A Real-World Precision Medicine Program Including the KidneyIntelX Test Effectively Changes Management Decisions and Outcomes for Patients With Early-Stage Diabetic Kidney Disease.

Introduction/objective: The KidneyIntelX is a multiplex, bioprognostic, immunoassay consisting of 3 plasma biomarkers and clinical variables that uses machine learning to predict a patient's risk for a progressive decline in kidney function over 5 years. We report the 1-year pre- and post-test clinical impact on care management, eGFR slope, and A1C along with engagement of population health clinical pharmacists and patient coordinators to promote a program of sustainable kidney, metabolic, and cardiac health.

Methods: The KidneyIntelX in vitro prognostic test was previously validated for patients with type 2 diabetes and diabetic kidney disease (DKD) to predict kidney function decline within 5 years was introduced into the RWE study (NCT04802395) across the Health System as part of a population health chronic disease management program from [November 2020 to April 2023].

Methods to derive composite indicators used for quality and safety measurement and monitoring in healthcare: a scoping review protocol.

Introduction: Composite indicators of quality and safety in healthcare summarise performance across multiple indicators into a single performance measure. Composite indicators can identify domains and drivers of quality, improve the ability to detect differences, aid prioritisation for quality improvement and facilitate decision making about future healthcare needs. However, the use of composite indicators can be controversial, particularly when used to rank healthcare providers.

Corrigendum: A novel approach to utilizing the essential public health functions in Ireland's health system recovery and reform.

[This corrects the article DOI: 10.3389/fpubh.2023.

Global cognitive performance at 4-year follow-up in individuals with atrial fibrillation-findings from The Irish Longitudinal Study on Ageing.

Introduction: Atrial fibrillation (AF) has been proposed as a risk factor for cognitive impairment, even in the absence of a history of stroke. This study investigates whether AF is associated with increased risk of cognitive decline in a community-dwelling population of adults over the age of 50.

Methods: Data from the 1st and 3rd waves of The Irish Longitudinal Study on Ageing (TILDA) were used (4-year follow-up period).

Linking death registration and survey data: Procedures and cohort profile for The Irish Longitudinal Study on Ageing (TILDA).

Research on mortality at the population level has been severely restricted by an absence of linked death registration and survey data in Ireland. We describe the steps taken to link death registration information with survey data from a nationally representative prospective study of community-dwelling older adults. We also provide a profile of decedents among this cohort and compare mortality rates to population-level mortality data.

Unreported urinary incontinence: population-based prevalence and factors associated with non-reporting of symptoms in community-dwelling people ≥ 50 years.

Purpose: Concerns exist around under-detection and under-treatment of urinary incontinence (UI) in specific patient groups, particularly older people. The aim of this study is to ascertain the prevalence of unreported UI in a large sample of older adults, to profile factors associated with under-reporting of UI and the association of unreported UI with quality of life (QOL).

Methods: This study was embedded within the Irish Longitudinal Study on Ageing, involving a population-representative sample of almost 7,000 older adults (55% female, mean age 65 years).

Real-time assessment of learning curve for robot-assisted laparoscopic prostatectomy.

Introduction: The learning curves analysed to date for robot-assisted laparoscopic prostatectomy are based on arbitrary cut-offs of the total cases.

Methods: We analysed a large dataset of robot-assisted laparoscopic prostatectomies from a single centre between 2008 and 2019 for assessment of the learning curve for perioperative outcomes with respect to time and individual cases.

Results: A total of 1,406 patients were evaluated, with mean operative time 198.

The association between benzodiazepine use and falls, and the impact of sleep quality on this association: data from the TILDA study.

Background: Benzodiazepines (BZD) are associated with adverse effects, particularly in older adults.

Aim: This study assesses the association between BZD use and falls, and the impact of sleep quality on this association, in community dwelling adults aged over 50.

Design: Cross-sectional analysis of data from wave 1 of The Irish Longitudinal Study on Ageing.

Vitamin D Status Is Not Associated With Orthostatic Hypotension in Older Adults.

There has been much interest in investigating vitamin D status with orthostatic hypotension. However, studies have been small, inconsistent, and with a lack of standardization. The aim of this study was to investigate the association with vitamin D status in a large, nationally representative older adult population using a traceable standard of measurement and an accurate assessment of beat-to-beat blood pressure (BP).

Do Differences in Spatiotemporal Gait Parameters Predict the Risk of Developing Depression in Later Life?

Background/objectives: There is growing interest in the association between gait disturbance and depression in later life. The aim of this study is to clarify the longitudinal relationship between specific gait parameters and incident depression within a population-representative sample of older people.

Design: Longitudinal analysis of spatiotemporal gait parameters at baseline (wave 1) and incident depression at 2 and 4 years (waves 2/3).

The association between frontal lobe perfusion and depressive symptoms in later life.

Background: Deficits in frontal lobe perfusion have been demonstrated in late-life depression; however, studies to date have generally involved small numbers, used neuroimaging rather than bedside testing and have not controlled for important covariates.AimsWe aimed to examine the association between depressive symptoms and frontal lobe perfusion during standing, in a large cohort of community-dwelling older people.

