Preference Trials Research Articles

Feed intake, preferences, in vivo digestibility, and nutritional value of tedera (B. bituminosa var. bituminosa) and maralfalfa (Pennisetum purpureum) in Canary sheep

This study evaluated the nutritional value and energy content of tedera (B. bituminosa var. bituminosa) and maralfalfa (Pennisetum purpureum) through analyses of chemical composition, digestibility, intake, and preference trials. Tedera was compared with maralfalfa and alfalfa hay (Medicago sativa). Tedera showed higher crude protein (193 g CP/kg DM) and estimated energy (10.5 MJ DE/kg DM) but lower dry matter (286.3 g DM/kg) and neutral detergent fiber (373 g NDF/kg DM) than both maralfalfa and alfalfa hay. The in vitro organic matter digestibility (IVOMD) of tedera was 61.7%, compared to 51.0% for alfalfa hay and 66.3% for maralfalfa. Digestible organic matter (DOM) ranged from 467 g/kg DM in alfalfa hay to 566.4 g/kg DM in tedera. Four Canary sheep with a mean body weight (BW) of 42.2 ± 5.0 kg were used for digestibility and preference trials. The live weights of the sheep were recorded at the start and end of the 12-day trial. Feed offered and refusals were weighed and recorded daily for eight days, while feces were collected for four days to calculate apparent in vivo digestibility. For tedera, the apparent in vivo OM digestibility, estimated digestible energy, and digestible organic matter were 69.4%, 11.8 MJ/kg DM, and 637.7 g/kg DM, respectively. Preference and feed intake were compared between tedera, maralfalfa and alfalfa hay. Total DM consumption was 1091.3 g/day (tedera + maralfalfa + alfalfa hay), with alfalfa hay intake representing 40.8%, maralfalfa 37.3%, and tedera 21.9% of the total DM consumed. However, no significant differences were observed in the ratio of forages consumed/offered (44.8% for tedera and 51.8% for maralfalfa) or in the total grams of DM, CP, and MJ/kg of DE consumed by the sheep with both forages. The sheep adopted different feeding strategies in response to the chemical composition and nutritive value of the forages. Preferences and intake in this trial were associated with high NDF content in maralfalfa and alfalfa hay and with the high CP content in tedera rather than digestibility results. This may be due to the complementarity of the three forages and the higher CP content in tedera affecting intake. Nevertheless, tedera and marafalfa could be a good forage considering its nutritive value, digestibility, and proven growth performance in herbivores.

Salpingectomy With Delayed Oophorectomy Versus Salpingo-Oophorectomy in BRCA1/2 Carriers: Three-Year Outcomes of a Prospective Preference Trial.

To compare menopause-related quality of life (QoL) after risk-reducing salpingectomy (RRS) versus risk-reducing salpingo-oophorectomy (RRSO) until 3 years of post-surgery. A prospective study (TUBA study) with treatment allocation based on patients' preference. Data were collected pre-surgery and at 3 months, 1 and 3 years of post-surgery. Multicentre prospective preference trial in thirteen hospitals in the Netherlands. BRCA1/2 pathogenic variant (PV) carriers aged 25-40 (BRCA1) or 25-45 (BRCA2), who were premenopausal, without a future child wish and without current (treatment for) malignancy. Treatment allocation was based on patients' preference: either RRS from the age of 25 years with delayed oophorectomy at the maximum age of 45 (BRCA1) or 50 (BRCA2), or RRSO between the ages of 35-40 (BRCA1) or 40-45 (BRCA2). After RRSO, hormone replacement therapy (HRT) was recommended, if not contraindicated. Primarily, menopause-related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC-scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC-score reflects more climacteric symptoms. Until April 2023, 410 participants had undergone RRS and 160 RRSO. The BRCA1/BRCA2 proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants 3 years after RRSO without HRT had a 4.3 (95% CI 2.1-6.5; p < 0.001) point higher increase in GCS-score from baseline compared to those after RRS, while the difference was 7.9 (95% CI 5.9-9.8) and 8.5 (95% CI 6.5-10.5) points at 3 and 12 months, respectively. Among participants with HRT after surgery, the RRSO group had a 2.4 (95% CI 0.8-3.9; p = 0.002) point higher increase in GCS-score from baseline compared to the RRS group. In this multicentre preference trial, menopause-related QoL was better after RRS than after RRSO, even with HRT after RRSO. Differences between arms were most pronounced until one-year post-surgery.

