Team Reports Research Articles

Scoping review and recommendation to establish standardized best practices for resuscitative endovascular balloon occlusion of the aorta in combat casualties: A North Atlantic Treaty Organization exploratory team report.

Truncal hemorrhage is a major cause of combat-related mortality, with delayed surgical access likely increasing future fatalities. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique to temporarily control hemorrhage until surgery can be performed. Differences in management, device selection, and training among North Atlantic Treaty Organization (NATO) allies can compromise patient care during deployments. In response, NATO formed a multinational team of REBOA experts to make recommendations for future efforts to standardize care and enhance interoperability. The team held virtual meetings to assess field use, materiel solutions, training programs, and persistent problems. A scoping review was conducted to identify relevant military medicine studies, including those using preclinical combat injury models, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews framework. Contributions came from published work, gray literature, and expert input. Experts from seven countries participated, identifying 52 key studies, 47 published combat uses, and 14 unpublished cases from Ukraine. Of the multitude of available catheters, only one had recent combat use cases for prolonged partial occlusion, and none were published. Unlike other countries, the United States and the United Kingdom possessed military-specific REBOA guidelines; however, both were outdated and assumed air superiority. Training programs varied significantly, with no standardized approach across NATO. Courses differed in the instructional method, intended audience, content, competencies, and refresher frequency; none included partial REBOA. As such, the Ukrainian military was reliant on training from catheter manufacturers. Arterial access challenges continue to hinder REBOA use. There is a critical need for ongoing data collection from combat to inform best practices. Given the rapid evolution of REBOA devices, the changing landscape of war, and limited published literature on these topics, further NATO research efforts should be applied to develop uniform guidance for REBOA in combat environments. Scoping Review; Level IV.

Challenges and Mitigation Strategies in the Development and Feasibility Assessment of a Digital Mental Health Intervention for Depression (VMood): Mixed Methods Feasibility Study.

Worldwide, the COVID-19 pandemic contributed to further gaps in mental health care, particularly in low- and middle-income countries such as Vietnam, where care is inaccessible for 90% of those who need it. There has subsequently been a considerable increase in the use of digital mental health interventions such as smartphone apps. Presently, the evidence for such interventions is limited, especially in cases in which the interventions have been adapted from evidence-based in-person formats. Implementation science aims to promote the incorporation of scientific findings into practice. A key determinant of implementation success is an intervention's usability. Hurdles to usability include an intervention being too confusing or time-intensive to use. Facilitators include incorporating a greater number of engagement features and integrating human support. The aim of this implementation science feasibility study was to describe the challenges and mitigation strategies used in the development, usability testing, and implementation of a digital depression intervention (VMood smartphone app) developed in Vietnam. VMood was adapted from an evidence-based in-person intervention originally developed in Canada that is grounded in principles of cognitive behavioral therapy with supportive coaching by a lay health or social services worker. The research team is currently testing the effectiveness and cost-effectiveness of VMood in a randomized controlled trial across 8 provinces in Vietnam informed by the results of this feasibility assessment. This mixed methods feasibility study was organized using an implementation outcome framework focused on acceptability, adoption, appropriateness, and feasibility. This study involved three data collection components: (1) usability testing (interviews and focus groups with app user and provider participants who tested VMood in 1 Vietnamese province), (2) app metrics (from the early phase of the randomized controlled trial in the same province but from different municipalities), and (3) discourse data (notes from various team meetings, communications, and reports on VMood's development and implementation). Qualitative data were analyzed using thematic content analysis. App use data were analyzed using basic descriptive statistics. The findings of the 3 data components showed that there were seven main challenges: (1) challenges with recruitment and uptake of the app, (2) challenges with use and engagement, (3) screening challenges, (4) digital divide, (5) limitations to digital applications for mental health, (6) technological challenges, and (7) funding and policy constraints. Various solutions to help mitigate the challenges were used by the team. The findings contribute important evidence on the challenges to the development and feasibility assessment of a digital depression app adapted from an in-person intervention in Vietnam. The findings have applicability for others looking to develop and implement digital interventions in similar contexts, serving as a unique opportunity to share the lessons learned regarding the development and testing process.

