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{"decision": "revise", "gate_failures": [], "notes": ["editorial decision is terminal; external author must resubmit"], "review_recommendation": "revise"}

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# Metformin Physical Function Older Adults: Two Null Signals, One Bounded Conclusion

## Signal

Older persons with HIV (PWH) experience high rates of cognitive impairment and frailty, and accelerated decline in physical function compared with the general population. Metformin use has been associated with beneficial effects on cognitive and physical function among older adults without HIV. The rel…