Journal articles on the topic '371.195 0944'

Abstract Abstract 1346 Acquired resistance to the proteasome inhibitor (PI) bortezomib (BTZ) is an emerging factor limiting its efficacy in the treatment of hematologic malignancies. The clinical impact of acquired resistance has been shown in Multiple Myeloma (MM) patients who were re-treated with BTZ. Although BTZ-retreatment was found to be effective, the response rate as well as the duration of response were less as compared to initial treatment, indicating the development of BTZ-resistance in a subgroup of patients. In line with that, we previously found increased expression of constitutive proteasome (cP) subunit ß5 harbouring a mutation in the BTZ-binding pocket and a decreased expression of non-mutated immunoproteasome subunits in BTZ-resistant cell lines of hematologic malignancies (Franke and Niewerth et al, Leukemia 2012). We here explore whether upregulation of immunoproteasome (iP) expression could restore sensitivity in BTZ-resistant leukemia cells towards BTZ and two epxoyketone-based irreversible PIs; carfilzomib (CFZ) and the ß5i-targeted ONX 0914. BTZ-resistant cell lines were of multiple myeloma (8226), T-cell (CEM) and myelomonocytic (THP1) origin and displayed resistance towards cell growth inhibition in the presence of 7–200 nM BTZ. Induction of iP in wild type (WT) and BTZ-resistant 8226, CCRF-CEM and THP1 cells was achieved by exposure to 100U/ml Interferon- γ (IFN-γ) for 6–72 h. IFN-γ transiently increased (maximum between 24–48 hours) mRNA levels of β5i, β1i, and β2i up to 8-fold, 30-fold and 4-fold, respectively. These findings were corroborated at the β5i, β1i and β2i protein expression level using Western blot analysis. Following IFN-γ exposure, chymotrypsin-like proteasome activity increased up to 2.5-fold compared to unstimulated controls, trypsin-like activity increased up to 1.5-fold, whereas caspase-like activity was slightly decreased. Consistent with increased proteasome activity, there was also an increased expression of cell surface HLA Class I molecules. The impact of IFN-γ induced upregulation of iPs on the sensitivity to the PI BTZ, CFZ, and ONX 0914, defined by the decrease in IC50, is summarized in Table 1. 8226/BTZ100 cells became 4-fold more sensitive towards BTZ after IFN-γ exposure, whereas THP1/BTZ200 and CEM/BTZ200 cells displayed nearly 2-fold increased sensitivity. For CFZ, a modest level of sensitization was observed in all cell lines with high level BTZ resistance. Interestingly, for the immunoproteasome inhibitor ONX 0914, IC50 values were markedly decreased (7-fold for 8226/BTZ100 and 3-fold for THP1/BTZ200 and CEM/BTZ200 cells). Additionally, in 8226 cells with low levels of BTZ resistance (8226/BTZ7), IFN-γ restored parental cell sensitivity to ONX 0914. Restoration of PI sensitivity after IFN-γ exposure was further confirmed by activation of PARP cleavage and accumulation of ubiquitinated proteins, pointing to restoration of BTZ activity under proteasome inhibition and consequent induction of apoptosis. Finally, to provide evidence that upregulation of β5i and or β1i by IFN-γ was responsible for the observed sensitization, siRNA downregulation of β5i and β1i was applied prior to exposure to IFN-γ. Under these conditions, mRNA levels and proteasome activity of β5i remained suppressed, even after exposure to IFN-γ. Moreover, after β5i silencing, PI sensitization and apoptosis were attenuated. Silencing of β1i expression had no effect on PI-sensitization. In conclusion, down-regulation of β5i subunit expression is a major determinant of BTZ-resistance and increasing its proteasomal assembly after IFN-γ exposure facilitates restoration of sensitivity in BTZ-resistant leukemia cells towards cP inhibitors and in particular iP inhibitors. Table 1. IC50 values of PIs ± IFN-γ pre-incubation (48 hr) of wild type and BTZ-resistant hematologic cell lines Cell lines BTZ BTZ + IFNy SF ONX 0914 ONX 0914 + IFNy SF CFZ CFZ + IFNy SF 8226/wt 2.6 1.8 1.4 54 46 1.5 0.4 0.4 1 8226/BTZ7 13.5 5.8 2.3 99 47 2.1 0.9 0.8 1.1 8226/BTZ100 208 57 3.6 1837 249 7.4 28 13 2.2 CEM/wt 4.1 3.9 1.1 75 65 1.2 0.4 0.3 1.3 CEM/BTZ200 416 223 1.9 1763 566 3.1 42 26 1.6 THP1/wt 6.2 5.1 1.2 52 19 2.7 0.9 1.3 0.7 THP1/BTZ200 641 347 1.8 4236 1376 3.1 49 34 1.4 50% inhibitory concentration compared to untreated controls (IC50 nM) as determined in a 4 days growth inhibition assay (MTT). Results depicted are means of at least 3 separate experiments. SF: sensitization factor: IC50 control/IC50 with IFN-g. Disclosures: No relevant conflicts of interest to declare.

ABSTRACT Observational studies of collimation in jets in active galactic nuclei (AGN) are a key to understanding their formation and acceleration processes. We have performed an automated search for jet shape transitions in a sample of 367 AGN using VLBA data at 15 and 1.4 GHz. This search has found 10 out of 29 nearby jets at redshifts z < 0.07 with a transition from a parabolic to conical shape, while the full analysed sample is dominated by distant AGN with a typical z ≈ 1. The ten AGN are UGC 00773, NGC 1052, 3C 111, 3C 120, TXS 0815−094, Mrk 180, PKS 1514+00, NGC 6251, 3C 371, and BL Lac. We conclude that the geometry transition may be a common effect in AGN jets. It can be observed only when sufficient linear resolution is obtained. Supplementing these results with previously reported shape breaks in the nearby AGN 1H 0323+342 and M87, we estimate that the break occurs at 105–106 gravitational radii from the nucleus. We suggest that the jet shape transition happens when the bulk plasma kinetic energy flux becomes equal to the Poynting energy flux, while the ambient medium pressure is assumed to be governed by Bondi accretion. In general, the break point may not coincide with the Bondi radius. The observational data support our model predictions on the jet acceleration and properties of the break point.

Zusammenfassung. Wir untersuchten die Wirkung eines gesundheitsorientierten Krafttrainings auf verschiedene Aspekte des psychischen Wohlbefindens für einen Zeitraum von 3 (t1) und 6 Monaten (t2). N = 531 Teilnehmer führten 6 Mal monatlich ein präventives (PKT, n = 317) oder medizinisches gesundheitsorientiertes Krafttraining (MKT, n = 109) durch oder gehörten einer Warte-Kontrollgruppe (KG, n = 105) an. Nach 6 Monaten zeigten sich Verbesserungen des Körperbildes. Für beide Trainingsformen verbesserte sich die vitale Körperdynamik (PKT: d = 0.59, MKT: d = 0.40), die ablehnende Körperbewertung reduzierte sich (PKT: d = –0.44, MKT: d = –0.32). Für Selbstwirksamkeitserwartung und Lebenszufriedenheit fanden wir anhand von Strukturgleichungsmodellen und Pfadanalysen indirekte Wirkmechanismen: Das durch gesundheitsorientiertes Krafttraining verbesserte Körperbild fördert eine Zunahme der Selbstwirksamkeitserwartung, die wiederum eine höhere Lebenszufriedenheit begünstigt (χ2 = 3.35, p = .501, df = 4, NFI = .98, CFI = 1.00, RMSEA = .00). Die Ergebnisse werden im Hinblick auf das Zusammenspiel der zugrunde liegenden körperlichen und psychischen Wirkmechanismen untersucht.

During August 2012, vertical oozing cankers were sporadically observed on trunks and branches of walnut trees (Juglans regia) in the city of Zánka, near Lake Balaton and other parts of Hungary including Budapest, Győr, and Tatabánya cities. Cankers were observed on trunks and branches where brownish-black exudates staining the bark appeared mainly in the summer. Isolations were performed primarily from exudates but also from infected tissues using King's medium B (KB) (3) and EMB medium (2). Colonies similar in appearance to Brenneria nigrifluens (syn.: Erwinia nigrifluens) (1,5) were isolated. The bacterium, first reported in California, was also recorded in Iran, Spain, France, and several Italian locations, on walnut trees. The bacterial strain was gram negative and did not induce a hypersensitive response on tobacco (Nicotiana tabacum L. ‘White Burley’) leaves. The bacterium grew at 26°C. Colonies on KB were white and non-fluorescent, but on EMB medium were a typical dark purple with metallic green sheen. The results of substrate utilization profiling using the API 20E kit (Biomérieux, Marcy l'Etoile, France) showed that the bacterium belonged to the Enterobacteriaceae. The strain was positive for citrate utilization, H2S, and acetoin production and urease, glucose, inositol, saccharose, and arabinose reactions. Pathogenicity was tested by injecting five young healthy walnut branches on two separate 2-year-old grafted potted plants with a bacterial suspension containing 107 CFU/ml. Negative controls were walnut branches injected with sterile distilled water. Branches were enclosed in plastic bags and incubated in a greenhouse under 80% shade at 26°C day and 17°C night temperatures. Three months after inoculation, necrotic lesions were observed in the inner bark and dark lines were observed in internal wood, but no external cankers were observed on inoculated branches. The negative control appeared normal. B. nigrifluens was re-isolated from lesions on inoculated branches and identified as described above; thus, Koch's postulates were fulfilled. For molecular identification of the pathogen, 16S rDNA amplification was performed using genomic DNA from strain Bn-WalnutZa-Hun1 with a universal bacterial primer set (63f and 1389r) (4). The PCR products were cloned into a pGEM T-Easy vector (Promega, Madison, WI) and transformed into Escherichia coli DH5α cells. A recombinant plasmid (2A2.5) was sequenced using M13 forward and reverse primers. The sequence was deposited in NCBI GenBank (Accession No. HF936707) and showed 99% sequence identity with a number of B. nigrifluens strains, including type strains Z96095.1, AJ233415.1, JX484740.1, JX484739.1, JX484738.1, and FJ611884.1. On the basis of the symptoms, colony morphology, biochemical tests, and 16S rDNA sequence identity, the pathogen was identified as Brenneria nigrifluens. To our knowledge, this is the first report of a natural outbreak of bacterial bark canker on walnut in Hungary and the presence of the pathogen may seriously influence in local orchards and garden production in the future. References: (1) L. Hauben et al. Appl Microbiol 21:384, 1998. (2) J. E. Holt-Harris and O. Teague. J. Infect. Dis. 18:596, 1916. (3) E. O. King et al. J. Lab. Clin. Med. 44:301, 1954. (4) A. M. Osborn et al. Environ. Microbiol. 2:39, 2000. (5) E. E. Wilson et al. Phytopathology 47:669, 1957.

