221 results on '"Jones BM"'
Search Results
2. Size distributions of arctic waterbodies reveal consistent relations in their statistical moments in space and time
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Muster, S, Riley, WJ, Roth, K, Langer, M, Aleina, FC, Koven, CD, Lange, S, Bartsch, A, Grosse, G, Wilson, CJ, Jones, BM, and Boike, J
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permafrost ,hydrology ,waterbodies ,size distribution ,thermokarst ,statistical moments ,ponds ,lakes ,Geology ,Geophysics ,Physical Geography and Environmental Geoscience - Abstract
Arctic lowlands are characterized by large numbers of small waterbodies, which are known to affect surface energy budgets and the global carbon cycle. Statistical analysis of their size distributions has been hindered by the shortage of observations at sufficiently high spatial resolutions. This situation has now changed with the high-resolution (
- Published
- 2019
3. Applied behavior analysis is ideal for the development of a land mine detection technology using animals
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Jones Bm
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Olfactory perception ,Special Section: Behavior Analysis and Animal Scent Detection ,Social Psychology ,Operations research ,Computer science ,medicine.medical_treatment ,05 social sciences ,Computer security ,computer.software_genre ,Humanitarian demining ,Ideal (ethics) ,Unexploded ordnance ,Clinical Psychology ,Identification (information) ,0502 economics and business ,medicine ,0501 psychology and cognitive sciences ,050102 behavioral science & comparative psychology ,Applied behavior analysis ,Land mine ,computer ,050203 business & management - Abstract
The detection and subsequent removal of land mines and unexploded ordnance (UXO) from many developing countries are slow, expensive, and dangerous tasks, but have the potential to improve the well-being of millions of people. Consequently, those involved with humanitarian mine and UXO clearance are actively searching for new and more efficient detection technologies. Remote explosive scent tracing (REST) using trained dogs has the potential to be one such technology. However, details regarding how best to train, test, and deploy dogs in this role have never been made publicly available. This article describes how the key characteristics of applied behavior analysis, as described by Baer, Wolf and Risley (1968, 1987), served as important objectives for the research and development of the behavioral technology component of REST while the author worked in humanitarian demining.
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- 2011
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4. Quantifying the performance of a top-down natural ventilation Windcatcher™
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Jones, BM and Kirby, R
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Building & Construction - Abstract
Estimating the performance of a natural ventilation system is very important if one is to correctly size the system for a particular application. Estimating the performance of a Windcatcher™ is complicated by the complex flow patterns that occur during the top-down ventilation process. Methods for predicting Windcatcher™ performance can currently be separated into simplistic analytic methods such as the envelope flow model and the use of complex and time consuming numerical methods such as CFD. This article presents an alternative semi-empirical approach in which a detailed analytic model makes use of experimental data published in the literature for 500 mm square Windcatchers™, in order to provide a fast but accurate estimate of Windcatcher™ performance. Included in the model are buoyancy effects, the effect of changes in wind speed and direction, as well as the treatment of sealed and unsealed rooms. The semi-empirical predictions obtained are shown to compare well with measured data and CFD predictions, and air buoyancy is shown only to be significant at relatively low flow velocities. In addition, a very simple algorithm is proposed for quantifying the air flow rates from a room induced by a Windcatcher™ in the absence of buoyancy effects. © 2009 Elsevier Ltd. All rights reserved.
- Published
- 2009
5. Indoor air quality in U.K. school classrooms ventilated by natural ventilation windcatchers
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Jones, BM, Kirby, R, Jones, BM, and Kirby, R
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The provision of good IAQ in schools is important both for the health of students and in maximising educational achievement. It is, however, common for school classrooms to be significantly under-ventilated and this can lead to high levels of CO 2 and other pollutants. Natural ventilation offers the potential to improve IAQ within schools whilst, at the same time reducing running and maintenance costs. Accordingly, this article examines a natural ventilation strategy based on the use of a roof mounted split-duct Windcatcher ventilator. Here, 16 U.K. classrooms are studied and CO 2, temperature, relative humidity and ventilation rates are measured for the summer and winter seasons. Results show that, during the summer months, the ventilator is capable of significantly improving ventilation rates as well as reducing CO 2 levels, especially when used in combination with open windows. However, in the winter months, the ventilator is seen not to open for a sufficient length of time and so CO 2 levels rise above those required in the standards. Thus, the ventilator is shown to have the potential to improve IAQ within school classrooms, but the operation of the ventilator should be carefully controlled in order to realise these benefits. It is common for ventilation rates in school classrooms to fall below the levels required by relevant standards. The data presented here demonstrates that by using a top-down natural ventilation Windcatcher as part of a well designed natural ventilation strategy, ventilation rates in school classrooms can be significantly improved.
- Published
- 2012
6. The performance of natural ventilation windcatchers in schools - A comparison between prediction and measurement
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Jones, BM, Kirby, R, Jones, BM, and Kirby, R
- Abstract
Windcatchers are roof mounted devices that use the action of the wind to provide top down natural ventilation to a room. Here, fresh air is channelled into a room while, at the same time, stale air is drawn out. This provides a simple but attractive natural ventilation methodology that is increasing in popularity in U.K. schools. However, an analysis of system performance has largely been limited to laboratory based measurements and the use of CFD to generate predictions. Moreover, analysis is normally restricted to the operation of an autonomous Windcatcher whereas, in reality, it is likely to operate in a building in which other sources of ventilation are present (an open window for example) which can significantly alter the performance. The aim of this paper is to provide a tool for estimating the performance of a Windcatcher from basic data that is typically available to the engineer in the building design phase. Accordingly, the methodology uses data that one could reasonably be expected to have for a building's ventilation performance. This paper also reviews in situ performance based on measurements in U.K. schools both with and without open windows. Predictions generated by a semi-empirical model are then compared against measurement data and this is shown to deliver generally good agreement between the two, both with and without open windows, provided the theoretical predictions are presented in terms of an upper and lower performance limit. Furthermore, both experiment and theory clearly demonstrate that a large increase in the ventilation rate is possible if one combines the operation of a Windcatcher with, say, an open window, and that this ventilation rate is greater than that which would be achievable from a window operating on its own.
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- 2010
7. A comparison of organisational learning practices at nuclear reactor sites in Finland, Sweden and the UK'
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Jones, BM, Cox, S.J., Wahlström, B, Kettunen, J, Reiman, T, Rollenhagen, Carl, Jones, BM, Cox, S.J., Wahlström, B, Kettunen, J, Reiman, T, and Rollenhagen, Carl
- Abstract
QC 20120228
- Published
- 2006
8. Does spell-checking software need a warning label?
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Galletta, DF, Durcikova, A, Everard, A, Jones, BM, Galletta, DF, Durcikova, A, Everard, A, and Jones, BM
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The problems faced by the users in the language-checking software are discussed. There are false negatives, where the language-checking software fails to detect true errors, and false positives, where the software detects problems that are not errors. False negatives are troublesome because they might allow users to overlook problems that could be obvious to the human reader. False positives are also troublesome, although this issue has not been studied extensively in a usage context. The level of trust that users attribute to language-checking software may not always commensurate with the software's ability to do the job without errors.
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- 2005
9. Libel tourism: why librarians should care.
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Jones BM
- Abstract
When plaintiffs can shop for friendly jurisdictions, intellectual freedom suffers. [ABSTRACT FROM AUTHOR]
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- 2009
10. Repeated Shifts in Sociality Are Associated With Fine-tuning of Highly Conserved and Lineage-Specific Enhancers in a Socially Flexible Bee.
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Jones BM, Webb AE, Geib SM, Sim S, Schweizer RM, Branstetter MG, Evans JD, and Kocher SD
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- Animals, Bees genetics, Evolution, Molecular, Genome, Insect, Biological Evolution, Conserved Sequence, Enhancer Elements, Genetic, Social Behavior
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Comparative genomic studies of social insects suggest that changes in gene regulation are associated with evolutionary transitions in social behavior, but the activity of predicted regulatory regions has not been tested empirically. We used self-transcribing active regulatory region sequencing, a high-throughput enhancer discovery tool, to identify and measure the activity of enhancers in the socially variable sweat bee, Lasioglossum albipes. We identified over 36,000 enhancers in the L. albipes genome from 3 social and 3 solitary populations. Many enhancers were identified in only a subset of L. albipes populations, revealing rapid divergence in regulatory regions within this species. Population-specific enhancers were often proximal to the same genes across populations, suggesting compensatory gains and losses of regulatory regions may preserve gene activity. We also identified 1,182 enhancers with significant differences in activity between social and solitary populations, some of which are conserved regulatory regions across species of bees. These results indicate that social trait variation in L. albipes is associated with the fine-tuning of ancient enhancers as well as lineage-specific regulatory changes. Combining enhancer activity with population genetic data revealed variants associated with differences in enhancer activity and identified a subset of differential enhancers with signatures of selection associated with social behavior. Together, these results provide the first empirical map of enhancers in a socially flexible bee and highlight links between cis-regulatory variation and the evolution of social behavior., Competing Interests: Conflict of Interest The authors have no conflict of interest to declare., (© The Author(s) 2024. Published by Oxford University Press on behalf of Society for Molecular Biology and Evolution.)
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- 2024
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11. Counting the Cost of Daptomycin Versus Vancomycin in Hospitalized Patients: A Cost Minimization Analysis.
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Wagner JL, Jones BM, Stover KR, Cleary JD, Bland CM, Schipper KE, Chastain DB, and Barber KE
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Daptomycin use for gram-positive infections has increased. This cost minimization analysis aimed to determine cost and/or time savings of daptomycin over vancomycin. The estimated hospital cost savings was US$166.41 per patient, and pharmacist time saved of almost 20 minutes per patient. Daptomycin has the potential to save both time and money., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
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- 2024
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12. Post-fire stabilization of thaw-affected permafrost terrain in northern Alaska.
