Subsequent Decisions Research Articles

Circulating tumour DNA (ctDNA) burden quantified through low-pass whole genome sequencing as an early pharmacodynamic biomarker of therapeutic response in patients enrolled on phase 1 trials.

23 Background: Early phase trials are conducted to determine the recommended dose and safety of an investigational therapy. Targeted therapies and immunotherapy may not always have dose-dependent toxicities. Therefore, dose finding is increasingly reliant on optimal biological dosing. Pharmacodynamic biomarkers are increasingly important to demonstrate proof of concept. Using ctDNA allows for dynamic and early tumour assessments compared to imaging. We sought to evaluate ctDNA as an early pharmacodynamic biomarker of therapeutic response. Methods: Patients (pts) enrolled on phase 1 trials at the National Cancer Centre Singapore were prospectively consented to collect serial blood samples at defined timepoints (pre-treatment, mid-cycle 1, end of cycle 1, and with subsequent imaging evaluations). ctDNA burden was quantified using low pass whole genome sequencing (lpWGS) with both established (ichorCNA) and novel (cell-free DNA degradation) bioinformatic analyses of ctDNA burden, and targeted panel sequencing. Early kinetics of ctDNA burden prior to imaging evaluation was evaluated as response (reduction in ctDNA burden) versus progression (increase in ctDNA burden). Results: Between May 2021 to Oct 2022, 68 plasma samples (median 3, range 2-5) were collected from 22 pts. Median age was 56 years (range 37-77) and 73% were male. Pts were enrolled on trials of targeted therapy (55%), immunotherapy (40%) or combinations of both (5%). Common tumour types were lung (36%), colorectal (23%) and pancreatic (9%) cancer. Best response on phase 1 trial as per imaging and RECIST v1.1 was partial response (PR) in 9%, stable disease (SD) in 45%, progressive disease (PD) in 27% and not evaluable (NE; taken off trial early due to toxicity) in 18%. Quantification of ctDNA burden using cell-free DNA fragment length pattern demonstrated enhanced limit of detection in detecting baseline ctDNA compared to cell-free DNA copy number profile based ichorCNA method (100% vs 59%). For pts on targeted therapies, early kinetics of ctDNA burden indicated ctDNA response in 9/13 pts, with subsequent imaging showing PR (n=2), SD (n=2), PD (n=2) or NE (n=3). In the remaining 4/13 pts on targeted therapies with early ctDNA progression, subsequent imaging showed SD (n=3) or NE (n=1). For pts on immunotherapy, early ctDNA progression was seen in 8/10 pts, with subsequent imaging showing SD (n=5) and PD (n=3). Patient enrolment and sample analysis is ongoing to further validate these initial findings and updated data will be presented. Conclusions: Early ctDNA evaluation via lpWGS may represent an early pharmacodynamic biomarker of therapeutic response. ctDNA has the potential to provide early proof of concept, particularly for targeted therapies, that may influence subsequent decisions for dose determination.

The slow rate of working memory consolidationfrom vision is a structural limit.

The speed with which information from vision is transformed into working memory (WM) representations that resist interference from ongoing perception and cognition is the subject of conflicting results. Using distinct paradigms, researchers have arrived at estimates of the consolidation time course ranging from 25 ms to 1 s - a range of more than an order of magnitude. However, comparisons of consolidation duration across very different estimation paradigms rely on the implicit assumption that WM consolidation speed is a stable, structural constraint of the WM system. The extremely large variation in WM consolidation speed estimates across measurement approaches motivated the current work's goal of determining whether consolidation speed truly is a stable structural constraint of WM encoding, or instead might be under strategic control as suggested by some accounts. By manipulating the relative task priority of WM encoding and a subsequent sensorimotor decision in a dual-task paradigm, the current experiments demonstrate that the long duration of WM consolidation does not change as a result of task-specific strategies. These results allow comparison of WM consolidation across estimation approaches, are consistent with recent multi-phase WM consolidation models, and are consistent with consolidation duration being an inflexible structural limit.

