bluuebunny/crossref_metadata_2025_split huggingface dataset:
Workload Differentiates Breast Surgical Procedures: NSM Associated with Higher Workload Demand than SSM
Authors: Hallbeck M. Susan , Law Katherine E. , Lowndes Bethany R. , Linden Anna R. , Morrow Melissa , Blocker Renaldo C. , Cain Stephen M. , Degnim Amy C. , Hieken Tina J. , Jakub James W. , Racz Jennifer M. , Farley David R. , Nelson Heidi , Boughey Judy C. 
Published: January 2020

Abstract
Background
Breast surgery has evolved with more focus on improving cosmetic outcomes, which requires increased operative time and technical complexity. Implications of these technical advances in surgery for the surgeon are unclear, but they may increase intraoperative demands, both mentally and physically. We prospectively evaluated mental and physical demand across breast surgery procedures, and compared surgeon ergonomic risk between nipple-sparing (NSM) and skin-sparing mastectomy (SSM) using subjective and objective measures.

Methods
From May 2017 to July 2017, breast surgeons completed modified NASA-Task Load Index (TLX) workload surveys after cases. From January 2018 to July 2018, surgeons completed workload surveys and wore inertial measurement units to evaluate their postures during NSM and SSM cases. Mean angles of surgical postures, ergonomic risk, survey items, and patient factors were analyzed.

Results
Procedural duration was moderately related to surgeon frustration, mental and physical demand, and fatigue (p < 0.001). NSMs were rated 23% more physically demanding (M = 13.3, SD = 4.3) and demanded 28% more effort (M = 14.4, SD = 4.6) than SSMs (M = 10.8, SD = 4.7; M = 11.8, SD = 5.0). Incision type was a contributing factor in workload and procedural difficulty. Left arm mean angle was significantly greater for NSM (M = 30.1 degrees, SD = 6.6) than SSMs (M = 18.2 degrees, SD = 4.3). A higher musculoskeletal disorder risk score for the trunk was significantly associated with higher surgeon physical workload (p = 0.02).

Conclusion
Nipple-sparing mastectomy required the highest surgeon-reported workload of all breast procedures, including physical demand and effort. Objective measures identified the surgeons’ left upper arm as being at the greatest risk for a work-related musculoskeletal disorder, specifically from performing NSMs.
Sport-Related Concussion Preceding Adrenal Insufficiency and Hypopituitarism
Authors: Northam Weston T. , Alexander Andrew , Carneiro Kevin 
Published: January 2020

AbstractA 49-year-old female with history of daily inhaled corticosteroid use for asthma presented to a concussion clinic 7 wk after sport-related head injury with headache, visual blurring, dizziness, nausea, fatigue, polydipsia, and polyuria. Examination revealed difficulty with vestibuloocculomotor testing due to nausea and visual straining. Cranial computed tomography/magnetic resonance imaging was unremarkable. Laboratory testing revealed critically low serum cortisol, hypernatremia, and urine studies suggesting diabetes insipidus. The patient was referred to the emergency department. Intravenous fluid resuscitation, corticosteroids, and desmopressin led to significant symptomatic relief. She was maintained on oral hydrocortisone after cosyntropin test revealed adrenal insufficiency. Her clinical picture suggested chronic subclinical adrenal suppression from inhaled corticosteroids which was exacerbated by hypopituitarism from concussion combined with diabetes insipidus. Adrenal insufficiency should be considered in athletes with history of corticosteroid use and endocrine-related symptoms after concussion, because this can create significant morbidity and can mimic traditional symptoms of concussion.
Neuromuscular versus Mechanical Stretch-induced Changes in Contralateral versus Ipsilateral Muscle
Authors: CÈ EMILIANO , CORATELLA GIUSEPPE , BISCONTI ANGELA VALENTINA , VENTURELLI MASSIMO , LIMONTA ELOISA , DORIA CHRISTIAN , RAMPICHINI SUSANNA , LONGO STEFANO , ESPOSITO FABIO 
Published: January 2020

ABSTRACT

Purpose
Whether or not the homologous contralateral muscle (CM) undergoes stretch-induced force reduction as the stretched muscle (SM) is still unclear. The neuromuscular and mechanical factors underlying the force reduction in CM and SM were investigated.

