Peritraumatic Context and Long-Term Outcomes of Concussion.

Importance: There has been a great deal of interest in mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) and their association with one another, yet their interaction and subsequent associations with long-term outcomes remain poorly understood.

Objective: To compare the long-term outcomes of mTBI that occurred in the context of psychological trauma (peritraumatic context) with mTBI that did not (nonperitraumatic context).

Design, Setting, And Participants: This cohort study of post-9/11 US veterans used data from the Translational Research Center for Traumatic Brain Injury and Stress Disorders (TRACTS) study at the Veterans Affairs Boston Healthcare System, which began in 2009; the current study utilized data from baseline TRACTS visits conducted between 2009 and 2024.

Comparative Effectiveness of Individual Sodium-Glucose Cotransporter 2 Inhibitors.

Importance: Evidence on cardiovascular benefits and safety of sodium-glucose cotransporter 2 (SGLT-2) inhibitors is mainly from placebo-controlled trials. Therefore, the comparative effectiveness and safety of individual SGLT-2 inhibitors remain unknown.

Objective: To compare the use of canagliflozin or dapagliflozin with empagliflozin for a composite outcome (myocardial infarction [MI] or stroke), heart failure hospitalization, MI, stroke, all-cause death, and safety outcomes, including diabetic ketoacidosis (DKA), lower-limb amputation, bone fracture, severe urinary tract infection (UTI), and genital infection and whether effects differed by dosage or cardiovascular disease (CVD) history.

Correlates of impaired sleep duration among adults with trauma alone and with posttraumatic stress disorder.

Objective: To elucidate the relationship between impaired sleep duration and trauma/posttraumatic stress disorder (PTSD) net of sociodemographic, behavioral, and comorbid diagnostic factors.

Method: We investigated this relationship using the National Epidemiologic Survey on Alcohol and Related Conditions-III data set, analyzing a nationally representative sample of 36,309 adults. Our study identified three groups: those without trauma/PTSD, those with trauma but no PTSD, and those with PTSD.

The potential impact of exercise on affect and neuroinflammation in older adults living with fibromyalgia: a scoping review.

Introduction: Fibromyalgia (FM) is a widespread chronic pain condition with prevalence increasing in older adults. Older adults living with FM experience longer pain symptom durations that can negatively impact their quality of life. Affect and neuroinflammation are potential factors that can exacerbate pain symptoms.

Single- versus two-test criteria for cognitive impairment: associations with CSF and imaging markers in former American football players.

 Cognitive impairment is a core feature of traumatic encephalopathy syndrome (TES), the putative clinical syndrome of chronic traumatic encephalopathy-a neuropathological disease associated with repetitive head impacts (RHI). Careful operationalization of cognitive impairment is essential to improving the diagnostic specificity and accuracy of TES criteria. We compared single- versus two-test criteria for cognitive impairment in their associations with CSF and imaging biomarkers in male former American football players.

Changes in weight and physical function for older African American women in Take Off Pounds Sensibly (TOPS): Study protocol for a randomized clinical trial.

Background: Obesity and frailty are positively linked. Compared to other groups, older African American women have the highest rates of both obesity and frailty. Several academic weight loss interventions have shown that older adults can lose weight and improve physical function through diet and exercise.

Reliability of remote video ratings of the scale for assessment and rating of ataxia.

Introduction: The Scale for Assessment and Rating of Ataxia (SARA) is a widely used clinical rating scale in ataxia. Remote video assessments of SARA examinations are increasingly used to reduce variability through centralized ratings. Remote video assessments have a high agreement with in-person ratings, but the intra- and inter-rater reliability of remote video ratings has not been examined.

Training T-shaped translational scientists.

Unlabelled: To evaluate the design of I-Corps@NCATS as a translational scientist training program, we mapped specific elements of the program's content and pedagogy to the characteristics of a translational scientist, as first defined by Gilliland et al. []: systems thinker, process innovator, boundary spanner, team player, and skilled communicator. Using a mixed-methods evaluation, we examined how the I-Corps@NCATS training program, delivered across twenty-two Clinical and Translational Science Award Hubs, impacted the development of these key translational scientist characteristics.

How Should Clinicians Discuss Deprescribing with Caregivers of Older Adults Living with Dementia? A Qualitative Study.

Background: Preventive medications are potential targets for deprescribing in older adults with dementia as goals of care change from preventive to palliative. Yet, prescribers lack communication guidance to address deprescribing.

Objective: Using bisphosphonates as a case example, we sought to characterize and compare communication preferences of prescribers and family/informal caregivers regarding deprescribing.

Functional capacity at rehabilitation discharge predicts physical activity characteristics twenty-four weeks later for people with total knee arthroplasty: a secondary analysis of a randomized controlled trial.

