Defining New Research Questions and Protocols in the Field of Traumatic Brain Injury through Public Engagement: Preliminary Results and Review of the Literature

Traumatic brain injury (TBI) is the most common cause of death and disability in the age group below 40 years. The financial cost of loss of earnings and medical care presents a massive burden to family, society, social care, and healthcare, the cost of which is estimated at £1 billion per annum (about brain injury (online)). At present, we still lack a full understanding on the pathophysiology of TBI, and biomarkers represent the next frontier of breakthrough discoveries. Unfortunately, many tenets limit their widespread adoption. Brain tissue sampling is the mainstay of diagnosis in neuro-oncology; following on this path, we hypothesise that information gleaned from neural tissue samples obtained in TBI patients upon hospital admission may correlate with outcome data in TBI patients, enabling an early, accurate, and more comprehensive pathological classification, with the intent of guiding treatment and future research. We proposed various methods of tissue sampling at opportunistic times: two methods rely on a dedicated sample being taken; the remainder relies on tissue that would otherwise be discarded. To gauge acceptance of this, and as per the guidelines set out by the National Research Ethics Service, we conducted a survey of TBI and non-TBI patients admitted to our Trauma ward and their families. 100 responses were collected between December 2017 and July 2018, incorporating two redesigns in response to patient feedback. 75.0% of respondents said that they would consent to a brain biopsy performed at the time of insertion of an intracranial pressure (ICP) bolt. 7.0% replied negatively and 18.0% did not know. 70.0% would consent to insertion of a jugular bulb catheter to obtain paired intracranial venous samples and peripheral samples for analysis of biomarkers. Over 94.0% would consent to neural tissue from ICP probes, external ventricular drains (EVD), and lumbar drains (LD) to be salvaged, and 95.0% would consent to intraoperative samples for further analysis

GRANIT project: a trap for gravitational quantum states of UCN

Previous studies of gravitationally bound states of ultracold neutrons showed the quantization of energy levels, and confirmed quantum mechanical predictions for the average size of the two lowest energy states wave functions. Improvements in position-like measurements can increase the accuracy by an order of magnitude only. We therefore develop another approach, consisting in accurate measurements of the energy levels. The GRANIT experiment is devoted to the study of resonant transitions between quantum states induced by an oscillating perturbation. According to Heisenberg's uncertainty relations, the accuracy of measurement of the energy levels is limited by the time available to perform the transitions. Thus, trapping quantum states will be necessary, and each source of losses has to be controlled in order to maximize the lifetime of the states. We discuss the general principles of transitions between quantum states, and consider the main systematical losses of neutrons in a trap.Comment: presented in ISINN 15 seminar, Dubn

I.B.S. coatings on large substrates: Towards an improvement of the mechanical and optical performances

présenté par A. RemillieuxLarge mirrors (350 mm), having extremely low optical loss (absorption, scattering, wavefront) were coated for the VIRGO interferometer. The new mirror generation needs better wavefront and lower mechanical loss. The first results are discussed

Original optical metrologies of large components

présentée par A. RemillieuxThe coating deposition on large optical components (diameter 350 mm) has required the development of new metrology tools at 1064 nm. To give realistic values of the optical performances, the whole surface of the component needs to be scanned. Our scatterometer (commercial system) has been upgraded to support large and heavy samples. The other metrology tools are prototypes we have developed. We can mention the absorption (photothermal effect) and birefringence bench, a control interferometer equipped with an original stitching option, the optical profilometer (RMS roughness and small defect measurements). A detailed description of these metrology benches will be exposed. Their sensitivity, accuracy and capability to map the optical properties of substrates or mirrors will be discussed. We will describe the recent developments: the stitching option adapted to the Micromap profilometer to measure the RMS roughness on larger area (exploration of a new spatial frequency domain), the accurate bulk absorption calibration

Gender specific profiles of white coat and masked hypertension impacts on arterial structure and function in the SardiNIA study

Background: There is no definite consensus on the CV burden associated to Masked hypertension (MH) or White Coat Hypertension (WCH)-conditions that can be detected by out-of-office blood pressure measurements (24 hour Ambulatory Blood Pressure Monitoring, 24 h ABPM). Methods: We investigated the association of WCH and MH with arterial aging, indexed by a range of parameters of large artery structure and function in 2962 subjects, taking no antihypertensive medications, who are participating in a large community-based population of both men and women over a broad age range (14-102 years). Results: The overall prevalence of WCH was 9.5% and was 5.0% for MH, with 54.9% of subjects classified as true normotensive and 30.6% as true hypertensive. Both WCH and MH were associated with a stiffer aorta, a less distensible and thicker common carotid artery, and greater central BP than true normotensive subjects. Notably, the profile of arterial alterations in WCH and MH did not significantly differ from what was observed in true hypertensive subjects. The arterial changes accompanying WCH and MH differed in men and women, with women showing a greater tendency towards concentric remodeling, greater parietal wall stress, and PWV than men. Conclusion: Both WCH, and MH are associatedwith early arterial aging, and therefore, neither can be regarded as innocent conditions. Future studies are required to establish whether measurement of arterial aging parameters in subjects with WCH or MHwill identify subjects at higher risk of CV events and cognitive impairment, who may require more clinical attention and pharmacological intervention

Ventricular-vascular coupling in hypertension: methodological considerations and clinical implications

The present review is addressed to analyse the complex interplay between left ventricle and arterial tree in hypertension. The different methodological approaches to the analysis of ventricular vascular coupling in the time and frequency domain are discussed. Moreover, the role of hypertension-related changes of arterial structure and function (stiffness and wave reflection) on arterial load and how ventricular-vascular coupling modulates the process of left ventricular adaptation to hypertension are analysed.The different interplay between vascular bed and left ventricle emerges as the pathophysiological basis for the development of the multiple patterns of ventricular structural adaptation in hypertension and provides a pathway for the interpretation of systolic and diastolic functional abnormalities observed in hypertensive patients. Targeting the therapeutic approach to improve ventricular-vascular coupling may have relevant impact on reversing left ventricular hypertrophy and improving systolic and diastolic dysfunctio

When should cardiovascular prevention begin? The importance of antenatal, perinatal and primordial prevention

Cardiovascular diseases represent a major health problem, being one of the leading causes of morbidity and mortality worldwide. Therefore, in this scenario, cardiovascular prevention plays an essential role although it is difficult to establish when promoting and implementing preventive strategies. However, there is growing evidence that prevention should start even before birth, during pregnancy, aiming to avoid the onset of cardiovascular risk factors, since events that occur early in life have a great impact on the cardiovascular risk profile of an adult. The two pillars of this early preventive strategy are nutrition and physical exercise, together with prevention of cardio-metabolic diseases during pregnancy. This review attempts to gather the growing evidence of the benefits of antenatal, perinatal and primordial prevention, discussing also the possibility to reverse or to mitigate the cardiovascular profile developed in the initial stages of life. This could pave the way for future research, investigating the optimal time and duration of these preventing measures, their duration and maintenance in adulthood, and the most effective interventions according to the different age and guiding in the next years, the best clinical practice and the political strategies to cope with cardiovascular disease