Healthy Lifestyle Beliefs Scale: Psychometric properties in Portuguese pregnant women.

Healthy lifestyle during pregnancy influences the pregnant woman's and child's physical and mental health, impacting perinatal outcomes. Healthy lifestyle beliefs are predictors of lifestyle behaviors, requiring a valid and reliable instrument to assess them during prenatal care. The 16-item Healthy Lifestyle Belief Scale (HLBS) measures a person's beliefs about their ability to live a healthy lifestyle. This study aimed to examine the psychometric properties of a Portuguese version of the HLBS among pregnant women. A methodological study was developed in two phases: cross-cultural adaptation and evaluation of the psychometric properties of the Portuguese version in a nonprobability sample of 192 Portuguese pregnant women. The exploratory factor analysis suggested three subscales, which explained 53.8% of the total variance. Cronbach's α was 0.83 for the overall scale and for the subscales ranged between 0.71 and 0.81. The HLBS is a reliable and valid instrument to assist health professionals in assessing the ability of Portuguese pregnant women to adopt a healthy lifestyle. Assessing healthy lifestyle beliefs potentially contributes to the development of health behavior interventions in pregnant women and consequently improves perinatal outcomes through evidence-based practices.

Correlates and impact of DSM-5 binge eating disorder, bulimia nervosa and recurrent binge eating: a representative population survey in a middle-income country.

PURPOSE: Binge eating disorder (BED), bulimia nervosa (BN) and recurrent binge eating (RBE) are binge eating spectrum conditions causing a significant impact in individual's health and functioning. Information regarding those conditions came mostly from high-income countries. The objective of this study was to assess the prevalence of DSM-5 BED, BN and RBE and correlates in a representative sample from a metropolitan area of a middle-income country. METHODS: The data were obtained from a cross-sectional population-based household survey in two stages in Rio de Janeiro, Brazil. Noninstitutionalized residents aged 18-60 years were assessed by lay interviewers using the Questionnaire of Eating and Weight Patterns-5 (QEWP-5). Positive cases and a paired sample screen-negative cases were reassessed by phone with the Eating Disorders Section of SCID-I-P (adapted for DSM-5). The data were collected from September 2019 to February 2020. RESULTS: Overall, 2297 individuals were interviewed. Prevalence of BED was 1.4%, BN 0.7%, RBE 6.2%. Psychiatric comorbidities, such as depression, anxiety and ADHD were significantly more prevalent in people with BED, BN and RBE than in people without these eating problems. Several medical conditions, when controlling for body mass index, were significantly more prevalent in people with BED, BN and RBE. People with BED and BN had marked impairments in work/school, social and family life, reduced mental and physical HRQoL and under half had sought treatment. CONCLUSION: As in high income countries, in Rio de Janeiro, Brazil, BED, BN and RBE are prevalent conditions and are associated with elevated BMI, functional impairment, psychiatric and medical comorbidity and poorer HRQoL.

Survey of the citrus leprosis vector (Brevipalpus yothersi) and phytoseiids in spontaneous plants of an organic citrus orchard.

Citrus leprosis (CL) is one of the most important viral diseases in sweet orange orchards in Latin America. It is caused by members of at least five species of the so-called Brevipalpus-transmitted viruses (BTV), and the prevalent is Citrus leprosis virus C (CiLV-C). This virus has the broadest host range amongst all CL-associated viruses and is transmitted by Brevipalpus yothersi, a polyphagous mite that can colonize a large variety of host plants, including some spontaneous ground cover plants. But if, on one hand, spontaneous plants can host CL virus and vector, on the other hand, they can offer alternative food for predators, equally common in organic citrus orchards. Brevipalpus yothersi and predator mites were surveyed in 33 spontaneous plants of a Westin sweet orange orchard conducted under organic production system in Brazil, from June 2010 to April 2011. Predatory mites were identified as phytoseiids, and Iphiseiodes zuluagai was the prevalent species, representing 58% of all predators. Other phytoseiids were considered accidental species in the area. Ageratum conyzoides and Alternanthera tenella were the most represented plant host species to predators, comprising 28 and 10% of the total surveyed plants, respectively. Brevipalpus yothersi specimens were detected on various spontaneous species: A. conyzoides, A. tenella, Amaranthus deflexus, Bidens pilosa, Ipomoea quamoclit, I. cairica, Merremia cissoides, Solanum americanum, Panicum maximum, and, predominantly, Commelina benghalensis. The latter has been previously reported as host of CiLV-C as well and, therefore, it is recommended to eliminate this species from citrus orchards.

