Edmund Manning - Academia.edu (original) (raw)
Papers by Edmund Manning
Optical Interactions with Tissue and Cells XXXI, 2020
Even though recent advances in medical devices have significantly improved clinical interventions... more Even though recent advances in medical devices have significantly improved clinical interventions, more accurate differentiation of biological tissues is still required to improve clinical decision-making. Tissue identification can be performed by using molecular-sensitive techniques such as diffuse reflectance spectroscopy (DRS), which is allows label-free, non-invasive, real-time and in situ interrogation of biological tissues. In this study, we used broadband DRS to extract biomolecule concentrations of gastrointestinal tissues and evaluated its potential for tissue identification and cancer detection. Diffuse reflectance spectra were analysed in an extended wavelength range between 350 nm and 1900 nm. This range covers the third optical window, which may allow better tissue identification for laparoscopy and gastrointestinal robotic surgery. Chromophore concentrations were obtained by using an inverse Monte Carlo Lookup table model to fit the reflectance spectrum.
The journal of nutrition, health & aging, 2016
Background: Malnutrition is common in older adults and is associated with high costs and adverse ... more Background: Malnutrition is common in older adults and is associated with high costs and adverse outcomes. The prevalence, predictors and outcomes of malnutrition on admission to hospital are not clear for this population. Design: Prospective Cohort Study. Setting: Six hospital sites (five public, one private). Participants: In total, 606 older adults aged 70+ were included. All elective and acute admissions to any speciality were eligible. Day-case admissions and those moribund on admission were excluded. Measurements: Sociodemographic and clinical data, including nutritional status (Mini-Nutritional Assessment-short form), was collected within 36 hours of admission. Outcome data was collected prospectively on length of stay, in-hospital mortality and new institutionalisation. Results: The mean age was 79.7; 51% were female; 29% were elective admissions; 67% were admitted to a medical specialty. Nutrition scores were available for 602/606; 37% had a 'normal' status, 45% were 'at-risk', and 18% were 'malnourished'. Malnutrition was more common in females, acute admissions, older patients and those who were widowed/ separated. Dementia, functional dependency, comorbidity and frailty independently predicted a) malnutrition and b) being at-risk of malnutrition, compared to normal status (p < .001). Malnutrition was associated with outcomes including an increased length of stay (p < .001), new institutionalisation (p =<0.001) and in-hospital mortality (p < .001). Conclusions: These findings support the prioritisation of nutritional screening in clinical practice and public health policy, for all patients ≥70 on admission to hospital, and in particular for people with dementia, increased functional dependency and/or multi-morbidity, and those who are frail.
Age and Ageing, 2016
Background: We have previously reported that almost 30% of older people admitted to acute hospita... more Background: We have previously reported that almost 30% of older people admitted to acute hospitals have dementia (Timmons et al., 2015), often un-diagnosed, but the prevalence of dementia in older people presenting to the Emergency Department (ED) is less well known. Method: Trained researchers assessed consecutive ED attendees in Mercy University Hospital, aged ≥70 years, for delirium and dementia using the Delirium Rating Scale-Revised 98 (DRS-R98; cutoff 18); standardised Mini-Mental State Examination; and
Age and Ageing, 2016
Background: Delirium is common but under-diagnosed in older people presenting to the Emergency De... more Background: Delirium is common but under-diagnosed in older people presenting to the Emergency Department (ED). ED staff need fast, valid tools to identify potential delirium in older attendees. The 4-AT is recommended nationally for delirium screening in ED, but has never been validated in an ED population. Method: A trained researcher assessed consecutive ED attendees ≥70 years for delirium and dementia using the Delirium Rating Scale-Revised 98 (DRS-R98; cutoff 18) and Informant Questionnaire on Cognitive Decline in the Elderly (cut-off 3.5), respectively.
