Development of low-cost pressure mapping device to evaluate force distribution for seat cushion modification.

This study aimed to determine the reliability and concurrent validity of a low-cost pressure mapping system (Smart mat) and reference standard pressure mapping (MatScan). Thirty healthy volunteers aged 29.57 ± 4.50 years who could sit still for at least one minute and had a hip width of less than 40 cm (36 ± 2.05 cm) were recruited. The participants sat on the Smart mat system and MatScan for 60 s per trial for 3 trials. The reliability of Smart mat using intraclass correlation coefficients (ICC) showed an excellent ICC of normalised total force (nTF) and normalised ischial width (nIW) in sitting (0.93, 0.98). The validity was assessed using Spearman correlation coefficients, which showed that nTF in sitting had a significantly strong correlation (r = 0.70**) and nIW in sitting had a significantly moderate correlation (r = 0.67**). This study's satisfactory results indicated that a low-cost pressure mapping system could be used for assessing forced distribution and ischial width during sitting.

Observations of the efficacy of the artificial lens cushion plate technique in hard-core cataract surgery.

Objective: To evaluate the efficacy of intraocular lens (IOL) cushion plate technology in reducing corneal endothelial cell loss during hard-core cataract surgery compared with conventional ultrasonic emulsification. Methods: Seventy-six patients with hard-core cataracts who underwent surgery at our institution from April 2019 to June 2022 were included. The patients were divided into an observation group (IOL cushion plate technology, 38 patients) and a control group (conventional ultrasonic emulsification, 38 patients). Surgical outcomes, including the corneal endothelial cell loss rate, best corrected visual acuity (BCVA), and central corneal thickness (CCTc), were compared between the two groups. Results: Preoperative patient characteristics were similar between the groups. Postoperatively, both groups demonstrated similar BCVA and CCTc values on days 7 and 30. However, compared with the observation group, the control group presented a significantly greater rate of corneal endothelial cell loss on postoperative days 7 and 30 (p < 0.05). Intraoperative complications and postoperative complications were notably greater in the control group (p < 0.05). The observation group had reduced ultramilk time and total energy consumption (p < 0.05). Conclusion: IOL cushion plate technology offers advantages in preserving corneal endothelial cells during hard-core cataract surgery, potentially improving surgical safety and efficacy.

Pelvis and thoracolumbar spine response in simulated under-body blast impacts and protective seat cushion design.

Purpose: The aim of this study is to investigate the dynamic and biomechanical response of the pelvis and thoracolumbar spine in simulated under-body blast (UBB) impacts and design of protective seat cushion for thoracolumbar spine injuries. Methods: A whole-body FE (finite element) human body model in the anthropometry of Chinese 50th% adult male (named as C-HBM) was validated against existing PHMS (Postmortem Human Subjects) test data and employed to understand the dynamic and biomechanical response of the pelvis and thoracolumbar spine from FE simulations of UBB impacts. Then, the protective capability of different seat cushion designs for UBB pelvis and thoracolumbar injury risk was compared based on the predictions of the C-HBM. Results: The predicted spinal accelerations from the C-HUM are almost within the PHMS corridors. UBB impact combined with the effects from physiological curve of the human thoracolumbar spine and torso inertia leads to thoracolumbar spine anterior bending and axial compression, which results in stress concentration in the segments of T4-T8, T12-L1 and L4-L5. Foam seat cushion can effectively reduce the risk of thoracolumbar spine injury of armored vehicle occupants in UBB impacts, and the DO3 foam has better protective performance than ordinary foam, the 60 mm thick DO3 foam could reduce pelvic acceleration peak and DRIz value by 52.8% and 17.2%, respectively. Conclusions: UBB spinal injury risk is sensitive to the input load level, but reducing the pelvic acceleration peak only is not enough for protection of spinal UBB injury risk, control of torso inertia effect would be much helpful.

Complete atrioventricular canal in a dog-sounds like a final judgment but is it actually one? A case report.

