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.

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.

Geo-referenced photo-mosaics of the Menez Gwen Hydrothermal Vent (Mid-Atlantic Ridge)

The Menez Gwen hydrothermal vents, located on the flanks of a small young volcanic structure in the axial valley of the Menez Gwen seamount, are the shallowest known vent systems on the Mid-Atlantic Ridge that host chemosynthetic communities. Although visited several times by research cruises, very few images have been published of the active sites, and their spatial dimensions and morphologies remain difficult to comprehend. We visited the vents on the eastern flank of the small Menez Gwen volcano during cruises with RV Poseidon (POS402, 2010) and RV Meteor (M82/3, 2010), and used new bathymetry and imagery data to provide first detailed information on the extents, surface morphologies, spatial patterns of the hydrothermal discharge and the distribution of dominant megafauna of five active sites. The investigated sites were mostly covered by soft sediments and abundant white precipitates, and bordered by basaltic pillows. The hydrothermally-influenced areas of the sites ranged from 59 to 200 m**2. Geo-referenced photomosaics and video data revealed that the symbiotic mussel Bathymodiolus azoricus was the dominant species and present at all sites. Using literature data on average body sizes and biomasses of Menez Gwen B. azoricus, we estimated that the B. azoricus populations inhabiting the eastern flank sites of the small volcano range between 28,640 and 50,120 individuals with a total biomass of 50 to 380 kg wet weight. Based on modeled rates of chemical consumption by the symbionts, the annual methane and sulfide consumption by B. azoricus could reach 1760 mol CH4 yr**-1 and 11,060 mol H2S yr**-1. We propose that the chemical consumption by B. azoricus over at the Menez Gwen sites is low compared to the natural release of methane and sulfide via venting fluids.