Personal Visits Research Articles

A panel study on the association of organophosphate ester flame retardant exposure with thyroid function related hormones in healthy older adults

Objective: To explore the impact of whole blood organophosphate esters (OPEs) flame retardant exposure on thyroid function-related hormones in healthy older adults. Methods: In this panel study, five repeated population-based epidemiological surveys and biological sample collection were conducted from September 2018 to January 2019, with 76 healthy older adults aged 60-69 years in the Dianliu Community of Jinan, Shandong Province. Information on the sociodemographic characteristics, diet, and health status of the respondents was systematically gathered through questionnaires and physical examinations. Fasting venous blood was collected to determine the levels of OPEs, thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4). A linear mixed-effects model was used to analyze the impact of OPEs exposure on thyroid function-related hormones in healthy older adults. Results: Each of the 76 subjects participated in at least two follow-up visits, resulting in a total of 350 person visits. The age of the study participants was (65.07±2.76) years, with 38 participants of both sexes. A total of eight OPEs were included with a detection rate exceeding 50%, and the M (Q1, Q3) for ∑OPEs was 3.85 (2.33, 5.74) ng/ml, with alkyl-OPEs being the major type of OPEs with an M (Q1, Q3) of 1.27 (0.64, 2.50) ng/ml. The M (Q1, Q3) for TSH, T3, and T4 was 3.74 (2.55, 5.69) μIU/ml, 1.32 (1.10, 1.60) ng/ml, and 45.04 (36.96, 53.27) ng/ml, respectively. Linear mixed-effects model showed that TSH was significantly decreased by 9.93% (95%CI:-15.17%, -4.36%) and 11.14% (95%CI:-15.94%, -6.06%) in older adults for each quartile level increase in TnBP and TEHP exposures, respectively. Gender-stratified analysis indicated that TEHP exposure was negatively associated with TSH levels in male older adults, whereas a decrease in TSH levels among female older adults was associated with TnBP exposure. Conclusion: Exposure to whole blood OPEs is associated with decreased TSH levels among healthy older adults, with notable gender differences.

Technology-enhanced palliative care for patients with advanced cancer undergoing phase I therapies: A pilot randomized clinical trial (RCT).

12017 Background: Outpatient palliative care (PC) has been found to improve quality of life (QOL). It is not known if more frequent symptom monitoring and PC nursing contacts between clinic visits would offer additional benefits. We conducted a pilot RCT to examine the effect of a specialist PC referral with and without technology-enhancement (TEC) on symptoms in patients undergoing Phase I cancer therapies. Methods: This single-center parallel group RCT enrolled adult patients with advanced solid tumors prior to starting Phase I therapies and at least 1 Edmonton Symptom Assessment Scale (ESAS) symptom ≥4/10 and ESAS Global Distress Score (GDS) ≥20/90. Patients were randomized to PC alone or PC + TEC in a 1:1 ratio. Over the 12 w period, the PC group had in person or virtual outpatient visits with a PC physician, nurse, and as needed psychotherapist every 4 weeks; the PC + TEC group also received weekly symptom monitoring with ESAS electronically and weekly nursing phone call. The primary outcome was within-group change of GDS from baseline to 2 w; secondary outcomes included change in GDS over 4, 8, and 12 w, and change in QOL (FACIT-Sp) over 2, 4, 8 and 12 w. We estimated that a sample size of 50 patients per group would provide 90% power to detect a within-group GDS difference of 6 units with a 2-sided α of 2.5% and 20% attrition. Results: Between 12/15/2020 and 12/21/2022, 115 patients were enrolled and 101 were randomized (PC + TEC n = 57, PC n = 44). By 2 w, PC + TEC showed a significant within-group improvement in GDS (mean change -5 [95% CI -8.9, -1.2]; P= 0.01) but not PC alone (Table). PC+TEC group also had a significant improvement in GDS at 8 w and 12 w and in FACIT-SP at 2 w, 8 w and 12 w. PC alone group had a significant within-group improvement in GDS at 4 w and 12 w but no significant differences in QOL were detected. This study was not powered for between group comparison; however, FACIT-SP at 12 w was significantly higher in PC+TEC vs. PC alone (Table; mean difference 13.9; P= 0.02). Conclusions: Higher intensity of PC with closer monitoring showed within-group improvement in symptoms and QOL, while PC alone had some symptom reduction but no QOL improvement. Further studies are needed to confirm the QOL benefit of PC + TEC over PC alone. Clinical trial information: NCT04989556 . [Table: see text]

