Late presentation increases risk and costs of non-infectious comorbidities in people with HIV: An Italian cost impact study

Background: Late presentation (LP) at the time of HIV diagnosis is defined as presentation with AIDS whatever the CD4 cell count or with CD4 <350 cells/mm. The objective of our study was to assess the prevalence of non-infectious comorbidities (NICM) and multimorbidity among HIV-positive individuals with and without a history of LP (HIV + LP and HIV + EP, respectively), and compare them to matched HIV-negative control participants from a community-based cohort. The secondary objective was to provide estimates and determinants of direct cost of medical care in HIV patients. Methods: We performed a matched cohort study including HIV + LP and HIV + EP among people attending the Modena HIV Metabolic Clinic (MHMC) in 2014. HIV-positive participants were matched in a 1:3 ratio with HIV-negative participants from the CINECA ARNO database. Multimorbidity was defined as the concurrent presence of 652 NICM. Logistic regression models were constructed to evaluate associated predictors of NICM and multimorbidity. Results: We analyzed 452 HIV + LP and 73 HIV + EP participants in comparison to 1575 HIV-negative controls. The mean age was 46 \ub1 9 years, 27.5% were women. Prevalence of NICM and multimorbidity were fourfold higher in the HIV + LP compared to the general population (p < 0.001), while HIV + EP present an intermediate risk. LP was associated with increased total costs in all age strata, but appear particularly relevant in patients above 50 years of age, after adjusting for age, multimorbidity, and antiretroviral costs. Conclusions: LP with HIV infection is still very frequent in Italy, is associated with higher prevalence of NICM and multimorbidity, and contributes to higher total care costs. Encouraging early testing and access to care is still urgently needed

Response of the Diatom Phaeodactylum tricornutum to Photooxidative Stress Resulting from High Light Exposure

The response of microalgae to photooxidative stress resulting from high light exposure is a well-studied phenomenon. However, direct analyses of photosystem II (PSII) D1 protein (the main target of photoinhibition) in diatoms are scarce. In this study, the response of the diatom model species Phaeodactylum tricornutum to short-term exposure to high light was examined and the levels of D1 protein determined immunochemically. Low light (LL) acclimated cells (40 µmol photons m−2 s−1) subjected to high light (HL, 1,250 µmol photons m−2 s−1) showed rapid induction of non-photochemical quenching (NPQ) and ca. 20-fold increase in diatoxanthin (DT) concentration. This resulted from the conversion of diadinoxanthin (DD) to DT through the activation of the DD-cycle. D1 protein levels under LL decreased about 30% after 1 h of the addition of lincomycin (LINC), a chloroplast protein synthesis inhibitor, showing significant D1 degradation and repair under low irradiance. Exposure to HL lead to a 3.2-fold increase in D1 degradation rate, whereas average D1 repair rate was 1.3-x higher under HL than LL, leading to decreased levels of D1 protein under HL. There were significant effects of both HL and LINC on P. tricornutum maximum quantum yield of PSII (Fv/Fm), showing a reduction of active PSII reaction centres. Partial recovery of Fv/Fm in the dark demonstrates the photosynthetic resilience of this diatom to changes in the light regime. P. tricornutum showed high allocation of total protein to D1 and an active D1-repair cycle to limit photoinhibition

Cartografia e diplomacia: usos geopolíticos da informação toponímica (1750-1850)

O artigo explora dimensões geopolíticas da toponímia, registradas em documentos cartográficos, desde as reformas empreendidas pelo consulado pombalino em meados do século XVIII, até às primeiras décadas do século XIX, em meio ao processo de afirmação do Estado imperial pós-colonial.This paper explores the geopolitical dimensions of toponymy as registered in cartographic documents dating from the reforms pushed through by the consulate of Marquis of Pombal in the mid 18th century to the early decades of the 19th century, as the post-colonial imperial State established itself

De-epoxidation state (DES) in <i>Phaeodactylum tricornutum</i>.

<p>Treatments (1 h duration): LL (low light, 40 µmol photons m⁻² s⁻¹); HL (high light, 1,250 µmol photons m⁻² s⁻¹); LL_LINC (low light with LINC); and HL_LINC (high light with LINC). Mean ± standard deviation (n = 4). Different letters indicate significant differences between treatments (<i>P</i><0.001).</p

Immunodetection of the PSII reaction centre protein D1 in <i>Phaeodactylum tricornutum</i>.

<p>Treatments (1 h duration): LL (low light, 40 µmol photons m⁻² s⁻¹); HL (high light, 1,250 µmol photons m⁻² s⁻¹); LL_LINC (low light with LINC); and HL_LINC (high light with LINC).</p

Variation in PSII maximum (<i>F</i>_v/<i>F</i>_m) and effective (Δ<i>F</i>/<i>F</i>_m′) quantum yield in <i>Phaeodactylum tricornutum</i>.

<p>Measurements before and during exposure to 1 h of high irradiance (1,250 µmol photons m⁻² s⁻¹), and subsequent recovery in the dark. Treatments: HL (control samples); and HL_LINC (LINC inhibited samples). Mean ± standard deviation (n = 5).</p

Maximum quantum yield of PSII (<i>F</i>_v/<i>F</i>_m) in <i>Phaeodactylum tricornutum</i>.

<p>Samples were dark-adapted for 10 min. Treatments (1 h duration): LL (low light, 40 µmol photons m⁻² s⁻¹); HL (high light, 1,250 µmol photons m⁻² s⁻¹); LL_LINC (low light with LINC); and HL_LINC (high light with LINC). Mean ± standard deviation (n = 4). Different letters indicate significant differences between treatments (<i>P</i><0.01).</p

Variation of non-photochemical quenching (NPQ) in <i>Phaeodactylum tricornutum</i>.

<p>Measurements before and during exposure to 1 h of high irradiance (1,250 µmol photons m⁻² s⁻¹), and subsequent recovery in the dark. Treatments: HL (control samples); and HL_LINC (LINC inhibited samples). Mean ± standard deviation (n = 5).</p

Pigment concentrations (fg cell⁻¹) in <i>Phaeodactylum tricornutum</i>.

<p>Treatments (1 h duration): LL (low light, 40 µmol photons m⁻² s⁻¹); HL (high light, 1,250 µmol photons m⁻² s⁻¹); LL_LINC (low light with LINC); and HL_LINC (high light with LINC). Mean ± standard deviation (n = 4). Different letters indicate significant differences between treatments (<i>P</i><0.001).</p