A New Multidisciplinary Home Care Telemedicine System to Monitor Stable Chronic Human Immunodeficiency Virus-Infected Patients: A Randomized Study

BACKGROUND: Antiretroviral therapy has changed the natural history of human immunodeficiency virus (HIV) infection in developed countries, where it has become a chronic disease. This clinical scenario requires a new approach to simplify follow-up appointments and facilitate access to healthcare professionals. METHODOLOGY: We developed a new internet-based home care model covering the entire management of chronic HIV-infected patients. This was called Virtual Hospital. We report the results of a prospective randomised study performed over two years, comparing standard care received by HIV-infected patients with Virtual Hospital care. HIV-infected patients with access to a computer and broadband were randomised to be monitored either through Virtual Hospital (Arm I) or through standard care at the day hospital (Arm II). After one year of follow up, patients switched their care to the other arm. Virtual Hospital offered four main services: Virtual Consultations, Telepharmacy, Virtual Library and Virtual Community. A technical and clinical evaluation of Virtual Hospital was carried out. FINDINGS: Of the 83 randomised patients, 42 were monitored during the first year through Virtual Hospital (Arm I) and 41 through standard care (Arm II). Baseline characteristics of patients were similar in the two arms. The level of technical satisfaction with the virtual system was high: 85% of patients considered that Virtual Hospital improved their access to clinical data and they felt comfortable with the videoconference system. Neither clinical parameters [level of CD4+ T lymphocytes, proportion of patients with an undetectable level of viral load (p = 0.21) and compliance levels >90% (p = 0.58)] nor the evaluation of quality of life or psychological questionnaires changed significantly between the two types of care. CONCLUSIONS: Virtual Hospital is a feasible and safe tool for the multidisciplinary home care of chronic HIV patients. Telemedicine should be considered as an appropriate support service for the management of chronic HIV infection. TRIAL REGISTRATION: Clinical-Trials.gov: NCT01117675.

Modeling soil system: complexity under your feet

A clear statement in these lines textually cited (Byers et al., 1938) defines the framework of this special issue: “True soil is the product of the action of climate and living organism upon the parent material, as conditioned by the local relief. The length of time during which these forces are operative is of great importance in determining the character of the ultimate product. Drainage conditions are also important and are controlled by local relief, by the nature of the parent material or underlying rock strata, or by the amount of precipitation in relation to rate of percolation and runoff water. There are, therefore, five principal factors of soil formation: Parent material, climate, biological activity, relief and time. These soil forming factors are interdependent, each modifying the effectiveness of the others.” Due to these various processes associated to its formation and genesis soil dynamics reveals high complexity that creates several levels of structure using this term in a broad sense

Growth response of broilers to lysine levels and hydrolyzed porcine digestive mucosa (Palbio) inclusion in diet from 1 to 21 d of age

Palbio (PAL, Palbio 50 RD, Bioibérica, Spain) is a protein concentrate based on hydrolyzed porcine digestive mucosa dried under a fluid bed system over a soybean carrier, currently used in piglet feeds. The digestibility of PAL is very high and the product may be an excellent source of protein for young chicks. An experiment was conducted with 1,280 straight-run one-d-old Ross 308 chicks to evaluate the growth response of broilers to dietary inclusion of PAL.

A Multiagent system model which suggests solutions to fuzzy incidents in the field of telecommunications

This article presents the model of a multi-agent system (SMAF), which objectives are the input of fuzzy incidents as the human experts express them with different severities degrees and the further search and suggestion of solutions. The solutions will be later confirm or not by the users. This model was designed, implemented and tested in the telecommunications field, with heterogeneous agents in a cooperative model. In the design, different abstract levels where considered, according to the agents? objectives, their ways to carry it out and the environment in which they act. Each agent is modeled with different spectrum of the knowledge base

HALA!'s White Paper. Towards Higher Levels of Automation in ATM

• Objectives of HALA! • Main Activities • HALA! Magement Team • Participants • Intended Audience • Heritage in ATM and Automation • The new paradigm shift in Automation in ATM • Overall system performance as main driver for ATM Automation • The three interdependent dimensions for the paradigm change. • New roles assignment based on : • “best time” • “decision place” • “best player” • HALA! main research areas

Driving assistance system applied in curves for real vehicles | Sistema de ayuda a la conducción en curvas para vehículos reales

Decreasing the accidents on highway and urban environments is the main motivation for the research and developing of driving assistance systems, also called ADAS (Advanced Driver Assistance Systems). In recent years, there are many applications of these systems in commercial vehicles: ABS systems, Cruise Control (CC), parking assistance and warning systems (including GPS), among others. However, the implementation of driving assistance systems on the steering wheel is more limited, because of their complexity and sensitivity. This paper is focused in the development, test and implementation of a driver assistance system for controlling the steering wheel in curve zones. This system is divided in two levels: an inner control loop which permits to execute the position and speed target, softening the action over the steering wheel, and a second control outer loop (controlling for fuzzy logic) that sends the reference to the inner loop according the environment and vehicle conditions. The tests have been done in different curves and speeds. The system has been proved in a commercial vehicle with satisfactory results.