Methods
Twenty-one participants underwent unilateral knee extensors passive stretching. In both CM and SM, before, immediately after (POST), 5 (POST5), and 10 min (POST10) after passive stretching, maximum voluntary contraction (MVC), peak force (pF), and voluntary activation (VA) were measured. During MVC, the electromyographic and mechanomyographic root mean square (EMG RMS and MMG RMS, respectively) was calculated in rectus femoris, vastus lateralis, and vastus medialis, together with M-wave. The total electromechanical delay (EMD), divided in time delay (Δt) EMG-MMG and Δt MMG-F was calculated.

Results
In CM at POST, the decrease in MVC (−11%; 95% confidence interval [CI], −13 to −9; effect size [ES], −2.27) was accompanied by a fall in VA (−7%; 95% CI, −9 to −4; ES, −2.29), EMG RMS (range, −22% to −11%; ES, −3.92 to −2.25), MMG RMS (range, −10% to −8%; ES, −0.52 to −0.39) and an increase in Δt EMG-MMG (≈+10%; ES, 0.73 to 0.93). All changes returned to baseline at POST5. In SM, decrease in MVC (−19%; 95% CI, −24 to −18; ES, −3.08), pF (−25%; 95% CI, −28 to −22; ES, −4.90), VA (−10%; 95% CI, −11 to −9; ES, −5.71), EMG RMS (≈−33%; ES, −5.23 to −3.22) and rise in MMG RMS (range, +25% to +32%; ES, 4.21 to 4.98) and EMD (≈+28%; ES, 1.59 to 1.77) were observed at POST and persisted at POST10. No change in M-wave occurred.

Conclusions
The contralateral central motor drive stretch-induced inhibition seems to account for the force reduction in CM. In SM, both central inhibition and mechanical factors concurred.
A new respiratory monitor system for four-dimensional computed tomography by measuring the pressure change on the back of body
Authors: Zhang Xianwen , Tang Jintian , Sharp Gregory C. , Xiao Lei , Xu Shouping , Lu Hsiao-Ming 
Published: January 2020

Objective:
A novel respiratory monitoring method based on the periodical pressure change on the patient’s back was proposed and assessed by applying to four-dimensional CT (4DCT) scanning.

Methods:
A pressure-based respiratory monitoring system is developed and validated by comparing to real-time position management (RPM) system. The pressure change and the RPM signal are compared with phase differences and correlations calculated. The 4DCT images are reconstructed by these two signals. Internal and skin artifacts due to mismatch between CT slices and respiratory phases are evaluated.

Results:
The pressure and RPM signals shows strong consistency (R = 0.68±0.19 (1SD)). The time shift is 0.26 ± 0.51 (1SD) s and the difference of breath cycle is 0.02 ± 0.17 (1SD) s. The quality of 4DCT images reconstructed by two signals is similar. For both methods, the number of patients with artifacts is eight and the maximum magnitudes of artifacts are 20 mm (internal) and 10 mm (skin). The average magnitudes are 8.8 mm (pressure) and 8.2 mm (RPM) for internal artifacts, and 5.2 mm (pressure) and 4.6 mm (RPM) for skin artifacts. The mean square gray value difference shows no significant difference (p = 0.52).

Conclusion:
The pressure signal provides qualified results for respiratory monitoring in 4DCT scanning, demonstrating its potential application for respiration monitoring in radiotherapy.

Advances in knowledge:
Pressure change on the back of body is a novel and promising method to monitor respiration in radiotherapy, which may improve treatment comfort and provide more information about respiration and body movement.
Sonoarthrographic examination of posterior labrocapsular structures of the shoulder joint
Authors: Ogul Hayri , Tas Nurmuhammet , Ay Mutlu , Kose Mehmet , Kantarci Mecit 
Published: January 2020

Objective:
To describe the posterior labral lesions and labrocapsular abnormalities of the shoulder on sonoarthrography and to compare these findings with MR arthrography results.

Methods:
82 shoulders were initially evaluated with ultrasonography and MRI and then were examined with sonoarthrography and MR arthrography following intraarticular injection of diluted gadolinium solution. The ultrasonography images were prospectively evaluated for the presence of posterior labral tear, sublabral cleft, and posterior capsular abnormalities by two radiologists. The diagnostic accuracy of sonoarthrography in the detection of posterior labral tears and posterior labrocapsular variants was compared with that of MR arthrography.

