Wednesday, August 31, 2005
Tuesday, August 30, 2005
Here’s my proposal in very truncated form. I've had to leave out all the references, study design, methods and technical sections. At least it doesn’t contain all the scary physics and equations of the full document though! I hope it makes it a bit clearer what I’ll be working on for the next three years. Please leave comments (click on the comments hyperlink at the bottom of the text) and feel free to ask any questions or request the whole document.
Over the past decade the incidence of low birth weight (infants weighing less than 2500g) has increased steadily, and now represents over 7% of all live births in England and Wales. Over the same period the incidence of very low birth weight (i.e. infants weighing less than 1500 grams) has increased at an even faster rate, now making up over 1% of all births. Although the outcomes for these infants vary widely across different neonatal intensive care units, recent improvements in perinatal care now mean that around 90% of these preterm infants will survive. The improvements in survival have been greatest in the most immature infants but have been accompanied by an increasing awareness of subsequent neurodevelopmental deficits. The immature developing brain is very vulnerable to injury, and many preterm infants suffer long-term morbidity that is more severe with prolonged exposure to the extrauterine environment. Impairments often continue into adolescence, with a high prevalence of behavioural problems documented, including psychiatric and attentional deficit disorders.
Magnetic resonance imaging (MRI) has been increasingly used within the field of neonatology over the past decade. Indeed, most of the recent insights into intrauterine and early extrauterine brain development have been achieved thanks to conventional (T1- and T2-weighted) magnetic resonance imaging techniques. MRI findings correlate with the well-recognised pathologies seen on ultrasound and, in addition, the high spatial resolution and excellent soft tissue contrast also allows the detection of more subtle abnormalities, including increased extracerebral space and diffuse excessive high signal intensity.
Diffusion tensor imaging (DTI) and diffusion weighted imaging (DWI) are magnetic resonance techniques that provide quantitative measures of water diffusion in tissue. By doing so they are able to show brain physiology and microstructure in vivo. The image contrast in DWI and DTI depends on the diffusion characteristics of water molecules, which are restricted by structural barriers including cell membranes and white matter tracts. Values of the apparent diffusion coefficient and fractional anisotropy can be determined from DTI and, by calculating the eigenvalues of the diffusion tensor, diffusion parallel and perpendicular to the white matter tracts can be measured. These are non-subjective measurements and provide information reflecting tissue microstructure. They can therefore be used to assess micro-structural abnormalities in the preterm brain.
Computer-assisted morphometric techniques, including voxel-based morphometry (VBM) and deformation based morphometry (DBM) use image registration and statistical analysis to quantify structural differences between groups To date, there have been no studies applying DBM techniques to diffusion scalar maps (apparent diffusion coefficient, fractional anisotropy and eigenvalue maps) in the preterm brain. However, data from animal and adult studies suggest that combining these two techniques (DBM and DTI) provides information regarding microstructural anomalies that may not be observed using traditional region of interest analysis of DTI data.
In this project I aim to use diffusion tensor imaging and deformation based morphometry to assess microstructural abnormalities in the preterm brain.
i. Deformation based morphometry of diffusion tensor imaging data is able to detect abnormal white matter development in infants who are born prematurely.
ii. Abnormal white matter development is the result of extreme preterm birth and is not associated with other events.
i. To compare diffusion tensor scalar maps of the preterm brain at term equivalent age to those of infants born at term using DBM.
ii. To assess the effect of gestational age at birth on white matter development by acquiring DTI data at three time-points for each preterm infant: within 1 week of birth, at 30 weeks GA and at term equivalent age.
iii. To investigate the effect of other factors on white matter development including antenatal infection, postnatal infection, chronic lung disease, intrauterine growth retardation and gender.
Monday, August 29, 2005
In the afternoon things picked up a little. Our first casualty, who was covered in chocolate (it’s a tradition at the start of the Carnival) was a guy who’d had a bit too much to drink and had collapsed. We had to transport him in an ambulance trolley all the way down Ladbroke grove, weaving in and out of the floats, till we reached the treatments centre. He was unconscious but thankfully hadn’t sustained any injuries and his observations were fine. When he came round four hours later, though, he couldn’t find his wallet and phones. In the time it took us get to him, someone had stolen all his valuables. And on top of all that, he couldn’t remember where he’d parked his car. I felt pretty sorry for the poor guy.
I still haven’t read up how to use the main features on my camera, but here is a picture I took, along with a better one I got from Flickr.
Sunday, August 28, 2005
This morning was the first meeting of the St John Ambulance youth representatives of the British Youth Council. The BYC is an umbrella body representing the voice of (some) of Britain’s young people and encourages them to get more involved with shaping issues concerning us all. Their annual general meeting is next month, and the eight of us got together for this first time to work out how we were going to find out the ideas of youngsters throughout the organisation. With thousands of members, it’s going to be tough. The team are all really helpful and enthusiastic though, so hopefully we’ll get everybody’s voices heard.