A Multi-agent System for Emergency Decision Support

This paper describes the multi-agent organization of a computer system that was designed to assist operators in decision making in the presence of emergencies. The application was developed for the case of emergencies caused by river floods. It operates on real-time receiving data recorded by sensors (rainfall, water levels, flows, etc.) and applies multi-agent techniques to interpret the data, predict the future behavior and recommend control actions. The system includes an advanced knowledge based architecture with multiple symbolic representation with uncertainty models (bayesian networks). This system has been applied and validated at two particular sites in Spain (the Jucar basin and the South basin).

An intelligent portable sensor system in diagnosing stress

Nowadays the stress is a frequent problem in the society. The level of stress could be important in order to recognise health problems later. Electrocardiogram technics allows to supervise the heart condition and the detection of anomalies about the patient. Sometimes the data collection systems by sensors placed on the patient restrict his mobility. Therefore the elimination of wires is a good solution for this trouble. Then the Bluetooth protocol is chosen as way for transmitting and receive data between stations. There are three ECG sensors placed on the right hand, the left hand and the right leg. It is possible to measure the heart signal with this technique. Besides there is an extra sensor in order to measure the temperature of the patient. Depending of the value of these parameters is possible to recognise stress levels. All sensors are connected to a special box with a microcontroller which treat every signal. This module has a Bluetooth part that transmitts wireless the new digital signal to the receiver. This one will be a dongle connected to the computer by Serial Port. A program in the computer has been implemented in order to receive the Bluetooth Data sent from the box and saving the data in a file for subsequent activities. El objetivo principal de este proyecto es el estudio de parámetros como la temperatura corporal y las señales de electrocardiograma para el diagnóstico del estrés. Existen varios estudios que relacionan estos parámetros y sus niveles con posibles casos de estrés y ansiedad. Para este fin usamos unos sensores colocados en el brazo derecho, brazo izquierdo y pierna izquierda. Esto forma el Eindhoven Triangle, que es conocido por dar una señal de electrocardiograma. A su vez también tendremos un sensor de temperatura colocado en un dedo de la mano para medir los grados a los que está el cuerpo en ese momento y así poder detectar ciertas anomalías. Estos sensores están conectados a un modulo que trata las señales analógicas recogidas, las une, y digitaliza para que el modulo transmisor pueda enviar via Bluetooth los datos hacia un receptor colocado en un área cercana. En el módulo hay una electrónica que ayuda a resolver problemas importantes como ruido o interferencias. Este receptor está conectado a un ordenador en el cual he desarrollado una aplicación que implementa el protocolo HCI y cuya funcionalidad es recoger los datos recibidos. Este programa es capaz de crear y gestionar conexiones Bluetooth entre dispositivos. El programa está preparado para que si las conexiones se cortan, se traten en la medida de lo posible los datos recogidos. Los datos se interpretarán y guardarán en un fichero .bin para posteriores usos, como graficaciones y análisis de parámetros. El programa está enteramente hecho en lenguaje Java y tiene un mecanismo de eventos que se activa cada vez que hay datos en el receptor, los recoge y los procesa con el fin de darles un trato posteriormente. Se eligió el formato .bin para los ficheros debido a su pequeño tamaño, ya que aunque sean más laboriosos de usar es mucho más eficiente que un .txt, que en este caso podría ocupar varios megabytes.

