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Fengting Wang,1,* Limin Rong,1,* Linlin Luo,2 Fuqin Mu,1 Liju Qian,3 Yandan Qian,4 Xinyao Zhang,1 Yuying Lang,1 Weijia Wang,1 Yan Liu,5,6 Ying Zhang,7 Jianli Wang1,8 1School of Mental Health, Jining Medical University, Jining, Shandong, People’s Republic of China; 2Department of Hematology, Tai’an Central Hospital, Tai’an, Shandong, People’s Republic of China; 3Shandong Daizhuang Hospital, Jining, Shandong, People’s Republic of China; 4The Third People’s Hospital of Jiashan County, Jiashan, Zhejiang, People’s Republic of China; 5School of Public Health, Jining Medical University, Jining, Shandong, People’s Republic of China; 6Center of Evidence-Based Medicine, Jining Medical University, Jining, Shandong, People’s Republic of China; 7School of Public Health, University of Sydney, Sydney, NSW, Australia; 8Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada*These authors contributed equally to this workCorrespondence: Fengting Wang, School of Mental Health, Jining Medical University, Jining, Shandong, 272013, People’s Republic of China, Email wft.0810@163.com Yan Liu, School of Public Health, Jining Medical University, Jining, Shandong, 272013, People’s Republic of China, Email hakunaly@163.comBackground: Youth and young adults have a high prevalence of major depressive disorder (MDD). Limited longitudinal research has explored the relationship between different dimensions of psychological stress and MDD. This study aimed to estimate the effect of psychological stress on the risk of first onset MDD in a sample of Chinese freshmen.Methods: Using a longitudinal design, 8079 Chinese first-year students were recruited at baseline, and 6985 were followed up one year later. The Psychological Stress Scale for College Students was utilized to evaluate the levels of psychological stress. MDD was evaluated using the Chinese version of the Composite International Diagnostic Interview (CIDI-3.0). Logistic regression modeling was utilized to estimate the associations between dimensions of psychological stress and the risk of MDD.Results: Two dimensions of psychological stress, namely learning stress (OR=1.05, 95% CI:1.01– 1.09, P=0.017) and economic stress (OR=1.11, 95% CI:1.04– 1.19, P=0.001), were significantly associated with the risk of MDD. Other dimensions of psychological stress (specify family stress, interpersonal stress, intimate relationship stress, employment stress and appearance stress) were not associated with MDD.Conclusion: Psychological stress, especially learning and economic stresses, could increase the risk of MDD in university students. These factors should be incorporated into mental health prevention and intervention programs at universities to reduce the risks of MDD.Keywords: major depressive disorder, psychological stress, longitudinal study, freshmen

Donna D Carstens,1 Diego J Maselli,2 Erin E Cook,3 Fan Mu,3 Jingyi Chen,3 Danni Yang,3 Jessica Karacz DeMartino,1 Yen Chung1 1Respiratory & Immunology, AstraZeneca, Wilmington, DE, USA; 2Division of Pulmonary Diseases & Critical Care, University of Texas Health, San Antonio, TX, USA; 3Health Economic and Outcomes Research, Analysis Group, Boston, MA, USACorrespondence: Jessica Karacz DeMartino, AstraZeneca Pharmaceuticals, 1800 Concord Pike, Wilmington, DE, 19897, USA, Tel +1 302-897-0843, Email jessica.demartino@astrazeneca.com

