Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Background: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons' knowledge and perception of using AI-based tools in clinical decision-making processes. Methods: An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society's website and Twitter profile. Results: 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion: The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI

Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey

Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. Discussion Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions

Long-range angular correlations on the near and away side in p-Pb collisions at root S-NN=5.02 TeV

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Angular correlations between charged trigger and associated particles are measured by the ALICE detector in p-Pb collisions at a nucleon-nucleon centre-of-mass energy of 5.02 TeV for transverse momentum ranges within 0.5 < P-T,P-assoc < P-T,P-trig < 4 GeV/c. The correlations are measured over two units of pseudorapidity and full azimuthal angle in different intervals of event multiplicity, and expressed as associated yield per trigger particle. Two long-range ridge-like structures, one on the near side and one on the away side, are observed when the per-trigger yield obtained in low-multiplicity events is subtracted from the one in high-multiplicity events. The excess on the near-side is qualitatively similar to that recently reported by the CMS Collaboration, while the excess on the away-side is reported for the first time. The two-ridge structure projected onto azimuthal angle is quantified with the second and third Fourier coefficients as well as by near-side and away-side yields and widths. The yields on the near side and on the away side are equal within the uncertainties for all studied event multiplicity and p(T) bins, and the widths show no significant evolution with event multiplicity or p(T). These findings suggest that the near-side ridge is accompanied by an essentially identical away-side ridge. (c) 2013 CERN. Published by Elsevier B.V. All rights reserved.719416992941State Committee of ScienceCalouste Gulbenkian Foundation from LisbonSwiss Fonds Kidagan, ArmeniaFinanciadora de Estudos e Projetos (FINEP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)National Natural Science Foundation of China (NSFC)Chinese Ministry of Education (CMOE)Ministry of Science and Technology of China (MSTC)Ministry of Education and Youth of the Czech RepublicDanish Natural Science Research CouncilCarlsberg FoundationDanish National Research FoundationThe European Research Council under the European Community's Seventh Framework ProgrammeHelsinki Institute of PhysicsAcademy of FinlandFrench CNRS-IN2P3, France'Region Pays de Loire', France'Region Alsace', France'Region Auvergne', FranceCEA, FranceGerman BMBFHelmholtz AssociationGeneral Secretariat for Research and Technology, Ministry of Development, GreeceHungarian OTKANational Office for Research and Technology (NKTH)Department of Atomic Energy of the Government of IndiaDepartment of Science and Technology of the Government of IndiaIstituto Nazionale di Fisica Nucleare (INFN), ItalyCentro Fermi - Museo Storico della Fisica e Centro Studi e Ricerche "Enrico Fermi", ItalyMEXTJoint Institute for Nuclear Research, DubnaNational Research Foundation of Korea (NRF)CONACYT, MexicoDGAPA, MexicoALFA-ECHELEN Program (High-Energy physics Latin-American-European Network)Stichting voor Fundamenteel Onderzoek der Materie (FOM), NetherlandsNederlandse Organisatie voor Wetenschappelijk Onderzoek (NWO), NetherlandsResearch Council of Norway (NFR)Polish Ministry of Science and Higher EducationNational Authority for Scientific Research - NASR (Autoritatea Nationala pentru Cercetare Stiintifica - ANCS)Ministry of Education and Science of Russian FederationInternational Science and Technology CenterRussian Academy of SciencesRussian Federal Agency of Atomic EnergyRussian Federal Agency for Science and InnovationsCERN-INTASMinistry of Education of SlovakiaDepartment of Science and Technology, South AfricaCIEMATEELAMinisterio de Educacion y Ciencia of SpainXunta de Galicia (Conselleria de Educacion)CEADENCubaenergia, CubaIAEA (International Atomic Energy Agency)Swedish Research Council (VR)Knut & Alice Wallenberg Foundation (KAW)Ukraine Ministry of Education and ScienceUnited Kingdom Science and Technology Facilities Council (STFC)The United States Department of EnergyUnited States National Science FoundationState of OhioState of TexasConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq