Managing Complexity in Socio-Technical Systems by Mimicking Emergent Simplicities in Nature: A Brief Communication.

In the context of socio-technical systems, traditional engineering approaches are inadequate, calling for a fundamental change in perspective. A different approach encourages viewing socio-technical systems as complex living entities rather than through a simplistic lens, which enhances our understanding of their dynamics. However, these systems are designed to facilitate human activities, and the goal is not only to comprehend how they operate but also to guide their function. Currently, we lack the appropriate terminology. Hence, we introduce two principal concepts, simplexity and complixity, drawing inspiration from how nature conceals intricate mechanisms beneath straightforward, user-friendly interfaces.

Mapping automatic social media information disorder. The role of bots and AI in spreading misleading information in society.

This paper presents an analysis on information disorder in social media platforms. The study employed methods such as Natural Language Processing, Topic Modeling, and Knowledge Graph building to gain new insights into the phenomenon of fake news and its impact on critical thinking and knowledge management. The analysis focused on four research questions: 1) the distribution of misinformation, disinformation, and malinformation across different platforms; 2) recurring themes in fake news and their visibility; 3) the role of artificial intelligence as an authoritative and/or spreader agent; and 4) strategies for combating information disorder. The role of AI was highlighted, both as a tool for fact-checking and building truthiness identification bots, and as a potential amplifier of false narratives. Strategies proposed for combating information disorder include improving digital literacy skills and promoting critical thinking among social media users.

Perioperative Glycemia Management in Patients Undergoing Craniotomy for Brain Tumor Resection: A Global Survey of Neuroanesthesiologists' Perceptions and Practices.

OBJECTIVE: There is a paucity of clinical evidence that guides perioperative glycemia management in patients undergoing craniotomy for brain tumor resection. The purpose of this study was to better understand global perceptions and practices related to glycemia management in these patients. METHODS: Neuroanesthesiologists throughout North America, South America, Europe, and Asia filled out a brief online questionnaire related to their perceptions and practices regarding glycemia management in patients undergoing craniotomy for brain tumor resection. RESULTS: Over 4 weeks, 435 participants practicing in 34 countries across 6 continents participated in this survey. Although responders in North America were found to perceive a higher risk hyperglycemia compared with those practicing in European (P = 0.024) and South Asian (P = 0.007) countries, responders practicing in South Asian countries (P = 0.030), Middle Eastern countries (P = 0.029), and South American (P = 0.005) countries were more likely than those from North America to remeasure glucose after an initial normal glucose measurement at incision. Responders from North America reported that a higher blood glucose threshold was necessary for them to delay or cancel the surgery compared with responders in Slavic (P < 0.001), European (P = 0.002), South American (P = 0.002), and Asian and Pacific (P < 0.001) countries. Responders from North America were more likely to report that they would delay or cancel the surgery because of a higher blood glucose threshold. CONCLUSIONS: Our survey results suggest that perceptions and practices related to blood glucose management in patients undergoing brain tumor resection are variable. This study highlights the need for stronger clinical evidence and guidelines to help guide decisions for when and how to manage blood glucose derangements in these patients.

Surveying work-as-done in post-operative delirium risk factors collection and diagnosis monitoring.

Post-operative delirium (POD) is a health hazard condition for the patients and it is associated with increased costs for the healthcare system. Following a system-theoretic approach, firstly a model, then a questionnaire, have been designed to probe the collective awareness about POD throughout the entire patient's perioperative pathway. The 58 reported answers pointed out that most of the information, specifically associated with POD, are routinely recorded but not used to stratify the patients' individual risk to develop POD. The results suggest the need for design a new socio-technical role within modern health care systems: the POD analyst. A Systems-Theoretic Accident Model and Processes (STAMP) model is proposed both to propel the awareness about POD and as a template for future POD risk factors collections.

An Analytic Framework to Assess Organizational Resilience.

BACKGROUND: Resilience engineering is a paradigm for safety management that focuses on coping with complexity to achieve success, even considering several conflicting goals. Modern sociotechnical systems have to be resilient to comply with the variability of everyday activities, the tight-coupled and underspecified nature of work, and the nonlinear interactions among agents. At organizational level, resilience can be described as a combination of four cornerstones: monitoring, responding, learning, and anticipating. METHODS: Starting from these four categories, this article aims at defining a semiquantitative analytic framework to measure organizational resilience in complex sociotechnical systems, combining the resilience analysis grid and the analytic hierarchy process. RESULTS: This article presents an approach for defining resilience abilities of an organization, creating a structured domain-dependent framework to define a resilience profile at different levels of abstraction, and identifying weaknesses and strengths of the system and potential actions to increase system's adaptive capacity. An illustrative example in an anesthesia department clarifies the outcomes of the approach. CONCLUSION: The outcome of the resilience analysis grid, i.e., a weighed set of probing questions, can be used in different domains, as a support tool in a wider Safety-II oriented managerial action to bring safety management into the core business of the organization.

A multicountry comparative survey about organizational resilience in anaesthesia.

RATIONALE, AIMS, AND OBJECTIVES: The application of resilience in health care requires the shift from a cause-effect approach to a systemic approach, yet few tools have been developed to measure resilience potential in this specific context. This study tests a resilience assessment grid (RAG) questionnaire to measure the resilience of anaesthesiologists, with a cross-country survey. METHOD: A study was conducted with an analytic hierarchy process (AHP) questionnaire containing 57 detailed questions; 16 nations and 172 respondents were involved in the study. The data were statistically analysed to identify insights from the questionnaire, main improvements for further assessment, and confirmation of the design of the questionnaire. The questionnaire reliability was assessed by Cronbach analysis. Weak items were identified by a detailed correlations analysis and through a weight-polarization matrix. Construct validity was confirmed by principal component analysis (PCA) and factor analysis (FA). RESULTS: The α level of Cronbach analysis is 0.910. PCA and FA confirmed the absence of underlying unexpected factors, with less than 8% from the first factor and a total of just 54% of variability explained by 17 factors. Suggestions for revising the questionnaire ensue from the analysis, with improvements for the questionnaire's significance. CONCLUSION: The questionnaire shows the potential to assess proxy measures of resilience, even confirming the relevance of a structured weighting approach based on the AHP. The exemplar statistical cross-country analyses encourage the widespread use of a centralized resilience questionnaire to support standardized analyses and the diffusion of best practices among organizations.