Brazilian Portuguese version of the Mediterranean diet scale: Translation procedures and measurement properties.

BACKGROUND AND AIM: The Mediterranean Diet Scale (MDS) is a questionnaire with characteristics which can contribute to the multidimensional assessment of patients with diabetes mellitus (DM) by the multidisciplinary team, as well as to evaluate the effect of specific educational and nutritional interventions. The aim of this study was to translate and perform a cross-cultural adaptation of a Canadian MDS and analyze the measurement properties of the Brazilian Portuguese version of the Mediterranean Diet Scale (MDS-Brazil) in individuals with DM in Brazil. METHODS: This was a cross-sectional study. The analyzed measurement properties were the internal consistency, floor and ceiling effects, reproducibility, and construct validity. The inclusion criteria were diagnosis of DM type 1 or type 2, literate, outpatients, and without eating restrictions. RESULTS: Of the 160 volunteers included in this study, 30 participated in pretesting, and another 130 (57.7% women, 74.6% DM type 2, 56.55 ± 14.88 years) agreed to participate in the evaluation stage of the measurement properties. All items were cross-culturally adapted. A factor analysis (KMO = 0.555 and X² = 137.22; p < 0.001) extracted five factors, with no floor or ceiling effects, Cronbach's alpha = 0.42, and reproducibility ICC = 0.75. CONCLUSIONS: The cross-cultural adaptation was performed maintaining the equivalences. The MDS-Brazil measurement properties showed substantial reproducibility, low internal consistency, and fair correlations of construct validity in patients with DM.

An evolutionary genomic approach reveals both conserved and species-specific genetic elements related to human disease in closely related Aspergillus fungi.

Aspergillosis is an important opportunistic human disease caused by filamentous fungi in the genus Aspergillus. Roughly 70% of infections are caused by Aspergillus fumigatus, with the rest stemming from approximately a dozen other Aspergillus species. Several of these pathogens are closely related to A. fumigatus and belong in the same taxonomic section, section Fumigati. Pathogenic species are frequently most closely related to nonpathogenic ones, suggesting Aspergillus pathogenicity evolved multiple times independently. To understand the repeated evolution of Aspergillus pathogenicity, we performed comparative genomic analyses on 18 strains from 13 species, including 8 species in section Fumigati, which aimed to identify genes, both ones previously connected to virulence as well as ones never before implicated, whose evolution differs between pathogens and nonpathogens. We found that most genes were present in all species, including approximately half of those previously connected to virulence, but a few genes were section- or species-specific. Evolutionary rate analyses identified over 1700 genes whose evolutionary rate differed between pathogens and nonpathogens and dozens of genes whose rates differed between specific pathogens and the rest of the taxa. Functional testing of deletion mutants of 17 transcription factor-encoding genes whose evolution differed between pathogens and nonpathogens identified eight genes that affect either fungal survival in a model of phagocytic killing, host survival in an animal model of fungal disease, or both. These results suggest that the evolution of pathogenicity in Aspergillus involved both conserved and species-specific genetic elements, illustrating how an evolutionary genomic approach informs the study of fungal disease.

The Aspergillus fumigatus transcription factor RglT is important for gliotoxin biosynthesis and self-protection, and virulence.

Aspergillus fumigatus is an opportunistic fungal pathogen that secretes an array of immune-modulatory molecules, including secondary metabolites (SMs), which contribute to enhancing fungal fitness and growth within the mammalian host. Gliotoxin (GT) is a SM that interferes with the function and recruitment of innate immune cells, which are essential for eliminating A. fumigatus during invasive infections. We identified a C6 Zn cluster-type transcription factor (TF), subsequently named RglT, important for A. fumigatus oxidative stress resistance, GT biosynthesis and self-protection. RglT regulates the expression of several gli genes of the GT biosynthetic gene cluster, including the oxidoreductase-encoding gene gliT, by directly binding to their respective promoter regions. Subsequently, RglT was shown to be important for virulence in a chemotherapeutic murine model of invasive pulmonary aspergillosis (IPA). Homologues of RglT and GliT are present in eurotiomycete and sordariomycete fungi, including the non-GT-producing fungus A. nidulans, where a conservation of function was described. Phylogenetically informed model testing led to an evolutionary scenario in which the GliT-based resistance mechanism is ancestral and RglT-mediated regulation of GliT occurred subsequently. In conclusion, this work describes the function of a previously uncharacterised TF in oxidative stress resistance, GT biosynthesis and self-protection in both GT-producing and non-producing Aspergillus species.