Cruzando los Andes (1890-1891). Fannie B. Ward’s WritingsAbout Peru in the Postwar Era

Afloat on Lake Titicaca! How the very name recalls schooldays and geography lessons, though in this early time, when we located unpronounceable names on the map of a country which to our young imagination did not exist anywhere but on paper, we had no idea of proving their reality by a personal visit. It is amusing to remember what incorrect pronunciation of most of these South American names the teachers laboriously drilled into us; and the fact remains in our best schools, by names which the residents of the places would hardly recognized.

Cruzando los Andes (1890-1891). Fannie B. Ward’s Writings About Peru in the Postwar Era

Afloat on Lake Titicaca! How the very name recalls schooldays and geography lessons, though in this early time, when we located unpronounceable names on the map of a country which to our young imagination did not exist anywhere but on paper, we had no idea of proving their reality by a personal visit. It is amusing to remember what incorrect pronunciation of most of these South American names the teachers laboriously drilled into us; and the fact remains in our best schools, by names which the residents of the places would hardly recognized.

"Spanish flu," encephalitis lethargica, and COVID-19: Progress made, lessons learned, and directions for future research.

One hundred years ago, an influenza pandemic swept across the globe that coincided with the development of a neurological condition, named "encephalitis lethargica" for the occurrence of its main symptom, the sudden onset of sleepiness that either developed into coma or gradually receded. Between 1917 and 1920, mortality of the flu was >20 million and of encephalitis lethargica approximately 1 million. For lessons to be learned from this pandemic, it makes sense to compare it with the COVID-19 pandemic, which occurred 100 years later. Biomedical progress had enabled testing, vaccinations, and drug therapies accompanied by public health measures such as social distancing, contact tracing, wearing face masks, and frequent hand washing. From todays' perspective, these public health measures are time honored but not sufficiently proven effective, especially when applied in the context of a vaccination strategy. Also, the protective effects of lockdowns of schools, universities, and other institutions and the restrictions on travel and personal visits to hospitals or old-age homes are not precisely known. Preparedness is still a demand for a future pandemic. Clinical trials should determine the comparative effectiveness of such public health measures, especially for their use as a combination strategy with vaccination and individual testing of asymptomatic individuals. It is important for neurologists to realize that during a pandemic the treatment possibilities for acute stroke and other neurological emergencies are reduced, which has previously led to an increase of mortality and suffering. To increase preparedness for a future pandemic, neurologists play an important role, as the case load of acute and chronic neurological patients will be higher as well as the needs for rehabilitation. Finally, new chronic forms of postviral disease will likely be added, as was the case for postencephalitic parkinsonism a century ago and now has occurred as long COVID.

Exploring the influence of activity participation on the economic value of nature-based recreation in the Sierra Nevada

A more comprehensive understanding of how recreational values and forest visitation rates vary across different activities enables forest managers to tailor conservation and management strategies to align with preferences among visitors, ensuring more effective allocation of budgetary resources. However, current research often focuses on only a few recreational activities, resulting in limited insights for forest managers. This study aims to expand the nature-based activities considered so that management can better serve the broader public. We conduct a travel cost analysis using a large survey-based dataset to estimate the value of nature-based recreation in national forests in the Sierra Nevada region and assess how these values differ across main activities. We categorize recreational activities into five broad groups (Passive, Active, Camping, Winter, and Other) to offer a comprehensive view of recreational preferences. A truncated negative binomial regression accounting for endogenous stratification is used to analyze the relationship between the number of trips to the forests, travel cost, activity categories, and socio-demographic variables. Our results suggest a mean consumer surplus (CS) of $65 per visit per person to national forests in the Sierra Nevada. Aggregated over annual per person visits, the total CS is approximately $313.3 million per year. Our findings reveal variations in CS across activity groups, with winter activities (e.g., skiing, snowboarding) and active activities (e.g., hiking, fishing) attracting the highest number of visits, and the highest total CS. Our results provide valuable insights for national forest managers, facilitating the strategic allocation of limited resources to recreational activities that maximize societal welfare.

