Initiation and Maintenance of Weight Loss after Laparoscopic Adjustable Gastric Banding. The role of Outcome Expectation and Satisfaction with the Psychosocial Outcome

Background  A premise of this study was that different psychological processes would predict the initiation and maintenance of weight loss after surgery for morbid obesity. Our aim was to examine whether more favorable preoperative expectations of psychosocial outcomes predict weight loss in the first year after laparoscopic adjustable gastric banding (LAGB) and whether postoperative satisfaction with these outcomes predicts weight maintenance in the second year after the operation. Methods  Six months before and 1 year after surgery, the “Obesity Psychosocial State Questionnaire” was filled out by 91 patients (77 female, 14 male, mean age 45 ± 9 years, mean preoperative body mass index 47 ± 6 kg/m²). We evaluated the preoperative outcome expectations and the postoperative satisfaction for the seven domains of psychosocial and physical functioning of this questionnaire, as well as the correlations between these scores and both weight loss and weight maintenance. Results  Patients showed high satisfaction with psychosocial outcomes after LAGB in all seven domains (p < 0.001), even though the improvement was less than expected in five of the domains (p ≤ 0.01). While weight loss 1 year after the operation was related to satisfaction with psychosocial outcomes (p ≤ 0.05), preoperative expectations were not related to weight loss in the first year after surgery, and satisfaction with the outcomes was not related to weight maintenance in the second year after surgery. Conclusion  Our study suggests that surgically induced effects of weight loss and weight maintenance are achieved independently of the patient’s preoperative expectations of and postoperative satisfaction with the psychosocial outcomes.     

A statistical assembled deformable model (SAMTUS) for vasculature reconstruction

Although many deformable models have been proposed in medical applications for segmenting isolated structures in the human anatomy, not much of such work had been done on tubular structures such as the vasculature. In this paper, we propose a statistical assembled model for tubular structures (SAMTUS) to segment entire tubular structure from three-dimensional (3D) volumetric data. To our knowledge, there is no literature about the statistical deformable model for entire tubular structures. Specifically, the statistical tubular model is composed of a statistical axis model (SAM) and a statistical surface model (SSM). Both of them are assembled from a set of branch segments through the control points. Instead of searching for fuzzy correspondence along tubular axes or surfaces, we build point matching between feature points along tubular segments, and train SAM and SSM independently to characterize, respectively, the axial and the cross-sectional variation of the entire structure. In this way, more accurate point correspondence can be established, and a larger number of deformation modes can be captured. Our SAMTUS-based segmentation process consists of three stages: initialization, model fitting and final refinement. The experimental results demonstrate that the algorithm obtains good quantifications on the morphology and volume of the vasculature of the zebrafish which is being used increasingly as a specimen for drug screening and genomic research.     

Feasibility and induced cognitive-emotional change of an emotional disclosure intervention adapted for home application

OBJECTIVE: Emotional engagement, cognitive restructuring, and positive future directedness are considered core elements to induce change in emotional disclosure interventions. Our aim was to examine the induction of these elements and the feasibility of an emotional disclosure intervention adapted for home application. METHODS: The intervention emphasized expression of negative and positive emotions (session 1-4), search for meaning (session 3), and a positive future-oriented ending (session 4). A randomized clinical trial in patients with rheumatoid arthritis compared the adapted intervention (n=40) with a time management control condition (n=28). Feasibility was evaluated regarding adherence, compliance with instructions, perceived viability, and clinical safety. Induction of core elements was evaluated by analysis of change in immediate affective responses and by computerized text analysis of word use. RESULTS: Feasibility criteria were successfully met. The disclosure condition produced higher immediate negative affect and use of emotion, insight, and optimism words compared to control, and induced the elements of change within sessions as intended. CONCLUSION: The adapted intervention is feasible for home application and induces change in variables that indicate emotional engagement, cognitive restructuring, and positive future directedness. PRACTICE IMPLICATIONS: Empirical support of health benefits of this emotional disclosure intervention will extend its applicability in patient self-care.