Visit Duration Research Articles

2264. Shorter Duration of Visit Associated with Inappropriate Antibiotic Prescribing for Respiratory Tract Infections in a National Sample of Ambulatory Visits, 2009 - 2016

Abstract Background Due to the reported decrease in the duration of primary care visits, it is important to assess provider adherence to guidelines when treating respiratory infections that are unlikely to necessitate antimicrobial treatment. This study aimed to investigate the relationship between the duration of visit and unnecessary antibiotic prescribing while considering patient and provider factors, including age, sex, race, and diagnosis. Methods This retrospective, cross-sectional study used outpatient, office-based data from the National Ambulatory Medical Care Survey from 2009 to 2016. All patients with a primary diagnosis of bronchitis, viral respiratory tract infection, influenza, and viral pneumonia were included for analysis. Patients with diagnoses that almost always require an antibiotic were excluded. Diagnoses were identified using ICD-9 or ICD-10 codes. Inappropriate antibiotic use was identified using multum codes and defined as at least one prescribed oral antibiotic during the visit. Provider status was defined as physician only or other provider. Multivariate logistic regression was used to determine predictors of inappropriate antibiotic prescribing. Data weights were applied to all analyses to generate national estimates. Results A total of 226,250,589 patient visits were included in the analysis, of which 83,404,484 (36.9%) resulted in an inappropriately prescribed antibiotic. Patients prescribed antibiotics were older (median age 42 vs. 13 years) and more often White (82.4% vs. 79.6%). After adjustment for covariates, time spent with provider less than 15 minutes (aOR 1.866, 95% CI 1.862-1.869), patient age 18-64 years (aOR 2.408, 95% CI 2.406-2.410), other provider types only (aOR 1.790, 95% CI 1.785-1.794), and viral pneumonia diagnosis (aOR 68.432, 95% CI 66.691-69.936) were most strongly associated with inappropriate antibiotic prescribing. Conclusion This study found that patients who spent less time with providers, had viral pneumonia, and were aged 18-64 years old were more likely to receive inappropriate treatment. Further investigation is necessary to determine reasons for inappropriate antimicrobial prescribing among outpatients. Disclosures Kelly Reveles, PharmD, PhD, Ferring Pharmaceuticals: Advisor/Consultant|Ferring Pharmaceuticals: Honoraria

Complementarity between urban land uses: a temporal analysis

ABSTRACT Despite great interest in land use mix and the set of benefits that it supposedly provides, there still is a gap in the understanding of how land uses interact to promote urban vitality. This article examines land use from a temporal perspective, analysing both the frequency of visits throughout the day and the average duration of visits. The results show that even land uses in the same conventional functional category have different daily visitation patterns. Furthermore, the temporal combination and complementarity of some land uses seemed to directly influence the intensity and distribution of urban life.

Behavioral guidance for improving dental care in autistic spectrum disorders.

Autism spectrum disorders (ASDs) impair many aspects of everyday life and may prevent access to dental care, often limiting it to emergencies. Impaired oral health has long-lasting negative consequences on health status and on the acquisition of oral habits (e.g., oral respiration and grinding) or competencies (e.g., proper speech production). Children with ASD may be scared in the dental setting, which is rich in sensory stimuli and requires physical contact. Due to their behavioral manifestations, they represent a challenge for dentists and hygienists. We created a dedicated pathway with behavioral support for children with ASD to allow dental care and possibly limit the use of general anesthesia. We evaluated the effects of behavioral support in a quasi-experimental design by comparing two groups of children with ASD. The first group (n = 84) was visited every 2 months for 3 years and received additional support (visual aids, caregiver training, and longer visit duration). A control group, matched for age and sex, was visited at least twice a year or more, if needed, according to standard healthcare guidelines. Compliance with the schedule was high throughout the 3 years. The degree of collaboration significantly improved after 1 year in the supported group, while the control group did not change. At the end of the study, collaboration remained significantly higher than at the beginning in the supported group. Half of dental treatments were possible without general anesthesia in supported children. No adverse effect was apparent on collaboration due to COVID-19 restrictions. Behavioral techniques improved the compliance of ASD children to regular dentistry visits and treatment. Furthermore, oral hygiene at home was similarly improved, addressing oral health from a lifelong perspective.