Emergency contraception for individuals weighing 80 kg or greater: A randomized trial of 30 mg ulipristal acetate and 1.5 mg or 3.0 mg levonorgestrel

ObjectiveTo compare the efficacy of oral emergency contraception (EC) regimens used within 72 hours of unprotected intercourse in individuals weighing >80 kg. Study DesignWe enrolled healthy women aged 18-40 years with a weight of at least 80 kg requesting EC in a multi-center, single-blind, randomized study of levonorgestrel 1.5 mg (LNG1X) and 3.0 mg (LNG2X) and ulipristal acetate 30 mg (UPA) (enrollment goal 1200). Key eligibility requirements included regular cycles, unprotected intercourse within 72 hours of enrollment, no use of hormonal contraception since last menstrual period, a negative urine pregnancy test (UPT), and willingness to abstain from intercourse until next menses. Study staff directly observed EC ingestion. To assess our primary outcome of incidence of pregnancy, participants completed home UPTs; if no menses by 2-weeks post-treatment, or a positive UPT, they returned for an in person visit with quantitative serum human chorionic gonadotropin (hCG) and ultrasound. ResultsWe enrolled and randomized 532; 44 were not dosed or not evaluable for primary end-point, leaving an analyzable sample of 488 (173 LNG1X, 158 LNG2X, 157 UPA) with similar demographics between groups [mean age 29.6 years (5.74), BMI 37.09 kg/m2 (6.95)]. Five pregnancies occurred during the study (LNG1X n = 1, LNG2X n = 1, UPA n = 3); none occurred during the highest at-risk window relative to estimated day of ovulation (day of ovulation and the 3 days prior). We closed the study prior to achieving our enrollment goal because the low pregnancy rate in all groups established futility based on an interim blinded analysis. ConclusionAlthough slow enrollment limited our study power, we found no differences in pregnancy rates between oral EC regimens among women weighing 80 kg or more. Our results are not able to refute or support differences between the three treatment arms. ImplicationsWomen weighing 80 kg or more experienced no differences in pregnancy rates between oral EC regimens but due to several significant study limitations including sample size and the lack of a study population at high risk of pregnancy, our results are not able to determine if differences in treatment effectiveness exist.

Unlocking the potential: leveraging blockchain technology for agri-food supply chain performance and sustainability

PurposeBlockchain technology (BCT) has emerged as a powerful tool for enhancing transparency and trust. However, the relationship between the benefits of BCT and agri-food supply chain performance (AFSCperf) remains underexplored. Therefore, the current study investigates the influence of BCT on AFSCperf and sustainability issues.Design/methodology/approachThrough a comprehensive literature review, various benefits of BCT are identified. Subsequently, a research framework is proposed based on data collected from questionnaire surveys and personal visits to professionals in the agri-food industry. The proposed framework is validated using partial least square structural equation modelling (PLS-SEM).FindingsThe findings reveal that BCT positively impacts AFSCperf by improving traceability, transparency, food safety and quality, immutability and trust. Additionally, BCT adoption enhances stakeholder collaboration, provides a decentralised network, improves data accessibility and yields a better return on investment, resulting in the overall improvement in AFSCperf and socio-economic sustainability.Practical implicationsThis study offers valuable practical insights for practitioners and academicians, establishing empirical links between the benefits of BCT and AFSCperf and providing a deeper understanding of BCT adoption.Originality/valueStakeholders, managers, policymakers and technology providers can leverage these findings to optimise the benefits of BCT in enhancing AFSCperf. Moreover, it utilises rigorous theoretical and empirical approaches, drawing on a multidisciplinary perspective encompassing food operations and supply chain literature, public policy, information technology, strategy, organisational theory and sustainability.

Poultry consumption and perceptions in Tehsil Shakargarh, Punjab, Pakistan: Implications for public health during COVID-19

