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Meguro T, Takayama F, Hammarlund H, Honjo M. Effects of a mobile health intervention on health-related outcomes in Japanese office workers: a pilot study. Int J Occup Med Environ Health 2024; 37:153-164. [PMID: 38375630 PMCID: PMC11142403 DOI: 10.13075/ijomeh.1896.02317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES The purpose of the current study was to explore the effects of a mobile health (mHealth) intervention based on the Persuasive System Design (PSD) model on health-related outcomes among office workers. MATERIAL AND METHODS The authors conducted a trial that consisted of a 4-week baseline and an 8-week intervention period by reference to 23 office workers in a private research company. The mHealth application was developed to improve these workers' daily step count, decrease their sedentary time, and increase their sleep duration in accordance with the PSD model. The app features included at least 1 principal factor from each of the 4 main categories of the PSD model (primary task support, dialogue support, system credibility support, and social support). The objective health-related variables were measured using a smartwatch (Fitbit Luxe) that was synchronized with the application using the Fitbit Web Application Programming Interface. Subjects used the app, which included self-monitoring, personalized messages, education, and a competition system for users, during the intervention period. RESULTS Sedentary time exhibited a significant decrease (a median reduction of 14 min/day, p < 0.05) during the intervention period. No significant differences in daily step count and sleep duration were observed between the baseline and intervention periods. CONCLUSIONS This study suggests that the mHealth intervention based on the PSD model was useful for reducing sedentary time among office workers. Given that many previous studies on this topic have not been based on any theories, future studies should investigate the impact of structured selection behavior change theories on health-related outcomes among office workers. Int J Occup Med Environ Health. 2024;37(2):153-64.
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Affiliation(s)
- Takumi Meguro
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
| | | | | | - Masaru Honjo
- KDDI Research, Inc., Life Science Laboratories, Saitama, Japan
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Watanabe K, Okusa S, Sato M, Miura H, Morimoto M, Tsutsumi A. mHealth Intervention to Promote Physical Activity Among Employees Using a Deep Learning Model for Passive Monitoring of Depression and Anxiety: Single-Arm Feasibility Trial. JMIR Form Res 2023; 7:e51334. [PMID: 37976094 PMCID: PMC10692887 DOI: 10.2196/51334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/04/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Physical activity effectively prevents depression and anxiety. Although mobile health (mHealth) technologies offer promising results in promoting physical activity and improving mental health, conflicting evidence exists on their effectiveness, and employees face barriers to using mHealth services. To address these problems, we recently developed a smartphone app named ASHARE to prevent depression and anxiety in the working population; it uses a deep learning model for passive monitoring of depression and anxiety from information about physical activity. OBJECTIVE This study aimed to preliminarily investigate (1) the effectiveness of the developed app in improving physical activity and reducing depression and anxiety and (2) the app's implementation outcomes (ie, its acceptability, appropriateness, feasibility, satisfaction, and potential harm). METHODS We conducted a single-arm interventional study. From March to April 2023, employees aged ≥18 years who were not absent were recruited. The participants were asked to install and use the app for 1 month. The ideal usage of the app was for the participants to take about 5 minutes every day to open the app, check the physical activity patterns and results of an estimated score of psychological distress, and increase their physical activity. Self-reported physical activity (using the Global Physical Activity Questionnaire, version 2) and psychological distress (using the 6-item Kessler Psychological Distress Scale) were measured at baseline and after 1 month. The duration of physical activity was also recorded digitally. Paired t tests (two-tailed) and chi-square tests were performed to evaluate changes in these variables. Implementation Outcome Scales for Digital Mental Health were also measured for acceptability, appropriateness, feasibility, satisfaction, and harm. These average scores were assessed by comparing them with those reported in previous studies. RESULTS This study included 24 employees. On average, the app was used for 12.54 days (44.8% of this study's period). After using the app, no significant change was observed in physical activity (-12.59 metabolic equivalent hours per week, P=.31) or psychological distress (-0.43 metabolic equivalent hours per week, P=.93). However, the number of participants with severe psychological distress decreased significantly (P=.01). The digitally recorded duration of physical activity increased during the intervention period (+0.60 minutes per day, P=.08). The scores for acceptability, appropriateness, and satisfaction were lower than those in previous mHealth studies, whereas those for feasibility and harm were better. CONCLUSIONS The ASHARE app was insufficient in promoting physical activity or improving psychological distress. At this stage, the app has many issues that are to be addressed in terms of both implementation and effectiveness. The main reason for this low effectiveness might be the poor evaluation of the implementation outcomes by app users. Improving acceptability, appropriateness, and satisfaction are identified as key issues to be addressed in future implementation. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trials Registry UMIN000050430; https://tinyurl.com/mrx5ntcmrecptno=R000057438.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | | | - Mitsuhiro Sato
