Team dynamics in emergency surgery teams: results from a first international survey

Background: Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma\u2019s causes or the patient\u2019s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods: An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients\u2019 and stakeholders\u2019 engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. Discussion: Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey\u2019s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions

Adaptive fuzzy sliding mode control of smart structures

Smart structures are usually designed with a stimulus-response mechanism to mimic the autoregulatory process of living systems. In this work, in order to simulate this natural and self-adjustable behavior, an adaptive fuzzy sliding mode controller is applied to a shape memory two-bar truss. This structural system exhibits both constitutive and geometrical nonlinearities presenting the snap-through behavior and chaotic dynamics. On this basis, a variable structure controller is employed for vibration suppression in the chaotic smart truss. The control scheme is primarily based on sliding mode methodology and enhanced by an adaptive fuzzy inference system to cope with modeling inaccuracies and external disturbances. The robustness of this approach against both structured and unstructured uncertainties enables the adoption of simple constitutive models for control purposes. The overall control system performance is evaluated by means of numerical simulations, promoting vibration reduction and avoiding snap-through behavior