Differences in foraging phenology dampen the impact of an invasive slug on ant-mediated seed dispersal of understory forest plants

Seed-dispersal mutualisms are important ecosystem functions that, if disrupted, influence plant fitness and community structure. Anthropogenic stressors such as invasive species and climate change may independently or synergistically influence animal-mediated seed dispersal. Aphaenogaster sp. ants are the primary dispersers of myrmecochorous plants that produce diaspores or seeds with lipid-rich appendages (elaiosomes) that make them attractive to ants in eastern North American forest understories. An invasive slug, Arion sp., damages diaspores by consuming elaiosomes, rendering seeds unattractive to ants. Here, in one forest site, we examine if slugs negatively affect seed dispersal by assessing interactions between seed-dispersing ants and invasive slugs on four species of myrmecochores that release diaspores at different times. We performed an exclusion experiment, excluding slugs and ants to diaspores on depots, when diaspores of four myrmecochore species were released from fruits. We also conducted a similar experiment presenting diaspores of all species at one time in the field and slug preference trials in the lab to determine if particular myrmecochore species are vulnerable to the invasive slug. We found that slugs did not reduce dispersal by ants despite slugs damaging diaspores. This was because peak ant and slug activity differed, with slugs damaging most diaspores of early-dehiscing Sanguinaria canadensis, and ants dispersing most diaspores of later-dehiscing Trillium grandiflorum. When diaspores were presented at the same time, ants and slugs preferred the same species, T. grandiflorum. While we did not find overlap in the phenology of ant and slug interactions in this study, phenological interactions are likely context-dependent. Thus, high-preference species may be vulnerable to invasive slugs if interacting species overlap in different contexts, including under climate change.

Is Sharing One’s Personal Story of Victimization Preferred? Incarcerated Women’s Perspectives on Group Treatment for Sexual Trauma

Treatment preferences are an important part of evidence-based practice and have been shown to affect treatment outcomes. In this two-part study, incarcerated women were asked about their preferences for two versions of a trauma-focused group treatment: one that requires sharing their personal memory of sexual victimization (Sharing Required) and one that does not (Sharing Not Required). Study 1 enrolled 88 non-treatment seeking women who evaluated the treatments based on descriptions of the groups. Study 2 was a partially randomized patient preference trial with 85 treatment-seeking women who either agreed to be randomly assigned to one of the two therapy groups or declined randomization and instead were directly assigned to their preferred therapy. Participants in Study 1 evaluated the Sharing Not Required condition more favorably (p &lt; 0.001, Cohen’s d = 0.39). However, the results were affected by PTSD symptom severity as those above the clinical cutoff for probable PTSD evaluated both group treatments more favorably than those below the cutoff (ps &lt; 0.05, Cohen’s ds ≥ 0.46). Study 2 found no significant difference between the proportion of participants who chose Sharing Required, Sharing Not Required, or had no personal preference, and the results did not differ by PTSD symptom severity (ps ≥ 0.70). Outcomes suggest that a variety of forms of trauma-focused therapy may be acceptable to incarcerated women, including those that involve personal narration of trauma memories and those that do not.

Predicting optimal treatment allocation for cognitive analytic-guided self-help versus cognitive behavioural-guided self-help.

Given the ubiquity in routine services of low-intensity guided self-help (GSH) psychological interventions, better patient selection for these brief interventions would be organizationally efficient. This study therefore sought to define who would respond best to two different types of GSH for anxiety to enable better future treatment matching. The study used outcome data from a patient preference trial (N = 209) comparing cognitive analytic therapy-guided self-help (CAT-GSH) with cognitive behavioural therapy-guided self-help (CBT-GSH). Elastic Net regularization and Boruta random forest variable selection methods were applied. Regression models calculated the patient advantage index (PAI) to designate which GSH was likely the most effective for each patient. Outcomes were compared for those receiving their PAI-indicated optimal and non-optimal GSH. Lower baseline depression and anxiety severity predicted better outcomes for both types of GSH. Patient preference status was not associated with outcome during either GSH. Sixty-three % received their model indicating optimal GSH and these had significantly higher rates of reliable and clinically significant reductions in anxiety at both post-treatment (35.9% vs. 16.6%) and follow-up (36.6% vs. 19.2%). No single patient with a large PAI had a reliable and clinically significant reduction in anxiety at post-treatment or follow-up when they did not receive their optimal GSH. Treatment matching algorithms have the potential to support evidenced-based treatment selection for GSH. Treatment selection and supporting patient choice needs to be integrated. Future research needs to investigate the use of the PAI for GSH treatment matching, but with larger and more balanced samples.

