Interventional Conditions Research Articles

Regular changes in foot strike pattern during prolonged downhill running do not influence neuromuscular, energetics, or biomechanical parameters

Research has suggested that a high variability in foot strike pattern during downhill running is associated with lower neuromuscular fatigue of the plantar flexors (PF). Given the popularity of trail running, we designed an intervention study to investigate whether a strategy with regular changes in foot strike pattern during downhill running could reduce the extent of fatigue on neuromuscular, energetics and biomechanical parameters as well as increase an uphill time-to-exhaustion trial (TTE) performance. Fourteen experienced trail runners completed two interventional conditions (separated by 15 days) in a pseudo-randomised and counter-balanced order that consisted of 2.5-h of treadmill graded running with (switch condition) or without (control condition) a change between fore- and rear-foot strike pattern every 30 s during the downhill sections. Pre and Post, neuromuscular tests were performed to assess PF central and peripheral fatigue. Energy cost of running was assessed using an indirect calorimetry system and biomechanical gait parameters were acquired with an instrumented treadmill. TTE was performed after both the graded running conditions. There were not significant condition × time interactions (p ≥ .085) for any of the variables considered, and TTE was not different between the two conditions (p = .755). A deliberate strategy to alternate between foot strike patterns did not reduce the extent of fatigue during prolonged graded running. We suggest that it is not the ability to switch between foot strike patterns that minimises fatigue; rather the ability to adapt foot strike pattern to the terrain and therefore a better running technique.

Anaesthetic management for endobronchial valve insertion: lessons learned from a single centre retrospective series and a literature review

BackgroundEndoscopic lung volume reduction using one or more endobronchial valves is a treatment option for a select group of patients with severe emphysema. Patients presenting for this procedure pose various challenges to the anaesthetist; in addition to their lung condition, they are often elderly with multiple comorbidities. The procedure is usually performed outside the operating room. Monitored anaesthesia care with intravenous sedation, and general anaesthesia with an endotracheal tube have both been described for these procedures, aiming for adequate ventilation and haemodynamic stability.MethodsWe present our experience on 20 of these procedures in relation to the anaesthetic techniques employed and discuss the perioperative challenges involved in managing these cases.ResultsTwenty one planned endobronchial valve insertion procedures were identified on 18 patients. There were ten cases of monitored anaesthesia care with sedation and 10 cases which used general anaesthesia with an endotracheal tube. Two have been excluded; one had features of anaphylaxis and the procedure was abandoned, and the other required conversion from monitored anaesthesia care to general anaesthesia with endotracheal tube.ConclusionsBoth monitored anaesthesia care with sedation and general anaesthesia with endotracheal tube were well tolerated during endobronchial valve insertion procedures. General anaesthesia with endotracheal tube may offer better interventional conditions, patient comfort and reduced anaesthetic time.

Gender identity development in the shadow of socialization: a grounded theory approach.

Gender identity is one of the basic forms of identity which has a key role in the mental health during adolescence. The present study was conducted to determine the process of gender identity development among Iranian female adolescents. In this grounded theory study, semi-structured interviews were conducted with 55 purposefully and theoretical selected participants including 30 female adolescents and 25 key informants who lived in urban society of Isfahan, Iran, in 2016-2018. Data were analyzed using Strauss and Corbin's mode of analysis (2008), through constant comparative method, applying levels of open, axial, and selective coding with MAXQDA software. Development of gender identity in the shadow of socialization was presented as the core category extracted from the data in this study. Female adolescents would use "sexual self-expression during puberty," "attachment to parents and peers," "tendency towards the opposite sex," and "effort for social acceptance" as the main strategies in the development of gender identity until achieving "stabilized gender identity." "Girls' communicational skills" and "parents' empowerment" were the causal conditions in this process. "Gender differences" and "sociocultural texture of the society" were the contextual conditions and the influence of "peers" and "media" was the interventional conditions in the development of gender identity in female adolescents. Improving girls' communicational skills, empowering parents for managing their interactions with their daughters, adjusting gender roles in the society, and creating appropriate content by the media could have an important role in helping female adolescents achieving stabilized gender identity.

