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Reducing contributions from non-neuronal sources is a crucial step in functional magnetic resonance imaging (fMRI) analyses. Many viable strategies for denoising fMRI are used in the literature, and practitioners rely on denoising benchmarks for guidance in the selection of an appropriate choice for their study. However, fMRI denoising software is an ever-evolving field, and the benchmarks can quickly become obsolete as the techniques or implementations change. In this work, we present a fully reproducible denoising benchmark featuring a range of denoising strategies and evaluation metrics, built primarily on the fMRIPrep and Nilearn software packages. We apply this reproducible benchmark to investigate the robustness of the conclusions across two different datasets and two versions of fMRIPrep. The majority of benchmark results were consistent with prior literature. Scrubbing, a technique which excludes time points with excessive motion, combined with global signal regression, is generally effective at noise removal. Scrubbing however disrupts the continuous sampling of brain images and is incompatible with some statistical analyses, e.g. auto-regressive modeling. In this case, a simple strategy using motion parameters, average activity in select brain compartments, and global signal regression should be preferred. Importantly, we found that certain denoising strategies behave inconsistently across datasets and/or versions of fMRIPrep, or had a different behavior than in previously published benchmarks, especially ICA-AROMA. These results demonstrate that a reproducible denoising benchmark can effectively assess the robustness of conclusions across multiple datasets and software versions. Technologies such as BIDS-App, the Jupyter Book and Neurolibre provided the infrastructure to publish the metadata and report figures. Readers can reproduce the report figures beyond the ones reported in the published manuscript. With the denoising benchmark, we hope to provide useful guidelines for the community, and that our software infrastructure will facilitate continued development as the state-of-the-art advances.

