Feedback from activity trackers improves daily step count after knee and hip arthroplasty: A randomized controlled trial

Background: Commercial wrist-worn activity monitors have the potential to accurately assess activity levels and are being increasingly adopted in the general population. The aim of this study was to determine if feedback from a commercial activity monitor improves activity levels over the first 6 weeks after total hip arthroplasty (THA) or total knee arthroplasty (TKA). Methods: One hundred sixty-three consecutive subjects undergoing primary TKA or THAwere randomized into 2 groups. Subjects received an activity tracker with the step display obscured 2 weeks before surgery and completed patient-reported outcome measures (PROMs). On day 1 after surgery, participants were randomized to either the “feedback (FB) group” or the “no feedback (NFB) group.” The FB group was able to view their daily step count and was given a daily step goal. Participants in the NFB group wore the device with the display obscured for 2 weeks after surgery, after which time they were also able to see their daily step count but did not receive a formal step goal. The mean daily steps at 1, 2, 6 weeks, and 6 months were monitored. At 6 months after surgery, subjects repeated PROMs and daily step count collection. Results: Of the 163 subjects, 95 underwent THA and 68 underwent TKA. FB subjects had a significantly higher (P \u3c .03) mean daily step count by 43% in week 1, 33% in week 2, 21% in week 6, and 17% at 6 months, compared with NFB. The FB subjects were 1.7 times more likely to achieve a mean 7000 steps per day than the NFB subjects at 6 weeks after surgery (P ¼ .02). There was no significant difference between the groups in PROMs at 6 months. Ninety percent of FB and 83% of NFB participants reported that they were satisfied with the results of the surgery (P ¼ .08). At 6 months after surgery, 70% of subjects had a greater mean daily step count compared with their preoperative level. Conclusion: Subjects who received feedback from a commercial activity tracker with a daily step goal had significantly higher activity levels after hip and knee arthroplasty over 6 weeks and 6 months, compared with subjects who did not receive feedback in a randomized controlled trial. Commercial activity trackers may be a useful and effective adjunct after arthroplasty

Simulations of Mixed Morphology Supernova Remnants With Anisotropic Thermal Conduction

We explore the role of anisotropic thermal conduction on the evolution of supernova remnants through interstellar media with a range of densities via numerical simulations. We find that a remnant expanding in a dense environment can produce centre-bright hard x-ray emission within 20 kyr, and centre-bright soft x-ray emission within 60 kyr of the supernova event. In a more tenuous environment, the appearance of a centre-bright structure in hard x-rays is delayed until about 60 kyr. The soft x-ray emission from such a remnant may not become centre bright during its observable lifetime. This can explain the observations that show that mixed-morphology supernova remnants preferentially occur close to denser, molecular environments. Remnants expanding into denser environments tend to be smaller, making it easier for thermal conduction to make larger changes in the temperatures of their hot gas bubbles. We show that the lower temperatures make it very favorable to use high-stage ions as diagnostics of the hot gas bubbles in SNRs. In particular, the distribution of O VIII transitions from shell-bright at early epochs to centre-bright at later epochs in the evolution of an SNR expanding in a dense ISM when the physics of thermal conduction is included.Comment: 8 pages, 5 figures, submitted to Monthly Notice

A class of residual distribution schemes and their relation to relaxation systems

Residual distributions (RD) schemes are a class of of high-resolution finite volume methods for unstructured grids. A key feature of these schemes is that they make use of genuinely multidimensional (approximate) Riemann solvers as opposed to the piecemeal 1D Riemann solvers usually employed by finite volume methods. In 1D, LeVeque and Pelanti [J. Comp. Phys. 172, 572 (2001)] showed that many of the standard approximate Riemann solver methods (e.g., the Roe solver, HLL, Lax-Friedrichs) can be obtained from applying an exact Riemann solver to relaxation systems of the type introduced by Jin and Xin [Comm. Pure Appl. Math. 48, 235 (1995)]. In this work we extend LeVeque and Pelanti's results and obtain a multidimensional relaxation system from which multidimensional approximate Riemann solvers can be obtained. In particular, we show that with one choice of parameters the relaxation system yields the standard N-scheme. With another choice, the relaxation system yields a new Riemann solver, which can be viewed as a genuinely multidimensional extension of the local Lax-Friedrichs scheme. This new Riemann solver does not require the use Roe-Struijs-Deconinck averages, nor does it require the inversion of an m-by-m matrix in each computational grid cell, where $m$ is the number of conserved variables. Once this new scheme is established, we apply it on a few standard cases for the 2D compressible Euler equations of gas dynamics. We show that through the use of linear-preserving limiters, the new approach produces numerical solutions that are comparable in accuracy to the N-scheme, despite being computationally less expensive.Comment: 46 pages, 14 figure