This study investigated the habits and attitudes of individuals towards poultry consumption, utilizing primary data collected through a survey of 5 households from 285 localities in Tehsil Shakargarh, Punjab, Pakistan (n = 1425). Household selection was randomized, and personal visits were conducted for data collection via formal interviews employing a structured questionnaire. Coordinates for each site were obtained using a Garmin eTrex device, in conjunction with meteorological data, to determine global positioning system (GPS) coordinates. A notable portion of respondents (38.8 %) possessed basic knowledge, while the majority (61.2 %) demonstrated intermediate knowledge regarding commercial broilers (chickens raised for meat production). A significant proportion (70.3 %) harbored misconceptions about the inclusion of hormones/antibiotics in poultry feed, with a minority (0.2 %) misinformed about broiler chickens' leg weakness. Some respondents (17.3 %) held both misconceptions, while others (12.2 %) had none. The majority (97.6 %) favored egg consumption, with 51.7 % preferring commercial chicken eggs and 48.3 % opting for domestic chicken eggs. Preference for white-colored eggs (51.5 %) slightly outweighed that for brown-colored eggs (48.5 %). A minority (1.3 %) speculated that poultry consumption could be a potential cause of COVID-19, while the majority (65.7 %) disagreed, and a portion (33.0 %) remained uncertain. Nearly all respondents (99.9 %) believed in the immunity-boosting properties of protein intake, with 65 % associating such benefits with poultry meat and eggs. Similarly, 99.7 % did not encounter difficulties in accessing poultry products during lockdowns. Approximately half (46.3 %) of respondents believed that consuming well-cooked and safely handled poultry meat was safe during outbreaks. Poultry meat and eggs emerged as potentially efficient sources of nutrition during the COVID-19 pandemic, especially for protein-deficient populations like Pakistan. Therefore, initiatives should focus on enhancing commercial poultry production and educating the populace about its advantages.

Family Involvement among Oregon Adult Foster Home Residents, 2018–2023

ObjectivesTo track the changes that occurred in family involvement among Oregon Adult Foster Home (AFH) residents following the COVID-19 pandemic and to examine the associations between home and resident characteristics and family involvement. DesignRetrospective analysis of repeated cross-sectional data. Setting and ParticipantsA total of 2027 responses from AFH providers that replied to a mailed questionnaire from a sample of eligible licensed Oregon AFH selected to participate annually between 2018 and 2023 (6 waves). MethodsAFH providers filled out a questionnaire containing questions about family involvement (residents who received 6 types of support from family members or friends, such as help with personal care or social visit) and resident characteristics (activities of daily living needs, payer mix, age, gender, dementia status). Additional contextual data (size, rural/urban) were obtained from state agencies. Associations among family involvement and home and resident characteristics were examined using multivariable linear regression models. ResultsBivariate analyses showed statistically significant declines in social visits and outings and help getting to medical appointments during the first 2 years (2021 and 2022) of the COVID-19 pandemic, but little change in help with personal care or taking medications or phone calls. By 2023, social visits had recovered to pre-pandemic levels but remained significantly lower for help getting to medical appointments and going on outings. Multiple regression models that included controls showed that rural AFH and those with higher Medicaid use reported significantly lower family involvement in social visits, outings, and help getting to medical appointments. Conclusions and ImplicationsThe continued decline in assistance for medical appointments and outings portends potential challenges in resident socioemotional well-being and accessing health care services in this setting. Understanding the long-term impacts of the pandemic on quality of life and quality of care for residents living in community-based care settings may require a multifaceted approach to measuring family involvement.

Gender Differences in Teacher’s Pedagogical Practices and Attitudes towards Students’ Learning

Education is crucial for building a strong and developed nation. Formal education begins with primary education which includes a variety of subjects such as Mathematics, languages, Science, Social studies, etc. Teachers’ Pedagogical Practices and Attitudes are vital for the teaching of a variety of subjects at the primary level. The study was opted to explore the Gender Differences in Teacher’s Pedagogical Practices and Attitudes towards Students' Learning. It is a case study of primary schools of district Sargodha having only one teacher. The research utilized a survey methodology in conjunction with a descriptive strategy to collect data. The 74 single elementary teachers in District Sargodha, both male and female, made up the population and sample. Data collection was conducted through personal visits using two questionnaires (1st for Pedagogical Practices and 2nd for Attitude towards student learning) that included a demographic variable (Gender) too. These questions were verified by specialists and pilot-tested, resulting in a Cronbach Alpha score of 0.92. The data analysis was conducted utilizing statistical measures such as frequencies, percentages, mean scores, and independent sample t-tests. There was no significant difference between the views of single primary school male and female teachers about pedagogical practices and their factors (lesson plan, teaching methods, teacher behavior, instructional materials/technology assessment, community involvement) but a significant difference existed in classroom management (p-value=0.03<0.05) between male and female where male teacher better regarding classroom management. There was also no significant difference between male and female single primary school teachers’ attitude towards students learning. It is recommended that single primary school teachers (Male/Female) be facilitated through training in classroom management.

