The advantage of modern progress on occupational safety and health with the help of online applications/platforms

The evolution of information and communication technologies has led to the development of an increasing number of interactive online tools, and the occupational safety and health sector is no stranger to this trend. In the context of the COVID-19 pandemic and the transfer of a very large percentage of activities online, the idea of this paper starts from the need to easily manage the documentation on safety and health at work, staff and work points, thus reducing time and eliminating travel costs and last but not least avoiding physical contact as much as possible, by implementing an application or a platform at institution level. These online tools are addressed to all employers, employees, workers and public authorities with responsibilities in the field of occupational safety and health. Although at present the specialists in the field of OSH face bureaucracy, being a rather complex field and at the same time so necessary in the practice of service activities, online training platforms or applications come to their aid to streamline the process of OSH training and testing of knowledge. Due to modern progress, training will be possible from any point of work, requiring only an internet connection.

Strategi pengelolaan pariwisata berkelanjutan di kawasan wisata alam sumber maron, kabupaten Malang

Wisata Alam Sumber Maron is a tourist destination in Malang Regency which is currently experiencing a surge in tourists. In addition, there are problems with the conversion of land from plantations to developed land. Both of these problems have an impact on the quality of the environment in Wisata Alam Sumber Maron, causing the tourist destination area to be unsustainable. The purpose of this research is to analyze the management strategies that can be applied in Wisata Alam Sumber Maron. The data analysis used is an analysis of the carrying capacity of the environment to determine its physical factors, stakeholder analysis to determine social factors and analysis of travel costs to determine economic factors. Based on the method used, the final result is ha the effective carrying capacity at the Wisata Alam Sumber Maron is 179 people/day. This figure is then used as a guideline for strategy formulation.The management strategy is formulated using the 4 pillars of tourism method as stated in the Undang-Undang Number 10 of 2009 about Kepariwisataan, namely the tourism industry, destinations, marketing, and tourism institutions.

On the stress potential of videoconferencing: definition and root causes of Zoom fatigue

As a consequence of lockdowns due to the coronavirus disease (COVID-19) and the resulting restricted social mobility, several billion people worldwide have recently had to replace physical face-to-face communication with computer-mediated interaction. Notably, the adoption rates of videoconferencing increased significantly in 2020, predominantly because videoconferencing resembles face-to-face interaction. Tools such as Zoom, Microsoft Teams, and Cisco Webex are used by hundreds of millions of people today. Videoconferencing may bring benefits (e.g., saving of travel costs, preservation of environment). However, prolonged and inappropriate use of videoconferencing may also have an enormous stress potential. A new phenomenon and term emerged, Zoom fatigue, a synonym for videoconference fatigue. This paper develops a definition for Zoom fatigue and presents a conceptual framework that explores the major root causes of videoconferencing fatigue and stress. The development of the framework draws upon media naturalness theory and its underlying theorizing is based on research published across various scientific fields, including the disciplines of both behavioral science and neuroscience. Based on this theoretical foundation, hypotheses are outlined. Moreover, implications for research and practice are discussed.

Patient-specific and healthcare real-world costs of atrial fibrillation in individuals treated with direct oral anticoagulant agents or warfarin

Background Anticoagulant therapies are used to prevent atrial fibrillation-related strokes, with warfarin and direct oral anticoagulant (DOAC) the most common. In this study, we incorporate direct health care costs, drug costs, travel costs, and lost working and leisure time costs to estimate the total costs of the two therapies. Methods This retrospective study used individual-level patient data from 4000 atrial fibrillation (AF) patients from North Karelia, Finland. Real-world data on healthcare use was obtained from the regional patient information system and data on reimbursed travel costs from the database of the Social Insurance Institution of Finland. The costs of the therapies were estimated between June 2017 and May 2018. Using a Geographical Information System (GIS), we estimated travel time and costs for each journey related to anticoagulant therapies. We ultimately applied therapy and travel costs to a cost model to reflect real-world expenditures. Results The costs of anticoagulant therapies were calculated from the standpoint of patient and the healthcare service when considering all costs from AF-related healthcare visits, including major complications arising from atrial fibrillation. On average, the annual cost per patient for healthcare in the form of public expenditure was higher when using DOAC therapy than warfarin therapy (average cost = € 927 vs. € 805). Additionally, the average annual cost for patients was also higher with DOAC therapy (average cost = € 406.5 vs. € 296.7). In warfarin therapy, patients had considerable more travel and time costs due the different implementation practices of therapies. Conclusion The results indicated that DOAC therapy had higher costs over warfarin from the perspectives of the patient and healthcare service in the study area on average. Currently, the cost of the DOAC drug is the largest determinator of total therapy costs from both perspectives. Despite slightly higher costs, the patients on DOAC therapy experienced less AF-related complications during the study period.