International Journal of Geriatric Psychiatry, 2016
Many countries use national hospital discharge data to analyse hospital activity in relation to c... more Many countries use national hospital discharge data to analyse hospital activity in relation to certain diseases or populations. The Hospital In-Patient Enquiry (HIPE) system is Ireland’s current method for collecting information on in-patients discharged from acute hospitals, performed by trained administrative staff, using information documented in the medical case notes (Health Information and Quality Authority, 2014). It provides data on large numbers of patients at low cost, facilitates identification of secular trends and allows comparisons between hospitals/regions/countries. Like all routinely generated data, it is vulnerable to poor documentation. Clarke et al. (2010) have suggested that clinicians need to be involved in the discharge diagnosis coding process. Others stress that the discrepancies within the system are unacceptable when these data are used for assessing discharges, making comparisons with other countries and for determining funding allocation by the government (O’Callaghan et al., 2012). HIPE data have been used to estimate hospital dementiarelated activity in Ireland on several occasions (Connolly et al., 2014), and similar hospital episode statistics for dementia have been used in many countries. However, we had concerns about the effects of under-diagnosis and under-recording of dementia in such national hospital discharge data-sets and took the opportunity to test the accuracy of HIPE coding in a cohort study of dementia in older people admitted to hospital.
Age and ageing, Jan 28, 2015
previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single ... more previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status. of 598 older patients admitted to acute ho...
Critical Care
Background Baricitinib has shown efficacy in hospitalized patients with COVID-19, but no placebo-... more Background Baricitinib has shown efficacy in hospitalized patients with COVID-19, but no placebo-controlled trials have focused specifically on severe/critical COVID, including vaccinated participants. Methods Bari-SolidAct is a phase-3, multicentre, randomised, double-blind, placebo-controlled trial, enrolling participants from June 3, 2021 to March 7, 2022, stopped prematurely for external evidence. Patients with severe/critical COVID-19 were randomised to Baricitinib 4 mg once daily or placebo, added to standard of care. The primary endpoint was all-cause mortality within 60 days. Participants were remotely followed to day 90 for safety and patient related outcome measures. Results Two hundred ninety-nine patients were screened, 284 randomised, and 275 received study drug or placebo and were included in the modified intent-to-treat analyses (139 receiving baricitinib and 136 placebo). Median age was 60 (IQR 49–69) years, 77% were male and 35% had received at least one dose of SAR...
European Journal of Nutrition
PurposeWhile animal and in vitro data demonstrate vasodilatory effects of egg white-derived pepti... more PurposeWhile animal and in vitro data demonstrate vasodilatory effects of egg white-derived peptides, human studies are lacking. We investigated for the first time the effects of an egg ovalbumin-derived protein hydrolysate on blood pressure (BP) and cardiovascular risk.MethodsA double-blind, placebo-controlled randomized crossover trial was implemented in 75 adults aged 50–70 years with systolic BP (130–≤ 150 mmHg). Participants were randomized to an egg ovalbumin-derived protein hydrolysate (3 g/day) or placebo (3 g/day). Participants completed two 6-week periods separated by a 3-week washout.ResultsData from 65 participants with a mean systolic BP (135.1 ± 11 mmHg) were included. Mean office and central BP and arterial stiffness (assessed by carotid-femoral pulse wave velocity (cfPWV) or pulse wave analysis (PWA)) did not change over time and no significant differences were observed between the egg protein hydrolysate and placebo groups (P > 0.05). Similarly, no significant effects of this egg ovalbumin-derived protein hydrolysate on blood lipid and glucose concentrations (P > 0.05) were observed.ConclusionThis is the first dietary intervention to investigate the effects of egg ovalbumin-derived protein hydrolysates on cardiovascular risk in humans. Despite promising findings from animal and in vitro studies, this RCT does not support the hypothesis that consumption of an egg ovalbumin-derived protein hydrolysate for 6 weeks in adults with a high-normal BP results in a reduction in BP or the modification of cardiovascular risk.
Mon Weather Rev, 1966
A series of barotropic forecasts has been prepared for several upper-air levels in the tropical P... more A series of barotropic forecasts has been prepared for several upper-air levels in the tropical Pacific. The
Clinical Nursing Studies, 2014
Purpose: This paper reports on results of a study to identify education needs of nurses in acute ... more Purpose: This paper reports on results of a study to identify education needs of nurses in acute care environments regarding dementia care in Ireland.
Monthly Weather Review, 1966
A series of barotropic forecasts has been prepared for several upper-air levels in the tropical P... more A series of barotropic forecasts has been prepared for several upper-air levels in the tropical Pacific. The
Age and ageing, Jan 28, 2015
previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single ... more previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status. of 598 older patients admitted to acute ho...
