Endoscopic and Open Release Similarly Safe for the Treatment of Carpal Tunnel Syndrome. A Systematic Review and Meta-Analysis.

BACKGROUND The Endoscopic Release of Carpal Tunnel Syndrome (ECTR) is a minimal invasive approach for the treatment of Carpal Tunnel Syndrome. There is scepticism regarding the safety of this technique, based on the assumption that this is a rather "blind" procedure and on the high number of severe complications that have been reported in the literature. PURPOSE To evaluate whether there is evidence supporting a higher risk after ECTR in comparison to the conventional open release. METHODS We searched MEDLINE (January 1966 to November 2013), EMBASE (January 1980 to November 2013), the Cochrane Neuromuscular Disease Group Specialized Register (November 2013) and CENTRAL (2013, issue 11 in The Cochrane Library). We hand-searched reference lists of included studies. We included all randomized or quasi-randomized controlled trials (e.g. study using alternation, date of birth, or case record number) that compare any ECTR with any OCTR technique. Safety was assessed by the incidence of major, minor and total number of complications, recurrences, and re-operations.The total time needed before return to work or to return to daily activities was also assessed. We synthesized data using a random-effects meta-analysis in STATA. We conducted a sensitivity analysis for rare events using binomial likelihood. We judged the conclusiveness of meta-analysis calculating the conditional power of meta-analysis. CONCLUSIONS ECTR is associated with less time off work or with daily activities. The assessment of major complications, reoperations and recurrence of symptoms does not favor either of the interventions. There is an uncertain advantage of ECTR with respect to total minor complications (more transient paresthesia but fewer skin-related complications). Future studies are unlikely to alter these findings because of the rarity of the outcome. The effect of a learning curve might be responsible for reduced recurrences and reoperations with ECTR in studies that are more recent, although formal statistical analysis failed to provide evidence for such an association. LEVEL OF EVIDENCE I.

Simultaneous multi-slice readout-segmented echo planar imaging for accelerated diffusion-weighted imaging of the breast

OBJECTIVES Readout-segmented echo planar imaging (rs-EPI) significantly reduces susceptibility artifacts in diffusion-weighted imaging (DWI) of the breast compared to single-shot EPI but is limited by longer scan times. To compensate for this, we tested a new simultaneous multi-slice (SMS) acquisition for accelerated rs-EPI. MATERIALS AND METHODS After approval by the local ethics committee, eight healthy female volunteers (age, 38.9±13.1 years) underwent breast MRI at 3T. Conventional as well as two-fold (2× SMS) and three-fold (3× SMS) slice-accelerated rs-EPI sequences were acquired at b-values of 50 and 800s/mm(2). Two independent readers analyzed the apparent diffusion coefficient (ADC) in fibroglandular breast parenchyma. The signal-to-noise ratio (SNR) was estimated based on the subtraction method. ADC and SNR were compared between sequences by using the Friedman test. RESULTS The acquisition time was 4:21min for conventional rs-EPI, 2:35min for 2× SMS rs-EPI and 1:44min for 3× SMS rs-EPI. ADC values were similar in all sequences (mean values 1.62×10(-3)mm(2)/s, p=0.99). Mean SNR was 27.7-29.6, and no significant differences were found among the sequences (p=0.83). CONCLUSION SMS rs-EPI yields similar ADC values and SNR compared to conventional rs-EPI at markedly reduced scan time. Thus, SMS excitation increases the clinical applicability of rs-EPI for DWI of the breast.

High Tunnel Bramble Production

In 2006, a study was initiated at the ISU Armstrong Research Farm (ARF) to evaluate the potential for growing high-value floricane and primocane type raspberries and blackberries in a high tunnel. The objectives were to determine if a high tunnel could be used to improve over-wintering of cold sensitive floricane types, and if the harvest season of primocane types could be advanced far enough ahead that they could replace the floricane types in such a production system. A second objective was to determine if these crops could be grown in a high tunnel without pesticides or minimum pesticide usage. This report summarizes the results for the 2009 through 2011growing seasons.

Rainwater Catchment from a High Tunnel for Irrigation Use

High tunnels are simple, plastic-covered, passive solar-heated structures in which crops are grown in the ground. They are used by fruit and vegetable growers to extend the growing season and intensify production in cold climates. The covered growing area creates a desert-like environment requiring carefully monitored irrigation practices. In contrast, the exterior expanse of a high tunnel generates a large volume of water with every measurable rainfall. Each 1,000 ft of high tunnel roof will generate approximately 300 gallons from a half inch of rain. Unless the high tunnel site is elevated from the surrounding area or drainage tiles installed, or other drainage accommodations are made around the perimeter, the soil along the inside edge of the high tunnel is nearly continuously saturated. High volumes of water can also create an erosion problem. The objective of this project was to design and construct a system that enables growers using high tunnels in their production operation to reduce drainage problems, erosion, and crop loss due to excess moisture in and around their high tunnel(s) without permanent environmental and soil mediations.

