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Background and Purpose: Research suggests that women and men may present with different transient ischemic attack (TIA) and stroke symptoms. We aimed to explore symptoms and features associated with a definite TIA/stroke diagnosis and whether those associations differed by sex. Methods: We completed a retrospective cohort study of patients referred to The Ottawa Hospital Stroke Prevention Clinic in 2015. Exploratory multinomial logistic regression was used to evaluate candidate variables associated with diagnosis and patient sex. Backwards elimination of the interaction terms with a significance level for staying in the model of 0.25 was used to arrive at a more parsimonious model. Results: Based on 1770 complete patient records, sex-specific differences were noted in TIA/stroke diagnosis based on features such as duration of event, suddenness of symptom onset, unilateral sensory loss, and pain. Conclusions: This preliminary work identified sex-specific differences in the final diagnosis of TIA/stroke based on common presenting symptoms/features. More research is needed to understand if there are biases or sex-based differences in TIA/stroke manifestations and diagnosis.

A 73-year-old man presented with sudden right-sided weakness, aphasia, and low-grade headache. Medical history was pertinent for obstructive sleep apnea, hypertension, diabetes, and dyslipidemia, for which he was appropriately treated, in addition to taking aspirin for primary prevention. Initial bloodwork, head CT, and vessel imaging were normal. MRI showed a nonenhancing, nonrestricting T2 hyperintensity in the left temporal lobe, in addition to multiple microhemorrhages (figure 1, A and B). Symptoms resolved within 24 hours and he was discharged on a second antiplatelet agent (clopidogrel). Three weeks later, a second episode of aphasia and right-sided weakness occurred, resolving within hours. He returned to the hospital the following day as symptoms recurred again. He had had been continually complaining of headaches, and his family had noted a gradual cognitive decline over the past month. Repeat bloodwork and erythrocyte sedimentation rate were normal. MRI demonstrated persistent microhemorrhages and superficial siderosis, worsening of the left temporal lobe subcortical changes, as well as diffuse leptomeningeal enhancement.

Background and Purpose: The diagnosis of transient ischemic attack (TIA) is largely dependent on a process of clinical decision-making that remains poorly characterized in the absence of a validated and accessible biomarker or imaging test. We performed a retrospective chart review to identify variables associated with a final neurologist diagnosis of TIA/stroke. Methods: Records for all patients seen in The Ottawa Hospital’s Stroke Prevention Clinic in 2015 were analyzed for patient and referral characteristics, features of the presenting neurological event, and final diagnosis by a stroke neurologist (classified as definite, possible, or definite not TIA/stroke). Multinomial logistic regression analysis with backward elimination was used to identify variables associated with the final diagnosis. Results: Our inclusion criteria were met by 1894 patients. After backward elimination, 23 potentially important variables were identified, including monocular vision loss (odds ratio [OR]: 30.4, 95% confidence interval [CI]: 14.6-63.3), symptoms of sudden onset (OR: 28.3, 95% CI: 14.2-56.2), unilateral weakness affecting 2 or 3 of face, arm, or leg (OR: 17.7, 95% CI: 9.8-31.7), and homonymous hemianopia (OR: 16.6, 95% CI: 8.1-34.0). Conclusions: Accurate diagnosis of TIA is essential to initiating appropriate secondary stroke prevention therapies. A focus on elements of the patient history most commonly associated with a final diagnosis of TIA/stroke may help to identify patients in greatest need of urgent SPC assessment and allow for the provision of effective and efficient stroke prevention services.

