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Introduction Single-anastomosis duodenal switch has been suggested to be an effective bariatric procedure that offers excellent weight loss and by lengthening the common channel the potential to reduce micronutrient deficiencies. Purpose To evaluate the weight loss, comorbidity resolution and the 1-year nutritional outcomes of the single-anastomosis duodenal switch (SADS) procedure. Setting Multiple US Hospitals. Methods From October 2014 to January 2017, 120 patients were enrolled at six sites across the USA and underwent the SADS procedure. Weight loss, comorbidities, quality of life, and adverse events were followed post-procedure for 12 months. Results At 1, 6, and 12 months, 98.3%, 85.5%, and 77.1% of the patients were available for assessment, respectively. At 12 months, patients showed significantly reduced body mass index when compared to baseline (46.8 ± 5.8 vs 29.8 ± 4.4, P P Conclusions SADS is a highly efficacious weight loss procedure with significant comorbidity reduction at 1 year. At 1 year, complications and vitamin and mineral deficits appear to be consistent with other malabsorption operations. Long-term follow-up is needed, especially around complications and vitamin deficiencies.

In recent years, there has been an increase in the perceived threat of biological agents being used against civilian populations. This has prompted an urgent need for the development and procurement of medical countermeasures (MCMs) against highly pathogenic viruses that can prevent morbidity and mortality from infections caused by these agents. To date, antiviral drug development has been largely focused on clinically prevalent chronic infections due to their commercial viability. This has left a huge gap in the drug development path for acute infections of biodefense importance. In this review, we discuss the antiviral research and development initiatives focusing specifically on poxviruses, filoviruses, and equine encephalitis viruses (EEV). We discuss the benefits and technical challenges in the current development strategies and the hurdles in the licensure path for MCMs against these highly pathogenic viruses under the FDA Animal Rule, and we provide recommendations for the path forward.

Nicotiana benthamiana leaves display a visible plant cell death response when infiltrated with a high titer inoculum of the non-host pathogen, Xanthomonas campestris pv. vesicatoria (Xcv). This visual phenotype was used to identify overlapping cosmid clones from a genomic cosmid library constructed from the Xcv strain, GM98-38. Individual cosmid clones from the Xcv library were conjugated into X. campestris pv. campestris (Xcc) and exconjugants were scored for an altered visual high titer inoculation response in N. benthamiana. The molecular characterization of the cosmid clones revealed that they contained a novel gene, xopX, that encodes a 74-kDa type III secretion system (TTSS) effector protein. Agrobacterium-mediated transient expression of XopX in N. benthamiana did not elicit the plant cell death response although detectable XopX protein was produced. Interestingly, the plant cell death response occurred when the xopX Agrobacterium-mediated transient expression construct was co-inoculated with strains of either XcvDeltaxopX or Xcc, both lacking xopX. The co-inoculation complementation of the plant cell death response also depends on whether the Xanthomonas strains contain an active TTSS. Transgenic 35S-xopX-expressing N. benthamiana plants also have the visible plant cell death response when inoculated with the non-xopX-expressing strains XcvDeltaxopX and Xcc. Unexpectedly, transgenic 35S-xopX N. benthamiana plants displayed enhanced susceptibility to bacterial growth of Xcc as well as other non-xopX-expressing Xanthomonas and Pseudomonas strains. This result is also consistent with the increase in bacterial growth on wild type N. benthamiana plants observed for Xcc when XopX is expressed in trans. Furthermore, XopX contributes to the virulence of Xcv on host pepper (Capsicum annuum) and tomato (Lycopersicum esculentum) plants. We propose that the XopX bacterial effector protein targets basic innate immunity in plants, resulting in enhanced plant disease susceptibility.

The fight against antibiotic resistance must be strengthened. We propose actions that U.S. government agencies and private sector entities can take to build a more comprehensive effort. These actions can increase the viability of investing in new antibiotics, ensure the quality and stewardship of all antibiotics, and make responses to emerging resistance more informed. Success requires the thoughtful exercise of federal authority and a firm commitment to share data and reward developers for the value generated with new, life-saving antibiotics.

The dialogue and debate over crops developed with genetic engineering (GE) has produced a host of questions. These questions merit consideration. Here a rational and optimistic reply is attempted.

In recent years, there has been an increase in the perceived threat of biological agents being used against civilian populations. This has prompted an urgent need for the development and procuremen...