Gaze and avoidant patterns of visual attention to aversive stimuli during fear habituation trial: A pilot eye tracking study

Previous studies have revealed that attentional bias toward aversive stimuli may play a causal role in the development and maintenance of anxiety disorders. This pilot study designed an experiment, using eye tracking, to capture gaze patterns individuals may display during a fear habituation trial. Three trials were conducted with twenty-eight subjects who reported aversion to insects. Pictures of cockroaches were used as aversive stimuli. The time proportion of the total visit duration and average visit duration toward aversive stimuli were analyzed using a mixed ANOVA, with three habituation trials and four self-report on fear level scores as within-participants factors. Across trials, the time proportion of total visit duration was relatively low when fear levels were high, and increased when fear levels decreased. Across trials, the average visit duration was short when fear levels were relatively high, and the average visit duration became relatively long as fear levels decreased. The results indicated that higher fear levels during exposure are likely to lead to attentional avoidance which might be a strategic effortful coping process (Eysenck, et al. 2007). This study is an crucial first step toward understanding the gaze patterns that fearful individuals may display during exposure trials. Using eye tracking technology, we objectively identified these gaze patterns and opened avenues to enhance the efficacy of exposure-based interventions tailored to address phobias.

Flexible feeding: Dairy cow personality affects changes in feeding behavior and milk production under feed competition conditions

The objective of this study was to determine the effect of individual cow personality traits on feeding behavior and production under low levels of feeding competition, and to determine whether personality traits influence how feeding behavior changes in response to greater feeding competition. Forty-two Holstein cows were assigned to 1 automated feed bin per cow (low competition condition) from 15 to 28 d in milk (DIM; period 1, P1), and 2 feed bins per 3 cows (higher competition condition) from 63 to 76 DIM (period 2, P2). A total mixed ration (TMR) was fed into the automated feed bins which recorded each feed bin visit time, duration, and intake. Cow personality traits were assessed at 21 DIM during P1 and at 70 DIM during P2 using a combined arena test, measuring behavioral responses to a novel environment, novel object, and novel human. Principal components analysis of behaviors observed during the P1 combined arena test revealed 1 factor (interpreted as active-explorative) from the novel environment test explaining 51% of the variance, and 3 factors (interpreted as fearfulness, active-explorative, and sociability toward conspecifics) from each of the novel object (76% cumulative variance) and human (75% cumulative variance) tests. The principal components analysis of behaviors observed during the P2 combined arena test revealed 2 factors jointly from the environment, object, and human tests (interpreted as fearfulness and active-explorative) that together explained 68% of the variance. Fearfulness and active-explorative trait scores were correlated across P1 and P2, indicating stability of personality over a challenging period and advancing DIM. In P2 when competition for feed was increased at greater stage of lactation, the more active-explorative cows appeared to make few alterations to their feeding behavior, yet still maintained their milk yield, compared with lower competition in P1. In contrast, cows who were more fearful increased their feed bin visits from P1 to P2, and less fearful cows increased their eating rate, without increased milk production, despite advanced lactation. Overall, the results indicate that cows of different personalities adopt different feeding strategies in response to a change in their environment, and may benefit from tailored management during challenging periods.

Distinct diurnal and nocturnal flower visitor communities provide pollination services in urban gardens

Abstract Urban gardens are considered a key tool for mitigating biodiversity and plant‐pollinator interaction loss due to their ubiquity in urban landscapes and the variety of resources they provide. To date, most urban garden pollination research has focused on diurnal pollination, omitting a potentially important group—nocturnal pollinators. To assess the diversity and pollination activity of both diurnal and nocturnal flower visitors in urban gardens, I monitored arthropods on focal inflorescences of Eupatorium perfoliatum, a common Michigan‐native species, for 24‐h cycles and recorded the number and duration of visits. I also measured diurnal and nocturnal communities' pollination services using a temporal floral visitation exclusion experiment. Flowers averaged nearly twice as many visits during the day as compared with night within 24‐h cycles, but nocturnal visit durations were 2.5‐fold longer on average. Day and night floral visitor communities were distinct, with day visits being dominated by Diptera, ants and other Hymenoptera, and night visits being carried out most frequently by ants, Dermaptera and Hemiptera. In the floral visitor exclusion experiment, plants open to only nocturnal visits produced larger seeds, whereas plants open to only diurnal visits trended towards producing more seeds, signalling a potential trade‐off between seed quantity and size among visitor communities. Overall, diurnal and nocturnal floral visitor communities were distinct, and nocturnally pollinated plants had reproductive output comparable to diurnally pollinated treatments. Given the emphasis on diurnal pollinators in most pollination studies, it is possible that relevant plant‐pollinator interaction information may be missed in cases where anthesis spans both day and night.