BackgroundIncreasing the availability of non-alcoholic options is a promising population-level intervention to reduce alcohol consumption, currently unassessed in naturalistic settings. This study in an online retail context aimed to estimate the impact of increasing the proportion of non-alcoholic (relative to alcoholic) drinks, on selection and purchasing of alcohol.Methods and ResultsAdults (n=737) residing in England and Wales who regularly purchased alcohol online were recruited between March-July 2021. Participants were randomly assigned to one of three groups: ‘25% non-alcoholic/75% alcoholic’; ‘50% non-alcoholic/50% alcoholic’; ‘75% non-alcoholic/25% alcoholic’, then selected drinks in a simulated online supermarket, before purchasing them in an actual online supermarket. The primary outcome was the number of alcohol units selected (with intention to purchase); secondary outcomes included actual purchasing. 607 participants (60% female, mean age = 38 years [range: 18-76]) completed the study and were included in the primary analysis. In the first part of a hurdle model, a greater proportion of participants in the ‘75% non-alcoholic’ group did not select any alcohol (13.1%) compared to the ‘25% non-alcoholic’ group (3.4%; 95% confidence interval [CI] - 2.09, -0.63; p < 0.001). There was no evidence of a difference between the ‘75% non-alcoholic’ and the ‘50% non-alcoholic’ (7.2%) groups (95% CI 0.10, 1.34; p = 0.022) or between the ‘50% non-alcoholic’ and the ‘25% non-alcoholic’ groups (95% CI -1.44, 0.17; p = 0.121). In the second part of a hurdle model in participants (559/607) selecting any drinks containing alcohol, the ‘75% non-alcoholic’ group selected fewer alcohol units compared to the ‘50% non-alcoholic’ (95% CI -0.44, -0.14; p < 0.001) and ‘25% non-alcoholic’ (95% CI - 0.54, -0.24; p < 0.001) groups, with no evidence of a difference between the ‘50% non-alcoholic’ and ‘25% non-alcoholic’ groups (95% CI -0.24, 0.05; p = 0.178). Overall, across all participants, 17.46 units (95% CI 15.24, 19.68) were selected in the ‘75% non-alcoholic’ group; 25.51 units (95% CI 22.60, 28.43) in the ‘50% non-alcoholic’ group; and 29.40 units (95% CI 26.39, 32.42) in the ‘25% non-alcoholic’ group. This corresponds to 8.1 fewer units (a 32% reduction) in the ‘75% non-alcoholic’ compared to the ‘50% non-alcoholic’ group, and 11.9 fewer alcohol units (41% reduction) compared to the ‘25% non-alcoholic’ group; 3.9 fewer units (13% reduction) were selected in the ‘50% non-alcoholic’ group than in the ‘25% non-alcoholic’ group.For all other outcomes, alcohol selection and purchasing were consistently lowest in the ‘75% non-alcoholic’ group.Study limitations include the setting not being entirely naturalistic due to using a simulated online supermarket as well as an actual online supermarket, and that there was substantial dropout between selection and purchasing.ConclusionsThis study provides evidence that substantially increasing the proportion of non-alcoholic drinks – from 25% to 50% or 75% - meaningfully reduces alcohol selection and purchasing. Further studies are warranted to assess whether these effects are realised in a range of real-world settings.Trial registrationISRCTN:11004483; OSF:https://osf.io/qfupwAuthor summaryWhy was this study done?Excessive alcohol consumption contributes to the global burden of non-communicable diseases, including cancer, heart disease and stroke. Interventions that change physical and economic environments have the potential to reduce alcohol consumption.Interventions targeting physical environments include availability interventions that involve changing the proportion of healthier options that are available, relative to less healthy options.A previous online study found that increasing the availability of non-alcoholic compared to alcoholic drinks reduced the hypothetical selection of alcoholic drinks, but there is an absence of evidence from naturalistic settings.What did the researchers do and find?This study evaluated the impact of increasing the proportion of non-alcoholic (relative to alcoholic) drinks, on selection and actual purchasing of alcohol.In a randomised controlled trial, 737 participants were randomly assigned to one of three groups with varying proportions of alcoholic versus non-alcoholic drinks ‘25% non-alcoholic/75% alcoholic’; ‘50% non-alcoholic/50% alcoholic’; ‘75% non-alcoholic/25% alcoholic’).Participants selected drinks from 64 options in a simulated online supermarket which was designed to look and function similarly to an online supermarket. Participants were then required to immediately purchase the same drinks in an actual online supermarket.It was found that increasing the proportion of non-alcoholic drinks – from 25% to 50% or 75% – reduced the amount of alcohol selected and bought, in this online supermarket setting.What do these findings mean?This study provides evidence that increasing the proportion of non-alcoholic drinks could reduce alcohol selection and purchasing, highlighting the potential for availability interventions to reduce alcohol sales at population level.Further studies are warranted to assess whether these effects are realised in a range of real-world settings

ObjectiveHealth warning and calorie labels on alcohol have the potential to reduce consumption at population level but remain unevaluated using robust designs with behavioural outcomes. The aim of the current study is to estimate the impact on selection and actual purchasing of (a) health warning labels (text-only and image-and-text) on alcoholic drinks and (b) calorie labels on alcoholic and non-alcoholic drinks.DesignParallel-groups randomised controlled trial.SettingParticipants selected drinks in a simulated online supermarket, before purchasing them in an actual online supermarket.ParticipantsAdults in England and Wales who regularly consumed and purchased beer or wine online (n= 644).InterventionsParticipants were randomised to one of six groups in a between-subjects 3 (Health warning labels (HWLs): i. image-and-text HWL, ii. text-only HWL, iii. no HWL) x 2 (Calorie labels: present vs absent) factorial design.Main outcome measuresThe number of alcohol units selected (with intention to purchase); secondary outcomes included alcohol units purchased and calories selected and purchased.Results608 participants completed the study and were included in the primary analysis. There was no evidence of an overall difference for either (a) HWLs, or (b) calorie labels on the number of alcohol units selected [HWLs: F(2,599) = 0.406, p = .666; calorie labels: F(1,599) = 0.002, p = .961]. There was also no evidence of an overall difference on any secondary outcomes, including the number of alcohol units purchased [HWLs: F(2,462) = 1.85, p = .159; calorie labels: F(1,462) = 0.193, p = .661].In pre-specified subgroup analyses comparing the ‘calorie label only’ group (n = 101) to the ‘no label’ group (n = 104) there was no evidence that calorie labels reduced the number of calories selected [unadjusted means: 1913 calories vs 2203 calories, p = .643]. Amongst the 75% of participants who went on to purchase drinks, those in the ‘calorie label only’ group (n = 74) purchased fewer calories than those in the ‘no label’ group (n = 79) [unadjusted means: 1532 calories vs 2090, p = .028].ConclusionThere was no evidence that health warning labels reduced the number of alcohol units selected or purchased in an online purchasing setting. There was some evidence suggesting that calorie labels on alcoholic and non-alcoholic drinks may reduce calories purchased. Further evaluation is warranted in suitably powered studies in real world settings.Trial registrationPre-registered protocol (https://osf.io/ch2sm/) and prospective ISCRTN registration: https://www.isrctn.com/ISRCTN10313219FundingThis study was funded by Wellcome [Grant number 206853/Z/17/Z].