Weak Lensing from Space I: Instrumentation and Survey Strategy

A wide field space-based imaging telescope is necessary to fully exploit the technique of observing dark matter via weak gravitational lensing. This first paper in a three part series outlines the survey strategies and relevant instrumental parameters for such a mission. As a concrete example of hardware design, we consider the proposed Supernova/Acceleration Probe (SNAP). Using SNAP engineering models, we quantify the major contributions to this telescope's Point Spread Function (PSF). These PSF contributions are relevant to any similar wide field space telescope. We further show that the PSF of SNAP or a similar telescope will be smaller than current ground-based PSFs, and more isotropic and stable over time than the PSF of the Hubble Space Telescope. We outline survey strategies for two different regimes - a ``wide'' 300 square degree survey and a ``deep'' 15 square degree survey that will accomplish various weak lensing goals including statistical studies and dark matter mapping.Comment: 25 pages, 8 figures, 1 table, replaced with Published Versio

Supernova / Acceleration Probe: A Satellite Experiment to Study the Nature of the Dark Energy

The Supernova / Acceleration Probe (SNAP) is a proposed space-based experiment designed to study the dark energy and alternative explanations of the acceleration of the Universe's expansion by performing a series of complementary systematics-controlled measurements. We describe a self-consistent reference mission design for building a Type Ia supernova Hubble diagram and for performing a wide-area weak gravitational lensing study. A 2-m wide-field telescope feeds a focal plane consisting of a 0.7 square-degree imager tiled with equal areas of optical CCDs and near infrared sensors, and a high-efficiency low-resolution integral field spectrograph. The SNAP mission will obtain high-signal-to-noise calibrated light-curves and spectra for several thousand supernovae at redshifts between z=0.1 and 1.7. A wide-field survey covering one thousand square degrees resolves ~100 galaxies per square arcminute. If we assume we live in a cosmological-constant-dominated Universe, the matter density, dark energy density, and flatness of space can all be measured with SNAP supernova and weak-lensing measurements to a systematics-limited accuracy of 1%. For a flat universe, the density-to-pressure ratio of dark energy can be similarly measured to 5% for the present value w0 and ~0.1 for the time variation w'. The large survey area, depth, spatial resolution, time-sampling, and nine-band optical to NIR photometry will support additional independent and/or complementary dark-energy measurement approaches as well as a broad range of auxiliary science programs. (Abridged)Comment: 40 pages, 18 figures, submitted to PASP, http://snap.lbl.go

Physiological changes to the swallowing mechanism following (Chemo)radiotherapy for head and neck cancer: a systematic review

Emerging research suggests that preventative swallowing rehabilitation, undertaken before or during (chemo)radiotherapy ([C]RT), can significantly improve early swallowing outcomes for head and neck cancer (HNC) patients. However, these treatment protocols are highly variable. Determining specific physiological swallowing parameters that are most likely to be impacted post-(C)RT would assist in refining clear targets for preventative rehabilitation. Therefore, this systematic review (1) examined the frequency and prevalence of physiological swallowing deficits observed post-(C)RT for HNC, and (2) determined the patterns of prevalence of these key physiological deficits over time post-treatment. Online databases were searched for relevant papers published between January 1998 and March 2013. A total of 153 papers were identified and appraised for methodological quality and suitability based on exclusionary criteria. Ultimately, 19 publications met the study’s inclusion criteria. Collation of reported prevalence of physiological swallowing deficits revealed reduced laryngeal excursion, base-of-tongue (BOT) dysfunction, reduced pharyngeal contraction, and impaired epiglottic movement as most frequently reported. BOT dysfunction and impaired epiglottic movement showed a collective prevalence of over 75 % in the majority of patient cohorts, whilst reduced laryngeal elevation and pharyngeal contraction had a prevalence of over 50 %. Subanalysis suggested a trend that the prevalence of these key deficits is dynamic although persistent over time. These findings can be used by clinicians to inform preventative intervention and support the use of specific, evidence-based therapy tasks explicitly selected to target the highly prevalent deficits post-(C)RT for HNC

