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Characterization of the visceral and neuronal phenotype of 4L/PS-NA mice modeling Gaucher disease
Authors: Victoria Schiffer aff001; Estibaliz Santiago-Mujika aff001; Stefanie Flunkert aff001; Staffan Schmidt aff002; Martina Farcher aff001; Tina Loeffler aff001; Irene Schilcher aff001; Maria Posch aff001; Joerg Neddens aff001; Ying Sun aff003; Jan Kehr aff002; Birgit Hutter-Paier aff001
Authors place of work: QPS Austria GmbH, Neuropharmacology, Grambach, Austria aff001; Pronexus Analytical AB, Bromma, Sweden aff002; Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America aff003; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America aff004
Published in the journal: PLoS ONE 15(1)
Category: Research Article
doi: https://doi.org/10.1371/journal.pone.0227077Summary
Gaucher disease is caused by a deficiency in glucocerebrosidase that can result in non-neuronal as well as neuronal symptoms. Common visceral symptoms are an increased organ size, specifically of the spleen, and glucosylceramide as well as glucosylsphingosine substrate accumulations as a direct result of the glucocerebrosidase deficiency. Neuronal symptoms include motor deficits and strong alterations in the cerebellum. To evaluate the effect of new compounds for the treatment of this devastating disease, animal models are needed that closely mimic the human phenotype. The 4L/PS-NA mouse as model of Gaucher disease is shown to present reduced glucocerebrosidase activity similar to human cases but an in-depth characterization of the model was still not performed. We therefore analyzed 4L/PS-NA mice for visceral alterations, motor deficits and also neuronal changes like glucocerebrosidase activity, substrate levels and neuroinflammation. A special focus was set at pathological changes of the cerebellum. Our results show that 4L/PS-NA mice have strongly enlarged visceral organs that are infiltrated by enlarged leukocytes and macrophages. Furthermore, animals present strong motor deficits that are accompanied by increased glucosylceramide and glucosylsphingosine levels in the brain, astrocytosis and activated microglia in the cortex and hippocampus as well as reduced calbindin levels in the cerebellum. The latter was directly related to a strong Purkinje cell loss. Our results thus provide a detailed characterization of the 4L/PS-NA mouse model over age showing the translational value of the model and validating its usefulness for preclinical efficiency studies to evaluate new compounds against Gaucher disease.
Keywords:
White blood cells – Spleen – Mouse models – Macrophages – Thymus – Hippocampus – Cerebellum – Animal models of disease
Introduction
Gaucher disease (GD) is a sphingolipidosis and thus belongs to the large group of lysosomal storage diseases. GD is autosomal recessively inherited and caused by a deficiency in glucocerebrosidase (GCase) resulting in an accumulation of its substrate glucosylceramide (GlcCer) as well as glucosylsphingosine (GlcSph). In most patients, the disease is caused by a point mutation in the GCase gene GBA1 and thus far more than 400 different GBA mutations are known according to the Human Genome Mutation Database (HGMD). Although the disease is today assumed to have a phenotypic spectrum from very weak to severe, historically 3 disease types can be distinguished. While the by far most common form of GD, Type 1, is characterized by almost pure visceral symptoms, Type 2 and 3 are characterized by visceral and neuronal symptoms. Patients carrying GBA1 mutations have an increased risk of developing Parkinson disease and Dementia with Lewy bodies [1, 2]. Currently, there are two different types of treatments available to patients: enzyme replacement therapy (ERT) and substrate reduction therapy (SRT). ERT is based on the provision of GCase that diseased cells are lacking. SRT is based on the reduction of excessive cytoplasmic GlcCer (for review see [3]). Both treatment types result in a slow but sufficient effect on visceral symptoms, but no evidence exists for an effect on neuronal symptoms [4]. Future drug developments are therefore ought to focus on compounds that are effective against neuronal GD symptoms. To test these new compounds in vivo, rodent animal models that properly mimic neuronal GD pathology are utilized. There are several GD mouse models available that are based on different disease aspects like depleted or reduced prosaposin expression [5, 6], Gba1 deletion [7, 8] or Gba1 point mutations [9, 10]. Major issues of these models are severely reduced life spans or weak pathological features, making these models impracticable for treatment studies. The 4L/PS-NA mouse model by Grabowski and colleagues combines two disease aspects by expressing the Gba1V394L/V394L mutation and additionally reduced prosaposin/saposins levels [11]. The model presents visceral and neuronal symptoms and a life span of approximately 22 weeks. The GCase and saposin activity of 4L/PS-NA mice are strongly reduced, resulting in early clusters of lipid storage cells in several visceral organs and enlarged storage cells in alveolar and interstitial spaces of the lung. Starting at 10 weeks, animals develop gait ataxia, generalized tremor and gross shaking which lead to a complete paralysis at the age of 20 weeks [11]. A detailed analysis of brain tissue revealed a 10-fold increase of GlcCer in the cerebellum and 2-4-fold increase in other brain regions. Furthermore, glucosylsphingosine a biomarker of GD [12] is 20-117-fold increased in these same regions [13].
So far, 4L/PS-NA mice have been mainly characterized and used for GD research by Grabowski and his team. We therefore analyzed 4L/PS-NA mice for general health and motor deficits over age using standardized behavioral tests. Afterwards, different visceral and neuronal tissues were weighted and visceral organs analyzed for morphological alterations of leukocytes and macrophages. Neuronal tissue was analyzed for GCase activity and substrate levels as well as the progression of neuroinflammation and expression of α-synuclein and calbindin in the cerebellum and hippocampus. Overall, our results show that the phenotype of 4L/PS-NA mice is characterized by a strong visceral and neuronal pathology resulting in severe and progressive motor deficits that can be quantified using different behavioral tests.
Materials and methods
Animals
All animals were bred and housed under identical conditions in individually ventilated cages on standardized rodent bedding (Rettenmayer®, Rosenberg, Germany) in the AAALAC-accredited animal facility of QPS Austria. Cotton nestlets (Plexx®, Elst, The Netherlands) were provided as nesting material. The room temperature was kept at approximately 24°C and the relative humidity between 40–70%. Mice were housed under constant light/dark cycle of 12 hours each. Dried pelleted standard rodent chow (Altromin®, Lage, Germany) and normal tap water were available to the animals ad libitum. Each individual animal was checked regularly for clinical signs. Animals of both sexes were used. Mice were housed in same sex groups of up to four animals. During weaning, less than 1 mm of the tail tip was cut from each animal and used for genotyping. Actual animal numbers are given in the figure legends. 4L/PS-NA mice with homozygous GbaV394L/V394L mutation (4L) [10], complete prosaposin knockout (PS-) and homozygous prosaposin transgene (NA) resulting in hypomorphic prosaposin levels [11], were bred by mating heterozygous 4L/PS+/-NA mice. For all analyses, homozygous 4L/PS-NA mice (called 4L/PS-NA) and control mice with a wild type prosaposin (4L/PS+/+NA) of the same age (called control) were used. Heterozygous 4L/PS+/-NA breeding pairs were provided by Dr Ying Sun and Dr. Gregory Grabowski, Division of Human Genetics, Children's Hospital Research Foundation and University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH, USA. For quantification of glucocerebrosidase, glucosylceramide and glucosylsphingosine also 18 week old C57Bl/6RccHsd mice (Envigo, Udine, Italy) were used as additional control.
Ethics statement
Animal studies conformed to the Austrian guidelines for the care and use of laboratory animals as well as being approved by the Ethics committee of the Styrian government, Austria (ABT13-78Jo199-2017). All efforts were made to minimize suffering.
Behavioral tests
All behavioral tests were performed during the early phase of the light cycle. Before the start of each behavioral test, animals were habituated to the experimental room for at least 1 hour. Groups were divided according to the phenotypic progression (from onset to late stage), representing relevant time points for compound tests. Animals were allocated to the corresponding experimental group according to their genotype. The following behavioral tests were performed longitudinally in week 8, 12 and 18 in the following order: day 1: Rota Rod and Wire suspension test; day 2: Pasta gnawing test; day 3: Beam Walk test.
The Rota Rod test, Wire suspension test and Pasta gnawing test were conducted as previously described [14, 15]. The Beam walk test was conducted as previously described using a 13 mm square beam for testing [15]. The body weight was measured on testing day 1 using a standard precision scale.
Tissue sampling
All mice were anesthetized by intraperitoneal injection of 600 mg/kg pentobarbital (Release ®, WDT, Germany). Once animals were deeply anesthetized, mice were transcardially perfused with physiological (0.9%) saline. Thereafter, spleen, liver, lung, thymus and brain were rapidly removed brains hemisected and all tissues weighted using a precision scale. The right hemispheres and all visceral organs were fixed by immersion at 4°C in freshly prepared 4% formaldehyde in phosphate buffer (pH 7.4) for 24 hours. After cryo-conservation in a 15% sucrose/phosphate buffered saline (PBS) solution, tissues were shock frozen in dry ice cooled liquid isopentane. All tissues were then stored at -80°C until used for histological procedures.
