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1
Guven, Deniz Can, Nicolas Sayegh, Nishita Tripathi, Mustafa Erman, Neeraj Agarwal, and Umang Swami. "Effect of docetaxel (D) use on survival outcomes in patients with metastatic castration-sensitive prostate cancer (mCSPC) treated with novel hormonal therapies (NHTs): A meta-analysis." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): 5079. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.5079.
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5079 Background: ARASENS and PEACE-1 trials have shown that the addition of NHTs to D + androgen deprivation therapy (ADT) improves overall survival (OS) outcomes in mCSPC. However, whether a true synergism is present with using NHT+ADT+D is unknown due to the lack of a trial testing the efficacy of adding D to the NHT+ADT backbone. Our objective was to evaluate the survival outcomes with NHTs according to D use in mCSPC. Methods: The literature search was done from PubMed and Embase databases to identify published studies until February 12th, 2022 for meta-analysis. The MeSH search terms were “castration-sensitive prostate cancer” OR “hormone-sensitive prostate cancer” OR “hormone-naïve prostate cancer” AND “abiraterone” OR “apalutamide” OR “enzalutamide” OR “darolutamide”. The target outcome measures were progression-free survival (PFS) and OS. Generic inverse-variance method with a fixed-effects model was used, with hazard ratios with 95% two-sided confidence intervals (CI) as the principal summary measure (Review Manager software, version 5.3, The Nordic Cochrane Center, The Cochrane Collaboration, Copenhagen, Denmark). P values below 0.05 were considered statistically significant. Results: The literature search retrieved a total of 2565 records. Six phase III studies encompassing 6701 patients evaluating survival outcomes with NHTs in mCSPC (TITAN, ARCHES, ENZAMET, LATITUDE, STAMPEDE Abi- M1, and PEACE-1) were included after filtering of the available records. Results summarized in below table. In the combined analysis, the addition of NHTs to standard of care (SOC) improved PFS and OS. PFS benefit with NHTs was similar in studies (or study subgroups) with or without D use. However the relative OS benefit with a NHT was higher in studies (or study subgroups) without D than studies permitting D (concurrent or sequential). Conclusions: In this meta-analysis, the PFS and OS benefit with NHT in mCSPC was observed independent of D use. A randomized phase III study comparing D+NHT+ADT with NHT+ADT is needed to evaluate the contribution of D to survival outcomes in patients with mCSPC receiving treatment with NHT+ADT. [Table: see text]
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Friedrich, Nadine Adriana, Jessica Janes, Joshua Parrish, Amanda Marie De Hoedt, Janis Pruett, Mark Fallick, Raj Gandhi, Emily Zhu, Robert Morlock, and Stephen J. Freedland. "Assessing racial differences in time to treatment escalation following androgen-deprivation therapy among veterans with prostate cancer." Journal of Clinical Oncology 41, no. 16_suppl (June 1, 2023): 5078. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.5078.
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5078 Background: Androgen deprivation therapy (ADT) is standard care first-line (1L) systemic treatment for advanced and metastatic prostate cancer (PC). Currently, there are no population-level studies assessing the duration of 1L ADT and time to treatment escalation (chemotherapy [CT], novel hormonal therapy [NHT], or non-steroidal antiandrogen [NSAA]). Methods: We performed a retrospective population-level analysis to assess the association between race and time to treatment escalation after ADT in the Veterans Affairs Health Care System. From 2001-2021, 164,477 patients (pt) diagnosed with PC and treated with ADT alone were identified. Baseline demographic and clinical characteristics were sorted by race: Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Hispanic, Other and compared among groups using chi square tests for categorical variables and Kruskal-Wallis tests for continuous variables. The primary outcome was time from ADT to treatment escalation, defined as receipt of NHT, NSAA, or CT. Men with no evidence of treatment escalation were censored at time of death or most recent visit. We estimated 5-year event rates by race using Kaplan-Meier (KM) analyses. Univariable and multivariable Cox proportional hazards models were used to test the association between race and time to treatment escalation with time of ADT as time zero. Multivariable models were adjusted for age, year, time from PC diagnosis to ADT, Charlson Comorbidity Index and BMI at ADT start along with PSA, testosterone level, and receipt of radiation therapy (RT) prior to ADT. Results: NHB were youngest (p<0.001), started ADT in more recent years (p<0.001), had the highest pre-ADT PSA (p<0.001) and testosterone levels (p<0.001), the most comorbidities (p<0.001), and the highest rate of RT prior to ADT (p<0.001) relative to other groups. During a median (Q1, Q3) follow-up of 55.2 (25.0, 102.4) months, 31,288 pt (19%) had treatment escalation, of which 12,093 (39%) were NHTs, 14,842 (47%) were NSAAs, 3,895 (12%) were CT and 458 (2%) were other 2nd line therapies. Compared to NHW, NHB had significantly lower rate of treatment escalation in univariable (HR=0.89, 95% CI=0.87-0.92) and multivariable analysis (HR=0.82, 95% CI=0.80-0.84). KM estimates at 5-year for the percent free from escalation was 80.5 (80.2-80.8%) in NHW vs. 83.0 (82.6-83.4%) in NHB. Rate of treatment escalation was similar for Hispanics and other races compared to NHW, with 5-year KM estimates of 81.0 (80.3-81.7%) and 81.0 (80.0-82.0%) for Hispanics and other races, respectively. Conclusions: This study assessing racial differences in time to treatment escalation of men receiving 1L ADT found that NHB had a significantly lower rate of treatment escalation. Whether this decreased rate of treatment escalation among NHB men represents improved outcomes (i.e. lower risk of progression) or undertreatment requires further study.
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Freedland, Stephen J., Matthew Davis, Andrew J. Epstein, Bhakti Arondekar, and Jasmina I. Ivanova. "Real-world treatment patterns among men with metastatic castration-resistant prostate cancer (mCRPC) in the U.S. Medicare population." Journal of Clinical Oncology 40, no. 28_suppl (October 1, 2022): 406. http://dx.doi.org/10.1200/jco.2022.40.28_suppl.406.
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406 Background: Multiple life-prolonging therapies have been approved for mCRPC, for example novel hormonal therapies (NHT; abiraterone [abi], enzalutamide [enza]), docetaxel (doc), cabazitaxel, sipuleucel-T, and radium-223. This study describes real-world treatment patterns with life-prolonging therapies and sequencing among men with mCRPC in the US Medicare population. Methods: Men newly diagnosed with mCRPC were identified in Medicare fee-for-service claims during 1/1/2014–6/30/2019. Adult men were required to have a diagnosis of prostate cancer, metastasis diagnosis, castration-resistance using a published claims-based algorithm, and continuous insurance coverage for ≥1 year before and ≥6 months after index mCRPC diagnosis unless patients died. Treatment patterns of life-prolonging therapies after mCRPC diagnosis and sequencing were described. Results: Among 14,780 men with mCRPC, median age was 75 years, 10% used NHT in the year prior to mCRPC, and 3% had prior taxane therapy. Median follow-up after mCRPC diagnosis was 17 months. 22% of men received no life-prolonging therapy after mCRPC diagnosis, 78% received ≥1 line of therapy with life-prolonging treatment after mCRPC diagnosis, 42% had ≥2, and 20% had ≥3. The most common first-line (1L) therapies were abi (36%), enza (28%), and doc (16%). The most common second-line (2L) therapies were enza (33%), abi (28%), and doc (15%). The most common third-line (3L) therapies were doc (24%), enza (19%), and abi (17%). Median time from start of 1L to next line of therapy or end of follow-up was 13.7 months, 10.9 months from the start of 2L, and 8.9 months from the start of 3L. The most common 1L to 2L treatment sequences among men with ≥2 lines were NHT followed by a different NHT (33%), chemotherapy followed by NHT (14%), and NHT followed by chemotherapy (13%). There were 5,630 men with ≥2 lines of therapy and ≥1 NHT, of whom 53% had ≥2 NHTs. Conclusions: Substantial proportions of men with mCRPC did not receive a life-prolonging therapy or had only 1L therapy after mCRPC diagnosis, with a 50% fall-off rate after each line of therapy. NHTs were the most common 1L and 2L therapies, and NHT followed by a different NHT was the most common treatment sequence. Further research is needed to understand how treatment patterns change as NHTs and doc are used earlier in the disease continuum and new therapies are introduced and ultimately to identify optimal treatment sequencing.
4
Yang, Amy, Chuchu Mei, Joshua Banks, Nikita Nikita, Amy L. Shaver, Scott W. Keith, and Grace L. Lu-Yao. "Differences in concomitant medication prescribing before and after novel hormonal therapy (NHT) in men with prostate cancer: A population-based study." Journal of Clinical Oncology 41, no. 6_suppl (February 20, 2023): 138. http://dx.doi.org/10.1200/jco.2023.41.6_suppl.138.
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138 Background: Prostate cancer (PCa) is the most common non-skin cancer affecting American men. Two common NHTs used to treat PCa are enzalutamide and abiraterone. Due to the different mechanisms of these two NHTs, we hypothesized that the concomitant medications prescribed might be related to therapy-related adverse effects. The purpose of this study was to examine whether changes in concomitant medications depended on the NHT prescribed. Methods: Medicare patients with a prescription of either enzalutamide or abiraterone in the Surveillance, Epidemiology, and End Results (SEER)–Medicare database diagnosed with prostate cancer from January 01, 2004 to December 31, 2015 were included. Medications were classified by Lexicomp’s pharmacologic category. Only oral prescriptions were included. McNemar’s test was used to compare the drug use prevalence of each category prior to and after initiation of NHT. Generalized logistic regression was used to evaluate whether changes in prescription drug class during the 6 months post-NHT initiation periods depended on the type of NHT. Results: Among the 1067 patients included, 354 were prescribed enzalutamide and 713 were prescribed abiraterone. We found statistically significant interactions between NHT (enzalutamide vs. abiraterone) and period (post vs. preinitiation NHT). Patients prescribed enzalutamide were more likely to discontinue prescriptions for steroids (p<0.01) as expected. The odds of fluoroquinolones, non-steroidal anti-inflammatory drugs (NSAIDs), and loop diuretics prescriptions were similar pre-NHT initiation for both enzalutamide and abiraterone patients; however, patients treated with enzalutamide were significantly less likely than abiraterone patients to have post-NHT initiation prescriptions for fluoroquinolones (Odds ratio (OR) 0.69 p=0.01) or loop diuretics (OR: 0.57 p<0.01). Conclusions: To our knowledge, this is the first population-based study to describe concurrent medication prescribing before and after NHT. Further studies are warranted to better understand the underlying reasons for the observed patterns.
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Barata, Pedro C., Andrea Leith, Amanda Ribbands, Rachel Montgomery, Matthew Last, Bhakti Arondekar, Alexander Niyazov, and Jasmina Ivanova. "Treatment (tx) patterns among men with metastatic castration resistant prostate cancer (mCRPC) in the United States (US)." Journal of Clinical Oncology 40, no. 6_suppl (February 20, 2022): 52. http://dx.doi.org/10.1200/jco.2022.40.6_suppl.052.
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52 Background: Novel hormonal therapies (NHTs) and docetaxel were initially approved for the tx of men with mCRPC. Over time, these agents moved earlier in the disease continuum and are now also used in metastatic castration sensitive prostate cancer (mCSPC). Little is known about first-line (1L) mCRPC tx patterns for men with prior taxane-based chemotherapy (CT) or NHT exposure. This study evaluated the impact of taxane CT or NHT use in mCSPC on recent 1L tx patterns among men with mCRPC in the US. Methods: Participating physicians collected information from medical charts for the next consecutive 4 adult men with mCRPC during January-August 2020. A subset of men had prior mCSPC tx information available. 1L mCRPC txs were described overall and stratified by previous tx with taxane CT or NHT during mCSPC. No statistical comparisons were performed. Results: 116 adult men with mCRPC and known mCSPC tx history were included. Mean age was 70 years; 15% had known family history of prostate cancer; 70% had bone metastases and 33% had visceral metastases at data collection. Overall, 10% (12/116) of men had been previously treated with taxane CT and 28% (32/116) were treated with NHT during mCSPC. 1L mCRPC tx was initiated on average 35 days after mCRPC diagnosis. NHT was the most common 1L mCRPC tx regardless of prior taxane CT or NHT use. Men pre-treated with taxane CT were more likely to initiate mCRPC tx with NHT than taxane naïve men. NHT pre-treated men were less likely to initiate 1L mCRPC tx with NHT and more likely to initiate tx with docetaxel than NHT naïve men. 53% of men with prior NHT tx were rechallenged with NHTs in 1L mCRPC. (Table). Conclusions: Findings from this US real-world study among men with mCRPC suggest physicians most commonly initiate 1L mCRPC life-prolonging tx with NHT regardless of prior taxane CT or NHT exposure. Additional studies with larger sample sizes are needed to confirm these findings and better understand optimal tx sequencing, especially as new tx options become available.[Table: see text]
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Enkerli, Jürg, Garima Bhatt, and Sarah F. Covert. "Nht1, a Transposable Element Cloned from a Dispensable Chromosome in Nectria haematococca." Molecular Plant-Microbe Interactions® 10, no. 6 (August 1997): 742–49. http://dx.doi.org/10.1094/mpmi.1997.10.6.742.
