Irish Property Price Estimation Using A Flexible Geo-spatial Smoothing Approach: What is the Impact of an Address?

Accurate and efficient valuation of property is of utmost importance in a variety of settings, such as when securing mortgage finance to purchase a property, or where residential property taxes are set as a percentage of a property's resale value. Internationally, resale based property taxes are most common due to ease of implementation and the difficulty of establishing site values. In an Irish context, property valuations are currently based on comparison to recently sold neighbouring properties, however, this approach is limited by low property turnover. National property taxes based on property value, as opposed to site value, also act as a disincentive to improvement works due to the ensuing increased tax burden. In this article we develop a spatial hedonic regression model to separate the spatial and non-spatial contributions of property features to resale value. We mitigate the issue of low property turnover through geographic correlation, borrowing information across multiple property types and finishes. We investigate the impact of address mislabelling on predictive performance, where vendors erroneously supply a more affluent postcode, and evaluate the contribution of improvement works to increased values. Our flexible geo-spatial model outperforms all competitors across a number of different evaluation metrics, including the accuracy of both price prediction and associated uncertainty intervals. While our models are applied in an Irish context, the ability to accurately value properties in markets with low property turnover and to quantify the value contributions of specific property features has widespread application. The ability to separate spatial and non-spatial contributions to a property's value also provides an avenue to site-value based property taxes.

The impact of changing the cut-off threshold of the interferon-gamma (IFN-γ) assay for diagnosing bovine tuberculosis in Ireland.

In Ireland, the interferon-gamma (IFN-γ) assay is routinely used as an ancillary test interpreted in parallel with the single intradermal comparative tuberculin test (SICTT) to maximize the detection of bovine tuberculosis (bTB) infected animals. Up until 2018, a positive test result was recorded in the IFN-γ ELISA assay following whole blood stimulation with purified protein derivative (PPD)-bovine (B), PPD-avian (A) and nil sample (N), using the interpretation criteria, B-N > 50 optical density units (OD), B > 100 and B-A > 0. Following a review of available data, the threshold of the B-A component changed to B-A > 80. As predicting the impact of changing the cut-off thresholds for the IFN-γ test de novo is challenging, the aims of this study were to follow animals that initially tested negative using the new IFN-γ assay interpretation criteria and investigate their future risk of disclosure with bTB, with a focus on animals that otherwise would have been removed when using the older interpretation criteria (0 < B-A ≤ 80). Enrolled animals (n = 28,669 cattle from 527 herds) were followed up for two years (2019-2021), or to point of bTB detection or death. At the end of follow-up, 1151 (4.0%) of enrolled animals were bTB cases. The majority of these cases were diagnosed using SICTT (80.5%). The cumulative number of positive animals that would have been removed if the old cut-off (0 < B-A ≤ 80) was used amounted to 1680 cattle (5.9% of the enrolled cohort). Of these, 127 (7.5%) were diagnosed with bTB during follow-up. In contrast, 1024 of the 1151 cattle which subsequently tested positive during the study period following a negative IFN-γ test would not have been identified with the old or new IFN-γ cut-off criteria. Survival analysis showed that animals that would have been removed under the old interpretation criteria were at increased risk of a positive diagnosis with bTB during follow-up compared to other test negative animals. A newly developed risk prediction model (using a Cox proportional hazard model) showed that age, animal number of SICTT tests, number of inconclusive SICTT tests, B-A (IFN-γ assay), B-N (IFN-γ assay), animals from store herds and the percentage of the rest of the herd that were positive during the breakdown were statistically significantly associated with bTB detection. However, inclusion of the IFN-γ OD variables did not show added value in terms of prediction performance of the model.

Dissimilarity-Preserving Representation Learning for One-Class Time Series Classification.

