Search Results (603)

Industrial systems such as lean practices, quality systems, workplace safety, and organisational culture are often managed as separate systems; however, in practice, they are interdependent. This study presents a preliminary survey instrument (CiE II) to assess organisational conditions commonly associated with effectiveness in manufacturing systems. A multi-stage refinement process was applied to an initial 107-item survey using pilot data (n = 127) collected from engineering students with work-integrated industry experience. The methodology combined exploratory factor analysis, item response theory, and thematic analysis to improve both statistical and conceptual coherence. The resulting instrument comprised 28 items, making it more suitable for industrial deployment. Analysis of responses (N = 127) identified three common facets that support lean, quality, safety, and culture. These are (i) Integrated Quality and Workflow Management (α = 0.960), referring to workers perceptions that quality standards exist and that they are resourced to meet them; (ii) Safe and Collaborative Work Culture (α = 0.901), referring to perceptions of behavioural norms and that workers will be treated fairly within the team; (iii) Supportive Leadership and Professional Growth (α = 0.852), referring to perceptions that management supports workers’ ongoing professional development. The potential benefit is the provision of a candidate survey that economically covers four key domains of relevance for manufacturing organisations. This has the potential to allow cross-domain correlations and larger-span regression models that integrate the four domains. Full article

Cardiogenic shock (CS) is the most lethal complication of acute myocardial infarction (AMI), with a 30-day mortality of approximately 40–50% despite early revascularization. Temporary mechanical circulatory support (tMCS) devices, including the intra-aortic balloon pump (IABP), microaxial flow pumps (MAFP) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO), are used as adjunctive therapy in refractory shock, but evidence of a survival benefit is limited and often conflicting. The IABP-SHOCK II trial found no 30-day mortality reduction with IABP, supporting a Class III (no benefit) recommendation, whereas the DanGer Shock trial reported a 12.7% absolute mortality reduction at 180 days with the MAFP Impella CP in highly selected patients. In contrast, the ECLS-SHOCK and ECMO-CS trials showed no improvement in survival with early VA-ECMO and noted high complication rates. Real-world data reveal significant disparities between trial populations and clinical practice, highlighting limitations of current evidence, since many AMI-CS patients are older, in more advanced shock or have multiple comorbidities and would not meet typical randomized controlled trial (RCT) inclusion criteria. In clinical practice, in-hospital mortality with IABP or VA-ECMO often exceeds 50–60%. Given the heterogeneity of AMI-CS, rapid identification of appropriate tMCS candidates and personalized therapy are essential. Management guided by individual patient profile, hemodynamic stage and neurological status, supported by multidisciplinary shock teams, may improve timely triage, device selection and outcomes. This review emphasizes the need for individualized, protocol-driven care within structured shock systems to optimize tMCS use in AMI-CS. Full article

Machine learning (ML) methods for network anomaly detection are emerging as effective proactive strategies in threat hunting, substantially reducing the time required for threat detection and response. However, the challenges in training and maintaining ML models, coupled with frequent false positives, diminish their acceptance and trustworthiness. In response, Explainable AI (XAI) techniques have been introduced to enable cybersecurity operations teams to assess alerts generated by AI systems more confidently. Despite these advancements, XAI tools have encountered limited acceptance from incident responders and have struggled to meet the decision-making needs of both analysts and model maintainers. Large Language Models (LLMs) offer a unique approach to tackling these challenges. Through tuning, LLMs have the ability to discern patterns across vast amounts of information and meet varying functional requirements. In this research, we introduce the development of HuntGPT, a specialized intrusion detection dashboard created to implement a Random Forest classifier trained utilizing the KDD99 dataset. The tool incorporates XAI frameworks like SHAP and Lime, enhancing user-friendliness and intuitiveness of the model. When combined with a GPT-3.5 Turbo conversational agent, HuntGPT aims to deliver detected threats in an easily explainable format, emphasizing user understanding and offering a smooth interactive experience. We investigate the system’s comprehensive architecture and its diverse components, assess the prototype’s technical accuracy using the Certified Information Security Manager (CISM) Practice Exams, and analyze the quality of response readability across six unique metrics. Our results indicate that conversational agents, underpinned by LLM technology and integrated with XAI, can enable a robust mechanism for generating explainable and actionable AI solutions, especially within the realm of intrusion detection systems. Full article