Sequential Deployment of Mobile Radiation Sensor Network Using Reinforcement Learning in Radioactive Source Search

Ever since the attack on the World Trade Center on September 11, prevention of nuclear terrorist attacks in urban environments has been a major focus for homeland security. To that end, mobile radiation sensor networks that are deployed within a specific area to acquire consecutive measurements are a first line of defense against the illicit movement of nuclear threats. However, sensor network deployment is a complex process imposed on physical and financial constraints and dynamically varying conditions. In this work, reinforcement learning (RL) is applied to control the sequential deployment of a mobile radiation sensor network within a specific geographic area. RL is utilized for dynamically learning of the environment and subsequent decision making on the optimal position of the network sensors driven by shared mutual information. RL has the benefit of allowing the network to learn and update a deployment strategy online from an initially unknown state. The performance of the RL method is demonstrated through self-contained exploration and interaction between sensors in a source search scenario for detecting a radioactive source with a set of mobile detectors within the space of the University of Texas at San Antonio campus. Results exhibit the efficiency and efficacy of (a-sequential) RL in comparison to the sequential placement of the mobile sensors, showcasing optimality in accuracy and efficiency in source detection.

Considerable Variability Among Transplant Nephrologists in Judging Deceased Donor Kidney Offers

Transplant clinicians may disagree on whether or not to accept a deceased donor kidney offer. We investigated the interobserver variability between transplant nephrologists regarding organ acceptance and whether the use of a prediction model impacted their decisions. We developed an observational online survey with 6 real-life cases of deceased donor kidneys offered to a waitlisted recipient. Per case, nephrologists were asked to estimate the risk of adverse outcome and whether they would accept the offer for this patient, or for a patient of their own choice, and how certain they felt. These questions were repeated after revealing the risk of adverse outcome, calculated by a validated prediction model. Sixty Dutch nephrologists completed the survey. The intraclass correlation coefficient of their estimated risk of adverse outcome was poor (0.20, 95% confidence interval [CI] 0.08-0.62). Interobserver agreement of the decision on whether or not to accept the kidney offer was also poor (Fleiss kappa 0.13, 95% CI 0.129-0.130). The acceptance rate before and after providing the outcome of the prediction model was significantly influenced in 2 of 6 cases. Acceptance rates varied considerably among transplant centers. In this study, the estimated risk of adverse outcome and subsequent decision to accept a suboptimal donor kidney varied greatly among transplant nephrologists. The use of a prediction model could influence this decision and may enhance nephrologists' certainty about their decision.

Multi-omics approach identifies PI3 as a biomarker for disease severity and hyper-keratinization in psoriasis

BackgroundPsoriasis is an immune-mediated inflammatory skin disease. Psoriasis severity evaluation is important for clinicians in the assessment of disease severity and subsequent clinical decision making. However, no objective biomarker is available for accurately evaluating disease severity in psoriasis. ObjectiveTo define and compare biomarkers of disease severity and progression in psoriatic skin. MethodsWe performed proteome profiling to study the proteins circulating in the serum from patients with psoriasis, psoriatic arthritis and ankylosing spondylitis, and transcriptome sequencing to investigate the gene expression in skin from the same cohort. We then used machine learning approaches to evaluate different biomarker candidates across several independent cohorts. In order to reveal the cell-type specificity of different biomarkers, we also analyzed a single-cell dataset of skin samples. In-situ staining was applied for the validation of biomarker expression. ResultsWe identified that the peptidase inhibitor 3 (PI3) was significantly correlated with the corresponding local skin gene expression, and was associated with disease severity. We applied machine learning methods to confirm that PI3 was an effective psoriasis classifier, Finally, we validated PI3 as psoriasis biomarker using in-situ staining and public datasets. Single-cell data and in-situ staining indicated that PI3 was specifically highly expressed in keratinocytes from psoriatic lesions. ConclusionOur results suggest that PI3 may be a psoriasis-specific biomarker for disease severity and hyper-keratinization.