375 Effects of Breed Type and Gender on Performance, Feeding Behavior, and Feed Efficiency in Growing goats

Abstract The objectives of this study were to examine the effects of gender and breed type on performance, feed efficiency, and feeding behavior traits in growing goats. The trial was conducted with 36 intact male (n = 16) and female (n = 20) goats of 4 breed types;12 purebred Spanish, 12 F1 Spanish x Boer (dam-sire), 8 F1 Boer x Spanish, and 4 purebred Boer. Goats with initial BW of 30.9 ± 6.0 kg and 38.8 ± 7.4 kg for females and males, respectively, were fed a concentrate diet in pens equipped with electronic feed bunks (GrowSafe System). Individual dry matter intake (DMI) and feeding behavior traits were collected daily for 44 d and BW measured weekly. Residual feed intake (RFI) was calculated as the residual from the regression of DMI on ADG and mid-test BW0.75. Feeding behavior traits evaluated were frequency and duration of bunk visit (BV) events, head-down (HD) duration, BV eating rate (BVER), and day-to-day variation of these traits, defined as the root mean squared error (RMSE) from linear regression of each trait on the day of trial. A mixed model (JMP) with fixed effects of gender, breed type, and gender x breed type interaction with pen as a random effect was used. Gender x breed type interactions were not significant for any traits. Male goats had heavier (P < 0.01) initial and final BW, but similar ADG during the trial. Male goats consumed more (P < 0.05) DMI, but had similar F:G and RFI compared with female goats. Gender did not affect feeding behavior traits, but male goats had greater BVER and more (P < 0.05) day-to-day variation in DMI than female goats. Purebred Boer goats had heavier (P < 0.05) initial and final BW and greater ADG than purebred Spanish and both F1 crosses. However, DMI and RFI were not affected by breed type. G:F was greater (P < 0.05) in Boer and Boer x Spanish goats (0.183, 0.153) than Spanish goats (0.115), with Spanish x Boer (0.132) goats being intermediate. Breed type did not affect feeding behavior traits in this trial. Minimal effects of gender and breed type on feed efficiency were detected in growing goats in this trial. Further research is warranted to examine effects of breed type on life-cycle feed efficiency including growing goats and female goats during pregnancy and lactation.

304 Precision Weighing Technologies to Measure Real-Time Drinking Behavior, Body Mass, and Growth in Steers Managed Using Virtual Fencing Technology in Extensive Pastures