The annual congress of the Italian Association of Plastic Aesthetic Surgery (AICPE) is one of the most relevant conference meetings in Europe concerning aesthetic plastic surgery as there are a number of participants, over 400, and an international team of invited speakers chosen for their renowned scientific value. The 12th meeting was held in Rimini (Italy) from 6 to 8 June 2025. The scientific issues concerned new advancements in aesthetic surgery. This book of abstracts contains research related to facial surgery, body contouring, breast surgery, and rhinoplasty, also including aesthetic medicine, AI’s impact on the medical profession, and forensic medicine. For the first time, the AICPE established an award in memory of Flavio Saccomanno for the best paper presented by a young surgeon with the endorsement of Surgical Techniques Development by MDPI. Full article

Background/Objectives: Quality improvement (QI) is widely used in global health to improve patient outcomes, reduce costs, and strengthen service delivery. The Texas Children’s Global Health Network (TCGHN) includes nine independent non-governmental organizations supporting healthcare in low- and middle-income countries (LMICs), with pediatric HIV clinical centers of excellence in six countries in sub-Saharan Africa (SSA), supported technically by Baylor College of Medicine. We describe the development of a virtual QI Community of Practice (QICoP) to connect geographically dispersed teams and strengthen local QI capacity. Methods: In 2022, QI and global health experts convened to design the QICoP and assess site readiness. Participants were recruited from the sites based on their interest. Meetings were held via Zoom, with attendance, evaluations, and organizer notes tracked. QI tools were used to identify site strengths, challenges, and strategies to improve engagement. Results: From January 2023 to September 2024, the QICoP held 15 sessions, including 3 abstract-writing workshops, averaging 35 participants per session. QI abstract submissions to the annual Network meeting doubled from 2023 to 2024. Across 15 sessions, 83% of participants reported positive experiences. Based on participant feedback and QI sessions from the 2022–2024 Network meetings, we developed a blended QI basics curriculum, recruited site champions to improve communication, and launched a WhatsApp platform to enhance engagement. Conclusions: A virtual QICoP may be a feasible model to support professional development, increase knowledge and idea sharing, and connect individuals across geographies over a shared mission to improve healthcare quality in LMICs. Full article

Background: Community-based combined lifestyle interventions (CLIs) are used to help children with overweight or obesity achieve a healthier lifestyle. CLIs utilize the combined knowledge and expertise of professionals from a variety of disciplines. Here, we describe the composition of teams of professionals and their approach to collaboration in four community-based CLIs designed for children with overweight or obesity (focusing on children 4–12 years of age) living in the Netherlands. Methods: A descriptive cross-case comparison was conducted in which four community-based CLIs implemented in ten communities were conceptualized as “cases”. Quantitative data regarding the frequency of contact within the teams, topics addressed in meetings of the CLI teams, the perceived importance of other relevant disciplines in the team, and perceived satisfaction with the collaboration between professionals within the team were collected via questionnaires answered by the professionals (n = 82 respondents). Descriptive analyses including frequencies, percentages, and cross-case comparisons of team characteristics and collaboration were also conducted. Results: The CLI teams differed in composition, size, and background disciplines. The frequency of contact was higher in small teams (<6 professionals) compared to large teams. Larger teams appeared to report a lower perceived satisfaction regarding collaboration. Moreover, the role of coordinator or central healthcare provider was perceived as more important in the large teams than in the small teams. Conclusions: Variation was observed in professional expertise and collaboration within CLI teams. Moreover, professionals in a team should collaborate based on the local possibilities. In large teams (>6 professionals) in particular, a coordinator or trained central healthcare provider can help facilitate collaboration. Full article

Background/Objectives: With the increasing need for interprofessional team-based care, a practical framework is necessary to evaluate the caring competencies of healthcare providers. This study aimed to develop a refined, concise version of the Technological Competency as Caring in Healthcare Instrument (TCCHI) by: (1) reducing the items from the original 38-item Delphi-validated pool through confirmatory factor analysis (CFA) and (2) providing a preliminary assessment of its structural validity and reliability. Methods: An online survey was conducted with 528 healthcare professionals across Japan. The CFA process began with the 38 items identified in a previous Delphi study. To optimize model fit and ensure interprofessional applicability, items were systematically refined based on both statistical criteria and theoretical relevance, resulting in a 12-item, three-factor structure. Results: The final 12-item model demonstrated an improved and generally acceptable fit: chi-square to degrees of freedom ratio (χ²/df) = 3.96, comparative fit index (CFI) = 0.947, Tucker–Lewis Index (TLI) = 0.931, and Root Mean Square Error of Approximation (RMSEA) = 0.0749. All factor loadings were statistically significant (p < 0.001) and ranged from 0.437 to 0.83. Composite reliability (CR) for the three factors ranged from 0.700 to 0.827, meeting the threshold for internal consistency. While average variance extracted (AVE) values for some factors were below 0.50, the overall model provided a stable and theoretically consistent structure, albeit as a preliminary psychometric refinement. Conclusions: This study provides preliminary evidence for the structural validity and reliability of a refined 12-item, three-factor TCCHI. By offering a concise measurement tool aligned with caring theory, the TCCHI has the potential to support interprofessional assessment, education, and professional development in technology-mediated healthcare environments. However, further research is required to address issues of discriminant validity and confirm measurement invariance across different professional groups. Full article