Stroke outcomes among young adults in Uganda are unclear. This study therefore determined the clinical characteristics and 30-day outcome among young adults with an acute stroke. In a prospective observational cohort study, 61 young adults with confirmed stroke were followed up for 30 days. Socio-demographic and clinical characteristics were collected using a study questionnaire. Kaplan–Meier curves, and modified Poisson regression were performed for factors associated with the 30-day mortality outcome. A third of the screened stroke survivors, (61/195) were young adults aged between 18 and 50 years. About two-thirds were male. More than half were diagnosed with ischaemic strokes while 42.6% had a haemorrhagic stroke. Nearly half (29/61) were known hypertensives, 43% (26/61) had a history of alcohol consumption with 95% classified as dependent on CAGE assessment. Ten percent had a prior smoking history while 29% of the female gender had a prior history of oral contraception use. Twenty-three percent (14/61) of the young stroke patients died within 30 days of stroke onset (95% CI: 0.01, 0. 901). A history of smoking (adjusted prevalence ratio: aPR;5. 094, 95% CI: 3.712, 6. 990) and stroke severity National Institutes of Health Stroke score (NIHSS) >16; Prevalence ratio (PR) -3. 301, 95%CI: 1. 395, 7. 808) and not drinking alcohol (aPR (adjusted prevalence ratio) -7. 247, 95% CI: 4. 491, 11.696) were associated with 30- day mortality. A third of all stroke survivors were young adults. About 23. 3% died within 30 days of stroke onset. Stroke severity and a history of smoking were associated with mortality. Identifying high risk patients and early outpatient follow up may help reduce the 30-day mortality in our settings.

AbstractBackgroundGaucher disease (GD), caused by a deficiency in acid β-glucosidase, leads to the accumulation of glucosylsphingosine (GluSph), which has been used as a powerful biomarker for the diagnosis and follow-up of GD. Our aim was to perform the first retrospective study of GluSph in Spanish patients, analyzing its relationship with classical biomarkers and other parameters of disease and its utility regarding treatment monitoring.MethodsClassical biomarkers were evaluated retrospectively by standard methods in a total of 145 subjects, including 47 GD patients, carriers, healthy controls and patients suffering from other lysosomal lipidoses. GluSph was also measured using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method developed as part of the present study.ResultsThe optimized method presented intra- and inter-assay variations of 3.1 and 11.5%, respectively, overall recovery higher than 96% and linearity up to plasma concentrations of 1000 ng/mL with 100% specificity and sensitivity. Only GD patients displayed GluSph levels above 5.4 ng/mL at diagnosis and this was significantly correlated with the classical biomarkers chitotriosidase (r = 0.560) and the chemokine CCL18/PARC (CCL18/PARC) (ρ = 0.515), as well as with the Spanish magnetic resonance imaging index (S-MRI, r = 0.364), whereas chitotriosidase correlated with liver volume (r = 0.372) and CCL18/PARC increased in patients with bone manifestations (p = 0.005). GluSph levels decreased with treatment in naïve patients.ConclusionsPlasma GluSph is the most disease-specific biomarker for GD with demonstrated diagnostic value and responsiveness to therapy. GluSph in the present series of patients failed to demonstrate better correlations with clinical characteristics at onset than classical biomarkers.

BackgroundPsoriatic arthritis (PsA) is a heterogenous disease that can present with various musculokeletal manifestations. Several studies have assessed the rate of sacroileitis in PsA population, however data on the involvement of other pelvic structures that may cause symptoms, such as major entheseal or hip involvevement, and progression rates during follow-up is scarce.ObjectivesThis study aimed to understand overall pelvis radiography findings and progression rates during follow-up in a cohort of patients with PsA under biologic treatment.MethodsPsA patients from the Hacettepe University biological database (HUR-BIO), were retreospectively analyzed for their pelvis radiographs. All radiographs for individual patient were consecutively scored. Modified New York (mNY) criteria was used to assess sacroileitis and ischium/ iliac wing/ greater-lesser trochanteric enthesopathy and symphysis pubis osteitis assessments were done using a grade 0, no changes, 1, minimal changes and grade 2 and more counted as significant changes (1). Hip involvement was scored using BASRI-hip score and data on prosthesis were noted (2). All of the assessments were done by an experienced rheumatologis (UK) and in cases with suspicion, another experienced rheumatologist reviewed the cases (LK) and a consensus was reached.ResultsOverall 273 patients (69.6% of females) with the mean (SD) age at the time of first radiography 43.3 (12) years were included. At their initial radiographic assessment, the median (IQR) PsA duration was 2 (7) years. Baseline radiographs showed 10 (%3.7) of the patients had transitional vertebra and 137 (50.2%) patients had sacroiletis according to mNY criteria. From patients without sacroileitis (n=136), 67 patients had following radiographs. After a mean (SD) 47.1 (37) months, 16 (23.8%) of them progressed to sacroiletitis according to mNY criteria. Regarding the major enthesopathies, Regarding significant changes, 26.8 % of the patients had ischium enthesopathy, 19.3% of the patients ad symphysis pubis involvement and 13.2% of the patients had iliac wing enthesopathy. Trochantor major enthesopathy rates were 2.4% and 1.4 % at right and left sites respectively. Only one patient had trochanter minor enthesitis on the left site (Table 1). Prosthesis requirement was observed in 4 hip joints and 4 hip joints had prosthesis. There was no correlation between meeting mNY criteria and having iliac, ischium, and pubis involvement ≥ 2. On the other hand, patients with when there is ischium enthesopathy ≥2 (17/46 (36.9%) vs 18/96 (18.7%), p=0.013) or iliac wing enthesopathy ≥2 above (10/18 (55.5%) vs. 26/129 (20.1%), p=0.001), any syndesmophyte in the spine is more commonly seen.Table 1.Distribution of major entheseal involvement and BASRI-hip socres and progression ratesLocationGradesFirst assessmentN (%)Progression rate*Ischium (n=164)409/65 (13.8)311 (6.7)233 (20.1)174 (45.1)046 (28)Symphysis Pubis408/78 (10.2)(n=191)35 (2.6)232(16.8)160 (31.4)094 (49.2)Iliac wing403/72 (4.1)(n=174)39 (5.2)214 (8.0)128 (16.1)0124 (71.3)BASRI score43 (1.4)0(right)32 (0.9)(n=220)21 (0.5)100214 (97.3)BASRI score400(left)34 (1.8)(n=219)22 (0.9)100213 (97.3)*Defined as one unit increase in the gradeConclusionHalf of the patients with PsA requiring advanced treatment modalities, had sacroileitis in a median 2 years of disease duration and the rest may progress to sacroileitis during the follow-up period. Major enthesopathy involvement was also seen in more than half of the patients. Ischium, iliac wing enthesopathies and spinal syndesmophytes may be all a part of the osteoproliferative process. Further assessment is needed to correlate those radiographic changes to clinical symptoms.References[1]van der Linden S, et al. Arthritis Rheum. 1984 Apr;27(4):361-8.[2]Calin A, et al. J Rheumatol 1999;26:988-92Disclosure of InterestsNone declared

Leipotylenchus abulbosus (Thorne, 1949) Sher, 1974 belongs to the family Tylenchidae, subfamily Leipotylenchinae, and order Tylenchida. During the spring and autumn months of 2008 to 2010, 80 samples were collected from rhizosphere soil of symptomatic plants including wheat (Tritichum aestivum L.), beet (Beta vulgaris L.), and maize (Zea mays L.) from Meighan and Gavar regions of Markazi Province in central Iran. Plants were dwarfed and leaves were chlorotic. Diseased plants comprised ~7% of all plants in the field. Sandy loam soil was collected from roots up to 15 cm from the base of the plants. Nematodes were extracted from the soil by sieving and centrifugation (3). For species identification, nematodes were transferred to anhydrous glycerin (2) and mounted on slides by the paraffin ring method. Identification was based on morphometric and morphological characteristics of females and males. No other forms of the nematode were isolated from collected samples. L. abulbosus was found in 10% of the collected samples. The nematodes showed typical characteristics of the genus Leipotylenchus: striated and anteriorly flattened lip region, stylet without basal knobs, didelphic gonads, four incisures in lateral fields that were areolated in the posterior portion, presence of deirids and adanal caudal alae, amphid inconspicuous in males. Males contained bursa in tail. Females contained an almost straight body, tapering anteriorly from median bulb and posteriorly beyond the anus; cuticle thick, annules fine. Labial framework was moderately sclerotized. Median bulb with prominent valvular apparatus in the center, oval, occupied two-thirds of the body. Deirids were prominent and at the level of the excretory pore. Vagina a transverse slit at right angles to body axis, extending less than half width into body. Tai1 finely annulated, short, tapering to a narrow tip but becoming broader just before the terminus. Phasmids small in anterior half of the tail. Measurements of 12 females: body length = 1,377 ± 90 (1,276 to 1,469) μm; a = 39.2 ± 1.62 (36.8 to 41.1); b = 7.2 ± 0.34 (6.6 to 8.30); c = 11.1 ± 0.16 (10.7 to 11.3); V% = 52.6 ± 1.42 (50.4 to 53.8); stylet length = 17 ± 0.22 (16.6 to 18) μm; tail length = 124 ± 6.83 (116 to 137) μm); and 7 males: (body length = 1,150 ± 56.84 (1,090 to 1,246) μm; a = 39.5 ± 1.48 (37.5 to 41.5); b = 6.4 ± 0.21 (6.1 to 6.8); c = 9.5 ± 0.06 (9.4 to 9.6); T% = 55.1 ± 0.91 (54.4 to 56.20); stylet length = 17.6 ± 0.36 (17 to 18) μm; tail length = 120 ± 3.77 (115 to 129) μm) conformed to the description of L. abulbosus. L. abulbosus, originally isolated from crop plants in surveyed regions, was cultured on beet (B. vulgaris L.) in the greenhouse. Pure cultures of the nematode were inoculated on beet seedlings at the 4- to 6-leaf stage as described previously (1). Sterilized soils were inoculated with 1,000 infective mature nematodes with three replications. Infection of beet roots by the nematode resulted in leaf chlorosis and reduction in plant height. Previously, L. amiri was collected from soils associated with the roots of onion (Allium cepa L.) plants in Pakistan (4). However there have not been any reports of L. abulbosus in crop plants before. To our knowledge, this is also the first report of L. abulbosus infecting wheat, beet, and maize plants in Iran. References: (1) K. R. Barker. Methodology 2:19, 1985. (2) A. De Grisse. Meded. Rijksfac. Landbouwwet. Gent. 34:351, 1969. (3) W. R. Jenkins. Plant Dis. Rep. 48:692, 1964. (4) M. A. Maqbool and F. Shahina. Rev. Nèmatol. 7:363, 1984.

