP) Project 639, “Sea Level Change from Minutes to Millennia”. This work is Earth Observatory of Singapore contribution 349. AP wishes to acknowledge the funding Science Foundation Ireland Career Development Award (17/CDA/4695); an investigator award (16/IA/4520); a Marine Research Programme funded by the Irish Government, co-financed by the European Regional Development Fund (Grant-Aid Agreement No. PBA/CC/18/01); European Union’s Horizon 2020 research and innovation programme under grant agreement No 818144; and SFI Research Centre awards 16/RC/3872 and 12/RC/2289_P2.

On September 16, 2015, a Mw 8.3 earthquake struck the north-central Chile coast, triggering a tsunami observed along 500 km of coastline, between Huasco (28.5°S) and San Antonio (33.5°S). This tsunami provided a unique opportunity to examine the nature of tsunami deposits in a semi-arid, siliciclastic environment where stratigraphic and sedimentological records of past tsunamis are difficult to distinguish. To improve our ability to identify such evidence, we targeted one of the few low-energy, organic-rich depositional environments in north-central Chile: Pachingo marsh in Tongoy Bay (30.3°S). We found sedimentary evidence of the 2015 and one previous tsunami as tabular sand sheets. Both deposits are composed of poorly to moderately sorted, gray-brown, fine-to medium-grained sand and are distinct from underlying and overlying organic-rich silt. Both sand beds thin (from ∼20 cm to <1 cm) and fine landward, and show normal grading. The older sand bed is thicker and extends over 125 m further inland than the 2015 tsunami deposit. To model the relative size of the tsunamis that deposited each sand bed, we employed tsunami flow inversion. Our results show that the older sand bed was produced by higher flow speeds and depths than those in 2015. Anthropogenic evidence along with 137Cs and 210Pb dating constrains the age of the older tsunami to the last ∼110 years. We suggest that the older sand bed was deposited by the large tsunami in 1922 CE sourced to the north of our study site. This deposit represents the first geologic evidence of a pre-2015 tsunami along the semi-arid north-central Chile coast and highlights the current and continuing tsunami hazard in the region.

Building robust age–depth models to understand climatic and geologic histories from coastal sedimentary archives often requires composite chronologies consisting of multi-proxy age markers. Pollen chronohorizons derived from a known change in vegetation are important for age– depth models, especially those with other sparse or imprecise age markers. However, the accuracy of pollen chronohorizons compared to other age markers and the impact of pollen chronohorizons on the precision of age–depth models, particularly in salt marsh environments, is poorly understood. Here, we combine new and published pollen data from eight coastal wetlands (salt marshes and mangroves) along the Atlantic Coast of the United States (U.S.) from Florida to Connecticut to define the age and uncertainty of 17 pollen chronohorizons. We found that 13 out of 17 pollen chronohorizons were consistent when compared to other age markers (radiocarbon, radionuclide 137Cs and pollution markers). Inconsistencies were likely related to the hyperlocality of pollen chronohorizons, mixing of salt marsh sediment, reworking of pollen from nearby tidal flats, misidentification of pollen signals, and inaccuracies in or misinterpretation of other age markers. Additionally, in a total of 24 models, including one or more pollen chronohorizons, increased precision (up to 41 years) or no change was found in 18 models.

Introduction: Despite an increase in the quality of clinical trials in stroke recovery, interventions have failed to markedly impact the trajectory of recovery after stroke. Failure may be due to the lack of consideration for the complexity of dose and its articulation within research trials. Prior to commencing the scoping review, we identified two research gaps to be addressed. Firstly, transparent application of a multidimensional definition of dose to clinical trial phases and secondly, the development of a quality tool to critique the articulation of dose across the pipeline. Building on this, we present the protocol for a scoping review that aims to synthesis what is known about dose articulation in stroke recovery in preclinical and clinical populations, and characterize research designs and statistical approaches used in dose articulation trials, and the associated advantages and disadvantages. Methods: The scoping review will apply Arksey and O'Malley's methodological framework. Two systematic searches that target preclinical and clinical literature will be run in Medline and Embase, which will be complimented by consultation with field experts and hand searching of included trials and relevant reviews. Search results will be imported into Covidence for transparent management. One reviewer will screen all abstracts and titles. Two reviewers will screen full text and a third reviewer included to resolve discrepancies. A standardized data charting form will be used to extract information and appraise the intervention description, risk of bias, and quality of both preclinical and clinical studies. Results will be summarized in tabular and narrative format to inform the development of recommendations for future research. Ethics approval is not required as data used will be secondary and de-identified. Conclusion: Development of a new quality tool to appraise the quality of both preclinical and clinical dose studies may serve to strengthen collaborative efforts

A major goal of the Stroke Recovery and Rehabilitation Roundtable (SRRR) is to accelerate development of effective treatments to enhance stroke recovery beyond that expected to occur spontaneously or with current approaches. In this paper, we describe key issues for the next generation of stroke recovery treatment trials and present the Stroke Recovery and Rehabilitation Roundtable Trials Development Framework (SRRR-TDF). An exemplar (an upper limb recovery trial) is presented to demonstrate the utility of this framework to guide the GO, NO-GO decision-making process in trial development.