Additionally, tissue of naïve 5 and 12 week old animals was sampled for biochemical and histological analyses.
Glucocerebrosidase measurement
CBE inhibitable GCase activity was measured with a fluorometric assay using 4-Methylumbelliferyl ß-D-glucopyranoside (4-MUG) as substrate. The 4-MUG assay was purchased from Sigma-Aldrich (St. Louis, MO, USA). Brain tissue was homogenized in 10 volumes homogenization buffer (250 mM Sucrose, 10 mM Tris pH 7.5, 0.1% Triton), sonicated on ice and spun at 20.000 xg for 15 min. The supernatants were used for analysis. Samples were mixed 1 : 1 with 150 mM McIlvaine buffer pH 4.8. Thereafter the substrate mix was added (3.7 mM 4-MUG in 150 mM McIlvaine buffer pH 4.8; 0.1% BSA; 0.4% taurocholate; 0.1% Triton) and incubated for 1 h at 37°C. The reaction was stopped by adding 0.2 M Glycine-NaOH pH 10.8 and fluorescence was detected at Ex WL = 365 nm, Em WL = 445 nm.
Each sample was analyzed in duplicates and a third replicate including 1 mM CBE was used to subtract the GBA1 unspecific signal.
Glucosylceramide and glucosylsphingosine measurements
Concentrations of glucosylceramide (GlcCer) and glucosylsphingosine (GlcSph) in the extracts from the mouse cerebellum were measured by ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS) following a slightly modified protocol as described elsewhere (Hamler et al., 2017). Glucosyl(β) ceramide (d18 : 1/18 : 0), galactosyl(β) ceramide (d18 : 1/18 : 0), glucosyl(β) ceramide-d5, glucosyl(β) sphingosine (d18 : 1), galactosyl(β) sphingosine (d18 : 1), glucosyl(β) sphingosine-d5, and galactosyl(β) sphingosine-d5 were purchased from Avanti Polar Lipids (Sigma-Aldrich, St. Louis, MO, USA). Acetonitrile (ACN), methanol (MeOH), formic acid, ammonium formate, all LC-MS grade were purchased from Fisher Scientific (Pittsburgh, PA, USA), dimethyl sulfoxide (DMSO) and all other chemicals were purchased from Sigma-Aldrich. Deionized water (>18 MΩ) was prepared by use of a Direct-Q-3 UV water purification system (Merck Millipore, Darmstadt, Germany).
The dissected brain samples (≈ 50 mg) were mixed with ice-cold water at a ratio 1 : 10 (w/v). Thereafter, 50 μl of the internal standards (deuterium-labeled GlcSph-d5 and GlcCer-d5, each 4,000 ng/ml) were pipetted, the samples were thoroughly mixed and placed in the ice bath and homogenized by use of a ultrasonic homogenizer Vibra-Cell VCX 130 (Sonics & Materials Inc., Newtown, CT, USA). Immediately after that, 100 μl of the homogenate was pipetted into the separate tubes and 1.3 ml of acetone-methanol (1 : 1) was added. The tubes were placed in a horizontal shaker and vortexed for 60 min. Thereafter, 1.2 ml of water-MeOH (1 : 3) was added, the samples were vortexed for 3 min and centrifuged in a refrigerated microcentrifuge Biofuge Fresco (Heraeus Instruments, Hanau, Germany) at 12,000 rpm, 4°C for 15 min. GlcCer and GlcSph were extracted from the brain homogenates by use of solid-phase extraction (SPE) cartridges, BondElut C18 (100 mg) and BondElut Certify (50 mg), respectively, both purchased from Agilent (Santa Clara, CA, USA). The BondElut C18 cartridge was preconditioned with 2 ml of MeOH followed by 2 ml of MeOH-acetone-H2O (67 : 23 : 10), the BondElut Certify cartridge was preconditioned with 1 ml of MeOH and 1 ml of water. The supernatant was divided into two equal volumes and slowly loaded onto each SPE column using a low vacuum. The BondElut C18 cartridge was washed with 2 ml MeOH-acetone-H2O (60 : 25 : 15) and glucosylceramides and galactosylceramides were eluted with 2 ml of acetone-MeOH (90 : 10). The BondElut Certify was washed with 2 ml of 0.1 M HCl followed by 2 ml of MeOH and glucosylsphingosine and galactosylsphingosine were eluted with 2 ml of freshly prepared 5% ammonium hydroxide in MeOH. The samples were placed in a vacuum centrifuge miniVac Duo concentrator (Genevac, SP Industries, Warminster, PA, USA) and evaporated to dryness. The samples for GlcCer analysis were reconstituted in 50 μl DMSO and 200 μl ACN-MeOH-H2O (95 : 2.5 : 2.5) containing 5 mM ammonium formate and 0.5% formic acid. The samples for GlcSph analysis were reconstituted in 50 μl DMSO and 200 μl ACN-MeOH-H2O (85 : 7.5 : 7.5) containing 5 mM ammonium formate and 0.5% formic acid. The UHPLC-MS/MS system included a PAL autosampler (CTC Analytics, Switzerland) operating at 4°C, an Advance UHPLC pump, EVOQ Elite triple quadrupole mass spectrometer (Bruker Daltonics, Billerica, MA, USA) equipped with an electrospray ionization (ESI) source operating in a positive mode, the ESI parameters were as follows: probe gas flow 30, nebulizer gas flow 45, probe temperature 400°C, cone gas flow 15, cone temperature 250°C, the CID gas was Ar set at 1.5 mTorr. The separation of GlcCer from galactosylceramide was achieved on a HALO HILIC column (2.1 x 150 mm, 2 μm particle size) purchased from Advanced Materials Technology (Wilmington, DE, USA), kept at 35°C. The mobile phase included a mixture of acetonitrile (ACN), methanol, water (95 : 2.5 : 2.5 v/v) and the final 5 mM ammonium formate and 0.5% formic acid, the flow rate was 0.2 ml/min. The precursor (m/z) and product ions for GlcSph were 462.3 > 282.3 (quantifier ion) and 462.3 > 264.3 (qualifier ion). The separation of GlcSph from galactosylsphingosine was achieved on a HALO HILIC column (2.1 x 100 mm, 2 μm particle size) kept at 35°C. The mobile phase was a mixture of ACN, MeOH and water (85 : 7.5 : 7.5), with final 5 mM ammonium formate and 0.5% formic acid, the flow rate was 0.3 ml/min. The precursor (m/z) mass and the product ion of GlcCer was 728.6 and 264.6, respectively, the corresponding m/z mass for the internal standard GlcCer-D5 was 733.6 > 269.6. Typically, 1–3 μl of reconstituted samples for the respective analyte were injected onto the column. Under these conditions the carryover of the method (blank sample injected after a sample with highest concentrations of GlCer and GlcSph was injected) was 0.17% for GlcSph and 0.13% for GlcCer.
Histology
Frozen brain hemispheres and tissue samples of liver, lung, spleen and thymus were cut in the sagittal or coronal plane at 10 μm thickness. Unless indicated otherwise, a systematic uniform random set of five sections per animal and per tissue sample were used for each immunofluorescent labeling. GFAP + IBA1 and Calbindin D-28k + α-synuclein immunofluorescence incubations of brain sections were conducted as previously described [15]. Sections of visceral organs were treated with a 1 mg/ml sodium borohydride/PBS solution followed by 1% hydrogen peroxide in methanol. To block unspecific labeling, sections were treated with 10% donkey serum for 30 min followed by incubation in primary antibody in 1% donkey serum in PBS overnight at 4°C. Sections were incubated in different highly cross-adsorbed fluorophore-conjugated secondary antibodies all raised in donkey for 1 hour at room temperature. Finally, sections were counterstained with DAPI. Information on the primary antibodies is provided in Table 1. Technical control experiments were routinely performed together with regular experiments.
Tab. 1. List of primary antibodies used for histological evaluations. Mosaic images of the labeled sections were recorded on a fully motorized Zeiss AxioImager Z1 microscope with high aperture lenses, equipped with a Zeiss AxioCam MRm camera and ZEN 2.3 software. Mosaic images were merged and converted to full resolution single channel tif files that were used for quantitative image analysis. The target area was identified by drawing an area of interest (AOI) on the images. Background correction was used if necessary, and the immunofluorescence signal was then quantified by adequate thresholding and morphological filtering (size, shape) to determine the percentage of AOI area covered by immune-positive objects. Once the parameters of the targeted objects had been defined in a test run, the quantitative image analysis ran automatically and macro-based resulting in rater-independent and fully reproducible data. All measurements were performed using ImageProPlus (v6.2) software.
Statistics
Data analysis was performed in GraphPad Prism 4.03 (GraphPad Software Inc., USA). Graphs show group means and standard error of the mean (SEM). The significance level was set at p < 0.05. Group means were compared using Two-way analysis of variance (ANOVA) with a subsequent post hoc test. The utilized statistical tests and exact sample size are mentioned in the figure legends.
