Does size matter?:Hospital volume and resource use in paediatric diabetes care

Aims: Paediatric diabetes care has become increasingly specialised due to the multidisciplinary approach and technological developments. Guidelines recommend sufficient experience of treatment teams. This study evaluates associations between hospital volume and resource use and hospital expenditure in Dutch children with diabetes. Methods: Retrospective cohort study using hospital claims data of 5082 children treated across 44 Dutch hospitals (2019–2020). Hospitals were categorised into three categories; small (≥20–100 patients), medium (≥100–200 patients) and large (≥200 patients). All-cause hospitalisations, consultations, technology and hospital expenditure were analysed and adjusted for age, sex, socio-economic status (SES) and hospital of treatment. Results: Fewer hospitalisations were observed in large hospitals compared to small hospitals (OR 0.48; [95% CI 0.32–0.72]; p &lt; 0.001). Median number of yearly paediatrician visits was 7 in large and 6 in small hospitals, the significance of which was attenuated in multilevel analysis (OR ≥7 consultations: 1.89; [95%CI 0.74–4.83]; p = 0.18). Technology use varies between individual hospitals, whereas pump usage and real-time continuous glucose monitoring showed no significant differences between hospital volumes. Mean overall expenditure was highest in medium-sized centres with €6434 per patient (IQR €2555–7955); the difference in diabetes care costs was not significant between hospital patient volumes. Conclusions: Care provision patterns vary by hospital patient volume. Large hospitals had the lowest hospitalisation rates. The use of diabetes technology was not different between hospital patient volumes. Medium-sized hospitals showed the highest overall expenditure, but diabetes care costs were similar across hospital volumes.</p

Infochemical-tritrophic Interactions of Soybean Aphids-host Plants-natural Enemies and Their Practical Applications in Pest Management

The soybean aphid, Aphis glycines Matsumura, is a newly invasive insect species that seriously threatens U.S. soybean production. This aphid pest has kept haunting many soybean growers by developing large colonies on soybeans in North America since 2000. Since its first appearance inWisconsin, it has spread to over half of US states and southern provinces in Canada. The heavy infestation of this pest whittles soybean growers’ profits and causes hundreds of million dollar losses. The present chapter will mainly describe efforts in studying aphid chemical ecology and sensory physiology for understanding how male aphids find their mates and host plants. It will also cover research efforts to understand host plant associated volatiles being used as cues for overwintering host plant location. In addition, findings on how soybean plant defensive system works against aphid infestation, as well as how those induced plant volatiles are used by aphid’s natural enemies for prey location will be presented. Finally, the use the basic understandings for developing useful tools for soybean aphid practical control will be discussed

Phylogenetic analysis and taxonomy of the Tropidurus group of lizards (Iguania, Tropiduridae). American Museum novitates ; no. 3033

68 p. : ill., maps ; 26 cm.Includes bibliographical references (p. 51-57