The purpose of this study was to assess an upper body exoskeleton during automotive assembly processes that involve elevated arm postures. Sixteen team members at Toyota Motor Manufacturing Canada were fitted with a Levitate Airframe, and each team member performed between one and three processes with and without the exoskeleton. A total of 16 assembly processes were studied. Electromyography (EMG) data were collected on the anterior deltoid, biceps brachii, upper trapezius, and erector spinae. Team members also completed a usability survey. The exoskeleton significantly reduced anterior deltoid mean active EMG amplitude (p = .01, Δ = −3.2 %MVC, d = 0.56 medium effect) and fatigue risk value (p < .01, Δ = −5.1 %MVC, d = 0.62 medium effect) across the assembly processes, with no significant changes for the other muscles tested. A subset of nine assembly processes with a greater amount of time spent in arm elevations at or above 90° (30 vs. 24%) and at or above 135° (18 vs. 9%) appeared to benefit more from exoskeleton usage. For these processes, the exoskeleton significantly reduced anterior deltoid mean active EMG amplitude (p < .01, Δ = −5.1 %MVC, d = 0.95 large effect) and fatigue risk value (p < .01, Δ = −7.4 %MVC, d = 0.96 large effect). Team members responded positively about comfort and fatigue benefits, although there were concerns about the exoskeleton hindering certain job duties. The results support quantitative testing to match exoskeleton usage with specific job tasks and surveying team members for perceived benefits/drawbacks.

Cover crops (CCs) play an important role in integrated weed management. Data necessary to evaluate the role of CCs in weed management at the watershed scale with topographic positions are lacking. We evaluated the effects of cereal rye and hairy vetch CCs on weed suppression at different topographic positions (shoulder, backslope, and footslope) at a watershed scale. Watersheds with a CC treatment followed a crop rotation of corn–cereal rye–soybean–hairy vetch, whereas watersheds without a CC (no-CC) had a crop rotation of corn–winter fallow–soybean–winter fallow. A negative relationship was present between CCs and weed biomass at the shoulder, backslope, and footslope topographic landscape positions, with R2 values of 0.40, 0.48, and 0.50, respectively. In 2016, a cereal rye CC reduced weed biomass 46% to 50% at footslope and shoulder positions compared to no CC. In 2018, a cereal rye CC reduced weed biomass between 52% and 85% at all topographic positions in CC treatment watersheds compared to no-CC watersheds. Hairy vetch in 2017 reduced weed biomass 62% to 72% at footslope and shoulder topographic positions in CC watersheds compared to no-CC. The C:N ratio of weed biomass in CC treatment watersheds was generally higher compared to watersheds without CCs. In this study, several significant interactions were found between the topographic positions and CC treatments. Cover crop–induced weed suppression at different topographic positions can lead to developing better site-specific weed control strategies. Therefore, CC interactions with topography, weed germination potential, and the role of soil moisture at the watershed scale should be further evaluated.

Introduction: Preservation of the spinal accessory nerve during neck dissection should be the rule rather than the exception. Despite the presence of many described techniques to locate the nerve, a tedious dissection is often required; as a consequence, it remains vulnerable to damage.

Method: We describe a novel method, not previously reported, based on identifying a constant vein which crosses the nerve. This aids in the nerve's early identification.

Conclusion: Our method enables the surgeon to locate the nerve precisely and to avoid damage to it, thereby maximizing post-operative function.

Objectives: The present study evaluated the cost-effectiveness of a behavioral graded exercise therapy (GET) program compared with usual care (UC) in terms of the performance of daily activities by patients with chronic shoulder complaints in primary care.

Methods: A total of 176 patients were randomly assigned either to GET (n=87) or to UC (n=89). Clinical outcomes (main complaints, shoulder disability [SDQ] and generic health-related quality of life [EQ-5D], and costs [intervention costs, direct health care costs, direct non–health-related costs, and indirect costs]) were assessed during the 12-week treatment period and at 52 weeks of follow-up.

Results: Results showed that GET was more effective than UC in restoring daily activities as assessed by the main complaints instrument after the 12-week treatment period (p=.049; mean difference, 7.5; confidence interval [CI], 0.0–15.0). These effects lasted for at least 52 weeks (p=.025; mean difference 9.2; CI, 1.2–17.3). No statistically significant differences were found on the SDQ or EQ5D. GET significantly reduced direct health care costs (p=.000) and direct non–health care costs (p=.029). Nevertheless, total costs during the 1-year follow-up period were significantly higher (p=.001; GET=€530 versus UC=€377) due to the higher costs of the intervention. Incremental cost-effectiveness ratios for the main complaints (0–100), SDQ (0–100), and EQ-5D (−1.0–1.0) were €17, €74, and €5,278 per unit of improvement, respectively.

Conclusions: GET proved to be more effective in the short- and long-term and reduces direct health care costs and direct non–health care costs but is associated with higher costs of the intervention itself.