Search results for: cumulative adversity score

Authors: Chen Jun

Abstract:

Antonia Susan Byatt’s Possession: A Romance has been misread as a postmodern pastiche novel since its publication because there are epics, epigraphs, lyrics, fairy tales, epistles, and even critical articles swollen in this work. The word ‘pastiche’ suggests messy, disorganized, and chaotic, which buries its artistic excellence while overlooking its subtitle, A Romance. The center of romance is the quest that the hero sets forth to conquer the adversity, hardship, and danger to accomplish a task to prove his identity or social worth. This paper argues that Byatt’s Possession is not a postmodern pastiche novel but rather a postmodern romance in which the characters in the academic world set forth their quest into the Victorian literary past that is nostalgically identified by Byatt as the Golden Age of English literature. In doing so, these five following issues are addressed: first, the origin of the protagonist Roland, and consequently, the nature of his quest; second, the central image of the dragon created by the fictional Victorian poet Henry Ash; third, Melusine as an image of female serpent created by the fictional Victorian poet Christabel LaMotte; fourth, the images of the two ladies; last, the image of water that links the dragon and the serpent. In Possession, the past is reinvented not as an unfortunate fall but as a Golden Age presented in the imaginative academic adventure. The dragon, a stereotypical symbol of evil, becomes the symbol of life in Byatt’s work, which parallels with the image of the mythical phoenix that can resurrect from its own ash. At the same time, the phoenix symbolizes Byatt’s efforts to revive the Victorian poetic art that is supposed to be dead in the post-capitalism society when the novel is the dominating literary genre and poetry becomes the minority. The fictional Victorian poet Ash is in fact Byatt’s own poetic mask through which she breathes life into the lost poetic artistry in the postmodern era.

Keywords: Byatt, possession, postmodern romance, literary past

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Authors: S. Rajeswari

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Medicinal Plant extracts and their bioactive compounds have been used for antimicrobial activities and have significant remedial properties. In the recent years, a wide range of investigations have been carried out throughout the world to confirm antimicrobial properties of different medicinally important plants. A number of plants showed efficient antimicrobial activities, which were comparable to that of synthetic standard drugs or antimicrobial agents. The large family Euphorbiaceae contains nearly about 300 genera and 7,500 speciesand one among is Ricinus communis or castor plant which has high traditional and medicinal value for disease free healthy life. Traditionally the plant is used as laxative, purgative, fertilizer and fungicide etc. whereas the plant possess beneficial effects such as anti-oxidant, antihistamine, antinociceptive, antiasthmatic, antiulcer, immunomodulatory anti diabetic, hepatoprotective, anti inflammatory, antimicrobial, and many other medicinal properties. This activity of the plant possess due to the important phytochemical constituents like flavonoids, saponins, glycosides, alkaloids and steroids. The presents study includes the phytochemical properties of Ricinus communis and to prediction of the anti-microbial activity of Ricinus communis using DNA gyrase of Staphylococcus aureus as molecular target. Docking results of varies chemicals compounds of Ricinus communis against DNA gyrase of Staphylococcus aureus by maestro 9.8 of Schrodinger show that the phytochemicals are effective against the target protein DNA gyrase. our studies suggest that the phytochemical from Ricinus communis such has INDICAN (G.Score 4.98) and SUPLOPIN-2(G.Score 5.74) can be used as lead molecule against Staphylococcus infections.

Keywords: euphorbiaceae, antimicrobial activity, Ricinus communis, Staphylococcus aureus

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Authors: Sabita Karki

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Occupational health hazards are recognized as global problems for health care workers, it is quiet high in developing countries. It is increasing day by day due to change in science and technology. This study aimed to assess the knowledge and practice of occupational health hazards among the nurses. A descriptive, cross sectional study was carried out among 339 nurses working in three different teaching hospitals of the Kathmandu from February 28, 2016 to March 28, 2016. A self-administered questionnaire was used to collect the data. The study findings revealed that out of 339 samples of all 80.5% were below 30 years; 51.6% were married; 57.5% were graduates and above; 91.4% respondents were working as staff nurse; 56.9% were working in general ward; 56.9% have work experience of 1 to 5 years; 79.1% respondents were immunized against HBV; only 8.6% have received training/ in-service education related to OHH and 35.4% respondents have experienced health hazards. The mean knowledge score was 26.7 (SD=7.3). The level of knowledge of occupational health hazards among the nurses was 68.1% (adequate knowledge). The knowledge was statistically significant with education OR = 0.288, CI: 0.17-0.46 and p value 0.00 and immunization against HBV OR= 1.762, CI: 0.97-0.17 and p value 0.05. The mean practice score was 7.6 (SD= 3.1). The level of practice on prevention of OHH was 74.6% (poor practice). The practice was statistically significant with age having OR=0.47, CI: 0.26-0.83 and p value 0.01; designation OR= 0.32, CI: 0.14-0.70 and p value 0.004; working department OR=0.61, CI: 0.36-1.02 and p value 0.05; work experience OR=0.562, CI: 0.33-0.94 and p value 0.02; previous in-service education/ training OR=2.25; CI: 1.02-4.92 and p value 0.04. There was no association between knowledge and practice on prevention of occupational health hazards which is not statistically significant. Overall, nurses working in various teaching hospitals of Kathmandu had adequate knowledge and poor practice of occupational health hazards. Training and in-service education and availability of adequate personal protective equipments for nurses are needed to encourage them adhere to practice.