The transformation of two intertidal environments from northern Spain during the last 150 years shows an evolution from a tidal flat into a salt marsh environment, with an intermediate transitional stage. The environment of deposition was reconstructed based on benthic foraminifera and sand content. Sediments were put into a temporal framework using short-lived radioisotope activities and heavy metal concentrations. The observed natural evolution responds to the availability of abundant sediment and the current sea-level rise scenario, where intertidal environments are trying to adapt to increasing flooding periods by accreting sediment rapidly. © 2019 Sociedad Geologica de Espana. All rights reserved.

© 2018 World Stroke Organization. Background/aim: We previously reported the feasibility of RecoverNow (a mobile tablet-based post-stroke communication therapy in acute care). RecoverNow has since expanded to include fine motor and cognitive therapies. Our objectives were to gain a better understanding of patient experiences and recovery goals using mobile tablets. Methods: Speech-language pathologists or occupational therapists identified patients with stroke and communication, fine motor, or cognitive/perceptual deficits. Patients were provided with iPads individually programmed with applications based on assessment results, and instructed to use it at least 1 h/day. At discharge, patients completed a 19-question quantitative and open-ended engagement survey addressing intervention timing, mobile device/apps, recovery goals, and therapy duration. Results: Over a six-month period, we enrolled 33 participants (three did not complete the survey). Median time from stroke to initiation of tablet-based therapy was six days. Patients engaged in therapy on average 59.6 min/day and preferred communication and hand function therapies. Most patients (63.3%) agreed that therapy was commenced at a reasonable time, although half expressed an interest in starting sooner, 66.7% reported that using the device 1 h/day was enough, 64.3% would use it after discharge, and 60.7% would use it for eight weeks. Sixty-seven percent of patients expressed a need for family/friend/caregiver to help them use it. Conclusion: Our results suggest that stroke patients are interested in mobile tablet-based therapy in acute care. Patients in the acute setting prefer to focus on communication and hand therapies, are willing to begin within days of their stroke and may require assistance with the tablets.

Since 2014, the Bureau of Ocean Energy Management (BOEM), has worked with collaborative partners in 11 states along the Atlantic coast of the US to inventory offshore sand resources in the 3-8 nautical mile (nm) Outer Continental Shelf (OCS) through the Atlantic Sand Assessment Project (ASAP). The purpose of ASAP is to augment the ability of coastal states to recover from the damaging impacts of hurricanes and other storms by providing information about offshore sand resources for beach renourishment projects. The geospatial inventory compiled for the first phase of the state cooperative projects (2014-2016) enhanced the overall state of knowledge regarding the type, quantity, and quality of data that exist within this area of the near OCS, and also facilitated the identification of gaps in data coverage. A needs assessment was also performed in order to better project the renourishment requirements of beach communities, based on historic trends. The first phase of the project revealed that the distance between renourished beaches and corresponding borrow sites is increasing. Because of this trend, exploitation of beach-compatible sand in the OCS is anticipated into the future as resources closer to the shoreline become depleted or are protected for habitat. More recently, the project has focused on processing and interpreting backscatter and shallow seismic data collected for the ASAP in 2015. Data were collected in targeted locations where historical data were lacking or where potential need for beach-compatible renourishment sand is high. In NC, reconnaissance data extend from near Bogue Banks to the SC border. In SC, these targeted areas are located offshore of North Myrtle Beach in Long Bay, Cape Romain, Folly and Kiawah Islands, and Hilton Head Island. The GA data are largely concentrated in a northern compartment offshore of Wassaw National Wildlife Refuge and Ossabaw Island, extending south to Little St. Simons Island, Sea Island, and Cumberland Island. The

Environmental enrichment (EE) has been widely used as a means to enhance brain plasticity mechanisms (e.g., increased dendritic branching, synaptogenesis, etc.) and improve behavioral function in both normal and brain-damaged animals. In spite of the demonstrated efficacy of EE for enhancing brain plasticity, it has largely remained a laboratory phenomenon with little translation to the clinical setting. Impediments to the implementation of enrichment as an intervention for human stroke rehabilitation and a lack of clinical translation can be attributed to a number of factors not limited to: (i) concerns that EE is actually the "normal state" for animals, whereas standard housing is a form of impoverishment; (ii) difficulty in standardizing EE conditions across clinical sites; (iii) the exact mechanisms underlying the beneficial actions of enrichment are largely correlative in nature; (iv) a lack of knowledge concerning what aspects of enrichment (e.g., exercise, socialization, cognitive stimulation) represent the critical or active ingredients for enhancing brain plasticity; and (v) the required "dose" of enrichment is unknown, since most laboratory studies employ continuous periods of enrichment, a condition that most clinicians view as impractical. In this review article, we summarize preclinical stroke recovery studies that have successfully utilized EE to promote functional recovery and highlight the potential underlying mechanisms. Subsequently, we discuss how EE is being applied in a clinical setting and address differences in preclinical and clinical EE work to date. It is argued that the best way forward is through the careful alignment of preclinical and clinical rehabilitation research. A combination of both approaches will allow research to fully address gaps in knowledge and facilitate the implementation of EE to the clinical setting.