Background and aims:- \ud \ud Health warning labels (HWLs) on tobacco products reduce smoking. There is an absence of evidence concerning the impact of alcohol HWLs on selection or purchasing in naturalistic settings. Using a commercial-standard naturalistic shopping laboratory, this study aimed to estimate the impact on selection of alcoholic drinks of HWLs describing adverse health consequences of excessive alcohol consumption.\ud Design:- \ud \ud A between-subjects randomised experiment with three groups was conducted: group 1: image-and-text HWL; group 2: text-only HWL; group 3: no HWL.\ud Setting:- \ud \ud A commercial-standard naturalistic shopping laboratory in the United Kingdom.\ud Participants:- \ud \ud Adults (n = 399, 55% female) over the age of 18 years, who purchased beer or wine weekly to drink at home.\ud Interventions:- \ud \ud Participants were randomised to one of three groups varying in the HWL displayed on the packaging of the alcoholic drinks: (i) image-and-text HWL (n = 135); (ii) text-only HWL (n = 129); (iii) no HWL (n = 135). Participants completed a shopping task, selecting items from a range of alcoholic and non-alcoholic drinks, and snacks.\ud Measurement:- \ud \ud The primary outcome was the proportion of alcoholic drinks selected. Secondary outcomes included HWL ratings on negative emotional arousal and label acceptability.\ud Findings:- \ud \ud There was no clear evidence of a difference in the HWL groups for the percentage of drinks selected that were alcoholic compared to no HWL (44%): image-and-text HWL: 46% (odds ratio [OR] = 1.08, 95% confidence interval [CI] = 0.82, 1.42); text-only HWL: 41% (OR = 0.87, 95% CI = 0.67, 1.14). Concordant with there being no difference between groups, there was extreme evidence in favour of the null hypothesis (Bayes factor [BF] < 0.01). Negative emotional arousal was higher (P < 0.001) and acceptability lower (P < 0.001) in the image-and-text HWL group, compared to the text-only HWL group.\ud Conclusions:- \ud \ud In a naturalistic shopping laboratory, there was no evidence that health warning labels describing the adverse health consequences of excessive alcohol consumption changed selection behaviour.