Keywords: occupational health hazard, nurses, knowledge, preventive practice

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Authors: Nordin Mamat, Abdul Rahim Razalli, Loy Chee Luen, Abdul Talib Hashim

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This study was designed to investigate preschool environment in multi-ethnic preschool in Malaysia. The objectives are to identify the quality of work environment in multi-ethnic preschools; to investigate the practices of teachers’ role and responsibility; and to identify the quality of human resources. The study involved 2004 respondents who are the staff of multi-ethnic preschool from the government agency who provide preschool service. This study was conducted using a mixed method in which questionnaires and interviews were used to obtain data from respondents. The findings were analysed using mean and used Likert scale to determine the three-stage level such as the high, moderate and low. Findings indicated that the work environment at a moderate level, but the facilities provided insufficient to carry out educational activities with children. The result based on ranking of duties and responsibilities of teachers in multi-ethnic preschool shows the teachers practice daily record of children's development is very little, that only 65 persons are recording the child's development. The poor ratio of teachers and child in multi-ethnic preschool is between 25 to 35 children per class which means the children need a lot of attention. Meanwhile, the work environment is moderate with a mean score of 3.65 and overall mean score for level of staff career development 3.66 also moderate. The findings indicate the facilities provided in their workplace and staff career development requires improvements. Overall, the level of work environment is moderate, and it needs an improvement in term of facilities.

Keywords: environment, human resources, multi-ethnic preschool, quality teacher

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Authors: Esra Danaci, Tugba Kavalali Erdogan, Sevil Masat, Selin Keskin Kiziltepe, Tugba Cinarli, Zeliha Koc

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This study was conducted in a descriptive and cross-sectional manner to determine that factors that influence the self-efficacy and self-sufficiency levels among oncology patients. The research was conducted between January 24, 2017 and September 24, 2017 in the oncology and hematology departments of a university hospital in Turkey with 179 voluntary inpatients. The data were collected through the Self-Sufficiency/Self-Efficacy Scale and a 29-question survey, which was prepared in order to determine the sociodemographic and clinical properties of the patients. The Self-Sufficiency/Self-Efficacy Scale is a Likert-type scale with 23 articles. The scale scores range between 23 and 115. A high final score indicates a good self-sufficiency/self-efficacy perception for the individual. The data were analyzed using percentage analysis, one-way ANOVA, Mann Whitney U-test, Kruskal Wallis test and Tukey test. The demographic data of the subjects were as follows: 57.5% were male and 42.5% were female, 82.7% were married, 46.4% were primary school graduate, 36.3% were housewives, 19% were employed, 93.3% had social security, 52.5% had matching expenses and incomes, 49.2% lived in the center of the city. The mean age was 57.1±14.6. It was determined that 22.3% of the patients had lung cancer, 19.6% had leukemia, and 43.6% had a good overall condition. The mean self-sufficiency/self-efficacy score was 83,00 (41-115). It was determined that the patients' self-sufficiency/self-efficacy scores were influenced by some of their socio-demographic and clinical properties. This study has found that the patients had high self-sufficiency/self-efficacy scores. It is recommended that the nursing care plans should be developed to improve their self-sufficiency/self-efficacy levels in the light of the patients' sociodemographic and clinical properties.

Keywords: oncology, patient, self-efficacy, self-sufficiency

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Authors: Hyeonkyeong Yang, Minseok Son, Taekbeom Yoo, Woojin Park

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Human error is the most salient contributing factor to railway accidents. To reduce the frequency of human errors, many researchers and train designers have adopted ergonomic design principles for designing display-control layout in rail cab. There exist a number of approaches for designing the display control layout based on optimization methods. However, the ergonomically optimized layout design may not be the best design for train drivers, since the drivers have their own mental models based on their experiences. Consequently, the drivers may prefer the existing display-control layout design over the optimal design, and even show better driving performance using the existing design compared to that using the optimal design. Thus, in addition to ergonomic design principles, train drivers’ mental models also need to be considered for designing display-control layout in rail cab. This paper developed an ergonomic assessment system of display-control layout design, and an interactive layout design system that can generate design alternatives and calculate ergonomic assessment score in real-time. The design alternatives generated from the interactive layout design system may not include the optimal design from the ergonomics point of view. However, the system’s strength is that it considers train drivers’ mental models, which can help generate alternatives that are more friendly and easier to use for train drivers. Also, with the developed system, non-experts in ergonomics, such as train drivers, can refine the design alternatives and improve ergonomic assessment score in real-time.

Keywords: display-control layout design, interactive layout design system, mental model, train drivers

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Authors: Shahlan Surat, Saemah Rahman, Saadiah Kummin

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When teachers reflect and evaluate whether their teaching methods actually have an impact on students’ learning, they will adjust their practices accordingly. This inevitably improves their students’ learning and performance. The approach in meta-teaching can invigorate and create a passion for teaching. It thus helps to increase the commitment and love for the teaching profession. This study was conducted to determine the level of metacognitive thinking of teachers in the process of teaching and learning in the classroom. Metacognitive thinking teachers include the use of metacognitive knowledge which consists of different types of knowledge: declarative, procedural and conditional. The ability of the teachers to plan, monitor and evaluate the teaching process can also be determined. This study was conducted on 377 graduate teachers in Klang Valley, Malaysia. The stratified sampling method was selected for the purpose of this study. The metacognitive teaching inventory consisting of 24 items is called InKePMG (Teacher Indicators of Effectiveness Meta-Teaching). The results showed the level of mean is high for two components of metacognitive knowledge; declarative knowledge (mean = 4.16) and conditional (mean = 4.11) whereas, the mean of procedural knowledge is 4.00 (moderately high). Similarly, the level of knowledge in monitoring (mean = 4.11), evaluating (mean = 4.00) which indicate high score and planning (mean = 4.00) are moderately high score among teachers. In conclusion, this study shows that the planning and procedural knowledge is an important element in improving the quality of teachers teaching in the classroom. Thus, the researcher recommended that further studies should focus on training programs for teachers on metacognitive skills and also on developing creative thinking among teachers.