Abstract Background: B-cell chronic lymphoproliferative disorders (B-CLPD) comprise several entities with similar clinical manifestations, within which chronic lymphocytic leukemia (CLL) account for the majority, others including follicular lymphoma (FL), hairy cell leukemia (HCL), splenic marginal zone lymphoma (SMZL),nodal marginal zone lymphoma (NMZL), gastric mucosa-associated lymphoid tissue (MALT) lymphoma, lymphoplasmacytic lymphoma/Waldenström's macroglobulinemia (LPL/WM), and other unclassified subtypes. Cytogenetic aberrations are now the main prognostic predicators in CLL, with deletion of TP53 or ATM as the adverse predicators, while sole deletion of 13q14 as the favorable one, trisomy 12 and IGH translocation as the neutral factors. The prognostic role of this cytogenetic aberrations panel has not been well established in other B-CLPD excluding CLL. Patients and methods: A panel of DNA probes were used to detect cytogenetic aberrations by fluorescence in situ hybridization (FISH), including RB1/D13S25 at 13q14, ATM at 11q22, TP 53 at 17p13, CEP12 and IGH translocation at 14q32. Totally, 870 patients were enrolled in this study, including 459 CLL patients, 41 SMZL patients, 24 HCL patients, 96 LPL/WM patients, 24 NMZL patients with bone marrows involvement (BMI) ,59 FL patients with BMI and 161 patients without definite subtype classification. Results: The incidence of each cytogenetic aberration in CLL is as follow: 38.0%(169/445) for del 13q14, 11.5% (46/400) for del 11q22, 14.5% (66/455) for del 17p13 , 23.8% (68/286) for +12, and 21.9% (97/443) for t(14q32). While in other B-CLPD excluding CLL is as follow: 10.3% (36/351) for del 13q14, 3.6% (11/305) for del 11q22, 7.9% (30/380) for del 17p13, 12.3% (23/ 187) for +12 and 24.1% (93/386) for t(14q32). The incidence of del 13q14 (p=.000), del 11q22 (p=.000), del17p13 (p=.003) and +12 (p=.002) were higher in CLL than in other B-CLPD. With a median follow-up of 46.0 months (2.0-288.0) in CLL and 39 months (3.0-239.0) in other B-CLPD, the median estimated progress-free survival (PFS) and overall survival (OS) in CLL were 80.0 months (95% CI 67.2-92.7) and 129 months (95% CI 111.5-146.5) respectively, while in other B-CLPD were 84 months (95% CI 71.8-96.1) and 135 months respectively. In CLL, the del 13q (p=.046), del 11q (p=.002) and del 17p (p<.001) were the adverse predictors for the PFS with only del 17p (p<.001) for the OS. There were no significant difference between patients with or without del 13q in aspect of OS (129.0 vs 110.5 months, p=.207). while sole del 13q was the favorable predictor for both PFS (p<.001) and OS (p=.001). Del 11q also indicated poor OS without statistical significance (p=.112). The median PFS for patients with or without +12 was 90 months (95% CI 60.5-119.5) and 93.0 months (95% CI 73.3-112.7) (p=.273), and the median OS was also similar (131.0 months vs. 129.0, p=.921). IGH translocation did not significantly influence both PFS (p=.198) and OS (p=.648). In other B-CLPD except CLL, the del 13q, del 17p and t (14q32) had no impact on both PFS (p=.983, p=.910 and p=.675 respectively) and OS (p=.171, p=.401 and p=.453 respectively). But patients with trisomy 12 had poor PFS (69.0 vs.86.0months, p=.094) and OS (69.0 vs.135.0months, p=.006) compared with those without. Del 11q also adversely impacted the OS (75.0 months vs. not reached, p=.059) but not PFS (62.0 vs. 84.0 months, p=.735). Conclusions: Del 11q and del 17p had the adverse prognostic impact in CLL. However, trisomy 12 was the predictor of poor survival in other B-CLPD which indicated neutral prognostic role in CLL. These results may imply different role of the same cytogenetic aberration in the pathology between CLL and other B-CLPD. Disclosures No relevant conflicts of interest to declare.

