Clear Reason Research Articles

A discussion of pediatric therapy-related acute myeloid leukemia with a rare t(8;16) translocation

Abstract Introduction/Objective Secondary acute myeloid leukemia is a type of blood cancer that arises after a previous myeloid neoplasm or after exposure to chemotherapy. Certain genetic mutations and chromosomal abnormalities can occur as a result of said cytotoxic drug-related effects. Here, we discuss a case of secondary acute myeloid leukemia with a rare translocation following hemophagocytic lymphohistiocytosis Etoposide treatment in a 13-year-old female. After less than a year into her initial treatment, the patient presented to the emergency department with severe bone pain. A full hematologic workup was performed, including bone marrow biopsy, flow cytometry analysis, and subsequent genetic studies. A diagnosis of therapy-related acute myeloid leukemia was made. Genetic studies revealed a rare t(8;16) translocation which presents with a unique morphology and prognosis that will be discussed here. Methods/Case Report A 13-year-old female presented to the emergency department for evaluation of fever, myalgia, and swelling in her clavicle. The patient’s history was notable for hemophagocytic lymphohistiocytosis with subsequent Etoposide chemotherapy treatment which she received less than a year prior to her visit. CBC was notable for low white blood cell count, low hemoglobin, increased neutrophilic bands, and decreased lymphocytes. Given her past medical history and worsening pain without a clear reason, hematology was consulted. Results (if a Case Study enter NA) A blast count of 61.8% was reported via flow cytometry with the cells seen in the dim CD45+, moderate to bright side-scatter region, co-expressing CD4, CD14 (dim, heterogeneous), CD15, CD16 (dim), CD64, HLA-DR, and MPO. The bone marrow biopsy was described as hypercellular with the predominant cell type as blasts at 66.4%. Numerous hemophagocytic blasts were noted as well. Acute leukemia next generation sequencing panel revealed a t(8;16)(p11;p13.3) KATA6A::CREBBP fusion without other abnormalities in the evaluated genes. This workup as a whole rendered the diagnosis of acute myeloid leukemia with KAT6A::CREBBP. Conclusion Diagnosing acute myeloid leukemia with KATA6A::CREBBP is important for prognostic factors. Knowing the patient’s history regarding her prior chemotherapy with Etoposide is also imperative for distinguishing a de novo presentation of this rare subtype, versus a therapy-related myeloid neoplasm. The patient was started on chemotherapy for her acute myeloid leukemia shortly thereafter the diagnosis.

Management of Shukrakshaya (Oligospermia) by implementing traditional Ayurveda treatment: A case report

Oligozoospermia (Low sperm count) is one of the most common causes of male infertility today, which is easily diagnosed via semen analysis, keeping in mind the semen qualitative parameters preset by WHO. There is however no clear reason as to why the condition occurs except for the congenital reasons. Heat, smoking, alcohol are certain factors that might affect the sperm count, are being studied. Ayurvedic scriptures explain Shukra Dhatu vitiation by Vata-Pitta-Kapha which leads to Shukra Dosha like Ksheen or Alpa Shukra or Shukrakshaya. The article here presents a case of a 35-year-old healthy male patient with a known case of Oligozoospermia (8 million/mL), infertile for 5 years, who was successfully managed by Ayurvedic intervention within a period of about 5 months. Accordingly, his condition was diagnosed as Shukrakshaya in the OPD, and his Ayurvedic intervention was thoroughly planned. The case was managed by initiating Agnidipaka and Aampachaka Chikitsa, followed by using Virechana for Shodhana. Later the patient was taken on Shaman-Vajikarana & Balya Chikitsa for 3 months, where a significant rise in the sperm count variables depicting normal values was observed, discussed further in this article.

Kajian Hukum Terhadap Proses Pemberhentian dan Pengangkatan Perangkat Desa di Kawasan Sumba Barat Daya

The decisions of the State Administrative Court play a crucial role in upholding the law and ensuring justice. The implementation of these decisions is also a critical part of ensuring justice. Efforts to ensure the execution of decisions, such as coercive measures and administrative sanctions, need to be taken to ensure that court decisions are truly enforced. This way, the principle of justice can be more effectively realized at all stages of the legal process, from hearings to the implementation of decisions. The research questions in this study are: (1) Whether the dismissal and appointment of village officials in Weepangali Village comply with Law Number 6 of 2014 concerning Villages; (2) How is the implementation of the procedures for the dismissal and appointment of village officials in Weepangali Village after Decision Number 39/G/2022/PTUN? The research found that the process of appointing the new Village Apparatus was carried out by dismissing the old Village Apparatus without any prior notification letter and without any clear reason. The conclusion is that the process of appointing and dismissing Village Apparatus is not in accordance with statutory provisions.

