Military Medicine最新文献

{"title":"Preliminary Effectiveness of a Companion Dog Whole Health Intervention for Improving Balance and Gait Quality in Veterans.","authors":"Julie Rekant, Jamie Giffuni, Odessa Addison, Heidi Ortmeyer","doi":"10.1093/milmed/usaf033","DOIUrl":"https://doi.org/10.1093/milmed/usaf033","url":null,"abstract":"<p><strong>Introduction: </strong>The benefits of exercise for older adults are well known; however, most older adults do not meet recommendations for regular physical activity. Alternative methods of improving physical activity are important and can be effective at improving mobility. This analysis evaluated if participation in a Whole Health companion dog adoption program supported changes in balance and gait performance for veterans. The role of time veteran and dog spent being physically active together (i.e., walking) on observed balance and gait changes was also explored.</p><p><strong>Materials and methods: </strong>Veterans were paired with companion dogs and physical function, self-reported physical activity, and gait quality with an instrumented 6-minute walk test were assessed at baseline and after 1 year of participation. Physical activity was captured by accelerometers worn by both the veteran and dog. Paired samples t-tests were used to evaluate change in gait and physical performance measures from baseline to follow-up. Simple linear regressions were used to explore the role of time the veteran and companion dog spent being active together on observed changes in gait and physical function. Participants completed informed consent before participation in the IRB-approved study procedures (HP-97664; 1651218).</p><p><strong>Results: </strong>Fourteen veterans (71.4% male, 62.3 ± 12.0 years) participated in the program. Improvements were seen in balance (Four Square Step Test change 95% CI: -3.94 to -1.36 s), lower body strength (30-second Chair Stand change 95% CI: 1.89-6.40 reps), and endurance (6-Minute Walk Test change 95% CI: 27.03-80.55 m). Gait quality improved (stance time 95% CI: -0.11 to -0.03 s, stride time 95% CI: -0.09 to -0.02 s). Of participants, 42% reported increased physical activity at follow-up. The percentage of the day veterans and their dogs spent being active together explained 31%-33% of the changes in functional performance.</p><p><strong>Conclusions: </strong>A Whole Health companion dog adoption intervention can improve gait, balance, physical functioning, and physical activity.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Endotracheal Weight-Based Epinephrine on Pharmacokinetics and Survival in Swine With a Cardiac Arrest.","authors":"Don Johnson, Dawn Blouin, Karen Brocklehurst, Joseph O'Sullivan","doi":"10.1093/milmed/usaf026","DOIUrl":"https://doi.org/10.1093/milmed/usaf026","url":null,"abstract":"<p><strong>Background: </strong>The aims of this study were to compare concentration maximum (Cmax), time to Cmax, area under the curve, mean concentration over 4 minutes, and frequency and time to return of spontaneous circulation (ROSC) by group.</p><p><strong>Methods: </strong>This was a prospective, experimental study using swine. In total, 40 pigs (n = 8 per group) were assigned as follows: 0.1 mg/kg endotracheal (ET) tube, 1 mg intravenous (IV), 2 mg ET, Cardio Pulmonary Resuscitation (CPR) + defibrillation (CPR + defib), and CPR-Only. Pigs were placed in arrest for 2 minutes, CPR was then initiated for 2 minutes, and epinephrine was then administered and repeated every 4 minutes or until ROSC. Blood samples were collected over 4 minutes. Defibrillation was initiated at 3 minutes and continued every 2 minutes for 30 minutes or until ROSC. CPR + defib and CPR-Only Groups served as controls. The CPR + defib Group had defibrillations but did not receive epinephrine. The CPR-Only Group did not receive defibrillations or epinephrine.</p><p><strong>Results and conclusions: </strong>The Cmax and area under the curve were significantly higher in the IV Group compared to the 0.1 mg/kg ET Group (P < .05). The time to Cmax was significantly longer in the 0.1 mg/kg Group than the 1 mg IV Group (P = .03). The mean concentration of the 1 mg IV Group was higher than the 0.1 mg/kg ET Group until 180 and 240 seconds. There was no significant difference between the groups relative to time to ROSC (P > .05). Return of spontaneous circulation frequencies were: 0.1 mg/kg ET Group (7 of 8); 1 mg IV Group (5 of 8); and 2 mg ET Group (1 of 8), and both CPR + defib and CPR-Only (0 out of 8). This study challenges the current guidelines relative to ET epinephrine administration. Based on our ROSC data, the 0.1 mg/kg dose of epinephrine by ET should be used as a first-line intervention.