Background There is ongoing clinical and research interest in determining whether providing personalised risk information could motivate risk-reducing health behaviours. We aimed to assess the impact on behaviours and risk factors of feeding back to individuals’ images of their bodies generated via medical imaging technologies in assessing their current disease status or risk. Methods and findings A systematic review with meta-analysis was conducted using Cochrane methods. MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to July 28, 2021, with backward and forward citation searches up to July 29, 2021. Eligible studies were randomised controlled trials including adults who underwent medical imaging procedures assessing current health status or risk of disease, for which personal risk may be reduced by modifying behaviour. Trials included an intervention group that received the imaging procedure plus feedback of visualised results and assessed subsequent risk-reducing health behaviour. We examined 12,620 abstracts and included 21 studies, involving 9,248 randomised participants. Studies reported on 10 risk-reducing behaviours, with most data for smoking (8 studies; n = 4,308), medication use (6 studies; n = 4,539), and physical activity (4 studies; n = 1,877). Meta-analysis revealed beneficial effects of feedback of visualised medical imaging results on reduced smoking (risk ratio 1.11, 95% confidence interval [CI] 1.01 to 1.23, p = 0.04), healthier diet (standardised mean difference [SMD] 0.30, 95% CI 0.11 to 0.50, p = 0.003), increased physical activity (SMD 0.11, 95% CI 0.003 to 0.21, p = 0.04), and increased oral hygiene behaviours (SMD 0.35, 95% CI 0.13 to 0.57, p = 0.002). In addition, single studies reported increased skin self-examination and increased foot care. For other behavioural outcomes (medication use, sun protection, tanning booth use, and blood glucose testing) estimates favoured the intervention but were not statistically significant. Regarding secondary risk factor outcomes, there was clear evidence for reduced systolic blood pressure, waist circumference, and improved oral health, and some indication of reduced Framingham risk score. There was no evidence of any adverse effects, including anxiety, depression, or stress, although these were rarely assessed. A key limitation is that there were some concerns about risk of bias for all studies, with evidence for most outcomes being of low certainty. In particular, valid and precise measures of behaviour were rarely used, and there were few instances of preregistered protocols and analysis plans, increasing the likelihood of selective outcome reporting. Conclusions In this study, we observed that feedback of medical images to individuals has the potential to motivate risk-reducing behaviours and reduce risk factors. Should this promise be corroborated through further adequately powered trials that better mitigate against risk of bias, such interventions could usefully capitalise upon the widespread and growing use of medical imaging technologies in healthcare.

Background The physical properties of tableware could influence selection and consumption of food and alcohol. There is considerable uncertainty, however, around the potential effects of different sizes and shapes of tableware on how much food and alcohol people self-serve. These studies aimed to estimate the impact of: 1. Plate size and shape on amount of food self-served; 2.Wine glass and bottle size on amount of wine self-poured. Methods 140 adults participated in two laboratory studies—each using randomised within-subjects factorial designs—where they self-served food (Study 1) and wine (Study 2): Study 1: 3 plate sizes (small; medium; large) × 2 plate shapes (circular; square). Study 2: 3 wine glass sizes (small; medium; large) × 2 wine bottle sizes (75 cl; 50 cl). Results Study 1: There was a main effect of plate size: less was self-served on small (76 g less, p p p = 0.46) or a size and shape interaction (p = 0.47). Study 2: There was a main effect of glass size: less was self-served in small (34 ml less, p p p = 0.20) or a glass and bottle size interaction (p = 0.18). Conclusions Smaller tableware (i.e. plates and wine glasses) decreases the amount of food and wine self-served in an initial serving. Future studies are required to generate estimates on selection and consumption in real world settings when numerous servings are possible. Protocol registration information: OSF (https://osf.io/dj3c6/) and ISRCTN (10.1186/ISRCTN66774780).

Background: Increasing the availability of lower energy foods increases their selection. The current studies examine the extent to which this effect could be mediated by social norms – assessed by perceived popularity of foods – which may be implied by their relative availability. Methods: Study 1 (Online): 2340 UK adults estimated the perceived popularity of lower energy products. For each of eight trials, participants were randomised to one of six groups (between-subjects 3x2) to see photos of cafeteria shelves varying in the availability of lower energy options (1/4 lower energy; 1/2 lower energy; 3/4 lower energy) and fullness of shelves (fuller; emptier).Study 2 (Laboratory): 139 English adults were asked to select a snack. Participants were randomised to select from trays varying in the availability of the lower energy option (1/3 lower energy; 2/3 lower energy) and fullness of tray (fuller; emptier). Results: Study 1: Evidence for an interaction was found, such that when shelves were full, a higher proportion of lower energy options led to greater perceived popularity of lower energy products (1/4 lower energy: 40.9% (95%CIs: 40.1,41.8); 3/4 lower energy: 47.2% (46.3,48.0)), whereas when shelves were emptier, a higher proportion of lower energy options led to lower perceived popularity (1/4 lower energy: 48.4% (47.5,49.2); 3/4 lower energy: 39.2% (38.3,40.0)).Study 2: When the tray was fuller, participants were more likely – albeit non-significantly (main effects: p=0.05; interactions: p=0.07) – to select a lower energy snack when 2/3 of the available snacks were lower energy (35.7% (18.5,52.9)) than when 1/3 were lower energy (15.4% (4.2,26.5)). For emptier trays, lower energy selections decreased as the relative availability of lower energy snacks increased (1/3 lower energy snacks: 36.0% (17.9,54.1); 2/3 lower energy snacks: 27.8% (13.9,41.7)). Conclusions:These studies provide novel evidence that social norms may mediate the impact of availability on food selection. In addition, they suggest that the effect of availability may vary in different contexts, moderated by display layout through its impact on perceived product popularity. Trial registration. ISRCTN: ISRCTN10512908; 31/01/2020