Keywords: metacognitive thinking skills, procedural knowledge, conditional knowledge, meta-teaching and regulation of cognitive

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Authors: Arinze Ezieke, Antonio Serrano, William Clarke, Denys Villa-Gomez

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Berry cultivation results in discharge of high organic strength putrescible solid waste which potentially contributes to environmental degradation, making it imperative to assess options for its complete management. Anaerobic digestion (AD) could be an ideal option when the target is energy generation; however, due to berry fruit characteristics high carbohydrate composition, the technology could be limited by its high alkalinity requirement which suggests dosing of additives such as buffers and trace elements supplement. Overcoming this limitation in an economically viable way could entail replacement of synthetic additives with recycled by-product waste. Consequently, ash from co-smouldering of high COD characteristic AD digestate and coco-coir could be a promising material to be used to enhance the AD of berry fruit waste, given its characteristic high pH, alkalinity and metal concentrations which is typical of synthetic additives. Therefore, the aim of the research was to evaluate the stability and process performance from the AD of BFW when ash from co-smoldered digestate and coir are supplemented as alkalinity and trace elements (TEs) source. Series of batch experiments were performed to ascertain the necessity for alkalinity addition and to see whether the alkalinity and metals in the co-smouldered digestate ash can provide the necessary buffer and TEs for AD of berry fruit waste. Triplicate assays were performed in batch systems following I/S of 2 (in VS), using serum bottles (160 mL) sealed and placed in a heated room (35±0.5 °C), after creating anaerobic conditions. Control experiment contained inoculum and substrates only, and inoculum, substrate and NaHCO3 for optimal total alkalinity concentration and TEs assays, respectively. Total alkalinity concentration refers to alkalinity of inoculum and the additives. The alkalinity and TE potential of the ash were evaluated by supplementing ash (22.574 g/kg) of equivalent total alkalinity concentration to that of the pre-determined optimal from NaHCO3, and by dosing ash (0.012 – 7.574 g/kg) of varying concentrations of specific essential TEs (Co, Fe, Ni, Se), respectively. The result showed a stable process at all examined conditions. Supplementation of 745 mg/L CaCO3 NaHCO3 resulted to an optimum TAC of 2000 mg/L CaCO3. Equivalent ash supplementation of 22.574 g/kg allowed the achievement of this pre-determined optimum total alkalinity concentration, resulting to a stable process with a 92% increase in the methane production rate (323 versus 168 mL CH4/ (gVS.d)), but a 36% reduction in the cumulative methane production (103 versus 161 mL CH4/gVS). Addition of ashes at incremental dosage as TEs source resulted to a reduction in the Cumulative methane production, with the highest dosage of 7.574 g/kg having the highest effect of -23.5%; however, the seemingly immediate bioavailability of TE at this high dosage allowed for a +15% increase in the methane production rate. With an increased methane production rate, the results demonstrated that the ash at high dosages could be an effective supplementary material for either a buffered or none buffered berry fruit waste AD system.

Keywords: anaerobic digestion, alkalinity, co-smoldered digestate ash, trace elements

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Watcharin Sangma, Onsiri Chanmuang, Pitsanu Tongkhow

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A forecasting model for steel demand uncertainty in Thailand is proposed. It consists of trend, autocorrelation, and outliers in a hierarchical Bayesian frame work. The proposed model uses a cumulative Weibull distribution function, latent first-order autocorrelation, and binary selection, to account for trend, time-varying autocorrelation, and outliers, respectively. The Gibbs sampling Markov Chain Monte Carlo (MCMC) is used for parameter estimation. The proposed model is applied to steel demand index data in Thailand. The root mean square error (RMSE), mean absolute percentage error (MAPE), and mean absolute error (MAE) criteria are used for model comparison. The study reveals that the proposed model is more appropriate than the exponential smoothing method.

Keywords: forecasting model, steel demand uncertainty, hierarchical Bayesian framework, exponential smoothing method

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Authors: Masoud Charkhabi

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We examine trade theory with this motivation. The full set of World Trade Organization data are organized into country-year pairs, each treated as a different entity. Topological Data Analysis reveals that among the 16 region and 240 region-year pairs there exists in fact a distinguishable group of region-period pairs. The generally accepted periods of shifts from dissimilar-dissimilar to similar-similar trade in goods among regions are examined from this new perspective. The period breaks are treated as cumulative and are flexible. This type of all-subsets analysis is motivated from computer science and is made possible with Lossy Compression and Graph Theory. The results question many patterns in similar-similar to dissimilar-dissimilar trade. They also show indications of economic shifts that only later become evident in other economic metrics.

Keywords: econometrics, globalization, network science, topological data, analysis, trade theory, visualization, world trade

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Authors: Shan-Yu Hsu, Hsin-Shu Huang

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The main purpose of this teaching research is to design an interdisciplinary team-assisted teaching method for trainees and interns and review the effectiveness of this teaching method on trainees' understanding of peritoneal dialysis. The teaching research object is the fifth and sixth-grade trainees in a medical center's medical school. The teaching methods include media teaching, demonstration of technical operation, face-to-face communication with patients, special case discussions, and field visits to the peritoneal dialysis room. Evaluate learning effectiveness before, after, and verbally. Statistical analysis was performed using the SPSS paired-sample t-test to analyze whether there is a difference in peritoneal dialysis professional cognition before and after teaching intervention. Descriptive statistics show that the average score of the previous test is 74.44, the standard deviation is 9.34, the average score of the post-test is 95.56, and the standard deviation is 5.06. The results of the t-test of the paired samples are shown as p-value = 0.006, showing the peritoneal dialysis professional cognitive test. Significant differences were observed before and after. The interdisciplinary team-assisted teaching method helps trainees and interns to improve their professional awareness of peritoneal dialysis. At the same time, trainee physicians have positive feedback on the inter-professional team-assisted teaching method. This teaching research finds that the clinical ability development education of trainees and interns can provide cross-professional team-assisted teaching methods to assist clinical teaching guidance.