Differential Associations of Specific Selective Serotonin Reuptake Inhibitors With Resting-State Heart Rate and Heart Rate Variability: Implications for Health and Well-Being.

OBJECTIVE: Debate has focused on the effects of the selective serotonin reuptake inhibitor (SSRI) antidepressants on heart rate (HR) and HR variability (HRV), both of which are predictors of adverse cardiovascular events. Here, we examine the associations between specific SSRI antidepressants and resting state HR (and HRV) after accounting for a host of potential confounding factors using propensity score techniques. METHODS: Participants included 10,466 not taking antidepressants, 46 participants taking escitalopram, 86 taking citalopram, 66 taking fluoxetine, 103 taking paroxetine, and 139 taking sertraline. HR and HRV (root mean square of successive squared differences, high frequency) were extracted from 10-minute resting-state ECGs. Analyses including propensity score weighting and matching were conducted using R-statistics to control for potentially confounding variables. RESULTS: Major findings indicated that users of all SSRI medications-except fluoxetine-displayed lower HRV relative to nonusers. Users of paroxetine also displayed significantly lower HRV relative to users of citalopram (Cohen's d = 0.42), fluoxetine (Cohen's d = 0.54), and sertraline (Cohen's d = 0.35), but not escitalopram. Although associations were also observed for HR, these were less robust than those for HRV. CONCLUSIONS: Although paroxetine is associated with decreases in HRV relative to nonusers, as well as users of other SSRI medications, fluoxetine was the only medication not to display significant alterations in HR or HRV. These conclusions are limited by the cross-sectional design and nonrandomized nature of medication prescriptions. Findings highlight the importance of focusing on specific medications, rather than more heterogeneous groupings according to antidepressant action, and may have implications for health and well-being for the longer term.

Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil--ECCAGE study.

BACKGROUND: Woman's nutritional status, before and during pregnancy, is a strong determinant of health outcomes in the mother and newborn. Gestational weight gain and postpartum weight retention increases risk of overweight or obesity in the future and they depend on the pregestational nutritional status and on food consumption and eating behavior during pregnancy. Eating behavior during pregnancy may be the cause or consequence of mood changes during pregnancy, especially depression, which increases likelihood of postpartum depression. In Brazil, a study carried out in the immediate postpartum period found that one in three women experienced some type of violence during pregnancy. Violence and depression are strongly associated and both exposures during pregnancy are associated with increased maternal stress and subsequent harm to the infant. The main objectives of this study are: to identify food intake and eating behaviors patterns; to estimate the prevalence of common mental disorders and the experience of violence during and after pregnancy; and to estimate the association between these exposures and infant's health and development. METHODS/DESIGN: This is a cohort study of 780 pregnant women receiving care in 18 primary care units in two cities in Southern Brazil. Pregnant women were first evaluated between the 16th and 36th week of pregnancy at a prenatal visit. Follow-up included immediate postpartum assessment and around the fifth month postpartum. Information was obtained on sociodemographic characteristics, living circumstances, food intake, eating behaviors, mental health and exposure to violence, and on infant's development and anthropometrics measurements. DISCUSSION: This project will bring relevant information for a better understanding of the relationship between exposures during pregnancy and how they might affect child development, which can be useful for a better planning of health actions aiming to enhance available resources in primary health care.