Intravenous thrombolysis with alteplase bolus followed by infusion is a global standard of care for patients with acute ischaemic stroke. We aimed to determine whether tenecteplase given as a single bolus might increase reperfusion compared with this standard of care.In this multicentre, open-label, parallel-group, registry-linked, randomised, controlled trial (AcT), patients were enrolled from 22 primary and comprehensive stroke centres across Canada. Patients were eligible for inclusion if they were aged 18 years or older, with a diagnosis of ischaemic stroke causing disabling neurological deficit, presenting within 4·5 h of symptom onset, and eligible for thrombolysis per Canadian guidelines. Eligible patients were randomly assigned (1:1), using a previously validated minimal sufficient balance algorithm to balance allocation by site and a secure real-time web-based server, to either intravenous tenecteplase (0·25 mg/kg to a maximum of 25 mg) or alteplase (0·9 mg/kg to a maximum of 90mg; 0·09 mg/kg as a bolus and then a 60 min infusion of the remaining 0·81 mg/kg). The primary outcome was the proportion of patients who had a modified Rankin Scale (mRS) score of 0-1 at 90-120 days after treatment, assessed via blinded review in the intention-to-treat (ITT) population (ie, all patients randomly assigned to treatment who did not withdraw consent). Non-inferiority was met if the lower 95% CI of the difference in the proportion of patients who met the primary outcome between the tenecteplase and alteplase groups was more than -5%. Safety was assessed in all patients who received any of either thrombolytic agent and who were reported as treated. The trial is registered with ClinicalTrials.gov, NCT03889249, and is closed to accrual.Between Dec 10, 2019, and Jan 25, 2022, 1600 patients were enrolled and randomly assigned to tenecteplase (n=816) or alteplase (n=784), of whom 1577 were included in the ITT population (n=806 tenecteplase; n=771 alteplase). The median age was 74 years (IQR 63-83), 755 (47·9%) of 1577 patients were female and 822 (52·1%) were male. As of data cutoff (Jan 21, 2022), 296 (36·9%) of 802 patients in the tenecteplase group and 266 (34·8%) of 765 in the alteplase group had an mRS score of 0-1 at 90-120 days (unadjusted risk difference 2·1% [95% CI - 2·6 to 6·9], meeting the prespecified non-inferiority threshold). In safety analyses, 27 (3·4%) of 800 patients in the tenecteplase group and 24 (3·2%) of 763 in the alteplase group had 24 h symptomatic intracerebral haemorrhage and 122 (15·3%) of 796 and 117 (15·4%) of 763 died within 90 days of starting treatment INTERPRETATION: Intravenous tenecteplase (0·25 mg/kg) is a reasonable alternative to alteplase for all patients presenting with acute ischaemic stroke who meet standard criteria for thrombolysis.Canadian Institutes of Health Research, Alberta Strategy for Patient Oriented Research Support Unit.

People living with diabetes are at higher risk for stroke and have a poorer prognosis following a stroke event than those without diabetes. Data from cardiovascular outcome trials and meta-analyses indicate that GLP-1RAs (glucagon-like peptide 1 receptor agonists) reduce the risk of stroke in individuals with type 2 diabetes. Accordingly, many guidelines now recommend the addition of GLP-1RAs to ongoing antihyperglycemic regimens to lower the risk of stroke in type 2 diabetes. The current work summarizes evidence supporting the use of GLP-1RAs for stroke reduction in people with type 2 diabetes and offers 2 new resources for neurologists who are considering GLP-1RAs for their patients—a list of frequently asked questions with evidence-based answers on safely initiating and managing GLP-1RAs, and a practical decision-making algorithm to assist in using GLP-1RAs as part of a stroke reduction strategy.

[Figure: see text].

This chapter provides a blueprint for corpus design and construction in minoritised language contexts. This blueprint is not exhaustive, but functions to provide a working scaffold, alongside technical and systematic recommendations from major language contexts for other linguistic communities aspiring to construct their own corpora.

In 2017, Welsh Government (WG) published an ambitious vision: to achieve a million Welsh speakers by 2050, almost doubling current numbers. The initial workplan to realise this aim, which includes a section on linguistic infrastructure, undertakes (by 2021) to: ‘support the production of more high-quality lexicographical, corpus and terminology resources to support learners and fluent speakers’ (Welsh Government, 2017). While the conceptualisation and commencement of the CorCenCC project pre-dated the publication of this WG plan, both result from – and contribute to – interest in building momentum for using Welsh with new technologies. Although the CorCenCC project is independent of WG, continued dialogue between the two entities has been a key feature of the project. From the hosting, at the Senedd (Welsh parliament), of the first briefing to potential stakeholders about the CorCenCC vision, regular meetings with WG through the project have focussed attention on how CorCenCC can inform the corpus planning efforts which must underpin the realisation of the Cymraeg 2050: A Million Speakers strategy.

