An Integrative, Holistic Treatment Approach for Veterans With Chronic Traumatic Brain Injury and Associated Comorbidities: Case Report

This case report of a veteran with a history of multiple traumatic brain injuries, posttraumatic stress, and chronic pain highlights the MossRehab Institute for Brain Health (MRIBH) model of care: a collaborative, interdisciplinary, intensive outpatient treatment program. Unique to this case was the severity of symptomatology and the concerted engagement by the clinicians, who fully tailored and adjusted their approaches based on team rounds and daily exchanges. The client\u27s main concerns of headaches, difficulty sleeping, difficulty with memory and cognition, depression, anxiety, posttraumatic stress, anger, and chronic musculoskeletal pain were addressed and significantly improved within three weeks. The outcome of this case is promising and suggests that the highly individualized and collaborative interdisciplinary approach provided at MRIBH is particularly beneficial for veterans with chronic TBI and PTSD and can provide a roadmap for the treatment of specific clinical scenarios

An empirical test of the role of small-scale transmission in large-scale disease dynamics

A key assumption of epidemiological models is that population-scale disease spread is driven by close contact between hosts and pathogens. At larger scales, however, mechanisms such as spatial structure in host and pathogen populations and environmental heterogeneity could alter disease spread. The assumption that small-scale transmission mechanisms are sufficient to explain large-scale infection rates, however, is rarely tested. Here, we provide a rigorous test using an insect-baculovirus system. We fit a mathematical model to data from forest-wide epizootics while constraining the model parameters with data from branch-scale experiments, a difference in spatial scale of four orders of magnitude. This experimentally constrained model fits the epizootic data well, supporting the role of small-scale transmission, but variability is high. We then compare this model's performance to an unconstrained model that ignores the experimental data, which serves as a proxy for models with additional mechanisms. The unconstrained model has a superior fit, revealing a higher transmission rate across forests compared with branch-scale estimates. Our study suggests that small-scale transmission is insufficient to explain baculovirus epizootics. Further research is needed to identify the mechanisms that contribute to disease spread across large spatial scales, and synthesizing models and multiscale data are key to understanding these dynamics.</p