Results:
In sonoarthrographic examinations of 82 shoulders, 5 and 6 posterior labral tears were identified by Observer 1 and 2, respectively. Moreover, 6 and 7 posterior sublabral clefts, and 2 and 3 posterior synovial folds were identified by Observer 1 and 2, respectively. All the 82 patients were examined with MR arthrography; however, only 14 patients underwent arthroscopic examination. No significant difference was found among the 82 patients with regard to age, gender, and the prevalence of posterior labral tear, posterior labral cleft, and posterior synovial fold (p &gt; 0.05). Interobserver variability showed substantial agreement between the sonoarthrographic and MR arthrographic results of the posterior labrocapsular structures (κ = 0.71, p &lt; 0.05).

Conclusion:
Posterior labral tears and posterior synovial folds of the shoulder joint can be evaluated non-invasively by sonoarthrography.

Advances in knowledge:
Variations and pathologies of posterior labrocapsular structures of the glenohumeral joint are relatively uncommon.
Direct (MR) arthrography is the gold-standard imaging modality to evaluate of posterior labrocapsular abnormalities of the glenohumeral joint.
Sonoarthrography of the glenohumeral joint may be utilized in clinical practice in patients with contraindications to (MRI).
Saúde e doença em aldeias Guarani: lidando com emoções
Authors: Pissolato Elizabeth 
Published: January 2020

Este artigo toma por base a etnografia contemporânea sobre grupos Guarani e propõe uma abordagem das relações de parentesco e das emoções nos termos de constantes e complexas negociações intersubjetivas voltadas à produção de saúde e do estado referido como “estar alegre” (-vy’ a). A ética do cuidado entre parentes define-se aqui pela produção de bembem-estar e disponibilização de habilidades de cura e evitação de processos agressivos (doença). Por outro lado, a lida com as emoções conecta-se diretamente com práticas de mudança residencial adotadas pelas pessoas quando não se sentem mais “alegres” ou suspeitam de agressões originadas no contexto em que vivem. Um jogo complexo que articula a percepção sobre as próprias aflições e impressões ou suspeitas quanto aos sentimentos e disposições de outras pessoas entra em cena, permitindo-nos uma abordagem das emoções como “estados intersubjetivos”, mastambém com implicações éticas e inscritas no social.
As emoções em Libras: uma análise da conversa entre Youtubers
Authors: Souza Isabelle A. L. , Pereira Maria das Graças Dias 
Published: January 2020

As emoções fazem parte da vida social, e podem ser analisadas discursivamente através de práticas sociais. Os sentimentos são inerentes a todos os seres humanos, mas as formas como eles expressam ou significam os sentimentos nas relações sociais são sensíveis ao contexto situacional e sócio-cultural. O presenta estudo analisa as emoções na interação, no contexto da rede social, na interação em Libras entre um surdo e uma ouvinte. O objetivo consiste em demonstrar a coconstrução das emoções enquanto fabricação dos sentimentos na situação analisada. A pesquisa é qualitativa, na perspectiva da Análise da Conversa, de natureza multimodal. Na abordagem teórica, foram utilizados estudos sobre o humor, a ironia e accounts. Como procedimento de geração e análise dos dados, foram desenvolvidas tradução/transcrição do vídeo disponível no Canal Youtube. A partir da análise, compreendemos que o humor e a ironia foram expostos accounts e como estratégia sócio interacional para autopreservação da imagem e defender a face de perguntas provocar uma situação embaraçosa e constrangedora.
Robotic-assisted unicompartmental knee arthroplasty has a greater early functional outcome when compared to manual total knee arthroplasty for isolated medial compartment arthritis
Authors: Clement Nicholas D. , Bell Allison , Simpson Philip , Macpherson Gavin , Patton James T. , Hamilton David F. 
Published: January 2020

