Neuropsychological evaluation of blast-related concussion: Illustrating the challenges and complexities through OEF/OIF case studies

Background/objective: Soldiers of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) sustain blast-related mild traumatic brain injury (concussion) with alarming regularity. This study discusses factors in addition to concussion, such as co-morbid psychological difficulty (e.g. post-traumatic stress) and symptom validity concerns that may complicate neuropsychological evaluation in the late stage of concussive injury. Case report: The study presents the complexities that accompany neuropsychological evaluation of blast concussion through discussion of three case reports of OEF/OIF personnel. Discussion: The authors emphasize uniform assessment of blast concussion, the importance of determining concussion severity according to acute-injury characteristics and elaborate upon non-concussion-related factors that may impact course of cognitive limitation. The authors conclude with a discussion of the need for future research examining the impact of blast concussion (particularly recurrent concussion) and neuropsychological performance

Evaluation Context Impacts Neuropsychological Performance of OEF/OIF Veterans with Reported Combat-Related Concussion

Although soldiers of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) encounter combat-related concussion at an unprecedented rate, relatively few studies have examined how evaluation context, insufficient effort, and concussion history impact neuropsychological performances in the years following injury. The current study explores these issues in a sample of 119 U.S. veterans (OEF/OIF forensic concussion, n = 24; non-OEF/OIF forensic concussion, n = 20; OEF/OIF research concussion, n = 38; OEF/OIF research without concussion, n = 37). The OEF/OIF forensic concussion group exhibited significantly higher rates of insufficient effort relative to the OEF/OIF research concussion group, but a comparable rate of insufficient effort relative to the non-OEF/OIF forensic concussion group. After controlling for effort, the research concussion and the research non-concussion groups demonstrated comparable neuropsychological performance. Results highlight the importance of effort assessment among OEF/OIF and other veterans with concussion history, particularly in forensic contexts

Direct Metal Laser-sintered Stainless Steel: Comparison Of Microstructure And Hardness Between Different Planes

Microstructural analysis and micro-hardness measurements were performed on different planes of 316L stainless steel fabricated by direct metal laser sintering (DMLS) technique. A fine cellular network was observed within the steel microstructure, where morphology of most cells changed from columnar on XZ-plane (vertical section) to equiaxed on XY-plane (horizontal section). Correspondingly, morphology of most grains was found to alter from columnar for the XZ-plane to equiaxed in the case of the XY-plane. Moreover, X-ray diffraction (XRD) analysis revealed a fully austenitic structure for both the planes. The average micro-hardness value for the XZ-plane and XY-plane was insignificantly (≈ 3%) different, which was attributed to the random grain orientation observed on both the planes. However, the average micro-hardness of the DMLS-fabricated 316L stainless steel in this contribution was approximately 25% higher than that of the as-cast one

Experimental Measurement Of Residual Stress And Distortion In Additively Manufactured Stainless Steel Components With Various Dimensions

Disk-shaped 316L stainless steel parts with various diameters and heights were additively manufactured using a direct metal laser sintering (DMLS) technique. Neutron diffraction was used to profile the residual stresses in the samples before and after removal of the build plate and support structures. Moreover, distortion level of the parts before and after the removal was quantified using a coordinate measuring machine (CMM). Large tensile in-plane stresses (up to ≈ 400 MPa) were measured near the as-built disk top surfaces, where the stress magnitude decreased from the disk center to the edges. The stress gradient was steeper for the disks with smaller diameters and heights. Following the removal of the build plate and support structures, the magnitude of the in-plane residual stresses decreased dramatically (up to 330 MPa) whereas the axial stress magnitude did not change significantly. The stress relaxation caused the disks to distort, where the distortion metric was higher for the disks with smaller diameters and heights. The distribution of the residual stresses revealed a marked breakdown of self-similarity in their distribution even comparing disk-shaped samples that were fabricated under identical printing parameters; the stress field profiles were not linearly scaled as a function of height and diameter

Neuropsychological Outcomes of U.S. Veterans with Report of Remote Blast-Related Concussion and Current Psychopathology

This study explored whether remote blast-related MTBI and/or current Axis I psychopathology contribute to neuropsychological outcomes among OEF/OIF veterans with varied combat histories. OEF/OIF veterans underwent structured interviews to evaluate history of blast-related MTBI and psychopathology and were assigned to MTBI (n = 18), Axis I (n = 24), Co-morbid MTBI/Axis I (n = 34), or post-deployment control (n = 28) groups. A main effect for Axis I diagnosis on overall neuropsychological performance was identified (F(3,100) = 4.81; p = .004), with large effect sizes noted for the Axis I only (d = .98) and Co-morbid MTBI/Axis I (d = .95) groups relative to the control group. The latter groups demonstrated primary limitations on measures of learning/memory and processing speed. The MTBI only group demonstrated performances that were not significantly different from the remaining three groups. These findings suggest that a remote history of blast-related MTBI does not contribute to objective cognitive impairment in the late stage of injury. Impairments, when present, are subtle and most likely attributable to PTSD and other psychological conditions. Implications for clinical neuropsychologists and future research are discussed. (JINS, 2012, 18, 1–11

