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.

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.

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.

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).

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.

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.

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.

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.

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.

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.

Building Innovative Teams: Exploring the Positive Contribute of Emotions Expression and Affective Commitment.

The current challenging organizational context demands that organizations adapt quickly and continuously in order to survive and maintain their competitive advantage. Considering this need, one of the responses given by companies has been the valorization of work teams and their capacity for innovation, as well as fostering positive skills and emergent states in employees, such as emotional carrying capacity and affective commitment, respectively. The aim of this research is thus to study the relationship between emotional carrying capacity and group innovation, considering affective commitment as the mediating variable. To test these relationships, an empirical cross-sectional study was conducted including 138 Portuguese work teams belonging to different sectors of activity, composed of 625 members and their respective leaders. The results were analyzed through structural equation modeling (SEM) and showed positive relationships between emotional carrying capacity and affective commitment, as well as between affective commitment and group innovation. In addition, the mediating role of affective commitment in the relationship between emotional carrying capacity and group innovation was also supported. Therefore, the results suggest that a work context in which members openly express their emotions contributes to reinforcing their affective attachment to the group, making them feel more involved and available to test and implement new ideas and procedures. The findings reinforce the benefits of promoting the expression of emotions and the development of healthy bonds between team members.

[How to Resume Elective Orthopaedic Surgical Procedures during the COVID-19 Pandemic?] / Como Retomar a Atividade Cirúrgica Eletiva em Ortopedia durante a Pandemia COVID-19?

This document was prepared by the College of Orthopedics of the Portuguese Medical Association with the aim of developing the guidelines on the resumption of elective surgical activity in Orthopedics during the COVID-19 pandemic. It sets the criteria that allow the prioritization of surgeries according to the severity of the clinical situation, based on existing and published classifications. Moreover, it provides an organizational model for patient preparation and describes the patient pathways in the preoperative, intraoperative and postoperative periods. It also describes safety rules for elective surgery and a model for monitoring patients after discharge according to scientific evidence.

Este documento foi elaborado pelo Colégio de Ortopedia da Ordem dos Médicos com o objetivo de estabelecer as orientações sobre a retoma da atividade cirúrgica programada em Ortopedia durante a pandemia COVID-19. As presentes normas de orientação: a) definem os critérios que permitem a priorização das cirurgias de acordo com a gravidade da situação clínica, com base em classificações existentes e publicadas; b) fornecem um modelo de organização para a preparação dos doentes, descrevendo os circuitos do doente nos períodos pré-operatório, intraoperatório e pós-operatório; c) realçam as regras de segurança para a realização de cirurgias e desenham um modelo de acompanhamento após a alta de acordo com a evidência científica.

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.

Surgical Treatment of Multiple Osteoporotic Fractures of the Dorsolumbar Spine: Case Report / Tratamento cirúrgico de fraturas osteoporóticas múltiplas da coluna dorsolombar: Relato de caso

Abstract 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.

Resumo As fraturas vertebrais osteoporóticas são um tipo comum de fratura e afetam um número significativo da população com osteoporose. Apesar do elevado risco de fratura, a ocorrência concomitante de fraturas vertebrais em níveis não contíguos é muito rara. Reportamos o caso de uma paciente com três fraturas explosivas da coluna dorsolombar em níveis não contíguos, tratada com cifoplastia e fixação posterior transpedicular por via percutânea. Seis meses após a cirurgia, a paciente tem marcha autônoma, sem dor, e, radiologicamente, não existem evidências de perda de redução das fraturas.

How does the Leader's Centrality affect Team Performance Assessment? Testing the Role of Leader's Satisfaction.

The study aims to test how the association between leader's centrality (outdegree and betweenness) in the group network, considering both workflow and friendship ties between leader and members, and the perception of team performance is mediated by the leader's satisfaction with the team. The research included a total of 74 formal leaders of organizational teams from several organizations. Total, direct and indirect effects were calculated through the estimation of an OLS regression-based mediation model, controlling for team size. Results revealed that only leader's outdegree and betweenness centrality in the team friendship network positively predicted the leader's perception of team performance. In contrast to the predictions, a significant negative indirect effect of outdegree centrality of the leader within the team workflow network on the evaluation of group performance through leader's satisfaction was observed. Also, both leader´s outdegree and betweenness centrality levels in the friendship network were shown to have a positive effect on leader's assessment of team performance through leader's satisfaction with the team. Overall, findings point to the negative effects of leader's centrality in the workflow team network and the positive effects of leader's centrality in the friendship team network on his/her attitudes toward the team. The effects of the more or less central position of the leader within each of the group networks are discussed.

How does the leader's centrality affect team performance assessment? Testing the role of leader's satisfaction

The study aims to test how the association between leader's centrality (outdegree and betweenness) in the group network, considering both workflow and friendship ties between leader and members, and the perception of team performance is mediated by the leader's satisfaction with the team. The research included a total of 74 formal leaders of organizational teams from several organizations. Total, direct and indirect effects were calculated through the estimation of an OLS regression-based mediation model, controlling for team size. Results revealed that only leader's outdegree and betweenness centrality in the team friendship network positively predicted the leader's perception of team performance. In contrast to the predictions, a significant negative indirect effect of outdegree centrality of the leader within the team workflow network on the evaluation of group performance through leader's satisfaction was observed. Also, both leader's outdegree and betweenness centrality levels in the friendship network were shown to have a positive effect on leader's assessment of team performance through leader's satisfaction with the team. Overall, findings point to the negative effects of leader's centrality in the workflow team network and the positive effects of leader's centrality in the friendship team network on his/her attitudes toward the team. The effects of the more or less central position of the leader within each of the group networks are discussed

