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

Formal techniques in the safety analysis of software components of a new dialysis machine

The paper is concerned with the practical use of formal techniques to contribute to the risk analysis of a new neonatal dialysis machine. The described formal analysis focuses on the controller component of the software implementation. The controller drives the dialysis cycle and deals with error management. The logic was analysed using model checking techniques and the source code was analysed formally, checking type correctness conditions, use of pointers and shared memory. The analysis provided evidence of the verification of risk control measures relating to the software component. The productive dialogue between the developers of the device, who had no experience or knowledge of formal methods, and the analyst using the formal analysis tools, provided a basis for the development of rationale for the effectiveness of the evidence. (C) 2019 Elsevier B.V. All rights reserved.This work has been funded by: EPSRC research grants EP/G059063/1 and EP/J008133/1: CHI+MED (Computer -Human Interaction for Medical Devices); and NanoSTIMA (ref. NORTE-01-0145-FEDER-000016) financed by the North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fund (ERDF). Leo Freitas would like to acknowledge EPSRC Trams2 project for financial support, Andrew Sims for providing access to the dialyser, which was used as our case study and Aleksandrs Baklanovs for doing some of the source analysis as part of an undergraduate project

Organizational Efficacy of Small and Medium-Sized Suppliers: The Role of Information Quality and Continuous Quality Improvement

The role of information quality and continuous quality improvement was analyzed in regards to the organizational efficacy of small and medium-sized suppliers. It was anticipated that both variables would have positive relationships with organizational efficacy. Results supported these hypotheses and demonstrate the importance of firms controlling the flow of quality information and emphasizing continuous quality improvement in order to strengthen organizational efficacy. Given the significant impact of efficacy on individual and group performance and the relationships confirmed as part of the current study, future research is called for such that we might better understand the qualities that characterize the successful supply chain relationships for SMEs

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