bluuebunny/crossref_metadata_2025_split huggingface dataset:
The cost of treating diabetic ketoacidosis in the UK: a national survey of hospital resource use
Authors: Dhatariya K. K. , Skedgel C. , Fordham R. 
Published: July 2017

AbstractAimDiabetic ketoacidosis is a commonly encountered metabolic emergency. In 2014, a national survey was conducted looking at the management of diabetic ketoacidosis in adult patients across the UK. The survey reported the clinical management of individual patients as well as institutional factors that teams felt were important in helping to deliver that care. However, the costs of treating diabetic ketoacidosis were not reported.MethodsWe used a ‘bottom up’ approach to cost analysis to determine the total expense associated with treating diabetic ketoacidosis in a mixed population sample. The data were derived from the source data from the national UK survey of 283 individual patients collected via questionnaires sent to hospitals across the country.ResultsBecause the initial survey collection tool was not designed with a health economic model in mind, several assumptions were made when analysing the data. The mean and median time in hospital was 5.6 and 2.7 days respectively. Based on the individual patient data and using the Joint British Diabetes Societies Inpatient Care Group guidelines, the cost analysis shows that for this cohort, the average cost for an episode of diabetic ketoacidosis was £2064 per patient (95% confidence intervals: 1800, 2563).ConclusionDespite relatively short stays in hospital, costs for managing episodes of diabetic ketoacidosis in adults were relatively high. Assumptions made in the calculations did not consider prolonged hospital stay due to comorbidities or costs incurred as a loss of productivity. Therefore, the actual costs to the healthcare system and society in general are likely to be substantially higher.
Continuous Improvement of Team Assignments: Using a Web‐Based Tool and the Plan‐Do‐Check‐Act Cycle in Design and Redesign
Authors: Morgan Shona D. , Stewart Alice C. 
Published: July 2017

ABSTRACTThe purpose of this brief is twofold. First, it describes a useful template for business instructors to improve teamwork assignment design and efficacy; and second, it provides an example of how to use data collected and analyzed from a Web‐based tool, Comprehensive Assessment of Team Member Effectiveness (CATME). Though CATME has been the subject of research regarding its impact on team effectiveness, less common is a clear description of its use for continuous improvement by instructors in the classroom. In this brief, we combine the well‐known continuous improvement framework of Deming's wheel—the plan‐do‐check‐act (PDCA) cycle—with CATME. We provide a template for systematic pedagogical adjustment to improve team assignments in the classroom and to ultimately impact improvement in team skills and behaviors. First, the CATME tool and its capabilities are introduced. Next, we provide a demonstration of how an instructor used the PDCA cycle and the CATME data to design, evaluate, and analyze team processes within her classroom and the actions planned to redesign her team assignment.
Female mate preference in an invasive phytopathogen vector: how learning may influence mate choice and fecundity in Diaphorina citri
Authors: Stockton D.G. , Pescitelli L.E. , Martini X. , Stelinski L.L. 
Published: July 2017

AbstractIn some arthropods, females learn in the context of reproduction to refine their mate choices and avoid males displaying traits associated with impotency. Previous studies have shown that males of the Asian citrus psyllid, Diaphorina citriKuwayama (Hemiptera: Psyllidae), associate female odor with copulatory rewards. However, it is unclear whether females similarly learn about male traits. We compared mate choice in females previously mated to either blue or orange males and found that females may associate male color with reproductive success, and avoided blue males after previous experience. Orange males mated more frequently than blue males and appeared to be more sexually aggressive in their mating attempts. In addition, females mated to orange males laid approximately twice as many eggs as those mated to blue males. We dissected male psyllids and measured the size of their reproductive organs to determine whether abdominal color was associated with reproductive development. Our morphometric analysis indicated that blue males may not be physiologically immature compared with orange males. Rather, blue males displayed larger testes and seminal vesicles than orange males, suggesting that differences in reproductive output may be behavioral in nature. Based on our data, we suggest that females learn about the appearance and mating behaviors of blue and orange males from early mating experiences, and subsequently avoid blue males in future matings. Although the roles of blue males within a population are unclear, it is possible that blue morphs may specialize in other functions such as dispersal.
The effect of depression and side effects of antiepileptic drugs on injuries in patients with epilepsy
Authors: Gur‐Ozmen S. , Mula M. , Agrawal N. , Cock H. R. , Lozsadi D. , von Oertzen T. J. 
Published: July 2017

