User Adoption Research Articles

Evaluation of a pilot implementation of a digital cognitive behavioral therapy platform for isolated older adults in county mental health services.

Technology-enabled services (TESs) have the potential to increase access to mental healthcare. However, little research has focused on how TESs can be integrated into publicly funded service settings. As part of the state-wide Help@Hand project, Marin County conducted a pilot implementation of myStrength, a digital cognitive behavioral therapy platform, to explore its potential to reduce loneliness among isolated older adults. We evaluated the pilot impact using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. A single-site 6-month pilot implementation recruited English (n = 15) and Spanish-speaking (n = 15) isolated older adults who received a digital literacy course followed by 8 weeks of myStrength access and human support. We evaluated factors related to reach, effectiveness, adoption, and implementation using the perspectives of users and County staff. Descriptive statistics were used to examine reach, adoption, and implementation. Nonparametric tests, including Friedman and Wilcoxon signed-rank, were used to examine effectiveness. Reach: Compared to overall county demographics, platform users were majority female (93.1% vs. 50.5%), ethnoracialized (62.1% vs. 24.2%), and of lower socioeconomic status (Mdn = $35,000 vs. $131,008). Effectiveness: Users reported a significant (z = -2.62, p < .001) decrease in loneliness. Adoption: Users logged into myStrength an average of 10 times and completed 33 activities during the 8 weeks of myStrength use. Implementation: Each pilot staff (N = 20) spent an average of 19.8 hr (SD = 16.51) supporting users' use of myStrength during the pilot. Pilot staff reported several adaptations to meet the needs of users. Successes included reaching the target population, reducing loneliness, and user adoption. However, pilot staff invested significant time to support those with lower digital literacy skills. As such, although TESs may address unmet needs, their use with underserved populations may require upfront and ongoing support provided by the settings where they are implemented. Testing a New Digital Therapy Tool for Isolated Older Adults in County Mental Health Services.

Exploring user adoption of online hotel booking platforms: A text mining approach

The growing importance of online hotel booking platforms has revolutionized the hospitality industry, generating new business opportunities and intense competition among service providers This study analyzes user-generated content from online reviews to understand what drives user adoption of online hotel booking platforms. Using topic modeling, categorical principal component analysis, and relative importance ranking, the study identifies key factors like comparison of hotel options and online booking features as crucial for user adoption. Conversely, negative hotel experiences contribute to dissatisfaction. The results offer valuable insights for the hospitality industry, emphasizing the dominance of online booking and price comparison in customer adoption.

Digital health and patient adherence: A qualitative study in older adults.

Computer confidence and computer self-efficacy can impact an individual's perceived ease of use and usefulness of technology, ultimately determining adherence to digital healthcare services. However, few studies focus on assessing the impact of non-clinical factors on the efficacy and adherence to digital healthcare platforms. We aimed to analyse the role of non-clinical factors (i.e. computer confidence and computer self-efficacy) in the interaction experience (IX) and the feasibility of a digital neuropsychological platform called NeuroVRehab.PT in a group of older adults with varying levels of computer confidence. Eight older adults (70.63 ± 6.1 years) evaluated the platform, and data was collected using the Think-Aloud method and a semi-structured interview. Sessions were audio-recorded and analysed through an inductive-deductive informed Thematic Analysis protocol. This study was conducted according to the Consolidated Criteria for Reporting Qualitative Research guidelines. Three main themes were identified (Interaction Experience, Digital Literacy, and Attitudes toward NeuroVRehab.PT). Computer anxiety and fear of making errors were not uncommon, even among older adults who perceive themselves as confident in technology use, and negatively impacted IX. Moreover, some game elements (e.g. three-star system, progression bar) were not intuitive to all participants, leading to misleading interpretations. On the other hand, human support and the platform's realism seemed to impact participants' IX positively. This study shed light on the barriers raised by non-clinical factors in adopting and using digital healthcare services by older adults. Furthermore, a critical analysis of the platform's features that promote user adoption is done, and suggestions for overcoming limitations are presented.

