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Article ; Online: In reply.

Missel, Amanda L / Donnelly, John P / Friedman, Charles

2023 Volume 82, Issue 3, Page(s) 415–416

Language	English
Publishing date	2023-08-18
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2023.05.005
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Article ; Online: Hospital usage for oral and dental conditions in Hawaii: A cross-sectional study using the 2021 Hawaii statewide hospital data.

Matsunaga, Masako / Donnelly, Patrick / Chen, John J

Journal of public health dentistry

2024

Abstract: Objective: To investigate the frequency of emergency department (ED) usage primarily for oral/dental conditions in Hawaii and to examine social-demographic factors associated with the identified ED visits.: Methods: This was a cross-sectional study ... ...

Abstract	Objective: To investigate the frequency of emergency department (ED) usage primarily for oral/dental conditions in Hawaii and to examine social-demographic factors associated with the identified ED visits. Methods: This was a cross-sectional study of the 2021 Hawaii Statewide Hospital data. We identified records indicating ED usage and a primary diagnosis of non-traumatic dental conditions (NTDC) and other oral dental conditions (OODC). Descriptive analyses of ED visits for NTDC and OODC were performed to identify vulnerable individuals based on age, sex, race/ethnicity, primary source of payment, county of residence, and total charges per hospital record. A multivariable negative binomial regression model included age, sex, and county of residence was used to obtain adjusted rate ratios (aRR) and 95% confidence intervals (CI) of ED visits for NTDC. Results: Among hospital records with diagnoses for oral or dental conditions (n = 12,336), 97% indicated ED, of which half had an NTDC diagnosis, and the remaining half had an OODC diagnosis. Distinct differences in the characteristics of ED visits were observed between NTDC and OODC. The median total charges per record indicating ED for NTDC and OODC were $1439 and $2439, respectively. A higher rate of ED visits for NTDC was found for those aged 21-44 (aRR [95%CI] = 3.02 [2.41, 3.80], reference: 0-9 years) and those living in a less populous county (Hawaii: 1.73 [1.43, 2.07]; Kauai: 1.78 [1.45, 2.19], reference: Honolulu). Conclusions: Continued effort to improve dental health is required to reduce ED visits for oral and dental conditions among Hawaii residents, especially for vulnerable individuals.
Language	English
Publishing date	2024-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	410719-6
ISSN	1752-7325 ; 0022-4006
ISSN (online)	1752-7325
ISSN	0022-4006
DOI	10.1111/jphd.12610
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Article ; Online: Exploring the utility of circulating miRNAs as diagnostic biomarkers of fasciolosis.

Chowdhury, Sumaiya / Ricafrente, Alison / Cwiklinski, Krystyna / Sais, Dayna / Dalton, John P / Tran, Nham / Donnelly, Sheila

Scientific reports

2024 Volume 14, Issue 1, Page(s) 7431

Abstract: Effective management and control of parasitic infections on farms depends on their early detection. Traditional serological diagnostic methods for Fasciola hepatica infection in livestock are specific and sensitive, but currently the earliest detection ... ...

Abstract	Effective management and control of parasitic infections on farms depends on their early detection. Traditional serological diagnostic methods for Fasciola hepatica infection in livestock are specific and sensitive, but currently the earliest detection of the parasite only occurs at approximately three weeks post-infection. At this timepoint, parasites have already entered the liver and caused the tissue damage and immunopathology that results in reduced body weight and loss in productivity. Here, we investigated whether the differential abundance of micro(mi)miRNAs in sera of F. hepatica-infected sheep has potential as a tool for the early diagnosis of infection. Using miRNA sequencing analysis, we discovered specific profiles of sheep miRNAs at both the pre-hepatic and hepatic infection phases in comparison to non-infected sheep. In addition, six F. hepatica-derived miRNAs were specifically identified in sera from infected sheep. Thus, a panel of differentially expressed miRNAs comprising four sheep (miR-3231-3p; miR133-5p; 3957-5p; 1197-3p) and two parasite miRNAs (miR-124-3p; miR-Novel-11-5p) were selected as potential biomarkers. The expression of these candidates in sera samples from longitudinal sheep infection studies collected between 7 days and 23 weeks was quantified using RT-qPCR and compared to samples from age-matched non-infected sheep. We identified oar-miR-133-5p and oar-miR-3957-5p as promising biomarkers of fasciolosis, detecting infection as early as 7 days. The differential expression of the other selected miRNAs was not sufficient to diagnose infection; however, our analysis found that the most abundant forms of fhe-miR-124-3p in sera were sequence variants (IsomiRs) of the canonical miRNA, highlighting the critical importance of primer design for accurate diagnostic RT-qPCR. Accordingly, this investigative study suggests that certain miRNAs are biomarkers of F. hepatica infection and validates miRNA-based diagnostics for the detection of fasciolosis in sheep.
MeSH term(s)	Animals ; Sheep/genetics ; MicroRNAs/genetics ; Circulating MicroRNA ; Fascioliasis/diagnosis ; Fascioliasis/genetics ; Fascioliasis/veterinary ; Biomarkers
Chemical Substances	MicroRNAs ; Circulating MicroRNA ; Biomarkers
Language	English
Publishing date	2024-03-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-57704-9
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Article ; Online: Emergency department resource utilization among nursing home residents, a National Cross-Sectional Study.

