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PURPOSE We undertook a trial to test the efficacy of a technology-assisted health coaching intervention for weight management, called Goals for Eating and Moving (GEM), within primary care. METHODS This cluster-randomized controlled trial enrolled 19 primary care teams with 63 clinicians; 9 teams were randomized to GEM and 10 to enhanced usual care (EUC). The GEM intervention included 1 in-person and up to 12 telephone-delivered coaching sessions. Coaches supported goal setting and engagement with weight management programs, facilitated by a software tool. Patients in the EUC arm received educational handouts. We enrolled patients who spoke English or Spanish, were aged 18 to 69 years, and either were overweight (body mass index 25-29 kg/[m.sup.2]) with a weight-related comorbidity or had obesity (body mass index [greater than or equal to] 30 kg/[m.sup.2]). The primary outcome (weight change at 12 months) and exploratory outcomes (eg, program attendance, diet, physical activity) were analyzed according to intention to treat. RESULTS We enrolled 489 patients (220 in the GEM arm, 269 in the EUC arm). Their mean (SD) age was 49.8 (12.1) years; 44% were male, 41% Hispanic, and 44% non- Hispanic Black. At 12 months, the mean adjusted weight change (standard error) was -1.4 (0.8) kg in the GEM arm vs -0.8 (1.6) kg in the EUC arm, a nonsignificant difference (P =.48). There were no statistically significant differences in secondary outcomes. Exploratory analyses showed that the GEM arm had a greater change than the EUC arm in mean number of weekly minutes of moderate to vigorous physical activity other than walking, a finding that may warrant further exploration. CONCLUSIONS The GEM intervention did not achieve clinically important weight loss in primary care. Although this was a negative study possibly affected by health system resource limitations and disruptions, its findings can guide the development of similar interventions. Future studies could explore the efficacy of higher-intensity interventions and interventions that include medication and bariatric surgery options, in addition to lifestyle modification. Key words: obesity; overweight; comorbidity; health coaching; motivation; self-management; primary care; lifestyle; goal setting; diet; weight loss; physical activity; veterans; ethnic and racial minorities; vulnerable populations; barriers; practice-based research; health informatics, https://doi.org/10.1370/afm.3150 INTRODUCTION Obesity is a serious global public health problem. (1,2) Veterans and racial and ethnic minority groups experience considerable disparities in obesity rates (2-4) and are thus at higher [...]

Whiskers (vibrissae) are important tactile sensors for most mammals. We introduce a novel approach to quantitatively compare 3D geometry of whisker arrays across species with different whisker numbers and arrangements, focusing on harbor seals (Phoca vitulina), house mice (Mus musculus) and Norway rats (Rattus norvegicus). Whiskers of all three species decrease in arclength and increase in curvature from caudal to rostral. They emerge from the face with elevation angles that vary linearly with dorsoventral position, and with curvature orientations that vary diagonally as linear combinations of dorsoventral and rostrocaudal positions. In seals, this diagonal varies linearly with horizontal emergence angles, and is orthogonal to the diagonal for rats and mice. This work provides the first evidence for common elements of whisker arrangements across species in different mammalian orders. Placing the equation-based whisker array on a CAD model of a seal head enables future mechanical studies of whisker-based sensing, including wake-tracking., (© 2024. Published by The Company of Biologists Ltd.)

Clinical trials are constantly evolving in the context of increasingly complex research questions and potentially limited resources. In this review article, we discuss the emergence of "adaptive" clinical trials that allow for the preplanned modification of an ongoing clinical trial based on the accumulating evidence with application across translational research. These modifications may include terminating a trial before completion due to futility or efficacy, re-estimating the needed sample size to ensure adequate power, enriching the target population enrolled in the study, selecting across multiple treatment arms, revising allocation ratios used for randomization, or selecting the most appropriate endpoint. Emerging topics related to borrowing information from historic or supplemental data sources, sequential multiple assignment randomized trials (SMART), master protocol and seamless designs, and phase I dose-finding studies are also presented. Each design element includes a brief overview with an accompanying case study to illustrate the design method in practice. We close with brief discussions relating to the statistical considerations for these contemporary designs., Competing Interests: The authors have no conflicts of interest to declare., (© The Author(s) 2023.)