Bacterias causantes de otitis media aguda antes y después de la aplicación de la vacuna antineumococica 13-valente / Acute otitis media-causing bacteria before and after the application of the 13-valent pneumococcal conjugate vaccine

Los microorganismos más frecuentemente responsables de la otitis media aguda (OMA) (Streptococcus pneumoniae y Haemophilus influenzae) son los mismos en los países en vías de desarrollo que en los desarrollados. En los países que administraron la vacuna antineumocócica conjugada, los neumococos disminuyeron como causa de OMA, pero con el tiempo comenzaron a resurgir, sobre todo a expensas de cepas pertenecientes a serotipos no incluidos en la vacuna. El objetivo de este trabajo fue documentar el cambio generado en la bacteriología de la OMA a partir de la incorporación en el calendario oficial argentino de la vacuna conjugada antineumocócica 13-valente en el año 2012. Se realizaron dos estudios prospectivos, descriptivos, transversales, uno previo a la incorporación de la vacuna al calendario nacional (mayo 2009-agosto 2010) donde la población estudiada no se encontraba cubierta para S. pneumoniae y otro posterior, donde la mayoría de los pacientes se encontraban inmunizados (enero-diciembre 2016). Se obtuvieron 433 muestras de 324 pacientes en el primer período y 461 de 246 pacientes en el segundo. Se aisló un total de 326 bacterias en el primer período y 388 en el segundo. Los microorganismos respectivamente aislados en ambos períodos fueron S. pneumoniae (39,5-21,1%), H. influenzae (37,4-44,6%), Moraxella catarrhalis (6,1-7,5%), Staphylococcus aureus (8,6-9,8%), Streptococcus pyogenes (3,0-5,9%), Turicella otitidis (1,8-2,1%), Pseudomonas aeruginosa (0,9-4,1%) y otros (2,4-4,9%). Los neumococos pertenecientes a serotipos vacunales sufrieron una disminución significativa, especialmente el 6A, 9V, 14, 18C, 19A, mientras que los serotipos no vacunales aumentaron significativamente, en particular el 15B, el 11A, el 7C, el 16F y el 22F (AU)

Organisms most frequently responsible for acute otitis media (AOM) (Streptococcus pneumoniae and Haemophilus influenzae) are the same in developing countries as in developed ones. In countries that administered the pneumococcal conjugate vaccine, pneumococci decreased as a cause of AOM, but over time began to re-emerge, especially due to strains belonging to serotypes not included in the vaccine. The objective of this work was to document the change generated in the bacteriology of the OMA from the incorporation of the 13-valent pneumococcal conjugate vaccine in 2012 in the official Argentinean calendar. Two prospective, descriptive, cross-sectional studies were carried out prior to the incorporation of the vaccine into the national calendar (May 2009-August 2010), where the population studied was not covered for S. pneumoniae and a subsequent one, where most of the patients were immunized (January 2016-December 2016). We obtained 433 samples from 324 patients in the first period and 461 from 246 patients in the second. A total of 326 bacteria were isolated in the first period and 388 in the second. The microorganisms respectively isolated in both periods were S.pneumoniae (39.5-21.1%), H.influenzae (37.4-44.6%), Moraxella catarrhalis (6.1-7.5%), Staphylococcus aureus (8.6-9.8%), Streptococcus pyogenes (3.0-5.9%), Turicella otitidis (1.8-2.1%), Pseudomonas aeruginosa (0.9-4.1%) and others (2.4-4.9%). Pneumococci belonging to vaccine serotypes suffered a significant decrease, especially 6A, 9V, 14, 18C, 19A, while nonvaccine serotypes increased significantly, particularly 15B, 11A, 7C, 16F, and 22F (AU)

Effect of anisotropy on ventricular vulnerability to unidirectional block and reentry by single premature stimulation during normal sinus rhythm in rat heart.