- Health & Productivity Management Promotion Division, Fujitsu General Limited, Kawasaki, Japan
| | | | | | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
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Zheng S, Edney SM, Mair JL, Kowatsch T, Castro O, Salamanca-Sanabria A, Müller-Riemenschneider F. Holistic mHealth interventions for the promotion of healthy ageing: protocol for a systematic review. BMJ Open 2023; 13:e066662. [PMID: 37130675 PMCID: PMC10163532 DOI: 10.1136/bmjopen-2022-066662] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
INTRODUCTION Maintaining physical and mental health is essential for healthy ageing. It can be supported by modifying lifestyle factors such as physical activity and diet. Poor mental health, in turn, contributes to the opposing effect. The promotion of healthy ageing may therefore benefit from holistic interventions integrating physical activity, diet and mental health. These interventions can be scaled up to the population level by using mobile technologies. However, systematic evidence regarding the characteristics and effectiveness of such holistic mHealth interventions remains limited. This paper presents a protocol for a systematic review that aims to provide an overview of the current state of the evidence for holistic mHealth interventions, including their characteristics and effects on behavioural and health outcomes in general adult populations . METHODS AND ANALYSIS We will conduct a comprehensive search for randomised controlled trials and non-randomised studies of interventions published between January 2011 and April 2022 in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, Scopus, China National Knowledge Infrastructure and Google Scholar (first 200 records). Eligible studies will be mHealth interventions targeting general adult populations with content on physical activity, diet and mental health. We will extract information on all relevant behavioural and health outcomes, as well as those related to intervention feasibility. Screening and data extraction processes will be carried out independently by two reviewers. Cochrane risk-of-bias tools will be used to assess risk of bias. We will provide a narrative overview of the findings from eligible studies. With sufficient data, a meta-analysis will be conducted. ETHICS AND DISSEMINATION Ethical approval is not required because this study is a systematic review based on published data. We intend to publish our findings in a peer-reviewed journal and present the study at international conferences. PROSPERO REGISTRATION NUMBER CRD42022315166.
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Affiliation(s)
- Shenglin Zheng
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Sarah Martine Edney
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Jacqueline Louise Mair
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Tobias Kowatsch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
- Institute for Implementation Science in Health Care, University of Zürich, Zürich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zürich, Zürich, Switzerland
| | - Oscar Castro
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Digital Health Centre, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Bizhanova Z, Sereika SM, Brooks MM, Rockette-Wagner B, Kariuki JK, Burke LE. Identifying Predictors of Adherence to the Physical Activity Goal: A Secondary Analysis of the SMARTER Weight Loss Trial. Med Sci Sports Exerc 2023; 55:856-864. [PMID: 36574734 PMCID: PMC10106377 DOI: 10.1249/mss.0000000000003114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION/PURPOSE Research is needed to inform tailoring supportive strategies for promoting physical activity (PA) in the context of behavioral treatment of obesity. We aimed to identify baseline participant characteristics and short-term intervention response predictors associated with adherence to the study-defined PA goal in a mobile health (mHealth) weight loss trial. METHODS A secondary analysis was conducted of a 12-month weight loss trial (SMARTER) that randomized 502 adults with overweight or obesity to either self-monitoring of diet, PA, and weight with tailored feedback messages ( n = 251) or self-monitoring alone ( n = 251). The primary outcome was average adherence to the PA goal of ≥150 min·wk -1 of moderate- and vigorous-intensity aerobic activities (MVPA) from Fitbit Charge 2™ trackers over 52 wk. Twenty-five explanatory variables were considered. Machine learning methods and linear regression were used to identify predictors of adherence to the PA goal. RESULTS The sample ( N = 502) was mostly female (80%), White (82%) with the average age of 45 ± 14.4 yr and body mass index of 33.7 ± 4.0 kg·m -2 . Machine learning methods identified PA goal adherence for the first week as the most important predictor of long-term PA goal adherence. In the parsimonious linear regression model, higher PA goal adherence for the first week, greater PA FB messages opened, older age, being male, higher education, being single and not having obstructive sleep apnea were associated with higher long-term PA goal adherence. CONCLUSIONS To our knowledge, this is the first study using machine learning approaches to identify predictors of long-term PA goal adherence in a mHealth weight loss trial. Future studies focusing on facilitators or barriers to PA among young and middle-age adults and women with low PA goal adherence are warranted.
