Detecting Mild Traumatic Brain Injury after Combat Deployment: Agreement Between Veterans Health Administration Clinical System and LIMBIC-CENC Research Protocol.

Identifying historical mild traumatic brain injury (TBI) is important for many clinical care reasons; however, diagnosing mild TBI is inherently challenging and utility of screening is unknown. This study compares a standardized research process to an established clinical process for screening and diagnosis of historical mild TBI during combat deployment in a military/Veteran cohort. Using validated instruments, the Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) prospective longitudinal study (PLS) screens for all potential concussive events (PCEs) and conducts structured concussion diagnostic interviews for each PCE.

Induction of Fc-dependent functional antibodies against different variants of SARS-CoV-2 varies by vaccine type and prior infection.

Background: SARS-CoV-2 transmission and COVID-19 disease severity is influenced by immunity from natural infection and/or vaccination. Population-level immunity is complicated by the emergence of viral variants. Antibody Fc-dependent effector functions are as important mediators in immunity.

Evidence on trends in uptake of childhood vaccines and association with COVID-19 vaccination rates.

Importance: Childhood vaccination rates have declined in recent years; there is also concern that resistance to COVID-19 vaccines could spill over to childhood vaccines.

Objectives: To use local-level data to study trends in childhood vaccination rates and heterogeneity in local rates; including how many areas are below herd-immunity thresholds, and assess the association between COVID-19 vaccine hesitancy and childhood vaccination.

Design: We report, for 11 states with available data, vaccination rates for measles, mumps, rubella (MMR), and diphtheria, tetanus, acellular pertussis (DTaP) vaccines, including percentage of schools/counties with rates ≥95 %, 90-95 %, 80-90 %, and < 80 %.

Pediatrics leading the way: co-enrollment as the next step in health-related social needs screening and referral.

Purpose Of Review: To contextualize how pediatrics led the field in developing and implementing tools to screen for social determinants of health in clinical care as well as in creating innovative interventions to mitigate them, and to summarize where the evidence points as the next frontier.

Recent Findings: The evidence showed that health-related social needs (HRSN), like food insecurity, energy insecurity, and housing instability, continue to drive poor health outcomes across the lifespan; patients and healthcare providers are open to discussing HRSN in clinical settings, though some providers feel ill-equipped to do so; to mitigate HRSN, healthcare plays a unique role in ensuring patients' HRSN are understood, referring to effective resources through building strong, lasting relationships with community partners, embedding services in the healthcare setting across all departments, and empowering patient families to participate in programs and services; and administrative burden hinders families from getting all the benefits to which they are entitled, which streamlined co-enrollment processes can address.

Summary: Pediatric providers can add a unique and credible voice to seeking changes to the safety-net, including co-enrollment, that could reduce administrative burden, address patients' HRSN, and improve health starting in the prenatal period through later adulthood.

Prevalence and progression of chronic kidney disease among adults undergoing creatinine testing in South African public healthcare facilities: a study leveraging data from South Africa's National Health Laboratory Service (NHLS).

Background: Chronic kidney disease (CKD) has emerged as a substantial global health challenge, with a marked rise in associated mortality. However, it often goes undetected until advanced stages, particularly in low-income and middle-income countries such as South Africa. We investigated the prevalence and progression of CKD in South Africa, utilising a subset of data from the National Health Laboratory Services Multi-morbidity Cohort.

Inequities in Access to Mental Health Services Among Asian American, Native Hawaiian, and Pacific Islander Medicaid Enrollees.

Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) people are often aggregated into a monolithic group, but when they are disaggregated into ethnic groups (e.g., Chinese), inequities can be identified.

Grayken Lessons: a patient who developed opioid use disorder after traumatic brain injury.

Background: Traumatic brain injury (TBI) is common in people with substance use disorders (SUDs). TBI often results in cognitive deficits which can affect the clinical course of SUD.

Case Presentation: Here we present the case of a 34-year-old Spanish-speaking man with severe opioid use disorder and two prior TBIs affecting his cognitive abilities.