An Improved Copula‐Based Framework for Efficient Global Sensitivity Analysis

AbstractGlobal sensitivity analysis (GSA) enhances our understanding of computational models and simplifies model parameter estimation. VarIance‐based Sensitivity analysis using COpUlaS (VISCOUS) is a variance‐based GSA framework. The advantage of VISCOUS is that it can use existing model input‐output data (e.g., water model parameters‐responses) to estimate the first‐ and total‐order Sobol’ sensitivity indices. This study improves VISCOUS by refining its handling of marginal densities of the Gaussian mixture copula model (GMCM). We then evaluate VISCOUS using three types of generic functions relevant to water system models. We observe that its performance depends on function dimension, input‐output data size, and non‐identifiability. Function dimension refers to the number of uncertain input factors analyzed in GSA, and non‐identifiability refers to the inability to estimate GMCM parameters. VISCOUS proves powerful in estimating first‐order sensitivity with a small amount of input‐output data (e.g., 200 in this study), regardless of function dimension. It always ranks input factors correctly in both first‐ and total‐order terms. For estimating total‐order sensitivity, it is recommended to use VISCOUS when the function dimension is not very high (e.g., less than 20) due to the challenge of producing sufficient input‐output data for accurate GMCM inferences (e.g., more than 10,000 data). In cases where all input factors are equally important (a rarity in practice), VISCOUS faces non‐identifiability issues that impact its performance. We provide a didactic example and an open‐source Python code, pyVISCOUS, for broader user adoption.

IoT in Home Automation: A Data-Driven User Behaviour Analysis and User Adoption Test

This research carried out a thorough data-driven examination of user behaviour, adoption rates, satisfaction, and energy efficiency in the context of IoT in home automation, within the quickly changing environment of smart homes and Internet of Things (IoT) technologies. The study found that users interacted with various kinds of IoT devices in diverse ways. Smart security systems and thermostats, for example, were quickly adopted and received high levels of satisfaction. The potential for significant energy savings demonstrated the contribution of IoT devices to sustainability. These results highlight the significance of making well-informed decisions when using IoT technology to create smarter, more efficient, and greener living environments. They also provide useful insights for manufacturers, legislators, and homeowners.

The impact of construction stakeholder’s readiness and acceptance of technology on the success of Indonesian digital government transformation in construction sector

Despite its potential to significantly improve the efficiency, effectiveness, transparency, and accountability of construction sector services, the implementation of digital government transformation in many countries has often failed to achieve desired results due to low user adoption. This study introduces a factor model to predict technology readiness and acceptance behavior in the implementation of digital government transformation within construction business licensing and procurement services by integrating the Technology Readiness and Technology Acceptance Models. Survey data collected from construction companies, experts, project managers, and procurement committees in Indonesia were used to test the model through Structural Equation Modelling (SMART-PLS). The findings reveal that positive technological readiness has a significant impact on perceived usefulness and users' intention to use the system. Additionally, it was discovered that a one-point increase in the intention to use led to a 0.625 increase in achievement value. This research contributes to addressing the slow adoption of digital government transformation by exploring intention-to-use behavior in the construction sector.

Privacy-preserving authentication and authorization in networks using blockchain

Blockchain-based solutions offer a promising avenue for privacy-preserving authentication and authorization mechanisms. Through the immutable and decentralized nature of blockchain, individuals can maintain control over their personal data while still engaging in secure transactions and interactions. These solutions leverage cryptographic techniques to ensure privacy, such as zero-knowledge proofs, which allow one party to prove possession of certain information without revealing the information itself.By storing authentication and authorization data on the blockchain, users can access services without having to repeatedly provide sensitive information. Smart contracts can automate authorization processes, ensuring that only authorized parties can access certain resources or perform specific actions. Additionally, blockchain-based identity systems offer a self-sovereign approach, where individuals have full control over their digital identities, reducing the reliance on centralized authorities. Moreover, blockchain networks provide transparency and auditability, allowing users to track how their data is being used and ensuring compliance with privacy regulations. However, challenges such as scalability, interoperability, and user adoption remain to be addressed for widespread implementation. Overall, blockchain-based solutions hold great potential in providing privacy-preserving authentication and authorization while empowering individuals with greater control over their data.Blockchain-based solutions offer a promising avenue for privacy-preserving authentication and authorization mechanisms. Through the immutable and decentralized nature of blockchain, individuals can maintain control over their personal data while still engaging in secure transactions and interactions. These solutions leverage cryptographic techniques to ensure privacy, such as zero-knowledge proofs, which allow one party to prove possession of certain information without revealing the information itself.

