Preference Trials Research Articles

Many people with mental health problems do not receive the care they need. Digital mental health interventions have been shown to be effective in many trials and offer a promising way to reach more people in need. However, their uptake and use remain limited, in part due to concerns about data privacy. However, these concerns may not be equally significant for all users. This trial aims to evaluate the efficacy of an anonymous online self-help tool for social anxiety that processes no personal data and has some disadvantages in terms of usability compared to an otherwise identical, nonanonymous evidence-based tool. Furthermore, the trial will investigate user preferences regarding the 2 program versions and evaluate the impact of these preferences on treatment outcomes. In this partially randomized patient preference trial, 2 versions (anonymous vs nonanonymous) of the same previously researched program will be compared among 452 participants with increased levels of social anxiety. Half of the participants will be randomized to one of the program versions, whereas the other half will be assigned to their preferred version. The primary outcome is social anxiety symptoms. Secondary outcomes include depression, stigma of mental illness, and quality of life. Recruitment started in September 2024. As of the date of manuscript submission in May 2025, over 350 participants have been included in the study. Recruitment ended in September 2025, and results are expected to be available and published in 2026. The results of this trial will determine whether anonymously accessible interventions, which could easily be made freely available, are less efficacious than their nonanonymous counterparts and will explore the impact of user preferences on treatment outcomes. The findings could contribute to making digital interventions more accessible and tailoring interventions to individual preferences. ClinicalTrials.gov NCT06465589; https://clinicaltrials.gov/study/NCT06465589. DERR1-10.2196/77573.

Factors Influencing Initial Trial Planning for Low Back Pain Among Veterans Health Administration Chiropractors: A Descriptive Observational Survey.

Simple SummaryGiant pandas are conservation reliant. Natural mating is more successful than artificial insemination. Mate preference is a critical factor in the natural reproduction of giant pandas, but it is poorly understood. Given the importance of improving the reproductive efficiency of the giant panda, this study focused on the physiological and metabolic changes in female giant pandas during mate preference trials conducted at estrus. In this study, we collected environmental biomarkers from 19 female pandas during mate preference trials with 3 males and performed metabolomics analysis. We identified several differential metabolites, including prostaglandin G2, prostaglandin E2, and estrone, which are potentially associated with female mate preference. In addition, through KEGG pathway enrichment analysis, we found that female mate preference was related to steroid hormone biosynthesis, phenylalanine metabolism, and tropane, piperidine and pyridine alkaloid biosynthesis. These results reveal potential physiological markers related to female mate preference, providing insights for formulating effective conservation and breeding strategies for the giant panda.The giant panda (Ailuropoda melanoleuca) is a vulnerable animal in China, and it is crucial to improve the reproduction efficiency of the giant panda. Mate preference is an important part of natural mating. We hypothesized that AGS metabolites differ according to their mate preference. In this study, we determined estrus-associated hormone levels in the urine of 19 female giant pandas. After confirming estrus via hormone levels and behavioral observation, we collected environmental biomarkers for metabolomics analysis. A total of 19 samples were divided to two groups according to the mating preference of female giant pandas. Metabolomics analysis by LC-MS/MS showed that a total of 115 differentially expressed metabolites were identified, including 97 upregulated metabolites and 18 downregulated metabolites. We found that prostaglandin B2, palmitoylcarnitine, prostaglandin G2, and estrone may be the potential markers of female mate preference. Pathway enrichment analysis showed that steroid hormone biosynthesis, phenylalanine metabolism, and tropane, piperidine, and pyridine alkaloid biosynthesis were the top three pathways. These results revealed the physiological changes in female giant pandas during mate preference trials, providing a perspective for understanding their chemical communication system reliant on anal gland secretions and improving the success rate of natural mating of giant pandas.

Injectable buprenorphine during transition out of prison: A pilot partially randomized preference trial protocol.

Patient preference trials in oncology: a scoping review and recommendations on reporting.

