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Background: Overpressure (OP) is an increase in air pressure above normal atmospheric levels. Military personnel are repeatedly exposed to low levels of OP caused by various weapon systems. Repeated OP may increase risk of neurological disease or psychological disorder diagnoses. A means to detect early phase effects that may be relevant to brain trauma remain elusive. Therefore, development of quantitative and objective OP-mediated effects during acute timeframes would vastly augment point-of-care or field-based decisions. This pilot study evaluated the amplitude of traumatic brain injury (TBI)–associated biomarkers in serum as a consequence of repeated OP exposure from .50-caliber rifle use over training multiple days. Objective: To determine the acute temporal profile of TBI-associated serum biomarkers and their relationship with neurocognitive decrements or self-reported symptoms among participants exposed to low-level, repeated OP from weapons used in a training environment. Methods: Study participants were enrolled in .50-caliber sniper rifle training and exposed to mild OP (peak pressure 3.8–4.5 psi, impulse 19.27–42.22 psi-ms per day) for three consecutive days (D1–D3). Defense automated neurobehavioral assessment (DANA) neurocognitive testing, symptom reporting, and blood collection were conducted 2–3 h before (pre-) and again 0.45–3 h after (post-) OP exposure. The TBI-associated serum biomarkers, glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), neurofilament light (Nf-L), tau, and amyloid beta peptides (Aβ-40 and Aβ-42) were measured using digital ELISAs. Results: Serum GFAP decreased on D1 and D3 but not D2 after OP exposure. Nf-L was suppressed on D3 alone. Aβ-40 was elevated on D2 alone while Aβ-42 was elevated each day after OP exposure. Suppression of GFAP and elevation of Aβ-42 correlated to OP-mediated impulse levels measured on D3. Conclusions: Acute measurement of Aβ-peptides may have utility as biomarkers of subconcussive OP caused by rifle fire. ...

"A Rifle Marksmanship Diagnostic and Training Guide was developed to assist Army drill sergeants diagnose and train Soldiers in the Initial Entry Training (IET) environment. The guide was based on subject matter expert input from the Infantry One Station Unit Training (OSUT) Brigade and the U.S. Army Marksmanship Unit (USAMU). These experts were interviewed to obtain effective training and diagnostic techniques and lessons learned through years of training IET Soldiers. The guide integrates this information, sequences it according to the marksmanship program, and thoroughly illustrates the major training principles and lessons learned. All information supplements and complements the Army marksmanship field manual. The guide is an Appendix to the report."--DTIC. ; Approved for public release; distribution is unlimited. ; Includes bibliographical references (p. 7-8). ; DTIC Identifier(s): PE633007. ; DTIC Descriptor(s): Marksmanship, Army Training, Enlisted Personnel, Officer Personnel, Rifles, Manuals, Field Army, Lessons Learned, Input, Diagnosis(General). ; "Army project number 633007A792." ; Author(s) subject terms: Initial Entry, Training Rifle Marksmanship, Drill Sergeants, U.S. Army Marksmanship Unit, BRM, ARM, Diagnosing Skills, Training, Marksmanship Fundamentals. ; "May 2011." ; Cover title. ; "A Rifle Marksmanship Diagnostic and Training Guide was developed to assist Army drill sergeants diagnose and train Soldiers in the Initial Entry Training (IET) environment. The guide was based on subject matter expert input from the Infantry One Station Unit Training (OSUT) Brigade and the U.S. Army Marksmanship Unit (USAMU). These experts were interviewed to obtain effective training and diagnostic techniques and lessons learned through years of training IET Soldiers. The guide integrates this information, sequences it according to the marksmanship program, and thoroughly illustrates the major training principles and lessons learned. All information supplements and complements the Army marksmanship field manual. The guide is an Appendix to the report."--DTIC. ; Contract or grant no. : W74V8H-08-D-0045 DO 0033 ; Mode of access: Internet.