Building a corpus entails the principled collection of a dataset, and corpora designed for general purposes commonly require the submission of that data to an annotation process whereby each item is ‘tagged’ according to its part of speech (POS). In some cases, a ready-made tag-set is applied to the data, and in other cases a bespoke tag-set is required. Corpora require a host infrastructure; building or sourcing this is the other essential element of corpus design. The creation of these components, along with a semantic tagger (to mark up the data for meaning as opposed to part of speech) and its own tag-set, plus the bespoke pedagogic toolkit (Y Tiwtiadur) constituted the CorCenCC construction plan. Decisions relating to the user-driven infrastructure and the collection and processing of data, in particular, present some specific challenges in the context of minoritised languages. In this chapter we outline how these challenges were addressed in the CorCenCC project.

Mae creu corpws yn cynnwys casglu set data ar sail egwyddorion, ac fel arfer yn achos corpora a gynlluniwyd at ddibenion cyffredinol, mae’n rhaid cyflwyno’r data hynny gan ddilyn proses anodi lle mae pob eitem yn cael ei ‘thagio’ yn ol ei rhan ymadrodd (RhY). Mewn rhai achosion, cymhwysir set barod o dagiau i’r data, ac mewn achosion eraill mae’n ofynnol cael set bwrpasol o dagiau. Mae’n rhaid i gorpora gael seilwaith i’w lletya; mae creu neu ddod o hyd i hwn yn un o elfennau hanfodol eraill cynllunio corpws. Creu’r cydrannau hyn, ynghyd â thagiwr semantig (i ddynodi ystyr y data yn hytrach na’r rhan ymadrodd) a’i set o dagiau ei hun, yn ogystal â’r pecyn cymorth pedagogaidd pwrpasol (Y Tiwtiadur) oedd cynllun creu CorCenCC. Mae’r penderfyniadau ynghylch y seilwaith wedi’i yrru gan ddefnyddwyr a chasglu a phrosesu data, yn benodol, yn cynnig heriau arbennig yng nghyd-destun ieithoedd lleiafrifoledig. Yn y bennod hon rydym yn amlinellu sut aeth prosiect CorCenCC i’r afael â’r heriau hyn.

Yn 2017, cyhoeddodd Llywodraeth Cymru (LlC) weledigaeth uchelgeisiol: cael miliwn o siaradwyr Cymraeg erbyn 2050, gan ddyblu’r niferoedd cyfredol, bron. Mae’r cynllun gwaith cychwynnol i wireddu’r nod hwn, sy’n cynnwys adran ar seilwaith ieithyddol, yn ymgymryd (erbyn 2021) i roi: ‘cefnogaeth i gynhyrchu rhagor o adnoddau geiriadurol, corpora a therminoleg o ansawdd uchel i gefnogi dysgwyr a siaradwyr rhugl’ (Llywodraeth Cymru, 2017). Er i gysyniad a dechrau’r gwaith ar brosiect CorCenCC ddigwydd cyn cyhoeddi’r cynllun hwn gan LlC, mae’r ddau yn ganlyniad i ddiddordeb mewn creu momentwm ar gyfer defnyddio’r Gymraeg gyda thechnoleg newydd, ac yn cyfrannu i hyn. Er bod prosiect CorCenCC yn annibynnol ar LlC, mae deialog barhaus rhwng y ddau endid wedi bod yn nodwedd allweddol ar y prosiect. O gynnal y cyfarfod briffio cyntaf ar gyfer darpar randdeiliaid ynghylch gweledigaeth CorCenCC yn y Senedd, mae cyfarfodydd cyson â LlC drwy’r prosiect wedi hoelio sylw ar sut gall CorCenCC lywio’r ymdrechion i gynllunio corpws sy’n hanfodol fel sylfaen i wireddu strategaeth Cymraeg 2050: Miliwn o siaradwyr.

