Duration of Highly Pathogenic Avian Influenza Virus and Newcastle Disease Virus Infectivity in Dried Ornithologic Study Skins.

Ornithologic study skins are specimens of avian skins that have been preserved by drying after removing the viscera and muscle. Because of the high value of study skins for scientific studies, specimens are shared among researchers. There is concern that study skins might be contaminated with high-consequence diseases such as highly pathogenic avian influenza virus (HPAIV) or Newcastle disease virus (NDV). To mitigate risk, thermal or chemical treatment of study skins may be required before transfer; however, such treatments might damage the specimens. Therefore, a study was conducted to evaluate the duration of infectivity of HPAIV and NDV in study skins prepared from infected chickens (Gallus gallus). Study skins were prepared from 10 chickens infected with each virus. Skin and feather pulp samples were taken at the time of study skin preparation to establish starting titers. Mean starting titers in the skin was 4.2 log10 and 5.1 log10 50% egg infectious doses (EID50) for HPAIV and NDV groups respectively, and were 6.7 log10 EID50 for HPAIV, and 6.4 log10 EID50 for NDV in feather pulp. Samples were collected at 2 and 4 wk of drying to quantify viable virus. At 2 wk, fewer samples had detectable virus and mean titers were 1.8 log10 (skin) and 2.1 log10 (feathers) EID50 for HPAIV, and 1.7 log10 (skin) and 3.5 log10 (feathers) EID50 for NDV. At 4 wk viable virus could not be detected in either tissue type.

Ketamine For Acute Pain After Trauma (KAPT): A Pragmatic, Randomized Clinical Trial.

INTRODUCTION: Non-narcotic intravenous medications may be a beneficial adjunct to oral multimodal pain regimens (MMPRs) which reduce but do not eliminate opioid exposure and prescribing after trauma. We hypothesized that the addition of a sub-dissociative ketamine infusion (KI) to a standardized oral MMPR reduces inpatient opioid exposure. METHODS: Eligible adult trauma patients admitted to the intermediate or intensive care unit were randomized upon admission to our institutional MMPR per usual care (UC) or UC plus sub-dissociative KI for 24 to 72 hours after arrival. The primary outcome was morphine milligram equivalents per day (MME/d) and secondary outcomes included total MME, discharge with an opioid prescription (OP%), and rates of ketamine side effects. Bayesian posterior probabilities (pp) were calculated using neutral priors. RESULTS: A total of 300 patients were included in the final analysis with 144 randomized to KI and 156 to UC. Baseline characteristics were similar between groups. The injury severity scores for KI were 19 [14, 29] versus UC 22 [14, 29]. The KI group had a lower rate of long-bone fracture (37% versus 49%) and laparotomy (16% versus 24%). Patients receiving KI had an absolute reduction of 7 MME/day, 96 total MME, and 5% in OP%. Additionally, KI had a relative risk (RR) reduction of 19% in MME/day (RR 0.81 [0.69 - 0.95], pp = 99%), 20% in total MME (RR 0.80 [0.64, 0.99], pp = 98%), and 8% in OP% (RR 0.92 [0.76, 1.11], pp = 81%). The KI group had a higher rate of delirium (11% versus 6%); however, rates of other side effects such as arrythmias and unplanned intubations were similar between groups. CONCLUSION: Addition of a sub-dissociative ketamine infusion to an oral MMPR resulted in a decrease in opioid exposure in severely injured patients. Sub-dissociative ketamine infusions can be used as a safe adjunct to decrease opioid exposure in monitored settings. LEVEL OF EVIDENCE: I; Therapeutic/Care Management.

Assessing Impact Amongst Chaplains in a University Setting: Phase Two of an Action Research Project.

This article, the result of an Action Research project, describes the process of creating and testing a resource for assessing the contribution of chaplaincy in a British university setting, and the resultant insights and outcomes: organisational and individual learning, changes in chaplains' attitudes to monitoring and evaluation, and a resource which is perceived as having benefits and limitations. This article considers the evaluation process as applied to chaplaincy and offers a model for further testing.

Assessing Impact Amongst Chaplains in a University Setting: Phase One of an Action Research Project.

This article reports findings from an action research project in which a university chaplaincy team explored the desirability and viability of assessing their impact. It uncovers a complexity in chaplains' understandings about their role and - chief amongst their fears - belief that quantitative measures can be harmful to pastoral and spiritual work. It also reveals a sense of institutional accountability and a desire to engage with processes for determining and articulating chaplaincy's value.