Enhancing user adoption and satisfaction: A study of factors influencing CliQ payment service in the fintech market

This study explores the factors affecting CliQ payment service adoption in Jordan as it represents a major shift in the Jordanian market to Fintech and mobile marketing. This study presented a distinctive model by integrating the “unified theory of acceptance” and the “technology acceptance model” TAM with the “use of technology UTAUT” to measure the behavioral intention of consumers and the satisfaction of the users towards utilizing the CliQ service. The study measured the linkage between four predictors (perceived usefulness, social influence, perceived ease of use, and financial risk) as well as both utilizers’ intention to CliQ service usage and utilizers’ satisfaction with using the service, along with observing the association between these predictors to determine their contribution to the users’ satisfaction mediated by the users’ intention to utilize the service mentioned above. A survey instrument was distributed to 604 respondents, and it was developed and validated by academics, as a pilot test. As well as a pre-test. Hypotheses were tested with multiple linear regression analysis using SmartPLS software to interpret path coefficients, and reliability and validity within the outer model were tested through correlation analysis. Additionally, internal consistency was explored by applying Cronbach’s alpha. The outcomes proved that the predictors significantly affect both utilizers’ behavioral attitudes and satisfaction with using the CliQ service, except for financial risk. The data analysis also indicated a significant indirect influence of all the independent variables on utilizers’ satisfaction through behavioral intention to utilize the CliQ service, except for financial risk, which had an insignificant indirect influence on utilizers’ satisfaction through behavioral intention for service usage. The findings of the current article close the gap found in the literature concerning measuring usability to enhance user satisfaction and adoption of Fintech services. Therefore, bank managers and policy planners can find insights for developing and improving mobile banking apps.

Factors Influencing User Adoption of Online Sports Training Services: A Systematic Review

Factors Influencing User Adoption of Online Sports Training Services: A Systematic Review

Oh, Won’t You Stay with Me? A Literature Review on Motivational Features in MHealth Apps

Mobile apps have become a go-to solution for interventions in many health areas that aim to influence user behavior, such as physical activity or nutrition. However, many apps still fail to bind users long-term. Although research has been conducted on individual mechanisms aiming to improve long-term user adoption, such as gamification, we lack an understanding of different approaches at the time of this research. Thus, in this research, we investigate different approaches and persuasive technology that aim to keep the users’ engagement with the app in use. Therefore, this study reviews existing literature and tries to identify how motivational mechanisms can be successfully implemented. In the course of this, identify 14 major motivational mechanisms to increase long-term user adoption of mobile apps. Based on these insights, we want to give advice on how to improve their impact through combination as well as give advice on future implementation.

Exploring Key Factors Shaping the Effectiveness of Mobile Banking in Pokhara’s Financial Landscape

In the contemporary financial landscape with the anticipated transformation of engagements through mobile banking, this study aims to understand the factors influencing the efficacy of mobile banking services in the Pokhara valley. Using a survey approach with 410 participants, the Confirmatory Factor Analysis indicates a well-fitting measurement model (RMSEA=0.034, GFI=0.941, AGFI=0.923, χ2/df = 1.486, CFI=0.901, TLI=0.887). Key associations reveal that User Adoption negatively impacts effectiveness, while Security Concerns, Ease of Use, and Customer Support positively influence it. Technical Issues, however, have a negative effect. The Squared Multiple Correlation for Mobile Banking Effectiveness is 0.608, emphasizing a substantial proportion of explained variance. Implications stress the need for Pokhara valley financial institutions to recognize and address user adoption and security concerns, with strategic efforts focusing on user education and technological support to enhance mobile banking effectiveness.