The Covid-19 pandemic had a dangerous impact on early-childhood education, lost learning in almost all aspects of child development. The house-to-house learning, with the name Moving Home Learning Program (MHLP), is an attractive offer as an emergency remote teaching solution. This study aims to describe the application of MHLP designed by early-childhood education institutions during the learning process at home. This study used a qualitative approach with data collection using interviews, observation, and documentation. The respondents involved in the interview were a kindergarten principal and four teachers. The research data were analyzed using the data content analysis. The Findings show that the MHLP has proven to be sufficiently in line with the learning needs of early childhood during the Covid-19 pandemic. Although, the application of the MHLP learning model has limitations such as the distance from the house that is far away, the number of meetings that are only once a week, the number of food and toy sellers passing by, disturbing children's concentration, and the risk of damage to goods at home. The implication of this research can be the basis for evaluating MHLP as an adaptive strategy that requires the attention of related parties, including policy makers, school principals, and teachers for the development of new, more effective online learning models. Keywords: Moving Home Learning Program (MHLP), Children Remote Teaching References:Abdollahi, E., Haworth-Brockman, M., Keynan, Y., Langley, M. J., & Oghadas, S. M. (2020). Simulating the effect of school closure during COVID-19 outbreaks in Ontario , Canada. BMC Medicine, 1–8. https://doi.org/https://doi.org/10.1186/s12916-020-01705-8 Arends, R. I., & Kilcher, A. (2010). 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Abstract Clonal evolution of DCIS to invasion Ductal carcinoma in situ (DCIS) is the most common form of preinvasive breast cancer and, despite treatment, a small fraction (5-10%) of DCIS patients develop subsequent invasive breast cancer (IBC). If not treated, at least 3 out of 4 women with DCIS will not develop IBC1-3. This implies many women with non-progressive, low-risk DCIS are likely to carry the burden of overtreatment. To solve this DCIS dilemma, two fundamental questions need to be answered. The first question is, how the subsequent IBC is related to the initial DCIS lesion. The second question is how to distinguish high- from low-risk DCIS at the time of diagnosis. This is essential to take well-informed DCIS management decisions, i.e., surgery, followed by radiotherapy in case of breast conserving treatment with or without subsequent endocrine treatment, or test whether active surveillance for low-risk DCIS is safe. How is the subsequent IBC related to the initial DCIS? The high genomic concordance in DNA aberrations between DCIS and IBC suggest that most driver mutations and CNA events are acquired at the earliest stages of DCIS initiation. It has therefore been assumed that most solid tumours arise from a single cell and that the probability of two independent tumours arising from the same tissue is low4-6. However, lineage tracing and genomic studies strongly suggest both direct and independent clonal lineages during the initiation of DCIS and evolution to IBC. In these processes, mammary stem cells have been implicated in DCIS initiation. Role of mammary stem cells in DCIS initiation Lineage tracing mouse model experiments have shown the fate of individual cells and lineages that acquire mutations before a tumour is established7-9. This is also relevant for DCIS initiation10,11, as different pools of MaSCs drive the growth and development of the ductal network and are considered the cell of origin for breast cancers9,10. The ductal trees remain quiescent until puberty, during which extension, branching and termination of terminal end buds (TEBs) leads to its expansion throughout the fat pad7,12,13. Any oncogenic mutation that occurs in a fetal MaSC will spread throughout the ductal network to a large part of the ductal tree, leading to sick lobes9. By contrast, oncogenic mutations acquired by a single MaSC during puberty spread to a smaller number of offspring located in small clusters in a part of the ductal network8,14. Direct lineage models for DCIS progression Direct lineage models postulate that DCIS has a single cell of origin that acquires mutations and progresses to IBC15-18. This is also supported by the high genomic concordance of CNAs and mutations in synchronous DCIS–IBC regions6,15,17,19-21 and the results of a recent large longitudinal study that profiled pure DCIS and recurrent IBC using multiple sequencing techniques, which estimated direct clonal lineages in approximately ~80% of patients18. Two distinct direct lineage models have been proposed: the evolutionary bottleneck model and the multiclonal invasion model. In the evolutionary bottleneckmodel, a single clone (or a limited number of clones) with an invasive genotype is selected and breaks through the basement membrane to migrate into surrounding tissues15,16,22, while other clones are unable to escape the ducts21-28. The multiclonal invasion model posits that most or all subclones can escape the basement membrane, establishing invasive disease6,16,17,20. The multiclonal model has not been studied widely in pure DCIS and recurrent IBC samples. Independent lineage model for DCIS progression DCIS lesions and IBCs can arise from different initiating cells in the same breast independently5,20,29-32. An analysis of sequential DCIS–IBC pairs in a unique, large-scale, in-depth study of 95 matched pure DCIS and recurrent IBC showed that ~20% of the IBC recurrences were indeed clonally unrelated to the primary DCIS18, as is also supported by some mathematical model studies33. The potential role of a field effect IBC can develop in the same breast as an initial DCIS even after treatment, which could be explained by the presence of a field effect34-37. Alternatively, the sick lobe hypothesis proposes that a single lobe harbours first-hit mutations, acquired in utero or during early mammary development37-42. This could also explain the restriction of IBC to the ipsilateral side of the breast39,43,44. Germline mutations may also explain the emergence of independent lineages in DCIS and IBC patients, lowering the threshold for cancer development32,43-46. Convergent evolution model of DCIS progression A third model for the emergence of IBC from DCIS is convergent evolution, in which the same mutations and CNA are selected and expanded during tumour growth such that environmental factors fuel competition between distinct clones and push them towards a similar genotype. Ultimately, two independent clonal lineages from different ancestral cells then happen to share multiple genomic aberrations or driver mutations across regions47-49. Although independent lineages are considered uncommon (~20%) in ipsilateral recurrences, they occur at much higher frequencies in contralateral recurrences (&gt;80%), in which single-nucleotide polymorphism and comparative genomic hybridization microarrays show few (or no) genomic alterations shared in tumours from the contralateral breast cancer18,50,51. How to distinguish high- from low-risk DCIS at the time of diagnosis? The genomic and transcriptomic profile present at the time of DCIS diagnosis may contain crucial information on the risk of progression of DCIS to IBC. Thus far, it has been unclear whether prognostic gene expression markers can be used to separate indolent DCIS from potentially progressive DCIS. To this end, microarrays and RNA-seq have been applied for the comparison of bulk RNA from microdissected DCIS and IBC tissue. In synchronous DCIS–IBC, a limited number of transcriptional differences have been found and the few events discovered often varied extensively across different tumours52-56. Although these differences were strong, the added value of these studies is uncertain as they are often confounded by small sample size, lack of matched receptor status data, and low sample purity. Despite these limitations, these studies have implicated the epithelial-mesenchymal transition (EMT) and extracellular matrix (ECM) remodelling pathways as potentially relevant for the progression of DCIS to IBC55-62. We studied two large DCIS cohorts: the Sloane cohort, a prospective breast screening cohort from the UK (median follow-up of 12.5 years), and a Dutch population-based cohort (NKI, median follow-up of 13 years). FFPE tissue specimens from patients with pure primary DCIS after breast-conserving surgery (BCS) +/- RT that did develop a subsequent ipsilateral event (DCIS or invasive) were considered as cases, whereas patients that did not develop any form of recurrence up to the last follow-up or death were considered as controls. We performed copy number analysis (CNA) and RNAseq analysis on 229 cases (149 IBC recurrences and 80 DCIS recurrences) and 344 controls. We classified DCIS into the PAM50 subtypes using RNAseq data which revealed an enrichment of luminal A phenotype in DCIS that did not recur (P = 0.01, Fisher Exact test). No single copy number aberration was more common in cases compared to controls. RNAseq data did not reveal any genes significantly over/under expressed in cases versus controls after false discovery rate (FDR) correction. However, by limiting the analysis to samples that had not had RT and excluding pure DCIS recurrences we developed a penalized Cox model from RNAseq data. The model was trained on weighted samples (to correct for the biased sampling of the case control dataset) from the NKI series with double loop cross validation. Using this predicted hazard ratio, the samples were split into high, medium and low risk quantiles, with a recurrence risk of 20%, 9% and 2.5%, respectively at 5 years (p&lt;0.001, Wald test). The NKI-trained predictor was independently validated in the Sloane No RT cohort (p = 0.02, Wald test). GSEA analysis revealed proliferation hallmarks enriched in the recurrence predictor (FDR = 0.058). The NKI-RNAseq predictor was more predictive of invasive recurrence than PAM50, clinical features (Grade, Her2 and ER) and the 12-gene Oncotype DCIS score (p &lt; 0.001, permutation test using the Wald statistic) in both the NKI and Sloane series. In the methylation analysis, 50 controls were compared with 35 cases. We could identify Variably Methylation Regions (VMRs) and Differentially Methylated Regions (DMRs) between cases and controls. Interestingly, VMRs were enriched in cell adhesion pathways Conclusion The recently acquired knowledge described above on how often the subsequent IBC is directly related to the initial DCIS and on molecular markers predicting the risk of DCIS progression is essential for accurate DCIS risk assessment. 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This research aims to determine the effect of self-esteem, career adaptability on employee performance with perceived organizational support as a mediating variable. The population of this research is employees of PT. Bank Sumut Syariah KC Padangsidimpuan City. The sample size was 30 people taken based on non-probability sampling. The questionnaire is a data collection tool used in this research, while the type is quantitative research. The data analysis technique uses path analysis with the SPSS Version 22 program. The findings of this research are 1) self-esteem has a positive and significant effect on perceived organizational support. 2) career adaptability has a positive and significant effect on perceived organizational support. 3) self-esteem has a positive and significant effect on performance. 4) career adaptability has a positive and significant effect on performance. 5) perceived organizational support has a positive and significant effect on performance. 6) self-esteem does not have a positive and significant effect on employee performance through perceived organizational support. 7) self-esteem does not have a positive and significant effect on performance through perceived organizational support at PT. Bank Sumut Syariah KC Padangsidimpuan. Keywords: Self esteem, career adaptability, perceived organizational support, performance, Bank Sumut Syariah ABSTRAK Penelitian ini bertujuan untuk mengetahui pengaruh self-esteem, adaptabilitas karir terhadap kinerja karyawan dengan perceived organizational support sebagai variabel mediasi. Populasi penelitian ini adalah karyawan PT. Bank Sumut Syariah KC Kota Padangsidimpuan. Adapun jumlah sampelnya 30 orang yang diambil berdasarkan non probability sampling. Angket merupakan alat pengumpul data yang digunakan pada penelitian ini sedangkan jenisnya merupakan penelitian kuantitatif. Teknik analisa data menggunakan analisis jalur dengan program SPSS Versi 22. Temuan penelitian ini adalah 1) self esteem berpengaruh positif dan signifikan terhadap perceived organizational support. 2) adaptabilitas karir berpengaruh positif dan signifikan terhadap perceived organizational support. 3) self esteem berpengaruh positif terhadap dan signifikan terhadap kinerja. 4) adaptabilitas karir berpengaruh positif dan signifikan terhadap kinerja. 5) perceived organizational support berpengaruh positif dan signifikan terhadap kinerja 6) self esteem tidak berpengaruh positif dan signifikan terhadap kinerja karyawan malalui perceived organizational support. 7) self esteem tidak berpengaruh positif dan signifikan terhadap kinerja melalui perceived organizational support pada PT. Bank Sumut Syariah KC Kota Padangsidimpuan. Kata kunci : Self esteem, adaptabilitas karir, perceived organizational support, kinerja, Bank Sumut Syariah. PENDAHULUAN Sumber daya manusia (SDM) merupakan kemampuan setiap manusia yang ditentukan oleh daya pikir dan kekuatan fisiknya (Wibowo, 2020). satu-satunya sumber daya yang memiliki akal, perasaan, keinginan, keterampilan, pengetahuan, dorongan, kekuasaan, dan pekerjaan. Hal ini mendukung tujuan perusahaan yang ingin dicapai. Di era modern ini, persaingan antar perusahaan semakin ketat untuk merebut pangsa pasar. Potensi dari sumber daya manusia yang ada dalam sebuah perusahaan haruslah dapat dikelola dengan baik, sehingga memberikan hasil yang maksimal sesuai dengan tujuan yang diinginkan perusahaan. Apabila sumber daya manusia yang dimiliki sesuai dengan ekspektasi, tentu saja perusahaan semakin dekat dengan tujuan mereka. Oleh karena itu, sangat perlu dilakukan evaluasi karyawan yang baik dan membentuk hubungan kerjasama yang baikantara karyawan dengan atasan. Kinerja menurut Kamus Besar Bahasa Indonesia (KBBI) adalah sesuatu yang dicapai, prestasi yang diperlihatkan, kemampuan kerja. Kinerja begitu penting untuk dikembangkan karena kinerja dapat dijadikan sebagai tolak ukur penilaian terhadap prestasi individual sesuai dengan moral maupun etika (Nitisemito A. S., 2019). Kinerja individual semakin tinggi atau rendah dapat disebabkan oleh beberapa faktor pendukung seperti rendah tingginya self-esteem, adaptabilitas karir terhadap kinerjanya, serta dukungan dari organisasi (perceived organizationalsupport). Mc.Clelland yang mengelompokkan kebutuhan manusia yang dapat memotivasi ia dalam bekerja adalah kebutuhan akan prestasi, kebutuhan afiliasi, dan kebutuhan akan kekuatan. Sementara itu Claude membagi kebutuhan menjadi kebutuhan akan upah yang layak, kesempatan untuk maju, pengakuan sebagai individu, keamanan kerja, tempat kerja yang baik, penerimaan oleh kelompok, perlakuan yang wajar, dan pengakuan atas prestasi. Dalam wawancara dan oberservasi yang penulis lakukan terhadap karyawan Bank Sumut, masih terdapat beberapa karyawan yang masih ragu akan kemampuan diri sendiri untuk menggambarkan keyakinan atas dirinya untuk pekerjaan yang dihadapi dan untuk bersaing menjadi yang terbaik, secara tidak langsung karyawan masih tidak puas terhadap kinerja kinerja yang dihasilkan saat ini (Soraya,2022). Dapat disimpulkan bahwa kebutuhan akan penghargaan (esteem) atau pengakuan sebagai individu merupakan salah satu kebutuhan yang sangat penting dalam memotivasi untuk meningkatkan kinerja, karena semua orang memerlukan pengakuan akan penghargaan (esteem) terhadap dirinya. Self-esteem juga memiliki peranan penting dalam kehidupan individu. Seseorang yang punya self-esteem yang tinggi akan menjadi produktif serta berhasil dengan baik terhadap pekerjaan yang dilakukan. Mereka tidak akan berpura-pura menjadi lebih unggul dari orang lain, tidak berusaha untukmenaungi perasaan negatif mereka karena dia merasa produktif. Mengetahui dirinya jika ia mampu, disayangi dan peduli dengan dirinya maupun terhadap orang lain yang dapat membuatnya merasa nyaman serta terlihat baik dalam menjalani rutinitasnya yang akan mempengaruhi kinerjanya. Karyawan yang memiliki self-esteem yang rendah akan menahan diri untuk berinteraksi dengan orang lain karena kurang percaya diri terhadap perilaku sosial yang mereka miliki. Dan pastinya akan membuat kinerja karyawan tidak memiliki perubahan yang signifikan dan terkesan mampet tanpa adanya kemajuan. Diharapkan pihak Bank Sumut Kantor Cabang Padang sidimpuan dapat lebih memperhatikan self-esteem para karyawannya agar visi dan misi serta tujuan perusahaan sesuai yang ditargerkan. Dalam suatu organisasi, instansi ataupun perusahaan terdapat karyawan yang bervariasi, baik dari segi usia, jenis kelamin (gender), tingkat pendidikan dan status keluarga. Kemampuan berpengalaman atau menyesuaikan diri dengan lingkungan kerja suatukeharusan yang harus dimiliki oleh individu. Dalam perusahaan, adaptabiltas karir tentulah bukan pekerjaan yang sederhana, apalagi jika perusahaan tersebut memiliki banyak karyawan dengan jumlah besar dengan berbagai latar belakang budaya, usia, dan pendidikan yang berbeda (Rakhmawati, 2017). Pada PT. Bank Sumut Syariah KC Kota Padangsidempuan terdapat beragam perbedaan antara karyawan baik dari segi usia, pendidikan, maupun dari segi pangkat dan jabatan. Karyawan merupakan salah satu asset dari setiap perusahaan, dimana ketika kinerja karyawan meningkat, maka akan meningkatkan produktivitas terhadap perusahaan dan begitu pula sebaliknya, ketika kinerja karyawan menurun, maka aka menurunkan produktivitas perusahaan tersebut. Setiap karyawan pasti menginginkan peningkatan kedudukan pangkat dan jabatan (jenjang karir) didalam suatu perusahaan, ketika mendapatkan promosi untuk kenaikan jabatan tentunya merupakan penghargaan terhadap kinerja yang telah individu lakukan. Dalam memasuki perkembangan karir dibutuhkan suatu proses adaptabilitas karir yang dipergunakan untung menunjang suatu kinerja. Penting disini ialah kesiapan seseorang untuk mengatasi tugas tugas yang ada dan suatu peran untuk berpartisipasi dalam lingkup kerja, penyesuaian terhadap perubahan yang akan terjadi pada lingkungan pekerjaan. Seseorang yang sukses dalam mengatasi transisi tersebut maka akan dapat mengembangkankinerja nyajuga,kinerjamerupakanhal yangberkaitandenganadaptabilitas karir. Kinerja adalah hasil kerja secara kualitas dan kuantitas yang dicapai oleh seorang karyawan dalam melaksanakan tugasnya sesuai tanggung jawab yang diberikan kepadanya. Karyawan mengharapkan adanya lingkungan kerja yang nyaman, yang bisa memanjakan karyawan dalam bekerja. Kemudian jika lingkungan tidak sehat dan nyaman akan menurunkan tingkat produktivitas maupun moral karyawan sehingga mempengaruhi tujuan perusahaan. Kinerja pegawai yang tinggi sangatlah diharapkan oleh perusahaan, semakin banyak karyawan yang memiliki kinerja tinggi, maka produktivitas perusahaan secara menyeluruh akan dapat bertahan dalam persaingan global. Setiap karyawan dituntut untuk mampu menyelesaikan tugas dan tanggung jawabnya secara efektif dan efisien. Menurut Eisenberger et al dalam (Febrianti, 2019) Perceived Organizational Support (POS) akan dipengaruhi oleh berbagai aspek cara perlakuan organisasi untuk karyawannya yang akan mempengaruhi interprestasi karyawan akan motif organisasi yang akan mendasari perlakuan tersebut, menandakan bahwa karyawan berharap untuk mendapat dukungan organisasi dalam berbagai macam situasi. Menurut Ketua Pembina Yayasan Lembaga Konsumen Indonesia (YLKI), Zumrotin K. Soesilo, menilai tingkat stres karyawan jasa keuangan perbankan cukup tinggi. (Adiwijaya, 2014) Hal ini berkaitan ketika karyawan mendapat tuntutan untuk terus meningkatkan kinerja mereka pada bidang pekerjaan mereka untuk mencapai tujuan dari perusahaan. Adaptasi karir berhubungan langsung dengan fleksibilitas, daya saing dan pengembangan perusahaan atau organisasi. Begitu juga dengan self-esteem dimana mengacu pada tinggi rendahnya kemampuan pada diri seorang individu. METODEPENELITIAN Metode penelitian merupakan serangkaian kegiatan dalam mencari kebenaran suatu studi penelitian, yangdiawali dengan suatu pemikiran yangmembentuk rumusan masalah sehingga menimbulkan hipotesis awal, dengan dibantu dan persepsi penelitian terdahulu (Sahir, 2021). Penelitian ini menggunakan jenis penelitian kausalitas yang ingin menganalisis pengaruh variabel self-esteem dan adaptabilitas karir terhadap variabel terikat kinerja karyawan melalui variabel mediasi yaitu perceived organizational support dengan menggunakan pendekatan kuantitatif, dimana jenis pendekatan ini adalah penelitian yang berfokus terhadap bagian pengukuran dengan objektif pada peristiwa sosialnya. Dalam melaksanakan pengukuran tersebut, masing-masing peristiwa atau kejadian dijabarkan dalam berbagai bagian permasalahan, variabel serta indikator. (Rahmani,2016). HASIL DAN PEMBAHASAN Uji Validitas Hasil Uji Validitas Self-esteem (X1) Pernyataan rhitung rtabel 5% Keterangan X1.1 0,541 0,3494 Valid X1.2 0,519 0,3494 Valid X1.3 0,530 0,3494 Valid X1.4 0,785 0,3494 Valid Sumber : Hasil data kuesioner yang diolah dengan SPSS versi 22 Berdasarkan tabel tersbut hasil uji validitas harapan Self-esteem diatas, menunjukkan bahwa setiap item pernyataan memiliki nilai rhitung yang lebih besar dari nilai rtabel. Maka dinyatakan setiap item pernyataan dari variabel self esteem adalah valid dan layak digunakan sebagai alat untuk mengukur objek yang diteliti. Hasil Uji Validitas Adaptabilitas Karir (X2) Pernyataan rhitung rtabel 5% Keterangan X1.1 0,775 0,3494 Valid X2.2 0,824 0,3494 Valid X3.3 0,704 0,3494 Valid X4.4 0,755 0,3494 Valid Sumber : Hasil data kuesioner yang diolah dengan SPSS versi 22 Berdasarkan tabel tersebut hasil uji validitas Adaptabilitas Karir diatas, menunjukkan bahwa setiap item pernyataan memiliki nilai rhitung yang lebih besar dari nilai rtabel. Maka dinyatakan setiap item pernyataan dari variabel adaptabilitas karir adalah valid dan layak digunakan sebagai alat untuk mengukur objek yang diteliti. Hasil Uji Validitas Kinerja (Y) Pernyataan rhitung rtabel 5% Keterangan Y1 0,483 0,3494 Valid Y2 0,518 0,3494 Valid Y3 0,742 0,3494 Valid Y4 0,436 0,3494 Valid Sumber : Hasil data kuesioner yang diolah dengan SPSS versi 22 Berdasarkan tabel tersebut hasil uji validitas Kinerja diatas, menunjukkan bahwa setiap item pernyataan memiliki nilai rhitung yang lebih besar dari nilai rtabel. Maka dinyatakan setiap item pernyataan dari variabel Kinerja adalah valid dan layak digunakan sebagai alat untuk mengukur objek yang diteliti. Hasil Uji Validitas Perceived Organizational Support (Z) Pernyataan rhitung rtabel 5% Keterangan Z1 0,644 0,3494 Valid Z2 0,648 0,3494 Valid Z3 0,744 0,3494 Valid Z4 0,533 0,3494 Valid Sumber : Hasil data kuisioner yang diolah dengan SPSS versi 22 Berdasarkan tabel tersebut hasil uji validitas Perceived Organizational Supportdiatas, menunjukkan bahwa setiap item pernyataan memiliki nilai rhitung yang lebih besar dari nilai rtabel. Maka dinyatakan setiap item pernyataan dari variabel Perceived Organizational Support adalah valid dan layak digunakan sebagai alat untuk mengukur objek yang diteliti. Uji Realibilitas. Hasil Uji Reliabilitas Variabel Cronbach’s Alpha Koefisien Alpha Keterangan Self esteem 0,708 0,60 Reliabel Adaptabilitas Karir 0,745 0,60 Reliabel Kinerja 0,682 0,60 Reliabel Perceived Organizational Support 0,734 0,60 Reliabel Sumber : Hasil data kuesioner yang diolah dengan SPSS versi 22 Berdasarkan tabel tersebut hasil uji reabilitas diatas menunjukkan bahwa semua data reliabel. Uji Asumsi Klasik Uji Normalitas Hasil pengujian normalitas data dapat dilihat dalam tabel berikut : Hasil Uji Normalitas Persamaan Substruktur Pertama One-Sample Kolmogorov-Smirnov Test Unstandardized Residual N 30 Normal Parametersa,b Mean .0000000 Std. Deviation 1.68623897 Most Extreme Differences Absolute .093 Positive .072 Negative -.093 Test Statistic .093 Asymp. Sig. (2-tailed) .200c,d a. Test distribution is Normal. b. Calculated from data. c. Lilliefors Significance Correction. d. This is a lower bound of the true significance. Hasil data kuesioner yang diolah dengan SPSS versi 22 Berdasarkan tabel tersebut hasil uji normalitas diatas dapat dilihat bahwa antara variabel independen dan variabel dependen dalam penelitian ini dinyatakan memiliki distribusi normal. Hasil Uji Normalitas Persamaan Substruktur Pertama Hasil data kuesioner yang diolah dengan SPSS versi 22 Pada gambar tersebut diatas merupakan hasil uji normalitas dengan metode probability plot. Dari gambar hasil uji normalitas diatas dapat dilihat bahwa titik menyebar di sekitar garis diagonal dan mengikuti arah garis diagonal. Dari ciri-ciri tersebut maka dapat dinyatakan bahwa model regresi tersebut berdistribusi normal. Hasil Uji Normalitas Persamaan Substruktur Kedua One-Sample Kolmogorov-Smirnov Test Unstandardized Residual N 30 Normal Parametersa,b Mean .0000000 Std. Deviation 1.73531352 Most Extreme Differences Absolute .121 Positive .121 Negative -.094 Test Statistic .121 Asymp. Sig. (2-tailed) .200c,d a. Test distribution is Normal. b. Calculated from data. c. Lilliefors Significance Correction. d. This is a lower bound of the true significance. Hasil data kuesioner yang diolah dengan SPSS versi 22 Berdasarkan tabel tersebut hasil uji normalitas diatas dapat dilihat bahwa antara variabel independen dan variabel dependen dalam penelitian ini dinyatakan memiliki distribusi normal. Hasil Uji Normalitas Persamaan Substruktur Kedua Hasil data kuesioner yang diolah dengan SPSS versi 22 Pada gambar tersebut diatas merupakan hasil uji normalitas dengan metode probability plot. Dari gambar hasil uji normalitas diatas dapat dilihat bahwa titik menyebar di sekitar garis diagonal dan mengikuti arah garis diagonal. Dari ciri-ciri tersebut maka dapat dinyatakan bahwa model regresi tersebut berdistribusi normal. Uji Multikolinieritas Hasil Uji Multikolinieritas Persamaan Substruktur Pertama Coefficientsa Model Collinearity Statistics Tolerance VIF 1 (Constant) Self esteem .881 1.135 Adaptabilitas Karir .881 1.135 a. Dependent Variable: Perceived Organizational Support Hasil data kuesioner yang diolah dengan SPSS versi 22 Hasil uji multikolinieritas untuk persamaan substruktur pertama mempunyai nilai VIF sebesar 1,135 < 10 dan nilai tolerance 0,881 > 0,10. Sehingga dapat disimpulkan bahwa persamaan pertama ini tidak terjadi gejala multikolinieritas. Uji multikilieritas untuk substruktur kedua bisa dilihat pada tabel berikut : Hasil Uji Multikolinieritas Persamaan Substruktur Kedua Coefficientsa Model Collinearity Statistics Tolerance VIF 1 (Constant) Self esteem .866 1.154 Adaptabilitas Karir .789 1.267 Perceived Organizational Support .843 1.187 a. Dependent Variable: Kinerja Hasil data kuesioner yang diolah dengan SPSS versi 22 Hasil uji multikolinieritas untuk substruktur kedua mempunyai nilai VIF untuk self esteem sebesar 1,154 < 10 dan nilai tolerance 0,866 > 0,10, untuk adaptabilitas karir nilai VIF 1,267 < 10 dan nilai tolerance 0,789 > 0,10, untuk perceived organizational support nilai VIF 1,187 < 10 dan nilai tolerance 0,843 > 10, sehingga dapat disimpulkan bahwa persamaan kedua ini terbebas gejala multikolieritas. Uji Heterokedastisitas Uji heterokedasititas bertujuan untuk menguji apakah dalam model regresi terjadi ketidaksamaan variance dari residual suatu pengamatan ke pengamatan yang lain. Uji Heterokedastisitas Persamaan Substruktur Pertama Penelitian ini menggunakan uji heterokedastisitas dengan diagram pancar (scatter plot) dengan menggunakan alat bantu SPSS. Uji diagram pancar menghasilkan gambar berikut : Hasil Uji Heterokedastisitas Substruktur Pertama Hasil data kuesioner yang diolah dengan SPSS versi 22 Gambar diatas merupakan hasil uji heterokedasitas dengan metode Scatterplot. Dari gambar hasil uji heterokedasitas diatas dapat dilihat bahwa titik – titik menyebar diatas dan dibawah, titik – titik juga tidak mengumpul saja dan penyebaran titik – titik data terlihat tidak membentuk pola. Dari ciri – ciri itu maka dapat disimpulkan bahwa tidak terjadi heteroskedastisitas. Hasil Uji Heterokedastisitas Substruktur Pertama Coefficientsa Model Unstandardized Coefficients Standardized Coefficients T Sig. B Std. Error Beta 1 (Constant) -1.001 1.125 -.890 .381 Self esteem .137 .077 .337 1.777 .087 Adaptabilitas Karir .028 .058 .093 .491 .627 a. Dependent Variable: Abs_res1 Sumber : Hasil data kuesioner yang diolah dengan SPSS versi 22 Berdasarkan tabel hasil uji heterokedasitas diatas dapat dilihat bahwa semua variabel tidak terjadi heteroskedastisitas karena setiap variabel memiliki nilai signifikan lebih dari 0,05 sebagai berikut : Variabel Self esteem memiliki nilai signifikan 0,087 > 0,05. Variabel adaptabilitas karir memiliki nilai signifikan 0,627 > 0,05 Uji Heterokedastisitas Persamaan Substruktur Kedua Penelitian ini menggunakan uji heterokedastisitas dengan diagram pancar (scatter plot) dengan menggunakan alat bantu SPSS. Uji diagram pancar menghasilkan gambar berikut : Hasil Uji Heterokedastisitas Substruktur Kedua Sumber : Hasil data kuesioner yang diolah dengan SPSS versi 22 Gambar diatas merupakan hasil uji heterokedasitas dengan metode Scatterplot. Dari gambar hasil uji heterokedasitas diatas dapat dilihat bahwa titik – titik menyebar diatas dan dibawah, titik – titik juga tidak mengumpul saja dan penyebaran titik – titik data terlihat tidak membentuk pola. Dari ciri – ciri itu maka dapat disimpulkan bahwa tidak terjadi heteroskedastisitas. Hasil Uji Heterokedastisitas Substruktur Kedua Coefficientsa Model Unstandardized Coefficients Standardized Coefficients t Sig. B Std. Error Beta 1 (Constant) 2.125 1.659 1.281 .211 Self esteem .141 .084 .301 1.686 .104 Adaptabilitas Karir -.192 .066 -.549 -2.931 .107 Perceived Organizational Support -.004 .116 -.007 -.037 .971 a. Dependent Variable: Abs_res2 Sumber : Hasil data kuesioner yang diolah dengan SPSS versi 22 Berdasarkan tabel hasil uji heterokedasitas diatas dapat dilihat bahwa semua variabel tidak terjadi heteroskedastisitas karena setiap variabel memiliki nilai signifikan lebih dari 0,05 sebagai berikut : Variabel Self esteem memiliki nilai signifikan 0,104> 0,05. Variabel adaptabilitas karir memiliki nilai signifikan 0,107> 0,05 Variabel Perceived Organizational Support memiliki nilai signifikan 0,971 > 0,05 Uji Hipotesis Analisis jalur merupakan perluasan dari analisis regresi berganda, atau dengan kata lain analisis jalur adalah penggunaan analisis regresi untuk menaksir hubungan kausalitas antar variabel yang telah ditetapkan sebelumnya berdsarkan teori. Analisis Jalur Persamaan Substuktur Pertama Persamaan Substuktur Pertama dalam model penelitian ini adalah untuk mengetahui dan menganalisis pengaruh secara positif dan signifikan Self esteem Uji F (Uji Serempak) Hasil Uji F (Serempak ANOVAa Model Sum of Squares df Mean Square F Sig. 1 Regression 17.872 3 5.957 335.828 .000b Residual 87.328 26 3.359 Total 105.200 29 a. Dependent Variable: Perceived Organizational Support b. Predictors: (Constant), ,Adaptabilitas Karir, Self esteem Sumber : Hasil data kuesioner yang diolah dengan SPSS versi 22 Hasil uji F pada tabel tersebut menunjukkan bahwa nilai F hitung substruktur pertama ialah sebesar 335,828 dengan nilai signifikan yaitu 0,000. Kemudian diperoleh Ftabel = 3,340. Nilai probabilitas 0,000 lebih kecil dari 0,05 sehingga hipotesis diterima. Dilihat dari nilai Fhitung (335,828) > Ftabel 3,340. Berarti self esteem (X1) dan Adaptabilitas Karir (X2) berpengaruh secara serempak terhadap Perceived Organizational Support (Z). Uji t (Uji Parsial Uji t substruktur pertama pada tabel berikut Hasil Uji t (Uji Parsial) Coefficientsa Model Unstandardized Coefficients Standardized Coefficients T Sig. B Std. Error Beta 1 (Constant) 9.780 2.011 4.863 .000 Self esteem .094 .138 .128 2.681 .001 Adaptabilitas Karir .183 .103 .334 1.774 .000 a. Dependent Variable: Perceived Organizational Support Sumber : Hasil data kuesioner yang diolah dengan SPSS versi 22 Hasil uji t pada tabel tersebut untuk substruktur pertama Self Esteem Hipotesis yang akan diuji adalah hipotesis pertama yang menyatakan self esteem berpengaruh positif dan signifikan terhadap perceived organizational support pada PT. Bank Sumut Syariah KC Kota Padangsidempuan. Hasil uji t menunjukkan nilai sig sebesar 0,001 lebih kecil dari 0,05. Jika dilihat dari nilai thitung sebesar 2,681 sedangkan nilai ttabel sebesar 1.701. nilai thitung> ttabel . sehingga berdasarkan nilai signifikan dan nilai t hitung hipotesis self esteem berpengaruh terhadap signifikan terhadap perceived organizational support diterima. Besarnya pengaruh self esteem (X1) terhadap perceived organizational support (Z) dapat diketahui dengan besar koefisien 0,128. Hasil ini menunjukkan bahwa jika semakin baik self esteem yang dimiliki karyawan maka hubungan dengan PT. Bank Sumut Syariah KC Kota Padangsidempuan berjalan lancar. Adaptabilitas karir Hipotesis yang akan diuji adalah hipotesis kedua yang menyatakan adaptabilitas karir berpengaruh positif dan signifikan terhadap perceived organizational support pada PT. Bank Sumut Syariah KC Kota Padangsidempuan. Hasil uji t menunjukkan nilai sig sebesar 0,000 lebih kecil dari 0,05. Jika dilihat dari nilai t diperoleh nilai t hitung sebesar 1,774 sedangkan nilai tabel sebesar 1.701. nilai thitung> ttabel sehingga berdasarkan nilai signifikan dan nilai t hitung hipotesis adaptabilitas karir berpengaruh terhadap signifikan perceived organizational support diterima. Besarnya adaptabilitas karir (X2) terhadap perceived organizational support (Z) dapat diketahui dengan besar koefisien 0,103. Nilai ini menunjukkan setiap kenaikan adaptabilitas karir akan menyebabkan kenaikan perceived organizational support sebesar 0,103 satuan. Hasil ini menunjukkan bahwa karyawan mampu memikirkan karir nya secara matang sebab bekerja di PT. Bank Sumut Syariah memberikan berupa reward kepada karyawan nya sehingga hasilnya signifikan. Koefisien determinasi (R Square) Nilai koefisien determinasi pada substruktur pertama dapat dilihat pada tabel berikut Nilai koefisien Determinasi (R2) Model Summary Model R R Square Adjusted R Square Std. Error of the Estimate 1 .924a .854 .851 3,388 a. Predictors: (Constant), Adaptabilitas Karir, Self esteem Nilai koefisien determinasi yang sudah disesuaikan adalah nilai adjusted R Square sebesar 0,854 pada substruktur pertama yang berarti bahwa 84,4% variabel perceived organizational support (Z) dapat dijelaskan oleh variabel Self esteem (X1) dan Adaptabilitas karir (X2). Sedangkan sisanya sebesar 14,6% dipengaruhi oleh faktor lain yang tidak diteliti dalam penelitian ini. Analisis jalur persamaan substuktur kedua Hasil Uji F (Serempak) Persamaan Substruktur Kedua ANOVAa Model Sum of Squares df Mean Square F Sig. 1 Regression 17.872 3 11.957 4.774 .003b Residual 87.328 26 3.359 Total 105.200 29 a. Dependent Variable: Kinerja b. Predictors: (Constant), Perceived Organizational Support, Self esteem, Adaptabilitas Karir Hasil uji F pada tabel tersebut menunjukkan bahwa nilai F hitung substruktur pertama ialah sebesar 335,828 dengan nilai signifikan yaitu 0,000. Kemudian diperoleh Ftabel = 2,975. Nilai probabilitas 0,003 lebih kecil dari 0,05 sehingga hipotesis diterima. Dilihat dari nilai Fhitung (4.774) > Ftabel 2,975. Hipotesis self esteem, adaptabilitas karir dan perceived organizational support berpengaruh secara serempak terhadap Kinerja karyawan. 2) Uji t (Uji Parsial) Uji t (Uji Parsial) substruktur kedua pada tabel berikut : Hasil uji T (Uji Parsial) Substruktur Kedua Coefficientsa Model Unstandardized Coefficients Standardized Coefficients T Sig. B Std. Error Beta 1 (Constant) 8.624 2.889 .986 .006 Self esteem .079 .146 .103 5.938 .003 Adaptabilitas Karir .128 .114 .226 3.121 .038 Perceived Organizational Support .221 .202 .213 6.094 .000 a. Dependent Variable: Kinerja Self esteem Uji t untuk melihat pengaruh variabel independen terhadap dependen secara parsial. Hipotesis yang akan diuji adalah hipotesis ketiga yang menyatakan self esteem berpengaruh positif dan signifikan terhadap kinerja karyawan PT. Bank Sumut Syariah KC Kota Padangsidempuan. Hasil uji t menuhnjukkan nilai sig sebesar 0,003 < 0,05. Jika dilihat dari nilai t diperoleh nilai t hitung sebesar 5,938 sedangkan nilai t tabel sebesar 1,706. thitung> ttabel sehingga berdasarkan nilai signifikan dan nilai t hitung hipotesis yang menyatakan self esteem berpengaruh terhadap signifikan perceived organizational support diterima. Besarnya pengaruh self esteem terhadap Kinerja (Y) dapat diketahui dengan besar koefisien 0,103. Nilai ini menunjukkan setiap tingginya self esteem seseorang maka akan meningkat nya kinerja sebesar 0,103 satuan. Hasil ini menunjukkan bahwa semakin tinggi self esteem karyawan maka akan meningkatkan kinerja nya terhadap perusahaan, yaitu PT. Bank Sumut Syariah KC Kota Padangsidempuan. Adaptabilitas karir Hipotesis yang akan diuji adalah hipotesis yang keempat menyatakan adaptabilitas karir berpengaruh positif dan signifikan terhadap kinerja karyawan pada PT. Bank Sumut Syariah KC Kota Padangsidempuan. Hasil uji t menunjukka nilai sig sebesar 0,038 lebih kecil dari 0,05. Jika dilihat dari nilai t diperoleh nilai t hitung sebesar 3,121 sedangkan nilai tabel sebesar 0,103. Nilai . thitung> ttabel sehingga berdasarkan nilai signifikan dan nilai t hitung hipotesis yang menyatakan adaptabilitas karir berpengaruh terhadap kinerja karyawan diterima. Besarnya pengaruh adaptabilitas karir (X2) terhadap kinerja (Y) dapat diketahui dengan besar koefisien 0,226. Nilai ini menunjukkan setiap kenaikan adaptabilitas karir akan menyebabkan kenaikan kinerja sebesar 0,226 satuan. Hasil ini menunjukkan bahwa jika karir masa depan yang diberikan oleh PT. Bank Sumut Syariah KC Kota Padangsidempuan meningkatkan kinerja. Perceived Organizational Support Hipotesis yang akan diuji adalah hipotesis kelima yang menyatakan perceived organizational support berpengaruh positif dan signifikan terhadap kinerja karyawan di PT. Bank SUMUT Syariah KC Kota Padangsidempuan. Hasil uji t menunjukkan nilai sig sebesar 0,000 lebih kecil dari 0,05. Jika dilihat dari nilai t yang diperoleh nilai t hitung sebesar 6,094 sedangkan nilai tabel sebesar 0,103. Nilai thitung> ttabel sehingga berdasarkan nilai signifikan dan nilai t hitung hipotesis yang menyatakan perceived organizational support berpengaruh dan signiifikan terhadap kinerja karyawan diterima. Besarnya pengaruh perceived organizational support (Z) terhadap Kinerja (Y) dapat diketahui dengan besar koefisien 0,213. Nilai ini menunjukkan setiap kenaikan perceived organizational support akan menyebabkan kenaikan pada Kinerja sebesar 0,213 satuan. Hasil ini menunjukkan bahwa jika semakin baik perceived organizational support yang diberikan oleh PT Bank Sumut Syariah KC Kota Padangsidempuan maka Kinerja karyawan akan semakin tinggi dengan signifikan. Koefisien determinasi (R Square) Hasil Uji Koefisien Determinasi (R2) Model Summary Model R R Square Adjusted R Square Std. Error of the Estimate 1 .912a .970 .974 1.832 a. Predictors: (Constant), Perceived Organizational Support, Self esteem, Adaptabilitas Karir Nilai koefisien determinasi yang suda disesuaikan (adjusted R Square) berdasarkan tabel diatas sebesar 0,912 yang berarti bahwa 91,2% variabel Kinerja (Y) dapat dijelaskan oleh variabel Self esteem (X), adaptabilitas karir (X2) dan Perceived Organizational support (Z). sedangkan sisanya 1,8% dijelaskan oleh sebab sebab lain diluar mdel atau variabel yang digunakan. Pengaruh Tidak Langsung (Indirect Effect) Pada penelitian ini terdapat pengaruh tidak langsung variabel independen terhadap dependen terdiri dari : Pengaruh self esteem terhadap kinerja karyawan melalui perceived organizational support Hipotesis yang akan diuji adalah hipotesis keenam yaitu self esteem berpengaruh positif dan signifikan terhadap kinerja karyawan melalui perceived organizational support pada PT. Bank Sumut Syariah KC Kota Padangsidempuan. Berdasarkan hasil pengujian koefisien jalur pada persamaan pertama dan kedua menunjukkan pengaruh self esteem terhadap kinerja karyawan melalui perceived organizational support, dimana pengaruh tersebut ditunjukkan hasil perkalian antara pengaruh self esteem yaitu 0,128 x 0,213 = 0,027264. Hasil ini menunjukkan bahwa pengaruh self esteem terhadap kinerja karyawan melalui perceived organizational support mempunyai pengaruh lebih kecil jika dibandingkan dengan pengaruh lansgung antara self esteem terhadap kinerja yaitu sebesar 0,103. Jika nilai sig < 0,05 maka hipotesis diterima dan jika nilai sig > 0,05 maka hipotesis ditolak. Hasil penelitian hipotesis besarnya pengaruh tidak lansgung didapat hasil perkalian koefisien (p1 x p5), dimana besarnya nilai koefisien (p1 = 0,128) dengan tingkat signifikn 0,000 < 0,005 dan besarnya nilai koefisien (p5 = 0,213) dengan tingkat signifikan 0,002 < 0,005 jadi besarnya pengaruh tidak langsung adalah 0,128 x 0,213 = 0,027264 namun koefisien pengaruh langsung self esteem terhadap kinerja lebih kecil(0,103). Kesimpulan yang diperoleh self esteem berpengaruh positif dan signifikan terhadap kinerja melalui perceived organizational support maka hipotesis ditolak. Pengaruh adaptabilitas karir terhadap kinerja melalui perceived organizational support Hipotesis yang akan diuji adalah hipotesis ketujuh yaitu adaptabilitas karir berpengaruh positif dan signifikan terhadap kinerja karyawan melalui perceived organizational support pada PT. Bank Sumut Syariah KC Kota Padangsidempuan. Berdasarkan hasil pengujian koefisien jalur pada persamaan pertama dan kedua menunjukkan pengaruh self esteem terhadap kinerja karyawan melalui perceived organizational support, dimana pengaruh tersebut ditunjukkan hasil perkalian antara pengaruh self esteem yaitu 0,334 x 0,213 = 0,071142. Hasil ini menunjukkan bahwa pengaruh adaptabilitas karir terhadap kinerja karyawan melalui perceived organizational support mempunyai pengaruh lebih kecil jika dibandingkan dengan pengaruh lansgung antara adaptabilitas karir terhadap kinerja yaitu sebesar 0,226. Pengaruh langsung dan tidak langsung variabel independen terhadap variabel dependen dapat dilihat pada gambar berikut 0,103 0,128 e1 = 0,3820 0,334 Pembahasan hasil penelitian Pengaruh Langsung (Dirrect Effect) Pengaruh Self esteem (X1)terhadap Kinerja (Y) pada karyawan Bank Sumut Syariah KC Kota Padangsidempuan Berdasarkan hasil penelitian ini, dapat diketahui bahwa self esteem berpengaruh positif dan signifikan terhadap kinerja karyawanPT. Bank Sumut Syariah KC Kota Padangsidempuan. Berdasarkan hasil path analysis Dimana self esteemmemiliki dengan tingkat signifikan 0,000< 0,05. Dengan demikian dapat diambil kesimpulan jika seseorang yang merasa dirinya begitu berharga dan berarti cenderung untuk melakukan yang terbaik dalam setiap tugas dan tanggung jawabnya baik sebagai anggota atau individual. Hasil penelitian ini sesuai dengan hasil penelitian yang dilakukan oleh (Widyasturi & Robert, 2020) menyatakan self esteem berpengaruh positif dan signifikan terhadap kinerja karyawan. Self esteem adalah penghargaan akan dirinya sendiri. Penilaian ini bisa positif maupun negative. Karyawan yang bisa menilai dirinya secara positif maka akan kepercayaan dan kemampuan dirinya meningkat, berani memutuskan sebuah perhitungan dengan cermat, dan sebaliknya jika karyawan yang memiliki self esteem rendah akan menimbulkan kecemasan dan keraguan akan dirinya yang justru menghambat atau penurunan kinerja. Dalam hal ini, karyawan yang memiliki self esteem tinggi, maka kinerja nya akan meningkat. Pengaruh Adaptabilitas Karir (X2) Terhadap Kinerja (Y) Pada PT. Bank Sumut Syariah KC Kota Padangsidempuan. Berdasarkan hasil penelitian ini, dapat diketahui bahwaadaptabilitas karir beerpengaruh positif dan signifikan terhadap kinerja karyawan PT. Bank Sumut Syariah KC Kota Padangsidempuan. Berdasarkan hasil path analysis adaptabilitas karir memiliki dengan tingkat signifikan 0,0132 < 0,05. Dengan demikian semakin tinggi adaptabilitas karir maka kinerja karyawan juga semakin meningkat. Hal ini dikarenakan tingkat pekerjaan telah memenuhi harapan setiap karyawan nya. Temuan tersebut didukung dengan hasil kuisioner yang memperlihatkan tingkat optimis karyawan untuk masa depan mereka karena beranggapan pemimpin akan melakukan peningkatan secara adil berdasarkan potensi dan kinerja karyawan tersebut, meningkatkan karir untuk menunjang masa depan sangat penting maka dari itu bimbingan serta memberikan reward dari perusahaan itu perlu. Karyawan selalu memahami dan mengenali dirinya mengenai passion yang akan menunjang karir yang telah disusun secara disiplin dan bertanggung jawab. Sehingga proses selama ini mampu memberikan hasil yang baik. Penelitian ini didukung oleh (Dewi Lestari, 2021) adaptabilitas karir memiliki efek positif dan signifikan terhadap kinerja karyawan. Pengaruh self esteem (X1) terhadap Perceived Organizational Support (Z) Berdasarkan hasil penelitian ini, dapat diketahui bahwaself esteem beerpengaruh positif dan signifikan terhadap Perceived Organizational Support . Berdasarkan hasil path analysis self esteem memiliki dengan tingkat signifikan 0,000 < 0,05. Dengan demikian karyawan yang menilai diri mereka sebagai individu yang penting dan berharga akan membuat karyawan merasa perusahaan menyatu dalam kehidupannya. Hal ini tentunya akan membuat karyawan untuk tetap tinggal bekerja dan bergabung dengan perusahaan. Dalam penelitian yang dilakukan oleh (Dwitasari et al, 2018) sebanyak 200 orang memiliki nilai yang cenderung tinggi pada aspek perceived organizational support. Nilai tersebut menunjukkan bahwa banyak subjek yang merasakan adanya dukungan dari perusahaan. Dan dari penelitian penulis adanya tunjangan yang diberikan atasan dan anggapan karyawan bahwa mereka mampu melakukan suatu pekerjaan dengan baik, membuat karyawan akan bekerja secara maksimal untuk mendapatkan hasil yang memuaskan, merasa mampu bekerja sama dengan rekan kerja dan atasan, dan berperan aktif dalam suatu pekerjaan atau tugas. Pengaruh adaptabilitas karir (X2) terhadap Perceived Organizational Support (Z) Berdasarkan hasil penelitian ini, dapat diketahui bahwaadaptabilitas karir beerpengaruh positif dan signifikan terhadap Perceived Organizational Support. Berdasarkan hasil path analysis adaptabilitas karir memiliki dengan tingkat signifikan 0,033 < 0,05. Dengan demikian bisa ditarik kesimpula

