| 1. |
- Eklund, Anders, et al.
(författare)
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The Pressure Difference between Eye and Brain Changes with Posture
- 2016
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Ingår i: Annals of Neurology. - : Wiley. - 0364-5134 .- 1531-8249. ; 80:2, s. 269-276
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The discovery of a posture-dependent effect on the difference between intraocular pressure (IOP) and intracranial pressure (ICP) at the level of lamina cribrosa could have important implications for understanding glaucoma and idiopathic intracranial hypertension and could help explain visual impairments in astronauts exposed to microgravity. The aim of this study was to determine the postural influence on the difference between simultaneously measured ICP and IOP.Methods: Eleven healthy adult volunteers (age = 46 ± 10 years) were investigated with simultaneous ICP, assessed through lumbar puncture, and IOP measurements when supine, sitting, and in 9° head-down tilt (HDT). The trans–lamina cribrosa pressure difference (TLCPD) was calculated as the difference between the IOP and ICP. To estimate the pressures at the lamina cribrosa, geometrical distances were estimated from magnetic resonance imaging and used to adjust for hydrostatic effects.Results: The TLCPD (in millimeters of mercury) between IOP and ICP was 12.3 ± 2.2 for supine, 19.8 ± 4.6 for sitting, and 6.6 ± 2.5 for HDT. The expected 24-hour average TLCPD on earth—assuming 8 hours supine and 16 hours upright—was estimated to be 17.3mmHg. By removing the hydrostatic effects on pressure, a corresponding 24-hour average TLCPD in microgravity environment was simulated to be 6.7mmHg.Interpretation: We provide a possible physiological explanation for how microgravity can cause symptoms similar to those seen in patients with elevated ICP. The observed posture dependency of TLCPD also implies that assessment of the difference between IOP and ICP in upright position may offer new understanding of the pathophysiology of idiopathic intracranial hypertension and glaucoma.
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| 2. |
- Holmlund, Petter, et al.
(författare)
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Human jugular vein collapse in the upright posture : implications for postural intracranial pressure regulation
- 2017
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Ingår i: Fluids and Barriers of the CNS. - : BioMed Central. - 2045-8118. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Intracranial pressure (ICP) is directly related to cranial dural venous pressure (P-dural). In the upright posture, P-dural is affected by the collapse of the internal jugular veins (IJVs) but this regulation of the venous pressure has not been fully understood. A potential biomechanical description of this regulation involves a transmission of surrounding atmospheric pressure to the internal venous pressure of the collapsed IJVs. This can be accomplished if hydrostatic effects are cancelled by the viscous losses in these collapsed veins, resulting in specific IJV cross-sectional areas that can be predicted from flow velocity and vessel inclination. Methods: We evaluated this potential mechanism in vivo by comparing predicted area to measured IJV area in healthy subjects. Seventeen healthy volunteers (age 45 +/- 9 years) were examined using ultrasound to assess IJV area and flow velocity. Ultrasound measurements were performed in supine and sitting positions. Results: IJV area was 94.5 mm(2) in supine and decreased to 6.5 +/- 5.1 mm(2) in sitting position, which agreed with the predicted IJV area of 8.7 +/- 5.2 mm(2) (equivalence limit +/- 5 mm(2), one-sided t tests, p = 0.03, 33 IJVs). Conclusions: The agreement between predicted and measured IJV area in sitting supports the occurrence of a hydrostatic-viscous pressure balance in the IJVs, which would result in a constant pressure segment in these collapsed veins, corresponding to a zero transmural pressure. This balance could thus serve as the mechanism by which collapse of the IJVs regulates P-dural and consequently ICP in the upright posture.
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| 3. |
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| 4. |
- Holmlund, Petter, et al.