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Jones BM, Kanevskiy MZ, Shur Y, Gaglioti BV, Jorgenson MT, Ward Jones MK, Veremeeva A, Miller EA, and Jandt R
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In 2007, the Anaktuvuk River fire burned more than 1000 km
2 of arctic tundra in northern Alaska, ~ 50% of which occurred in an area with ice-rich syngenetic permafrost (Yedoma). By 2014, widespread degradation of ice wedges was apparent in the Yedoma region. In a 50 km2 area, thaw subsidence was detected across 15% of the land area in repeat airborne LiDAR data acquired in 2009 and 2014. Updating observations with a 2021 airborne LiDAR dataset show that additional thaw subsidence was detected in < 1% of the study area, indicating stabilization of the thaw-affected permafrost terrain. Ground temperature measurements between 2010 and 2015 indicated that the number of near-surface soil thawing-degree-days at the burn site were 3 × greater than at an unburned control site, but by 2022 the number was reduced to 1.3 × greater. Mean annual ground temperature of the near-surface permafrost increased by 0.33 °C/yr in the burn site up to 7-years post-fire, but then cooled by 0.15 °C/yr in the subsequent eight years, while temperatures at the control site remained relatively stable. Permafrost cores collected from ice-wedge troughs (n = 41) and polygon centers (n = 8) revealed the presence of a thaw unconformity, that in most cases was overlain by a recovered permafrost layer that averaged 14.2 cm and 18.3 cm, respectively. Taken together, our observations highlight that the initial degradation of ice-rich permafrost following the Anaktuvuk River tundra fire has been followed by a period of thaw cessation, permafrost aggradation, and terrain stabilization., (© 2024. The Author(s).)- Published
- 2024
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13. Current and projected flood exposure for Alaska coastal communities.
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Buzard RM, Maio CV, Erikson LH, Overbeck JR, Kinsman NEM, and Jones BM
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Globally, coastal communities experience flood hazards that are projected to worsen from climate change and sea level rise. The 100-year floodplain or record flood are commonly used to identify risk areas for planning purposes. Remote communities often lack measured flood elevations and require innovative approaches to estimate flood elevations. This study employs observation-based methods to estimate the record flood elevation in Alaska communities and compares results to elevation models, infrastructure locations, and sea level rise projections. In 46 analyzed communities, 22% of structures are located within the record floodplain. With sea level rise projections, this estimate increases to 30-37% of structures by 2100 if structures remain in the same location. Flood exposure is highest in western Alaska. Sea level rise projections suggest northern Alaska will see similar flood exposure levels by 2100 as currently experienced in western Alaska. This evaluation of record flood height, category, and history can be incorporated into hazard planning documents, providing more context for coastal flood exposure than previously existed for Alaska. This basic flood exposure method is transferable to other areas with similar mapping challenges. Identifying current and projected hazardous zones is essential to avoid unintentional development in floodplains and improve long-term safety., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
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- 2024
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14. The prevalence of gram-negative bacteria with difficult-to-treat resistance and utilization of novel β-lactam antibiotics in the southeastern United States.
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Tsai YV, Bookstaver PB, Kohn J, Justo JA, Childress D, Stramel S, Slain D, Tu P, Wingler MJB, Jones BM, Anderson DT, Seddon MM, Cretella DA, Eudy J, Winders H, Antosz K, Bailey P, and Al-Hasan MN
- Abstract
Objective: To evaluate temporal trends in the prevalence of gram-negative bacteria (GNB) with difficult-to-treat resistance (DTR) in the southeastern United States. Secondary objective was to examine the use of novel β-lactams for GNB with DTR by both antimicrobial use (AU) and a novel metric of adjusted AU by microbiological burden (am-AU)., Design: Retrospective, multicenter, cohort., Setting: Ten hospitals in the southeastern United States., Methods: GNB with DTR including Enterobacterales, Pseudomonas aeruginosa , and Acinetobacter spp. from 2015 to 2020 were tracked at each institution. Cumulative AU of novel β-lactams including ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/cilastatin/relebactam, and cefiderocol in days of therapy (DOT) per 1,000 patient-days was calculated. Linear regression was utilized to examine temporal trends in the prevalence of GNB with DTR and cumulative AU of novel β-lactams., Results: The overall prevalence of GNB with DTR was 0.85% (1,223/143,638) with numerical increase from 0.77% to 1.00% between 2015 and 2020 ( P = .06). There was a statistically significant increase in DTR Enterobacterales (0.11% to 0.28%, P = .023) and DTR Acinetobacter spp. (4.2% to 18.8%, P = .002). Cumulative AU of novel β-lactams was 1.91 ± 1.95 DOT per 1,000 patient-days. When comparing cumulative mean AU and am-AU, there was an increase from 1.91 to 2.36 DOT/1,000 patient-days, with more than half of the hospitals shifting in ranking after adjustment for microbiological burden., Conclusions: The overall prevalence of GNB with DTR and the use of novel β-lactams remain low. However, the uptrend in the use of novel β-lactams after adjusting for microbiological burden suggests a higher utilization relative to the prevalence of GNB with DTR., Competing Interests: Potential conflicts of interest. D.C. reports that he is pending a patent with Genus, group, species, and/or strain-specific 16s rdna sequences. B.J. reports that he is the member of the speaker’s bureau for Abbie, Paratek, Innoviva, and Ferring. M.A. reports that he serves on IDSA Antimicrobial Resistance Committee, International Working Group for Diabetic Foot Infection Guideline Panel, and WHO Antimicrobial Resistance Expert Group on Human Health Research. P.B. reports that she has two ongoing grants (CDC-RFA-CK22-2203 and University of South Carolina Center for Rural and Primary Healthcare). J.A.J. reports that she is on the advisory board for Entasis Therapeutics and Shionogi. Potential conflicts of interest. All other authors report no conflicts of interest relevant to this article., (© The Author(s) 2024.)
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- 2024
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15. Dalbavancin Sequential Therapy for Gram-Positive Bloodstream Infection: A Multicenter Observational Study.
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Rebold N, Alosaimy S, Pearson JC, Dionne B, Taqi A, Lagnf A, Lucas K, Biagi M, Lombardo N, Eudy J, Anderson DT, Mahoney MV, Kufel WD, D'Antonio JA, Jones BM, Frens JJ, Baumeister T, Geriak M, Sakoulas G, Farmakiotis D, Delaportas D, Larew J, Veve MP, and Rybak MJ
- Abstract
Introduction: Long-acting lipoglycopeptides such as dalbavancin may have utility in patients with Gram-positive bloodstream infections (BSI), particularly in those with barriers to discharge or who require prolonged parenteral antibiotic courses. A retrospective cohort study was performed to provide further multicenter real-world evidence on dalbavancin use as a sequential therapy for Gram-positive BSI., Methods: One hundred fifteen patients received dalbavancin with Gram-positive BSI, defined as any positive blood culture or diagnosed with infective endocarditis, from 13 centers geographically spread across the United States between July 2015 and July 2021., Results: Patients had a mean (SD) age of 48.5 (17.5) years, the majority were male (54%), with many who injected drugs (40%). The most common infection sources (non-exclusive) were primary BSI (89%), skin and soft tissue infection (SSTI) (25%), infective endocarditis (19%), and bone and joint infection (17%). Staphylococcus aureus accounted for 72% of index cultures, coagulase-negative Staphylococcus accounted for 18%, and Streptococcus species in 16%. Dalbavancin started a median (Q
1 -Q3 ) of 10 (6-19) days after index culture collection. The most common regimen administered was dalbavancin 1500 mg as one dose for 50% of cases. The primary outcome of composite clinical failure occurred at 12.2%, with 90-day mortality at 7.0% and 90-day BSI recurrence at 3.5%., Conclusions: Dalbavancin may serve as a useful tool in facilitating hospital discharge in patients with Gram-positive BSI. Randomized controlled trials are anticipated to validate dalbavancin as a surrogate to current treatment standards., (© 2024. The Author(s).)- Published
- 2024
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16. From Rarity to Recognition: Infantile Botulism and the Broad Spectrum of Differential Diagnoses.
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Authement MC, Jones BM, Kahoud RJ, and Ristagno EH
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This case illustrates a 5-week-old girl who presented with decreased activity, decreased feeds, poor suck, weak cry, lethargy, hypotonia, and areflexia. The child was found to have infant botulism. The case demonstrates the importance of a full history and broad differential in an ill-appearing infant. The differential for an ill-appearing infant should always include infectious etiologies and may include metabolic disorders, congenital anomalies, nonaccidental trauma, neurologic disorders, and endocrine disorders. The broad differential diagnosis may make rapid diagnosis and treatment for infantile botulism a challenge., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Matthew C. Authement et al.)
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- 2024
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17. Gender Representation Among Academic US Radiation Oncology Department Chairs: Who are They?
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Hsieh K, Bloom JR, Jones BM, Hsieh C, Hassan A, Nehlsen AD, Salgado LR, Goodman KA, Green S, Rowley JP, and Sindhu KK
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Purpose: Women are underrepresented in academic radiation oncology (RO), particularly in leadership positions. In this study, we sought to better understand the characteristics of individuals who currently serve as academic RO chairpersons at institutions with an associated Accreditation Council for Graduate Medical Education-accredited RO residency training program., Methods and Materials: We created a database of academic RO chairpersons in the United States by using publicly available sources, including residency training program websites, hospital/institutional websites, Doximity, LinkedIn, the American Society for Radiation Oncology (ASTRO) website, the American College of Radiation Oncology website, and the National Plan and Provider Enumeration System National Provider Identifier Registry. We used the χ
2 Goodness of Fit test, Mann-Whitney U test, and Fisher exact test via R version 4.1.1 to evaluate for statistical significance among categorical variables, medians, and proportions, respectively., Results: We identified 85 of the 90 chairpersons (94.4%) currently serving at institutions with an Accreditation Council for Graduate Medical Education-accredited RO residency training program, 5 of whom hold interim positions and were thus excluded from further analyses. Of the remaining 80 chairpersons, 9 (11.3%) are women, and 71 (88.8%) are men ( P < .01). Seventy-six chairpersons (95.0%) are full professors, and 19 (23.8%) hold dual MD PhD degrees. Thirty-two chairpersons (40.0%) hold an official leadership role in a cancer center affiliated with their current institution (43.7% of men vs 11.1% of women; P = .08). Seventy-three chairpersons (91.3%) secured their current positions a median of 16 years (range, 6-33 years) after completing RO residency. Thirty-five chairpersons (43.8%) were promoted to chair from positions within their current institutions (40.8% of men vs 66.7% of women; P = .17). The majority of chairpersons are ASTRO Fellows (62.5%); notably fewer are ASTRO (5.0%) or American College of Radiation Oncology (2.5%) Gold Medalists. Eight RO residency programs trained more than half of current chairpersons., Conclusion: Significantly more men than women currently serve as RO chairpersons. Future interventions that promote the recruitment, retention, and promotion of talented women in academic RO should be considered., Competing Interests: Kristin Hsieh is the 2023 American Society for Radiation Oncology AstraZeneca Radiation Oncology Research Training Fellow. Karyn A. Goodman participates in Viewray Data Safety Monitoring Board, RenovoRx Advisory Board, and Philips Advisory Board; and she is a cochair of National Cancer Institute Gastrointestinal Steering Committee. The remaining authors declare that they have no conflict of interest., (© 2024 The Author(s).)- Published
- 2024
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18. Eravacycline, the first four years: health outcomes and tolerability data for 19 hospitals in 5 U.S. regions from 2018 to 2022.
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Kunz Coyne AJ, Alosaimy S, Lucas K, Lagnf AM, Morrisette T, Molina KC, DeKerlegand A, Schrack MR, Kang-Birken SL, Hobbs AL, Agee J, Perkins NB 3rd, Biagi M, Pierce M, Truong J, Andrade J, Bouchard J, Gore T, King MA, Pullinger BM, Claeys KC, Herbin S, Cosimi R, Tart S, Veve MP, Jones BM, Rojas LM, Feehan AK, Scipione MR, Zhao JJ, Witucki P, and Rybak MJ
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- Humans, Retrospective Studies, Drug Resistance, Multiple, Bacterial, Microbial Sensitivity Tests, Outcome Assessment, Health Care, Gram-Negative Bacteria, Tetracyclines therapeutic use, Tetracyclines pharmacology, Anti-Bacterial Agents adverse effects
- Abstract
Importance: The rise of multidrug-resistant (MDR) pathogens, especially MDR Gram-negatives, poses a significant challenge to clinicians and public health. These resilient bacteria have rendered many traditional antibiotics ineffective, underscoring the urgency for innovative therapeutic solutions. Eravacycline, a broad-spectrum fluorocycline tetracycline antibiotic approved by the FDA in 2018, emerges as a promising candidate, exhibiting potential against a diverse array of MDR bacteria, including Gram-negative, Gram-positive, anaerobic strains, and Mycobacterium. However, comprehensive data on its real-world application remain scarce. This retrospective cohort study, one of the largest of its kind, delves into the utilization of eravacycline across various infectious conditions in the USA during its initial 4 years post-FDA approval. Through assessing clinical, microbiological, and tolerability outcomes, the research offers pivotal insights into eravacycline's efficacy in addressing the pressing global challenge of MDR bacterial infections., Competing Interests: S.A. is a current employee of Nestle Health Sciences. T.M. is currently funded through Stellus Rx and has participated in scientific advisory boards for AbbVie Inc. and Basilea Pharmaceutica. J.A. is a speaker for Shionogi Inc. M.A.K. is a speaker for Tetraphase. M.P.V. received research funding from Paratek Pharmaceuticals, Cumberland Pharmaceuticals, NIAID, and advisory Boards for Ferring Pharmaceuticals, Melinta Therapeutics, and Merck & Co. K.C.M. has consulted for Shionogi. B.M.J. has participated in speaking bureaus for Abbvie, La Jolla, and Paratek. A.L.V.H. has participated in speaking bureaus and has received research funding from Tetraphase. M.J.R. has received research and consulting from or participated in speaking bureaus for Abbvie, Melinta, Merck, Paratek, Shionogi, T2 Biosystems, and Tetraphase (La Jolla). All other authors declare no conflict of interest.
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- 2024
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19. A Baker's Dozen of Top Antimicrobial Stewardship Intervention Publications in 2022.
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Barfield RK, Brown ML, Albrecht B, Barber KE, Bouchard J, Carr AL, Chahine EB, Cluck D, Covington EW, Deri CR, Durham SH, Faulkner-Fennell C, Freeman LK, Gauthier TP, Gibson GM, Green SB, Hobbs ALV, Jones BM, Jozefczyk CC, Marx AH, McGee EU, McKamey LJ, Musgrove R, Perez E, Slain D, Stover KR, Turner MS, White C, Bookstaver PB, and Bland CM
- Abstract
Keeping abreast of the antimicrobial stewardship-related articles published each year is challenging. The Southeastern Research Group Endeavor identified antimicrobial stewardship-related, peer-reviewed literature that detailed an actionable intervention during 2022. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight actionable interventions used by antimicrobial stewardship programs to capture potentially effective strategies for local implementation., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts. The views and opinions expressed in this paper represent those of the authors and do not necessarily reflect the position or policy of any previous, current, or potential future employer., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
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- 2024
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20. Outcomes of transcatheter aortic valve replacement in patients with cardiogenic shock.
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Goel K, Shah P, Jones BM, Korngold E, Bhardwaj A, Kar B, Barker C, Szerlip M, Smalling R, and Dhoble A
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- Humans, United States, Shock, Cardiogenic, Quality of Life, Treatment Outcome, Aortic Valve surgery, Registries, Risk Factors, Transcatheter Aortic Valve Replacement methods, Aortic Valve Stenosis complications, Aortic Valve Stenosis surgery, Aortic Valve Stenosis diagnosis
- Abstract
Aims: The safety and efficacy of transcatheter aortic valve replacement (TAVR) with contemporary balloon expandable transcatheter valves in patients with cardiogenic shock (CS) remain largely unknown. In this study, the TAVRs performed for CS between June 2015 and September 2022 using SAPIEN 3 and SAPIEN 3 Ultra bioprosthesis from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry were analysed., Methods and Results: CS was defined as: (i) coding of CS within 24 h on Transcatheter Valve Therapy Registry form; and/or (ii) pre-procedural use of inotropes or mechanical circulatory support devices and/or (iii) cardiac arrest within 24 h prior to TAVR. The control group was comprised of all the other patients undergoing TAVR. Baseline characteristics, all-cause mortality, and major complications at 30-day and 1-year outcomes were reported. Landmark analysis was performed at 30 days post-TAVR. Cox-proportional multivariable analysis was performed to determine the predictors of all-cause mortality at 1 year. A total of 309 505 patients underwent TAVR with balloon-expandable valves during the study period. Of these, 5006 patients presented with CS prior to TAVR (1.6%). The mean Society of Thoracic Surgeons score was 10.76 ± 10.4. The valve was successfully implanted in 97.9% of patients. Technical success according to Valve Academic Research Consortium-3 criteria was 94.5%. In a propensity-matched analysis, CS was associated with higher in-hospital (9.9% vs. 2.7%), 30-day (12.9% vs. 4.9%), and 1-year (29.7% vs. 22.6%) mortality compared to the patients undergoing TAVR without CS. In the landmark analysis after 30 days, the risk of 1-year mortality was similar between the two groups [hazard ratio (HR) 1.07, 95% confidence interval (CI) 0.95-1.21]. Patients who were alive at 1 year noted significant improvements in functional class (Class I/II 89%) and quality of life (ΔKCCQ score +50). In the multivariable analysis, older age (HR 1.02, 95% CI 1.02-1.03), peripheral artery disease (HR 1.25, 95% CI 1.06-1.47), prior implantation of an implantable cardioverter-defibrillator (HR 1.37, 95% CI 1.07-1.77), patients on dialysis (HR 2.07, 95% CI 1.69-2.53), immunocompromised status (HR 1.33, 95% CI 1.05-1.69), New York Heart Association class III/IV symptoms (HR 1.50, 95% CI 1.06-2.12), lower aortic valve mean gradient, lower albumin levels, lower haemoglobin levels, and lower Kansas City Cardiomyopathy Questionnaire scores were independently associated with 1-year mortality., Conclusion: This large observational real-world study demonstrates that the TAVR is a safe and effective treatment for aortic stenosis patients presenting with CS. Patients who survived the first 30 days after TAVR had similar mortality rates to those who were not in CS., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2023
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21. Combining Radiotherapy and Immunotherapy in Head and Neck Cancer.
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Runnels J, Bloom JR, Hsieh K, Dickstein DR, Shi Y, Jones BM, Lehrer EJ, and Bakst RL
- Abstract
Head and neck squamous cell carcinoma (HNSCC) is a leading cause of morbidity and mortality globally. Despite significant advances in well-established treatment techniques, prognosis for advanced-stage HNSCC remains poor. Recent, accumulating evidence supports a role for immunotherapy in HNSCC treatment. Radiation therapy (RT), a standard treatment option for HNSCC, has immunomodulatory and immunostimulatory effects that may enhance the efficacy of immunotherapy. In several cancer types, combining RT and immunotherapy has been shown to improve tumor response rates, increase survival, and reduce toxicity compared to traditional chemotherapy and radiation therapy. This review provides a timely overview of the current knowledge on the use of RT and immunotherapy for treating HNSCC. It highlights the potential advantages of combining these therapies, such as improved tumor response rates, increased survival, and reduced toxicity. The review also discusses the challenges that need to be addressed when redefining the standard of care in HNSCC, and proposes further research to optimize treatment combinations, minimize radiation-induced toxicity, and identify suitable patient populations for treatment.
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- 2023
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22. Glioblastoma Mesenchymal Transition and Invasion are Dependent on a NF-κB/BRD2 Chromatin Complex.
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Vadla R, Miki S, Taylor B, Kawauchi D, Jones BM, Nathwani N, Pham P, Tsang J, Nathanson DA, and Furnari FB
- Abstract
Glioblastoma (GBM) represents the most aggressive subtype of glioma, noted for its profound invasiveness and molecular heterogeneity. The mesenchymal (MES) transcriptomic subtype is frequently associated with therapy resistance, rapid recurrence, and increased tumor-associated macrophages. Notably, activation of the NF-κB pathway and alterations in the PTEN gene are both associated with this malignant transition. Although PTEN aberrations have been shown to be associated with enhanced NF-κB signaling, the relationships between PTEN, NF-κB and MES transition are poorly understood in GBM. Here, we show that PTEN regulates the chromatin binding of bromodomain and extraterminal (BET) family proteins, BRD2 and BRD4, mediated by p65/RelA localization to the chromatin. By utilizing patient-derived glioblastoma stem cells and CRISPR gene editing of the RELA gene, we demonstrate a crucial role for RelA lysine 310 acetylation in recruiting BET proteins to chromatin for MES gene expression and GBM cell invasion upon PTEN loss. Remarkably, we found that BRD2 is dependent on chromatin associated acetylated RelA for its recruitment to MES gene promoters and their expression. Furthermore, loss of BRD2 results in the loss of MES signature, accompanied by an enrichment of proneural signature and enhanced therapy responsiveness. Finally, we demonstrate that disrupting the NFκB/BRD2 interaction with a brain penetrant BET-BD2 inhibitor reduces mesenchymal gene expression, GBM invasion, and therapy resistance in GBM models. This study uncovers the role of hitherto unexplored PTEN-NF-κB-BRD2 pathway in promoting MES transition and suggests inhibiting this complex with BET-BD2 specific inhibitors as a therapeutic approach to target the MES phenotype in GBM.
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- 2023
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23. The mast cell stimulator compound 48/80 causes urothelium-dependent increases in murine urinary bladder contractility.
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Jones BM, Mingin GC, and Tykocki NR
- Subjects
- Mice, Animals, Muscle, Smooth metabolism, Urothelium metabolism, Muscle Contraction, Urinary Bladder metabolism, Mast Cells
- Abstract
Mast cells and degranulation of preformed inflammatory mediators contribute to lower urinary tract symptoms. This study investigated pathways by which the mast cell stimulator compound 48/80 alters urinary bladder smooth muscle contractility via mast cell activation. We hypothesized that 1 ) mast cell degranulation causes spontaneous urinary bladder smooth muscle contractions and 2 ) these contractions are caused by urothelium-derived PGE
2 . Urothelium-intact and -denuded urinary bladder strips were collected from mast cell-sufficient (C57Bl/6) and mast cell-deficient (B6.Cg-Kitw-sh ) mice to determine if compound 48/80 altered urinary bladder smooth muscle (UBSM) contractility. Electrical field stimulation was used to assess the effects of compound 48/80 on nerve-evoked contractions. Antagonists/inhibitors were used to identify prostanoid signaling pathways activated or if direct activation of nerves was involved. Compound 48/80 caused slow-developing contractions, increased phasic activity, and augmented nerve-evoked responses in both mast cell-sufficient and -deficient mice. Nerve blockade had no effect on these responses; however, they were eliminated by removing the urothelium. Blockade of P2 purinoreceptors, cyclooxygenases, or G protein signaling abolished compound 48/80 responses. However, only combined blockade of PGE2 (EP1), PGF2α (FP), and thromboxane A2 (TP) receptors inhibited compound 48/80-induced responses. Thus, the effects of compound 48/80 are urothelium dependent but independent of mast cells. Furthermore, these effects are mediated by druggable inflammatory pathways that may be used to manage inflammatory nonneurogenic bladder hyperactivity. Finally, these data strongly suggest that great care must be taken when using compound 48/80 to determine mast cell-dependent responses in the urinary bladder. NEW & NOTEWORTHY Urothelial cells are first responders to noxious contents of the urine. Our study demonstrates that the urothelium is not only a barrier but also a modulator of urinary bladder smooth muscle phasic activity and contractility independent of immune cell recruitment in response to an inflammatory insult.- Published
- 2023
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24. Critical illness myopathy and trajectory of recovery in acute kidney injury requiring continuous renal replacement therapy: a prospective observational trial protocol.
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Teixeira JP, Griffin BR, Pal CA, González-Seguel F, Jenkins N, Jones BM, Yoshida Y, George N, Israel HP, Ghazi L, Neyra JA, and Mayer KP
- Subjects
- Humans, Aftercare, Critical Illness therapy, Intensive Care Units, Multicenter Studies as Topic, Observational Studies as Topic, Patient Discharge, Prospective Studies, Renal Replacement Therapy methods, Acute Kidney Injury etiology, Continuous Renal Replacement Therapy, Muscular Diseases
- Abstract
Introduction: Acute kidney injury requiring renal replacement therapy (AKI-RRT) is common in the intensive care unit (ICU) and is associated with significant morbidity and mortality. Continuous RRT (CRRT) non-selectively removes large amounts of amino acids from plasma, lowering serum amino acid concentrations and potentially depleting total-body amino acid stores. Therefore, the morbidity and mortality associated with AKI-RRT may be partly mediated through accelerated skeletal muscle atrophy and resulting muscle weakness. However, the impact of AKI-RRT on skeletal muscle mass and function during and following critical illness remains unknown. We hypothesise that patients with AKI-RRT have higher degrees of acute muscle loss than patients without AKI-RRT and that AKI-RRT survivors are less likely to recover muscle mass and function when compared with other ICU survivors., Methods and Analysis: This protocol describes a prospective, multicentre, observational trial assessing skeletal muscle size, quality and function in ICU patients with AKI-RRT. We will perform musculoskeletal ultrasound to longitudinally evaluate rectus femoris size and quality at baseline (within 48 hours of CRRT initiation), day 3, day 7 or at ICU discharge, at hospital discharge, and 1-3 months postdischarge. Additional skeletal muscle and physical function tests will be performed at hospital discharge and postdischarge follow-up. We will analyse the effect of AKI-RRT by comparing the findings in enrolled subjects to historical controls of critically ill patients without AKI-RRT using multivariable modelling., Ethics and Dissemination: We anticipate our study will reveal that AKI-RRT is associated with greater degrees of muscle loss and dysfunction along with impaired postdischarge recovery of physical function. These findings could impact the in-hospital and postdischarge treatment plan for these patients to include focused attention on muscle strength and function. We intend to disseminate findings to participants, healthcare professionals, the public and other relevant groups via conference presentation and publication without any publication restrictions., Trial Registration Number: NCT05287204., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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25. Penicillin-allergy delabelling resources for clinicians practicing in resource-limited settings: a full educational resource review of the grey literature.
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Staicu ML, Jeffres MN, Jones BM, Stover KR, Wagner JL, and Bland CM
- Abstract
Background: The clinical and financial consequences associated with a penicillin-allergy label are increasingly evident and have garnered support from international organizations to prioritize penicillin-allergy delabelling programmes. Most settings lack access to resources including drug allergy specialists and rely on general practitioners (GPs) and pharmacists., Objectives: The aim of this scoping review was to identify and describe freely available penicillin-allergy delabelling materials to guide clinicians practising in resource-limited settings with initiative application., Methods: This scoping review searched two grey literature databases, six targeted websites and consulted content experts to identify freely available materials in the English language that provided evidence-based and actionable penicillin-allergy delabelling strategies. Study investigators ranked and voted on which screened resources should be included in the final review. Characteristics of resources were evaluated and compared., Results: Out of 1191 total citations, 6 open-access resources were included. Penicillin-allergy toolkits featuring various delabelling strategies were identified in four resources. The toolkits supported a broad range of downloadable and adaptable materials, predominantly targeted towards GPs. Patient educational materials were also provided. Another resource highlighted a point-of-care penicillin-allergy risk assessment calculator via a free mobile app that quickly and accurately identified low-risk penicillin-allergic patients. The final resource, a supplemental instructional video, presented impactful and standardized delabelling strategies that clinicians can adopt into daily practices., Conclusions: Limited penicillin-allergy delabelling materials are available in the grey literature but existing resources provide broad and diverse opportunities. Additional support from health protection agencies is critical to augment ongoing delabelling efforts., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)
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- 2023
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26. Automated monitoring of honey bees with barcodes and artificial intelligence reveals two distinct social networks from a single affiliative behavior.
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Gernat T, Jagla T, Jones BM, Middendorf M, and Robinson GE
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- Bees, Animals, Social Behavior, Artificial Intelligence, Behavior, Animal
- Abstract
Barcode-based tracking of individuals is revolutionizing animal behavior studies, but further progress hinges on whether in addition to determining an individual's location, specific behaviors can be identified and monitored. We achieve this goal using information from the barcodes to identify tightly bounded image regions that potentially show the behavior of interest. These image regions are then analyzed with convolutional neural networks to verify that the behavior occurred. When applied to a challenging test case, detecting social liquid transfer (trophallaxis) in the honey bee hive, this approach yielded a 67% higher sensitivity and an 11% lower error rate than the best detector for honey bee trophallaxis so far. We were furthermore able to automatically detect whether a bee donates or receives liquid, which previously required manual observations. By applying our trophallaxis detector to recordings from three honey bee colonies and performing simulations, we discovered that liquid exchanges among bees generate two distinct social networks with different transmission capabilities. Finally, we demonstrate that our approach generalizes to detecting other specific behaviors. We envision that its broad application will enable automatic, high-resolution behavioral studies that address a broad range of previously intractable questions in evolutionary biology, ethology, neuroscience, and molecular biology., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
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- 2023
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27. Gender Differences in the Research Productivity of Radiation Oncology Resident Graduates in the United States: 2015 to 2019.
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Jones BM, Rowley JP, Sindhu KK, Lehrer EJ, Hsieh K, Nehlsen AD, Green S, and Goodman KA
- Abstract
Purpose: It is well-documented that gender disparities exist in academic radiation oncology departments. The purpose of this study was to analyze gender differences in research productivity during residency among recent graduates of radiation oncology training programs in the United States (US)., Methods and Materials: We used several publicly available sources to create a database of US radiation oncology residents who graduated between 2015 and 2019. We systematically collected gender information from the National Plan and Provider Enumeration System National Provider Identifier Registry and Medicare claims registry. Postresidency employment information was collected using several publicly available sources. PubMed was queried to identify first-author publications of residents. A secondary analysis of metadata including impact factor, number of citations, modified Hirsch index ( h index), and type of publication was performed. A multivariable linear regression was performed to evaluate the effect of gender on research productivity during residency., Results: There were 910 total graduates identified during this period and who were entered into this database, of whom all had available gender information. Female trainees comprised 29.0% (n = 264) of RO residents and had fewer first-author publications and citations, had lower mean modified h index, and were published in journals with lower impact factors. On multivariable linear regression analysis, female gender was independently associated with decreased total number of publications ( P = .005), mean number of citations ( P < .001), and modified h index ( P = .001) when controlling for residency size and advanced (PhD or master's) degrees., Conclusions: In the US, female RO trainees had lower research productivity, which was not explained by advanced degrees or residency size. A significant gender gap in trainee research productivity persists, which has known implications in terms of academic achievement, promotions, and career trajectory. Future interventions to improve resident research productivity and mentorship are warranted., (© 2022 The Authors.)
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- 2022
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28. A Review of the Role of Stereotactic Radiosurgery and Immunotherapy in the Management of Primary Central Nervous System Tumors.
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Lehrer EJ, Jones BM, Sindhu KK, Dickstein DR, Cohen M, Lazarev S, Quiñones-Hinojosa A, Green S, and Trifiletti DM
- Abstract
Stereotactic radiosurgery (SRS) and immune checkpoint inhibitors (ICIs) are widely used in the management of brain metastases. These therapies are commonly administered concurrently; as SRS may enhance anti-tumor immunity and responsiveness to ICIs. However, the use of ICIs with and without SRS in the management of primary brain tumors remains a controversial topic. Meningiomas are the most common nonmalignant and extra-parenchymal brain tumor, which often respond well to surgery and radiotherapy. However, higher grade meningiomas tend to be resistant to these treatments, and the use of chemotherapy and targeted agents in this setting have yielded disappointing results. Thus, there is heightened interest in the utilization of ICIs. Glioblastoma is the most common malignant primary intraparenchymal brain tumor. It is associated with a grim prognosis with a median overall survival of approximately 20 months, despite optimal therapy. While SRS in the adjuvant setting, and ICI in the recurrent setting, have failed to demonstrate a survival benefit, SRS in the preoperative setting has the potential to enhance anti-tumor immunity and responsiveness to ICIs. Thus, these treatments represent an attractive option to add to the armamentarium of meningioma and glioblastoma management. In this review, we provide a detailed overview of the evidence supporting the use of ICIs and SRS in each of these settings.
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- 2022
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29. The Rise of Open Access Journals in Radiation Oncology: Influence on Resident Research, 2015 to 2019.
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Sindhu KK, Rowley JP, Smith WH, Nehlsen AD, Smith AW, Lehrer EJ, Jones BM, Buckstein M, Lazarev S, and Rosenzweig KE
- Abstract
Purpose: While a rising share of scientific research articles are being published in open access (OA) journals, their impact on resident research in radiation oncology is unknown. Thus, we sought to determine the number, content, and costs of first-author, PubMed-searchable articles radiation oncology residents in the United States (US) published in OA journals in recent years., Methods and Materials: We built a database of first-author, PubMed-searchable articles published by US radiation oncology residents who graduated between 2015 and 2019. We then classified each journal in which these articles appeared as either OA or non-OA and obtained the current article-processing charge (APC) for each publication that appeared in an OA journal., Results: The residents in this study published 2637 first-author, PubMed-searchable articles, 555 of which (21.0%) appeared in 138 OA journals. The number of publications in OA journals per resident increased from 0.47 for the class of 2015 to 0.79 for the class of 2019. Publications in OA journals garnered fewer citations than those in non-OA journals (8.9 vs 14.9, P < .01). Furthermore, 90.6% of OA journals levy an APC for original research reports (median, $1896), which is positively correlated with their 2019 impact factor ( r = 0.63, P < .01). Aggregate APCs totaled $900,319.21 and appeared to increase over the study period., Conclusions: The number of first-author, PubMed-searchable articles published by graduating US radiation oncology residents in OA journals rose significantly between 2015 and 2019. To maximize the benefits of OA publishing in the future, US radiation oncology residents will need to ensure that they use vetted OA journals to publish their research findings and avoid predatory journals., (© 2022 The Author(s).)
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- 2022
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30. A Baker's Dozen of Top Antimicrobial Stewardship Intervention Publications for Hospitalized Patients in 2021.
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Marx AH, Cluck D, Green SB, Anderson DT, Stover KR, Chastain DB, Covington EW, Jones BM, Lantz E, Rausch E, Tu PJY, Wagner JL, White C, Bland CM, and Bookstaver PB
- Abstract
Keeping abreast of the antimicrobial stewardship-related articles published each year is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related, peer-reviewed literature that detailed an "actionable" intervention among hospitalized populations during 2021. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight "actionable" interventions used by antimicrobial stewardship programs in hospitalized populations to capture potentially effective strategies for local implementation., Competing Interests: Potential conflicts of interest. All authors: no reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
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- 2022
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31. In Regard to Huang et al.
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Sindhu KK, Jones BM, Nehlsen AD, Lehrer EJ, Smith AW, and Rowley JP
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- 2022
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32. The Cognitive Effects of Radiotherapy for Brain Metastases.
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Lehrer EJ, Jones BM, Dickstein DR, Green S, Germano IM, Palmer JD, Laack N, Brown PD, Gondi V, Wefel JS, Sheehan JP, and Trifiletti DM
- Abstract
Brain metastases are the most common intracranial neoplasm and are seen in upwards of 10-30% of patients with cancer. For decades, whole brain radiation therapy (WBRT) was the mainstay of treatment in these patients. While WBRT is associated with excellent rates of intracranial tumor control, studies have demonstrated a lack of survival benefit, and WBRT is associated with higher rates of cognitive deterioration and detrimental effects on quality of life. In recent years, strategies to mitigate this risk, such as the incorporation of memantine and hippocampal avoidance have been employed with improved results. Furthermore, stereotactic radiosurgery (SRS) has emerged as an appealing treatment option over the last decade in the management of brain metastases and is associated with superior cognitive preservation and quality of life when compared to WBRT. This review article evaluates the pathogenesis and impact of cranial irradiation on cognition in patients with brain metastases, as well as current and future risk mitigation techniques., Competing Interests: PB reports contribution to UpToDate outside of the submitted work. JW is on the advisory board of Bayer, he serves as a consultant to Angiochem, Bayer, Juno, Novocure, Vanquish Oncology, and GT Medical technologies. JP reports research funding and honoraria from Varian and research funding from Genentech, NIH, and Kroger; he serves on the advisory board of Novocure. IM serves as a consultant to BrainLab and Integra; DT reports institutional support from Novocure Ltd and consulting for Boston Scientific Corporation outside to the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lehrer, Jones, Dickstein, Green, Germano, Palmer, Laack, Brown, Gondi, Wefel, Sheehan and Trifiletti.)
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- 2022
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33. Management of Older Adults with Locally Advanced Head and Neck Cancer.
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Dickstein DR, Lehrer EJ, Hsieh K, Hotca A, Jones BM, Powers A, Sharma S, Liu J, Gupta V, Mell L, Husain Z, Kirke D, Misiukiewicz K, Posner M, Genden E, and Bakst RL
- Abstract
Thirty percent of patients with head and neck squamous cell carcinoma (HNSCC) are at least 70 years of age. This number continues to rise as life expectancy continues to increase. Still, older adults with HNSCC remain underrepresented in clinical trials, resulting in ambiguity on optimal management. Older adults are a complex patient population, often requiring increased support due to issues relating to functional and performance status, medical comorbidities, and medication management. Furthermore, in older adults with HNSCC, many of these conditions are independently associated with increased toxicity and worse outcomes. Toxicity in the older adult remains difficult to predict and to understand, and as treatment decisions are based on treatment tolerability, it is essential to understand the toxicities and how to minimize them. Novel predictive scores are being developed specifically for older adults with HNSCC to understand toxicity and to assist in personalized treatment decisions. There are clinical trials presently underway that are investigating shortened radiation courses and novel, less toxic systemic treatments in this population. In the forthcoming sections, we provide a detailed overview of the clinical data, treatment paradigms, and considerations in this population. This review provides a comprehensive overview of existing clinical data and clinical considerations in the older adult head and neck cancer population. Additionally, we provide a detailed overview of pertinent current and ongoing clinical trials, as well as future areas for investigation.
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- 2022
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34. Expanding beaver pond distribution in Arctic Alaska, 1949 to 2019.
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Tape KD, Clark JA, Jones BM, Kantner S, Gaglioti BV, Grosse G, and Nitze I
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- Alaska, Animals, Arctic Regions, Tundra, Ponds, Rodentia
- Abstract
Beavers were not previously recognized as an Arctic species, and their engineering in the tundra is considered negligible. Recent findings suggest that beavers have moved into Arctic tundra regions and are controlling surface water dynamics, which strongly influence permafrost and landscape stability. Here we use 70 years of satellite images and aerial photography to show the scale and magnitude of northwestward beaver expansion in Alaska, indicated by the construction of over 10,000 beaver ponds in the Arctic tundra. The number of beaver ponds doubled in most areas between ~ 2003 and ~ 2017. Earlier stages of beaver engineering are evident in ~ 1980 imagery, and there is no evidence of beaver engineering in ~ 1952 imagery, consistent with observations from Indigenous communities describing the influx of beavers over the period. Rapidly expanding beaver engineering has created a tundra disturbance regime that appears to be thawing permafrost and exacerbating the effects of climate change., (© 2022. The Author(s).)
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- 2022
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35. Transcatheter Aortic Valve Replacement for Severe Aortic Regurgitation in Patients With a Left Ventricular Assist Device.
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Dhillon AS, Jones BM, Hodson RW, and Korngold EC
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- Aortic Valve diagnostic imaging, Aortic Valve surgery, Cardiac Catheterization methods, Humans, Prosthesis Design, Retrospective Studies, Treatment Outcome, Aortic Valve Insufficiency diagnosis, Aortic Valve Insufficiency etiology, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis complications, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Heart-Assist Devices, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Background: There are limited invasive treatment options for patients with end-stage heart failure and left ventricular assist device (LVAD) who develop severe aortic valve regurgitation (AR). One option for such patients is transcatheter aortic valve replacement (TAVR). There are limited data on outcomes of patients with LVAD who receive TAVR for severe AR. We present a series of 4 consecutive patients with LVAD who underwent TAVR for severe AR., Methods and Results: This is a retrospective chart review of 4 consecutive patients with LVAD who underwent TAVR for severe AR. All 4 patients underwent TAVR with a 34-mm self-expanding valve (Medtronic). One patient received a 29-mm balloon-expandable valve (Edwards Lifesciences) within the self-expanding valve (SEV) to postdilate the SEV and minimize paravalvular leak (PVL). All 4 procedures were technically successful. The patient who received rescue valve-in-valve TAVR continued to have persistent mild to moderate PVL., Conclusion: Although technically challenging, TAVR is a feasible option for carefully selected LVAD patients with severe AR. Procedural issues to consider include oversizing the transcatheter heart valve (THV) while being cognizant of the risks of annular rupture and valve dislocation, anticipating and avoiding ventricular migration of the THV and being ready to postdilate the THV if necessary, to limit hemodynamically significant PVL.
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- 2022
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36. Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolates.
- Author
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Jones BM, Wagner JL, Chastain DB, Bookstaver PB, Stover K, Lin J, Matson H, White N, Motesh M, and Bland CM
- Subjects
- Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Case-Control Studies, Humans, Incidence, Microbial Sensitivity Tests, Retrospective Studies, Risk Factors, Gram-Negative Bacterial Infections drug therapy, Gram-Negative Bacterial Infections epidemiology, Stenotrophomonas maltophilia
- Abstract
Background: Stenotrophomonas maltophilia is a cause of infection most commonly in the opportunistic host. Trimethoprim-sulfamethoxazole and levofloxacin are considered first-line treatment agents. With reports of increasing resistance to these first-line agents, it is important to determine risk factors associated with a non-susceptible isolate., Methods: This was a real-world, multicentre, retrospective case-control study from five centres in the southeast United States evaluating S. maltophilia. The primary outcome was risk factors associated with non-susceptibility of S. maltophilia isolates to ≥1 antimicrobial agents. Secondary outcomes include incidence of S. maltophilia non-susceptibility, all-cause mortality, and 30-day readmission rates., Results: There were 325 patients included in the study. For the primary outcome, the only factor associated with non-susceptibility per univariate analysis was isolation from urine culture (13.3% vs. 5.4%; P = 0.014), whereas the presence of mechanical ventilation (37.7% vs. 21.5%) and intensive care unit admission (35.3% vs. 18.4%) were associated with susceptibility (P < 0.001). For the secondary outcomes, non-susceptibility was present in 49% of isolates with 43 of 325 (13.2%), 53 of 324 (16.4%), and 105 of 172 (61%) to TMP-SMX, levofloxacin, and ceftazidime, respectively. Resistance to chloramphenicol and tigecycline was observed among 5/26 and 11/16 of tested isolates, respectively. Sixty-six patients (20%) experienced all-cause, inpatient mortality (18% susceptible vs. 23% non-susceptible; P = 0.280) and 44 patients (17%) were readmitted within 30 days of discharge (16% susceptible vs. 18% non-susceptible; P = 0.673)., Conclusion: S. maltophilia non-susceptibility had a prevalence of ∼50% to at least one first-line or commonly used agent. More research is needed to delineate risk factors for non-susceptible isolates., Competing Interests: Declaration of Competing Interest The following authors report potential conflicts of interest: Jones BM: Speaker's bureau (Allergan/Abbvie, La Jolla, Paratek), Grant Funding (Merck, ALK Abello), Bookstaver PB: Speaker's bureau (Biomerieux), Consulting (TRC Healthcare, FreeCE.com), Bland CM: Speaker's bureau (Merck, La Jolla), Grant Funding (Merck, ALK Abello), Advisory Board (Merck), Consulting (BioMerieux). All other authors report no conflicts of interest. These findings were presented, in part, as an accepted abstract at the European Congress of Clinical Microbiology and Infectious Diseases 2020 in Paris, France (conference cancelled due to COVID-19)., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2022
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37. Histamine receptors rapidly desensitize without altering nerve-evoked contractions in murine urinary bladder smooth muscle.
- Author
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Jones BM, Mingin GC, and Tykocki NR
- Subjects
- Animals, Drug Tolerance, Electric Stimulation, Histamine H1 Antagonists pharmacology, In Vitro Techniques, Male, Mice, Inbred C57BL, Muscle, Smooth innervation, Muscle, Smooth metabolism, Receptors, Histamine H1 genetics, Receptors, Histamine H1 metabolism, Receptors, Histamine H2 genetics, Receptors, Histamine H2 metabolism, Urinary Bladder innervation, Urinary Bladder metabolism, Mice, Efferent Pathways physiology, Histamine pharmacology, Histamine Agonists pharmacology, Muscle Contraction drug effects, Muscle, Smooth drug effects, Receptors, Histamine H1 drug effects, Urinary Bladder drug effects
- Abstract
Histamine has been implicated in urinary bladder dysfunction as an inflammatory mediator driving sensory nerve hypersensitivity. However, the direct influence of histamine on smooth muscle has not been thoroughly investigated. We hypothesized that histamine directly contracts urinary bladder smooth muscle (UBSM) independent of effects on nerves. Single cell quantitative RT-PCR determined that only histamine H
1 and H2 receptors were expressed on UBSM cells. In isolated tissue bath experiments, histamine (200 µM) caused a highly variable and rapidly desensitizing contraction that was completely abolished by the H1 receptor antagonist fexofenadine (5 µM) and the Gq/11 inhibitor YM254890 (1 µM). Neither the muscarinic receptor antagonist atropine (1 µM), the Na+ channel blocker tetrodotoxin (1 µM), nor the transient receptor potential vanilloid type 1 antagonist capsazepine (10 µM) altered responses to histamine, suggesting that nerve activation was not involved. UBSM desensitization to histamine was not due to receptor internalization, as neither the cholesterol-depleting agent methyl-β-cyclodextrin (10 mM), the dynamin-mediated endocytosis inhibitor dynasore (100 µM), nor the clathrin-mediated endocytosis inhibitor pitstop2 (15 µM) augmented or prolonged histamine contractions. Buffer from desensitized tissues still contracted histamine-naïve tissues, revealing that histamine was not metabolized. Prolonged exposure to histamine also had no effect on contractions due to electrical field stimulation, suggesting that both efferent nerve and UBSM excitability were unchanged. Together, these data suggest that histamine, although able to transiently contract UBSM, does not have a lasting effect on UBSM excitability or responses to efferent nerve input. Thus, any acute effects of histamine directly on UBSM contractility are unlikely to alter urinary bladder function. NEW & NOTEWORTHY Histamine is commonly associated with inflammatory bladder pathologies. We sought to investigate the role of histamine on urinary bladder contractility. Histamine contracts the bladder, but this response is highly variable and desensitizes completely in minutes. This desensitization is not due to internalization of the receptor or metabolism of histamine. Because nerve-evoked contractions are also not increased in the presence of histamine, our findings suggest that histamine is not directly acting to change contractility.- Published
- 2022
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38. Moving beyond Definitive Therapy: Increasing Physical Activity in Survivors of Cancers of the Head and Neck.
- Author
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Nehlsen AD, Sindhu KK, Jones BM, Lehrer EJ, Rowley JP, and Bakst RL
- Subjects
- Exercise, Humans, Survivors, Survivorship, Head and Neck Neoplasms therapy
- Abstract
As chemotherapeutic, radiation, and surgical techniques have improved, there has been a dramatic improvement in survival in patients diagnosed with cancers of the head and neck. As a result, a heightened focus on survivorship by clinicians will increasingly prove necessary. In particular, medical care teams will have to pay special attention to mitigating the long-term sequelae of definitive cancer treatments, many of which act as barriers to exercise. This is unfortunate, as the benefits of exercise in patients with cancer have become increasingly recognized. In this review, we discuss the potential benefits of and barriers to exercise in survivors of cancers of the head and neck. We also review existing exercise guidelines and strategies by which clinicians can promote exercise in this unique patient population.
