A method for optimal fit of patient-specific fracture fixation plates

Anatomically pre-contoured fracture fixation plates are a treatment option for bone fractures. A well-fitting plate can be used as a tool for anatomical reduction of the fractured bone. However, recent studies showed that some plates fit poorly for many patients due to considerable shape variations between bones of the same anatomical site. Therefore, the plates have to be manually fitted and deformed by surgeons to fit each patient optimally. The process is time-intensive and labor-intensive, and could lead to adverse clinical implications such as wound infection or plate failure. This paper proposes a new iterative method to simulate the patient-specific deformation of an optimally fitting plate for pre-operative planning purposes. We further demonstrate the validation of the method through a case study. The proposed method involves the integration of four commercially available software tools, Matlab, Rapidform2006, SolidWorks, and ANSYS, each performing specific tasks to obtain a plate shape that fits optimally for an individual tibia and is mechanically safe. A typical challenge when crossing multiple platforms is to ensure correct data transfer. We present an example of the implementation of the proposed method to demonstrate successful data transfer between the four platforms and the feasibility of the method.

Automated fit assessment of intramedullary nail designs during insertion

Modern intramedullary nails, which are utilised for the treatment of bone fractures, need to be designed to fit the anatomy of the patient population. Traditional and recent semi-automated approaches for quantifying the anatomical fit between bones and nail designs suffer from various drawbacks. This thesis proposed an automated comprehensive nail design validation method. The developed software tool was utilised to quantify the anatomical fit of four commercial nail designs. Furthermore, the thesis demonstrated the existence of a bone-nail specific nail entry point. The developed method is of great benefit for the implant manufacturing industry as a nail design validation tool.

Nintendo Wii Fit as an adjunct to physiotherapy following lower limb fractures: Preliminary feasibility, safety and sample size considerations

Objective The Nintendo Wii Fit integrates virtual gaming with body movement, and may be suitable as an adjunct to conventional physiotherapy following lower limb fractures. This study examined the feasibility and safety of using the Wii Fit as an adjunct to outpatient physiotherapy following lower limb fractures, and reports sample size considerations for an appropriately powered randomised trial. Methodology Ambulatory patients receiving physiotherapy following a lower limb fracture participated in this study (n = 18). All participants received usual care (individual physiotherapy). The first nine participants also used the Wii Fit under the supervision of their treating clinician as an adjunct to usual care. Adverse events, fracture malunion or exacerbation of symptoms were recorded. Pain, balance and patient-reported function were assessed at baseline and discharge from physiotherapy. Results No adverse events were attributed to either the usual care physiotherapy or Wii Fit intervention for any patient. Overall, 15 (83%) participants completed both assessments and interventions as scheduled. For 80% power in a clinical trial, the number of complete datasets required in each group to detect a small, medium or large effect of the Wii Fit at a post-intervention assessment was calculated at 175, 63 and 25, respectively. Conclusions The Nintendo Wii Fit was safe and feasible as an adjunct to ambulatory physiotherapy in this sample. When considering a likely small effect size and the 17% dropout rate observed in this study, 211 participants would be required in each clinical trial group. A larger effect size or multiple repeated measures design would require fewer participants.

Can we safely deform a plate to fit every bone? Population-based fit assessment and finite element deformation of a distal tibial plate

Anatomically precontoured plates are commonly used to treat periarticular fractures. A well-fitting plate can be used as a tool for anatomical reduction of the fractured bone. Recent studies highlighted that some plates fit poorly for many patients due to considerable shape variations between bones of the same anatomical site. While it is impossible to design one shape that fits all, it is also burdensome for the manufacturers and hospitals to produce, store and manage multiple plate shapes without the certainty of utilization by a patient population. In this study, we investigated the number of shapes required for maximum fit within a given dataset, and if they could be obtained by manually deforming the original plate. A distal medial tibial plate was automatically positioned on 45 individual tibiae, and the optimal deformation was determined iteratively using finite element analysis simulation. Within the studied dataset, we found that: (i) 89% fit could be achieved with four shapes, (ii) 100% fit was impossible through mechanical deformation, and (iii) the deformations required to obtain the four plate shapes were safe for the stainless steel plate for further clinical use. The proposed framework is easily transferable to other orthopaedic plates.

An assessment of m-health in developing countries using task technology fit model

Health challenges present arguably the most significant barrier to sustainable global development. The introduction of ICT in healthcare, especially the application of mobile communications, has created the potential to transform healthcare delivery by making it more accessible, affordable and effective across the developing world. However, current research into the assessment of mHealth from the perspective of developing countries particularly with community Health workers (CHWs) as primary users continues to be limited. The aim of this study is to analyze the contribution of mHealth in enhancing the performance of the health workers and its alignment with existing workflows to guide its utilization. The proposed research takes into account this consideration and aims to examine the task-technology alignment of mHealth for CHWs drawing upon the task technology fit as the theoretical foundation.