Are cows pickier than goats? Linnaeus’s innovative large-scale feeding experiment

Abstract In 1749, Linnaeus published Pan Svecicus, a thesis that was defended by his student Nils Hesselgren. The thesis describes food preference trials in cows, goats, sheep, horses, and pigs, and includes 2325 tests with 643 plant species. The data had surprisingly little bearing on the text in the thesis, and even though the experiments quickly became internationally known, the data were merely repeated, rather than discussed. We have digitized the data and linked the species names to modern nomenclature and present the first analysis and discussion of the results. Pigs were most selective (eating 32% of the 204 plant species that were tested on all animals), followed by horses (59%), cows (66%), sheep (82%), and goats (85%). The ruminants (especially goats and sheep) had high overlap in food choice, and the pigs deviated most (despite the fact that pigs are more closely related to the ruminants than are horses). Among plant orders, Fabales and Poales were generally preferred, while Lamiales and Ranunculales were avoided, especially by cows and horses. Cows and horses were also more keen to avoid toxic plant species. All animals showed a preference for species that are today considered nutritious. We now make the data available, for further analyses in ecology, history of science, and other disciplines.

Asymmetric mate preference and reproductive interference mediate climate-induced changes in mate availability in a small mammal hybrid zone.

Range expansion and contraction are among the most common biotic responses to changing environmental conditions, yet much is to be learned about the mechanisms that underlie range-edge population dynamics, especially when those areas are points of secondary contact between closely related species. Here, we present field-measured parentage data that document the reproductive outcomes of changes in mate availability at a secondary contact zone between two species of woodrat in the genus Neotoma. Changes in mate availability resulted from drought-driven differential survival between the species and their hybrids. As the availability of conspecific mates declined, rates of hybridization increased, leading to the accumulation of admixed individuals in the zone of contact. Patterns of reproductive success in the wild appear to be the result of a combination of both pre-mating isolation and post-zygotic selection resulting from genomic incompatibilities between the parental lineages. Evidence of asymmetric mate preference between the parental lineages came from both skewed reproductive output in the field and laboratory preference trials. Moreover, partial genomic incompatibility was evident from the near-zero reproductive success of F1 males and because nearly all surviving hybrids had one pure parent. Nonetheless, the high reproductive success of F1 females and backcrossing in both parental directions allow for introgression between the parental species. These findings reveal how climate change may alter evolutionary outcomes for species at the edge of their ranges through an interplay of behavioral, demographic, and genetic mechanisms.

Should I stay for local hormone therapy or should I go for radiofrequency to treat vulvovaginal atrophy? A patient preference trial.

To compare patient satisfaction rate in postmenopausal women who chose dynamic quadripolar radiofrequency or topical estrogens as their preferred treatment for genitourinary syndrome of menopause. Patients were divided into two groups according to their preference: one was treated with estrogen therapy (ET) and the other with dynamic quadripolar radiofrequency treatment (RF). All patients included fulfilled a series of validated questionnaires, at baseline and at the 6-mo follow-up, in order to evaluate the discomfort degree associated with the presence of vulvovaginal atrophy and the impact of the reported symptoms on QoL and sexuality. After propensity score matching, the proportion of women considering themselves satisfied with their genital health conditions was extremely small at study entry (5.2% of the RF group and 6.9% of the ET group), while at a 6-mo follow-up, it increased to 46.7% and 46.6%, respectively. No statistically significant between-group differences were found regarding mean numerical rating scale scores for dryness and dyspareunia at follow-up (5.6 ± 2.6 vs 5.3 ± 2.3, P = 0.5; and 2.9 ± 2.5 vs 3.0 ± 2.7, P = 0.46). At 6-mo follow-up, we observed no statistically significant differences between the two groups regarding the other items evaluated. RF treatment was overall well tolerated. The use of quadripolar radiofrequency devices seems effective, but it is not associated with better clinical outcomes compared with topical hormone treatment, which is a substantially cheaper and more convenient treatment for genitourinary syndrome of menopause. Therefore, we suggest limiting the use of dynamic quadripolar radiofrequency selectively when topical estrogens are not effective, not tolerated, or contraindicated.