Multi-decadal mass balance series of three Kyrgyz glaciers inferred from modelling constrained with repeated snow line observations

Glacier surface mass balance observations in the Tien Shan and Pamir are relatively sparse and often discontinuous. Nevertheless, glaciers are one of the most important components of the high-mountain cryosphere in the region as they strongly influence water availability in the arid, continental and intensely populated downstream areas. This study provides reliable and continuous surface mass balance series for selected glaciers located in the Tien Shan and Pamir-Alay. By cross-validating the results of three independent methods, we reconstructed the mass balance of the three benchmark glaciers, Abramov, Golubin and Glacier no. 354 for the past 2 decades. By applying different approaches, it was possible to compensate for the limitations and shortcomings of each individual method. This study proposes the use of transient snow line observations throughout the melt season obtained from satellite optical imagery and terrestrial automatic cameras. By combining modelling with remotely acquired information on summer snow depletion, it was possible to infer glacier mass changes for unmeasured years. The model is initialized with daily temperature and precipitation data collected at automatic weather stations in the vicinity of the glacier or with adjusted data from climate reanalysis products. Multi-annual mass changes based on high-resolution digital elevation models and in situ glaciological surveys were used to validate the results for the investigated glaciers. Substantial surface mass loss was confirmed for the three studied glaciers by all three methods, ranging from -0.30±0.19 to -0.41±0.33mw.e. yr-1 over the 2004-2016 period. Our results indicate that integration of snow line observations into mass balance modelling significantly narrows the uncertainty ranges of the estimates. Hence, this highlights the potential of the methodology for application to unmonitored glaciers at larger scales for which no direct measurements are available.Publisher PDFPeer reviewe

Re-establishing glacier monitoring in Kyrgyzstan and Uzbekistan, Central Asia

Glacier mass loss is among the clearest indicators of atmospheric warming. The observation of these changes is one of the major objectives of the international climate monitoring strategy developed by the Global Climate Observing System (GCOS). Long-term glacier mass balance measurements are furthermore the basis for calibrating and validating models simulating future runoff of glacierised catchments. This is essential for Central Asia, which is one of the driest continental regions of the Northern Hemisphere. In the highly populated regions, water shortage due to decreased glacierisation potentially leads to pronounced political instability, drastic ecological changes and endangered food security. As a consequence of the collapse of the former Soviet Union, however, many valuable glacier monitoring sites in the Tien Shan and Pamir Mountains were abandoned. In recent years, multinational actors have re-established a set of important in situ measuring sites to continue the invaluable long-term data series. This paper introduces the applied monitoring strategy for selected glaciers in the Kyrgyz and Uzbek Tien Shan and Pamir, highlights the existing and the new measurements on these glaciers, and presents an example for how the old and new data can be combined to establish multi-decadal mass balance time series. This is crucial for understanding the impact of climate change on glaciers in this region

Influence of different digital terrain models (DTMs)on alpine permafrost modeling

The thawing of alpine permafrost due to changes in atmospheric conditions can have a severe impact, e.g., on the stability of rock walls. The energy balance model, PERMEBAL, was developed in order to simulate the changes and distribution of ground surface temperature (GST) in complex high-mountain topography. In such environments, the occurrence of permafrost depends greatly on the topography, and thus, the digital terrain model (DTM) is an important input of PERMEBAL. This study investigates the influence of the DTM on the modeling of the GST. For this purpose, PERMEBAL was run with six different DTMs. Five of the six DTMs are based on the same base data, but were generated using different interpolators. To ensure that only the topographic effect on the GST is calculated, the snow module was turned off and uniform conditions were assumed for the whole test area. The analyses showed that the majority of the deviations between the different model outputs related to a reference DTM had only small differences of up to 1 K, and only a few pixels deviated more than 1 K. However, we also observed that the use of different interpolators for the generation of a DTM can result in large deviations of the model output. These deviations were mainly found at topographically complex locations such as ridges and foot of slopes

Potential climatic transitions with profound impact on Europe

We discuss potential transitions of six climatic subsystems with large-scale impact on Europe, sometimes denoted as tipping elements. These are the ice sheets on Greenland and West Antarctica, the Atlantic thermohaline circulation, Arctic sea ice, Alpine glaciers and northern hemisphere stratospheric ozone. Each system is represented by co-authors actively publishing in the corresponding field. For each subsystem we summarize the mechanism of a potential transition in a warmer climate along with its impact on Europe and assess the likelihood for such a transition based on published scientific literature. As a summary, the ‘tipping’ potential for each system is provided as a function of global mean temperature increase which required some subjective interpretation of scientific facts by the authors and should be considered as a snapshot of our current understanding. <br/