Risk of a vector-borne endemic zoonosis for wildlife: Hosts, large-scale geography, and diversity of vector-host interactions for Trypanosoma cruzi.

Drivers for wildlife infection are multiple and complex, particularly for vector-borne diseases. Here, we studied the role of host competence, geographic area provenance, and diversity of vector-host interactions as drivers of wild mammal infection risk to Trypanosoma cruzi, the aetiological agent of Chagas disease. We performed a systematic sampling of wild mammals in 11 states of Mexico, from 2017 to 2018. We tested the positivity of T. cruzi with the Tc24 marker in tissues samples for 61 wild mammal species (524 specimens sampled). 26 mammal species were positive for T. cruzi, of which 11 are new hosts recorded in Mexico 75 specimens were positive and 449 were negative for T. cruzi infection, yielding an overall prevalence of 14.3%. The standardized infection risk of T. cruzi of our examined specimens was similar, no matter the host species or their geographic origins. Additionally, we used published data of mammal positives for T. cruzi to complement records of T. cruzi infection in wild mammals and inferred a trophic network of Triatoma spp. (vectors) and wild mammal species in Mexico, using spatial data-mining modelling. Infection with T. cruzi was not homogeneously distributed in the inferred trophic network. This information allowed us to develop a predictive model for T. cruzi infection risk for wild mammals in Mexico, considering risk as a function of the diversity of vector-host spatial associations in a large-scale geographic context, finding that the addition of competent vectors to a multi-host parasite system amplifies host infection risk. The diversity of vector-host interactions per se constitutes a relevant driver of infection risk because hosts and vectors are not isolated from each other.

Evolutionary success of the thrifty genotype depends on both behavioral adaptations and temporal variability in the food environment.

Obesity is a result of a long-term energy imbalance due to decisions associated with energy intake and expenditure. Those decisions fit the definition of heuristics: cognitive processes with a rapid and effortless implementation which can be very effective in dealing with scenarios that threaten an organism's viability. We study the implementation and evaluation of heuristics, and their associated actions, using agent-based simulations in environments where the distribution and degree of richness of energetic resources is varied in space and time. Artificial agents utilize foraging strategies, combining movement, active perception, and consumption, while also actively modifying their capacity to store energy-a "thrifty gene" effect-based on three different heuristics. We show that the selective advantage associated with higher energy storage capacity depends on both the agent's foraging strategy and heuristic, as well as being sensitive to the distribution of resources, with the existence and duration of periods of food abundance and scarcity being crucial. We conclude that a "thrifty genotype" is only beneficial in the presence of behavioral adaptations that encourage overconsumption and sedentariness, as well as seasonality and uncertainty in the food distribution.

A brief history of the development and use of vulcanised rubber in dentistry.

Until the late nineteenth century, denture baseplates and removable orthodontic appliances were usually made of gold. Though now largely forgotten, the discovery of vulcanised rubber was instrumental in making these forms of dental treatment widely available to the general public. While Charles Goodyear is recognised for his role in the development of vulcanite in America, that of Thomas Hancock in the UK is less well-known.

The Low Variability of Tc24 in Trypanosoma cruzi TcI as an Advantage for Chagas Disease Prophylaxis and Diagnosis in Mexico.

