An Integrated Data Acquisition Approach for the Structural Health Monitoring and Real-Time Earthquake Response Assessment of a Retrofitted Adobe Church in Peru.

The structural health monitoring (SHM) of buildings provides relevant data for the evaluation of the structural behavior over time, the efficiency of maintenance, strengthening, and post-earthquake conditions. This paper presents the design and implementation of a continuous SHM system based on dynamic properties, base accelerations, crack widths, out-of-plane rotations, and environmental data for the retrofitted church of Kuñotambo, a 17th century adobe structure, located in the Peruvian Andes. The system produces continuous hourly records. The organization, data collection, and processing of the SHM system follows different approaches and stages, concluding with the assessment of the structural and environmental conditions over time compared to predefined thresholds. The SHM system was implemented in May 2022 and is part of the Seismic Retrofitting Project of the Getty Conservation Institute. The initial results from the first twelve months of monitoring revealed seasonal fluctuations in crack widths, out-of-plane rotations, and natural frequencies, influenced by hygrothermal cycles, and an apparent positive trend, but more data are needed to justify the nature of these actions. This study emphasizes the necessity for extended data collection to establish robust correlations and refine monitoring strategies, aiming to enhance the longevity and safety of historic adobe structures under seismic risk.

The transformation of masculinity orientations and work-related attitudes in men treated for depression (TRANSMODE): study protocol for a mixed-methods observational study.

BACKGROUND: Masculinity norms play a crucial role in men's help-seeking behaviors, service-use, and coping strategies for depression. While previous studies provided evidence for the association between gender role orientations, work related attitudes, stigmatization of men with depression and depressive symptoms, it remains unclear to what extent gender role orientations change over time and whether psychiatric and psychotherapeutic treatment have an impact on these transformations. Additionally, the role of partners in supporting depressed men and the impact of dyadic coping on these processes have not been explored. The aim of this study is to investigate how masculinity orientations and work-related attitudes change over time in men treated for depression, and to examine the role of their partners and dyadic coping in these transformation processes. METHODS: TRANSMODE is a prospective longitudinal mixed-methods study investigating the transformation of masculinity orientations and work-related attitudes in men treated for depression between the ages of 18 and 65 from different settings in Germany. The study will recruit 350 men from various settings for quantitative analysis. By applying a latent transition analysis, the primary outcome are changes in masculine orientations and work-related attitudes over time, measured at four times (t0, t1, t2, t3) with intervals of 6 months. Qualitative interview with a subsample of depressed men selected using latent profile analysis, will be conducted between t0 and t1 (a1) with a follow-up of 12 months (a2). In addition, qualitative interviews with the partners of depressed men will be conducted between t2 and t3 (p1). Qualitative data will be analysed using qualitative structured content analysis. DISCUSSION: A comprehensive understanding of the transformation processes of masculinity orientations over time including the impact of psychiatric/psychotherapeutic treatment and the role of partners can lead to the development of gender-sensitive depression treatment tailored to the unique needs of men with depression. Thus, the study can promote more effective and successful treatment outcomes and further contribute to reducing the stigma surrounding mental health issues among men and encourage them for mental health service use. TRIAL REGISTRATION: This study is registered in the German Clinical Trail Register (DRKS) and the WHO International Clinical Trials Registry Platform (ICTRP) under registration number DRKS00031065 (Date of registration 06 February 2023).

Methodologies and Challenges for Optimal Sensor Placement in Historical Masonry Buildings.

As ageing structures and infrastructures become a global concern, structural health monitoring (SHM) is seen as a crucial tool for their cost-effective maintenance. Promising results obtained for modern and conventional constructions suggested the application of SHM to historical masonry buildings as well. However, this presents peculiar shortcomings and open challenges. One of the most relevant aspects that deserve more research is the optimisation of the sensor placement to tackle well-known issues in ambient vibration testing for such buildings. The present paper focuses on the application of optimal sensor placement (OSP) strategies for dynamic identification in historical masonry buildings. While OSP techniques have been extensively studied in various structural contexts, their application in historical masonry buildings remains relatively limited. This paper discusses the challenges and opportunities of OSP in this specific context, analysing and discussing real-world examples, as well as a numerical benchmark application to illustrate its complexities. This article aims to shed light on the progress and issues associated with OSP in masonry historical buildings, providing a detailed problem formulation, identifying ongoing challenges and presenting promising solutions for future improvements.