Congenital heart disease (CHD) is an important subset of all cardiovascular diseases in dogs. Among them, there are a number of other less commonly described congenital malformations. One of these is the atrioventricular canal, which involves a defect that has several phenotypes. This report details a case of a complete atrioventricular canal (cAVC) defect. Using Rastelli's classification scheme, the diagnosis of a type-A cAVC defect was based on two-dimensional, contrast, and color Doppler echocardiography. Despite a severe defect that resulted in the atypical anatomy of the atrioventricular apparatus, as well as significant hemodynamic changes in the heart, the affected dog remained asymptomatic throughout the 48-month follow-up period. Due to its stable clinical condition, the decision was made not to begin pharmacological therapy. As this defect is rare in dogs, there are limited data in the literature on this condition. Therefore, in clinical practice, the management and monitoring of the patient may pose difficulties. Due to such limited data, it can be very difficult to provide a prognosis. For the above reasons, we hope that the following case will contribute valuable information for the monitoring of this kind of CHD.

Deficient GATA6-CXCR7 signaling leads to bicuspid aortic valve.

The cardiac outflow tract (OFT) transiently links the ventricles to the aortic sac and forms the arterial valves. Abnormalities in these valves, such as bicuspid aortic valve (BAV), are common congenital anomalies. GATA6-inactivating variants cause cardiac OFT defects and BAV, but their mechanisms are unclear. We generated Gata6STOP/+ mice using CRISPR-Cas9, which show highly penetrant BAV (70%) and membranous ventricular septal defects (43%). These mice exhibited decreased proliferation and increased ISL1-positive progenitor cells in the OFT, indicating abnormal cardiovascular differentiation. Gata6 deletion with the Mef2cCre driver line recapitulated Gata6STOP/+ phenotypes, indicating a cell-autonomous role for Gata6 in the second heart field. Gata6STOP/+ mice showed reduced OFT length and caliber, associated with deficient cardiac neural crest cell contribution, which may cause valvulo-septal defects. RNA-sequencing analysis showed depletion in pathways related to cell proliferation and migration, highlighting Cxcr7 (also known as Ackr3) as a candidate gene. Reduced mesenchymal cell migration and invasion were observed in Gata6STOP/+ OFT tissue. CXCR7 agonists reduced mesenchymal cell migration and increased invasion in wild-type but not in Gata6STOP/+ explants, indicating the GATA6-dependent role of CXCR7 in OFT development and its potential link to BAV.

Biomechanical and histological variables differ by site but not by lameness in equine digital cushion samples from forelimbs.

The equine digital cushion (DC) has been a poorly understood structure regarding its mechanical properties and composition. The objective of this study was to develop a sampling technique and to compare the biomechanical and histologic properties of DC between lame and non-lame forelimbs. Both forefeet from horses with induced carpal lameness were radiographed prior to humane euthanasia. Radiographs were used to guide sample collection of two, post-mortem, midline DC samples, palmar and dorsal, via an 8mm biopsy punch. Samples were subjected to compressive testing to determine elastic modulus. Histological evaluation was used to quantify collagen, adipose, ground substance, elastic fibers, and blood vessels. Comparisons of variables between palmar and dorsal DC sites and lame and non-lame limbs were made using student's t-tests or Wilcoxon signed rank tests with P < 0.05. There were no differences in histologic or biomechanical properties in DCs of lame and non-lame forelimbs. The dorsal DC sampling site had a significantly higher median elastic modulus (median: 0.054 MPa, range: 0.001 - 2.110 MPa) and a larger median percentage of ground substance (median: 15 %, 95 % CI: 3 - 30 %) compared to the palmar DC site (elastic modulus: median: 0.023 MPa, range: 0 - 0.576 MPa; ground substance: median 5 %, 95 % CI: 3 - 25 %) (P = 0.03, <0.001; respectively). This study demonstrated that adequate samples could be collected from the DC for biomechanical and histological analysis. Differences in elastic modulus and ground substance between palmar and dorsal samples may reflect different roles of these sites within the DC.

Size-Exclusion Chromatography: A Path to Higher Yield and Reproducibility Compared to Sucrose Cushion Ultracentrifugation for Extracellular Vesicle Isolation in Multiple Myeloma.