Single high-intensity premature stimuli when applied to the ventricles during ventricular drive of an ectopic site, as in Winfree's "pinwheel experiment," usually induce reentry arrhythmias in the normal heart, while single low-intensity stimuli barely do. Yet ventricular arrhythmia vulnerability during normal sinus rhythm remains largely unexplored. With a view to define the role of anisotropy on ventricular vulnerability to unidirectional conduction block and reentry, we revisited the pinwheel experiment with reduced constraints in the in situ rat heart. New features included single premature stimulation during normal sinus rhythm, stimulation and unipolar potential mapping from the same high-resolution epicardial electrode array, and progressive increase in stimulation strength and prematurity from diastolic threshold until arrhythmia induction. Measurements were performed with 1-ms cathodal stimuli at multiple test sites (n = 26) in seven rats. Stimulus-induced virtual electrode polarization during sinus beat recovery phase influenced premature ventricular responses. Specifically, gradual increase in stimulus strength and prematurity progressively induced make, break, and graded-response stimulation mechanisms. Hence unidirectional conduction block occurred as follows: 1) along fiber direction, on right and left ventricular free walls (n = 23), initiating figure-eight reentry (n = 17) and tachycardia (n = 12), and 2) across fiber direction, on lower interventricular septum (n = 3), initiating spiral wave reentry (n = 2) and tachycardia (n = 1). Critical time window (55.1 ± 4.7 ms, 68.2 ± 6.0 ms) and stimulus strength lower limit (4.9 ± 0.6 mA) defined vulnerability to reentry. A novel finding of this study was that ventricular tachycardia evolves and is maintained by episodes of scroll-like wave and focal activation couplets. We also found that single low-intensity premature stimuli can induce repetitive ventricular response (n = 13) characterized by focal activations.NEW & NOTEWORTHY We performed ventricular cathodal point stimulation during sinus rhythm by progressively increasing stimulus strength and prematurity. Virtual electrode polarization and recovery gradient progressively induced make, break, and graded-response stimulation mechanisms. Unidirectional conduction block occurred along or across fiber direction, initiating figure-eight or spiral wave reentry, respectively, and tachycardia sustained by scroll wave and focal activations.

Enteric-coating of pulsatile-release HPC capsules prepared by injection molding.

Capsular devices based on hydroxypropyl cellulose (Klucel® LF) intended for pulsatile release were prepared by injection molding (IM). In the present work, the possibility of exploiting such capsules for the development of colonic delivery systems based on a time-dependent approach was evaluated. For this purpose, it was necessary to demonstrate the ability of molded cores to undergo a coating process and that coated systems yield the desired performance (gastric resistance). Although no information was available on the coating of IM substrates, some issues relevant to that of commercially-available capsules are known. Thus, preliminary studies were conducted on molded disks for screening purposes prior to the spray-coating of HPC capsular cores with Eudragit® L 30 D 55. The ability of the polymeric suspension to wet the substrate, spread, start penetrating and initiate hydration/swelling, as well as to provide a gastroresistant barrier was demonstrated. The coating of prototype HPC capsules was carried out successfully, leading to coated systems with good technological properties and able to withstand the acidic medium with no need for sealing at the cap/body joint. Such systems maintained the original pulsatile release performance after dissolution of the enteric film in pH 6.8 fluid. Therefore, they appeared potentially suitable for the development of a colon delivery platform based on a time-dependent approach.

Haematological and physiological responses of Piemontese beef cattle to different housing conditions.

Public concern for animal welfare has progressively grown over the recent years. In this context, stress has a great economical impact on growth of animals and quality of animal products. The development and validation of methods to assess animal stress, particularly at the farm level, are desirable to evaluate animal production systems. Piemontese breed is traditionally tie-stall housed in the fattening period. Hence, the objective of this study was to characterise a profile of physiological and haematological changes of Piemontese beef cattle under different management conditions (tie-stall and loose housing). Our results suggest that the housing system is an important factor in animal welfare. Indeed, the values of the total protein, lysozyme, cortisol, serum and faecal corticosterone concentration and GR-α gene expression indicate that the tie-stall housing is more stressful than the loose system. All the alterations highlighted in this study considered together may be effective biomarkers of stress and disease susceptibility.

Seasonality of reproduction in wild boar (Sus scrofa) assessed by fecal and plasmatic steroids.

