Publications by authors named "Boyko E"

Objectives: Type 2 diabetes (T2D) and prediabetes are associated with poor walking endurance, a marker of physical function. We aimed to examine the long-term effects of metformin or intensive lifestyle intervention in adults at high risk of T2D on their 6-min walk test (6MWT) performance.

Methods: Participants were randomized in the 3-year Diabetes Prevention Program (DPP) to one of the three groups: lifestyle intervention, metformin, or placebo, and were subsequently followed in the DPP Outcomes Study.

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Although 1990-1991 Gulf War deployment has been linked to worse health outcomes such as chronic multisymptom illness (CMI), often referred to as Gulf War Illness, among deployed Gulf War Veterans, less is known regarding Gulf War service and mortality. Using 20 years of longitudinal data from Gulf War Veteran and Era personnel from the Millennium Cohort Study (2001-2021; n=45381), Cox proportional hazard models estimated the relative effects of Gulf War service status, CMI, and their corresponding interaction on all-cause mortality. Although age- and sex-adjusted mortality ratios suggested that Gulf War Veterans had higher mortality rates than Era personnel, no association was observed between Gulf War service status and mortality risk.

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  • COVID-19 survivors, particularly older adults, experience increased frailty, which can lead to new medical conditions and functional impairments.
  • A study involving over 91,000 older Veterans showed that those who had COVID-19 developed significantly more health deficits in the year following infection compared to uninfected controls.
  • The most common new health issues identified were fatigue, anemia, muscle atrophy, gait abnormalities, and arthritis, indicating long-term health risks associated with COVID-19.
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Introduction: COVID-19 triggers prothrombotic and proinflammatory changes, with thrombotic disease prevalent in up to 30% SARS-CoV-2 infected patients. Early work suggests that aspirin could prevent COVID-19 related thromboembolic disorders in some studies but not others. This study leverages data from the largest integrated healthcare system in the United States to better understand this association.

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Aims: Visceral fat predicts the development of metabolic syndrome (MetS), but it is not known whether the visceral to subcutaneous fat area ratio (VSR) measured using imaging predicts MetS risk as well or better. Thus, we aimed to examine if VSR predicted future risk of MetS over 10-years.

Methods: We followed 329 participants in the longitudinal Japanese American Community Diabetes Study without MetS at baseline for its development over 10 years.

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Purpose: The goal of this study was to estimate all-cause mortality among Operations Enduring Freedom, Iraqi Freedom, and New Dawn era service members and veterans and to identify protective and risk factors for mortality.

Methods: Using 20 years of longitudinal data from the Millennium Cohort Study (2001-2021), sequential Cox proportional hazard models were conducted to examine demographic, military, and health-related characteristics associated with all-cause mortality among service members and veterans.

Results: Among 201,619 participants, 3806 (1.

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  • A study investigates whether COVID-19 is linked to long-term financial hardships among Veterans, particularly those enrolled in the Veterans Health Administration, finding that many face challenges even 18 months post-infection.
  • The research involved a survey of 194 Veterans with a history of COVID-19 and 194 Veterans without, measuring various financial strains and hardships related to health costs and material needs.
  • Results show that 67% of participants experienced financial hardship, with COVID-19 infected Veterans being at significantly higher risk for severe financial strain compared to their uninfected counterparts.
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Geographic variation in hardship, especially health-related hardship, was identified prior to and during the pandemic, but we do not know whether this variation is consistent among Veterans Health Administration (VHA)-enrolled veterans, who reported markedly high rates of financial hardship during the pandemic, despite general and veteran-specific federal policy efforts aimed at reducing hardship. In a nationwide, regionally stratified sample of VHA-enrolled veterans, we examined whether the prevalence of financial hardship during the pandemic varied by US Census region. We found veterans in the South, compared with those in other census regions, reported higher rates of severe-to-extreme financial strain, using up all or most of their savings, being unable to pay for necessities, being contacted by collections, and changing their employment due to the kind of work they could perform.

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In this Review, we aim to complement the 2023 update of the guidelines of the International Working Group on the Diabetic Foot. We highlight the complexity of the pathological processes that underlie diabetes-related foot ulceration (DFU) and draw attention to the potential implications for clinical management and outcome. Variation observed in the incidence and outcome of DFUs in different communities might result from differences in study populations and the accessibility of care.