Background and purposePeople with epilepsy are at increased risk of accidents and injuries but, despite several studies on this subject, data regarding preventable causes are still contradictory. The aim of this study was to investigate the relationship between injuries, side effects of antiepileptic drugs (AEDs) and depression.MethodsData from a consecutive sample of adult patients with epilepsy attending the outpatient clinics at St George's University Hospital in London were included. All patients were asked if they had had any injury since the last clinic appointment and completed the Liverpool Adverse Event Profile (LAEP) and Neurological Disorders Depression Inventory for Epilepsy.ResultsAmong 407 patients (243 females, mean age 43.1 years), 71 (17.4%) reported injuries since the last appointment. A two‐step cluster analysis revealed two clusters with the major cluster (53.5% of the injured group) showing a total score for LAEP ≥45, a positive Neurological Disorders Depression Inventory for Epilepsy screening and presence of AED polytherapy. A total score for LAEP ≥45 was the most important predictor.ConclusionsAntiepileptic drug treatment should be reviewed in patients reporting injuries in order to evaluate the potential contribution and burden of AED side effects.
The Impact of Ecological Factors on Game‐Based L2 Practice and Learning
Authors: Ibrahim Karim 
Published: July 2017

AbstractVarious empirical studies have demonstrated that digital gaming can promote second language (L2) use and learning and that game‐based L2 learning is a dynamic, emergent activity that is shaped by the interactions of different factors. Although a deeper understanding of gaming ecology on game‐based L2 use and learning is necessary to inform the selection and adaptation of digital games for L2 learning and teaching, to date the ecology of digital game‐based learning remains underexplored. To address this gap, the present exploratory case study investigated the effect of learners’ L2 proficiency, L2 learner identity, and gaming experience on the use of L2 in‐game discourse of six learners of Arabic when playing the simulation‐management video game Baalty. Informed by ecological approaches to L2 learning, data collected through questionnaires, think‐aloud protocols, observations, walk‐throughs, gaming journals, and interviews were analyzed and triangulated. Data analysis revealed that player–game interaction was deeply embedded in the gaming ecology and that learners’ L2 proficiency, L2‐learner identities, and gaming experience shaped the L2 learning potential of digital gaming. Pedagogical implications are discussed.
Altered sediment biota and lagoon habitat carbonate dynamics due to sea cucumber bioturbation in a high‐pCO2 environment
Authors: Wolfe Kennedy , Vidal‐Ramirez Francisco , Dove Sophie , Deaker Dione , Byrne Maria 
Published: July 2017

AbstractThe effects of global change on biological systems and functioning are already measurable, but how ecological interactions are being altered is poorly understood. Ecosystem resilience is strengthened by ecological functionality, which depends on trophic interactions between key species and resilience generated through biogenic buffering. Climate‐driven alterations to coral reef metabolism, structural complexity and biodiversity are well documented, but the feedbacks between ocean change and trophic interactions of non‐coral invertebrates are understudied. Sea cucumbers, some of the largest benthic inhabitants of tropical lagoon systems, can influence diel changes in reef carbonate dynamics. Whether they have the potential to exacerbate or buffer ocean acidification over diel cycles depends on their relative production of total alkalinity (AT) through the dissolution of ingested calcium carbonate (CaCO3) sediments and release of dissolved inorganic carbon (CT) through respiration and trophic interactions. In this study, the potential for the sea cucumber, Stichopus herrmanni, a bêche‐de‐mer (fished) species listed as vulnerable to extinction, to buffer the impacts of ocean acidification on reef carbonate chemistry was investigated in lagoon sediment mesocosms across diel cycles. Stichopus herrmanni directly reduced the abundance of meiofauna and benthic primary producers through its deposit‐feeding activity under present‐day and near‐future pCO2. These changes in benthic community structure, as well as AT (sediment dissolution) and CT (respiration) production by S. herrmanni, played a significant role in modifying seawater carbonate dynamics night and day. This previously unappreciated role of tropical sea cucumbers, in support of ecosystem resilience in the face of global change, is an important consideration with respect to the bêche‐de‐mer trade to ensure sea cucumber populations are sustained in a future ocean.
Defaunation leads to interaction deficits, not interaction compensation, in an island seed dispersal network
Authors: Fricke Evan C. , Tewksbury Joshua J. , Rogers Haldre S. 
Published: July 2017

