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Biomedical subjects

G Calvert

Publications and source records attributed to G Calvert.

9 recordsLinked to original sources

Colored noise and computational inference in neurophysiological (fMRI) time series analysis: resampling methods in time and wavelet domains.

Even in the absence of an experimental effect, functional magnetic resonance imaging (fMRI) time series generally demonstrate serial dependence. This colored noise or endogenous autocorrelation typically has disproportionate spectral power at low frequencies, i.e., its spectrum is (1/f)-like. Various pre-whitening and pre-coloring strategies have been proposed to make valid inference on standardised test statistics estimated by time series regression in this context of residually autocorrelated errors. Here we introduce a new method based on random permutation after orthogonal transformation of the observed time series to the wavelet domain. This scheme exploits the general whitening or decorrelating property of the discrete wavelet transform and is implemented using a Daubechies wavelet with four vanishing moments to ensure exchangeability of wavelet coefficients within each scale of decomposition. For (1/f)-like or fractal noises, e.g., realisations of fractional Brownian motion (fBm) parameterised by Hurst exponent 0 < H < 1, this resampling algorithm exactly preserves wavelet-based estimates of the second order stochastic properties of the (possibly nonstationary) time series. Performance of the method is assessed empirically using (1/f)-like noise simulated by multiple physical relaxation processes, and experimental fMRI data. Nominal type 1 error control in brain activation mapping is demonstrated by analysis of 13 images acquired under null or resting conditions. Compared to autoregressive pre-whitening methods for computational inference, a key advantage of wavelet resampling seems to be its robustness in activation mapping of experimental fMRI data acquired at 3 Tesla field strength. We conclude that wavelet resampling may be a generally useful method for inference on naturally complex time series.

Artifacts↗

Cortical substrates for the perception of face actions: an fMRI study of the specificity of activation for seen speech and for meaningless lower-face acts (gurning).

Can the cortical substrates for the perception of face actions be distinguished when the superficial visual qualities of these actions are very similar? Two fMRI experiments are reported. Compared with watching the face at rest, observing silent speech was associated with bilateral activation in a number of temporal cortical regions, including the superior temporal sulcus (STS). Watching face movements of similar extent and duration, but which could not be construed as speech (gurning; Experiment 1b) was not associated with activation of superior temporal cortex to the same extent, especially in the left hemisphere. Instead, the peak focus of the largest cluster of activation was in the posterior part of the inferior temporal gyrus (right, BA 37). Observing silent speech, but not gurning faces, was also associated with bilateral activation of inferior frontal cortex (BA 44 and 45). In a second study, speechreading and observing gurning faces were compared within a single experiment, using stimuli which comprised the speaker's face and torso (and hence a much smaller image of the speaker's face and facial actions). There was again differential engagement of superior temporal cortex which followed the pattern of Experiment 1. These findings suggest that superior temporal gyrus and neighbouring regions are activated bilaterally when subjects view face actions--at different scales--that can be interpreted as speech. This circuitry is not accessed to the same extent by visually similar, but linguistically meaningless actions. However, some temporal regions, such as the posterior part of the right superior temporal sulcus, appear to be common processing sites for processing both seen speech and gurns.

Adult↗

Dioxin and diabetes mellitus: an analysis of the combined NIOSH and Ranch Hand data.

OBJECTIVES: To reanalyze in a similar manner the two principal studies of TCDD (tetrachlorodibenzo-p-dioxin) and diabetes in an attempt to reconcile disparate results. METHODS: Data from 990 United States Air Force veterans (Ranch Hand) and 1275 referents were reanalyzed, and a NIOSH population of 267 chemical workers and 227 referents. The Ranch Hand veterans had lower concentrations of lipid adjusted serum TCDD (median 12 parts per trillion (ppt)) than the NIOSH workers (median 75 ppt) when examined in the late 1980s. An analysis was conducted of the combined data sets, adopting a uniform approach to outcome definition, data analysis, and covariate control. RESULTS: The combined exposed groups did not differ markedly from the combined non-exposed groups for prevalence of diabetes (odds ratio (OR) 1.17, 95% confidence interval (95% CI) 0.92 to 1.48), with no evidence of heterogeneity of exposure effect between studies. Also virtually no difference was found between combined exposed and non-exposed groups in mean fasting serum glucose (difference in log serum glucose 0.002, 95% CI -0.006 to 0.010), and there was little evidence in either study of a dose-response trend for fasting serum glucose. An increasing trend was found (p=0.0001) in prevalence of diabetes with increased TCDD (at the time of examination or at time of last exposure) among the Ranch Hand population, with excess risk largely confined to the highest 8% of the exposed group (>78 ppt serum TCDD), which had an OR of 3.21 (95% CI 1.81 to 5.72) versus those with <10 ppt TCDD. However, no such positive dose-response was found in the NIOSH population. CONCLUSIONS: There was little overall evidence that the exposed workers were at higher risk than the non-exposed workers of diabetes or abnormal fasting glucose. However, the Ranch Hand subjects showed a positive dose-response for diabetes, whereas the more highly exposed NIOSH subjects did not. The reason for the difference in diabetes dose-response trends between the two studies is unknown.

Blood Glucose↗

The United Medical and Dental School of Guy's and St Thomas' Hospitals' MSc in general practice: graduates' perspectives.