(1) Background: Chagas disease is the main neglected tropical disease in America. It is estimated that around 6 million people are currently infected with the parasite in Latin America, and 25 million live in endemic areas with active transmission. The disease causes an estimated economic loss of USD 24 billion dollars annually, with a loss of 75,200 working years per year of life; it is responsible for around ~12,000 deaths annually. Although Mexico is an endemic country that recorded 10,186 new cases of Chagas disease during the period of 1990-2017, few studies have evaluated the genetic diversity of genes that could be involved in the prophylaxis and/or diagnosis of the parasite. One of the possible candidates proposed as a vaccine target is the 24 kDa trypomastigote excretory-secretory protein, Tc24, whose protection is linked to the stimulation of T. cruzi-specific CD8+ immune responses. (2) Methods: The aim of the present study was to evaluate the fine-scale genetic diversity and structure of Tc24 in T. cruzi isolates from Mexico, and to compare them with other populations reported in the Americas with the aim to reconsider the potential role of Tc24 as a key candidate for the prophylaxis and improvement of the diagnosis of Chagas disease in Mexico. (3) Results: Of the 25 Mexican isolates analysed, 48% (12) were recovered from humans and 24% (6) recovered from Triatoma barberi and Triatoma dimidiata. Phylogenetic inferences revealed a polytomy in the T. cruzi clade with two defined subgroups, one formed by all sequences of the DTU I and the other formed by DTU II-VI; both subgroups had high branch support. Genetic population analysis detected a single (monomorphic) haplotype of TcI throughout the entire distribution across both Mexico and South America. This information was supported by Nei's pairwise distances, where the sequences of TcI showed no genetic differences. (4) Conclusions: Given that both previous studies and the findings of the present work confirmed that TcI is the only genotype detected from human isolates obtained from various states of Mexico, and that there is no significant genetic variability in any of them, it is possible to propose the development of in silico strategies for the production of antigens that optimise the diagnosis of Chagas disease, such as quantitative ELISA methods that use this region of Tc24.

"Does a Respiratory Virus Have an Ecological Niche, and If So, Can It Be Mapped?" Yes and Yes.

Although the utility of Ecological Niche Models (ENM) and Species Distribution Models (SDM) has been demonstrated in many ecological applications, their suitability for modelling epidemics or pandemics, such as SARS-Cov-2, has been questioned. In this paper, contrary to this viewpoint, we show that ENMs and SDMs can be created that can describe the evolution of pandemics, both in space and time. As an illustrative use case, we create models for predicting confirmed cases of COVID-19, viewed as our target "species", in Mexico through 2020 and 2021, showing that the models are predictive in both space and time. In order to achieve this, we extend a recently developed Bayesian framework for niche modelling, to include: (i) dynamic, non-equilibrium "species" distributions; (ii) a wider set of habitat variables, including behavioural, socio-economic and socio-demographic variables, as well as standard climatic variables; (iii) distinct models and associated niches for different species characteristics, showing how the niche, as deduced through presence-absence data, can differ from that deduced from abundance data. We show that the niche associated with those places with the highest abundance of cases has been highly conserved throughout the pandemic, while the inferred niche associated with presence of cases has been changing. Finally, we show how causal chains can be inferred and confounding identified by showing that behavioural and social factors are much more predictive than climate and that, further, the latter is confounded by the former.

Disentangling the contributions of biotic and abiotic predictors in the niche and the species distribution model of Trypanosoma cruzi, etiological agent of Chagas disease.

The potential benefits of incorporating biotic, as well as abiotic, predictors in niche and species distribution models (SDMs), as well as how to achieve this, is still debated, with their interpretability and explanatory potential being particularly questioned. It is therefore important to stress test modelling methodologies that include biotic factors against use cases where there is ample knowledge of the potential biotic component of the niche. Relatively well studied and important vector-borne diseases offer just such an opportunity, where knowledge of the agents involved in the transmission cycle -vectors and hosts- can serve to calibrate and test the niche model and corresponding SDM. Here, we study the contributions of biotic -14 vectors, 459 potential hosts- and abiotic -258 climatic categories- predictors to the explanatory and predictive features of the niche and corresponding SDM for the etiological agent of Chagas disease, Trypanosoma cruzi, in Mexico. Using an established spatial data mining technique, we generate biotic, abiotic and biotic+abiotic niche and SDM models. We test our models by comparing predictions of the most important probable hosts of Chagas disease with a previously published list of confirmed hosts. We quantify, compare, and contrast the individual and total contributions of predictors to the niche and distribution of Chagas disease in Mexico. We assess the relative predictive potential of these variables to model performance, showing that models that include relevant biotic niche variables lead to more predictive, more ecologically realistic SDMs. Our research illustrates a useful general procedure for identifying and ranking potential biotic interactions and for assessing the relative importance of biotic and abiotic predictors. We conclude that the inclusion of both abiotic and biotic predictors in SDMs not only provides more predictive and accurate models but also models that are more understandable and explainable from an ecological niche perspective.

A Case Report of Anesthesia-induced Diffuse Alveolar Hemorrhage Presenting to the Emergency Department.

