The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

The Reliability of Transcranial Magnetic Stimulation-Derived Corticomotor Inhibition as a Brain Health Evaluation Tool in Soccer Players

Background The suitability of corticomotor inhibition and corticospinal excitability to measure brain health outcomes and recovery of sport-related head impact (concussion and subconcussion) depends on good inter-day reliability, which is evaluated in this study. Transcranial magnetic stimulation (TMS) reliability in soccer players is assessed by comparing soccer players, for whom reliability on this measure may be reduced due to exposure to head impacts, to generally active individuals not engaged in contact sport. Methods TMS-derived corticomotor inhibition and corticospinal excitability were recorded from the rectus femoris muscle during two testing sessions, spaced 1–2 weeks apart in 19 soccer players (SOC—age 22 ± 3 years) and 20 generally active (CON—age 24 ± 4 years) healthy volunteers. Inter-day reliability between the two time points was quantified by using intra-class correlation coefficients (ICC). Intra-group reliability and group differences on actual measurement values were also explored. Results Good inter-day reliability was evident for corticomotor inhibition (ICCSOC = 0.61; ICCCON = 0.70) and corticospinal excitability (ICCSOC = 0.59; ICCCON = 0.70) in both generally active individuals and soccer players routinely exposed to sport-related head impacts. Corticomotor inhibition showed lower coefficients of variation than excitability for both groups (InhibSOC = 15.2%; InhibCON = 9.7%; ExcitabSOC = 41.6%; ExcitabCON = 39.5%). No group differences between soccer players and generally active individuals were found on the corticomotor inhibition value (p > 0.05), but levels of corticospinal excitability were significantly lower in soccer players (45.1 ± 20.8 vs 85.4 ± 6.2%Mmax, p < 0.0001). Corticomotor inhibition also showed excellent inter-rater reliability (ICC = 0.87). Conclusions Corticomotor inhibition and corticospinal excitability are stable and maintain good degrees of reliability when assessed over different days in soccer players, despite their routine exposure to head impacts. However, based on intra-group reliability and group differences of the levels of excitability, we conclude that corticomotor inhibition is best suited for the evaluation of neuromuscular alterations associated with head impacts in contact sports.

Estimation of the Impact of Basement Heterogeneity on Thermal History Reconstruction: The Western Siberian Basin

Some of the simplifying assumptions frequently used in basin modelling may adversely impact the quality of the constructed models. One such common assumption consists of using a laterally homogeneous crustal basement, despite the fact that lateral variations in its properties may significantly affect the thermal evolution of the model. We propose a new method for the express evaluation of the impact of the basement’s heterogeneity on thermal history reconstruction and on the assessment of maturity of the source rock. The proposed method is based on reduced-rank inversion, aimed at a simultaneous reconstruction of the petrophysical properties of the heterogeneous basement and of its geometry. The method uses structural information taken from geological maps of the basement and gravity anomaly data. We applied our method to a data collection from Western Siberia and carried out a two-dimensional reconstruction of the evolution of the basin and of the lithosphere. We performed a sensitivity analysis of the reconstructed basin model to assess the effect of uncertainties in the basement’s density and its thermal conductivity for the model’s predictions. The proposed method can be used as an express evaluation tool to assess the necessity and relevance of laterally heterogeneous parametrisations prior to a costly three-dimensional full-rank basin modelling. The method is generally applicable to extensional basins except for salt tectonic provinces.

Breastfeeding Is Associated With a Reduced Maternal Cardiovascular Risk: Systematic Review and Meta‐Analysis Involving Data From 8 Studies and 1 192 700 Parous Women

Background Breastfeeding has been robustly linked to reduced maternal risk of breast cancer, ovarian cancer, and type 2 diabetes. We herein systematically reviewed the published evidence on the association of breastfeeding with maternal risk of cardiovascular disease (CVD) outcomes. Methods and Results Our systematic search of PubMed and Web of Science of articles published up to April 16, 2021, identified 8 relevant prospective studies involving 1 192 700 parous women (weighted mean age: 51.3 years at study entry, 24.6 years at first birth; weighted mean number of births: 2.3). A total of 982 566 women (82%) reported having ever breastfed (weighted mean lifetime duration of breastfeeding: 15.6 months). During a weighted median follow‐up of 10.3 years, 54 226 CVD, 26 913 coronary heart disease, 30 843 stroke, and 10 766 fatal CVD events were recorded. In a random‐effects meta‐analysis, the pooled multivariable‐adjusted hazard ratios comparing parous women who ever breastfed to those who never breastfed were 0.89 for CVD (95% CI, 0.83–0.95; I 2 =79.4%), 0.86 for coronary heart disease (95% CI, 0.78–0.95; I 2 =79.7%), 0.88 for stroke (95% CI, 0.79–0.99; I 2 =79.6%), and 0.83 for fatal CVD (95% CI, 0.76–0.92; I 2 =47.7%). The quality of the evidence assessed with the Grading of Recommendations Assessment, Development, and Evaluation tool ranged from very low to moderate, which was mainly driven by high between‐studies heterogeneity. Strengths of associations did not differ by mean age at study entry, median follow‐up duration, mean parity, level of adjustment, study quality, or geographical region. A progressive risk reduction of all CVD outcomes with lifetime durations of breastfeeding from 0 up to 12 months was found, with some uncertainty about shapes of associations for longer durations. Conclusions Breastfeeding was associated with reduced maternal risk of CVD outcomes.