Availability of data and materials
All data generated or analyzed during this study are included in this published article and its supplementary files “S1 Table”.
Results
General health and motor deficits of 4L/PS-NA mice over age
To evaluate the health status of 4L/PS-NA mice, animals were weighted over age but no significant changes were observed compared to control animals. Both groups gained weight with increasing age (Fig 1A). The muscle strength of 4L/PS-NA mice was tested in the wire suspension test. Eight week old 4L/PS-NA mice showed a similar muscle strength as control animals but muscle strength significantly decreased over age. Finally, 18 week old 4L/PS-NA mice had a significantly shorter hanging time compared to age matched control animals (Fig 1B). Further analysis of motor deficits in the beam walk test revealed a significant increase of slips in 4L/PS-NA mice compared to controls at 12 week of age. This difference strongly worsened at the age of 18 weeks (Fig 1C). Parallel analysis of the active time in the beam walk test showed that already at the age of 8 weeks 4L/PS-NA mice needed longer to cross the beam compared to control animals. This parameter also worsened over time. 18 week old 4L/PS-NA mice needed more than 4 times the time to cross the beam compared to control animals (Fig 1D). Additional analysis of 4L/PS-NA mice for motor deficits in the Rota Rod test showed a significantly reduced latency to fall off the rod at the age of 18 weeks compared to controls. Furthermore, control animals showed a longer latency to fall off the rod at the age of 18 weeks compared to 12 weeks that was not observed in 4L/PS-NA mice (Fig 1E) suggesting that control animals can improve their performance by learning the motor task over age while 4L/PS-NA mice do not improve. An alternative method to evaluate motor deficits in rodents that does not depend on the animal’s fore - and hind limb muscles is the pasta gnawing test, which is used for analyzing orofacial motor deficits [14]. Analysis of 12 and 18 week old 4L/PS-NA mice in this test revealed no significant changes in the number of bites per episode compared to age matched control animals although a clear trend towards a reduced number of bites per episode in 4L/PS-NA mice was obvious (Fig 1F).
Fig. 1. General health and motor deficits of 4L/PS-NA mice over age. Eight, 12 and 18 week old 4L/PS-NA mice and control littermates were analyzed for body weight (A), the hanging time in seconds in the wire suspension test (B), the total number of slips (C) and the active time in the beam walk test (D), the latency to fall off the rotating rod of the Rota Rod test (E) and the number of bites per episode in the pasta gnawing test (F). Two-way ANOVA followed by Bonferroni’s post hoc test. n = 7 per group. Mean ± SEM. *differences between genotypes; #differences between age groups; *p<0.05; **p<0.01; ***p<0.001. Progressive tissue weight changes of 4L/PS-NA mice
As already shown in Fig 1A, the total body weight of 4L/PS-NA mice did not change compared to control animals. Since 4L/PS-NA mice are known to display a neuronal as well as non-neuronal phenotype, the weight of different organs of 5, 12 and 18 week old 4L/PS-NA and control mice was measured. The results show that the total weight of liver, lung and spleen of 4L/PS-NA mice was significantly increased at the age of 12 and 18 weeks compared to control animals while no differences were observed at the age of 5 weeks (Fig 2A, 2B and 2C). The total weight of the thymus was highest at 5 weeks of age in 4L/PS-NA as well as control mice and decreased significantly with age but no significant changes were observed between genotypes (Fig 2D).
Fig. 2. Tissue weight of 4L/PS-NA mice over age. Tissue weight of liver (A), lung (B), spleen (C), thymus (D), cerebellum (left hemisphere, E) and left brain hemisphere without cerebellum (F) were measured at 5, 12, or 18 week of age. Two-way ANOVA followed by Bonferroni’s post hoc test. 4L/PS-NA: 5 weeks: n = 6; 12 weeks: n = 7; 18 weeks: n = 15; Control: 5 weeks: n = 5; 12 weeks: n = 7; 18 weeks: n = 16; Mean + SEM. *differences between genotypes; #differences between age groups; *p<0.05; **p<0.01; ***p<0.001. Weight measurement of neuronal tissue was performed separately for the cerebellum and the remaining brain. While the weight of the cerebellum was decreased in 4L/PS-NA mice compared to control mice from 12 weeks onwards, the weight of the remaining brain did not change over time compared to controls. (Fig 2E and 2F).
It can be summarized that the weight of non-neuronal tissue of 4L/PS-NA mice mostly increased over age while the weight of some neuronal tissue, specifically the cerebellum, decreased over age.
Non-neuronal phenotype of 4L/PS-NA mice
To evaluate the visceral pathology of 4L/PS-NA mice, liver, lung, spleen and thymus were immunofluorescently labeled with the specific leukocyte and macrophage markers CD45 and F4/80, respectively. Qualitative analysis of these labelings revealed a progressive increase of leukocyte size in the liver of 4L/PS-NA mice with enlarged cells at the age of 12 weeks. These enlarged cells increased in number and size over age compared to control mice and earlier age groups. The leukocyte size did not seem to further increase at the age of 18 weeks compared to 12 week old animals (Fig 3A). CD45 labeling of leukocytes in the lung of 4L/PS-NA mice showed already many enlarged cells at the age of 5 weeks. Differences between age groups seemed to be minor (Fig 3B). In the spleen of 4L/PS-NA mice, leukocytes were enlarged at the age of 18 weeks compared to control animals. Younger animals barely showed differences in leukocyte size (Fig 3C). Leukocytes in the thymus of 4L/PS-NA mice were strongly enlarged at the age of 5 weeks and progressively inflated until reaching an enormous size at the age of 18 weeks (Fig 3D). The largest leukocytes could thus be observed in liver and thymus.
Fig. 3. Enlarged leukocytes in visceral organs of 4L/PS-NA mice. The liver (A), lung (B), spleen (C) and thymus (D) of 4L/PS-NA mice and control littermates were labeled with CD45 antibody at the age of 5, 12 and 18 weeks; green: CD45; blue: DAPI. Scale bars: Overview: 100 μm, inserts: 10 μm. Analysis of macrophage labeling with F4/80 antibody revealed only slightly enlarged macrophages in the liver of 5 week old 4L/PS-NA mice that further progressively inflated (Fig 4A). In the lung of 4L/PS-NA mice, macrophages were slightly enlarged at the age of 5 and 12 weeks and highly enlarged at the age of 18 weeks (Fig 4B). A very prominent feature in the lung was the accumulation of macrophages surrounding alveoli of 4L/PS-NA mice as indicated by white arrows in Fig 4B. Macrophages in the spleen were highly enlarged in 18 week old 4L/PS-NA compared to control mice. The spleen of younger 4L/PS-NA mice did not seem to contain enlarged macrophages (Fig 4C). Labeling of macrophages in the thymus of 4L/PS-NA mice revealed highly inflated macrophages already at the age of 5 weeks that progressively increased in size (Fig 4D). The largest macrophages could thus be observed in the spleen and thymus.
Fig. 4. Enlarged macrophages in visceral organs of 4L/PS-NA mice. The liver (A), lung (B), spleen (C) and thymus (D) of 4L/PS-NA mice and control littermates were labeled with F4/80 antibody at the age of 5, 12 and 18 weeks; green: F4/80; blue: DAPI. Scale bars: Overview: 100 μm, inserts: 10 μm. Arrows indicate enlarged macrophages surrounding alveoles. Neuronal phenotype of 4L/PS-NA mice
To evaluate the enzyme activity of glucocerebrosidase and measure the substrates glucosylceramide and glucosylsphingosine, neuronal tissue of 5, 12 and 18 week old 4L/PS-NA mice, control animals as well as C57Bl/6 mice was analyzed by 4-MUG assay, UHPLC-MS/MS and UPLC-TOF, respectively.
Analysis of the GCase activity revealed that 4L/PS-NA mice and also control animals presented a drastically reduced signal of only approximately 6% compared to C57Bl/6 mice (Fig 5A). This result was independent of the animal’s age.