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- 2022
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39. Healthcare Disparities and Outcomes of Cancer Patients in a Community Setting from a COVID-19 Epicenter.
- Author
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Jones BM, Lehrer EJ, Saraf A, Shafaee Z, Resende Salgado L, and Osborn VW
- Subjects
- COVID-19 Testing, Healthcare Disparities, Humans, Male, Pandemics, Retrospective Studies, SARS-CoV-2, United States epidemiology, COVID-19 epidemiology, Neoplasms epidemiology, Neoplasms therapy
- Abstract
There have been numerous studies demonstrating how cancer patients are at an increased risk of mortality. Within New York City, our community hospital emerged as an epicenter of the first wave of the pandemic in the spring of 2020 and serves a unique population that is predominately uninsured, of a lower income, and racially/ethnically diverse. In this single institution retrospective study, the authors seek to investigate COVID-19 diagnosis, severity and mortality in patients with an active cancer diagnosis. Demographic, clinical characteristics, treatment, SARS-CoV-2 laboratory results, and outcomes were evaluated. In our community hospital during the first wave of the COVID-19 pandemic in the United States, patients with active cancer diagnosis appear to be at increased risk for mortality (30%) and severe events (50%) due to the SARS-CoV-2 infection compared to the general population. A higher proportion of active cancer patients with Medicaid insurance, Hispanic ethnicity, other race, and male sex had complications and death from COVID-19 infection. The pandemic has highlighted the health inequities that exist in vulnerable patient populations and underserved communities such as ours.
- Published
- 2022
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40. A Continuing Education Activity Durably Addressed Knowledge Gaps Related to Penicillin Allergies Among Pharmacists and Pharmacy Technicians.
- Author
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Covington EW, Durham SH, Bland CM, Bookstaver PB, Chahine EB, Cho JC, Diggs F, Jones BM, Kyle JA, Stover KR, Wagner JL, and Hughes PJ
- Abstract
Background: Penicillin allergy is one of the most frequent self-reported allergies; however, only about 10% of reported allergies are accurate. Objectives: Through the creation of a continuing pharmacy education (CPE) activity, we sought to assess knowledge gaps and comfort levels in the management of penicillin allergies. Methods: A 1-hour enduring-content CPE activity was offered as an interactive course from September 20, 2019, to September 20, 2020. Participants completed 3 surveys (pre-survey, post-survey, and follow-up survey). Participants were pharmacists and pharmacy technicians who completed, at a minimum, the activity and both pre- and post-surveys. The primary outcome was the percentage of participants scoring >80% on knowledge-based questions on the post-survey compared with the pre-survey. Secondary outcomes included pre-post comparisons on knowledge-based questions, participants' self-report of an allergy, and comfort levels dispensing cephalosporins in a patient with a self-reported penicillin allergy. Results: A total of 389 participants completed the CPE activity, with 176 included for analysis. Significantly more participants scored >80% on knowledge-based questions on the post-survey compared with the pre-survey (71.6% vs 22.7%, P < .001). There was no significant difference between the percentage of participants scoring >80% on the post-survey and the follow-up survey (71.6% vs 65%, P = .119). The majority of participants (74%) felt comfortable dispensing a cephalosporin in a patient with a penicillin allergy on the pre-survey, with similar percentages on the post- and follow-up surveys (77% and 90%, respectively). Conclusion: A targeted continuing education program improved overall knowledge, which was sustained for up to 2 months., Competing Interests: Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SHD: has served on the advisory boards for Shionogi Pharmaceuticals and Theratechnologies.CMB: Advisory Board: Merck Pharmaceuticals; Speaker’s Bureau: Merck Pharmaceuticals; Grant Funding: ALK Abello, Inc, and Merck Pharmaceuticals.PBB: receives consultation fees from Kedrion Biopharma; content developer and CE provider for programs funded by Eli Lilly.EBC: serves on the advisory board for Theratechnologies and on the speakers’ bureau of Paratek Pharmaceuticals.JCC: serves on the speaker’s bureau for Allergan and has served on the advisory board for AcelRx Pharmaceuticals.BMJ: serves on the speaker’s bureau or has consulted for Allergan/Abbvie, Tetraphase/La Jolla, Merck, Melinta, and Paratek, and has received grant funding from Merck and ALK Abello.PJH: serves on the Continuing Pharmacy Education Commission for the Accreditation Council for Pharmacy Education (ACPE). The views expressed in this work only represent the authors’ views and do not necessarily represent the views of ACPE.EWC, FD, JAK, KRS, and JLW: have nothing to disclose., (© The Author(s) 2021.)
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- 2022
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41. The Benefits of Transcarotid Access for Transcatheter Aortic Valve Replacement: When Will We Stop Being So Surprised?
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Kirker E and Jones BM
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- Aortic Valve diagnostic imaging, Aortic Valve surgery, Fluoroscopy, Humans, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement
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- 2021
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42. Influence of Probiotics on the Development of Clostridioides difficile Infection in Patients Receiving Fluoroquinolones.
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Sheffield ME, Jones BM, Terrell B, Wagner JL, and Bland CM
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Fluoroquinolones are associated with an increased risk of Clostridioides difficile infection (CDI). Probiotic supplementation has been shown to reduce the risk of antibiotic-associated diarrhea with variable effects on CDI. The objective of this study was to evaluate receipt of probiotics on development of primary CDI among hospitalized patients receiving fluoroquinolones. A retrospective cohort was evaluated that consisted of two groups of 100 patients each, admitted August 2018 through August 2020 that received ≥3 days of definitive monotherapy with levofloxacin or ciprofloxacin within 72 h of admission. Primary outcome was incidence of CDI. Secondary outcomes included rates of C. difficile diagnostic stool testing, additional infectious diagnostic testing, and non-CDI related gastrointestinal side effects. Patients on fluoroquinolones who received probiotics had a non-statistically significantly lower incidence in overall cases of CDI compared to those who did not receive probiotics (0% vs. 3%, p = 0.246). Patients who received probiotics had statistically significantly fewer C. difficile diagnostic stool tests performed (4% vs. 16%, p = 0.005) and fewer additional infectious diagnostic testing performed (4% vs. 10%, p = 0.096), respectively. Further research is warranted to optimize and standardize probiotic prescribing in high-risk patients.
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- 2021
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43. Examination of the innominate movements in individuals with and without a positive march test.
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Jones BM and Yoshida Y
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[Purpose] The March Test (MT), evaluating hypomobility of the sacroiliac joint (SIJ), is often used in clinical practice to evaluate low back pain but has limited reported validity and reliability. Capturing the innominate movement at SIJ associated with the results of MT has not been examined. The purpose of this study was to determine if there was a significant difference in the motion of the innominate between a positive and a negative MT. [Participants and Methods] Sixteen healthy volunteers were assigned into two groups: positive or negative results of the MT. All participants were asked to perform three different tasks: standing on both limbs, static standing on one-limb and flexing the hip to 90 and 100 degrees, and active flexing the hip past 90 degrees. In a 3D motion analysis system, virtual vectors created by landmarks over the ilium defined innominate movement of the ilium related to the sacrum, which were compared between the groups. [Results] There was significantly limited innominate movement in the March Test positive group compared to the March Test negative group. [Conclusion] This study showed hypomobility at SIJ in the March test positive groups. Further investigation is needed for clinical applications., (2021©by the Society of Physical Therapy Science. Published by IPEC Inc.)
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- 2021
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44. Voluntary Wheel Running Partially Attenuates Early Life Stress-Induced Neuroimmune Measures in the Dura and Evoked Migraine-Like Behaviors in Female Mice.
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Eller OC, Yang X, Fuentes IM, Pierce AN, Jones BM, Brake AD, Wang R, Dussor G, and Christianson JA
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Migraine is a complex neurological disorder that affects three times more women than men and can be triggered by endogenous and exogenous factors. Stress is a common migraine trigger and exposure to early life stress increases the likelihood of developing chronic pain disorders later in life. Here, we used our neonatal maternal separation (NMS) model of early life stress to investigate whether female NMS mice have an increased susceptibility to evoked migraine-like behaviors and the potential therapeutic effect of voluntary wheel running. NMS was performed for 3 h/day during the first 3 weeks of life and initial observations were made at 12 weeks of age after voluntary wheel running (Exercise, -Ex) or sedentary behavior (-Sed) for 4 weeks. Mast cell degranulation rates were significantly higher in dura mater from NMS-Sed mice, compared to either naïve-Sed or NMS-Ex mice. Protease activated receptor 2 (PAR2) protein levels in the dura were significantly increased in NMS mice and a significant interaction of NMS and exercise was observed for transient receptor potential ankyrin 1 (TRPA1) protein levels in the dura. Behavioral assessments were performed on adult (>8 weeks of age) naïve and NMS mice that received free access to a running wheel beginning at 4 weeks of age. Facial grimace, paw mechanical withdrawal threshold, and light aversion were measured following direct application of inflammatory soup (IS) onto the dura or intraperitoneal (IP) nitroglycerin (NTG) injection. Dural IS resulted in a significant decrease in forepaw withdrawal threshold in all groups of mice, while exercise significantly increased grimace score across all groups. NTG significantly increased grimace score, particularly in exercised mice. A significant effect of NMS and a significant interaction effect of exercise and NMS were observed on hindpaw sensitivity following NTG injection. Significant light aversion was observed in NMS mice, regardless of exercise, following NTG. Finally, exercise significantly reduced calcitonin gene-related peptide (CGRP) protein level in the dura of NMS and naïve mice. Taken together, these findings suggest that while voluntary wheel running improved some measures in NMS mice that have been associated with increased migraine susceptibility, behavioral outcomes were not impacted or even worsened by exercise., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Eller, Yang, Fuentes, Pierce, Jones, Brake, Wang, Dussor and Christianson.)