Introduction: The inhaled anesthetic sevoflurane is an uncommon etiology of diffuse alveolar hemorrhage (DAH). As DAH typically presents in the inpatient, postoperative setting, it has been infrequently reported in the anesthesiology literature and, to our knowledge, has not been reported in the emergency medicine literature to date. Case Report: We describe the presentation of a young, healthy male in respiratory distress to a busy urban emergency department (ED) after an outpatient surgical procedure. We highlight the etiology of post-anesthesia DAH and the acute management of this rare diagnosis in the ED. Conclusion: With outpatient surgical centers becoming an increasingly popular option for lower risk procedures, emergency physicians would benefit from understanding this presentation and its pathophysiology.

The host cytoskeleton: a key regulator of early HIV-1 infection.

Due to its central role in cell biology, the cytoskeleton is a key regulator of viral infection, influencing nearly every step of the viral life cycle. In this review, we will discuss the role of two key components of the cytoskeleton, namely the actin and microtubule networks in early HIV-1 infection. We will discuss key contributions to processes ranging from the attachment and entry of viral particles at the cell surface to their arrival and import into the nucleus and identify areas where further research into this complex relationship may yield new insights into HIV-1 pathogenesis.

Toward New Epidemiological Landscapes of Trypanosoma cruzi (Kinetoplastida, Trypanosomatidae) Transmission under Future Human-Modified Land Cover and Climatic Change in Mexico.

Chagas disease, caused by the protozoa Trypanosoma cruzi, is an important yet neglected disease that represents a severe public health problem in the Americas. Although the alteration of natural habitats and climate change can favor the establishment of new transmission cycles for T. cruzi, the compound effect of human-modified landscapes and current climate change on the transmission dynamics of T. cruzi has until now received little attention. A better understanding of the relationship between these factors and T. cruzi presence is an important step towards finding ways to mitigate the future impact of this disease on human communities. Here, we assess how wild and domestic cycles of T. cruzi transmission are related to human-modified landscapes and climate conditions (LUCC-CC). Using a Bayesian datamining framework, we measured the correlations among the presence of T. cruzi transmission cycles (sylvatic, rural, and urban) and historical land use, land cover, and climate for the period 1985 to 2012. We then estimated the potential range changes of T. cruzi transmission cycles under future land-use and -cover change and climate change scenarios for 2050 and 2070 time-horizons, with respect to "green" (RCP 2.6), "business-as-usual" (RCP 4.5), and "worst-case" (RCP 8.5) scenarios, and four general circulation models. Our results show how sylvatic and domestic transmission cycles could have historically interacted through the potential exchange of wild triatomines (insect vectors of T. cruzi) and mammals carrying T. cruzi, due to the proximity of human settlements (urban and rural) to natural habitats. However, T. cruzi transmission cycles in recent times (i.e., 2011) have undergone a domiciliation process where several triatomines have colonized and adapted to human dwellings and domestic species (e.g., dogs and cats) that can be the main blood sources for these triatomines. Accordingly, Chagas disease could become an emerging health problem in urban areas. Projecting potential future range shifts of T. cruzi transmission cycles under LUCC-CC scenarios we found for RCP 2.6 no expansion of favourable conditions for the presence of T. cruzi transmission cycles. However, for RCP 4.5 and 8.5, a significant range expansion of T. cruzi could be expected. We conclude that if sustainable goals are reached by appropriate changes in socio-economic and development policies we can expect no increase in suitable habitats for T. cruzi transmission cycles.

Ketamine for acute pain after trauma: the KAPT randomized controlled trial.

BACKGROUND: Evidence for effective pain management and opioid minimization of intravenous ketamine in elective surgery has been extrapolated to acutely injured patients, despite limited supporting evidence in this population. This trial seeks to determine the effectiveness of the addition of sub-dissociative ketamine to a pill-based, opioid-minimizing multi-modal pain regimen (MMPR) for post traumatic pain. METHODS: This is a single-center, parallel-group, randomized, controlled comparative effectiveness trial comparing a MMPR to a MMPR plus a sub-dissociative ketamine infusion. All trauma patients 16 years and older admitted following a trauma which require intermediate (IMU) or intensive care unit (ICU) level of care are eligible. Prisoners, patients who are pregnant, patients not expected to survive, and those with contraindications to ketamine are excluded from this study. The primary outcome is opioid use, measured by morphine milligram equivalents (MME) per patient per day (MME/patient/day). The secondary outcomes include total MME, pain scores, morbidity, lengths of stay, opioid prescriptions at discharge, and patient centered outcomes at discharge and 6 months. DISCUSSION: This trial will determine the effectiveness of sub-dissociative ketamine infusion as part of a MMPR in reducing in-hospital opioid exposure in adult trauma patients. Furthermore, it will inform decisions regarding acute pain strategies on patient centered outcomes. TRIAL REGISTRATION: The Ketamine for Acute Pain Management After Trauma (KAPT) with registration # NCT04129086 was registered on October 16, 2019.