Mae creu corpws mewn cyd-destun iaith leiafrifol yn cynnig heriau diddorol, ond mae hefyd yn cynnig cyfleoedd nad ydynt ar gael bob amser i ddatblygwyr corpora ar gyfer ieithoedd mwy. Mae’r llyfr hwn yn dangos sut mae archwilio cyd-destun unigryw iaith leiafrifoledig benodol, a chydweithredu ystyrlon â grwpiau defnyddwyr posibl, yn gallu pennu’r gwaith o gynllunio a chreu corpws. Rydym yn dogfennu’r dewisiadau a wnaed yn y broses o gynllunio ac adeiladu CorCenCC, Corpws Cenedlaethol Cymraeg Cyfoes, yn archwilio’r rhesymwaith y tu ol i’r dewisiadau hynny, yn nodi’r cyfyngiadau, yr heriau a’r cyfleoedd a ddaw yn sgil cyd-destun iaith leiafrifoledig, ac yn cloriannu i ba raddau y gwireddwyd gweledigaeth CorCenCC. Yn y bennod gyntaf yma, awn i’r afael â rhai cysyniadau allweddol sydd weithiau’n broblemus: ieithoedd lleiafrifol/lleiafrifoledig, corpora iaith a chymhwyso corpws; rydym yn dangos sut yr eir i’r afael â hwy a’u diffinio mewn perthynas â CorCenCC.

As noted in Chap. 1.1, CorCenCC’s vision rested on two guiding principles: first, the language data captured within the corpus should be as representative as possible of the ways in which Welsh is currently used and encountered. Second, the corpus infrastructure should address the needs of the multiple community user groups operating in and/or engaging with the Welsh language. In this chapter we evaluate the extent to which these principles are represented in the project outcomes. First, we reflect on CorCenCC’s vision of representativeness, by considering the size and scope of the corpus, and the provenance of data in terms of language topic, context, genre and mode on the one hand, and contributor profiles on the other. We then document some of the specific challenges, including unanticipated ones, encountered during the project, and the steps taken to mitigate their impact. Next, we consider the extent to which the project has identified, and addressed, the specific needs of user group communities. This necessitates a reflection on our engagement and communication with potential corpus user groups throughout the project. Finally, we summarise the technical tools and resources developed to support the realisation of the CorCenCC vision. Throughout the chapter we report on the dynamic decision-making regarding method and approach that shaped the project as it progressed.

Mae’r bennod hon yn rhoi glasbrint ar gyfer cynllunio a chreu corpws yng nghyd-destunau ieithoedd lleiafrifoledig. Nid yw’r glasbrint hwn yn cynnwys popeth, ond mae’n rhoi sgaffald defnyddiol, ynghyd ag argymhellion technegol a systematig o gyd-destunau ieithoedd mawr i gymunedau ieithyddol eraill sy’n dymuno creu eu corpora eu hunain.