Extended Tromograph Surveys for a Full Experimental Characterisation of the San Giorgio Cathedral in Ragusa (Italy).

Geophysical surveys are widely used to reconstruct subsoil seismo-stratigraphic structures with a non-invasive approach. In this study the geophysical surveys were carried out with the aim to characterise the San Giorgio Cathedral in Ragusa (Italy) and the area on which it is built from a dynamic point of view. A 3D subsoil model was realised through the integration of two active (i.e., seismic tomography and multichannel analysis of surface waves) and one passive seismic technique (horizontal to vertical spatial ratio). The instrumentation used for the latter method consists of a tromograph (Tromino®), which is also employed for the characterisation of the building, focusing on the façade and the dome, by means of an ambient vibration test, processed through the standard spectral ratio and frequency domain decomposition methods. Integration of the 3D model, showing the distribution of areas with different physicomechanical characteristics, enables identifying anomalies that are likely attributable to the remains of the ancient Byzantine church of San Nicola. Four lower modes mainly involving the two investigated macroelements are identified. The experimental results outline the advantages of the use of the tromograph both for soil and structural characterisation, especially for massive masonry buildings located in areas with high seismic hazard.

Genetic prediction of ICU hospitalization and mortality in COVID-19 patients using artificial neural networks.

There is an unmet need of models for early prediction of morbidity and mortality of Coronavirus disease-19 (COVID-19). We aimed to a) identify complement-related genetic variants associated with the clinical outcomes of ICU hospitalization and death, b) develop an artificial neural network (ANN) predicting these outcomes and c) validate whether complement-related variants are associated with an impaired complement phenotype. We prospectively recruited consecutive adult patients of Caucasian origin, hospitalized due to COVID-19. Through targeted next-generation sequencing, we identified variants in complement factor H/CFH, CFB, CFH-related, CFD, CD55, C3, C5, CFI, CD46, thrombomodulin/THBD, and A Disintegrin and Metalloproteinase with Thrombospondin motifs (ADAMTS13). Among 381 variants in 133 patients, we identified 5 critical variants associated with severe COVID-19: rs2547438 (C3), rs2250656 (C3), rs1042580 (THBD), rs800292 (CFH) and rs414628 (CFHR1). Using age, gender and presence or absence of each variant, we developed an ANN predicting morbidity and mortality in 89.47% of the examined population. Furthermore, THBD and C3a levels were significantly increased in severe COVID-19 patients and those harbouring relevant variants. Thus, we reveal for the first time an ANN accurately predicting ICU hospitalization and death in COVID-19 patients, based on genetic variants in complement genes, age and gender. Importantly, we confirm that genetic dysregulation is associated with impaired complement phenotype.

Reducing the Training Samples for Damage Detection of Existing Buildings through Self-Space Approximation Techniques.

Data-driven methodologies are among the most effective tools for damage detection of complex existing buildings, such as heritage structures. Indeed, the historical evolution and actual behaviour of these assets are often unknown, no physical models are available, and the assessment must be performed only based on the tracking of a set of damage-sensitive features. Selecting the most representative state indicators to monitor and sampling them with an adequate number of records are therefore essential tasks to guarantee the successful performance of the damage detection strategy. Despite their relevance, these aspects have been frequently taken for granted and little attention has been paid to them by the scientific community working in the field of Structural Health Monitoring. The present paper aims to fill this gap by proposing a multistep strategy to drive the selection of meaningful pairs of correlated features in order to support the damage detection as a one-class classification problem. Numerical methods to reduce the number of necessary acquisitions and estimate the performance of approximation techniques are also provided. The analyses carried out to test and validate the proposed strategy exploit a dense dataset collected during the long-term monitoring of an outstanding heritage structure, i.e., the Church of 'Santa Maria de Belém' in Lisbon.