Serina, Peter T / Xu, Chuyun / Baird, Janette / Wang, Henry E / Donnelly, John P / Amanullah, Siraj / Lo, Alexander X

The American journal of emergency medicine

2024 Volume 78, Page(s) 76–80

Abstract: Objectives: Persons 65 years and older (older persons), particularly residents of nursing homes (NHs), disproportionately access the emergency department (ED) and utilize more medical resources. The goal of this study is to provide a contemporary ... ...

Abstract	Objectives: Persons 65 years and older (older persons), particularly residents of nursing homes (NHs), disproportionately access the emergency department (ED) and utilize more medical resources. The goal of this study is to provide a contemporary description of healthcare utilization patterns and disposition decisions for United States (US) NH residents presenting to EDs. Methods: Older persons presenting to EDs in the US were identified in the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2017, 2018 and 2019 datasets. We examined demographic, clinical, and resource use characteristics and outcomes. After survey weighting, we compared the frequency of different imaging, medications, clinical interventions, and outcomes in the ED between NH residents and those residing outside NHs. Results: From 2017 to 2019, older persons made 24,441,285 annual visits to the ED, comprising 17.5% of all visits. Among these, 1,579,916 visits (6.5%) were by NH residents. Compared with non-NH residents, NH residents were older (mean age: 81.2 [95%CI 81.5-82.9] vs 76.1 [95%CI 75.8-76.4]), underwent more imaging (82.8% [95%CI 79.5-86.1] vs 71.6% [95%CI 69.9-73.3]), were administered fewer potentially inappropriate medications (PIMs) in the ED or upon discharge (9.5% [95%CI 6.2-2.7] vs 17.1% [95%CI 15.8-18.4]), and had a higher proportion of visits resulting in hospital admission (44.1% [95%CI 38.2-49.9] vs 26.0% [95%CI 23.3, 28.7]). Conclusions: Older NH residents presenting to the ED use more resources and are more likely to be hospitalized compared to older persons residing outside NHs. The resource-intensive nature of these visits highlights the importance of targeted, multi-disciplinary interventions that optimize ED care for this population.
MeSH term(s)	Humans ; United States ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Hospitalization ; Nursing Homes ; Patient Discharge ; Emergency Service, Hospital
Language	English
Publishing date	2024-01-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2024.01.008
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Article ; Online: Blood count derangements after sepsis and association with post-hospital outcomes.

Denstaedt, Scott J / Cano, Jennifer / Wang, Xiao Qing / Donnelly, John P / Seelye, Sarah / Prescott, Hallie C

Frontiers in immunology

2023 Volume 14, Page(s) 1133351

Abstract: ... and improved model discrimination above clinical characteristics alone (likelihood ratio test, p<0.02 ...

Abstract	Rationale: Predicting long-term outcomes in sepsis survivors remains a difficult task. Persistent inflammation post-sepsis is associated with increased risk for rehospitalization and death. As surrogate markers of inflammation, complete blood count parameters measured at hospital discharge may have prognostic value for sepsis survivors. Objective: To determine the incremental value of complete blood count parameters over clinical characteristics for predicting 90-day outcomes in sepsis survivors. Methods: Electronic health record data was used to identify sepsis hospitalizations at United States Veterans Affairs hospitals with live discharge and relevant laboratory data (2013 to 2018). We measured the association of eight complete blood count parameters with 90-day outcomes (mortality, rehospitalization, cause-specific rehospitalizations) using multivariable logistic regression models. Measurements and main results: We identified 155,988 eligible hospitalizations for sepsis. Anemia (93.6%, N=142,162) and lymphopenia (28.1%, N=29,365) were the most common blood count abnormalities at discharge. In multivariable models, all parameters were associated with the primary outcome of 90-day mortality or rehospitalization and improved model discrimination above clinical characteristics alone (likelihood ratio test, p<0.02 for all). A model including all eight parameters significantly improved discrimination (AUROC, 0.6929 v. 0.6756) and reduced calibration error for the primary outcome. Hemoglobin had the greatest prognostic separation with a 1.5 fold increased incidence of the primary outcome in the lowest quintile (7.2-8.9 g/dL) versus highest quintile (12.70-15.80 g/dL). Hemoglobin and neutrophil lymphocyte ratio provided the most added value in predicting the primary outcome and 90-day mortality alone, respectively. Absolute lymphocyte count added little value in predicting 90-day outcomes. Conclusions: The incorporation of discharge complete blood count parameters into prognostic scoring systems could improve prediction of 90-day outcomes. Hemoglobin had the greatest prognostic value for the primary composite outcome of 90-day rehospitalization or mortality. Absolute lymphocyte count provided little added value in multivariable model comparisons, including for infection- or sepsis-related rehospitalization.
MeSH term(s)	Humans ; United States/epidemiology ; Retrospective Studies ; Lymphocytes ; Sepsis ; Inflammation ; Hospitals
Language	English
Publishing date	2023-02-28
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1133351
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Article ; Online: Hospitalizations for chronic conditions following hurricanes among older adults: A self-controlled case series analysis.

