Towards machine learning-based quantitative hyperspectral image guidance for brain tumor resection.

Background: Complete resection of malignant gliomas is hampered by the difficulty in distinguishing tumor cells at the infiltration zone. Fluorescence guidance with 5-ALA assists in reaching this goal. Using hyperspectral imaging, previous work characterized five fluorophores' emission spectra in most human brain tumors.

Reduced 30-day in-hospital but increased long-term mortality for weekend vs weekday acute medical admission.

Background: Acute medical admission at the weekend has been reported to be associated with increased mortality. We aimed to assess 30-day in-hospital mortality and subsequent follow-up of all community deaths following discharge for acute medical admission to our institution over 21 years.

Methods: We employed a database of all acute medical admissions to our institution over 21 years (2002-2023).

Red Cell Distribution Width as a Prognostic Indicator in Acute Medical Admissions.

The red cell distribution width (RDW) is the coefficient of variation of the mean corpuscular volume (MCV). We sought to evaluate RDW as a predictor of outcomes following acute medical admission. We studied 10 years of acute medical admissions (2002-2011) with subsequent follow-up to 2021.

Time-to-Event Analysis of Factors Influencing Delay in Discharge from a Subacute Complex Discharge Unit during the First Year of the Pandemic (2020) in an Irish Tertiary Centre Hospital.

Our study aimed to analyse delaying factors amongst patients with a length of stay (LOS) > 15 days during the COVID-19 pandemic using time-to-event analysis. A total of 390 patients were admitted between March 2020-February 2021 to the subacute complex discharge unit in St James's Hospital: 326 (83.6%) were >65 years of age and 233 (59.

Prognostic value and clinical utility of NT-proBNP in acute emergency medical admissions.

Background: NT-proB-type natriuretic peptide (NT-proBNP) is a frequently utilized test in congestive cardiac failure. There is little data on its utility in unselected emergency medical admissions.

Aim: This study aims to investigate the clinical utility and prognostic value of NT-proBNP in emergency medical admissions and to determine whether such testing influenced downstream investigations and length of stay (LOS).

Hospital mortality and length of stay differences in emergency medical admissions related to 'on-call' specialty.

Background: The outcomes of acute medical admissions have been shown to be influenced by a variety of factors including system, patient, societal, and physician-specific differences.

Aim: To evaluate the influence of on-call specialty on outcomes in acute medical admissions.

Methods: All acute medical admissions to our institution from 2015 to 2020 were evaluated.

Severe COVID-19 is characterised by inflammation and immature myeloid cells early in disease progression.

SARS-CoV-2 infection causes a wide spectrum of disease severity. Identifying the immunological characteristics of severe disease and the risk factors for their development are important in the management of COVID-19. This study aimed to identify and rank clinical and immunological features associated with progression to severe COVID-19 in order to investigate an immunological signature of severe disease.

Title: Understanding a Low Vitamin D State in the Context of COVID-19.

While a low vitamin D state has been associated with an increased risk of infection by SARS-CoV-2 in addition to an increased severity of COVID-19 disease, a causal role is not yet established. Here, we review the evidence relating to i) vitamin D and its role in SARS-CoV-2 infection and COVID-19 disease ii) the vitamin D status in the Irish adult population iii) the use of supplemental vitamin D to treat a deficient status and iv) the application of the Bradford-Hill causation criteria. We conclude that reverse causality probably makes a minimal contribution to the presence of low vitamin D states in the setting of COVID-19.

Emergency medical admissions and COVID-19: impact on 30-day mortality and hospital length of stay.

Background: The COVID-19 pandemic has put considerable strain on healthcare systems.

Aim: To investigate the effect of the COVID-19 pandemic on 30-day in-hospital mortality, length of stay (LOS) and resource utilization in acute medical care.

Methods: We compared emergency medical admissions to a single secondary care centre during 2020 to the preceding 18 years (2002-2019).

Investigating the Relationship between Vitamin D and Persistent Symptoms Following SARS-CoV-2 Infection.

