Association between disability measures and healthcare costs after initial treatment for acute stroke

<p><b>Background and Purpose:</b> The distribution of 3-month modified Rankin scale (mRS) scores has been used as an outcome measure in acute stroke trials. We hypothesized that hospitalization and institutional care home stays within the first 90 days after stroke should be closely related to 90-day mRS, that each higher mRS category will reflect incremental cost, and that resource use may be less clearly linked to the National Institutes of Health Stroke Scale (NIHSS) or Barthel index.</p> <p><b>Methods:</b> We examined resource use data from the GAIN International trial comparing 90-day mRS with total length of stay in hospital or other institutions during the first 90 days. We repeated analyses using NIHSS and Barthel index scores. Relationships were examined by analysis of variance (ANOVA) with Bonferroni contrasts of adjacent score categories. Estimated costs were based on published Scottish figures.</p> <p><b>Results:</b> We had full data from 1717 patients. Length of stay was strongly associated with final mRS (P<0.0001). Each mRS increment from 0 to 1–2 to 3–4 was significant (mean length of stay: 17, 25, 44, 58, 79 days; P<0.0005). Ninety-five percent confidence limits for estimated costs (£) rose incrementally: 2493 to 3412, 3369 to 4479, 5784 to 7008, 7300 to 8512, 10 095 to 11 141, 11 772 to 13 560, and 2623 to 3321 for mRS 0 to 5 and dead, respectively. Weaker relationships existed with Barthel and NIHSS.</p> <p><b>Conclusions:</b> Each mRS category reflects different average length of hospital and institutional stay. Associated costs are meaningfully different across the full range of mRS outcomes. Analysis of the full distribution of mRS scores is appropriate for interpretation of treatment effects after acute stroke and more informative than Barthel or NIHSS end points.</p&gt

Domoic acid poisoning as a possible cause of seasonal cetacean mass stranding events in Tasmania, Australia

The periodic trend to cetacean mass stranding events in the Australian island state of Tasmania remains unexplained. This article introduces the hypothesis that domoic acid poisoning may be a causative agent in these events. The hypothesis arises from the previously evidenced role of aeolian dust as a vector of iron input to the Southern Ocean; the role of iron enrichment in Pseudo-nitzschia bloom proliferation and domoic acid production; and importantly, the characteristic toxicosis of domoic acid poisoning in mammalian subjects leading to spatial navigation deficits. As a pre-requisite for quantitative evaluation, the plausibility of this hypothesis was considered through correlation analyses between historical monthly stranding event numbers, mean monthly chlorophyll concentration and average monthly atmospheric dust loading. Correlation of these variables, which under the domoic acid stranding scenario would be linked, revealed strong agreement (r=0.80-0.87). We therefore advocate implementation of strategic quantitative investigation of the role of domoic acid in Tasmanian cetacean mass stranding events

Ensembles of ecosystem service models can improve accuracy and indicate uncertainty

Many ecosystem services (ES) models exist to support sustainable development decisions. However, most ES studies use only a single modelling framework and, because of a lack of validation data, rarely assess model accuracy for the study area. In line with other research themes which have high model uncertainty, such as climate change, ensembles of ES models may better serve decision-makers by providing more robust and accurate estimates, as well as provide indications of uncertainty when validation data are not available. To illustrate the benefits of an ensemble approach, we highlight the variation between alternative models, demonstrating that there are large geographic regions where decisions based on individual models are not robust. We test if ensembles are more accurate by comparing the ensemble accuracy of multiple models for six ES against validation data across sub-Saharan Africa with the accuracy of individual models. We find that ensembles are better predictors of ES, being 5.0 6.1% more accurate than individual models. We also find that the uncertainty (i.e. variation among constituent models) of the model ensemble is negatively correlated with accuracy and so can be used as a proxy for accuracy when validation is not possible (e.g. in data-deficient areas or when developing scenarios). Since ensembles are more robust, accurate and convey uncertainty, we recommend that ensemble modelling should be more widely implemented within ES science to better support policy choices and implementation. © 2020 The Author

Outperforming markets: IC and the long-term performance of Japanese IPOs

This article studies the effects of disclosure practices of Japanese IPO prospectuses on long-term stock performance and bid–ask spread, as a proxy for cost of capital, after a company is admitted to the stock exchange. A disclosure index methodology is applied to 120 IPO prospectuses from 2003. Intellectual capital information leads to significantly better long-term performance against a reference portfolio, and is thus important to the capital market. Further, superior disclosure of IC reduces bid–ask spread in the long-term, indicating that such disclosures are important in an IPO setting. Analysts and investors can attain higher long-term returns by understanding IC

How age influences phonotaxis in virgin female Jamaican field crickets (Gryllus assimilis)

Female mating preference can be a dominant force shaping the evolution of sexual signals. However, females rarely have consistent mating preferences throughout their lives. Preference flexibility results fromcomplex interactions of predation risk, social and sexual experience, and age. Because residual reproductive value should theoretically decline with age, older females should not be as choosy as younger females. We explored how age influences phonotaxis towards a standard mate attraction signal using a spherical treadmill (trackball) and a no-choice experimental protocol. Female Jamaican field crickets, Gryllus assimilis, were highly variable in their phonotaxis; age explained up to 64% of this variation. Females 10 days post imaginal eclosion and older oriented toward the mate attraction signal, with 10-and 13-day females exhibiting the greatest movement in the direction of the signal. Our study suggests 10-and 13-day old females would be most responsive when quantifying the preference landscape for G. assimilis sexual signals

Glasses in hard spheres with short-range attraction

We report a detailed experimental study of the structure and dynamics of glassy states in hard spheres with short-range attraction. The system is a suspension of nearly-hard-sphere colloidal particles and non-adsorbing linear polymer which induces a depletion attraction between the particles. Observation of crystallization reveals a re-entrant glass transition. Static light scattering shows a continuous change in the static structure factors upon increasing attraction. Dynamic light scattering results, which cover 11 orders of magnitude in time, are consistent with the existence of two distinct kinds of glasses, those dominated by inter-particle repulsion and caging, and those dominated by attraction. Samples close to the `A3 point' predicted by mode coupling theory for such systems show very slow, logarithmic dynamics.Comment: 22 pages, 18 figure