Abstract 6473: Evaluation of bladder cancer patients' utilization of urologic telehealth services

Abstract Introduction: Infection control practices and public policy in response to the COVID-19 pandemic shifted healthcare practices towards a telemedicine format. Even two years after peak onset of the pandemic, many clinics, including our own institution, maintain a working telehealth option for patient visits. Our objective was to evaluate patient utilization of telehealth visits versus in-person visits at our institution and whether this was impacted by clinical stage, rural/urban status, distance from a large urban academic center, payor status, or comorbidities. Methods: Medical Record Numbers for all patients with bladder cancer were pulled via the Qlik platform from the period 7/1/2019-2/28/2022. Chart review was conducted to pull clinical data on patients including telehealth versus in person visits, demographic data, clinical stage, comorbidities (diabetes, smoking status, BMI), rural/urban status by zip code (>50,000, <50,000 individuals) and income levels by zip code (25K-49.9K, 50K-99.9K, <100K), payor status (Medicare, Managed care, Medicaid, other government, ODRC, or self-pay), patient distance, and gas savings/carbon footprint. Results: 430 patients completed in person visits while 268 completed telehealth visits. There was no statistically significant difference for in person visits vs. telehealth visits regarding patients’ race (p=0.541), ethnicity (p=0.394) age (p=0.862), urban/rural status (p=0.507), payor status (p=0.127), mean zip code income (p=0.175), and comorbidities (p=0.626 for diabetes, p = 0.706 for smoking, p = 0.459 for BMI), and clinical stage (p=0.07). There was a statistically significant difference in mean distance (14.85 miles versus 26.86 miles, p<0.01). Conclusion: Patients’ with bladder cancer receive care from their urologist via in person visits versus telehealth at similar rates irrespective of their urban/rural status, demographics, payor status, relevant comorbidities, or relative income. Patients are more likely to engage in care with their urologist via telehealth if they live farther from a large urban academic center, which produces an economical and environmental impact via gas/time savings and reduced carbon footprint. Citation Format: Steven Goldenthal, Tasha Posid, Victor Heh, Dairon Denis-Diaz, Hafsa Asif, Chase Arnold, Henry Gold, Tae-Hee Kim, Amara Ndumele, Sabrina Amin, Matthew Lierz, Vivian Xu, Tyler Cronin, Aliza Khuhro, Cheryl Lee. Evaluation of bladder cancer patients' utilization of urologic telehealth services [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6473.

Traditional Ecological Farming Practices in the Eastern Himalayan Mountain Environment: Case of a Naga Village, Nagaland (India)

The farming systems practised by the tribal communities in the mountain environment of the North-Eastern region of India are eco-friendly and local climate responsive. These play a significant role in ensuring food security and conserving the local agro-ecological diversity. These farming practices are rooted in the local ecological set up, and they reflect the Indigenous people’s response to the environment of the area. The inhabitants of the Khonoma village of Kohima district, Nagaland, the study village, have been traditionally practising unique Alder tree-based jhum (shifting) cultivation, terrace-based panikheti (wet cultivation) and kitchen gardening based on their Indigenous knowledge and skills. They have been practising mixed farming by integrating crops, fish and livestock. The local communities have also evolved some methods for managing the natural settings to sustain their agriculture and livelihoods. This study is an attempt to investigate the methods of traditional farming system of Khonoma, a mountain village in the Eastern Himalayas. This study is based on primary data/ information collected through household survey using semi-structured household survey schedule, participatory rural appraisal (PRA), focus group discussion (FGD), and interviews with key informants and personal field visit in early 2021. The terrace-based panikheti, adopted by the people of Khonoma village, has been proved a location specific eco-friendly method for soil and water conservation. The Alder tree-based jhum practice, as opined by the villagers, is a sustainable livelihood option in the context of the mountain ecological setting and unique cultural values of the people.

