Objective To compare manual and automated pre- and postoperative hippocampal volume measurements in patients with intractable epilepsy. Methods We studied 34 patients referred to the Clinical Epilepsy Section, NINDS, NIH for evaluation of intractable epilepsy and 21 normal volunteers who received 1.5 or 3 T GE Signa MRI scans. Hippocampal volumes were manually traced on each slice and assembled into three-dimensional volumes by investigators blinded to other data. Automated volumetric measurements were obtained using FreeSurfer (http://surfer.nmr.mgh.harvard.edu/). Statistical analysis was performed with GraphPad Prism. Results Automated hippocampal volumes were larger than manual volumes in both patients and normal volunteers, p<.05. Right to left hemisphere hippocampal ratio and percent of hippocampus resected did not significantly differ by segmentation method. It was not possible to obtain accurate total resection volumes with the automated method. Significance Values such as side-to-side ratio and percent resected may be more directly translatable between manual and automated methods than absolute measures of volume. Accurate determination of resection volumes is important for studies of the effects of surgery on both seizure control and postoperative neuropsychological deficits. Our preliminary data suggest that FreeSurfer may provide an accurate and simple method for quantitating hippocampal resections. However, it may be less valuable for large or extratemporal resections, or when distortions of normal anatomy are present.

Functional recovery of the upper limb is poor and as many as 50% of stroke survivors still have impairments at 6 months post stroke, despite rehabilitation efforts. With the move towards early supported discharge and community-based rehabilitation, novel solutions are needed to deliver the amount of quality therapy that is required for optimum recovery. We propose a rehabilitation aid that provides patients with augmented visual feedback of their motor performance during task orientated upper limb therapy with the aim of facilitating motor relearning and maximising patients functional outcomes.

This paper describes the ongoing process of the development and evaluation of prototype visualisation software, designed to assist in the understanding and the improvement of appropriate movements during rehabilitation. The process of engaging users throughout the research project is detailed in the paper, including how the design of the visualisation software is being adapted to meet the emerging understanding of the needs of patients and professionals, and of the rehabilitation process. The value of the process for the design of the visualisation software is illustrated with a discussion of the findings of pre-pilot focus groups with stroke survivors and therapists.

Background: Blended-care behavior change interventions (BBCI) are a combination of digital care and coaching by health care professionals (HCP), which are proven effective for weight loss. However, it remains unclear what specific elements of BBCI drive weight loss. Objectives: This study aims to identify the distinct impact of HCP-elements (coaching) and digital elements (self-monitoring, self-management, and education) for weight loss in BBCI. Methods: Long-term data from 25,706 patients treated at a digital behavior change provider were analyzed retrospectively using a ridge regression model to predict weight loss at 3, 6, and 12 months. Results: Overall relative weight loss was −1.63 kg at 1 month, −3.61 kg at 3 months, −5.28 kg at 6 months, and −6.55 kg at 12 months. The four factors of BBCI analyzed here (coaching, self-monitoring, self-management, and education) predict weight loss with varying accuracy and degree. Coaching, self-monitoring, and self-management are positively correlated with weight losses at 3 and 6 months. Learn time (i.e., self-guided education) is clearly associated with a higher degree of weight loss. Number of appointments outside of app coaching with a dietitian (coach) was negatively associated with weight loss. Conclusions: The results testify to the efficacy of BBCI for weight loss-with particular positive associations per time point-and add to a growing body of research that characterizes the distinct impact of intervention elements in real-world settings, aiming to inform the design of future interventions for weight management.

Obesity continues to be a global health problem with significant costs associated with management, treatment, and obesity-related comorbidities. Tier 3 weight management programmes support patients with complex obesity and traditionally offer interventions through face-to-face delivery. In this study, a service evaluation compared weight loss for adults with a BMI ≥ 45 kg/m 2 or ≥ 40 kg/m 2 with a comorbidity, who were offered a non-randomized dietetic intervention through face-to-face, telephone, or digital support using the Oviva smartphone app as part of a tier 3 weight management programme. One hundred and sixty-nine patients commenced the core programme. There were no significant differences in weight loss between patients receiving face-to-face (5.3 ± 5.5 kg [−4.1%]), telephone (−4 ± 5.3 kg [−3.4%]) and digital support (−6.1 ± 4.9 kg [−4.5%]) (P = .061), with data reported as intention-to-treat using baseline observation carried forward imputation. Completer data were also analysed at an optional 12-week follow-up where weight loss was maintained with no significant differences between face-to-face (−7.6 ± 9.3 kg [−5.6%]) and digital support (−9.2 ± 7.6) kg [−6.8%]) (P = .135). Furthermore, there were no significant differences in the acceptability of the interventions (P = .261).Due to the potential scalability, resource, and cost-savings of digital care, and improvement in accessibility for some people, digital delivery of weight management programmes should be considered as a care option in weight management services.

The techniques of anaerobic continuous culture, microscopy and image analysis were combined for the study of attachment, colonisation and biofilm development on surfaces, by strictly anaerobic microbial populations. The Anaerobic Continuous Culture Microscopy Unit (ACCMU) is a miniature continuous culture chamber, which is detachable, self-sealing, oxygen-impermeable, transparent and fits onto a microscope stage. The ACCMU system was used to record colonisation processes on different materials, by naturally occurring, mixed species, functioning microbial associations, isolated from the anaerobic layers of a landfill site. The same fields were sampled through time, allowing a colonisation rate (in μm2 d−1) to be calculated. Paper, wood, cotton and polyester fabric remained poorly or not colonised over a three week study period. Cellophane and selected non-biodegradable materials (glass, plastic and polythene) were rapidly colonised in 2–3 weeks.

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