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  • Research shows that SARS-COV-2 infection can lead to increased depression symptoms, particularly among veterans who often have pre-existing mental and physical health issues.
  • This study aimed to investigate the specific link between SARS-COV-2 infection and depression in U.S. Military Veterans, filtering out other contributing factors.
  • Results indicated that veterans who contracted SARS-COV-2 exhibited significantly higher levels of depression symptoms, particularly psychological indicators like low mood and suicidal thoughts, compared to those who did not get infected.
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Importance: Research demonstrates that SARS-CoV-2 infection is associated with increased risk of all-cause hospitalization. However, no prior studies have assessed the association between SARS-CoV-2 and potentially preventable hospitalizations-that is, hospitalizations for conditions that can usually be effectively managed in ambulatory care settings.

Objective: To examine whether SARS-CoV-2 is associated with potentially preventable hospitalization in a nationwide cohort of US veterans.

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  • This study investigates how COVID-19 infection affects daily functioning of veterans 18 months after infection, comparing those who had COVID-19 with those who didn't.
  • It analyzed data from 186 veterans with COVID-19 and 186 matched veterans without the infection, examining various factors to ensure a fair comparison.
  • Results showed that 44.9% of veterans who had COVID-19 reported diminished capabilities in daily activities compared to 35.3% of those in the control group, highlighting the lasting impact of the virus.
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The current study investigated the associations among probable posttraumatic stress disorder (PTSD), recent Veterans Health Administration (VHA) health care use, and care-seeking for PTSD in U.S. military veterans.

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Brush cytology is a sampling technique extensively used for mucosal surfaces, particularly to identify malignancies. A sample is obtained by rubbing the brush bristles over the stricture or lesion several times until cells are trapped. Brush cytology detection rate varies, with malignancy confirmed in 15-65% of cases of adenocarcinoma-associated biliary strictures and 44-80% of cases of cholangiocarcinoma.

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  • - The study aimed to investigate how COVID-19 infection impacted outpatient healthcare utilization among veterans, comparing those infected with those who were not across various care categories.
  • - It analyzed data from a large cohort of matched veterans using records from Veterans Affairs and Medicare, focusing on outpatient visits pre- and post-COVID infection over a year.
  • - Results showed that veterans with COVID-19 had significantly more outpatient visits (especially in primary care) during the peri-infection period compared to uninfected veterans, with a notable increase of 5.12 additional visits per 30 days.
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Background And Aims: To prospectively investigate associations of plasma sphingolipids with insulin sensitivity, β-cell function, and incident diabetes in the Japanese American Community Diabetes Study.

Methods And Results: Baseline plasma samples from adults without diabetes (n = 349; mean age 56.7 years, 51 % men) were assayed for circulating ceramide and sphingomyelin species.

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Objective: To identify plasma miRNAs related to treatment failure in youth with type 2 diabetes (T2D).

Research Design And Methods: We examined whether a panel of miRNAs could predict treatment failure in training/test data sets among participants in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study (N = 209). We also examined whether individual miRNAs were associated with treatment failure.

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Importance: A significant proportion of SARS-CoV-2 infected individuals experience post-COVID-19 condition months after initial infection.

Objective: To determine the rates, clinical setting, risk factors, and symptoms associated with the documentation of International Statistical Classification of Diseases Tenth Revision (ICD-10), code U09.9 for post-COVID-19 condition after acute infection.

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  • The study investigates the effectiveness of the oral antiviral nirmatrelvir-ritonavir in preventing post-COVID-19 conditions (PCCs) among nonhospitalized veterans who tested positive for COVID-19.
  • Conducted through a retrospective analysis, it compares outcomes of veterans treated with the antiviral to those who did not receive treatment over a period spanning 31 to 180 days post-infection.
  • Results showed no significant differences in the incidence of most PCCs between treated and untreated groups, but a notable reduction in venous thromboembolism and pulmonary embolism was observed in those treated with nirmatrelvir-ritonavir.
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  • A study analyzed data from an Ontario-wide concussion study to identify factors predicting persistent concussion symptoms in patients with acute concussions (≤ 14 days) compared to those with prolonged symptoms (≥ 90 days).* -
  • The study found no significant differences in sex, mental health history, headaches/migraines, or past concussions between the two groups, but noted higher proportions of females among both groups.* -
  • Patients with prolonged post-concussion symptoms were older, more symptomatic, more likely to have been injured in transport incidents, and often lived outside major cities, suggesting the need for updated risk factor evaluations as concussions increasingly affect non-athletes.*
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