Cerebrospinal fluid dynamics in idiopathic intracranial hypertension : a literature review and validation of contemporary findings

Publisher Copyright: © 2021, The Author(s).Background: Idiopathic intracranial hypertension (IIH) is a rare disease of unknown aetiology related possibly to disturbed cerebrospinal fluid (CSF) dynamics and characterised by elevated intracranial pressure (ICP) causing optic nerve atrophy if not timely treated. We studied CSF dynamics of the IIH patients based on the available literature and our well-defined cohort. Method: A literature review was performed from PubMed between 1980 and 2020 in compliance with the PRISMA guideline. Our study includes 59 patients with clinical, demographical, neuro-ophthalmological, radiological, outcome data, and lumbar CSF pressure measurements for suspicion of IIH; 39 patients had verified IIH while 20 patients did not according to Friedman’s criteria, hence referred to as symptomatic controls. Results: The literature review yielded 19 suitable studies; 452 IIH patients and 264 controls had undergone intraventricular or lumbar CSF pressure measurements. In our study, the mean CSF pressure, pulse amplitudes, power of respiratory waves (RESP), and the pressure constant (P0) were higher in IIH than symptomatic controls (p < 0.01). The mean CSF pressure was higher in IIH patients with psychiatric comorbidity than without (p < 0.05). In IIH patients without acetazolamide treatment, the RAP index and power of slow waves were also higher (p < 0.05). IIH patients with excess CSF around the optic nerves had lower relative pulse pressure coefficient (RPPC) and RESP than those without (p < 0.05). Conclusions: Our literature review revealed increased CSF pressure, resistance to CSF outflow and sagittal sinus pressure (SSP) as key findings in IIH. Our study confirmed significantly higher lumbar CSF pressure and increased CSF pressure waves and RAP index in IIH when excluding patients with acetazolamide treatment. In overall, the findings reflect decreased craniospinal compliance and potentially depleted cerebral autoregulation resulting from the increased CSF pressure in IIH. The increased slow waves in patients without acetazolamide may indicate issues in autoregulation, while increased P0 could reflect the increased SSP.Peer reviewe

Cerebrospinal fluid dynamics in idiopathic intracranial hypertension: a literature review and validation of contemporary findings

Background Idiopathic intracranial hypertension (IIH) is a rare disease of unknown aetiology related possibly to disturbed cerebrospinal fluid (CSF) dynamics and characterised by elevated intracranial pressure (ICP) causing optic nerve atrophy if not timely treated. We studied CSF dynamics of the IIH patients based on the available literature and our well-defined cohort. Method A literature review was performed from PubMed between 1980 and 2020 in compliance with the PRISMA guideline. Our study includes 59 patients with clinical, demographical, neuro-ophthalmological, radiological, outcome data, and lumbar CSF pressure measurements for suspicion of IIH; 39 patients had verified IIH while 20 patients did not according to Friedman's criteria, hence referred to as symptomatic controls. Results The literature review yielded 19 suitable studies; 452 IIH patients and 264 controls had undergone intraventricular or lumbar CSF pressure measurements. In our study, the mean CSF pressure, pulse amplitudes, power of respiratory waves (RESP), and the pressure constant (P0) were higher in IIH than symptomatic controls (p p p p Conclusions Our literature review revealed increased CSF pressure, resistance to CSF outflow and sagittal sinus pressure (SSP) as key findings in IIH. Our study confirmed significantly higher lumbar CSF pressure and increased CSF pressure waves and RAP index in IIH when excluding patients with acetazolamide treatment. In overall, the findings reflect decreased craniospinal compliance and potentially depleted cerebral autoregulation resulting from the increased CSF pressure in IIH. The increased slow waves in patients without acetazolamide may indicate issues in autoregulation, while increased P0 could reflect the increased SSP.</p

Pathways towards a sustainable future envisioned by early-career conservation researchers

Scientists have warned decision-makers about the severe consequences of the global environmental crisis since the 1970s. Yet ecological degradation continues and little has been done to address climate change. We investigated early-career conservation researchers' (ECR) perspectives on, and prioritization of, actions furthering sustainability. We conducted a survey (n = 67) and an interactive workshop (n = 35) for ECR attendees of the 5th European Congress of Conservation Biology (2018). Building on these data and discussions, we identified ongoing and forthcoming advances in conservation science. These include increased transdisciplinarity, science communication, advocacy in conservation, and adoption of a transformation-oriented social–ecological systems approach to research. The respondents and participants had diverse perspectives on how to achieve sustainability. Reformist actions were emphasized as paving the way for more radical changes in the economic system and societal values linked to the environment and inequality. Our findings suggest that achieving sustainability requires a strategy that (1) incorporates the multiplicity of people's views, (2) places a greater value on nature, and (3) encourages systemic transformation across political, social, educational, and economic realms on multiple levels. We introduce a framework for ECRs to inspire their research and practice within conservation science to achieve real change in protecting biological diversity.</p