Artificial Intelegence Pemanfaatan Metode Hill Climbing Mencari Lintasan Terpendek Objek Wisata Menggunakan sistem Informasi

The search is often used to search for the shortest route, the Hill Climbing Method is a part of the test that uses heuristic functions. The problem that is often encountered is in the form of miscalculations in calculating the distance so that it requires long distances, costs a lot and takes a very long time. To solve this case, it can be solved by making a structure graph by looking at the city points from the two sides of the point to be passed. Using an algorithm can help make it easier to find a location and save time and travel costs that will be passed. This advantage is that all points will be obtained and checked from the right and left sides one by one so as to obtain effective and maximum results. The Hill Climbing method that will be used has the concept of a geographic information system as a guide and is used as a system for decision making. The heuristic search method is one of the methods commonly used in finding a way

Is Ecological Birdwatching Tourism a More Effective Way to Transform the Value of Ecosystem Services?—A Case Study of Birdwatching Destinations in Mingxi County, China

Ecological birdwatching tourism is an ecological product and an essential part of ecotourism, and the realization of its recreation value is crucial for improving human well-being, and realization of the local benefits of ecosystem services for areas focused on biodiversity conservation, especially in bird species. In this study, we use travel cost interval analysis, one of the travel cost derived models featuring more easily satisfied assumptions and less limited data, to evaluate the recreation value of the ecological bird-watching tourism destination, and compare it with the general ecotourism, of Mingxi County destination in China. The results show that, firstly, the per capita recreation value of eco-birdwatching is 3.9 times that of general eco-tourism, its per capita social benefit is three times that of general eco-tourism, and its per capita economic benefit is 4.5 times that of general eco-tourism. Secondly, compared with general ecotourists, the per capita travel costs of eco-birdwatchers are higher, and there were significant statistical differences in the expenses for catering, tickets, shopping, opportunity cost, and total travel expenses between these two groups. Thirdly, in comparison with general ecotourists, the marginal cost of an individual eco-birdwatcher is higher, and the travel intention of an eco-birdwatcher is more robust at the same cost level. The price of a single eco-birdwatcher is higher under the same travel intention demand level. In short, the ecological bird-watching industry has a higher marginal value than general eco-tourism and has higher social, economic, and ecological benefits, bringing a higher level of development for the local tourism industry.

Service quality of transit and demand-supply forecasting for ride-hailing in the Jakarta Greater Area, Indonesia

The extensive use of smartphones by individuals has led innovators to develop application-based transportation services. Ride-hailing systems have been extensively operated in more than 600 cities worldwide. With the competition between taxis and ride-hailing, the number of fleets must be regulated. Identifying factors that influence the demand of taxi and ride-hailing and how the quality transit service is very important. The aims of this research are to identify the factors that influence demand for taxis and ride-hailing and the service quality of taxis and ride-hailing service. The study identified socio-demographic and trip characteristics from 949 respondents in the Jakarta Greater area, Indonesia. Respondents interviewed about the waiting time, travel time and travel costs for the origin-destination of trips that are most often done using taxi, ride-hailing, and bus. The service quality of ride-hailing and taxi was analyzed based on the respondent’s preferences from an important-performance analysis survey. The forecasting demand of taxi and ride-hailing in the Jakarta Greater area using demand-supply model is 71,660 vehicles. The research findings are that service quality of ride-hailing is better than conventional taxis based on waiting time, travel time and travel cost variable.