Fel y nodwyd ym Mhennod 2.1, roedd dwy egwyddor arweiniol i weledigaeth CorCenCC: yn gyntaf, dylai’r data iaith a gipiwyd yn y corpws gynrychioli cystal â phosibl y ffyrdd y mae’r Gymraeg yn cael ei defnyddio a’i chanfod ar hyn o bryd. Yn ail, dylai seilwaith y corpws ymdrin ag anghenion y grwpiau amrywiol o ddefnyddwyr cymunedol sy’n gweithredu yn Gymraeg neu sy’n ymgysylltu â’r Gymraeg. Yn y bennod hon, rydym yn gwerthuso i ba raddau y cynrychiolir yr egwyddorion hyn yng nghanlyniadau’r prosiect. Yn gyntaf, rydym yn adfyfyrio ar weledigaeth cynrychioldeb CorCenCC, drwy ystyried maint a chwmpas y corpws, a tharddiad y data o ran testun, cyd-destun, genre a modd iaith ar y naill law, a phroffiliau cyfranwyr ar y llaw arall. Wedyn rydym yn cofnodi rhai o’r heriau penodol, gan gynnwys rhai nas rhagwelwyd, y daethpwyd ar eu traws yn ystod y prosiect, a’r camau a gymerwyd i liniaru ar eu heffaith. Nesaf, rydym yn ystyried i ba raddau y mae’r prosiect wedi nodi anghenion penodol cymunedau o grwpiau defnyddwyr ac wedi ymdrin â nhw. I wneud hyn, mae angen ystyried sut buom yn ymgysylltu â grwpiau o ddefnyddwyr posibl y corpws drwy gydol y prosiect ac yn cyfathrebu â nhw. Yn olaf, rydym yn crynhoi’r offer a’r adnoddau technegol a ddatblygwyd i gefnogi gwireddu gweledigaeth CorCenCC. Drwy gydol y bennod rydym yn adrodd ar y gwneud penderfyniadau dynamig o ran dull ac ymagwedd a luniodd y prosiect wrth iddo fynd rhagddo.

Background SPOTLIGHT was a Canadian multicentre, placebo-controlled, randomized trial of emergency treatment with recombinant Factor VIIa for patients with acute intracerebral hemorrhage that enrolled a subset of eligible patients via deferral of consent. We investigated attitudes towards deferral of consent among participants and their legally-authorized representatives (LARs). Methods All participants or LARs approached for enrolment in SPOTLIGHT were invited to complete an 11-item questionnaire within the first 4 days of enrolment, and again at 90 days. Results Eight out of 50 participants in SPOTLIGHT (16%) were enrolled via deferral of consent. Ten LARs for participants (20%) completed the initial survey and 6 completed the 90 day follow-up survey. Ninety percent of respondents agreed with the process of deferral of consent both in principle and specifically for the SPOTLIGHT trial. Participants were more likely to support deferral of consent for low-risk or time-sensitive interventions, or in situations with no alternative treatment options. Conclusions The majority of respondents were supportive of using deferral of consent to enrol participants into SPOTLIGHT and acute stroke trials.

Background Identifying and treating patients with transient ischemic attack is an effective means of preventing stroke. However, making this diagnosis can be challenging, and over a third of patients referred to stroke prevention clinic are ultimately found to have alternate diagnoses. Aims We performed a systematic review to determine how neurologists diagnose transient ischemic attack. Summary of review A systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using MEDLINE, Embase, and the Cochrane Library databases. Publications eligible for inclusion were those that included information on the demographic or clinical features neurologists use to diagnose transient ischemic attacks or transient ischemic attack–mimics. Of 1666 citations, 210 abstracts were selected for full-text screening and 80 publications were ultimately deemed eligible for inclusion. Neurologists were more likely to diagnose transient ischemic attack based on clinical features including negative symptoms or speech deficits. Patients with positive symptoms, altered level of consciousness, or the presence of nonfocal symptoms such as confusion or amnesia were more likely to be diagnosed with transient ischemic attack–mimic. Neurologists commonly include mode of onset (i.e. sudden versus gradual), recurrence of attacks, and localizability of symptoms to a distinct vascular territory in the diagnostic decision-making process. Transient ischemic attack diagnosis was more commonly associated with advanced age, preexisting hypertension, atrial fibrillation, and other vascular risk factors. Conclusions Neurologists rely on certain clinical and demographic features to distinguish transient ischemic attacks from mimics, which are not currently reflected in widely used risk scores. Clarifying how neurologists diagnose transient ischemic attack may help frontline clinicians to better select patients for referral to stroke prevention clinics.

