Diagnosis and Management of Ecthyma Gangrenosum in Chronic Renal Failure Patient

Jordan D Frey,Jo-Ann M Latkowski,Eddie Louie,Ernest S Chiu 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.3

Preoperative Embolization of Cerebral Arteriovenous Malformations with Silk Suture and Particles: Technical Considerations and Outcomes

Jordan R. Conger,Avery J. Evans,Dale Ding,Daniel M. Raper,Robert M. Starke,Christopher R. Durst,Kenneth C. Liu,Mary E. Jensen 대한뇌혈관외과학회 2016 Journal of Cerebrovascular and Endovascular Neuros Vol.18 No.2

Objective:Embolization of cerebral arteriovenous malformations (AVMs) is commonly performed prior to surgical resection in order to reduce intraoperative bleeding and improve the safety of resection. Although most modern embolization procedures utilize permanent embolic agents, silk suture and polyvinyl alcohol (PVA) particles may offer unique advantages for preoperative devascularization. The aims of this retrospective cohort study are to describe the technical considerations and determine the outcomes for preoperative silk suture and PVA particle embolization (SPE) of AVMs. Materials and Methods:We performed a retrospective review of our AVM embolization database. AVM patients who underwent preoperative SPE and subsequent surgical resection were included for analysis. Baseline patient demographics, AVM characteristics, embolization and operative records, and post-treatment outcomes were reviewed. Results:A total of 11 patients who underwent 12 preoperative SPE procedures were included for analysis. Five AVMs were ruptured (45%), and the median nidus volume was 3.0 cm3 (range: 1.3-42.9 cm3). The Spetzler-Martin grade was I-II in seven patients (64%) and III-IV in four patients (36%). The degree of nidal obliteration was less than 25% in two procedures (17%), 25-50% in one procedure (8%), 50-75% in eight procedures (67%), and greater than 75% in one procedure (8%). The rates of post-embolization AVM hemorrhage and mortality were 8% and 0%, respectively. The postoperative angiographic obliteration rate was 100%, and the modified Rankin Scale score improved or stable in 91% of patients (median follow-up duration 2 months). Conclusion:Preoperative AVM SPE affords a reasonable risk to benefit profile for appropriately selected patients.

Are coach education programmes the most effective method for coach development?

Jordan Maclean,Ross Lorimer 한국코칭능력개발원 2016 International Journal of Coaching Science Vol.10 No.2

The purpose of this study is to establish whether coaches from a multi-sport context develop most effectively through coach education programmes and whether formal learning is fostering coach effectiveness. A sample of eight qualified male multi-sports’ coaches participated with an age range of 24 to 52 years (M = 32.6, ± = 8.9) and 9 to 18 years coaching experience (M = 12.6, ± = 3.8). Qualitative semi structured interviews were employed, lasting approximately 30 to 60 minutes. The data then underwent a thematic analysis process reducing the data into six overarching themes: values of the coach; the coach’s role on athlete development; forms of learning; barriers regarding coach education; role of governing bodies; coaches career pathway. The findings of the study indicated coaches access a wide range of sources to enhance their practice, but informal learning was preferred (interacting with other coaches and learning by doing). This resulted from numerous barriers experienced surrounding the delivery, cost and access to coach education programmes preventing coaches from progressing through the pathway. However, coaches in the study feel coach education should be a mandatory process for every coach. The findings have implications for policymakers and sport organisations in developing their coach education structure.

No causal effects of serum urate levels on the risk of chronic kidney disease: A Mendelian randomization study

Jordan, Daniel M.,Choi, Hyon K.,Verbanck, Marie,Topless, Ruth,Won, Hong-Hee,Nadkarni, Girish,Merriman, Tony R.,Do, Ron Public Library of Science 2019 PLoS medicine Vol.16 No.1

