Step Method Research Articles

Pathways linking loneliness and depressive symptoms among Chinese adolescents: The mediating role of sleep disturbance

BackgroundDespite growing evidence linking loneliness and depressive symptoms, the underlying pathways remain unclear. This study aims to assess the impact of loneliness on depressive symptoms among Chinese adolescents and investigate the potential mediating role of sleep disturbance. MethodsA cross-sectional study was conducted between November and December 2021. Loneliness, depressive symptoms, and sleep disturbance were assessed using the UCLA Loneliness Scale, the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index questionnaire, respectively. Baron and Kenny's causal steps method and the Karlson-Holm-Breen method were applied to explore the mediating role of sleep disturbance. Subgroup analysis by gender was also conducted. ResultsA total of 6838 adolescents were included, with 52.2 % boys and a mean age of 14.5 (SD = 1.6) years. Approximately 15.8 % of the adolescents reported depressive symptoms. Loneliness was positively associated with depressive symptoms after controlling for covariates (OR = 1.34, 95%CI = 1.31–1.36). After incorporating sleep disturbance into the model, the association was still significant (OR = 1.28, 95%CI = 1.25–1.31). Sleep disturbance partially mediated this association, contributing to 18.89 % of the total effects. The associations and mediation effects were consistent across both genders, with no moderating effect of gender observed. LimitationsThe cross-sectional design limits the ability to establish causality. ConclusionLoneliness was significantly associated with depressive symptoms in Chinese adolescents and this association was partially mediated by sleep disturbance. Interventions aimed at reducing loneliness and improving sleep quality may help lower the risk of depressive symptoms in Chinese adolescents, regardless of genders. Nevertheless, further randomized controlled trials are needed to confirm these findings.

Associations of cathepsins with pulmonary arterial hypertension mediated by circulating metabolites: A Mendelian randomization study.

The correlation between cathepsins and pulmonary arterial hypertension (PAH) is well-established, but the causative link between them remains uncertain. This study aimed to explore the causal role of circulating metabolites mediating cathepsins in PAH using Mendelian randomization (MR). A 2-sample 2-step MR method was used to identify causal relationship between cathepsins and PAH; causal relationship between circulating metabolites and PAH; and mediated effects of these circulating metabolites. GWAS summary statistics on circulating metabolites were from the Canadian longitudinal study on aging cohort, human plasma cathepsins from The INTERVAL study, and PAH from FinnGen version R10. Two-sample MR analyses involving 9 cathepsins (cathepsin B, E, F, G, H, L2, O, S, and Z). Cathepsin S was associated with high risk of PAH (OR: 1.346, 95% CI: 1.039-1.742, P = .024), and positively with circulating metabolite 1-oleoylglycerol (18:1) levels (OR: 1.062, 95% CI: 1.018-1.108, P = .005). Finally, mediation analysis showed evidence of mediated effect of cathepsin S on PAH through 1-oleoylglycerol (18:1) levels (OR: 0.062, CI: 0.0183-0.106) with a mediated proportion of 20.9% of the total effect. This study reveals cathepsin S increases the risk of PAH mediating by circulating metabolite 1-oleoylglycerol (18:1) levels.

DOP037 The V-Sync study: Validation of the synchronization of the ENEIDA and UR-CARE registry

Abstract Background European Crohn’s and Colitis Organisation [ECCO] to facilitate daily clinical practice and research studies in inflammatory bowel disease (IBD)1,2. The ENEIDA registry, promoted by the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU), aims to facilitate the prospective collection of clinical data of interest for clinical care practice3. Recently, a significant milestone was achieved by synchronizing these two databases, aimed at harmonizing and enhancing clinical data collection, streamlined research, and more effectively conducting translational studies. This synchronization allows for a unified approach to IBD data management among different countries, thereby facilitating comprehensive data analysis and improved patient care strategies. The aim of the V-SYNC study is to validate the synchronization between the databases, ensuring data integrity, consistency, and compatibility across both platforms. Furthermore, to draw learnings for future synchronization efforts between existing (national) databases and UR-CARE. Methods In a data comparison step, 100 patient data subsets will be randomly selected from the ENEIDA and URCARE databases, comprising 50 Crohn’s disease and 50 ulcerative colitis cases with complete datasets. Each group will be stratified by disease duration (<5 years or ≥5 years) and advanced therapy initiation. Key variables such as demographics, diagnosis, treatment history, outcomes, and follow-up data will be compared. Validation metrics, including concordance rates, correlation coefficients, and discrepancy analysis, will assess data consistency, with only patients having complete datasets included. In a functional testing step, usability tests will verify effective query and retrieval of synchronized data. Additionally, 10 quality of care queries will be applied to both registries to check for consistent results. These queries evaluate metrics such as advanced therapy usage, pre-treatment screenings, osteoporosis/osteopenia diagnosis, IBD and primary sclerosis cholangitis management, postoperative outcomes, biologic therapy responses, and smoking status. Results Data subsets from both registries are currently being exported and the validation is expected to be finalised by 2024. Conclusion Successful validation of the ENEIDA and URCARE database synchronization will set a precedent for data harmonization in IBD research, leading to improved data management practices, more accurate research findings, and ultimately better patient outcomes. This study will provide a framework for future synchronization efforts across other clinical and research databases.