Epigenome-wide association studies identify novel DNA methylation sites associated with PTSD: a meta-analysis of 23 military and civilian cohorts.

Background: The occurrence of post-traumatic stress disorder (PTSD) following a traumatic event is associated with biological differences that can represent the susceptibility to PTSD, the impact of trauma, or the sequelae of PTSD itself. These effects include differences in DNA methylation (DNAm), an important form of epigenetic gene regulation, at multiple CpG loci across the genome. Moreover, these effects can be shared or specific to both central and peripheral tissues.

Defining the transition from new to normal: a qualitative investigation of the clinical change process.

Background: Understanding how and when a new evidence-based clinical intervention becomes standard practice is crucial to ensure that healthcare is delivered in alignment with the most up-to-date knowledge. However, rigorous methods are needed to determine when a new clinical practice becomes normalized to the standard of care. To address this gap, this study qualitatively explores how, when, and why a clinical practice change becomes normalized within healthcare organizations.

Curation and validation of electronic medical record-based dementia diagnoses in the VA Million Veteran Program.

Background: The age distribution and diversity of the VA Million Veteran Program (MVP) cohort make it a valuable resource for studying the genetics of Alzheimer's disease (AD) and related dementias (ADRD).

Objective: We present and evaluate the performance of several International Classification of Diseases (ICD) code-based classification algorithms for AD, ADRD, and dementia for use in MVP genetic studies and other studies using VA electronic medical record (EMR) data. These were benchmarked relative to existing ICD algorithms and AD-medication-identified cases.

Protecting historically marginalized groups or targeted marketing? A computational analysis of individuals engaging with public and protected cigar-branded tweets.

Introduction: Swisher Sweets, a leading brand of little cigars and cigarillos in the United States, switched its Twitter account to protected status, limiting access to its tweets. This study examines how the protected status of Swisher Sweets tweets influences post engagement, aiming to inform regulatory strategies for branded tobacco promotions on social media.

Method: Using natural language processing, we predicted the demographics of individuals replying to Swisher Sweets' public and protected tweets.

Harms from others' drinking among college students: Prevalence and risk factors, 2022.

Introduction: Alcohol's harms to others (AHTO) refers to the negative effects experienced by individuals other than the drinker. This study investigates the prevalence and risk factors of AHTOs among US college students (sophomores/juniors), based on the first national probability-based survey conducted in 20 years.

Methods: We assessed AHTOs in the fall of 2021 from 1918 participants across 46 US schools, weighting the data to reflect the US undergraduate sophomore/junior population.

Global amyloid burden enhances network efficiency of tau propagation in the brain.

Background: Amyloid-β (Aβ) and hyperphosphorylated tau are crucial biomarkers in Alzheimer's disease (AD) pathogenesis, interacting synergistically to accelerate disease progression. While Aβ initiates cascades leading to tau hyperphosphorylation and neurofibrillary tangles, PET imaging studies suggest a sequential progression from amyloidosis to tauopathy, closely linked with neurocognitive symptoms.

Objective: To analyze the complex interactions between Aβ and tau in AD using probabilistic graphical models, assessing how regional tau accumulation is influenced by Aβ burden.

Associations Between Retinal Vascular Occlusions and Dementia.

Background/objectives: Retinal vascular occlusions, such as retinal vein occlusion (RVO) and retinal artery occlusion (RAO), are associated with cognitive impairment, including dementia. Our objective was to examine the odds of dementia among patients with retinal vascular occlusion.

Methods: This cross-sectional study included 474 patients with retinal vascular occlusion and 948 patients without retinal vascular occlusion (comparison group).

Tai Chi and Wellness Interventions for Veterans with Gulf War Illness: A Randomized Controlled Feasibility Trial.