We propose to embed time series in a latent space where pairwise Euclidean distances (EDs) between samples are equal to pairwise dissimilarities in the original space, for a given dissimilarity measure. To this end, we use auto-encoder (AE) and encoder-only neural networks to learn elastic dissimilarity measures, e.g., dynamic time warping (DTW), that are central to time series classification (Bagnall et al., 2017). The learned representations are used in the context of one-class classification (Mauceri et al., 2020) on the datasets of UCR/UEA archive (Dau et al., 2019). Using a 1-nearest neighbor (1NN) classifier, we show that learned representations allow classification performance that is close to that of raw data, but in a space of substantially lower dimensionality. This implies substantial and compelling savings in terms of computational and storage requirements for nearest neighbor time series classification.

An Update on the Diagnosis and Management of Acute Right Heart Failure.

Right ventricular (RV) dysfunction and resultant acute right heart failure (ARHF) is a rapidly growing field of interest, driven by increasing appreciation of its contribution to heart failure morbidity and mortality. Understanding of ARHF pathophysiology has advanced dramatically over recent years and can be broadly described as RV dysfunction related to acute changes in RV afterload, contractility, preload, or left ventricular dysfunction. There are several diagnostic clinical signs and symptoms as well as imaging and hemodynamic assessments that can provide insight into the degree of RV dysfunction. Medical management is tailored to the different causative pathologies, and in cases of severe or end-stage dysfunction, mechanical circulatory support can be utilized. In this review, we describe the pathophysiology of ARHF, how its diagnosis is established by clinical signs and symptoms and imaging findings, and provide an overview of treatment options, both medical and mechanical.

Upgraded main ion charge exchange recombination spectroscopy on the C-2W field reversed configuration (FRC) plasma.

A prototype main-ion CHarge Exchange Recombination Spectroscopy (mCHERS) diagnostic is providing measurements of the main-ion (hydrogen or deuterium) temperature and velocity in the C-2W field reversed configuration plasma using charge exchange Balmer-alpha emission at five different radial locations with 500 Hz frequency and a per-pixel velocity resolution of 15 km/s. Measurement along the entire plasma radius of C-2W is enabled by a diagnostic neutral beam (DNB) that passes through the center of plasma, unlike the larger diameter heating neutral beams that have impact parameters of 20 cm. DNB provides high time resolution via beam modulation and spatial resolution via its small cross section. The goals of the current mCHERS upgrade are to double the number of spatial channels, improve the per-pixel velocity resolution by three times, and increase the measurement frequency to match the maximum modulation frequency of the diagnostic neutral beam (∼10 kHz). To accomplish these goals, a new astigmatism-free Isoplane spectrometer has been commissioned. Progress and results from the newly upgraded mCHERS system are detailed.

Dynamic Load Model Systems of Tendon Inflammation and Mechanobiology.

Dynamic loading is a shared feature of tendon tissue homeostasis and pathology. Tendon cells have the inherent ability to sense mechanical loads that initiate molecular-level mechanotransduction pathways. While mature tendons require physiological mechanical loading in order to maintain and fine tune their extracellular matrix architecture, pathological loading initiates an inflammatory-mediated tissue repair pathway that may ultimately result in extracellular matrix dysregulation and tendon degeneration. The exact loading and inflammatory mechanisms involved in tendon healing and pathology is unclear although a precise understanding is imperative to improving therapeutic outcomes of tendon pathologies. Thus, various model systems have been designed to help elucidate the underlying mechanisms of tendon mechanobiology via mimicry of the in vivo tendon architecture and biomechanics. Recent development of model systems has focused on identifying mechanoresponses to various mechanical loading platforms. Less effort has been placed on identifying inflammatory pathways involved in tendon pathology etiology, though inflammation has been implicated in the onset of such chronic injuries. The focus of this work is to highlight the latest discoveries in tendon mechanobiology platforms and specifically identify the gaps for future work. An interdisciplinary approach is necessary to reveal the complex molecular interplay that leads to tendon pathologies and will ultimately identify potential regenerative therapeutic targets.

