Participant retention practices in longitudinal clinical research studies with high retention rates

Abstract Background There is a need for improving cohort retention in longitudinal studies. Our objective was to identify cohort retention strategies and implementation approaches used in studies with high retention rates. Methods Longitudinal studies with ≥200 participants, ≥80% retention rates over ≥1 year of follow-up were queried from an Institutional Review Board database at a large research-intensive U.S. university; additional studies were identified through networking. Nineteen (86%) of 22 eligible studies agreed to participate. Through in-depth semi-structured interviews, participants provided retention strategies based on themes identified from previous literature reviews. Synthesis of data was completed by a multidisciplinary team. Results The most commonly used retention strategies were: study reminders, study visit characteristics, emphasizing study benefits, and contact/scheduling strategies. The research teams were well-functioning, organized, and persistent. Additionally, teams tailored their strategies to their participants, often adapting and innovating their approaches. Conclusions These studies included specialized and persistent teams and utilized tailored strategies specific to their cohort and individual participants. Studies’ written protocols and published manuscripts often did not reflect the varied strategies employed and adapted through the duration of study. Appropriate retention strategy use requires cultural sensitivity and more research is needed to identify how strategy use varies globally

HgCdTe Avalanche Photodiode Array Detectors with Single Photon Sensitivity and Integrated Detector Cooler Assemblies for Space Lidar Applications

A HgCdTe avalanche photodiode (APD) focal plane array assembly with linear mode photon-counting capability has been developed for space lidar applications. An integrated detector cooler assembly (IDCA) has been built using a miniature Stirling cooler. A microlens array has been included to improve the fill factor. The HgCdTe APD has a spectral response from 0.9- to 4.3-m wavelengths, a photon detection efficiency as high as 70%, and a dark count rate of <250 kHz at 110 K. The mass of the IDCA is 0.8 kg and the total electrical power consumption is about 7 W. The HgCdTe APD arrays have been characterized at NASA Goddard Space Flight Center. A series of environmental tests have been conducted for the IDCAs, including vibration, thermal cycling, and thermal vacuum tests. A description of the device and the test results at NASA are given in this paper

Trends in Venous Thromboembolism Anticoagulation in Patients Hospitalized With COVID-19

Importance: Venous thromboembolism (VTE) is a common complication of COVID-19. It is not well understood how hospitals have managed VTE prevention and the effect of prevention strategies on mortality. Objective: To characterize frequency, variation across hospitals, and change over time in VTE prophylaxis and treatment-dose anticoagulation in patients hospitalized for COVID-19, as well as the association of anticoagulation strategies with in-hospital and 60-day mortality. Design, Setting, and Participants: This cohort study of adults hospitalized with COVID-19 used a pseudorandom sample from 30 US hospitals in the state of Michigan participating in a collaborative quality initiative. Data analyzed were from patients hospitalized between March 7, 2020, and June 17, 2020. Data were analyzed through March 2021. Exposures: Nonadherence to VTE prophylaxis (defined as missing ≥2 days of VTE prophylaxis) and receipt of treatment-dose or prophylactic-dose anticoagulants vs no anticoagulation during hospitalization. Main Outcomes and Measures: The effect of nonadherence and anticoagulation strategies on in-hospital and 60-day mortality was assessed using multinomial logit models with inverse probability of treatment weighting. Results: Of a total 1351 patients with COVID-19 included (median [IQR] age, 64 [52-75] years; 47.7% women, 48.9% Black patients), only 18 (1.3%) had a confirmed VTE, and 219 (16.2%) received treatment-dose anticoagulation. Use of treatment-dose anticoagulation without imaging ranged from 0% to 29% across hospitals and increased over time (adjusted odds ratio [aOR], 1.46; 95% CI, 1.31-1.61 per week). Of 1127 patients who ever received anticoagulation, 392 (34.8%) missed 2 or more days of prophylaxis. Missed prophylaxis varied from 11% to 61% across hospitals and decreased markedly over time (aOR, 0.89; 95% CI, 0.82-0.97 per week). VTE nonadherence was associated with higher 60-day (adjusted hazard ratio [aHR], 1.31; 95% CI, 1.03-1.67) but not in-hospital mortality (aHR, 0.97; 95% CI, 0.91-1.03). Receiving any dose of anticoagulation (vs no anticoagulation) was associated with lower in-hospital mortality (only prophylactic dose: aHR, 0.36; 95% CI, 0.26-0.52; any treatment dose: aHR, 0.38; 95% CI, 0.25-0.58). However, only the prophylactic dose of anticoagulation remained associated with lower mortality at 60 days (prophylactic dose: aHR, 0.71; 95% CI, 0.51-0.90; treatment dose: aHR, 0.92; 95% CI, 0.63-1.35). Conclusions and Relevance: This large, multicenter cohort of patients hospitalized with COVID-19, found evidence of rapid dissemination and implementation of anticoagulation strategies, including use of treatment-dose anticoagulation. As only prophylactic-dose anticoagulation was associated with lower 60-day mortality, prophylactic dosing strategies may be optimal for patients hospitalized with COVID-19

U.S. Inhibitor Pilot Project: Study Design And Methods Validation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106090/1/jth01876.pd