Statistics and data science education as a vehicle for empowering citizens – short summary of a survey

This article is a short summary of the report of survey team 3, presented to the 15th International Congress on Mathematical Education (ICME-15) in Sydney in July 2024.

Case Analysis of Improved Capstone Project Quality through a Course for Methods in Engineering Research

This paper highlights the impact of implementing a course about engineering research on the quality of capstone projects by master’s students with limited science, technology, engineering, and math background. In the academic year 2020, the Naval Postgraduate School Systems Engineering Department began requiring students in the Systems Engineering Management for Acquisition program to take a course focused on engineering research. The graduation requirement for students in this program is a capstone team project and report. Prior to implementing an engineering course in the academic matrix, faculty assessments of the final reports identified shortcomings, specifically in the research approach, analysis, value proposition, and overall scholarship. The Department responded by developing a course in engineering research with an emphasis on applying engineering reasoning and critical thinking within the systems engineering design process. After the student’s completion and submission of a final capstone report to the thesis processing office, faculty advisors provide a subjective assessment of the work. The evaluation criteria include the level that the students have demonstrated mastery of the discipline, rigorous application of research and analysis methods, critical thinking, and publication worthiness of the document. Using five years of data, the author conducted a comparative analysis of evaluations from project advisors before and after the course was required. The results of the analysis show significant improvements in the areas that were lacking in student work before the introduction of the engineering research course. Additionally, the author discusses specific elements of the course that indicate their contributions to improvements in the research approach and the overall quality of the work and final products. This case analysis asks the engineering community to consider elements of the engineering research course in future investigations or as a guide to develop a similar program of instruction.

Differences in Symptom Reporting by Children With Cancer, Caregivers, and Care Teams.

Differences in Symptom Reporting by Children With Cancer, Caregivers, and Care Teams.

Toward a Global Planetary Boundary Layer Observing System: A Summary

Abstract A global Planetary Boundary Layer (PBL) observing system is urgently needed to address fundamental PBL science questions and societal applications related to climate, weather and air quality. Such a PBL observing system should optimally combine emerging yet technically viable space-based observations of the PBL thermodynamic structure with complementary surface-based and suborbital assets, while taking advantage of, and helping improve, climate and weather models as well as data assimilation systems. The Earth science community has expressed great interest in improving the characterization of the atmospheric PBL in the recent National Academies of Sciences, Engineering and Medicine (NASEM) 2017-2027 decadal survey for Earth Science and Applications from Space (ESAS). Specifically, higher spatial and temporal resolution observations of PBL temperature and water vapor profiles, and of PBL height, were selected as priorities by the decadal survey, which recommended a PBL mission in its incubation class. In response, NASA established the decadal survey incubation program and a PBL study team focused on prioritizing PBL science and technology that would require advancement and development prior to implementation. In this paper we summarize the key findings of the NASA PBL study team report.

Individual or team analyst reports? The organization of analyst research activities

Abstract Given the importance of research resource allocation within brokerage firms, we examine key factors that influence the issuance of individual versus team analyst reports. Using a comprehensive sample of analyst reports from China for the 2008–2021 period, we find that this decision is influenced by (1) the brokerage firm's client interests, whereby firms held by the brokerage firm's mutual fund clients and firms that are the brokerage firm's underwriting clients receive more team than individual reports from the brokerage firm, and (2) the nature of corporate events, whereby routine events receive more team reports and nonroutine events receive more individual reports. Additional analyses suggest that analysts' personal traits and analyst team characteristics also affect the decision. Our findings further the understanding of the factors that affect the organization and resource allocation of sell‐side equity research.

