Considering Parental Hearing Status as a Social Determinant of Deaf Population Health: Insights from Experiences of the \ Dinner Table Syndrome\

The influence of early language and communication experiences on lifelong health outcomes is receiving increased public health attention. Most deaf children have non-signing hearing parents, and are at risk for not experiencing fully accessible language environments, a possible factor underlying known deaf population health disparities. Childhood indirect family communication-such as spontaneous conversations and listening in the routine family environment (e.g. family meals, recreation, car rides)-is an important source of health-related contextual learning opportunities. The goal of this study was to assess the influence of parental hearing status on deaf people\u27s recalled access to childhood indirect family communication. We analyzed data from the Rochester Deaf Health Survey-2013 (n = 211 deaf adults) for associations between sociodemographic factors including parental hearing status, and recalled access to childhood indirect family communication. Parental hearing status predicted deaf adults\u27 recalled access to childhood indirect family communication (χ2 = 31.939, p \u3c .001). The likelihood of deaf adults reporting sometimes to never for recalled comprehension of childhood family indirect communication increased by 17.6 times for those with hearing parents. No other sociodemographic or deaf-specific factors in this study predicted deaf adults\u27 access to childhood indirect family communication. This study finds that deaf people who have hearing parents were more likely to report limited access to contextual learning opportunities during childhood. Parental hearing status and early childhood language experiences, therefore, require further investigation as possible social determinants of health to develop interventions that improve lifelong health and social outcomes of the underserved deaf population

Collaboration With Deaf Communities to Conduct Accessible Health Surveillance

Introduction Populations of deaf sign language users experience health disparities unmeasured by current public health surveillance. Population-specific health data are necessary to collaboratively identify health priorities and evaluate interventions. Standardized, reproducible, and language-concordant data collection in sign language is impossible via written or telephone surveys. Methods Deaf and hearing researchers, community members, and other stakeholders developed a broad computer-based health survey based on the telephone-administered Behavioral Risk Factor Surveillance System. They translated survey items from English to sign language, evaluated the translations, and filmed the survey items for inclusion in their custom software. They initiated the second Rochester Deaf Health Survey in 2013 (n=211). Analyses (conducted in 2015) compared Rochester Deaf Health Survey 2013 findings with those of the Behavioral Risk Factor Surveillance System with the general adult population in the same community (2012, n=1,816). Results The Rochester Deaf Health Survey 2013 participants’ mean age was 44.7 (range, 18—87) years. Most were deaf since birth or early childhood (87.1%) and highly educated (53.6% with ≥4 years of college). The median household income was \u3c $35,000. The prevalence of current smokers was low (8.1%). Nearly all (93.8%) reported having health insurance, yet barriers to appropriate health care were evident, with high emergency department use (16.2% with two or more past-year visits) and 22.7% forgoing needed health care in the past year because of cost. Conclusions Community-engaged research with deaf populations identifies strengths and priorities, providing essential information otherwise missing from existing public health surveillance, and forming a foundation for collaborative dissemination to facilitate broader inclusion of deaf communities

initMIP-Antarctica: an ice sheet model initialization experiment of ISMIP6

Ice sheet numerical modeling is an important tool to estimate the dynamic contribution of the Antarctic ice sheet to sea level rise over the coming centuries. The influence of initial conditions on ice sheet model simulations, however, is still unclear. To better understand this influence, an initial state intercomparison exercise (initMIP) has been developed to compare, evaluate, and improve initialization procedures and estimate their impact on century-scale simulations. initMIP is the first set of experiments of the Ice Sheet Model Intercomparison Project for CMIP6 (ISMIP6), which is the primary Coupled Model Intercomparison Project Phase 6 (CMIP6) activity focusing on the Greenland and Antarctic ice sheets. Following initMIP-Greenland, initMIP-Antarctica has been designed to explore uncertainties associated with model initialization and spin-up and to evaluate the impact of changes in external forcings. Starting from the state of the Antarctic ice sheet at the end of the initialization procedure, three forward experiments are each run for 100 years: a control run, a run with a surface mass balance anomaly, and a run with a basal melting anomaly beneath floating ice. This study presents the results of initMIP-Antarctica from 25 simulations performed by 16 international modeling groups. The submitted results use different initial conditions and initialization methods, as well as ice flow model parameters and reference external forcings. We find a good agreement among model responses to the surface mass balance anomaly but large variations in responses to the basal melting anomaly. These variations can be attributed to differences in the extent of ice shelves and their upstream tributaries, the numerical treatment of grounding line, and the initial ocean conditions applied, suggesting that ongoing efforts to better represent ice shelves in continental-scale models should continue

