Objective Data Research Articles

Exploring genetic testing requests, genetic alterations and clinical associations in a cohort of children with autism spectrum disorder.

Several studies show great heterogeneity in the type of genetic test requested and in the clinicopathological characteristics of patients with ASD. The following study aims, firstly, to explore the factors that might influence professionals' decisions about the appropriateness of requesting genetic testing for their patients with ASD and, secondly, to determine the prevalence of genetic alterations in a representative sample of children with a diagnosis of ASD. Methods: We studied the clinical factors associated with the request for genetic testing in a sample of 440 children with ASD and the clinical factors of present genetic alterations. Even though the main guidelines recommend genetic testing all children with an ASD diagnosis, only 56% of children with an ASD diagnosis were genetically tested. The prevalence of genetic alterations was 17.5%. These alterations were more often associated with intellectual disability and dysmorphic features. There are no objective data to explicitly justify the request for genetic testing, nor are there objective data to justify requesting one genetic study versus multiple studies. Remarkably, only 28% of males were genetically tested with the recommended tests (fragile X and CMA). Children with dysmorphic features and organic comorbidities were more likely to be genetic tested than those without. Previous diagnosis of ASD (family history of ASD) and attendance at specialist services were also associated with Genetically tested Autism Spectrum Disorder GTASD. Our findings emphasize the importance of establishing algorithms to facilitate targeted genetic consultation for individuals with ASD who are likely to benefit, considering clinical phenotypes, efficiency, ethics, and benefits.

Nursing care in a patient with hysterectomy for cervical cancer

Introduction: Cervical cancer continues to be the leading cause of death worldwide for many women, this type of cancer does not start suddenly, but has a previous evolution from precursor or precancerous lesions, the diagnosis is made in advanced stages of the disease, decreasing or canceling the chances of curative treatment. It is expected that by the year 2032 there will be 21.4 million new patients dealing with this disease in the world. Objective: To develop specialized and individualized comprehensive nursing care in patients with cervical cancer, based on scientific evidence recommendations and interventions. We present the assessment of a post-operative hysterectomy patient for cervical cancer where the nursing care process is applied. Methodology: A clinical case study, a 44-year-old patient was selected for convenience, applying the methodology of the nursing care process, the assessment was made through the 11 functional patterns of Marjory Gordon, the data were obtained from the clinical history, interview and physical examination of the patient. The main human responses are identified to analyze objective and subjective data, clinical judgments are made to implement care plans under the NANDA, NOC, NIC taxonomy. Results: 7 altered patterns were identified; considering as main diagnosis: acute pain and risk of complication; hemorrhage. Nursing care plans were implemented according to the Area model. A change score of +1 and +2 was obtained, which subsequently improved with nursing care. Conclusions: after the surgical procedure; According to the altered patterns, the nursing care process was carried out, observing improvement in the altered patterns, however, the patient remained hospitalized to continue with the specialized therapeutic plans, this implies that the gynecological-obstetric service must have professionals in nursing specialized in this area.

Identifying nutrition risk in emergency patients: What is the most appropriate screening tool?

The emergency department (ED) is the most frequent access route to the hospital. Nutrition risk (NR) screening allows the early identification of patients at risk of malnutrition. This study aimed to evaluate the feasibility and predictive validity of five different tools in EDs: Nutritional Risk Screening 2002 (NRS-2002), Nutritional Risk Emergency 2017 (NRE-2017), Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), Malnutrition Universal Screening (MUST), and Malnutrition Screening Tool (MST). Patients with scores ≥3 according to the NRS-2002, ≥1.5 according to the NRE-2017, and ≥2 according to the MUST, RFH-NPT, or MST were classified with NR. Prolonged length of stay (LOS) and 1-year mortality were evaluated. 431 patients were evaluated (57.31 ± 15.6 years of age; 54.4% women) in a public hospital in southern Brazil. The prevalence of NR was: 35% according to the NRS-2002, 43% according to the MST, 45% according to the NRE-2017 and MUST, and 49% according to the RFH-NPT. Patients with NR, had a greater risk of prolonged LOS (P < 0.001). The presence of NR was associated with an increased risk of 1-year mortality according to the NRS-2002 (hazard ratio [HR]: 4.04; 95% CI, 2.513-6.503), MST (HR: 2.60; 95% CI, 1.701-3.996), NRE-2017 (HR: 4.82; 95% CI, 2.753-8.443), MUST (HR: 4.00; 95% CI, 2.385-6.710), and RFH-NPT (HR: 5.43; 95% CI, 2.984-9.907). NRE-2017 does not require objective data and presented predictive validity for all outcomes assessed, regardless of the severity of the disease, and thus appears to be the most appropriate tool for carrying out NR screening in the ED.

