780 research outputs found

    Quality of Work Life of Employees Working in Public and Private Sector Banks of Uttarakhand

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    An organization's strength is determined by the quality of its human resources which play a pivotal role in the utilization of the other resources. Since organizations are managed and staffed by people, the challenges and the opportunities of creating and managing them frequently emerge from the people themselves. It is the responsibility of those who are managing the capital, the material and other information assets, to add value to the organization, also by managing their human resources, the human capital effectively. Banking industry is growing ever since its inception but after liberisation it has gained wider scope. The study focuses on the quality of work life of employees in banking sector. It aims to gain an insight into current working life policies and practices, as well as work-life balance issues of employees. Notable factors that influence Quality of Work Life considered for the study are Working conditions, Welfare measures, Safety measures, Supervision, Participation in decision making, Communication, etc

    Development of ANFIS Control System for Seismic Response Reduction using Multi-Objective Genetic Algorithm

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    Adaptive neuro fuzzy inference system (ANFIS) and Genetic algorithm (GA) was proposed in this study to reduce dynamic responses of a seismically excited building. A multi-objective genetic algorithm (MOGA) was used to optimize the ANFIS+GA controller. Two MR dampers were used as multiple control devices and a scaled five-story building model was selected as an example structure. A fuzzy control algorithm was compared with the proposed ANFIS and ANFIS+GA controller. Adaptive neuro-fuzzy inference system (ANFIS) and Ganetic algorithm with several outputs was proposed. In case study, after numerical simulation, it has been verified that the ANFIS control algorithm can present better control performance compared to the fuzzy control algorithm in reducing both displacement and acceleration responses

    Bone Tumors: Types and Treatments

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    The tumors associated with bone are mostly of mesenchymal origin and contribute to approximately 1% of all the known tumors. These could be primary/benign tumors (that originate in the bone), secondary tumors (that originate in some other tissue/organ and metastasize to the bone), or malignant primary bone tumors (that originate in bone and metastasize to distant tissue). These tumors are majorly due to defects in the regulation of tumor suppressor genes and oncogenes and/or misregulation of signal transduction pathways. Chemotherapy and radiotherapy used for the treatment have several side effects. During the recent years, therapeutic strategies involving hormone deprivation (estrogen, androgen), hormone replacements (estrogen analogs), hormone receptor modulators (SERMs), growth factors and cytokines, small-molecule inhibitors, and gene therapy have emerged as a promising alternative to chemo- and radiotherapy. In the present chapter, we have provided an extensive account of tumors associated with the bone and various therapeutic options related to hormone deprivation, hormone replacements, hormone receptor modulators, and hormone inhibition

    In vivo assessment of brainstem depigmentation in Parkinson’s: potential as severity marker for multi-centre studies

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    Purpose: To investigate the pattern of neuromelanin signal intensity loss within the substantia nigra pars compacta (SNpc), locus coeruleus, and ventral tegmental area in Parkinson disease (PD); the specific aims were (a) to study regional magnetic resonance (MR) quantifiable depigmentation in association with PD severity and (b) to investigate whether imaging- and platform-dependent signal intensity variations can be normalized. Materials and Methods: This prospective case-control study was approved by the local ethics committee and the research department of Nottingham University Hospitals. Written informed consent was obtained from all participants before enrollment in the study. Sixty-nine participants (39 patients with PD and 30 control subjects) were investigated with neuromelanin-sensitive MR imaging by using two different 3-T platforms and three differing protocols. Neuromelanin-related volumes of the anterior and posterior SNpc, locus coeruleus, and ventral tegmental area were determined, and normalized neuromelanin volumes were assessed for protocol-dependent effects. Diagnostic test performance of normalized neuromelanin volume was investigated by using receiver operating characteristic analyses, and correlations with the Unified Parkinson’s Disease Rating Scale scores were tested. Results: Reduction of normalized neuromelanin volume in PD was most pronounced in the posterior SNpc (median, −83%; P < .001), followed by the anterior SNpc (−49%; P < .001) and the locus coeruleus (−37%; P < .05). Normalized neuromelanin volume loss of the posterior and whole SNpc allowed the best differentiation of patients with PD and control subjects (area under the receiver operating characteristic curve, 0.92 and 0.88, respectively). Normalized neuromelanin volume of the anterior, posterior, and whole SNpc correlated with Unified Parkinson’s Disease Rating Scale scores (r2 = 0.25, 0.22, and 0.28, respectively; all P < .05). Conclusion: PD-induced neuromelanin loss can be quantified across imaging protocols and platforms by using appropriate adjustment. Depigmentation in PD follows a distinct spatial pattern, affords high diagnostic accuracy, and is associated with disease severity

    High-risk Pathologic Features Based on Presenting Findings in Advanced Intraocular Retinoblastoma A Multicenter, International Data-Sharing American Joint Committee on Cancer Study