Fengchun Mu,1,2,&ast; Bingjie Fan,1,&ast; Butuo Li,1 Wenru Qin,1 Haoqian Li,1,2 Chunni Wang,1 Bing Zou,1 Shijiang Wang,1 Linlin Wang1 1Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People’s Republic of China; 2Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 271016, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Linlin Wang, Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250117, People’s Republic of China, Tel +86-531-67626142, Fax +86-531-67626141, Email wanglinlinatjn@163.comPurpose: The present study aimed to evaluate the incidence rate of radiation pneumonitis (RP) in patients with advanced lung adenocarcinoma treated with first-generation (1G), second-generation (2G), or third-generation (3G) epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) combined with thoracic radiotherapy (TRT).Patients and Methods: Patients with advanced lung adenocarcinoma simultaneously treated with 1G/2G/3G EGFR-TKIs and TRT between 2015– 2021 at Shandong Cancer Hospital and Institute were screened. The incidence rate of clinical and imaging RP was compared between the three groups.Results: A total of 200 patients treated with EGFR-TKIs were enrolled in this study, including 100 patients who were treated with 1G EGFR-TKIs, 50 patients who were treated with 2G EGFR-TKIs, and 50 patients who were treated with 3G EGFR-TKIs (patients matched in a 2:1:1 ratio for tumor characteristics). The overall incidence of clinical RP in the 1G, 2G, and 3G EGFR-TKI groups were 29%, 48%, and 28% (p=0.043), respectively, and that of imaging RP were 33%, 58%, and 36% (p=0.010), respectively. The incidence of RP with a clinical grade ≥ 3 in the three groups were 14%, 28%, and 12% (p=0.055), respectively, and that with an imaging grade ≥ 3 in the three groups were 11%, 32%, and 10% (p=0.002), respectively. The incidence of clinical RP was higher in the CFRT group than in the SBRT group, with an overall clinical grade of 38% vs 10% (p< 0.001) and imaging grade of 46% vs 10% (p< 0.001), respectively. In the multivariate analysis, only GTV volume was an independent predictive factor for all risks of clinical and imaging RP. V20 and grouping of 1G/2G/3G EGFR-TKIs were other independent predictive factors for the risk factors of RP for imaging grades.Conclusion: Compared with 2G EGFR-TKIs combined with TRT, 1G or 3G EGFR-TKIs combined with TRT achieved a lower incidence of RP.Keywords: EGFR-TKI, molecular targeted therapy, radiation pneumonitis, thoracic radiotherapy, lung adenocarcinoma

Background Immunosuppressed recipients of liver transplantation (LT) are more likely to develop coronavirus disease 2019 (COVID-19) and may have an increased risk of developing worse outcomes. Aim To assess the effect of ursodeoxycholic acid (UDCA) on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in LT recipients. Design Adult patients (aged ≥ 18 years) who underwent LT between 1 January 2015 and 31 December 2022 were included and categorized into two groups according to their use of UDCA. Methods The prevalence and severity of COVID-19 among transplantation patients between the UDCA and non-UDCA groups were estimated and compared. Results Among the 897 LT patients who met the inclusion criteria, infection rate of SARS-CoV-2 was 78.4%, and the rate of severe illness was 5.1% from January 2022 to January 2023 in China. In the multivariate analysis, only UDCA treatment (P  = 0.006) was found to be a protective factor against SARS-CoV-2 infection. After propensity score matching, the SARS-CoV-2 infection rate in the UDCA group was lower than that in the non-UDCA group (74.1% vs. 84.6%, P  = 0.002). This rate was further reduced to 62.1% (P  = 0.002) when the oral administration dose was >15 mg/kg/day. There was no difference in the rates of severe COVID-19 illness, ICU admission, or ventilation rate or length of hospital stay with or without UDCA treatment (all P  > 0.05). Conclusions The use of UDCA in LT patients significantly reduced the SARS-CoV-2 infection rate and showed a dose-dependent protective effect. [ABSTRACT FROM AUTHOR]

The pressure and density dependence of the shear strength of sand poses a tricky problem in pile foundation design. In this study, a correlation is suggested to link the effective friction angle of sand with its initial confining pressure and relative density, and a simple approach incorporating this correlation is presented for predicting pile end bearing capacity. Assessment of the approach against pile load tests shows reasonably good agreement between predictions and measurements. It is also shown that the effect of the state-dependent strength is particularly important in cases where long piles are installed in dense sand deposits and the use of critical state friction angle will produce a conservative prediction in such cases. CE Database subject headings: Bearing capacity; Piles; Pile foundations; Sand; Shear strength.

Buried pipelines are widely used, so it is necessary to analyze and study their fracture characteristics. The locations of corrosion defects on the pipe are more susceptible to fracture under the influence of internal pressure generated during material transportation. In the open literature, a large number of studies have been conducted on the failure pressure or residual strength of corroded pipelines. On this basis, this study conducts a fracture analysis on buried pipelines with corrosion areas under seismic loads. The extended finite element method was used to model and analyze the buried pipeline under seismic load, and it was found that the stress value at the crack tip was maximum when the circumferential angle of the crack was near 5° in the corrosion area. The changes in the stress field at the crack tip in the corrosion zone of the pipeline under different loads were compared. Based on the BP algorithm, a neural network model that can predict the stress field at the pipe crack tip is established. The neural network is trained using numerical model data, and a prediction model with a prediction error of less than 10% is constructed. The crack tip characteristics were further studied using the BP neural network model, and it was determined that the tip stress fluctuation range is between 450 MPa and 500 MPa. The neural network model is optimized based on the GA algorithm, which solves the problem of convergence difficulties and improves the prediction accuracy. According to the prediction results, it is found that when the internal pressure increases, the corrosion depth will significantly affect the crack tip stress field. The maximum error of the optimized neural network is 5.32%. The calculation data of the optimized neural network model were compared with the calculation data of other models, and it was determined that GA-BPNN has better adaptability in this research problem.