In the evening it was Lily’s birthday. I haven’t caught up with lots of medical school friends since I started at Hammersmith Hospital, so it was great to see everyone again. The birthday girl had rented out our own karaoke room and we spent the night entertaining each other with our voices. Unfortunately, I was atrocious – toneless, tuneless and LOUD! Halfway thought a group of little girls entered, intrigued by all the warblings and sang their way through Britney’s ‘Hit Me Baby…’. They really did put us to shame.
I left at midnight, and on the way back home, came across this:
Alas the picture’s not too good, but it’s an overturned car. It was on Ladbroke Grove, where revellers were congregating in preparation for the Notting Hill Carnival. Things got a bit out of hand and a group of people flipped over the car and were dragging it along along the road before police got to the scene. I took a couple of quick pictures before sprinting back home on my bike.
I am a bit more worried about first aiding at the Carnival tomorrow though. Most people have a great time but with around one million people expected to attend this year, gang violence is once again expected. I just hope there aren’t too many collapses and head injuries to treat.
Friday, August 26, 2005
In the evening, though, was something a bit more fun: our department's annual skive. It was advertised with the following fun email. Just don't tell my supervisor!
Sent: 12 August 2005 17:27
Subject: The grand skive 2005
Footnotes are annotated with a superscript letter. References are annotated with a square bracketed number. Footnotes and references can be found at the bottom of the text
Technical definition: Sitting still, drinking and occasional chat will henceforth be known as "the event". "the event" may alternatively be defined as "having fun" or "the grand skive"
A little later than in previous years I am organizing the annual ISD grand skive [a]. This is an afternoon out for the Physics and Engineering members of the Imaging Sciences Despartment (ISD) [b]. The location is the Dove beer garden, by the river in Hammersmith. The evening will end in Sagar restaurant, Hammersmith. The time: We will leave the hospital at 3pm Thursday 25th August.
Staff representative: MC
Student representative: HM
For those of you who have not been around for previous years the events ideology and guidelines are below:
The event is an acknowledgement of the fact that often inaction is as productive as action .
The event is a celebration of summer and laziness but it is never cancelled for bad weather .
The event is a "torch to be passed from generation to generation"
Ideally several drinks should be consumed before 5pm, the "being paid to drink" [c] concept is a vital part of the event.
Preferably one or more important work deadlines should be missed because of this event. [d]
Conversational subject matter should not relate to your own work [e].
Sleeping is not encouraged at the event but will be tolerated.
The first person to the bar will be bought a complementary drink by the organizer.
Freestyle entertainment is encouraged, nudity is not [f].
Friends, partners etc are all welcome [g].
Finally, these are only guidelines, there are no rules at the event...
The faculty look forward to seeing you.
“We achieve certain things by being energetic, but it may be questioned whether, on balance, the things that we achieve are of any value..” Bertrand Russell
 Tony Benn
[a] skive: skive verb skived, skiving colloq To evade work or a duty, especially through laziness.
Example: I'm going to skive class today
Example: We're skiving off class today
Form: skive off (also)
1. The act or an instance of skiving.
Example: I chose biology instead of physics ‘cos it's such a skive
Etymology: 19c: from Norse skifa.
[b] Carefully chosen affiliates are also invited.
[c] Being paid loosely refers to the exchange of money for services, no judgment on value or quality is made here. The assumption that work officially ends at 5pm is implied and is reasonable for the purposes of this event.
[d] A prize will be awarded for the most irresponsible skive.
[e] Discussion of general science is accepted up to and including the 3rd drink.
[f] The faculty accept that there is a fine line between these for some, please ask a faculty member before initiating entertainment if you are in doubt about its content.
[g] Overt displays of affection are not encouraged out of sensitivity to those currently without love.
Tuesday, August 23, 2005
The moral of the story? Don’t become preoccupied with one developmental milestone to the detriment of others!
Friday, August 19, 2005
Halfway though the meeting we were interrupted by a call from his son, who'd just received his A-Level results. Having worked 'like a dog', he achieved four 'A' grades. Well done son!
What’s the funniest/smartest thing you did as a kid? When I was little and we had guests at home that I really liked, I used to hide their shoes so they couldn’t leave. It was endearing for a while, but sooner or later people got pretty darned frustrated.
Wednesday, August 17, 2005
Monday, August 15, 2005
On the way back, one thing did brighten up my day though – a young Asian boy was with his friends, and as they passed a girl he turned round to stare.
Boy [to Girl]: Hello. Hi. Can I just say something to you? You’re really buff.
Girl [pointing over her shoulder]: That’s my mum.
Mum: OK OK son. Please carrying on walking.
Boy: No no, no disrespect or anything aunty. No disrespect at all. You’re daughter’s just really fit though, and it had to be said, innit…Innit?
Unknown boy, I salute you.