Keywords: monitor quality, patient safety, health promotion objective, cross-professional team-assisted teaching methods

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Authors: Salima R. Rajwani, Tazeen Ali, Rubina Barolia, Yasmin Parpio, Nasreen Alwani, Salima B. Virani

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Introduction: Nurses and physicians have a critical role in initiating lifesaving interventions during cardiac arrest. It is important that timely delivery of high quality Cardio Pulmonary Resuscitation (CPR) with advanced resuscitation skills and management of cardiac arrhythmias is a key dimension of code during cardiac arrest. It will decrease the chances of patient survival if the healthcare professionals are unable to initiate CPR timely. Moreover, traditional training will not prepare physicians and nurses at a competent level and their knowledge level declines over a period of time. In this regard, simulation training has been proven to be effective in promoting resuscitation skills. Simulation teaching learning strategy improves knowledge level, and skills performance during resuscitation through experiential learning without compromising patient safety in real clinical situations. The purpose of the study is to evaluate the effectiveness of simulation training in Advanced Cardiac Life Support Courses by using the selfefficacy tool. Methods: The study design is a quantitative research design and non-randomized quasi-experimental study design. The study examined the effectiveness of simulation through self-efficacy in two instructional methods; one is Medium Fidelity Simulation (MFS) and second is Traditional Training Method (TTM). The sample size was 220. Data was compiled by using the SPSS tool. The standardized simulation based training increases self-efficacy, knowledge, and skills and improves the management of patients in actual resuscitation. Results: 153 students participated in study; CG: n = 77 and EG: n = 77. The comparison was done between arms in pre and post-test. (F value was 1.69, p value is <0.195 and df was 1). There was no significant difference between arms in the pre and post-test. The interaction between arms was observed and there was no significant difference in interaction between arms in the pre and post-test. (F value was 0.298, p value is <0.586 and df is 1. However, the results showed self-efficacy scores were significantly higher within experimental group in post-test in advanced cardiac life support resuscitation courses as compared to Traditional Training Method (TTM) and had overall (p <0.0001) and F value was 143.316 (mean score was 45.01 and SD was 9.29) verses pre-test result showed (mean score was 31.15 and SD was 12.76) as compared to TTM in post-test (mean score was 29.68 and SD was 14.12) verses pre-test result showed (mean score was 42.33 and SD was 11.39). Conclusion: The standardized simulation-based training was conducted in the safe learning environment in Advanced Cardiac Life Suport Courses and physicians and nurses benefited from self-confidence, early identification of life-threatening scenarios, early initiation of CPR, and provides high-quality CPR, timely administration of medication and defibrillation, appropriate airway management, rhythm analysis and interpretation, and Return of Spontaneous Circulation (ROSC), team dynamics, debriefing, and teaching and learning strategies that will improve the patient survival in actual resuscitation.

Keywords: advanced cardiac life support, cardio pulmonary resuscitation, return of spontaneous circulation, simulation

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Authors: Yanhui Jia, Ning Guo, Juan Li, Yunkui Sun, Wei Yang, Tianping Zhang, Lin Ma, Wei Meng, Hai Geng

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The current statuses of lifetime test of LaB6 hollow cathode at the Lanzhou institute of physics (LIP), China, was described. 5A LaB6 hollow cathode was designed for LIPS-200 40mN Xenon ion thruster and it could be used for LHT-100 80 mN Hall thruster, too. Life test of the discharge and neutralizer modes of LHC-5 hollow cathode were stared in October 2011, and cumulative operation time reached 17,300 and 16,100 hours in April 2015, respectively. The life of cathode was designed more than 11,000 hours. Parameters of discharge and key structure dimensions were monitored in different stage of life test indicated that cathodes were health enough. The test will continue until the cathode cannot work or operation parameter is not in normally. The result of the endurance test of cathode demonstrated that the LaB6 hollow cathode is satisfied for the required of thruster in life and performance.

Keywords: LaB6, hollow cathode, thruster, lifetime test, electric propulsion

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Authors: Cao Yuping, Li Longfei, Zhao Xingfu, Zhang Yalin

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Purpose: This study examined the effects of exposure to domestic physical violence (DPV) on children’s behavior in a community sample. Method: Ninety-three 12-16 year-old adolescents exposed to DPV were matched with 54 adolescents with no exposure to DPV based on age, gender, family composition and parental age and education level. Participation included assessment with the Childhood Trauma Questionnaire (CTQ-SF) and Child Behavior Checklist (CBCL) by the adolescents and their parents respectively. Results: CBCL total score and anxiety/depression, social interaction problems, attention problems, delinquency, aggression and externalizing scores were significantly higher in adolescents exposed to DPV than those in controls (all ps<0.05).The CBCL total score and scores of anxiety/depression, social interaction problems, attention problems, delinquency, aggression and externalizing behaviors of boys were significantly higher in the research group than in the controls (all ps<0.05). Delinquency scores in abused adolescents were significantly higher than in DPV witnessed (p<0.05), but no other scores of CBCL were significant different. Different subtypes of behavioral problems were associated with different types of abuse. Conclusions: DPV exposure is associated with adverse behaviors in children, especially among boys. Children witness DPV alone have similar behavioral scores as the abused children. We recommend that both abused and DPV witness adolescents in Chinese communities need treatment to mitigate the effects on maladjusted behaviors.