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Certain isolates of the plant-pathogenic fungus Nectria haematococca mating population VI (MPVI) contain dispensable chromosomes that are unstable during sexual reproduction. Several of these chromosomes carry genes for phytoalexin detoxification and thus contribute to the pathogenic potential of this organism. A repeated DNA sequence, Nht1, was cloned from one of these dispensable chromosomes in N. haematococca MPVI. One copy of the repeated element (Nht1A) was completely sequenced. It is 2,198 bp long and it possesses incomplete inverted terminal repeats (ITRs) at each end. Nht1B, a partially sequenced copy of Nht1, has complete ITRs. Nht1A appears to contain 2 introns and encodes a protein of 550 amino acids that is highly similar to the protein encoded by the Fusarium oxysporum transposon, Fot1. Due to the presence of ITRs, its repeated nature, and its similarity to Fot1, we conclude that Nht1 is a transposable element. Within North American N. haematococca MPVI populations, Nht1 is distributed discontinuously. Its copy number in different field isolates varies from zero to approximately 100 copies per genome. The Nht1A source isolate is estimated to contain nine to 11 copies of Nht1; at least six are on the chromosome from which Nht1A was cloned.
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Scher, Howard I., Fred Saad, Maneesha Mehra, Sandhya Nair, Lindsay Dearden, and Ravi C. Potluri. "Impact of upstream use of novel hormonal therapy on progression of patients (pts) to metastatic castration-resistant prostate cancer (mCRPC) in the United States (US)." Journal of Clinical Oncology 38, no. 6_suppl (February 20, 2020): 92. http://dx.doi.org/10.1200/jco.2020.38.6_suppl.92.
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92 Background: Novel hormonal therapies (nHTs) provide significant delay in disease progression in metastatic castration-sensitive prostate cancer (mCSPC) and non-metastatic (nm)CRPC. The impact of earlier use of these agents on the epidemiological burden of PC in the US was assessed. Methods: A disease stage transition model capturing pt flow through eight clinical states and tracking pt treatment history was used, with each nHT being used once. Progression-free survival (PFS) and overall survival (OS) data for each drug/regimen were derived from published sources where available. We analyzed scenarios 1) no nHTs and 2) with nHTs: (abiraterone acetate + prednisone [AAP], apalutamide [APA] and enzalutamide [ENZA] in high-risk mCSPC, and APA and ENZA in low-risk mCSPC and in high-risk nmCRPC). Resultant state progression parameters were compared, evaluating the impact of nHTs. The assumed nHT utilization was 17.2% in high-risk mCSPC, 7.1% in low-risk mCSPC, and 60.0% in high-risk nmCRPC. Results: For 2018, the model resulted in PC incidence of 240,150 and prevalence of 2,445,173; 49,450 pts progressed to mCRPC, 42% from PSA biochemical recurrence, 31% from mCSPC, and 27% from nmCRPC states. Longer PFS and OS afforded by novel treatments extended the mean time spent from 4.4 to 4.7 yrs in mCSPC and from 2.4 to 3.0 yrs in nmCRPC. This further resulted in reduction in inflow to mCRPC over 2019 – 2025 (table). Conclusions: Novel hormonal therapies are currently used earlier in PC, a trend anticipated to intensify. The disease model shows this change in the treatment paradigm to result in delaying progression to mCRPC and increasing OS in PC.[Table: see text]
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Davidson, Alyssa J., Gregory M. Ellis, Kimberly Jenkins, Melissa Kokx-Ryan, and Douglas S. Brungart. "Examining the Use and Benefits of Low-/Mild-Gain Hearing Aids in Service Members with Normal Hearing Thresholds and Self-Reported Hearing Difficulties." Healthcare 12, no. 5 (March 1, 2024): 578. http://dx.doi.org/10.3390/healthcare12050578.
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Low- (or mild-) gain hearing aids (LGHAs) are increasingly considered for individuals with normal peripheral hearing but significant self-reported hearing difficulties (SHDs). This study assesses the benefits of LGHAs as a management option for individuals with normal hearing thresholds (NHTs) and SHDs, comparing LGHA use and benefit to individuals with non-significant hearing difficulties (NHDs) and those with peripheral hearing loss. Questionnaires addressing hearing aid usage, benefit, hearing difficulties, and tinnitus were administered to 186 individuals who self-identified as hearing aid users in a sample of 6652 service members who were receiving their annual hearing tests. Participants were divided into SHD and NHD groups based on the normative cutoff of the Tinnitus and Hearing Survey-Hearing Subscale (THS-H), and into hearing impairment (HI) and NHT based on their audiometric air-conduction thresholds. Individuals with SHDs and NHTs reported higher LGHA usage and benefit than individuals with NHDs and NHTs. Comparable use and benefit were noted between groups with SHDs regardless of peripheral hearing loss status. The findings support LGHAs as a suitable management option for individuals with NHTs and SHDs, as indicated by hearing aid use and benefit. Quantifying the level of perceived auditory processing deficits (i.e., SHDs), notably with the THS-H, enhances sensitivity in identifying those who may benefit the most from this treatment option.
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Rosenberg, Ted, Patrick Montgomery, Vikki Hay, and Rory Lattimer. "Using frailty and quality of life measures in clinical care of the elderly in Canada to predict death, nursing home transfer and hospitalisation - the frailty and ageing cohort study." BMJ Open 9, no. 11 (November 2019): e032712. http://dx.doi.org/10.1136/bmjopen-2019-032712.
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ObjectiveTo assess the value of using frailty measures in primary care for predicting death, nursing home transfer (NHT) and hospital admission.DesignCohort study.Setting and participantsAll 380 people, mean age 88.4, living in the community and receiving home-based primary geriatric care from one practice in Victoria, Canada.Interventions/measurementsA 60 min baseline assessment which included: Clinical Frailty Scale (CFS), EuroQol EQ-5D-5L (EQ-5D), EuroQol Visual Analogue Scale (EQ-VAS) and Gait Speed (Gaitspeed).OutcomesDeath, NHT and hospital admission.ResultsDuring 18 months of follow-up, there were 39 (10.3%) deaths, 48 (12.6%) NHTs and 93 (24.5%) individuals admitted to hospital. All three outcomes were predicted by: CFS Level 6+7/4+5 (HR death 5.92, 95% CI 3.12 to 11.22, NHT 6.00, 95% CI 3.37 to 10.66 and hospital admission 2.92, 95% CI 1.93 to 4.40); EQ-5D Quintile 1/Quintile 5 (death 6.26, 95% CI 2.11 to 18.62; NHT 3.18, 95% CI 1.29 to 7.82 and hospital admission 2.94, 95% CI 1.47 to 5.87); EQ-VAS Q1/Q5 (death 7.0, 95% CI 2.34 to 20.93; NHT 3.38, 95% CI 1.22 to 9.35 and hospital admission 6.69, 95% CI 3.20 to 13.99) and Gaitspeed (death 5.87, 95% CI 1.78 to 19.34; NHT 8.51, 95% CI 3.18 to 22.79 and hospital admission 11.05, 95% CI 5.45 to 22.40). Medical diagnoses, multiple comorbidities and polypharmacy were weaker predictors of these outcomes. Cox regression analyses showed CFS (adjusted HR 2.88, 95% CI 1.23 to 6.68), EQ-VAS (0.96, 95% CI 0.93 to 0.98), estimated glomerular filtration rate (0.97, 95% CI 0.95 to 1.00) and haemoglobin (0.97, 95% CI 0.94 to 0.99) were independently associated with death. Gaitspeed (0.13, 95% CI 0.03 to 0.57), Geriatric Depression Scale (1.39, 95% CI 1.07 to 1.82) and dementia diagnosis (4.61, 95% CI 1.86 to 11.44) were associated with NHT. Only CFS (1.75, 95% CI 1.21 to 2.51) and EQ-VAS (0.98, 95% CI 0.96 to 0.99) were associated with hospital admission. No other diagnoses, polypharmacy nor multiple comorbidities predicted these outcomes.ConclusionsFor elderly people, standardised simple measures of frailty and health status were stronger predictors of death, NHT and hospital admission than medical diagnoses. Consideration should be given to adding these measures into usual medical care for this age group.
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Barata, Pedro C., Andrea Leith, Amanda Ribbands, Rachel Montgomery, Matthew Last, Bhakti Arondekar, Alexander Niyazov, and Jasmina Ivanova. "Treatment trends among men with metastatic castration sensitive prostate cancer (mCSPC): Results from the US component of an international study." Journal of Clinical Oncology 40, no. 6_suppl (February 20, 2022): 66. http://dx.doi.org/10.1200/jco.2022.40.6_suppl.066.
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66 Background: Novel hormonal therapies (NHTs) and taxane-based chemotherapy (CT) were initially approved for the treatment of metastatic castration resistant prostate cancer (mCRPC) and are now approved for use in mCSPC. Little is known about the recent uptake of these treatments in mCSPC. This study evaluated mCSPC treatment trends from 2016 to 2020 in the US. Methods: Participating physicians collected information from medical charts for the next consecutive 8 men with advanced prostate cancer (4 men with mCSPC, and 4 men with mCRPC) during January-August 2020. A subset of men with current mCRPC had historical mCSPC treatment information available. Treatments were categorized into 4 mutually exclusive categories: (1) androgen deprivation therapy (ADT) ± first-generation anti-androgen (1st gen AA); treatment intensification with (2) NHT, (3) taxane CT ± NHT, and (4) other treatments (e.g., radium-223, sipuleucel-T, non-taxane CT). To account for the availability of new mCSPC treatments, treatment patterns across all lines of mCSPC therapy were described for men initiating treatment in 2016-2018 and 2019-2020. Results: 239 men with mCSPC were included (146 with mCSPC at data collection; 93 with mCRPC at data collection and who had historical information on mCSPC treatments). Mean age was 69 years; 69% had bone metastases and 30% had visceral metastases. Most patients were managed by oncologists (75%), while 48% were treated at academic/cancer centers. From 2016-2018 to 2019-2020, mCSPC treatment intensification with NHT increased while treatment intensification with taxane CT or other therapies declined. (Table) Conclusions: In this real-world study of adult men with mCSPC, increased use of NHT was observed over time indicating that more men will have been exposed to NHT when they progress to mCRPC. This suggests an unmet need for novel therapies in mCRPC. Funding: Pfizer. [Table: see text]
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Graf, Ryon, Russell Madison, Ole Gjoerup, Lei Zhong, Samantha Morley, Sunandini Chopra, Leah Comment, et al. "Real-world overall survival (OS) and time to therapy discontinuation (TTD) of patients (pts) with mCRPC treated with second-generation novel hormonal therapies (NHT) associated with tissue-based comprehensive genomic profiling (CGP)." Journal of Clinical Oncology 39, no. 6_suppl (February 20, 2021): 142. http://dx.doi.org/10.1200/jco.2021.39.6_suppl.142.