The collection of biological samples through non-invasive techniques represents one way of monitoring in vivo physiological changes associated with reproductive activity. Such techniques are particularly important for the study of animal species in the wild. The goals of this study were 1) to evaluate fecal progestogen (P), estrogen (E), and androgen (A) by means of radioimmunoassays, in male and female wild boars culled in the Piedmont, Italy area; 2) to compare them with plasmatic concentrations and the animals' reproductive status; and 3) to assess variations in reproductive seasonality between two populations of wild boars living in a mountainous vs. a plain habitat in Piedmont. The results demonstrate a positive correlation between fecal and plasmatic steroid concentrations (r=0.46, 0.58, and 0.45 for plasma P(4) and P, E(2) and E, and T and A; P<0.05). Moreover, high fecal levels of both P and E (>170 ng/g and >100 pg/g respectively) were found in 70.6% of pregnant sows and in none of the non-pregnant animals, thus supporting the use of this technique for detecting pregnancy status in wild boar. Similar birth patterns were displayed by the mountain and plain populations, but births peaked significantly only in the mountain population, in the spring (46%, P<0.05, vs. other seasons). A corresponding autumnal peak of plasma testosterone concentrations in males was displayed only by the mountain population (7.4 vs.<2.0 ng/mL in the other seasons, P<0.05). The correlation between fecal and plasmatic steroid concentrations obtained in this study supports the applicability of this non-invasive sampling technique for monitoring reproductive status in wild boar, thus enabling a more informed and correct management of the species.

Positive effect of silymarin on cell growth and differentiation in bovine and murine mammary cells.

Silymarin, a naturally acknowledged hepatoprotector used in humans to treat liver diseases has been tested in murine (HC11) and bovine (BME-UV) mammary epithelial cell lines to evaluate a possible direct effect on cell growth and differentiation in mammary gland. Silymarin enhanced cell proliferation (p < 0.05) from 10 to 1000 ng/ml in association with growth factors, (up to 20%) or alone (up to 15%) versus controls. Furthermore, silymarin (100 ng/ml) was able to increase (p < 0.05) beta-casein gene expression alone or in association with prolactin (5 microg/ml). These effects may be related with protein kinase B (AKT) activation induced by silymarin treatment (p < 0.05) and/or by a dose-related inhibitory effect (p < 0.05) on caspase-3 activity related to a protective role in cell apoptosis. These data suggest that silymarin should be considered a candidate to support mammary gland activity during a lactogenetic state.

Hepatocyte growth factor exerts multiple biological functions on bovine mammary epithelial cells.

The met proto-oncogene product Met is a member of the family of tyrosine kinase growth factor receptors, and hepatocyte growth factor/scatter factor (HGF/SF) has been identified as its only ligand. Bovine Met and HGF/SF have been recently cloned and their expression has been characterized in the mammary gland, but no data regarding the biological effects of this ligand/receptor couple in bovine mammary cells are yet available. We examined the role of HGF/SF and its receptor in a bovine mammary epithelial cell line (BME-UV). Expression of Met at the mRNA level in BME-UV mammary epithelial cells evaluated by real-time PCR was similar to the expression in MDCK cells, a widely used model for Met biology. Met expression in BME-UV at the protein level was confirmed by western blot. The analysis of some signal transductional pathways downstream from the Met receptor revealed that HGF/SF addition to BME-UV cells induced activation of the extracellular signal-regulated kinase 1/2 proliferative pathway and the Akt antiapoptotic pathway. The BME-UV cells treated with HGF responded with increased proliferation, cell scatter, and motility. Met activation by HGF induced degradation of the extracellular matrix and migration through matrigel coated transwells. Moreover, BME-UV cells included in a 3-dimensional matrix of collagen and treated with HGF developed tubular structures, reminiscent of the mammary gland ducts. These data indicate that HGF and Met might be important regulators of mammary gland growth, morphogenesis, and development in the bovine.

Comparison between plasma and milk levels of leptin during pregnancy and lactation in cow, a relationship with beta-lactoglobulin.

Leptin gene is expressed in the mammary tissue and the expression of both leptin and its receptor changes significantly during pregnancy and lactation, with high levels during the first half of pregnancy and a decrease at delivery. The aim of this work was to investigate into leptin concentration in plasma and in milk during pregnancy and the first week after parturition in dairy cow and to analyze the correlation between leptin and beta-lactoglobulin (beta-LG) concentrations in plasma and in milk. The trial was conducted on six Holstein dairy cows, reared in the same environmental conditions and evaluated with similar body condition score, during the complete reproductive cycle from insemination to the delivery. Blood from the jugular vein and milk samples were collected at weekly intervals. Plasma leptin concentration showed a lower level (p < 0.05) at the beginning of pregnancy. Milk leptin concentration showed a higher level (p < 0.01) than plasma level from week 23 to week 29 of pregnancy. Plasma beta-LG concentrations were higher (p < 0.01) compared to plasma concentrations during the first part of pregnancy, then milk levels rise and become higher than plasma levels during the last weeks before dry period. A positive correlation (p < 0.01) was observed between leptin and beta-LG both in plasma and in milk profiles.