Keywords: domestic violence, child, behavior, community, China

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Authors: Sahar Nasr, Lin Li, Edwin Wang

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Bladder cancer (BLCA) is known as the 13th cause of death among cancer patients worldwide, and ~575,000 new BLCA cases are diagnosed each year. Urothelial carcinoma (UC) is the most prevalent subtype among BLCA patients, which can be categorized into muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). Currently, various therapeutic options are available for UC patients, including (1) transurethral resection followed by intravesical instillation of chemotherapeutics or Bacillus Calmette-Guérin for NMIBC patients, (2) neoadjuvant platinum-based chemotherapy (NAC) plus radical cystectomy is the standard of care for localized MIBC patients, and (3) systematic chemotherapy for metastatic UC. However, conventional treatments may lead to several challenges for treating patients. As an illustration, some patients may suffer from recurrence of the disease after the first line of treatment. Recently, immune checkpoint therapy (ICT) has been introduced as an alternative treatment strategy for the first or second line of treatment in advanced or metastatic BLCA patients. Although ICT showed lucrative results for a fraction of BLCA patients, ~80% of patients were not responsive to it. Therefore, novel treatment methods are required to augment the ICI response rate within BLCA patients. It has been shown that the infiltration of T-cells into the tumor microenvironment (TME) is positively correlated with the response to ICT within cancerous patients. Therefore, the goal of this study is to enhance the infiltration of cytotoxic T-cells into TME through the identification of target genes within the tumor that are responsible for the non-T-cell inflamed TME and their inhibition. BLCA bulk RNA-sequencing data from The Cancer Genome Atlas (TCGA) and immune score for TCGA samples were used to determine the Pearson correlation score between the expression of different genes and immune score for each sample. The genes with strong negative correlations were selected (r < -0.2). Thereafter, the correlation between the expression of each gene and survival in BLCA patients was calculated using the TCGA data and Cox regression method. The genes that are common in both selected gene lists were chosen for further analysis. Afterward, BLCA bulk and single-cell RNA-sequencing data were ranked based on the expression of each selected gene and the top and bottom 25% samples were used for pathway enrichment analysis. If the pathways related to the T-cell infiltration (e.g., antigen presentation, interferon, or chemokine pathways) were enriched within the low-expression group, the gene was included for downstream analysis. Finally, the selected genes will be used to calculate the correlation between their expression and the infiltration rate of the activated CD+8 T-cells, natural killer cells and the activated dendric cells. A list of potential target genes has been identified and ranked based on the above-mentioned analysis and criteria. SUN-1 got the highest score within the gene list and other identified genes in the literature as benchmarks. In conclusion, inhibition of SUN1 may increase the tumor-infiltrating lymphocytes and the efficacy of ICI in BLCA patients. BLCA tumor cells with and without SUN-1 CRISPR/Cas9 knockout will be injected into the syngeneic mouse model to validate the predicted SUN-1 effect on increasing tumor-infiltrating lymphocytes.

Keywords: data analysis, gene expression analysis, gene identification, immunoinformatic, functional genomics, transcriptomics

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Authors: Jitendra Jain, Cassandra Hidajat, Hansraj Riteesh Bookun

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Graft patency underpins long-term prognosis after coronary artery bypass grafting surgery (CABG). The benefits of the combined use of only the left internal mammary artery and radial artery, referred to as total arterial revascularisation (TAR), on long-term clinical outcomes and quality of life are relatively unknown. The aim of this study was to identify whether there were differences in long term clinical outcomes between recipients of TAR compared to a cohort of mostly arterial revascularization involving the left internal mammary, at least one radial artery and at least one saphenous vein graft. A retrospective analysis was performed on all patients who underwent TAR or were re-vascularized with supplementary saphenous vein graft from February 1996 to December 2004. Telephone surveys were conducted to obtain clinical outcome parameters including major adverse cardiac and cerebrovascular events (MACCE) and Short Form (SF-36v2) Health Survey responses. A total of 176 patients were successfully contacted to obtain postop follow up results. The mean follow-up length from time of surgery in our study was TAR 12.4±1.8 years and conventional 12.6±2.1. PCS score was TAR 45.9±8.8 vs LIMA/Rad/ SVG 44.9±9.2 (p=0.468) and MCS score was TAR 52.0±8.9 vs LIMA/Rad/SVG 52.5±9.3 (p=0.723). There were no significant differences between groups for NYHA class 3+ TAR 9.4% vs. LIMA/Rad/SVG 6.6%; or CCS 3+ TAR 2.35% vs. LIMA/Rad/SVG 0%.

Keywords: CABG; MACCEs; quality of life; total arterial revascularisation

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Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

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Osteoporosis is one of the important problems in postmenopausal women due to an increased risk of sudden and unexpected fractures. This study is aimed to determine the connection between bone mineral density (BMD) and trabecular bone score (TBS) in Ukrainian women suffering from metabolic syndrome. Participating in the study, 566 menopausal women aged 50-79 year-old were examined and divided into two groups: Group A included 336 women with no obesity (BMI ≤ 29.9 kg/m²), and Group B – 230 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). Dual-energy X-ray absorptiometry was used for measuring of lumbar spine (L1-L4), femoral neck, total body and forearm BMD and bone quality indexes (last according to Med-Imaps installation). Data were analyzed using Statistical Package 6.0. A significant increase of lumbar spine (L1-L4), femoral neck, total body and ultradistal radius BMD was found in women with metabolic syndrome compared to those without obesity (p < 0.001) both in their totality and in groups of 50-59 years, 60-69 years, and 70-79 years. TBS was significantly higher in non-obese women compared to metabolic syndrome patients of 50-59 years and in the general sample (p < 0.05). Analysis showed significant positive correlation between body mass index (BMI) and BMD at all levels. Significant negative correlation between BMI and TBS (L1-L4) was established. Despite the fact that BMD indexes were significantly higher in women with metabolic syndrome, the frequency of vertebral and non-vertebral fractures did not differ significantly in the groups of patients.

