Situations Of Uncertainty Research Articles

Performance Shortfall, Top Management Team Faultlines, and R&D Investment: Evidence from China

With the increasing uncertainty of the world economic situation, enterprises are facing the pressure of downward performance, and R&D has been an important strategic choice to solve the performance fall problem of high-tech enterprises. The article tries to explore the changes in the R&D investment intensity of enterprises under different performance lag levels and investigate the influence of the combination of characteristics of top management team(TMT) members on the strategic decision-making process. It is found that the relationship between the degree of performance disparity and R&D investment intensity is inverted U-shaped; the strength of the fracture faultline of the top management team negatively regulates the relationship between the degree of performance disparity and R&D investment and makes the inverted U-shaped curve flat. A further study of specific characteristic fracture bands revealed that team fracture bands based on tenure characteristics had a significant negative moderating effect, while professional and functional background fracture bands had a significant positive moderating effect. This study not only theoretically expands the understanding of the performance shortall and TMT disconnection on the deep-seated motivation of enterprise R&D investment, but also provides practical references for solving the problem of performance gap, optimizing the allocation of TMT human resources, and rationally promoting enterprise R&D investment to achieve transformation.

Explanatory Stabilization in Situations of Evidential Uncertainty

Abstract In this article I issue a challenge to what I call the Independence Thesis of Theory Assessment (ITTA). According to ITTA, the evidence for (or against) a theory must be assessed independently from the theory explaining the evidence. I argue that ITTA is undermined by cases of evidential uncertainty, in which scientists have been guided by the explanatory power of their theories in the assessment of the evidence. Instead, I argue, these cases speak in favor of a model of theory assessment in which explanatory power may indeed contribute to the stabilization of the evidential basis.

The development and validation of the Intolerance of Uncertainty in Social Interactions Scale.

Intolerance of uncertainty (IU) is commonly defined as the tendency for one to interpret uncertainty as negative or threatening. Most general or non-specific measures of IU show a strong relationship with worry and generalized anxiety disorder symptoms; however, a specialized measure of intolerance of uncertainty in social situations could provide insight into the role of IU in social anxiety. The purpose of this study was the development and preliminary validation of the Intolerance of Uncertainty in Social Interactions Scale (IU-SIS), a comprehensive measure designed to assess intolerance of uncertainty in social situations. Participants consisted of a non-referred sample. Based on an exploratory factor analysis, a two-factor solution was retained, with factors labelled Social Ambiguity and Need to Reduce. Both subscales were found to have good reliability and validity. Both subscales of the IU-SIS predicted up variance on measures of social anxiety after controlling for variance explained by a well-established general/non-specific measure of IU. Overall, the IU-SIS shows promise as a tool to elucidate the association between intolerance of uncertainty and social anxiety.