Since its modern inception in the late nineteenth century, research on word associations has developed into a large and diverse area of study, including work with both applied linguistic and psycholinguistic orientations. However, despite significant recent interest in the use of word association to investigate second language (L2) vocabulary knowledge and testing, there has until now been no systematic attempt to review the wider word association research tradition for the benefit of L2-oriented researchers and practitioners. This paper seeks to address this, drawing together linguistic research from the past 150 years, with a focus on research published since 2000. We evaluate the current state of L2 word association research, before identifying methodological and theoretical themes from a broader range of disciplinary approaches. Emerging from this, new paradigms are identified which have potential to catalyse a new phase of work for second language word association scholars, and which indicate priority foci for future work.

This paper offers a solution to a significant problem for teachers and researchers of\ud language learning that confounds their interpretations and expectations of test data:\ud the apparent simplicity of tests of vocabulary knowledge masks the complexity of the\ud constructs they claim to measure. We first scrutinise task elements in two widely cited\ud productive vocabulary measures, Lex30 (Meara and Fitzpatrick, 2000) and the\ud Lexical Frequency Profile (LFP, Laufer and Nation, 1995), in order to gain a more\ud precise understanding of the relationship between test performance and learner\ud knowledge. Next, in three empirical studies (N = 80, 80, 100) we compare L2\ud learners’ performance on Lex30, as the static point of reference, with LFP and with\ud two new tests designed to investigate specific elements of the vocabulary test tasks.\ud Correlation analyses indicate systematic differences in the tests’ capacity to capture\ud information about the quality of learners’ word knowledge and the size of their\ud vocabulary resource. Using the findings from this empirical work, we formulate a\ud model of vocabulary ‘capture’ onto which test tasks can be mapped. We demonstrate\ud how capturing key elements of the relationship between test scores and lexical\ud competence can guide teachers and researchers in applying and interpreting\ud vocabulary tests.

Effective management of Transient Ischemic Attack (TIA) and stroke hinges on accurate diagnosis. Research suggests that women and men present with different TIA/stroke symptoms, and those more commonly reported by women are often considered atypical, or benign. For this reason, TIA or stroke in women may be underdiagnosed and undertreated. Growing evidence that women are disproportionately affected by stroke underpins this study focused on neurologist diagnosis of stroke/TIA in association with presenting symptoms. A retrospective chart review was performed using data from the charts of all patients referred to The Ottawa Hospital Stroke Prevention Clinic in 2015 with a provisional diagnosis of TIA/stroke. Demographics, event characteristics, and final diagnosis were extracted from each chart. Multinomial logistic regression analysis with backwards elimination and a significance level staying in the model of α=0.15 was used to identify variables associated with a final diagnosis of definite TIA/stroke. A sub-analysis was completed for the final model by sex. Of the 1864 included patients, 932 (50%) were women. There were no significant differences in age or final diagnosis of definite TIA/stroke based on sex. Among patients reporting classic stroke symptoms such as unilateral weakness, aphasia, and amaurosis fugax both sexes demonstrated significantly higher odds of a final diagnosis of TIA/stroke; however the odds were higher for men than women. For example, men with unilateral weakness, aphasia or amaurosis fugax had an odds ratio (OR) of 32.7, 7.7, and 27.8 respectively of having a final diagnosis of TIA/stroke, whereas the OR for women was 10.9, 5.4, and 22.2 respectively, although the 95% confidence intervals overlapped. In contrast, women reporting homonymous hemianopsia or any combination of ataxia, diplopia, or vertigo had a higher odds than men of being diagnosed with TIA/stroke (OR 21 and 8.5 respectively for women and OR 11.4 and 5.1 respectively for men). The trend in differences noted for the odds of definite TIA/stroke diagnosis among men and women may imply that women are less likely to be diagnosed with TIA even when reporting classical symptoms. More research is needed to understand sex-based differences in the diagnosis of TIA/stroke.