Fictional girls who play to play: pushing on narratives of competition in young adult sports literature

ABSTRACT Traditional narratives of sport posit winning as the defining goal in ways that can feel and be exclusionary to young people and result in a lack of enjoyment and subsequent decision to avoid or discontinue involvement in sport. This is particularly true for girls and young women who participate in sport at lower rates and quit at higher rates than boys and young men. Shifting the focus of sport away from winning can open space for a wider range of girls and young women to see themselves as athletes. Scholars have highlighted how story in the form of counter-narratives can play a role in changing readers’ perspectives. However, no attention has been paid to fictional representations of athletes engaging in non-competitive sport and how these depictions might invite girls and young women to imagine themselves differently in sporting spaces. This paper employs thematic inductive analysis to examine three, girl-centric young adult sports novels that work as counter-narratives to examine what happens when winning is not the central goal of participation in sport. Specifically, it explores what fictional young women athletes gain through their participation in non-competitive sport and what young adult readers might gain in their engagement with these titles. Findings reveal how participation in non-competitive sport gives the fictional athletes a sense of full personhood, confidence and pride in what their bodies can do, and connection with something larger than themselves. These titles can show readers that their engagement in sport is desirable, that non-competitive sport is beneficial to them, and that their engagement in sport is possible, that non-competitive sport is for them. The paper suggests that stories of non-competitive sport have the potential to open equitable access by inviting more young people, particularly those who have not seen themselves in stories of sport, to engage as athletes.

Multiparametric MRI radiomics in prostate cancer for predicting Ki-67 expression and Gleason score: a multicenter retrospective study

PurposeProstate cancer (PCa) with high Ki-67 expression and high Gleason Scores (GS) tends to have aggressive clinicopathological characteristics and a dismal prognosis. In order to predict the Ki-67 expression status and the GS in PCa, we sought to construct and verify MRI-based radiomics signatures.Methods and materialsWe collected T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) images from 170 PCa patients at three institutions and extracted 321 original radiomic features from each image modality. We used support vector machine (SVM) and least absolute shrinkage and selection operator (LASSO) logistic regression to select the most informative radiomic features and built predictive models using up sampling and feature selection techniques. Using receiver operating characteristic (ROC) analysis, the discriminating power of this feature was determined. Subsequent decision curve analysis (DCA) assessed the clinical utility of the radiomic features. The Kaplan–Meier (KM) test revealed that the radiomics-predicted Ki-67 expression status and GS were prognostic factors for PCa survival.ResultThe hypothesized radiomics signature, which included 15 and 9 selected radiomics features, respectively, was significantly correlated with pathological Ki-67 and GS outcomes in both the training and validation datasets. Areas under the curve (AUC) for the developed model were 0.813 (95% CI 0.681,0.930) and 0.793 (95% CI 0.621, 0.929) for the training and validation datasets, respectively, demonstrating discrimination and calibration performance. The model's clinical usefulness was verified using DCA. In both the training and validation sets, high Ki-67 expression and high GS predicted by radiomics using SVM models were substantially linked with poor overall survival (OS).ConclusionsBoth Ki-67 expression status and high GS correlate with PCa patient survival outcomes; therefore, the ability of the SVM classifier-based model to estimate Ki-67 expression status and the Lasso classifier-based model to assess high GS may enhance clinical decision-making.

Exploring healthcare authorities’ decisions to sustain or abandon a management control initiative

AbstractWe explore how a management control initiative travels across and is translated within organizations—from the decision motives for adoption or rejection to the subsequent decision motives for sustaining or abandoning the control—through the lens of diffusion theory. Our empirical case is the journey of activity‐based funding of hospitals across 21 Swedish healthcare authorities. We develop a framework in which the abandonment or sustainment of a management control is explained by the interplay between the decision motive underlying the adoption and the propensity to continuously adapt it in response to new organizational goals and circumstances. This propensity is determined by fits and misfits between organizational characteristics and properties of the control.