Complex modeling of complicated processes: analytical model parameters adaptation in solving qualimetric problems

The relevance of the study is due to the fact that despite the sustainable development of methods and technologies for creating models of various classes and purposes, the tasks of managing their quality (the so-called inverse problems of theoretical qualimetry) are often neglected. For example, in the field of information technology, much more attention is paid to assessing the quality of software products, which is reflected in the corresponding standards. These tasks become especially relevant when models reflect a complex process (CP), and such processes may be unique, and obtaining complete objective data on such CPs prior to modeling is difficult or impossible (accidents and disasters models, military operations, natural disasters, and others like that). The article’s main purpose is to consider the issues of solving the inverse qualimetric problem by parametric adaptation of analytical models to unpredictable possible changes in the complex processes’ nature. The solution to this problem is based on the combined (analytical and simulation) modeling of unique processes. Theoretical qualimetry involves a quantitative assessment of any product's qualitative properties; to ensure the adequacy level of analytical models (based on the results of their parametric adaptation), it is planned to evaluate with the use of well-known metrology principles regarding relative measurement deviations. In this case, detailed simulation modelling results are used as a reference for combined modelling. The complexity of the processes conditiond by the expediency of their polymodel description in order to mutually compensate for the objective deficiencies of heterogeneous models, as well as the use of simulation capabilities to adjust the parameters of analytical models in cases where the use of the latter is due to strict time constraints on obtaining calculation results and developing control actions based onthem. A variant of the formalized statement of the problem of parametric adaptation of analytical models is presented. A presented example that considers the adaptation of parameters of the Lanchestertype analytical model conducted on simulation data. The adaptation of parameters could be carried out in different ways, and the expediency of choosing a certain one is determined by the assessment of mutual deviations of the results of heterogeneous modeling. The results of the calculations witnesses that parametric adaptation can be an effective element in solving one of the key tasks of model qualimetry, namely, ensuring their required qualitative properties. The prospect of further research is to consider the issues of structural adaptation of simulation models to the given conditions for displaying complex processes.

Application of Modern Approaches to Species Delimitation in Freshwater Erpobdellidae (Hirudinea: Arhynchobdellida) with a New Interpretation of Their Genera

The traditional taxonomy of freshwater invertebrates is a labor-intensive process requiring extensive knowledge and experience. In addition, this science is largely subjective, which makes its digitalization difficult. However, accurate species attribution is becoming increasingly important for environmental surveys and conservation efforts. In the 21st century, molecular biology methods have proven to be a successful tool for objectively determining biodiversity. Achieving objectivity in identifying the taxa of non-parasitic leeches of the family Erpobdellidae was the main goal of this study. To this end, various bioinformatic approaches to DNA sequence analysis have been tested. As a result, the phylogenetic diversity amounted to 47 species versus 29 morphospecies defined traditionally. The use of molecular species delimitation methods made it possible to identify seven complexes of morphologically hidden (cryptic) species and some morphological misidentifications, as well as to discover a new species from Eastern Siberia (Erpobdella sibirica) with a unique molecular diagnosis (DNA barcode). A pioneering attempt to apply the same approach to higher taxa showed that Erpobdellidae probably consists of seven genera, including the unambiguous elimination of the genus Motobdella. Obtaining quantitative and, therefore, objective data is an advantage of the molecular approach, which has proven to be effective in recognizing species and genera, at least in leeches.

Ultrasonic Evaluation of the Asian Nasal Soft Tissue Envelope.