The effects on team emotions and team effectiveness of coaching in interprofessional health and social care teams.

The purpose of this study was to examine the effects of coaching behaviours provided by peers and by the leader on the emotions experienced by interprofessional health and social care teams and on members' satisfaction with the team, as well as on team performance. Data were obtained from a survey among 344 employees working in 52 interprofessional health and social care teams from nine Portuguese organizations. The results show that leader coaching and peer coaching have a positive effect on the level of team members' satisfaction with the team and on positive emotions, and a negative effect on negative emotions. Furthermore, coaching provided by peers presents a positive effect on team performance as assessed by the leader of the team. Our findings put forward the importance of engaging in coaching behaviours to promote quality of the team experience, as well as the achievement of team performance objectives. Further studies should explore how coaching behaviours impact the patient, whose well-being is the ultimate objective of a team in the health and social care system, namely in terms of the patient's perception of quality care or patient outcomes.

A Cusp Catastrophe Model for Team Learning, Team Potency and Team Culture.

This paper examines team learning behaviors within a nonlinear dynamical system (NDS) perspective. The present research is based on a sample of 36 project workgroups, where data were collected at two moments of their life cycle, with visual analogue scales. Using both the least squares method and maximum likelihood, it proposes a cusp catastrophe model for explaining team learning. The cusp model is superior to its linear alternatives and implements team culture as the asymmetry variable and team potency as bifurcation. The findings of cusp structure in the data support the existence of discontinuous shifts in learning behavior and furthermore a proposition that the punctuated equilibrium model (PEM) might be a reasonable model for describing group functioning, since it encompasses such sudden changes between distinct stages (attractors). A discussion on small group research is also provided by highlighting the nonlinear dynamics of team processes, along with further implications for research and practice.

Fracture Characterization of Human Cortical Bone Under Mode I Loading.

A miniaturized version of the double cantilever beam (DCB) test is used to determine the fracture energy in human cortical bone under pure mode I loading. An equivalent crack length based data-reduction scheme is used with remarkable advantages relative to classical methods. Digital image correlation (DIC) technique is employed to determine crack opening displacement at the crack tip being correlated with the evolution of fracture energy. A method is presented to obtain the cohesive law (trapezoidal bilinear softening) mimicking the mechanical behavior observed in bone. Cohesive zone modeling (CZM) (finite-element method) was performed to validate the procedure showing excellent agreement.

Bone turnover markers for early detection of fracture healing disturbances: A review of the scientific literature.

Imaging techniques are the standard method for assessment of fracture healing processes. However, these methods are perhaps not entirely reliable for early detection of complications, the most frequent of these being delayed union and non-union. A prompt diagnosis of such disorders could prevent prolonged patient distress and disability. Efforts should be directed towards the development of new technologies for improving accuracy in diagnosing complications following bone fractures. The variation in the levels of bone turnover markers (BTMs) have been assessed with regard to there ability to predict impaired fracture healing at an early stage, nevertheless the conclusions of some studies are not consensual. In this article the authors have revised the potential of BTMs as early predictors of prognosis in adult patients presenting traumatic bone fractures but who did not suffer from osteopenia or postmenopausal osteoporosis. The available information from the different studies performed in this field was systematized in order to highlight the most promising BTMs for the assessment of fracture healing outcome.

Evaluating the Role of Mortar Composition on the Cyclic Behavior of Unreinforced Masonry Shear Walls.