(författare)
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Venous collapse regulates intracranial pressure in upright body positions
- 2018
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Ingår i: American Journal of Physiology. Regulatory Integrative and Comparative Physiology. - : American Physiological Society. - 0363-6119 .- 1522-1490. ; 314:3, s. R377-R385
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Tidskriftsartikel (refereegranskat)abstract
- Recent interest in intracranial pressure (ICP) in the upright posture has revealed that the mechanisms regulating postural changes in ICP are not fully understood. We have suggested an explanatory model where the postural changes in ICP depend on well-established hydrostatic effects in the venous system and where these effects are interrupted by collapse of the internal jugular veins (IJVs) in more upright positions. The aim of this study was to investigate this relationship by simultaneous invasive measurements of ICP, venous pressure and IJV collapse in healthy volunteers. ICP (monitored via the lumbar route), central venous pressure (PICC-line) and IJV cross-sectional area (ultrasound) were measured in 11 healthy volunteers (47±10 years) in seven positions, from supine to sitting (0°-69°). Venous pressure and anatomical distances were used to predict ICP in accordance with the explanatory model, and IJV area was used to assess IJV collapse. The hypothesis was tested by comparing measured ICP to predicted ICP. Our model accurately described the general behavior of the observed postural ICP changes (mean difference: -0.03±2.7 mmHg). No difference was found between predicted and measured ICP for any tilt-angle (p-values: 0.65 - 0.94). The results support the hypothesis that postural ICP changes are governed by hydrostatic effects in the venous system and IJV collapse. This improved understanding of the postural ICP regulation may have important implications for the development of better treatments for neurological and neurosurgical conditions affecting ICP.
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| 5. |
- Pinty, B, et al.
(författare)
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An Operational Anthropogenic CO₂ Emissions Monitoring & Verification Support Capacity : Needs and High Level Requirements for in situ Measurements
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This is the third report form the CO2 Monitoring Task Force on the multiple input streams of in-situ observations that are requirement for the Copernicus CO2 Monitoring and Verification Support capacity to: (i) calibrated and validate the space component, (ii) assimilate data in the models and integrate information in the core of the system, and (iii) evaluate the output generated by the system for its end users. The availability of sustained in situ networks is currently a significant factor of risk that needs to be mitigated to establish a European CO 2 support capacity which is fit-for-purpose. The current status of existing networks may be the source of large uncertainties in anthropogenicCO2 emission estimates as well as limited capability in meeting the requirements for country, large city and point source scale assessments. This conclusion results from a risk analysis formulated for four scenarios: 1) maintaining the status quo, 2) assuring sustained funding for the status quo, 3) enhancing network capabilities at European scale with sustained funding and 4) with a significantly improved in situ infrastructure in Europe and beyond. This report substantiates the multifaceted needs and requirements of the European CO2 support capacity with respect to in situ observations. The analysis concerns all core elements of the envisaged integrated system with a particular attention on the impact of such observations in achieving the proposed objectives. The specific needs for the validation of products delivered by the space component that is, the Copernicus Sentinels CO2 monitoring constellation, are addressed as another prerequisite for the success of the CO2 support capacity. This European asset will represent a significant contribution to the virtual constellation proposed by the Committee on Earth Observation Satellites (CEOS) and, accordingly, complementary requirements are elaborated in that international frame.The report highlights that although high measurement standards are present within existing networks such as ICOS, in the context of the needs for targeted in situ data for the realization of the operational system, these data are not fully fit-for-purpose. A fundamental prerequisite is to have a good geographical coverage over Europe for evaluating the data assimilation and modeling system over a large variety of environmental conditions such as, for instance, urban areas, agricultural regions, forested zones and industrial complexes. The in situ observations need to be extended under a coordinated European lead with sustained infrastructure and targeted additional and maintained long-term funding.It has been clearly understood from the onset that the international dimension of the European CO2 support capacity would be critical and that these aspects should be developed in parallel to, and in synergy with the definition and implementation of a European contributing system. It was also understood that this international dimension had both strategic, policy relevant and technical dimensions and the Commission and the relevant European institutional partners have started since several years to engage both bilaterally and multilaterally with the relevant stakeholders and counterparts to develop these relations. Specifically, CEOS will undertake, over the next few years,dedicated preparatory work in a coordinated international context, to provide cumulative added value to the specific programmatic activities of their member agencies. Concerted efforts have already begun in the context of the European Commission's Chairmanship of CEOS in 2018. It is recognized in the context of the European efforts, and increasingly by our international counterparts that a broad and holistic system approach is required to address the requirements which are represented by the climate policy, of which the satellite component, whilst important, cannot effectively be developed in isolation. This system indeed includes the satellite observing capability but in addition, the required modelling component and data integration elements, prior information, ancillary data and in situ observations delivered by essential networks.Acknowledging the need for an efficient coordination at international level for instance via the Global Atmosphere Watch programme of the World Meteorological Organisation is a key towards a successful implementation of appropriate actions to ensure the sustainability of essential networks, to enhance current network capabilities with new observations and to propose adequate governance schemes. Such actions to mitigate current network limitations are deemed critical to implementing the Copernicus CO 2 Monitoring & Verification Support capacity in its full strength.
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