Abstract Attaining sustainability of livestock production and understanding environmental synergies requires in-depth knowledge of grazing animal growth and behavior. A pilot study (2021-22) was conducted at the South Dakota State University Cottonwood Field Station as part of a broader project to evaluate precision livestock technology and environmental synergies on native rangelands. Yearling Angus steers (n = 262) were fitted with virtual fencing collars (Vence), weighed on a traditional chute scale, and allocated to one of six native grass pastures equipped with individual weighing (SmartScale) scales at the water source. Each pasture was assigned either Rotational (RG) or Continuous (CG) grazing strategy and one of three stocking rates (Low, Medium, and High, 0.3, 0.42, and 0.7 AUMs, respectively) in a 2x3 factorial design. The data were downloaded, (Rcore Team, 2023), and spurious weights identified and removed using Robust Regression (hwts > 0.99, Parsons et al. 2023). Effects of stocking rate and grazing strategy were analyzed on water visits, time spent drinking, and growth using a linear mixed effects model to calculate effect sizes. Differences between BW and ADG calculated using the smart-scale vs. traditional chute weights were evaluated using a paired t-test. Steers visited the smart-scale 3.44 ± 2.79 visits per day, with significant effect of RG vs. CG strategies (3.65 ± 0.09 vs. 2.89 ± 0.10 visits per day respectively, P < 0.05). Total water visit duration averaged 5.04 ± 7.58 minutes per day, with most visits occurring between 0600 and 2000 hours and no observations occurring between 2000 and 0000 hours. RG managed steers exhibited significantly higher water visit duration (5.28 ± 0.308 vs 4.16 ± 0.317 minutes/day, P < 0.05) compared with CG managed steers. Smartscale measured weights were significantly heavier than chute weights at the beginning and end of the study period, (7.47 ± 24.54 and 9.77 ± 46.25 kg respectively, P < 0.05). No differences in overall ADG were found between smartscale and traditional chute weights(P > 0.58), however, significant temporal interactions occurred (P < 0.05), which demonstrates that ADG varied over the trial duration. This created significant discrepancies in predicted vs. actual stocking rates in heavy stocked pastures (0.84 AUM, P < 0.05), indicating pastures exceeded their target stocking rate. Overall, we found steers readily acclimated to smart-scale weighing systems, and creates a viable technology to monitor watering behavior, real-time body weight, and ADG in extensively managed cattle. Further, we showed RG vs CG grazing strategies significantly affect animal drinking behavior, while stocking rate resulted in inequalities between expected vs. actual assigned animal unit months. Precision livestock technologies offer a vital solution towards enhancing sustainable livestock management practices and improving nutrition and modeling in extensive rangeland systems.

Training & prompting pre-service teachers’ noticing in a standardized classroom simulation – a mobile eye-tracking study

Numerous events happening in classrooms require a teacher to select important and filter out irrelevant information. This crucial and challenging skill is referred to as noticing. For noticing classroom management events pre-service teachers have a smaller knowledge base and little teaching experience compared to expert teachers. Supporting pre-service teachers in developing their classroom management knowledge and noticing skill is, thus, of great importance for teacher education. Previous research finds positive effects of interventions on teachers’ noticing during video observation. To our knowledge, no studies depict noticing during teaching. We examined N = 46 pre-service teachers’ noticing with regard to classroom management during classroom teaching in a quasi-experimental between-subjects design. Pre-service teachers’ took part in a standardized classroom simulation after a classroom management training, with one group receiving prompting regarding evidence-based classroom management strategies before and during the classroom simulation and one group receiving only training. We also included a control group without classroom management training. To assess differences in pre-service teachers’ noticing, the classroom simulation elicited comparable conditions, including standardized classroom management events and student behavior. Mobile eye-tracking as well as retrospective video observations were used to explore teachers’ event-related and global noticing. Event-related noticing was assessed via count and accuracy of noticed classroom management events. Global noticing included objective parameters of teachers eye movements (visit/fixation counts and duration) onto the students in the standardized classroom simulation. The results show that training and prompting significantly affected pre-service teachers’ event-related noticing, with both experimental groups making fewer target and time errors compared to the control group. No significant differences were found with regard to global noticing. This includes fixation and visit count and duration on students. Correlational analysis showed a positive association between higher noticing accuracy and share of fixations on students. This study expands upon previous empirical research using mobile eye-tracking to obtain objective measures of teachers’ noticing. It sheds light on the relevance of knowledge for teachers’ noticing during teaching. It also takes a first step toward understanding how pre-service teachers’ noticing during classroom teaching can be promoted through fostering knowledge about classroom management through a training.