The thickness of the nasal soft tissue envelope (STE) plays a crucial role in the final rhinoplasty results. The Asian nasal contour is typically characterized by a thicker STE and broader nasal tip, but objective data are lacking. The purpose of this study was to objectively measure nasal dermal thickness and overall STE thickness and to determine any demographic differences. From July to September 2023, 110 patients presenting for consultation underwent ultrasound evaluation of their nasal STE. STE thickness was measured at predetermined subsites and compared with published data on white patients. The thickness of the STE in Asian patients was greater than that in white patients. The STE was thickest at the supratip (mean [SD]), (4.88 [0.74]mm) rather than at the nasion and thinnest at the rhinion (2.25 [0.51]mm). The nasal tip (4.07 [0.72]mm) showed comparable STE thickness with the nasion (4.13 [0.72]mm) but had a significantly thicker dermis than the nasion (2.35 ± 0.49mm vs. 1.35 ± 0.35mm, P < 0.05). Male sex and higher BMI tended to be correlated with a thicker nasal STE, but age did not show any relationship. A thicker nasal tip STE showed significantly greater nasal tip width and nasal alar thickness. STE thickness at different nasal subsites varies and affects external nasal contour and rhinoplasty outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Accelerometer-based gait characteristics and their discrimination of gait independence in inpatients with subacute stroke

BackgroundGait analysis using inertial measurement devices can identify multifaceted gait disorders after a stroke. Although the usefulness of gait assessment using inertial measurement devices has been reported, its accuracy in discriminating gait independence in patients hospitalized for subacute stroke has not yet been validated. Research questionCan trunk acceleration indices discriminate between dependent and independent walking in patients with subacute stroke? MethodsThirty-five patients with subacute stroke (mean ± standard deviation, 75.5 ± 9.8 years, 19 males), who were able to understand instructions, had a premorbid modified Rankin scale <3, and were able to walk 16 m straight ahead under supervision were included. The stride regularity, harmonic ratio, and normalized root mean square of trunk accelerations were measured in three directions (mediolateral, vertical, and anterioposterior) during comfortable walking. The Functional Ambulation Categories were used as the dependent variable to classify the patients into two groups (dependent and independent walking groups), and each trunk acceleration index was used as the independent variable to calculate the area under the curve using receiver operating characteristic curves. ResultsTwelve patients were in the dependent group and 23 were in the independent group. The normalized root mean square in both the mediolateral and vertical directions were excellent discriminators of walking independence, with an area under the curve greater than 0.8. The cutoff values (sensitivity/specificity) were 2.20 m2/s2 (0.783/0.833) and 2.82 m2/s2 (0.739/0.833), respectively. SignificanceThe magnitude of vertical and lateral acceleration during gait in patients with subacute stroke, has excellent accuracy in discriminating between dependent and independent gaits. The results of this study will be useful for inexperienced clinicians working with stroke patients presenting with gait disturbances to accurately determine gait independence based on objective data.

Characterization of the Relative Change in Objective and Subjective Metrics by Baselining Patients Who Have Wearable Technology Before Total Knee Arthroplasty

BackgroundWearable sensors and associated supporting technologies (ie, patient applications) can provide both objective (joint position, step counts, etc.) and subjective data (ie, pain scores and patient-reported outcome measures) to track a patient’s episode of care. Establishing a subjective and objective baseline of a patient’s experience may arguably be beneficial for multiple reasons, including setting recovery expectations for the patient and demonstrating the effectiveness or success of the intervention. MethodsIn this pilot study, we characterized a subset of patients (n = 82 from 7 surgeons) using a wearable sensor system at least 6 days before total knee arthroplasty and provided postsurgical data up to 50 days postintervention. The 5-day average before surgery for total step counts (activity), achieved flexion and extension on a progress test (functional limit) and visual analog scale daily pain score were calculated. The difference from baseline was then calculated for each patient for each day postsurgery and reported as averages. ResultsOn average, a patient will experience a relative deficit of 4,000 steps immediately following surgery that will return to near-baseline levels 50 days postintervention. A 30° deficit in flexion and a 10° deficit in extension will return at a similar rate as steps. Relative pain scores will worsen with an increase of approximately 3 points immediately following surgery. However, pain will decrease by 2 points relative to baseline between 40 and 50 days. ConclusionsThe results of this pilot study demonstrate a method to baseline a patient’s presurgical subjective and objective data and to provide a reference for postsurgical recovery expectations. Applications for these data include benchmarking for evaluating intervention success as well as setting patient expectations.

Analisis Filsafat terhadap Pentingnya Komunikasi dalam Perilaku Organisasi

The importance of communication in organizational behavior has significant implications in the context of education. In the educational environment, the aspect of communication is an integral part of the learning process and student development. In education, communication is defined as more than just the exchange of information. From the quote, there is an explanation of the type of research used, namely library research. This research is conducted by accumulating information from various sources, such as books, journals, theses, dissertations, and the internet. Before analyzing the literature, researchers must clearly understand where objective data will be obtained. This research shows that organizational behavior is related to how people act and react in all types of organizations. In organizational life, people are employed, educated and trained, given information, protected, and developed. In other words, organizational behavior is how people behave within an organization.