Leptin concentration in plasma and in milk during the interpartum period in the mare.

The aim of this work is to investigate on plasma profiles of leptin and estradiol 17beta during the interpartum period and leptin concentrations in the milk and in the colostrum during the period from parturition to the successive delivery in mare. Leptin plasma concentration varied from 5.1+/-2.3 ng/ml after the first parturition (week 0) to 3.0+/-0.7 at week 21 (p<0.05), then it increased to maximal level at week 49 (6.9+/-1.0 ng/ml, p<0.05). Leptin concentration in the colostrum and in the milk has been significantly (p<0.05) higher than that in plasma samples at week 1 (milk 8.8+/-2.3 versus plasma 5.2+/-0.6 ng/ml) and between week 12 and 17. This difference may be explained with a local leptin production at mammary level and supports a role of leptin in the mammary gland and/or in foal intestine. Estradiol 17beta increased from week 15 (17.9+/-2.3 pg/ml) up to 487.9+/-67.7 pg/ml at week 43. Plasma estradiol 17beta rise anticipated by 4 weeks plasma leptin increase and it does not seem to be positively correlated to leptin secretion.

[The mechanism of impulse initiation: high-resolution epicardial pace-mapping in rat heart]. / Meccanismo di insorgenza del battito stimolato: misura del potenziale epicardico ad alta risoluzione spaziale nel cuore di ratto.

UNLABELLED: Simulations of cardiac tissue bidomain model indicate that point cathodal stimulation gives rise to a dog-bone depolarized region (virtual cathode) extending across fibers, limited by two symmetric hyperpolarized regions (virtual anode) extending along fibers. These predictions were experimentally confirmed by optical mapping studies of transmembrane potentials while no direct validation is reported at the extracellular level. The present study aims at defining the influence of the virtual cathode on extracellular potentials by means of high-density epicardial mapping. METHODS: Epicardial potentials were measured in seven exposed rat hearts by means of a 11 x 11 electrode array with 360 x 540 microns resolution. Cathodal current pulses, 100-200 microA intensity and 1 ms duration, to avoid superposition of stimulus and activation potentials, were delivered from one of the electrode array and unipolar potentials were measured from all other electrodes. RESULTS AND DISCUSSION: a) During stimulus, negative equipotential lines were elliptic along fibers, as expected, but for a 2 mm circular region at the pacing site. b) During 1-2 ms interval between stimulus offset and start of activation, equipotential lines became elliptic across fibers in the presence of the region directly excited by the stimulus field. Start of activation was either symmetric with isochrones initially circular around the pacing site and then elliptic along fibers, or asymmetric initiating at only one side of the pacing site across fibers with isochrones elliptic along fibers. In the latter case, the wave front was blocked through the refractory region directly excited by the stimulus field, subdivided into two wings which collided and merged at the opposite side, giving rise to a plane wave front propagating across fibers away from the pacing site. CONCLUSIONS: High spatial resolution epicardial potential mapping reveals the existence of the virtual cathode and its influence on impulse initiation and conduction. The unexpected existence of a region of conduction block at the pacing site, due to spatial asymmetry of normal cardiac tissue which enhances activation threshold at one of the two sides of the virtual cathode, is intriguing since it is one of the requirements for reentry of conduction in the presence of a circuit with decreased conduction velocity and short duration of refractory period.

Myocardial remodeling and arrhythmogenesis in moderate cardiac hypertrophy in rats.