Optimizing rabbit production under heat stress: cage density and cage size during fattening, and breeding system and water quality on rabbit does

The aim of this work was to evaluate different management strategies to optimize rabbit production under chronic heat stress. To achieve it, three trials were conducted. In the first trial, to find the optimal cage density in tropical very dry forest condition, were measured growth performance, mortality rate, injured animals and carcass performance over an initial population of 300 cross-breed rabbits of New Zealand, California, Butterfly, Dutch and Satin, weaned at 30 days (535 ± 8 g, standard error). Treatments evaluated were: 6, 12, 18 and 24 rabbits/m2 (3, 6, 9 and 12 rabbits/cage, respectively, each cage of 0.5 m2). The maximal temperature-humidity index indicated a severe heat stress from weaning to 2.2 kg body weight (experimental time). At the end of experimental period 10, 20, 30 and 30 rabbits from the treatments of 6, 12, 18 and 24 rabbits/m2, respectively, were slaughtered and carcass performance recorded. Average daily gain and feed intake decreased by 0.31 ± 0.070 and 1.20 ± 0.25 g, respectively, per each unit that the density increased at the beginning of the experiment (P = 0.001). It increased the length of the fattening period by 0.91 ± 0.16 d (P = 0.001) per each unit of increment of density. However, rabbit production (kg/m2) increased linear and quadratically with the density (P < 0.008). Animals housed at the highest density compared to the lower one tended to show a higher incidence of ringworm (68.9 vs 39.4%; P = 0.075), injured animals (16.8 vs 3.03%; P = 0.12) and mortality (20.5 vs 9.63%; P = 0.043). The proportion of scapular fat (P = 0.042) increased linearly with increasing levels of density. Increasing density reduced linearly dorsal length (P = 0.001), and reduced linear and quadratically drip loss percentage (P = 0.097 and 0.018, respectively). In the second trial, 46 nulliparous rabbit does (23 clipped and 23 unclipped) with a BW of 3.67 ± 0.05 kg (s.e.) were used to evaluate heat stress and circadian rhythms comparing unclipped and clipped rabbit does, and to study if a more extensive breeding system increase litters performance at weaning without impairing rabbit doe performance,. Rectal temperature, feed and water 4 intake were recorded for 24 h. Rabbit does were mated 7 d after circadian measurements, and randomly assigned to two breeding systems. Control (C): mated at 14 d after parturition + litter weaned at 35 d of age. Extensive (E): mate at 21 after parturition + litter weaned at 42 d of age. The first three cycles were evaluated concerning to rabbit doe and litter performance. Two hundred twenty eight weaned rabbits, were divided into two cage sizes: 0.5 and 0.25 m2 with same density (16 rabbit/m2) and growing performance was recorded. Farm and rectal temperatures were minimal and feed and water intake maximal during the night (P < 0.001). Unclipped rabbit does showed higher rectal temperature (P = 0.045) and lower feed intake respect to clipped does (P = 0.019) which suggest a lower heat stress in the latter. Kits weaned per litter was reduced by 33% (P=0.038) in C group. This reduction was more important in the 2nd and 3rd cycles compared to the first (P ≤ 0.054). Rabbit doe feed efficiency tended to decrease in E respect C group (P = 0.093), whereas it was impaired from the first to the third cycle by 48% (P = 0.014). Growing rabbits from the E group were heavier at weaning (by 38%. P < 0.001), showed a higher feed intake (+7.4%) and lower feed efficiency (-8.4%) throughout the fattening period (P ≤ 0.056) respect to C group. Cage size had minor influence in growing performance. In the third trial, forty five non pregnant and non lactating rabbit does (21 nulliparous and 24 multiparous) were assigned randomly to farm water and to potable water to study if a water quality improvement can affect positively rabbit doe response to heat stress during pregnancy and lactation. A transponder was implanted in each animal to record subcutaneous temperature at 07:30 and 14:30 h. Experimental period extended from pregnancy (with no lactation) to the next lactation (until day 28). Body temperature and milk production were recorded daily, and body condition, feed and water intake weekly. Water quality did not affect any trait (P ≥ 0.15). Pregnant rabbit does were classified as does that weaned (W: 47%), not weaned (NW: 44%) or those pregnant that did not deliver (NB: 9%). Body temperature and feed intake decreased during pregnancy (P ≤ 0.031), but water intake remained constant. In this period body temperature decreased with metabolic weight (P ≤ 0.009). In W and NW does, 5 from mating to birth energy and protein balance impaired (P≤0.011). Body temperature of W does tended to be the lowest (P ≤ 0.090). Pregnancy length and total number of kits born tended to be longer and higher in NW than in W does (P = 0.10 and 0.053, respectively). Kit mortality at birth and from birth to 14 d of lactation was high, being worse for NW than for W does (97 vs. 40%; P<0.001). Body temperature during lactation was maximal at day 12, and milk production increased it (P ≤ 0.025). . In conclusion, in our heat stress conditions densities higher than 18 rabbits/m2 (34 kg/m2) at the end of fattening, are not recommended despite cage size, gestation and lactation productivity impaired not only when lactation is extended and along successive reproductive cycles but also due to a reduced embryo/kit survival and finally water quality improvement did not attenuate negative effect of heat stress. RESUMEN El propósito de éste trabajo fue evaluar diferentes estrategias de manejo para optimizar la producción de conejos bajo estrés térmico. Para lo cual se desarrollaron tres experimentos. En el primer experimento, para encontrar el número óptimo de gazapos por m2 de jaula durante el cebo en condiciones de bosque muy seco tropical, se estudiaron los rendimientos durante el cebo, mortalidad, animales