Objectives: We have previously reported that brachial-ankle PWV (baPWV) is more strongly related to lipoprotein subclasses than carotid-femoral PWV (cfPWV) among middle-aged white men. The current study examined the associations of baPWV, cfPWV and femoral ankle PWV (faPWV) with lipoprotein subclasses in Japanese Americans, Koreans, and Whites. Methods: The ERA JUMP Study is an international population-based study of subclinical atherosclerosis in men aged 40-49 without clinical CVD in the US, Korea, Hawaii and Japan. Participants for the current study were 310 whites, 303 Japanese Americans and 302 Koreans. PWV was assessed using an automated waveform analyzer (VP2000, Omron, Japan). Lipoprotein subclasses were assessed by NMR lipoproteins. Multiple linear regressions were performed to analyze the association of each PWV with NMR lipoprotein distributions after adjusting for age, body mass index, systolic blood pressure, and other potential confounders. Results: Both baPWV and faPWV had significant association with total, large, and small LDL-P after adjusting for race and other confounders, and across three racial groups except for faPWV in whites ( Table ). cfPWV had also significant associations with total and small LDL-P after adjusting for race and other confounders but these associations were weaker than those with baPWV and faPWV. Similarly, both baPWV and faPWV had significant associations with VLDL-P (total, large and small VLDL-P) and HDL-P (total, large, medium, and small HDL-P) but the associations of cfPWV with these lipoproteins were weaker and mostly non-significant. Conclusions: As compared to cfPWV, both baPWV and faPWV had stronger associations with lipoprotein distributions across three racial groups with very different lifestyle. Our results suggest that baPWV and faPWV are more related to atherosclerosis than cfPWV whereas cfPWV may represent arteriosclerosis. Table 1. Association between LDL subclasses(LDL-P) and carotid-femoral, brachial-ankle and femoral-ankle pulse wave velocities among young men in Korea, Hawaii and North America: Multiple linear regression derived beta (β) values (SE) @ Large LDL Small LDL Total LDL Particles cfPWV All participants $ −0.074 (.050) 0.405 (.204) * 0.152 (.072) * Whites −0.045 (.081) 0.442 (.309) 0.197 (.094) * Koreans −0.179 (.084) * 1.143 (.375) ** 0.337 (.140) * Japanese Americans 0.060 (.98) 0.064 (.361) 0.016 (.151) faPWV All participants $ −0.252 (.067) *** 1.201 (.264) *** 0.331 (.099) *** Whites 0.007 (.100) 0.368 (.389) 0.165 (.122) Koreans −0.252 (.113) * 1.609 (.502) ** 0.472 (.189) * Japanese Americans −0.501 (.152) ** 2.266 (.552) *** 0.698 (.225) ** baPWV All participants $ −0.310 (.053) *** 1.334 (.210) *** 0.404 (.075) *** Whites −0.212 (.108) * 1.220 (.415) ** 0.425 (.131) ** Koreans −0.245 (.079) ** 1.398 (.351) *** 0.493 (.126) *** Japanese Americans −0.194 (.098) * 1.132 (.357) ** 0.392 (.143) ** * p<0.05, ** p<0.01, *** p<0.001 # After excluding participants with diabetes mellitus, and those taking medicines for diabetes mellitus, hypertension and hyperlipidemia, number of participants were 248 Whites, 262 Koreans and 192 Japanese Americans. @ Adjusted for age, systolic blood pressure, body mass index, fasting glucose, pack-years smoking, alcohol intake and LDL cholesterol. $ Additionally adjusting for race.