Assessment and Optimizing Task Performance through Artificial Intelligence Systems in Hangzhou Ruinan Information Technology Co., Ltd

This research study employs a quantitative-descriptive approach to evaluate and enhance task performance through the utilization of Artificial Intelligence (AI) systems at Hangzhou Ruinan Information Technology Co., Ltd., a key player in the technology hub of Hangzhou City, China. The study comprises four main parts: examining AI system characteristics and provisioning, assessing actual task performance, investigating factors influencing system effectiveness, and identifying challenges impacting performance. Participants include management, IT professionals, and employees working with AI systems, providing valuable insights into system implementation and operation. Data analysis, utilizing weighted mean and verbal description techniques, offers both quantitative and qualitative perspectives on AI's role in optimizing task performance. Findings reveal strong scalability, efficient overall performance, and positive impacts on workflow processes and resource utilization. Security measures, especially in data protection, and usability aspects require attention for further enhancement. The study underscores the importance of reliable data, seamless user adoption, enhanced expertise, and consistent system performance in optimizing task performance through AI within the organization. Conclusions emphasize the need to strengthen security measures, enhance usability, and address areas for improvement. The study underscores the value of AI in achieving the organization's goal of enhancing task performance and productivity. Recommendations include initiatives to enhance data quality, streamline user acceptance, invest in employee skill development, and improve scalability and performance. These recommendations aim to guide Hangzhou Ruinan Information Technology Co., Ltd. in refining its AI systems to drive efficiency and excellence in its operations.

Propagation characteristics of exposure effect on double-layer weighted social networks

Abstract The information propagation on complex networks has attracted much attention in recent years. We found that there is an exposure effect in social propagation which is often used to describe the psychological phenomenon. The user adoption behaviour in social propagation is also consistent with the exposure effect. According to the exposure effect, people are more likely to accept an object when it is exposed for a longer period. Therefore, we propose the exposure initial threshold, exposure final threshold, and the gate-like adoption probability function to better explain the exposure effect. Then, we construct a social propagation model based on exposure effect utilizing the exposure time and gate-like adoption probability function on a double-layer weighted network. To further understand the mechanism of social propagation, we also provide an edge-based compartmental theory based on the exposure effect. Experiments demonstrate that the exposure initial threshold and exposure duration can affect the propagation range to a certain extent. Next, given the propagation probability and exposure duration, there exists an optimal exposure initial threshold that maximizes the propagation range, which we call the optimal exposure ability. In addition, we explore the effect of the degree heterogeneity of nodes on social propagation under the exposure effect. The numerical simulations support the theoretical hypotheses of this work quite well.

The diffusion path of distributed photovoltaic power generation technology driven by individual behavior

The widespread adoption of distributed photovoltaic (PV) power generation technologies among electricity consumers is a crucial factor in enabling the power system's low-carbon transition. While extensive research has explored consumers' willingness to adopt this technology, prior studies have primarily focused on static psychological factors. This study, however, takes a heterogeneous behavioral perspective by examining the dynamic effects of individual behavioral interactions on technology diffusion. Utilizing behavior-driven simulation technology, we developed a diffusion model pertaining to photovoltaic power generation technology. The model enhances the explanatory capacity and predictive accuracy of subjects' behavioral choices by quantifying the effects of adoption scale and external economic interventions. Our simulation results indicate that residential environment constraints, resulting from individual behavioral differences, can influence the diffusion potential of technology. Furthermore, non-mandatory promotion methods are more effective in enhancing user adoption willingness. Interestingly, we found that free installation interventions tend to reduce the diffusion effect in later stages and should not be implemented in isolation. These insights can contribute to enhancing the diffusion of distributed PV power generation technology and furthering the development of low-carbon electricity.

Acceptability and concerns about innovative wearable health sensors in persons with and without chronic disease diagnosis

Advances in biomedical engineering continue to produce innovative wearable health sensors capable of real-time ambulatory assessments (e.g., of physiology, the environment), holding great potential for advancing precision monitoring and interventions through the integration of such devices and data into eHealth systems. As with any novel device, however, user views on acceptability and concerns about the technology must be evaluated to facilitate widespread implementation and user adoption of such devices. One factor that may strongly influence user views is the potential relevance to, and need for, self-care for chronic disease management. We examined if acceptability and concerns regarding innovative wearable devices differed between individuals living with or without chronic disease. A U.S. adult sample (N = 448; 20-70 yrs.; 34 % Female; 60 % White, 35 % Hispanic) completed a web-based survey regarding their thoughts/opinions related to innovative wearable sensors. Two-thirds (67 %, N = 298) reported at least one chronic disease; one-third (33 %, N = 150) reported no chronic health conditions. Participants viewed learning modules about two innovative devices: a watch to detect environmental gases for respiratory health, and a chest-patch monitoring real-time ECG. For each device, participants rated acceptability across multiple dimensions, and then rated potential concerns (including general concerns and specific worries about negative health impacts). Respondents with and without chronic disease differed in education, race, and ethnicity. Controlling for these differences, individuals with chronic disease reported significantly higher acceptability for the watch and for the chest-patch. Healthy participants reported significantly higher general concerns about technology. However, when concern questions were asked specifically about the potential negative impacts of the two study devices on physical health and well-being, participants with chronic disease reported significantly higher concerns. Overall, results show that living with chronic disease influences acceptability and concerns associated with adoption of innovative sensors. These findings suggest it is essential to take potential users' health status into account when studying the design and implementation of innovative wearable sensors. Dissemination strategies may benefit from emphasizing the beneficial features of these devices, addressing hesitations, and customizing implementation approaches by user group.