Aims The primary aim of the study was to compare the knee-specific functional outcome of robotic unicompartmental knee arthroplasty (rUKA) with manual total knee arthroplasty (mTKA) for the management of isolated medial compartment osteoarthritis. Secondary aims were to compare length of hospital stay, general health improvement, and satisfaction between rUKA and mTKA. Methods A powered (1:3 ratio) cohort study was performed. A total of 30 patients undergoing rUKA were propensity score matched to 90 patients undergoing mTKA for isolated medial compartment arthritis. Patients were matched for age, sex, body mass index (BMI), and preoperative function. The Oxford Knee Score (OKS) and EuroQol five-dimension questionnaire (EQ-5D) were collected preoperatively and six months postoperatively. The Forgotten Joint Score (FJS) and patient satisfaction were collected six months postoperatively. Length of hospital stay was also recorded. Results There were no significant differences in the preoperative demographics (p ⩾ 0.150) or function (p ⩾ 0.230) between the groups. The six-month OKS was significantly greater in the rUKA group when compared with the mTKA group (difference 7.7, p < 0.001). There was also a greater six-month postoperative EQ-5D (difference 0.148, p = 0.002) and FJS (difference 24.2, p < 0.001) for the rUKA when compared to the mTKA. No patient was dissatisfied in the rUKA group and five (6%) were dissatisfied in the mTKA, but this was not significant (p = 0.210). Length of stay was significantly (p < 0.001) shorter in the rUKA group (median two days, interquartile range (IQR) 1 to 3) compared to the mTKA (median four days, IQR 3 to 5). Conclusion Patients with isolated medial compartment arthritis had a greater knee-specific functional outcome and generic health with a shorter length of hospital stay after rUKA when compared to mTKA. Cite this article: Bone Joint Res 2019;9(1):15–22.
Optimization Modeling Analysis for Grain Harvesting Management
Authors: Lin Tao , Liao Wei-Ting , Rodríguez Luis F. , Shastri Yogendra N. , Ouyang Yangfeng , Tumbleson M. E. , Ting K. C. 
Published: January 2020

HighlightsAn optimization model, called BioGrain, was developed to optimize grain harvesting decisions.The results highlight the tradeoffs between grain losses and drying costs for profit maximization.The optimization model can provide decision support for individual farms in different regions. Abstract. Appropriate farm management practices can improve agricultural productivity and reduce grain losses. An optimization model, called BioGrain, was developed to maximize farmers’ profits by optimizing critical grain harvesting decisions including agricultural machinery selection and harvesting schedules. This model was applied to 18 representative farms of varied sizes in Illinois, Iowa, and Minnesota. Our optimization showed that understanding crop moisture dynamics is critical for maximizing profits at the farm scale. Our results highlight the tradeoffs between grain losses and drying costs when considering profit maximization. By optimizing harvesting dates and machinery size, large farms can reduce the grain loss rate to 10%, and small farms can achieve a 5% grain loss rate. Large farms outperformed small farms on unit profits despite their higher grain loss rate. The model considers both revenue and cost related factors in harvesting decisions and quantifies the tradeoffs among corn yield, drying, and equipment selection. The model can be used to provide decision support for individual farms in different regions considering their local crop and market information. Keywords: Grain losses, Harvesting schedule, Machinery selection, Optimization, Profits.
Quantifying Nitrate Dynamics of a Confluence Floodplain Wetland in a Disturbed Appalachian Watershed: High-Resolution Sensing and Modeling
Authors: Jensen Alexandria K. , Ford William I. 
Published: January 2020

Abstract. Floodplain wetlands often form at confluences of main river channels and small, low-order tributary streams, yet their impact on nutrient removal and downstream loading is poorly understood. We coupled high-resolution water quality data with deterministic numerical modeling of hydrologic, hydraulic, and biochemical processes impacting nitrate fate and transport in a confluence floodplain wetland along the Ohio River from June 2017 to May 2018. The modeling results were used to quantify loading from a disturbed forested watershed (Fourpole Creek watershed) and the nitrate removal capacity of the wetland. Loading from the Fourpole Creek watershed to the wetland was on the same order of magnitude of other disturbed forested systems on an annual basis (3.6 kg N ha-1 year-1); however, the timing of peak nitrate loading and concentration from the tributary was associated with high flow conditions, contrasting with the timing of loadings typical of disturbed forested landscapes. Our results show that coupling the model with high-resolution data allowed us to estimate removal rates in the wetland, suggesting that 2.6% to 58.5% (optimally 12.7%) of nitrate was removed on an annual basis, despite the wetland comprising only 0.42% of the overall drainage area. We found that increasing inundation of the wetland confluence promoted enhanced residence times of stormflows and was the most important driver of nitrate removal rate and loading, with peak wetland inundation periods representing 26% of the removal load but occurring only 9% of the time. The findings of this study highlight the importance of using high-resolution data-model integration to quantify nutrient dynamics in complex landscapes, identifies the significance of connectivity of watershed nitrate loadings to floodplain wetland soils, and highlights the importance that these features will have in the future, given the enhanced potential for harmful algal blooms in the Ohio River. Keywords: Confluence floodplain wetlands, High-resolution water quality data, Nitrate fate and transport modeling, Nitrate loading, Wetland nitrate removal.
Measurements and Comparative Air Quality Analysis of a Goat Farm Operation
Authors: Howard Arndreya , Botlaguduru Venkata S. V. , Du Hongbo , Kommalapati Raghava R. , Huque Ziaul 
Published: January 2020