Variations in Mitral Valve Leaflet and Scallop Anatomy on Three-Dimensional Transesophageal Echocardiography.

BACKGROUND: Textbook depictions of the mitral valve (MV) often illustrate it as composed of a single nonscalloped anterior leaflet, with the posterior leaflet having three symmetric and evenly spaced scallops. However, common variations in this anatomy have been noted in autopsy series for decades. Improved cardiac imaging with three-dimensional transesophageal echocardiography (TEE) now affords the ability to detect variations in scallop anatomy in vivo. The aims of this study were to catalog variations in mitral anatomy and to examine for association with mitral regurgitation in patients referred for clinical three-dimensional TEE. METHODS: Three-dimensional transesophageal echocardiographic images of the MV from 107 subjects were reviewed for MV variations. Three-dimensional analysis software was used to characterize mitral leaflet anatomy and assess the relative sizes of posterior leaflet scallops. RESULTS: Variations from the classic MV configuration were seen in 58.9%. Symmetric variations in the posterior leaflet (dominant P2 scallop, accessory P2 scallop, absent P2 scallop, and dichotomous P2 scallop) were seen in 33.6% of the study group. Asymmetric variants in the posterior leaflet (fused P1 and P2, fused P2 and P3, commissural scallop, accessory scallops, dichotomous P1 or P3, and dominant P2 or P3) were seen in 24.3%. Indentations or folds in the anterior leaflet were noted in 5.6%. Leaflet variations were not associated with patient demographics, indication for TEE, mitral regurgitation, mitral annular dimensions, or Carpentier class. CONCLUSIONS: Mitral leaflet morphologic variants were well characterized using three-dimensional TEE. Variants are common and were present with a frequency consistent with autopsy series. Mitral scallop variations were not associated with mitral regurgitation.

An age-structured SEIR model for COVID-19 incidence in Dublin, Ireland with framework for evaluating health intervention cost.

Strategies adopted globally to mitigate the threat of COVID-19 have primarily involved lockdown measures with substantial economic and social costs with varying degrees of success. Morbidity patterns of COVID-19 variants have a strong association with age, while restrictive lockdown measures have association with negative mental health outcomes in some age groups. Reduced economic prospects may also afflict some age cohorts more than others. Motivated by this, we propose a model to describe COVID-19 community spread incorporating the role of age-specific social interactions. Through a flexible parameterisation of an age-structured deterministic Susceptible Exposed Infectious Removed (SEIR) model, we provide a means for characterising different forms of lockdown which may impact specific age groups differently. Social interactions are represented through age group to age group contact matrices, which can be trained using available data and are thus locally adapted. This framework is easy to interpret and suitable for describing counterfactual scenarios, which could assist policy makers with regard to minimising morbidity balanced with the costs of prospective suppression strategies. Our work originates from an Irish context and we use disease monitoring data from February 29th 2020 to January 31st 2021 gathered by Irish governmental agencies. We demonstrate how Irish lockdown scenarios can be constructed using the proposed model formulation and show results of retrospective fitting to incidence rates and forward planning with relevant "what if / instead of" lockdown counterfactuals. Uncertainty quantification for the predictive approaches is described. Our formulation is agnostic to a specific locale, in that lockdown strategies in other regions can be straightforwardly encoded using this model.

Spatio-temporal models of bovine tuberculosis in the Irish cattle population, 2012-2019.

