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

Cooperative Carbon Dioxide Adsorption in Alcoholamine- and Alkoxyalkylamine-Functionalized Metal-Organic Frameworks.

A series of structurally diverse alcoholamine- and alkoxyalkylamine-functionalized variants of the metal-organic framework Mg2 (dobpdc) are shown to adsorb CO2 selectively via cooperative chain-forming mechanisms. Solid-state NMR spectra and optimized structures obtained from van der Waals-corrected density functional theory calculations indicate that the adsorption profiles can be attributed to the formation of carbamic acid or ammonium carbamate chains that are stabilized by hydrogen bonding interactions within the framework pores. These findings significantly expand the scope of chemical functionalities that can be utilized to design cooperative CO2 adsorbents, providing further means of optimizing these powerful materials for energy-efficient CO2 separations

Stigma as a fundamental hindrance to the United States opioid overdose crisis response.

Alexander Tsai and co-authors discuss the role of stigma in responses to the US opioid crisis

Mass balance re-analysis of Findelengletscher, Switzerland; benefits of extensive snow accumulation measurements

A re-analysis is presented here of a 10 year mass balance series at Findelengletscher, a temperate mountain glacier in Switzerland. Calculating glacier-wide mass balance from the set of glaciological point balance observations using conventional approaches, such as the profile or contour method, resulted in significant deviations from the reference value given by the geodetic mass change over a 5 year period. This is attributed to the sparsity of observations at high elevations and to the inability of the evaluation schemes to adequately estimate accumulation in unmeasured areas. However, measurements of winter mass balance were available for large parts of the study period from snow probings and density pits. Complementary surveys by helicopter-borne ground-penetrating radar (GPR) were conducted in three consecutive years. The complete set of seasonal observations was assimilated using a distributed mass balance model. This model-based extrapolation revealed a substantial mass loss at Findelengletscher of −0.43 m w.e.a⁻¹ between 2004 and 2014, while the loss was less pronounced for its former tributary, Adlergletscher (−0.30 m w.e.a⁻¹). For both glaciers, the resulting time series were within the uncertainty bounds of the geodetic mass change. We show that the model benefited strongly from the ability to integrate seasonal observations. If no winter mass balance measurements were available and snow cover was represented by a linear precipitation gradient, the geodetic mass balance was not matched. If winter balance measurements by snow probings and snow density pits were taken into account, the model performance was substantially improved but still showed a significant bias relative to the geodetic mass change. Thus, the excellent agreement of the model-based extrapolation with the geodetic mass change was owed to an adequate representation of winter accumulation distribution by means of extensive GPR measurements