DCIS knowledge of women choosing between active surveillance and surgery for low-risk DCIS

BackgroundDuctal carcinoma in situ (DCIS) can progress to invasive breast cancer (IBC), but often never will. As we cannot predict accurately which DCIS-lesions will or will not progress to IBC, almost all women with DCIS undergo breast-conserving surgery supplemented with radiotherapy, or even mastectomy. In some countries, endocrine treatment is prescribed as well. This implies many women with non-progressive DCIS undergo overtreatment. To reduce this, the LORD patient preference trial (LORD-PPT) tests whether mammographic active surveillance (AS) is safe by giving women with low-risk DCIS a choice between treatment and AS. For this, sufficient knowledge about DCIS is crucial. Therefore, we assessed women's DCIS knowledge in association with socio-demographic and clinical characteristics. MethodsLORD-PPT participants (N = 376) completed a questionnaire assessing socio-demographic and clinical characteristics, risk perception, treatment choice and DCIS knowledge after being informed about their diagnosis and treatment options. Results66 % of participants had poor knowledge (i.e., answered ≤3 out of 7 knowledge items correctly). Most incorrect answers involved overestimating the safety of AS and misunderstanding of DCIS prognostic risks. Overall, women with higher DCIS knowledge score perceived their risk of developing IBC as being somewhat higher than women with poorer knowledge (p = 0.049). Women with better DCIS knowledge more often chose surgery whilst most women with poorer knowledge chose active surveillance (p = 0.049). DiscussionOur findings show that there is room for improvement of information provision to patients. Decision support tools for patients and clinicians could help to stimulate effective shared decision-making about DCIS management.

Gothenburg Breast reconstruction (GoBreast) II protocol: a Swedish partially randomised patient preference, superiority trial comparing autologous and implant-based breast reconstruction

IntroductionAlthough breast reconstruction is an integral part of breast cancer treatment, there is little high-quality evidence to indicate which method is the most effective. Randomised controlled trials (RCTs) are generally...

The feasibility of a social media-based foot self-management education and support program for adults with diabetes: A partially randomized preference trial

AimTo assess the feasibility of Diabetic Foot Care Group (DFCG), a social media-based self-management education and support intervention, for people with diabetes (PWD) empowerment in diabetes-related foot ulceration prevention. MethodsA partially randomized preference trial was conducted among 32 PWD. DFCG was implemented through Facebook. Participants in the intervention group joined the DFCG in addition to their usual care, while the control group received usual care. Data were collected online using questionnaires on participants' DFCG acceptance, engagement and preliminary efficacy on nine diabetes foot care-related outcomes at baseline, one, and three months post-intervention. ResultsThe participants' study intervention acceptability and engagement rates were 84.2% and 55.2%, respectively. DFCG efficacy rate compared to usual care was 88.9% to 22.2%. Three diabetes foot care-related outcomes increased significantly in the intervention group three-month post-intervention: foot self-care adherence (p = 0.001, ηp2 = 0.35), preventive foot self-care practice (p = 0.002, ηp2 = 0.33), and physical health status (p < 0.02, ηp2 = 0.23). ConclusionDFCG is feasible and could effectively improve diabetes foot care-related outcomes. InnovationSocial media is an innovative approach healthcare professionals could utilize to virtually support PWD in ongoing learning and engagement in optimal foot self-care activities. Trial registrationClinicalTrials.gov, Identifier: NCT04395521

The effectiveness of a protocol without routine radiographs for follow-up of adolescent idiopathic scoliosis patients (CURVE): a study protocol.

Current follow-up protocols for adolescent idiopathic scoliosis (AIS) are based on consensus and consist of regular full-spine radiographs to monitor curve progression and surgical complications. Consensus exists to avoid inappropriate use of radiographs in children. It is unknown whether a standard radiologic follow-up (S-FU) approach is necessary or if a patient-empowered follow-up (PE-FU) approach can reduce the number of radiographs without treatment consequences. A nationwide multicenter pragmatic randomized preference trial was designed for 3 follow-up subgroups (pre-treatment, post-brace, post-surgery) to compare PE-FU and S-FU. 812 patients with AIS (age 10-18 years) will be included in the randomized trial or preference cohorts. Primary outcome is the proportion of radiographs with a treatment consequence for each subgroup. Secondary outcomes consist of the proportion of patients with delayed initiation of treatment due to non-routine radiographic follow-up, radiation exposure, societal costs, positive predictive value, and interrelation of clinical assessment, quality of life, and parameters for initiation of treatment during follow-up. Outcomes will be analyzed using linear mixed-effects models, adjusted for relevant baseline covariates, and are based on intention-to-treat principle. Study summary: (i) a national, multicenter pragmatic randomized trial addressing the optimal frequency of radiographic follow-up in patients with AIS; (ii) first study that includes patient-empowered follow-up; (iii) an inclusive study with 3 follow-up subgroups and few exclusion criteria representative for clinical reality; (iv) preference cohorts alongside to amplify generalizability; (v) first study conducting an economic evaluation comparing both follow-up approaches.