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142 Background: Robust biomarkers for personalization of NHT treatment decisions remains an unmet need. Most assessments of candidate biomarkers to predict NHT resistance have been conducted in clinical trials or academic centers, meriting additional validation in diverse community settings. We sought to correlate real-world outcomes on NHT with comprehensive genomic profiling (CGP)-reported alterations, hypothesizing that AR amplification ( ARamp) and deleterious genomic alterations (GAs) in BRCA2, PTEN, RB1, TP53 would correlate with worse outcomes on NHT. Methods: Following a prespecified analysis plan, pts were selected from Flatiron Health (FH)-Foundation Medicine (FMI) clinico-genomic database (CGDB), a nationwide deidentified electronic health record database linked to FMI CGP. Inclusion criteria: mCRPC diagnosis, treatment in FH network and CGP result between 1/1/11-3/30/20 where tissue collected prior to initiation of first line (1L) or second (2L) NHT (within 180 days for ARamp +/- comparison). A priori power analyses were conducted. Adjusted hazard ratios (aHR) from multivariable Cox proportional hazard models were utilized for TTD and OS comparisons from start of NHT including: GA groups, adjusted for age, line number, practice type, and left truncation. Results: Among 1626 evaluable pts, 397 received 1L (n = 287; 72%) or 2L (n = 110; 28%) NHT with majority treated in community setting (n = 297; 75%). Abiraterone (n = 242; 61%) and enzalutamide (n = 145; 39%) were most common NHTs. Incidence: ARamp (15%) and deleterious GA in TP53 (45%), PTEN (28%), RB1 (3%), and BRCA2 (8%). Cohort was strongly powered to assess TP53 & PTEN, moderately for ARamp & BRCA2, weakly for RB1. As hypothesized, ARamp correlated with worse TTD (aHR: 3.37 [1.26-9.0]) and OS (aHR: 4.92 [1.47-16.5]). BRCA2 GA correlated with improved OS (aHR: 0.41 [0.21-0.81]), but no differences in TTD (aHR: 1.25 [0.82-1.9]). RB1 GA had trends for worse OS (aHR: 2.0 [0.93-4.28]) and worse TTD (aHR – 1.41 [0.72-2.8]). TP53 GA had worse OS (aHR: 1.47 [1.1-2.0]), but no difference in TTD (aHR: 1.08 [0.85-1.4]), and PTEN GA did not correlate with TTD (aHR: 0.94 [0.72-1.2]) or OS (aHR: 1.01 [0.74-1.38]). Conclusions: ARamp is associated with worse TTD and OS in mCRPC pts treated with NHT in real-world, mostly community practice, consistent with prior academic center studies and trials data. Surprisingly, BRCA2 GA correlated with improved OS but not TTD. RB1 GA were directionally consistent with prior studies but underpowered. This study supports using CGP to inform decisions for escalation of non-NHT treatment use in conjunction with patient goals and predictive CGP biomarkers for other drugs. Additional biomarkers, multivariable models and, NHT vs taxane chemo predictive assessments will be reported at symposium.
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Freedland, Stephen J., Neeraj Agarwal, Krishnan Ramaswamy, Rickard Sandin, Dave Russell, Agnes Hong, Hongbo Yang, Wei Gao, Kaitlin Hagan, and Daniel J. George. "Real-world utilization of advanced therapies and racial disparity among patients with metastatic castration-sensitive prostate cancer (mCSPC): A Medicare database analysis." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 5073. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.5073.
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5073 Background: Several randomized controlled trials have shown that adding docetaxel or novel hormonal therapy (NHT) to androgen deprivation therapy (ADT) improves survival in mCSPC patients. This study aimed to evaluate the real-world utilization of advanced therapies over time and to provide data on utilization patterns among racial minorities that are often under-represented in clinical trials. Methods: This was a retrospective analysis of a Medicare database (Jan 2009-Dec 2018). Adult men with ≥1 claim for prostate cancer (PC) who initiated ADT (index date) within 90 days prior to or any time after a metastasis diagnosis were included. The first-line (1L) treatment was grouped by PC drugs prescribed within 30 days prior to and 120 days after the index date, in 4 categories: ADT alone, ADT + first-generation anti-androgen (AA; ≥90 days to avoid capturing AA for flare control), ADT + docetaxel, and ADT + NHT (abiraterone, apalutamide, and enzalutamide). The 1L treatment distributions were described over time and stratified by race. Results: A total of 35,195 patients with mCSPC were included in the study, with a mean (SD) age of 76.5 (7.9) years. 11.8% were Black, 5.3% Hispanic, and 78.5% White. 76.4% received ADT alone as 1L treatment, 14.3% ADT + AA, 4.8% ADT + docetaxel, and 4.5% ADT + NHT. While the proportion of patients treated with ADT alone and ADT + AA slowly decreased over time, the utilization of ADT + docetaxel increased since 2015 and the utilization of ADT + NHT increased since 2017 (Table). After the emergence of NHTs for treatment of mCSPC in 2017, treatment intensification with ADT + NHT was numerically lower for Black than White patients. Data from before 2017 also suggest a similar lower use of ADT + AA in Black patients (Table). Survival analysis across treatment cohorts and race are ongoing. Conclusions: In this large and nationally representative sample of mCSPC patients, less than one-third of patients received treatment intensification by 2018, possibly due to patient/disease characteristics, provider awareness or therapeutic inertia, or cost. Importantly, the data showed less frequent treatment intensification in Black vs White patients. Further study is required to elucidate underlying reasons for this disparity.[Table: see text]
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Malangone-Monaco, Elisabetta, Weiyan Li, Virginia Noxon, Shan Jiang, Suvina Amin, Sameer Ghate, Umang Swami, and Neeraj Agarwal. "Real-world treatment patterns among patients with metastatic castration-resistant prostate cancer (mCRPC) in the US." Journal of Clinical Oncology 40, no. 6_suppl (February 20, 2022): 49. http://dx.doi.org/10.1200/jco.2022.40.6_suppl.049.
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49 Background: mCRPC is an incurable disease with poor prognosis. Though multiple treatments such as novel hormonal therapies (NHT: abiraterone [abi], enzalutamide [enza], docetaxel [doce], cabazitaxel [caba], sipuleucel-T [Sip-T] etc.) are approved, real-world data regarding treatment sequencing are lacking. This study assesses the real-world treatment patterns within the context of FDA-approved life-prolonging treatments for mCRPC. Methods: The IBM MarketScan database was used to identify newly diagnosed (incident) mCRPC patients from 1/1/2014-5/31/2020. Adult males were required to have a diagnosis of PC, and subsequently evidence of metastasis and castration (medical or surgical). Incident mCRPC status (index) was determined 3 ways: 1) treatment with an NHT within 3 months after castration and an FDA-approved mCRPC treatment ≥3 months after NHT; 2) first FDA-approved treatment ≥6 months after castration; 3) first FDA-approved treatment 3-6 months after castration and a second FDA-approved treatment ≥3 months after treatment. Lines of therapy (LOT) were measured in the variable-length follow-up of ≥1 month and consisted of all drugs observed within 28 days of first observed treatment. Duration of therapy was measured as start of line to start of next line or end of enrollment. Results: A total of 2,912 mCRPC patients met all study criteria and received ≥1 LOT. Among those, 48.7% had ≥2 LOT, and 21.8% had ≥3 LOT. Patients were an average age of 71 years at index and used leuprolide (87%), abi (10%), doce (9%) and enza (8%) prior to index. In mCRPC the most common observed first line (1L) monotherapy regimens were abi (35%), enza (34%), and doce (14%). The most common observed second-line (2L) treatments were enza (36%), abi (27%), and doce (14%). Mean duration of 1L was 292 days compared to 245 days in 2L. The most frequently observed treatment sequences (1L to 2L) are reported in the table. Opioids (62%) and denosumab (47%) use was common in mCRPC patients. Conclusions: Among mCRPC patients, NHTs were the most common 1st and 2nd LOTs and alternate NHT after a first NHT was the most common sequence. With rapidly evolving treatment options in metastatic prostate cancer, these data can help guide estimation of eligible patients for different clinical trials. Further studies are needed to understand the high attrition from 1L to subsequent lines of therapy, the reasons for treatment preference and impact on clinical outcomes with different treatment sequencings.[Table: see text]
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Nakamura, Tatsunosuke, Yumiko Fujisaki, Hiromi Enomoto, Yuji Nakayama, Teruhiro Takabe, Naoto Yamaguchi, and Nobuyuki Uozumi. "Residue Aspartate-147 from the Third Transmembrane Region of Na+/H+ Antiporter NhaB ofVibrio alginolyticus Plays a Role in Its Activity." Journal of Bacteriology 183, no. 19 (October 1, 2001): 5762–67. http://dx.doi.org/10.1128/jb.183.19.5762-5767.2001.
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ABSTRACT NhaB is a bacterial Na+/H+ antiporter with unique topology. The pH dependence of NhaB from Vibrio alginolyticus differs from that of the Escherichia coli NhaB homolog. Replacement of Asp-147 with Glu made high H+ concentrations a requirement for the NhaB activity. Replacement of Asp-147 with neutral amino acids inactivated NhaB.
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Pásztor, Dorottya Tímea, János Nemcsik, Johanna Takács, Zsófia Kekk, Csaba Farsang, Attila Simon, Dénes Páll, et al. "AN UPDATED REPORT FROM THE HUNGARIAN AMBULATORY BLOOD PRESSURE MONITORING REGISTRY." Journal of Hypertension 42, Suppl 1 (May 2024): e72-e73. http://dx.doi.org/10.1097/01.hjh.0001019972.67173.c9.
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Objective: Ambulatory blood pressure monitoring (ABPM) is recommended by current European guidelines for the early diagnosis of hypertension and to monitor the efficacy of antihypertensive treatments. The Hungarian Society of Hypertension has initiated a 5-year, nationwide program in 2021 to promote the routine use of ABPM and to improve the motivation of doctors and patients. This is an updated report on the Hungarian ABPM Registry. Design and method: This is an ongoing, multicenter, open-label, observational study. Adult (age >18 years) patients with known hypertension(HT), or with suspected/newly diagnosed hypertension(nHT) can be involved in the study. ABPM monitoring is performed by GPs, internists, and cardiologists using validated Meditech ABPM-06 monitors. Current report analyzed ABPM data between 21.02.2021-16.11.2023, that were collected into an electronic case report. Overall, 40621 ABPMs were performed, due to protocol deviation 1901 patients were excluded from the analysis. Results: 26315 patients were HTs(68.3%), 12193 patients were nHTs(31.5%). In the HT group 95.5%, in the nHT group 21.5% were treated. 63.6% of all patients were hypertensives according to the 24-hour average blood pressure(BP) values. Mean 24-hour systolic and diastolic BP was 133.84±14.5 mmHg and 79.2±10.3 mmHg, respectively. There was no difference in the 24-hour mean systolic BP between HT and nHT patients (133.75±13.96mmHg vs. 133.86±14.72mmHg, respectively, p=NS). Obesity(BMI >30 kg/m2) increased the risk of hypertension(OR=1.82[1.73;1.92]for 24-hour average). Coffee consumption(more than 3/day)(OR=1.22[1.16;1.29]for 24-hour average), snoring(OR=1.39[1.33;1.46]for 24-hour average)and smoking(OR=1.10[1.03;1.18]for 24-hour average)all increased the risk of hypertension, primarily affecting more the daytime BP values(OR=1.24[1.18;1.31]for daytime in coffee consumption, OR=1.13[1.07;1.19]for nighttime in coffee consumption; OR=1.42[1.36;1.49]for daytime in snoring, OR=1.31[1.25;1.38]for nighttime in snoring; OR=1.09[1.01;1.16]for daytime in smoking, OR=1.01[0.94;1.08]for nighttime in smoking (NS)). Lack of regular sport(less than 3x30 minutes weekly)increased the risk of hypertension(OR=1.11[1.05;1.18]for 24-hour average), primarily affecting more the nighttime values(OR=1.19[1.12;1.26]for nighttime, OR= 1.02[0.96;1.07]for daytime(NS)). Conclusions: Hypertension is highly prevalent in both HT and nHT patients, irrespectively of gender or treatment. Obesity, lack of regular sport, coffee consumption, snoring and smoking are all significant risk factors in developing hypertension, latter ones affecting more the daytime BP values, whereas lack of regular sport affects more the nighttime BP values.
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Rickwood, Lucinda, Sean Perera, Suneeta Soni, and Gillian Dean. "P083 How do HIV testing initiatives impact on HIV testing rates and diagnosis in primary care?" Sexually Transmitted Infections 93, Suppl 1 (June 2017): A44.1—A44. http://dx.doi.org/10.1136/sextrans-2017-053232.128.