The problem of educational research: its concept, methods of selection, evaluation, and steps for clarifying it

The problem of educational research: its concept, methods of selection, evaluation, and steps for clarifying it

Resident-Driven Guideline to Reduce Iatrogenic Pneumothoraxes From Small-Bore Feeding Tubes: A Quality and Safety Improvement Project.

Small-bore feeding tubes (SBFT) in vulnerable patients carry a risk of iatrogenic pneumothorax by misplacement into the lung. This institution noted a series of iatrogenic pneumothoraxes caused by the placement of these devices. A resident-led, multidisciplinary team developed a hospital guideline through a consensus-driven process. The guideline mandated SBFT placement by approved "super-users" via the CORTRAK Enteral Access System or via non-CORTRAK Methods, including the 2-step X-ray Method, fluoroscopy, or direct visualization techniques. A "super-user" Program for the CORTRAK Enteral Access System was developed to assure competency and consistency. With the development of the guideline and "super-user" program, the authors observed a decrease in the number of SBFT-related iatrogenic pneumothoraxes. Following a brief period of adoption, the three-hospital organization has had no SBFT-related iatrogenic pneumothoraxes. This project demonstrates the effectiveness of developing a resident-driven, evidence-based hospital guideline for the safe passage of SBFTs.

Robust scaling strategies for outlier handling in orthogonal projection to latent structures discriminant analysis (OPLS-DA)

Orthogonal projection to latent structures discriminant analysis (OPLS-DA) is a widely used statistical method in multivariate data analysis, particularly in class pattern recognition. In addition, OPLS-DA is an extension of partial least square (PLS) that separately considers the variance of correlated and orthogonal predictors in the projection process to the response. PLS is a linear method that is very sensitive to outliers, making OPLS-DA susceptible to the influence of outliers. Investigations have shown that outliers commonly exist in datasets and can significantly affect statistical analysis. Therefore, this research aimed to propose a robust scaling method in the pre-processing step of OPLS-DA to address outliers. The proposed method was tested using both simulated and actual datasets, and the result showed effectiveness in handling outliers and improving classification accuracy. Consequently, Robust OPLS-DA could be designed to achieve optimal classification results by effectively separating classes and increasing robustness against outliers.

Evaluasi Pengelolaan Hutan Kemasyarakatan (HKm) dan Dampaknya Terhadap Kondisi Hutan di Kelompok Perhutanan Hkm Buli Uher, Desa Ilinmedo Kecamatan Waiblama Kabupaten Sikka

The aims of evaluation of the community forest management of HKm Buli Uher, Ilinmedo Village, Waiblama District, Sikka Regency to observe and assess the implementation of HKm. The method used mixed method between qualitative and quantitative methods. The results of the quantitative method were a scoring evaluation of HKm management, which is based on the weight of several variables, including institutional, community empowerment, HKm area governance, and HKm business governance, as well as data collection on land cover analysis and vegetation analysis. A simple random sample is the first step method in the vegetation analysis process, and a line transect is subsequently used. Meanwhile, the qualitative method is information or data from interviews, observations, and documents related to the management of Buli Uher HKm. The results showed that the management of the Buli Uher HKm in Ilinmedo Village received an assessment with good criteria. In the meantime, the Ilinmedo Protected Forest in HKm Buli Uher experienced a notable reduction in forest conditions in 2023, according to the results of a vegetation study and land cover changes, with vegetation that is changing after being damaged. It happened as a result of the community's logging and forest burning.

Topic Modeling of Nursing Issues in the Media During 4 Emerging Infectious Disease Epidemics in South Korea: Descriptive Analysis.