Keywords: bone mineral density, trabecular bone score, metabolic syndrome, fracture

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Authors: Kingkan Chumjamras

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There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

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Authors: R. Harihara Prakash, Shweta R. Parikh, Sangna S. Sheth

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The purpose of this study was to explore the usefulness of the Mini-BESTest compared to the Berg Balance Scale in evaluating balance in people with Parkinson's Disease (PD) of varying severity. Evaluation were done to obtain (1) the distribution of patients scores to look for ceiling effects, (2) concurrent validity with severity of disease, and (3) the sensitivity & specificity of separating people with or without postural response deficits. Methods and Material: Seventy-seven(77) people with Parkinson's Disease were tested for balance deficits using the Berg Balance Scale, Mini-BESTest. Unified Parkinson’s Disease Rating Scale (UPDRS) III and the Hoehn & Yahr (H&Y) disease severity scales were used for classification. Materials used in this study were case record sheet, chair without arm rests or wheels, Incline ramp, stopwatch, a box, 3 meter distance measured out and marked on the floor with tape [from chair]. Statistical analysis used: Multiple Linear regression was carried out of UPDRS jointly on the two scores for the Berg and Mini-BESTest. Receiver operating characteristic curves for classifying people into two groups based on a threshold for the H&Y score, to discriminate between mild PD versus more severe PD.Correlation co-efficient to find relativeness between the two variables. Results: The Mini-BESTest is highly correlated with the Berg (r = 0.732,P < 0.001), but avoids the ceiling compression effect of the Berg for mild PD (skewness −0.714 Berg, −0.512 Mini-BESTest). Consequently, the Mini-BESTest is more effective than the Berg for predicting UPDRS Motor score (P < 0.001 Mini-BESTest versus P = 0.72 Berg), and for discriminating between those with and without postural response deficits as measured by the H&Y (ROC).

Keywords: balance, berg balance scale, MINI BESTest, parkinson's disease

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Authors: Sulastriningsih Djumingin

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This study has some objectives. It aims at describing the ability of the second-grade students to write review text without applying the Lesson Study model at SMPN 18 Makassar. Second, it seeks to describe the ability of the second-grade students to write review text by applying the Lesson Study model at SMPN 18 Makassar. Third, it aims at testing the effectiveness of the Lesson Study model in writing review text at SMPN 18 Makassar. This research was true experimental design with posttest Only group design involving two groups consisting of one class of the control group and one class of the experimental group. The research populations were all the second-grade students at SMPN 18 Makassar amounted to 250 students consisting of 8 classes. The sampling technique was purposive sampling technique. The control class was VIII2 consisting of 30 students, while the experimental class was VIII8 consisting of 30 students. The research instruments were in the form of observation and tests. The collected data were analyzed using descriptive statistical techniques and inferential statistical techniques with t-test types processed using SPSS 21 for windows. The results shows that: (1) of 30 students in control class, there are only 14 (47%) students who get the score more than 7.5, categorized as inadequate; (2) in the experimental class, there are 26 (87%) students who obtain the score of 7.5, categorized as adequate; (3) the Lesson Study models is effective to be applied in writing review text. Based on the comparison of the ability of the control class and experimental class, it indicates that the value of t-count is greater than the value of t-table (2.411> 1.667). It means that the alternative hypothesis (H1) proposed by the researcher is accepted.

Keywords: application, lesson study, review text, writing

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Authors: Chen Yang, Jun Hu, Ping Li, Lili Xue

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Most companies pay careful attention to consumer feedback collection, so it is popular to find the ‘feedback’ button of all kinds of mobile apps. Yet it is much more changeling to analyze these feedback texts and to catch the true feelings of a consumer regarding either a problem or a complimentary of consumers who hands out the feedback. Especially to the Chinese content, it is possible that; in one context the Chinese feedback expresses positive feedback, but in the other context, the same Chinese feedback may be a negative one. For example, in Chinese, the feedback 'operating with loudness' works well with both refrigerator and stereo system. Apparently, this feedback towards a refrigerator shows negative feedback; however, the same feedback is positive towards a stereo system. By introducing Bradley, M. and Lang, P.'s Affective Norms for English Text (ANET) theory and Bucci W.’s Referential Activity (RA) theory, we, usability researchers at Pingan, are able to decipher the feedback and to find the hidden feelings behind the content. We subtract 2 disciplines ‘valence’ and ‘dominance’ out of 3 of ANET and 2 disciplines ‘concreteness’ and ‘specificity’ out of 4 of RA to organize our own rating system with a scale of 1 to 5 points. This rating system enables us to judge the feelings/emotion behind each feedback, and it works well with both single word/phrase and a whole paragraph. The result of the rating reflects the strength of the feeling/emotion of the consumer when he/she is typing the feedback. In our daily work, we first require a consumer to answer the net promoter score (NPS) before writing the feedback, so we can determine the feedback is positive or negative. Secondly, we code the feedback content according to company problematic list, which contains 200 problematic items. In this way, we are able to collect the data that how many feedbacks left by the consumer belong to one typical problem. Thirdly, we rate each feedback based on the rating system mentioned above to illustrate the strength of the feeling/emotion when our consumer writes the feedback. In this way, we actually obtain two kinds of data 1) the portion, which means how many feedbacks are ascribed into one problematic item and 2) the severity, how strong the negative feeling/emotion is when the consumer is writing this feedback. By crossing these two, and introducing the portion into X-axis and severity into Y-axis, we are able to find which typical problem gets the high score in both portion and severity. The higher the score of a problem has, the more urgent a problem is supposed to be solved as it means more people write stronger negative feelings in feedbacks regarding this problem. Moreover, by introducing hidden Markov model to program our rating system, we are able to computerize the scoring system and are able to process thousands of feedback in a short period of time, which is efficient and accurate enough for the industrial purpose.