:SEO & SEMالتسويق عبر محركات البحث أهميتها وفوائدها وطريقة عملها واستراتيجياتها ومدى موافقتها مع الشريعة الإسلامية THE MARKETING THROUGH SEARCH ENGINES SEO&SEM: IMPORTANCE, BENEFITS, METHOD OF WORK AND STRATEGIES

Search engine marketing is one of the latest means of e-marketing in the modern era, as it is known by the term (SEO) Search Engine Optimization, one of the completely new ways that marketers use through the use of modern digital tools in order to reach customers, and the main goal of it is to facilitate the link between marketing companies and users When anyone searches through search engines, the link, video, or marketing images appear to them at the top of the search results, which helps them to decide to enter and possibly buy, and therefore the better your pages appear in the search results, the more likely it is to attract attention and attract potential and existing customers to your business. As reports indicate that in 2019, more than $55 billion was spent on search engine marketing, and studies and projections indicate that spending could exceed $86 billion by 2023, which is a huge number and a very strong indicator of the importance of e-marketing for small businesses. The current study follows the descriptive approach by explaining and describing methods, programs, and most important marketing strategies through search engines, where the importance of the research lies in presenting scientific material that highlights the importance of modern marketing methods to enhance the performance of institutions, develop their work, and explain their legal ruling. One of the most important theoretical results of the study is that search engine optimization (SEO) has significant positive results by influencing the number of user visits to small and medium-sized companies' websites, increasing the average duration of user visits, as well as the company's overall sales and revenues generated.

166 Influence of Source of Metabolizable Protein and Implant Status on Feedlot Performance and Feeding Behavior in Yearling Steers

Abstract Crossbred steers (n = 60; beginning BW 454 ± 24 kg) were used in a split-plot design with a 2 x 3 factorial arrangement of treatments to determine effects of source of metabolizable AA and implant status on animal performance and feeding behavior. Calves were blocked by initial BW and assigned to 1 of 5 BW blocks. Pen (n = 2 pens, 6 steer/pen) within each BW block were fed diets formulated to meet the RDP requirement of cattle and provide 150% and 152% the metabolizable Lys and Met requirement (RP-AA), or a diet designed to meet RDP and closely match the predicted metabolizable Lys and Met requirement (RDP-ONLY; metabolizable Lys = 99.3% of required; metabolizable Met = 119% of required, NASEM, 2016). Subsequently, within pen two calves were randomly assigned to 1 of 3 implant strategies: no implant, moderate (100 mg trenbolone acetate and 14 mg estradiol; Synovex Choice) or potent (200 mg trenbolone acetate and 28 mg estradiol; Synovex Plus). Cattle were fed for 125 days and feed intake and feeding behavior was determined using a semi-autonomous feed monitoring system (GrowSafe System Ltd). Data were analyzed using the MIXED procedure of SAS. There was a tendency for an interaction of source of metabolizable AA and implant status on dry matter intake; calves with a moderate implant consumed less feed when fed RP-AA while calves with a potent implant consumed greater amounts. Dry matter intake was not affected by metabolizable AA supply (P = 0.87) or implant status (P = 0.43). There was an interaction of source of metabolizable AA and implant status on ADG; implanted calves gained similar amount regardless of source of metabolizable AA, but non-implanted calves fed RP-AA gained 25% less compared with RDP-ONLY diet. Moderate and potent implants had greater ADG (P < 0.01) than non-implanted cattle. Overall, ADG was not affected by source of metabolizable AA (P=0.95). Feeding behavior was largely unaffected by source of metabolizable AA or implant status. Feed intake per meal, number of meals per day, meal duration and visit duration were not influenced by source of metabolizable AA or implant status (P ≥ 0.16). Number of visits per meal tended (P = 0.07) to be greater for RP-AA while feeding rate tended (P = 0.09) to be less. There was a significant interaction of source of metabolizable AA and implant status on feeding rate (P < 0.01) as non-implanted and potently implanted calves ate feed at a lesser rate when fed RP-AA but moderately implanted calves fed RP-AA ate feed at a greater rate compared with RDP-ONLY. These data demonstrate that metabolizable AA requirements of growing cattle are dynamically related to implant status in cattle, but that implant status does not largely influence feeding behavior.