The house fly, Musca domestica L., plays a crucial role as a mechanical vector for a variety of pathogens that impact both humans and animals, highlighting the need for effective control measures. Conventional approaches, including sanitation and waste management, exhibit certain constraints, resulting in a dependence on synthetic insecticides that carry potential risks of toxicity and the development of resistance. This research examined the lethal and behavioral effects of Cinnamomum verum (cinnamon) extracts on house flies, employing an age-stage two-sex life table methodology to evaluate life table parameters. The analysis utilizing gas chromatography-mass spectrometry (GC-MS) revealed significant phytochemicals present in cinnamon bark, such as cinnamaldehyde and eugenol, which are recognized for their insecticidal and behavioral effects in insects. Acute toxicity assessments demonstrated lethal concentrations (LC5, LC25, and control) of cinnamon extracts, significantly affecting developmental and reproductive parameters. Interestingly, lower concentrations (LC5) promoted fecundity and intrinsic growth rates compared to higher concentrations (LC25), suggesting a biphasic response that aligns with the concept of pesticide-induced hormesis. Furthermore, oviposition preference trials confirmed a concentration-dependent deterrent effect of cinnamon extracts, with higher doses significantly reducing egg-laying behavior in gravid females. This research has included traditional GC-MS-based phytochemical screening by incorporating comprehensive biological and molecular assessments, offering a more integrated approach for biopesticide identification. The identification of phytochemicals like cinnamaldehyde and α-muurolene establishes a robust basis for the screening of additional bioactive compounds and exploring novel insecticidal agents.

Randomized controlled trial(RCT) is considered to represent the gold standard for evaluating the efficacy of interventions and has been widely used to evaluate the clinical efficacy of traditional Chinese medicine(TCM). However, there are unique challenges in implementing RCT in TCM. Patients seeking TCM treatment often have preferences for TCM due to the unsatisfactory therapeutic effect of western medicine, their personal intolerance, and their rejection of certain drugs, medical devices, or surgery. Patients are generally reluctant to be randomly assigned to a group, making it challenging to enroll patients in the control group of western medicine during the implementation of RCT in TCM. This has become a prominent problem restricting the implementation of RCT in TCM and needs to be solved urgently. Therefore, this paper introduced commonly used research designs used in solving the problem of enrolling patients in control group during the implementation of RCT in TCM, including Zelen design, partially randomized patient preference trial(PRPP), single-arm objective performance criteria(OPC), cohort studies, single-arm clinical trials using real world data(RWD) alone as the external control group, and the design method based on RWD-augmented control group samples in RCT. The paper outlined the definitions and principles of these methods, evaluated their advantages, disadvantages, and applicable scenarios, and explored their applications in the TCM field, so as to offer insights for solving the difficulty in enrolling patients in the control group during the implementation of RCT in TCM.

Prescribing methadone in prison predicts linkage to HIV care after release from prison: A randomized and patient preference trial.

Internet-delivered cognitive behaviour therapy for university students: Preference trial for various course durations

<p><strong>Context and relevance.</strong> Development of optimal eye movement strategies at preschool age is essential for future academic and social performance. <strong>Objective.</strong> To clarify the relationships between the perceptual actions and executive functions in preschoolers of different ages. <strong>Hypothesis.</strong> The level of executive functions makes a significant contribution to the peculiarities of eye movement strategies in preschoolers of different ages. <strong>Methods and materials.</strong> The study involved 34 preschoolers 4-5 years old (average age — 4.3 years) and 28 preschoolers 6-7 years old (average age — 6.3 years). Participants’ executive functions were assessed with the NEPSY-II subtests, as well as the tests "The Dimensional Change Card Sort" and "Walk a Line Slowly". Next, 3 toy preference trials were conducted with each participant. The toys were presented on the laptop screen. Within each trial, the oculomotor activity of children was recorded using a stationary GP3 eye tracker. <strong>Results.</strong> The results have showed that senior preschoolers are characterized by a more abbreviated and minimized information processing strategy with concentrated, relevant fixations on target areas than 4-5 years old preschoolers. It was revealed that these features of visual information processing are associated with the auditory working memory, cognitive flexibility and cognitive inhibitory control. At the same time, high level of cognitive flexibility is a predictor of more optimal strategies, regardless of age. <strong>Conclusions. </strong>The results point to the developing potential of executive functions, in particular cognitive flexibility, in correcting visual information processing strategies in preschoolers. The research opens up prospects for creating psychological and pedagogical programs, exercises for the visual perception development.</p>

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.

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.