<▼1><P><B>Background</B></P><P>Studies have shown strong positive associations between serum urate (SU) levels and chronic kidney disease (CKD) risk; however, whether the relation is causal remains uncertain. We evaluate whether genetic data are consistent with a causal impact of SU level on the risk of CKD and estimated glomerular filtration rate (eGFR).</P><P><B>Methods and findings</B></P><P>We used Mendelian randomization (MR) methods to evaluate the presence of a causal effect. We used aggregated genome-wide association data (<I>N</I> = 110,347 for SU, <I>N</I> = 69,374 for gout, <I>N</I> = 133,413 for eGFR, <I>N</I> = 117,165 for CKD), electronic-medical-record-linked UK Biobank data (<I>N</I> = 335,212), and population-based cohorts (<I>N</I> = 13,425), all in individuals of European ancestry, for SU levels and CKD. Our MR analysis showed that SU has a causal effect on neither eGFR level nor CKD risk across all MR analyses (all <I>P</I> > 0.05). These null associations contrasted with our epidemiological association findings from the 4 population-based cohorts (change in eGFR level per 1-mg/dl [59.48 μmol/l] increase in SU: −1.99 ml/min/1.73 m<SUP>2</SUP>; 95% CI −2.86 to −1.11; <I>P</I> = 8.08 × 10<SUP>−6</SUP>; odds ratio [OR] for CKD: 1.48; 95% CI 1.32 to 1.65; <I>P</I> = 1.52 × 10<SUP>−11</SUP>). In contrast, the same MR approaches showed that SU has a causal effect on the risk of gout (OR estimates ranging from 3.41 to 6.04 per 1-mg/dl increase in SU, all <I>P</I> < 10<SUP>−3</SUP>), which served as a positive control of our approach. Overall, our MR analysis had >99% power to detect a causal effect of SU level on the risk of CKD of the same magnitude as the observed epidemiological association between SU and CKD. Limitations of this study include the lifelong effect of a genetic perturbation not being the same as an acute perturbation, the inability to study non-European populations, and some sample overlap between the datasets used in the study.</P><P><B>Conclusions</B></P><P>Evidence from our series of causal inference approaches using genetics does not support a causal effect of SU level on eGFR level or CKD risk. Reducing SU levels is unlikely to reduce the risk of CKD development.</P></▼1><▼2><P><B>Author summary</B></P><P><B>Why was this study done?</B></P><P>Epidemiological studies have shown strong correlations between serum urate (SU) levels and chronic kidney disease (CKD) risk.</P><P>Elevated SU levels are often found in patients with CKD, but it is not clear whether high serum urate is a cause of kidney disease or just a common co-occurrence.</P><P>Previous studies examining whether SU levels had a causal effect on CKD were limited due to not having large enough samples to detect a true causal relationship if it existed and/or had limitations related to the methodology.</P><P>Several clinical trials have been started that aim to use urate-lowering medication to prevent CKD.</P><P><B>What did the authors do and find?</B></P><P>To determine whether SU level has a causal effect on CKD, we used a methodology known as Mendelian randomization to test whether genetic variants known to increase SU level also increased the risk of CKD.</P><P>We used multiple datasets to perform Mendelian randomization analyses, which included meta-analyses performed across multiple population-based cohorts, 4 individual population-based cohorts, and the large electronic-medical-record-linked UK Biobank.</P><P>Across all datasets, we found no significant causal connection between SU level and risk of CKD.</P><P><B>What do these findings mean?</B></P><P>Our findings do not support a causal role of SU level in CKD.</P><P>Lower SU levels would be unlikely to translate into reduced risk of CKD.</P></▼2>

Mutualism: A Factor in Ecological Succession Through its Influence on Nutrient Resource Ratios

Jordan,Carl F,Lee,Do-Won 서울大學校 環境大學院 1994 環境論叢 Vol.32 No.-

Mutualism as well as competition is important in succession. Plant communities change the resource base upon which they survive through mutualistic interaction with microbes. The changing resource base in turn causes a change in the plant communities which depend on the resources. When a series of these interactions begins on a nutrient-poor substrate, the ratio of resources often changes in a regular and predictable sequence. The resultant change in plant communities may be considered to be succession.

옥외환기용 공기의 최적 고정 백분율을 결정하는 방법

Jordan Carl H. 대한설비공학회 1973 설비저널 Vol.2 No.3

Cutaneous Patches to Monitor Myoelectric Activity of the Gastrointestinal Tract in Postoperative Pediatric Patients

Jordan S. Taylor,Vivian de Ruijter,Ryan Brewster,Anand Navalgund,Lindsay Axelrod,Steve Axelrod,James C.Y. Dunn,James K. Wall 대한소아소화기영양학회 2019 Pediatric gastroenterology, hepatology & nutrition Vol.22 No.6