Keywords: computerized scoring system, feeling/emotion of consumer feedback, referential activity, text mining

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Authors: Ahmed Mohamed Elnady Mohamed Elsafty

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This paper explains a developed applied objective model to measure the culture qualitatively and quantitatively, whether in individuals or in teams, in order to be able to use culture correctly or modify it efficiently. This model provides precise measurements and consistent interpretations by being comprehensive, updateable, and protected from being misled by imitations. Methodically, the provided model divides the culture into seven dimensions (total 43 cultural factors): First dimension is outcome-orientation which consists of five factors and should be highest in leaders. Second dimension is details-orientation which consists of eight factors and should be in highest intelligence members. Third dimension is team-orientation which consists of five factors and should be highest in instructors or coaches. Fourth dimension is change-orientation which consists of five factors and should be highest in soldiers. Fifth dimension is people-orientation which consists of eight factors and should be highest in media members. Sixth dimension is masculinity which consists of seven factors and should be highest in hard workers. Last dimension is stability which consists of seven factors and should be highest in soft workers. In this paper, the details of all cultural factors are explained. Practically, information collection about each cultural factor in the targeted person or team is essential in order to calculate the degrees of all cultural factors using the suggested equation of multiplying 'the score of factor presence' by 'the score of factor strength'. In this paper, the details of how to build each score are explained. Based on the highest degrees - to identify which cultural dimension is the prominent - choosing the tested individual or team in the supposedly right position at the right time will provide a chance to use minimal efforts to make everyone aligned to the organization’s objectives. In other words, making everyone self-motivated by setting him/her at the right source of motivation is the most effective and efficient method to achieve high levels of competency, commitment, and sustainability. Modifying a team culture can be achieved by excluding or including new members with relatively high or low degrees in specific cultural factors. For conclusion, culture is considered as the software of the human beings and it is one of the major compression factors on the managerial discretion. It represents the behaviors, attitudes, and motivations of the human resources which are vital to enhance quality and safety, expanding the market share, and defending against attacks from external environments. Thus, it is tremendously essential and useful to use such a comprehensive model to measure, use, and modify culture.

Keywords: culture dimensions, culture factors, culture measurement, cultural analysis, cultural modification, self-motivation, alignment to objectives, competency, sustainability

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Authors: Shariful Islam, Sharun Akter Khushbu, S. M. Shaqib, Shahriar Sultan Ramit

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In the construction sector, ensuring worker safety is of the utmost significance. In this study, a deep learning-based technique is presented for identifying safety gear worn by construction workers, such as helmets, goggles, jackets, gloves, and footwear. The suggested method precisely locates these safety items by using the YOLO v7 (You Only Look Once) object detection algorithm. The dataset utilized in this work consists of labeled images split into training, testing and validation sets. Each image has bounding box labels that indicate where the safety equipment is located within the image. The model is trained to identify and categorize the safety equipment based on the labeled dataset through an iterative training approach. We used custom dataset to train this model. Our trained model performed admirably well, with good precision, recall, and F1-score for safety equipment recognition. Also, the model's evaluation produced encouraging results, with a [email protected] score of 87.7%. The model performs effectively, making it possible to quickly identify safety equipment violations on building sites. A thorough evaluation of the outcomes reveals the model's advantages and points up potential areas for development. By offering an automatic and trustworthy method for safety equipment detection, this research contributes to the fields of computer vision and workplace safety. The proposed deep learning-based approach will increase safety compliance and reduce the risk of accidents in the construction industry.

Keywords: deep learning, safety equipment detection, YOLOv7, computer vision, workplace safety

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Authors: Ge Sun, Monika Trzpis, Robbert J. de Haas, Paul M. A. Broens

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Introduction: Dynamic magnetic resonance defecography is frequently used to assess defecation disorders. We aimed to investigate the usefulness of dynamic magnetic resonance defecography for assessing the severity of defecation disorder. Methods: We included patients retrospectively from our tertiary referral hospital who had undergone dynamic magnetic resonance defecography, anorectal manometry, and anal electrical sensitivity tests to assess defecation disorders between 2014 and 2020. The primary outcome was the association between the dynamic magnetic resonance defecography variables and the severity of defecation disorders. We assessed the severity of fecal incontinence and constipation with the Wexner incontinence and Agachan constipation scores. Results: Out of the 32 patients included, 24 completed the defecation questionnaire. During defecation, the M line length at magnetic resonance correlated with the Agachan score (r = 0.45, p = 0.03) and was associated with anal sphincter pressure (r=0.39, p=0.03) just before defecation. During rest and squeezing, the H line length at imaging correlated with the Wexner incontinence score (r=0.49, p=0.01 and r=0.69, p< 0.001, respectively). H line length also correlated positively with the anal electrical sensation threshold during squeezing (r=0.50, p=0.004) and during rest (r= 0.42, p=0.02). Conclusions: The M and H line lengths at dynamic magnetic resonance defecography can be used to assess the severity of constipation and fecal incontinence respectively and reflect anatomic changes of the pelvic floor. However, as these anatomic changes are generally late-stage and irreversible, anal manometry seems a better diagnostic approach to assess early and potentially reversible changes in patients with defecation disorders.