The mechanical behavior of unreinforced masonry (URM) shear walls under in-plane cyclic loading is crucial for assessing their seismic performance. Although masonry structures have been extensively studied, the specific influence of varying lime content in cement-lime mortars on the cyclic behavior of URM walls has not been adequately explored. This study addresses this gap by experimentally evaluating the effects of three mortar mixes with increasing lime content, 1:0:5, 1:1:6, and 1:2:9 (cement:lime:sand, by volume), on the cyclic performance of brick URM walls. Nine single-leaf wall specimens 900 mm × 900 mm were constructed and subjected to combined vertical compression and horizontal cyclic loading. Key parameters such as drift capacity, stiffness degradation, and energy dissipation were measured. The results indicated that the inclusion of lime leads to a moderate improvement in drift capacity and ductility of the walls, with the 1:1:6 mix showing the highest lateral capacity (0.55 MPa), drift at cracking (0.08%), and drift at peak capacity (0.31%). Stiffness degradation and energy dissipation were found to be comparable across all mortar types. These findings suggest that partial substitution of cement with lime can enhance certain aspects of masonry performance. Further research is recommended to optimize mortar compositions for unreinforced masonry applications.

Surgical treatment of post-traumatic vertebral osteonecrosis including intravertebral expansive implants-clinical, functional and imaging outcomes and a center experience over 7 years.

Background: The effective treatment of post-traumatic vertebral osteonecrosis continues to be an under discussion and controversial subject. Armed kyphoplasty with expansive intravertebral implants is an emerging procedure, which, in theory, allow for a more effective preservation of the restored vertebral height. The development of the indications for these recent devices has given rise to auspicious outcomes in vertebral non-union situations. The aim of this study is to evaluate the clinical, functional and imaging outcomes of the surgical treatment of situations of post-traumatic vertebral necrosis, following a therapeutic algorithm that includes armed kyphoplasty with intravertebral expansive implants and bridge pedicular stabilization, according to a predefined necrosis stage. Methods: We present a retrospective observational study, in which 35 patients took part, including a total of 35 cases of post-traumatic vertebral osteonecrosis submitted to surgical treatment over 7 years (between 2016 and 2023) at the same center according to a defined therapeutic algorithm. The cases were staged according to vertebral morphology (non-plana or plana) and mobility (mobile or immobile)-stages 1m (mobile necrotic vertebra non-plana), 1i (immobile necrotic vertebra non-plana), 2m (mobile necrotic vertebra plana), and 2i (immobile necrotic vertebra plana)-and the following surgeries were performed: armed kyphoplasty with intravertebral expansive implants filled with bone cement, associated or not to adjacent pedicle instrumentation; or bridge pedicle fixation of the adjacent levels. Clinical results [Patient Global Impression of Change (PGIC), Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI)] as well as imaging outcomes (restoration and preservation of the heights of the vertebral body) were studied. The mean follow-up time corresponded to 3.17 years (range, 1-7.5 years). Results: Most of the clinical-functional and imaging parameters showed important improvements after surgical treatment, with few complications. A statistically significant greater degree of functional improvement was found in plana vertebrae when compared to non-plana, which reflects that the first are quite symptomatic and disabling at the beginning and improve a lot with surgical treatment. Significant indirect correlations were found between the time from the initial fracture to surgical intervention after diagnosis of vertebral necrosis and the anterior sagittal height in the immediate postoperative time and at the ending of the follow-up. Also, a significant direct correlation was identified between this time and the VAS for pain at the end of the follow-up and the PGIC scale in the same period. It was also found that patients with surgical complications had a statistically significantly longer time between the initial fracture and surgery for post-traumatic necrosis. Conclusions: We present the results of a surgical therapeutic algorithm that includes the use of recent expansive intravertebral implants at post-traumatic vertebral osteonecrosis, resulting in satisfactory clinical, functional and imaging results. This work shows a pioneering statistical demonstration of the clinical, functional and imaging importance of early detection of this condition (ideally in vertebrae non-plana morphology stages), so that there is still sufficient bone tissue in the vertebral body to permit the stabilization and restoration of its anatomy through a minimally invasive interior reconstruction, with percutaneous access and quicker convalescence, that is to say, armed kyphoplasty, avoiding the unwanted disease progression that will require more aggressive surgical solutions that doesn't allow anatomical restauration.

Feasibility and effectiveness of a 24-weeks outdoor exercise program on the physical and mental health of persons with schizophrenia.

