Power grip, pinch grip, manual muscle testing or thenar atrophy - which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review

<p>Abstract</p> <p>Background</p> <p>Objective assessment of motor function is frequently used to evaluate outcome after surgical treatment of carpal tunnel syndrome (CTS). However a range of outcome measures are used and there appears to be no consensus on which measure of motor function effectively captures change. The purpose of this systematic review was to identify the methods used to assess motor function in randomized controlled trials of surgical interventions for CTS. A secondary aim was to evaluate which instruments reflect clinical change and are psychometrically robust.</p> <p>Methods</p> <p>The bibliographic databases Medline, AMED and CINAHL were searched for randomized controlled trials of surgical interventions for CTS. Data on instruments used, methods of assessment and results of tests of motor function was extracted by two independent reviewers.</p> <p>Results</p> <p>Twenty-two studies were retrieved which included performance based assessments of motor function. Nineteen studies assessed power grip dynamometry, fourteen studies used both power and pinch grip dynamometry, eight used manual muscle testing and five assessed the presence or absence of thenar atrophy. Several studies used multiple tests of motor function. Two studies included both power and pinch strength and reported descriptive statistics enabling calculation of effect sizes to compare the relative responsiveness of grip and pinch strength within study samples. The study findings suggest that tip pinch is more responsive than lateral pinch or power grip up to 12 weeks following surgery for CTS.</p> <p>Conclusion</p> <p>Although used most frequently and known to be reliable, power and key pinch dynamometry are not the most valid or responsive tools for assessing motor outcome up to 12 weeks following surgery for CTS. Tip pinch dynamometry more specifically targets the thenar musculature and appears to be more responsive. Manual muscle testing, which in theory is most specific to the thenar musculature, may be more sensitive if assessed using a hand held dynamometer – the Rotterdam Intrinsic Handheld Myometer. However further research is needed to evaluate its reliability and responsiveness and establish the most efficient and psychometrically robust method of evaluating motor function following surgery for CTS.</p

Control of sulphide during anaerobic treatment of S-containing wastewaters by adding limited amounts of oxygen or nitrate

Sulphide generated during anaerobic treatment of S-containing wastewaters represents an environmental problem. Adding limited amounts of oxygen or nitrate (or nitrite) to biologically (or chemically) oxidise sulphide forms a simple process level strategy to control this problem. This short review evaluates the feasibility and limitations of this strategy on the basis of the results of bioreactor studies.Sulphide generated during anaerobic treatment of S-containing wastewaters represents an environmental problem. Adding limited amounts of oxygen or nitrate (or nitrite) to biologically (or chemically) oxidise sulphide forms a simple process level strategy to control this problem. This short review evaluates the feasibility and limitations of this strategy on the basis of the results of bioreactor studies.Spanish Ministry of Education and Science; AEA Technology Environment; Nova Energie; The Swedish Gas Centre; University of Southern Denmark

Transport of Folded Proteins by the Tat System

The twin-arginine protein translocation (Tat) system has been characterized in bacteria, archaea and the chloroplast thylakoidal membrane. This system is distinct from other protein transport systems with respect to two key features. Firstly, it accepts cargo proteins with an N-terminal signal peptide that carries the canonical twin-arginine motif, which is essential for transport. Second, the Tat system only accepts and translocates fully folded cargo proteins across the respective membrane. Here, we review the core essential features of folded protein transport via the bacterial Tat system, using the three-component TatABC system of Escherichia coli and the two-component TatAC systems of Bacillus subtilis as the main examples. In particular, we address features of twin-arginine signal peptides, the essential Tat components and how they assemble into different complexes, mechanistic features and energetics of Tat-dependent protein translocation, cytoplasmic chaperoning of Tat cargo proteins, and the remarkable proofreading capabilities of the Tat system. In doing so, we present the current state of our understanding of Tat-dependent protein translocation across biological membranes, which may serve as a lead for future investigations

Sec- and Tat-mediated protein secretion across the bacterial cytoplasmic membrane:Distinct translocases and mechanisms

AbstractIn bacteria, two major pathways exist to secrete proteins across the cytoplasmic membrane. The general Secretion route, termed Sec-pathway, catalyzes the transmembrane translocation of proteins in their unfolded conformation, whereupon they fold into their native structure at the trans-side of the membrane. The Twin-arginine translocation pathway, termed Tat-pathway, catalyses the translocation of secretory proteins in their folded state. Although the targeting signals that direct secretory proteins to these pathways show a high degree of similarity, the translocation mechanisms and translocases involved are vastly different

Electrocatalysts for oxygen reduction prepared by plasma treatment of carbon supported cobalt tetramethoxyphenylporphyrin

Heat treated cobalt tetramethoxyphenylporphyrin CoTMPP on carbon support Black Pearls is well known as highly active material for the electroreduction of oxygen in acidic electrolytes. However, in the process of catalyst formation at high temperatures aggregation of the carbon supported particles occurs causing a detrimental decrease of the active surface. This contribution describes for the first time an alternative preparation method for a CoTMPP based electrocatalyst via low temperature plasma treatment suppressing particle aggregation. Different parameters of plasma duration of treatment, power, gas composition have been varied in order to investigate their influence on the preparation process. After treatment, the electrochemical activity of the samples has been tested by Rotating Disc Electrode technique RDE and Cyclovoltammetry CV . Their structural features were characterised by UV VIS and IR spectroscopy. A comparison of the results with Argon plasma treated carbon supported CoTMPP catalyst reveals higher electrochemical activity as with heat treated sample. The investigations open up new preparation strategies using the special features of plasma technology for surface optimised catalytic material

Comparative study of the carbonisation of CoTMPP by low temperature plasma and by heat treatment

Low temperature plasma treatment LTP of cobalt tetramethoxyphenylporphyrin CoTMPP has been applied as a promising alternative method to the conventional heat treatment in order to attain high active catalysts for the electroreduction of oxygen. In this contribution it is shown that CoTMPP can be completely transformed into a carbon matrix by adjusting adequate LTP parameters. The carbonisation process of CoTMPP is investigated at different operation conditions by Raman and IR spectroscopy and compared with the structural features of the heat treated one. As a result it appears that the LTP occurs via a different carbonisation process which yields in a more homogeneous defined molecular carbon structur

Plasma modification of catalysts for cathode reduction of hydrogen peroxide in fuel cells

Plasma techniques have been extensively utilized in catalysis. Catalyst preparation using plasma treatment allows improving dispersion, enhancing catalyst performance and stability. In this paper, the low pressure RF discharge is shown as an efficient method to enhance activity of Co based electrocatalyst for the reduction of hydrogen peroxide. It was found 20 CoTMPP C catalyst treated by plasma presents 2 fold higher catalytic activity than catalyst prepared by without plasma treatment. The influence of catalyst treatment on elemental surface and bulk concentration and performance of catalysts for hydrogen peroxide in a fuel cell was investigate