Modeling the Subsurface Structure Beneath Mount Lawu, Karanganyar and Magetan Regencies Based on Magnetic and Gravity Data

Abstract Indonesia is one of the countries with the most potential geothermal resources in the world. One of the mountains that is a prospective area in Java is Mount Lawu, which has an estimated resource of 195 MW and a hypothetical resource of 137 MW. Unfortunately, the data in previous study have not been thoroughly processed. In addition, the modelling carried out was limited to each method. Therefore, this research aims to reconstruct magnetic and gravity observation data and model the subsurface structure related to the location of geothermal reservoirs on Mount Lawu. The magnetic and gravity data used were obtained from the Geophysical Integrated Survey Team report of Mount Lawu in 2009. Before modeling, the gravity data was corrected again. Forward modelling was then carried out using Oasis Montaj. In this study, the susceptibility value used has a range of 000034 - 0.049 cm3/g, while the density value has a range of 1.6 - 2.82 g/cm3. The modelling is done by making three sections with the error range of the magnetic method from 11.597 - 16.712 nT and the gravity method from 1.587 - 2.95 mGal. From the modelling done, it resulted in a subsurface structure that matches the geological conditions. Geothermal reservoirs have been identified in the area around Candradimuka Fumarole at a depth of 1500 m from the surface and the rock is Jobolarangan Lava 1. It is hoped that the results of this research will be taken into consideration in determining the location of exploration wells in the Mount Lawu area so that they can be exploited as soon as possible.

Rome Foundation Working Team Report on overlap in disorders of gut-brain interaction.

In patients with disorders of gut-brain interaction (DGBI), overlapping non-gastrointestinal conditions such as fibromyalgia, headaches, gynaecological and urological conditions, sleep disturbances and fatigue are common, as is overlap among DGBI in different regions of the gastrointestinal tract. These overlaps strongly influence patient management and outcome. Shared pathophysiology could explain this scenario, but details are not fully understood. This overlap has been shown to be of great relevance for DGBI. In addition, symptoms considered to be caused by a DGBI could have a detectable organic cause, and in patients with a diagnosed organic gastrointestinal disease, symptoms not clearly explained by the pathology defining this organic disease are common. Thus, the aims of this Rome Foundation Working Team Report were to review the literature on overlapping conditions among patients with paediatric and adult DGBI and, based on the available epidemiological and clinical evidence, make recommendations for the current diagnostic and therapeutic approach, and for future research. Specifically, we focused on other DGBI in the same or different gastrointestinal anatomical region(s), DGBI overlap with organic bowel diseases in remission, and DGBI overlap with non-gastrointestinal, non-structural conditions.

Review Article: Rome Foundation Working Team Report: Consensus Statement on the Design and Conduct of Behavioural Clinical Trials for Disorders of Gut-Brain Interaction.

Brain-gut behaviour therapies (BGBT) have gained widespread acceptance as therapeutic modalities for the management of disorders of gut-brain interaction (DGBI). However, existing treatment evaluation methods in the medical field fail to capture the specific elements of scientific rigour unique to behavioural trial evaluation. To offer the first consensus on the development and testing of BGBT in DGBI. An international, interdisciplinary team of experts developed a consensus statement heavily informed by best practice recommendations for behavioural clinical trials for chronic diseases, organised by a selected treatment development model. We suggest an existing behavioural treatment development model that has an iterative progression aligned with the drug development model with nuances specific to BGBT. We describe the iterative phases through initial discovery and experimental work, assembly of a mechanistic pathway and candidate treatment components, treatment refinement and optimisation, initial proof-of-concept, feasibility of clinical trials and, finally, confirmatory efficacy and effectiveness testing. We delineate recommendations for and provide examples that lend themselves to gastroenterologists planning to develop or test BGBT, reviewing proposals for or results from BGBT studies or writing management guidelines for DGBI. This working team report facilitates a shared understanding of the elements of scientific rigour necessary for BGBT development and could support future standards on which BGBT are evaluated in gastroenterology.