In 47 male adult Wistar rats with 4-wk aortic coarctation (AC) and 39 age-matched sham-operated rats (SO) chronically instrumented for telemetry electrocardiogram recording, we investigated the mechanisms of arrhythmogenesis in moderate cardiac hypertrophy, with an approach from "in vivo" toward the cellular level, analyzing 1) stress-induced cardiac arrhythmias in all rats and 2) myocardial fibrosis in 35 animals and action potential duration and density of hyperpolarization-activated current in 19 others at the ventricular level. Aortic banding increased arterial blood pressure, cardiac weight, and ventricular myocyte volume by 11, 25, and 14%, respectively (P < 0.001-0.05). Ventricular arrhythmias occurred at similar rates in AC and SO rats throughout the stress procedure. Action potential duration and hyperpolarization-activated current were about twice as great and myocardial fibrosis about four times greater in AC animals (P < 0.005-0.05). Electrocardiogram data also revealed more supraventricular arrhythmias in AC rats during the baseline period and after stress and fewer atrioventricular block episodes after stress (P < 0.05). Thus stress-induced supraventricular and atrioventricular nodal, but not ventricular, arrhythmias were affected in moderate cardiac hypertrophy when ventricular morphofunctional alterations were evident.

High-density epicardial mapping during current injection and ventricular activation in rat hearts.

The purpose of this study is to report new methods for manufacturing precision electrode arrays for recording high-resolution potential distributions from epicardial surfaces of small-animal hearts. Electrode arrays of 64 leads (8 x 8) and 121 leads (11 x 11) were constructed with a tulle substrate to which insulated, fine silver wires (60-micrometer diameter) were attached by knots at mesh node intervals of 540 x 720 micrometers. Insulation was removed at the tips of the knots. Potential distributions and waveforms were recorded from saline solutions and rat heart epicardium during ventricular paced beats and during passive current injection in the diastolic interval. Electrical responses obtained from rat epicardium compared favorably with those observed in studies of larger-animal hearts, which used arrays having greater electrode spacing, and revealed the effects of myocardial anisotropy. Epicardial potentials measured early after stimulation in the region surrounding the pacing site were interpreted in terms of potentials generated by an equivalent quadrupolar source. We conclude that electrode arrays for epicardial mapping of small hearts can be constructed with sufficient ease and precision to allow detailed study of fiber structure and electrophysiology in these hearts in normal and pathological conditions.

Two new variants of the bovine PAS-1 glycoprotein.

Two new alleles (A and E) of the bovine MUC locus which encodes PAS-1 protein, a glycoprotein of the milk fat globule membrane, are reported. The A allele was found in Italian Brown while E was present in the Jersey and the Piedmont breeds.

Effect of myocardial fiber direction on epicardial potentials.

BACKGROUND: Understanding the relations between the architecture of myocardial fibers, the spread of excitation, and the associated ECG signals is necessary for addressing the forward problem of electrocardiography, that is, predicting intracardiac and extracardiac ECGs from known intracardiac activity. So far, these relations have been studied experimentally only in small myocardial areas. In this study, we tested the hypothesis that potential distributions measured over extensive epicardial regions during paced beats reflect the direction of superficial and intramural fibers through which excitation is spreading in both the initial and later stages of ventricular excitation. We also tried to establish whether the features of the epicardial potential distribution that correlate with fiber direction vary as a function of pacing site, intramural pacing depth, and time elapsed after the stimulus. An additional purpose was to compare measured epicardial potentials with recently published numerical simulations depicting the three-dimensional spread of excitation in the heart muscle and the associated potential fields. METHODS AND RESULTS: The hearts of 18 mongrel dogs were exposed and 182 to 744 unipolar electrograms were recorded from epicardial electrode arrays (2.3 x 3.0 to 6.5 x 6.5 cm). Hearts were paced at various intramural depths through an intramural needle. The overall number of pacing sites in 18 dogs was 241. Epicardial potential distributions, electrographic waveforms, and excitation time maps were displayed, and fiber directions in the ventricular wall underlying the electrodes were determined histologically. During the early stages of ventricular excitation, the position of the epicardial maxima and minima revealed the orientation of myocardial fibers near the pacing site in all cases of epicardial and intramural pacing and in 60% of cases of endocardial or subendocardial pacing. During later stages of propagation, the rotation and expansion of the positive areas correlated with the helical spread of excitation through intramurally rotating fibers. Marked asymmetry of potential patterns probably reflected epicardial-endocardial obliqueness of intramural fibers. Multiple maxima appeared in the expanding positive areas. CONCLUSIONS: For 93% of pacing sites, results verified our hypothesis that epicardial potential patterns elicited by ventricular pacing reflect the direction of fibers through which excitation is spreading during both the initial and later stages of propagation. Epicardial potential distributions provided information on the site of origin and subsequent helical spread of excitation in an epicardial-endocardial, endocardial-epicardial, or double direction. Results were in agreement with previously published numerical simulations except for the asymmetry and fragmentation of the positive areas.