In their study on DWI positivity after TIA and minor stroke,1 Hurford et al. pay little attention to a major issue plaguing many such studies, differentiating patients with TIA from those with other transient neurologic symptoms. Hurford et al. excluded 725 patients from their analysis because they were given an alternative diagnosis by the senior author, although why that diagnosis was given remains unclear. Including those patients, or even some fraction of them, would likely have altered their results. A recent prospective study found that even patients who neurologists believed were unlikely to have had TIA had a nontrivial rate of DWI positivity on subsequent MRI.2 We sought to explore the problem of TIA diagnosis in our own work—namely through a systematic review3 and a retrospective analysis of neurologists' decision-making.4 Prospectively correlating patients' presenting symptoms (motor and speech vs other), demographics (especially patient sex) with neurologists' diagnosis (definite TIA, possible TIA, and not TIA), and MRI positivity could help to arrive at criteria to ensure that patients with true TIA are not being missed. Enhanced diagnostic reliability would improve risk stratification, use of investigations, and efficacy of stroke prevention treatments.

A 46-year-old woman sustained a penetrating left eye (OS) injury after tripping and falling onto a motorcycle antenna. She removed the antenna immediately and presented to the emergency room complaining of diplopia. Examination demonstrated proptosis and subconjunctival hemorrhage OS. Her diplopia was initially attributed to mechanical restriction OS secondary to retrobulbar hemorrhage visualized on CT scan (figure 1). Careful examination, however, revealed left conjugate horizontal gaze palsy and left internuclear ophthalmoplegia. This was consistent with one-and-a-half syndrome from left pons penetrating trauma, confirmed on MRI (figure 2). Two months later, her condition had improved, but she continued to demonstrate abduction paresis OS.

Cancer patients appear to be at increased risk for atrial fibrillation. Although surgery and chemotherapy exacerbate this risk, this association is observed even in the absence of any cancer-specific treatment. The underlying mechanism of this is likely multifactorial, but systemic inflammation and autonomic dysregulation are hypothesized to play critical roles. Cancer and atrial fibrillation are both independent risk factors for ischemic stroke; however, it is not clear whether this translates to an increased risk of stroke in patients with both comorbidities. As such, commonly used risk stratification tools including the CHADS2 score currently do not take cancer into account as a variable and it is possible that stroke risk is underestimated in this population. There is a paucity of data regarding anticoagulant choice in cancer patients with atrial fibrillation. Vitamin K antagonists are often preferred over direct oral anticoagulants; however, this may be changing in the near future as new trials specific to this patient population emerge.

What measurements should linguists use when comparing texts written by different writers? We report aspects of a systematic evaluation of 381 different language measures derived from 200 analytic tools, carried out during the pilot for a study exploring genetic contributions to language variation. The measures covered lexis, structure, meaning, and discourse features, and were evaluated with a focus on capturing numerically the qualitative features that linguists consider central to differentiating one text from another. We review principles for selecting analytic tools, and the choices faced by the researcher in processing and analysing data. We then identify and demonstrate five of the measures, which between them provide a useful profile of different linguistic features, and note correlations with psychometric measures taken for each writer. We conclude with some caveats regarding general issues of validity and some indications about potential links between our work and research into authorship attribution for forensic purposes

Adult second language learners often come across as proficient but not native-like, with a command of the words and grammar of the language, but not of its idiomaticity. Idiomaticity resides in selecting the most native-like turn of phrase from a larger set of ways in which a particular message might be grammatically expressed. This article investigates what happens when learners are pushed to use native-like phrases in conversation. In an experiment inspired by TALK (a computer-assisted speech aid for the disabled), L2 learners of English were provided with native-like ways of expressing specific messages for targeted conversations. Both TALK and the L2 study represent artificial approaches to conversational interaction, retaining characteristics of ‘normal’ conversation along with a range of additional features arising from the limitations of being forced to rely on prefabricated material. Comparative evaluations of the two types of interaction indicate that even entirely fixed formulaic language can be highly effective in conversation. However, the extreme conditions of language use explored here also expose persistent weaknesses inherent in relying too heavily on formulaic material. The study exemplifies the value of research at the interface of lexical and grammatical processing and identifies related implications for the language learner.