Core knowledge and its role in explaining uniquely human cognition: Some questions.

Questions can be raised about the central status that evolutionarily ancient core knowledge systems are given in Spelke's otherwise very compelling theory. So, the existence of domain-general learning capacities has to be admitted, too, and no clear reason is provided to doubt the existence of uniquely human cognitive adaptations. All of these factors should be acknowledged when explaining human thought.

Assessment of Continuous Growth of Glacial Lakes in the Teesta River Basin Using Semi-Automated Geospatial Approach

Global warming is one of the primary causes contributing to melting glaciers and shrinking of glaciers moth. Because of the glacier retreat, more lakes increase the risk of flooding in people’s homes and lives. Several studies on the surging glaciers have been conducted by researchers using various techniques, as well as with the aid of multiple models like the Normalized Differential Water Index (NDWI). The Number of glacial lakes is increasing in the Himalayan region due to climate change (rise of the temperature). Some glacial lakes are potentially dangerous so monitoring is very necessary. It is necessary to evaluate such vulnerable lakes. Therefore, current work is carried out to identify such glacial lakes present in the Teesta River Basin (Eastern Himalaya). Spatiotemporal Landsat data for the last four decades at intervals of ten years from 1990 to 2020 has been considered which was cloud-free and spatial resolution of 30 meters. The dataset mentioned above was used for lake identification and delineation. The findings indicate the presence of lakes with respective areas of 275 (18.90 km2), 337 (24.92 km2), 295 (22.96 km2), and 419 (31.44 km2). It has also been observed that the growth rate is increasing with approximate water spread from 1990 to 2000 (+129%), 2000 to 2010 (+106%), and 2010 to 2020 (+136%). The present study aimed to identify such glacial lakes based on their water spreading area, which is an essential step followed in the study of GLOF (Glacial Lake Outburst Flood) as it will be helpful in the identification of hazardous lakes. In that study, we found that eleven glacial lakes are in the potentially dangerous category situated in the upper Teesta Basin due to the presence of glaciers, which gives a clear reason for the time-to-time assessment of such lakes. By the conducted study it has been observed that the number of glacial lakes has increased, due to which water spread has also increased in the area. It can also be demonstrated that GIS (Geographical Information System), along with remote sensing, is one of the best tools for assessing and monitoring such change detection and differentiation of hazardous glacial lakes in the cryosphere, along with the supporting data.

Rethinking Insecurity and Scoping Security Threat in Nigeria: Looking Ahead

Early in the 2000s, Boko Haram emerged with an Islamisation agenda concentrating mostly on Nigeria the largest African economy. There is empirical evidence suggesting that the government of Nigeria has not successfully warded off this group’s hostility. Yet there are gaps in security threats and extant literature. This study therefore examined the instability and anomic conditions resulting from this insurgency using the document analysis method and the Containment Theory employed as the theoretical framework. The analysis showed that there is no clear reason why the Nigerian military has failed to contain the Boko Haram insurgency given the army’s undoubted gallantry after excelling in several international peacekeeping assignments. It was recommended that public programs for enlightenment through community engagement and transparency would influence positively the government’s efforts to contain these terrorist activities. Given the complex nature of terrorism, there is a need for robust empirical studies that have to be done before any meaningful policy implementation can be considered. This study will amplify the international awareness of violent extremist activities in this most populated African nation. It will significantly provide the Nigerian government, human rights groups, researchers, civil society, policymakers, and public and private security agents with more knowledge to understand these terrorists better. Keywords: Nigeria, Threat, Peace, Security, Boko Haram

Simulation trouble and gender trouble

ABSTRACT Is it impossible to imaginatively simulate what it’s like to be someone with a different gender experience – to understand them empathically? Or is it simply difficult, a challenge requiring effort and dedication? I first distinguish three different sorts of obstacle to empathic understanding that are sometimes discussed: Missing Ingredient problems, Awkward Combination Problems, and Inappropriate Background Problems. I then argue that, although all three should be taken seriously, there is no clear reason to think that any of them are both genuinely intractable and also significant impediments to the kind of empathic understanding we might want. To that extent, the challenge to interpersonal understanding here may be more a matter of skill and work than a hard boundary.