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IntroductionUndiagnosed HIV leads to late presentation, increased morbidity, and contributes to onward transmission. It is estimated that in our area approximately 17% of those living with HIV are undiagnosed. Little is known about the impact of National HIV Testing Week (NHTW) initiatives in general practice (GP). In 2016 we implemented a ‘pop-up’ message alerting GPs that it was NHTW, with a ‘one-click’ pathway to adding an HIV-test to bloods requested for other reasons.MethodsNumber of HIV tests carried out in GP and new HIV diagnoses made were collected between 20thAugust 2016 and 20thFebruary 2017 and separated into the time period spanning 3 months pre-NHTW, NHTW itself and 3 months post-NHTW.Results464 HIV tests were performed in 37 GP practices in the pre-NHTW period (approx. 36/week), 96 test during NHTW and 534 tests in 3 month post-NHTW (approx. 41/week). 1 HIV-diagnosis was made in GP during the pre-NHTW period (c.f. 20 across all services), no new diagnoses in NHTW and 1 case (7 across all services) in the 3 month post-NHTW period.DiscussionTesting initiatives result in greater awareness across the city and an increase in HIV testing, which was sustained, although no increase in new HIV diagnoses. The decrease in HIV diagnoses in this study reflects the national trend of a reduction in HIV diagnoses despite increased testing; this is attributed partly to the efficacy and increased use of Pre-exposure prophylaxis (PrEP).
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Avila-Villa, Luz A., Teresa Gollas-Galván, Marcel Martínez-Porchas, Fernando Mendoza-Cano, and Jorge Hernández-López. "Experimental Infection and Detection of Necrotizing Hepatopancreatitis Bacterium in the American LobsterHomarus americanus." Scientific World Journal 2012 (2012): 1–4. http://dx.doi.org/10.1100/2012/979381.
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Necrotizing hepatopancreatitis bacterium (NHPB) is an obligated intracellular bacteria causing severe hepatopancreatic damages and mass mortalities in penaeid shrimp. The worldwide distribution of penaeid shrimp as alien species threatens the life cycle of other crustacean species. The aim of the experiment was to evaluate the possibility of experimentally infecting the American lobster (Homarus americanus) with NHPB extracted from shrimp hepatopancreas. Homogenates from infected shrimp were fed by force to lobsters. Other group of lobsters was fed with homogenates of NHPB-free hepatopancreas. After the 15th day from initial inoculation, the presence of NHPB was detected by polymerase chain reaction in feces and hepatopancreas from lobsters inoculated with infected homogenates. Necrotized spots were observed in the surface of lobster hepatopancreas. In contrast, lobsters fed on NHPB-free homogenates resulted negative for NHPB. Evidence suggests the plasticity of NHPB which can infect crustacean from different species and inhabiting diverse latitudes. Considering the results, the American lobster could be a good candidate to maintain available NHPBin vivo.
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Didier, Andrea, Richard Dietrich, Stephanie Gruber, Stefanie Bock, Maximilian Moravek, Tadashi Nakamura, Toril Lindbäck, Per Einar Granum, and Erwin Märtlbauer. "Monoclonal Antibodies Neutralize Bacillus cereus Nhe Enterotoxin by Inhibiting Ordered Binding of Its Three Exoprotein Components." Infection and Immunity 80, no. 2 (November 21, 2011): 832–38. http://dx.doi.org/10.1128/iai.05681-11.
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ABSTRACTThe Nhe enterotoxin fromBacillus cereusis known to induce cytotoxicity on Vero and CaCo-2 cells by ordered binding of its single components NheA, NheB, and NheC. This study aimed to elucidate functional sites on NheB by identifying the epitopes of the neutralizing monoclonal antibodies 1E11 and 2B11. The binding regions of both antibodies were determined by using recombinant NheB fragments and synthetic peptides. The antigenic site of antibody 1E11 was located within the amino acids 321 to 341 of NheB, whereas reactivity of antibody 2B11 was dependent on the presence of amino acids 122 to 150 and on conformation. Both antibodies were able to bind simultaneously to NheB and did not interfere with target cell binding as shown by immunofluorescence microscopy. A set of neutralization assays revealed that antibody 2B11 most likely interfered with the interaction between NheB and NheC both on the epithelium cell surface and in solution. In contrast, antibody 1E11 inhibited association between NheA and cell-bound NheB in a competitive manner, and effectively neutralized Nhe cytotoxicity on a variety of human cell lines. This distinct mechanism further supports that NheA is the key component during the Nhe mode of action and the C-terminal epitope recognized by antibody 1E11 points to an important functional region of NheB.
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Albertus-Cámara, Inés, Cristina Rochel-Vera, Jose-Luis Lomas-Albaladejo, Vicente Ferrer-López, and Ignacio Martínez-González-Moro. "Ventilatory Pattern Influences Tolerance to Normobaric Hypoxia in Healthy Adults." International Journal of Environmental Research and Public Health 20, no. 6 (March 10, 2023): 4935. http://dx.doi.org/10.3390/ijerph20064935.
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Introduction: Tolerance to breathing in conditions with a decreased oxygen ratio is subject-specific. A normobaric hypoxia tolerance test (NHTT) is performed to assess the ability of each individual, as this may be influenced by genetic or personal factors such as age or gender. The aim of this study is to test the influence of deep breathing on hypoxia tolerance time. Material and methods: A total of 45 subjects (21 parachutists and 24 students) performed two NHTTs at 5050 m altitude (iAltitude). Arterial (SatO2) and muscle (SmO2) oxygen saturation were monitored with the Humon Hex® device. The first NHTT was performed with free breathing, without any instructions; and the second NHTT was performed with wide, slow, diaphragmatic breathing. The NHTT was terminated at the end of 10 min or when a value of less than 83% was obtained. Results: The first NHTT was completed by 38.1% of parachutist and 33.3% of students while the second NHTT was completed by 85.7% and 75%, respectively. In the second NHTT, both parachutists and students had a significantly (p = 0.001) longer duration compared to the first NHTT. SmO2 and SatO2 values also increased significantly (p < 0.001) in both groups (p < 0.05). Conclusion: Performing controlled diaphragmatic breathing is successful in increasing hypoxia tolerance time and/or SatO2 values.
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Barata, Pedro C., Ella X. Du, Hongbo Yang, Chunyi Xu, Helen Guo, Caroline Cui, Jonathan Nazari, and Alexander Niyazov. "Real world (rw) racial differences in treatment (tx) patterns and clinical outcomes among patients (pts) with mCRPC." Journal of Clinical Oncology 41, no. 6_suppl (February 20, 2023): 95. http://dx.doi.org/10.1200/jco.2023.41.6_suppl.95.
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95 Background: Contemporary rw data is needed to describe the heterogeneity of the tx landscape among diverse pt populations. This study assessed rw tx patterns and clinical outcomes among US pts receiving tx for mCRPC. Methods: Data from pts with mCRPC initiating first line (1L) tx between 2016 and 2019 were abstracted from medical charts. Clinical characteristics and tx patterns stratified by race (White [W], Black [B], and Other [O]) were compared using descriptive statistics. Rw progression-free survival (rwPFS) and overall survival (OS) were analyzed using Kaplan–Meier method. A multivariate Cox model explored associations between race and rwPFS/OS, controlling for confounders. Results: 122 physicians contributed data from 260 charts (W n=127, B n=81, O n=52 pts). The median age was 69 years; 64 (25%) had ECOG score ≥2. Common sites of metastases (mets) were bone (73%) and lymph nodes (34%); median Gleason score (GS) was 8.0, with no significant differences in sites of mets or GS among B and W pts. Most common txs prior to mCRPC included androgen deprivation therapy (ADT) monotherapy (39%), chemotherapy (CT; 15%), and novel hormonal therapy (NHT; 9%). Prior to mCRPC, more B pts were offered tx intensification with NHTs or CT compared with W pts (35% vs 14%). NHT was the most common 1L mCRPC therapy, followed by CT (Table). Compared with W pts, more B pts were offered NHT (65% vs 59%, P=0.44) and CT (26% vs 20%, P=0.38) in the 1L setting. Adjusted median rwPFS on 1L tx was 43.7 months (mo; 95% CI: 27–not estimable [NE]). A longer rwPFS was observed for B vs W pts; median rwPFS NE (95% CI: 34.7–NE) vs 34.7 mo (95% CI: 21.0–NE), hazard ratio (HR)=0.58 (95% CI: 0.35–0.97; P<0.05). B pts had numerically greater OS vs W pts, HR=0.58 (95% CI: 0.31–1.1; P=0.09). Conclusions: In this rw study of pts receiving 1L tx for mCRPC, rwPFS was better compared with clinical trial data, particularly among B pts, who were more likely to receive life-prolonging txs in the 1L setting. These data suggest B pts might respond better to systemic therapies compared with W pts, and disparities observed in other settings may be attributed to access barriers. [Table: see text]
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Chung, Nguyễn Hoàng. "Rủi ro phá sản, bảng cân đối kế toán ngân hàng thương mại trong điều kiện bất định tại Việt Nam." TẠP CHÍ KHOA HỌC ĐẠI HỌC MỞ THÀNH PHỐ HỒ CHÍ MINH - KINH TẾ VÀ QUẢN TRỊ KINH DOANH 19, no. 5 (April 5, 2024): 59–71. http://dx.doi.org/10.46223/hcmcoujs.econ.vi.19.5.2934.2024.
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Nghiên cứu sử dụng dữ liệu cấp Ngân Hàng Thương Mại (NHTM) tại Việt Nam trong giai đoạn 2007 - 2019 để đo lường tính bất định vi mô trong NHTM thông qua việc phân tán các cú sốc cấp NHTM nhằm kiểm định mối quan hệ giữa tính bất định và sự thay đổi của bảng cân đối kế toán các NHTM. Các kiểm định thực nghiệm được thực hiện bằng phương pháp ước tính mô men theo phương pháp tổng quát hệ thống hai bước (Generalized Method of Moments - GMM) và sau đó được xác minh bằng kỹ thuật sửa biến giả bình phương nhỏ nhất (Least Square Dummy Variables - LSDVC). Kết quả cho thấy các NHTM có xu hướng giảm các khoản tín dụng rủi ro, tích trữ nhiều thanh khoản hơn và giảm đòn bẩy tài chính để đối phó với tính bất định cao hơn. Mối quan hệ giữa tính bất định và phản ứng của bảng cân đối kế toán của các NHTM rõ rệt hơn đối với các NHTM chịu nhiều rủi ro tín dụng và rủi ro tổng thể, do đó hỗ trợ khả năng phòng ngừa rủi ro của các ngân hàng thương mại.
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Phạm Hải Nam and Phạm Thị Hồng Nhung. "Cấu trúc vốn và lợi nhuận của các ngân hàng thương mại Việt Nam: Tiếp cận bằng Bayes." Tạp chí Kinh tế và Ngân hàng châu Á, no. 193 (June 1, 2023): 18–31. http://dx.doi.org/10.63065/ajeb.vn.2022.193.80013.
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Bài nghiên cứu được thực hiện nhằm đánh giá tác động của cấu trúc vốn (CTV) đến lợi nhuận của các ngân hàng thương mại (NHTM) Việt Nam trong giai đoạn 2012–2020. Trong nghiên cứu này, biến đại diện cho CTV của NHTM là tiền gửi khách hàng và nợ phi tiền gửi, được đo lường bằng tiền gửi khách hàng trên tổng tài sản và nợ phi tiền gửi trên tổng tài sản. Sử dụng dữ liệu thứ cấp của 30 NHTM Việt Nam với kỹ thuật hồi quy Bayes thông qua thuật toán lấy mẫu Gibbs, kết quả hồi quy cho thấy tiền gửi khách hàng có tác động ngược chiều đến lợi nhuận của NHTM. Trong khi đó, nợ phi tiền gửi có tác động cùng chiều đến lợi nhuận của NHTM. Ngoài ra, các biến kiểm soát là quy mô ngân hàng, dư nợ cho vay, chi phí hoạt động có tác động tích cực trong khi lạm phát, tăng trưởng GDP có tác động tiêu cực đến lợi nhuận của NHTM.
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Lindbäck, Toril, Simon P. Hardy, Richard Dietrich, Marianne Sødring, Andrea Didier, Maximilian Moravek, Annette Fagerlund, et al. "Cytotoxicity of the Bacillus cereus Nhe Enterotoxin Requires Specific Binding Order of Its Three Exoprotein Components." Infection and Immunity 78, no. 9 (July 12, 2010): 3813–21. http://dx.doi.org/10.1128/iai.00247-10.