Epicardial excitation during ventricular pacing. Relative independence of breakthrough sites from excitation sequence in canine right ventricle.

In a previous investigation, epicardial recordings with 1,124 closely spaced electrodes revealed 20-35 breakthrough (BKT) sites and an equal number of separate wave fronts on the ventricular surface of exposed dog hearts during normal sinus rhythm. In the present study we tried 1) to determine whether ventricular pacing also produced multiple BKTs and wave fronts and 2) to determine whether the number and location of BKTs were, to some degree, independent of pacing site. The study mainly focused on right ventricular BKTs observed during right ventricular pacing. To test hypotheses 1 and 2 we identified many breakthrough sites during sinus rhythm in seven exposed dog hearts and then paced the heart from several BKT and non-BKT sites on the right ventricle. Epicardial potential maps and excitation time maps were obtained by using 1,124 epicardial electrodes covering the anterior right ventricle and part of the anterior left ventricle. A primary wave front spread radially for several centimeters from the pacing site, and no BKTs appeared in the areas covered by the primary wave front. In the remaining areas (secondary areas), multiple BKTs appeared; their number was close to that observed during sinus rhythm in the same areas (113 versus 115, respectively, in 12 paced beats). The majority of paced BKTs (83 out of 115, or 72%) occurred exactly at the same locations where they appeared during sinus rhythm. However, 30 right ventricular BKTs observed during sinus rhythm disappeared in the secondary areas and were replaced by approximately the same number of new BKTs. Many areas without BKTs in normal beats remained so in paced beats.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnostic features of body surface potential maps in patients with myocardial ischemia and normal resting 12-lead electrocardiograms.

Body surface maps recorded from 35 ischemic patients with normal resting 12-lead electrocardiograms were compared with those obtained from 36 age- and sex-matched normal subjects. From instantaneous maps of each subject 187 variables were derived relating to the configuration (80 variables) and magnitude (104 variables) of the potential distribution and duration of the electrocardiographic intervals (3 variables). By using stepwise discriminant analysis we selected 3 variables whose linear combination enabled us to correctly allocate 91% of the study population (jacknife procedure; specificity 92%, sensitivity 91%). To substantiate the validity of the results the discriminant function was tested on a new independent population consisting of 27 ischemic patients and 54 normal subjects from another laboratory. A proper allocation was obtained in 86% of the cases (specificity 87%, sensitivity 85%). The large number of correctly classified ischemic patients and the repeatability of the results indicate that the adopted criteria are good markers of ischemic heart disease.

Role of Motility and Chemotaxis in Efficiency of Nodulation by Rhizobium meliloti.

Spontaneous mutants of Rhizobium meliloti L5-30 defective in motility or chemotaxis were isolated and compared against the parent with respect to symbiotic competence. Each of the mutants was able to generate normal nodules on the host plant alfalfa (Medicago sativa), but had slightly delayed nodule formation, diminished nodulation in the initially susceptible region of the host root, and relatively low representation in nodules following co-inoculation with equal numbers of the parent. When inoculated in growth pouches with increasing dosages of the parental strain, the number of nodules formed in the initially susceptible region of the root increased sigmoidally, with an optimum concentration of about 10(5) to 10(6) bacteria/plant. The dose-response behavior of the nonmotile and nonchemotactic mutants was similar, but they required 10- to 30-fold higher concentrations of bacteria to generate the same number of nodules. The distribution frequencies of nodules at different positions along the primary root were very similar for the mutants and parent, indicating that reduced nodulation by the mutants in dose-response experiments probably reflects reduced efficiency of nodule initiation rather than developmentally delayed nodule initiation. The number of bacteria that firmly adsorbed to the host root surface during several hours of incubation was 5- to 20-fold greater for the parent than the mutants. The mutants were also somewhat less effective than their parent as competitors in root adsorption assays. It appears that motility and chemotaxis are quantitatively important traits that facilitate the initial contact and adsorption of symbiotic rhizobia to the host root surface, increase the efficiency of nodule initiation, and increase the rate of infection development.