Atmospheric stilling offsets the benefits from reduced nutrient loading in a large shallow lake

As part of a global phenomenon, a 30% decrease in average wind speed since 1996 in southern Estonia together with more frequent easterly winds resulted in 47% decrease in bottom shear stress in the large (270 km2), shallow (mean depth 2.8 m), and eutrophic Lake Võrtsjärv. Following a peak in eutrophication pressure in the 1970s–80s, the concentrations of total nutrients were declining. Nonmetric Multidimensional Scaling (NMDS) ordination of a 54-year phytoplankton community composition time-series (1964–2017) revealed three distinct periods with breaking points coinciding with changes in wind and/or water level. Contrary to expectations, we detected no decrease in optically active substances that could be related to wind stilling, whereas phytoplankton biomass showed an increasing trend despite reduced nutrient levels. Here we show how opening of the “light niche,” caused by declining amount of suspended sediments, was capitalized and filled by the light-limited phytoplankton community. We suggest that wind stilling is another global factor, complementary to climate warming that counteracts eutrophication mitigation in lakes and may provide a challenge to assessment of the lake ecological status.Main financial support for EMU: European Union’s Horizon 2020 research and innovation programme Under the Marie Skłodowska-Curie Action, Innovative Training Networks, European Joint Doctorates.Project name, acronym and grant number: Management of climatic extreme events in lakes and reservoirs for the protection of ecosystem services, MANTEL, grant agreement No 722518.Publication date and, if applicable, length of embargo period: Published as Early View on 07.10.2019, no embargo period.Main financial support for EMU: European Union’s Horizon 2020 research and innovation programme Under the Marie Skłodowska-Curie Action, Innovative Training Networks, European Joint Doctorate

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Ценностные ориентации, как основа для формирования профессиональных компетенций учащихся специальности «Медико-профилактическое дело»

ОБРАЗОВАНИЕ МЕДИЦИНСКОЕМЕДИЦИНСКИЕ УЧЕБНЫЕ ЗАВЕДЕНИЯПРОФЕССИОНАЛЬНЫЕ КОМПЕТЕНЦИИСТУДЕНТЫ МЕДИЦИНСКИХ УЧЕБНЫХ ЗАВЕДЕНИЙКОМПЕТЕНТНОСТНЫЙ ПОДХОДЦЕННОСТНЫЕ ОРИЕНТАЦИИМЕДИКО-ПРОФИЛАКТИЧЕСКОЕ ДЕЛО (СПЕЦИАЛЬНОСТЬ

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

The Holocene sedimentation history of Lake Vortsjärv, central Estonia

Lake Vortsjärv is one of the biggest lakes in Eastern Europe and possesses a complex geological history. Bottom deposits consist mostly of fine sand and silt, accompanied with sapropel (up to 9 m thick) and lake marl (up to 8 m thick). In places, especially in the northern part where the bottom deposits are absent, varved clay or till are exposed in the lake basin. In the southern part of the lake the deposits are much thicker, indicating a gradual rise of water-level. Like the majority of lakes in the Northern Hemisphere, Lake Vortsjärv possesses a more open eastern and a more swampy and overgrown western bank. Shore types and the lithological composition of shore sediments are varied and highly controlled by the bedrock and glacial deposits. Long-shore transport of sediments is limited. The mineral composition of bottom sediments shows great qualitative and quantitative variability which relates to the grain-size and petrography of the parent deposits. Organic-rich sapropel can be used in agriculture and evidently also for medicinal purposes

Sustainable management of mineral resources, soil cover and geosites in Estonia

Konserwacja przyrody i ochrona dziedzictwa geologicznego mają już długą tradycję w Estonii. Pierwszy rezerwat przyrody został ustanowiony w 1910 r. W 1935 r. przyjęto pierwszą ustawę o ochronie przyrody. W 1995 r. parlament Estonii przyjął ustawę o zrównoważonym rozwoju, a w 1996 r. rząd zatwierdził Estońską Strategię Środowiskową. Chociaż niewielka, Estonia jest stosunkowo bogata w zasoby mineralne (łupki bitumiczne, fosforyty, torf, materiały budowlane itd.). Surowce te, wraz dużymi obszarami leśnymi (około 50% terytorium kraju) oraz wysoko produktywnym rolnictwem, będą podstawą gospodarki i wniosą duży wkład do dochodu narodowego. Podczas okupacji sowieckiej gleby Estonii poddane były poważnej degradacji. Około 1,9% terytorium Estonii wykorzystywane było na obiekty militarne. Tereny te są nadal silnie zanieczyszczone. Silny wzrost wydobycia surowców mineralnych także spowodował niekorzystny wpływ na środowisko. W niepodległej Republice Estonii konserwacja przyrody i ochrona bogactw mineralnych uzyskały pierwszorzędne znaczenie i ich sytuacja uległa poprawie

Ancient buried valleys in the city of Tallinn and adjacent area

The distribution, morphology, fillings, and origin of buried valleys are discussed. The direction of the valleys varies from NW to NE. Within the Viru-Harju Plateau the valleys have a more or less symmetric profile, but asymmetric profiles are dominating in the pre-klint area. They are mainly filled with glacial (till), glaciofluvial (sand, gravel, and pebbles), glacio­lacustrine (varved clay), and marine (fine-grained sand) deposits. The Tallinn valley with its tributary valleys (Saku and Sausti) and fore-klint branches (Harku, Lilleküla, and Kadriorg) looks like a river system. The fore-klint branches extend over 20 km in the Gulf of Finland. They are probably tributaries of the ancient river Pra-Neva. Most likely, the formation of valleys was continuous, starting from pre-Quaternary river erosion, and was sculptured by variable processes during the ice ages and influenced by flowing water during the interglacial periods