Brevipalpus Species Vectoring Citrus Leprosis Virus (Cilevirus and Dichorhavirus).

Citrus leprosis (CL) is one of the most devastating viral diseases of orchards, and industries correspondingly invest highly in the management and control of the virus vector. In Brazil, the disease is caused most predominantly by the citrus leprosis virus C (CiLV-C, Kitaviridae: Cilevirus), and also by citrus leprosis virus N (CiLV-N, Rhabdoviridae: Dichorhavirus). Both viruses are transmitted by false spider mites and at least three different species, Brevipalpus yothersi Baker, B. papayensis Baker, and B. phoenicis (Geijskes) sensu stricto, have been reported in citrus orchards. The main goal of this study was to evaluate the capacity of three Brevipalpus species to transmit citrus leprosis virus (cytoplasmic and nuclear types). The capacity of false spider mites to acquire the virus was accomplished using RT-PCR and the ability to inoculation the virus to host plants (common bean and sweet orange) was assessed via viral transmission assays. Common beans infested with B. yothersi and B. papayensis showed symptoms of CiLV-C in 87.5 and 17% of the plants assessed, respectively. In sweet orange, B. yothersi was exclusively able to inoculate CiLV-C, and around 83% of samples were symptomatic. Host plants infected with CiLV-N showed symptoms only when infested with B. phoenicis sensu stricto (s.s.). All the Brevipalpus species (Acari: Tenuipalpidae) were able to acquire both viruses (CiLV-C and CiLV-N), but not infect plants. These results suggest the existence of virus-vector specificity in the leprosis pathosystem, and this information will be critical for enhancing our further understanding of epidemiological features and disease management.

Machine Learning Approaches Applied to GC-FID Fatty Acid Profiles to Discriminate Wild from Farmed Salmon.

In the last decade, there has been an increasing demand for wild-captured fish, which attains higher prices compared to farmed species, thus being prone to mislabeling practices. In this work, fatty acid composition coupled to advanced chemometrics was used to discriminate wild from farmed salmon. The lipids extracted from salmon muscles of different production methods and origins (26 wild from Canada, 25 farmed from Canada, 24 farmed from Chile and 25 farmed from Norway) were analyzed by gas chromatography with flame ionization detector (GC-FID). All the tested chemometric approaches, namely principal components analysis (PCA), t-distributed stochastic neighbor embedding (t-SNE) and seven machine learning classifiers, namely k-nearest neighbors (kNN), decision tree, support vector machine (SVM), random forest, artificial neural networks (ANN), naïve Bayes and AdaBoost, allowed for differentiation between farmed and wild salmons using the 17 features obtained from chemical analysis. PCA did not allow clear distinguishing between salmon geographical origin since farmed samples from Canada and Chile overlapped. Nevertheless, using the 17 features in the models, six out of the seven tested machine learning classifiers allowed a classification accuracy of ≥99%, with ANN, naïve Bayes, random forest, SVM and kNN presenting 100% accuracy on the test dataset. The classification models were also assayed using only the best features selected by a reduction algorithm and the best input features mapped by t-SNE. The classifier kNN provided the best discrimination results because it correctly classified all samples according to production method and origin, ultimately using only the three most important features (16:0, 18:2n6c and 20:3n3 + 20:4n6). In general, the classifiers presented good generalization with the herein proposed approach being simple and presenting the advantage of requiring only common equipment existing in most labs.

Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?

INTRODUCTION: Single ventricle physiology management is challenging, especially in low-income countries. OBJECTIVE: To report the palliation outcomes of single ventricle patients in a developing African country. METHODS: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock-Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure). RESULTS: Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 ± 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P = .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P = .002) impacted survival. CONCLUSION: A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required.

Citrus leprosis resistance within the citrus group.