An international survey of SEEG cortical stimulation practices.

Cortical stimulation is an important component of stereoelectroencephalography (SEEG). Despite this, there is currently no standardized approach and significant heterogeneity in the literature regarding cortical stimulation practices. Via an international survey of SEEG clinicians, we sought to examine the spectrum of cortical stimulation practices to reveal areas of consensus and variability. A 68-item questionnaire was developed to understand cortical stimulation practices including neurostimulation parameters, interpretation of epileptogenicity, functional and cognitive assessment and subsequent surgical decisions. Multiple recruitment pathways were pursued, with the questionnaire distributed directly to 183 clinicians. Responses were received from 56 clinicians across 17 countries with experience ranging from 2 to 60 years (M = 10.73, SD = 9.44). Neurostimulation parameters varied considerably, with maximum current ranging from 3 to 10 mA (M = 5.33, SD = 2.29) for 1 Hz and from 2 to 15 mA (M = 6.54, SD = 3.68) for 50 Hz stimulation. Charge density ranged from 8 to 200 μC/cm2 , with up to 43% of responders utilizing charge densities higher than recommended upper safety limits, i.e. 55 μC/cm2 . North American responders reported statistically significant higher maximum current (P < 0.001) for 1 Hz stimulation and lower pulse width for 1 and 50 Hz stimulation (P = 0.008, P < 0.001, respectively) compared to European responders. All clinicians evaluated language, speech, and motor function during cortical stimulation; in contrast, 42% assessed visuospatial or visual function, 29% memory, and 13% executive function. Striking differences were reported in approaches to assessment, classification of positive sites, and surgical decisions guided by cortical stimulation. Patterns of consistency were observed for interpretation of the localizing capacity of stimulated electroclinical seizures and auras, with habitual electroclinical seizures induced by 1 Hz stimulation considered the most localizing. SEEG cortical stimulation practices differed vastly across clinicians internationally, highlighting the need for consensus-based clinical guidelines. In particular, an internationally standardized approach to assessment, classification, and functional prognostication will provide a common clinical and research framework for optimizing outcomes for people with drug-resistant epilepsy.

Preparation for cardiac procedures: a cross-sectional study identifying gaps between outpatients' views and experiences of patient-centred care.

To examine and identify gaps in care perceived as essential by patients; this study examined outpatients': (1) views on what characterizes essential care and (2) experiences of care received, in relation to cardiac catheterization and subsequent cardiovascular procedures. Cross-sectional descriptive study. Surveys were posted to outpatients who had undergone elective cardiac catheterization in the prior 6 months at an Australian hospital. Participants completed a 65-item survey to determine: (a) aspects of care they perceive as essential to patients receiving care for a cardiac condition (Important Care Survey); or (b) their actual care received (Actual Care Survey). Numbers and percentages were used to calculate the most frequently identified essential care items; and the experiences of care received. Items rated as either 'Essential'/'Very important' by at least 80% of participants were determined. A gap in patient-centred care was identified as being any item that was endorsed as essential/very important by 80% or more of participants but reported as received by <80% of participants. Of 582 eligible patients, 264 (45%) returned a completed survey. A total of 43/65 items were endorsed by>80% of participants as essential. Of those, for 22 items, <80% reported the care as received. Gaps were identified in relation to general practitionerconsultation (1 item), preparation (1 item) subsequent decision making for treatment (1 item), prognosis (6 items), and post-treatment follow-up (1 item). Areas were identified where actual care fell short of patients' perceptions of essential care.

A Risk-Based Approach for Managing Affinity Resin Contaminations.

This commentary outlines a proposed approach for navigating remediation (non-routine sanitization) of contaminated affinity-based resins. The methodology for collection of relevant information and for subsequent decision-making is presented, along with a tool for determining risk to the process associated with proposed return-to-use of remediated resin.