The Thermal Stability of Newcastle Disease Virus in Poultry Litter.

Sanitary disposal of contaminated organic material during recovery from an animal disease outbreak is costly and laborious. Characterizing the thermal stability of avian paramyxovirus type 1 (APMV-1; virulent APMV-1 strains cause Newcastle disease in poultry) will help inform risk assessments on the presence of viable virus on infected premises or in organic waste from infected premises. In some environments and housing types, heat may also be used as a decontamination method. Therefore, the objective of this study was to characterize the thermal stability (i.e., decimal reduction values [D values]) of APMV-1 in poultry litter. Virus inactivation was evaluated at seven temperatures from 10.0 C through 43.3 C, at 5.5 C intervals (50-110 F in 10 F intervals), using the I2 isolate of APMV-1, a vaccine strain known to be thermally stable. A high titer of virus (approximately 108 50% egg infectious doses) was added to wood shavings based, soiled chicken litter (poultry litter). Litter with both low and high moisture levels were evaluated. Samples were collected at different time intervals, and infectious virus was titrated in embryonated chicken eggs. At high temperatures (37.8 C-43.3 C), infectious virus could not be detected after 2-7 days, whereas at lower temperatures (10 C-21.1 C), it took up to 112 days for virus to decrease to undetectable levels. Furthermore, the D values were almost always shorter in the high moisture litter.

Estabilidad térmica del virus de la enfermedad de Newcastle en la cama avícola. La eliminación sanitaria de material orgánico contaminado durante la recuperación de un brote de enfermedad en los animales es costosa y laboriosa. La caracterización de la estabilidad térmica del paramixovirus aviar tipo 1 (APMV-1; las cepas virulentas de APMV-1 que causan la enfermedad de Newcastle en avicultura) contribuirá con información para las evaluaciones de riesgo sobre la presencia de virus viables en las instalaciones infectadas o en los desechos orgánicos de las instalaciones infectadas. En algunos entornos y tipos de casetas, el calor también se puede utilizar como método de descontaminación. Por lo tanto, el objetivo de este estudio fue caracterizar la estabilidad térmica (es decir, valores de reducción decimal [valores D]) del APMV-1 en la cama de aves. La inactivación del virus se evaluó a siete temperaturas, desde 10.0 C hasta 43.3 C, en intervalos de 5.5 C (50­110 F en intervalos de 10 F), utilizando el aislamiento I2 de APMV-1, que es una cepa vacunal conocida por ser térmicamente estable. Se añadió el virus con un título alto (aproximadamente 108 dosis infecciosas de embrión de pollo al 50%) a la cama de pollo con base de virutas de madera (cama avícola). Se evaluaron camas con niveles de humedad altos y bajos. Se recolectaron muestras en diferentes intervalos de tiempo y se tituló el virus infeccioso en huevos embrionados de pollo. A altas temperaturas (37.8 C­43.3 C), el virus infeccioso no se pudo detectar después de dos a siete días, mientras que a temperaturas más bajas (10 C­21.1 C), el virus tardó hasta 112 días en disminuir a niveles no detectables. Además, los valores D fueron casi siempre más cortos en la cama con alta humedad.

Optimizing sample collection methods for detection of respiratory viruses in poultry housing environments.