Reported in Brazil since the 1930's, citrus leprosis, caused mainly by citrus leprosis virus C, has been a major concern for the national sweet orange production. In recent years, the disease has spread to several other countries and it is now considered a worldwide threat. The occurrence of the disease has been studied almost exclusively in sweet oranges because other citrus genotypes are of secondary relevance in Brazil and in some other American countries where it occurs. Here we report 12 resistant citrus genotypes among 160 accessions evaluated. After 90 days of the infestation with viruliferous mites, asymptomatic genotypes were observed in sour orange, lemon, grapefruit, mandarins, tangelo, and tangor groups. The results revealed promising genotypes resistant to the disease, which can be incorporated in citrus breeding programs aiming to obtain varietal resistance, and confirmed the susceptibility of many citrus genotypes to CiLV-C. This assay ratify the already reported uneven level of susceptibility within the citrus group.

Association between dietary patterns and mental disorders in pregnant women in Southern Brazil.

OBJECTIVE:: To evaluate the association between dietary patterns and mental disorders among pregnant women in southern Brazil. METHODS:: Cross-sectional study with 712 pregnant women recruited from the Study of Food Intake and Eating Behaviors in Pregnancy (ECCAGe). Food intake assessment was performed using the Food Frequency Questionnaire. Dietary patterns were identified by cluster analysis. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to evaluate participants' mental health. Poisson regression models with robust variance were fitted to estimate prevalence ratios (PR). RESULTS:: In the adjusted models, there was a high prevalence of major depressive disorder among women with low fruit intake (43%, PR 1.43, 95%CI 1.04-1.95) and high sweets and sugars intake (91%, PR 1.91, 95%CI 1.19-3.07). Women with a common-Brazilian dietary pattern had higher prevalence of major depressive disorder compared to those with a varied consumption pattern (PR 1.43, 95%CI 1.01-2.02). Low intake of beans was significantly associated with generalized anxiety disorder (PR 1.40, 95%CI 1.01-1.93). CONCLUSIONS:: Low consumption of fruits and beans and intake of the common-Brazilian dietary pattern during pregnancy were associated with higher prevalence of mental disorders. These results reinforce the importance of an adequate dietary intake to ensure better mental health in pregnancy.

Common mental disorders and sociodemographic characteristics: baseline findings of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

OBJECTIVE: To assess the prevalence of common mental disorders (CMD) and the association of CMD with sociodemographic characteristics in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. METHODS: We analyzed data from the cross-sectional baseline assessment of the ELSA-Brasil, a cohort study of 15,105 civil servants from six Brazilian cities. The Clinical Interview Schedule-Revised (CIS-R) was used to investigate the presence of CMD, with a score ≥ 12 indicating a current CMD (last week). Specific diagnostic algorithms for each disorder were based on the ICD-10 diagnostic criteria. Prevalence ratios (PR) of the association between CMD and sociodemographic characteristics were estimated by Poisson regression. RESULTS: CMD (CIS-R score ≥ 12) was found in 26.8% (95% confidence intervals [95%CI] 26.1-27.5). The highest burden occurred among women (PR 1.9; 95%CI 1.8-2.0), the youngest (PR 1.7; 95%CI 1.5-1.9), non-white individuals, and those without a university degree. The most frequent diagnostic category was anxiety disorders (16.2%), followed by depressive episodes (4.2%). CONCLUSION: The burden of CMD was high, particularly among the more socially vulnerable groups. These findings highlight the need to strengthen public policies aimed to address health inequities related to mental disorders.

Citrus leprosis virus C Infection Results in Hypersensitive-Like Response, Suppression of the JA/ET Plant Defense Pathway and Promotion of the Colonization of Its Mite Vector.