The Role of Law Enforcement in Combating Financial Cybercrime in Tanzania: Examining the Laws and Practice

Financial cybercrime is defined as the use of the internet or computer to commit criminal activity for financial gain. Digital financial services development plays a pivotal role in economic growth despite the rise of financial cybercrime. Not only that but also mobile financial services hold great potential to expand financial access among people. While this progress lingers, some users have engaged themselves in financial cybercrimes for illegal gain. The Cybercrime Act of Tanzania 2015 provided for law enforcement officers including a Police officer with the rank of assistant inspector or an investigator of equivalent rank of inspector and above, a member of the Tanzania National Intelligence Service, Prosecutors and other authorized persons or the officer commanding station (OCS) termed as a law enforcement officer. The report of the Tanzania computer emergence response team beginning from the 9th day of June 2023 to the 15th day of June 2024 shows how financial cybercrime is seriously increasing despite the measurements taken. This paper explores the legal and practical role of law enforcement in combating financial cybercrime examining the adequacy of existing laws, enforcement limitations, and social issues that complicate intervention efforts. Highlighting legal analysis, case studies, and comparative insights, the study discusses potential reforms and offers recommendations for more effective prevention and response mechanisms. This study aims to contribute to an improved understanding of the unique challenges Tanzania faces in combating financial cybercrime that address legal, educational, and technological issues

Impact of delayed mobile medical team dispatch for respiratory distress calls: a propensity score matched study from a French emergency communication center

BackgroundShortness of breath is a common complaint among individuals contacting emergency communication center (EMCCs). In some prehospital system, emergency medical services include an advanced life support (ALS)-capable team. Whether such team should be dispatched during the phone call or delayed until the BLS-capable paramedic team reports from the scene is unclear. We aimed to evaluate the impact of delayed MMT dispatch until receiving the paramedic review compared to immediate dispatch at the time of the call on patient outcomes.MethodsA cross-sectional study conducted in Lyon, France, using data obtained from the departmental EMCC during the period from January to December 2019. We included consecutive calls related to adult patients experiencing acute respiratory distress. Patients from the two groups (immediate mobile medical team (MMT) dispatch or delayed MMT dispatch) were matched on a propensity score, and a conditional weighted logistic regression assessed the adjusted odds ratios (ORs) for each outcome (mortality on days 0, 7 and 30).ResultsA total of 870 calls (median age 72 [57–84], male 466 53.6%) were sought for analysis [614 (70.6%) “immediate MMT dispatch” and 256 (29.4%) “delayed MMT” groups]. The median time before MMT dispatch was 25.1 min longer in the delayed MMT group (30.7 [26.4–36.1] vs. 5.6 [3.9–8.8] min, p < 0.001). Patients subjected to a delayed MMT intervention were older (median age 78 [66–87] vs. 69 [53–83], p < 0.001) and more frequently highly dependent (16.3% vs. 8.6%, p < 0.001). A higher proportion of patients in the delayed MMT group required bag valve mask ventilation (47.3% vs. 39.1%, p = 0.03), noninvasive ventilation (24.6% vs. 20.0%, p = 0.13), endotracheal intubation (7.0% vs. 4.1%, p = 0.07) and catecholamine infusion (3.9% vs. 1.3%, p = 0.01). After propensity score matching, mortality at day 0 was higher in the delayed MMT group (9.8% vs. 4.2%, p = 0.002). Immediate MMT dispatch at the call was associated with a lower risk of mortality on day 0 (0.60 [0.38;0.82], p < 0.001) day 7 (0.50 [0.27;0.72], p < 0.001) and day 30 (0.56 [0.35;0.78], p < 0.001)ConclusionsThis study suggests that the deployment of an MMT at call in patients in acute respiratory distress may result in decreased short to medium-term mortality compared to a delayed MMT following initial first aid assessment.

Innovation in hospital pharmacy: Modeling the installation of automated dispensing systems based on an oncology hospital experience transfer.

ObjectiveThis study explores automated dispensing systems (ADS) implementation in hospitals, focusing on experience transfer between the National Institute of Oncology of Rabat (NIO) and the specialties hospital of Rabat (SHR) to develop a transferable ADS installation and management model.MethodA retrospective implementation and experience data analysis of 3 years ADS implementation at NIO and a prospective planification for SHR new implementation on 6 months were employed. Data collection included pharmacist team reports, personnel interviews, direct observations, and information system data exports. The study focused on identifying challenges a plan-do-check-act (PDCA) cycle.ResultsThe analysis revealed overestimation in ADS needs at NIO about 42%, leading to: Resource exhaustion; Challenges in timeline installation staff training and management, Disruptions in data integration and Incident Reports. These issues underscored the importance of a phased, well-planned implementation process.DiscussionThe study highlighted the crucial role of many comprehensive strategies. In accordance with the results of several studies, this work demonstrates the benefits of ADS in reducing medication errors and enhancing resource management, while also pointing out the necessity for accurate system sizing, effective integration with hospital information systems, and comprehensive staff training.ConclusionThe experience transfer between NIO and SHR provides a valuable model for ADS implementation in hospital pharmacies, proposing optimizations on: Implementation process; Timelines and mapping; Risk management and incident reports; Staff training, sensibilization and change control.