Viral respiratory diseases, such as avian influenza, Newcastle disease, infectious bronchitis and infectious laryngotracheitis, have considerable negative economic implications for poultry. Ensuring the virus-free status of premises by environmental sampling after cleaning and disinfection is essential for lifting a quarantine and/or safely restocking the premises following an outbreak. The objectives of this study were to identify optimal sample collection devices and to determine the locations in poultry housing which are best for poultry respiratory virus sample collection. Chickens exposed to infectious bronchitis virus, which was used as a representative virus for enveloped poultry respiratory viruses, were housed in floor-pens in either a curtain-sided wood framed house or a cement block house. Foam swabs, cellulose sponges, polyester swabs, dry cotton gauze and pre-moistened cotton gauze were evaluated for comparative efficiency in recovering viral RNA. Cotton gauze pre-moistened with the viral transport media had the highest sensitivity among the devices (wood-framed house: 78% positive, geometric mean titre [GMT] of 2.6 log10 50% egg infectious doses [EID50 ] equivalents/ml; cement block houses: 55% positive, GMT of 1.7 log10 EID50 equivalents/ml). Targeting virus deposition sites is also crucial for efficient virus elimination procedures and subsequent testing; therefore, 10 locations within the houses were compared for virus detection. In both housing types, the highest viral RNA loads were recovered from the tops of drinker lines within the pen. Places the chickens could contact directly (e.g., feeder rim) or were contacted by caretaker feet (hallway floor) also yielded higher levels of viral RNA more consistently. These results will facilitate the establishment of efficient environmental sampling procedures for respiratory viruses of poultry.

Prehospital Trauma Airway Management: An NAEMSP Position Statement and Resource Document.

Definitive management of trauma is not possible in the out-of-hospital environment. Rapid treatment and transport of trauma casualties to a trauma center are vital to improve survival and outcomes. Prioritization and management of airway, oxygenation, ventilation, protection from gross aspiration, and physiologic optimization must be balanced against timely patient delivery to definitive care. The optimal prehospital airway management strategy for trauma has not been clearly defined; the best choice should be patient-specific. NAEMSP recommends:The approach to airway management and the choice of airway interventions in a trauma patient requires an iterative, individualized assessment that considers patient, clinician, and environmental factors.Optimal trauma airway management should focus on meeting the goals of adequate oxygenation and ventilation rather than on specific interventions. Emergency medical services (EMS) clinicians should perform frequent reassessments to determine if there is a need to escalate from basic to advanced airway interventions.Management of immediately life-threatening injuries should take priority over advanced airway insertion.Drug-assisted airway management should be considered within a comprehensive algorithm incorporating failed airway options and balanced management of pain, agitation, and delirium.EMS medical directors must be highly engaged in assuring clinician competence in trauma airway assessment, management, and interventions.

Prehospital Airway Management Training and Education: An NAEMSP Position Statement and Resource Document.

AbstractAirway management competency extends beyond technical skills to encompass a comprehensive approach to optimize patient outcomes. Initial and continuing education for airway management must therefore extend beyond a narrow focus on psychomotor skills and task completion to include appreciation of underlying pathophysiology, clinical judgment, and higher-order decision making. NAEMSP recommends:Active engagement in deliberate practice should be the guiding approach for developing and maintaining competence in airway management.EMS learners and clinicians must be educated in an escalating approach to airway management, where basic airway maneuvers form the central focus.Educational activities should extend beyond fundamental knowledge to focus on the development of clinical judgment.Optimization of patient outcomes should be valued over performance of individual airway management skills.Credentialing and continuing education activities in airway management are essential to advance clinicians beyond entry-level competency.Initial and continuing education programs should be responsive to advances in the evidence base and maintain adaptability to re-assess content and expected outcomes on a continual basis.

WAKsing plant immunity, waning diseases.

With the requirement to breed more productive crop plants in order to feed a growing global population, compounded by increasingly widespread resistance to pesticides exhibited by pathogens, plant immunity is becoming an increasingly important area of research. Of the genes that contribute to disease resistance, the wall-associated receptor-like kinases (WAKs) are increasingly shown to play a major role, in addition to their contribution to plant growth and development or tolerance to abiotic stresses. Being transmembrane proteins, WAKs form a central pillar of a plant cell's ability to monitor and interact with the extracellular environment. Found in both dicots and monocots, WAKs have been implicated in defence against pathogens with diverse lifestyles and contribute to plant immunity in a variety of ways. Whilst some act as cell surface-localized immune receptors recognizing either pathogen- or plant-derived invasion molecules (e.g. effectors or damage-associated molecular patterns, respectively), others promote innate immunity through cell wall modification and strengthening, thus limiting pathogen intrusion. The ability of some WAKs to provide both durable resistance against pathogens and other agronomic benefits makes this gene family important targets in the development of future crop ideotypes and important to a greater understanding of the complexity and robustness of plant immunity.