Statistical Considerations and Software for Designing Sequential, Multiple Assignment, Randomized Trials (SMART) with a Survival Final Endpoint

ABSTRACT Sequential, multiple assignment, randomized trial (SMART) designs are appropriate for comparing adaptive treatment interventions, in which intermediate outcomes (called tailoring variables) guide subsequent treatment decisions for individual patients. Within a SMART design, patients may be re-randomized to subsequent treatments following the outcomes of their intermediate assessments. In this paper, we provide an overview of statistical considerations necessary to design and implement a two-stage SMART design with a binary tailoring variable and a survival final endpoint. A chronic lymphocytic leukemia trial with a final endpoint of progression-free survival is used as an example for the simulations to assess how design parameters, including, choice of randomization ratios for each stage of randomization, and response rates of the tailoring variable affect the statistical power. We assess the choice of weights from restricted re-randomization on data analyses and appropriate hazard rate assumptions. Specifically, for a given first-stage therapy and prior to the tailoring variable assessment, we assume equal hazard rates for all patients randomized to a treatment arm. After the tailoring variable assessment, individual hazard rates are assumed for each intervention path. Simulation studies demonstrate that the response rate of the binary tailoring variable impacts power as it directly impacts the distribution of patients. We also confirm that when the first stage randomization is 1:1, it is not necessary to consider the first stage randomization ratio when applying the weights. We provide an R-shiny application for obtaining power for a given sample size for SMART designs.

Focal Liver Lesions in Budd-Chiari Syndrome: Spectrum of Imaging Findings.

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by hepatic venous outflow obstruction, resulting in liver congestion and subsequent chronic parenchymal damage. This condition often leads to the development of focal liver lesions, including benign focal nodular hyperplasia-like regenerative nodules, hepatocellular carcinoma, and perfusion-related pseudo-lesions. Computed tomography, ultrasound, and magnetic resonance are the commonly employed imaging modalities for the follow-up of BCS patients and for the detection and characterization of new-onset lesions. The accurate differentiation between benign and malignant nodules is crucial for optimal patient management and treatment planning. However, it can be challenging due to the variable and overlapping characteristics observed. This review aims to provide a comprehensive overview of the imaging features and differential diagnosis of focal liver lesions in BCS, emphasizing the key findings and discussing the challenges associated with their interpretation, with the purpose of facilitating the subsequent clinical decision-making.

QUEST FOR THE TRUTH IN TRANSLATION: TO THE ONTOLOGICAL FUNDAMENTALS OF ANALYSIS IN TRANSLATION

The paper presents an attempt to explain the phenomenon of correspondence in translation through the notion of truth. The truth of translation is conceived as a complex category that manifests itself through a system of functional oppositions. The central object of this study, contrastively combining all the aspects of translation, is transformation. The paper stands against a unilateral structural linguistic view on the phenomenon of transformation, considering transformation as an interpretative means of translation combining invariable and variable sides. The paper equates transformation to interpretation in translation. In translation the interpretation is represented by transformation. Constructively any interpretation unfolds from its invariable side to its variable side. In the usual scenario of communication, interpretation represents a transition from the linguistic form to the sense where the sense is variable representing a common field of understanding shared between communicants. In translation, the sense is the invariable side; consequently, the interpretation unfolds from the sense to the linguistic form. The link between the invariable and variable sides in translation is treated in terms of inductive logic. The equivalence is seen through the category of transitivity (a potential substitutability of semantic elements on the basis of the same sense). The truth of translation is a binary category with the sense being its foundation and the referential semantic side being its boundary where semantic variability up to some limits is supposed. The interrelationship between the boundary and the foundation of the truth is the matter of analytical work of interpreter. The truth of translation is subject to the logical verification and falsification procedures. The logical procedures precede the translation forming the base of the subsequent decision the interpreter takes to choose an equivalent. The paper deals also with the function of style, sociocultural and figurative nuances in translation. From this perspective, categories of foreignization and domestication in their functional interconnection are taken into consideration. Their interconnection means that one category may result from the other. The paper presents a number of examples of English-Russian and Portuguese-Russian translation. The paper may be of interest to specialists in translation studies, contrastive linguistics and general linguistics.