Method: Participants aged ≥50 years underwent continuous measurement of orthostatic blood pressure by finometry, and frontal lobe perfusion by near-infrared spectroscopy.

Is Baseline Orthostatic Hypotension Associated With a Decline in Global Cognitive Performance at 4-Year Follow-Up? Data From TILDA (The Irish Longitudinal Study on Ageing).

Background It is postulated that orthostatic hypotension ( OH ), a reduction in blood pressure (≥20/10 mm Hg) within 3 minutes of standing, may increase cognitive decline because of cerebral hypoperfusion. This study assesses the impact of OH on global cognition at 4-year follow-up, and the impact of age and hypertension on this association. Methods and Results Data from waves 1 and 3 of TILDA (The Irish Longitudinal Study on Ageing) were used.

The association between antidepressant use and orthostatic hypotension in older people: a matched cohort study.

Orthostatic hypotension (OH) is often reported as a significant potential adverse effect of antidepressant use but the association between phasic blood pressure (BP) and antidepressants has not yet been investigated. This cross-sectional study compares continuously measured phasic BP and prevalence of OH in a cohort of antidepressant users ≥50 years compared with an age- and sex-matched cohort not taking antidepressants. OH was defined as a drop in systolic BP ≥ 20 mm Hg or in diastolic BP ≥ 10 mm Hg at 30 seconds after standing, measured using continuous beat-to-beat finometry.

Subpubic cartilaginous cyst: an unusual cause of urinary tract infection.

It is important to consider alternative causes when treating refractory cases of urinary tract infection in the elderly population.

Can Anterior Prostatic Fat Harbor Prostate Cancer Metastasis? A Prospective Cohort Study.

Objectives: Traditionally anterior prostatic fat (APF) hasn't been included in pelvic lymph node (LN) dissection templates following radical prostatectomy. In this study we evaluate the incidence of lymphoid tissue in the APF and the incidence of LN metastasis in APF in patients who have undergone robotic-assisted laparoscopic radical prostatectomy (RALP).

Methods: A prospective database of RALP has been maintained between January 2010 and September 2015.

Is orthostatic hypotension more common in individuals with atrial fibrillation?-Findings from The Irish Longitudinal Study on Ageing (TILDA).

Introduction: atrial fibrillation (AF) and orthostatic hypotension (OH) share common risk factors such as age, hypertension and cardiovascular (CV) disease. The autonomic nervous system (ANS) also plays a role in the pathogenesis of both AF and OH. The aim of this study is to assess whether individuals with AF are more likely to have OH than those without AF.

The Management of Unplanned Erection during Endoscopic Urological Surgery.

Penile erection at the time of urological surgery is a rare but problematic event which can delay, complicate or even lead to the cancellation of planned surgery. Erection may occur irrespective of the type of anesthetic method employed. Several techniques for treatment of this troublesome complication have been described in the literature, all with varying levels of success and potential adverse effects.

The management of vasovagal syncope.

Vasovagal syncope, or the "common faint", is the most common cause of syncope. Although it is considered a benign condition, there is a significant economic burden and significant impact on quality of life in patients with recurrent syncope, particularly in older adults. Typical vasovagal syncope usually occurs in young adults, and can often be diagnosed on the basis of history, in the absence of structural heart disease.

Clinical performance of prostate health index in men with tPSA>10ng/ml: Results from a multicentric European study.

Background: Evidence regarding the diagnostic accuracy of a [-2]proPSA derivative, namely, the prostate health index (PHI), to predict the presence of prostate cancer (PCa) in individuals with high total prostate-specific antigen (tPSA) levels is lacking. We tested the hypothesis that these markers could assist clinicians in the biopsy decision path of patients with tPSA>10ng/ml.

Methods: The primary endpoint was to evaluate the sensitivity, specificity, and diagnostic accuracy of PHI in determining the presence of PCa at biopsy in comparison to tPSA, free PSA, and % of free to total PSA.

Integrative review on the non-invasive management of lower urinary tract symptoms in men following treatments for pelvic malignancies.

Aim: To develop a non-invasive management strategy for men with lower urinary tract symptoms (LUTS) after treatment for pelvic cancer, that is suitable for use in a primary healthcare context.

Methods: PubMed literature searches of LUTS management in this patient group were carried out, together with obtaining a consensus of management strategies from a panel of authors for the management of LUTS from across the UK.

Results: Data from 41 articles were investigated and collated.

Generating selective saccharide binding affinity of phenyl boronic acids by using single-walled carbon nanotube corona phases.

Saccharides recognition is challenging due to their low affinity for substrates, yet this recognition is critical for human immunity and glycobiology. Herein, we demonstrate that a polymer or surfactant corona phase surrounding a single-walled carbon nanotube can substantially modify the selectivity of pre-adsorbed phenyl-boronic acids (PBA) for mono-, di-, and poly-saccharides. A library of 17 PBAs including carboxy, nitro, and amino PBA with ortho-, meta-, or para- substitutions are used to generate 144 distinct corona phases.