Bell, Sue Anne / Donnelly, John P / Li, Wang / Davis, Matthew A

Journal of the American Geriatrics Society

2022 Volume 70, Issue 6, Page(s) 1695–1703

Abstract: Background/purpose: Extreme events such as hurricanes adversely impact healthcare systems and the communities they serve. The degree to which hurricanes affect healthcare use among high need groups such as older adults with chronic conditions has not ... ...

Abstract	Background/purpose: Extreme events such as hurricanes adversely impact healthcare systems and the communities they serve. The degree to which hurricanes affect healthcare use among high need groups such as older adults with chronic conditions has not been well examined, nor has the impact of hurricane severity on health outcomes. We characterized hospitalizations among older adults by chronic condition after eight large-scale hurricanes in the United States. Methods: Using a combination of administrative healthcare data and the Federal Emergency Management Agency's Disaster Declaration database we conducted a self-controlled case series analysis. We identified Medicare beneficiaries who were exposed to one of eight hurricanes and compared hospitalizations in the 30-days after a hurricane to hospitalizations in the rest of the calendar year of the hurricane. We examined hospitalizations (1) in total, (2) separately for diabetes, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) admissions, and (3) by hurricane damage category. Results: Among all older adults exposed, hospitalizations in the 30-day period after each disaster increased for all three chronic conditions; diabetes (incidence rate ratio [IRR] = 1.06, 95% confidence interval [CI] 1.03, 1.10), COPD (IRR = 1.06, 95% CI 1.04, 1.08), and CHF (IRR = 1.19, 95% CI 1.17, 1.21. In the 30-to-60-day period hospitalizations also increased for each chronic condition; diabetes (IRR = 1.06, 95% CI 1.03, 1.10), COPD (IRR = 1.12, 95% CI 1.10, 1.15), and CHF (IRR = 1.32, 95% CI 1.30, 1.34). Substantial differences in hospitalizations were observed according to individual hurricane and by the chronic disease examined. Conclusion: Exposure to hurricanes is associated with an increase in hospitalizations for chronic conditions across all hurricane damage categories. As disasters are expected to increase in strength and frequency, our results underscore the need for response strategies and health policy planning for healthcare systems designed to address the health needs of older Americans with chronic conditions.
MeSH term(s)	Aged ; Chronic Disease ; Cyclonic Storms ; Heart Failure ; Hospitalization ; Humans ; Medicare ; Pulmonary Disease, Chronic Obstructive ; United States/epidemiology
Language	English
Publishing date	2022-02-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.17702
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Article ; Online: Understanding gender disparities in outcomes after sepsis.

Elizabeth Wilcox, M / Donnelly, John P / Lone, Nazir I

Intensive care medicine

2020 Volume 46, Issue 4, Page(s) 796–798

MeSH term(s)	Cohort Studies ; Critical Illness ; Humans ; Sepsis ; Sex Factors
Language	English
Publishing date	2020-02-18
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-020-05961-3
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Article ; Online: Correction to: Understanding gender disparities in outcomes after sepsis.

Elizabeth Wilcox, M / Donnelly, John P / Lone, Nazir I

Intensive care medicine

2020 Volume 46, Issue 5, Page(s) 1086

Abstract: The original version of this article unfortunately contained a mistake. There was an error in figure one. The correct figure can be found below. We apologize for the mistake. ...

Abstract	The original version of this article unfortunately contained a mistake. There was an error in figure one. The correct figure can be found below. We apologize for the mistake.
Language	English
Publishing date	2020-03-13
Publishing country	United States
Document type	Published Erratum
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-020-06006-5
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Article ; Online: Over-EXTENDing the Window for Thrombolytic Therapy in Cerebrovascular Accident: September 2019 Annals of Emergency Medicine Journal Club.

Spiegel, Rory J / Donnelly, John P / Radecki, Ryan P

Annals of emergency medicine

2019 Volume 74, Issue 3, Page(s) 457–461

Language	English
Publishing date	2019-08-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2019.07.010
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Article ; Online: Penalizing Readmissions After Sepsis Could Do More Harm Than Good.

Prescott, Hallie C / Donnelly, John P

Critical care medicine

2017 Volume 45, Issue 7, Page(s) 1243–1244

MeSH term(s)	Humans ; Medicare ; Patient Readmission ; Sepsis ; United States
Language	English
Publishing date	2017-06-16
Publishing country	United States
Document type	Editorial ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000002495
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