Health-related information labelling on alcohol products falls behind that of food and tobacco despite numerous health harms associated with its consumption. The chapter reviews alcohol product labelling, regarding its content (e.g. calories and standard drinks), the inclusion of health warning labels, and its implementation. Evidence is considered for how to optimise labelling, including the provision of content information per serving as a proportion of guideline amounts, and the use of negatively framed health messages that emphasise the long-term health risks and display images. Well-implemented labelling interventions have the potential to impact drinkers’ capability and motivation to control their drinking behaviour, which are key requirements of successful behaviour change that can be targeted as part of a broader strategy to reduce alcohol-related harm.

OBJECTIVES:\ud To evaluate the effectiveness, acceptability and costs of Active Residents in Care Homes, ARCH - a programme aiming to increase opportunities for activity in older care home residents.\ud \ud DESIGN:\ud Feasibility study.\ud \ud SETTING:\ud Residential care homes for older people.\ud \ud PARTICIPANTS:\ud 10-15 residents, staff and family members will be recruited in each of the three participating care homes.\ud \ud INTERVENTION:\ud ARCH is a 12-month 'whole-systems' programme implemented by occupational therapists and physiotherapists. They will conduct a comprehensive assessment of each care home, considering the physical environment, working practices and organisation structure as well as residents' individual needs, and recommend ways to address barriers and increase residents' activity levels. The therapists will then work with staff to improve understanding of the issues, instigate training, environmental, organisational and working practice changes as necessary.\ud \ud MAIN OUTCOME MEASURES:\ud Residents' activity levels, health and quality of life will be tested using several measures to see which are practicable and appropriate for this population in this context. This includes: Assessment of Physical Activity in Frail Older People; Pool Activity Level Checklist; Dementia Care Mapping observations; and EQ-5D-5L. Residents will be assessed prior to programme implementation then 4- and 12-months post-implementation. Semi-structured interviews will explore the experiences of residents, staff, family members and therapists.\ud \ud CONCLUSIONS:\ud Providing evidence of effectiveness and acceptability of ARCH, and documenting factors that impede/facilitate implementation will help us identify ways to enhance the care and quality of life of older people in residential care, and our understanding of how to implement them.

Aims:- \ud \ud Information provided on glass labels may be an effective method to reduce alcohol consumption. The aim of this study was to assess the impact of glass labels conveying unit information and a health warning in reducing ad libitum alcohol consumption.\ud Methods:- \ud \ud A cluster-randomized experimental study was conducted to measure the efficacy of a labeled glass in reducing alcohol consumption in a semi naturalistic bar laboratory setting, in a sample of 81 pairs (n = 162) of UK young adult drinkers. Pairs were randomized to receive two 340-ml glasses of beer or wine: labeled or plain (control). Alcohol consumption was assessed in an ad libitum drinking period, and urge to drink was measured at baseline and postdrinking period. Focus groups (n = 2) were conducted, and thematic analysis was used to gain an insight into the acceptability and the perceived effectiveness of the glasses.\ud Results:- \ud \ud Mean unit consumption was 1.62 (SD ± 0.83) units in the labeled glass condition and 1.69 (SD ± 0.82) units in the non labeled glass condition. There were no significant effects of the labeled glasses on ad libitum alcohol consumption (95% CI −0.25 to 0.37, p = 0.35), despite participants (85%) noticing the information. Qualitative analysis of focus groups indicated that although participants perceived the glasses as a useful tool for increasing awareness of units and guidelines, they were viewed as limited in their potential to change drinking behavior due to the unappealing design of the glass and a view that unit guidelines were not relevant to drinking patterns or contexts.\ud Conclusions:- \ud \ud Labeled glasses did not change alcohol consumption in the current study, potentially due to ineffectiveness of this type of message in a young adult population. The information on the glasses was attended to, highlighting that glasses could be a feasible tool for providing information.

