Children and Megadisasters: Lessons Learned in the New Millennium

Hurricane Katrina is America’s most recent encounter with a megadisaster. But what made it a megadisaster instead of just another category 3 hurricane of the type that seasonally exists in the Gulf of Mexico? Katrina was not the largest or strongest hurricane to strike the United States mainland in the recent past, but its effects were devastating and wide reaching beyond our wildest nightmares, far beyond those of Hurricane Andrew (1992), a category 5 hurricane that scoured much of Florida and the Gulf Coast. Hurricane Katrina’s track directly targeted gaping vulnerabilities in infrastructure and society, and set in motion a series of events that culminated in the deaths of nearly 2000 people, resulted in hundreds of missing individuals, and caused a potential economic impact of up to $150 billion. The disruption of people’s lives was immeasurable, as was the impact on the long-term physical and mental health of the victims, which continues today. Katrina also led to a substantial decline in the confidence that the public has in its government to provide essential services during a disaster. Children are among the most susceptible members of a community when catastrophes such as these strike because of their dependent nature as well as their physiologic and psychological vulnerability. Children affected by Katrina were no exception. Persistent critical gaps exist in the ability to prepare for and respond to the needs of the youngest victims. These were clearly exposed as children endured an at times ineffectual disaster response followed by a stressful recovery that is still ongoing. An analysis of the issues that faced children during this event and some others from the recent past may help society reduce the impact of such disasters on children in the future. This article focuses on a few of the major shortfalls in the care of children that have become especially apparent in the last few years: Facilitating evacuation; Providing shelter; Caring for those with special medical needs; Addressing mental health needs

Schools in the shadow of terrorism: Psychosocial adjustment and interest in interventions following terror attacks

Following terrorist events, teachers and nonteaching school personnel are important in helping children recover, yet little is known about their willingness to assist with this. We surveyed 399 employees from a Washington, D.C.-area school district following terror attacks (September 11, 2001, attacks; sniper shootings) about their exposure, adjustment, interest, and involvement in psychosocial interventions. Between 10% and 27% experienced one or more symptoms of posttraumatic stress (depending on category of symptom) in the month prior to the survey. Regression analyses revealed that peritraumatic distress, behavior change, and posttraumatic growth predicted interest in information on psychosocial interventions. Feeling prepared, adaptively managing work responsibilities, and perceiving an increase in student problems were related to intervening with students. Implications for school preparedness are discussed. © 2010 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/77430/1/20493_ftp.pd

MRI estimates of brain iron concentration in normal aging: Comparison of field-dependent (FDRI) and phase (SWI) methods

Different brain structures accumulate iron at different rates throughout the adult life span. Typically, striatal and brain stem structures are higher in iron concentrations in older than younger adults, whereas cortical white matter and thalamus have lower concentrations in the elderly than young adults. Brain iron can be measured in vivo with MRI by estimating the relaxivity increase across magnetic field strengths, which yields the Field-Dependent Relaxation Rate Increase (FDRI) metric. The influence of local iron deposition on susceptibility, manifests as MR phase effects, forms the basis for another approach for iron measurement, Susceptibility-Weighted Imaging (SWI), for which imaging at only one field strength is sufficient. Here, we compared the ability of these two methods to detect and quantify brain iron in 11 young (5 men, 6 women; 21 to 29 years) and 12 elderly (6 men, 6 women; 64 to 86 years) healthy adults. FDRI was acquired at 1.5 T and 3.0 T, and SWI was acquired at 1.5 T. The results showed that both methods detected high globus pallidus iron concentration regardless of age and significantly greater iron in putamen with advancing age. The SWI measures were more sensitive when the phase signal intensities themselves were used to define regions of interest, whereas FDRI measures were robust to the method of region of interest selection. Further, FDRI measures were more highly correlated than SWI iron estimates with published postmortem values and were more sensitive than SWI to iron concentration differences across basal ganglia structures. Whereas FDRI requires more imaging time than SWI, two field strengths, and across-study image registration for iron concentration calculation, FDRI appears more specific to age-dependent accumulation of non-heme brain iron than SWI, which is affected by heme iron and non-iron source effects on phase.National Institutes of Health (U.S.) (Grant AG017919)National Institutes of Health (U.S.) (Grant AA005965)National Institutes of Health (U.S.) (Grant AA017168

MRI estimates of brain iron concentration in normal aging using quantitative susceptibility mapping