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holistic Tri-Service Military Pathology: A Proposed Paradigm for Consolidation.","authors":"Nathaniel E Smith, William O'Connell, Rebecca Johnson, George Leonard","doi":"10.1093/milmed/usaf035","DOIUrl":"https://doi.org/10.1093/milmed/usaf035","url":null,"abstract":"<p><p>Historically, military anatomic pathology (AP) services have been significantly compartmentalized, with each branch independently executing its laboratory support mission. The result is redundant and costly duplication of nearly identical services in close geographic proximity. The duplication of AP services disperses the overall caseload, resulting in pathologist diagnostic acumen atrophy, excessive support personnel requirements, inadequate utilization of subspecialty expertise, and overall lower-quality patient care. Unlike many medical specialties, implementing AP services does not require direct patient interaction and is principally not as time-sensitive as other clinical laboratory testing. The practice of AP is conducive to a more consolidatory paradigm to achieve economies of scale. Pathology service unification would also afford the stationing of predominantly subspecialists at tertiary care centers to handle higher caseloads. Larger groups of pathologists increase patient safety enhancing peer-to-peer and subspeciality quality assurance processes during case review. Conversely, the nature of clinical pathology services requires a more widespread presence-even at the smaller, auxiliary clinics throughout the military health system. Clinical pathology services would also benefit from additional triservice cooperation including standardization of quality management processes, increased resource sharing, exchange, and cooperative contingency planning. Laboratory directorships also benefit from consolidating expertise, where pathologists could be physically located at a central site with remote oversight of laboratory services. Here, we propose a holistic triservice consolidation plan for military pathology to optimize resource utilization and ultimately realize the overarching strategic plan for military medicine set forth by the Defense Health Agency.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genito-Urinary Trauma in the War Context: A Review of Two Decades of Experience From the French Armed Forces.","authors":"Yohann Vincent, Paul Chiron, Christopher Agüero, Pierre-Henrie Savoie, Arthur Peyrottes, Thibaut Long Depaquit","doi":"10.1093/milmed/usaf031","DOIUrl":"https://doi.org/10.1093/milmed/usaf031","url":null,"abstract":"<p><strong>Background: </strong>In recent conflicts, injuries to urogenital organs ranged from 5 to 7.2% of all combat-related injuries. Open surgery remains the main approach in combat settings, and in the French military, urgent surgical procedures are mostly performed by general surgeons with no specialization in urological care. To explore the specific needs in advanced surgery courses, we aimed to describe the epidemiology and management of genito-urinary traumas in recent conflicts in French Medical Treatment Facilities (MTFs).</p><p><strong>Methods: </strong>Data were extracted from the OPEX® registry, which prospectively recorded surgical activity from 2001 to 2021. All patients treated in French Role 2 Enhanced or 3 MTFs requiring emergency surgery for urogenital injury were included. The mechanism of trauma, type of genito-urinary injury (GUI), and surgical management were reported.</p><p><strong>Results: </strong>After screening, a total of 4,603 patients were admitted for emergency or delayed emergency surgery. Among them, 31 (0.67%) patients had urogenital injuries requiring immediate management. Most injuries were combat-related (77.4%), caused by gunshots (45%) and explosions (29%). Ten patients (32%) were hemodynamically unstable at initial management. Bladder and testicular injuries were the most common (12 [39%] and 8 [25.8%], respectively). Kidney injuries were rare but led to organ extirpation in 60% of the cases. Associated digestive injuries occurred in 45.2% of the cases. All procedures used the open approach.