Publications by authors named "Johnston E"

Purpose: Contrast-enhanced CT (CECT) may be performed immediately following microwave liver ablation for assessment of ablative margins. However, practices and protocols vary among institutions. Here, we compare a standardized bolus-tracked biphasic CECT protocol and compare this with a single venous phase fixed delay protocol for ablation zone (AZ) assessment.

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Background: Multimorbidity, the co-existence of two or more conditions within an individual at any one time, is globally increasing and forecasted to rise. This poses a significant challenge for current models of healthcare delivery, which are now ill-equipped to meet the future population health needs. Interprofessional collaborative practice is a specific way professionals work closely together and with patients and their families to improve patient outcomes.

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  • The study investigates how using vaginal lubricants during transvaginal ultrasound (TVUS) affects the vaginal microbiota, focusing on beneficial bacteria like Lactobacillus spp.
  • The researchers monitored 104 participants over 10 weeks, collecting vaginal swabs before, during, and after the use of lubricant to examine changes in microbiota composition.
  • Results showed no immediate changes in microbiota composition after one week, highlighting the need for further research on the long-term impact of lubricants on vaginal health.
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Objectives: While emergency cholecystectomy is the preferred treatment for acute cholecystitis, conservative management can be used as a bridge to definitive surgical management in situations where emergency surgical services are limited. The objective of this systematic review is to identify factors associated with conservative management failure as defined as either failed resolution of symptoms on initial presentation, or the recurrence of symptoms whilst awaiting an elective cholecystectomy. This study aims to allow clinicians to make evidence-based recommendations for conservative versus operative management.

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End-of-life (EOL) care is a critical part of sickle cell disease (SCD) management. However, barriers to high-quality EOL care remain, including (1) disease-related barriers (prior opioid exposure, risk of vaso-occlusive crises, chronic conditions with conflicting needs, and limitations of receiving disease-directed therapy on hospice); (2) communication-related barriers (challenges of identifying and responding to religious and spiritual concerns, limited health literacy, and previous health care system experience); (3) systemic issues (social determinants of health, structural racism, and mistrust of the medical system). However, palliative care and interdisciplinary collaboration can overcome many of these barriers.

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Underserved communities were disproportionately affected during the coronavirus (COVID-19) pandemic. Limited data exist on the impact of COVID-19 among refugee populations because refugee status is not often classified in electronic medical record (EMR) systems, unlike race or primary language. The study aim was to evaluate the PCR-based prevalence of SARS-CoV-2 in a delivering population over the first 2 years of the pandemic by refugee status, ethnicity, insurance, and vaccination status.

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Breast cancer is the most common cancer in women worldwide. Many breast cancers originate from the cells lining the milk duct and some become invasive. Breast cancer lacking estrogen, progesterone receptors (ER-, PR-) and epidermal growth factor receptor 2 (HER2-) amplification, termed "Triple negative" (TNBC) is reported to frequently affect Black women and younger women.

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  • There's a growing population of older adults with kidney disease, but there's not enough evidence to help improve their clinical care, prompting the KDARC to conduct a study on research priorities in geriatric nephrology.
  • The study used a modified Delphi approach involving clinicians and researchers in the US and Canada to gather and prioritize important research topics for better care of older adults with kidney issues.
  • Five key research priorities were identified: improving communication about treatment options, enhancing quality of life and symptom management, addressing frailty, tailoring therapies for older adults, and providing caregiver support, all underlined by the importance of health equity and patient-centered care.
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Rationale And Objectives: Intratumoral heterogeneity means single site tumor biopsy might not be representative. Here we develop and optimize an MRI-informed robotic multiregional 'smart' biopsy technique in retroperitoneal and pelvic sarcomas (RPS). We also explore the relationship between imaging and histological biomarkers.

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Background: Online forums are a key source of information about complementary and alternative medicine (CAM) for people affected by cancer, especially when information needs are not met in healthcare settings. This study therefore investigated nutrition-related CAM information seeking and sharing in online forums for people affected by cancer.

Methods: This study was conducted in a major online platform that hosts over 10 forums for people affected by cancer and has more than 10,000 registered users.

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Utilization of guideline-directed medical therapy in patients hospitalized for acute heart failure is suboptimal during the hospitalization and after discharge. An inpatient heart failure order set may be a convenient and useful intervention to improve heart failure therapy in the inpatient setting. This is a retrospective study that assessed the use of an inpatient heart failure order set on pharmacologic therapy in patients hospitalized for acute heart failure from May to August 2022.