여성 퍼스널 트레이너의 몸 관리와 자리매김하기

This study develops a substantive theory by analyzing how women personal trainers perceive and interpret body management, and how they establish themselves as personal trainers. The study subjects were limited to women personal trainers who had experiences of participating in a body fitness competition. The author selected the subjects by snowball sampling which is used for qualitative studies. They were recommended by a female personal trainer who was the author’s long-time acquaintance. After the subjects received explanation on the intention of the study, 8 subjects who had intention to participate in the study were selected. For the data collection, the non-participant observation and in-depth interview were conducted. The data analysis was conducted according to open coding, axial coding and selective coding which were provided by Strauss and Corbin (1998). In the source data collected by the in-depth interview, 81 concepts, 15 subcategories and 9 upper categories were derived. The central phenomena were found to be body management and participating competitions, and the causal situations for these phenomena weer prejudice and anxiety for the occupation. These causal situations reflected context situations of body management fever and career building. In addition, the subjects gave effort to manage their bodies and adapt to be a personal trainer based on interventional conditions such as achieving recognition or self-satisfaction. With interactive strategies such as seeking fun in body management and having self-esteem, they established themselves as women personal trainers. Their experiences of body management had positive effects on establishing themselves as trainers while they instructed the fitness center members using their experiences. These experiences are the driving force that makes the subjects continue body management. These become their own ability, which can be the strategy to establish themselves as women trainers in the male-oriented world of trainers.

Qualitative analysis of the process of restoring social esteem by the women with multiple sclerosis

The present study has been conducted with the purpose of analyzing the process of restoring the social esteem of the women with multiple sclerosis (MS) in the Iranian society through the approach of grounded theory. To this end, a number of 10 women with MS who had referred to Sina Hospital and Iranian MS Society were selected through theoretical sampling. The data collection was conducted through semi-structured interview, on-field note taking, investigating the documents, and memoing. Based on analyzing data, six processes emerged which, according to the order of occurrence, are: (1) seeking and finding treatment, (2) change of the perceived social esteem, (3) struggle to preserve or regain possessions, (4) seeking support and sponsorship, (5) attempt to achieve a desirable consistency, and ultimately, (6) restoring social esteem. The results obtained from this study indicated that though a considerable number of the cases feel changes in their social esteem due to rejection, being abandoned by their spouses, emergence of a co-wife, feeling of burden, financial shortages, and divorce, depending on interventional and contextual conditions including belief in spirituality and supernatural, patient and society’s awareness of the nature of the disease, and the extent of social support, they have experienced varied circumstances. Ultimately, a central level titled “repeated and recurring adjustment of goals” was proposed to reflect the process of restoring the social esteem of the women with MS in Iran.

A human-like visual-attention-based artificial vision system for wildland firefighting assistance

In this work we contribute to development of a “Human-like Visual-Attention-based Artificial Vision” system for boosting firefighters’ awareness about the hostile environment in which they are supposed to move along. Taking advantage from artificial visual-attention, the investigated system’s conduct may be adapted to firefighter’s way of gazing by acquiring some kind of human-like artificial visual neatness supporting firefighters in interventional conditions’ evaluation or in their appraisal of the rescue conditions of people in distress dying out within the disaster. We achieve such a challenging goal by combining a statistically-founded bio-inspired saliency detection model with a Machine-Learning-based human-eye-fixation model. Hybridization of the two above-mentioned models leads to a system able to tune its parameters in order to fit human-like gazing of the inspected environment. It opens appealing perspectives in computer-aided firefighters’ assistance boosting their awareness about the hostile environment in which they are supposed to evolve. Using as well various available wildland fires images’ databases as an implementation of the investigated concept on a 6-wheeled mobile robot equipped with communication facilities, we provide experimental results showing the plausibility as well as the efficiency of the proposed system.

A Grounded theory study of the intention of nurses to leave the profession.

ABSTRACTObjective:this study explores the process of the development of an intention to leave bedside nursing. Method:the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results:according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion:the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them.

