VA Boston Healthcare System

Photomapping electrically coupled networks of the mature thalamus and cortex

Electrical synapses are expressed ubiquitously across the brain and are crucial components of active neural circuitry and connectomes. Identification of coupled networks in living tissue is limited by technical demands of multiplexed recordings, and no dyes, fluorescent reporters...

Sleep trajectories in pregnancy: associations with trauma exposure, PTSD, and postpartum depression

Sleep during the perinatal period is often highly disrupted due to maternal biopsychosocial changes that accompany pregnancy. Poor sleep quality is a symptom of PTSD, while insomnia often emerges after a traumatic event and commonly co-occurs with PTSD. Trauma exposure as well as...

Functional seizures: care experiences of U.S. Veterans and their care partners

Functional seizures (FS) present substantial diagnostic and treatment challenges, particularly for Veterans with multiple medical and psychiatric comorbidities including post traumatic stress disorder, mood disorders and traumatic brain injury. To more effectively care for Vetera...

Epigenome-Wide Association Study of Abdominal Aortic Aneurysm Identifies Central Role for Inflammatory Pathways

BACKGROUND: Epigenetic mechanisms underlying susceptibility to abdominal aortic aneurysm (AAA) remain poorly understood. Identifying causal DNA methylation markers for AAA can elucidate the regulatory processes that drive aneurysm formation and accelerate translational applicatio...

Comparative Renal Effectiveness of GLP-1RA and SGLT2i in US Veterans with Type 2 Diabetes and CKD

Objective: To address limited comparative evidence in older, clinically complex patients with type 2 diabetes and moderate-to-advanced chronic kidney disease (CKD), we compared nephroprotective outcomes after GLP-1RA versus SGLT2i initiation among US Veterans aged ≥65 years with...

Local Adaptations of Hospital in Home: Variations in Structure and Implementation Across Six VA Programs

ABSTRACT Background The VA Hospital in Home (HIH) model of care delivers acute‐level hospital care to Veterans at home across the country. We aim to examine the similarities and differences in the structure and implementation of existing HIH programs across sites to identify best...

Audiovisual interactions modulate visuocortical gain

How is vision shaped by other senses? Visual cortex is not merely a passive recipient of retinal inputs. It is also responsive to other sensory modalities, particularly audition. While auditory signals have been shown to penetrate early visual cortices, the mechanisms driving the...

Modifiable Lifestyle Factors in Cardiovascular Disease Prevention: Current Evidence and Future Directions

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide despite substantial advances in pharmacologic and interventional therapies. Modifiable lifestyle behaviors are major determinants of cardiovascular risk and essential targets for primary a...

International variation in neuropsychological test use practices: Implications for test adaptation and fair assessment

Neuropsychological test selection varies substantially across countries and languages, yet which instruments clinicians use internationally remains poorly documented. Using a survey of International Neuropsychological Society members (INSConnect, 2023), we examined instrument end...

Posttraumatic Stress Disorder, Health-Related Social Needs, and Cognitive Outcomes in US Veterans

Importance Posttraumatic stress disorder (PTSD) and health-related social needs (HRSNs) have been associated with cognitive decline, but their joint associations with mild cognitive impairment (MCI), Alzheimer disease (AD), and AD-related dementias (ADRD) are unclear. Objective T...

Validity of EHR-Derived Phenotypes for Outcome Ascertainment in the PRESERVE Trial: Implications for Embedding RCTs in Healthcare Systems

Randomized controlled trials (RCTs) are crucial for determining effective interventions but are costly, time-consuming, and complex. Electronic health records (EHRs) offer the potential to enhance research using clinical data, reducing costs and improving efficiency. We evaluated...

Per- and polyfluoroalkyl substances levels other than PFOS, PFOA, or PFHxS and liver cancer risk: a nested case-control analysis

Abstract Epidemiologic studies of PFAS and liver cancer risk have produced conflicting results with no strong or clear associations for pre-diagnostic perfluorooctanesulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorohexanesulfonate (PFHxS). We now report analyses of nine...

Age-Friendly Health Systems in Hospital at Home: An Integrated Healthcare System Cross-Sectional Survey

Background Age-Friendly Health Systems (AFHS) is an evidenced-based initiative structured on the 4Ms framework (What Matters, Medications, Mentation, and Mobility) to improve care for older adult patients and has been implemented across the United States in various care settings....

Embracing the DIGNITY of Resident Relationships: A Case Study of the Decision-Making in Aging and Dementia for Autonomy (DIGNITY) Protocol

Public policies governing U.S. nursing homes emphasize resident rights, autonomy, and person-centered care, yet translating these principles into everyday practice remains challenging – particularly for residents living with dementia whose preferences involve perceived risk. Regu...

Radiology considerations for the PREMIUM study: a multicenter randomized controlled trial of abbreviated MRI versus ultrasound for liver cancer screening in cirrhosis

Abstract This paper describes the rationale and radiology considerations in the implementation of the Preventing Liver Cancer Mortality through Imaging with Ultrasound versus MRI (PREMIUM) study. PREMIUM is a multicenter, randomized controlled trial sponsored by the Department of...

Omic risk scores are associated with COPD-related traits across three cohorts

Background: Chronic obstructive pulmonary disease (COPD) exhibits marked heterogeneity in lung function decline, mortality, exacerbations, and other disease-related outcomes. Omic risk scores (ORS) estimate the cumulative contribution of omics, such as the transcriptome, proteome...

Evaluation of Disease Severity Using CSF Biomarkers in Patients With Probable Cerebral Amyloid Angiopathy

Cerebral amyloid angiopathy (CAA) is currently diagnosed using MRI-based Boston criteria. However, imaging markers represent downstream consequences of vascular injury and may not fully reflect disease severity. CSF biomarkers, particularly β-amyloid 1–42 (Aβ42) and β-amyloid 1–4...

Respecting Spinal Cord Injury Patient Autonomy in the Context of Terminal Extubation

Terminal extubation, or palliative or compassionate extubation, is a legally and ethically accepted practice in the United States where mechanical ventilation is withdrawn when ongoing life-sustaining treatment no longer aligns with a patient's stated goals of care. Nearly 42% of...

Identifying Contextual Factors affecting Hospital In Home Program Implementation within the Veterans Health Administration

Abstract Background and Objectives Understanding the factors that enable or hinder successful implementation is essential for improving patient outcomes. Hospital in Home (HiH) programs provide hospital-level care in patients' homes to reduce hospitalization, enhance satisfaction...

Veterans' Urgent Care Use and Subsequent Utilization in the Community

OBJECTIVE: To evaluate the impact of Veterans' urgent care use in non-Veterans Health Administration (VHA) clinics on their later use of specialty and emergency care. STUDY SETTING AND DESIGN: A retrospective cohort study analyzing urgent care, specialty care, and emergency depar...