Escape Trials Research Articles

Newly developed exit options for European otters from fish fykes

AbstractEntrapment and subsequent drowning in fish fykes poses an anthropogenic mortality hazard to Eurasian otters (Lutra lutra). Different concepts on how to solve this problem have been debated in the past. To proactively prevent future fatal interactions and increase acceptance among fishers, this study tested two exit mechanisms for otters to safely escape from fyke nets, while still retaining full trap functionality for inland fisheries. Both exit options, a tearable latex lacing around flexible metal wires (100% success rate, n = 6) and a steel hoop‐spring construction (90%, n = 10) were successfully tested in 16 otter escape trials and 30 additional tests for fish (pike, eel, and common bream) retention (100%). The results indicate that the modifications of the fish traps were effective for otter conservation and commercial fisheries. Thus, both options can be recommended as equally good otter protection measures for fyke‐net fisheries of the tested type and similar sizes. However, these data were yielded under controlled conditions and it is possible that field results could differ. Hence, the presented results should be additionally verified under field conditions.

Editors' Note: Clinical Outcome After Endovascular Treatment in Patients With Active Cancer and Ischemic Stroke: A MR CLEAN Registry Substudy

In “Clinical Outcome After Endovascular Treatment in Patients With Active Cancer and Ischemic Stroke: A MR CLEAN Registry Substudy,” Verschoof et al. reported that despite similar technical success, patients with active cancer who underwent endovascular thrombectomy (EVT) experienced worse functional outcomes and a higher risk of mortality 90 days poststroke than patients without active cancer. Moores and Ganesh noted that these findings are consistent with results from the ESCAPE and ESCAPE-NA1 trials and it remains unclear how to identify patients who meet existing selection criteria for EVT but have no potential for benefit from EVT because they experience active cancer. They emphasized the importance of shared decision-making in these challenging situations, particularly when workup for acute stroke uncovers a new diagnosis of cancer. Verschoof et al. responded that the ESCAPE and ESCAPE-NA1 trials included 4 patients with cancer but did not comment on whether it was active. Because of the difficulty forming conclusions about the use of EVT in patients with active cancer through observational studies, they recommended the need for a controlled trial to study EVT in patients with active cancer. In “Clinical Outcome After Endovascular Treatment in Patients With Active Cancer and Ischemic Stroke: A MR CLEAN Registry Substudy,” Verschoof et al. reported that despite similar technical success, patients with active cancer who underwent endovascular thrombectomy (EVT) experienced worse functional outcomes and a higher risk of mortality 90 days poststroke than patients without active cancer. Moores and Ganesh noted that these findings are consistent with results from the ESCAPE and ESCAPE-NA1 trials and it remains unclear how to identify patients who meet existing selection criteria for EVT but have no potential for benefit from EVT because they experience active cancer. They emphasized the importance of shared decision-making in these challenging situations, particularly when workup for acute stroke uncovers a new diagnosis of cancer. Verschoof et al. responded that the ESCAPE and ESCAPE-NA1 trials included 4 patients with cancer but did not comment on whether it was active. Because of the difficulty forming conclusions about the use of EVT in patients with active cancer through observational studies, they recommended the need for a controlled trial to study EVT in patients with active cancer.

Reader Response: Clinical Outcome After Endovascular Treatment in Patients With Active Cancer and Ischemic Stroke: A MR CLEAN Registry Substudy.

We thank the authors for their contribution to an improved understanding of efficacy and complications of endovascular treatment (EVT) in patients with active malignancy.1 The findings of the study that patients with active cancer experienced worse outcomes after EVT, even with favorable prestroke function and technical success, is in agreement with data from the ESCAPE and ESCAPE-NA1 trials of EVT. In both these trials, we found that experiencing comorbid cancer was strongly associated with poor functional outcomes according to the modified Rankin scale score in patients at 90 days, despite achieving small final infarct volumes after EVT.2,3 While these data can help us adjust our expectations regarding post-EVT outcomes in patients with cancer, it remains challenging to identify a subset of these patients for whom EVT would be definitively futile, or even harmful, to justify withholding acute therapy—assuming they are otherwise eligible. In our clinical experience, we have found that treatment decisions become especially complex when the acute stroke evaluation unexpectedly uncovers a potential malignancy, such as an intracranial metastasis. Shared decision-making strategies have proven helpful in such settings, making the uncertain variables clear to the patient or their proxies.4