Neurological outcomes and mortality after neonatal seizures with electroencephalographical verification. A systematic review

AimTo conduct a systematic review of post-neonatal neurological outcomes and mortality following neonatal seizures with electroencephalographical verification. MethodsThe databases Medline, Embase and Web of Science were searched for eligible studies. All abstracts were screened in a blinded fashion between research team members and reports found eligible were obtained and screened in full text by two members each. From studies included, outcome results for post-neonatal epilepsy, cerebral palsy, intellectual disability, developmental delay, mortality during and after the neonatal period and composite outcomes were extracted. A quality assessment of each study was performed. ResultsIn total, 5518 records were screened and 260 read in full text. Subsequently, 31 studies were included, containing cohorts of either mixed or homogenous etiologies. Follow-up time and gestational ages varied between studies. No meta-analysis could be performed due to the low number of studies with comparable outcomes and effect measures. Reported cumulative incidences of outcomes varied greatly between studies. For post-neonatal epilepsy the reported incidence was 5–84%, for cerebral palsy 9–78%, for intellectual disability 24–67%, for developmental delay 10–67% and for mortality 1–62%. Subgroup analysis had more coherent results and in cohorts with status epilepticus a higher incidence of post-neonatal epilepsy from 46 to 84% was shown. ConclusionThe large variation of reported incidences for neurological outcomes and mortality found even when restricting to cohorts with electroencephalographically verified neonatal seizures indicates selection bias as a significant confounder in existing studies. Population-based approaches are thus warranted to correctly predict outcomes in this group.

A Clinical Case Report of a Hospital-Based Violence Intervention Treatment Team Serving a Client with Complex Medical and Social Needs

A Clinical Case Report of a Hospital-Based Violence Intervention Treatment Team Serving a Client with Complex Medical and Social Needs

Factors Impacting Maltreatment Evaluation and Reports to Child Protective Services in Pediatric Substance Exposures.

The objective of this study was to assess demographic, clinical, and psychosocial factors associated with pediatric substance exposures, describe the medical evaluation, and identify factors associated with social work (SW) and hospital-based child protection team (CPT) safety assessments and reports to child protective services (CPS). We retrospectively reviewed charts of electronic medical records for children ages 0 to 72 months presenting for accidental ingestion evaluated May 1, 2015 to May 1, 2021 at a level 1 pediatric trauma center. Cases of environmental exposures, iatrogenic medication errors, dosing errors, and allergies/adverse reactions were excluded. Data were analyzed using descriptive statistics; χ 2 and multivariable logistic regression analysis assessed factors associated with two primary outcomes of interest, SW/CPT assessment and CPS report. Among 773 total cases of substance exposures during the studied time frame, 27% were referred to SW/CPT for further safety assessments and 15.4% were reported to CPS. Being admitted to the hospital, prescription medication or recreational/illegal/illicit substance exposures, and increasing psychosocial risk factors were found to be significantly associated with referrals. Age, race, and insurance status were not found to be associated. Toxicology screening was performed in only 24.7% of cases. Of those eligible for further imaging per hospital protocol, skeletal surveys were obtained in 5.5% of cases and head imaging was obtained in 9% of cases. There is significant variability in pediatric substance exposure assessment practices. Disparities based on demographic characteristics are uncommon. Perceived severity of condition, exposures involving recreational/illegal/illicit substances, and greater prevalence of family psychosocial adversities are associated with higher rates of SW/CPT assessment and CPS reports.

