{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T15:57:32Z","timestamp":1768319852900,"version":"3.49.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,19]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>We evaluated the risk factors associated with gastrointestinal disorders (GD) among the soldiers of the Army and Marine Aviation community (AMAC) using an exposomic approach. Specifically, we aimed to determine the medical and operational factors associated with reported GD in the Military Health System.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Longitudinal data were obtained from the Medical Assessment and Readiness System (MARS) housed at Womack Army Medical Center, Fort Liberty, NC, for a retrospective cohort study that included 79,249 active duty United States AMAC active duty service members (ADSMs) from October 2015 to December 2019. Multivariable mixed-effects logistic regression was used to assess the relationship between the incidence occurrence of GD and variables including rank, service time, deployment, Armed Forces Qualification Test score, education, tobacco use, alcohol use, age, gender, race, ethnicity, body mass index (BMI), and marital status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The incidence of GD included 22,813 person-years of observations with a rate of 2.2 per 100 person-years and a period prevalence of 3.2%. GD was independently associated with rank, service time, and deployment (all P\u2009&amp;lt;\u20090.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The high-risk categories associated with GD in the AMAC included age, BMI, race (not ethnicity), marital status, and service time. Our data also show that deployment time, not geographical location, was associated with a higher risk of GD. Together, these analyses suggest that White ADSMs older than 33\u2009years of age who have experienced marriage, longer service time, and deployments appear to have a higher risk of GDs. Our assessment shows the utility of using an exposomic approach to create a member-specific, big data-informed personalized clinical algorithm of health outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usae036","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T16:08:46Z","timestamp":1724083726000},"page":"31-38","source":"Crossref","is-referenced-by-count":1,"title":["Exposome Signatures of Gastrointestinal Disorders Among Active Duty Service Members"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7484-9942","authenticated-orcid":false,"given":"Carlos J","family":"Maldonado","sequence":"first","affiliation":[{"name":"Department of Clinical Investigation, Womack Army Medical Center , Fort Liberty, NC 28310, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica A","family":"White-Phillip","sequence":"additional","affiliation":[{"name":"Department of Clinical Investigation, Womack Army Medical Center , Fort Liberty, NC 28310, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuliang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Veterans Administration Central Office , Washington, DC 20420, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y Sammy","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Clinical Investigation, Womack Army Medical Center , Fort Liberty, NC 28310, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"key":"2024082004005189000_R1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268818003187","article-title":"Magnitude, distribution, risk factors and care-seeking behaviour of acute, self-reported gastrointestinal illness among US Army Soldiers: 2015","volume":"147","author":"Mullaney","year":"2019","journal-title":"Epidemiol Infect"},{"issue":"5","key":"2024082004005189000_R2","doi-asserted-by":"publisher","first-page":"912","DOI":"10.4269\/ajtmh.15-0200","article-title":"Gastrointestinal infections in deployed forces in the Middle East Theater: an historical 60 year perspective","volume":"93","author":"Riddle","year":"2015","journal-title":"Am J Trop Med Hyg"},{"key":"2024082004005189000_R3","article-title":"Study on health of helicopter and tiltrotor pilots, S 2943, NDAA Conference Report for FY 2017, 114-840, Sec. 750 (8 Feb 2019)"},{"issue":"1","key":"2024082004005189000_R4","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1038\/ajg.2015.386","article-title":"The epidemiology of irritable bowel syndrome in the US Military: findings from the Millennium Cohort Study","volume":"111","author":"Riddle","year":"2016","journal-title":"Am J Gastroenterol"},{"issue":"4","key":"2024082004005189000_R5","doi-asserted-by":"publisher","first-page":"713","DOI":"10.4269\/ajtmh.2005.73.713","article-title":"Impact of illness and non-combat injury during Operations Iraqi Freedom and Enduring Freedom (Afghanistan)","volume":"73","author":"Sanders","year":"2005","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"2024082004005189000_R6","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1093\/ije\/dyr236","article-title":"The exposome: from concept to utility","volume":"41","author":"Wild","year":"2012","journal-title":"Int J Epidemiol"},{"issue":"6","key":"2024082004005189000_R7","doi-asserted-by":"publisher","DOI":"10.1289\/EHP3127","article-title":"What is your gut telling you? 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