The emergence of persistent symptoms following SARS-CoV-2 infection, known as , is providing a new challenge to healthcare systems. The cardinal features are fatigue and reduced exercise tolerance. Vitamin D is known to have pleotropic effects far beyond bone health and is associated with immune modulation and autoimmunity.

Non-Specific Clinical Presentations are Not Prognostic and do not Anticipate Hospital Length of Stay or Resource Utilization.

Aim: To investigate whether a specific (SP) or non-specific (NSP) clinical presentation, predicts prognosis and in-hospital resource utilization in emergency medical admissions.

Methods: We studied admissions over 5 years (2015-2019) and classified the symptom presentation as SP or NSP. The predictive capacity of the NSP category was related to 30-day in-hospital mortality with a multivariable logistic regression model.

Is there excessive troponin testing in clinical practice? Evidence from emergency medical admissions.

Aim: To investigate whether excessive high-sensitivity cardiac troponin T (hscTnT) testing, in non-cardiac presentations, increases hospital length of stay (LOS) by driving down-stream investigations.

Methods: We report on all hscTnT tests in emergency medical admissions, performed over a 9-year period between 2011-2019. Troponin testing frequency in different risk cohorts was determined and related to 30-day in-hospital mortality with a multivariable logistic regression model adjusted for other outcome predictors.

Comparative influence of Acute Illness Severity and comorbidity on mortality.

Background: The extent to which illness severity and comorbidity determine the outcome of an emergency medical admission is uncertain. We aim to quantitate the relative effect of these factors on mortality.

Methods: We evaluated all emergency medical admission to our institution between 2002 and 2018.

Outcomes in acute medicine - Evidence from extended observations on readmissions, hospital length of stay and mortality outcomes.

Background: The Acute Medical Admission Unit (AMAU) model of care has been widely deployed, we examine changes in hospital readmission rates, length of stay (LOS) and 30-day in-hospital mortality over 16 years.

Methods: All emergency medical admissions between 2002 and 2017 were examined. We assessed 30-day in-hospital mortality, readmission rates, and LOS using logistic regression and margins statistics modelled outcomes against predictor variables.

Lung function and outcomes in emergency medical admissions.

Background: We examine the ability of pre-existing measures of Forced Expiratory Volume in 1 s (FEV1), and Diffusion Capacity for Carbon Monoxide (DLCO) to determine the subsequent 30-day mortality outcome following unselected acute medical admission.

Methods: Between 2002 and 2017, we studied all emergency medical admissions (106,586 episodes in 54,928 patients) of whom 8071 were classified as respiratory. We employed logisitic multiple variable regression models to evaluate the ability of FEV1 or DLCO to predict the 30-day hospital mortality outcome.

Hyponatraemia during an emergency medical admission as a marker of illness severity & case complexity.

Background: Altered sodium balance at time of an emergency medical admission adversely impacts on outcome; whether hyponatraemia is independently associated with outcomes or a surrogate of acute illness severity has been debated.

Methods: All emergency medical admissions between 2002 and 2017 were studied and a risk score calculated. We compared univarate deciles of admission sodium using a multivariable model, adjusting for risk score.

Admission and readmission rate incidences from deprived areas-impact of a classical or multi-dimensional model.

Introduction: Classical deprivation instruments use a factor analytical approach relying on a smaller number of dimensions, factors or components. Multi-dimensional deprivation models attempt classification in fine detail-even down to street level.

Methods: Single-centre retrospective cohort study using routinely collected aggregated and anonymised data on emergency medical admissions (96,526 episodes in 50,731 patients; 2002-2016).

Relationship of the clinical acuity & complexity to the outcome of an emergency medical admission.

Background: An Illness Severity and Co-morbidity composite score can predict 30-day mortality outcome.

Methods: We computed a summary risk score (RS) for emergency medical admissions and used cluster analysis to define four subsets Results: Four cluster groups were defined. Cluster 1 - RS 7 points (IQR 5, 8) Cluster 2 - 9 (IQR 8, 11), Cluster 3 - 12 (IQR 11, 13) and Cluster 4 - 14 (IQR 13, 15).