Hip MRI findings and outcomes following imaging-guided hip injections

OBJECTIVE To determine if MRI findings prior to intra-articular corticosteroid hip infiltration are related to treatment outcomes. METHODS This prospective outcome study with retrospective MRI evaluation includes 100 consecutive patients with MRI within 6 months before a therapeutic intra-articular hip injection. Labrum, bone marrow, acetabular and femoral cartilage abnormalities were assessed by two radiologists blinded to patient outcomes: the proportion reporting "improvement" on the Patient's Global Impression of Change (PGIC) scale at 1 day, 1 week and 1 month follow-up were compared based on MRI findings using χ$^{2}$. The t-test was used to compare pain change scores with MRI abnormalities. RESULTS Patients with a normal labrum in the posterosuperior quadrant were more likely to report PGIC "improvement" at 1 week compared to labral degeneration (p = 0.048). Significant differences in pain change scores were found at all time points for the labral anteroinferior quadrant (p = 0.001, 1 day; p = 0.010, 1 week; p = 0.034, 1 month) with the highest reduction in patients with labral degeneration. Females were 2.80 times more likely to report clinically relevant "improvement" at 1 day (p = .049) and 2.90 times more likely to report clinically relevant "improvement" at 1 month (p = .045). CONCLUSION Cartilage defects and marrow abnormalities were not associated with outcomes. Patients with a normal labrum in the posterosuperior quadrant had better outcomes at 1 week. Patients with labral degeneration of the anteroinferior quadrant had higher levels of pain reduction at all time points. Females were significantly more likely to report PGIC "improvement". ADVANCES IN KNOWLEDGE A significant treatment outcome was observed amongst gender, although there were no significant differences in the MRI findings

Reduction of Metal Artifacts in Patients with Total Hip Arthroplasty with Slice-encoding Metal Artifact Correction and View-Angle Tilting MR Imaging

Purpose: To compare the new "warp" sequence (slice-encoding metal artifact correction [SEMAC], view-angle tilting [VAT], and increased bandwidth) for the reduction of both through-plane and in-plane magnetic resonance (MR) artifacts with current optimized MR sequences in patients with total hip arthroplasty (THA). Materials and Methods: The institutional review board issued a waiver for this study. Forty patients with THA were prospectively included. SEMAC, VAT, and increased bandwidth were applied by using the warp turbo-spin-echo sequence at 1.5 T. Coronal short tau inversion-recovery (STIR)-warp and transverse T1-weighted warp (hereafter, T1-warp) images, as well as standard coronal STIR and transverse T1-weighted sequence images optimized with high bandwidth (STIR-hiBW and T1-hiBW), were acquired. Fifteen additional patients were examined to compare the T1-warp and T1-hiBW sequence with an identical matrix size. Signal void was quantified. Qualitative criteria (distinction of anatomic structures, blurring, and noise) were assessed on a five-point scale (1, no artifacts; 5, not visible due to severe artifacts) by two readers. Abnormal imaging findings were recorded. Quantitative data were analyzed with a t test and qualitative data with a Wilcoxon signed rank test. Results: Signal void around the acetabular component was smaller for STIR-warp than STIR-hiBW images (21.6 cm(2) vs 42.4 cm(2); P = .0001), and for T1-warp than T1-hiBW images (17.6 cm(2) vs 20.2 cm(2); P = .0001). Anatomic distinction was better on STIR-warp compared with STIR-hiBW images (1.9-2.8 vs 3.6-4.6; P = .0001), and on T1-warp compared with T1-hiBW images (1.3-2.8 vs 1.8-3.2; P < .002). Distortion, blurring, and noise were lower with warp sequences than with the standard sequences (P = .0001). Almost half of the abnormal imaging findings were missed on STIR-hiBW compared with STIR-warp images (55 vs 105 findings; P = .0001), while T1-hiBW was similar to T1-warp imaging (50 vs 55 findings; P = .06). Conclusion: STIR-warp and T1-warp sequences were significantly better according to quantitative and qualitative image criteria, but a clinically relevant artifact reduction was only present for STIR images. © RSNA, 2012