Leprosis is a serious disease of citrus caused by Citrus leprosis virus C (CiLV-C, genus Cilevirus) whose transmission is mediated by false spider mites of the genus Brevipalpus. CiLV-C infection does not systemically spread in any of its known host plants, thus remaining restricted to local lesions around the feeding sites of viruliferous mites. To get insight into this unusual pathosystem, we evaluated the expression profiles of genes involved in defense mechanisms of Arabidopsis thaliana and Citrus sinensis upon infestation with non-viruliferous and viruliferous mites by using reverse-transcription qPCR. These results were analyzed together with the production of reactive oxygen species (ROS) and the appearance of dead cells as assessed by histochemical assays. After interaction with non-viruliferous mites, plants locally accumulated ROS and triggered the salicylic acid (SA) and jasmonate/ethylene (JA/ET) pathways. ERF branch of the JA/ET pathways was highly activated. In contrast, JA pathway genes were markedly suppressed upon the CiLV-C infection mediated by viruliferous mites. Viral infection also intensified the ROS burst and cell death, and enhanced the expression of genes involved in the RNA silencing mechanism and SA pathway. After 13 days of infestation of two sets of Arabidopsis plants with non-viruliferous and viruliferous mites, the number of mites in the CiLV-C infected Arabidopsis plants was significantly higher than in those infested with the non-viruliferous ones. Oviposition of the viruliferous mites occurred preferentially in the CiLV-C infected leaves. Based on these results, we postulated the first model of plant/Brevipalpus mite/cilevirus interaction in which cells surrounding the feeding sites of viruliferous mites typify the outcome of a hypersensitive-like response, whereas viral infection induces changes in the behavior of its vector.

Acute suicidal ideation in middle-aged adults from Brazil. Results from the baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Suicidal ideation represents an important burden worldwide. However, little is known about it in low-/middle-income countries. We investigated this issue in a large cross-sectional of Brazilian civil servants (ELSA-Brasil, the Brazilian Health Longitudinal Study, n=15,105). Logistic univariate and multivariate analyses were performed to evaluate the strength of association (odds ratio, OR) between clinical and sociodemographic variables with acute life-weariness (tiredness of life) and suicidal thoughts. The presence of major depressive disorder (MDD), common mental disorders (CMDs), stressful life-events (SLEs) and poor self-perceived physical health was also collected. MDD and CMDs were strongly associated with suicidal ideation in univariate and multivariate analyses. For life-weariness thoughts, a modest, consistent association was found for female gender, being single, non-White ethnicity and poor education. SLEs and poor self-perceived physical health were also associated with suicidal ideation. Espiritism-Kardecism, but not other religions or Atheism/Agnosticism, was associated with lower rates of life-weariness and suicidal thoughts. To conclude, suicidal ideation does not differ in Brazil compared to developed countries, being primarily associated with psychiatric disorders and, to a lesser but significant extent, to social disadvantage, SLEs, poor self-perceived health and being single.

Anomalous Origin of One Pulmonary Artery From the Ascending Aorta: From Diagnosis to Treatment in Angola.

BACKGROUND: Anomalous origin of one pulmonary artery is a rare congenital heart disease in which one pulmonary artery branch originates from the ascending aorta. OBJECTIVE: To describe the experience of a cardiothoracic center in an African country to repair anomalous origin of one pulmonary artery in the context of Portugal-Angola collaboration. METHODS: Between March 2011 and March 2015, four consecutive patients with anomalous origin of pulmonary artery branch underwent surgical correction. The mean age was 1.6 months. The mean weight was 4 kg. All had right pulmonary artery branch originating from the ascending aorta. All patients underwent direct implantation of right pulmonary branch to main pulmonary artery. Two patents had patent ductus arteriosus and one had atrial septal defect. Two patients had pulmonary hypertension. RESULTS: There was no registration of death. The mean cardiopulmonary bypass time was 75.5 ± 4.5 minutes, mean aortic cross-clamping time was 40 ± 5.6 minutes, and mean duration of the postoperative intensive care unit stay was 6.8 ± 5.7 days. At discharge, one patient had residual gradient of 25 mm Hg, the remainder had no significant gradient. The mean follow-up time was 11 months (5-28 months). One week after discharge, one patient presented operative wound dehiscence. At the last follow-up, all patients were alive, and no significant residual gradient or stenosis at site of anastomosis was observed. No reintervention was required. CONCLUSION: Anomalous origin of one pulmonary artery is a rare but potentially treatable lesion if operated early in life. Direct implantation was a good technique with good short-term results.