Emerging infectious disease disasters receive extensive media coverage and public attention. Nurse burnout and attrition peak during health crises such as pandemics. However, there is limited research on nursing issues related to repeated emerging infectious disease crises over time. The purpose of this study was to analyze and draw implications from changes in key nursing issues reported by the news media during the outbreaks of severe acute respiratory syndrome (SARS; 2003), influenza A (2009), Middle East respiratory syndrome (MERS; 2015), and COVID-19 (2020) in Korea using topic modeling. A total of 51,489 news articles were extracted by searching for the keywords "nursing" or "nurse" in the title or body of articles published from April 2003 to May 2021 (during new infectious disease outbreaks) in the open integrated database. The selected news articles were preprocessed then analyzed for text and structure using a 3-step keyword analysis method, latent Dirichlet allocation topic modeling, and keyword network analysis. Among the 51,489 news articles collected with the search terms "nursing" and "nurse," 17,285 (33.6%) were selected based on the eligibility criteria and used in the final analysis. Using topic modeling, we derived 5 topics each for SARS, influenza A, and MERS and 6 topics for COVID-19. The themes commonly identified through topic modeling and keyword network analysis across the 4 epidemics were "response to emerging infectious diseases in Korea," "demand for nurses," "vulnerability in the work environment," and "roles and responsibilities of nurses." Although the topic names were the same, the meanings implied by the comprehensive keywords for each epidemic varied depending on the epidemic and the times. Analysis of the identified themes and associated keyword network revealed that issues related to nurse shortages, working conditions, and poor treatment were not unique to the COVID-19 pandemic but rather recurring themes from previous epidemics. Our findings can be used to inform strategies to improve the professional roles, work environment, and treatment of nurses during health crises. Suggestions for future nursing-related policy impact and change research are also provided.

Optimizing Prescribing for Individuals With Type 2 Diabetes and Chronic Kidney Disease Through the Development and Validation of Algorithms for Community Pharmacists.

Diabetes is the leading cause of kidney disease and contributes to 38% of kidney failure requiring dialysis. A gap in detection and management of type 2 diabetes (T2D) in chronic kidney disease (CKD) exists in primary care. Community pharmacists are positioned to support those not able to access kidney care through traditional pathways. Algorithms were developed and validated to assist community pharmacists in identifying individuals with T2D in CKD and prescribing kidney-protective medications. The objective was to develop and validate pharmacist algorithms to confirm T2D and CKD and to prescribe guideline-directed therapies for individuals with an estimated glomerular filtration rate (eGFR) of 30 to 60 mL/min/1.73 m² in community pharmacy primary care clinics in Nova Scotia. Lynn's method was utilized for algorithm development and content validation. Interview data were analyzed using qualitative descriptive analysis. Pharmacists working in primary care clinic settings completed content and face algorithm validation, and virtual interviews were conducted following each round of validation. The algorithms aim to support individuals with T2D and CKD in primary care by optimizing the resources and capacity of community pharmacists while ensuring safety and quality of care through a team-based approach. Patient partners were not part of algorithm development and validation. Content validity was computed using an item-level content validity index (I-CVI) and scale-level content validity index (S-CVI/Ave) per round. To measure face validity, percentages of those that "agreed" or "strongly agreed" to five statements were calculated. Evidence- and expert-informed algorithms were developed and revised using Lynn's 3-step method (domain identification, item generation per domain, and instrument formation). Best evidence was collated with literature searches, and experts in nephrology, endocrinology, family medicine, nursing, and pharmacy revised the algorithms until there was consensus agreement on 4 final algorithms (detection of T2D and CKD, initiation/titration of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and initiation/management of sodium-glucose cotransporter-2 inhibitors and finerenone). Six community pharmacists per round for 3 rounds were needed to validate the algorithms. A 2-part questionnaire was utilized where pharmacists rated content and face validity using Likert scales. I-CVI and S-CVI/Ave per round and across 3 rounds were determined. Percentages were calculated for the rating level of agreement to 5 statements. Interviews were conducted and analyzed. Revisions were made to the algorithms between rounds. Eighteen community pharmacists (6 per round) participated with a mean ± standard deviation of 18 ±11 years of experience. The I-CVI of each item of the algorithms per round ranged from 0.83 to 1, which met the content validity threshold of 0.83 (P < .05) for at least 6 participants. The overall S-CVI/Ave across 3 rounds was 0.97. The overall percentage of participants across 3 rounds who agreed or strongly agreed to 5 face validity statements ranged from 83% to 100%, which was above the prespecified threshold for face validity consensus. The algorithms are intended for individuals with an eGFR of 30 to 60 mL/min/1.73m². While guideline medications are indicated below this threshold, this cut point was selected as these individuals should typically be referred to a nephrologist. There is a potential for delays in initiation of kidney-protective medications below this threshold while waiting to be seen by nephrology. This is the first study to develop and validate algorithms for a new model of care that utilizes community pharmacists to identify and manage T2D and CKD in primary care. The algorithms achieved high content and face validity. Future implementation and evaluation will determine the effectiveness and safety of the algorithms. Not registered.