With the large-scale integration of distributed renewable energy into low-voltage distribution station areas, rapidly growing services put forward new requirements on transparent monitoring. In order to accurately and objectively quantify the transparency of various distribution station areas and measure the impact of different dimensional indexes on the transparency evaluation of distribution station areas, this paper proposes a confidence relative off-target distance-based multi-dimensional transparency evaluation method. First, a multi-dimensional transparency evaluation index system with electrical and communication integration is constructed. Second, an improved gray target model combining both positive and negative target vectors is established to realize bi-directional quantitative analysis. Then, the relative off-target distance is calculated based on the endowment coefficient by leveraging both subjective and objective weights. Finally, the confidence of the relative off-target distance is calculated based on fuzzy entropy to improve the reliability of transparency evaluation. The simulation results show that this method can effectively distinguish the transparency gap between different distribution station areas, identify the single dimensional index with the greatest contribution or potential, and verify the effectiveness of the proposed method applied to the transparency evaluation of distribution station areas.

The global football market has grown in the past three decades, and football clubs' sustainable financial operations have gradually gained attention. This study aims to construct a financial risk assessment model applicable to the football industry, explore globally listed football clubs' overall financial operating characteristics, and analyse the leading causes of the club's financial crisis. We selected a sample of 24 currently listed football clubs worldwide and an exploratory factor analysis (EFA) model to construct the model of financial risk assessment for football clubs. The model identified and classified the financial risk components for listed football clubs, thus facilitating risk warning and prevention for modern professional clubs. This study found that football clubs are at higher financial risk overall, with the following general characteristics: (1) small amount of listed capital; (2) high asset-liability ratio; (3) low net profits and a large proportion of clubs make losses; and (4) weak asset liquidity. Finally, the study discussed the leading causes of the financial crises of football clubs in both external and internal dimensions, providing a reference for the self-sustainability of clubs and football authorities.

In the past 30 years, the global influence of the FIFA World Cup has continued to grow. According to statistics, the final match of the 2022 World Cup in Qatar attracted an audience of over 3 billion. Nowadays, nations (and regions) emphasize the correlation between overall social progress, football tradition, and national sporting prowess. This study aims to comprehend the dynamics of international football development and secure a competitive edge in the global arena. The study collected panel data from 68 countries (regions) participating in the final stage of the World Cup from 1994 to 2022. It modelled them using a generalized linear mixed model (GLMM) to reveal the macro determinants of success and winning patterns in international football performance. The findings show that (1) football tradition's “characteristic values” (e.g. World Cup host, the experience of hosting the World Cup and the number of all-time World Cup winners) and national comprehensive sporting strength (as represented by the Olympic Games results) have significantly contributed to the national team's World Cup performance; (2) the country's Human Development Index (HDI) has a significant negative impact on World Cup performance; (3) the history of football participation (e.g. the number of years of membership in the Intercontinental Football Association (IFA), history of professional leagues) will have little impact on World Cup performance; (4) two interactive variables: population scale × national comprehensive sporting strength (GPOP × CSOGMedals) and economic level × football tradition (lnGDP × PLHistory), have a negative and positive combined effect on World Cup performance, respectively.

ABSTRACTFlexoelectric effect can be used to design actuators to control engineering structures including beams, plates, and shells. Multiple flexoelectric actuators method has the advantage of less stress concentration and better control effect, but the mode-dependent optimal actuator locations could influence the flexoelectric actuation effect significantly. In this work, a neural network model is established to study the optimal combinations of multiple flexoelectric actuators on a rectangular plate. In the physical model, an atomic force microscope (AFM) probe was employed to generate an electric field gradient in the flexoelectric patch, so that flexoelectric control force and moment can be obtained. Multiple flexoelectric actuators on the plate was considered. Case studies showed that the flexoelectricity induced stress mainly concentrate near the probe, the size and shape of the flexoelectric patch have limited effect on the actuation, hence, only the actuator positions were choosing as the input of the ANN model. Using the prediction of the neural network model, the driving effect of a large number of actuators at different positions can be quickly obtained, and the optimal position of the actuator can be analyzed more accurately.