Amphibian-Friendly Water Drainages for Agricultural Landscapes, Based on Multiple Species Surveys and Behavioural Trials for Pelophylax nigromaculatus

Amphibians are the most threatened vertebrate group on earth, and one of the reasons for their decline is habitat loss. While some populations have persisted in agricultural wetlands such as rice paddies, the current anthropisation of landscapes is dealing a new blow to the survival of these species. In rice paddies, the new threats are especially visible through the increased channelization of water bodies with increasingly efficient drainage ditches, which become deadly traps. We first conducted surveys over three years to determine the use of ditches by frog species for natural versus concrete ditches, and thus relate to habitat adequacy as well as the probability of becoming trapped in concrete ditches. We then set up four types of experimental arena for escape trials. Experiments were replicated for the Black-spotted pond frog (Pelophylax nigromaculatus), as a proxy for other species abundant in rice paddies in the Republic of Korea. We determined that a slope of at least 70 degrees, with engraved patterns, was the only set-up from which frogs managed to escape. We recommend the implementation of this type of device in areas where a high concentration of animals is trapped, before phasing out the ancient design and relying on amphibian-friendly drainage ditches as they also support higher amphibian biodiversity.

What does the Historical Record Say about the Chances of Surviving an Escape from a Disabled Submarine?

IntroductionDespite US Navy and international Disabled Submarine (DISSUB) rescue capabilities, escape remains an important means of DISSUB crew survival as the crew may be forced to conduct an escape before rescue assets arrive on site due to adverse conditions onboard or operational or engineering constraints that may render rescue impossible. The main aims of the current study were to conduct an analysis of historical DISSUB records to describe the likely biomedical evolution of crew survivability following the disabling of a submarine in shallow waters, in order to develop a casualty estimate and define the main risks to escapee survival.MethodsFrom unclassified historical and scientific publications, we collated and categorized international DISSUB events in which escape was effected or attempted by any part of the crew, dating from the earliest documented DISSUB escape in 1851 until September 2019. Both non‐combat and combat sinkings were included. We also reviewed at‐sea submarine escape trial experience and medical incidents from US Navy pressurized submarine escape training records to estimate air embolism and extra‐alveolar air casualties and fatalities during escape training. Our analysis identified the casualty risk for DISSUB survivors for the following three phases: (1) survival in the submarine before escape, (2) survival during the escape ascent, and (3) survival on the surface.Results & ConclusionsUsing historical data from a total of 437 attempted DISSUB escapes that included 37 accidental and combat submarine sinkings, the following observations were made: The largest number of casualties occurred during the onboard survival phase due to atmospheric toxicity. 72% of the submariners who attempted an escape survived the escape. Escapes have been successful from a DISSUB as deep as 240 feet sea water (fsw) and experimentally during at sea submarine escape trials from depths down to 600 fsw. All historical escapes were effected within the current 72‐hour time to first rescue timeframe, with the majority occurring within 4 hours of DISSUB onset. The majority of escapees who survived were recovered from the water within 60 min. Early rescue surface response mobilization and detailed crew knowledge of escape equipment, procedures, and the physiological phenomena encountered under increased and changing pressures are essential to enhance escapee survivability. US Navy submarine escape training records indicated very low risk (<0.5%) of pulmonary over inflation syndrome or arterial gas embolism and no fatalities during the past 11 years of pressurized escape training.

Excito-repellency of Myristica fragrans Houtt. and Curcuma longa L. extracts from Southern Thailand against Aedes aegypti (L.).

