Ralstonia solanacearum gram‐negative phytopathogenic bacterium exerts its virulence through a type III secretion system (T3SS) that translocates type III effectors (T3Es) directly into the host cells. T3E secretion is finely controlled at the posttranslational level by helper proteins, T3SS control proteins, and type III chaperones. The HpaP protein, one of the type III secretion substrate specificity switch (T3S4) proteins, was previously highlighted as a virulence factor on Arabidopsis thaliana Col‐0 accession. In this study, we set up a genome‐wide association analysis to explore the natural diversity of response to the hpaP mutant of two A. thaliana mapping populations: a worldwide collection and a local population. Quantitative genetic variation revealed different genetic architectures in both mapping populations, with a global delayed response to the hpaP mutant compared to the GMI1000 wild‐type strain. We have identified several quantitative trait loci (QTLs) associated with the hpaP mutant inoculation. The genes underlying these QTLs are involved in different and specific biological processes, some of which were demonstrated important for R. solanacearum virulence. We focused our study on four candidate genes, RKL1, IRE3, RACK1B, and PEX3, identified using the worldwide collection, and validated three of them as susceptibility factors. Our findings demonstrate that the study of the natural diversity of plant response to a R. solanacearum mutant in a key regulator of virulence is an original and powerful strategy to identify genes directly or indirectly targeted by the pathogen.

The Gram-negative bacterium Ralstonia solanacearum, the causal agent of bacterial wilt, is a worldwide major crop pathogen whose virulence strongly relies on a type III secretion system (T3SS). This extracellular apparatus allows the translocation of proteins, called type III effectors (T3Es), directly into the host cells. To date, very few data are available in plant-pathogenic bacteria concerning the role played by type III secretion (T3S) regulators at the posttranslational level. We have demonstrated that HpaP, a putative T3S substrate specificity switch protein of R. solanacearum, controls T3E secretion. To better understand the role of HpaP on T3S control, we analyzed the secretomes of the GMI1000 wild-type strain as well as the hpaP mutant using a mass spectrometry experiment (liquid chromatography tandem mass spectrometry). The secretomes of both strains appeared to be very similar and highlighted the modulation of the secretion of few type III substrates. Interestingly, only one type III-associated protein, HrpJ, was identified as specifically secreted by the hpaP mutant. HrpJ appeared to be an essential component of the T3SS, essential for T3S and pathogenicity. We further showed that HrpJ is specifically translocated in planta by the hpaP mutant and that HrpJ can physically interact with HpaP. Moreover, confocal microscopy experiments demonstrated a cytoplasmic localization for HrpJ once in planta. When injected into Arabidopsis thaliana leaves, HrpJ is able to trigger a necrosis on 16 natural accessions. A genome-wide association mapping revealed a major association peak with 12 highly significant single-nucleotide polymorphisms located on a plant acyl-transferase.

AIMTo identify factors influencing the use of telemedicine in diabetes management from the perspectives of healthcare professionals.METHODSThis was a quantitative study that was conducted in 2016. The participants were 240 nurses and 55 physicians from three teaching hospitals as well as from one endocrinology and metabolism research center. No sampling method was used and the data were collected by using a five-point (1 to 5) Likert scale questionnaire, which had 37 questions. Descriptive and inferential statistics (Mann-Whitney U test) were used to analyze the data.RESULTSThe findings showed that both physicians (4.06 ± 0.69) and nurses (4.02 ± 0.61) tended to use telemedicine technology for managing diabetes. Overall, the lowest mean value for physicians (3.79 ± 0.82) was related to the compatibility of telemedicine with other clinical activities in diabetes management. For nurses, the lowest mean value pertained to the usefulness of telemedicine in diabetes management (3.99 ± 0.53) and their attitude toward using this technology (3.99 ±0.65).CONCLUSIONAlthough physicians and nurses agreed on using telemedicine technology in diabetes management, it is necessary to consider their concerns prior to the implementation and deployment of new technologies. This approach will help to improve the level of technology acceptance among the users.