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Affiliation(s)
| | - Susan M. Sereika
- University of Pittsburgh Graduate School of Public Health, PA
- University of Pittsburgh School of Nursing, PA
| | - Maria M. Brooks
- University of Pittsburgh Graduate School of Public Health, PA
| | | | | | - Lora E. Burke
- University of Pittsburgh Graduate School of Public Health, PA
- University of Pittsburgh School of Nursing, PA
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Alexandrou C, Henriksson H, Henström M, Henriksson P, Delisle Nyström C, Bendtsen M, Löf M. Effectiveness of a Smartphone App (MINISTOP 2.0) integrated in primary child health care to promote healthy diet and physical activity behaviors and prevent obesity in preschool-aged children: randomized controlled trial. Int J Behav Nutr Phys Act 2023; 20:22. [PMID: 36810069 PMCID: PMC9942425 DOI: 10.1186/s12966-023-01405-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/02/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Childhood overweight and obesity is a public health priority. We have previously reported the efficacy of a parent-oriented mobile health (mHealth) app-based intervention (MINISTOP 1.0) which showed improvements in healthy lifestyle behaviors. However, the effectiveness of the MINISTOP app in real-world conditions needs to be established. OBJECTIVE To evaluate the real-world effectiveness of a 6-month mHealth intervention (MINISTOP 2.0 app) on children's intake of fruits, vegetables, sweet and savory treats, sweet drinks, moderate-to-vigorous physical activity, and screen time (primary outcomes), and on parental self-efficacy (PSE) for promoting healthy lifestyle behaviors, and children's body mass index (BMI) (secondary outcomes). METHODS A hybrid type 1 effectiveness-implementation design was utilized. For the effectiveness outcomes, a two-arm, individually randomized controlled trial was conducted. Parents (n = 552) of 2.5-to-3-year-old children were recruited from 19 child health care centers across Sweden, and, randomized to either a control (standard care) or intervention group (MINISTOP 2.0 app). The 2.0 version was adapted and translated into English, Somali and Arabic to increase reach. All recruitment and data collection were conducted by the nurses. Outcomes were assessed at baseline and after six months, using standardized measures (BMI) and a questionnaire (health behaviors, PSE). RESULTS Among the participating parents (n = 552, age: 34.1 ± 5.0 years), 79% were mothers and 62% had a university degree. Twenty-four percent (n = 132) of children had two foreign-born parents. At follow-up, parents in the intervention group reported lower intakes of sweet and savory treats (-6.97 g/day; p = 0.001), sweet drinks (-31.52 g/day; p < 0.001), and screen time (-7.00 min/day; p = 0.012) in their children compared to the control group. The intervention group reported higher total PSE (0.91; p = 0.006), PSE for promoting healthy diet (0.34; p = 0.008) and PSE for promoting physical activity behaviors (0.31; p = 0.009) compared to controls. No statistically significant effect was observed for children's BMI z-score. Overall, parents reported high satisfaction with the app, and 54% reported using the app at least once a week. CONCLUSION Children in the intervention group had lower intakes of sweet and savory treats, sweet drinks, less screen time (primary outcomes) and their parents reported higher PSE for promoting healthy lifestyle behaviors. Our results from this real-world effectiveness trial support the implementation of the MINISTOP 2.0 app within Swedish child health care. TRIAL REGISTRATION Clinicaltrials.gov NCT04147039; https://clinicaltrials.gov/ct2/show/NCT04147039.
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Affiliation(s)
- Christina Alexandrou
- Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, 581 83, Linköping, Sweden. .,Department of Biosciences and Nutrition, Karolinska Institutet, NEO, Huddinge, 141 83, Sweden.