There is considerable uncertainty regarding the impact of tableware size on food consumption. Most existing studies have used small and unrepresentative samples and have not followed recommended procedures for randomised controlled trials, leading to increased risk of bias. In the first pre-registered study to date, we examined the impact on consumption of using larger versus smaller plates for self-served food. We also assessed impact on the underlying meal micro-structure, such as number of servings and eating rate, which has not previously been studied. The setting was a purpose-built naturalistic eating behaviour laboratory. A general population sample of 134 adult participants (aged 18–61 years) was randomly allocated to one of two groups varying in the size of plate used for self-serving lunch: large or small. The primary outcome was amount of food energy (kcal) consumed during a meal. Additionally, we assessed impact on meal micro-structure, and examined potential modifying effects of executive function, socio-economic position, and sensitivity to perceptual cues. There was no clear evidence of a difference in consumption between the two groups: Cohen’s d = 0.07 (95% CI [− 0.27, 0.41]), with participants in the large plate group consuming on average 19.2 (95% CI [− 76.5, 115.0]) more calories (3%) compared to the small plate group (large: mean (SD) = 644.1 (265.0) kcal, versus small: 624.9 (292.3) kcal). The difference between the groups was not modified by individual characteristics. There was no evidence of impact on meal micro-structure, with the exception of more food being left on the plate when larger plates were used. This study suggests that previous meta-analyses of a low-quality body of evidence may have considerably overestimated the effects of plate size on consumption. However, the possibility of a clinically significant effect – in either direction – cannot be excluded. Well-conducted trials of tableware size in real-world field settings are now needed to determine whether changing the size of tableware has potential to contribute to efforts to reduce consumption at population-level. The study protocol ( https://osf.io/e3dfh/ ) and data analysis plan ( https://osf.io/sh5u7/ ) were pre-registered on the Open Science Framework.

Objective Previous research suggests that wine glass size affects sales of wine in bars, with more wine purchased when served in larger glasses. The current four studies, conducted in one restaurant (Studies 1 and 2) and two bars (Studies 3 and 4) in Cambridge, England, aim to establish the reproducibility of this effect of glass size on sales. A multiple treatment reversal design was used, involving wine being served in sequential fortnightly periods in different sized glasses of the same design (290 ml, 350 ml, and 450 ml). The primary outcome was daily wine volume (ml) sold. Results Restaurant: Daily wine volume sold was 13% (95% CI 2%, 24%) higher when served with 350 ml vs. 290 ml glasses in Study 1. A similar direction of effect was seen in Study 2 (6%; 95% CI − 1%, 15%). Bars: Daily wine volume sold was 21% (95% CI 9%, 35%) higher when served with 450 ml vs. 350 ml glasses in Study 3. This effect was not observed in Study 4 (− 7%, 95% CI − 16%, 3%). Meaningful differences were not demonstrated with any other glass comparison. These results partially replicate previous studies showing that larger glasses increase wine sales. Considerable uncertainty remains about the magnitude of any effect and the contexts in which it might occur. Trial registration Study 1: ISRCTN17958895 (21/07/2017), Study 2: ISRCTN17097810 (29/03/2018), Study 3 and 4: ISRCTN39401124 (10/05/2018)