Situational and personality factors of students’ adaptation preparedness

Introduction. The relevance of studying situational and personality factors of students’ adaptation preparedness is conditioned by the growing uncertainty of the future and the increasingly stressful conditions of social life. The study of adaptation preparedness factors is conditioned by the demand for psychological and pedagogical support of students at different stages of professionalisation at the university. The aim of the study is to identify the situational and personality factors of students’ adaptation preparedness and their correlation with regard for the significance, uncertainty and stressfulness of situations in the higher education environment. Materials and methods. The survey involved a number of higher education organisations of Saratov and its administrative region, Volgograd and Moscow (n=385) and was based on the following diagnostic toolkit: M.V. Grigoriev’s method of diagnosing adaptation preparedness of a personality, A.V. Zverkov’s and E.V. Eidman’s test-questionnaire “Study of volitional self-regulation”, V.I. Morosanova’s questionnaire “Self-regulation behaviour style – SBS-98”, as well as the author’s questioning scales in the context of assessing the learning environment situational parameters with regard for the significance, stressfulness and uncertainty of situations in the educational environment. Data processing was carried out using the IBM SPSS Statistics 27 package and AMOS software. The statistical procedures included descriptive statistics calculations, Pearson’s correlation analysis, stepwise regression analysis, and moderation effect assessment procedure. Results. The students’ reported situations of greatest significance included lectures (3.81), practical classes (4.19), interaction with classmates having good relations with the respondent (4.40), and proper relations with the administration (4.01). Positive correlations were revealed between the adaptation preparedness indicators, the significance of situational factors and the pronouncement of personality-associated factors within the range of (0.103-0.631), as well as negative correlations between the adaptation preparedness components and independence within the range of (-0.126 – -0.225). The regression analysis revealed positive personality predictors of adaptive preparedness (perseverance (β= 0.223), flexibility (β= 0.281), modelling (β= 0.168), programming (β= 0.143) and self-control (β= 0.186)) and negative predictors represented by autonomy (β= -0.169). The significance of interaction with classmates having good relations with the respondent is a positive situational predictor (β= 0.198), while the negative predictors are represented by the stressfulness of practical classes (β= -0.168) and the significance of interaction with classmates negatively treating the respondent (β= -0.169). The subsequent moderation analysis of the interrelationship between assessing a situation (as significant, stressful and uncertain) and self-regulation revealed the pronounced level of personal self-regulation [β=0.521; R2=0.32] and marked assessment of situation uncertainty [β= -0.139; R2=0.02]. Conclusion. The obtained results may be of interest both for researchers exploring adaptation issues and practising psychologists providing support to students at a higher education organisation.

Where There's Hope, There's Life 1 : On the Importance of Hope in Health Care.

It is widely supposed that it is important to ensure that patients undergoing medical procedures hope that their treatments will be successful. But why is hope so important, if indeed it is? After examining the answers currently on offer in the literature, we identify a hitherto unrecognized reason for supposing that it is important that patients possess hope for a successful treatment, which draws on prospect theory, Kahneman and Tversky's hugely influential descriptive theory about decision-making in situations of risk and uncertainty. We also consider some concerns about patient consent and the potential manipulation of patients that are raised by our account.

Building a New Ideology in the conditions of a Transitional State-Legal System (the Case Study of the Russian Republic in February — October 1917)

The paper presents the author’s point of view regarding the spiritual sphere of Russian society, changes in which were caused by the crisis resulting from the revolutionary events of February 1917, and the related experience of building a new ideology in the conditions of the transitional state law system in the Russian state in March-October 1917. The author, based on the study of a wide range of sources, critically analyzed this experience and made a number of conclusions: such construction in the conditions of permanent spiritual crisis was difficult and it was conditioned by a set of factors, namely, political, socio-economic, cultural-religious, etc. The author’s analysis of this experience was based on the study of a wide range of sources. The state of a state law anomie, that can rightly be considered one of the characteristic features of the transitional state-legal system, was the result of a deep spiritual, religious, ideological, cultural conflict that emerged, starting from the first days of the formation of the «new» Russian state, and the resulting spiritual vacuum and situation of ideological and religious uncertainty. The changing position of the Russian Orthodox Church in relation to the new bourgeois government and its reformist plans due to the political situation also contributed to the deepening of the spiritual crisis in Russian post-revolutionary society. The emphatically indifferent position of the Russian clergy towards the Provisional Government once again emphasized the unpopularity of its decisions in the eyes of society, deprived its projects of ideological support. Thus, this contributed to the loss of the government’s authority among the population. Under such conditions, all attempts of the central government to form a new post-revolutionary bourgeois-republican ideology were unsuccessful.