Impacto clínico de la videocápsula endoscópica en pacientes con sospecha de hemorragia de intestino delgado: experiencia en un hospital de alta complejidad de Colombia

Introduction and aimsCapsule endoscopy is part of the diagnostic approach to patients with suspected small bowel bleeding and data on its clinical impact are still limited in developing countries. The primary aim of the present study was to determine its impact on subsequent diagnostic and therapeutic decisions. Material and methodsA retrospective study was conducted that included all the patients that underwent capsule endoscopy with the PillCam™ SB 3 Capsule system due to suspected small bowel bleeding treated at the Hospital Universitario Fundación Valle del Lili between January 2011 and December 2020. ResultsA total of 158 patients met the inclusion criteria. Mean patient age was 63years (interquartile range [IQR], 52-74), 53.6% of the patients were women, and high blood pressure was the most frequent comorbidity (43.7%). The main indication was overt bleeding (58.2%). Of all the capsule endoscopies carried out, 63.9% showed lesions that were potentially responsible for bleeding. Medical or surgical treatment was indicated in 63.3% of the case total. Rebleeding at 6months occurred in 15 patients and there were 2deaths due to gastrointestinal bleeding at 6months. ConclusionsCapsule endoscopy has a high impact on patients with suspected small bowel bleeding, with respect to clinical decision-making, as well as rebleeding, hospitalization, and mortality outcomes. The positivity rate of lesions potentially responsible for bleeding was similar to that reported in developed countries.

Unitary system of patent protection as an element of innovation policy of the European Union

The article analyzes the process of establishing a unitary system of patent protection in the European Union as an alternative to national and regional systems and its importance for enhancing the innovation potential and economic development of the EU. It examines the preconditions for the transition from national patents to regional (and subsequently unitary) patents, which are based on the intention of the EU Member States to overcome the territorial principle of patent rights by extending the patent owner’s exclusive rights beyond the territorial borders of one state.It is noted that the transformation of the economy into an innovative one, in which a key role is assigned to intellectual property rights (as a precondition for innovation), has actualized the issue of effective intellectual property legal protection, in particular, concerning patent rights. Since 1997, the European Commission has been highlighting the importance of patents as one of the tools available for protecting innovation and the need to reform the European patent system to increase Europe’s innovation potential and competitiveness. Subsequent decisions of the EU Council were taken to fulfill this task, resulting in the introduction of a unitary system, which includes the European Patent with Unitary Effect (the Unitary Patent) and the Unified Patent Court, as of June 1, 2023. As a result, inventors can obtain unitary patent protection based on the Unitary Patent in all EU Member States participating in the enhanced cooperation mechanism.It is concluded that the unitary patent protection system extends the territoriality principle beyond the national borders of the State within the EU borders, but does not destroy the basic principles of intellectual property rights. In contrast, the article examines the US case law, which demonstrates its own approaches to understanding the principle of territoriality and the presumption against extraterritoriality of patent rights, allowing in certain cases the US patent holder to extend its monopoly to foreign markets.

Principles and assumptions of psychometric measurement

Introduction: the validity of claims about learner self-reports depends on the credibility of the measures used. Inventories developed within the psychometric tradition are expected to provide theoretical and empirical evidence for the validity and reliability of the measures to support subsequent interpretations and decisions. These practices depend on a set of assumptions based on latent trait theory that are essential to understanding what psychometric measures can do. This tutorial outlines essential characteristics of design and reporting of psychometric self-report data.

Removing Barriers to Emergency Medicine Point-of-Care Ultrasound: Illustrated by a Roadmap for Emergency Medicine Point-of-Care Ultrasound Expansion in India.