An examination of the content of diabetes websites targeting Arabic speakers

BackgroundThere has been an increase in the numbers of people in the Middle East and North Africa (MENA) region seeking online information about diabetes, as the Internet is considered a helpful tool for finding information about disease prevention and treatment. It is important that the sources available are reliable, trustworthy and easily accessible. However, the quality and readability of such information is questionable. This study examines the content of Arabic diabetes websites and offers recommendations to improve engagement and access to health information. MethodsThis study employed a cross-sectional analysis approach to assess diabetes websites targeting Arabic speakers in the MENA countries. Google trends was utilized to reveal the top searched topics across the MENA region, which were used as search terms to identify the websites in search engines, resulting in the examination of 26 websites. The analysis combined automated tools with expert evaluation methods and involved five dimensions: quality, readability, engagement, popularity, and availability. ResultsOverall, the majority of the websites performed poorly in the five dimensions and thus require careful reassessment of their content, design, and readability; no website performed well in all dimensions. Only two websites (7.6%) were HONcode certified, and none of the websites achieved a high score in the DISCERN analysis. The readability scores indicated that most websites were above the recommended level of reading. The results also revealed that all websites had poor engagement. Half of the websites had good ranking, and 58% of the websites covered all of the target topics. Of the websites examined, the non-commercial and non-professional sites (classified as “others”) seem to have greater readability, higher bounce rates and longer visit duration than the commercial sites. ConclusionsThe results from this study show a need for improving the content of diabetes information websites available to Arabic speakers. In order to develop websites that contain easy-to-read and understand high-quality information, collaboration between multiple stakeholders is necessary.

Multidisciplinary Clinics in Neuromuscular Medicine.

Multidisciplinary care is comprehensive, coordinated clinical care across medical disciplines and allied health professions. Neuromuscular disorders, such as amyotrophic lateral sclerosis and muscular dystrophies, are often associated with disabling weakness and extramuscular symptoms and may benefit from care in a model that consolidates numerous clinic visits into a single more efficient multidisciplinary clinic visit. The goal of the neuromuscular multidisciplinary care model is to improve patient outcomes, patient satisfaction, quality of life, access to medications and equipment, and survival. Although the costs of running a multidisciplinary clinic are high, they are likely associated with cost savings from the patient's perspective. Several barriers to acceptance of multidisciplinary clinics include the distance needed to travel to the clinic and the duration of the clinic visit. Telehealth multidisciplinary clinic visits may address some of these concerns. Further study is needed to understand the value of multidisciplinary clinics and is a necessary step toward creating a sustainable model.

Optimizing the pathway for simple stable fractures.

In the Netherlands, general practitioners (GPs) can request radiographs. After a radiologically diagnosed fracture, patients are immediately referred to the emergency department (ED). Since 2020, the Máxima Medical Centre has implemented a new care pathway for minor trauma patients, referring them immediately to the traumatology outpatient clinic (OC) instead of the ED. We investigated whether this altered care pathway leads to a reduction in healthcare consumption and concomitant costs. In this retrospective cohort study, patients were included if a radiologist diagnosed a fracture on a radiograph requested by the GP from August to October 2019 (control group) or August to October 2020 (research group), on weekdays between 8.30 am and 4.00 pm. The study compared various outcomes between groups, including the length of the initial hospital visit, frequency of hospital visits and medical procedures, extent of imaging, and healthcare expenses. A total of 634 patients were included. The results show a median reduction of 25 minutes in duration of initial hospital visits, one fewer hospital visit, overall fewer medical procedures, and a decrease in healthcare costs of €303.40 per patient in the research group compared to the control group. No difference was found in the amount of imaging. The implementation of the new care pathway has resulted in a substantial reduction in healthcare use and costs. Moreover, the pathway provides advantages for patients and helps prevent crowding at the ED. Hence, we recommend immediately referring all minor trauma patients to the traumatology OC instead of the ED.

Staminal hairs increase pollinator attraction and pollination accuracy in Tradescantia fluminensis (Commelinaceae).

Staminal hairs are the particular appendages of stamens, which may affect pollinator foraging behaviour and pollen transfer. However, experimental evidence of the functions of staminal hairs in pollination remains scarce. Here, we conducted staminal hair manipulation experiments in Tradescantia fluminensis (Commelinaceae) to investigate their effects on visitation and pollen transfer by bees. Our observations revealed that both visitation rates and visit duration of honeybees (Apis cerana) to control flowers were significantly higher than that of hairless flowers. Moreover, removing the staminal hairs significantly decreased pollen deposition by honeybees (A. cerana), but did not affect pollen removal. The staminal hair was similar in length to the stamen and the pistil of T. fluminensis. The staminal hairs provide more footholds for honeybees, and they lay prone on the staminal hairs to collect pollen, which increased the accuracy of pollination through the consistent pollen placement and pick-up on the ventral surface of honeybees. These results showed that the staminal hairs in T. fluminensis may represent an adaptation to attract pollinators and enhance pollination accuracy.