Background: Gulf War Illness (GWI) is a chronic multi-symptom illness that affects up to one-third of the 700,000 American military personnel deployed to the Persian Gulf region in 1990 and 1991. We conducted a randomized controlled trial to examine feasibility and the relative efficacy of two 12-week in-person group treatments (Tai Chi and Wellness) to address GWI symptoms of chronic pain, fatigue, and changes in mood and cognitive functioning.

Method: Male and female veterans were randomly assigned to Tai Chi (n = 27) or Wellness (n = 26) group interventions and assessed at four time points: baseline, post-treatment, 3-, and 9-month follow-up.

A prospective study of male physical activity and fecundability.

Study Question: To what extent is male physical activity (PA) associated with fecundability (per-cycle probability of conception)?

Summary Answer: Preconception levels of vigorous, moderate, or total PA were not consistently associated with fecundability across Danish and North American cohorts, but there was suggestive evidence that bicycling with a 'soft, comfort seat' was associated with reduced fecundability in both cohorts, especially among males with greater BMI.

What Is Known Already: Among males, some studies indicate that moderate PA might improve fertility, whereas vigorous PA, especially bicycling, might be detrimental.

Study Design, Size, Duration: We assessed the association between male PA and fecundability among couples participating in two preconception cohort studies: SnartForaeldre.

Atrial Fibrillation: A Review.

Importance: In the US, approximately 10.55 million adults have atrial fibrillation (AF). AF is associated with significantly increased risk of stroke, heart failure, myocardial infarction, dementia, chronic kidney disease, and mortality.

Assessing the Impact of Exposure Misclassification in Case-Control Studies of Self-Reported Medication Use.

Background: Empirically evaluating the potential impact of recall bias on observed associations of prenatal medication exposure is crucial.

Objective: We sought to assess the effects of exposure misclassification on previous studies of the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in early pregnancy and increased risk of amniotic band syndrome (ABS).

Methods: Using data from the National Birth Defects Prevention Study (NBDPS) on births from 1997 to 2011, we included 189 mothers of infants with ABS and 11,829 mothers of infants without congenital anomalies.

Prevalence of adults with stimulant misuse and/or stimulant use disorder in Massachusetts, USA, 2014-2021.

Background And Aims: Stimulant-involved overdose deaths are increasing throughout the United States. Because stimulant misuse (i.e.

Hepatic Steatosis and Fibrosis, Cardiorespiratory Fitness, and Metabolic Mediators in the Community.

Background And Aims: Individuals with steatotic liver disease (SLD) are at high cardiovascular disease (CVD) risk, but approaches to characterise and mitigate this risk are limited. By investigating relations, and shared metabolic pathways, of hepatic steatosis/fibrosis and cardiorespiratory fitness (CRF), we sought to identify new avenues for CVD risk reduction in SLD.

Methods: In Framingham Heart Study (FHS) participants (N = 2722, age 54 ± 9 years, 53% women), vibration-controlled transient elastography (VCTE) was performed between 2016-2019 to assess hepatic steatosis (continuous attenuation parameter [CAP]) and fibrosis (liver fibrosis measure [LSM]).

An initial randomized controlled trial of a Combined Medication and Behavioral Activation Treatment (CoMBAT) for people with opioid use disorder.

Introduction: Opioid use disorder is a chronic, relapsing disease and a major source of morbidity and mortality in the U.S. Medications for opioid use disorder (MOUD) have been shown to reduce opioid use; however, MOUD maintenance is often suboptimal.

Effectiveness of electronic medical record-based strategies for death and hospital admission endpoint capture in pragmatic clinical trials.

Objective: Event capture in clinical trials is resource-intensive, and electronic medical records (EMRs) offer a potential solution. This study develops algorithms for EMR-based death and hospitalization capture and compares them with traditional event capture methods.

Materials And Methods: We compared the effectiveness of EMR-based event capture and site-captured events adjudicated by a clinical endpoint committee in the multi-center INfluenza Vaccine to Effectively Stop cardio Thoracic Events and Decompensated heart failure (INVESTED) trial for participants from the Veterans Affairs healthcare system.