A gradient method for solving the boundary value problem of the underwater large deformation cable

A nonlinear large deformation cable equation system based on arc length is employed to determine the configuration of the cable under current and buoyancy loads. Different from a traditional initial method and a shooting method, we have solved this nonlinear problem as a boundary value problem with nonlinear and global boundary conditions directly. A finite difference scheme is proposed to solve the large deformation cable equation, and the Newton–Raphson iteration is used to search for numerical approximate solution. We demonstrate that this system degenerates into the catenary equation in the case of vanishing bending stiffness for the first time. The solution of the catenary equation serves as the initial guess for the three-section cable problem. This method overcomes the disadvantages of the initial value method and step method, avoiding the need to adjust the boundary location. The spatial shapes of the large deformation cable and the effects of the length and position of the buoyancy section are discussed. The impact of ocean currents is also analyzed using Morison's formula.

An enhanced interface-sharpening algorithm for accurate simulation of underwater explosion in compressible multiphase flow on complex grids

In underwater explosion simulations, the accuracy is critically affected by numerical diffusion and the quality of the computational grid. An enhanced interface-sharpening algorithm, based on the five-equation model and an anti-diffusion source term, is proposed to simulate the strongly compressible multiphase flow with an arbitrary number of phases in underwater explosions. To enhance the precision of interface and maintain computational stability on nonuniform and unstructured grids, an adaptive factor algorithm and a continuous interface capture function are developed. Furthermore, a redesigned fractional step method incorporating a special iteration stop criteria is proposed to solve the volume fraction equation. A pressure–density cutoff model is used to calculate the mixture density at the saturation pressure to account for the effect of cavitation. The quadratic monotone upstream-centered scheme for conservation laws reconstruction scheme and the improved advection upstream splitting method (AUSM+-up) flux scheme are also adopted to compute the flux across the grid interfaces. The overall computational framework is constructed upon a density-based explicit finite volume method. To assess the accuracy and robustness of the proposed numerical model, four representative test cases were chosen. The results reveal that the model refines the phase interface, adeptly capturing the complexities inherent in underwater explosion scenarios with both precision and efficiency across a diverse array of conditions.

Performance of the fractional step method with various temporal discretization and adaptive time step size schemes for pulsating ventilation

Performance of the fractional step method with various temporal discretization and adaptive time step size schemes for pulsating ventilation

Methodical Conflict among the Ways for Drying out of Historic Masonry

The purpose of this paper is to give a focus on evaluation of effectiveness of technologies aimed on remedy of unwanted moisture in masonry constructions of historic architectural heritage buildings standing under architectural heritage protection. There are many ways how to achieve the wonted state of the constructions, but some of them are quite invasive, some are not that much invasive and some of them are doubtful. The usual resistance of a group of officers of Heritage authorities to invasive technologies makes the practise complicated, as the, so called invasive technologies are usually the most effective. Officers usually welcome not that much invasive technologies and a special place in their understanding of this problem is held by the Method of Sequential Steps. This method is based on step by step introduced ways of solving of the problem, which should start with minimal interventions and continue towards more intervening interventions. This approach might be relatively sensitive to the structures, but it takes a lot of time and a success is not ensured.