AbstractFollowing defaunation, the loss of interactions with mutualists such as pollinators or seed dispersers may be compensated through increased interactions with remaining mutualists, ameliorating the negative cascading impacts on biodiversity. Alternatively, remaining mutualists may respond to altered competition by reducing the breadth or intensity of their interactions, exacerbating negative impacts on biodiversity. Despite the importance of these responses for our understanding of the dynamics of mutualistic networks and their response to global change, the mechanism and magnitude of interaction compensation within real mutualistic networks remains largely unknown. We examined differences in mutualistic interactions between frugivores and fruiting plants in two island ecosystems possessing an intact or disrupted seed dispersal network. We determined how changes in the abundance and behavior of remaining seed dispersers either increased mutualistic interactions (contributing to “interaction compensation”) or decreased interactions (causing an “interaction deficit”) in the disrupted network. We found a “rich‐get‐richer” response in the disrupted network, where remaining frugivores favored the plant species with highest interaction frequency, a dynamic that worsened the interaction deficit among plant species with low interaction frequency. Only one of five plant species experienced compensation and the other four had significant interaction deficits, with interaction frequencies 56–95% lower in the disrupted network. These results do not provide support for the strong compensating mechanisms assumed in theoretical network models, suggesting that existing network models underestimate the prevalence of cascading mutualism disruption after defaunation. This work supports a mutualist biodiversity‐ecosystem functioning relationship, highlighting the importance of mutualist diversity for sustaining diverse and resilient ecosystems.
Thermal affinity as the dominant factor changing Mediterranean fish abundances
Authors: Givan Or , Edelist Dor , Sonin Oren , Belmaker Jonathan 
Published: July 2017

AbstractRecent decades have seen profound changes in species abundance and community composition. In the marine environment, the major anthropogenic drivers of change comprise exploitation, invasion by nonindigenous species, and climate change. However, the magnitude of these stressors has been widely debated and we lack empirical estimates of their relative importance. In this study, we focused on Eastern Mediterranean, a region exposed to an invasion of species of Red Sea origin, extreme climate change, and high fishing pressure. We estimated changes in fish abundance using two fish trawl surveys spanning a 20‐year period, and correlated these changes with estimated sensitivity of species to the different stressors. We estimated sensitivity to invasion using the trait similarity between indigenous and nonindigenous species; sensitivity to fishing using a published composite index based on the species’ life‐history; and sensitivity to climate change using species climatic affinity based on occurrence data. Using both a meta‐analytical method and random forest analysis, we found that for shallow‐water species the most important driver of population size changes is sensitivity to climate change. Species with an affinity to warm climates increased in relative abundance and species with an affinity to cold climates decreased suggesting a strong response to warming local sea temperatures over recent decades. This decrease in the abundance of cold‐water‐associated species at the trailing “warm” end of their distribution has been rarely documented. Despite the immense biomass of nonindigenous species and the presumed high fishing pressure, these two latter factors seem to have only a minor role in explaining abundance changes. The decline in abundance of indigenous species of cold‐water origin indicates a future major restructuring of fish communities in the Mediterranean in response to the ongoing warming, with unknown impacts on ecosystem function.
Changes in leaf epicuticular wax load and its effect on leaf temperature and physiological traits in wheat cultivars (Triticum aestivum L.) exposed to high temperatures during anthesis
Authors: Huggins T. D. , Mohammed S. , Sengodon P. , Ibrahim A. M. H. , Tilley M. , Hays D. B. 
Published: July 2017

AbstractThe physiological functions of epicuticular wax (EW) include reflectance of irradiation and the reduction of water loss. When a plant experiences stressful conditions, most notably, high irradiance and temperature, damage to the photosynthetic apparatus can occur and is signalled by a decrease in the Fv/Fmax ratio. In this study, we examined the influence of increased EW on physiological function in terms of chlorophyll fluorescence (ChFl), stomatal conductance (gs), leaf temperature and spectral reflectance indices (SRI) of bread wheat (Triticum aestivum L.) cultivars. The wheat cultivars were subjected to high temperature stress (HT) (38–40°C) under greenhouse conditions when the primary inflorescence was fully emerged to determine its effect on leaf EW deposition. Leaf temperature depression (LTD) was generally lower in control (2.3°C—2012, 0.94°C—2013) compared to HT stress (3.13°C—2012, 4.05°C—2013). Cultivars in control (0.69 to 0.74 Fv/Fmax) had significantly higher ChFl compared to HT (0.58 to 0.74 Fv/Fmax). HT treatment resulted in higher EW (1.28—2012, 4.59 mg dm−2—2013) compared to control treatment (1.04—2012 to 4.56 mg dm−2—2013). Leaves devoid of EW showed significant variation among cultivars at reproductive stages for water index (WI), normalized phaeophytinization index (NPQI) and simple ratio index (SRI). In HT stress conditions, significant correlations were observed between EWL and SRI only at 3DAFE (days after full emergence), suggesting that increased EWL induced by HT and irradiation in early development may provide relief and prevent grain loss. EWL significantly associated with the physiological traits ChFl, gs, LTD and spike temperature depression (SpTD). These observations suggest that EWL may lessen the effect of high irradiance, thereby, effectively adjusting stomatal conductance, ChFl and leaf temperature, limiting the risk of over excitation of photosystem II.
A randomized controlled trial on a nurse‐led smartphone‐based self‐management programme for people with poorly controlled type 2 diabetes: A study protocol
Authors: Wang Wenru , Seah Betsy , Jiang Ying , Lopez Violeta , Tan Cherry , Lim Suan Tee , Ren Hongliang , Khoo Yin Hao 
Published: July 2017