Telemedicine maintains good glucose control in children with type 1 diabetes but is not time saving for healthcare professionals: KITES randomized study

AimsTo evaluate glucose control non-inferiority and time benefits of telemedicine follow-up in children with type 1 diabetes (CwD). MethodsIn a single-center 9-month-long randomized controlled study (clinicaltrials.gov NCT05484427), 50 children were randomized to either telemedicine group (TG) followed-up distantly by e-mail, or to face-to-face group (FFG) attending standard personal visits. The primary endpoint was non-inferiority of HbA1c at final visit (level of non-inferiority was set at 5 mmol/mol). The secondary endpoints were subcutaneous glucose monitoring parameters and time consumption from both study subjects’ and the physicians’ point of view. ResultsNon-inferiority of HbA1c in the TG was proven (mean HbA1C 45.8 ± 7.3 [TG] vs. 50.0 ± 12.6 [FFG] mmol/mol, 6.3 vs. 6.7 % DCCT, p = 0.17; between groups HbA1C difference 95 % CI −10.2 to 1.9 mmol/mol). Telemedicine saved time for participants (mean visit duration [MVD] 50 [TG] vs. 247 min [FFG], p < 0.001). There were no other differences between groups neither in CGM parameters nor physician’s time consumption (MVD 19 [TG] vs. 20 min [FFG], p = 0.58). ConclusionsNine-month telemedicine follow-up of the children with well-controlled T1D is not inferior to standard face-to-face visits. Telemedicine visits saved time for the participants but not for their diabetologists.

Abstract WMP56: Diagnosis of Acute Central Retinal Artery Occlusion With a Nonmydriatic Ocular Fundus Camera Combined With Optical Coherence Tomography in the Emergency Department: A New Paradigm

Background: Central retinal artery occlusion (CRAO) is a retinal infarction with causes/management similar to cerebral infarction. However, CRAO diagnosis is often delayed, resulting in missed opportunities for rapid treatment. Diagnosis by ophthalmologists is essential prior to management by stroke neurologists and may be challenging within a few hours of vision loss. Our goal is to provide a new paradigm in the emergency department (ED) with the implementation of a nonmydriatic ocular fundus camera (NMFP) combined with optical coherence tomography (OCT) to allow for ultrarapid remote diagnosis and stroke alert as soon as patients present to the ED. Methods: Prospective collection of data from consecutive patients who had NMFP-OCT for acute monocular vision loss in our general ED affiliated with a comprehensive stroke center. We collected timing of photographs; final diagnosis (CRAO/other causes of vision loss); time between vision loss onset and CRAO diagnosis; NMFP-OCT findings. Results: Over 9 weeks, 27 patients had NMFP-OCT obtained for acute monocular visual loss, including 9 CRAO [others included 7 retinal detachments; 8 vitreous hemorrhages; 3 temporal arteritis]. Diagnosis of acute CRAO was made remotely on NMFP-OCT obtained 30, 33, 36 min after arriving in ED in 3 patients presenting to ED within 3.5 hrs of vision loss. In all 3 patients, the ocular color photographs were almost normal and acute CRAO diagnosis was made primarily from the OCT showing inner retinal edema/hyperreflectivity. Conclusion: Incorporating NMFP-OCT into the ED workflow can be used as a substitute for funduscopic examination/pupillary dilation, allowing for remote diagnosis of CRAO by ophthalmologists who can provide real time recommendations before in person visit. These positive preliminary results suggest that this strategy accelerates the diagnosis of urgent vision loss, resulting in improved patient outcomes. Results of the first 6 months will be presented at the conference.

Impact of the COVID-19 Pandemic on Diabetic Foot Patients: A Shift in the Infectious Agent Profile Toward Nonfermentative Gram-Negative Bacilli.

Diabetes foot infection is a very important public health problem that causes serious health problems, mortality, and high health expenditures, and is one of the most important complications of diabetes mellitus. There are concerns that approaches such as limited personal visits to doctors, avoidance of hospitals, and restrictions on nonemergency surgical procedures during the coronavirus disease of 2019 pandemic pose a threat to those with diabetic foot problems, including diabetic foot ulcers (DFUs), ischemia, and infection, resulting in increased limb loss and mortality. This multicenter, retrospective, cross-sectional study was conducted in 14 tertiary care hospitals from various regions of Turkey. A total of 1,394 patient records were evaluated, 794 of which were between January 1, 2019, and January 30, 2020 (prepandemic [Pre-P]), and 605 of which were between February 1, 2020, and February 28, 2021 (pandemic period [PP]). During the PP, diabetic foot patient follow-up decreased by 23.8%. In addition, the number of hospitalizations attributable to DFU has decreased significantly during the PP (P = .035). There was no difference between the groups regarding patient demographics, medical history, DFU severity, biochemical and radiologic findings, or comorbidities, but the mean duration of diabetes mellitus years was longer in patients in the Pre-P than in those in the PP (15.1 years versus 13.7 years). There was no difference between the two groups in terms of major complications such as limb loss and mortality, but infection recurrence was higher in the PP than in the Pre-P (12.9% versus 11.4%; P < .05). The prevalence of nonfermentative gram-negative bacteria as causative agents in DFU infections increased during the PP. In particular, the prevalence of carbapenem-resistant Pseudomonas spp. increased statistically during the PP. The rapid adaptation to the pandemic with the measures and changes developed by the multidisciplinary diabetic foot care committees may be the reasons why there was no increase in complications because of DFU during the pandemic in Turkey.