Body Image and Nutritional Status Are Associated with Physical Activity in Men and Women: The ELSA-Brasil Study.

The association of body image dissatisfaction and obesity with physical activity is likely to differ according to gender. To investigate this hypothesis, we conducted a cross-sectional study among the ELSA-Brasil cohort members aged 34-65 years (n=13,286). The body image dissatisfaction was present even among normal weight individuals of both sexes and was associated with lesser chances of practicing moderate physical activity in women and intense physical activity in men. Men and women with central obesity were less prone to practice physical activity of high or moderate intensity. Overweight and obese men were more likely to report vigorous physical activity while obese women were less likely to report this level of physical activity. Body images as well as nutritional status are related to physical activity in both sexes, but the association with physical activity differs by gender.

The Association between Antidepressant Medications and Coronary Heart Disease in Brazil: A Cross-Sectional Analysis on the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil).

BACKGROUND: Recent studies have highlighted associations between use of antidepressant medications and coronary heart disease (CHD). Tricyclic antidepressants (TCA) are not recommended in patients with CHD as they may increase morbidity and mortality. However, this class of antidepressants is freely prescribed in public health pharmacies, while access to other classes of antidepressants is restricted in Brazil. Here, we examine the associations between antidepressant use and prevalent CHD in a large cohort from Brazil. METHODS: Participants included 14,994 civil servants aged 35-74 years from the baseline assessment of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). CHD (n = 710) included stable angina, myocardial infarction, and coronary revascularization. Univariate (unadjusted) and multivariate (adjusted) logistic regression analyses were conducted to estimate odds ratios and confidence intervals. RESULTS: After full adjustment for covariates, TCA use (n = 156) was associated with a twofold increase in prevalent CHD, relative to non-use (n = 14,076). Additional sensitivity analysis revealed a threefold association for myocardial infarction (OR: 2.96, 95% CI: 1.41-6.21) and coronary revascularization (OR: 2.92, 95% CI: 1.28-6.66). There were no significant associations between antidepressant use and stable angina pectoris. CONCLUSION: Findings highlight a strong association between TCA use and prevalent CHD. While the cross-sectional design is an important limitation of the present study, findings have important implications for the treatment of cardiac patients in Brazil.

The association between mood and anxiety disorders, and coronary heart disease in Brazil: a cross-sectional analysis on the Brazilian longitudinal study of adult health (ELSA-Brasil).

BACKGROUND: Associations between major depressive disorder (MDD) and coronary heart disease (CHD) have been established, and these associations increase risk of future morbidity and mortality. Prior research has been carried out in high-income countries. Here we examine associations between the mood and anxiety disorders, and CHD in a large cohort at baseline from Brazil, a country facing a variety of challenges that may affect these associations. METHODS: Participants included 15,105 civil servants aged 35 to 74 at baseline (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). CHD (N = 721) included self-reported angina pectoris (n = 305), myocardial infarction (n = 259) and coronary revascularization (n = 239). Hierarchical logistic regression analyses were conducted to estimate odds ratios and confidence intervals. RESULTS: Major findings indicate that comorbid MDD and anxiety disorders (n = 434) are associated with a threefold increase in CHD, MDD alone (n = 170) with a twofold increase in CHD, while generalized anxiety disorder alone (n = 1,394) and mixed anxiety and depression disorder (n = 1,844) - symptoms present, but diagnostic threshold not reached - are associated with a 1.5-fold increase in CHD, after full adjustment for covariates. CONCLUSION: The association with CHD is greatest in those with psychiatric comorbidity, while associations were also observed in MDD and generalized anxiety disorder without comorbidity. While findings are limited by the cross-sectional design of the study, given the known risks associated with comorbidity of the mood and anxiety disorders with CHD, findings reinforce the importance of comprehensive health assessment in Brazil.