Small extracellular vesicles (EVs) play a pivotal role in intercellular communication across various physiological and pathological contexts. Despite their growing significance as disease biomarkers and therapeutic targets in biomedical research, the lack of reliable isolation techniques remains challenging. This study characterizes vesicles that were isolated from conditioned culture media (CCM) sourced from three myeloma cell lines (MM.1S, ANBL-6, and ALMC-1), and from the plasma of healthy donors and multiple myeloma patients. We compared the efficacy, reproducibility, and specificity of isolating small EVs using sucrose cushion ultracentrifugation (sUC) vs. ultrafiltration combined with size-exclusion chromatography (UF-SEC). Our results demonstrate that UF-SEC emerges as a more practical, efficient, and consistent method for EV isolation, outperforming sUC in the yield of EV recovery and exhibiting lower variability. Additionally, the comparison of EV characteristics among the three myeloma cell lines revealed distinct biomarker profiles. Finally, our results suggest that HBS associated with Tween 20 improves EV recovery and preservation over PBS. Standardization of small EV isolation methods is imperative, and our comparative evaluation represents a significant step toward achieving this goal.

Effects on tissue oxygenation in the gluteal region with a smart pressure redistribution wheelchair cushion compared to a pressure relief manoeuvre.

OBJECTIVE: The study examines the effects of the air-bladder offloading mode of a smart pressure redistribution wheelchair cushion on tissue oxygenation in the gluteal tissue of non-disabled participants. The hypothesis is that the cushion's offloading mode, which involves sequentially deflating its five air-bladders one at a time for a specific duration, would improve tissue oxygenation during sitting. METHODS: Two procedures were conducted. The first compared the cushion's offloads to a loaded control (LC) with the cushion on static mode, and the second compared the cushion's offloading mode to a standard manual offload performed by the participant. Three trials of each procedure were performed in randomized order. Tissue oxygenation was continuously monitored with three oxygenation parameters analysed: oxygen saturation (SO2), oxygenated haemoglobin (OxyHb), and deoxygenated haemoglobin (DeoxyHb). Data recordings were segmented in each step of the offloading sequence for analysis. A paired t-test was performed for comparisons with significance considered at α = 0.05. Ten healthy adults participated in the study. IMPACT: Results showed that as the air bladders deflated over time, the three evaluated parameters changed, affecting oxygenation even when other tissue areas were offloaded. The results indicated that the cushion's sacral offload had the greatest impact on improving tissue oxygenation among the five air-bladders in all ten subjects (p < 0.05). Furthermore, SO2 during the cushion's offload in the sacral region was similar to a manual offload. The study results suggest that the cushion could benefit tissue oxygenation, especially for individuals unable to change positions independently. Further research is needed to determine its effectiveness for wheelchair users.

The cushion's offloads, which involved deflating its five air-cell bladders one at a time for a specific duration, improved tissue oxygenation in the gluteal region of non-disabled individuals while seated.The cushion's offload in the sacral region had the greatest impact on improving tissue oxygenation among the five air-bladders in all ten subjects.This cushion could be an alternative for users who have limitations in performing pressure relief manoeuvres for the prevention of pressure injuries.A cushion that enhances tissue oxygenation while the user remains seated allows longer sitting periods, improving their quality of life, regardless of their ability to perform pressure relief manoeuvres.

Smart Cushions with Machine Learning-Enhanced Force Sensors for Pressure Injury Risk Assessment.

Prolonged sitting can easily result in pressure injury (PI) for certain people who have had strokes or spinal cord injuries. There are not many methods available for tracking contact surface pressure and shear force to evaluate the PI risk. Here, we propose a smart cushion that uses two-dimensional force sensors (2D-FSs) to measure the pressure and shear force in the buttocks. A machine learning algorithm is then used to compute the shear stresses in the gluteal muscles, which helps to determine the PI risk. The 2D-FS consists of a ferroelectret coaxial sensor (FCS) unit placed atop a ferroelectret film sensor (FFS) unit, allowing it to detect both vertical and horizontal forces simultaneously. To characterize and calibrate, two experimental approaches are applied: one involves simultaneously applying two perpendicular forces, and one involves applying a single force. To separate the two forces, the 2D-FS is decoupled using a deep neural network technique. Multiple FCSs are embedded to form a smart cushion, and a genetic algorithm-optimized backpropagation neural network is proposed and trained to predict the shear strain in the buttocks to prevent PI. By tracking the danger of PI, the smart cushion based on 2D-FSs may be further connected with home-based intelligent care platforms to increase patient equality for spinal cord injury patients and lower the expense of nursing or rehabilitation care.

Translocation of Antimicrobial Peptides across Model Membranes: The Role of Peptide Chain Length.