Fig. 5. Quantification of glucocerebrosidase, glucosylceramide and glucosylsphingosine in 4L/PS-NA mice over age. The cortex of 5, 12 and 18 week old 4L/PS-NA mice, control animals as well as C57Bl/6 mice was analyzed for glucocerebrosidase activity by 4-MUG assay (A). Whole brain homogenates of 5, 12 and 18 week old 4L/PS-NA mice, control animals as well as C57Bl/6 mice were analyzed for glucosylceramide (B) and glucosylsphingosine (C) levels in μg/g wet weight (B) or ng/g wet weight (C). Two-way ANOVA followed by Bonferroni’s post hoc test. Values of C57Bl/6 mice (triangles in B and C) were excluded from all statistical analyses; n = 5 for 4L/PS-NA and control animals; n = 3 for C57Bl/6 mice. Mean + SEM. *differences between genotypes; #differences between age groups; *p<0.05; **p<0.01; ***p<0.001. Substrate measurements in brain homogenates showed significantly increased glucosylceramide and glucosylsphingosine levels as early as 5 week of age (Fig 5B and 5C). At this early age glucosylceramide levels were already about 6-fold higher, while glucosylsphingosine levels where about 5-fold higher compared to controls. Levels of both substrates significantly increased over age in 4L/PS-NA and control animals. While glucosylceramide levels in control animals increased from week 5 to 18 about 2.5-fold, levels of 4L/PS-NA mice were about 7.5-fold increased. This effect was weaker for glucosylsphingosine levels. In control animals the substrate increased from week 5 to 18 about 1.8-fold and in 4L/PS-NA mice about 2.7-fold. For both substrate measurements tissue of 12 week old C57Bl/6 mice was evaluated as additional control since the control littermates of 4L/PS-NA mice are still genetically altered (Fig 5B and 5C). The analysis of C57Bl/6 mouse tissue showed only a minor signal for both substrates (Fig 5B and 5C, grey triangles).
A common neuronal pathology in GD is neuroinflammation [16, 17]. The cortex and hippocampus of 5, 12 and 18 week old 4L/PS-NA mice were thus analyzed for astrocytosis and activated microglia using GFAP - and IBA1-specific antibodies, respectively. Quantification of the immunoreactive area (IR area) showed a similar expression of GFAP and IBA1 labeling in both brain regions. The IR area of both neuroinflammation markers was significantly increased in 12 and 18 week old 4L/PS-NA mice compared to controls and to 5 week old 4L/PS-NA mice. In 5 week old animals, no significant changes were observed (Fig 6A–6D). Representative images of GFAP and IBA1 labeling of the hippocampal CA1 region in 18 week old 4L/PS-NA and control mice are shown in Fig 6E.
Fig. 6. Quantification of astrocytosis and activated microglia in 4L/PS-NA mice over age. The cortex (A,C) and hippocampus (B,D) of 4L/PS-NA mice was analyzed for GFAP (A,B) and IBA1 (C,D) immunoreactive area (IR) in percent at the age of 5, 12 and 18 weeks compared to control littermates. Two-way ANOVA followed by Bonferroni’s post hoc test. n = 5 per group. Mean + SEM. *differences between genotypes; #differences between age groups; **p<0.01; ***p<0.001. E: Representative images of GFAP, IBA1 and DAPI labeling of the hippocampal CA1 region in 18 week old 4L/PS-NA and control mice. Scale bar: 50 μm. GD is characterized by an increased aggregation of α-synuclein protein, linking the disease to synucleinopathies [18–20]. α-synuclein was therefore labeled in the cerebellum and hippocampus of 5, 12 and 18 week old 4L/PS-NA mice and the IR area compared to age matched controls. The α-synuclein IR area was highest in the cerebellum and hippocampus of 5 week old control and 4L/PS-NA animals. In the cerebellum α-synuclein levels decreased over age in both groups without significant differences between genotypes (Fig 7A). In the hippocampus, only a minor decrease of α-synuclein levels over age could be observed with the here applied method (Fig 7B).
Fig. 7. Quantification of α-synuclein and calbindin in 4L/PS-NA mice over age. The cerebellum (A,C) and hippocampus (B,D) of 4L/PS-NA mice was analyzed for pan α-synuclein (A,B) and calbindin (C,D) immunoreactive area (IR) in percent at the age of 5, 12 and 18 weeks compared to control littermates. Two-way ANOVA followed by Bonferroni’s post hoc test. n = 5 per group. Mean + SEM. *differences between genotypes; #differences between age groups; *p<0.05; **p<0.01; ***p<0.001. E: Representative images of pan α-synuclein, calbindin and DAPI labeling of the hippocampal CA1 region in 5 week old 4L/PS-NA and control mice. Scale bar: 50 μm. Labeling the cerebellum with an antibody against the calcium binding protein calbindin showed highly decreased calbindin levels in 4L/PS-NA mice at the age of 12 and 18 weeks compared to control animals. The decrease in the calbindin signal worsened over age in 4L/PS-NA mice while in control animals the signal decreased only in 18 month old animals (Fig 7C). In the hippocampus on the contrary, calbindin labeling stayed constant over age in 4L/PS-NA mice while the levels were high in control animals at the age of 5 weeks and progressively decreasing over age. This effect resulted in significantly decreased calbindin levels in 5 week old 4L/PS-NA mice compared to control animals of the same age (Fig 7D). Representative images of α-synuclein and calbindin labeling in the hippocampal CA1 region of 5 week old 4L/PS-NA and control mice are shown in Fig 7E.
Cerebellar alterations of 4L/PS-NA mice
Since the tissue weight and the calbindin signal in the cerebellum of 4L/PS-NA mice decreased over age (Figs 2E and 7C), the pathological features of the cerebellum were analyzed in more detail. Sagittal sections of the cerebellum of 4L/PS-NA and control animals were immunofluorescently labeled with antibodies against α-synuclein and calbindin and nuclei were stained with DAPI. Qualitative analyses revealed a strongly disturbed Purkinje cell layer with a decreased number of Purkinje cells in 4L/PS-NA mice. The molecular layer containing i.a. the dendritic tree of Purkinje cells was thus strongly striped and scattered in 4L/PS-NA mice (Fig 8B). In the granule cell layer single Purkinje cell axons labeled by calbindin could be observed (arrow head in Fig 8B). α-synuclein labeling was almost limited to the granule cell layer in 4L/PS-NA mice.
Fig. 8. Pathological alterations in the cerebellum of 4L/PS-NA mice. The cerebellum of 18 week old 4L/PS-NA mice (B) and control littermates (A) were labeled with antibodies against α-synuclein (red) and calbindin (green) and nuclei were visualized with DAPI (blue). Scale bar: 1,000 μm. 1, 2, 3 and 4 show magnifications of areas indicated in the overview images. DAPI staining is not shown in higher magnification images. arrow: Purkinje cell axon; ML: molecular layer; PCL: Purkinje cell layer; GCL: granule cell layer; WM: white matter. All experiments were not sex-specifically analyzed since group sizes would have been too small for statistical analyses. No obvious differences between male and female 4L/PS-NA mice could be observed.
Discussion
Motor deficits of 4L/PS-NA mice
Here we show for the first time the results of a standardized longitudinal behavioral test battery of 4L/PS-NA mice that are summarized in Table 2. Previously the phenotype of 4L/PS-NA was described to start after the age of 10 weeks presenting gait ataxia, gross shaking and as first symptom a lack of rear limb control that at the age of approximately 20 weeks ends in a complete paralysis [11]. These results seem to be based on cage side observation without quantification or statistical analyses. Here we could show that first signs of motor deficits are already quantitatively measurable starting at 8 week of age and that the observed phenotype progresses over age. With this behavioral test battery it was thus possible to analyze 4L/PS-NA mice for symptoms that are similarly described in GD patients like abnormal gait and bulbar dysfunctions like respiratory problems, dysphagia and altered speech [21–25].
Tab. 2. Summary of health and behavioral changes in 4L/PS-NA mice compared to control animals. Visceral alterations in 4L/PS-NA mice
Analysis of 4L/PS-NA mouse organs revealed a weight increase of most visceral organs. Specifically the liver and spleen of 4L/PS-NA mice showed a strong increase in weight, a pathology that is commonly observed in GD patients [26]. In 4L/PS-NA mice an organ weight increase of about 1.5-fold could be observed, a result that is relatively minor compared to GD patients that can present spleen sizes that are in most patients with a still intact spleen more than 5 times the size compared to healthy controls [26]. The weight of the lung of 4L/PS-NA mice doubled compared control animals, suggesting a strong effect of the genetic alterations on pulmonary pathology. Pulmonary problems are mostly described as rare in GD patients, although a post mortem study revealed pulmonary involvement in all analyzed cases [27]. The weight of the thymus of 4L/PS-NA mice did not significantly change, a finding that seems to fit to the literature, since the thymus is barely mentioned in GD case studies. The observed progressive decrease in thymus weight independent of the genetic alteration is a well-known physiological loss of organ mass, called involution, and associated with a decrease in thymus activity (see review [28] for overview). Evaluation of macrophages and leukocytes in these four analyzed visceral organs revealed a very early onset of leukocyte and macrophage enlargement in lung and thymus, while this effect was delayed in liver and latest seen in spleen. These results are in line with analyses by Sun and colleagues [11], but morphological changes do not relate to the observed tissue weights. Additionally, the strongest phenotype observed in GD patients relates to liver and spleen, both organs that in the mouse model show a delayed symptom onset compared to the lung and thymus that are in patients not that obvious or not at all affected [26]. For an overview of the visceral phenotype see Table 3.