The development of local plant extracts as a mosquito repellent is environmentally safe, inexpensive, and easily accessible for residents. In this study, three extracts from two local plants, Myristica fragrans Houtt. (flesh and mace) and Curcuma longa L. (rhizome) from southern Thailand, were investigated for their inherent repellent activity using the excito-repellency (ER) assay system against insectary-colonized Aedes aegypti (L.) (Diptera: Culicidae). The escape responses of mosquitoes exposed to concentrations of 0.5% to 5.0% (w/v) were measured to determine the contact irritant and non-contact repellent properties of each extract. Both the flesh and mace extracts of M. fragrans had relatively limited contact irritants (28.1% and 34.6% escape) and non-contact repellent (16.7% and 18.3% escape) activities against Ae. aegypti, respectively. The C. longa rhizome extract produced higher escape responses in the non-contact (42.6% escape) and contact (41.4% escape) trials at concentrations of 5.0% and 1.0%, respectively. GC-MS analysis found diethyl malate (56.5%) and elemicin (11.7%) to be the main components of the flesh and mace extracts, respectively, while ar-turmerone (24.6%), β-turmerone (15.2%), α-turmerone (10.5%) were the primary constituents of the rhizome extract. Overall, our results indicate that both M. fragrans extracts primarily caused Ae. aegypti escape through contact irritation. For C. longa, lower concentrations (0.5% and 1.0%) exhibited contact irritancy, but higher concentrations (2.5% and 5.0%) exhibited non-contact repellency against Ae. aegypti. Although they had limited efficacy, further experiments (e.g., mixing with other plant-based compounds) could enhance the ER of both local plant extracts. Additional evaluation of these extracts against other mosquito species and the ER of their chemical components, either alone or in combination, would also be beneficial for the development of green repellents. Our findings emphasize the possibility of utilizing plant-based mosquito repellent as an alternative personal protection method for future mosquito control programs.

Young Investigator Interview With CSCI Distinguished Scientist Awardee Dr. Michael Hill.

Dr. Michael Hill is President of the Canadian Neurology Federation and Director of the Stroke Unit for the Calgary Stroke Program. He is also a professor at the University of Calgary at the Department of Clinical Neurosciences. Dr. Hill has made outstanding contributions to the field of stroke research, particularly through the ESCAPE and ESCAPE-NA1 trials. Dr. Hill was a recipient of the Canadian Society for Clinical Investigation (CSCI) Distinguished Scientist Award in 2021-recognized as an expert and innovative leader in his research.

Escape behaviour varies with distance from safe refuge

Abstract Locomotor performance and behaviour are important for escape from predators, yet the intersection of these strategies is poorly studied. Escape behaviour is context dependent, and optimal escape theory predicts that animals that are farther from a safe refuge will generally use faster running speeds but might choose to use more variable escape paths. We studied locomotor performance and behaviour of six-lined racerunner lizards (Aspidoscelis sexlineata) escaping on natural surface runways that were varied experimentally to be either 5 or 10 m from a safe refuge. On the 5 m runway, lizards usually escaped directly towards the refuge, attained a slower maximal running speed (3.2 m s−1) at ~3 m from the start, and reached the target refuge in most of the trials (80%). On the 10 m runway, lizards used more variable behaviour, including reversals and turns, attained a faster maximal running speed (3.7 m s−1) at ~6 m from the start, and reached the final refuge in only 43% of trials. Free-ranging racerunners were rarely > 5 m from their nearest refuge and used escape paths that were typically < 5 m. Our findings align with predictions from optimal escape theory, in that the perceived risk of a predator–prey encounter can drive adjustments in locomotor behaviour and performance. Additionally, we show that the escape behaviour of free-ranging lizards closely matches their escape behaviour and performance during controlled escape trials.