Point-of-care ultrasound (PoCUS) has a potentially vital role to play in emergency medicine (EM), whether it be in high-, medium-, or low-resourced settings. However, numerous barriers are present which impede EM PoCUS implementation nationally and globally: (i) lack of a national practice guideline or scope of practice for EM PoCUS, (ii) resistance from non-PoCUS users of ultrasound imaging (USI) and lack of awareness from those who undertake parallel or post-EM patient care, and (iii) heterogeneous pattern of resources available in different institutes and settings. When combined with the Indian Preconception and Prenatal Diagnostic Techniques (PCPNDT) Act, this has led to the majority of India's 1.4 billion citizens being unable to access EM PoCUS. In order to address these barriers (globally as well as with specific application to India), this article outlines the three core principles of EM PoCUS: (i) the remit of the EM PoCUS USI must be well defined a priori, (ii) the standard of EM PoCUS USI must be the same as that of non-PoCUS users of USI, and (iii) the imaging performed should align with subsequent clinical decision-making and resource availability. These principles are contextualized using an integrated PoCUS framework approach which is designed to provide a robust foundation for consolidation and expansion across different PoCUS specialisms and health-care settings. Thus, a range of mechanisms (from optimization of clinical practice through to PoCUS educational reform) are presented to address such barriers. For India, these are combined with specific mechanisms to address the PCPNDT Act, to provide the basis for influencing national legislation and instigating an addendum to the Act. By mapping to the recent Lancet Commission publication on transforming access to diagnostics, this provides a global and cross-discipline perspective for the recommendations.

Adding fuel to the fire: The impact of stress on decision-making in dilemmas among emergency service personnel

IntroductionCertain professions are particularly exposed to stress and must make decisions with far-reaching consequences. Recent research indicates that stress alters subsequent decision-making. The two current studies examine the predictive effect of perceived stress and leadership responsibility on moral decision-making among emergency service personnel. ObjectiveWe hypothesized that under high levels of perceived stress, fewer utilitarian and fewer altruistic decisions are made. Utilitarian decisions involve saving the lives of more people while sacrificing a smaller number of people. Altruistic decisions lead to outcomes that benefit others rather than oneself. Furthermore, we hypothesized that leaders under high levels of perceived stress make more utilitarian and altruistic decisions than non-leaders. MethodTwo different samples (N1=368; N2=562) were exposed to two different types of moral dilemmas (Sample 1: sacrificial dilemmas, Sample 2: everyday dilemmas). Stress levels were assessed using the Perceived Stress Scale. The hypotheses were tested with hierarchical regression analysis. ResultsAs hypothesized, in sacrificial dilemmas, high perceived stress levels predicted a decrease in utilitarian decisions. Moreover, highly stressed leaders made more utilitarian decisions compared to non-leaders. In everyday dilemmas, high-perceived stress levels predicted fewer altruistic decisions. No moderating effect of leadership responsibility was observed. ConclusionOur results indicate that perceived stress predicts moral decision-making among emergency service personnel.

Цифровая модульная система мониторинга, оценки и прогнозирования состояния бетона при производстве монолитных работ на основе технологии интернета вещей

This article explores the strength characteristics of concrete structures in relation to their production technology, as well as investigates the potential for improving quality control methods in concrete casting through the integration of modern IIoT technologies.&#x0D; During the construction process, there is a frequent necessity to conduct rapid assessments of the condition of concrete and concrete structures directly at the construction site. This need arises from the logical reasoning that upon detecting any structural defects, such as cracks or sinks, it is essential to obtain initial information about the concrete's condition to facilitate subsequent analysis and decision-making without conducting complex laboratory studies.&#x0D; In this study, we made an analysis of existing temperature control systems employed to monitor concreting concrete structures during winter conditions. Additionally, detailed insights and practical experience are presented regarding the utilization of a state-of-the-art monitoring system at construction sites, enabling real-time temperature monitoring both on the surface and within the structure.