BARRIERS AND SOLUTIONS TO OPEN SOURCE APPROPRIATE TECHNOLOGY FOR SUSTAINABLE DEVELOPMENT: INNOVATION THROUGH COLLABORATION

It has been proposed that the field of appropriate technology (AT) - small-scale, energy efficient and low-cost solutions, can be of tremendous assistance in many of the sustainable development challenges, such as food and water security, health, shelter, education and work opportunities. Unfortunately, there has not yet been a significant uptake of AT by organizations, researchers, policy makers or the mainstream public working in the many areas of the development sector. Some of the biggest barriers to higher AT engagement include: 1) AT perceived as inferior or ‘poor persons technology’, 2) questions of technological robustness, design, fit and transferability, 3) funding, 4) institutional support, as well as 5) general barriers associated with tackling rural poverty. With the rise of information and communication technologies (ICTs) for online networking and knowledge sharing, the possibilities to tap into the collaborative open-access and open-source AT are growing, and so is the prospect for collective poverty reducing strategies, enhancement of entrepreneurship, communications, education and a diffusion of life-changing technologies. In short, the same collaborative philosophy employed in the success of open source software can be applied to hardware design of technologies to improve sustainable development efforts worldwide. To analyze current barriers to open source appropriate technology (OSAT) and explore opportunities to overcome such obstacles, a series of interviews with researchers and organizations working in the field of AT were conducted. The results of the interviews confirmed the majority of literature identified barriers, but also revealed that the most pressing problem for organizations and researchers currently working in the field of AT is the need for much better communication and collaboration to share the knowledge and resources and work in partnership. In addition, interviews showcased general receptiveness to the principles of collaborative innovation and open source on the ground level. A much greater focus on networking, collaboration, demand-led innovation, community participation, and the inclusion of educational institutions through student involvement can be of significant help to build the necessary knowledge base, networks and the critical mass exposure for the growth of appropriate technology.

Contingency Fit, Institutional Fit, and Firm Performance: A Metafit Approach to Organization–Environment Relationships

In this paper, we attempt to reconcile contingency and institutional fit approaches concerning the organization-environment relationship. While prior scholarly research has examined both theories and compared their impacts on organizational fit and performance, we lay the groundwork for a meta-fit approach by investigating how contingency and institutional fit interact to influence firm performance. We test our theoretical framework using a dataset of 3,259 respondents from 1,904 companies regarding task environmental demands and institutional demands on organizational design across a broad range of industries and firm size classes. Our results show that contingency and institutional fit provide complementary and interdependent explanations of firm performance. Importantly, our findings indicate that for firms under conditions of “quasi-fit” rather than perfect contingency fit or optimal institutional fit, improvements in contingency and/or institutional fit will result in better performance. However, firms with high contingency fit are less vulnerable to deviation from institutional fit in the formation of firm performance, while firms with perfect institutional fit will slightly decrease their performance when they strive to achieve contingency fit.

Horses for courses: Relating innovation diffusion concepts to the stage of the diffusion process

The research uses a sociological perspective to build an improved, context specific understanding of innovation diffusion within the UK construction industry. It is argued there is an iterative interplay between actors and the social system they occupy that directly influences the diffusion process as well as the methodology adopted. The research builds upon previous findings that argued a level of best fit for the three innovation diffusion concepts of cohesion, structural equivalence and thresholds. That level of best fit is analysed here using empirical data from the UK construction industry. This analysis allows an understanding of how the relative importance of these concepts' actually varies within the stages of the innovation diffusion process. The conclusion that the level of relevance fluctuates in relation to the stages of the diffusion process is a new development in the field.

The impact of overseas training on curriculum innovation and change in English language education in Western China

This article assesses the impact of a UK-based professional development programme on curriculum innovation and change in English Language Education (ELE) in Western China. Based on interviews, focus group discussions and observation of a total of 48 English teachers who had participated in an overseas professional development programme influenced by modern approaches to education and ELE, and 9 of their colleagues who had not taken part, it assesses the uptake of new approaches on teachers’ return to China. Interviews with 10 senior managers provided supplementary data. Using Diffusion of Innovations Theory as the conceptual framework, we examine those aspects of the Chinese situation that are supportive of change and those that constrain innovation. We offer evidence of innovation in classroom practice on the part of returnees and ‘reinvention’ of the innovation to ensure a better fit with local needs. The key role of course participants as opinion leaders in the diffusion of new ideas is also explored. We conclude that the selective uptake of this innovation is under way and likely to be sustained against a background of continued curriculum reform in China.