Background: Coronary artery disease occurs frequently in patients undergoing aortic reconstruction, and it has been presumed that internal carotid artery occlusive disease is also common. This has led to the practice of screening for and repairing significant carotid lesions in asymptomatic patients prior to aortic reconstruction. The purpose of this study was to determine the true prevalence of internal carotid artery disease in these patients. Methods: The records of 240 patients who underwent duplex ultrasound screening for carotid artery disease prior to aortic reconstruction were reviewed. Surgery was performed for aortic aneurysm (AA) or aorto-iliac occlusive disease (AO). The prevalence of hyperlipidemia and coronary artery disease was similar between the two groups, but tobacco use, hypertension, and diabetes mellitus differed. Results: Internal carotid artery stenosis ≥50% occurred in 26.7% of the total group (64 of 240 cases). Stenosis ≥50% was more common in the AO group (40 of 101 cases, 39.6%) than the AA group (24 of 139 cases, 17.3%, P = 0.0001). Severe disease (70% to 99%) was also more common in the AO group than the AA group (9.9% versus 3.6%, P = 0.0464). Conclusion: Internal carotid artery disease occurs commonly in patients undergoing aortic reconstruction, and screening is worthwhile. Significant disease is more common in patients with aorto-iliac occlusive disease than in those with aortic aneursym, although atherosclerotic risk factors occur with varying frequency in the two groups. These findings suggest that additional factors may contribute to the higher prevalence of internal carotid artery stenosis in aorto-iliac occlusive disease.

Nicotiana benthamiana leaves display a visible plant cell death response when infiltrated with a high titer inoculum of the non-host pathogen, Xanthomonas campestris pv. vesicatoria (Xcv). This visual phenotype was used to identify overlapping cosmid clones from a genomic cosmid library constructed from the Xcv strain, GM98-38. Individual cosmid clones from the Xcv library were conjugated into X. campestris pv. campestris (Xcc) and exconjugants were scored for an altered visual high titer inoculation response in N. benthamiana. The molecular characterization of the cosmid clones revealed that they contained a novel gene, xopX, that encodes a 74-kDa type III secretion system (TTSS) effector protein. Agrobacterium-mediated transient expression of XopX in N. benthamiana did not elicit the plant cell death response although detectable XopX protein was produced. Interestingly, the plant cell death response occurred when the xopX Agrobacterium-mediated transient expression construct was co-inoculated with strains of either XcvDeltaxopX or Xcc, both lacking xopX. The co-inoculation complementation of the plant cell death response also depends on whether the Xanthomonas strains contain an active TTSS. Transgenic 35S-xopX-expressing N. benthamiana plants also have the visible plant cell death response when inoculated with the non-xopX-expressing strains XcvDeltaxopX and Xcc. Unexpectedly, transgenic 35S-xopX N. benthamiana plants displayed enhanced susceptibility to bacterial growth of Xcc as well as other non-xopX-expressing Xanthomonas and Pseudomonas strains. This result is also consistent with the increase in bacterial growth on wild type N. benthamiana plants observed for Xcc when XopX is expressed in trans. Furthermore, XopX contributes to the virulence of Xcv on host pepper (Capsicum annuum) and tomato (Lycopersicum esculentum) plants. We propose that the XopX bacterial effector protein targets basic innate immunity in plants, resulting in enhanced plant disease susceptibility.