Cushioned lipid bilayers are structures consisting of a lipid bilayer supported on a solid substrate with an intervening layer of soft material. They offer possibilities for studying the behavior and interactions of biological membranes more accurately under physiological conditions. In this work, we continue our studies of cushion formation induced by histatin 5 (24Hst5), focusing on the effect of the length of the peptide chain. 24Hst5 is a short, positively charged, intrinsically disordered saliva peptide, and here, both a shorter (14Hst5) and a longer (48Hst5) peptide variant were evaluated. Experimental surface active techniques were combined with coarse-grained Monte Carlo simulations to obtain information about these peptides. Results show that at 10 mM NaCl, both the shorter and the longer peptide variants behave like 24Hst5 and a cushion below the bilayer is formed. At 150 mM NaCl, however, no interaction is observed for 24Hst5. On the contrary, a cushion is formed both in the case of 14Hst5 and 48Hst5, and in the latter, an additional thick, diffuse, and highly hydrated layer of peptide and lipid molecules is formed, on top of the bilayer. Similar trends were observed from the simulations, which allowed us to hypothesize that positively charged patches of the amino acids lysine and arginine in all three peptides are essential for them to interact with and translocate over the bilayer. We therefore hypothesize that electrostatic interactions are important for the interaction between the solid-supported lipid bilayers and the peptide depending on the linear charge density through the primary sequence and the positively charged patches in the sequence. The understanding of how, why, and when the cushion is formed opens up the possibility for this system to be used in the research and development of new drugs and pharmaceuticals.

The link between ancient whole-genome duplications and cold adaptations in the Caryophyllaceae.

PREMISE: The Caryophyllaceae (the carnation family) have undergone multiple transitions into colder climates and convergence on cushion plant adaptation, indicating that they may provide a natural system for cold adaptation research. Previous research has suggested that putative ancient whole-genome duplications (WGDs) are correlated with niche shifts into colder climates across the Caryophyllales. Here, we explored the genomic changes potentially involved in one of these discovered shifts in the Caryophyllaceae. METHODS: We constructed a data set combining 26 newly generated transcriptomes with 45 published transcriptomes, including 11 cushion plant species across seven genera. With this data set, we inferred a dated phylogeny for the Caryophyllaceae and mapped ancient WGDs and gene duplications onto the phylogeny. We also examined functional groups enriched for gene duplications related to the climatic shift. RESULTS: The ASTRAL topology was mostly congruent with the current consensus of relationships within the family. We inferred 15 putative ancient WGDs in the family, including eight that have not been previously published. The oldest ancient WGD (ca. 64.4-56.7 million years ago), WGD1, was found to be associated with a shift into colder climates by previous research. Gene regions associated with ubiquitination were overrepresented in gene duplications retained after WGD1 and those convergently retained by cushion plants in Colobanthus and Eremogone, along with other functional annotations. CONCLUSIONS: Gene family expansions induced by ancient WGDs may have contributed to the shifts to cold climatic niches in the Caryophyllaceae. Transcriptomic data are crucial resources that help unravel heterogeneity in deep-time evolutionary patterns in plants.

Double outlet right atrium in a dog.

Double outlet right atrium is a rare congenital cardiac abnormality that has been previously reported in humans and cats, but not in dogs. A double outlet right atrium is typically characterized by the presence of a leftward deviation of the interatrial septum and atrial septal defect. Therefore, the right atrium drains into both ventricles. The unique features consistent with double outlet right atrium were identified by transthoracic echocardiography and computed tomography in a puppy. This case report describes the clinical, echocardiographic, and tomographic findings of a five-month-old Cocker Spaniel diagnosed with this rare congenital abnormality.

Evaluation of the cushion effect in blunt abdominal trauma patients: A computerized analysis.