AbstractSeveral studies provide evidence of the importance of future time perspective (FTP) for individual success. However, little research addresses the relationship between FTP and personality traits, particularly if FTP can mediate their influence on behavior. In this study we analyze the mediating of FTP in the influence of personality traits on the way adolescents live their life at school. Sample consisted in 351 students, aged from 14 to 18 years-old, at different schooling levels. Instruments were the Portuguese version of the MMPI-A, particularly the PSY-5 dimensions (Aggressiveness, Psychoticism, Disconstraint, Neuroticism, Introversion), a FTP questionnaire, and a survey on school life, involving several indicators of achievement, social integration, and overall satisfaction. With the exception of Neuroticism, the results show significant mediation effects (p < .001) of FTP on most relationships between PSY-5 dimensions and school life variables. Concerning Disconstraint, FTP mediated its influence on overall satisfaction (β = –.125) and school achievement (β = –.106). In the case of Introversion, significant mediation effects occurred for interpersonal difficulties (β = .099) and participation in extracurricular activities (β = –.085). FTP was also a mediator of Psychoticism influence in overall satisfaction (β = –.094), interpersonal difficulties (β = .057), and behavior problems (β = .037). Finally, FTP mediated the influence of Aggressiveness on overall satisfaction (β = –.061), interpersonal difficulties (β = .040), achievement (β = –.052), and behavior problems (β = .023). Results are discussed considering the importance of FTP in the impact of some personality structural characteristics in students’ school adaptation.

