By analyzing successive lifestyle stages of a model Rhizobium–legume symbiosis using mariner-based transposon insertion sequencing (INSeq), we have defined the genes required for rhizosphere growth, root colonization, bacterial infection, N2-fixing bacteroids, and release from legume (pea) nodules. While only 27 genes are annotated as nif and fix in Rhizobium leguminosarum, we show 603 genetic regions (593 genes, 5 transfer RNAs, and 5 RNA features) are required for the competitive ability to nodulate pea and fix N2. Of these, 146 are common to rhizosphere growth through to bacteroids. This large number of genes, defined as rhizosphere-progressive, highlights how critical successful competition in the rhizosphere is to subsequent infection and nodulation. As expected, there is also a large group (211) specific for nodule bacteria and bacteroid function. Nodule infection and bacteroid formation require genes for motility, cell envelope restructuring, nodulation signaling, N2 fixation, and metabolic adaptation. Metabolic adaptation includes urea, erythritol and aldehyde metabolism, glycogen synthesis, dicarboxylate metabolism, and glutamine synthesis (GlnII). There are 17 separate lifestyle adaptations specific to rhizosphere growth and 23 to root colonization, distinct from infection and nodule formation. These results dramatically highlight the importance of competition at multiple stages of a Rhizobium–legume symbiosis.
41 42 By analyzing successive lifestyle stages of a model Rhizobium-legume symbiosis using 43 mariner-based transposon insertion sequencing (INSeq), we have defined the genes 44 required for rhizosphere growth, root colonization, bacterial infection, N2-fixing 45 bacteroids and release from legume (pea) nodules. While only 27 genes are annotated 46 as nif and fix in Rhizobium leguminosarum, we show 603 genetic regions (593 genes, 5 47 tRNAs and 5 RNA features) are required for the competitive ability to nodulate pea and 48 fix N2. Of these, 146 are common to rhizosphere growth through to bacteroids. This 49 large number of genes, defined as rhizosphere-progressive, highlights how critical 50 successful competition in the rhizosphere is to subsequent infection and nodulation. As 51 expected, there is also a large group (211) specific for nodule bacteria and bacteroid 52 function. Nodule infection and bacteroid formation require genes for motility, cell 53 envelope restructuring, nodulation signalling, N2 fixation, and metabolic adaptation. 54 Metabolic adaptation includes urea, erythritol and aldehyde metabolism, glycogen 55 synthesis, dicarboxylate metabolism and glutamine synthesis (GlnII). There are 56 separate lifestyle adaptations specific to rhizosphere growth (17) and root colonization 57 (23), distinct from infection and nodule formation. These results dramatically highlight 58
The purpose of this study is to update the available literature with information on the current use of robotic assisted surgery (RAS) in the Department of Defense (DoD) compared to the civilian world, and how the coronavirus disease 2019 (COVID-19) pandemic impacted RAS in the DoD. A total of 9,979 RAS cases between 01st October 2017 and 31st December 2020 were reviewed from every DoD Military Treatment Facility (MTF) that meets our inclusion criteria and employs various models of da Vinci robotic surgical systems (Intuitive Surgical). Specialty, number, and facility were recorded for each case. These data were then compared to previously known trends about RAS use in the DoD as well as with civilian trends. Before COVID-19, the use of RAS had increased over time, but not at the same rate as in the civilian sector. General surgery cases constituted most RAS cases in both the DoD and the civilian sector. The arrival of COVID-19 in the United States significantly decreased the use of RAS in the DoD as well as in the civilian sector in all surgical specialties because it led to postponement or cancellation of many non-emergent surgical procedures. In conclusion, the use of RAS has continued to increase, and general surgery cases continue to constitute most of these cases. However, since the COVID-19 pandemic began, there was a significant decline in both DoD and civilian RAS cases, with a more pronounced decline in the DoD.
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