</p><p><strong>Conclusion: </strong>This study is the first to examine genito-urinary traumas in overseas operations during French army deployments. The results highlight the relatively low incidence of urological trauma, with most injuries involving the bladder and testis. Our findings highlight the importance of equipping military surgeons with the skills necessary to manage complex cases.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Preliminary Analysis of Psychological Strengths: Service Members' Well-being Post-deployment.","authors":"Stephen V Bowles, Eric R Neumaier, Evan R Hughes, Lucas Guberman, Francesca M Cozzi, Paul T Bartone, Paul Switzer, Sybil D Mallonee, Anna S Goyette, Dustin A Seidler, Julia Kelly, Tim Hoyt","doi":"10.1093/milmed/usaf011","DOIUrl":"https://doi.org/10.1093/milmed/usaf011","url":null,"abstract":"<p><p>Deployments are stressful for both service members and their families. To promote the overall health and welfare of those impacted by military deployment, it is important to identify individual resilience-building resources that service members can employ to strengthen their own well-being, the well-being of their families, and the readiness of the force. This pilot study examines different resilience-building skills that may impact individual well-being, relationship quality, and family satisfaction post-deployment. A cross-sectional sample of 78 married U.S. military enlisted service members (n = 24) and commissioned officers (n = 54) completed the Coping Self-Efficacy Scale, Resilience Scale for Adults, Humor Styles Questionnaire, Mindful Attention Awareness Scale, Dispositional Resilience Scale, the emotional well-being and spirituality subscales of the Work-Life Well-Being Inventory, and the Social Problem-Solving Inventory-Revised. The use of a positive humor style was significantly associated with individual well-being. Spirituality and religious practices were significantly predictive of a service member's family satisfaction. Responding to qualitative open-ended questions, service members identified their top 6 subcategories of stress, which were communication, moving, finances, family separation, children, and future employment during post-deployment. The strengths and resources reported as contributing the most to family effectiveness and well-being were personal character traits, external relationship skills, emotional maturity, and the ability to work. The results identified unique individual resilience-building resources for service members, which contribute to their well-being and the well-being of their families. Findings suggest that training on individual resilience-building resources for service members can offer support to the entire family system following military deployment.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vision Loss in an Infantryman With Complex Hearing Loss: Case Report and Review of Susac Syndrome.","authors":"Lester H Lambert, Caroline J Kernan, Kathryn M Hartmann, Stephen R O'Connell, Brittany E Powell","doi":"10.1093/milmed/usaf015","DOIUrl":"https://doi.org/10.1093/milmed/usaf015","url":null,"abstract":"<p><p>Susac syndrome can resemble various disorders resulting in a delayed or missed diagnosis and subsequent delays in treatment. Here, we present how successful consideration of patient history, symptoms, and ancillary testing led to prompt diagnosis and treatment of Susac syndrome by ophthalmologists. A 27-year-old active duty infantryman presented with sudden vision loss in the right eye during strenuous exercise after experiencing similar symptoms in the left eye 5 months earlier. The patient's medical history was notable for mixed conductive and sensorineural hearing loss, confounded by a history of concussions, syncope, frequent ear infections, tympanic membrane perforation requiring tympanoplasty, and loud noise exposures. Identification of branch retinal artery occlusions on fluorescein angiography and low-to-mid frequency hearing loss confirmed the diagnosis of Susac syndrome. The patient was immediately treated with high-dose oral prednisone and subsequently transitioned to rituximab infusions to preserve vision. Susac syndrome should be considered when a patient presents with vision loss, hearing deficits, and or cognitive changes, even if symptoms are separated by time and seemingly attributed to more common causes.