AbstractAimTo develop and compare a nurse‐led smartphone‐based self‐management programme with an existing nurse‐led diabetes service on health‐related outcomes for people with poorly controlled type 2 diabetes in Singapore.BackgroundOver the past decades, Asia has emerged as the “diabetes epicentre” in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective care management strategies in response to this rising diabetes epidemic.DesignA randomized controlled trial with pre‐ and repeated posttests control group design.MethodologyA total of 128 adults with poorly controlled type 2 diabetes will be recruited from the diabetes clinic of a public acute hospital in Singapore through convenience sampling. Study participants will be randomly allocated either to the experimental group or the control group. Outcome measures will include the 10‐item General Self‐Efficacy Scale, 11‐item Revised Summary of Diabetes Self‐care Activities and 19‐item Diabetes‐Dependent Quality of Life. Data will be collected at three time points: baseline, 3 and 6 months from the baseline.DiscussionIt is expected that this programme will be an alternative offered to diabetes patients to master their self‐care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Furthermore, the self‐supporting and less resource‐intensive nature of this programme, using a smartphone application as the mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention.The study has been registered with ClinicalTrials.gov. The trial registration number is NCT03088475.
Early warning systems and rapid response to the deteriorating patient in hospital: A systematic realist review
Authors: McGaughey Jennifer , O'Halloran Peter , Porter Sam , Blackwood Bronagh 
Published: July 2017

AbstractAimTo determine the Rapid Response System programme theory and investigate how the mechanisms of implementation and the characteristics of context combine to enable or constrain the implementation of Rapid Response Systems and the achievement of desired outcomes.BackgroundRapid Response Systems have been implemented internationally to improve the recognition and management of patient deterioration, reduce the need for cardiopulmonary resuscitation and improve patient outcomes.DesignRealist review.Data sourcesWe searchedDARE,CENTRAL,NHSEED,MEDLINE, Medline In Process, EMBASE,CINAHL, PubMed, Scopus, The Web of Science and PychInfo databases from 1997 ‐ 2017 in addition to purposively searching the grey literature looking for articles supporting, refuting or explaining Rapid Response System programme theories.Review methodsIncluded studies were critically appraised and graded using the Critical Appraisal Skills Programme tool. Data extraction and synthesis investigated the Rapid Response System theoretical propositions against the empirical evidence to refine Rapid Response System programme theories.ResultsThe review found that the Rapid Response System programme theory achieved desired outcomes when there were sufficient skills mix of experienced staff,EWSprotocols were used flexibly alongside clinical judgement and staff had access to ongoing, multiprofessional, competency‐based education. However, ward cultures, hierarchical referral systems, workload and staffing resources had a negative impact on the implementation of the Rapid Response System.ConclusionTo improve the recognition and management of patient deterioration, policymakers need to address those cultural, educational and organizational factors that have an impact on the successful implementation of Rapid Response Systems in practice.
Stereotype content of people with acquired brain injury: Warm but incompetent
Authors: Fresson Megan , Dardenne Benoit , Geurten Marie , Meulemans Thierry 
Published: July 2017

AbstractSince stereotypes about people with acquired brain injury (ABI) can lead to prejudice, studying these stereotypes is highly important. In two studies, we examined these stereotypes both on idiosyncratic dimensions and on the two dimensions of the Stereotype Content Model. Participants completed a specific questionnaire about ABI and warmth and competence questionnaires regarding people with ABI and other social groups. Specific stereotypes about ABI were found to be underpinned by dimensions of “cognitive impairments and ADL limitations,” “catastrophic outcomes,” and “personal and interpersonal development.” Within the model, people with ABI were seen as being warm but incompetent. The ambivalent ABI stereotype could elicit prejudicial attitudes that may impede rehabilitation.
Sorry seems to be the hardest word: Cultural differences in apologizing effectively
Authors: Shafa Saïd , Harinck Fieke , Ellemers Naomi 
Published: July 2017

AbstractApologies can have desirable effects on the reduction of anger and may foster forgiveness. Yet, we know little about the effectiveness of apologies across different cultures. In this research, we distinguished two important components of apologies: admission of blame by the self and the expression of remorse for the plight of the other. We investigated how these two components resonate with cultural values associated with dignity and honor. Results revealed that although an apology increased forgiveness in both cultures, honor‐culture members tended to forgive less and retaliate more than dignity‐culture members, after an apology. This cultural difference was mediated by the extent to which honor‐culture (vs. dignity‐culture) members perceived the apology to express (less) remorse and thus be (less) sincere.