| | - Hanna Henriksson
- grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, 581 83 Linköping, Sweden
| | - Maria Henström
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, NEO, Huddinge, 141 83 Sweden
| | - Pontus Henriksson
- grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, 581 83 Linköping, Sweden
| | - Christine Delisle Nyström
- grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, NEO, Huddinge, 141 83 Sweden
| | - Marcus Bendtsen
- grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, 581 83 Linköping, Sweden
| | - Marie Löf
- grid.5640.70000 0001 2162 9922Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, 581 83 Linköping, Sweden ,grid.4714.60000 0004 1937 0626Department of Biosciences and Nutrition, Karolinska Institutet, NEO, Huddinge, 141 83 Sweden
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Wu CC, Huang CW, Wang YC, Islam MM, Kung WM, Weng YC, Su CH. mHealth Research for Weight Loss, Physical Activity, and Sedentary Behavior: Bibliometric Analysis. J Med Internet Res 2022; 24:e35747. [PMID: 35675126 PMCID: PMC9218882 DOI: 10.2196/35747] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/15/2022] [Accepted: 05/10/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Research into mobile health (mHealth) technologies on weight loss, physical activity, and sedentary behavior has increased substantially over the last decade; however, no research has been published showing the research trend in this field. OBJECTIVE The purpose of this study was to provide a dynamic and longitudinal bibliometric analysis of recent trends of mHealth research for weight loss, physical activity, and sedentary behavior. METHODS A comprehensive search was conducted through Web of Science to retrieve all existing relevant documents published in English between January 1, 2010, and November 1, 2021. We developed appropriate research questions; based on the proven bibliometric approaches, a search strategy was formulated to screen the title for eligibility. Finally, we conducted bibliometric analyses to explore the growth rate of publications; publication patterns; and the most productive authors, institutions, and countries, and visualized the trends in the field using a keyword co-occurrence network. RESULTS The initial search identified 8739 articles, of which 1035 were included in the analyses. Our findings show an exponential growth trend in the number of annual publications of mHealth technology research in these fields. JMIR mHealth and uHealth (n=214, 20.67%), Journal of Medical Internet Research (n=71, 6.86%), and BMC Public Health (n=36, 3.47%) were the top 3 journals, publishing higher numbers of articles. The United States remained the leading contributor in these areas (n=405, 39.13%), followed by Australia (n=154, 14.87%) and England (n=125, 12.07%). Among the universities, the University of Sydney (n=36, 3.47%) contributed the most mHealth technology research in these areas; however, Deakin University (n=25, 2.41%) and the National University of Singapore (n=23, 2.22%) were in the second and third positions, respectively. CONCLUSIONS Although the number of papers published on mobile technologies for weight loss, physical activity, and sedentary behavior was initially low, there has been an overall increase in these areas in recent years. The findings of the study indicate that mobile apps and technologies have substantial potential to reduce weight, increase physical activity, and change sedentary behavior. Indeed, this study provides a useful overview of the publication trends and valuable guidance on future research directions and perspectives in this rapidly developing field.
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Affiliation(s)
- Chieh-Chen Wu
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei, Taiwan
| | - Chih-Wei Huang
- International Center for Health Information Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Yao-Chin Wang
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
| | - Md Mohaimenul Islam
- International Center for Health Information Technology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- AESOP Technology, Taipei, Taiwan
| | - Woon-Man Kung
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Yung-Ching Weng
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei, Taiwan
| | - Chun-Hsien Su
- Graduate Institute of Sport Coaching Science, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
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Rubery PT, Ramirez G, D'Agostino CR, Vasalos K, Thirukumaran C. A workplace wellness program at an academic health center influences employee health, satisfaction, productivity and the rate of workplace injury. Int Arch Occup Environ Health 2022; 95:1603-1632. [PMID: 35501508 DOI: 10.1007/s00420-022-01865-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/07/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Workplace wellness (WP) programs are an employer strategy to improve employee health and satisfaction. Their impact on productivity and benefit expense remains unclear. This study examines the association of a voluntary WP at an academic health center with both employee metrics and employer costs. METHODS We retrospectively reviewed prospectively collected data from January 2016 to April 2018 for employees who voluntarily underwent screening for a WP at an academic medical center. We used their demographic, social, work, and clinical data to address the central research question. The primary outcomes included wellness measures from the Patient-Reported Outcomes Measurement Information System (PROMIS), secondary wellness outcomes such as body mass index, job-related outcomes such as job satisfaction, and workers' compensation metrics such as the claim amount. The key independent variables were whether an observation was from before or after the WP. For workers' compensation metrics, additional key independent variables were intervention/control group, and an interaction between the before/after and intervention/control variables. We conducted univariate and bivariate/unadjusted analyses, and estimated multivariable linear, logistic, and gamma regression models that also controlled for confounders. RESULTS The study included 370 employees. Participation in the program was associated with significant improvements in the PROMIS pain interference, fatigue and sleep quality domains. Hip circumference diminished, and functional movement outcomes were improved. Job satisfaction improved by 4.4 percentage points (95% Confidence Interval [CI]: 0.3-8.5, p = 0.04) and self-reported productivity by 14.5 percentage points (95% Confidence Interval [CI]: 9.5-19.5, p < 0.001). The likelihood of a new compensation claim during the 12-month follow-up period fell by 10.1% (95% Confidence Interval [CI]: - 15.5 to - 4.7, p < 0.001). However, the value of a new claim was unchanged. CONCLUSION Employees who completed a WP at an academic medical center demonstrated improvements in several recognized patient-reported outcome measures, in job satisfaction and self-reported productivity, a decrease in hip circumference, an improvement in functional motion and a decreased rate of compensable injury.
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Affiliation(s)
- Paul T Rubery
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA.
| | - Gabriel Ramirez
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA
| | - Charles R D'Agostino
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA
| | - Kostantinos Vasalos
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA
| | - Caroline Thirukumaran
- Department of Orthopaedics, University of Rochester, 601 Elmwood Ave. Box 665, Rochester, NY, 14642, USA
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