Clinical impact of EVT with failed reperfusion in patients with acute ischemic stroke: results from the ESCAPE and ESCAPE-NA1 trials

Endovascular treatment (EVT) is a powerful treatment for large vessel occlusion (LVO) stroke if reperfusion can be achieved, while in cases with failed reperfusion, EVT may cause harm, as procedure-related complications may occur. We hypothesized that EVT with failed recanalization does not result in worse outcomes compared to best medical management and compared clinical outcomes of LVO stroke patients who underwent EVT with failed reperfusion to those who were treated with best medical management. We included patients with failed reperfusion from the control (EVT-only) arm of the ESCAPE-NA1 trial and the EVT arm of the ESCAPE trial and patients of the ESCAPE control arm who were treated with best medical management. Failed reperfusion following EVT was defined as modified thrombolysis in cerebral infarction score 0-2a. Proportions of good outcome (modified Rankin scale 0-2) were compared between patients who did and did not undergo EVT, and adjusted effect size estimates for EVT on outcomes were obtained. We included 260 patients (110 failed EVT and 150 non-EVT patients). Proportions of good outcome were 38/110 (34.6%) with failed EVT vs.43/147 (29.3%) without EVT (adjusted odds ratio[aOR]: 1.48 [95%CI: 0.81-2.68]). Mortality and proportions of sICH in the failed EVT group vs. patients treated with best medical management were 26/110 (23.6%) vs. 28/147 (19.1%), aOR: 1.12 (95%CI: 0.56-2.24), and 7/110 (6.4%) vs. 4/150 (2.7%), aOR: 2.34 (95%CI: 0.00-22.97). Clinical outcomes of EVT patients with failed reperfusion did not differ significantly from patients treated with best medical management.

Evaluation of open- and closed-eyed entrances on retention and escape of invasive swimming crabs and associated fauna from pots in their native range

Fishing trials targeting several invasive swimming crab species in their native habitat were undertaken using two types of collapsible pot, one with open-eyed entrances and the other with closed-eyed entrances, to analyse differences in catch retention between them. The open-eyed pot was dome-shaped with two funnel entrances located at opposite ends, whereas the closed-eyed pot had two soft sleeves that ended in slits and had to be pushed through by organisms to ingress, supposedly reducing escape. Retention fishing trials (100 pot hauls per pot type) using a 1-day soaking and fish bait confirmed no significant difference in crab catches between pot types; differences were only detected for large fish (morays and congers). A second set of 4-day escape trials (20 pots per type) was undertaken to investigate how long organisms would be detained in the pots. Escape was significantly affected, and half-residences were typically delayed by 1–2 days for most crabs and fish in closed-eyed entrance pots because the entrances closed. Closed-eyed entrances hampered escape and may be useful when longer soakings are needed; however, because no differences were detected in crab numbers between the two entrance types for short soakings, we recommend open-eyed entrance pots in order to mitigate possible ghost fishing effects from lost gear.

Unraveling behavioral and pace-of-life syndromes in a reduced parasite and predation pressure context: personality and survival of the Barbary ground squirrel

Personality traits overlap in behavioral syndromes that are assumed to be related to physiology and life history traits, shaping pace-of-life syndromes. Boldness and explorative behavior are frequently associated with higher parasite loads, increased resource acquisition, less efficient antipredator behavior, and reduced survival (e.g., through predation). We explored how personality is related to these biological traits using an invasive species—Atlantoxerus getulus in Fuerteventura island—as a model system with reduced parasitism and low predation pressure. We used breath rate during handling, open field tests, and escape trials to test for the existence of interindividual differences in boldness, explorative behavior, and escape speed, respectively. We also tested whether the personality traits were related and formed behavioral syndromes in A. getulus. At the same time, we explored how personality is related to ectoparasite load, body condition, and survival in the species. We found strong between-individual differences in breath rate, readiness to get in the open field arena, and escape speed. We found a behavioral syndrome, linking open field entrance and escape speed, in A. getulus. However, personality was not related to parasite load or body condition and survival was higher for bolder individuals. As a whole, our results suggest reduced parasites and predator pressures on Fuerteventura may have potentially neutralized the typical drawbacks of a fast pace-of-life in the introduced population of A. getulus. Research on the interactions of animal personality with other ecological and evolutionary factors, such as parasitism and selection gradients, has yielded some intriguing perspectives about many ecological and evolutionary processes. However, our understanding of the eco-evolutionary consequences of animal personality and how it interacts with other relevant biological processes is still limited. Invasive species often experience specific ecological conditions that can allow testing of the general assumptions related to animal personality. The present contribution explores if and how personality traits are related to key ecological and evolutionary factors, such as parasitism and survival, in the context of an invasive population subjected to reduced parasite and predation pressure. Unlike other studies conducted under different ecological contexts, our results suggest Barbary ground squirrels from the assessed population with fast pace-of-life syndromes have higher survival chances than their counterparts.