How large language model-powered conversational agents influence decision making in domestic medical triage contexts

IntroductionEffective delivery of healthcare depends on timely and accurate triage decisions, directing patients to appropriate care pathways and reducing unnecessary visits. Artificial Intelligence (AI) solutions, particularly those based on Large Language Models (LLMs), may enable non-experts to make better triage decisions at home, thus easing the healthcare system's load. We investigate how LLM-powered conversational agents influence non-experts in making triage decisions, further studying different persona profiles embedded via prompting.MethodsWe designed a randomized experiment where participants first assessed patient symptom vignettes independently, then consulted one of the two agent profiles—rational or empathic—for advice, and finally revised their triage ratings. We used linear models to quantify the effect of the agent profile and confidence on the weight of advice. We examined changes in confidence and accuracy of triage decisions, along with participants' perceptions of the agents.ResultsIn a study with 49 layperson participants, we found that persona profiles can be differentiated in LLM-powered conversational agents. However, these profiles did not significantly affect the weight of advice. Notably, less confident participants were more influenced by LLM advice, leading to larger adjustments to initial decisions. AI guidance improved alignment with correct triage levels and boosted confidence in participants' decisions.DiscussionWhile LLM advice improves triage recommendations accuracy, confidence plays an important role in its adoption. Our findings raise design considerations for human-AI interfaces, highlighting two key aspects: encouraging appropriate alignment with LLMs' advice and ensuring that people are not easily swayed in situations of uncertainty.

MODELS FOR REAL-TIME TRAFFIC FLOW MANAGEABILITY AND DECISION-MAKING IN INTELLIGENT TRANSPORTATION SYSTEMS

This article explores models in Intelligent Transportation Systems for real-time traffic flow manageability, focusing on decision-making processes. It covers forecasting, planning, implementing, and controlling strategies to manage traffic flow and ease congestion. Traffic flow prediction models, like dynamic route guidance and traffic flow prediction, utilize historical data and real-time inputs for proactive decision-making. Traffic flow planning models, such as dynamic route guidance index and route efficiency factor, aid in route selection and signal timing optimization. In order to streamline the boundless complexity, the authors assume that it is effective to delineate the managerial capacity paradigm of intelligent transportation systems into the two separate scenarios of “stable and known situation” and “unstable and with large uncertainty situation”. The article proposes a hypothesis to improve the decision-making process in traffic flow. The distinction between these two situations is essential for the smooth running of the business and requires a thorough understanding of the traffic flow in real time, making decisions in intelligent transport systems in order to direct the traffic. The article focuses on data-driven decisions for smoother traffic flow.

From Calculation to Communication: Using Risk Score Calculators to Inform Clinical Decision Making and Facilitate Patient Engagement.

Risk score calculators are a widely developed tool to support clinicians in identifying and managing risk for certain diseases. However, little is known about physicians' applied experiences with risk score calculators and the role of risk score estimates in clinical decision making and patient communication. Physicians providing care in outpatient community-based clinical settings (N = 20) were recruited to participate in semi-structured individual interviews to assess their use of risk score calculators in practice. Two study team members conducted an inductive thematic analysis using a consensus-based coding approach. Participants referenced at least 20 risk score calculators, the most common being the Atherosclerotic Cardiovascular Disease Risk Calculator. Ecological factors related to the clinical system (e.g., time), patient (e.g., receptivity), and physician (e.g., experience) influenced conditions and patterns of risk score calculator use. For example, compared with attending physicians, residents tended to use a greater variety of risk score calculators and with higher frequency. Risk score estimates were generally used in clinical decision making to improve or validate clinical judgment and in patient communication to serve as a motivational tool. The degree to which risk score estimates influenced physician decision making and whether and how these scores were communicated to patients varied, reflecting a nuanced role of risk score calculator use in clinical practice. The theory of planned behavior can help explain how attitudes, beliefs, and norms shape the use of risk score estimates in clinical decision making and patient communication. Additional research is needed to evaluate best practices in the use of risk score calculators and risk score estimates. The risk score calculators and estimates that participants referenced in this study represented a range of conditions (e.g., heart disease, anxiety), levels of model complexity (e.g., probability calculations, scales of severity), and output formats (e.g., point estimates, risk intervals).Risk score calculators that are easily accessed, have simple inputs, and are trusted by physicians appear more likely to be used.Risk score estimates were generally used in clinical decision making to improve or validate clinical judgment and in patient communication to serve as a motivational tool.Risk score estimates helped participants manage the uncertainty and complexity of various clinical situations, yet consideration of the limitations of these estimates was relatively minimal.Developers of risk score calculators should consider the patient- (e.g., response to risk score estimates) and physician- (e.g., training status) related characteristics that influence risk score calculator use in addition that of the clinical system.

