Multimorbidity and Its Impact in Older United States Veterans Newly Treated for Advanced Non-Small Cell Lung Cancer.

Rationale: Older adults make up the majority of patients with advanced non-small cell lung cancer (NSCLC) and often carry multiple other comorbidities (multimorbidity) when initiating treatment. The nature and impact of multimorbidity remain largely unknown, given the limitations of standard count-based comorbidity indices in aging patients and their exclusion from clinical trials.

Objective: Our objective is to identify and define multimorbidity patterns in older U.

Clinical impact of UV mutational signatures in Veterans with cancer.

Background: UV-related DNA damage signature (UVsig) is highly specific for cutaneous cancers. The prevalence of UVsig among tumors without a primary site and tumors of extracutaneous origin were previously reported, suggesting potential misclassification of cancers. Our study aims to assess if the knowledge of UVsig at diagnosis would change first-line treatment recommendation.

Preoperative dysphagia and adverse postoperative outcomes in middle aged and older adults.

Background: Dysphagia is a swallowing impairment with adverse health consequences. The impact of preoperative dysphagia on postoperative outcomes is not known. This study will examine the association between preoperative dysphagia and postoperative outcomes.

Association between beta-blocker atenolol use and prostate cancer upgrading in active surveillance.

Objectives: The objective of this study is to investigate the association between the use of beta-adrenergic antagonist atenolol and risk of pathologic upgrade in patients on active surveillance, considering growing literature implicating adrenergic innervation with disease progression mediated through beta-adrenergic signalling.

Patients And Methods: Men with low-risk or favourable intermediate-risk prostate cancer who were placed on an active surveillance protocol between 2006 and 2020 across three diverse urban hospitals were included. Exposure was duration of atenolol use, and outcome was pathologic grade group upgrading (to GG ≥ 3) on final prostate biopsy.

Tell Me about yourself: Analyzing self-referential language use in borderline personality disorder.

Depression and some other illnesses are associated with increased self-reference and negative emotion in language. Research findings on lexical patterns in Borderline Personality Disorder (BPD) have been inconsistent. We conducted two studies to evaluate lexical markers of distress in BPD: First compared to healthy controls (HC), and later compared to Post-Traumatic stress disorder (PTSD) patients and trauma-exposed controls (TC).

Post-Metastasis Survival of Patients with High-Risk Localized and Locally Advanced Prostate Cancer Undergoing Primary Treatment in the United States: A Retrospective Study.

Background: Patients with high-risk localized and locally advanced prostate cancer (HR-LPC/LAPC) have increased risk of metastasis, leading to reduced survival rates. Segmenting the disease course [time to recurrence, recurrence to metastasis, and post-metastasis survival (PMS)] may identify disease states for which the greatest impacts can be made to ultimately improve survival.

Objective: Evaluate real-world PMS of patients with HR-LPC/LAPC who received primary radical prostatectomy (RP) or radiotherapy (RT) with or without androgen deprivation therapy (ADT).

Stress tests and biomarkers of resilience: Proceedings of the second state of resilience science conference.

The "Stress Tests and Biomarkers of Resilience" conference, hosted by the American Geriatrics Society and the National Institute on Aging, marks the second in a series aimed at advancing the field of resilience science. Held on March 4-5, 2024, in Bethesda, Maryland, this conference built upon the foundational work from the first conference, which focused on defining resilience across various domains-physical, cognitive, and psychosocial. This year's gathering centered around three factors: the biology that underlies resilient outcomes; the social, environmental, genetic, and psychosocial factors that impact that resilience biology; and the biomarker testing and imaging that predicts resilient outcomes for older adults.

Physical activity and symmetry following total knee arthroplasty: Results of a pilot randomized trial.

Objective: This pilot trial examined a Physical Activity and Symmetry (PAS) intervention focused on common deficits of physical inactivity and joint loading asymmetry following total knee arthroplasty (TKA).

Design: Participants (n ​= ​60) were enrolled during routine physical therapy (PT) following TKA and randomized to the PAS intervention or an attention (ATT) control group. The PAS intervention included physical activity counseling and balance exercise to address joint loading symmetry; content was delivered during 2 sessions at the end of routine PT plus supplemental sessions 4-weeks and 8-weeks following PT.