Avoidance and escape: Defensive reactivity and trait anxiety

Although avoidance and escape behaviors each contribute to maintaining anxiety disorders, only avoidance completely eliminates exposure to the aversive context. Current research compared anticipatory defensive engagement when aversion could either be completely avoided or escaped after initial exposure; in addition, this research examined the impact of trait anxiety on coping-related defensive engagement. Cues signaled that upcoming rapid action would avoid (block), escape (terminate), or not affect subsequent aversive exposure; the acoustic startle reflex was measured during each anticipatory interval to index defensive engagement, and blink magnitudes were compared across low-, moderate-, and high-anxious individuals. For all participants, startle was potentiated when aversive exposure was uncontrollable and attenuated when aversion was avoidable. On escape trials, on the other hand, startle potentiation increased with rising participant anxiety. Results suggest 1) defensive engagement is generally reduced in avoidance contexts relative to contexts in which exposure is certain, and; 2) trait anxiety increases defensive engagement specifically when aversive exposure can be controlled but remains certain.

Escape behavior of Side-blotched Lizards (Utastansburiana) in response to model predators

Few field studies have tested for geographic variation in escape behavior and even fewer have examined responses of prey to multiple predators despite most prey occurring in multipredator environments. We performed 458 escape trials on Side-blotched Lizards (Uta stansburiana Baird and Girard, 1852) from 10 populations that differed in predator abundances. We quantified escape behavior of Side-blotched Lizards when approached with one of two model predators: a lizard (Great Basin Collared Lizard (Crotaphytus bicinctores N.M. Smith and Tanner, 1972)) or a snake (Western Yellow-bellied Racer (Coluber mormon Baird and Girard, 1852)). Our results suggest that the escape responses of Side-blotched Lizards (flight initiation distance, distance fled, refuge entry) do not differ when approached by either a model predatory lizard or a model predatory snake. Nor do the escape responses of individual Side-blotched Lizards differ in relation to the abundances of predatory lizards or snakes in the local environment. Rather, only the directness of fleeing toward a refuge differed based on model predator type with Side-blotched Lizards fleeing more directly toward a refuge in response to a model lizard. These findings suggest that Side-blotched Lizards tend to use a more generalized escape response to approaching predators.

Escaping aversive exposure

This research examined human defensive reactivity when exposure to an aversive event could be escaped but not entirely avoided. Prolonged visual cues indicated whether exposure to an upcoming aversive (i.e., disgusting) picture could be terminated after onset (escaped) or not, or that a neutral go signal would appear. Acoustically elicited startle reflexes were measured during each cue interval, as were cardiac and skin conductance activity. Early in the cuing interval, startle reflexes were potentiated during both escape and inescapable exposure trials, compared to the simple motor context. Later in the interval, reflexes remained potentiated for both escapable and inescapable trials, with potentiation further enhanced when aversive exposure could not be escaped compared to when exposure could be escaped. Heart rate deceleration in the cuing interval indicated increased vigilance when preparing any (escape or neutral) action, whereas skin conductance responding indicated enhanced sympathetic action mobilization particularly in an escape context. These data suggest that startle reflexes engaged in an escape context reflect both motor-related response inhibition and aversive potentiation, and they indicate that defensive motivation is engaged whenever aversive exposure is guaranteed, regardless of whether it can be escaped or not.

Strong interactions between learned helplessness and risky decision-making in a rat gambling model.