ASSESSING THE DEVELOPMENT POTENTIAL, FEASIBILITY AND VISITOR ASSESSMENT IN THE SIPINSUR GEOSITE NATURAL TOURISM AREA, TOBA CALDERA GLOBAL GEOPARK, INDONESIA

This study aims to examine the potential of tourism objects, development feasibility, visitor assessment of aspects of travel satisfaction, services and conditions of infrastructure, as well as visitor participation in conservation and the environment. This research was conducted using the analysis method of Analysis of Operation Areas of Natural Tourism Objects and Attractions (AOA-NTOA) and descriptive analysis using survey and interview methods. The research instrument used is the Guidelines for AOA-NTOA issued by the Director General of Forest Protection and Nature Conservation, Ministry of Forestry of the Republic of Indonesia. The results showed that Sipinsur Nature Tourism has three potentials, namely; 1) The beauty of natural scenery with a cool mountain microclimate, the diversity of various types of aesthetic flora and fauna, namely various species of aesthetic trees such as Sumatran pine (Pinus merkusii) and red shoot tree (Syzygium oleana), various palms, and flower plants; 2) Various exotic fauna such as wild cats and eagles; 3) Camping ground area as a center for adventure tourism activities. The results of the development feasibility analysis were declared feasible to be developed into a more developed tourist attraction with an average feasibility index of 73.98%. Visitors' assessment of the aspect of travel satisfaction shows that the majority visit more than 1 time and disseminate information to other parties. The majority of visitors (80.1%) get information about Sipinsur’s natural attractions from friends/relatives. The majority of visits were carried out in groups (96%), namely with groups of friends/professionals 56.56% and family (42.42%). As many as 78.78% of visitors make Sipinsur the main destination, with the most visit duration between 2-4 hours (34.34%). In the aspect of visitor assessment of the service and condition of facilities and infrastructure of tourism objects, the majority of visitors rate like/interested/good, some rate very like/very good/very interested, and only a few rate less good / less attractive on the overall assessment indicators. For the aspect of visitor participation in conservation and the environment, it shows that the majority of visitors reject various irresponsible behaviors and actions and are willing to participate in conservation efforts and preservation of the surrounding environment. The development feasibility analysis was declared feasible to be developed into a more developed tourist attraction. Assessment of tourism satisfaction aspects shows that the majority visit more than once and disseminate information to other parties. The majority of visitors like and have a good impression of aspects of service, facilities, and infrastructure. For the aspect of participation in conservation and the environment, it shows that the majority of visitors are aware of the responsibility and willing to participate.

Teledentistry and Forensic Odontology: Qualitative Study on the Capacity of Implementation.

The postmortem identification of people without an identity is performed either by using DNA, dental charts, or fingerprints (until advanced decomposition prevents their study). The lack of forensic dentists who can conduct identifications lead us to reflect on the use of digital technology in this area. The aim of this study was to validate the organizational capacity of using teledentistry for the identification of bodies in a forensic medicine department. A mixed observational study was conducted on 55 cases between July 2020 and February 2021 in the Forensic Medicine and Thanatology Department of Montpellier University Hospital. The protocol was structured in five steps: an initial interview with the agent (a forensic autopsy technician/caregiver specialized in forensic medicine), regarding the idea they had in terms of using telemedicine in their daily practice; agent training in the telemedicine system; realization of a clinical examination using an intra-oral camera by the agent; data analysis by a dental surgeon; final interview with the agent. The study was conducted on 55 subjects. The average age was 54 years old, with more than two-thirds of the patients being male (69%). The videos had an average duration of 29 min. There was an increase in visit duration when rigidity was high; this was also the case when there were many dental specificities in the oral cavity. The quality of the videos was either good or excellent. This study showed that remote identification could be considered as a new non-invasive identification tool. Many features were analyzed to create a training guide for forensic institutes.