Genomic and Phenotypic Heterogeneity of Clinical Isolates of the Human Pathogens Aspergillus fumigatus, Aspergillus lentulus, and Aspergillus fumigatiaffinis.

Fungal pathogens are a global threat to human health. For example, fungi from the genus Aspergillus cause a spectrum of diseases collectively known as aspergillosis. Most of the >200,000 life-threatening aspergillosis infections per year worldwide are caused by Aspergillus fumigatus. Recently, molecular typing techniques have revealed that aspergillosis can also be caused by organisms that are phenotypically similar to A. fumigatus but genetically distinct, such as Aspergillus lentulus and Aspergillus fumigatiaffinis. Importantly, some of these so-called cryptic species are thought to exhibit different virulence and drug susceptibility profiles than A. fumigatus, however, our understanding of their biology and pathogenic potential has been stymied by the lack of genome sequences and phenotypic profiling of multiple clinical strains. To fill this gap, we phenotypically characterized the virulence and drug susceptibility of 15 clinical strains of A. fumigatus, A. lentulus, and A. fumigatiaffinis from Spain and sequenced their genomes. We found heterogeneity in drug susceptibility across species and strains. We further found heterogeneity in virulence within each species but no significant differences in the virulence profiles between the three species. Genes known to influence drug susceptibility (cyp51A and fks1) vary in paralog number and sequence among these species and strains and correlate with differences in drug susceptibility. Similarly, genes known to be important for virulence in A. fumigatus showed variability in number of paralogs across strains and across species. Characterization of the genomic similarities and differences of clinical strains of A. lentulus, A. fumigatiaffinis, and A. fumigatus that vary in disease-relevant traits will advance our understanding of the variance in pathogenicity between Aspergillus species and strains that are collectively responsible for the vast majority of aspergillosis infections in humans.

Pathogenic Allodiploid Hybrids of Aspergillus Fungi.

Interspecific hybridization substantially alters genotypes and phenotypes and can give rise to new lineages. Hybrid isolates that differ from their parental species in infection-relevant traits have been observed in several human-pathogenic yeasts and plant-pathogenic filamentous fungi but have yet to be found in human-pathogenic filamentous fungi. We discovered 6 clinical isolates from patients with aspergillosis originally identified as Aspergillus nidulans (section Nidulantes) that are actually allodiploid hybrids formed by the fusion of Aspergillus spinulosporus with an unknown close relative of Aspergillus quadrilineatus, both in section Nidulantes. Evolutionary genomic analyses revealed that these isolates belong to Aspergillus latus, an allodiploid hybrid species. Characterization of diverse infection-relevant traits further showed that A. latus hybrid isolates are genomically and phenotypically heterogeneous but also differ from A. nidulans, A. spinulosporus, and A. quadrilineatus. These results suggest that allodiploid hybridization contributes to the genomic and phenotypic diversity of filamentous fungal pathogens of humans.

Effects of Inspiratory Muscle Training in Older Adults.