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    Purpose: To determine the value of clinical features for advanced intraocular retinoblastoma as defined by the eighth edition of the American Joint Committee on Cancer (AJCC) cT3 category and AJCC Ophthalmic Oncology Task Force (OOTF) Size Groups to predict the high-risk pathologic features. Design: International, multicenter, registry-based retrospective case series. Participants: Eighteen ophthalmic oncology centers from 13 countries over 6 continents shared evaluations of 942 eyes enucleated as primary treatment for AJCC cT3 and, for comparison, cT2 retinoblastoma. Methods: International, multicenter, registry-based data were pooled from patients enrolled between 2001 and 2013. High-risk pathologic features were defined as AJCC categories pT3 and pT4. In addition, AJCC OOTF Size Groups were defined as follows: (1) less than half, (2) more than half but less than two thirds, (3) more than two thirds of globe volume involved, and (4) diffuse infiltrating retinoblastoma. Main Outcome Measures: Statistical risk of high-risk pathologic features corresponding to AJCC cT3 subcategories and AJCC OOTF Size Groups. Results: Of 942 retinoblastoma eyes treated by primary enucleation, 282 (30%) showed high-risk pathologic features. Both cT subcategories and AJCC OOTF Size Groups (P < 0.001 for both) were associated with high-risk pathologic features. On logistic regression analysis, cT3c (iris neovascularization with glaucoma), cT3d (intraocular hemorrhage), and cT3e (aseptic orbital cellulitis) were predictive factors for high-risk pathologic features when compared with cT2a with an odds ratio of 2.3 (P = 0.002), 2.5 (P = 0.002), and 3.3 (P = 0.019), respectively. Size Group 3 (more than two-thirds globe volume) and 4 (diffuse infiltrative retinoblastoma) were the best predictive factors with an odds ratio of 3.3 and 4.1 (P < 0.001 for both), respectively, for high-risk pathologic features when compared with Size Groups 1 (i.e., < 50% of globe volume). Conclusions: The AJCC retinoblastoma staging clinical cT3c-e subcategories (glaucoma, intraocular hemorrhage, and aseptic orbital cellulitis, respectively) as well as the AJCC OOTF Size Groups 3 (tumor more than two thirds of globe volume) and 4 (diffuse infiltrative retinoblastoma) both allowed stratification of clinical risk factors that can be used to predict the presence of high-risk pathologic features and thus facilitate treatment decisions. (C) 2022 by the American Academy of Ophthalmology.Peer reviewe

    Evaluation of safety, clinical outcomes, and patient-reported outcomes after meniscus repair using surestitch all inside meniscal repair implant: a retrospective and observational study

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    Background: Anterior cruciate ligament (ACL) injuries and meniscus injuries frequently co-occur, underscoring the interconnected nature of knee joint structures. Meniscus injuries, often caused by sports trauma or degenerative changes, necessitate careful management to preserve joint function and prevent complications like osteoarthritis. This retrospective observational study evaluates the safety, clinical outcomes, and patient-reported outcomes of meniscus repair using Surestitch all inside meniscal repair implant, a contemporary solution designed to optimize meniscal repair. Methods: The study, approved by the institutional ethics committee, included patients aged 18-80 years who underwent meniscus repair with Surestitch between October 2020 and July 2022. Data on demographics, surgical details, and outcomes were collected from medical records and telephonic follow-ups. Results: Among 36 subjects, the mean age was 36.89 years. The mean (SD) duration of follow-up was 364 days (127). There was no meniscus repair failure noted in any of the patients. Functional patient-reported outcomes assessed using international knee documentation committee (IKDC) with a score of (60.15±12.40), and Lysholm scores (77.03±14.45) demonstrated favorable results. The knee injury and osteoarthritis outcome score (KOOS) of (54.63) further indicated positive knee health across domains. There were no adverse events or reoperations. Conclusions: The study demonstrated favorable safety, clinical outcomes, and patient-reported outcomes, yielding satisfactory results, and consequently establishing the safety and effectiveness of the Surestitch All inside meniscal repair implant in meniscus repair

    Metastatic Death Based on Presenting Features and Treatment for Advanced Intraocular Retinoblastoma A Multicenter Registry-Based Study