Abstract PO4-08-02: Genetic testing among patients with triple-negative breast cancer at a single health system: a quality improvement project

Abstract Background: Breast cancer is the most common type and the second leading cause of cancer-related deaths in women. Approximately 15-20% of patients have triple-negative breast cancer (TNBC) at diagnosis. TNBC is aggressive, difficult to treat, prone to relapse, and associated with an increased mortality rate. The incidence of BRCA1/2 mutation is about 20% in patients with TNBC (Hartman et al. 2012). Despite the high prevalence of germline mutations in cancer susceptibility genes among TNBC patients, many do not received genetic counseling (GC) or genetic testing (GT). National Comprehensive Cancer Network (NCCN) guidelines now recommend GT for all patients with TNBC, regardless of age, especially after the approval of Poly Adenosine diphosphate Ribose Polymerase (PARP) inhibitors for targeted therapy against BRCA1/2 mutations. The aim of this quality improvement (QI) project was to identify patients with TNBC who did not receive GT and design an intervention to understand potential barriers to receiving GC and GT. Methods: We implemented a QI project to identify previously diagnosed adult patients with TNBC (18 years and older) of any stage (early or advanced/metastatic) without prior GT or family history of genetic disorders with active follow-up at the Henry Ford health breast cancer clinic. Eligible patients diagnosed between January 2015 and January 2020 from the Syapse Learning Health Network database were included. Baseline information as well as additional data including demographics, breast cancer treatment details, and whether GT and/or GC was offered or not was obtained through electronic health record review after institutional review board committee approval. Bi-monthly meetings were held amongst breast cancer providers, genetic counselors, and nurse navigators to develop an intervention to contact the patients who did not undergo GT and/or GC. After obtaining the list of patients who did not undergo GT and/or GC despite meeting eligibility criteria, they were contacted by their primary breast cancer providers via telephone regarding their willingness to obtain GT and/or GC at this time and participate in a questionnaire-based interview to understand barriers towards the same. Results: In the 5 years, a total of 123 patients were noted to have been diagnosed with triple-negative breast cancer. Of these, 93 patients were actively being followed at the Henry Ford breast clinic at the time of the QI project. 2 of the 9 patients who underwent GT and GC were positive for BRCA1/2 mutation. Of the remaining 83 patients that did not receive GC or GT, 65 (78.3%) had no clear reason explained in the chart, 27 patients (32.5%) chose not to get tested, 23 (27.7%) were not deemed to be eligible upon initial assessment and 4 (4.8%) had pending orders placed by breast surgeons upon initial diagnosis. Unfortunately, 29 of these 83 patients were noted to have been deceased when the intervention was being designed. Remaining 54 patients were contacted by their primary breast cancer oncologists to determine their willingness in participating in the questionnaire-based interview. Conclusion: Based on the results of our QI project, we have now developed a process to contact the identified patients and renew the offer for GT and GC as well as participation in a questionnaire-based interview to understand the potential barriers to testing. We also plan to improve physician education and awareness by conducting mini sessions during our annual symposium meetings as well as grand rounds and develop a protocol for ordering GT and GC in patients with TNBC at our institution. Citation Format: Manasi Godbole, Mary Nyhuis, Travis Washburn, Joann Hirth, Haythem Ali. Genetic testing among patients with triple-negative breast cancer at a single health system: a quality improvement project [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-08-02.

Relationship Between Parents' Attention And Learning Motivation On The Trutching Behavior Of Private Madrasah Aliyah (MAS) Alwashliyah Tebing Tinggi City Students

Adolescence is a period of human development. This period is a period of change or transition from childhood to adulthood which includes biological changes, psychological changes, social changes. Truant behavior is one of the negative behaviors of students who often leave school or class without any clear reason. The aim of this research is to determine and analyze the relationship between parental attention and learning motivation and the expected behavior of Alwashliyah MAs students in Tebing Tinggi City. This research uses a quantitative research method, namely the method for collecting research data using a questionnaire with respondents to obtain information about the variables studied using a questionnaire. The research results show a significant negative relationship between parental attention and supportive behavior as seen from the coefficient value (Rxy) = -0.572 with p = 0.000 < 0.050. , the terminant coefficient (R2) value is 0.327, meaning that parental attention contributes 32.7% to students' correct behavior at MAs Alwashliyah, Tebing Tinggi City.