Determinants of Hospital Information Management System (HIMS) Implementation at Puri Medika Hospital

Background: Hospital Information Management System (HIMS) plays a pivotal role in modern healthcare facilities, encompassing administrative, medical, and financial components. Ensuring high-quality healthcare services hinges on the accuracy, continuity, and security of data, aligning with HIMS's mission. This quantitative research investigates the determinants influencing the implementation of HIMS at Puri Medika Hospital. Method: The research employs a dual-model approach, combining a modified HOT-Fit model with the DeLone and McLean Information Systems Success Model (D&amp;M model), facilitating a comprehensive evaluation of factors affecting HIMS implementation. Result: The study scrutinizes pathways involving human, organizational, technological, and net benefit factors, shedding light on their intricate interactions. The findings reveal that determinants such as information quality, system development, user satisfaction, system benefits, service quality, system quality, organizational structure, environment, and user adoption significantly impact HIMS implementation at Puri Medika Hospital. Conclusion: This research contributes valuable insights into enhancing HIMS effectiveness and healthcare service quality.

Development of Research on Continuous usage Intention of M-Wallets: A Systematic Review of Literature from 2011 to 2021

Mobile payment usage must be maintained for mobile wallet companies to survive. Long-term user relationships can assist businesses in lowering costs and increasing profitability to retain customers which ultimately will lead to continuance intention. Despite M-wallets' relative maturity, a study in this sector has been limited to first acceptance/rejection. No study has particularly evaluated the technology's post-adoption impacts. Existing studies mostly examine the initial adoption of mobile wallet users and their antecedents. Though many people use M-wallets regularly, consistency is rare. Thus, both academic researchers and practitioners must investigate mobile wallet users' continued usage behaviour. This research conducts a thorough evaluation of the systematic review of literature on M-wallet continuous usage intentions from 2011 to 2021. The authors of this study employed systematic review methods to analyse the current state of continuous usage of M-wallet research. They identified current research streams and offered ideas for future research. The review identified the Geographic representation of mobile wallet continuous usage research, methodological approaches to investigate continuous usage intention of m-wallets, and popular theories adopted to investigate continuance intention. Through research synthesis, predictors and moderators/mediators of mobile wallets were also identified. The authors then discovered various service quality characteristics that demonstrated how trust, flow, and satisfaction—which have primarily been studied—had a direct impact on behavioural intentions as a result of service quality. The authors recommend the direction of potential future research in mobile wallets. This paper is a systematic review of the continuance usage of mobile wallets based on the dimensions of service quality and is one of the very few papers to offer a systematic review of continuous usage.

Digital Transformation in Public Service: A Case Study of SIPRAJA Innovation in Sidoarjo

This research investigates the digital innovation of the Sidoarjo Public Service System (SIPRAJA) through a qualitative descriptive methodology, employing data collection techniques such as observation, interviews, and recordkeeping, utilizing both primary and secondary data. The findings reveal that the community has effectively embraced the SIPRAJA application and website, marking SIPRAJA as a noteworthy digital public service innovation. The study aligns with Rogers' innovation characteristics, highlighting SIPRAJA's relative advantage, compatibility with community needs, low user complexity, smooth trialability despite minor technical disruptions, and observable positive outcomes. Despite challenges, the 24-hour service provision and established performance measurement mechanisms for operators underscore the successful implementation of the SIPRAJA innovation, showcasing its potential impact on global public service advancements. Highlights: User Adoption: The study underscores the community's seamless adoption of the SIPRAJA application, showcasing its relative advantage and compatibility with user needs. Operational Performance: Despite minor technical challenges, the 24-hour service provision and established performance measurement mechanisms highlight the successful implementation and observability of SIPRAJA's impact on public service operations. Global Relevance: The research suggests the potential for SIPRAJA's digital innovation to contribute to global advancements in public service, emphasizing its applicability beyond local boundaries. Keywords: Digital Innovation, Public Service, SIPRAJA, Qualitative Research, Community Adoption