STRESS TOLERANCE OF PEOPLE OF DIFFERENT AGES IN THE CONTEXT OF THEIR FINANCIAL LITERACY

The work is devoted to the analysis of the concept of “stress tolerance” in the context of personal financial literacy. An important aspect of this research is the study of age-related characteristics of people’s exposure to stress, hardiness, and constructive coping behaviour in situations of financial uncertainty. The results of the empirical study are presented and conclusions are drawn regarding the relationship between the level of financial literacy and stress tolerance of representatives of different age groups. The data presented in the article can form a basis for further research in this direction and substantiate the importance of developing financial literacy among people of different age categories.

Grey models for data analysis and decision-making in uncertainty during pandemics

We analyse in this study quite a few uncertain decision-making situations concomitant to a pandemic spread and some of the models using grey theory to deal with such situations. We present four stylised models to tackle different decision support situations at the time of any pandemic crisis, such as COVID-19. Eight diverse problems or situations of risk mitigation and decision-making under uncertainties are proposed in this research and the methodologies employing grey incidence analysis, grey clustering, grey prediction, and grey programming models are offered. Numerical illustrations of the applications of these methodologies are also typified in this paper for future development. A practical application of the widely used grey prediction model is also demonstrated in this study to predict the number of COVID-19 infections and fatalities of five Indian states during a considered period of study. The implications of the study are for data scientists, decision-makers, and practitioners to use the benefits of grey theory in dealing with various situations of uncertainty, such as a spread of a pandemic.

Orbitofrontal Cortex Mediates Sustained Basolateral Amygdala Encoding of Cued Reward-Seeking States.

Basolateral amygdala (BLA) neurons are engaged by emotionally salient stimuli. An area of increasing interest is how BLA dynamics relate to evolving reward-seeking behavior, especially under situations of uncertainty or ambiguity. Here, we recorded the activity of individual BLA neurons in male rats across the acquisition and extinction of conditioned reward seeking. We assessed ongoing neural dynamics in a task where long reward cue presentations preceded an unpredictable, variably time reward delivery. We found that, with training, BLA neurons discriminated the CS+ and CS- cues with sustained cue-evoked activity that correlated with behavior and terminated only after reward receipt. BLA neurons were bidirectionally modulated, with a majority showing prolonged inhibition during cued reward seeking. Strikingly, population-level analyses revealed that neurons showing cue-evoked inhibitions and those showing excitations similarly represented the CS+ and behavioral state. This sustained population code rapidly extinguished in parallel with conditioned behavior. We next assessed the contribution of the orbitofrontal cortex (OFC), a major reciprocal partner to the BLA. Inactivation of the OFC while simultaneously recording in the BLA revealed a blunting of sustained cue-evoked activity in the BLA that accompanied reduced reward seeking. Optogenetic disruption of BLA activity and OFC terminals in the BLA also reduced reward seeking. Our data indicate that the BLA represents reward-seeking states via sustained, bidirectional cue-driven neural encoding. This code is regulated by cortical input and is important for the maintenance of vigilant reward-seeking behavior.