DETERMINATION OF QUALITATIVE INDICATORS OF PRESS EQUIPMENT IMPROVEMENT FOR SEA BUCKTHORN JUICE PRODUCTION

This paper will describe the result of analysis of local wild sea buckthorn products taken as an object of research for further enrichment of food products with valuable vitamins and minerals.Sea buckthorn is a valuable source of a number of important biologically active compounds. Its fruits contain water-soluble and fat-soluble vitamins, lipids, polyphenols, carbohydrates, amino acids and minerals. Nevertheless, it is of great interest because of the presence of its unique oil, which has high physiological activity and is used in the treatment of a number of diseases.A brief description of a high-performance liquid chromatograph used for analytical purposes is given. Standard solutions of vitamins, phosphoric acid, acetonitrile for liquid chromatography were used for analysis. In the method of vitamin determination we start with the preparation of the sample to be analyzed and show Step by Step method of analysis.The nutritional value as a result of the analysis was given in the form of a ring diagram and it was observed that sea buckthorn contains considerable, that is, 81 - 89% water, so it belongs to the group of juicy fruits. It was found that sea buckthorn is rich in fat-soluble and water-soluble vitamins (groups E, B) and macro- and micro - elements useful for proper formation of the body.

Cloud PricingOps: A Decision Support Framework to Explore Pricing Policies of Cloud Services

To maximize the business value of the cloud, the cost of cloud solutions is explored alongside technical quality and performance. To enable this form of exploration engineering, finance and business teams collaborate in the context of FinOps, the operational framework that provides the required decision-making. Prominent providers, such as Google and Microsoft, provide FinOps to their customers, integrating cost factors when designing a cloud solution. However, different providers apply different pricing policies for their products, and these policies also change through time. Therefore, there are numerous efforts to explore price evolution through time for different cloud products applying different decision-making methods using different datasets. In an effort to establish a systematic approach to support decision-making on alternative pricing policies for cloud services and compare them across services and providers, the CloudPricingOps framework is proposed in this paper. It constitutes a decision support system that provides alternative decision-making methods, such as hedonic models, time series, and clustering and machine learning techniques, to deal with problems related to cloud product pricing policy analysis, comparison and prediction. It also constitutes a systematic method of discrete steps to integrate additional decision-making methods to deal with these problems and input datasets to be used regardless of the method or the cloud pricing problem that needs to be solved. Two discrete examples based on real data are also presented in this paper to demonstrate the usefulness of the CloudPricingOps framework for cloud engineering and business teams.

DETERMINING THE STATE VARIABLES OF A DISCRETE PNEUMATIC DRIVE BY USING THE SECANT METHOD WHEN LINEARIZING A MATHEMATICAL MODEL

The pneumatic drive as a thermodynamic system is described based on the principles of "thermodynamics of a body of variable mass". In describing thermodynamic and gas-dynamic processes in pneumatic drives, two scientific schools have developed: researchers of the first school represent processes in the cavities of the drive as polytropic processes with a variable polytropic index, and the second consider processes based on the equation of energy (heat) balance of the gas-pneumatic drive in an open space. The authors investigate a nonlinear mathematical model obtained on the concepts of the second school. In the cycles of reducing the number of independent parameters that determine the nature of the transient process in the drive, a transition to a dimensionless form of equations is carried out based on the principle of minimizing dimensionless complexes (dynamic similarity criteria) that determine the nature of the transient process. The task of linearization of the nonlinear model was set with the purpose of obtaining analytical expressions for all state variables based on the linear model, which will allow avoiding the numerical step methods of integration of the original nonlinear model in calculations. It is shown that the replacement of nonlinear dependencies by the first terms of their expansion in a Taylor series (the tangent method), which is practiced for servo hydraulic pneumatic drives, leads to large errors in relation to discrete drives. The proposed linearization by the secant method with the choice of the optimal form of the sowing allowed to significantly increase the calculated accuracy of the linear mathematical model. and obtain the state variables of the pneumatic drive in analytical form. The calculations performed using the second-order linear model convincingly indicate that it is quite adequate to the calculated accuracy of the nonlinear mathematical model. In the entire range of the most probable parameters, the calculated accuracy of the second-order mathematical model is quite sufficient for practical use. Thus, the need to use step-by-step numerical methods for integrating the equations of a nonlinear model and organizing the computational process on a computer is eliminated.

NUMERICAL SOLUTION OF THE IONIZATION EQUATIONS BY STEP FRACTIONS

The fractional steps method is applied to solve electron-ion plasma ionization equations involving neutrals, with a focus on processes in stationary plasma thrusters (SPT). The approach is based on splitting by physical processes: plasma evolution is represented as a superposition of pure transport in an external field in phase space followed by ionization. The particle-in-cell method is used for calculating transport. In the case of planar symmetry, the ionization process is calculated using explicit analytical formulas. The derived formulas of the fractional steps method are compared with the numerical solution of the plasma evolution equation through a well-known physical ionization model.