Background/Objectives: Stage III non-small cell lung cancer (NSCLC) is a heterogeneous and clinically challenging disease. Despite therapeutic advances, decisions regarding resectability and treatment sequencing remain complex. Multidisciplinary discussion (MDD) is increasingly recognized as key to personalized, evidence-based care. Methods: The “Integrate 6.0” conference gathered approximately 90 lung cancer specialists, including oncologists, thoracic surgeons, and radiation oncologists, divided into mixed groups simulating multidisciplinary team (MDT) meetings. Groups reviewed complex clinical cases, supported by facilitators providing concise, evidence-based updates. A pre-event survey explored MDT structure and dynamics across institutions. Results: The survey highlighted considerable variability in MDT composition and practices. Most participants had significant involvement in thoracic oncology. Discussions revealed higher consensus in straightforward cases, while complex stage III scenarios—especially with driver mutations or bulky nodal disease—required more nuanced, collaborative decision making. Key topics included neoadjuvant chemoimmunotherapy, surgery in borderline resectable cases, and managing immune-related toxicities. Conclusions: “Integrate 6.0” effectively connected theoretical knowledge with real-world practice through interactive, multidisciplinary dialogue. It underscored the vital role of MDD in managing complex stage III NSCLC and the need for adaptable treatment strategies. Future conferences should assess MDD’s impact on outcomes and expand participation to include molecular pathologists and geriatricians. Full article

On behalf of the Strength and Conditioning Society (SCS), we are pleased to present the abstracts submitted for the SCS 8th Annual Meeting. The event was held at the Norwegian School of Sport Sciences in Oslo, Norway, on 8–10 October 2025, and comprised several invited sessions held by international and national speakers on a variety of topics related to biochemistry and exercise physiology, strength and conditioning practices and their application to health, injury prevention, and sports performance. These included strength training in high-performance sports, sport science and training–competition load management in elite environments, biochemistry and exercise physiology and prescription, nutrition and biomechanics, among others. The conference also included practical workshops held by renowned academics and practitioners on eccentric training, change of direction ability, and strength and power training in professional team sports, combat sports, and ergospirometry and exercise prescription in specific populations. Finally, the event disseminated up-to-date strength and conditioning research by providing practitioners and researchers with the opportunity to present their most recent findings. All abstracts presented at the SCS 8th Annual Meeting can be found in this Conference Report. Full article

Background: Multidisciplinary team meetings (MDTs) are a mandatory requirement of modern oncology. During the COVID-19 pandemic, virtual MDTs replaced nearly all face-to-face MDTs. This study evaluated strengths, weaknesses, perceived quality, and outcomes of virtual MDTs compared to face-to-face MDTs. Furthermore, the extent of permanent implementation of virtual MDTs in oncology after COVID-19 was evaluated. Methods: Switzerland-wide, participants of MDTs were surveyed with 44 questions concerning different dimensions of perceived meeting quality and technical aspects. Descriptive and comparative analysis was performed. Results: In 170 responses, communication discipline, meeting dedication, or perceived quality were rated comparably to standard MDTs. Time efficiency and outcomes of virtual meetings were rated similarly by 68% and 75% of all participants, respectively. Workspace setup did not significantly influence the subjective quality, while surgeons were less likely to rate the quality as good. After COVID-19, 41 (38%) of 108 MDTs have been permanently converted to a virtual format. Conclusion: A substantial proportion of Swiss MDTs have permanently switched to a purely virtual format or offer a hybrid option. Meeting quality, communication discipline, and dedication were comparable. However, assessing the quality of MDTs remains challenging due to their multifactorial nature. Full article

Public Safety Personnel (PSP) face numerous potentially psychologically traumatic events in the line of duty. Resilience courses intended to mitigate the effects of operational stress injuries in this population—many of which are available online—have proliferated in recent years. An environmental scan yielded 15 courses that met all inclusion criteria. Courses were required to be offered for $250 or less and had to be created and/or hosted in Canada. Courses focused on individual (n = 7), family (n = 2), or workplace (n = 6) resilience. A qualitative content analysis was conducted. Data were extracted from public-facing documents and course materials, and supplemented by additional text materials and contacting program staff for clarification, when necessary. Coding and synthesis were completed in iterative team meetings. Courses were compared across numerous dimensions, including focus, intended audience, cost, enrollment details, length, instructional style, customization for PSP, and completion requirements. Nearly half of the courses (46.7%) were available free of charge. Outcome data were available for four of the courses, with most studies showing initial gains in resilience, skills, knowledge, attitudes, intentions, and/or behaviors, but with evidence of skill decay over time. The potential benefit of short refresher sessions warrants further investigation. Full article