INTRODUCTION: Bovine tuberculosis (bTB) is an important zoonotic disease which has serious and sometimes fatal effects on both human and non-human animals. In many countries it is endemic in the cattle population and has a considerable economic impact through losses in productivity and impacts on trade. The incidence rate in Ireland varies by herd and location and it is hoped that statistical disease-mapping models accounting for both spatio-temporal correlation and covariates might contribute towards explaining this variation. METHODS: Ireland was divided into equally sized hexagons for computational efficiency (n = 997). Different spatio-temporal random-effects models (e.g. negative binomial Besag-York-Mollié) were explored, using comprehensive data from the national bTB eradication programme to examine the association between covariates and the number of bTB cattle. Leveraging a Bayesian framework, model parameter estimates were obtained using the integrated nested Laplace approximation (INLA) approach. Exceedance probabilities were calculated to identify spatial clusters of cases. RESULTS: Models accounting for spatial correlation significantly improved model fit in comparison to non-spatial versions where independence between regions was assumed. In our final model at hexagon level, the number of cattle (IR = 1.142, CrI: 1.108 - 1.177 per 1000), the capture of badgers (IR = 5.951, CrI: 4.482 - 7.912), percentage of forest cover (IR = 1.031, CrI: 1.020 - 1.042) and number of farm fragments (IR = 1.012, CrI: 1.009 - 1.015 per 10 fragments) were all associated with an increased incidence of bTB. Habitat suitability for badgers, percentage of dairy herds and the number of cattle movements into the herd were not. As an epidemiological tool and to suggest future work, an interactive online dashboard was developed to monitor disease progression and disseminate results to the general public. CONCLUSION: Accounting for spatial correlation is an important consideration in disease mapping applications and is often ignored in statistical models examining bTB risk factors. Over time, the same regions in Ireland generally show highest incidences of bTB and allocation of more resources to these areas may be needed to combat the disease. This study highlights national bTB incidence rates. Shifting from national level analysis to smaller geographical regions may help identify localised high-risk areas.

Main ion charge exchange recombination spectroscopy on C-2W FRC plasmas.

A main ion charge exchange recombination spectroscopy (mChERS) diagnostic has been developed to measure the velocity and temperature of the main deuterium ions in the C-2W (also called Norman) field-reversed configuration (FRC) device. A modulated diagnostic neutral beam (DNB) of hydrogen with 40 keV full energy and a nominal current of 8.5 A provides the charge exchange signal. The DNB can achieve a fast modulation frequency of up to 10 kHz, a rare attribute to find on other fusion devices, which defines the time resolution of mChERS. Currently, the mChERS diagnostic provides simultaneous measurements at five spatial locations in the FRC plasma using a high-speed camera. The design and capabilities of the mChERS system are presented along with first experimental data.

Neck injury following nonimpact mild traumatic brain injury in motor vehicle collisions.

Several studies of neurocognitive differences between selected samples of nonimpact and impact patients experiencing mild traumatic brain injury (mTBI) in a single motor vehicle accident have been conducted. The results suggested comparable and essentially normal brain-related cognitive skills for these clinical groups, but with notable exceptions for nonimpact individuals involving tactile- and visual-spatial perceptual and memory deficiencies. These findings raised the possibility that some nonimpact patients were experiencing dysfunction of post-central cerebral regions due to neck injury that was interfering with vertebral artery function. Neck injury was presented in this study as a hypothetical correlate of vertebral artery dysfunction. The hypothesis that neck injury was more likely for this sample of nonimpact mTBI patients was tested by comparing frequencies of neck injury complaints and diagnostic conclusions of neck injury, and agreement between these variables, for nonimpact and impact patients. While frequency differences for neck injury complaints and diagnostic conclusions did not quite achieve statistical significance, concordance between these variables was significantly higher for nonimpact individuals. Agreement between neck injury complaints and diagnostic conclusions was significantly more likely for nonimpact patients, supporting the possibility of a notable relationship between nonimpact mTBI and neck injury in motor vehicle collisions.

The clinical presentation, treatment and outcome of serologically confirmed paediatric Lyme disease in the Republic of Ireland over a 5-year period: a retrospective cohort study.