Mycotoxins in feed are known to negatively affect growth and other physiological processes in pigs. Two experiments were conducted to investigate the effects of feeding diets with varying levels of mycotoxins and boron (a nutrient reported to mitigate some aspects of mycotoxicosis). Screenings from the 2020 crop year corn contained mycotoxin levels of 23,038 ppb total fumonisins (FUM), 1,446 ppb zearalenone (ZEA), and 5,032 ppb total deoxynivalenol (DON). The corn fines were added to a corn-soybean meal diet formulated to meet or exceed NRC (National Research Council. 2012. Nutrient requirements of swine. 11th Revised Edition. Washington, DC: The National Academies Press. doi:10.17226/13298) nutrient requirements as a replacement for corn at 0, 10, and 20% for Diets 1 to 3. Diets 4 to 6 were Diets 1 to 3, respectively, plus 40ppm boron from sodium tetraborate decahydrate. Diets 3 and 6 were formulated to approximate the guidance level of fumonisin and the advisory level of DON stated by the FDA. Exp. 1 used 48 crossbred pigs (initial body weight [BW] = 9.18kg ± 0.12kg) blocked by sex and BW and randomly allotted to 1 of 3 treatment comparisons: Comparison 1) Diet 1 vs. Diet 2; Comparison 2) Diet 1 vs. Diet 3; and Comparison 3) Diet 2 vs. Diet 3. There were 4 replicates (4 pigs/pen) for the 21-d preference trial. Exp. 2 used 144 crossbred pigs (mean initial BW = 10.20 ± 0.23kg) blocked by sex and BW and randomly allotted to diets for a total of 6 replicates (4 pigs/pen) for a 21-d growth trial. On d 21, serum was collected from the heaviest and lightest pig in each pen for clinical chemistry assessment. Exp. 1 demonstrated the barrows' ability to discern between diets in Comparisons 2 and 3 (P < 0.01) for each week while gilts only started to exhibit that ability during Week 3 for Comparison 2 (P = 0.06). Increasing mycotoxin levels in Exp. 2 had no effect on overall ADG, ADFI, and G:F (P = 0.16, 0.53, and 0.92, respectively). The increasing mycotoxin levels affected serum glucose and cholesterol (P = 0.03, and P < 0.01, respectively). There was no effect of boron on the same performance measures (P = 0.81, 0.59, and 0.76, respectively) although it did lower serum glucose (P = 0.02). In conclusion, pigs can differentiate and choose between diets containing these mixed mycotoxins but when not given a choice, the pigs do not necessarily have different growth performance using the particular mycotoxins and concentrations within the framework of this assessment.

Growing evidence highlights the critical role of patient choice of treatment, with significant benefits for outcomes found in some studies. While four meta-analyses have previously examined the association between treatment choice and outcomes in mental health, robust conclusions have been limited by the inclusion of studies with biased preference trial designs. The current systematic review included 30 studies across three common and frequently comorbid mental health disorders (depression N=23; anxiety, N=5; eating disorders, N=2) including 7055 participants (Mage 42.5years, SD 11.7; 69.5% female). Treatment choice most often occurred between psychotherapy and antidepressant medication (43.3%), followed by choice between two different forms of psychotherapy, or elements within psychotherapy (36.7%). There were insufficient studies with stringent designs to conduct meta-analyses for anxiety or eating disorders as outcomes, or for treatment uptake. Treatment choice significantly improved outcomes for depression (d=0.17, n=18) and decreased therapy dropout, both in a combined sample targeting depression (n=12), anxiety (n=4) and eating disorders (n=1; OR=1.46, 95% CI: 1.17, 1.83), and in a smaller sample of the depression studies alone (OR=1.65, 95% CI: 1.05, 2.59). All studies evaluated the impact of adults making treatment choices with none examining the effect of choice in adolescents. Clear directions in future research are indicated, in terms of designing studies that can adequately test the treatment choice and outcome association in anxiety and eating disorder treatment, and in youth.

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

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.

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.

Abstract Licorice of the taxonomic genus Glycyrrhiza is a traditional Chinese medicinal plant. Its large-scale cultivation is threatened by insect pests, including the whitefly Bemisia tabaci Gennadius (Hemiptera: Aleyrodidae). Our study (1) examined the preference of B. tabaci for G. uralensis Fischer ex de Candolle, G. glabra L., and G. inflata Batalin through caged trials; (2) identified the volatile organic compounds (VOCs) released by the three Glycyrrhiza species using headspace gas chromatography–mass spectrometry (HS-GC-MS); and (3) screened the olfactory behavior responses of B. tabaci to the key VOCs identified. The caged host preference trial showed that B. tabaci had a clear preference for G. uralensis over G. inflata and G. glabra. Through HS-GC-MS analysis, we identified 26, 33, and 31 VOCs from G. uralensis, G. glabra, and G. inflata, respectively. (3Z)-Hexen-3-ene-1-yl acetate, trans-3-hexen-1-ol, cis-3-hexen-1-ol, 3-carene, and β-pinene were selected for further olfactory response assays on the basis of variable importance projection values and quantity differences. From these, we learned that cis-3-hexene-1-ol and trans-3-hexene-1-ol, abundant in G. uralensis, attract B. tabaci, whereas 3-carene and β-pinene, abundant in G. inflata, repel B. tabaci. The different VOCs from these three species of licorice may be primary factors affecting the preference for and feeding on cultivated licorice by B. tabaci. Our results will facilitate studies on the potential of using selected VOCs for managing B. tabaci, perhaps in push–pull strategies of their use against the pest.

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.

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.