Tab. 3. Summary of visceral changes in 4L/PS-NA mice compared to control animals. Neuronal alterations in 4L/PS-NA mice
Analysis of tissue weight in the brain revealed a weight loss for the cerebellum but not for the whole brain hemisphere, suggesting that the loss is area-specific. A corresponding disorganization and reduction of Purkinje cells could be observed by immunofluorescent labeling as already previously shown by Sun and colleagues [11]. Measurement of GCase activity revealed no significant changes between 4L/PS-NA and control animals. Since both strains contain the homozygous GbaV394L/V394L mutation it was expected that the GCase activity is similarly reduced in both groups. Our results thus show that the GbaV394L/V394L mutation is not sufficient to cause a GD-related phenotype in mice since control mice do not show any neuronal or visceral alterations, a result that is in agreement with previous work by Xu and colleagues [10]. Only in combination with the prosaposin or saposins C reduction, animals present a disease-relevant neuronal and visceral phenotype [11, 29].
Quantification of GlcCer and GlcSph in the cerebellar brain extracts from 4L/PS-NA mice revealed dramatic and age-dependent increases both in the GlcCer and in GlcSph levels. Thus, GlcCer concentrations increased about 18 times in the cerebellum of 18 week old 4L/PS-NA mice as compared to controls at the same age, which is comparable to the reported 23 times increase in 20 week old 4L/PS-NA mice [30]. Even a higher, 32.6-fold increase in the levels of GlcCer d18 : 1/18 : 0 in the cerebellum of 18 week old 4L/PS-NA mice was reported [31]. A possible reason for the difference in the estimated GlcCer ratio between the 4L/PS-NA and control mice could be a lower estimated level of GlcCer in 4L/PS-NA mice, since the mean cerebellar GlcCer levels in the 4L/PS-NA mice reported by [31] were about 145 μg/g, which is similar to the levels of 180 μg/g wet weight measured in our study. The highest levels of GlcSph in the cerebellum of 18 week old 4L/PS-NA mice was in average 8.4 times higher as compared to control mice, which is well in agreement to the reported 9 times higher GlcSph in the 4L/PS-NA of 20 week old mice [30]. Interestingly, almost the same (8.3) fold increase in GlcSph was measured already in 5 week old 4L/PS-NA mice, as compared to only 6.4 times increase in GlcCer levels. This indicates that the abnormal levels of GlcSph in the brain of 4L/PS-NA mice occur already at juvenile age and the ratio to the GlcSph levels in the controls remains constant over the following 3 to 4 months. This finding suggests that GlcSph may serve as a more reliable biomarker to study therapeutic interventions in the 4L/PS-NA mouse model of GD compared to GlcCer, Indeed, plasma GlcSph was recently proposed as a more sensitive and specific biomarker for primary diagnostic and follow-up monitoring in GD patients [12, 32, 33].
Already in 2004, Wong and colleagues showed astrocytosis in hippocampal post mortem tissue of GD patients [16]. Furthermore, Burrow and colleagues could show activated microglia/macrophages by CD68 labeling in the cerebellum, basal ganglia and hippocampus of a GD patient [34]. Evaluations of neuroinflammation in different GD mouse models showed repeatedly strong inflammatory processes [35–37]. In these mouse models, increased proinflammatory markers as well as activated microglia and astrocytosis could be verified and linked to neuronal loss in distinct brain regions [35, 36]. Here we show strong neuroinflammation using activated microglia and astrocytosis marker in the cortex and hippocampus of 12 week old 4L/PS-NA mice. In combination with results of other GD mouse models these results suggest that neuroinflammation is a common and solid phenotype of these animal models. The phenotype should thus be well-suited to evaluate the neuronal effect of new compounds that are expected to influence inflammation and other neuronal phenotypes of the disease.
In recent years GBA1 mutations were repeatedly linked to Parkinson’s disease, suggesting that Parkinson’s disease patients present GBA1 mutations significantly more frequently than healthy control groups [38–40]. Additionally, it was shown that GBA1 mutations can influence the aggregation of α-synuclein in in vitro experiments [41] by its substrate GlcSph [42]. We therefore analyzed 4L/PS-NA mice for α-synuclein in the cerebellum and hippocampus resulting in no major changes between age groups. This result contradicts with previous results of α-synuclein aggregations in 4L/PS-NA mice [13] and the effect of GBA1 downregulation on α-synuclein accumulation [20, 43]. Observed differences might depend on analyzed brain regions or even more likely the used primary α-synuclein antibody. Future studies are thus needed to evaluate if 4L/PS-NA mice indeed show increased α-synuclein accumulations. Such phenotype would allow the use of the mouse model for analysis of GBA-associated Parkinson’s disease.
Histological analyses of the 4L/PS-NA mouse cerebellum and hippocampus revealed strong quantitative changes in calbindin levels compared to control animals. Cerebellar changes and corresponding neuronal symptoms are common in GD patients, especially children [44, 45]. In an animal model with a mutation of the saposin C domain of the prosaposin gene a reduction of Purkinje cells was observed, suggesting that this phenotype depends on the hypomorphic prosaposin levels of 4L/PS-NA mice [46, 47]. For a summary of neuronal changes in 4L/PS-NA mice see Table 4.
Tab. 4. Summary of quantitative neuronal changes in 4L/PS-NA mice compared to control animals. Comparison of 4L/PS-NA mice with other mouse models of Gaucher disease
Researchers struggled for a long time to develop proper mouse models of GD. First attempts were made by developing a mouse model with a targeted disruption of the GBA gene. This intervention caused a strong reduction of the GCase activity but also a very early death of these animals at postnatal day 1 [7, 8]. Several research groups than tried to introduce point mutations into the GBA gene to induce GD. Introduction of the RecNcil mutation caused a strong reduction in GCase activity and accumulations of different substrates in the liver and brain. The same researchers also tested the effect of the GBAL444P mutation in mice that caused a weaker GCase reduction and no substrate accumulations. Interestingly, both models died within 48 hours after birth [9]. Further analysis of different GBA mutations caused either a neonatal lethality (GBAN370S) [10], short survival of 4 weeks with only a minor inflammatory phenotype [48] or no gross phenotype at all (GBAD409H, D409V, V394L) [10]. Another attempt was performed by completely deleting the prosaposin gene that was either neonatally fatal or caused a very rapidly progressing neurological and hepatic phenotype with a maximal survival time of 38 days [6]. A partial rescue of the prosaposin deletion as performed by Sun and colleagues resulted in an extended survival time, depending on the rate of rescue of up to 230 days but in parallel causing an almost complete loss of phenotype [5]. From these studies it was concluded that prosaprosins/saposins need to be reduced below a specific threshold to induce a GD-relevant phenotype in mice [5]. In the here characterized GD mouse model a new approach of reduced prosaposin/saposins expression combined with homozygous Gba1V394L was therefore used, resulting in a strong visceral and neuronal phenotype and a survival time that provides modifiable disease symptoms and an adequate time window for treatment studies, respectively.
Comparison of 4L/PS-NA and human GD phenotype
When comparing the symptoms observed in GD mouse models with the human disease, it becomes obvious that most published models as described above mimic the type 2 GD by having a very short survival time as described for this acute neuronopathic disease form. 4L/PS-NA mice show many of the visceral and neuronal symptoms observed in type 2 and 3 GD but with an extended survival time suggesting that these mice represent type 3 GD, the chronic neuronopathic disease form. Due to the strong similarities in geno - and phenotype of 4L/PS-NA mice compared to type 3 GD, a high translational value for 4L/PS-NA mice can be concluded.
Conclusions
The here presented detailed characterization of 4L/PS-NA mice shows for the first time a quantification of motor deficits over age. Visceral organs like liver, lung and spleen of 4L/PS-NA mice present a strong increase in weight combined with highly enlarged leukocytes and macrophages. The neuronal phenotype of 4L/PS-NA mice is characterized by a reduced glucocerebrosidase activity and at the same time highly increased glucosylceramide and glucosylsphingosine substrate levels. Additionally, a strong neuroinflammation as indicated by astrocytosis and activated microglia in the cortex and hippocampus of 4L/PS-NA mice was found. A detailed analysis of cerebellar tissue revealed tissue weight loss and decreased calbindin levels that are combined with a strong Purkinje cell loss in 4L/PS-NA mice while α-synuclein levels did not change compared to control animals. These results show that 4L/PS-NA mice present a phenotype that is highly comparable to the pathological alterations described for GD patients. 4L/PS-NA mice have therefore a high translational value for the development and analysis of new compounds against this devastating lysosomal storage disease.
Supporting information
S1 Table [xlsx]
Raw data of Figs , , , and .