BACKGROUND: Inspiratory muscle training (IMT) has been widely applied to different populations, including the general population of older adults. In addition to increasing inspiratory muscle strength, other benefits of IMT in the health of this population have been reported. The primary aim of this study was to review the effects of IMT on the general parameters of health (eg, respiratory, functional, physical, and other variables) in older adults (≥ 60 y), and the secondary aim was to analyze the main IMT protocol used in the studies. METHODS: We searched the MEDLINE, PEDro, SciELO, and LILACS databases to identify relevant randomized controlled clinical trials, and we assessed their methodological quality according to the PEDro scale. The Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines were used to guide the development of the protocol for this systematic review. RESULTS: The search yielded 7 studies involving 248 participants from 917 titles. The main outcomes investigated in response to IMT were related to the respiratory, functional, and physical variables. The results indicate that IMT promotes an increase of inspiratory muscle strength and diaphragmatic thickness in older adults. There was heterogeneity in the protocols described for this population with respect to the total training time (4-8 weeks), intensity (30-80% of the maximum inspiratory pressure), and weekly frequency (5 or 7 sessions). CONCLUSIONS: The reviewed studies revealed a positive trend for the effectiveness of IMT in improving inspiratory muscle performance in elderly subjects. More randomized studies are needed to evaluate other outcomes (eg, functional capacity, exercise capacity, cardiac autonomic control, quality of life, and others) to provide robust evidence that this training modality can promote improvements in health parameters in this population. In addition, the usual IMT prescription in this population is based on sets and repetitions, of mild to moderate intensity, performed on most days of the week, for ≥ 4 weeks.

The Aspergillus fumigatus transcription factor RglT is important for gliotoxin biosynthesis and self-protection, and virulence

Aspergillus fumigatus is an opportunistic fungal pathogen that secretes an array of immune-modulatory molecules, including secondary metabolites (SMs), which contribute to enhancing fungal fitness and growth within the mammalian host. Gliotoxin (GT) is a SM that interferes with the function and recruitment of innate immune cells, which are essential for eliminating A. fumigatus during invasive infections. We identified a C6 Zn cluster-type transcription factor (TF), subsequently named RglT, important for A. fumigatus oxidative stress resistance, GT biosynthesis and self-protection. RglT regulates the expression of several gli genes of the GT biosynthetic gene cluster, including the oxidoreductase-encoding gene gliT, by directly binding to their respective promoter regions. Subsequently, RglT was shown to be important for virulence in a chemotherapeutic murine model of invasive pulmonary aspergillosis (IPA). Homologues of RglT and GliT are present in eurotiomycete and sordariomycete fungi, including the non-GT-producing fungus A. nidulans, where a conservation of function was described. Phylogenetically informed model testing led to an evolutionary scenario in which the GliT-based resistance mechanism is ancestral and RglT-mediated regulation of GliT occurred subsequently. In conclusion, this work describes the function of a previously uncharacterised TF in oxidative stress resistance, GT biosynthesis and self-protection in both GT-producing and non-producing Aspergillus species.

Characterizing the Pathogenic, Genomic, and Chemical Traits of Aspergillus fischeri, a Close Relative of the Major Human Fungal Pathogen Aspergillus fumigatus.