Olfaction foraging in visually oriented tropical arboreal ants Oecophylla smaragdina: Implications for insect predation studies using artificial sentinel prey

AbstractBecause of the brief and cryptic nature of predatory behavior, sentinel prey has been widely adopted as an indirect way to identify predators and understand trophic interactions. However, sentinel prey presents only static visual cues, potentially biasing toward visually oriented predators while ignoring those that utilize other sensory cues for foraging. Despite this, the effectiveness of sentinel prey has rarely been tested. In this study, we focused on the weaver ant Oecophylla smaragdina Fabricius (Hymenoptera: Formicidae), a keystone predator widespread in the Asian and Australian tropics. As this species has large eyes and is known to visually navigate in its arboreal habitats, we hypothesized that it relies on visual cues to forage and that its predatory behavior will be captured by caterpillar‐shaped sentinel prey. Ants were collected as colonies, and preference trials on baits were conducted using combinations of olfactory and static visual cues, including the caterpillar shape. Surprisingly, O. smaragdina showed little or no preference for baits in the absence of olfactory cues and did not differentiate the shapes of baits regardless of olfactory cues. Our results indicate that O. smaragdina is likely to make predatory decisions based primarily on olfactory cues, whereas visual cues might be used for other behaviors. Furthermore, O. smaragdina is likely to be left out by the predation studies using sentinel prey models, which is particularly alarming considering the dominant role of this species in the trophic interactions of tropical rainforests. Our study demonstrates that morphological characteristics, arboreal habitats, and visually oriented behavior do not necessarily suggest the use of static visual cues for predatory decisions. We suggest that sentinel prey models should not be used alone when the dominant predators are unlikely to use visual cues to make predatory decisions.

Add-On Deep Brain Stimulation versus Continued Vagus Nerve Stimulation for Childhood Epilepsy (ADVANCE): A Partially Randomized Patient Preference Trial.

Outcomes following vagus nerve stimulation (VNS) improve over years after implantation in children with drug-resistant epilepsy. The added value of deep brain stimulation (DBS) instead of continued VNS optimization is unknown. In a prospective, non-blinded, randomized patient preference trial of 18 children (aged 8-17 years) who did not respond to VNS after at least 1 year, add-on DBS resulted in greater seizure reduction compared with an additional year of VNS optimization (51.9% vs. 12.3%, p = 0.047). Add-on DBS also resulted in less bothersome seizures (p = 0.03), but no change in quality of life. DBS may be considered earlier for childhood epilepsy after non-response to VNS. ANN NEUROL 2024;96:405-411.

Impact of distinct cognitive domains on gait variability in individuals with mild cognitive impairment and dementia.

Gait variability is a common feature in neurodegenerative diseases and has been linked to cognitive impairment. Despite this link, the influence of specific cognitive domains, such as memory, visual spatial skills, executive function, and verbal function on gait variability is not well-understood. To investigate the predictive value of these specific cognitive domains on gait variability in people with mild cognitive impairment (MCI) and dementia during preferred and dual task walking. One hundred and two participants with either MCI or dementia underwent a comprehensive cognitive assessment and completed preferred and dual-task walking trials on a pressure-sensing walkway. Gait variability was assessed using the PKMAS software. Lower extremity function was evaluated with a self-reported validated scale. Our findings indicate that only visual spatial abilities had a moderate predictive value on gait variability [F (1, 78) = 17.30, p < 0.01, r = 0.43], both in preferred pace walking (70% direct effect) and dual-task walking (90% direct effect) (p's < 0.05). Additionally, lower extremity functional skills had a significant indirect effect (30%) on gait variability in preferred walking contexts. For individuals diagnosed with MCI or dementia, increased gait variability may be driven by deficits in visual spatial processing. An increased understanding of the role of visual spatial processing in gait variability can aid in the assessment and management of individuals with MCI or dementia, potentially leading to targeted interventions to improve mobility and safety.