OBJECTIVE: Tree stand falls are a well-known cause of hunting-related injury. Spine and brain injuries associated with these falls result in a significant incidence of permanent disability. Prior studies indicate that hunting tree stand injuries are largely preventable with the proper use of safety belts; however, compliance with safety belt use is variable. The purposes of this study were to determine 1) current compliance with safety belt use, 2) alterations in the spectrum of injury, and 3) causes of the falls. METHODS: From January 1996 to October 2001, 51 tree stand-related injuries referred to either of two regional trauma centers or their region's medical examiner's office were reviewed. Data had been recorded in each hospital's trauma registry, and the registries were searched for falls. Medical records were reviewed for additional data retrospectively, with an emphasis on determining the use of safety belts, and mechanisms contributing to the fall. RESULTS: Fifty-one cases of tree stand-associated injuries were identified. These injuries all occurred in men, with a mean age of 42.6 years (range, 22-69 years). Alcohol use was present in 10% of patients and in two of the three deaths. The mean Injury Severity Score was 18.1 (range, 2-75). The most common injuries were spinal fractures (51% of series) and extremity fractures (41% of series). Closed head injuries were identified in 24% and lung injuries were identified in 22% of patients. Abdominal visceral injuries were present in 8% and genitourinary injuries were present in 4%. Three patients died. In addition to injury from the fall, a significant number (six patients [12%]) had additional morbidity from exposure. Only two patients reported the use of a safety belt (4% of series). There were no cases of gunshot wounds in this review, either self-inflicted or hunter-related. The chief reasons reported for these falls were errors in placement that resulted in structural failure of the stand, or errors made while climbing into or out of the stand (50% of falls). CONCLUSION: Devastating spine and brain injuries continue to occur after falls from tree stands during recreational hunting when safety belts are not used. Our results suggest a continuing need for the education of hunters concerning safe tree stand hunting practices, including proper methods of stand placement, assessment of tree branch strength, avoidance of fatigue and alcohol, anticipation of firearm recoil, and proper methods of stand entrance and exit. Trauma prevention programs directed toward heightened public awareness of these injuries during hunting season are still needed.

The bacterium Agrobacterium tumefaciens transforms eukaryotic hosts by transferring DNA to the recipient cell where it is integrated and expressed. Bacterial factors involved in this interkingdom gene transfer have been described, but less is known about host-cell factors. Using the yeast Saccharomyces cerevisiae as a model host, we devised a genetic screen to identify yeast mutants with altered transformation sensitivities. Twenty-four adenine auxotrophs were identified that exhibited supersensitivity to A. tumefaciens -mediated transformation when deprived of adenine. We extended these results to plants by showing that purine synthesis inhibitors cause supersensitivity to A. tumefaciens transformation in three plant species. The magnitude of this effect is large and does not depend on prior genetic manipulations of host cells. These data indicate the utility of yeast as a model for the transformation process and identify purine biosynthesis as a key determinant of transformation efficiency. These findings should increase the utility of A. tumefaciens in genetic engineering.

Quist and Chapela claim that transgenic DNA constructs have been introgressed into a traditional maize variety in Mexico, and furthermore suggest that these constructs have been reassorted and introduced into different genomic backgrounds. However, we show here that their evidence for such introgression is based on the artefactual results of a flawed assay; in addition, the authors misinterpret a key reference to explain their results, concluding that reassortment of integrated transgenic DNA occurs during transformation or recombination.

The Arabidopsis genes EDS1 and NDR1 were shown previously by mutational analysis to encode essential components of race-specific disease resistance. Here, we examined the relative requirements for EDS1 and NDR1 by a broad spectrum of Resistance ( R ) genes present in three Arabidopsis accessions (Columbia, Landsberg- erecta , and Wassilewskija). We show that there is a strong requirement for EDS1 by a subset of R loci ( RPP2 , RPP4 , RPP5 , RPP21 , and RPS4 ), conferring resistance to the biotrophic oomycete Peronospora parasitica , and to Pseudomonas bacteria expressing the avirulence gene avrRps4 . The requirement for NDR1 by these EDS1 -dependent R loci is either weak or not measurable. Conversely, three NDR1 -dependent R loci, RPS2 , RPM1 , and RPS5 , operate independently of EDS1 . Another RPP locus, RPP8 , exhibits no strong exclusive requirement for EDS1 or NDR1 in isolate-specific resistance to P. parasitica , although resistance is compromised weakly by eds1 . Similarly, resistance conditioned by two EDS1 -dependent RPP genes, RPP4 and RPP5 , is impaired partially by ndr1 , implicating a degree of pathway cross-talk. Our results provide compelling evidence for the preferential utilization of either signaling component by particular R genes and thus define at least two disease resistance pathways. The data also suggest that strong dependence on EDS1 or NDR1 is governed by R protein structural type rather than pathogen class.

Quist and Chapela claim that transgenic DNA constructs have been introgressed into a traditional maize variety in Mexico, and furthermore suggest that these constructs have been reassorted and introduced into different genomic backgrounds. However, we show here that their evidence for such introgression is based on the artefactual results of a flawed assay; in addition, the authors misinterpret a key reference to explain their results, concluding that reassortment of integrated transgenic DNA occurs during transformation or recombination.