Ligaments of the Lisfranc joint in MRI: 3D-SPACE (sampling perfection with application optimized contrasts using different flip-angle evolution) sequence compared to three orthogonal proton-density fat-saturated (PD fs) sequences

PURPOSE: To compare the detection rate and visibility of the ligaments in the Lisfranc joint with a single 3D (-SPACE) MR sequence and three orthogonal PD fat-saturated sequences. MATERIALS AND METHODS: Thirty-one asymptomatic feet and 15 patients with posttraumatic pain in the Lisfranc joint were evaluated with a 3D-SPACE-sequence (0.5 mm section thickness, acquisition time 10:22 min, secondary reformations) and three orthogonal PD fs sequences (2 mm section thickness, 9:20 min). The Lisfranc-ligament, the dorsal and plantar tarsometatarsal ligaments (TMT), the dorsal, interosseous, and plantar intermetatarsal ligaments (IMT) (24 ligaments for each foot) were assessed. RESULTS: In asymptomatic feet, 692 ligaments were detected with the SPACE sequence, thereof 90.6 % exhibited normal signal, and most (96.9 %) were completely visible on one single image. A total of 659 ligaments were detected with the PD fs sequence, thereof 86.6 % yielded normal signal, and 28.5 % were completely visible on one single image. In patients, 327 ligaments were detected with SPACE, thereof 50.6 % appeared completely visible with high signal. On PD fs, 308 ligaments were detected, 42.2 % of the ligaments had high signals. CONCLUSIONS: The ligaments of the Lisfranc joint are better detected with a single 3D-SPACE sequence and secondary reformations than with three orthogonal PD fs sequences

STIR sequence with increased receiver bandwidth of the inversion pulse for reduction of metallic artifacts

OBJECTIVE: The purpose of this study was to evaluate a STIR sequence with an optimized inversion pulse that entails use of increased receiver bandwidth for metal artifact reduction. CONCLUSION: Image distortion, artifacts, insufficient fat suppression, and detection of relevant findings improved with the STIR optimized inversion pulse, which was associated with significant artifact reduction

Antarctic ice sheet response to sudden and sustained ice-shelf collapse (ABUMIP)

Antarctica's ice shelves modulate the grounded ice flow, and weakening of ice shelves due to climate forcing will decrease their 'buttressing' effect, causing a response in the grounded ice. While the processes governing ice-shelf weakening are complex, uncertainties in the response of the grounded ice sheet are also difficult to assess. The Antarctic BUttressing Model Intercomparison Project (ABUMIP) compares ice-sheet model responses to decrease in buttressing by investigating the 'end-member' scenario of total and sustained loss of ice shelves. Although unrealistic, this scenario enables gauging the sensitivity of an ensemble of 15 ice-sheet models to a total loss of buttressing, hence exhibiting the full potential of marine ice-sheet instability. All models predict that this scenario leads to multi-metre (1-12 m) sea-level rise over 500 years from present day. West Antarctic ice sheet collapse alone leads to a 1.91-5.08 m sea-level rise due to the marine ice-sheet instability. Mass loss rates are a strong function of the sliding/friction law, with plastic laws cause a further destabilization of the Aurora and Wilkes Subglacial Basins, East Antarctica. Improvements to marine ice-sheet models have greatly reduced variability between modelled ice-sheet responses to extreme ice-shelf loss, e.g. compared to the SeaRISE assessments