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Transformational leadership and team effectiveness: the mediating role of affective team commitment / El liderazgo transformacional y la eficacia grupal: el papel mediador del compromiso afectivo con el equipo

This paper investigates the effects of transformational leadership on team effectiveness. In particular, we studied the effects of transformational leadership on three criteria of team effectiveness: viability, team process improvement, and quality of group experience. In addition, we examined the indirect effect of transformational leadership on team effectiveness via affective team commitment. Ninety teams working in different organizational contexts in Portugal were surveyed. Two different questionnaires were administrated, respectively, to team members and team leaders. Team members (N = 445) were surveyed about leadership, team commitment, and quality of the group experience, whereas team leaders (N = 90) were asked to assess team viability and team process improvement. Hypotheses were tested through structural equation modelling. Results revealed that affective team commitment partially mediates the relationship between transformational leadership and quality of the group experience. The mediational role of affective team commitment between transformational leadership and both team viability and team process improvement was not supported. Implications for practice and suggestions for further research are provided

El objetivo de esta investigación fue contribuir a aclarar los efectos del liderazgo transformacional en la eficacia de los equipos. Hemos estudiado los efectos directos e indirectos del liderazgo transformacional en tres criterios de eficacia del equipo: la viabilidad, la mejora del proceso en equipo y la calidad de la experiencia grupal. Además, analizamos el efecto indirecto del liderazgo transformacional en la eficacia grupal a través del compromiso afectivo con el equipo. Se encuestó a 90 equipos que trabajaban en diferentes contextos organizacionales en Portugal. Se administraron dos cuestionarios diferentes respectivamente a los miembros del equipo y a los líderes. Los miembros del equipo (N = 445) fueron encuestados sobre el liderazgo, el compromiso con el equipo y la calidad de la experiencia grupal, mientras que a los líderes (N = 90) se les pidió que evaluasen la viabilidad del equipo y la mejora del proceso en equipo. Las hipótesis se examinaron mediante modelos de ecuaciones estructurales. Los resultados revelaron que el compromiso afectivo con el equipo media parcialmente la relación entre el liderazgo transformacional y la calidad de la experiencia grupal. El rol de mediación del compromiso afectivo del equipo entre el liderazgo transformacional, la viabilidad de éste y la mejora del proceso en equipo, no ha sido sustentado empíricamente. Además, presentamos implicaciones para la práctica y sugerencias para futuras investigaciones

Bouncing Back from Setbacks: On the Mediating Role of Team Resilience in the Relationship Between Transformational Leadership and Team Effectiveness.

The purpose of this study was to clarify the role of team resilience on different facets of effectiveness (team viability and quality of the group experience). Moreover, given the importance of team resilience for the organizational context, it was also our aim to contribute to the study of the conditions that promote team resilience, analyzing the role of transformational leadership. Finally, we examined whether the relationship between transformational leadership and team resilience stimulates positive team outcomes. Ninety teams (445 employees from 40 companies) were surveyed and path analysis was used in the test of the hypotheses. The results showed a positive direct effect of team resilience on both team viability and the quality of the group experience. Moreover, a positive relationship was also identified between transformational leadership and team resilience. Finally, support was found for the mediated effect of team resilience on the relationship between transformational leadership and the dimensions of team effectiveness considered. The findings of this study highlight the role of team resilience as an intervening process between transformational leadership and team effectiveness. Supervisors should promote team resilience, adopting transformational leadership behaviors, in order to contribute to increase team viability and the quality of the group experience.

Liderança transformacional e a eficácia grupal: o papel mediador dos comportamentos de suporte / Transformational leadership and team effectiveness. The mediator role of supportive behaviors

O objetivo deste estudo foi analisar o papel mediador dos comportamentos de suporte na relação entre a liderança transformacional e quatro critérios da eficácia da equipe (designadamente, o desempenho, a viabilidade, a qualidade da experiência grupal e os processos de melhoria). Conduziu-se um estudo empírico com uma amostra composta por 653 participantes de 117 equipes de diferentes setores de atividade (e.g., indústria, proteção civil, consultoria), onde foram testadas as relações previstas. Os resultados mostraram um efeito direto positivo da liderança transformacional nos comportamentos de suporte, assim como dos comportamentos de suporte na eficácia da equipe (nomeadamente, no desempenho, na viabilidade, na qualidade da experiência grupal e nos processos de melhoria). Além disso, foi igualmente identificado um efeito mediador dos comportamentos de suporte na relação entre a liderança transformacional e os quatro critérios da eficácia da equipe. Implicações para a investigação, para a prática profissional e pistas para futuras pesquisas foram apresentadas.

The aim of the present study was to analyse the mediator role of supportive behaviours in the relationship between transformational leadership and four team effectiveness criteria: performance, viability, quality of group experience, and improvement processes. An empirical study was conducted with a sample of 653 participants from 117 teams from different professional practice sectors (e.g., industry, civil protection, and consultancy), in which these relationships were tested. The results showed a positive direct effect of transformational leadership on supportive behaviours and on team effectiveness (including performance, viability, quality of the group experience, and improvement process). Furthermore, the present study also identified the mediator effect of supportive behaviours on the relationship between transformational leadership and the four team effectiveness criteria considered. Implications for research and professional practice were discussed, and suggestions for further studies were offered.