Outdoor exercise can be a novelty and effective therapeutic strategy to achieve positive physical and mental health outcomes in persons with schizophrenia. The aim of this study was to assess the feasibility and effectiveness of a 24-weeks outdoor exercise program in the physical and mental health of persons with schizophrenia. Fifty-two outpatients with schizophrenia were conveniently assigned to a 24-weeks walking/jogging combined with cycling outdoor program (n = 23, male = 14) or control group (n = 29, male = 20). Demographic and clinical measures were collected. Physical health was evaluated using anthropometric measures, 6 min walk test, Eurofit and accelerometer. Mental health was evaluated using self-esteem, motivation for exercise and quality of life questionnaires. Attendance rate to the outdoor program was 92 %. The exercise program significantly decreased participant's body mass index and improved functional exercise capacity and balance. No effects were reported in the self-esteem, motivation for physical activity and quality of life. Significant decreases were found in abdominal strength, hand grip and self-esteem levels of the control group. The outdoor exercise combining walking/jogging and cycling was an effective intervention to decrease body mass index and to improve physical fitness. It can be suggested as a therapeutic approach with an important impact on the management of schizophrenia.

C1-C2 Transarticular Anterior Fixation for the Treatment of Atlantoaxial Traumatic Dislocation: A Clinical Case.

Fractures of the odontoid apophysis are one of the most frequent lesions in the elderly population, and an increasingly preponderant problem with the progressive aging of the world population. In the present work, we report a clinical case of an 88-year-old male patient who suffered a fall resulting in a type-II fracture of the odontoid apophysis on the Anderson-D'Alonzo classification. Given the age and comorbidities of the patient, we decided to perform osteosynthesis of the fracture through anterior fixation with a transarticular screw in combination with fixation with an odontoid screw. This technique enables the necessary stability for the consolidation of Anderson-D'Alonzo's type II odontoid apophysis fracture, with the advantage of the lower levels of dissection of the cervical extensor musculature and hemorrhage resulting from this aggression when compared with the posterior approach; moreover, it is a readily-available technique that yields clear benefits in the treatment of this pathology in the geriatric population.

The "we" and the "others" in an interprofessional surgical context: findings from a Portuguese study.

The social identity of an individual is defined by the recognition they make which belongs to a particular group (Tajfel, 1984). In this sense, will doctors and nurses, when together in the surgical team, recognize themselves as its members, thus leaving the background identities associated with their own professions? Using social identity theory of Tajfel (1984), this study explored the extent that profession-specific identity, present in the surgical team, acting as a barrier to a shared team identity. A case study design was adopted, and structured interviews were gathered from 20 clinicians based in a surgical unit in a single Portuguese hospital. The results indicated that the profession-specific identifies acted as a barrier to the surgical team identity as the participants defined themselves as its members of their profession, and not as surgical team members. Therefore, based on the results of this small study, there is a tendency of surgical clinicians to maintain the distinction between "us" (their own profession) and "others" (the other individuals in the surgical team).

Design of Strain-Hardening Natural TRM Composites: Current Challenges and Future Research Paths.

This paper discusses the challenges in using natural fibers for the development of textile-reinforced mortar (TRM) composites with pseudo-strain-hardening and multiple cracking behavior. The particular characteristics of natural vegetal fibers are analyzed with reference to data from the literature. It is concluded that the efficient use of these fibers as composite reinforcement requires the development of treatment or impregnation protocols for overcoming durability issues, eliminating crimping effects in tensile response and imparting dimensional stability. Relevant experimental research on the synthesis and performance of natural TRMs is reviewed, showing that the fabrication of such systems is, at present, largely based on empirical rather than engineering design. In order to set a framework regarding the properties that the constituents of natural TRM must meet, a comparative analysis is performed against inorganic matrix composites comprising synthetic, mineral and metallic reinforcement. This highlights the need for selecting matrix materials compatible with natural fibers in terms of stiffness and strength. Furthermore, a rational methodology for the theoretical design of natural TRM composites is proposed. First-order analysis tools based on rule-of-mixtures and fracture mechanics concepts are considered. Based on the findings of this study, paths for future research are discussed.

Stent-armed kyphoplasty in osteoporotic thoracolumbar fractures-clinical and functional results and a center experience over 10 years.