The Clean Beauty Trend Among Millennial and Generation Z Consumers: Assessing the Safety, Ethicality, and Sustainability Attributes of Cosmetic Products

The concept of clean beauty lacks a precise definition and its defining attributes remain unclear. This study assesses the impact of clean beauty on Millennial and Generation Z consumers, identifies its main attributes, and provides a new index for determining products’ cleanness. To this end, 120 Korean participants were recruited; they used 10 cosmetic products and completed relevant questionnaires. Clean beauty awareness and product satisfaction were assessed from the cognitive and emotional perspectives. The Reliable Cleanness Score (RCS) was calculated using emotional product satisfaction. Participants’ preference for clean beauty products was correlated with engaged cosmetic shopping behaviors. The key clean beauty attributes were sustainability, safety, and ethicality—in that order. Machine learning-based regression analysis showed that objective and subjective data could be used to calculate the RCS, resulting in an R2 value of .721. With the results of this study, manufacturers, retailers, and consumers will be able to predict RCS.

Insight From Integrating Objective Data Into Psychiatric Encounters

We present the case of Mr. B, who was part of a NIMH-funded, longitudinal, observational study (2013 to 2016) that recruited unmedicated participants who were experiencing a range of palpable symptoms related to states of negative affect and who were assessed on multiple objective measures. A feedback report was generated based on Mr. B's multimodal measurements. One of the authors, LMW, along with Mr. B's psychotherapist, discussed the results with Mr. B in a feedback session. Mr. B's objective testing profile was consistent with a history of trauma, allowing him for the first time to be comfortable with revealing to his therapist that he experienced early-life trauma. Mr. B's case highlights several known advantages of integrating objective data into psychiatric encounters, including reducing stigma, motivating patients to pursue treatment, and improving clinical outcomes by aiding in identification of the right treatment, which is the ultimate goal of precision psychiatry. [ Psychiatr Ann . 2024;54(4):e113–e118.]

The Role of Remote Diagnostics to Better Assess Uroflow Variability: Insights From Combining at Home Uroflows and Frequency Volume Charts From 19,868 Voids Using a Novel, Hand Held, Cellular Embedded Device

ObjectiveTo examine how representative 24-hour data collection is of the overall patient experience utilizing a home uroflow device in men with benign prostatic hyperplasia. Materials and MethodsHome uroflow data was collected with the iO Urology CarePath device from men at a single urology clinic and retrospectively analyzed. Void characteristics were summarized for data collected over 24-hours compared to data collected over several days or weeks with the device (overall study excludes the 24-hour data). A linear mixed effects model was used to evaluate differences in average Qmax from voids collected during a single 24-hour period compared to the overall study. ResultsA total of 486 men (mean age 67.4) used the device resulting in 465 included in the analysis with a total of 15.521 voids in the overall study and 4,347 voids in the single day analysis. Average Qmax from the model was 11.2 ml/s (95% CI: 10.80, 11.65) and 11.2 ml/s (95% CI: 10.81, 11.64) in the 24-hour and overall study groups, respectively. Both groups had similar between- (20.3% vs 20.4%) and within-subject (12.0% vs 11.9%) variance. The difference in Qmax was not significantly different (p=0.970). A subgroup analysis including voids >150 ml yielded similar results. ConclusionsData shows variability in voiding parameters, but similar average Qmax collected in 24-hours as compared to several days/weeks. The combination of home uroflowmetry with frequency-volume chart information can provide objective data and a unique perspective on uroflow variability for clinician review to support the development of individualized patient treatment plans.