Black Carp Mylopharyngodon piceus (Richardson, 1846) Mouth Gape and Size Preference of a Bivalve Prey

Black carp Mylopharyngodon piceus (Richardson, 1846) have been widely used as biological control of snails in aquaculture and were imported to the United States in the 1970s and 1980s for this purpose. Prior research emphasizes the species’ propensity to control gastropods, but since subsequent escape and establishment of black carp in portions of the Mississippi River Basin, concerns now focus on the numerous endangered and endemic bivalve species upon which black carp may predate. Black carp mouth gape may limit predation on larger bivalves, but bite force is also a factor. We used regression of fish length to mouth gape of wild-caught black carp and compared these results to tank forage size preference trials with bivalve prey Corbicula fluminea clams. Wild-caught black carp ranged from 429 to 1580 mm total length, a size range larger than measured in previous studies. Regression of fish length and mouth gape indicated greater variability among sizes, as expected from wild versus cultured populations. Clam consumption was size-dependent. Black carp commonly engulfed but did not consume the largest clams in tank feeding trials. Shell width was a better predictor of successful consumption than length or height. Predation was restricted at sizes less than the mouth gape of test black carp as observed by individuals engulfing but failing to consume prey. This result indicates that either bite force or the pharyngeal apparatus gape (i.e., the distance between the pharyngeal teeth and keratinous pad) limited successful crushing of engulfed shells. Bivalve predation by black carp is limited by both a fish’s ability to engulf prey and the ability to fracture the shell of larger prey items that cannot be broken or swallowed whole. The results of this research may be used to assess potential prey sizes of wild black carp and anticipated effects of predation on bivalve communities.

Internet-delivered therapy for alcohol misuse: engagement, satisfaction, and outcomes when patients select their preference for therapist- or self-guided treatment

BackgroundAlcohol misuse is common and causes substantial harm. Internet-delivered cognitive behaviour therapy (ICBT) is effective in reducing alcohol misuse; however, the literature investigating how treatment outcomes are impacted by patients’ preferences for therapist- versus self-guided ICBT for alcohol misuse is sparse.MethodsIn this preference trial, 74 eligible patients (who reported ≥ 14 drinks in the previous week and obtained scores suggesting hazardous or harmful drinking) chose between enrolling in either therapist- or self-guided ICBT for alcohol misuse. We investigated whether those who chose therapist- versus self-guided ICBT differed in their (a) drinking outcomes—as measured by Timeline Follow-Back (TLFB) and heavy drinking days (HDD) at post-treatment and 3-month follow-up—and (b) post-treatment ICBT engagement and satisfaction.ResultsThe majority (81.1%) of eligible patients chose therapist-guided ICBT. These patients reported higher psychotropic medication use, drinking difficulties, and anxiety symptoms. For both the therapist- and self-guided patients, a modified intention-to-treat analysis revealed large within-group treatment effects for TLFB (β = − 2.64, SE 0.66; p < 0.001) and HDD (β = − 0.34, SE 0.07; p < 0.001), with large pre-to-post-treatment Cohen’s effect sizes of d = 0.97 (95% CI [0.49, 1.45]) for TLFB and d = 1.19 (95% CI [0.69, 1.68]) for HDD. The interaction comparing the effects of therapist- to self-guided ICBT over time was not significant for TLFB (p = 0.34) or HDD (p = 0.06). With treatment, for both therapist- and self-guided patients, there was a significant improvement in drinking difficulties, cravings, and confidence with controlling cravings, as well as in anxiety, depression, and functional impairment. Further, the majority (75.7%) of patients completed five or more lessons, as well as reported overall satisfaction with the treatment (88.9%) and increased confidence in managing their symptoms (86.7%); these outcomes also did not differ between therapist- and self-guided patients.ConclusionsThe current study shows that ICBT for alcohol misuse is associated with reduced drinking and comorbid mental health difficulties over time, irrespective of whether patients chose to complete the course on their own or with therapist guidance.Trial registration number: NCT04611854 (https://clinicaltrials.gov/ct2/show/NCT04611854).

Prospective evaluation of patient-reported outcomes of invisible ink tattoos for the delivery of external beam radiation therapy: the PREFER trial.