Optical Interactions with Tissue and Cells XXXI, 2020
Even though recent advances in medical devices have significantly improved clinical interventions... more Even though recent advances in medical devices have significantly improved clinical interventions, more accurate differentiation of biological tissues is still required to improve clinical decision-making. Tissue identification can be performed by using molecular-sensitive techniques such as diffuse reflectance spectroscopy (DRS), which is allows label-free, non-invasive, real-time and in situ interrogation of biological tissues. In this study, we used broadband DRS to extract biomolecule concentrations of gastrointestinal tissues and evaluated its potential for tissue identification and cancer detection. Diffuse reflectance spectra were analysed in an extended wavelength range between 350 nm and 1900 nm. This range covers the third optical window, which may allow better tissue identification for laparoscopy and gastrointestinal robotic surgery. Chromophore concentrations were obtained by using an inverse Monte Carlo Lookup table model to fit the reflectance spectrum.
The journal of nutrition, health & aging, 2016
Background: Malnutrition is common in older adults and is associated with high costs and adverse ... more Background: Malnutrition is common in older adults and is associated with high costs and adverse outcomes. The prevalence, predictors and outcomes of malnutrition on admission to hospital are not clear for this population. Design: Prospective Cohort Study. Setting: Six hospital sites (five public, one private). Participants: In total, 606 older adults aged 70+ were included. All elective and acute admissions to any speciality were eligible. Day-case admissions and those moribund on admission were excluded. Measurements: Sociodemographic and clinical data, including nutritional status (Mini-Nutritional Assessment-short form), was collected within 36 hours of admission. Outcome data was collected prospectively on length of stay, in-hospital mortality and new institutionalisation. Results: The mean age was 79.7; 51% were female; 29% were elective admissions; 67% were admitted to a medical specialty. Nutrition scores were available for 602/606; 37% had a 'normal' status, 45% were 'at-risk', and 18% were 'malnourished'. Malnutrition was more common in females, acute admissions, older patients and those who were widowed/ separated. Dementia, functional dependency, comorbidity and frailty independently predicted a) malnutrition and b) being at-risk of malnutrition, compared to normal status (p < .001). Malnutrition was associated with outcomes including an increased length of stay (p < .001), new institutionalisation (p =<0.001) and in-hospital mortality (p < .001). Conclusions: These findings support the prioritisation of nutritional screening in clinical practice and public health policy, for all patients ≥70 on admission to hospital, and in particular for people with dementia, increased functional dependency and/or multi-morbidity, and those who are frail.
Age and Ageing, 2016
Background: We have previously reported that almost 30% of older people admitted to acute hospita... more Background: We have previously reported that almost 30% of older people admitted to acute hospitals have dementia (Timmons et al., 2015), often un-diagnosed, but the prevalence of dementia in older people presenting to the Emergency Department (ED) is less well known. Method: Trained researchers assessed consecutive ED attendees in Mercy University Hospital, aged ≥70 years, for delirium and dementia using the Delirium Rating Scale-Revised 98 (DRS-R98; cutoff 18); standardised Mini-Mental State Examination; and
Age and Ageing, 2016
Background: Delirium is common but under-diagnosed in older people presenting to the Emergency De... more Background: Delirium is common but under-diagnosed in older people presenting to the Emergency Department (ED). ED staff need fast, valid tools to identify potential delirium in older attendees. The 4-AT is recommended nationally for delirium screening in ED, but has never been validated in an ED population. Method: A trained researcher assessed consecutive ED attendees ≥70 years for delirium and dementia using the Delirium Rating Scale-Revised 98 (DRS-R98; cutoff 18) and Informant Questionnaire on Cognitive Decline in the Elderly (cut-off 3.5), respectively.