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ABSTRACT This study focuses on the interaction of the three components of the Bacillus cereus Nhe enterotoxin with particular emphasis on the functional roles of NheB and NheC. The results demonstrated that both NheB and NheC were able to bind to Vero cells directly while NheA lacked this ability. It was also shown that Nhe-induced cytotoxicity required a specific binding order of the individual components whereby the presence of NheC in the priming step as well as the presence of NheA in the final incubation step was mandatory. Priming of cells with NheB alone and addition of NheA plus NheC in the second step failed to induce toxic effects. Furthermore, in solution, excess NheC inhibited binding of NheB to Vero cells, whereas priming of cells with excess NheC resulted in full toxicity if unbound NheC was removed before addition of NheB. By using mutated NheC proteins where the two cysteine residues in the predicted β-tongue were replaced with glycine (NheCcys−) or where the entire hydrophobic stretch was deleted (NheChr−), the predicted hydrophobic β-tongue of NheC was found essential for binding to cell membranes but not for interaction with NheB in solution. All data presented here are compatible with the following model. The first step in the mode of action of Nhe is associated with binding of NheC and NheB to the cell surface and probably accompanied by conformational changes. These events allow subsequent binding of NheA, leading to cell lysis.
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Alirezaei, Toktam, Hamid Soori, Rana Irilouzadian, and Hadis Najafimehr. "Novel Anthropometric Indices as Screening Tools for Obesity: A Study on Healthy Iranians." Journal of Nutrition and Metabolism 2023 (October 3, 2023): 1–9. http://dx.doi.org/10.1155/2023/6612411.
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Background and Aims. Upper body fat distribution is more related to cardiometabolic diseases than central obesity. Neck circumference (NC) and neck-to-height ratio (NHtR) are two indicators of upper body obesity that are affordable, easy to obtain, highly reproducible, and more practical in the crowded health centers than the classic anthropometric indices. Methods. 18–65-year-old individuals with no past medical history were included. After obtaining written informed consent, they were screened for hypertension, high blood glucose, and other abnormal laboratory results. Data were analyzed using SPSS and Mann–Whitney U test, Chi square test, Spearman’s correlation coefficient, and ROC curve. Results. In our 2,812 participants, NC had the lowest area under the curve (AUC) in both male and female obese and overweight subjects. NHtR and hip circumference (HC) had the highest AUC in men and women with obesity, respectively. The highest sensitivity for overweight men and women belonged to waist circumference (WC) and waist-to-height ratio (WHtR), respectively, and for both males and females with obesity, NHtR had the highest sensitivity. The cutoff point of NHtR had the same value for males and females. HC and NHtR had the highest positive likelihood ratio (PLR) for obesity in men. In addition, HC and WC had the highest PLR for obesity in women. Conclusion. In this study, we revealed that NC had the lowest and NHtR and HC had the highest predictive value for obesity. Furthermore, for both males and females with obesity, NHtR had the highest sensitivity. HC had the highest PLR for obesity in both genders. Our results warrant prospective studies to evaluate the role of NHtR and other novel anthropometric indices in the risk of cardiometabolic diseases.
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Wang, Dequan, Minfu Liao, Rufan Wang, Tenghui Li, Jun Qiu, Jinjin Li, Xiongying Duan, and Jiyan Zou. "Research on Vacuum Arc Commutation Characteristics of a Natural-Commutate Hybrid DC Circuit Breaker." Energies 13, no. 18 (September 15, 2020): 4823. http://dx.doi.org/10.3390/en13184823.
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Vacuum arc commutation is an important process in natural-commutate hybrid direct current (DC) circuit breaker (NHCB) interruption, as the duration of vacuum arc commutation will directly affect the arcing time and interrupting time of NHCB. In this paper, the vacuum arc commutation model of NHCB was established by simplifying solid-state switch (SS) and vacuum arc voltage. Through theoretical analysis and experiments, the vacuum arc commutation characteristics of NHCB were studied. The mathematical formula of the effect of main parameters on the duration of vacuum arc commutation is obtained, and the changing law of the influence of the main parameters on the duration of the vacuum arc commutation is explored. The concept of vacuum arc commutation coefficient is proposed, and it is a key parameter that influences the vacuum arc commutation characteristics. The research on the characteristics of vacuum arc commutation can provide theoretical foundation for the structure and parameter optimization of NHCB and other equipment that uses vacuum arc commutation.
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Cù Nguyễn Hà Trang, Trần Linh Anh, Lê Minh Anh, and Nguyễn Thị Thu Huyền. "Chuyển đổi số: Tác động của ứng dụng công nghệ thông tin tới rủi ro của ngân hàng thương mại." VNU JOURNAL OF ECONOMICS AND BUSINESS. 4, no. 1 (February 25, 2024): 42. http://dx.doi.org/10.57110/jebvn.v4i1.248.
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Sự tác động của công nghệ thông tin và chuyển đổi số đã đặt ra nhiều thách thức đối với sự ổn định tài chính của ngân hàng. Dựa vào bộ dữ liệu gồm 11 ngân hàng thương mại (NHTM) tại Việt Nam giai đoạn 2005-2020, nghiên cứu kiểm định tác động của ứng dụng công nghệ thông tin đến rủi ro của các NHTM. Kết quả cho thấy sự ứng dụng công nghệ thông tin tác động tích cực, làm giảm thiểu rủi ro của các NHTM, từ đó giúp ổn định hệ thống ngân hàng. Nghiên cứu cũng chỉ ra rằng rủi ro của NHTM tương đối nhạy cảm với các yếu tố mang tính đặc thù của ngân hàng như quy mô ngân hàng và tỷ suất sinh lời trên vốn chủ sở hữu. Bên cạnh đó, kết quả nghiên cứu cho thấy các NHTM nên tập trung nâng cao hạ tầng nhân lực và ứng dụng công nghệ thông tin nội bộ, góp phần giảm thiểu rủi ro cho ngân hàng. Trên cơ sở đó, nhóm tác giả đưa ra một số hàm ý đối với hoạt động quản trị và các chính sách quản lý nhằm giảm thiểu rủi ro cho các NHTM tại Việt Nam.
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Nguyễn An Giang and Phan Diên Vỹ. "Tác động của nhận thức về dịch vụ ngân hàng số, trải nghiệm khách hàng đến hiệu suất hoạt động của các ngân hàng thương mại Việt Nam." Tạp chí Kinh tế và Ngân hàng châu Á, no. 209 (August 24, 2023): 97–109. http://dx.doi.org/10.63065/vol.iss209.id82990.
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Các yếu tố trải nghiệm của khách hàng có ảnh hưởng đến việc nâng cao hiệu quả ứng dụng công nghệ để nâng cao hiệu suất hoạt động cho các ngân hàng thương mại (NHTM). Do đó, trải nghiệm của khách hàng cần được xem xét trong mối quan hệ giữa ngân hàng số và hiệu suất hoạt động của các NHTM Việt Nam. Nghiên cứu này được thực hiện nhằm xác định cụ thể tác động của nhận thức về dịch vụ ngân hàng số, trải nghiệm khách hàng đến hiệu suất hoạt động của các NHTM Việt Nam. Bài viết sử dụng phương pháp phân tích nhân tố khẳng định (CFA), phương pháp phân tích mô hình cấu trúc tuyến tính (SEM) với dữ liệu 443 khách hàng có sử dụng dịch vụ ngân hàng số tại các NHTM Việt Nam. Kết quả nghiên cứu cho thấy, các nhân tố Khả năng sử dụng (KNSD), Nhận thức tiện lợi (STL), Chất lượng chức năng (CLC), Chất lượng dịch vụ (CDV), Nhận thức an toàn (RR), Nhận thức thương hiệu (TH) đều tác động đến trải nghiệm của khách hàng đối với dịch vụ ngân hàng số tại các NHTM. Bên cạnh đó, trải nghiệm của khách hàng đối với dịch vụ ngân hàng số có tác động tích cực đến hiệu suất hoạt động của các NHTM. Trên cơ sở kết quả nghiên cứu, nhóm tác giả đề xuất một số hàm ý quản trị nhằm nâng cao hiệu suất hoạt động của các NHTM Việt Nam.
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Nguyễn An Giang and Phan Diên Vỹ. "Tác động của nhận thức về dịch vụ ngân hàng số, trải nghiệm khách hàng đến hiệu suất hoạt động của các ngân hàng thương mại Việt Nam." Tạp chí Kinh tế và Ngân hàng châu Á, no. 209 (August 24, 2023): 97–109. http://dx.doi.org/10.63065/ajeb.vn.2023.209.82990.
Full textAbstract:
Các yếu tố trải nghiệm của khách hàng có ảnh hưởng đến việc nâng cao hiệu quả ứng dụng công nghệ để nâng cao hiệu suất hoạt động cho các ngân hàng thương mại (NHTM). Do đó, trải nghiệm của khách hàng cần được xem xét trong mối quan hệ giữa ngân hàng số và hiệu suất hoạt động của các NHTM Việt Nam. Nghiên cứu này được thực hiện nhằm xác định cụ thể tác động của nhận thức về dịch vụ ngân hàng số, trải nghiệm khách hàng đến hiệu suất hoạt động của các NHTM Việt Nam. Bài viết sử dụng phương pháp phân tích nhân tố khẳng định (CFA), phương pháp phân tích mô hình cấu trúc tuyến tính (SEM) với dữ liệu 443 khách hàng có sử dụng dịch vụ ngân hàng số tại các NHTM Việt Nam. Kết quả nghiên cứu cho thấy, các nhân tố Khả năng sử dụng (KNSD), Nhận thức tiện lợi (STL), Chất lượng chức năng (CLC), Chất lượng dịch vụ (CDV), Nhận thức an toàn (RR), Nhận thức thương hiệu (TH) đều tác động đến trải nghiệm của khách hàng đối với dịch vụ ngân hàng số tại các NHTM. Bên cạnh đó, trải nghiệm của khách hàng đối với dịch vụ ngân hàng số có tác động tích cực đến hiệu suất hoạt động của các NHTM. Trên cơ sở kết quả nghiên cứu, nhóm tác giả đề xuất một số hàm ý quản trị nhằm nâng cao hiệu suất hoạt động của các NHTM Việt Nam.
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Takao, Ken-ichi, Akihiro Ogura, Keisuke Yoshida, and Siro Simizu. "Total Synthesis of Natural Products Using Intramolecular Nozaki–Hiyama–Takai–Kishi Reactions." Synlett 31, no. 05 (February 3, 2020): 421–33. http://dx.doi.org/10.1055/s-0039-1691580.
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In this Account, we describe our studies on the total synthesis of several natural products using intramolecular Nozaki–Hiyama–Takai–Kishi (NHTK) reactions. In each synthesis, an NHTK reaction is used to efficiently construct a medium-sized ring. These examples demonstrate the utility of the intramolecular NHTK reaction in natural product synthesis.1 Introduction2 Total Synthesis of (+)-Pestalotiopsin A3 Total Synthesis of (+)-Cytosporolide A4 Total Synthesis of (+)-Vibsanin A5 Total Syntheses of (+)-Aquatolide and Related Humulanolides6 Conclusion
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Bird, Guy, Mark Glyde, Giselle Hosgood, Alex Hayes, and Rob Day. "Effect of Plate Type and Working Length on a Synthetic Compressed Juxta-Articular Fracture Model." VCOT Open 03, no. 02 (July 2020): e119-e128. http://dx.doi.org/10.1055/s-0040-1716722.
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Abstract Objective This investigation compared the biomechanical properties of a 2.0 mm locking compression notched head T-plate (NHTP) and 2.0 mm straight locking compression plate (LCP), in a compressed, short, juxta-articular fragment fracture model. Methods Two different screw configurations were compared for the NHTP and LCP, modelling short (configuration 1) and long working length (configuration 2). Constructs were tested in compression, perpendicular and tension four-point bending and torsion. Plate surface strain was measured at 12 regions of interest using three-dimensional digital image correlation. Stiffness and strain were compared. Results The LCP was stiffer than the NHTP in all three planes of bending (p < 0.05). The NHTP was stiffer than the LCP in torsion (p < 0.05). The NHTP had greater strain than the LCP during compression bending and torsion (p < 0.0005). The short working length NHTP was stiffer in all three planes of bending and in torsion (p < 0.05) than the longer working length. The short working length LCP was stiffer in compression bending and in torsion (p < 0.05) than the longer working length. The long working length showed greater strain than the short working length at multiple regions of interest. Conclusion In this experimental model of a compressed transverse fracture with a juxta-articular 9 mm fragment, a 2.0 mm LCP with two hybrid screws in the short fragment was stiffer than a 2.0 mm NHTP with three locking screws in the short fragment in three planes of bending but not torsion. Extending the working length of each construct reduced construct stiffness and increased plate strain.