Lyme disease (LD) is the most common tick-borne illness in Europe. Population-based studies in European children are few. This study aimed to assess the incidence, clinical presentation, treatment and outcome of serologically confirmed paediatric LD in the Republic of Ireland over a 5-year period. A retrospective review of records from accredited laboratories performing Borrelia burgdorferi serological testing was undertaken. Proformas were distributed to clinicians of children and adolescents with positive Lyme serology. Data were requested regarding clinical presentation, treatment and outcome. Updated NICE guidelines were used to classify clinical cases. Serology testing for B. burgdorferi was performed on 2908 samples. Sixty-three (2.2%) children were two-tier positive, generating a crude annual incidence rate of 1.15/100,000. Proformas were returned for 55 (87%) and 47 met clinical and laboratory criteria for LD. Twenty-seven (57%) presented with non-focal symptoms (erythema migrans and/or influenza-like symptoms), and 20 (43%) with focal symptoms (cranial nerve involvement, 11; CNS involvement, 8; arthritis, 1). Median age at presentation was 8.2 (2.5-17.9) years. Seventeen (36%) acquired LD overseas. Twenty-five (83%) of the remaining 30 children acquired infection in the West/Northwest of Ireland. Full resolution of symptoms was reported in 97% of those with available data. Serologically confirmed LD in children is relatively rare in the Republic of Ireland. Ninety-eight percent of children tested were seronegative. Of the seropositive cases, 40% could have been diagnosed based on clinical findings alone. Neurological presentations (40%) were common. Full resolution of symptoms occurred in almost all (97%) where data were available.

Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle.

BACKGROUND: The failure of some high-income countries to retain their medical graduates is one driver of doctor immigration from low- and middle-income countries. Ireland, which attracts many international medical graduates, implemented a doctor retention strategy from early 2015. This study measures junior doctors' migration intentions, the reasons they leave and likelihood of them returning. The aim is to identify the characteristics and patterns of doctors who plan to emigrate to inform targeted measures to retain these doctors. METHODS: A national sample of 1148 junior hospital doctors completed an online survey in early 2018, eliciting their experiences of training and working conditions. Respondents were asked to choose between the following career options: remain in Ireland, go and return, go and stay away, or quit medicine. Bivariate analyses and a two-stage multivariable analysis were used to model the factors associated with these outcomes. RESULTS: 45% of respondents planned to remain in Ireland, 35% leave but return later, 17% leave and not return; and 3% to quit medicine. An intention to go abroad versus remain in Ireland was independently associated (P<.05) with the doctor being under 30 years (odds ratio [OR]=1.09 per year under 30), a non-European Union (EU) national (OR=1.54), a trainee (OR=1.50), and with hospital specialization, especially in Anesthesiology (OR=5.09). Respondents were more likely to remain if they had experienced improvements in supervision and training costs. Intention to go abroad and not return versus go and return was independently associated (P<.05) with: age over 30 years (OR=1.16 per year over 30); being a non-EU (OR=9.85) or non-Irish EU (OR=3.42) national; having trained through a graduate entry pathway (OR=2.17), specializing in Psychiatry (OR=4.76) and reporting that mentoring had become worse (OR=5.85). CONCLUSION: Ireland's doctor retention strategy has not addressed the root causes of poor training and working experiences in Irish hospitals. It needs a more diversified retention strategy that addresses under-staffing, facilitates circular migration by younger trainees who choose to train abroad, identifies and addresses specialty-specific factors, and builds mentoring linkages between trainees and senior specialists.

Inspiratory muscle training in young, race-fit Thoroughbred racehorses during a period of detraining.