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    Purpose: To evaluate presenting features, tumor size, and treatment methods for risk of metastatic death due to advanced intraocular retinoblastoma (RB). Design: International, multicenter, registry-based retrospective case series. Participants: A total of 1841 patients with advanced RB. Methods: Advanced RB was defined by 8th edition American Joint Committee on Cancer (AJCC) categories cT2 and cT3 and new AJCC-Ophthalmic Oncology Task Force (OOTF) Size Groups (1: 50% but 2/3, and 4: diffuse infiltrating RB). Treatments were primary enucleation, systemic chemotherapy with secondary enucleation, and systemic chemotherapy with eye salvage. Main Outcome Measures: Metastatic death. Results: The 5-year Kaplan-Meier cumulative survival estimates by patient-level AJCC clinical subcategories were 98% for cT2a, 96% for cT2b, 88% for cT3a, 95% for cT3b, 92% for cT3c, 84% for cT3d, and 75% for cT3e RB. Survival estimates by treatment modality were 96% for primary enucleation, 89% for systemic chemotherapy and secondary enucleation, and 90% for systemic chemotherapy with eye salvage. Risk of metastatic mortality increased with increasing cT subcategory (P 2/3 globe volume) and 4 (diffuse infiltrating RB) provided a robust stratification of clinical risk for metastatic death in advanced intraocular RB. Primary enucleation offered the highest survival rates for patients with advanced intraocular RB. (C) 2022 by the American Academy of Ophthalmology.Peer reviewe

    A Multicenter, International Collaborative Study for American Joint Committee on Cancer Staging of Retinoblastoma Part I : Metastasis-Associated Mortality

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    Purpose: To evaluate the ability of the 8th edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual to estimate metastatic and mortality rates for children with retinoblastoma (RB). Design: International, multicenter, registry-based retrospective case series. Participants: A total of 2190 patients from 18 ophthalmic oncology centers from 13 countries over 6 continents. Methods: Patient-specific data fields for RB were designed and selected by subcommittee. All patients with RB with adequate records to allow tumor staging by the AJCC criteria and follow-up for metastatic disease were studied. Main Outcome Measures: Metastasis-related 5- and 10-year survival data after initial tumor staging were estimated with the KaplaneMeier method depending on AJCC clinical (cTNM) and pathological (pTNM) tumor, node, metastasis category and age, tumor laterality, and presence of heritable trait. Results: Of 2190 patients, the records of 2085 patients (95.2%) with 2905 eyes were complete. The median age at diagnosis was 17.0 months. A total of 1260 patients (65.4%) had unilateral RB. Among the 2085 patients, tumor categories were cT1a in 55 (2.6%), cT1b in 168 (8.1%), cT2a in 197 (9.4%), cT2b in 812 (38.9%), cT3 in 835 (40.0%), and cT4 in 18 (0.9%). Of these, 1397 eyes in 1353 patients (48.1%) were treated with enucleation. A total of 109 patients (5.2%) developed metastases and died. The median time (n = 92) from diagnosis to metastasis was 9.50 months. The 5-year KaplaneMeier cumulative survival estimates by clinical tumor categories were 100% for category cT1a, 98% (95% confidence interval [CI], 97-99) for cT1b and cT2a, 96% (95% CI, 95-97) for cT2b, 89% (95% CI, 88-90) for cT3 tumors, and 45% (95% CI, 31-59) for cT4 tumors. Risk of metastasis increased with increasing cT (and pT) category (P <0.001). Cox proportional hazards regression analysis confirmed a higher risk of metastasis in category cT3 (hazard rate [HR], 8.09; 95% CI, 2.55-25.70; P <0.001) and cT4 (HR, 48.55; 95% CI, 12.86-183.27; P <0.001) compared with category cT1. Age, tumor laterality, and presence of heritable traits did not influence the incidence of metastatic disease. Conclusions: Multicenter, international, internet-based data sharing facilitated analysis of the 8th edition AJCC RB Staging System for metastasis-related mortality and offered a proof of concept yielding quantitative, predictive estimates per category in a large, real-life, heterogeneous patient population with RB. (C) 2020 by the American Academy of Ophthalmology. This is an open access article under the CC BY-NC-ND licensePeer reviewe

    Retinoblastoma seeds : impact on American Joint Committee on Cancer clinical staging

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    Aim To investigate whether the American Joint Committee on Cancer (AJCC) clinical category cT2b needs to be subclassified by the type and distribution of retinoblastoma (RB) seeding. Methods Multicentre, international registry-based data were collected from RB centres enrolled between January 2001 and December 2013. 1054 RB eyes with vitreous or subretinal seeds from 18 ophthalmic oncology centres, in 13 countries within six continents were analysed. Local treatment failure was defined as the use of secondary enucleation or external beam radiation therapy (EBRT) and was estimated with the Kaplan-Meier method. Results Clinical category cT2b included 1054 eyes. Median age at presentation was 16.0 months. Of these, 428 (40.6%) eyes were salvaged, and 430 (40.8%) were treated with primary and 196 (18.6%) with secondary enucleation. Of the 592 eyes that had complete data for globe salvage analysis, the distribution of seeds was focal in 143 (24.2%) and diffuse in 449 (75.8%). The 5-year Kaplan-Meier cumulative globe-salvage (without EBRT) was 78% and 49% for eyes with focal and diffuse RB seeding, respectively. Cox proportional hazards regression analysis confirmed a higher local treatment failure risk with diffuse seeds as compared with focal seeds (hazard rate: 2.8; pPeer reviewe
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