Decrease in Sperm Parameters in the 21st Century: Obesity, Lifestyle, or Environmental Factors? An Updated Narrative Review.

Semen quality represents a compelling factor for fertility, and delineating the normal values has proven difficult. In the last four decades, several authors have reported a noticeable decline in sperm parameters. Also, studies investigating 'time to pregnancy' have shown that fecundity begins to be reduced when sperm numbers decrease below 30 million, even though according to the 6th edition of the WHO manual, the normal value is currently 16 million/mL or 39 million per ejaculate. There exists sufficient data to suggest a decline in sperm counts over time, even though the clear reason for this adverse trend is not well established, but some associations have been hypothesised, such as maternal smoking during pregnancy. Additional potential factors have yet to be fully illustrated but involve poor diet, increased obesity, and exposure to environmental toxins. Moreover, the change in environmental conditions and more common exposure to endocrine-disrupting chemicals (EDCs), such as pesticides and herbicides, as well as bisphenol A, phthalates, polychlorinated biphenyls, and heavy metals, starting from prenatal life and continuing into adulthood, may exhibit probable features explaining the reduction in sperm parameters. Therefore, the main goal of this narrative review is to furnish an overview of the possible effects of exposure to EDCs on testicular function and spermatogenesis and, also, to summarise the evidence regarding a decrease in sperm quality and examine its potential consequences.

Women and insurance pricing policies: a gender-based analysis with GAMLSS on two actuarial datasets

In most of the United States, insurance companies may use gender to determine car insurance rates. In addition, several studies have shown that women over the age of 25 generally pay more than men for car insurance. Then, we investigate whether the distributions of claims for women and men differ in location, scale and shape by means of the GAMLSS regression framework, using microdata provided by U.S. and Australian insurance companies, to use this evidence to support policy makers’ decisions. We also develop a parametric-bootstrap test to investigate the tail behavior of the distributions. When covariates are not considered, the distribution of claims does not appear to differ by gender. When covariates are included, the regressions provide mixed evidence for the location parameter. However, for female claimants, the spread of the distribution is lower. Our research suggests that, at least for the contexts analyzed, there is no clear statistical reason for charging higher rates to women. While providing evidence to support unisex insurance pricing policies, given the limitations represented by the use of country-specific data, this paper aims to promote further research on this topic with different datasets to corroborate our findings and draw more general conclusions.

Dampak Kecanduan Game Online Terhadap Prestasi Belajar Mahasiswa IAIN Syekh Nurjati Cirebon

The development of technology is currently increasingly rapidly providing convenience and benefits for humans, one example of technology that provides entertainment benefits is online games. However, online game addiction is one of several forms of addiction caused by technological developments, one of which is the internet or better known as internet addictive disorder. The objectives of this research are: 1) Analyzing online game addiction experienced by students IAIN Sheikh Nurjati Cirebon. 2) Analyze the learning achievements experienced by IAIN Syekh Nurjati Cirebon students. 3) Analyzing the influence of online games on the learning achievement of IAIN Syekh Nurjati Ciebon students. This research uses descriptive qualitative methods. The data collection technique applied in the research was interviewing 5 students and distributing questionnaires which were filled in by 15 students. The results of this study show 1) Most respondents (50%) had difficulty stopping playing online games, while 33.3% admitted that they had fairly good control but still felt interested in continuing to play. 2) Effective learning can help pupils and students to achieve learning goals. 3) It can be concluded that 37.5% stated that they do not like playing online games, because they have a very bad effect on learning. In the same percentage, 37.5% stated that they did not agree with online games, but did not provide clear reasons. It can be concluded that the research shows that the majority of respondents have difficulty stopping playing online games, while effective learning can help achieve learning goals, and around 37.5% of respondents stated that they do not like or disagree with online games because they have a bad effect on learning, although some of them they didn't give a clear reason.
 

