Army Warrior Care Project (AWCP): Rationale and methods for a longitudinal study of behavioral health care in Army Warrior Transition Units using Military Health System data, FY2008-2015.

OBJECTIVES: Warrior Transition Units (WTUs) are specialized military units co-located with major military treatment facilities providing a Triad of Care involving primary care physicians, case managers, and military leadership to soldiers needing comprehensive medical care. We describe the rationale and methods for studying behavioral health care in WTUs and characterize soldiers assigned to WTUs. METHODS: The Army Warrior Care Project (AWCP) analyzes U.S. Department of Defense Military Health System data to examine behavioral health problems and service utilization among Army soldiers who were assigned to WTUs after returning from Afghanistan and Iraq deployments, FY2008-2015. RESULTS: WTU members (N = 31,094) comprised 3.5% of the AWCP cohort (N = 883,091). Almost all (96.5%) had one WTU assignment for a median of 327 days; 77.3% were assigned before deployment ended, ≤30 or >365 days post-deployment; 59.4% had deployment-related behavioral health diagnoses. CONCLUSIONS: An overwhelming majority of soldiers had one WTU assignment for almost a year. A substantial proportion of WTU soldiers had psychological impairment, which limited performance of their military duties. The AWCP is the first longitudinal study of redeployed soldiers assigned to WTUs and provides a unique opportunity to advance our understanding of behavioral health among soldiers needing comprehensive medical care after combat deployments.

Atorvastatin restores endothelial function in offspring of protein-restricted rats in a cholesterol-independent manner.

Maternal protein restriction in rats leads to endothelial dysfunction and decreased NO bioavailability in the offspring. Statins (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors) are recognized to have pleiotropic actions including increasing NO bioavailability and reducing inflammation and oxidative damage. This study assessed statin treatment on vascular function in a model of endothelial dysfunction, which is independent of dyslipidemia. Wistar rats were fed a control (18% casein) or protein-restricted (9% casein) diet throughout pregnancy. At weaning, a subset of the protein-restricted group was given atorvastatin (10 mg/kg per day) in the drinking water. At 145 days of age, offspring were euthanized by CO(2) inhalation. Plasma samples were collected for markers of inflammation, vascular reactivity of the thoracic aorta, and small mesenteric arteries were assessed on the wire myograph, and tissues were snap frozen for molecular biology analysis. Thoracic aorta endothelial-dependent vasodilatation was attenuated in the male offspring from both protein-restricted groups compared with controls (P<0.05) but was similar in females (P value not significant). Endothelial-dependent dilatation of mesenteric arteries was attenuated in male and female protein-restricted offspring (P<0.05) and was corrected by atorvastatin. Maternal protein restriction increased plasma inflammatory markers granulocyte chemotactic protein, lipocalin-2, and beta(2)-microglobulin in male and C-reactive protein in female offspring (P<0.05). Atorvastatin had no effect on inflammatory markers in the males but restored C-reactive protein to control levels in the females (P<0.05). Aortic and mesenteric artery mRNA levels of endothelial NO synthase, superoxide dismutase 1, and tumor necrosis factor-alpha were unchanged. These data suggest that atorvastatin can restore endothelial function in this model, but its effects are gender specific and dependent on the vascular bed.