Aspergillus fischeri is closely related to Aspergillus fumigatus, the major cause of invasive mold infections. Even though A. fischeri is commonly found in diverse environments, including hospitals, it rarely causes invasive disease. Why A. fischeri causes less human disease than A. fumigatus is unclear. A comparison of A. fischeri and A. fumigatus for pathogenic, genomic, and secondary metabolic traits revealed multiple differences in pathogenesis-related phenotypes. We observed that A. fischeri NRRL 181 is less virulent than A. fumigatus strain CEA10 in multiple animal models of disease, grows slower in low-oxygen environments, and is more sensitive to oxidative stress. Strikingly, the observed differences for some traits are of the same order of magnitude as those previously reported between A. fumigatus strains. In contrast, similar to what has previously been reported, the two species exhibit high genomic similarity; ∼90% of the A. fumigatus proteome is conserved in A. fischeri, including 48/49 genes known to be involved in A. fumigatus virulence. However, only 10/33 A. fumigatus biosynthetic gene clusters (BGCs) likely involved in secondary metabolite production are conserved in A. fischeri and only 13/48 A. fischeri BGCs are conserved in A. fumigatus Detailed chemical characterization of A. fischeri cultures grown on multiple substrates identified multiple secondary metabolites, including two new compounds and one never before isolated as a natural product. Additionally, an A. fischeri deletion mutant of laeA, a master regulator of secondary metabolism, produced fewer secondary metabolites and in lower quantities, suggesting that regulation of secondary metabolism is at least partially conserved. These results suggest that the nonpathogenic A. fischeri possesses many of the genes important for A. fumigatus pathogenicity but is divergent with respect to its ability to thrive under host-relevant conditions and its secondary metabolism.IMPORTANCEAspergillus fumigatus is the primary cause of aspergillosis, a devastating ensemble of diseases associated with severe morbidity and mortality worldwide. A. fischeri is a close relative of A. fumigatus but is not generally observed to cause human disease. To gain insights into the underlying causes of this remarkable difference in pathogenicity, we compared two representative strains (one from each species) for a range of pathogenesis-relevant biological and chemical characteristics. We found that disease progression in multiple A. fischeri mouse models was slower and caused less mortality than A. fumigatus Remarkably, the observed differences between A. fischeri and A. fumigatus strains examined here closely resembled those previously described for two commonly studied A. fumigatus strains, AF293 and CEA10. A. fischeri and A. fumigatus exhibited different growth profiles when placed in a range of stress-inducing conditions encountered during infection, such as low levels of oxygen and the presence of chemicals that induce the production of reactive oxygen species. We also found that the vast majority of A. fumigatus genes known to be involved in virulence are conserved in A. fischeri, whereas the two species differ significantly in their secondary metabolic pathways. These similarities and differences that we report here are the first step toward understanding the evolutionary origin of a major fungal pathogen.

Effect of Resistance Training on Blood Pressure and Autonomic Responses in Treated Hypertensives.

Trevizani, GA, Seixas, MB, Benchimol-Barbosa, PR, Vianna, JM, da Silva, LP, and Nadal, J. Effect of resistance training on blood pressure and autonomic responses in treated hypertensives. J Strength Cond Res 32(5): 1462-1470, 2018-This study evaluated the effect of resistance training (RT) on heart rate variability (HRV) and on blood pressure (BP) responses to acute and short-term exposure in treated hypertensive (HT) subjects. Twenty-one men participated in the study, 8 HT under drug treatment regimen and achieving adequate BP control before inclusion and 13 normotensive (NT). The RT protocol consisted of 12 sessions with eight exercises (leg extension, leg press, leg curl, bench press, seated row, triceps push-down, seated calf flexion, and seated arm curl) performed for two sets of 15-20 repetitions with 50% of one repetition maximum with 2-minute rest intervals in between sets, 3×/week. Heartbeat measurements were taken before and after RT, and BP was measured at the beginning and at the end of each session after 10-minute rest. The repeated measures analysis of variance (effect: group vs. training) evaluated BP and HRV responses. Effect size (ES) calculation measured the magnitude of the RT effect on these variables. There was a statistically significant reduction in postexercise systolic BP in both groups (p = 0.040), without significant change in resting BP along RT (p = 0.159). Regarding HRV, it was observed a reduced sympathetic-vagal balance (training interaction vs. group: p = 0.058, ES = -0.83) in HT subjects. Resistance training promotes a significant acute reduction of BP in the HT and NT groups and provides a slight benefit of cardiac autonomic balance in the HT.

Cardiac autonomic changes in middle-aged women: identification based on principal component analysis.