Although inspiratory muscle training (IMT) is reported to improve inspiratory muscle strength in humans little has been reported for horses. We tested the hypothesis that IMT would maintain and/or improve inspiratory muscle strength variables measured in Thoroughbreds during detraining. Thoroughbreds from one training yard were placed into a control (Con, n = 3 males n = 7 females; median age 2.2±0.4 years) or treatment group (Tr, n = 5 males, n = 5 females; median age 2.1±0.3 years) as they entered a detraining period at the end of the racing/training season. The Tr group underwent eight weeks of IMT twice a day, five days per week using custom-made training masks with resistance valves and an incremental threshold of breath-loading protocol. An inspiratory muscle strength test to fatigue using an incremental threshold of breath-loading was performed in duplicate before (T0) and after four (T1) and eight weeks (T2) of IMT/no IMT using a custom-made testing mask and a commercial testing device. Inspiratory measurements included the total number of breaths achieved during the test, average load, peak power, peak volume, peak flow, energy and the mean peak inspiratory muscle strength index (IMSi). Data were analysed using a linear mixed effects model, P≤0.05 significant. There were no differences for inspiratory measurements between groups at T0. Compared to T0, the total number of breaths achieved (P = 0.02), load (P = 0.003) and IMSi (P = 0.01) at T2 had decreased for the Con group while the total number of breaths achieved (P<0.001), load (P = 0.03), volume (P = 0.004), flow (P = 0.006), energy (P = 0.01) and IMSi (P = 0.002) had increased for the Tr group. At T2 the total number of breaths achieved (P<0.0001), load (P<0.0001), volume (P = 0.02), energy (P = 0.03) and IMSi (P<0.0001) were greater for the Tr than Con group. In conclusion, our results support that IMT can maintain and/or increase aspects of inspiratory muscle strength for horses in a detraining programme.

Exploratory study of HRB signs, patterns, and right-left differences relating to spatial cognition following nonimpact mild traumatic brain injury.

Sweeney and Johnson found that response time on the Tactile Form Recognition Test (TFR) of the Halstead-Reitan Test Battery (HRB) requiring speeded tactile- and visual-spatial recognition was deficient for Nonimpact mild traumatic brain injury (mTBI) individuals in comparison to Impact mTBI and No mTBI participants. A follow-up study by Sweeney and Slade noted that skills most sensitive to Deficient TFR performance of mTBI subjects involved tactile-spatial perception, with lateralization of inferior performances contralateral to cerebral regions known to specialize in the spatial skills required. The current study compared frequencies of HRB Pathognomonic Signs, atypical Score Patterns, and abnormal Right-Left Differences for Nonimpact mTBI groups that exhibited Deficient, Perfectly Normal, or Normal TFR performances. The only statistically significant finding was that the Deficient TFR group produced a disproportionately greater number of errors with the right hand relative to the left hand on Fingertip Number Writing Perception. Deficient TFR mTBI individuals were 5.29 times more likely to commit errors with the right hand on the Fingertip Number Writing Perception Test than Perfectly Normal and Normal TFR mTBI subjects. Tentative clinical markers of neuropsychological changes that appear to be associated with Nonimpact mTBI, based on a series of investigations, were provided.

Preliminary study of spatial cognition relating to nonimpact mTBI.

Sweeney and Johnson found that individuals that sustained mild traumatic brain injury without impact to the head (Nonimpact) demonstrated significantly slower performance than participants that suffered mild traumatic brain injury with impact to the head and normal controls on the Tactile Form Recognition Test (TFR). The current study explored the spatial cognition of three groups of Nonimpact participants classified as Deficient, Perfectly Normal, and Normal on the basis of TFR response time. Dependent variables consisted of neuropsychological tests requiring tactile- and/or visual-spatial perception and memory. Univariate analysis of variance (ANOVAs) were carried out, with false positive findings controlled by adjusting p-values using the False Detection Rate. Deficient TFR individuals performed at significantly inefficient levels relative to both Perfectly Normal and Normal TFR patients on tactile-spatial tests requiring the perception and recognition of multiple geometric configurations with the left hand, tactile-spatial memory for these shapes, and identification of numbers traced on the fingertips of the right hand. TFR Deficiency appeared to negatively affect performance on visual-spatial tests involving memory for abstract concepts and rapid association of numbers and geometric shapes, but only in relation to Perfectly Normal participants.

Implementation of outcome measurement (HoNOS) in an outpatient psychiatric clinic in Sligo/Leitrim mental health service.