Analysis of prospects and problems in the development of human resources for the employment of Ukrainian refugees

An influx of workers who have accumulated knowledge in labor markets other than the current one can have particularly large effects on the development of the host country's human resources. Other things being equal, a region with higher fluctuations in the number of highly skilled workers should be in a better position than a region with low mobility. Refugee laws are in constant evolution, reflecting the changing political, economic, and legal environments. This paper examines the situation that has developed in the Czech Republic after the arrival of a large number of refugees from Ukraine, in terms of their opportunities and prospects, as well as their ability to enter the labor market in accordance with their education and previous professional activities. The purpose of this study is to analyse the potential and obstacles to the labor integration of Ukrainian refugees, given the situation of uncertainty and the measures taken by the Czech government and state structures to receive refugees. The article considers the objective and subjective prerequisites for the labor integration of refugees, taking into account their socio-demographic characteristics and subjective intentions for the future.

Analýza judikatury Nejvyššího správního soudu týkající se požadavků na odůvodnění opatření podle tzv. pandemického zákona

The article reflects the requirements for the justification of extraordinary measures adopted pursuant to Act No. 94/2021 Sb. (the so-called Pandemic Act), which result from the case law of the Supreme Administrative Court of the Czech Republic. In addition to the requirements for the justification of extraordinary measures, a detailed analysis of all decisions of the Supreme Administrative Court concerning the relevant topic identifies the most important specific errors in the justification of extraordinary measures, as well as the limits of the justification of extraordinary measures, i.e. exceptions to the obligation to justify a specific legal regulation. The identified requirements and limits of the justification of extraordinary measures point to a balanced approach of the Supreme Administrative Court, which does not intend to substitute its decisions for the expert decisions of the primary decision-maker in emergency situations, but at the same time does not give up its role as a body reviewing general measures, even in a situation of uncertainty and changing conditions that accompanied the COVID-19 pandemic. On the basis of the requirements, limitations and specific errors identified in the justification of extraordinary measures adopted under the Pandemic Act, the article draws more general conclusions concerning the justification of acts of a public authority adopted during states of emergency, even outside the legislative framework of the Pandemic Act.

Validity of estimated aortic pulse wave velocity measured during the 6-min walk test to predict anaerobic fitness before major non-cardiac surgery

BackgroundThis study aimed to assess the efficacy of estimated preoperative aortic pulse wave velocity (AoPWV) to discriminate between low and high 6 min walk test (6MWT) distance in patients awaiting major non-cardiac surgery. MethodsProspective observational study in 133 patients undergoing non cardiac surgery. AoPWV and the distance walked during a 6MWT were assessed. Receiver operating characteristic (ROC) curve analysis was used to determine two different AoPWV cut-points for predicting a distance of 427 m in the 6MWT. We also calculated lower and upper AoPWV cut-points (probability ≥ 0.75) for predicting a distance of < 427 m, ≥427 m, and also 563 m in the 6MWT. ResultsThe ROC curve analysis for the < 427 m distance revealed an area under the curve (AUC) of 0.68 (95% confidence interval 0.56–0.79) and an AUC of 0.72 (95% confidence interval 0.61–0.83) for >563 m. Patients with AoPWV > 10.97 m/s should be considered high risk, while those with <9.42 m/s can be considered low risk. ConclusionsAoPWV is a simple, non-invasive, useful clinical tool for identifying and stratifying patients awaiting major non-cardiac surgery. In situations of clinical uncertainty, additional measures should be taken to assess the risk.

Exploring the temporal-spatial characteristics and determinants of high-quality development of city clusters in China