This study addresses the question of how augmented reality (AR) technologies can be designed and integrated into maritime navigation systems to meet the needs of young navigators within contemporary socio-technical bridge environments. The article is based on a qualitative, literature-based research methodology involving a structured analysis and synthesis of peer-reviewed journal articles and conference proceedings related to AR interfaces, human performance, decision support, and maritime training. The reviewed studies indicate that AR can enhance perceptual and situational awareness by overlaying navigational information directly into the navigator’s field of view, thereby reducing head-down time, improving spatial alignment of information, and supporting performance in low-visibility and high-traffic conditions. The literature also shows that AR-enabled visualizations and shared displays can support individual and team-based decision-making by facilitating real-time, context-aware information exchange on the ship’s bridge. Safety-related benefits are identified as indirect outcomes of improved perception and cognitive support rather than as isolated technological effects. Simultaneously, the findings highlight that these benefits depend strongly on human-centered interface design and appropriate training. The study concludes that AR has significant potential to enhance maritime navigation for young navigators when integrated as part of a balanced socio-technical system combining technology, human factors, and structured education. Full article

Puberty health and sex education (PHSE) curricula are not comprehensive or inclusive towards gender-independent, intersex, non-binary, or transgender (GIaNT) youth. A majority of this population seeks this information in online settings. Over the past two years, our research team, in collaboration with GIaNT communities, has developed an open-access online educational resource (OER) intending to bridge this gap in comprehensive PHSE for GIaNT youth in a gender-affirming, fun, and interactive way. After the OER was developed, our team recruited participants (aged 16–26) to navigate our website and complete a multi-method survey to gain their feedback, insights, and perceptions on this new OER. The survey responses indicated two key themes for the development and use of the OER: facilitators and strengths, and areas for improvement. The findings from this study were used to better meet the wants and needs of this population vis-à-vis changes to be made to our OER before its public launch for open-access, free use. Full article

Staff retention and functional teamwork are major challenges in Early Childhood Education and Care (ECEC), where leadership is increasingly viewed as a shared team-level process. This study investigates how team leadership (TL), conceptualised as the functions through which teams meet their needs, is enacted among Swedish ECEC staff and how it supports collaborative work under current policy conditions. Using a revised version of the Team Leadership Taxonomy. 122 ECEC professionals completed a survey with both quantitative items and open-ended responses. The results show patterns of strong strategic alignment, high awareness of pedagogical goals, and robust relational support within teams, but substantial variability in operational clarity, task distribution, problem-solving responsibility, and psychological safety. Participants described challenges linked to shifting team compositions, unequal pedagogical competence, and inconsistent organisational support from principals, which often constrained their ability to enact both positional and distributed leadership. Overall, the findings suggest that ECEC teams possess considerable capacity for collaborative leadership, yet uneven organisational conditions limit the consistency of TL functions. Strengthening role clarity, planning structures, and reflective routines may enhance team functioning and contribute to a more sustainable ECEC workforce. Full article

Background: Recruiting care partners (CPs) of hospitalized people living with dementia is challenging due to rapid discharge timelines and complex inpatient workflows. This study identified barriers to CP recruitment encountered during the first year of a hospital-based randomized controlled trial and the strategies implemented in response to them. Methods: A qualitative descriptive study using thematic analysis of twelve study coordination and implementation meeting transcripts was conducted. Recruitment outcomes were examined to assess changes before and after implementation of the enhanced recruitment workflow. Results: Eight recruitment barriers were identified, including fragmented electronic health record (EHR) documentation, uncertainty in CP presence, limited clinician availability, passive study promotion, and inefficient clinical–research team collaboration. Nine strategies were developed and implemented in response to these barriers. The enhanced recruitment workflow was temporally associated with an increase in average monthly enrollment from 0.25 participants (April–July 2024) to 4 participants (August 2024–December 2025). Over the same periods, the cumulative enrollment rate was 3% and 23%, respectively. Conclusions: Care partner recruitment in inpatient settings is highly context-dependent and requires iterative, implementation-informed adaptation. Effective recruitment may be supported by embedding processes into routine inpatient workflows, clarifying recruitment roles, leveraging EHR-supported identification, and maintaining close clinical–research team collaboration to respond to the unpredictable presence of care partners and short discharge windows. Full article