Genetic and ecological consequences of small population size in Lychnis viscaria

Human induced changes in the landscape and resulting habitat destruction is endangering the survival of numerous plant species. In this thesis I used Lychnis viscaria (Caryophyllaceae), a perennial herb, as a model plant to study some of the genetic and ecological factors related to habitat fragmentation that may influence the viability of small plant populations. L. viscaria is common in Southern Finland but occurs in small, endangered populations in Central Finland. Small and isolated populations had less genetic variation, measured with allozymes, but the viability of individuals in these populations (germination rate, seedling mass or seed yield) was not lower than in large populations. However, in longer time scale the loss of genetic variation in small populations may endanger their ability to adapt to changing environment. Although levels of allozyme variation do not necessarily reflect the levels of adaptively significant variation, in L. viscaria a relationship between levels of allozyme variation and morphological variation was found. However morphological population differentiation did not reflect the allozyme differentiation. Habitat fragmentation can also affect the mutualistic plantpollinator interactions. The pollinator visitation rates were higher in large and, surprisingly, sparse populations. Higher visitation rates in sparser populations were probably due to their larger area and inflorescence size. Pollinator behaviour was also affected by plant density. The changes in the plantpollinator relationship did not directly affect reproductive success of the plants, but probably lowered the quality of seeds by increasing inbreeding depression. The study on the expression of inbreeding depression revealed that inbred populations may be adapted to inbreeding, expressing less inbreeding depression at early life stages (germination), but may still express relatively high inbreeding depression at later stages. This study provides information to be applied in modern conservation biology, when designing management plans and policies for endangered plant populations

Biosuodattimia, hevoshakoja ja viherkattoja – yhdessä oppiminen luontopohjaisten ratkaisujen luomisessa

&nbsp; This article explores mutual learning as part of a process of co-creating nature-based solutions - a biofilter, a green roof, and a horse park. Nature-based solutions are located in Tampere and are part of the EU project Unalab. The research has been conducted from within the pilot project and it has focused on concrete situations of learning. This study confirmed that mutual learning is the most important achievement of co-creation and should be clearly set also as a goal of co-creation. Creating a shared vision is important in the early stages of a project. Mutual learning enhances equality between participants and creates space for managing the complexity of nature-based solutions. If co-creation focuses too much on practical implementation planning instead of learning, the views of the experts will be emphasized and the citizens' views will remain marginal. Many urban actors also have the capacity to design nature-based solutions, but this requires more targeted methods of co-creation. The best progress was made when co-creating with a small and flexible group from the city, together with key stakeholders of the demonstration. Site visits and personal conversations developed a common will and commitment. In large planning groups, negotiations between institutions made implementation difficult.Ilmastonmuutoksen ja kaupungistumisen aiheuttamiin ympäristöongelmiin on viime vuosina haettu ratkaisuja luonnosta. Kaupungit kehittävät luontopohjaisia ratkaisuja usein yhdessä eri sidosryhmien, kuten kansalaisten, yritysten ja yliopistojen kanssa. Tässä artikkelissa tutkitaan luontopohjaisten ratkaisujen yhteiskehittämistä ja keskitytään sen ytimeen, yhdessä oppimiseen. Tutkitut luontopohjaisten ratkaisujen kokeilut – biosuodatin, viherkatto ja hevoshaka – sijaitsevat Tampereella ja ovat osa EU:n rahoittamaa Unalab-projektia. Tutkimus on tehty pilottiprojektin sisältä päin keskittymällä konkreettisiin yhdessä oppimisen tilanteisiin. &nbsp; Tutkimus vahvisti, että yhdessä oppiminen on yhteiskehittämisen tärkein saavutus ja se kannattaa nostaa selkeästi yhteiskehittämisen tavoitteeksi. Yhteisen vision luominen on tärkeää projektin alkuvaiheessa. Yhdessä oppiminen mahdollistaa osallistujien tasavertaisen kohtaamisen ja luo tilaa luontopohjaisten ratkaisujen monimutkaisuuden hallinnalle. Jos yhteiskehittämisessä keskitytään oppimisen sijaan liikaa käytännön toteutussuunnitteluun, asiantuntijoiden näkemykset korostuvat ja kansalaisten näkemyksen jäävät sivuosaan. Kaupungin monilla toimijoilla on valmiuksia suunnitella ja toteuttaa luontopohjaisia ratkaisuja, mutta silloin tarvitaan laajoja työpajoja tarkemmin rajattuja yhteiskehittämisen menetelmiä. Parhaiten edistyivät ne kokeilut, joita kehitti pieni ja joustava ryhmä kaupungilta yhdessä kohteen kannalta keskeisten sidosryhmien kanssa. Maastoon jalkautuminen ja henkilökohtaiset keskustelut kehittivät yhteistä tahtotilaa ja sitoutumista. Laajoissa suunnitteluryhmissä instituutioiden välinen kitka vaikeutti toteutusta