The purpose of this study was to investigate the application of the principal component analysis (PCA) technique on power spectral density function (PSD) of consecutive normal RR intervals (iRR) aiming at assessing its ability to discriminate healthy women according to age groups: young group (20-25 year-old) and middle-aged group (40-60 year-old). Thirty healthy and non-smoking female volunteers were investigated (13 young [mean ± SD (median): 22·8 ± 0·9 years (23·0)] and 17 Middle-aged [51·7 ± 5·3 years (50·0)]). The iRR sequence was collected during ten minutes, breathing spontaneously, in supine position and in the morning, using a heart rate monitor. After selecting an iRR segment (5 min) with the smallest variance, an auto regressive model was used to estimate the PSD. Five principal component coefficients, extracted from PSD signals, were retained for analysis according to the Mahalanobis distance classifier. A threshold established by logistic regression allowed the separation of the groups with 100% specificity, 83·2% sensitivity and 93·3% total accuracy. The PCA appropriately classified two groups of women in relation to age (young and Middle-aged) based on PSD analysis of consecutive normal RR intervals.

Cardiac autonomic responses after resistance exercise in treated hypertensive subjects.

The aim of this study was to assess and to compare heart rate variability (HRV) after resistance exercise (RE) in treated hypertensive and normotensive subjects. Nine hypertensive men [HT: 58.0 ± 7.7 years, systolic blood pressure (SBP) = 133.6 ± 6.5 mmHg, diastolic blood pressure (DBP) = 87.3 ± 8.1 mmHg; under antihypertensive treatment] and 11 normotensive men (NT: 57.1 ± 6.0 years, SBP = 127 ± 8.5 mmHg, DBP = 82.7 ± 5.5 mmHg) performed a single session of RE (2 sets of 15-20 repetitions, 50% of 1 RM, 120 s interval between sets/exercise) for the following exercises: leg extension, leg press, leg curl, bench press, seated row, triceps push-down, seated calf flexion, seated arm curl. HRV was assessed at resting and during 10 min of recovery period by calculating time (SDNN, RMSSD, pNN50) and frequency domain (LF, HF, LF/HF) indices. Mean values of HRV indices were reduced in the post-exercise period compared to the resting period (HT: lnHF: 4.7 ± 1.4 vs. 2.4 ± 1.2 ms(2); NT: lnHF: 4.8 ± 1.5 vs. 2.2 ± 1.1 ms(2), p < 0.01). However, there was no group vs. time interaction in this response (p = 0.8). The results indicate that HRV is equally suppressed after RE in normotensive and hypertensive individuals. These findings suggest that a single session of RE does not bring additional cardiac autonomic stress to treated hypertensive subjects.

Can a first-order exponential decay model fit heart rate recovery after resistance exercise?

The time-constant of postexercise heart rate recovery (HRRτ ) obtained by fitting heart rate decay curve by a first-order exponential fitting has being used to assess cardiac autonomic recovery after endurance exercise. The feasibility of this model was not tested after resistance exercise (RE). The aim of this study was to test the goodness of fit of the first-order exponential decay model to fit heart rate recovery (HRR) after RE. Ten healthy subjects participated in the study. The experimental sessions occurred in two separated days and consisted of performance of 1 set of 10 repetitions at 50% or 80% of the load achieved on the one-repetition maximum test [low-intensity (LI) and high-intensity (HI) sessions, respectively]. Heart rate (HR) was continuously registered before and during exercise and also for 10 min of recovery. A monoexponential equation was used to fit the HRR curve during the postexercise period using different time windows (i.e. 30, 60, 90, … 600 s). For each time window, (i) HRRτ was calculated and (ii) variation of HR explained by the model (R(2) goodness of fit index) was assessed. The HRRτ showed stabilization from 360 and 420 s on LI and HI, respectively. Acceptable R(2) values were observed from the 360 s on LI (R(2) > 0.65) and at all tested time windows on HI (R(2) > 0.75). In conclusion, this study showed that using a minimum length of monitoring (~420 s) HRR after RE can be adequately modelled by a first-order exponential fitting.

Effects of load and type of physical training on resting and postexercise cardiac autonomic control.