Шахтний туризм як чинник регенерації індустріального міста: кейс шахти «Цольферайн», м. Ессен (Німеччина)

Many post-industrial regions reinterpret their industrial past as a resource for tourism. In this context, the experience of the Ruhr region in Germany is a classic example. This area has gone from being one of the largest industrial centres in Europe to a virtually completely regenerated area based on the principles of post-industrialism. This makes this area a benchmark for the development of industrial tourism in general and mine tourism in particular. This paper examines the case study of the Zollverein mine, which positions itself as the most beautiful mine in the world. The complex of the mine and the nearby coke plant is used both for direct tourism and marketing purposes and as an instrument of memory and identity politics. Through a personal visit and an expert interview with a representative of the mine, the key areas of its regeneration and the creation of a number of different locations that preserve a universal industrial history aimed at a wide audience were studied. The article analyses the activities that attract the attention of the public and tourists, forming a certain set of narratives about industrial heritage aimed at strengthening the economic position of the region. The industrial regions of Ukraine, most of which continue to develop on the principles of mono-structural production organisation, should look to the Ruhr region as a model for effectively overcoming post-industrial challenges, and the Zollverein mine is an exemplary example of this.

Enablers of the successful implementation of the strategy of technological innovation in higher education

Technological innovation has emerged as a formidable challenge for higher education institutions in the contemporary landscape. The present study explores the enablers of the successful implementation of technological innovation in Saudi Arabian higher education. We based this study’s conceptual framework on a rigorous literature review like Wu et al. (2002), Kihn (2010), and Packendorff et al. (2014). The study applied quantitative methods and collected 220 valid samples from employees of higher education institutions in Saudi Arabia through personal visits and online questionnaires. Employing structural equation modeling (SEM), the results of the study found a negative effect of project leadership (PL) on the implementation effectiveness of technological innovation (IETE). Further, the results demonstrate a positive significant impact of financial resources (FR) and top management style (TMS) on IETE. The study findings would provide valuable insights and evidence-based recommendations to practitioners and scholars in innovation management and organizational leadership. This study can inform strategic decisions, resource allocation, and leadership development within organizations, ultimately enhancing their ability to adapt to technological changes and leverage innovation for sustainable success.

Simulation model of a queuing system in the service of state registration, cadastre and cartography

The results of formalizing the queuing system in the public not-for-profit company Roskadastr have been presented in this study. For this purpose, all objects involved in processing applications have been identified. Applications included all services that the company provided when the client contacted the appropriate specialist during a personal visit or electronically. The channels for processing applications and the states in which they might be have been established. Based on this, a parametric model has been developed that characterized the processes arising when processing any applications. Models of behavior of clients and company employees have been built. Based on the obtained data and the developed parametric model, a three-dimensional simulation model has been generated, demonstrating different scenarios of system behavior.

India desperately needs synergy between university and industry to make education globally competitive

This paper presents the brief need and importance of synergy between higher and technical education and industry. A win-win game between industry and institute is very essential in raising their respective performances to greater heights. If synergy is achieved, then higher and technical education in India can hope to become globally competitive. India can then become a hub of education to attract students from abroad, as desired by the government. Synergy will also enable Indian industry to be competitive by world standards and enable India to become a developed country with a high rank in the world. NEP-2020 recommends synergy between the university and industry. In the past, many conferences and seminars in India have taken place, but the progress has been rather slow. This paper makes suggestions to bring synergy into practice. This paper is based on observations made during personal visits to several universities in developed countries, like the USA, UK, Germany, and India.