Leukemic Stem Cells of Monocytic AMLs Are Not-Resistant to BCL-2 Inhibition

Treatment with Hypomethylating agents (HMA) such as 5-Azazytidine (AZA) in combination with the BCL-2 inhibitor Venetoclax (VEN) has recently become the standard of care for AML patients unsuitable for intensive induction chemotherapy and shows results superior to treatment with AZA alone (DiNardo et al., 2020, NEJM). However upfront resistance and relapse following initial response remain major obstacles. It has recently been proposed that monocytic differentiation predicts resistance to AZA/VEN treatment in AML (Pei et al., 2020 Cancer Discovery). This appears to be due to increased expression of other anti-apoptotic proteins such as MCL-1 in monocytic AMLs, which conveys resistance to AZA/VEN therapy, as survival of leukemic cells in these patients is no longer dependent on BCL-2. However, an independent study found no impaired outcome in patients with monocytic AMLs treated with HMA/VEN (Maiti et al., 2020, Blood, ASH abstract). Here, we show that monocytic AML cell lines and bulk cells of monocytic primary AML cells are indeed intrinsically resistant to AZA/VEN treatment. However, in a collective of 30 patients treated with HMA/VEN at Heidelberg University Medical Center between 2018 and 2020, monocytic differentiation assessed by flow cytometry was not an independent risk factor for refractory disease. We hypothesized that the conflicting data may be caused by intra-patient heterogeneity of AZA/VEN sensivitity and assessed killing efficiency in various immunophenotypic subpopulations of 12 primary AML patient samples in vitro. The CD64 +CD11b +, differentiated blast population made up >50% of leukemic cells in monocytic and <20% in primitive samples and showed high levels of resistance to AZA/VEN therapy in both primitive and monocytic leukemias but did not engraft when transplanted into NSG mice, arguing they do not contain leukemic stem cells (LSC). In contrast, we found immature CD64 -CD11b - GPR56 + LSC to be sensitive to AZA/VEN treatment irrespective whether they were derived from monocytic or primitive types of primary AMLs. As expected, LSCs from either monocytic or primitive AMLs initiated disease in NSG mice, highlighting that targeting LSCs is essential for the effect of AML therapy. Next, we investigated expression of BCL-2, MCL-1 and BCL-xL in the same primary patient samples and observed high MCL-1 expression in monocytic AML samples. However, MCL-1 expression was restricted to the CD64 +CD11b + population whereas in the LSC sub-populations robust expression of BCL-2 but low levels of MCL-1 and BCL-xL were detected, independent of whether monocytic or primitive AMLs were analyzed. To further validate the sensitivity of LSCs of monocytic AML to BCL-2-I, we established a platform combining BH-3 profiling with multi-color flow cytometry, allowing for single cell assessment of cellular dependencies on independent apoptotic pathways. We found that LSCs of both AML types show high VEN/BAD but low MS-1 induced apoptosis, functionally confirming the expression patterns of BCL-2 and MCL-1. As LSCs are rare in monocytic samples, investigation of samples in bulk are dominated by MCL-1 expressing and resistant non-LSCs, explaining the overall higher MCL-1 expression/survival of monocytic compared to immature AML cells. However, our data uncovers sensitivity of LSCs to AZA/VEN independent of overall monocytic or primitive sample classification and provide a mechanistic explanation for the clinical data of Maiti et al. and our Heidelberg AML collective, which found no increased resistance of monocytic AMLs to AZA/VEN treatment. Disclosures Unglaub: JazzPharma: Consultancy, Other: travel costs/ conference fee; Novartis: Consultancy, Other: travel costs/ conference fee. Schlenk: Abbvie: Honoraria; Agios: Honoraria; Astellas: Honoraria, Research Funding, Speakers Bureau; Celgene: Honoraria; Daiichi Sankyo: Honoraria, Research Funding; Hexal: Honoraria; Neovio Biotech: Honoraria; Novartis: Honoraria; Pfizer: Honoraria, Research Funding, Speakers Bureau; Roche: Honoraria, Research Funding; AstraZeneca: Research Funding; Boehringer Ingelheim: Research Funding. Müller-Tidow: Janssen: Consultancy, Research Funding; Bioline: Research Funding; Pfizer: Research Funding.