Tinjauan Yuridis Perbuatan Ingkar Janji (Wanprestasi) Oleh Buruh Tani Ditinjau Dari Kompilasi Hukum Ekonomi Syariah

The problem in this research is about the practice of broken promises (defaults) by farm workers in the village of Lumban Dolok. This type of research is field research. The primary data source in this study is by conducting direct interviews with farm workers who own the plantation, the Head of Lumban Dolok Village, traditional leaders. while the secondary data is in the form of fiqh muamalah books, and journals related to this research. Data collection techniques using field studies, namely observation, interviews, and documentation. The data analysis technique used in this study is to use a qualitative descriptive method. The results of the study show that the act of breaking a promise (default) by this farm worker begins with a verbal agreement between the owner of the garden and the farm worker in the agreement, one of the points is not being able to cancel the agreement suddenly and not asking for wages before doing the work. . However, in reality, when he was about to implement the farm labor agreement, he canceled the agreement with the garden owner, and asked for his wages on the grounds that he really needed it. This practice of breaking promises (defaults) by farm workers when viewed from a juridical view of this agreement is considered a unilateral cancellation of the agreement without the consent of the other party, in accordance with Article 1338 paragraph (2) of the Civil Code, it is clear that the agreement cannot be canceled unilaterally, because if the agreement is canceled unilaterally, it means that the agreement is not binding between the people who made it. Meanwhile, if viewed from the compilation of sharia economic law, it is explained in article 36 which explains that breaking a promise occurs if you do not do what has been promised, in this case the farm worker does not carry out the agreement in accordance with the agreement and terminates the agreement suddenly without any clear reason. This also contradicts the compilation of sharia economic law article 21 which states that there is no trustworthiness from farm workers, besides that there is also no attitude of openness and good faith from farm workers to find a replacement to be able to continue the agreement that has been canceled.

Problems of the Logotherapeutic Terminological System Formation (A Linguistic Aspect)

This article considers the formation and arrangement of the logotherapeutic terminological system. The latter developed after Viktor Frankl had introduced his logotherapy, a psychotherapeutic approach that revolves around the search for meaning; however, since that time, the advance of psychology and logotherapy has been accompanied by the emergence of many new terms and the growing need for clarification of some of the already established concepts. Now, it is getting increasingly important to create a more complete system of logotherapeutic terms that would be in line with the modern logotherapeutic idea of a human, as well as with the phenomena defining our personality from multiple angles and the world in general. Here, based on two logotherapeutic glossaries (one in Russian from A.I. Averyanov’s “Logotherapy and Existential Analysis: A Theory of Personality”, the other in English from M.H. Lewis’ “Logotherapy and Existential Analysis: A Glossary of English Terms”), the above need was justified. It was concluded that such a system should be structured as a glossary with regard to certain aspects (the presence of closed lexical groups, high-frequency words, and consistency of descriptions in all entries). Some problems and difficulties that arise at the macrostructural (including or ignoring items in the glossary without a clear reason, violating the alphabetical order, and spelling errors) and microstructural (in relation to defining the components of an entry) levels of the future glossary of logotherapeutic terms were identified and analyzed.

RESILIENCE IN AGRICULTURE: IS THERE THEORETICAL AND METHODOLOGICAL CHAOS?

The increasingly volatile conditions of doing business and the existence of societies are a clear reason to explore the category of resilience. The article aims to present and structure selected theoretical and methodological problems concerning resilience in agriculture. The results of a bibliometric analysis indicate a research gap referring to the category of financial resilience. The category of ‘resilience’ is based on relatively modern concepts from business management, particularly those close to risk management theory. Identifying and measuring capacities to build and strengthen resilience seems to be very important. Quantitative and qualitative methods may be used to explore the category ‘financial resilience’ in agriculture. There has been a noticeable research gap in agricultural finance to fill in. The indicator system for measuring the resilience of agricultural enterprises/farms has some limitations related to the aggregated nature of some financial categories. It would be advisable to develop a global measure of risk resistance in parallel (e.g., in the form of a synthetic index).

Are Commonly Used Geographically Based Social Determinant of Health Indices in Orthopaedic Surgery Research Correlated With Each Other and With PROMIS Global-10 Physical and Mental Health Scores?

Are Commonly Used Geographically Based Social Determinant of Health Indices in Orthopaedic Surgery Research Correlated With Each Other and With PROMIS Global-10 Physical and Mental Health Scores?