The complexity, severity, and uncertainty of the international situation have prompted the development of city clusters to focus more on resilience and the building of infrastructures and safeguards. Chinese-style modernization proposes a new realization path for the high-quality development (HQD) of city clusters, based on which an evaluation system for HQD indicators of city clusters is constructed. We also measured the HQD levels of 19 city clusters from 2011 to 2021 and analyzed their spatial differentiation characteristics, agglomeration evolution characteristics, and influencing factors by using kernel density, standard deviation ellipse, Moran's index, geographic detector, and geographically weighted regression. The study revealed that (1) the overall level of HQD of China's city clusters shows a trend of continuous growth, and there is obvious polarization in the high quality of city clusters in different regions. (2) The spatial distribution of HQD in city clusters decreased in the "East, Center and West" direction, but the spatial patterns of "Southeast highlighting" and "Northwest rising" became more obvious. (3) The HQD of city clusters shows obvious spatial agglomeration characteristics and overall presents a spatial pattern of "hot in the east and cold in the west", with the scope of the cold spot area gradually shrinking, and the hot spot area tends to spread outward, with mature city clusters at the core. (4) The influencing factors of HQD in Chinese city clusters are diverse, with financial levels, digital economics, human capital and green innovations having decreasing influence on HQD in city clusters but showing an obvious two-factor enhancement trend, with financial levels being able to effectively stimulate the driving potential of other factors. Financial levels can effectively stimulate the driving potential of other factors. (5) The coefficients of the driving factors affecting the HQD of city clusters vary significantly spatially, with human capital, financial levels and green innovations showing a north‒south hierarchical banded distribution of "high in the south and low in the north", and digital economy shows an east-west hierarchical belt distribution of "high west and low east". Based on the above conclusions, the realization path of accelerating the HQD of China's city clusters is proposed by optimizing the functional division of labor of the city clusters, giving full play to the comparative advantages of the hinterland city clusters, and relying on the high level of the city clusters for opening up.

Intervención dirigida por catéter en la embolia aguda de pulmón. Posicionamiento SEC-Asociación de Cardiología Intervencionista/SEC-Asociación de Cardiopatía Isquémica y Cuidados Agudos Cardiovasculares/SEC-GT Hipertensión Pulmonar

Pulmonary embolism (PE) is the leading cause of hospital death and the third most frequent cause of cardiovascular mortality. Traditionally, treatment options have included anticoagulation, thrombolysis, or surgery; however, catheter-directed interventions (CDI), including catheter-directed thrombolysis and aspiration thrombectomy, have been developed for patients with intermediate- or high-risk PE. These techniques can rapidly improve right ventricular function, hemodynamic status, and mortality in some patients, although there is a lack of evidence from randomized controlled trials. This document, prepared by the Interventional Cardiology Association, the Association of Ischemic Heart Disease and Acute Cardiovascular Care, and the Working Group on Pulmonary Hypertension of the Spanish Society of Cardiology (SEC), reviews the current recommendations and available evidence on the management of PE. It emphasizes the importance of rapid response teams, risk stratification, and early patient monitoring in identifying candidates for reperfusion. Based on existing clinical evidence on CDI, the document discusses various clinical scenarios and provides guidance on patient selection, particularly in situations of uncertainty due to insufficient evidence. Lastly, it describes periprocedural support, highlighting the necessary multidisciplinary approach to improve outcomes and reduce morbidity and mortality in patients with PE.

The Role of Attitude to Uncertainty When Choosing Adaptive Strategies and Implementing Them: A Comparative Analysis on a Sample Of Students And Teachers