Background: The optimal treatment of osteoporotic vertebral fractures is still a controversial and under discussion topic. Armed kyphoplasty with expansive intravertebral implants is an emerging procedure, which, in theory, it not only makes it possible to achieve instant analgesia, and to get stabilization gains of benefits of kyphoplasty and vertebroplasty, but also, allows for a more effective maintenance of the restored vertebral height. Methods: A retrospective observational study is presented, in which 30 patients participated, including a total of 33 osteoporotic thoracolumbar compression burst vertebral fractures with involvement of one or both vertebral platforms and of more than one fifth of the posterior wall. These individuals underwent armed kyphoplasty with VBS® stents (or stentoplasty) filled with bone cement over 10 years (between 2012 and 2022) at the same center. Clinical (visual analogue scale, Oswestry Disability Index and Patient Global Impression of Change) and imaging results (restoration and maintenance of vertebral body heights) achieved were investigated. The mean follow-up time was 4.5 years (range, 1-10 years). Results: There was a statistically significant improvement in all clinical and functional parameters evaluated, as well as a statistically significant difference in the various vertebral body heights between preoperative and end of follow-up time [increase of 10.7-15.2-5.0 mm (anterior-median-posterior) in the sagittal plane and 6.7-11.6-9.7 mm (right-median-left) in the coronal plane]. There was a statistically significant direct correlation between vertebral heights in the coronal plane, and between the Beck index assessed at the end of the follow-up period and the improvement in functional disability. Conclusions: The percutaneous transpedicular posterior approach, the ability to anatomically restore the fractured vertebra and to maintain it in the medium-long term, as well as the reduced risk of adverse effects, make stent-armed kyphoplasty a very attractive treatment option for osteoporotic compressive thoracolumbar fractures. A clinical-morphological correlation was demonstrated regarding the surgical treatment of these fractures, it was found that a more effective morphological restoration of vertebral heights in both the sagittal and coronal planes is associated with superior satisfactory clinical functional parameters.

Innovation in Teams: The Role of Psychological Capital and Team Learning.

The main purpose of the present research was to analyze the relationship between team psychological capital and innovation, considering team learning as a mediating variable. A field survey was carried out, which included 124 work teams belonging to organizations from different sectors of activity. Hypotheses were tested through PROCESS. Results supported a direct positive relationship between team psychological capital and team innovation and an indirect influence of team psychological capital on team innovation, through team learning. The findings of this study highlight the role of team learning as an intervening process between team psychological capital and team innovation. Accordingly, managers should seek to develop team psychological capital and learning behaviors among their teams to promote innovation.

Dynamics of Team Learning Behaviours: The Effect of Time and Team Culture.

This research study focused on team learning behaviours, particularly the extent to which teams use learning behaviours over time, as well as the influence of different team cultures on learning behaviours over time. Data from 33 university project teams were collected longitudinally at three moments (beginning, halfway point, and end of the project) and the analysis was conducted through growth modelling. A linear relationship between time and team learning through experimenting behaviour was found, suggesting that experimenting behaviour tends to increase over time in project teams. Moreover, the early development of team cultures that promote mutual understanding and good interpersonal relationships, the accomplishment of objectives, flexibility, and the search for alternative ways to perform tasks/problem solving are conducive to experimenting behaviours from the beginning of the teamwork. This study highlights the relevance of the temporal dynamics of team learning behaviours and their interaction with team culture.

Surgical Treatment of Multiple Osteoporotic Fractures of the Dorsolumbar Spine: Case Report.

Osteoporotic vertebral fractures are a common type of fracture and affect a significant number of subjects with osteoporosis. Despite the high fracture risk, the concomitant occurrence of vertebral fractures at non-contiguous levels is very rare. We report the case of a patient with three burst dorsolumbar spine fractures at non-contiguous levels who was treated with percutaneous kyphoplasty and transpedicular posterior fixation. Six months after the surgery, the patient walks autonomously and without pain; in addition, there is no radiological evidence of fracture reduction loss.