The aim of the study was to investigate the influence of training load and exercise mode on heart rate variability and heart rate recovery (HRR) in healthy individuals. The subjects were divided into three groups: sedentary (SED), resistance trained (RT) and aerobically trained (RT). Resting and postmaximal exercise RR intervals were recorded on supine and seated position, respectively. The HRV indices calculated in the resting position were RMSSD and LF and HF power densities. The following HRR indices were calculated throughout the 5-minute postmaximal recovery period: semi-logarithmic regression analysis of the first 30 s (T30); absolute difference between the peak and 60 s HR (HRR(60s)); and mono-exponential time constant of HRR (HRRτ). The RMSSD on subsequent 30-s segments (RMSSD(30s)) on recovery period was also calculated. Both RT and AT groups presented faster HRR than SED (P<0·05). The aerobic trained group was the only group that presented vagal reactivation, when analysing the RMSSD(30s). There were no correlations between the Baecke sport score and the HRV vagal-related indices. However, it was significantly correlated with HRR. It was concluded that that the training load positively influences the HRR, but has no effect on the HRV at rest and that the type of exercise, showed a marked influence on HRV recovery.

Influência do nível de atividades físicas laborais, de lazer e locomoção na modulação autonômica cardíaca de repouso e na frequência cardíaca de recuperação / Influence of labor, leisure and locomotion physical activity level on resting cardiac autonomic modulation and in heart rate recovery

O objetivo deste estudo foi verificar a influência do nível das atividades laborais, de lazer e locomoção na modulação autonômica cardíaca de repouso e na freqüência cardíaca de recuperação. Métodos: Vinte jovens, saudáveis, do sexo masculino, que não praticavam exercício físico regular, foram divididos em dois grupos de acordo com o nível de atividade física habitual, obtido a partir do cálculo do escore total (ET), do questionário de Baecke: ‘menos ativos’ (n=10; 22,8±1,9 anos) e ‘mais ativos’ (n=10; 22,3±2,2 anos). Os registros dos intervalos R-R dos voluntários foram feitos em repouso, na posição supina por 15 minutos; durante o teste cardiopulmonar máximo e; por 5 minutos do período de recuperação. A variabilidade da freqüência cardíaca (VFC) foi analisada no domínio do tempo e da freqüência durante os últimos 5 minutos da coleta de repouso. Analisaram-se também índices de recuperação da freqüência cardíaca (FCrec). Resultados: Não houve diferença significativa entre os dois grupos em nenhum dos índices da VFC, assim como nos índices da FCrec. Conclusão: sugere-se que apenas atividades laborais, de lazer e te locomoção parecem não promover efeitos significativos na modulação autonômica cardíaca de repouso e na freqüência cardíaca de recuperação em jovens saudáveis. Nesse sentido, reforça-se a necessidade de atividades físicas sistematizadas e/ou aumento na intensidade das atividades laborais, de lazer e locomoção para promover adaptações autonômicas cardíacas.

Objective: The aim of this study was to investigate the labour, leisure and locomotion physical activities level on resting cardiac autonomic modulation and in heart rate recovery (HRR). Methods: 20 young healthy men, that didn’t practice physical exercise regularly, were divided into twogroups, according to their habitual physical activity level, obtained by the calculation of the total score, from Baecke’s questionnaire: ‘less actives’ (n=10; 22,8±1,9 years) and ‘more actives’ (n=10; 22,3±2,2years). The subjects’ R-R interval register was done by the supine resting position for 15 minutes; during the maximal effort text and; for 5 minutes from the recovery period. The heart rate variability (HRV) was analyzed in time and frequency domains, during the last 5 minutes of the resting register. It was alsoanalyzed HRR indexes. Results: There aren’t significant differences between the two groups in none of the HRV nor in the HRR indexes. Conclusion: In summary, it is suggested that only labour, leisure and locomotion activities seem not to provide significant effects on the resting cardiac autonomic modulation likewise in the HRR in healhy young men. Therefore, systematized physical activity or the rising of the intensity of labour, leisure and locomotionis are reinforced to provide positive cardiac autonomic adaptations.