Introduction. This article explores the relationship between the attitude towards uncertainty and the nature of personality adaptability in the context modern life situation’s risks. The relevance of this topic lies in the possibility of choosing not only constructive, but also destructive adaptation schemes in situations of uncertainty, which are increasingly arising in the lives of young people today. The analysis of studies existing in this subject field made it possible to identify a number of subjective predictors of a successful adaptation. The novelty of this research is identifying and describing the influence of the attitude towards uncertainty on the adaptation of an individual in the context of modern risks. The contents of the article include analysis of various adaptation profiles and their link to the attitude towards uncertainty.Purpose. Studying the relationship between the attitude to tolerance and adaptation of an individual in the context of modern risks.Materials and Methods. This study features the following methodological tools: the McLean Uncertainty Tolerance Scale; the S. Maddy Resilience Test (adapted by D. A. Leontiev); the methodology for diagnosing socio-psychological adaptation (K. Rogers and R. Diamond); the “Attitude to Uncertainty” questionnaire (T.N. Shcherbakova). Statistical data processing was carried out using the Spearman rank correlation coefficient.Results. A structured analysis of the factors that determine the adaptability of students and teachers in different regions in the context of modern risks is presented in this section. The peculiarities of the severity of indicators of tolerance to uncertainty and resilience of an individual, as well as their relationship with adaptability – maladaptivity were found.Discussion. The results of the empirical study reflect the importance of the attitude and tolerance of an individual to uncertainty for their successful adaptation. For the first time, the interrelation of the components of resilience and tolerance to uncertainty with adaptability – maladaptiveness of students from different regions personalities in the context of information, social and educational risks are shown. Thus, it can be said that there is a connection between the adaptability of students’ personalities and their attitude to uncertainty, indicators of tolerance to rapidly changing conditions, and the severity of the parameters of resilience. The level of reflection of the features of the projections of uncertainty allows to develop resilience and increase the level of adaptability to the relevant life conditions on a personal level. A model of a program of psychological support for increasing the level of adaptation of students in the context of modern risks of uncertainty is proposed.

Relational Work and Accounting: What Venture Capital Analysts Do with Accounting and Other Information in Situations of Uncertainty

Analysts in venture capital (VC) organizations are important mediators in the entrepreneurial economy, operating as both ‘scouts’ and ‘coaches’ of early-stage ventures. Research shows that these analysts invest heavily in collecting and scrutinizing accounting and a wide range of other information at all stages of their work. However, we lack an integrative theorization of how, in the presence of fundamental or ‘Knightian’ uncertainty, analysts effectively use this information. We explore this topic through interviews with VC analysts and project makers operating in Denmark in 2009 and 2010. Drawing on and extending the work of Viviana Zelizer, we show, firstly, how the multiple, different uses of accounting and other information function in relation to each other and the communication and transformation of social relations. Each stage of analyst work involves a double movement in which economic media is differentiated and the relationships between analysts and project makers and their ventures are created, negotiated, maintained, and changed. Secondly, we show how this double movement provides an indirect and ‘ontological’ mode of handling situations of uncertainty in which accounting information adds matter and form to the new business venture. We conclude by exploring opportunities for further applications of relational work in accounting research.

Next-generation sequencing-based evaluation of the actionable landscape of genomic alterations in solid tumors: the "MOZART" prospective observational study.

The identification of the most appropriate targeted therapies for advanced cancers is challenging. We performed a molecular profiling of metastatic solid tumors utilizing a comprehensive next-generation sequencing (NGS) assay to determine genomic alterations' type, frequency, actionability, and potential correlations with PD-L1 expression. A total of 304 adult patients with heavily pretreated metastatic cancers treated between January 2019 and March 2021 were recruited. The CLIA-/UKAS-accredit Oncofocus assay targeting 505 genes was used on newly obtained or archived biopsies. Chi-square, Kruskal-Wallis, and Wilcoxon rank-sum tests were used where appropriate. Results were significant for P < .05. A total of 237 tumors (78%) harbored potentially actionable genomic alterations. Tumors were positive for PD-L1 in 68.9% of cases. The median number of mutant genes/tumor was 2.0 (IQR: 1.0-3.0). Only 34.5% were actionable ESCAT Tier I-II with different prevalence according to cancer type. The DNA damage repair (14%), the PI3K/AKT/mTOR (14%), and the RAS/RAF/MAPK (12%) pathways were the most frequently altered. No association was found among PD-L1, ESCAT, age, sex, and tumor mutational status. Overall, 62 patients underwent targeted treatment, with 37.1% obtaining objective responses. The same molecular-driven treatment for different cancer types could be associated with opposite clinical outcomes. We highlight the clinical value of molecular profiling in metastatic solid tumors using comprehensive NGS-based panels to improve treatment algorithms in situations of uncertainty and facilitate clinical trial recruitment. However, interpreting genomic alterations in a tumor type-specific manner is critical.