Zdroje
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- Long term impact of PositiveLinks: Clinic-deployed mobile technology to improve engagement with HIV care
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- A network analysis revealed the essential and common downstream proteins related to inguinal hernia
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- Exploratory analysis of the potential for advanced diagnostic testing to reduce healthcare expenditures of patients hospitalized with meningitis or encephalitis
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- Research on motion planning for an indoor spray arm based on an improved potential field method
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- Detailed analysis of the transverse arch of hallux valgus feet with and without pain using weightbearing ultrasound imaging and precise force sensors
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- Surrogate R-spondins for tissue-specific potentiation of Wnt Signaling
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- Treating patients with driving phobia by virtual reality exposure therapy – a pilot study
- The impact of race relations on NFL attendance: An econometric analysis
- The potential impact of the Affordable Care Act and Medicaid expansion on reducing colorectal cancer screening disparities in African American males
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- Early life experience and alterations of group composition shape the social grooming networks of former pet and entertainment chimpanzees (Pan troglodytes)
- Muscarinic modulation of M and h currents in gerbil spherical bushy cells
- Therapeutic hypothermia after out of hospital cardiac arrest improve 1-year survival rate for selective patients
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- Deep learning based image reconstruction algorithm for limited-angle translational computed tomography
- Subterranean Deuteraphorura Absolon, 1901, (Hexapoda, Collembola) of the Western Carpathians — Troglomorphy at the northern distributional limit in Europe
- Fragmentation and inefficiencies in US equity markets: Evidence from the Dow 30
- Association between coffee drinking and telomere length in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
- Hyperbaric oxygen preconditioning and the role of NADPH oxidase inhibition in postischemic acute kidney injury induced in spontaneously hypertensive rats
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- Aqueous ethanol extract of Libidibia ferrea (Mart. Ex Tul) L.P. Queiroz (juca) exhibits antioxidant and migration-inhibiting activity in human gastric adenocarcinoma (ACP02) cells
- Diagnostic differences in respiratory breathing patterns and work of breathing indices in children with Duchenne muscular dystrophy
- The role of narrative in collaborative reasoning and intelligence analysis: A case study
- Proportions of CD4 test results indicating advanced HIV disease remain consistently high at primary health care facilities across four high HIV burden countries
- Modelling of amino acid turnover in the horse during training and racing: A basis for developing a novel supplementation strategy
- Single-modal and multi-modal false arrhythmia alarm reduction using attention-based convolutional and recurrent neural networks
- Eye-gaze information input based on pupillary response to visual stimulus with luminance modulation
- Predictive value of comb-push ultrasound shear elastography for the differentiation of reactive and metastatic axillary lymph nodes: A preliminary investigation
- Type 1 diabetes is associated with an increased risk of venous thromboembolism: A retrospective population-based cohort study
- Trends of litter decomposition and soil organic matter stocks across forested swamp environments of the southeastern US
- Post mortem evaluation of inflammation, oxidative stress, and PPARγ activation in a nonhuman primate model of cardiac sympathetic neurodegeneration
- Were ancient foxes far more carnivorous than recent ones?—Carnassial morphological evidence
- Disruption in daily eating-fasting and activity-rest cycles in Indian adolescents attending school
- Plasma proteome profiling of freshwater and seawater life stages of rainbow trout (Oncorhynchus mykiss)
- Association between baseline abundance of Peptoniphilus, a Gram-positive anaerobic coccus, and wound healing outcomes of DFUs
- The earliest farming communities north of the Carpathians: The settlement at Gwoździec site 2
- Trends of the prevalence and incidence of hypertrophic cardiomyopathy in Korea: A nationwide population-based cohort study
- Percent amplitude of fluctuation: A simple measure for resting-state fMRI signal at single voxel level
- Antimicrobial activity of Asteraceae species against bacterial pathogens isolated from postmenopausal women
- Designing information provision to serve as a reminder of altruistic benefits: A case study of the risks of air pollution caused by industrialization
- Are changes in depressive symptoms, general health and residential area socio-economic status associated with trajectories of waist circumference and body mass index?
- Extracellular vesicles of U937 macrophage cell line infected with DENV-2 induce activation in endothelial cells EA.hy926
- FlexGraph: Flexible partitioning and storage for scalable graph mining
- Post-weaning infant-to-mother bonding in nutritionally independent female mice
- A little good is good enough: Ethical consumption, cheap excuses, and moral self-licensing
- Link-centric analysis of variation by demographics in mobile phone communication patterns
- Multimodal hand gesture recognition using single IMU and acoustic measurements at wrist
- Variance based weighting of multisensory head rotation signals for verticality perception
- Eligibility for hepatitis B antiviral therapy among adults in the general population in Zambia
- Tobacco smoking and health-related quality of life among university students: Mediating effect of depression
- Drivers of the opioid crisis: An appraisal of financial conflicts of interest in clinical practice guideline panels at the peak of opioid prescribing
- Nutritional inadequacies in commercial vegan foods for dogs and cats
- LTA1 and dmLT enterotoxin-based proteins activate antigen-presenting cells independent of PKA and despite distinct cell entry mechanisms
- The Shapley value for a fair division of group discounts for coordinating cooling loads
- Comparison and evaluation of the morphology of crowns generated by biogeneric design technique with CEREC chairside system
- Assessing risk factors and impact of cyberbullying victimization among university students in Myanmar: A cross-sectional study
- Incidence of hospital-acquired pressure ulcers in patients with "minimal risk" according to the "Norton-MI" scale
- Intra-host symbiont diversity in eastern Pacific cold seep tubeworms identified by the 16S-V6 region, but undetected by the 16S-V4 region
- Lipoprotein(a) plasma levels are not associated with survival after acute coronary syndromes: An observational cohort study
- Use of Nanotrap particles for the capture and enrichment of Zika, chikungunya and dengue viruses in urine
- Pancreatic secretory trypsin inhibitor reduces multi-organ injury caused by gut ischemia/reperfusion in mice
- The effect of diet on the gastrointestinal microbiome of juvenile rehabilitating green turtles (Chelonia mydas)
- Biochemical characterization of Ty1 retrotransposon protease
- Lateral pressure equalisation as a principle for designing support surfaces to prevent deep tissue pressure ulcers
- Immunomodulatory function of the cystic fibrosis modifier gene BPIFA1
- The validation of the Beijing version of the Montreal Cognitive Assessment in Chinese patients undergoing hemodialysis
- All of gene expression (AOE): An integrated index for public gene expression databases
- Characterization of the visceral and neuronal phenotype of 4L/PS-NA mice modeling Gaucher disease
- Inflammasome expression is higher in ovarian tumors than in normal ovary
- HCV genotype profile in Brazil of mono-infected and HIV co-infected individuals: A survey representative of an entire country
- Engaging with change: Information and communication technology professionals’ perspectives on change at the mid-point in the UK/EU Brexit process
- Adherence to iron-folic acid supplement and associated factors among antenatal care attending pregnant mothers in governmental health institutions of Adwa town, Tigray, Ethiopia: Cross-sectional study
- Flower, seed, and fruit development in three Tunisian species of Polygonum: Implications for their taxonomy and evolution of distyly in Polygonaceae
- Development of a risk score for prediction of poor treatment outcomes among patients with multidrug-resistant tuberculosis
- Preclinical evaluation of AT-527, a novel guanosine nucleotide prodrug with potent, pan-genotypic activity against hepatitis C virus
- Aqueous extract from Mangifera indica Linn. (Anacardiaceae) leaves exerts long-term hypoglycemic effect, increases insulin sensitivity and plasma insulin levels on diabetic Wistar rats
- Marine seafood production via intense exploitation and cultivation in China: Costs, benefits, and risks
- Signatures of medical student applicants and academic success
- Discovery of Jogalong virus, a novel hepacivirus identified in a Culex annulirostris (Skuse) mosquito from the Kimberley region of Western Australia
- The effects of extended photoperiod and warmth on hair growth in ponies and horses at different times of year
- Modeling the effect of prolonged ethanol exposure on global gene expression and chromatin accessibility in normal 3D colon organoids
- Clinical, cytogenetic and molecular genetic characterization of a tandem fusion translocation in a male Holstein cattle with congenital hypospadias and a ventricular septal defect
- Severity of misophonia symptoms is associated with worse cognitive control when exposed to misophonia trigger sounds
- Detection of Torque Teno Virus (TTV) and TTV-Like Minivirus in patients with presumed infectious endophthalmitis in India
- CD4 rate of increase is preferred to CD4 threshold for predicting outcomes among virologically suppressed HIV-infected adults on antiretroviral therapy
- The evolution of secondary flow phenomena and their effect on primary shock conditions in shock tubes: Experimentation and numerical model
- Estimating the basic reproduction number of a pathogen in a single host when only a single founder successfully infects
- What drugs modify the risk of iatrogenic impulse-control disorders in Parkinson’s disease? A preliminary pharmacoepidemiologic study
- Evaluating emotional distress and health-related quality of life in patients with heart failure and their family caregivers: Testing dyadic dynamics using the Actor-Partner Interdependence Model
- Community- and trophic-level responses of soil nematodes to removal of a non-native tree at different stages of invasion
- Association of ECG parameters with late gadolinium enhancement and outcome in patients with clinical suspicion of acute or subacute myocarditis referred for CMR imaging
- Sonographic measurement of normal common bile duct diameter and associated factors at the University of Gondar comprehensive specialized hospital and selected private imaging center in Gondar town, North West Ethiopia
- Catchment-scale export of antibiotic resistance genes and bacteria from an agricultural watershed in central Iowa
- Impact of multi-drug resistant bacteria on economic and clinical outcomes of healthcare-associated infections in adults: Systematic review and meta-analysis
- Characterization of a universal screening approach for congenital CMV infection based on a highly-sensitive, quantitative, multiplex real-time PCR assay
- Proof-of-concept for a non-invasive, portable, and wireless device for cardiovascular monitoring in pediatric patients
- On PTV definition for glioblastoma based on fiber tracking of diffusion tensor imaging data
- Multiregional origins of the domesticated tetraploid wheats
- Racism against Totonaco women in Veracruz: Intercultural competences for health professionals are necessary
- Increased inflammation and endothelial markers in patients with late severe post-thrombotic syndrome
- Genes associated with body weight gain and feed intake identified by meta-analysis of the mesenteric fat from crossbred beef steers
- Intraoperative computed tomography imaging for dose calculation in intraoperative electron radiation therapy: Initial clinical observations
- Multiple paedomorphic lineages of soft-substrate burrowing invertebrates: parallels in the origin of Xenocratena and Xenoturbella
- Human lung epithelial BEAS-2B cells exhibit characteristics of mesenchymal stem cells
- Simple non-mydriatic retinal photography is feasible and demonstrates retinal microvascular dilation in Chronic Obstructive Pulmonary Disease (COPD)
- Evaluating poverty alleviation strategies in a developing country
- RNAmountAlign: Efficient software for local, global, semiglobal pairwise and multiple RNA sequence/structure alignment
- Maternal depressive symptoms and children’s cognitive development: Does early childcare and child’s sex matter?