BackgroundIt is unknown whether endovascular thrombectomy (EVT) is cost effective in large ischemic core infarcts.MethodsIn the prospective, multicenter, cohort study of imaging selection study (SELECT), large core was defined as computed tomography (CT) ASPECTS<6 or computed tomography perfusion (CTP) ischemic core volume (rCBF<30%) ≥50 cc. A Markov model estimated costs, quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER) of EVT compared with medical management (MM) over lifetime. The willingness to pay (WTP) per QALY was set at $50 000 and $100 000 and the net monetary benefits (NMB) were calculated. Probabilistic sensitivity analysis (PSA) and cost-effectiveness acceptability curves (CEAC) for EVT were assessed in SELECT and other pivotal trials.ResultsFrom 361 patients enrolled in SELECT, 105 had large core on CT or CTP (EVT 62, MM 43). 19 (31%) EVT vs 6 (14%) MM patients achieved modified Rankin Scale (mRS) score 0–2 (OR 3.27, 95% CI 1.11 to 9.62, P=0.03) with a shift towards better mRS (cOR 2.12, 95% CI 1.05 to 4.31, P=0.04). Over the projected lifetime of patients presenting with large core, EVT led to incremental costs of $33 094 and a gain of 1.34 QALYs per patient, resulting in ICER of $24 665 per QALY. EVT has a higher NMB compared with MM at lower (EVT -$42 747, MM -$76 740) and upper (EVT $155 041, MM $57 134) WTP thresholds. PSA confirmed the results and CEAC showed 77% and 92% acceptability of EVT at the WTP of $50 000 and $100 000, respectively. EVT was associated with an increment of $29 225 in societal costs. The pivotal EVT trials (HERMES, DAWN, DEFUSE 3) were dominant in a sensitivity analysis at the same inputs, with societal cost-savings of $37 901, $86 164 and $22 501 and a gain of 1.62, 2.36 and 2.21 QALYs, respectively.ConclusionsIn a non-randomized prospective cohort study, EVT resulted in better outcomes in large core patients with higher QALYs, NMB and high cost-effectiveness acceptability rates at current WTP thresholds. Randomized trials are needed to confirm these results.Clinical trial registrationNCT02446587