BACKGROUND: Obesity may serve as a protective factor in blunt abdominal trauma (BAT) patients due to a "cushion effect". In this study, we aim to use computed tomography (CT) scans to measure abdominal adiposity and its correlation with injury severity in BAT patients. METHODS: We conducted a retrospective analysis of male BAT patients who had undergone CT scans. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were manually measured and height-normalized for analysis at lumbar levels L2 and L3. Statistical methods were used to compare differences in adiposity between patients with and without severe abdominal injuries. For controls, we also compared adipose tissue in patients with and without severe trauma to the chest, where less fat typically accumulates. RESULTS: We included 361 male participants and conducted a comparative analysis of their demographic and injury characteristics. Patients without severe abdominal injuries had significantly higher SAT and VAT indices at both L2 and L3 (p < 0.05). However, these measures showed no significant differences between patients with and without severe chest trauma. Solid organ injuries, particularly liver injuries, were associated with decreased SAT and VAT. CONCLUSION: Increase abdominal adiposity was linked to lower abdominal injury severity and solid organ injuries, particularly liver injuries. In addition to conventional BMI for evaluating obesity, either subcutaneous or visceral adipose tissue over lumbar levels L2 and L3 can be used to assess the "cushion effect."

Stability of ischial pressure with 3D thermoplastic elastomer cushion and the characteristics of four types of cushions in pressure redistribution.

Wheelchair cushions are recommended to be used with wheelchair and can protect the buttocks from pain and injury by relieving interface pressure for wheelchair users. However, further investigations are required for proper use in response to the development of new types of wheelchair cushions. The objective of this study was to evaluate physical characteristics of wheelchair cushions by comparing pressure redistributing effects of four types of cushions. The participants were 16 healthy adults who consented to participate in this study. A pressure mapping system (CONFORMat, Nitta Corp.) was used for the measurements. Pressure at ischium was measured immediately after the stabilization of the sitting posture and 10 minutes after. The pressure at ischium significantly decreased with any wheelchair cushions (P < 0.01). A significant negative correlation between body mass index and pressure at ischium was observed without a wheelchair cushion (r = - 0.70), however, the correlation disappeared upon use of a wheelchair cushion. The pressure at ischium increased over time with cushions of urethane, air, and urethane-air hybrid while that with the 3D thermoplastic elastomer cushion did not, and the change in the pressure was statistically less than that in other cushions (P < 0.01). Use of wheelchair cushions was effective in redistribution of the pressure at ischium, and the overtime change in the pressure depends on the type of used cushions.

Sponge-like porous polyvinyl alcohol/chitosan-based hydrogel with integrated cushioning, pH-indicating and antibacterial functions.

Developing a packaging material with integrated cushioning, intelligent and active functions is highly desired but remains challenging in the food industry. Here we show that a sponge-like porous hydrogel with pH-indicating and antibacterial additives can meet this requirement. We use polyvinyl alcohol and chitosan as the primary polymers to construct a hydrogel with hierarchical structures through a freeze-casting method in combination with salting-out treatment. The synergy of aggregated polymer chains and the sponge-like porous structure makes the hydrogel resilient and efficient in energy absorption. It also enables rapid movement of molecules/particles and fast reaction due to the large specific surface area of the pore structures and the large amount of free water in it, leading to a sensitive pH-indicating function. The hydrogel shows an obvious color variation within a wide pH range in 3 min. The silver nanoparticles are fixed in the dense polymer networks, enabling a lasting release of silver ions. The porous structure makes the silver ion reach the protected item in a short time, achieving an antibacterial effect against S. aureus and E. coli with little cytotoxicity. This work paves the way for fabricating multifunctional hydrogels for diverse advanced packaging systems.

Molecular Pathways and Animal Models of Ebstein's Anomaly.

Ebstein's anomaly is a congenital malformation of the tricuspid valve characterized by abnormal attachment of the valve leaflets, resulting in varying degrees of valve dysfunction. The anatomic hallmarks of this entity are the downward displacement of the attachment of the septal and posterior leaflets of the tricuspid valve. Additional intracardiac malformations are common. From an embryological point of view, the cavity of the future right atrium does not have a direct orifice connected to the developing right ventricle. This chapter provides an overview of current insight into how this connection is formed and how malformations of the tricuspid valve arise from dysregulation of molecular and morphological events involved in this process. Furthermore, mouse models that show features of Ebstein's anomaly and the naturally occurring model of canine tricuspid valve malformation are described and compared to the human model. Although Ebstein's anomaly remains one of the least understood cardiac malformations to date, the studies summarized here provide, in aggregate, evidence for monogenic and oligogenic factors driving pathogenesis.

Inflow Tract Development.