Grounded theory approach on Dance Teaching Artists' Professionality Formation Process for Arts and Culture Education

문화예술교육정책에 힘입어 지난 10년간 학교와 사회의 다양한 영역에서 ‘가르치는 무용가(dance teaching artist)"의 일자리가 늘어난 것은 고무적인 일이었다. 그러나 계약직이라는 고용불안과 처우, 직무환경의 개선 등 현실적으로 직면하는 어려움들은 여전히 산적해 있다. 이러한 현안을 해결하기 위해서는 그들의 전문성을 발굴하고 입증해 내는 학문적, 실천적 노력들이 지속적으로 필요하다. 그들이 어떤 역할을 하는 사람들인지, 교육현장과 사회에서 어떠한 기여를 하고 있는지, 그리고 그들의 전문성은 어떻게 형성되는지를 언급할 필요가 있다. 이에 이 연구는 ‘가르치는 무용가’의 전문성 형성과정에 관한 근거이론 접근을 시도하였으며, 다음과 같은 결론을 도출하였다. 첫째, 총 223개의 개념어, 33개의 하위범주, 14개의 상위범주로 범주화하였으며 이 중 역할정의, 핵심가치, 창의적 과정을 포함하는 ‘가르치는 무용가의 문화예술교육 전문역량’을 중심현상으로 보았다. 이에 영향을 미치는 조건들로, ‘학위와 자격’, ‘필연적인 교수경로’를 인과적 조건으로, 그리고 ‘문화복지 확대’와 ‘전문인력 제도’를 맥락적 조건으로 도출하였다. 또한 ‘열악한 처우’, ‘이상과의 간극’, ‘역할 혼합성’의 중재적 조건과 ‘예술적 상호작용’, ‘맥락의 확장’, ‘집단 지성화’ 등의 상호작용전략 속에서 결과적으로 ‘교육자와 예술가 사이의 균형’, ‘학교-사회의 창조적 매개’, ‘무용교육의 층위 높이기’의 실천을 지향하고 있다는 상황적 관계를 진술하였다. 둘째, 이 연구는 선택코딩을 통해 ‘학교와 사회에서 무용을 통해 문화예술교육의 가치를 실천하며 가르치는 무용가로 성장하기’를 핵심범주로 도출하였으며, 무용교육 실행의 가치지향점이라는 속성에 따라 ‘무용치유 중심형’과 ‘창의교육 중심형’의 유형화를 도출하였다. 끝으로 이 연구는 무용교육의 전문성 개발이라는 화두가 더 이상 장르중심 교육에 국한하지 않고, 문화예술교육의 환경과 그 패러다임 변화에 부응할 수 있는 융복합의 확장된 영역을 추구하고 있으며, 정체된 전문성이 아닌 지속적으로 개발되어지는 과정의 산물로 그 형성 과정을 보아야 한다는 관점에서 Strauss와 Corbin(1998)의 근거이론을 토대로 과정과 맥락 중심으로 논의하였다. This study attempted to approach the grounded theory on dance teaching artists" professional competency formation process for culture and arts education. For the foregoing, this study analyzed the process of dance teaching artists" professional competency formation for culture and arts education based on Strauss and Corbin(1998)’s coding paradigm. It was categorized as 223 concept words, 33 subcategories and 14 upper categories, and the result of axial coding is as follows. While competency of dancers who teach role definition, core values and creative process were considered a center phenomenon, degree and qualification, customary image of dance educator and teaching experience affecting the aforementioned were regarded as causal conditions, and contextual conditions were in interpreted to be based on the expansion of culture and welfare with professional manpower system. In addition, it was interpreted to cause the results such as balance between educator and artist, creative intermediation between school-society, raising the level of dance education through interaction strategies like expansion of artistic interaction, context and collective intellectualization etc. in the interventional conditions such as poor treatment, gap with ideals, mixed role etc. According to the selective coding, this study stereotyped dance teaching artists" professional competency into dance healing-oriented type and creative education-oriented type on the basis of attribute which is a value directing point of the execution of dance education, deducting ‘Growing to a dancer who teaches with professional competency fulfilling the value of culture and arts education in schools and communities’ as a core category.

Improving Pediatric Radiography Patient Stress, Mood, and Parental Satisfaction Through Positive Environmental Distractions: A Randomized Control Trial

To evaluate how a positive environmental distraction intervention impacted pediatric radiography patient behavioral stress-responses, mood states, and parental satisfaction. Behavioral observation, rating scales, surveys on 182 pediatric patients and their parents randomly assigned to three positive distraction levels (minimum, light, light and animation). Under interventional conditions, patients exhibited less low-stress coping behaviors (ps<0.001-0.007) and more verbal behaviors indicating positive affect (p=0.003); parents more favorably rated environmental pleasantness (ps<0.001), sense of environmental control (ps=0.002), and willingness to return and recommend the facility (ps=0.001-0.005). The intervention improved pediatric radiography experience but needs further investigation in more stressful settings.