Characteristics of patients with anxiety disorder without selective serotonin reuptake inhibitor prescription over a two-year period of pharmacotherapy.

Pharmacotherapy such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-noradrenaline reuptake inhibitors is recommended for the treatment of anxiety disorders. Although there are patients with persisted symptoms of anxiety disorders who are treated with monotherapy of benzodiazepine anxiolytics without SSRIs, the characteristics of these patients are unclear. In the present study, we investigated the characteristics of patients with persisted symptoms of anxiety disorder without SSRI prescription. From a prescription dataset covering 2018 and 2020, the prescriptions of 243 patients with anxiety disorder were analyzed. Patients were classified into two groups: SSRI non-prescription and prescription groups. The SSRI non-prescription group had a higher ratio of females than did the SSRI prescription group (60.1% vs. 44.6%, respectively, p = 3.12 × 10-2 ), but statistically not significant after the Bonferroni correction. No significant differences in age, body mass index, or duration of outpatient visits were found between groups. Among the independent variables, sex (female) was the only variable identified that predicted SSRI non-prescription. The present study showed that among patients with anxiety disorders, sex (female) was the only variable that predicted SSRI non-prescription.

Paying attention in metaverse: an experiment on spatial attention allocation in extended reality shopping

PurposeMetaverse, that is extended reality (XR)-based technologies such as augmented reality (AR) and virtual reality (VR), are increasingly believed to facilitate fundamental human practice in the future. One of the vanguards of this development has been the consumption domain, where the multi-modal and multi-sensory technology-mediated immersion is expected to enrich consumers' experience. However, it remains unclear whether these expectations have been warranted in reality and whether, rather than enhancing the experience, metaverse technologies inhibit the functioning and experience, such as cognitive functioning and experience.Design/methodology/approachThis study utilizes a 2 (VR: yes vs no) × 2 (AR: yes vs no) between-subjects laboratory experiment. A total of 159 student participants are randomly assigned to one condition — a brick-and-mortar store, a VR store, an AR store and an augmented virtuality (AV) store — to complete a typical shopping task. Four spatial attention indicators — visit shift, duration shift, visit variation and duration variation — are compared based on attention allocation data converted from head movements extracted from recorded videos during the experiments.FindingsThis study identifies three essential effects of XR technologies on consumers' spatial attention allocation: the inattention effect, acceleration effect and imbalance effect. Specifically, the inattention effect (the attentional visit shift from showcased products to the environmental periphery) appears when VR or AR technology is applied to virtualize the store and disappears when AR and VR are used together. The acceleration effect (the attentional duration shift from showcased products to the environmental periphery) exists in the VR store. Additionally, AR causes an imbalance effect (the attentional duration variation increases horizontally among the showcased products).Originality/valueThis study provides valuable empirical evidence of how VR and AR influence consumers' spatial bias in attention allocation, filling the research gap on cognitive function in the metaverse. This study also provides practical guidelines for retailers and XR designers and developers.

Captive Animal Behavior Study by Video Analysis.

Three video analysis-based applications for the study of captive animal behavior are presented. The aim of the first one is to provide certain parameters to assess drug efficiency by analyzing the movement of a rat. The scene is a three-chamber plastic box. First, the rat can move only in the middle room. The rat's head pose is the first parameter needed. Secondly, the rodent could walk in all three compartments. The entry number in each area and visit duration are the other indicators used in the final evaluation. The second application is related to a neuroscience experiment. Besides the electroencephalographic (EEG) signals yielded by a radio frequency link from a headset mounted on a monkey, the head placement is a useful source of information for reliable analysis, as well as its orientation. Finally, a fusion method to construct the displacement of a panda bear in a cage and the corresponding motion analysis to recognize its stress states are shown. The arena is a zoological garden that imitates the native environment of a panda bear. This surrounding is monitored by means of four video cameras. We have applied the following stages: (a) panda detection for every video camera; (b) panda path construction from all routes; and (c) panda way filtering and analysis.