Abstract. Air pollutants such as hydrogen sulfide, ammonia, particulate matter (PM10 and PM2.5), methane, and volatile organic compounds (VOCs) are harmful to the respiratory systems of humans and animals. Livestock facilities have been documented as a major source of dangerous air pollutants; however, there is a lack of data on the emissions from goat farms. This study investigated a goat farm in Texas to evaluate the emission levels and determine the correlation of meteorological conditions with these pollutants. Two locations on the goat farm were selected for monitoring: inside a goat barn, and at a manure lagoon. The monitoring campaign was conducted over a 53-day period during winter and summer seasons. Carbon dioxide, ozone, nitrous oxide, ammonia, PM10, PM2.5, hydrogen sulfide, methane, and VOCs were measured to determine hourly average concentrations using chemiluminescent instruments. An analysis of meteorological conditions using multiple regression was conducted to investigate probable correlations between emission rates and characteristic climate data, such as temperature, humidity, barometric pressure, and solar radiation. Particle size distributions of PM10 and PM2.5 were evaluated for the two monitoring locations during the different seasons to determine the typical particle diameter and the impact of season on particle diameter. The highest emission rate of 364.4 ±50 g m-2 d-1 occurred at the manure lagoon for methane, which contributed the most to the overall emissions at this animal operation. The regression results for the manure lagoon had the highest positive correlations for ozone with temperature and solar radiation. The outdoor meteorological conditions had the most significant influence on pollutants at both locations. Therefore, meteorological conditions are instrumental in the intensity of the air pollutants found on animal farms. The particle diameters ranged from 0.1 to 6.0 µm in the goat barn and from 0.3 to 1.0 µm at the manure lagoon. Even though moderate levels of emissions were monitored at this facility, the emissions from the goat farm do not pose a risk to human health and do not significantly impact the ambient air quality when compared to other livestock facilities.HighlightsEmissions from a goat farm were measured inside a goat barn and at a manure lagoon over summer and winter seasons.The highest methane emission rate of 364.4 ±50 g m-2 d-1 occurred at the manure lagoon during summer.Meteorological conditions significantly influenced emissions at both locations, especially for O3 at the manure lagoon.Emissions from goat farm operations are much lower than those from cow, swine, and chicken farm operations. Keywords: Air quality, Ammonia, Emissions, Goat farm, Methane, Multiple regression analysis.
Performance, Energy, and Product Quality Aspects of a Modified Pneumatic Dryer for Rapid Drying of High-Moisture Paddy
Authors: Nimmol Chatchai 
Published: January 2020

The application of surface roughness on the drying column was combined with a multipass drying concept (first-pass and second-pass drying) to improve the performance and energy utilization of a conventional pneumatic dryer during rapid drying of high-moisture paddy. The surface roughness on the drying column was characterized by the ratio of the corrugated surface length (C) to the total length (L) of the column (i.e., C/L). The effects of drying temperature (120°C, 150°C, and 180°C) and C/L value (0, 0.5, and 1.0) on the dryer performance, energy utilization of the drying process, and rice milling quality were determined. The drying column with a higher C/L value had higher potential for improving the dryer performance and energy utilization of the drying process. For first-pass drying, a drying column with C/L values of 0.5 and 1.0 could reduce energy consumption by 14% to 17% and by 41% to 44%, respectively, compared with a column without a corrugated surface (C/L = 0). However, for second-pass drying, the drying system that used a drying column with a corrugated surface consumed more energy. The moisture content reduction of paddy could also be significantly increased after second-pass drying. For both first-pass and second-pass drying, a higher drying temperature and higher C/L value resulted in a lower head rice yield from the milled rice, while the effects of drying temperature and C/L value on the whiteness value of the milled rice were found to be insignificant.HighlightsCharacteristics of the drying column had more significant effects on the dryer performance and energy utilization than the drying temperature.A drying column with C/L = 1 (totally corrugated surface) showed significant potential for increasing the dryer performance and energy utilization of the drying process.A drying column with a higher C/L value may not be necessary for paddy with a small amount of surface moisture.Multipass drying of paddy using a pneumatic dryer is not suggested due to the significant reduction in head rice yield. Keywords: Drying column, Energy utilization, Milling quality, Multipass drying, Pneumatic dryer, Surface roughness.