Invisible ink tattoos (IITs) avoid cosmetic permanence of visible ink tattoos (VITs) while serving as more reliable landmarks for radiation setup than tattooless setups. This trial evaluated patient-reported preference and feasibility of IIT implementation. In an IRB-approved, single institution, prospective trial, patients receiving proton therapy underwent IIT-based treatment setup. A survey tool assessed patient preference on tattoos using a Likert scale. Matched patients treated using our institutional standard tattooless setup were identified; treatment times and image guidance requirements were evaluated between tattooless and IIT-based alignment approaches. Distribution differences were estimated using Wilcoxon rank-sum tests or Chi-square tests. Of 94 eligible patients enrolled, median age was 58 years, and 58.5% were female. Most common treatment sites were breast (18.1%), lung (17.0%) and pelvic (14.9%). Patients preferred to receive IITs versus VITs (79.8% pre-treatment and 75.5% post-treatment, respectively). Patients were willing to travel farther from home to avoid VITs versus IITs (p<0.01). Females were willing to travel (45.5% vs. 23.1%; p=0.04) and pay additional money to avoid VITs (34.5% vs. 5.1%; p<0.01). Per-fraction average +treatment time and time from on table/in room to first beam were shorter with IIT-based vs. tattooless setup (12.3min vs. 14.1min; p=0.04 and 24.1min vs. 26.2min; p=0.02, respectively). In the largest prospective trial on IIT-based radiotherapy setup to date, we found that patients prefer IITs to VITs. Additionally, IIT-based alignment is an effective and efficient strategy in comparison with tattooless setup. Standard incorporation of IITs for patient setup should be strongly considered.

Native ants vary in their use of seeds from a recently introduced myrmecochorous exotic plant

AbstractMyrmecochory is a common mutualism between ants and plants benefiting both partners: ants obtain a nutrient-rich food source, while plants enjoy a host of benefits ranging from enhanced dispersal to protected germination sites. However, this mutualism can be exploited by invasive myrmecochores, where native ants spread invasive plant seeds, possibly to the detriment of native plant assemblages. With the recent introduction of a potentially invasive myrmecochorous plant (Thesium ramosum) in Alberta, Canada, we tested ant interest in T. ramosum. To evaluate both general interest in T. ramosum as a food source, and preference for T. ramosum over other food sources, we collected colonies of four commonly occurring native Formica species and conducted seed removal trials and food preference trials. We then evaluated interest in and preference for T. ramosum seeds through assessing mean rate of seed removal and food item removal, total number of seeds and food items removed, and trends in seed and food item removal through time. We found that while all ant species tested showed interest in T. ramosum, interest level varied among species, and additional factors such as colony size and presence of host species in socially parasitic species influenced interest in T. ramosum. Considering native ant interest in T. ramosum as a food source, it seems plausible that Formica species may act as a dispersal vector for T. ramosum, potentially enhancing its invasiveness.

Muscle activity and rehabilitation in spinal stenosis (MARSS) after conservative therapy and surgical decompression with or without fusion: Protocol for a partially randomized patient preference trial on rehabilitation timing

BackgroundPatients affected by lumbar spinal stenosis (LSS) suffer from a multifactorial degeneration of the lumbar spine resulting in narrowing of the neuroforamina and spinal canal, leading to various functional limitations. It remains unclear whether LSS patients after surgery would benefit from early post-operative rehabilitation, or if a delayed rehabilitation would be more advantageous. The purpose of this partially randomized patient preference trial is to evaluate the impact of post-operative rehabilitation timing as well as surgical intervention type on psychometric properties and functional outcomes in patients with LSS. MethodsData for this patient preference trial are collected before and after surgical (decompression only or decompression and fusion) and rehabilitative interventions as well as six, 12 and 24 months after completing rehabilitation. The study participants are patients diagnosed with LSS who are at least 18 years old. After a medical check-up, participants will complete patient-reported outcome measures (PAREMO-20, SIBAR, FREM-8, SF-12, SFI, ODI) and different functional assessments (functional reach test, loaded reach test, handgrip strength, standing balance control, 6-min walk test). Ethics and disseminationThe results of this study will be published through peer-reviewed publications and scientific contributions at national and international conferences. This research has been approved by the Institutional Review Board of Martin Luther University Halle-Wittenberg (reference number: 2022-128).