lesionados y rendimiento de la canal sobre una población inicial de 300 conejos mestizos de Nueva Zelanda, California, Mariposa, Holandés y Satin, destetados a los 30 días de edad (535 ± 8g, error estándar). Los tratamientos evaluados fueron: 6, 12, 18 y 24 conejos/m2 (3, 6, 9 y 12 conejos/jaula, respectivamente, en jaulas de 0.5 m2). Durante el período experimental (destete a 2.2 kg de peso vivo), se observaron valores de THI correspondientes con un estrés térmico severo (THI max. De 31 a 35). Al final del período experimental, 10, 20, 30, y 30 conejos de los tratamientos con densidades de 6, 12, 18 y 24 conejos/m2, respectivamente, fueron sacrificados y su canal fue valorada. El promedio de la ganancia diaria y el consumo de alimento disminuyeron en 0.31 ± 0.070 y 1.20 ± 0.25 g, respectivamente, por cada unidad de incremento en la densidad al inicio del experimento (P=0.001). Esto alargó el período de engorde en 0.91 ± 0.16 d (P=0.001) por cada unidad de incremento de la densidad. Sin embargo, la producción de conejos (kg/m2) aumentó lineal y cuadráticamente con la densidad (P<0.008). Los animales alojados en las mayores densidades en comparación con el resto tendieron a mostrar una mayore incidencia de tiña (68.9 vs 39.4%; P=0.075), de cantidad de animales heridos (16.8 vs 3.03%; P=0.12), así como de mortalidad (20.5 vs 9.63%; P=0.043). El aumento en la densidad aumentó linealmente la proporción de grasa escapular (P=0.042) y redujo linealmente la longitud dorsal (P=0.001), y lineal y cuadráticamente el porcentaje de pérdida por goteo (P=0.018). En el segundo experimento, 46 conejas nulliparas (23 rasuradas y 23 no rasuradas) con un peso vivo de 3.67 ± 0.05 kg (e.e.) fueron usadas para evaluar el estrés 8 térmico y los ritmos circadianos comparando conejas rasuradas o no, y estudiar si un sistema de crianza más extensivo mejora el desempeño de la camada al destete sin perjudicar la productividad de la coneja. Durante 24 h se midió la temperatura rectal, consumo de alimento y de agua. Las conejas fueron montadas 7 días después, y distribuidas en dos sistemas de crianza. El control (C): monta a 14 días posparto y destete a 35 d de edad. El extensivo (E): monta a 21 días posparto y destete a 42 d de edad. Se controló la productividad de la coneja y la camada durante los tres primeros ciclos. Doscientos veintiocho gazapos fueron distribuidos en dos tamaños de jaulas (0.5 y 0.25 m2) con la misma densidad (16 conejos/m2) y se controlaron sus rendimientos productivos. Durante la noche se observaron los valores mínimos para la temperatura ambiental y rectal, y los máximos para consumo de alimento y agua (P< 0.001). Las conejas no rasuradas mostraron mayor temperatura rectal (P=0.045) y menores valores de consumo de alimento con respecto a las conejas rasuradas (P=0.019), lo que sugiere un menor estrés térmico en las últimas. El número de gazapos destetados por camada se redujo en 33% (P=0.038) en el grupo C. Este comportamiento se acentuó en el 2do y 3er ciclo en comparación con el primero (P≤0.054). La eficiencia alimenticia de las conejas tendió a disminuir en el grupo E con respecto al grupo C (P=0.093), dicha tendencia se acentúa del primer al tercer ciclo en un 48% (P=0.014). Los gazapos en fase de crecimiento provenientes del grupo E fueron más pesados al momento del destete (en 38% P<0.001), mostrando un mayor consumo de alimento (+7.4%) y menor eficiencia alimenticia (-8.4%) a lo largo del engorde (P≤0.056) con respecto al grupo C. El tamaño de la jaula tuvo una mínima influencia en el comportamiento durante el crecimiento de éstos gazapos. En el tercer experimento, cuarenta y cinco conejas no gestantes ni lactantes (21 nulíparas y 24 multíparas) se les asignó al azar agua dos tipos de agua: común de la granja y agua potable, con el fin de estudiar si una mejora en la calidad del agua puede afectar positivamente la respuesta de la coneja al estrés térmico durante la gestación y la lactancia. Se les implantó un transponder para registrar la temperatura subcutánea a las 7:30 y a las 14:30 h. El período experimental se extendió desde la gestación (sin 9 lactancia) hasta la lactanción consecutiva (hasta los 28 días). La temperatura corporal y la producción de leche se controlaron diariamente, y la condición corporal, consumo de agua y alimento, semanalmente. La calidad del agua no afectó a ninguna variable (P≥0.15). Las conejas preñadas fueron clasificadas como conejas que destetaron (W: 47%), que no destetaron (NW:44%) o aquellas que no parieron (NB: 9%). La temperatura corporal y consumo de alimento disminuyeron durante la gestación (P≤0.031), mientras que el consumo de agua se mantuvo constante. La temperatura corporal descendió con el peso metabólico durante la gestación (P≤0.009). El balance de energía y proteína disminuyó desde la monta al parto para las conejas W y NW (P≤0.011). Durante la gestación la temperatura corporal tendió a ser menor en las conejas W (P≤0.090). La longitud de la gestación y el número total de gazapos nacidos tendieron a ser mayores en conejas NW que en conejas W (P=0.10 y 0.053, respectivamente). La mortalidad de los gazapos al parto y del parto a los 14 días de lactancia fue alta, siendo peor para las conejas NW que para las W (97 vs 40%; P<0.001). Durante la lactancia la temperatura corporal alcanzó su valor máximo para el día 12, y la producción de leche indujo un incremento en la misma (P≤0.025). En conclusión, en nuestras condiciones de estrés térmico y sin importar el tamaño de la jaula, no se recomiendan densidades mayores a 18 conejos/m2 (34 kg/m2) al final del engorde. La productividad de la gestación y la lactancia disminuyen cuando la lactancia es mayor y se suceden varios ciclos reproductivos seguidos. Esto se debe al efecto negativo del estrés térmico sobre la vitalidad y supervivencia del embrión/gazapo. La mejora de la calidad del agua atenuó el efecto negativo del estrés térmico. Las conejas más productoras parece que son aquéllas que consiguen manejar mejor el estrés térmico.