An explorative analysis of the antecedents and consequents of gamification in the digital therapeutic context

PurposeGamification unlocks unprecedented opportunities in healthcare, wellness and lifestyle context. In this scenario, by leveraging on such an approach, information technologies now enabled gamification-based mobile applications primarily employed in health and wellness contexts, focusing on areas such as disease prevention, self-management, medication adherence and telehealth programs. The synergistic integration of gamification-based methodologies in conjunction with the utilization of digital tools, (e.g. as for Internet of Things, mobile applications) for the realm of digital therapeutics (DTx), thus unveiled powerful approaches and paradigms, yielding innovative applications that, through the harnessing of sensors and software-based systems, transform healthcare maintenance, wellness and lifestyle into an engaging pursuit, as a game. This paper explores the factors influencing individuals' intention to autonomously utilize mobile gamification-based apps for self-care and wellness maintenance.Design/methodology/approachThrough explorative research designs an experiment has been conducted among a sample of 376 participants regarding the use of a fictitious gamification-based DTx solution, consisting in a mobile app namely “Health'n’Fit”.FindingsFindings from an experiment conducted with a sample of 460 participants shed light on the possible antecedents and consequents of gamification. Results of the SEM model indicate that customization (CU), trust (TR), mobility (MO) and social value (SV) are the main determinants, although at a different extent of the playful experience; Moreover, gamification positively impacts attitudes and, in turn, perceived usefulness, intention to use and behavioral intentions.Practical implicationsThis paper offers a dual-pronged approach that holds practical significance in the realm of healthcare innovation. First, the authors delve into the antecedents shaping individuals' intention to engage with gamification-based DTx, unraveling the factors that influence user adoption. Beyond this, the authors extend their focus to the realm of healthcare service design. By harnessing the potential of gamification and technology, the authors illuminate pathways to conceptualize and create novel healthcare services. This work not only identifies the building blocks of user engagement but also serves as a guide to innovatively craft healthcare solutions that leverage this amalgamation of technology and gamification, contributing to the evolution of modern healthcare paradigms.Social implicationsIn a social context, the paper introduces pioneering technological synergies that merge gamification and DTx to enhance individuals' health and wellness maintenance. By proposing innovative combinations, the authors present novel avenues for promoting healthier lifestyles and behavior change. This not only underscores the potential of technology to positively impact individuals but also highlights the significance of aligning technological advancements with societal well-being. As the research advocates for these innovative solutions, it reinforces the importance of collaborative technological and marketing endeavors, ultimately contributing to the betterment of society as a whole.Originality/valueThis is the first paper exploring the combined effect of gamification and DTx, by shedding light on the peculiarities of both the antecedents of individuals' intention to use such combined technologies.

Enabling Proregenerative Medical Devices via Citrate-Based Biomaterials: Transitioning from Inert to Regenerative Biomaterials.

Regenerative medicine aims to restore tissue and organ function without the use of prosthetics and permanent implants. However, achieving this goal has been elusive, and the field remains mostly an academic discipline with few products widely used in clinical practice. From a materials science perspective, barriers include the lack of proregenerative biomaterials, a complex regulatory process to demonstrate safety and efficacy, and user adoption challenges. Although biomaterials, particularly biodegradable polymers, can play a major role in regenerative medicine, their suboptimal mechanical and degradation properties often limit their use, and they do not support inherent biological processes that facilitate tissue regeneration. As of 2020, nine synthetic biodegradable polymers used in medical devices are cleared or approved for use in the United States of America. Despite the limitations in the design, production, and marketing of these devices, this small number of biodegradable polymers has dominated the resorbable medical device market for the past 50 years. This perspective will review the history and applications of biodegradable polymers used in medical devices, highlight the need and requirements for regenerative biomaterials, and discuss the path behind the recent successful introduction of citrate-based biomaterials for manufacturing innovative medical products aimed at improving the outcome of musculoskeletal surgeries.