BACKGROUND: Routine clinical outcome monitoring (RCOM) is the standardised gathering of measures of clinical outcomes in everyday practice. HoNOS (Health of the Nation Outcome Scales) is a tool used in RCOM. AIMS: To examine (a) agreement between HoNOS and Global Assessment of Functioning (GAF), (b) HoNOS changes over time/attendance and (c) clinical parameters affecting HoNOS scores. METHODS: Data from outpatient clinics were collected at each contact over 2 years until June 2016 including: gender, age, diagnosis (ICD-10) and HoNOS scores. In a subsample, the GAF also were completed by community psychiatric nurses blind to HoNOS scores. RESULTS: A number of 470 outpatients have undergone 1125 HoNOS assessments during the study period. Mean age of the attendants was 43.12; SD 14.6. Male = 220 (46.8%). Longitudinal analysis demonstrated that lower HoNOS scores are independently significantly associated to number of assessments and diagnosis in ICD-10 categories of F20-F29 (Schizophrenia, schizotypal and delusional disorders) F30-F39 (mood disorders) F40-F48 (neurotic, stress-related and somatoform disorders) and F50-F59 (behavioural disorders associated with physiological disturbances). Gender and age were not significantly associated with decline of HoNOS scores. Neither were other diagnostic categories. Agreement between HoNOS and GAF was excellent (N = 261, rho = - 0.919, p < 0.001). CONCLUSIONS: This study shows that HoNOS is a feasible instrument which can be potentially used in ROCM in mental health services in Ireland and supports further the need for implementation of routine measurements in Mental Health Services. It adds longitudinal data which is lacking in similar previous studies.

Halstead-Reitan characteristics of nonimpact and impact mTBI litigants and insurance claimants.

The purpose of this study was to investigate possible neuropsychological differences in Halstead-Reitan characteristics between motor vehicle accident litigants and insurance claimants that sustained uncomplicated mild traumatic brain injury (mTBI) and did or did not sustain direct impact to the head (i.e., Impact vs. Nonimpact mTBI), and to compare these clinical groups with a control group that did not suffer mTBI (No mTBI). The Tactile Form Recognition Test (TFR) was the only level of performance test in the Halstead-Reitan Battery (HRB) that generated statistically significant differences. The TFR resembles a complex reaction time test. TFR response time was significantly longer for Nonimpact mTBI patients than for Impact mTBI and No mTBI participants. Frequency comparisons of abnormal score patterns demonstrated that Nonimpact patients produced significantly more aberrant Impairment Index vs. FSIQ score patterns than Impact and No mTBI participants. Given the components of the score pattern, this finding suggests that Nonimpact patients may experience less recovery from neuropsychological deficits than Impact participants. Complex perceptual reaction times and score patterns comparing sensitive and "hold" test results may represent heuristic avenues of future research in the study of compensation-seeking Nonimpact and Impact mTBI patients.

An index of decline or recovery following nonimpact and impact mTBI.

This study investigated the degree to which litigants/insurance claimants sustaining Nonimpact mild traumatic brain injury (mTBI) in motor vehicle accidents differed from compensation-seeking motor vehicle accident victims that suffered Impact mTBI in terms of neuropsychological decline/recovery, using as a control litigants/insurance claimants that did not experience mTBI in motor vehicle accidents. A clinical index (C-Voc) was employed as the dependent measure for decline/recovery, consisting of T-score algebraic differences between a highly sensitive neurocognitive measure (Category Test) and a relatively insensitive "hold" measure (Wechsler Adult Intelligence Scale Vocabulary subtest). Nonimpact mTBI subjects showed significantly greater neurocognitive decline than Impact mTBI participants and, interestingly, Impact mTBI individuals did not differ significantly from individuals with no diagnosis of mTBI. These findings suggest that Nonimpact subjects may experience significantly greater persistent neurocognitive residua of mTBI than Impact participants.