Objective: To determine the association between performance-based and patient-reported functional capacity at the conclusion of 12-week rehabilitation with average daily step counts and peak walking cadence 38 weeks following total knee arthroplasty (TKA).

Design: Secondary analysis of an RCT.

Setting: Veterans Affairs Medical Center.

Veterans' Motivation, Preference, and Feedback After Completing a Novel Physical Therapy Treatment.

Objectives: This study evaluated Veterans' motivation and perception of different components of a novel physical therapy (PT) treatment aimed at increasing mobility, motivation, and exercise adoption.

Methods: Patient-satisfaction surveys were administered to middle-aged to older Veterans (≥50 years old) with slow walking speed who completed the 8-week PT treatment. Mixed methods were employed to assess rating-based responses and examine themes derived from open-ended responses.

A systematic review of participant diversity in psychedelic-assisted psychotherapy trials.

A lack of diverse and representative participant samples in mental health intervention research perpetuates mental health disparities. This issue has become a salient concern in studies of psychedelic-assisted psychotherapy (PAT), which is emerging as a promising mental health intervention. This systematic review evaluates the reporting, representation, and analysis of participant sociodemographic characteristics in randomized controlled trials (RCTs) of PAT.

Comparison of sample characteristics of Wisconsin Alzheimer's Disease Research Center participants with the Wisconsin state population-An evaluation of the recruitment effort.

Introduction: Understanding how a research sample compares to the population from which it is drawn can help inform future recruitment planning. We compared the Wisconsin Alzheimer's Disease Research Center (WADRC) participant sample to the Wisconsin state population (WI-pop) on key demographic, social exposome, and vascular risk measures.

Methods: The WADRC sample included 930 participants.

The Impact of Executive Function on Retention and Compliance in Physical Therapy in Veterans.

Objective: To examine retention and compliance to a novel physical therapy (PT) treatment among Veterans with and without executive function deficits (EFD+/EFD-).

Design: This study was a preplanned secondary analysis of an ongoing randomized controlled trial.

Setting: Outpatient PT at VA Boston Healthcare System.

Association of Step Count with Cardiorespiratory Fitness: Results from the Virtual 2-Minute Step Test.

Objective: To test the hypothesis that step count based on a virtual 2-minute step test (2MST) predicts cardiorespiratory fitness (CRF).

Design: Cross-sectional study.

Setting: Veteran Affairs Medical Centers participating in a randomized trial of functional exercise training delivered by videoconferencing.

Lived Experiences of Patients Hospitalized With Acute Decompensated Heart Failure and Kidney Dysfunction.

Importance: For patients hospitalized with acute decompensated heart failure (ADHF), the presence of kidney dysfunction can substantially shape prognosis and treatment options. Yet little is known about the lived experiences of these medically vulnerable patients.

Objective: To elicit accounts of the illness and care experiences of patients currently or recently hospitalized with ADHF and kidney dysfunction in order to identify potential opportunities to improve care.

Geriatrics-Focused vs Traditional Primary Care in the Veterans Affairs Health Care System.

Importance: Older adults often require specialized health care expertise, but the effects of geriatrics-focused models of primary care have not been fully evaluated.

Objective: To compare the effects of geriatrics-focused primary care vs traditional primary care for older patients in the Veterans Affairs (VA) health care system.

Design, Setting, And Participants: In this cohort study, geriatrics-focused primary care and traditional primary care patient dyads matched on variables associated with geriatrics-focused primary care entry and outcomes were enrolled from VA medical centers with operational geriatrics-focused primary care clinics serving 500 or more patients annually in fiscal year 2016.

"I was angry that I fell" all the way to "if I fall, I fall": a qualitative study of the spectrum of behavioral fall risk factors for veterans with dysvascular lower-limb amputation.

Purpose: To explore behavioral risk factors contributing to fall and near-fall scenarios for Veterans with dysvascular lower-limb amputation.

Materials And Methods: Participants were a convenience sample of Veterans with unilateral dysvascular lower-limb amputation, receiving care at a single Veterans Administration Regional Amputation Center, who participated in an interview (12/2021-04/2023). We used phenomenological research and directed content analysis to explore participant perspectives on fall scenarios.

Anti-Amyloid Therapies for Alzheimer's Disease and Amyloid-Related Imaging Abnormalities: Implications for the Emergency Medicine Clinician.

Alzheimer's disease is the neurodegenerative disorder responsible for approximately 60% to 70% of all cases of dementia and is expected to affect 152 million by 2050. Recently, anti-amyloid therapies have been developed and approved by the Food and Drug Administration as disease-modifying treatments given as infusions every 2 to 5 weeks for Alzheimer's disease. Although this is an important milestone in mitigating Alzheimer's disease progression, it is critical for emergency medicine clinicians to understand what anti-amyloid therapies are and how they work to recognize, treat, and mitigate their adverse effects.