Keywords: defecation disorders, dynamic magnetic resonance defecography, anorectal manometry, anal electrical sensitivity tests, H line, M line

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Authors: Md. Obidul Haque, Abbasi Khanm

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Port city Chittagong, the commercial capital of Bangladesh, is flourished with fascinating topography and climatic context along with basic resources for livelihood; both shape this city and become living archives of its ecologies. Chittagong has been witnessing numerous urban development measures being taken by city development authority, though some of those seem incomplete because of lack of proper planning. Due to this unplanned trail, the blessings of nature have become the reason of sufferings for city dwellers. One of which is the water clogging due to heavy rainfall, seepage, high tide, absence of well-knit underground drainage system, and so on. The problem has reached such an extent that the first monsoon rain is enough to shut down the entire city and causing immense sufferings to livestock, specially most vulnerable groups such as children and office going people. Study shows that total discharge is higher than present drainage capacity of the canals, thus, resulting in overflow, as major channels are clogged up by dumping waste or illegal encroachment, which are supposed to flush out rain water. This paper aims to address natural and manmade causes behind urban water clogging, adverse socio-environmental hazardous effects, possibilities for probable solutions on basis of local people’s experience and rational urban planning and landscape architectural proposals such as facilitating well planned drainage system, along with waste management policies etc. which can be able to intervene in these movements to activate the mighty port city’s unfulfilled potentials.

Keywords: drainage, high-tide, urban storm water logging (USWL), urban planning, water management

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Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

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Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

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Authors: Shokouh Momeni, Mohammad Reza Salamat, Ali Asghar Rastegari

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Background: Osteoporosis is the most prevalent metabolic bone disease in postmenopausal women associated with reduced bone mass and increased bone fracture. Measuring bone density in the lumbar spine and hip is a reliable measure of bone mass and can therefore specify the risk of fracture. Dual-energy X-ray absorptiometry(DXA) is an accurate non-invasive system measuring the bone density, with low margin of error and no complications. The present study aimed to investigate the relationship between biochemical parameters with bone density in postmenopausal women. Materials and methods: This cross-sectional study was conducted on 87 postmenopausal women referred to osteoporosis centers in Isfahan. Bone density was measured in the spine and hip area using DXA system. Serum levels of calcium, phosphorus, alkaline phosphatase and magnesium were measured by autoanalyzer and serum levels of vitamin D were measured by high-performance liquid chromatography(HPLC). Results: The mean parameters of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium did not show a significant difference between the two groups(P-value>0.05). In the control group, the relationship between alkaline phosphatase and BMC and BA in the spine was significant with a correlation coefficient of -0.402 and 0.258, respectively(P-value<0.05) and BMD and T-score in the femoral neck area showed a direct and significant relationship with phosphorus(Correlation=0.368; P-value=0.038). There was a significant relationship between the Z-score with calcium(Correlation=0.358; P-value=0.044). Conclusion: There was no significant relationship between the values ​​of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium parameters and bone density (spine and hip) in postmenopaus

Keywords: osteoporosis, menopause, bone mineral density, vitamin d, calcium, magnesium, alkaline phosphatase, phosphorus

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Authors: Khalil Bachiri, Ali Yahyaouy, Nicoleta Rogovschi

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Improved user experience is a goal of contemporary recommender systems. Recommender systems are starting to incorporate reinforcement learning since it easily satisfies this goal of increasing a user’s reward every session. In this paper, we examine the most effective Reinforcement Learning agent tactics on the Movielens (1M) dataset, balancing precision and a variety of recommendations. The absence of variability in final predictions makes simplistic techniques, although able to optimize ranking quality criteria, worthless for consumers of the recommendation system. Utilizing the stochasticity of Leonard-Ornstein processes, our suggested strategy encourages the agent to investigate its surroundings. Research demonstrates that raising the NDCG (Discounted Cumulative Gain) and HR (HitRate) criterion without lowering the Ornstein-Uhlenbeck process drift coefficient enhances the diversity of suggestions.

Keywords: recommender systems, reinforcement learning, deep learning, DDPG, Leonard-Ornstein process

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Authors: Rajandeep Kaur, Rajeev Gupta

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Background: Chronic myeloid leukemia (CML) is the most common leukaemia in India. The annual incidence of chronic myeloid leukemia in India was originally reported to be 0.8 to 2.2 per 1,00,000 population. CML is a clonal disorder that is usually easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph1). The approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity, has significantly reduced the mortality rate associated with chronic myeloid leukemia (CML) and revolutionized treatment. Material and Methods: 80 diagnosed cases of CML were taken. Investigations were done. Bone marrow and molecular studies were also done and with EUTOS, patients were stratified into low and high-risk groups and then treatment with Imatinib was given to all patients and the molecular response was evaluated at 6 months and 12 months follow up with BCR-ABL by RT-PCR quantitative assay. Results: In the study population, out of 80 patients in the study population, 40 were females and 40 were males, with M: F is 1:1. Out of total 80 patients’ maximum patients (54) were in 31-60 years age group. Our study showed a most common symptom of presentation is abdominal discomfort followed by fever. Out of the total 80 patients, 25 (31.3%) patients had high EUTOS scores and 55 (68.8%) patients had low EUTOS scores. On 6 months follow up 36.3% of patients had Complete Molecular Response, 16.3% of patients had Major Molecular Response and 47.5% of patients had No Molecular Response but on 12 months follow up 71.3% of patients had Complete Molecular Response, 16.25% of patients had Major Molecular Response and 12.5% patients had No Molecular Response. Conclusion: In this study, we found a significant correlation between EUTOS score and Molecular response at 6 months and 12 months follow up after Imatinib therapy.

Keywords: chronic myeloid leukemia, European treatment and outcome study score, hematological response, molecular response, tyrosine kinase inhibitor

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