- Pan-cancer analysis of somatic mutations and epigenetic alterations in insulated neighbourhood boundaries
- Evaluation of a bioengineered ACL matrix’s osteointegration with BMP-2 supplementation
- Psychosocial profiles of physical activity fluctuation in office employees: A latent profile analysis
- Prevalence and characteristics of Livestock-Associated Methicillin-Resistant Staphylococcus aureus (LA-MRSA) isolated from chicken meat in the province of Quebec, Canada
- HIV treatment response among female sex workers participating in a treatment as prevention demonstration project in Cotonou, Benin
- Soluble AXL as a marker of disease progression and survival in melanoma
- Using machine learning methods to determine a typology of patients with HIV-HCV infection to be treated with antivirals
- Quantifying tourism booms and the increasing footprint in the Arctic with social media data
- Gender differences influence over insomnia in Korean population: A cross-sectional study
- Impact of scion/rootstock reciprocal effects on metabolomics of fruit juice and phloem sap in grafted Citrus reticulata
- Adapting cognitive diagnosis computerized adaptive testing item selection rules to traditional item response theory
- Usability assessment of seven HIV self-test devices conducted with lay-users in Johannesburg, South Africa
- Autumn shifts in cold tolerance metabolites in overwintering adult mountain pine beetles
- Management of veterinary anaesthesia in small animals: A survey of current practice in Quebec
- Genetic structure of the European hedgehog (Erinaceus europaeus) in Denmark
- Molecular karyotyping of Siberian wild rye (Elymus sibiricus L.) with oligonucleotide fluorescence in situ hybridization (FISH) probes
- Umbilical cord separation time, predictors and healing complications in newborns with dry care
- The strain distribution in the lumbar anterior longitudinal ligament is affected by the loading condition and bony features: An in vitro full-field analysis
- Marine resource congestion in China: Identifying, measuring, and assessing its impact on sustainable development of the marine economy
- Analysis of attitudinal components towards statistics among students from different academic degrees
- Effects of fatigue induced by repeated-sprint on kicking accuracy and velocity in female soccer players
- A pre-clinical validation plan to evaluate analytical sensitivities of molecular diagnostics such as BD MAX MDR-TB, Xpert MTB/Rif Ultra and FluoroType MTB
- Leadership for success in transforming medical abortion policy in Canada
- Clinical correlates associated with the long-term response of bipolar disorder patients to lithium, valproate or lamotrigine: A retrospective study
- Determinants of change in long-acting or permanent contraceptives use in Ethiopia; A multivariate decomposition analysis of data from the Ethiopian demographic and health survey
- Forecasting stock prices with long-short term memory neural network based on attention mechanism
- On the genus Crossaster (Echinodermata: Asteroidea) and its distribution
- Intracellular and in vivo evaluation of imidazo[2,1-b]thiazole-5-carboxamide anti-tuberculosis compounds
- Serum amyloid P component promotes formation of distinct aggregated lysozyme morphologies and reduces toxicity in Drosophila flies expressing F57I lysozyme
- Optogenetically induced cellular habituation in non-neuronal cells
- An integrated vitamin E-coated polymer hybrid nanoplatform: A lucrative option for an enhanced in vitro macrophage retention for an anti-hepatitis B therapeutic prospect
- The effect of strontium and silicon substituted hydroxyapatite electrochemical coatings on bone ingrowth and osseointegration of selective laser sintered porous metal implants
- Modeling the Theory of Planned Behaviour to predict adherence to preventive dental visits in preschool children
- Molecular prevalence of Bartonella, Babesia, and hemotropic Mycoplasma species in dogs with hemangiosarcoma from across the United States
- Color discrimination and gas chromatography-mass spectrometry fingerprint based on chemometrics analysis for the quality evaluation of Schizonepetae Spica
- Comparisons of recurrence-free survival and overall survival between microwave versus radiofrequency ablation treatment for hepatocellular carcinoma: A multiple centers retrospective cohort study with propensity score matching
- Transcriptome-wide identification of novel circular RNAs in soybean in response to low-phosphorus stress
- Oral misoprostol, low dose vaginal misoprostol, and vaginal dinoprostone for labor induction: Randomized controlled trial
- The association between dietary patterns before and in early pregnancy and the risk of gestational diabetes mellitus (GDM): Data from the Malaysian SECOST cohort
- Gene expression noise in a complex artificial toxin expression system
- Dynamic Extreme Aneuploidy (DEA) in the vegetable pathogen Phytophthora capsici and the potential for rapid asexual evolution
- Assertive, trainable and older dogs are perceived as more dominant in multi-dog households
- Prediction of Uropathogens by Flow Cytometry and Dip-stick Test Results of Urine Through Multivariable Logistic Regression Analysis
- Accelerated brain aging towards transcriptional inversion in a zebrafish model of the K115fs mutation of human PSEN2
- Copper to Tuscany – Coals to Newcastle? The dynamics of metalwork exchange in early Italy
- The Brazilian TP53 mutation (R337H) and sarcomas
- Interleukin 6 is increased in preclinical HNSCC models of acquired cetuximab resistance, but is not required for maintenance of resistance
- Detection of amitraz resistance and reduced treatment efficacy in the Varroa Mite, Varroa destructor, within commercial beekeeping operations
- Impact of viral disease hypophagia on pig jejunal function and integrity
- Enzyme response of activated sludge to a mixture of emerging contaminants in continuous exposure
- Molecular evidence for horizontal transmission of chelonid alphaherpesvirus 5 at green turtle (Chelonia mydas) foraging grounds in Queensland, Australia
- Technology anxiety and resistance to change behavioral study of a wearable cardiac warming system using an extended TAM for older adults
- Evaluation and validation of 2D biomechanical models of the knee for radiograph-based preoperative planning in total knee arthroplasty
- Soil-Transmitted Helminth infections reduction in Bhutan: A report of 29 years of deworming
- Age-related differences in the temporal dynamics of spectral power during memory encoding
- cagA gene EPIYA motif genetic characterization from Colombian Helicobacter pylori isolates: Standardization of a molecular test for rapid clinical laboratory detection
- Mugharat an-Nachcharini: A specialized sheep-hunting camp reveals high-altitude habitats in the earliest Neolithic of the Central Levant
- Spectral characteristics of urine from patients with end-stage kidney disease analyzed using Raman Chemometric Urinalysis (Rametrix)
- Clinicians’ communication with patients receiving a MCI diagnosis: The ABIDE project
- Quantitative PCR provides a simple and accessible method for quantitative microbiota profiling
- Fast quantitative time lapse displacement imaging of endothelial cell invasion
- Two novel mutations in MSX1 causing oligodontia
- 7,200 years old constructions and mudbrick technology: The evidence from Tel Tsaf, Jordan Valley, Israel
- Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia
- Dome-shaped macula in children and adolescents
- Barriers in the access, diagnosis and treatment completion for tuberculosis patients in central and western Nepal: A qualitative study among patients, community members and health care workers
- Evaluation of KRAS, NRAS and BRAF mutations detection in plasma using an automated system for patients with metastatic colorectal cancer
- Targeted transcriptomic study of the implication of central metabolic pathways in mannosylerythritol lipids biosynthesis in Pseudozyma antarctica T-34
- Preliminary evidences of the presence of extracellular DNA single stranded forms in soil
- A comparison of quality of life between patients treated with different dialysis modalities in Taiwan
- The effectiveness of substance use interventions for homeless and vulnerably housed persons: A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder
- Spatiotemporal characteristics and driving forces of construction land expansion in Yangtze River economic belt, China
- Comparison of Monocyte Distribution Width (MDW) and Procalcitonin for early recognition of sepsis
- Morphological association between the muscles and bones in the craniofacial region
- Transcriptome analysis of Actinidia chinensis in response to Botryosphaeria dothidea infection
- Evaluating two decision aids for Australian men supporting informed decisions about prostate cancer screening: A randomised controlled trial
- Serum galectins as potential biomarkers of inflammatory bowel diseases
- Linguistic Z-number weighted averaging operators and their application to portfolio selection problem
- Comparative study on skin protection activity of polyphenol-rich extract and polysaccharide-rich extract from Sargassum vachellianum
- Real-world data about emotional stress, disability and need for social care in a German IBD patient cohort
- The regenerative compatibility: A synergy between healthy ecosystems, environmental attitudes, and restorative experiences
- Fusion of augmented reality imaging with the endoscopic view for endonasal skull base surgery; a novel application for surgical navigation based on intraoperative cone beam computed tomography and optical tracking
- Functional characterization of NK cells in Mexican pediatric patients with acute lymphoblastic leukemia: Report from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia
- Radiomics signature for prediction of lateral lymph node metastasis in conventional papillary thyroid carcinoma
- Antenatal depression and its association with adverse birth outcomes in low and middle-income countries: A systematic review and meta-analysis
- Perceptions of risk and influences of choice in pregnant women with obesity. An evidence synthesis of qualitative research
- The role of refugee and migrant migration status on medication adherence: Mediation through illness perceptions
- Job stress and emotional exhaustion at work in Spanish workers: Does unhealthy work affect the decision to drive?