Quantifying tissue iron concentration in vivo is instrumental for understanding the role of iron in physiology and in neurological diseases associated with abnormal iron distribution. Herein, we use recently-developed Quantitative Susceptibility Mapping (QSM) methodology to estimate the tissue magnetic susceptibility based on MRI signal phase. To investigate the effect of different regularization choices, we implement and compare ℓ[subscript 1] and ℓ[subscript 2] norm regularized QSM algorithms. These regularized approaches solve for the underlying magnetic susceptibility distribution, a sensitive measure of the tissue iron concentration, that gives rise to the observed signal phase. Regularized QSM methodology also involves a pre-processing step that removes, by dipole fitting, unwanted background phase effects due to bulk susceptibility variations between air and tissue and requires data acquisition only at a single field strength. For validation, performances of the two QSM methods were measured against published estimates of regional brain iron from postmortem and in vivo data. The in vivo comparison was based on data previously acquired using Field-Dependent Relaxation Rate Increase (FDRI), an estimate of MRI relaxivity enhancement due to increased main magnetic field strength, requiring data acquired at two different field strengths. The QSM analysis was based on susceptibility-weighted images acquired at 1.5 T, whereas FDRI analysis used Multi-Shot Echo-Planar Spin Echo images collected at 1.5 T and 3.0 T. Both datasets were collected in the same healthy young and elderly adults. The in vivo estimates of regional iron concentration comported well with published postmortem measurements; both QSM approaches yielded the same rank ordering of iron concentration by brain structure, with the lowest in white matter and the highest in globus pallidus. Further validation was provided by comparison of the in vivo measurements, ℓ[subscript 1]-regularized QSM versus FDRI and ℓ[subscript 2]-regularized QSM versus FDRI, which again yielded perfect rank ordering of iron by brain structure. The final means of validation was to assess how well each in vivo method detected known age-related differences in regional iron concentrations measured in the same young and elderly healthy adults. Both QSM methods and FDRI were consistent in identifying higher iron concentrations in striatal and brain stem ROIs (i.e., caudate nucleus, putamen, globus pallidus, red nucleus, and substantia nigra) in the older than in the young group. The two QSM methods appeared more sensitive in detecting age differences in brain stem structures as they revealed differences of much higher statistical significance between the young and elderly groups than did FDRI. However, QSM values are influenced by factors such as the myelin content, whereas FDRI is a more specific indicator of iron content. Hence, FDRI demonstrated higher specificity to iron yet yielded noisier data despite longer scan times and lower spatial resolution than QSM. The robustness, practicality, and demonstrated ability of predicting the change in iron deposition in adult aging suggest that regularized QSM algorithms using single-field-strength data are possible alternatives to tissue iron estimation requiring two field strengths.National Institutes of Health (U.S.) (Grant NIH R01 EB007942)National Institutes of Health (U.S.) (Grant AG019717)National Institutes of Health (U.S.) (Grant AA005965)National Institutes of Health (U.S.) (Grant AA017168)National Institutes of Health (U.S.) (Grant EB008381)National Science Foundation (U.S.) (Grant 0643836)Siemens CorporationSiemens-MIT AllianceMIT-Center for Integration of Medicine and Innovative Technology (Medical Engineering Fellowship

Predicting Fluid Intelligence of Children using T1-weighted MR Images and a StackNet

In this work, we utilize T1-weighted MR images and StackNet to predict fluid intelligence in adolescents. Our framework includes feature extraction, feature normalization, feature denoising, feature selection, training a StackNet, and predicting fluid intelligence. The extracted feature is the distribution of different brain tissues in different brain parcellation regions. The proposed StackNet consists of three layers and 11 models. Each layer uses the predictions from all previous layers including the input layer. The proposed StackNet is tested on a public benchmark Adolescent Brain Cognitive Development Neurocognitive Prediction Challenge 2019 and achieves a mean squared error of 82.42 on the combined training and validation set with 10-fold cross-validation. In addition, the proposed StackNet also achieves a mean squared error of 94.25 on the testing data. The source code is available on GitHub.Comment: 8 pages, 2 figures, 3 tables, Accepted by MICCAI ABCD-NP Challenge 2019; Added ND

Television Watching and Mental Health in the General Population of New York City After September 11

The September 11, 2001 terrorist attacks were watched on television by millions. Using data from a telephone survey of New York City residents in January 2002 (N = 2001), we examined the relations between television watching and probable posttraumatic stress disorder (PTSD) after the attacks. Among those who were directly affected by the attacks or had prior traumatic experiences, watching television was associated with probable PTSD. Experiencing a peri-event panic reaction accounted for some of the association between television watching and probable PTSD. Future research directions are suggested for better understanding the mechanisms behind observed associations between television watching and PTSD.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40284/2/Ahern_Television Watching and Mental Health in_2005.pd

Quantitative Susceptibility Mapping by Inversion of a Perturbation Field Model: Correlation With Brain Iron in Normal Aging

There is increasing evidence that iron deposition occurs in specific regions of the brain in normal aging and neurodegenerative disorders such as Parkinson's, Huntington's, and Alzheimer's disease. Iron deposition changes the magnetic susceptibility of tissue, which alters the MR signal phase, and allows estimation of susceptibility differences using quantitative susceptibility mapping (QSM). We present a method for quantifying susceptibility by inversion of a perturbation model, or “QSIP.” The perturbation model relates phase to susceptibility using a kernel calculated in the spatial domain, in contrast to previous Fourier-based techniques. A tissue/air susceptibility atlas is used to estimate B[subscript 0] inhomogeneity. QSIP estimates in young and elderly subjects are compared to postmortem iron estimates, maps of the Field-Dependent Relaxation Rate Increase, and the L1-QSM method. Results for both groups showed excellent agreement with published postmortem data and in vivo FDRI: statistically significant Spearman correlations ranging from Rho=0.905 to Rho=1.00 were obtained. QSIP also showed improvement over FDRI and L1-QSM: reduced variance in susceptibility estimates and statistically significant group differences were detected in striatal and brainstem nuclei, consistent with age-dependent iron accumulation in these regions.National Institutes of Health (U.S.) (Grant P41EB015902)National Institutes of Health (U.S.) (Grant P41RR013218)National Institutes of Health (U.S.) (Grant P41EB015898)National Institutes of Health (U.S.) (Grant P41RR019703)National Institutes of Health (U.S.) (Grant T32EB0011680-06)National Institutes of Health (U.S.) (Grant K05AA017168)National Institutes of Health (U.S.) (Grant R01AA012388