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stressors and Support Experienced by Active Duty U.S. Navy Sailors at Sea.","authors":"Lauren M Hurtado, Elizabeth M Harrison, Robyn M Englert, Vanessa G Perez, Cynthia J Thomsen, Emily A Schmied","doi":"10.1093/milmed/usaf030","DOIUrl":"https://doi.org/10.1093/milmed/usaf030","url":null,"abstract":"<p><strong>Introduction: </strong>High occupational stress is generally associated with poorer mental health and reduced performance in military personnel, whereas access to support resources is associated with positive outcomes. However, little research has examined the unique stressors and supports experienced by sailors on ships while underway at sea. The objectives of this study were to (1) identify sailors' underway stressors and supports and (2) examine how these differ as a function of demographic and operational factors.</p><p><strong>Materials and methods: </strong>Active duty U.S. Navy sailors reporting an underway period lasting at least 30 days within the last 5 years (n = 441; 74.7% male, 90% enlisted) completed an anonymous retrospective survey. Sailors completed measures assessing underway stressors (25 items) and supports (9 items), as well as demographic, military, and operational characteristics (sex, rank, ship type, and underway duration). The study protocol was approved by the Naval Health Research Center Institutional Review Board in compliance with all applicable federal regulations governing the protection of human subjects.</p><p><strong>Results: </strong>Overall, the stressors rated as most problematic were exposure to loud noises, inability to rest when needed, unavailability of quality mental and physical health care, and not having enough people to complete the mission. Sailors perceived the most available supports to be opportunities to socialize, safety while performing duties, and finding ways to relieve stress. Female and enlisted personnel, relative to male and officer personnel, respectively, generally perceived stressors as more problematic and support resources as less available. Nearly half of the sample (48.3%) reported that services and programs to help them deal with stress while at sea were inadequate.</p><p><strong>Conclusion: </strong>Sailors experience many stressors while underway. Increasing the resources available to underway sailors may be warranted, especially for female and enlisted personnel. Additional research is necessary to develop targeted interventions and resources. Possible recommendations include noise mitigation, berthing area improvements, sleep and/or scheduling interventions, improved access to mental and physical health care, and interventions to reduce the stigma associated with seeking mental health care.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Army Combat Fitness Test 12-Week Exercise Program Among Females.","authors":"Michel J H Heijnen, Angila Berni, Phoebe McNabb, Steven Caldwell, Stephen Holland, Bill Kawczynski, Alexander T McDaniel, Sarah Noland, Shaila Strayhorn, Wayland Tseh","doi":"10.1093/milmed/usaf034","DOIUrl":"https://doi.org/10.1093/milmed/usaf034","url":null,"abstract":"<p><strong>Introduction: </strong>The dearth of research investigating the efficacy of virtual Army Combat Fitness Test (ACFT) training programs among female populations necessitates further exploration. This study aims to evaluate the effectiveness of a 12-week ACFT virtual exercise program among female participants.</p><p><strong>Materials and methods: </strong>Nine female participants (age = 19.7 ± 1.3 years, height = 165.9 ± 4.9 cm, and body mass = 62.7 ± 5.9 kg) volunteered to complete 2 assessment sessions and the 12-week ACFT virtual exercise training program. In session 1, baseline height, body mass, body composition, and ACFT scores were collected. Upon completion of session 1, under supervisory guidance, all participants were scheduled to complete the 12-week exercise training program in-person. The ACFT exercise training program required participants to complete a warmup/cool down and exercise with suspension training straps 4 days per week, 60 minutes for 12 weeks. In session 2, post-assessments of body mass, body composition, and ACFT scores were collected. Statistical analyses were conducted utilizing paired sample t-tests to assess differences between pre- and post-intervention ACFT scores with P ≤ .05. Cohen's d was calculated to quantify the magnitude of the observed effect.