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Benjamin, David Joseph, and Arash Rezazadeh. "Characterization and survival benefit of drugs approved for metastatic prostate cancer." Journal of Clinical Oncology 41, no. 6_suppl (February 20, 2023): 81. http://dx.doi.org/10.1200/jco.2023.41.6_suppl.81.
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81 Background: The treatment landscape of metastatic prostate cancer (mPC) drastically changed with the approval of chemotherapy (docetaxel) in 2004, and novel hormonal therapy (NHT) abiraterone in 2011. Since then, several other therapies have been approved in the metastatic castrate-sensitive (mCSPC) and -resistant (mCRPC) settings. Despite multiple drug approvals, it remains unclear how much improvement in survival these therapies have provided. Methods: We reviewed the US Food and Drug Administration (FDA) website to evaluate all approvals for prostate cancer from 2004 to 2022. We collected progression-free survival (PFS) and overall survival (OS) from the approval notification or from the corresponding clinical trial cited for drug approval. Results: Between 2004 and 2022, there were 14 drug (single or combination) approvals for mPC. Most approvals (81.3%) were granted through regular approval. Average PFS benefit for mCSPC was 4.8 months and average OS benefit for mCSPC was not reached in ongoing trials. Average PFS benefit for mCRPC was 3.7 months (range 1.9-5.4) and average OS benefit for mCRPC was 3.67 months. Conclusions: Despite 14 drug (single or combination) approvals for mPC since 2004, the improvements in average PFS and OS were modest in both castrate-sensitive and -resistant settings. OS data for several NHTs continues to mature, and may alter average OS benefits once median OS is reached. Nonetheless, continued drug development for mPC is warranted. [Table: see text]
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Botero Bernal, Andrés, Javier Orlando Aguirre Román, and Juan David Almeyda Sarmiento. "“No hay tiempo que perder”: disincronía temporal, desfactificación y psicopolítica como paradigmas del neoliberalismo contemporáneo." Universitas Philosophica 39, no. 79 (December 16, 2022): 179–207. http://dx.doi.org/10.11144/javeriana.uph.39-79.nhtp.
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El presente escrito tiene por objetivo demostrar cómo el estado actual del capitalismo neoliberal, entendido como una fuerza productora de la subjetividad basada en el rendimiento [síntesis de la disciplina (Foucault) y el control (Deleuze y Guattari) que se cataliza con la digitalidad (Han, Berardi, Fisher, entre otros)], se centra en ejercer una colonización frente al tiempo como concepto estructural de la existencia humana para poder desplegar un sistema de dispositivos psicopolíticos que le permitan su reproducción sistémica. Para conseguir este objetivo la investigación cuenta con tres momentos: el primero expone el paso del domino espacial del capitalismo fordista al neoliberalismo actual de carácter temporal desde una disincronía del tiempo. El segundo explica la desfactificación del mundo como la pérdida del vínculo humano con la realidad, lo que perturba directamente el estado de ánimo de los sujetos desde un peso cargado de nihilismo. Finalmente, se expone la psicopolítica como un concepto que parte tanto de la disincronía como de la desfactificación para posicionar un dominio sugestivo de la psique humana.
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Võ Thị Thúy Kiều. "Ảnh hưởng của độ mở tài chính và thể chế đến sự ổn định hệ thống ngân hàng thương mại tại các nước châu Á." Tạp chí Kinh tế và Ngân hàng châu Á, no. 214.215 (January 25, 2024): 102–15. http://dx.doi.org/10.63065/ajeb.vn.2024.214.215.98567.
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Bài viết nghiên cứu tác động của độ mở tài chính (ĐMTC) và thể chế đến sự ổn định hệ thống ngân hàng thương mại (NHTM) tại 35 nước châu Á giai đoạn 2011–2020. Thông qua phương pháp bình phương tối thiểu tổng quát khả thi (Feasible Generalized Least Square-FGLS), kết quả nghiên cứu cho thấy ĐMTC được đo lường theo Chinn & Ito (2008) có tác động cùng chiều mạnh mẽ đến sự ổn định hệ thống NHTM được đo lường bằng ZSCORE; đồng thời các chỉ số thể chế bao gồm kiểm soát tham nhũng, hiệu quả chính phủ, pháp quyền, tiếng nói và trách nhiệm giải trình tốt sẽ gia tăng sự ổn định hệ thống NHTM. Từ đó, bài viết gợi ý các chính sách nhằm gia tăng sự ổn định hệ thống NHTM.
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Zhou, Mengxi, Harshraj Leuva, Rumen Stamatov, Prabhjot Singh Mundi, Yeun-Hee Anna Park, Susan Elaine Bates, Izak Faiena, and Antonio Tito Fojo. "An analysis to inform the timing of docetaxel use leveraging data from the United States Veterans Administration on patients with metastatic castration-sensitive prostate cancer (mCSPC)." Journal of Clinical Oncology 41, no. 16_suppl (June 1, 2023): 5085. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.5085.
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5085 Background: Every oncologist caring for patients(pts) with a diagnosis of mCSPC at some point finds themselves deciding whether to use docetaxel (DOCE) in 1st line or later, a difficult selection often based on perceived tolerability. In1st line mCSPC, both novel hormonal therapies (NHTs) and DOCE have been shown effective, with direct comparisons lacking. We conducted the present analysis to help address this issue. Methods: All pts with mCSPC diagnosis in the VA Corporate Data Warehouse (CDW) who received either DOCE or NHT (abiraterone or enzalutamide) in the mCSPC setting and the converse after disease progression to castrate-resistant prostate cancer (mCRPC) were eligible for comparison. The cohort date range was from 7/2015 to 6/2022. We then created two arms — DOCE 1st and DOCE later — matched 1:1 exactly for age, race, total lines of therapy received, PSA at diagnosis, Gleason score (GS), Charlson comorbidity index (CI) excluding cancer diagnosis, and rurality. Results: 580 pts met study eligibility, with two 147 patient cohorts identified for matched analysis. Median age was 69 (64-73) and 70 (65-73) for the DOCE 1st and DOCE later cohorts, respectively. In both cohorts, 66%/31% were white/black. Starting PSA was <20/≥20 in 36%/64%. 60% had GS≥8. CI was <5/≥5 in 80%/20%. 2/≥3 total lines of therapy had been given to 32%/68%. Urban/rural distribution was 74%/26%. Median follow up of 30.2/23.7 months for DOCE 1st/DOCE later, reflects DOCE approval in mCSPC two years before approval of NHTs. Median OS were 37.9/31.6 months for DOCE 1st/DOCE later, [HR 0.65 (0.48-0.89), p=0.012], with HRs when comparing those from each cohort with GS≥8 or with starting PSA≥20, of 0.7 (0.47-1.05), p=0.018 for GS≥8, and 0.48 (0.32-0.73) p=0.001 for starting PSA≥20, both in favor of DOCE 1st. Duration of abiraterone treatment was greater in DOCE later with values of 284 (160-460) and 153 (90-286) days, p<0.0001 for DOCE later and DOCE 1st, respectively. Durations of DOCE treatment was statistically insignificant between cohorts at 135 (94-141) and 93 (51-177) days, p=0.35 for DOCE 1st and DOCE later, respectively. Surprisingly, time to mCRPC, defined as time from diagnosis to 1st mCRPC therapy, was longer but not statistically significant for DOCE later than for DOCE 1st, with durations of 23.7 and 20.3 months, respectively, p=0.23. Conclusions: Our data in US Veterans suggest the strategy of using DOCE upfront in those with mCSPC followed by a NHT on progression results in superior OS compared with DOCE later in mCRPC, especially in men with PSA≥20 as a surrogate for high volume disease. Concordant with data from CHAARTED and STAMPEDE arm C where single agent ADT was the reference and ADT + DOCE emerged as the SOC for high volume or high-risk disease, the 6.3-month survival difference between strategies in this analysis argues for consideration of a prospective comparative study.
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Nishioka, Hiroaki, and Yuuki Okumura. "Transient Aortitis after COVID-19 mRNA Vaccination." Mediterranean Journal of Rheumatology 35, no. 1 (March 2024): 195. http://dx.doi.org/10.31138/mjr.231020.nht.
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McCabe, Esther D., Mike E. King, Karol E. Fike, Maggie J. Smith, Kevin L. Hill, Glenn M. Rogers, and Kenneth G. Odde. "14 Effect of implant status and non-hormone treated cattle status on sale price of beef calves-Superior Livestock Video Auction." Journal of Animal Science 97, Supplement_2 (July 2019): 7. http://dx.doi.org/10.1093/jas/skz122.012.
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Abstract The objective was to determine the sale prices of beef calf lots enrolled in the non-hormone treated cattle (NHTC) program and those that received implants, sold through summer video auctions from 2010 through 2018. Data analyzed were collected from 67 summer livestock video auctions from 2010 through 2018. There were 40,941 lots of beef calves used in the analyses. All lot characteristics that could be accurately quantified or categorized were used to develop multiple regression models that evaluated the effects of independent factors on sale price each year using a backwards selection procedure. A value of P < 0.05 was used to maintain a factor in the final models. The NHTC program is a USDA-approved program created in 1999, when the European Union and the United States agreed to control measures for trade of non-hormone treated beef. By definition, these cattle could not receive growth-promoting implants. The percentage of lots enrolled in the NHTC program grew from 5.2% to 23.8% from 2010 through 2018 (Table 1). The largest increase was 8 percentage points from 2017 to 2018. For seven of the nine years, premiums were associated with NHTC lots. The added value for a lot of beef calves enrolled in the NHTC program ranged from $1.02/45.36 kg in 2013 to $4.04/45.36 kg in 2014. In the nine years of analysis, implant status did not result in price reduction in any year. While the percentage of NHTC lots grew, we did not see a corresponding decline in the value of implanted lots.
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NURFAIJA, NURFAIJA. "PENERAPAN MODEL PEMBELAJARAN KOOPERATIF TIPE NUMBERED HEAD TOGETHER (NHT) TERHADAP MOTIVASI DAN HASIL BELAJAR SISWA PADA MATERI SISTEM PEREDARAN DARAH KELAS XI IPA SMA NEGERI 1 NABIRE." Jurnal Ilmu Pendidikan Indonesia 5, no. 3 (June 28, 2018): 49–58. http://dx.doi.org/10.31957/jipi.v5i3.320.
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Penelitian ini bertujuan untuk mengetahui pengaruh model pembelajaran kooperatif NHT terhadap motivasi belajar siswa dan pengaruh model pembelajaran kooperatif NHT terhadap hasil belajar siswa pada sistem peredaran materi. Jenis penelitian ini adalah studi eksperimental yang melibatkan dua kelompok atau kelas eksperimen kelas dengan menggunakan model pembelajaran kooperatif NHT dan kontrol kelas dengan menggunakan model pembelajaran konvensional. Pengambilan sampel dilakukan secara purposive sampling. Hasil penelitian menunjukkan beberapa perbedaan motivasi siswa untuk menggunakan model pembelajaran kooperatif NHT dan penggunaan model konvensional, dapat dilihat dari perbedaan skor yang diperoleh kelas eksperimen 84,24% dengan nilai total 138,25 dan kelas kontrol 82,99% dengan nilai total 136,10. Hasil perbedaan kelas dan kelas NHT secara konvensional diperoleh sig <0,05 (0,000 <0,05) berarti ada perbedaan penggunaan model pembelajaran kooperatif NHT terhadap motivasi belajar siswa. Demikian pembelajaran kooperatif tipe NHT untuk mengetahui hasil pada sistem peredaran material n-Gain yang diperoleh adalah 0,70 untuk kelas konvensisonal dan kelas NHT 0,58. NHT termasuk kategori kelas tinggi, sedangkan kategori kelas konvensional kelas, ini mengindikasikan bahwa model pembelajaran kooperatif NHT dapat meningkatkan hasil belajar siswa. Ada perbedaan hasil belajar siswa antara kelas dan kelas NHT thit <t tabel (0,02 <0,05). Hasil penelitian ini menunjukkan bahwa terdapat perbedaan motivasi dan hasil belajar siswa dengan menggunakan model pembelajaran kooperatif NHT dan bahwa dengan menggunakan model konvensional pada sistem perumusan materi pelajaran kelas XI IPA di SMA Negeri 1 Kabupaten 1 Nabire. Kata kunci: NHT, motivasi, hasil belajar, sistem peredaran darah.