Unsupervised system to classify SO2 pollutant concentrations in Salamanca, Mexico

Salamanca is cataloged as one of the most polluted cities in Mexico. In order to observe the behavior and clarify the influence of wind parameters on the Sulphur Dioxide (SO2) concentrations a Self-Organizing Maps (SOM) Neural Network have been implemented at three monitoring locations for the period from January 1 to December 31, 2006. The maximum and minimum daily values of SO2 concentrations measured during the year of 2006 were correlated with the wind parameters of the same period. The main advantages of the SOM Neural Network is that it allows to integrate data from different sensors and provide readily interpretation results. Especially, it is powerful mapping and classification tool, which others information in an easier way and facilitates the task of establishing an order of priority between the distinguished groups of concentrations depending on their need for further research or remediation actions in subsequent management steps. For each monitoring location, SOM classifications were evaluated with respect to pollution levels established by Health Authorities. The classification system can help to establish a better air quality monitoring methodology that is essential for assessing the effectiveness of imposed pollution controls, strategies, and facilitate the pollutants reduction.

Effect of Biodiversity Changes in Disease Risk: Exploring Disease Emergence in a Plant-Virus System

The effect of biodiversity on the ability of parasites to infect their host and cause disease (i.e. disease risk) is a major question in pathology, which is central to understand the emergence of infectious diseases, and to develop strategies for their management. Two hypotheses, which can be considered as extremes of a continuum, relate biodiversity to disease risk: One states that biodiversity is positively correlated with disease risk (Amplification Effect), and the second predicts a negative correlation between biodiversity and disease risk (Dilution Effect). Which of them applies better to different host-parasite systems is still a source of debate, due to limited experimental or empirical data. This is especially the case for viral diseases of plants. To address this subject, we have monitored for three years the prevalence of several viruses, and virus-associated symptoms, in populations of wild pepper (chiltepin) under different levels of human management. For each population, we also measured the habitat species diversity, host plant genetic diversity and host plant density. Results indicate that disease and infection risk increased with the level of human management, which was associated with decreased species diversity and host genetic diversity, and with increased host plant density. Importantly, species diversity of the habitat was the primary predictor of disease risk for wild chiltepin populations. This changed in managed populations where host genetic diversity was the primary predictor. Host density was generally a poorer predictor of disease and infection risk. These results support the dilution effect hypothesis, and underline the relevance of different ecological factors in determining disease/infection risk in host plant populations under different levels of anthropic influence. These results are relevant for managing plant diseases and for establishing conservation policies for endangered plant species.