Risky decision-making is characteristic of depression and of addictive disorders, including pathological gambling. However it is not clear whether a propensity to risky choices predisposes to depressive symptoms or whether the converse is the case. Here we tested the hypothesis that rats showing risky decision-making in a rat gambling task (rGT) would be more prone to depressive-like behaviour in the learned helplessness (LH) model. Results showed that baseline rGT choice behaviour did not predict escape deficits in the LH protocol. In contrast, exposure to the LH protocol resulted in a significant increase in risky rGT choices on retest. Unexpectedly, control rats subjected only to escapable stress in the LH protocol showed a subsequent decrease in riskier rGT choices. Further analyses indicated that the LH protocol affected primarily rats with high baseline levels of risky choices and that among these it had opposite effects in rats exposed to LH-inducing stress compared to rats exposed only to the escape trials. Together these findings suggest that while baseline risky decision making may not predict LH behaviour it interacts strongly with LH conditions in modulating subsequent decision-making behaviour. The suggested possibility that stress controllability may be a key factor should be further investigated.

Excito-Repellency of Citrus hystrix DC Leaf and Peel Essential Oils Against Aedes aegypti and Anopheles minimus (Diptera: Culicidae), Vectors of Human Pathogens.

The essential oils of kaffir lime (Citrus hystrix DC.) at four different concentrations (0.5, 1.0, 2.5, and 5.0% v/v) were studied for their repellency, excitation, and knockdown properties against laboratory strains of Aedes aegypti (L.) and Anopheles minimus Theobald using an excito-repellency test system. Both contact and noncontact escape responses to leaf- and peel-derived kaffir lime oils were observed. Comparing unadjusted escape responses for An. minimus, leaf oil had strong combined irritant and repellent activity responses at 1-5% concentrations (90.0-96.4% escape) and the strongest spatial repellent activity at 1% and 2% (85.9% and 87.2% escape, respectively). The peel oil exhibited good excitation with repellency at concentrations of 2.5% (89.8% escape) and 5% (96.28% escape), while concentrations 1-5% showed more moderate repellent activity against An. minimus. For Ae. aegypti, 2.5% leaf oil produced the greatest response for both contact (56.1% escape) and noncontact (63.3% escape) trials, while 2.5% produced the strongest response among all concentrations of peel oil, with 46.5% escape. However, after adjusting the contact trial escape (a measure of combined excitation and repellency), the estimated escape due to contact alone was a much weaker response than spatial repellency for both species. Knockdown responses above 50% were only observed in Ae. aegypti exposed to 5% leaf oil. Kaffir lime oils were more active against An. minimus than Ae. aegypti mosquitoes. There were statistically significant differences between leaf (more active) and peel oils at each concentration against An. minimus in contact and noncontact trials, except at the highest (5%) concentration.

Abstract 1: Effect of Intra-arterial Treatment in Patients Who are not Eligible for Intravenous alteplase. A Post-hoc Mr Clean Subgroup Analysis and Meta-analysis

Introduction: MR CLEAN showed benefit of intra-arterial therapy (IAT) with retrievable stents in patients with acute ischemic stroke caused by a proximal intracranial occlusion in the anterior circulation. Uncertainty exists about the effect of IAT in patients who are not eligible for pretreatment with intravenous alteplase (IVT). We tested for treatment effect modification of IAT by IVT. Hypothesis: The effect of IAT is not modified by IVT in patients with acute ischemic stroke. Methods: All 500 patients who were randomized in MR CLEAN were included in this substudy. We distinguished between patients who were and were not pretreated with IVT. Primary outcome was the modified Rankin Scale (mRS) at 90 days. We estimated the effect of IAT on the shift on the mRS and tested for interaction of IVT with IAT by introducing a multiplicative term in a multivariable ordinal logistic regression model. We then combined published unadjusted treatment effect estimates in patients without IVT from MR CLEAN, REVASCAT and ESCAPE trials, of treatment effect in patients without IVT in a fixed effects model after testing for heterogeneity. Results: In MR CLEAN, 55 (11%) patients were not pre-treated with IVT, The effect size in patients not treated with IVT was 2.06 [95% Confidence Interval (CI): 0.69-6.13], and 1.71 [95% CI: 1.22-2.40] in patients pretreated with IVT, without statistical interaction between IAT and IVT (p=0.92). In REVASCAT, the effect of IAT in 56 patients not treated with IVT was 2.6 [95% CI: 1.0-7.1]) and in ESCAPE it was 2.6 [95% CI: 1.1-5.9] in 76 patients. The combined estimate was 2.3 [95% CI: 1.5-3.7], without heterogeneity (p=0.78). Conclusion: The available evidence suggests that patients with acute ischemic stroke and a proximal intracranial anterior circulation occlusion, presenting within 6 hours with contra-indications for intravenous alteplase, benefit from IAT.