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Quỳnh, Nguyễn Thị Như, and Lê Đình Luân. "Tác động của chuyển đổi số đến năng lực cạnh tranh của các Ngân hàng Thương mại tại Việt Nam." TẠP CHÍ KHOA HỌC ĐẠI HỌC MỞ THÀNH PHỐ HỒ CHÍ MINH - KINH TẾ VÀ QUẢN TRỊ KINH DOANH 18, no. 2 (October 18, 2022): 104–18. http://dx.doi.org/10.46223/hcmcoujs.econ.vi.18.1.2098.2023.
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Bối cảnh hội nhập ngày một sâu và rộng với thế giới đã yêu cầu các Ngân Hàng Thương Mại (NHTM) trong nước phải gia tăng năng lực cạnh tranh, nhất là cuộc Cách Mạng Công Nghiệp lần thứ tư (CMCN 4.0) đang diễn ra mạnh mẽ. Mục tiêu của nghiên cứu nhằm phân tích tác động của chuyển đổi số đến năng lực cạnh tranh của các NHTM tại Việt Nam. Với dữ liệu khảo sát từ 150 nhân sự của các NHTM vào tháng 10/2021, thông qua phương pháp phân tích yếu tố khám phá (EFA), bài viết đã chỉ ra, chuyển đổi số thông qua các ứng dụng ngân hàng điện tử và ngân hàng số cũng như quá trình xâm nhập nhanh của các công ty công nghệ tài chính (fintech) là yếu tố quan trọng ảnh hưởng tích cực đến khả năng cạnh tranh của các NHTM. Ngoài chuyển đổi số, đa dạng hóa dịch vụ cũng ảnh hưởng tích cực đến nhân tố này trong khi rủi ro lại là nhân tố ảnh hưởng ngược chiều đến khả năng cạnh tranh. Từ kết quả được rút ra, nhóm tác giả đề xuất một số hàm ý chính sách để nâng cao khả năng cạnh tranh của các NHTM trong thời gian tới.
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Quỳnh, Nguyễn Thị Như, and Lê Đình Luân. "Tác động của chuyển đổi số đến năng lực cạnh tranh của các Ngân hàng Thương mại tại Việt Nam." TẠP CHÍ KHOA HỌC ĐẠI HỌC MỞ THÀNH PHỐ HỒ CHÍ MINH - KINH TẾ VÀ QUẢN TRỊ KINH DOANH 18, no. 2 (October 18, 2022): 104–18. http://dx.doi.org/10.46223/hcmcoujs.econ.vi.18.2.2098.2023.
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Bối cảnh hội nhập ngày một sâu và rộng với thế giới đã yêu cầu các Ngân Hàng Thương Mại (NHTM) trong nước phải gia tăng năng lực cạnh tranh, nhất là cuộc Cách Mạng Công Nghiệp lần thứ tư (CMCN 4.0) đang diễn ra mạnh mẽ. Mục tiêu của nghiên cứu nhằm phân tích tác động của chuyển đổi số đến năng lực cạnh tranh của các NHTM tại Việt Nam. Với dữ liệu khảo sát từ 150 nhân sự của các NHTM vào tháng 10/2021, thông qua phương pháp phân tích yếu tố khám phá (EFA), bài viết đã chỉ ra, chuyển đổi số thông qua các ứng dụng ngân hàng điện tử và ngân hàng số cũng như quá trình xâm nhập nhanh của các công ty công nghệ tài chính (fintech) là yếu tố quan trọng ảnh hưởng tích cực đến khả năng cạnh tranh của các NHTM. Ngoài chuyển đổi số, đa dạng hóa dịch vụ cũng ảnh hưởng tích cực đến nhân tố này trong khi rủi ro lại là nhân tố ảnh hưởng ngược chiều đến khả năng cạnh tranh. Từ kết quả được rút ra, nhóm tác giả đề xuất một số hàm ý chính sách để nâng cao khả năng cạnh tranh của các NHTM trong thời gian tới.
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Phan Hữu Việt, Trần Thị Hòa, Nguyễn Hải Ninh, and Nguyễn Duy Anh. "Tình hình phát triển mạng lưới của các ngân hàng thương mại tại Việt Nam: Thực trạng và giải pháp." Tạp chí Kinh tế và Ngân hàng châu Á, no. 199 (July 10, 2023): 71–85. http://dx.doi.org/10.63065/ajeb.vn.2022.199.81420.
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Thông tư số 21/2013/TT-NHNN quy định về cấp phép mạng lưới của các ngân hàng thương mại (NHTM) và các Thông tư sửa đổi bổ sung (Thông tư 21) là một trong những chính sách quan trọng nhằm đảm bảo việc mở rộng mạng lưới đi kèm với an toàn, hiệu quả hoạt động (HQHĐ), từng bước đáp ứng nhu cầu phát triển kinh tế-xã hội ở địa phương và phù hợp với định hướng của Đảng, Chính phủ về tài chính toàn diện. Sau một thời gian triển khai, Thông tư 21 đã đạt được một số hiệu quả nhất định trong việc cấp phép mở rộng mạng lưới của các NHTM tại Việt Nam. Nhằm đánh giá tình hình hoạt động của mạng lưới các NHTM được cấp phép theo quy định Thông tư 21, nhóm tác giả đã sử dụng mô hình DEA để từ đó đề xuất giải pháp định hướng sửa đổi, bổ sung quy định pháp lý nhằm cơ cấu lại mạng lưới các NHTM trong tương lai. Qua đó, các dịch vụ ngân hàng được cung ứng một cách toàn diện hơn cho nền kinh tế, từng bước phát triển kinh tế theo hướng bền vững cũng như nâng cao HQHĐ của chính các NHTM, đặc biệt là những khu vực vùng sâu, vùng xa.
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Farzat, Mahmoud, Peter Weib, Iurii Sukhanov, Josef Rosenbauer, Christian Tanislav, and Florian M. Wagenlehner. "Effect of Neoadjuvant Hormonal Therapy on the Postoperative Course for Patients Undergoing Robot-Assisted Radical Prostatectomy." Journal of Clinical Medicine 12, no. 9 (April 22, 2023): 3053. http://dx.doi.org/10.3390/jcm12093053.
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Objectives: Neoadjuvant hormonal therapy (NHT) preceding robot-assisted radical prostatectomy (RARP) may be beneficial in high-risk cases to facilitate surgical resection. Yet, its improvement in local tumor control is not obvious. Its benefit regarding overall cancer survival is also not evident, and it may worsen sexual and hormonal functions. This study explores the effect of NHT on the perioperative course after RARP. Methods: In this study, 500 patients from a tertiary referral center who underwent RARP by a specialized surgeon were retrospectively included. Patients were divided into two groups: the NHT (n = 55, 11%) group, which included patients who received NHT (median: 1 month prior to RARP), and the standard non-NHT (NNHT) group (n = 445, 89%). Demographic and perioperative data were analyzed. Postoperative results, complications, and readmission rates were compared between the groups. Results: NHT patients were heterogeneous from the rest regarding cancer parameters such as PSA (25 vs. 7.8 ng/mL) and tumor risk stratification, and they were more comorbid (p = 0.006 for the ASA score). They also received fewer nerve-sparing procedures (14.5% vs. 80.4%), while the operation time was similar. Positive surgical margins (PSM) (21.8% vs. 5.4%) and positive lymph nodes (PLN) (56.4% vs. 12.7%) were significantly higher in the NHT group compared to the non-NHT (NNHT) group. Hospital stay was equal, whereas catheter days were 3 days longer in the NHT group. NHT patients also suffered more minor vesicourethral-anastomosis-related complications. Major complications (p = 0.825) and readmissions (p = 0.070) did not differ between groups. Conclusion: Patients receiving NHT before RARP did not experience more major complications or readmissions within 90 days after surgery. Patients with unfavorable, high-risk tumors may benefit from NHT since it facilitates surgical resection. Randomized controlled trials are necessary to measure the advantages and disadvantages of NHT.
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Bùi Đan Thanh and Nguyễn Quang Huy. "Tác động của sở hữu nước ngoài đến rủi ro thanh khoản tại các ngân hàng thương mại Việt Nam." Tạp chí Kinh tế và Ngân hàng châu Á, no. 194 (June 1, 2023): 23–40. http://dx.doi.org/10.63065/ajeb.vn.2022.194.80019.
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Bài viết nghiên cứu ảnh hưởng của tỷ lệ sở hữu nước ngoài (SHNN) đến rủi ro thanh khoản (RRTK) của các ngân hàng thương mại (NHTM) Việt Nam trong giai đoạn 2009–2020. Sử dụng các phương pháp hồi quy dữ liệu bảng bao gồm Pooled OLS, FEM, REM và GLS với mẫu dữ liệu của 30 NHTM Việt Nam, kết quả nghiên cứu cho thấy tỷ lệ SHNN càng cao thì RRTK của các NHTM càng giảm. Bên cạnh đó, các biến rủi ro tín dụng, tỷ lệ vốn chủ sở hữu, tỷ lệ cho vay trên huy động vốn và tăng trưởng kinh tế có tác động đáng kể đến RRTK.
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Kang, Jihyeon, Jinho Kim, Chae-Min Shin, and Boyoung Park. "An investigation of the current status of the new Health Technology Assessment in Korea and factors influencing assessment results." Journal of the Korean Medical Association 67, no. 1 (January 10, 2024): 54–66. http://dx.doi.org/10.5124/jkma.2024.67.1.54.
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Background: This study aims to evaluate factors influencing assessment results in the new Health Technology Assessment (nHTA) in Korea.Methods: We analyzed publicly available nHTA reports obtained from the program’s website. A total of 258 reports, encompassing 305 technologies, were included. Reported details were categorized into three main areas: technical characteristics, evaluation methods, and publication types. To investigate differences in evidence level (high, medium, or low) and assessment results (pass or fail) according to these categories, we employed a chi-squared test. Univariate and multivariate logistic regression analyses were further conducted to identify factors associated with evidence level and assessment results.Results: nHTA reports employing meta-analysis and included randomized trials for evidence synthesis exhibited a higher likelihood of achieving high evidence level (odds ratio [OR], 5.008; 95% confidence interval [CI], 1.265- 18.826 and OR, 27.052; 95% CI, 7.802-103.330, respectively). Increasing evidence level was significantly associated with a higher possibility of passing the assessment (OR 2.789; 95% CI, 1.284-6.057). However, in univariate analysis, neither performing meta-analysis nor including randomized trials, both of which were associated with evidence level, demonstrated a statistically significant association with assessment results.Conclusion: This study represents the first systematic analysis of factors influencing nHTA assessment results in Korea. While increased evidence level was associated with positive assessment outcomes, factors affecting the evidence level itself did not directly influence assessment results. This suggests the need for further efforts to effectively integrate high-level evidence into assessment decisions within the nHTA program.
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Rijal, Muhammad, Ajeng Gelora Mastuti, Dian Safitri, Suhaedir Bachtiar, and Salma Samputri. "Differences in learners’ critical thinking by ability level in conventional, NHT, PBL, and integrated NHT-PBL classrooms." International Journal of Evaluation and Research in Education (IJERE) 10, no. 4 (December 1, 2021): 1133. http://dx.doi.org/10.11591/ijere.v10i4.21408.
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<span>This study aimed to analyze the effect of conventional, Problem-Based Learning (PBL), Numbered-Head Together (NHT), and integrated PBL-NHT learning models on the low- and high-ability students’ critical thinking. This quasi-experimental study used a pretest-post-test nonequivalent control group design with a four-by-two factorial pattern. The analysis results showed that learners’ critical thinking was impacted by learning models implemented in the classroom and influenced by the interaction between the learning models and learners’ academic abilities. There was no difference in critical thinking among low-ability students who were taught with PBL, conventional, and integrated PBL-NHT, but a difference was found in students taught using NHT. There was no difference in critical thinking between high-ability students taught with conventional and NHT instruction, but there was a difference between students taught with PBL and integrated PBL-NHT instruction. To foster critical thinking, pupils with low academic ability should be taught using NHT, whereas those with high academic ability should be taught using PBL or an integrated PBL-NHT approach.</span>
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Pangestika, Liana. "Efektivitas model NHT tipe kepala bernomor terstruktur berbantuan Word Square." AKSIOMA : Jurnal Matematika dan Pendidikan Matematika 10, no. 2 (December 13, 2019): 155–61. http://dx.doi.org/10.26877/aks.v10i2.3739.