Acute urinary retention: a few simple rules for a successful catheterization

Acute urinary retention is a common emergency condition in elderly men. Transurethral and suprapubic catheterization are easy and safe procedures provided that a few simple rules are followed. Primarily, a transurethral catheter is placed if there is no urethral injury or stricture. Local anaesthesia of the urethra up to the sphincter region and a well-stretched penis warrant an atraumatic insertion of the catheter into the bladder. The use of a thick catheter with a round tip or of a catheter with a bended tip under rectal guidance facilitate the insertion of the catheter in difficult conditions. Alternatively, a suprapubic catheterization can be performed provided that no contraindication such as history or suspicion of transitional cell carcinoma is present. Optimal interventional conditions using ultrasound-guidance are mandatory in patients after abdominal surgery and with hemorrhagic diathesis in view of a safe and straight-forward placement of the suprapubic catheterization. In case of persistent bleeding after insertion of a suprapubic catheter, the suprapubic catheter should be replaced by one with a balloon blocked and kept under tension for several minutes.

Suboptimal interventional conditions for the occlusion of ruptured intracranial aneurysms do not increase periprocedural complications and poor clinical outcomes.

Occluding a ruptured intracranial aneurysm as early as possible may entail certain periprocedural conditions that compromise the outcome. The aim of the present study was to evaluate the effectiveness, safety, and clinical outcome of endovascular coiling procedures performed on an emergency basis under potentially suboptimal conditions, and to compare results with those from scheduled procedures under potentially optimal conditions. Interventions performed on 66 SAH patients were retrospectively analysed by classifying them into two groups: under emergency (within three hours from diagnosis or during non-standard working hours) or scheduled conditions. A binary logistic regression analysis was also performed to identify characteristics associated with poor outcomes. No differences in effectiveness, periprocedural complications, or clinical outcomes were found between the two groups. Rebleeding was detected in 4.8 % of the emergency interventions and 2.2 % of the scheduled interventions. Multivariate analysis identified age and Hunt and Hess grade, but no conditions of treatment, as the factors associated to poor outcome. Suboptimal interventional conditions for occluding ruptured intracranial aneurysms, such as performing procedures outside of standard working hours or within three hours of diagnosis, do not result in increased periprocedural complications and poor clinical outcomes compared with scheduled procedures under potentially optimal conditions. These results suggest the need for treatment to be provided as soon as possible.

Plasma PCSK9 concentrations during an oral fat load and after short term high-fat, high-fat high-protein and high-fructose diets

BackgroundPCSK9 (Proprotein Convertase Subtilisin Kexin type 9) is a circulating protein that promotes hypercholesterolemia by decreasing hepatic LDL receptor protein. Under non interventional conditions, its expression is driven by sterol response element binding protein 2 (SREBP2) and follows a diurnal rhythm synchronous with cholesterol synthesis. Plasma PCSK9 is associated to LDL-C and to a lesser extent plasma triglycerides and insulin resistance. We aimed to verify the effect on plasma PCSK9 concentrations of dietary interventions that affect these parameters.MethodsWe performed nutritional interventions in young healthy male volunteers and offspring of type 2 diabetic (OffT2D) patients that are more prone to develop insulin resistance, including: i) acute post-prandial hyperlipidemic challenge (n=10), ii) 4 days of high-fat (HF) or high-fat/high-protein (HFHP) (n=10), iii) 7 (HFruc1, n=16) or 6 (HFruc2, n=9) days of hypercaloric high-fructose diets. An acute oral fat load was also performed in two patients bearing the R104C-V114A loss-of-function (LOF) PCSK9 mutation. Plasma PCSK9 concentrations were measured by ELISA. For the HFruc1 study, intrahepatocellular (IHCL) and intramyocellular lipids were measured by 1H magnetic resonance spectroscopy. Hepatic and whole-body insulin sensitivity was assessed with a two-step hyperinsulinemic-euglycemic clamp (0.3 and 1.0 mU.kg-1.min-1).FindingsHF and HFHP short-term diets, as well as an acute hyperlipidemic oral load, did not significantly change PCSK9 concentrations. In addition, post-prandial plasma triglyceride excursion was not altered in two carriers of PCSK9 LOF mutation compared with non carriers. In contrast, hypercaloric 7-day HFruc1 diet increased plasma PCSK9 concentrations by 28% (p=0.05) in healthy volunteers and by 34% (p=0.001) in OffT2D patients. In another independent study, 6-day HFruc2 diet increased plasma PCSK9 levels by 93% (p<0.0001) in young healthy male volunteers. Spearman’s correlations revealed that plasma PCSK9 concentrations upon 7-day HFruc1 diet were positively associated with plasma triglycerides (r=0.54, p=0.01) and IHCL (r=0.56, p=0.001), and inversely correlated with hepatic (r=0.54, p=0.014) and whole-body (r=−0.59, p=0.0065) insulin sensitivity.ConclusionsPlasma PCSK9 concentrations vary minimally in response to a short term high-fat diet and they are not accompanied with changes in cholesterolemia upon high-fructose diet. Short-term high-fructose intake increased plasma PCSK9 levels, independent on cholesterol synthesis, suggesting a regulation independent of SREBP-2. Upon this diet, PCSK9 is associated with insulin resistance, hepatic steatosis and plasma triglycerides.