Clinicians’ approach to predicting post-cardiac arrest outcomes for patients enrolled in a United States clinical trial

PurposePerceived poor prognosis can lead to withdrawal of life-sustaining therapies (WLST) in patients who might otherwise recover. We characterized clinicians’ approach to post-arrest prognostication in a multicenter clinical trial. MethodsSemi-structured interviews were conducted with clinicians who treated a comatose post-cardiac arrest patient enrolled in the Influence of Cooling Duration on Efficacy in Cardiac Arrest Patients (ICECAP) trial (NCT04217551). Two authors independently analyzed each interview using inductive and deductive coding. The clinician reported how they arrived at a prognosis for the specific patient. We summarized the frequency with which clinicians reported using objective diagnostics to formulate their prognosis, and compared the reported approaches to established guidelines. Each respondent provided demographic information and described local neuroprognostication practices. ResultsWe interviewed 30 clinicians at 19 US hospitals. Most claimed adherence to local hospital neuroprognostication protocols (n = 19). Prognostication led to WLST for perceived poor neurological prognosis in 15/30 patients, of whom most showed inconsistencies with guidelines or trial recommendations, respectively. In 10/15 WLST cases, clinicians reported relying on multimodal testing. A prevalent theme was the use of “clinical gestalt,” defined as prognosticating based on a patient's overall appearance or a subjective impression in the absence of objective data. Many clinicians (21/30) reported using clinical gestalt for initial prognostication, with 9/21 expressing high confidence initially. ConclusionClinicians in our study state they follow neuroprognostication guidelines in general but often do not do so in actual practice. They reported clinical gestalt frequently informed early, highly confident prognostic judgments, and few objective tests changed initial impressions. Subjective prognostication may undermine well-designed trials.

Differences in aging rates based on different methods of calculation in patients with arterial hypertension and subclinical hypothyroidism

Objective — to evaluate two distinct methods for determining biological age (BA) and aging rates among patients with arterial hypertension (AH) in combination with subclinical hypothyroidism (SH) that can be applicable to practical medical settings.&#x0D; Materials and methods. The study involved 150 patients (women 54.7%, n=82) with an average age of 47.1 [39.7;54.0] years, who were divided into three groups reciprocal by age and sex: the main group included 70 patients with AH in combined with SH, the comparison group consisted of 50 subjects with isolated AH, and control group of 30 healthy volunteers. All subjects were assessed for objective data, anthropometric status, standard clinical‑biochemical indicators, insulin, HOMA IR, C‑reactive protein (CRP), tumor necrosis factor‑alpha (TNF‑α), thyroid‑stimulating hormone (TSH), free thyroxine (T4), and sirtuin 1 (SIRT1). Additionally, the pro‑oxidant‑antioxidant balance was evaluated by assessing total hydroperoxides (THP) levels and total antioxidant activity (TAA). The assessment of BA and aging rates (ΔBA) were chosen as the main markers of premature aging and were performed with two different methods: by M. Levin et al. (ΔBA1), by authors’ own method (ΔBA2). Depending on ΔBA, patients from all three groups were divided into subgroups with normal/slowed aging rates (ΔBA ≤0) and accelerated aging rates (ΔBA &gt;0).&#x0D; Results. According to ΔBA1 (p=0.004), 4 subjects with accelerated aging rates reveled in the controls, while in the main group the rate was 2.2 times higher than in the comparison group (40.0% versus 18%). According to ΔBA2 (p=0.0001), more people had an increased aging rates both in the main group and in the comparison group (57.1% versus 38.0%). Patients with AH and accelerated aging rates according to ΔBA1 had significant differences in the levels of SIRT1 (p=0.012), aspartate aminotransferase (AST) (p=0.012), alanine aminotransferase (ALT) (p=0.005), uric acid (p=0.011), and diastolic blood pressure (DBP) (p=0.001), and according to ΔBA2, higher levels of insulin (p=0.019), HOMA IR (p=0.013), triglycerides (TG) (p=0.011), very low‑density lipoprotein cholesterol (VLDL‑C) (p=0.020), DBP (p=0.032), and lower levels of total protein (p=0.048), compared to patients with AH and normal/slower aging rates. In the group of patients with AH combined with SH, differences in the levels of THP (p=0.023), uric acid (p=0.044), and body mass index (BMI) (p=0.046) were found among patients with different aging rates according to ΔBA1, and according to the results of the ΔBA2 assessment — in the levels of glucose (p=0.045) and uric acid (p=0.026). Among the studied patients in the AH group and in the group with a combined course of AH and SH, there were 52 patients whose aging rates (accelerated and normal/slowed) did not coincide in the assessment according to ΔBA1 and ΔBA2 : 11 patients had accelerated aging rates only according to ΔBA1, and 23 patients — only according to ΔBA2. Among the aforementioned 52 patients, 50% had elevated levels of ALT, 32.7% — AST, 3.8 — alkaline phosphatase (ALP), 90.2% — HOMA IR, 80.8% — total cholesterol (TC), 28.8% — triglycerides (TG), 26.9% had decreased levels of high‑density lipoprotein cholesterol (HDL‑C), 82.7% had elevated levels of LDL‑C, 15.4% — creatinine, 46.2% had decreased eGFR, 15.4% had elevated levels of CRP, 3.8% — TNF‑α, and 50.0% had uncontrolled levels of systolic and diastolic BP.&#x0D; Conclusions. Assessment of BA should be mandatory for patients with AH and SH to enable early detection and prevention of premature aging. As an indicator of accelerated aging rates, the combined use of ΔBA assessment based on clinical and biochemical indicators according to the method of M. Levin et al. (2018), as well on our own developed method based on the assessment of anthropometric indicators, TSH levels and the content of THP can be effective. Primary determination of BA can be conducted during regular (e.g., annual) preventive screening of patients. In case of detection of cardiometabolic disorders, repeat determination of BA can be performed after some time following their correction.&#x0D;