Appressorium turgor pressure of Colletotrichum kahawae might have a role in coffee cuticle penetration.

The method of penetration of fungi through the host cuticle by means of cutinase versus mechanical pressure exerted by melanized appresoria has been the subject of debate. Colletotrichum kahawae Bridge & Waller infects green coffee berries in Africa, inducing 70-80% losses. Turgor pressure (TP) of the appresoria was estimated in vitro to be 2.6 MPa, about twice the osmotic pressure (OP) of the green berries. Appresoria exposed in vitro to polyethylene glycol (PEG) solution with OPs of 7.0 MPa and above immediately collapsed. However, collapsed appresoria subjected to OP as high as 46.5 MPa could recover. Green berries inoculated with conidial suspensions, if subjected to OP of 28.5 MPa, showed 7% of them with necrotic lesions. Total inhibition of infection was achieved at 46.5 MPa. The OP of PEG solutions applied to inoculated green fruit decreased to the OP of the green berries in 48 h. The resistance of appresoria to osmotic stress, combined with the rapid dilution of PEG by solutes (water) from the fruit might explain the rate of infection even at very high OP. Unmelanized appresoria induced by tricyclazole showed TPs as low as one-quarter of melanized ones and, as a consequence, the percentage of infection on leaves and green berries was much lower. Cutinase was present in conidial mucilage and in extracellular fluids of germinated conidia in vitro and in planta. Cutinase was induced by growing the fungus in Czapek-Dox medium if cutin was used as the sole carbon source. Diisopropyl fluorophosphate, a cutinase inhibitor, totally inhibited cutinase activity of culture filtrates and extracellular fluids but did not prevent infection. It is suggested that the TP of C. kahawae appresoria might play a major role in coffee cuticle penetration, according to our results.

Effects of depression, anxiety, comorbidity, and antidepressants on resting-state heart rate and its variability: an ELSA-Brasil cohort baseline study.

OBJECTIVE: Increases in resting-state heart rate and decreases in its variability are associated with substantial morbidity and mortality, yet contradictory findings have been reported for the effects of the mood and anxiety disorders and of antidepressants. The authors investigated heart rate and heart rate variability in a large cohort from Brazil, using propensity score weighting, a relatively novel method, to control for numerous potential confounders. METHOD: A total of 15,105 participants were recruited in the Brazilian Longitudinal Study of Adult Health. Mood and anxiety disorders were ascertained using the Portuguese version of the Clinical Interview Schedule-Revised. Heart rate and its variability were extracted from 10-minute resting-state electrocardiograms. Regressions weighted by propensity scores were carried out to compare participants with and without depressive or anxiety disorders, as well as users and non-users of antidepressants, on heart rate and heart rate variability. RESULTS: Use of antidepressants was associated with increases in heart rate and decreases in its variability. Effects were most pronounced for the tricyclic antidepressants (Cohen's d, 0.72-0.81), followed by serotonin and norepinephrine reuptake inhibitors (Cohen's d, 0.42-0.95) and other antidepressants (Cohen's d, 0.37-0.40), relative to participants not on antidepressants. Only participants with generalized anxiety disorder showed robust, though small, increases in heart rate and decreases in its variability after propensity score weighting. CONCLUSIONS: The findings may, in part, underpin epidemiological findings of increased risk for cardiovascular morbidity and mortality. Many factors that have an adverse impact on cardiac activity were controlled for in this study, highlighting the importance of cardiovascular risk reduction strategies. Further study is needed to examine whether, how, and when such effects contribute to morbidity and mortality.