Abstract Inadequate response to antipsychotic treatment is common in patients with schizophrenia. This study evaluated pimavanserin, a 5-HT2A receptor inverse agonist/antagonist, as adjunctive treatment in patients with inadequate response. This was a 6-week, randomized, double-blind, placebo-controlled, study conducted in North America and Europe. Adult outpatients with schizophrenia and inadequate response to current antipsychotic were enrolled. Inclusion criteria included Positive and Negative Syndrome Scale (PANSS) total score ≥65 and ≤110 and retrospective antipsychotic treatment stability of 8 weeks. Pimavanserin 20 mg/day or placebo added to ongoing antipsychotic was tested in a flexible-dose paradigm with dose adjustments allowed during the first 3 weeks. The primary efficacy endpoint, PANSS total score change from baseline to week 6, was not met, although improvement was greater with pimavanserin than placebo (LS mean difference: –2.1, [95% CI: –4.5, 0.4]; P = .094). As a hierarchical testing procedure was used, additional efficacy analyses were exploratory. Clear separation from placebo was observed with pimavanserin at week 6 for the PANSS Negative Symptoms subscale (LS mean difference: –0.7, [95% CI: –1.5, 0.0]) and Marder Negative Symptom Factor score (–0.9, [–1.7, –0.1]). Analysis of European sites (81.5% of patients) revealed a difference for pimavanserin versus placebo on PANSS total score (LS mean difference: –3.1, [95% CI: –5.8, –0.4]) and Clinical Global Impressions–Severity score (–0.2, [–0.4, –0.0]). Treatment-emergent adverse events occurred in 39.9% with pimavanserin and 36.4% with placebo. Although statistical significance for the primary endpoint was not met, a trend toward improvement in negative symptoms was observed with pimavanserin, warranting further study.

В статье представлены результаты исследования, проведенного с целью определения ранних значимых маркеров метаболического синдрома (МС) на основе неинвазивной визуализации внутренних органов брюшной полости. В исследование были включены 125 человек, 100 человек основной группы были поделены на две подгруппы. I подгруппа – пациенты с нормативными значениями индекса массы тела (ИМТ), но с повышенными показателями коэффициента окружность талии / объем бедер (ОТ/ОБ); II – с повышенными показателями ИМТ и ОТ/ОБ. Контрольная группа составила 25 человек. По данным анализа полученных результатов настоящего исследования была выявлена прямая зависимость между величиной ИМТ, показателем абдоминального ожирения (АО) (ОТ/ОБ) и изменением ультразвуковой эхоструктуры печени, поджелудочной железы, линейными размерами печени и показателем жесткости печеночной ткани. К ранним признакам МС были отнесены: 1. Повышение эхогенности и снижение звукопроводимости структуры печени. 2. Гепатомегалия (увеличение линейных размеров печени: краниовертикальный размер (КВР) (правой доли) более 150 мм, краниокаудальный размер (ККР) (левой доли) более 100 мм, хвостатой доли более 54 мм) была выявлена у 51 человека II подгруппы (40,8%) (р < 0,05). 3. Изменение ультразвуковой структуры содержимого и стенки желчного пузыря, полипоз. 4. Повышение эхогенности ткани поджелудочной железы.

AbstractExposure to air pollution is of great concern for public health although studies on the associations between exposure estimates and personal exposure are limited and somewhat inconsistent. The aim of this study was to quantify the associations between personal nitrogen oxides (NOx), ozone (O3) and particulate matter (PM10) exposure levels and ambient levels, and the impact of climate and time spent outdoors in two cities in Sweden. Subjects (n = 65) from two Swedish cities participated in the study. The study protocol included personal exposure measurements at three occasions, or waves. Personal exposure measurements were performed for NOx and O3 for 24 h and PM10 for 24 h, and the participants kept an activity diary. Stationary monitoring stations provided hourly data of NOx, O3 and PM, as well as data on air temperature and relative humidity. Data were analysed using mixed linear models with the subject-id as a random effect and stationary exposure and covariates as fixed effects. Personal exposure levels of NOx, O3 and PM10 were significantly associated with levels measured at air pollution monitoring stations. The associations persisted after adjusting for temperature, relative humidity, city and wave, but the modelled estimates were slightly attenuated from 2.4% (95% CI 1.8–2.9) to 2.0% (0.97–2.94%) for NOx, from 3.7% (95% CI 3.1–4.4) to 2.1% (95% CI 1.1–2.9%) for O3 and from 2.6% (95% 0.9–4.2%) to 1.3% (95% CI − 1.5–4.0) for PM10. After adding covariates, the degree of explanation offered by the model (coefficient of determination, or R2) did not change for NOx (0.64 to 0.63) but increased from 0.46 to 0.63 for O3, and from 0.38 to 0.43 for PM10. Personal exposure to NOx, O3 and PM has moderate to good association with levels measured at urban background sites. The results indicate that stationary measurements are valid as measure of exposure in environmental health risk assessments, especially if they can be refined using activity diaries and meteorological data. Approximately 50–70% of the variation of the personal exposure was explained by the stationary measurement, implying occurrence of misclassification in studies using more crude exposure metrics, potentially leading to underestimates of the effects of exposure to ambient air pollution.

Platelet-rich plasma (PRP) is an autologous physiological product that has a platelet concentration above baseline. The PRP contains a high level of important growth factors and cytokines such as PDGF, EGF, VEGF, TGF-β,... which play important roles in healing and tissue regeneration. The PRP is currently used in various medical fields, including orthopedic, plastic surgery, dermatology, dentistry, musculoskeletal and obstetrics-gynecology. To date, the results from in vitro, in vivo studies to clinical trials have proved the effectiveness of PRP in the treating of many diseases. Altogether, PRP is considered to be a very promising futuristic therapy by dint of its simple and highly potential clinical application. Keywords: Platelet-rich plasma, PRP, growth factors, applications of platelet-rich plasma. References [1] J. S. F. Moure, J. L. V. Eps, F. J. Cabrera, Z. Barbosa, G. M. D. Rosal, B. K. 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Colberg, Optimization of Ingredients, Procedures and Rehabilitation for Platelet-rich Plasma Injections for Chronic Tendinopathy, Pain Management, Vol. 1, No. 6, 2011, pp. 523-532, https://doi.org/10.2217/pmt.11.56.[10] C. Kia, J. Baldino, R. Bell, A. Ramji, C. Uyeki, A. Mazzocca, Platelet-rich Plasma: Review of Current Literature on its Use for Tendon and Ligament Pathology, Current Reviews in Musculoskeletal Medicine, Vol. 11, No. 4, 2018, pp. 566-572, https://doi.org/10.1007/s12178-018-9515-y.[11] J. Alsousou, M. Thompson, P. Hulley, A. Noble, K. Willett, The Biology of Platelet-rich Plasma and its Application in Trauma and Orthopaedic Surgery: A Review of The Literature, The Journal of Bone and Joint Surgery British volume, Vol. 91, No. 8, 2009, pp. 987-996, https://doi.org/10.1302/0301-620X.91B8.22546.[12] W. J. Berghoff, W. S. Pietrzak, R. D. 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Wielkoszynski, Antibacterial Effect of Autologous Platelet Gel Enriched with Growth Factors and Other Active Substances: An in Vitro Study, The Journal of Bone and Joint Surgery British volume, Vol. 89, No. 3, 2007, pp. 417-420, https://doi.org/10.1302/0301-620X.89B3.18491.[19] D. J. Moojen, P. A. Everts, R. M. Schure, E. P. Overdevest, A. V. Zundert, J. T. Knape et al., Antimicrobial Activity of Platelet-leukocyte Gel Against Staphylococcus Aureus, Journal of Orthopaedic Research, Vol. 26, No. 3, 2008, pp. 404-410, https://doi.org/10.1002/jor.20519.[20] D. M. D. Ehrenfest, L. Rasmusson, T. Albrektsson, Classification of Platelet Concentrates: from Pure Platelet-rich Plasma (P-PRP) to Leucocyte- and Platelet-rich Fibrin (L-PRF), Trends in Biotechnology, Vol. 27, No. 3, 2009, pp. 158-167, https://doi.org/10.1016/j.tibtech.2008.11.009.[21] R. E. Marx, E. R. Carlson, R. M. Eichstaedt, S. R. Schimmele, J. E. Strauss, K. R. 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