A Framework for Analyzing Co-Creation Value Chain Mechanisms in Community-Based Approaches: A Literature Review

Community co-creation is critical for tackling complex challenges and building a sustainable future, and necessitates collaboration between public and private sectors to co-create value chains. This paper highlights existing frameworks and proposes a heuristic approach that integrates Collective Impact (CI), Social Impact Assessment (SIA), and Community Capital (CC). Through a narrative review, the paper explores how SIA and CC can empower CI by aligning objective data with community context, ensuring solutions that resonate with local needs, promoting equity by fostering inclusive participation and understanding diverse perspectives, and revealing valuable resources within communities and leveraging their strengths for sustainable development. Although the paper delves into roles and responsibilities for each sector involved in co-creation, it acknowledges limitations in areas such as leadership-capacity building for effective collaboration and long-term commitment, impact measurement methodologies that capture nuanced social change over time, and inclusion of diverse participation methods to ensure all voices are heard and represented. By addressing these limitations, the paper calls for further research and development to strengthen community-driven social change.

도시의 공간 패턴 분석을 통한 메타버스 기반 근접성 향상 실용화 방안 연구

This study proposes a method for addressing the limitations of physical proximity in real-world walking environments and focusing on Metaverse-based solutions. The first phase of the research entailed a community analysis centered on locations in Daejeon, through which problematic areas were identified and defined. The second phase involved conducting a survey among users of the Metaverse environment to explore methods of enhancing proximity. Based on these findings, the study developed three approaches to improve proximity in a Metaverse-based environment. It emphasizes the importance of objective data analysis and precise problem definition, underscoring the necessity of developing and designing solutions within the Metaverse environment. Moreover, the study suggests that to enhance user experiences in the Metaverse, a thorough analysis of regional characteristics is essential, followed by the development of tailored Metaverse solutions.

Body mass index moderates the association between diabetes distress and objective self-management behaviours in adolescents with type 1 diabetes and elevated A1Cs.

To examine the cross-sectional associations between diabetes distress, BMI (zBMI; BMI z-score), objectively measured mean daily blood glucose readings and insulin boluses administered, and A1C in adolescents with type 1 diabetes (T1D) using insulin pumps. T1D self-management behaviour data were downloaded from adolescents' (N = 79) devices and mean daily frequency of blood glucose readings and insulin boluses were calculated. Diabetes distress was measured (Problem Areas in Diabetes-Teen questionnaire [PAID-T]), A1C collected, and zBMI calculated from height and weight. Three multiple linear regressions were performed with blood glucose readings, insulin boluses, and A1C as the three dependent variables and covariates (age, T1D duration), zBMI, diabetes distress, and the diabetes distress x zBMI interaction as independent variables. Participants (55.7% female) were 14.9 ± 1.9 years old with T1D for 6.6 ± 3.4 years. zBMI moderated the relationship between diabetes distress and mean daily insulin boluses administered (b = -0.02, p = 0.02); those with higher zBMI and higher diabetes distress administered fewer daily insulin boluses. zBMI was not a moderator of the association between diabetes distress and blood glucose readings (b = -0.01, p = 0.29) or A1C (b = 0.002, p = 0.81). Using objective behavioural data is useful for identifying how adolescent diabetes distress and zBMI affect daily bolusing behaviour amongst adolescent insulin pump users. Although distinct interventions exist to improve T1D self-management or diabetes distress, none addresses them together while considering zBMI. Decreasing diabetes distress could be especially important for youth with high zBMI.