The development of the inflow tract is undoubtedly one of the most complex remodeling events in the formation of the four-chambered heart. It involves the creation of two separate atrial chambers, the formation of an atrial/atrioventricular (AV) septal complex, the incorporation of the caval veins and coronary sinus into the right atrium, and the remodeling events that result in pulmonary venous return draining into the left atrium. In these processes, the atrioventricular mesenchymal complex, consisting of the major atrioventricular (AV) cushions, the mesenchymal cap on the primary atrial septum (pAS), and the dorsal mesenchymal protrusion (DMP), plays a crucial role.

A prospective cohort study of factors associated with the digital cushion thickness in dairy cattle.

Key factors such as stage of lactation, parity, and body fat reserves have been associated with the digital cushion thickness (DCT), however, there are discrepancies between the results of previously published studies. The objective of this study was to examine the association of stage of lactation, body fat reserves, parity, and lesion incidence with DCT in a large cohort of intensively monitored cows. Across 4 UK farms, 2,352 cows were prospectively enrolled and assessed at 4 time points: before calving (T1-Precalving), immediately after calving (T2-Calving), in early lactation (T3-Early), and in late lactation (T4-Late). At each time point, BCS was recorded, the presence of sole lesions (sole ulcers and sole hemorrhage) and white line lesions was assessed by veterinarians, and an ultrasound image was taken to retrospectively measure the backfat thickness (BFT) in the pelvic region and the digital cushion on the hind left lateral claw. Mixed effects multivariable linear regression models, with the cow as a random effect, were fit to examine the association between the explanatory variables and DCT. The explanatory variables tested were farm, parity, stage of lactation, BCS, BFT, height, the presence of a lesion at the time of measurement, the chronicity of a lesion during early lactation, the predicted maximum daily milk yield, and the rate of milk production rise in early lactation. Stage of lactation and farm were both associated with DCT; however, an interaction was present, and this DCT pattern of change was farm-dependent. Two distinct patterns emerged; one indicated the nadir to occur shortly after calving, the other indicated the nadir to occur during early lactation. Neither BFT nor BCS were significantly associated with DCT. Heifers displayed thinner digital cushions compared with multiparous cows; however, this effect was dependent on the stage of lactation, with heifers having a thinner digital cushion up until late lactation, by which time DCT was commensurate with multiparous animals. Sole lesions and white line lesions at the time of measurement were associated with DCT (sole lesion: estimate = -0.07 mm, 95% CI = -0.14-0.00; white line lesion: estimate = 0.28 mm, 95% CI = 0.15-0.42).

Transcervical side by side Foley balloons for preterm breech birth: A new concept to enhance safety.

Preterm breech birth risks head entrapment. Three side-by-side Foley balloons as previously described for labour induction/augmentation may prevent breech expulsion until adequate cervical dilation. We present an illustrative case.

Plant triterpenoid saponins function as susceptibility factors to promote the pathogenicity of Botrytis cinerea.

The gray mold fungus Botrytis cinerea is a necrotrophic pathogen that causes diseases in hundreds of plant species, including high-value crops. Its polyxenous nature and pathogenic success are due to its ability to perceive host signals in its favor. In this study, we found that laticifer cells of Euphorbia lathyris are a source of susceptibility factors required by B. cinerea to cause disease. Consequently, poor-in-latex (pil) mutants, which lack laticifer cells, show full resistance to this pathogen, whereas lot-of-latex mutants, which produce more laticifer cells, are hypersusceptible. These S factors are triterpenoid saponins, which are widely distributed natural products of vast structural diversity. The downregulation of laticifer-specific oxydosqualene cyclase genes, which encode the first committed step enzymes for triterpene and, therefore, saponin biosynthesis, conferred disease resistance to B. cinerea. Likewise, the Medicago truncatula lha-1 mutant, compromised in triterpenoid saponin biosynthesis, showed enhanced resistance. Interestingly, the application of different purified triterpenoid saponins pharmacologically complemented the disease-resistant phenotype of pil and hla-1 mutants and enhanced disease susceptibility in different plant species. We found that triterpenoid saponins function as plant cues that signal transcriptional reprogramming in B. cinerea, leading to a change in its growth habit and infection strategy, culminating in the abundant formation of infection cushions, the multicellular appressoria apparatus dedicated to plant penetration and biomass destruction in B. cinerea. Taken together, these results provide an explanation for how plant triterpenoid saponins function as disease susceptibility factors to promote B. cinerea pathogenicity.