Abstract: Six intermediate/advanced learners of English, studying in the United Kingdom, identified messages that they wanted to convey in specific future conversations and memorized native-like versions of them. Their ability to use them in practice and in the real conversation was analyzed. Propensity to attempt using memorized material correlated with aural-repetition aptitude, but neither propensity nor accuracy of reproduction correlated with proficiency. It is hypothesized that increased proficiency invites increased risk-taking during memorization. Individual differences in motivation and attitude, and the relationship with the interlocutor, are all discussed as salient variables.

Word associations have traditionally been used in linguistic research as a means of accessing information about the organisation of the mental lexicon. A number of important studies have revealed differences in word association behaviour in the L1 and the L2, but have failed to find consistent behaviour patterns. The study reported here suggests that this failure might be due to two factors: the choice of stimulus words and the categorisation of responses, which impose artificial constraints on both association behaviour and the exploration of response types. In order to move the investigation of L2 word associations forward, this study compares native speaker responses to a specific set of stimuli with those of advanced non-native speakers. The types of association response made by each group of subjects are investigated by means of a retrospective interview, and patterns in response types are mapped. This results in a new method of categorising word association responses, and provides more precise insight into the differences between L1 and L2 association patterns.

This paper argues that, across different psychological contexts, the methods of data collection, treatment and analysis in word association tests have hitherto been\ud inconsistent. We demonstrate that this inconsistency has resulted from inadequate control, in previous studies, of certain important variables including the basis of norm\ud comparisons, and we present a principled method for collecting, scoring and analysing association responses, to address these issues. The method is evaluated using test and\ud retest datasets from 16-year-old and over-65-year-old twins (n=636), which enable us to (a) compare samples matched for key environmental variables, (b) assess the transferability of norming information between age cohorts, and (c) evaluate the reliability of the scoring protocols. We find systematic differences in the association behaviour of the two age cohorts, indicating the importance of evaluating data only\ud against norms lists which are matched to the target population. Individual association behaviour is found to be consistent across test times, both in terms of response\ud stereotypy and response type.

In the present study, we propose a complementary approach to the traditional analysis of lexical availability studies by looking at learners’ word responses from the perspective of word frequency. We apply a word frequency framework to data produced by 6th and 8th English as a Foreign Language Learners in Spanish Primary and Secondary schools in response to nine cue words traditionally used in lexical availability studies. The chapter looks at learner profiles according to the number of words produced in the nine semantic domains, and the proportion of infrequent words to frequent words in each domain. The findings are relevant for lexical availability studies as they open a new line of research in the field. They are also relevant for vocabulary research as they question the assumption of a linear pattern of vocabulary acquisition through frequency bands.

Empirical evidence suggests that the study abroad experience accelerates growth in global vocabulary knowledge. The exact nature of this growth is rarely reported, however, and there is little documented evidence to indicate whether it is linear or uneven, whether the speed of growth is constant or changing, or whether the study abroad context favours the acquisition of certain aspects of vocabulary knowledge over others. This paper introduces and evaluates a method of tracking incremental changes in vocabulary knowledge during a year of overseas study. Lexical knowledge is elicited through a word association task completed by the learner at six-weekly intervals. Responses to the task, although not formally constrained, are dependent on the conceptual and lexical associations of the test-taker. Data sets are analysed using a word-knowledge framework, and findings reveal a gradual increase in some aspects of vocabulary knowledge (the number of collocations and native speaker-like associations), but striking inconsistencies over time in others (e.g. word form, form-meaning connections, orthography). The study uses an innovative application of an investigative tool to capture stages in the micro-development of the lexicon, thus exposing the complex and multi-dimensional nature of lexical acquisition.

The volume contains articles focussing on the role of prefabricated items in language. It provides both a discussion of Sinclair's seminal work including unpublished pieces of his manuscripts as well as articles from linguists of various fields demonstrating the relevance of this topic in theoretical as well as more applied contexts.