Study of the innovation management process in the development of a discontinuous product case: Motorola RAZR V3

This study will collaborate by bringing some detailed analysis and findings on a special case study of a discontinuous product development process, trying to answer how the discontinuous product development process takes place and the main factors that influence this process. Additionally, it tried to explore some explanations for the difficulties generally faced by the companies to sustain innovation. The case is about the Motorola cell phone RAZR V3, launched in 2004. RAZR V3 was noted by industry experts as game-changing feat of design and engineering, selling more than 110 million units by end of 2008 and recognized as one of the fastest selling products in the industry. The study uses a single case methodology, which is appropriate given the access to a phenomenon that happened inside corporate dominium and it is not easily accessed for academic studies, besides being a rare case of success in the cellular phone industry. In order to magnify the understanding of the phenomenon, the exploration was extended to contrast the RAZR development process and the standard product development process in Motorola. Additionally, it was integrated a longitudinal reflection of the company product development evolution until the next breakthrough product hitting the cellular phone industry. The result of the analysis shows that discontinuous products do not fit well traditional product development process (in this case, stage-gate). This result reinforces the results obtained on previous studies of discontinuous product development conducted by other authors. Therefore, it is clear that the dynamics of discontinuous product development are different from the continuous product development, requiring different treatment to succeed. Moreover, this study highlighted the importance of the management influence in all the phases of the process as one of the most important factors, suggesting a key component to be carefully observed in future researches. Some other findings of the study that were considered very important for a discontinuous product development process: have champions (who believe and protect the project) and not only one champion; create a right atmosphere to make flow the creative process; question paradigms to create discontinuous products; simple guiding light to focus the team; company culture that accepts and knows how to deal with risks; and undoubtedly, have a company strategy that understands the different dynamics of continuous and discontinuous product development processes and treat them accordingly.

Leader-organization fit: comparing the effectiveness of paternalistic and transformational leadership in different organizational cultures

Research on paternalistic leadership (PL) has been based exclusively on national cultures´ differences. However there are cues that other contextual variables can add to the explanation of this construct. Due to its capacity to influence expectations of individuals in organizations, organizational culture can contribute to fill this gap. To test if organizational culture influences the effectiveness of leadership style, we conducted two experimental studies using Amazon’s Mechanical Turk, comparing effects of paternalistic and transformational leadership on followers’ outcomes. Using video clips and vignettes, we found that PL is better related to followers´ outcomes in cultures oriented to people than outcome, and that TL has a better relationship in cultures oriented to innovation than stability. The results suggest that organizational culture helps in explaining PL endorsement, and that further analysis of the influence of this variable to PL can provide a better understanding of the expression of this leadership style in organizations.

Making energy service companies (ESCOS) future fit

Energy service companies (ESCOs) are faced with a range of challenges and opportunities associated with the rapidly changing and flexible requirements of energy customers (end users) and rapid improvements in technologies associated with energy and ICT. These opportunities for innovation include better prediction of energy demand, transparency of data to the end user, flexible and time dependent energy pricing and a range of novel finance models. The liberalisation of energy markets across the world has leads to a very small price differential between suppliers on the unit cost of energy. Energy companies are therefore looking to add additional layers of value using service models borrowed from the manufacturing industry. This opens a range of new product and service offerings to energy markets and consumers and has implications for the overall efficiency, utility and price of energy provision.

Trust - Networking - Innovation

From innovation point of view the agri-food industry is seen as matured branch of the economy, where revolutionary new products and processes are very rare. Especially the SMEs are in squeezing situation: they have to fit very sharp prerequisites and demands on one side and very much constrained resources to give them power in order to formulate appropriate answers on the other side. They are looking for partners beyond the boundaries of their organization, mainly with other firms, universities, research organisations and government agencies. Adopting an effective innovation process to successfully introduce and develop new products to the market has become one of the most important strategies for food companies. The innovation dimension of networking activity contributes to growing network complexity, which in turn also affects the nature of traditional governance structure. Trust and other relational factors are playing an increasing role in these structures. Our research interest is whether the trust as coordination form of governance structure plays significant role in the Hungarian agri-food industry. Empirical data was drawn from a survey carried out in Central Hungary and aiming at the research of cooperation and knowledge management within the SMEs of the food economy. Structural Equation Modelling (SEM) is applied in order to determine the relationship among the three (Trust, Networking, Innovation) latent factors. We have found that trust plays significant positive role in increasing networking activity and innovation, but the extent of it is less than expected.