Oncogenic Alterations, Race, and Survival in US Veterans with Metastatic Prostate Cancer Undergoing Somatic Tumor Next Generation Sequencing.

Purpose: National guidelines recommend next generation sequencing (NGS) of tumors in patients diagnosed with metastatic prostate cancer (mPCa) to identify potential actionable alterations. We sought to describe the spectrum and frequency of alterations in PCa-related genes and pathways, as well as associations with self-identified race/ethnicity, and overall survival in US Veterans.

Patients And Methods: This retrospective cohort study included Non-Hispanic Black (NHB) and Non-Hispanic white (NHW) Veterans with mPCa who obtained NGS through the Veterans Affairs National Precision Oncology Program.

Initiation and Persistence of Antipsychotic Medications at Hospital Discharge Among Community-Dwelling Veterans With Dementia.

Objectives: Adults with dementia are frequently prescribed antipsychotic medications despite concerns that risks outweigh benefits. Understanding conditions where antipsychotics are initially prescribed, such as hospitalization, may offer insights into reducing inappropriate use.

Design, Setting, Participants: Retrospective cohort study of community-dwelling veterans with dementia aged ≥68 with VA hospitalizations in 2014, using Veterans Health Administration (VA) and Medicare data.

Burden of chronic skin disease from an Asian perspective: Assessment of health state utilities and quality of life in a Singapore cohort.

Background: Understanding health state utilities of skin diseases is essential for health economic evaluations in an era of rising health care costs.

Objective: To create a catalog of utility values of chronic skin diseases among Asians.

Methods: This is a cross-sectional study of adults attending a dermatology outpatient clinic from February 2019 to March 2023 with one of the following skin diseases: (1) eczema, (2) psoriasis, (3) acne vulgaris, (4) chronic urticaria, (5) pigmentary disorders, (6) hair loss, (7) viral warts, (8) fungal infections, and (9) keloids.

Study to determine the efficacy and onset of Bonipar, a topical analgesic for the management of acute and chronic musculoskeletal pain.

Background: Opioid abuse and mortality are ravaging American society, highlighting the need to find alternative effective analgesics with fewer side effects. FDA-approved topical analgesics, including non-steroidal anti-inflammatory drugs (NSAIDs), are commonly used to treat musculoskeletal pain but can cause adverse effects. Natural compounds, including essential oils, are potential therapeutic alternatives for managing musculoskeletal pain.

Inpatient clinicians' approach to diagnosis of urinary tract infections in older adults using the COM-B model: a qualitative assessment.

Our interviews of inpatient clinicians (physicians, physician assistants) modeled after the Capability, Opportunity, and Motivation Model of Behavior model revealed opportunity and motivation as important drivers for overdiagnosis and overprescribing for asymptomatic bacteriuria in older adults. Understanding these barriers is an important step toward implementing age-friendly stewardship interventions.

Intervening on Metabolic Dysfunction-Associated Steatotic Liver Disease in Latino/a and Black Patients with Diabetes: A Feasibility Pilot.

Introduction: Patients with type 2 diabetes (T2D), particularly those from historically marginalized racial and ethnic groups, are at high risk of poor outcomes from metabolic dysfunction-associated steatotic liver disease (MASLD). Evidence-based management (EBM) of MASLD can prevent its progression to cirrhosis and poor outcomes, yet rates of EBM of MASLD are low in T2D.

Methods: In this pilot study of ten participants, we examined the feasibility and acceptability of a telehealth intervention that delivered EBM of MASLD in Latino/a and Black patients with T2D in the Duke Healthcare System.

Association Between Healthy Eating Index-2020 and Oral Microbiome Among Postmenopausal Women.

Background: Dietary intake has been suggested to be associated with the oral microbiome, but no study has examined the association between overall diet quality and the oral microbiome.

Objectives: This study aimed to investigate the cross-sectional association between the Healthy Eating Index-2020 (HEI-2020) and the diversity and composition of the oral microbiome among participants in the Buffalo Osteoporosis and Periodontal Disease (OsteoPerio) Study.

Methods: In 1175 postmenopausal women (mean age: 67 ± 7.