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Background: Kidney transplant (KT) candidates often experience hospitalizations, increasing their delirium risk. Hospitalizations and delirium are associated with worse post-KT outcomes, yet their relationship with pre-KT outcomes is less clear. Pre-KT delirium may worsen access to KT due to its negative impact on cognition and ability to maintain overall health.

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Purpose: Caregivers provide vital support to people with cancer but often report feeling unsupported themselves. This study investigated rural caregivers' experiences seeking support for their health and wellbeing while caring for someone with cancer.

Methods: Through semi-structured interviews, 20 rural caregivers described their experiences seeking and accessing support for their own health and wellbeing while caring for someone with cancer, including what support was, or would have been, helpful.

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Background: Directly-injected therapies (DIT) include a broad range of agents within a developing research field in cancer immunotherapy, with encouraging clinical trial results in various tumour subtypes. Currently, the majority of such therapies are only available within clinical trials; however, more recently, talimogene laherparepvec (T-VEC, Imlygic) has been approved as the first oncolytic virus therapy in the USA and Europe. Our institution contributes to multiple different trials exploring the efficacy of DIT, the majority of which are performed by oncologists in clinic.

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Introduction: Dietary restrictions for patients with end-stage kidney disease (ESKD) are burdensome. Kidney transplantation (KT) candidates who lack neighborhood resources and are burdened by dietary restrictions may have decreased access to KT.

Methods: In our two-center prospective cohort study (2014-2023), 2471 ESKD patients who were evaluated for KT (candidates) reported their perceived burden of dietary restrictions (not at all, somewhat/moderately, or extremely bothered).

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Introduction: Variants of uncertain significance (VUS) are commonly reported in cancer with the widespread adoption of diagnostic massive parallel sequencing. The rate of reclassification of VUS in patients with haematological malignancy is not known and we evaluated this retrospectively. We also investigated whether re-evaluating VUS in 12-24 months or greater than 24 months post-initial classification was significant.

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Background: Cancer is the fourth leading cause of death in adolescents and young adults (AYA) worldwide. Although successful treatment of cancer in AYA has increased in recent years in most of the world, this is not true for many low- and middle-income countries (LMIC) where over 80% of all AYA live. This study investigated the needs of AYA with cancer in parts of Latin America (LATAM) through the perspectives of non-physician health care providers and partners.

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Article Synopsis
  • - The review investigates how eHealth interventions can improve outcomes for patients suffering from Post Intensive Care Syndrome (PICS), which includes long-term physical, psychological, and cognitive impairments after critical care. - Thirteen studies were analyzed, showing significant variability in how eHealth was delivered and the outcomes measured, with a focus predominantly on feasibility and limited targeting of cognitive impairments. - Although interventions aimed at psychological recovery report some positive effects, the studies lacked robust data and comprehensive assessments of their acceptability; aspects like usability and perceived usefulness were noted as facilitators, while acceptability remained an unexplored barrier in many cases.
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AbstractSuccessional dynamics can vary because of a range of ecological and environmental factors, but our understanding of biogeographic variation in succession, and the processes contributing to community development across ecosystems, is limited. The pattern and rate of recruitment of dispersive propagules likely differs over large spatial scales and can be an important predictor of successional trajectory. Over a 20° tropical-temperate latitudinal gradient, we measured sessile invertebrates over 12 months of community development and successive 3-month recruitment windows to understand succession and how it is influenced by recruitment.

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Many studies have documented discrepancies in student evaluation of teaching ratings between male and female instructors and between ethnic majority and minority instructors. Given the importance of such ratings to academic careers and the likelihood of potential intergroup bias, it is crucial that institutions consider approaches to mitigate such biases. Several recent studies have found that simple bias mitigation messaging can be effective in reducing gender and other biases.

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  • There is a need for quick assessment tools to evaluate diet among US Spanish-speaking adults to identify those at risk for cardiometabolic disease (CMD).
  • Bilingual medical students helped translate the validated Diet Risk Score into Spanish (DRS-S) and administered it alongside a 24-hour dietary recall assessment to participants from a health center.
  • The study found a significant correlation between the DRS-S and the Healthy Eating Index (HEI)-2015 scores, indicating that the DRS-S is a useful tool in low-resource settings for diet assessment and referral to registered dietitian nutritionists (RDNs).
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Context: Palliative care (PC) has shown significant growth in the US and is associated with improved patient and caregiver experiences. Nevertheless, there are concerns that PC is underutilized in pediatric oncology. Understanding parental attitudes towards PC is crucial to improving PC utilization.

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