Saturday, August 13, 2005
Smokey Robinson, a Motown legend
A pudding bowl haircut
Friday, August 12, 2005
- Learnt how to use an automated external defibrillator (AED). I am now qualified to shock people.
- Asked a van driver for directions near Piccadilly Circus. He ignored me.
- Gave me supervisor a headache. I’m sorry!
- Caught up with good ole high school friends over an eye-wateringly spicy curry.
- Studied like there’s no tomorrow.
- Got clipped round the ear by my mum. It’s the first time she’s slapped me in about eight years.
- Tried yak meat, offered by one of my lab mates who just returned from a trip to China. She didn’t know the English work for yak, and described it as a cow with feathers.
- Ate four packets of salt and vinegar flavoured Pom Bear crisps for lunch.
- Cried along with every else as England won the second test match in the Ashes cricket series.
Wednesday, August 10, 2005
I got this forwarded email from a friend in Bangalore about the recent torrential downpour in Mumbai, India. It included the heaviest daily rains in the country’s history, and over one thousand people died in the state of Maharastra. I think the city is getting back to normal now, but now there seem to be heavy rains across North-Eastern China. Here in London we barely ever get extremes of weather and it’s fascinating to hear about how people have coped with the disruption and, in some cases, the loss of their homes. What’s the most extreme weather you’ve ever witnessed?
Tuesday, 26th July 2005
(Bombay) Mumbai was having a regular rainy season day. All of a sudden clouds gathered and downpour started and within the blink of an eye rains had taken over the whole city into its dark vision. Mumbai was having the heaviest downpour ever recorded. People thought it was normal rains of the rainy season and would stop in some time.
Whole of the city was covered with the globe of darkness and seemed like it was 8:00pm at night. There was no end of the rains... which had started around 10 - 11 am. Visibility was so poor you couldn’t see further than the next building. The whole city was under the spell of rains and light fog. It was a chilly rainy atmosphere which made everyone freeze out of the terror of further flooding to come.
Whole Mumbai city was at a standstill. Government had declared high alert. Local transportation from trains to buses were all halted. Mumbai city was experiencing the heaviest rain-fall but no one ever had thought that this rain will bring such havoc to the city.
Mumbai, the city that never sleeps, was at a standstill. Local city transportation was totally out. Whole Mumbai's population was stranded and left out with nothing and nowhere to go. All roads, streets, by-lanes and even highways were submerged... flooded from 2.5ft to 6ft. There was no chance of moving a centimetre. All roads were jam packed with traffic.
Mumbai under water, city at a standstill... all office goers were left behind with no mode of transportation to take them home. They could not move out into the rains and take the challenge to walk down home in chest-level flooded roads and streets. The only option which they were left with was to remain calmly in their offices, the safest place on such a rainy, dark night.
Those who left early from their jobs to go home were stranded at stations and bus stops. They were helpless and had to sleep there for the night.
Mumbai was hit by the Century's heaviest rainfall, 94.4 centimetres in a single day, swamping the previously recorded highest rainfall of 83.82 centimetres at Cherrapunji in Meghalaya in 1910! Cherrapunji is officially the world's wettest place.
State Government declared two days (Wed & Thurs) officially off. All government offices, banks, schools, colleges, courts were all closed until Mumbai came out of this Natural Disaster.
Thursday, 28th July 2005.
The day after rains...
Government offices, national banks, schools and colleges have a holiday. Only a handful of trains are running.
On the roads Western and Eastern Express Highways are still waterlogged. Some traffic is squeezing through, but barely. The Pune-Mumbai corridor was closed but controlled traffic flow has been allowed to resume.
At airports: Call your airline. Authorities hope to resume some operations, but water-logging and power at airport still a problem. Even if some flights arrive or land, don't expect normalcy.
ATMs: Most didn't work on Wednesday because of power failures and downed communication links. Bankers say they will try their best to make them run on Thursday.
Phone calls: Cell phones working but many dropped calls and errors. Landlines down in many western, eastern suburbs and Navi Mumbai because telephone exchanges have no power. Standby batteries are drained, gensets out of diesel.
Sunday, August 07, 2005
If anyone wants to give me guitar lessons I’d be very happy!
Monday, August 01, 2005
On the way back home yesterday I was thinking of some of the really stupid things I've done. Not stupid as in bad life decisions or anything, but just things I've done that show how dumb I can really be. The most vivid recollection I have was when I was thirteen. I was a latchkey kid and got home from school before my parents had arrived, and for some reason had an intense craving for peas. I didn't know how to boil them though, so thought it would be quicker and easier if I just added some water to the kettle, added the frozen peas to the water, and brought the kettle to the boil. Genius, n'est pas? Well, no. I ended up having to skip dinner and spent the rest of the evening removing all the lodged peas from the kettle heating element.
What's the dumbest thing you've ever done?
Random picture of a kettle heating element