</p><p><strong>Results: </strong>Overall mean ACFT pre-intervention scores (487.2 ± 66.5) increased significantly when compared to mean ACFT post-intervention scores (521.6 ± 44.0) (Cohen's d = 0.86, P = .03). No statistical differences were displayed among the individual mean ACFT pre- versus post-intervention scores. A consistent decline in adherence of 3.9% per week ensued from week 1 through week 12.</p><p><strong>Conclusions: </strong>Following the intervention, female participants experienced a significant increase of approximately 7% in their overall ACFT scores, with upward trends observed across all 6 individual ACFT events. These findings suggest that 12-week virtual suspension training can be a valuable tool for enhancing physical fitness and performance among female participants, particularly within the context of military readiness.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine-Induced Annular Atrophic Lichen Planus.","authors":"Curtis Perz, Jay Chittoor, Liesel Grenier","doi":"10.1093/milmed/usaf032","DOIUrl":"https://doi.org/10.1093/milmed/usaf032","url":null,"abstract":"<p><p>Annular atrophic lichen planus (AALP) is a chronic subtype of lichen planus that classically does not respond to treatment with topical steroids. An inflammatory reaction in the dermal infiltrate may play a role in the development of AALP, but the exact pathogenesis remains unclear. We present the case of a 54-year-old-female with lesions on her trunk and extremities that developed following vaccination. Her failed treatment response warranted further workup for AALP, which was confirmed around 1 year after initiation. Although vaccine-induced lichen planus is not common, it has been reported in various cases. We present a rare case of AALP following vaccination and then provide an in-depth discussion of factors associated with the condition and current treatment response.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Disordered Eating and Musculoskeletal Injury Among Marine Officers Upon Entry to the Basic School.","authors":"Lt Shannon L Exley, Natasha A Schvey, Emily Ricker, Sorana Raiciulescu, Amelia S Barrett, Sarah J de la Motte","doi":"10.1093/milmed/usaf025","DOIUrl":"https://doi.org/10.1093/milmed/usaf025","url":null,"abstract":"<p><strong>Introduction: </strong>Active duty service members (ADSMs) may be at heightened risk for eating disorders (EDs) and sub-clinical disordered eating (DE). ADSMs are also at a high risk for musculoskeletal injury (MSK-I). Given the risk for EDs/DE among ADSMs as well as robust physical requirements of military training, additional research is needed to elucidate links between DE and risk for MSK-I among ADSMs. The aim of the present study was to assess the prevalence of DE and associations with MSK-I among Marine Corps officers entering a 6 month leadership course.</p><p><strong>Materials and methods: </strong>The current cross-sectional study is part of a large, prospective study, the Initiation of Marine Physiological Assessment of Combat Training (IMPACT) study. Participants completed the Eating Disorder Examination-Questionnaire Short (EDE-QS) and self-reported the presence of a recent (≤6 months) MSK-I upon entry to an officer training course. A logistic regression was used to assess the association between elevated DE (EDE-QS ≥15) and recent MSK-I, adjusting for age, race, sex, and commissioning source.</p><p><strong>Results: </strong>N = 1,382 officers (11.6% female, MAge: 24.8 ± 2.9 years, 26.6% racial/ethnic minority) completed the questionnaires. Seven percent had elevated DE (EDE-QS score ≥15) (female: 10.6%, male: 6.9%, P = .10); 18.3% self-reported recent MSK-I (female: 26.3%, male: 17.3%; P = .009). Females had 17% greater odds of MSK-I compared to males (aOR: 1.17, 95% CI: 1.03-1.33, P = .02). Moreover, females with elevated DE had greater odds of MSK-I than males with elevated DE (aOR= 1.38); among females, odds of MSK-I were greatest among those with elevated DE (aOR= 1.35).</p><p><strong>Conclusions: </strong>In this sample of Marine officers, DE was associated with greater odds of a recent MSK-I among women only. Results align with previously reported relationships between DE and skeletal health in female athletes. Prospective research is needed to elucidate the temporal nature of these relationships.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}