Background The COVID-19 Pandemic has affected the way health care systems function across the globe. Apart from eliminating the risk of being in a vulnerable environment during the pandemic such as a hospital setting, virtual arthroplasty follow-up reduces the demand on funding and resources on the National Health Services (NHS). Methods We retrospectively reviewed our shoulder arthroplasty patients (55) operated between October 2018 to November 2020 at both our hospital sites. For remote follow-up, patients were contacted on a scheduled appointment date via telephone by an orthopaedic surgeon to enquire about their wound, pain and function. Patients were questioned as per questionnaire from the Oxford Shoulder Score (OSS) and American Shoulder and Elbow Surgeons (ASES) Standardised Assessment form. Results 50 patients were included in the final data set after excluding those who had died (5 patients). All patients had had final x-rays with full Covid-19 precautions at the time of final follow-up. No patient had wound problems except one who had concerns of wound appearance. There were no cases of notching, impingement, deep infection, dislocation or nerve injury. Of the 50 patients, 40 (80%) patients were satisfied to have a remote follow-up. 36 (72%) patients said they wouldn't mind a remote follow-up appointment. Conclusion Remote follow-up via audio consultation may be an effective alternative to in person visits after shoulder arthroplasty. Patients in this series demonstrated a high level of satisfaction with virtual visits and post-operative complications were effectively identified.
Plasma is a framework for scalable off-chain computation. We describe and evaluate Plasma Cash, an improved Plasma construction which leverages non-fungible tokens and Sparse Merkle Trees to reduce the data storage and bandwith requirements for users. We analyze the cryptoeconomic exit and challenge mechanisms used to keep user funds secured, even when the Plasma Cash chain's consensus algorithm is compromised. A reference implementation is provided for evaluation. Finally, we briefly discuss further improvements that can be made to the Plasma Cash protocol such as arbitrary denomination payments, less user data checking, fast and optimistic exits.
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