Implementation of a module for risk of ozone impacts assessment to vegetation in the integrated assessment modelling system for the Iberian peninsula. Evaluation for wheat and holm oak

A module to estimate risks of ozone damage to vegetation has been implemented in the Integrated Assessment Modelling system for the Iberian Peninsula. It was applied to compute three different indexes for wheat and Holm oak; daylight AOT40 (cumulative ozone concentration over 40 ppb), cumulative ozone exposure index according to the Directive 2008/50/EC (AOT40-D) and PODY (Phytotoxic Ozone Dose over a given threshold of Y nmol m−2 s−1). The use of these indexes led to remarkable differences in spatial patterns of relative ozone risks on vegetation. Ozone critical levels were exceeded in most of the modelling domain and soil moisture content was found to have a significant impact on the results. According to the outputs of the model, daylight AOT40 constitutes a more conservative index than the AOT40-D. Additionally, flux-based estimations indicate high risk areas in Portugal for both wheat and Holm oak that are not identified by AOT-based methods.

Functional validation of MB-OFDM system using HW-in the loop

Functional validation of complex digital systems is a hard and critical task in the design flow. In particular, when dealing with communication systems, like Multiband Orthogonal Frequency Division Multiplexing Ultra Wideband (MB-OFDM UWB), the design decisions taken during the process have to be validated at different levels in an easy way. In this work, a unified algorithm-architecture-circuit co-design environment for this type of systems, to be implemented in FPGA, is presented. The main objective is to find an efficient methodology for designing a configurable optimized MB-OFDM UWB system by using as few efforts as possible in verification stage, so as to speed up the development period. Although this efficient design methodology is tested and considered to be suitable for almost all types of complex FPGA designs, we propose a solution where both the circuit and the communication channel are tested at different levels (algorithmic, RTL, hardware device) using a common testbench.

Analysis and optimized design of a distributed multi-stage EMC filter for an interleaved three-phase PWM-rectifier system for aircraft applications

Different possible input filter configurations for a modular three-phase PWM rectifier system consisting of three interleaved converter cells are studied. The system is designed for an aircraft application where MIL-STD-461E conducted EMI standards have to be met and system weight is a critical design issue. The importance of a LISN model on the simulated noise levels and the effect of interleaving and power unbalance between the different converter modules is discussed. The effect of the number of filter stages and the degree of distribution of the filter stages among the individual converter modules on the weight and losses of the input filter is studied and optimal filter structures are proposed.

Functional and expression analysis of the metal-inducible dmeRF system from Rhizobium legumionosarum bv. viciae

A gene encoding a homolog to the cation diffusion facilitator protein DmeF from Cupriavidus metallidurans has been identified in the genome of Rhizobium leguminosarum UPM791. The R. leguminosarum dmeF gene is located downstream of an open reading frame (designated dmeR) encoding a protein homologous to the nickel- and cobalt-responsive transcriptional regulator RcnR from Escherichia coli. Analysis of gene expression showed that the R. leguminosarum dmeRF genes are organized as a transcriptional unit whose expression is strongly induced by nickel and cobalt ions, likely by alleviating the repressor activity of DmeR on dmeRF transcription. An R. leguminosarum dmeRF mutant strain displayed increased sensitivity to Co(II) and Ni(II), whereas no alterations of its resistance to Cd(II), Cu(II), or Zn(II) were observed. A decrease of symbiotic performance was observed when pea plants inoculated with an R. leguminosarum dmeRF deletion mutant strain were grown in the presence of high concentrations of nickel and cobalt. The same mutant induced significantly lower activity levels of NiFe hydrogenase in microaerobic cultures. These results indicate that the R. leguminosarum DmeRF system is a metal-responsive efflux mechanism acting as a key element for metal homeostasis in R. leguminosarum under free-living and symbiotic conditions. The presence of similar dmeRF gene clusters in other Rhizobiaceae suggests that the dmeRF system is a conserved mechanism for metal tolerance in legume endosymbiotic bacteria.