Interaction between service exercise and gender on field tennis service skills

Purpose. The purpose of this study was to determine the interaction between service exercise and gender on field tennis service skills. Materials and Methods. The population in this study were Faculty of Sports, Universitas Sebelas Maret students, totaling 85 male students and 27 female students. The sample used was 24 male students and 24 female students. Collecting data on tennis serve skills using the Hewitt Tennis Achievement Test. The skill of serving tennis in court tennis is the accuracy and constancy of a tennis player's serve to start the game and being able to be skilled in serving tennis. The number of hits/ball contact with the racket is 10 hits with the target. To test the statistical hypothesis, the Tukey test was used at a significance level of α = 0,05 using SPSS 25. Results. The results of data analysis showed that at α = 0.05 a maximum value of 0.000 < α 0.05 was obtained , for service training a maximum average value of 28.79 was obtained and an average minimum value was obtained 27.54 while gender obtained an average maximum value of 32.04 and an average minimum value of 23.79 so that a decision could be made that reject H0 and accept H1. Conclusions. So it can be concluded that there is an interaction between service training and gender on the service skills. The form of interaction shown by the results of this calculation provides a clear reason that the diversity of student characteristics will have an impact on the difference in service training, in this case a service training should pay attention to aspects of physical ability in this case gender in the implementation of training, so between service training and gender will influence each other and interact positively in the training process, especially in achieving the results of service skills which is good.

Prions in Microbes: The Least in the Most.

Prions are infectious proteins that mostly replicate in self-propagating amyloid conformations (filamentous protein polymers) and consist of structurally altered normal soluble proteins. Prions can arise spontaneously in the cell without any clear reason and are generally considered fatal disease-causing agents that are only present in mammals. However, after the seminal discovery of two prions, [PSI+] and [URE3], in the eukaryotic model microorganism Saccharomyces cerevisiae, at least ten more prions have been discovered, and their biological and pathological effects on the host, molecular structure, and the relationship between prions and cellular components have been studied. In a filamentous fungus model, Podospora anserina, a vegetative incomparability-related [Het-s] prion that directly triggers cell death during anastomosis (hyphal fusion) was discovered. These prions in eukaryotic microbes have extended our understanding to overcome most fatal human prion/amyloid diseases. A prokaryotic microorganism (Clostridium botulinum) was reported to have a prion analog. The transcriptional regulators of C. botulinum-Rho can be converted into the self-replicating prion form ([RHO-X-C+]), which may affect global transcription. Here, we outline the major issues with prions in microbes and the lessons learned from the relatively uncovered microbial prion world.

Study of the solubility of xonotlite

AbstractXonotlite (Ca6Si6O17(OH)2) is a hydrated crystalline calcium silicate with CaO/SiO2 = 1, which forms under hy‐drothermal conditions at temperature above ∼100°C. It has good thermal stability, it dehydrates to wollastonite only at 770 to 800°C and shows a good resistance to high pressures. Deposits of xonotlite are rare in nature, but it can easily obtained by hydrothermal synthesis in the temperature range of 180 to 350°C. Several studies have been conducted to better understand the formation conditions of xonotlite in terms of optimum temperature, duration and starting materials, but very little is known about its solubility under different conditions. The two solubility data sets available in literature differ by as much as 10 log units with no clear reason for this difference. The aim of the present study is to determine the solubility of xonotlite at 20°C and to compare this data with the available data in literature. To achieve this goal, solubility experiments from undersaturation were carried out at ambient temperature (20°C). Thermodynamic modelling was used to calculate the solubility product of xonotlite based on the measured total aqueous concentrations. The derived solubility of xonotlite is comparable to the solubility previous reported for synthetic xonotlite at 25°C. The synthesized xonotlite is several log units more stable than the solubility reported in literature for natural xonotlite, which seems to describe rather the solubility of amorphous C‐S‐H.

Human Resource Optimization: Best Practices in Talent Management and Organizational Performance

Human resources are one of the important assets for a company or organization. Maintaining high-value human resources is not something that is easy. Many workers in the millennial generation leave or leave the company without any clear reason, this is what many resource management are afraid of. human power. Because losing a worker is a normal thing that happens and burdens the company, such as lost productivity and damaged morale are one of the reasons behind the high price of losing a worker, therefore an optimal strategy is needed so that employees are comfortable and loyal to the organization or company. The aim of this research is to find out what efforts to optimize human resources are like. This research uses descriptive qualitative research methods and library research which is useful for expanding the discussion. The results of this research are that optimization efforts carried out by implementing talent management strategies by providing training, mentoring and education for employees can have a significant impact on performance for companies or government organizations.