Association of Donor and Recipient Interleukin-1 Gene Single Nucleotide Polymorphisms with Outcome after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood

Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment approach for hematological malignancies, genetic diseases, and severe immune deficiencies. Despite the matching of the human leucocyte antigens (HLA), HSCT is still associated with a considerable rate of morbidity and mortality caused by infections, relapse, and graft-versus-host disease (GVHD). Therefore, non-HLA polymorphisms like cytokines and their receptors are considered as important contributing factors. Interleukin-1 (IL-1) is a cytokine that initiates and maintains the immune response as well as the development of GVHD in the recipient. Single nucleotide polymorphisms (SNPs) of the IL-1 gene are associated with a higher risk of malignancies, an elevated death rate because of infections, and a higher chance to suffer from autoimmune or chronic diseases. This study aimed to analyze the association of IL-1 gene SNPs with outcome in a pediatric population undergoing allogeneic HSCT. Methods: We included 270 pediatric patients with a median age of 9 years who underwent an allogeneic HSCT and their respective donors. We used TaqMan real-time polymerase chain reaction to analyze the SNPs IL-1-alpha rs1800587 (-889, A/T), IL-1-beta rs1143627 (-31, A/T), and IL-1-beta rs16944 (-511, A/T). The underlying diseases were acute lymphoblastic leukemia (n=89), acute myeloid leukemia (n=63), chronic myeloid leukemia (n=10), juvenile myelomonocytic leukemia (n=9), myelodysplastic syndrome (n=29), lymphoma (n=7), solid tumor (n=11), genetic disease (n=41), and aplastic anemia (n=11). The stem cell sources were bone marrow (n=178), peripheral blood (n=90) or umbilical cord blood (n=2). Two hundred donors were HLA-matched, and 70 donors were HLA-mismatched. Conditioning regimen was myeloablative in all cases and based on chemotherapy in 180 children or total body irradiation in 90 children. The predominant post-transplant immunosuppression was cyclosporine A and methotrexate in 148 patients or cyclosporine A alone in 55 patients. The genotyped SNPs were compared using the Kaplan-Meier method for event-free survival (EFS) and overall survival (OS) and the Gray test for acute GVHD, chronic GVHD, relapse rate (RR), and transplant-related mortality (TRM). Results: We observed a significant association between the SNP IL-1-alpha rs1800587 (-889, A/T) of the donor and the rate of acute GVHD. The genotypes of IL-1-alpha rs1800587 had the following distributions in the donor: CC genotype n=132 (49%), CT genotype n=114 (42%), and TT genotype n=24 (9%). Overall, 63 children (23%) suffered from moderate to severe acute GVHD (grade II-IV). We found a significantly increased incidence of moderate to severe acute GVHD (grade II-IV) if the patient was transplanted from a donor with the CC/CT genotype compared to the TT genotype (25% versus 4%; p=0.028). We found no significant associations of the SNP IL-1-alpha rs1800587 (-889, A/T) for chronic GVHD, RR, TRM, EFS, and OS. In addition, we observed no significant associations of the other studied genotypes IL-1-beta rs16944 (-511, A/T) and rs1143627 (-31, A/T) in either donors or recipients for acute and chronic GVHD, RR, TRM, EFS, and OS. Conclusion: Our study identified the IL-1-alpha rs1800587 CC/CT genotype of the donor as a genetic risk factor for the development of moderate to severe acute GVHD (grade II-IV) in pediatric allogeneic HSCT recipients. After confirmation in further studies, these findings could implicate the adjustment of prophylactic measures to reduce the risk of acute GVHD in children. Disclosures Gruhn: AmgenGmbh: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: travel costs; Bellicum Pharma Gmbh: Membership on an entity's Board of Directors or advisory committees, Other: travel costs; EUSA Pharma Gmbh: Membership on an entity's Board of Directors or advisory committees; Jazz Pharmaceuticals: Honoraria, Other: travel costs; Novartis Pharma Inc.: Honoraria, Other: travel costs; pfizer: Honoraria; servier: Honoraria, Other: travel costs; Neovii Biotech GmbH: Other: travel costs; medac GmbH: Other: travel costs.