Simulation of the vulnerability of the steppe landscape and climate zone of Ukraine to climate changes based on space image data

Now, the whole world, including Ukraine, is facing one of the biggest environmental problems, namely, climate change. The steppe landscape-climate zone is one of the territories considered the most sensitive to Ukraine's current and future climate change threats. Studying the vulnerability to climate change of the steppe zone of Ukraine based on data from space surveys requires analysing a large amount of objective data, namely the products of remote sensing data processing. The article presents the results of combining remote sensing, geographic information systems, and multi-criteria decision analysis to identify vulnerable areas to the impact of climate change in the steppe landscape-climatic zone. This information will be used to recommend adaptation systems to modern conditions and reduce the impact of adverse climate changes. The proposed decision-making structure was developed in three stages: 1) collection and processing of available data from space surveys; 2) development of a model of vulnerability to climate change of the steppe landscape-climatic zone of Ukraine based on the method of analysis of hierarchies; 3) construction of the resulting map, which includes degrees of vulnerability to climate changes of the studied territory. Modern cloud processing methods for space survey data provide access to a large number of geo-informational products, including the characteristics of the earth's surface and the spatial distribution of climatic indicators accumulated over a long period. These products allow the processing of these data for large areas to be implemented quickly. This technique allows, based on expert assessments, to assess the combined impact of the most significant characteristics of the earth's surface and regional climate, prioritise their impact on the studied territory's vulnerability to climate changes, and implement its quantitative multi-criteria assessment.

Optical Coherence Tomography Versus Optic Disc Photo Assessment in Glaucoma Screening.

Optical coherence tomography (OCT) and optic disc photography present valuable but distinct capabilities for glaucoma screening. This review article examines the strengths and limitations of OCT and optic disc photography in glaucoma screening. A comprehensive literature review was conducted, focusing on the accuracy, feasibility, cost-effectiveness, and technological advancements in OCT and optic disc photography for glaucoma screening. OCT is highly accurate and reproducible but faces limitations due to its cost and less portable nature, making widespread screening challenging. In contrast, optic disc photos are more accessible and cost-effective but are hindered by subjective interpretation and inconsistent grading reliability. A critical challenge in glaucoma screening is achieving a high PPV, particularly given the low prevalence of the disease, which can lead to a significant number of false positives. The advent of artificial intelligence (AI) and deep learning models shows potential in improving the diagnostic accuracy of optic disc photos by automating the detection of glaucomatous optic neuropathy and reducing subjectivity. However, the effectiveness of these AI models hinges on the quality of training data. Using subjective gradings as training data, will carry the limitations of human assessment into the AI system, leading to potential inaccuracies. Conversely, training AI models using objective data from OCT, such as retinal nerve fiber layer thickness, may offer a promising direction. Both OCT and optic disc photography present valuable but distinct capabilities for glaucoma screening. An approach integrating AI technology might be key in optimizing these methods for effective, large-scale screening programs.

Криминологическая обоснованность внесения изменений в уголовный закон: использование статистики и роль средств массовой информации

Introduction. The foundation of the state’s strategic activity in the fight against crime (criminal policy) is a set of initial data of a criminological and social nature, the objectivity (compliance with the truth) of which is often rightly questioned, and therefore the issues of searching and selecting sources for the formation of criminal policy in order to achieving the requirement of criminological validity. Methods. In work based on the dialectical-materialistic method of scientific knowledge, the legal-dogmatic method, formal-logical and systemic methods are used. Results. Despite the fact that the scale of criminologically significant information is quite large, an obstacle to the formation of a criminologically based criminal policy is the lack of the required volume of objective data on crime. Recognizing that certain indicators themselves must be correctly interpreted (including in their interrelation and interdependence), it can be argued that correct criminological forecasting requires an appropriate methodological basis that clearly indicates how it is necessary to process what is significant for the fight against crime information. Recognizing the problem of crime latency, it is worth emphasizing the need to find tools for objectifying crime data. In particular, it is worth paying attention to the promise of an integrated approach to the analysis of criminal phenomena, including, at a minimum, “cross-reconciliation” of data from various government bodies and non-state structures (subject to confidence in the objectivity of the information they provide). When making changes to the criminal law, the use of official statistics as a basic source of information is recognized as justified. Of particular importance is the issue of searching for alternative sources of information, which are now increasingly referred to as social expectations.