AIM: Higher degrees have been proposed as one means whereby general practitioners can continue their professional development and avoid a slow decline into professional isolation and burnout. The United Medical and Dental School of Guy's and St Thomas' Hospitals' MSc in general practice has been available to experienced general practitioners for over a decade. This study reports some of the outcomes of participation for the 76 graduates of the first nine cohorts. METHOD: As part of an ongoing programme of evaluation the graduates were sent a questionnaire which, in addition to seeking information about attainment of intended outcomes, gave respondents the opportunity to write freely about the contribution made by the course to their own professional and personal development. Seventy-one graduates completed the questionnaire, a response rate of 93%. RESULTS AND CONCLUSIONS: An increased confidence that arises not only from a broadened knowledge base and increased skills but also from a sense of having been enabled to explore more deeply into their discipline, is the most frequently and highly valued outcome of participation. Graduates appreciated having additional protected time and demonstrated an ability to use it productively. A further significant outcome was the ability of the course to confront those habitual assumptions of doctors which inform their practice in a manner that was both challenging and supportive. Tendencies to professional isolation and burnout appear to have been reversed with a greater sense of connectedness to their discipline. Doctors seeking to diversify their general practice careers beyond the task of providing medical services have found the MSc an important route for change.

Attitude of Health Personnel↗

The UMDS MSc in general practice: attainment of intended outcomes.

BACKGROUND: The United Medical and Dental School's (UMDS's) MSc in general practice is one of the longest running courses of its kind. Although descriptive accounts of such courses have been published, little is known about their outcomes. AIM: To measure the extent to which graduates feel they have personally achieved 16 intended outcomes derived from the course objectives, and to record current academic activities, particularly teaching and research. METHOD: A postal questionnaire to graduates of the UMDS MSc in General Practice. RESULTS: The response rate was 93%. Of the 71 responders, 23 have gone on to register for or complete other degrees or diplomas. Over two-thirds of responders had an academic commitment following the MSc. Two-thirds were currently engaged in research and over half reported having had work accepted for publication. The majority of graduates confirmed the attainment of all 16 outcomes, although outcomes related to personal achievements were endorsed more strongly than those related to service delivery. CONCLUSION: UMDS graduates are making a significant contribution to their discipline and are unanimous in describing the course as an important event in their personal development. As a result of this study, the course organizers are seeking to increase the links between academic study and everyday practice.

Adult↗

Pesticide prioritization for a brain cancer case-control study.

The incidence of brain cancer is rising in the United States while the causes remain largely unknown. Epidemiologic studies indicate that individuals working in agriculture have an increased risk of brain cancer. The National Institute for Occupational Safety and Health is conducting a case-control study of incident brain cancer cases in Iowa, Michigan, Minnesota, and Wisconsin to evaluate the risk associated with several environmental exposures, in particular agricultural pesticides. Hundreds of different pesticides are used in agriculture and it is not feasible to evaluate the association between brain cancer and exposure to each of these chemicals; therefore, a strategy was developed to identify which pesticides would be targeted in the study. First lists of pesticides were created, documenting usage in each of the four states and the United States as a whole, by using data from reports prepared by the U.S. Department of Agriculture and Departments of Agriculture and land grant colleges within the four states. Then the following factors were considered in prioritizing pesticides for evaluation in the study: total volume of use prior to 1985, ranking of use in the four states and the United States as a whole by pesticide category, and toxicological evidence of carcinogenic, teratogenic, or mutagenic effects. Pesticide usage prior to 1985 was determined to allow for a minimum 10-year latency for the incident brain cancer cases diagnosed in 1995 or later. The selected pesticides include 56 herbicides, 49 insecticides, 12 fungicides, and 17 fumigants, accounting for over 99% of the total pounds of herbicides and insecticides and over 98% of the total pounds of fungicides and fumigants applied pre-1985. Prompt lists of the pesticides are sent to study participants a few days before the study questionnaire is administered to allow them time to recall past use of pesticides; the lists include the common chemical names, trade names, the crops that the pesticides are most commonly used on, and the years that the pesticides have been marketed. The methods used to select this subset of 134 pesticides document historical usage and may be useful in prioritizing pesticides for other research studies.

Brain Neoplasms↗

Teens teach skin cancer prevention.

Cumulative sun exposure has been linked to about 95 percent of all skin cancers. Farmers and their families, by nature of their occupations, are exposed to an abundance of sun over a long period of time and, therefore, are at an increased risk for skin cancer. Because education is known to be a primary means of health, Future Farmers of America (FFA) peer facilitators (teen educators) provided third graders in rural communities sun protection education with the hope that the message would reach the entire family. The FFA facilitators (n = 217) from 39 FFA organizations throughout Wisconsin were trained with skin cancer and sun protection information. The FFA facilitators then gave presentations on sun protection to third graders (n = 2,007) in their school districts. Control schools included 57 facilitators and 669 third graders. Evaluation involved pre-, post-, and six-month follow-up surveys testing knowledge gained by the third graders. Students who correctly responded to a question on the post-survey after incorrectly answering it on the pre-survey were said to have had a knowledge gain for that question. By using chi-square tests, the intervention group demonstrated a statistically significant (P < 0.001) higher proportion of students experiencing knowledge gain than did the control group from pre- to post-surveys for nine of the 10 questions. Summary statistics were used to describe the study population. In addition to skin cancer knowledge questions, the survey of facilitators included sun protection behavior and attitude questions. This intervention was able to use peer educators as instructors to demonstrate knowledge gain in the youths of the target population. The pilot project materials costs were +0.55 per third grade student and +3.50 per facilitator. Using a school-based organization such as FFA provided a cost-effective means of reaching the rural population.

Adolescent↗