The Upshot of Management Competency on Latent Growth of Unicorns

To assess an organization's development and success, its management team and financial reports serve as the cornerstones. Thus, the goal of this research is to unveil and measure the impact of the key financial as well as management-oriented determinants on revenue, growth, and profitability of e-startups especially tech startups or Indian Unicorns. The relationship and level of significance between the variables have been examined using multivariate analysis. The data of total 109 Startup Unicorns have been gathered for the study. While startup talky, LinkedIn profiles, and other sources have been used to get information on the management team characteristics, financial data has been gathered from the Traxcn, Crunchbase, and Dealroom databases. The previous startup and management experiences of the Indian Unicorns founders have a substantial and positive influence on EBITDA growth, and the authors discover that "Team Completeness" has a significant and positive impact on the financial parameters.

Risk factors for spinal subdural hematoma after minimally invasive transforaminal lumbar Interbody Fusion (MI-TLIF): a multivariate analysis

BackgroundSpinal subdural hematoma (SSH) is a rare cause of compression of the neutral elements of the spinal cord. However, little is known about the presentation of acute SSH after lumbar spine surgery. The reason for this may be that symptomatic SSH occurs rarely and is not given enough attention by spine surgeons. Currently, the decision to perform MRI postoperatively is more dependent on surgeon preference; therefore, no high-quality studies have been published. Our team reports our experience in the diagnosis and management of SSH after lumbar decompression and fusion surgery.MethodsWe retrospectively studied 215 patients who underwent routine MRI following minimal invasive transforaminal lumbar interbody fusion (MI-TLIF) between 2020-01-01 and 2022-06-30. The patients were divided into SSH group (17 cases) and non-SSH group (198 cases) according to the occurrence of SSH. Univariate analysis and multivariate logistic regression analysis were performed to identify relevant risk factors that increase the risk of SSH postoperatively.ResultsNone of the patients presented with serious neurologic symptoms, such as lower extremity paralysis or cauda equina syndrome that required emergency hematoma debridement. SSH was found in 17 (7.9%) patients and non-SSH in 198 (92.1%). Factors affecting SSH were presence of hypertension, presence of diabetes and postoperative anticoagulant therapy. The significantly independent risk factor of postoperative SSH were diabetes (P = 0.008, OR: 6.988) and postoperative anticoagulant therapy (P = 0.003, OR: 8.808).ConclusionsSSH after MI-TLIF is not a rare condition, with generally no requirement of emergency evacuation. Comprehensive anti-symptomatic treatment could achieve satisfactory results. Diabetes mellitus and postoperative anticoagulant therapy are independent risk factors for SSH. Spine surgeons should hold applicability of the use of anticoagulants after lumbar surgery.

Beyond implementation: A collective case study exploring the conceptions and facilitators of sustainability in a quality improvement collaborative

Beyond implementation: A collective case study exploring the conceptions and facilitators of sustainability in a quality improvement collaborative

Combating Scientific Disinformation on Gender-Affirming Care.

Scientific disinformation is false and misleading information that is used intentionally by legal and political actors to sway public opinion and oppose facts. In recent years, disinformation has become a tool for authorities to limit gender-affirming health care (GAC) for transgender and gender-expansive youth who experience gender dysphoria. Existing modes of expert intervention in health policy may not be sufficient to match the pace of these quickly unfolding health care bans. A cross-disciplinary team of academics in medicine, psychology, and law assembled to challenge scientific disinformation on GAC with 2 rapid-response rebuttal reports. Reports were produced in 3 to 10 weeks after the passage of GAC bans in Texas, Alabama, and Florida in 2022. They were posted online to facilitate dissemination and engage litigators, judges, policy experts, advocates, parents, and others. The team's efforts complemented public statements by medical societies and lawsuits brought by national LGBTQ litigators. The team's reports were cited in legal challenges to GAC bans in Texas, Alabama, and Florida. The team also filed amicus briefs for direct consideration by the courts and public comments to health care agencies in Florida. The reports received coverage in local and national media outlets in broadcast and print media. This advocacy case study describes the process used to challenge disinformation about GAC with rapid-response rebuttal reports, as well as the impact of this work and associated challenges. In an increasingly polarized political climate, this process may be adapted to other areas of health policy in which scientific disinformation takes root.