Genetic prediction of the effect of gut microbiota on uveitis via blood metabolites: A mediated Mendelian randomization investigation.

The gut microbiota (GM) may be associated with uveitis. However, the causal relationship between the GM and uveitis and whether blood metabolites act as mediators of the GM remain unclear. We extracted the GM, blood metabolites, and uveitis data from genome-wide association study (GWAS) summary data. We used Mendelian randomization (MR) to investigate the causal relationships among GM, blood metabolites, and uveitis. The primary statistical method used was the inverse variance weighted (IVW) method. In addition, we used 2-sample MR, bidirectional MR, 2-step method and multiple MR to explore whether blood metabolites were mediators of the association between the GM and uveitis. After removing confounding factors, the abundances of the order Bacillales and the genus Holdemanella are risk factors for uveitis, and the abundances of Peptococcus and Ruminococcaceae UCG010 are protective factors. The inverse analysis revealed that uveitis affected 6 GM taxa - 4 positively and 2 negatively. In addition, N-methyl proline and 2-hydroxy sebacate were identified as risk factors for uveitis, and N-formy1 phenylalanine, 1-ribosyl-imidazole acetate, 1-palmitoyl-2-arachidonoyl-GPE (16:0/20:4) and alpha-ketoglutarate/pyruvate were identified as protective factors for uveitis. Finally, there was a causal association between 3 GM taxa and 6 blood metabolites, with 6 positive and 2 negative effects. N-methylproline possessed the greatest mediated effect (9.41%) between Ruminococcaceae UCG010 and uveitis. These results provide new insights into the pathogenesis of uveitis and offer a new approach to uveitis prevention and treatment from GM and blood metabolites perspective.

Synthesis, Crystal Structure, and Thermal Decomposition Kinetics of Six New Lanthanide Complexes

ABSTRACTSix novel binuclear complexes have been reported in this paper: [Ln(2‐Cl‐6‐FBA)2(5,5′‐DM‐2,2′‐bipy)(NO3)]2, (Ln = Nd(1), Pr(2)); [Ln(2‐Cl‐6‐FBA)3(5,5′‐DM‐2,2′‐bipy)(H2O)]2, (Ln = Gd(3), Er(4), Eu(5), Ho(6); 2‐Cl‐6‐FBA = 2‐chloro‐6‐fluorobenzoate; 5,5′‐DM‐2,2′‐bipy = 5,5′‐dimethyl‐2,2′‐bipyridine). The complexes underwent comprehensive characterization, incorporating both elemental analysis and X‐ray diffraction (XRD) methodologies. The subsequent X‐ray single‐crystal structure diffraction analysis illuminated the existence of diverse coordination characteristics within these complexes: the coordination number of complexes 1 and 2 is 9, and the coordination number of complexes 3–6 is 8. The fluorescence spectra of complex 5 were obtained by fluorescence test. The detailed decomposition processes of the six complexes were studied by TG‐DTG‐DSC/FTIR technique. The nonisothermal kinetics of complex 6 at the third step were discussed by using M. J. Starink method, NL‐INT method, and double equal‐double step method.

Pengaruh Motivasi Dan Disiplin Kerja Terhadap Kinerja Pegawai Dengan Gaya Kepemimpinan Sebagai Variabel Moderating (Studi Pada Kominfo Kota Metro)

Based on the recap of absences for Metro City Kominfo employees in 2022, it can be seen in theabsentee recap that the average employee in a year has an absentee level or no informationwhich still tends to be high. Therefore agencies can provide motivation to employees in the formof appreciation, bonuses and leave so that employees always increase discipline in doing theirwork. This study has the objectives, namely to find out whether work motivation influencesemployee performance, to find out whether work discipline affects employee performance, to findout whether motivation influences employee performance with leadership style as a moderatingvariable, to find out whether work discipline affects employee performance with leadership styleas a moderating variable. The samples of this research were Kominfo employees of Metro Cityas many as 42 employees. Data collection used a questionnaire, data analysis used a ValidityTest, Reliability Test, Normality Test, Linearity Test, Homogeneity Test and Regression Analysiswith the Causal Step Method with the proggram (SPSS25). The result showed that there was a positive and significant effect of motivation on the performance of Metro City Kominfoemployees. There is a positive and significant influence of work discipline on the performance ofMetro City Kominfo employees. There is a positive and significant effect of motivation onemployee performance with leadership style as a moderating variable. There is a positive andsignificant effect of work discipline on employee performance with leadership style as amodera