International Journal of Geriatric Psychiatry, 2016
Many countries use national hospital discharge data to analyse hospital activity in relation to c... more Many countries use national hospital discharge data to analyse hospital activity in relation to certain diseases or populations. The Hospital In-Patient Enquiry (HIPE) system is Ireland’s current method for collecting information on in-patients discharged from acute hospitals, performed by trained administrative staff, using information documented in the medical case notes (Health Information and Quality Authority, 2014). It provides data on large numbers of patients at low cost, facilitates identification of secular trends and allows comparisons between hospitals/regions/countries. Like all routinely generated data, it is vulnerable to poor documentation. Clarke et al. (2010) have suggested that clinicians need to be involved in the discharge diagnosis coding process. Others stress that the discrepancies within the system are unacceptable when these data are used for assessing discharges, making comparisons with other countries and for determining funding allocation by the government (O’Callaghan et al., 2012). HIPE data have been used to estimate hospital dementiarelated activity in Ireland on several occasions (Connolly et al., 2014), and similar hospital episode statistics for dementia have been used in many countries. However, we had concerns about the effects of under-diagnosis and under-recording of dementia in such national hospital discharge data-sets and took the opportunity to test the accuracy of HIPE coding in a cohort study of dementia in older people admitted to hospital.
Age and ageing, Jan 28, 2015
previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single ... more previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status. of 598 older patients admitted to acute ho...
Critical Care
Background Baricitinib has shown efficacy in hospitalized patients with COVID-19, but no placebo-... more Background Baricitinib has shown efficacy in hospitalized patients with COVID-19, but no placebo-controlled trials have focused specifically on severe/critical COVID, including vaccinated participants. Methods Bari-SolidAct is a phase-3, multicentre, randomised, double-blind, placebo-controlled trial, enrolling participants from June 3, 2021 to March 7, 2022, stopped prematurely for external evidence. Patients with severe/critical COVID-19 were randomised to Baricitinib 4 mg once daily or placebo, added to standard of care. The primary endpoint was all-cause mortality within 60 days. Participants were remotely followed to day 90 for safety and patient related outcome measures. Results Two hundred ninety-nine patients were screened, 284 randomised, and 275 received study drug or placebo and were included in the modified intent-to-treat analyses (139 receiving baricitinib and 136 placebo). Median age was 60 (IQR 49–69) years, 77% were male and 35% had received at least one dose of SAR...
European Journal of Nutrition
PurposeWhile animal and in vitro data demonstrate vasodilatory effects of egg white-derived pepti... more PurposeWhile animal and in vitro data demonstrate vasodilatory effects of egg white-derived peptides, human studies are lacking. We investigated for the first time the effects of an egg ovalbumin-derived protein hydrolysate on blood pressure (BP) and cardiovascular risk.MethodsA double-blind, placebo-controlled randomized crossover trial was implemented in 75 adults aged 50–70 years with systolic BP (130–≤ 150 mmHg). Participants were randomized to an egg ovalbumin-derived protein hydrolysate (3 g/day) or placebo (3 g/day). Participants completed two 6-week periods separated by a 3-week washout.ResultsData from 65 participants with a mean systolic BP (135.1 ± 11 mmHg) were included. Mean office and central BP and arterial stiffness (assessed by carotid-femoral pulse wave velocity (cfPWV) or pulse wave analysis (PWA)) did not change over time and no significant differences were observed between the egg protein hydrolysate and placebo groups (P > 0.05). Similarly, no significant effects of this egg ovalbumin-derived protein hydrolysate on blood lipid and glucose concentrations (P > 0.05) were observed.ConclusionThis is the first dietary intervention to investigate the effects of egg ovalbumin-derived protein hydrolysates on cardiovascular risk in humans. Despite promising findings from animal and in vitro studies, this RCT does not support the hypothesis that consumption of an egg ovalbumin-derived protein hydrolysate for 6 weeks in adults with a high-normal BP results in a reduction in BP or the modification of cardiovascular risk.
Mon Weather Rev, 1966
A series of barotropic forecasts has been prepared for several upper-air levels in the tropical P... more A series of barotropic forecasts has been prepared for several upper-air levels in the tropical Pacific. The
Clinical Nursing Studies, 2014
Purpose: This paper reports on results of a study to identify education needs of nurses in acute ... more Purpose: This paper reports on results of a study to identify education needs of nurses in acute care environments regarding dementia care in Ireland.
Monthly Weather Review, 1966
A series of barotropic forecasts has been prepared for several upper-air levels in the tropical P... more A series of barotropic forecasts has been prepared for several upper-air levels in the tropical Pacific. The
Age and ageing, Jan 28, 2015
previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single ... more previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status. of 598 older patients admitted to acute ho...