The effectiveness of interventions to change six health behaviours: a review of reviews

Background: Several World Health Organisation reports over recent years have highlighted the high incidence of chronic diseases such as diabetes, coronary heart disease and cancer. Contributory factors include unhealthy diets, alcohol and tobacco use and sedentary lifestyles. This paper reports the findings of a review of reviews of behavioural change interventions to reduce unhealthy behaviours or promote healthy behaviours. We included six different health-related behaviours in the review: healthy eating, physical exercise, smoking, alcohol misuse, sexual risk taking (in young people) and illicit drug use. We excluded reviews which focussed on pharmacological treatments or those which required intensive treatments (e. g. for drug or alcohol dependency). Methods: The Cochrane Library, Database of Abstracts of Reviews of Effectiveness (DARE) and several Ovid databases were searched for systematic reviews of interventions for the six behaviours (updated search 2008). Two reviewers applied the inclusion criteria, extracted data and assessed the quality of the reviews. The results were discussed in a narrative synthesis. Results: We included 103 reviews published between 1995 and 2008. The focus of interventions varied, but those targeting specific individuals were generally designed to change an existing behaviour (e. g. cigarette smoking, alcohol misuse), whilst those aimed at the general population or groups such as school children were designed to promote positive behaviours (e. g. healthy eating). Almost 50% (n = 48) of the reviews focussed on smoking (either prevention or cessation). Interventions that were most effective across a range of health behaviours included physician advice or individual counselling, and workplace- and school-based activities. Mass media campaigns and legislative interventions also showed small to moderate effects in changing health behaviours. Generally, the evidence related to short-term effects rather than sustained/longer-term impact and there was a relative lack of evidence on how best to address inequalities. Conclusions: Despite limitations of the review of reviews approach, it is encouraging that there are interventions that are effective in achieving behavioural change. Further emphasis in both primary studies and secondary analysis (e.g. systematic reviews) should be placed on assessing the differential effectiveness of interventions across different population subgroups to ensure that health inequalities are addressed.</p

Direct Observation of Longitudinally Polarised W Bosons

The three different helicity states of W bosons, produced in the reaction e+e- -> W+W- -> l nu q q~ are studied using leptonic and hadronic W decays at sqrt{s}=183GeV and 189GeV. The W polarisation is also measured as a function of the scattering angle between the W- and the direction of the e- beam. The analysis demonstrates that W bosons are produced with all three helicities, the longitudinal and the two transverse states. Combining the results from the two center-of-mass energies and with leptonic and hadronic W decays, the fraction of longitudinally polarised W bosons is measured to be 0.261 +/- 0.051(stat.) +/- 0.016(syst.) in agreement with the expectation from the Standard Model

Search for Charginos with a Small Mass Difference with the Lightest Supersymmetric Particle at \sqrt{s} = 189 GeV

A search for charginos nearly mass-degenerate with the lightest supersymmetric particle is performed using the 176 pb^-1 of data collected at 189 GeV in 1998 with the L3 detector. Mass differences between the chargino and the lightest supersymmetric particle below 4 GeV are considered. The presence of a high transverse momentum photon is required to single out the signal from the photon-photon interaction background. No evidence for charginos is found and upper limits on the cross section for chargino pair production are set. For the first time, in the case of heavy scalar leptons, chargino mass limits are obtained for any \tilde{\chi}^{+-}_1 - \tilde{\chi}^0_1 mass difference

K0s K0s Final State in Two-Photon Collisions and Implications for Glueballs

The K0s K0s final state in two-photon collisions is studied with the L3 detector at LEP. The mass spectrum is dominated by the formation of the f_2'(1525) tensor meson in the helicity-two state with a two-photon width times the branching ratio into K Kbar of 76 +- 6 +- 11 eV. A clear signal for the formation of the f_J(1710) is observed and it is found to be dominated by the spin-two helicity-two state. No resonance is observed in the mass region around 2.2 GeV and an upper limit of 1.4 eV at 95% C.L. is derived for the two-photon width times the branching ratio into K0s K0s for the glueball candidate xi(2230)