Radiation tolerance of GaAs1-xSbx solar cells

High radiation tolerance of GaAs1-xSbx based solar cells is demonstrated for the low-intensity-low-temperature (LILT) conditions of the target planets Saturn, Jupiter, and Mars. The GaAs1-xSbx-based cells are irradiated with high energy electrons to assess the effect of harsh radiation environment on the solar cell and the response of the cell is then investigated in terms of its photovoltaic operation. This system shows significant radiation resistance to the high energy electron environment for the conditions of the planets of interest. An unusual increase of the short circuit current after irradiation is observed at low temperature, which is supported by a simultaneous increase in the external quantum efficiency of the cell under the same conditions. The open circuit voltage and fill factor of the cell are especially tolerant to irradiation, which is also reflected in unchanged dark current-voltage characteristics of the solar cell upon irradiation particularly at LILT

Radiation tolerance of GaAs1-xSbx solar cells: A candidate III-V system for space applications

The high radiation tolerance of GaAs0.86Sb0.14 based solar cells with a band gap suitable for PV is demonstrated at the low intensity low temperature (LILT) conditions. This system shows remarkable radiation hardness at AM0, and more prominently, at the conditions of several outer planetary targets. This is attributed to an irradiation induced change in the absorber band gap due to local heating and strain relaxation, and the generation of less prohibitive shallow Sb-based defects in the GaAs 1-x Sb x absorber

Nucleon-nucleon elastic scattering analysis to 2.5 GeV

A partial-wave analysis of NN elastic scattering data has been completed. This analysis covers an expanded energy range, from threshold to a laboratory kinetic energy of 2.5 GeV, in order to include recent elastic pp scattering data from the EDDA collaboration. The results of both single-energy and energy-dependent analyses are described.Comment: 23 pages of text. Postscript files for the figures are available from ftp://clsaid.phys.vt.edu/pub/said/n

Profiling tropospheric CO_2 using Aura TES and TCCON instruments

Monitoring the global distribution and long-term variations of CO_2 sources and sinks is required for characterizing the global carbon budget. Total column measurements are useful for estimating regional-scale fluxes; however, model transport remains a significant error source, particularly for quantifying local sources and sinks. To improve the capability of estimating regional fluxes, we estimate lower tropospheric CO_2 concentrations from ground-based near-infrared (NIR) measurements with space-based thermal infrared (TIR) measurements. The NIR measurements are obtained from the Total Carbon Column Observing Network (TCCON) of solar measurements, which provide an estimate of the total CO_2 column amount. Estimates of tropospheric CO_2 that are co-located with TCCON are obtained by assimilating Tropospheric Emission Spectrometer (TES) free tropospheric CO_2 estimates into the GEOS-Chem model. We find that quantifying lower tropospheric CO_2 by subtracting free tropospheric CO_2 estimates from total column estimates is a linear problem, because the calculated random uncertainties in total column and lower tropospheric estimates are consistent with actual uncertainties as compared to aircraft data. For the total column estimates, the random uncertainty is about 0.55 ppm with a bias of −5.66 ppm, consistent with previously published results. After accounting for the total column bias, the bias in the lower tropospheric CO_2 estimates is 0.26 ppm with a precision (one standard deviation) of 1.02 ppm. This precision is sufficient for capturing the winter to summer variability of approximately 12 ppm in the lower troposphere; double the variability of the total column. This work shows that a combination of NIR and TIR measurements can profile CO_2 with the precision and accuracy needed to quantify lower tropospheric CO_2 variability

Proton-proton scattering above 3 GeV/c

A large set of data on proton-proton differential cross sections, analyzing powers and the double polarization parameter A_NN is analyzed employing the Regge formalism. We find that the data available at proton beam momenta from 3 GeV/c to 50 GeV/c exhibit features that are very well in line with the general characteristics of Regge phenomenology and can be described with a model that includes the rho, omega, f_2, and a_2 trajectories and single Pomeron exchange. Additional data, specifically for spin-dependent observables at forward angles, would be very helpful for testing and refining our Regge model.Comment: 16 pages, 19 figures; revised version accepted for publication in EPJ

Motivational interviewing for low mood and adjustment early after stroke: a feasibility randomised trial

Background Management of psychological adjustment and low mood after stroke can result in positive health outcomes. We have adapted a talk-based therapy, motivational interviewing (MI), and shown it to be potentially effective for managing low mood and supporting psychological adjustment post-stroke in a single-centre trial. In the current study, we aimed to explore the feasibility of delivering MI using clinical stroke team members, and using an attention control (AC), to inform the protocol for a future definitive trial. Methods This parallel two-arm feasibility trial took place in north-west England. Recruitment occurred between December 2012 and November 2013. Participants were stroke patients aged 18 years or over, who were medically stable, had no severe communication problems, and were residents of the hospital catchment. Randomisation was to MI or AC, and was conducted by a researcher not involved in recruitment using opaque sealed envelopes. The main outcome measures were descriptions of study feasibility (recruitment/retention rates, MI delivery by clinical staff, use of AC) and acceptability (through qualitative interviews and completion of study measures), and fidelity to MI and AC (through review of session audio-recordings). Information was also collected on participants’ mood, quality of life, adjustment, and resource-use. Results Over 12 months, 461 patients were screened, 124 were screened eligible, and 49 were randomised: 23 to MI, 26 to AC. At 3 months, 13 MI and 18 AC participants completed the follow-up assessment (63% retention). This was less than expected based on our original trial. An AC was successfully implemented. Alternative approaches would be required to ensure the feasibility of clinical staff delivering MI. The study measures, MI, and AC interventions were considered acceptable, and there was good fidelity to the interventions. There were no adverse events related to study participation. Conclusions It was possible to recruit and retain participants, train clinical staff to deliver MI, and implement an appropriate AC. Changes would be necessary to conduct a future multi-centre trial, including: assuming a recruitment rate lower than that in the current study; implementing more strategies to increase participant retention; and considering alternative clinical staff groups to undertake the delivery of MI and AC