Summary: Background: Hidradenitis suppurativa (HS), a chronic cutaneous disease, can negatively affect work life. Objectives: This retrospective cohort study evaluates the indirect burden among employed patients with HS in the U.S.A. Methods: Newly diagnosed and general patients with HS, who were employees (age 18–64 years) from a large claims database (Q1 1999 to Q1 2015), were matched 1 : 5 to controls. Income growth and risk of leaving the workforce were assessed among the newly diagnosed HS and control cohorts in the 5‐year study period. Income, work loss days and indirect costs (absenteeism and disability) were assessed among the general HS and control cohorts in the 1‐year study period. Results: Newly diagnosed (n = 1003, mean age 39·5 years, 66·3% female) and general patients with HS (n = 1204, mean age 39·9 years, 69·1% female) were matched to 5015 and 6020 controls, respectively. Newly diagnosed patients with HS had significantly slower income growth ($324 per year) and higher risk of leaving the workforce (adjusted hazard ratio 1·65, 95% confidence interval 1·45–1·88) compared with controls (all P < 0·05). General patients with HS had more total days of work loss (18·4 vs. 7·7), higher annual total indirect costs ($2925 vs. $1483) and lower annual income ($54 925 vs. $62 357) than controls (all P < 0·001). Conclusions: Patients with newly diagnosed HS and general patients with HS experienced a greater indirect burden than matched controls. What's already known about this topic? Hidradenitis suppurativa (HS), a chronic inflammatory disease, can negatively affect work life. What does this study add? This retrospective claims analysis found that HS is associated with high indirect burden, in terms of slower income growth, higher risk of leaving the workforce and higher indirect costs.These results indicate that patients with HS have unmet disease management needs. Linked Editorial: Zouboulis. Br J Dermatol 2019; 181:7–8. Plain language summary available online Respond to this article [ABSTRACT FROM AUTHOR]

For the design of new jointed plain concrete pavements (JPCPs), three national calibrations of the AASHTOWare Pavement ME Design have been necessary due to model and database updates. Local calibration is also recommended to better match a state’s experience. To date, 8 states have changed the calibration coefficients to local values, while 11 states have implemented national coefficients. This study presents a review of the national and local calibrations and a comparison in terms of, (1) pavement performance prediction and (2) thickness design. It was found that the difference between the local and national calibrations was significant in terms of predicted pavement performance, but much less with respect to thickness design. Furthermore, a full factorial was conducted to study the impact of various design features on the local calibrations. The results showed that the difference between the national and local calibrations decreased as optimum design features such as short joint spacing were used. [ABSTRACT FROM AUTHOR]