Reducing harmful consumption of food (including non-alcoholic drinks) and alcoholic drinks would prevent much disease. Evidence from tobacco control shows that placing health warning labels (HWLs) on these products reduces their selection and consumption. A systematic review with meta-analysis was conducted using Cochrane methods to assess the impact on selection (including hypothetical selection) or consumption of food or alcoholic drinks with image-and-text (sometimes termed ‘pictorial’) and text-only HWLs placed on these products. Studies were required to be randomised or quasi-randomised controlled trials. Fourteen studies were included, three on alcohol, eleven on food. For our primary outcomes, eleven studies measured selection and one measured consumption (two measured only other secondary outcomes). Meta-analysis of twelve comparisons from nine studies (n=12,635) found HWLs reduced selection of the targeted product compared to a control group with no HWL (RR=0.74 (95% CI 0.68 to 0.80)), with participants 26% less likely to choose a product displaying a HWL. A planned subgroup analysis suggested a larger effect on selection of image-and-text HWLs (RR=0.65 (95% CI 0.54 to 0.80)) than text-only HWLs (RR=0.79 (95% CI 0.74 to 0.85)), but this difference was not statistically significant. These findings suggest significant potential for HWLs to reduce selection of food and alcohol, but all experimental studies to date were conducted in laboratory or online settings with outcomes assessed immediately after a single exposure. Studies in field and more naturalistic laboratory settings are urgently needed to estimate the potential effects of HWLs on food and alcohol.

Anomia therapy typically aims to improve patients' communication ability through targeted practice in naming a set of particular items. For such interventions to be of maximum benefit, the use of trained (or relearned) vocabulary must generalise from the therapy setting into novel situations. We investigated relearning in three patients with semantic dementia, a condition that has been associated with poor generalisation of relearned vocabulary. We tested two manipulations designed to improve generalisation of relearned words by introducing greater variation into the learning experience. In the first study, we found that trained items were retained more successfully when they were presented in a variety of different sequences during learning. In the second study, we found that training items using a range of different pictured exemplars improved the patients' ability to generalise words to novel instances of the same object. However, in one patient this came at the cost of inappropriate over-generalisations, in which trained words were incorrectly used to name semantically or visually similar objects. We propose that more variable learning experiences benefit patients because they shift responsibility for learning away from the inflexible hippocampal learning system and towards the semantic system. The success of this approach therefore depends critically on the integrity of the semantic representations of the items being trained. Patients with naming impairments in the context of relatively mild comprehension deficits are most likely to benefit from this approach, while avoiding the negative consequences of over-generalisation., Highlights • SD patients attempted to recover lost vocabulary by naming pictures daily. • Learning was more successful when pictures presented in a different order each day. • One patient benefitted from naming multipleexemplars of each item. • But in the other patient, this resulted in over-generalisation of the trained name.

Diffusion Tensor Imaging (DTI) Segmentation (D-SEG) relies on variation in tissue microstructure characteristics of the diffusion tensor to segment regions of the brain with similar diffusion properties. Previously shown to be a reliable tool for parcelating and classifying volumes of interest (VOIs) within brain tumours, generating objective tissue type boundaries (Jones et al., 2014), it also relates to differences in age, executive function and working memory (Williams et al., unpublished data). We applied D-SEG to a novel data set comprising 18 DTI scans; 9 controls and 9 patients with clinically and/or radiologically confirmed focal dementia syndromes: 4 Progressive non-fluent Aphasia (PnFA), 2 Semantic Dementia (SD) and 3 Logopenic Aphasia (LPA). The D-SEG clustering technique takes isotropic (p) and anisotropic (q) diffusion values plotted in a 2D space and uses iterative k-means clustering analysis to segment the images into areas representing tissue with similar diffusion properties. We found a statistical difference between patients and control groups in 2 of the segments, specifically grey matter and well organised white matter. Greater grey matter was positively correlated with scores on the Mini Linguistic State Examination (MLSE). These findings add to the growing body of work supporting D-SEG as a valid tool for image analysis in clinical populations.

A questionnaire survey was conducted to investigate the relative comfort of a comprehensive range of diagnostic procedures. The mean comfort ranking and variability in comfort were examined. Pure tone audiometry and speech audiometry are the most comfortable tests, while caloric testing and transtympanic electrocochleography are the least comfortable. However, caloric testing and glycerol dehydration are not significantly different in comfort to magnetic resonance imaging (MRI), and brainstem evoked response testing is more comfortable than other diagnostic tests, including MRI. The reasons for these differences and the implications for diagnostic management are discussed.