Author Contributions: Dr Webber had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Webber, Seguin, Burnett, Clark, Otto.
Acquisition of data: Webber, Seguin, Clark.
Analysis and interpretation of data: Webber, Seguin, Burnett, Clark, Otto.
Drafting of the manuscript: Webber, Seguin, Burnett, Clark.
Critical revision of the manuscript for important intellectual content: Webber, Seguin, Burnett, Clark, Otto.
Statistical analysis: Webber, Burnett.
Administrative, technical, or material support: Seguin, Otto.
Study supervision: Seguin, Burnett, Clark, Otto.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Funding/Support: This study was supported by the Uniformed Services University of the Health Sciences (USUHS), Armed Forces Medical Examiner System (AFMES), and Armed Forces Health Surveillance Center (AFHSC).
Role of the Sponsor: The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation or review of the manuscript. USUHS, AFMES, and AFHSC approved the manuscript prior to submission.
Disclaimer: This work is the sole responsibility of the authors and does not represent the official views of USUHS, AFMES, AFHSC, or Department of Defense.
Online-Only Material: The Author Video Interview is available here.
Additional Contributions: We thank USUHS faculty members Roger Gibson, DVM, MPH, PhD; Ann Scher, PhD; and Elizabeth Rouse, MD, for their help with study design, statistical analyses, and forensic pathology consultation, respectively; Steve Taubman, PhD, and Joel Gaydos, MD, MPH, of AFHSC, for data acquisition and for scientific review of the manuscript, respectively; and the study's participants, for their service. No contributors received compensation in addition to their federal government salary.