High Tunnel Production: Inputs, Labor, and Crop Productivity

The 30 × 12 × 96 ft (W × H × L, 2,880 ft 2 ) high tunnel was planted and maintained as part of a high tunnel production budget project funded by a Specialty Crop Grant through the Iowa Department of Agriculture and Land Stewardship. Six growers throughout the state participated in the project with the objectives of creating an enterprise budgeting tool that estimates the costs and revenues associated with producing specific crops in a high tunnel, either as a single crop or multi-crop system. The budgeting tool will estimate the production cost and net profit per square foot in a high tunnel from mono-culture (one crop per tunnel) or multi-cropping, successionplanted systems. This report summarizes the findings from the high tunnel at the ISU Horticulture Research Station. The plantings in this high tunnel were used to collect labor and yield data as well as demonstrate a continuous, multi-cropping production system. A publication containing the enterprise budgeting tool, using this data and data collected from the other six farms, will be available through Iowa State University Extension and Outreach in the fall of 2012.

Early Planting of Tomatoes in a High Tunnel with Plant Coverings

High tunnels have been successfully used in Iowa to modify the climate and extend the growing season for tomatoes and other crops. Without the use of supplemental heat these ventilated, single layered plastic structures have typically increased average inside air temperatures by 10°F or more over outside temperatures for the growing season. The same tunnel, however, will only increase the daily low temperature by about 1 or 2°F, thus making early season high tunnel plantings without additional heat or plant coverings risky in Iowa. Fabric row covers are commonly used in high tunnels to provide for an additional 2-4°F frost protection during cold evenings. The recommended planting date for high tunnel tomatoes in Iowa has been about April 16 (4 to 5 weeks ahead of the recommended outside planting date). Producers are also advised to have some sort of plant covering material available to protect plants during a late spring frost.

Unravelling the moisture sources of the Alpine Glaciers using tunnel valleys as constraints

A lack of archives has impeded reconstructions of moisture pathways for past glaciations in the European Alps. Here, we focus on the confluence area of two palaeoglaciers in the Swiss Plateau that were sourced on the northern (Aare glacier) and southern sides (Valais glacier) of the European Alps. We mapped tunnel valleys in the region using a drilling database, based on which we inferred the relative extent of each glacier c. 270 ka ago when the valleys were formed. We then compared this situation with that of the LGM. We found that, while the Valais glacier expanded farther into the foreland than the Aare glacier during the LGM, the opposite was the case c. 270 ka ago. We also found that LGM glaciers were non-erosive in the distal foreland. These contrasts in extents and erosional efficiencies imply differences in moisture pathways between the LGM and the time when the tunnel valleys were formed.

Segmented ionization chambers for beam monitoring in hadrontherapy.

Segmented ionization chambers represent a good solution to monitor the position, the intensity and the shape of ion beams in hadrontherapy. Pixel and strip chambers have been developed for both passive scattering and active scanning dose delivery systems. In particular, strip chambers are optimal for pencil beam scanning, allowing for spatial and time resolutions below 0.1 mm and 1 ms, respectively. The MATRIX pixel and the Strip Accurate Monitor for Beam Applications (SAMBA) detectors are described in this paper together with the results of several beam tests and industrial developments based on these prototypes.

A level II reliability approach to tunnel support design

A reliability approach to tunnel support design is presented in this paper. The aim of the work is the incorporation of classical Level II techniques to the current design method based on the study of the ground-support interaction diagram.

Components of a Wind Tunnel Balance: Design and Calibration

Components of a Wind Tunnel Balance: Design and Calibration

Measurement of Distributed Antenna Systems at 2.4 GHz in a Realistic Subway Tunnel Environment.

Accurate characterization of the radio channel in tunnels is of great importance for new signaling and train control communications systems. To model this environment, measurements have been taken at 2.4 GHz in a real environment in Madrid subway. The measurements were carried out with four base station transmitters installed in a 2-km tunnel and using a mobile receiver installed on a standard train. First, with an optimum antenna configuration, all the propagation characteristics of a complex subway environment, including near shadowing, path loss,shadow fading, fast fading, level crossing rate (LCR), and average fade duration (AFD), have been measured and computed. Thereafter, comparisons of propagation characteristics in a double-track tunnel (9.8-m width) and a single-track tunnel (4.8-m width) have been made. Finally, all the measurement results have been shown in a complete table for accurate statistical modeling.