Step, Error, and Event Frameworks in Endovascular Aortic Repair

Objective: Competency-based surgical education requires detailed and actionable feedback to ensure adequate and efficient skill development. Comprehensive operative capture systems such as the Operating Room Black Box (ORBB; Surgical Safety Technologies, Inc), which continuously records and synchronizes multiple sources of intraoperative data, have recently been integrated into hybrid rooms to provide targeted feedback to endovascular teams. The objective of this study is to develop step, error, and event frameworks to evaluate technical performance in elective endovascular aortic repair (EVAR) comprehensively captured by the ORBB (Surgical Safety Technologies, Inc; Toronto, Canada). Methods: This study is based upon a modified Delphi consensus process to create evaluation frameworks for steps, errors, and events in EVAR. International experts from Vascular Surgery and Interventional Radiology were identified, based on their records of publications and invited presentations, or serving on relevant journal editorial boards. In an initial open-ended survey round, experts were asked to volunteer a comprehensive list of steps, errors, and events for a standard EVAR of an infrarenal aorto-iliac aneurysm (AAA). In subsequent survey rounds, the identified items were presented to the expert panel to rate on a 5-point Likert scale. Delphi survey rounds were repeated until the process reached consensus with a predefined agreement threshold (Cronbach α>0.7). The final frameworks were constructed with items achieving an agreement (responses of 4 or 5) from greater than 70% of experts. Results: Of 98 invited proceduralists, 38 formed the expert consensus panel (39%), consisting of 29 vascular surgeons and 9 interventional radiologists, with 34% from North America and 66% from Europe. Consensus criteria were met following the third round of the Delphi consensus process (Cronbach α=0.82–0.93). There were 15, 32, and 25 items in the error, step, and event frameworks, respectively (within-item agreement=74%–100%). Conclusion: A detailed evaluation tool for the procedural steps, errors, and events in infrarenal EVAR was developed. This tool will be validated on recorded procedures in future work: It may focus skill development on common errors and hazardous steps. This tool might be used to provide high-quality feedback on technical performance of trainees and experienced surgeons alike, thus promoting surgical mastery.

Correlation Analysis between Cultural Differences and Normal Music Perception Based on Embedded Voice Multisensor

In order to effectively improve the sense of difference brought by the extracorporeal machine to users and minimize the related derived problems, the implementation based on embedded multisensor has become a major breakthrough in the research of cochlear implant. To explore the impact of different cultural differences on timbre perception, effectively evaluate the correlation between cultural differences and music perception teaching based on embedded multisensor normal hearing, evaluate the discrimination ability of embedded multisensor normal hearing to music timbre, and analyse the correlation between cultural differences and timbre perception, it provides a basis for the evaluation of music perception of normal hearing people with embedded multisensor and the design and development of evaluation tool. In this paper, adults with normal hearing in different cultures matched with music experience are selected to test their recognition ability of different musical instruments and the number of musical instruments by using music evaluation software, and the recognition accuracy of the two tests is recorded. The results show that the accuracy of musical instrument recognition in the mother tongue group is 15% higher than that in the foreign language group, and the average recognition rates of oboe, trumpet, and xylophone in the foreign language group are lower than those in the mother tongue group, the recognition rate of oboe and trumpet in wind instruments was low in both groups, and the recognition rate of oboe and trumpet in foreign language group was high.

Psychometric Characteristics of Different Versions of Vocal Tract Discomfort (VTD) Scale: A Systematic Review

Background: This review compare different Vocal Tract Discomfort (VTD) versions. This comparison is based on their validity and reliability parameters in the translation and adaptation process. We aimed to prepare numerical evidence to prove the validity of this easy screening tool. VTD is able to perform an accurate diagnosis of voice discomforts, particularly in primary stages. Methods: Articles were selected from databases including Google Scholar, PubMed, Science Direct and Scopus. Our relevant papers were gathered by searching the phrase: VTD in titles, abstracts, and keys. Studies not followed an adaptive procedure were excluded. Based on the selection criteria, out of 23 collected articles, eight were studied in this review. Results: Standard psychometric protocol steps were followed in all selected articles and simultaneously high reliability and validity were reported in their translation procedure. Such analogous results may confirm the efficacy of this research tool. Conclusion: This review affirms VTD, perceptual patient-based scale, as a valuable evaluation tool to investigate the occurrence of voice disorders. Based on its structure and performance, VTD can work as a quick and precise source for predicting vocal discomforts. Moreover, this capability can help professional therapists to plan more efficient treatment procedures. The other important advantage of VTD is its diagnostic and prognostic capacity to inform patients about their current and future conditions so that they would be motivated to follow treatment procedures more consistently.