Purpose: Limited means exist to assess gastrointestinal activity in pediatric patients postoperatively. Recently, myoelectric gastrointestinal activity recorded by cutaneous patches has been shown in adult patients to be predictive of clinical return of gastrointestinal function postoperatively. The aim of this case series is to demonstrate the feasibility of this system in pediatric patients and to correlate myoelectric signals with return of bowel function clinically. Methods: Pediatric patients undergoing abdominal surgery were recruited to have wireless patches placed on the abdomen within two hours postoperatively. Myoelectric data were transmitted wirelessly to a mobile device with a user-interface and forwarded to a cloud server where processing algorithms identified episodes of motor activity, quantified their parameters and nominally assigned them to specific gastrointestinal organs based on their frequencies. Results: Three patients (ages 5 months, 4 year, 16 year) were recruited for this study. Multiple patches were placed on the older subjects, while the youngest had a single patch due to space limitations. Rhythmic signals of the stomach, small intestine, and colon could be identified in all three subjects. Patients showed gradual increase in myoelectric intestinal and colonic activity leading up to the first recorded bowel movement. Conclusion: Measuring myoelectric intestinal activity continuously using a wireless patch system is feasible in a wide age range of pediatric patients. The increase in activity over time correlated well with the patients' return of bowel function. More studies are planned to determine if this technology can predict return of bowel function or differentiate between physiologic ileus and pathologic conditions.

Defect Reduction in MBE-Grown AlN by Multicycle Rapid Thermal Annealing

Jordan D. Greenlee,Brendan Gunning,Boris N. Feigelson,Travis J. Anderson,Andrew D. Koehler,Karl D. Hobart,Francis J. Kub,W. Alan Doolittle 대한금속·재료학회 2016 ELECTRONIC MATERIALS LETTERS Vol.12 No.1

Multicycle rapid thermal annealing (MRTA) is shown to reduce thedefect density of molecular beam epitaxially grown AlN films. Nodamage to the AlN surface occurred after performing the MRTA processat 1520°C. However, the individual grain structure was altered, with theemergence of step edges. This change in grain structure and diffusion ofAlN resulted in an improvement in the crystalline structure. The RamanE2 linewidth decreased, confirming an improvement in crystal quality. The optical band edge of the AlN maintained the expected value of6.2 eV throughout MRTA annealing, and the band edge sharpened afterMRTA annealing at increased temperatures, providing further evidence ofcrystalline improvement. X-ray diffraction shows a substantial improvementin the (002) and (102) rocking curve FWHM for both the 1400 and1520°C MRTA annealing conditions compared to the as-grown films,indicating that the screw and edge type dislocation densities decreased. Overall, the MRTA post-growth annealing of AlN lowers defect density,and thus will be a key step to improving optoelectronic and powerelectronic devices.

Obesity as a Possible Risk Factor for Lost-time Injury in Registered Nurses: A Literature Review

Jordan, Gillian,Nowrouzi-Kia, Behnam,Gohar, Basem,Nowrouzi, Behdin Occupational Safety and Health Research Institute 2015 Safety and health at work Vol.6 No.1

Time-loss injuries are still a major occurrence in Canada, injuring thousands of Canadian workers each year. With obesity rates on the rise across the country, as well as around the world, it is important that the possible effects of obesity in the workplace be fully understood, especially those effects linked to lost-time injuries. The aim of this paper was to evaluate predictors of workplace lost-time injuries and how they may be related to obesity or high body mass index by examining factors associated with lost-time injuries in the health care sector, a well-studied industry with the highest number of reported time loss injuries in Canada. A literature review focusing on lost-time injuries in Registered Nurses (RNs) was conducted using the keywords and terms: lost time injury, workers' compensation, occupational injury, workplace injury, injury, injuries, work, workplace, occupational, nurse, registered nurse, RN, health care, predictors, risk factors, risk, risks, cause, causes, obese, obesity, and body mass index. Data on predictors or factors associated with lost-time injuries in RNs were gathered and organized using Loisel's Work Disability Prevention Management Model and extrapolated upon using existing literature surrounding obesity in the Canadian workplace.

Extensive Resection for Treatment of Locally Advanced Primary Mucinous Adenocarcinoma Arising From Fistula-in-Ano

Jordan Au,Francis M. Hulme-Moir,Andrew Herd,Mathew A. Kozman 대한대장항문학회 2021 Annals of Coloproctolgy Vol.37 No.S

We report a case of a 66-year-old male who presented with a locally advanced primary mucinous adenocarcinoma arising from a fistula-in-ano. The presentation was typical for perianal sepsis and fistula-in-ano with anal pain and chronic discharge. Initial treatments with fistula debridement and seton were performed. Subsequent review of histology revealed underlying adenocarcinoma, while magnetic resonance imaging (MRI) showed local invasion into the prostate. The patient received neoadjuvant chemoradiotherapy followed by pelvic exenteration to maximize the chance of achieving cure. Features of this case are discussed together with its implications, including treatment guidelines and typical MRI findings.