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- 2021
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45. Eosinophilic pneumonia caused by cefepime: A case report and review.
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Jones BM, Murray EY, Crosby C, Rojas S, and Bland CM
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Eosinophilic pneumonia (EP) is characterized by accumulation of eosinophils in the lungs and has been associated with several medications, including antimicrobials. Cefepime is a commonly used broad-spectrum antimicrobial agent for the treatment of nosocomial infections but to date has not been associated with EP. We report the first documented case of EP secondary to cefepime for the treatment of pneumonia. The patient's peripheral eosinophilia and leukocytosis resolved promptly after discontinuation of cefepime and initiation of steroid treatment., (© 2021 The Authors.)
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- 2021
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46. Individual differences in honey bee behavior enabled by plasticity in brain gene regulatory networks.
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Jones BM, Rao VD, Gernat T, Jagla T, Cash-Ahmed AC, Rubin BE, Comi TJ, Bhogale S, Husain SS, Blatti C, Middendorf M, Sinha S, Chandrasekaran S, and Robinson GE
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- Animals, Individuality, Phenotype, Social Behavior, Transcription Factors metabolism, Bees physiology, Behavior, Animal physiology, Brain physiology, Gene Regulatory Networks, Neuronal Plasticity physiology
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Understanding the regulatory architecture of phenotypic variation is a fundamental goal in biology, but connections between gene regulatory network (GRN) activity and individual differences in behavior are poorly understood. We characterized the molecular basis of behavioral plasticity in queenless honey bee ( Apis mellifera ) colonies, where individuals engage in both reproductive and non-reproductive behaviors. Using high-throughput behavioral tracking, we discovered these colonies contain a continuum of phenotypes, with some individuals specialized for either egg-laying or foraging and 'generalists' that perform both. Brain gene expression and chromatin accessibility profiles were correlated with behavioral variation, with generalists intermediate in behavior and molecular profiles. Models of brain GRNs constructed for individuals revealed that transcription factor (TF) activity was highly predictive of behavior, and behavior-associated regulatory regions had more TF motifs. These results provide new insights into the important role played by brain GRN plasticity in the regulation of behavior, with implications for social evolution., Competing Interests: BJ, VR, TG, TJ, AC, BR, TC, SB, SH, CB, MM, SS, SC, GR No competing interests declared, (© 2020, Jones et al.)
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- 2020
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47. Financial Analysis of Dalbavancin for Acute Bacterial Skin and Skin Structure Infections for Self-Pay Patients.
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Pizzuti AG, Murray EY, Wagner JL, Gaul DA, Bland CM, and Jones BM
- Abstract
Introduction: Acute bacterial skin and skin structure infections (ABSSSI) are an increasing cause of admission in the self-pay population. We previously reported that patients with ABSSSI discharged to receive dalbavancin showed a decreased length of stay (LOS) and total direct costs without increasing 30-day readmission rate. For patients who are financially eligible, a dalbavancin vial replacement program can offset costs. The objective of this study was to determine cost differences in treating ABSSSI in self-pay inpatients discharged to receive dalbavancin compared to standard of care (SOC)., Methods: This retrospective cohort within a community health system compared self-pay adult inpatients with ABSSSI from February 3, 2016 to August 5, 2019 discharged to receive dalbavancin at an outpatient infusion center with SOC intravenous antibiotics. Patients were included with cellulitis, abscess, or postoperative wound infections diagnoses on the basis of International Classification of Disease, Tenth Revision (ICD-10) codes. Excluded populations were patients without dalbavancin vial replacement performed, pregnant, infections caused exclusively by gram-negative bacteria or fungi, or ICD-10 codes not consistent with ABSSSI. The primary outcome was direct cost of hospital stay. Secondary outcomes included length of stay (LOS), 30-day readmission rates, adverse events (AE), and indirect hospital costs. On the basis of previous studies, a one-sided Student's t test was performed on financial data., Results: Twelve dalbavancin and 263 SOC patients met inclusion criteria. Direct cost ($2758 vs $4010, p = 0.105) and indirect hospital cost ($2913 vs $3646 , p = 0.162) per patient were less in the dalbavancin group. There was no significant difference between median LOS (4 vs 4, p = 0.888), AE (0% vs 14.8%), and 30-day readmission rates for dalbavancin vs SOC group (8.3% vs 7.2%, p = 0.604)., Conclusion: Self-pay patients with ABSSSI discharged to receive dalbavancin with vial replacement resulted in decreased direct and indirect costs per patient with similar 30-day readmission rates, AE, and LOS. More studies targeted toward this population are warranted to determine ultimate benefit.
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- 2020
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48. Transcarotid Versus Subclavian/Axillary Access for Transcatheter Aortic Valve Replacement With SAPIEN 3.
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Kirker E, Korngold E, Hodson RW, Jones BM, McKay R, Cheema M, Heimansohn D, Moainie S, Hermiller J, Chatriwalla A, Saxon J, and Allen KB
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- Aged, Aged, 80 and over, Aortic Valve Stenosis complications, Aortic Valve Stenosis mortality, Cardiac Catheterization adverse effects, Carotid Arteries, Female, Heart Valve Prosthesis, Hospitalization, Humans, Male, Middle Aged, Propensity Score, Retrospective Studies, Survival Rate, Transcatheter Aortic Valve Replacement adverse effects, Treatment Outcome, Aortic Valve Stenosis surgery, Cardiac Catheterization methods, Postoperative Complications epidemiology, Stroke epidemiology, Transcatheter Aortic Valve Replacement methods
- Abstract
Background: Subclavian/axillary (TAx) access has become the most frequently used alternative access route for transcatheter aortic valve replacement (TAVR). Transcarotid (TC) TAVR has grown in popularity recently. Comparative data between these 2 contemporary access methods is lacking., Methods: Data were extracted from The Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry™ (June 2015 to October 2019) for patients undergoing TAVR by TC or TAx access with the SAPIEN 3 and SAPIEN 3 Ultra (Edwards Lifesciences, Irvine, CA) transcatheter heart valves. Procedural, index hospitalization, and 30-day outcomes were analyzed for TC vs TAx groups after 1:2 propensity matching of patient baseline characteristics., Results: The study included 3903 cases, of which 801 TC and 3102 TAx procedures were compared. After 1:2 propensity matching, TC TAVR was associated with similar 30-day mortality (4.3% vs 5.2%, P = .34) but a significantly lower risk of stroke (4.2% vs 7.4%; hazard ratio, 0.56; 95% confidence interval, 0.38-0.83; P = .003) compared with TAx access. Other outcomes that favored TC over TAx included shorter procedure time (117.0 vs 132.4 minutes; P < .001) and fluoroscopy time (16.6 vs 21.6 min; P < .001), lower contrast volume (78.5 vs 96.7 mL; P < .001), shorter length of stay in the intensive care unit (24.3 vs 25.0 hours; P = .02) and hospital (2.0 vs 3.0 days; P = .002), and more patients discharged to home (82.9% vs 74.6%; P < .001)., Conclusions: TC TAVR is associated with similar mortality and a significant reduction in stroke compared with the TAx approach. If femoral access is precluded, TC may be a safe, or at times, preferred avenue of transcatheter valve delivery., (Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
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- 2020
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49. Femoral condylar locking compression plates: a case series. The Rural District General Hospital Experience.
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Jones BM, Nugent L, and Griffin SJ
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Most studies regarding the use of locking condylar plates in distal femoral fractures have been carried out in tertiary centres. The aim of this case series was to examine outcomes for patients managed in a rural setting and to answer the question: 'should we be shipping these patients out to a regional trauma centre?' Recent insertions of condylar locking compression plates (LCPs) at a rural district general hospital were examined. (All used the Synthes LCP Condylar Plate 4.5/5.0 periarticular plating system) . Their clinical records and radiology were reviewed to identify failure rates and facilitate discussion of such cases. Of 36 reviewed cases, 4 instances of failure were identified (11%), and their cases are discussed individually herein. This review not only affords the opportunity to discuss cases of failure and to speculate upon their potential causes, but also highlights reassuringly high quality of outcomes for these patients outside of larger teaching hospitals., (Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.)
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- 2020
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50. Behavior-related gene regulatory networks: A new level of organization in the brain.
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Sinha S, Jones BM, Traniello IM, Bukhari SA, Halfon MS, Hofmann HA, Huang S, Katz PS, Keagy J, Lynch VJ, Sokolowski MB, Stubbs LJ, Tabe-Bordbar S, Wolfner MF, and Robinson GE
- Subjects
- Animals, Brain growth & development, Gene Expression Regulation, Developmental, Humans, Behavior, Brain physiology, Gene Regulatory Networks
- Abstract
Neuronal networks are the standard heuristic model today for describing brain activity associated with animal behavior. Recent studies have revealed an extensive role for a completely distinct layer of networked activities in the brain-the gene regulatory network (GRN)-that orchestrates expression levels of hundreds to thousands of genes in a behavior-related manner. We examine emerging insights into the relationships between these two types of networks and discuss their interplay in spatial as well as temporal dimensions, across multiple scales of organization. We discuss properties expected of behavior-related GRNs by drawing inspiration from the rich literature on GRNs related to animal development, comparing and contrasting these two broad classes of GRNs as they relate to their respective phenotypic manifestations. Developmental GRNs also represent a third layer of network biology, playing out over a third timescale, which is believed to play a crucial mediatory role between neuronal networks and behavioral GRNs. We end with a special emphasis on social behavior, discuss whether unique GRN organization and cis -regulatory architecture underlies this special class of behavior, and review literature that suggests an affirmative answer., Competing Interests: The authors declare no competing interest.
- Published
- 2020
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