Purpose: To explore the efficacy of nimodipine, nifedipine, and edaravone (EDA) combined with Nao-Xue-Shu in patients with hypertensive intracerebral hemorrhage (HICH) and to determine the best western medicine combined with Nao-Xue-Shu for treating HICH patients using a ranking method.Methods: After a comprehensive search of the China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP information database, Chinese Biomedical Database (CBM), PubMed, Embase, and Cochrane Library database from the database establishment 31 December 2021, data extraction and quality assessment were conducted for the included articles. The primary outcome measure was the effectiveness after treatment. Secondary outcome measures were after-treatment the National Institutes of Health Stroke Scale (NIHSS) scores, hematoma volume, perihematoma edema volume, and inflammatory factor expression levels. Statistical analyses were performed using Stata 16.0 and RevMan 5.3.0 software.Results: We included 19 randomized controlled trials (RCTs) and six non-RCTs. The effective rate after treatment was ranked from the best to the worst as follows: routine cure measure (RCM) + nifedipine + Nao-Xue-Shu, RCM + EDA + Nao-Xue-Shu, RCM + Nao-Xue-Shu, RCM + nimodipine + Nao-Xue-Shu, RCM + EDA, and RCM. The post-treatment NHISS scores from lowest to highest were as follows: RCM + EDA + Nao-Xue-Shu, RCM + nifedipine + Nao-Xue-Shu, RCM + EDA, RCM + nimodipine + Nao-Xue-Shu, RCM + Nao-Xue-Shu, RCM + Nao-Xue-Kang, and RCM. The post-treatment hematoma volume from minimum to maximum was as follows: RCM + EDA + Nao-Xue-Shu, RCM + nimodipine + Nao-Xue-Shu, RCM + nifedipine + Nao-Xue-Shu, RCM + Nao-Xue-Shu, RCM + Nao-Xue-Kang, and RCM. The post-treatment perihematoma edema volume from minimum to maximum was as follows: RCM + EDA + Nao-Xue-Shu, RCM + nifedipine + Nao-Xue-Shu, RCM + nimodipine + Nao-Xue-Shu, RCM + Nao-Xue-Shu, and RCM. For inflammatory factor expression levels after treatment, IL-6 concentration levels after treatment from lowest to highest wasas follows: RCM + Nao-Xue-Shu, RCM + nifedipine + Nao-Xue-Shu, RCM + nimodipine + Nao-Xue-Shu, RCM + EDA + Nao-Xue-Shu, and RCM. TNF-α concentration levels after treatment from lowest to highest was as follow: RCM + nimodipine + Nao-Xue-Shu, RCM + nifedipine + Nao-Xue-Shu, RCM + Nao-Xue-Shu, and RCM.Conclusion: Nao-Xue-Shu combined with nifedipine showed better effectiveness after treatment in HICH patients compared with the other combinations. Nao-Xue-Shu combined with EDA was more effective for improving neurological function and reducing both hematoma and edema volumes around the hematoma compared with the other combinations. However, Nao-Xue-Shu alone or Nao-Xue-Shu combined with nimodipine may be more effective for reducing proinflammatory factor expression.

Abstract A mouse model of human Familial Adenomatous Polyposis responds favorably to pharmacological inhibition of 5′-methylthioadenosine phosphorylase (MTAP). Methylthio-DADMe-Immucillin-A (MTDIA) is an orally available, transition state analogue inhibitor of MTAP. 5′-Methylthioadenosine (MTA), the substrate for MTAP, is formed in polyamine synthesis and is recycled by MTAP to S-adenosyl-l-methionine (SAM) via salvage pathways. MTDIA treatment causes accumulation of MTA, which inhibits growth of human head and neck (FaDu) and lung (H359, A549) cancers in immunocompromised mouse models. We investigated the efficacy of oral MTDIA as an anti-cancer therapeutic for intestinal adenomas in immunocompetent APCMin/+ mice, a murine model of human Familial Adenomatous Polyposis. Tumors in APCMin/+ mice were decreased in size by MTDIA treatment, resulting in markedly improved anemia and doubling of mouse lifespan. Metabolomic analysis of treated mice showed no changes in polyamine, methionine, SAM or ATP levels when compared with control mice but indicated an increase in MTA, the MTAP substrate. Generation of an MTDIA-resistant cell line in culture showed a four-fold amplification of the methionine adenosyl transferase (MAT2A) locus and expression of this enzyme. MAT2A is downstream of MTAP action and catalyzes synthesis of the SAM necessary for methylation reactions. Immunohistochemical analysis of treated mouse intestinal tissue demonstrated a decrease in symmetric dimethylarginine, a PRMT5-catalyzed modification. The anti-cancer effects of MTDIA indicate that increased cellular MTA inhibits PRMT5-mediated methylations resulting in attenuated tumor growth. Oral dosing of MTDIA as monotherapy has potential for delaying the onset and progression of colorectal cancers in Familial Adenomatous Polyposis (FAP) as well as residual duodenal tumors in FAP patients following colectomy. MTDIA causes a physiologic inactivation of MTAP and may also have efficacy in combination with inhibitors of MAT2A or PRMT5, known synthetic-lethal interactions in MTAP −/− cancer cell lines.