Video-based Gait Analysis for Functional Evaluation of Healing Achilles Tendon in Rats

Video-based walking track systems have been developed for gait analysis in rat models. However, there is no previous study using video-based tracking systems to address the gait parameters to evaluate the recovery of Achilles tendon rupture models. This study conducted a comprehensive gait analysis using a video-based image processing system. Eighteen Sprague-Dawley rats were randomly assigned to one of three interventional conditions: sham surgery, Achilles tendon repair, and Achilles tendon defect. After surgery, all animals were evaluated using a video-based walking track system. The gait parameters and the Achilles functional index (AFI) were further analyzed. The ankle joint angles of the injury side at mid-stance and pre-swing were highly correlated with the AFI. However, lack of sensitivity was found for the AFI. Increased measurement sensitivity of the Achilles tendon healing condition was found in the ankle joint angle of the involved side at the pre-swing and the level of asymmetry of the hindlimb joint position and stance/swing time. The overall sensitivity of the ankle motion analysis was significantly higher than that of AFI. We conclude that the ankle motion analysis is a reliable, reproducible, and sensitive tool for Achilles tendon analysis in rats.

An active pixel sensor to detect diffused X-ray during Interventional Radiology procedure

Interventional radiologists and staff members are frequently exposed to protracted and fractionated low doses of ionizing radiation due to diffused X-ray radiation. The authors propose a novel approach to monitor on line staff during their interventions by using a device based on an Active Pixel Sensor developed for tracking applications. Two different photodiode configurations have been tested in standard Interventional Radiology working conditions. Both options have demonstrated the capability to measure the photon flux and the energy flux to a sufficient degree of uncertainty.

Evaluierung einer neuen Seldinger-Nadel für computertomografisch gesteuerte Interventionen: Erste Erfahrungen

To evaluate a new Seldinger puncture device for computed tomography-guided interventions under difficult conditions, to analyze applicability, and to investigate assets and drawbacks. From November 2007 to March 2008, we performed CT-guided interventions in 16 patients (7 women, 9 men; mean age 62 years old) using a new 20G-Seldinger needle (Sika-Med, Wiehl, Germany). This novel needle serves as a guide for many different interventional devices due to a guide wire welded on the proximal needle end. It allows continuous application of anesthesia via four tiny holes at the distal needle end until the region of interest is reached. Each intervention was subject to difficult interventional conditions. The indications for intervention were drainage (n = 7), Trucut biopsy of tumor (n = 8) and radiofrequency ablation (n = 1). Handling, success, advantages, drawbacks, complications and patient tolerance were noted after each procedure. A pain scale from 1 - 10 was used to grade the pain level during the intervention. All interventions were performed successfully and no severe complications were observed. Patient tolerance was very good resulting in a mean pain score of 2 +/- 1. Regions with dangerous and difficult access were successfully reached with the new Seldinger needle in 15 of 16 cases by dilatation of the puncture tract and continuous administration of local anesthesia via the system. Furthermore, different devices such as Trucut systems and a drainage catheter were able to be inserted without complication via the needle. With a proximal removable luer-lock connection, liquid material was able to be aspirated in six cases. Under difficult interventional conditions, the use of a Seldinger needle as a reliable technique for CT-guided interventions can provide a safe and successful procedure.