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Sebagian besar peserta didik kelas VIII SMP N 19 Tegal mempunyai prestasi belajar yang rendah dibawah KKM. Hal ini didasari dengan penggunaan model pembelajaran konvensional yang berpusat kepada guru. Berkaitan dengan hal ini perlu adanya usaha dari guru untuk menjadikan pelajaran matematika sebagai pelajaran yang menarik dan menyenangkan dengan menerapkan model pembelajaran yang tepat. Usaha yang ditempuh adalah menerapkan model pembelajaran NHT Tipe Kepala Bernomor Terstruktur berbantuan word square. Tujuan penelitian ini adalah (1)terdapat perbedaan prestasi belajar matematika peserta didik antara yang diajar dengan model pembelajaran NHT Tipe Kepala Bernomor Terstruktur berbantuan word square dengan yang diajar menggunakan model pembelajaran NHT Tipe Kepala Bernomor Terstruktur tanpa berbantuan word square; (2)model pembelajaran NHT Tipe Kepala Bernomor Terstruktur berbantuan word square lebih baik daripada model pembelajaran NHT Tipe Kepala Bernomor Terstruktur tanpa berbantuan word square. Teknik analisis data yang digunakan adalah uji t dua pihak dan uji t satu pihak kanan, yang sebelumnya telah dilakukan uji prasyarat yaitu uji normalitas dan uji homogenitas. Hasil penelitian menunjukkan bahwa: (1)terdapat perbedaan prestasi belajar matematika peserta didik antara yang diajar dengan model pembelajaran NHT Tipe Kepala Bernomor Terstruktur berbantuan word square dengan yang diajar menggunakan model pembelajaran NHT Tipe Kepala Bernomor Terstruktur tanpa berbantuan word square; (2) model pembelajaran NHT Tipe Kepala Bernomor Terstruktur berbantuan word square lebih baik daripada model pembelajaran NHT Tipe Kepala Bernomor Terstruktur tanpa berbantuan word square.Kata kunci: Prestasi Belajar; Word Square; NHT Tipe Kepala Bernomor Terstruktur
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Hariana, Hilda Cahyani. "Improvement of Student Geography Learning Achievement Trough Application of Coperative Learning Model Type “Numbered Head Together” in X Grade SMAN 2 Watansoppeng." UNM Geographic Journal 2, no. 1 (September 1, 2018): 48. http://dx.doi.org/10.26858/ugj.v2i1.5561.
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This study aimed to assess whether NHT cooperative learning model to improve learning outcomes of students geography. Implementation of the actions performed by 2 cycles, each cycle consists of planning, action, observation and evaluation, and reflection. Analysis using quantitative descriptive analysis. The results showed that: there is an increase in learning outcomes for implementing cooperative learning model NHT during the execution of the learning cycle I and xycle II. The everage value of the learning outcomes before deploying cooperative learning model NHT increased 68,09 after applied cooperative learning model NHT, in the first cycle is obtained mean values obtained by an average of 76,26. It can be concluded that through the application of learning models on the subjects geography of NHT can improve student learning outcomes geography class X2 SMAN 2 Watansoppeng.Penelitian ini bertujuan untuk mengkaji apakah model pembelajaran kooperatif tipe NHT dapat meningkatkan hasil belajar geografi siswa. Pelaksanaan tindakan yang dilakukan sebanyak 2 siklus, tiap siklus terdiri dari tahap perencanaan, pelaksanaan tindakan, observasi dan evaluasi dan refleksi. Teknik analisis data menggunakan analisis deskriptif kuantitatif. Hasil penelitian menunjukkan bahwa: ada peningkatan hasil belajar selama menerapkan model pembelajaran kooperatif tipe NHT selama pelaksanaan pembelajaran siklus I dan siklus II. Nilai rerata hasil belajar siswa yang sebelum diterapakan model pembelajaran kooperatif tipe NHT 68,09 meningkat sesudah diterapkan model pembelajaran kooperatif tipe NHT, pada siklus I diperoleh nilai rerata 69,74 dan Pada siklus II diperoleh nilai rerata sebesar 76,26.Dengan demikian dapat disimpulkan bahwa melalui penerapan model pembelajaran NHT pada mata pelajaran geografi dapat meningkatkan hasil belajar geografi siswa kelas X2 SMA Negeri 2 Watansoppeng.
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Muharromah, Sarah Devi, and Muslimin Ibrahim. "Pengembangan Lembar Kegiatan Peserta Didik (LKPD) berbasis Numbered Heads Together(NHT) untuk Mengurangi Dominasi Peserta Didik." Berkala Ilmiah Pendidikan Biologi (BioEdu) 10, no. 2 (February 25, 2021): 343–51. http://dx.doi.org/10.26740/bioedu.v10n2.p343-351.
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Dominasi peserta didik tertentu membuat penyerapan konsep materi tidak merata, khususnya bagi peserta didik yang kurang aktif. Panduan dalam kegiatan pembelajaran yang sesuai untuk mencegah dominasi salah satunya adalah LKPD yang memadukan karakteristik model pembelajaran Numbered Heads Together (NHT). Tujuan penelitian ini yaitu menghasilkan Lembar Kegiatan Peserta Didik (LKPD) berbasis Numbered Heads Together (NHT) untuk mengurangi dominasi peserta didik yang valid dan praktis. Kevalidan LKPD berbasis NHT dilakukan dengan metode validasi oleh dua orang dosen yaitu dosen ahli pendidikan dan dosen ahli materi menggunakan instrumen validasi yang berisi aspek isi, pedagogi, bahasa, cover, kesesuaian huruf, dan urutan langkah NHT. Kepraktisan LKPD diukur melalui keterbacaan teks yang ada dalam LKPD dan disesuaikan dengan Grafik Fray serta respon guru melalui metode wawancara terbuka. LKPD berabsis NHT berisi petunjuk peggunaan LKPD, permasalahan yang harus dipecahkan oleh peserta didik, serta kegiatan praktikum dan mejawab pertanyaan yang sesuai dengan karakteristik LKPD. Hasil dari penilaian validasi menyebutkan bahwa LKPD berbasis NHT valid dengan perolehan skor rata-rata aspek isi 3,83; aspek pedagogi 4; aspek bahasa 4; aspek penyajian cover 4; aspek kesesuaian huruf 4; dan aspek urutan langkah NHT 3,83 dengan katagori sangat valid. Hasil Kepraktisan LKPD dengan mengukur keterbacaan teks dalam LKPD yaitu praktis karena sesuai dengan tingkatan kelas peserta didik (kelas 11 SMA) dengan jumlah suku kata 142,4 dan 3,3 kalimat serta respon positif guru terhadap LKPD NHT dengan jawaban sesuai. Dengan dikembangkannya LKPD berbasis NHT maka dominasi peserta didik tertentu akan berkurang sehingga pemahaman konsep yang dimiliki peserta didik merata. Berdasarkan hasil penelitian maka dapat disimpulkan bahwa LKPD berbasis NHT valid dan praktis untuk mengurangi dominasi peserta didik tertentu secara teoritis.
Kata Kunci : LKPD, NHT, Dominasi, Peserta Didik, Valid, Praktis dan Efektif.
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Đặng Trí Dũng and Huỳnh Hồ Yến Linh. "Tác động của tỷ lệ sở hữu đến sự chấp nhận rủi ro của các ngân hàng thương mại Việt Nam." Tạp chí Kinh tế và Ngân hàng châu Á, no. 209 (August 24, 2023): 52–64. http://dx.doi.org/10.63065/vol.iss209.id82985.
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Nghiên cứu phân tích sự tác động của tỷ lệ sở hữu đến việc chấp nhận rủi ro (CNRR) của các ngân hàng thương mại Việt Nam (NHTM). Bài viết áp dụng phương pháp ước lượng bình phương bé nhất tổng quát khả thi (FGLS) từ dữ liệu bảng thu thập được của 32 NHTM Việt Nam giai đoạn 2012–2022, với biến phụ thuộc là Z-score đại diện cho CNRR và các biến đại diện cho tỷ lệ sở hữu của các NHTM Việt Nam là sở hữu nhà nước, sở hữu tư nhân và sở hữu nước ngoài. Kết quả cho thấy, sở hữu tư nhân ảnh hưởng tiêu cực và sở hữu nhà nước ảnh hưởng tích cực đến CNRR của các ngân hàng, cuối cùng là sở hữu nước ngoài không có tác động. Dựa vào đó, nhóm tác giả đề xuất một số khuyến nghị: (i) Tăng quy mô đi kèm với nâng cao chất lượng quản trị rủi ro; (ii) Giữ nguyên tỷ lệ sở hữu nhà nước ở mức độ nhất định; và (iii) Đồng thời nâng tỷ lệ sở hữu tư nhân trong các NHTM.
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Đặng Trí Dũng and Huỳnh Hồ Yến Linh. "Tác động của tỷ lệ sở hữu đến sự chấp nhận rủi ro của các ngân hàng thương mại Việt Nam." Tạp chí Kinh tế và Ngân hàng châu Á, no. 209 (August 24, 2023): 52–64. http://dx.doi.org/10.63065/ajeb.vn.2023.209.82985.
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Nghiên cứu phân tích sự tác động của tỷ lệ sở hữu đến việc chấp nhận rủi ro (CNRR) của các ngân hàng thương mại Việt Nam (NHTM). Bài viết áp dụng phương pháp ước lượng bình phương bé nhất tổng quát khả thi (FGLS) từ dữ liệu bảng thu thập được của 32 NHTM Việt Nam giai đoạn 2012–2022, với biến phụ thuộc là Z-score đại diện cho CNRR và các biến đại diện cho tỷ lệ sở hữu của các NHTM Việt Nam là sở hữu nhà nước, sở hữu tư nhân và sở hữu nước ngoài. Kết quả cho thấy, sở hữu tư nhân ảnh hưởng tiêu cực và sở hữu nhà nước ảnh hưởng tích cực đến CNRR của các ngân hàng, cuối cùng là sở hữu nước ngoài không có tác động. Dựa vào đó, nhóm tác giả đề xuất một số khuyến nghị: (i) Tăng quy mô đi kèm với nâng cao chất lượng quản trị rủi ro; (ii) Giữ nguyên tỷ lệ sở hữu nhà nước ở mức độ nhất định; và (iii) Đồng thời nâng tỷ lệ sở hữu tư nhân trong các NHTM.
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Lê Đình Luân, Nguyễn Thị Như Quỳnh, and Tạ Thu Hồng Nhung. "Tác động của đa dạng hóa thu nhập đến ổn định tài chính: Nghiên cứu trường hợp các ngân hàng thương mại Việt Nam." Tạp chí Kinh tế và Ngân hàng châu Á, no. 185 (April 26, 2023): 52–68. http://dx.doi.org/10.63065/ajeb.vn.2021.185.78787.
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Trong bối cảnh hội nhập quốc tế ngày một sâu rộng và cạnh tranh gay gắt, việc đa dạng hóa thu nhập (ĐDHTN) là xu hướng tất yếu để các ngân hàng gia tăng lợi nhuận, giảm rủi ro. Nghiên cứu được tiến hành nhằm xem xét mối quan hệ giữa ĐDHTN và ổn định tài chính của các ngân hàng thương mại (NHTM) Việt Nam thông qua dữ liệu của 27 NHTM trong giai đoạn 2008–2019 với phương pháp ước lượng SGMM. Kết quả nghiên cứu chỉ ra ngân hàng có mức độ ĐDHTN lớn thì rủi ro của ngân hàng càng gia tăng; hay nói một cách khác, ĐDHTN không phải là yếu tố giúp các NHTM Việt Nam tăng cường sự ổn định. Ngoài ra, nhóm tác giả cũng chỉ ra rằng, các yếu tố thuộc về nội tại ngân hàng như quy mô, hiệu quả quản trị chi phí và tỷ lệ tổng tiền gửi trên tổng nợ phải trả cũng như các yếu tố kinh tế vĩ mô có tác động đáng kể đến ổn định tài chính tại các NHTM Việt Nam.