ABSTRACT: Objective: To evaluate the clinical validity of a new ultrahigh‐throughput non‐invasive prenatal test (NIPT) based on combinatorial probe–anchor ligation (cPAL) sequencing of cell‐free fetal DNA (cffDNA) using centralized testing. Methods: Maternal plasma samples were obtained from 10 594 singleton pregnancies in high‐risk populations at 20 centers in China, including 8155 that were collected retrospectively and 2439 prospectively. Fetal outcome data and karyotyping results were documented as gold standard and were double blinded during NIPT. The clinical performance of the ultrahigh‐throughput sequencing method, cPAL, for NIPT was validated by evaluating its sensitivity, specificity and positive predictive value (PPV) in detecting trisomies 21, 18 and 13 as the centralized testing mode in the reference laboratory. To ensure stable and reproducible performance of centralized cPAL‐based NIPT in detecting trisomies, a series of quality‐control systems, including sequencing of two sets of artificial samples, were employed and evaluated. Results: Ten prospective cases were excluded from the study because of incomplete clinical data. Four prospective samples failed to generate a NIPT result due to assay failure, presenting a failure rate of 0.16% (4/2429). A total of 168 retrospective cases and 47 prospective cases had a positive NIPT result for trisomy, giving respective positive rates of 2.06% and 1.94%. Four false‐positive and no false‐positive cases were observed in the retrospective and prospective groups, respectively, resulting in PPV of 97.62% (95% CI, 94.02–99.35%) and 100% (95% CI, 92.45–100%), respectively. In the retrospective group, sensitivity and specificity were, respectively, 100% (95% CI, 97.07–100%) and 99.98% (95% CI, 99.94–100%) for trisomy 21, 100% (95% CI, 97.75–100%) and 99.98% (95% CI, 99.94–100%) for trisomy 18, and 100% (95% CI, 15.81–100%) and 100% (95% CI, 99.95–100%) for trisomy 13. In the prospective group, sensitivity and specificity were, respectively, 100% (95% CI, 90.75–100%) and 100% (95% CI, 99.85–100%) for trisomy 21, 100% (95% CI, 63.06–100%) and 100% (95% CI, 99.85–100%) for trisomy 18, and 100% (95% CI, 2.50–100%) and 100% (95% CI, 99.85–100%) for trisomy 13. Conclusion: In this multicenter study with a full quality‐control system, NIPT by centralized cPAL‐based testing showed high stability and performance comparable to those of previous validation studies in high‐risk populations. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

A cohesive zone model is proposed to simulate the interface debonding, a preponderant cause of failure for bonded concrete overlay of asphalt (BCOA). The model is constructed by superimposing four root models, each representing the mechanism of one subcritical failure at the interface zone observed in laboratory experiments. The model parameters are established through an inverse analysis of wedge splitting tests performed on BCOA specimens. These inputs are mainly a function of the materials at the interface zone, such as microtexture and macrotexture, and thus can be expected to be applicable to the numerical simulation of a full scale BCOA slab. For modeling across scales, the impact of specimen size, milling depth and initial flaw size on the model, in terms of peak traction and fracture energy, is also discussed. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to estimate the acute healthcare costs of ischemic stroke during hospitalization and the quarterly all-cause healthcare costs for the first year after discharge by discharge status.Methods: Adult patients with a hospitalization with a diagnosis of ischemic stroke (ICD-9-CM: 434.xx or 436.xx) between 1 January 2006 and 31 March 2015 were identified from a large US commercial claims database. Patients were classified into three cohorts based on their discharge status from the first stroke hospitalization, i.e. dead at discharge, discharged with disability, or discharged without disability. Third-party (medical and pharmacy) and out-of-pocket costs were adjusted to 2015 USD.Results: A total of 7919 patients dead at discharge, 45,695 patients discharged with disability, and 153,778 patients discharged without disability were included in this analysis. The overall average age was 59.7 years and 52.3% were male. During hospitalization, mean total costs (third-party and out-of-pocket) were $68,370 for patients dead at discharge, $73,903 for patients discharged with disability, and $24,448 for patients discharged without disability (p < .001 for each pairwise comparison); mean third-party costs were $63,605 for patients dead at discharge, $67,861 for patients discharged with disability and $19,267 for patients discharged without disability (p < .001 for each pairwise comparison). During the first year after discharge, mean total costs for patients discharged with disability vs. without disability were $46,850 vs. $30,132 (p < .001). Mean third-party costs for patients discharged with disability vs. without disability were $19,116 vs. $10,976 during the first quarter after discharge, $10,236 vs. $6926 during the second quarter, $8241 vs. $5810 during the third quarter, and $6875 vs. $5292 during the fourth quarter (p < .001 for each quarter).Conclusion: The results demonstrated the high economic burden of ischemic stroke, especially among patients discharged with disability with the highest costs incurred during the inpatient stays. [ABSTRACT FROM AUTHOR]