Dietary carotenoid supplementation improves the escape performance of the southern corroboree frog

Nutritional conditions experienced by an individual are known to affect phenotype and performance. In particular, dietary carotenoids influence vertebrate immune function, vision and coloration and have recently been suggested to enhance exercise performance. Despite growing interest in investigating the effect of dietary carotenoids on exercise performance, studies to date have been limited to short-term supplementation during a single life stage. The present study elucidates, for the first time, the effect of long-term carotenoid supplementation during both developmental and adult life stages on the aquatic and terrestrial escape performance of adult southern corroboree frogs, Pseudophryne corroboree, testing the predictions of the ‘environmental matching’ and the ‘silver spoon’ hypotheses. Individuals (N = 24 per treatment) were exposed to one of four dietary treatments: (1) both developmental and adult life stages were fed a carotenoid-supplemented diet (C–C); (2) developmental life stage, but not adult life stage, was fed a carotenoid-supplemented diet (C–U); (3) adult life stage, but not developmental life stage, was fed a carotenoid-supplemented diet (U–C); (4) both developmental and adult life stages were fed an unsupplemented diet (U–U). There was no effect of dietary carotenoids on swimming speed, hopping speed or righting ability. However, our results do indicate an effect of carotenoid supplementation on both swimming distance and hopping distance. Frogs receiving a carotenoid-supplemented diet during both developmental and adult life stages consistently outperformed other dietary treatments in the distance travelled during aquatic and terrestrial escape trials. Our results do not show support for either the silver spoon or the environmental matching hypothesis, but indicate an overall benefit of exposure to a carotenoid-rich environment across both life stages.

Stent retriever thrombectomy for acute ischemic stroke: Indications, results and management in 2015.

The functional benefit of stent retriever thrombectomy in acute ischemic stroke has been clearly demonstrated in recent positive MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, REVASCAT and THRACE trials. Thrombectomy, in association with intravenous thrombolysis, should now be offered to patients with documented occlusion of the distal internal carotid or proximal middle cerebral arteries, with a relatively normal unenhanced computed tomography (CT), and within 6hours after the onset of symptoms. Thrombectomy results in a mean absolute decrease in handicap of 22% (14 to 31%). Of the 3 up to 8 patients treated, 1 is independent at 3 months according to the initial selection. In case of a contraindication to thrombolysis, early primary thrombectomy should be considered. In acute basilar artery occlusion, thrombectomy should be performed alone or combined with thrombolysis. In an effort to increase the number of patients treated, a very rapid transfer to interventional neuroradiology centers is mandatory. In the future, thrombectomy should be evaluated in patients with distal arterial occlusion, or beyond 6hours after the onset of symptoms, or when the time of symptoms onset is unknown.

Time Is Brain: A Critical Analysis of the EXTEND-IA and ESCAPE Trials

Mechanical thrombectomy (MT) has been established as a standard of care for patients with acute ischemic stroke for the past five years. However, the direct benefits of this treatment in patients with baseline disability remains unclear. This study aims to elucidate the cost impact of performing MT on patients with moderate-to-severe baseline disability to work towards an optimized system of care for acute ischemic stroke. We developed a Markov economic model with a life-time horizon analysis of costs associated with mechanical thrombectomy in patients grouped on baseline disability as defined by modified Rankin Score. Our clinical and economic data is based on an American payer perspective. Our results identified a marginal cost-effective ratio (mCER) of $18,835.00 per quality-adjusted life year (QALY) when mechanical thrombectomy is reserved as a treatment only for patients with no-to-minimal baseline disability as compared to those with any level of baseline disability. Our results provide a framework for these future studies and highlight key sectors that drive cost in the surgical treatment and life-long care of patients with acute ischemic stroke.