- Correction: Amphibians on the hotspot: Molecular biology and conservation in the South American Atlantic Rainforest
- Sexual risk classes among youth experiencing homelessness: Relation to childhood adversities, current mental symptoms, substance use, and HIV testing
- Time for change is now: Experiences of participants in a community-based approach for iron and folic acid supplementation in a rural county in Kenya, a qualitative study
- Non-invasive genetic monitoring for the threatened valley elderberry longhorn beetle
- Statistical learning for turboshaft helicopter accidents using logistic regression
- Vegetation change over seven years in the largest protected Pacific Northwest Bunchgrass Prairie remnant
- The effect of various metal-salts on the sedimentation of soil in a water-based suspension
- Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: Is there a differential effect by race?
- Effects of CK2β subunit down-regulation on Akt signalling in HK-2 renal cells
- Novel broad-spectrum activity-based probes to profile malarial cysteine proteases
- Health-related quality of life in cancer patients treated with immune checkpoint inhibitors: A systematic review on reporting of methods in randomized controlled trials
- Environmental tobacco smoke (ETS) and hyperlipidemia modified by perceived work stress
- Association between opioid analgesic therapy and initiation of buprenorphine management: An analysis of prescription drug monitoring program data
- Effect of a community-based approach of iron and folic acid supplementation on compliance by pregnant women in Kiambu County, Kenya: A quasi-experimental study
- Radiocarbon dating of two old African baobabs from India
- Improvement project in higher education institutions: A BPEP-based model
- An updated evaluation of serum sHER2, CA15.3, and CEA levels as biomarkers for the response of patients with metastatic breast cancer to trastuzumab-based therapies
- Genome-wide association study of metabolic syndrome in Korean populations
- The diagnostic accuracy of liver fibrosis in non-viral liver diseases using acoustic radiation force impulse elastography: A systematic review and meta-analysis
- Drug therapy problems and treatment satisfaction among ambulatory patients with epilepsy in a specialized hospital in Ethiopia
- Short- & long-term effects of monetary and non-monetary incentives to cooperate in public good games: An experiment
- Niche modeling reveals life history shifts in birds at La Brea over the last twenty millennia
- Morphological consequences of artificial cranial deformation: Modularity and integration
- Distributed flux balance analysis simulations of serial biomass fermentation by two organisms
- Plasma kynurenines and prognosis in patients with heart failure
- Occurrence and distribution of anthropogenic persistent organic pollutants in coastal sediments and mud shrimps from the wetland of central Taiwan
- Intensified visual clutter induces increased sympathetic signalling, poorer postural control, and faster torsional eye movements during visual rotation
- Restoration of cortical symmetry and binaural function: Cortical auditory evoked responses in adult cochlear implant users with single sided deafness
- A smartphone-enabled wireless and batteryless implantable blood flow sensor for remote monitoring of prosthetic heart valve function
- Gut microbiota composition alterations are associated with the onset of diabetes in kidney transplant recipients
- Shock index and TIMI risk index as valuable prognostic tools in patients with acute coronary syndrome complicated by cardiogenic shock
- Merit overrules theory of mind when young children share resources with others
- Economic burden of maternal morbidity – A systematic review of cost-of-illness studies
- Comparison of balance changes after inspiratory muscle or Otago exercise training
- Correction: Escherichia coli and Salmonella spp. isolated from Australian meat chickens remain susceptible to critically important antimicrobial agents
- Metabolic analysis of amino acids and vitamin B6 pathways in lymphoma survivors with cancer related chronic fatigue
- Cell-free DNA donor fraction analysis in pediatric and adult heart transplant patients by multiplexed allele-specific quantitative PCR: Validation of a rapid and highly sensitive clinical test for stratification of rejection probability
- Immunopathogenesis of canine chronic ulcerative stomatitis
- Correction: Quantification of speech and synchrony in the conversation of adults with autism spectrum disorder
- Efficacy and safety of ultrasonic circular cyclocoagulation with second-generation probe in glaucoma: A retrospective study
- Generalizing findings from a randomized controlled trial to a real-world study of the iLookOut, an online education program to improve early childhood care and education providers’ knowledge and attitudes about reporting child maltreatment
- Self-selection of food ingredients and agricultural by-products by the house cricket, Acheta domesticus (Orthoptera: Gryllidae): A holistic approach to develop optimized diets
- Machine learning detection of Atrial Fibrillation using wearable technology
- Comparative proteomic analysis of different stages of breast cancer tissues using ultra high performance liquid chromatography tandem mass spectrometer
- A cross-sectional study of psychopathy and khat abuse among prisoners in the correctional institution in Jimma, Ethiopia
- Head impulse compensatory saccades: Visual dependence is most evident in bilateral vestibular loss
- Complementarity of empirical and process-based approaches to modelling mosquito population dynamics with Aedes albopictus as an example—Application to the development of an operational mapping tool of vector populations
- Pepsin promotes laryngopharyngeal neoplasia by modulating signaling pathways to induce cell proliferation
- When and what to test for: A cost-effectiveness analysis of febrile illness test-and-treat strategies in the era of responsible antibiotic use
- Comparison of effects and safety in providing controlled hypotension during surgery between dexmedetomidine and magnesium sulphate: A meta-analysis of randomized controlled trials
- The gene encoding the ketogenic enzyme HMGCS2 displays a unique expression during gonad development in mice
- Seroepidemiological study of rubella in Vojvodina, Serbia: 24 years after the introduction of the MMR vaccine in the national immunization programme
- Efficacy of a mitochondrion-targeting agent for reducing the level of urinary protein in rats with puromycin aminonucleoside-induced minimal-change nephrotic syndrome
- Association of endothelial nitric oxide synthase (NOS3) gene polymorphisms with primary open-angle glaucoma in a Saudi cohort
- Antitrust analysis with upward pricing pressure and cost efficiencies
- Machine learning models for identifying preterm infants at risk of cerebral hemorrhage
- Natural selection contributes to food web stability
- Pyramiding QTLs controlling tolerance against drought, salinity, and submergence in rice through marker assisted breeding
- Diversity and plant growth-promoting functions of diazotrophic/N-scavenging bacteria isolated from the soils and rhizospheres of two species of Solanum
- Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression
- Sofosbuvir-based regimen for genotype 2 HCV infected patients in Taiwan: A real world experience
- The virulence domain of Shigella IcsA contains a subregion with specific host cell adhesion function
- Sequencing artifacts derived from a library preparation method using enzymatic fragmentation
- Analysis of the Rdr1 gene family in different Rosaceae genomes reveals an origin of an R-gene cluster after the split of Rubeae within the Rosoideae subfamily
- Concomitant phytonutrient and transcriptome analysis of mature fruit and leaf tissues of tomato (Solanum lycopersicum L. cv. Oregon Spring) grown using organic and conventional fertilizer
- Quantitative analysis of adsorption and desorption of volatile organic compounds on reusable zeolite filters using gas chromatography
- Comparing bioinformatic pipelines for microbial 16S rRNA amplicon sequencing
- TMEM98 is a negative regulator of FRAT mediated Wnt/ß-catenin signalling
- Modeling migration patterns in the USA under sea level rise
- Quo vadis Pantanal? Expected precipitation extremes and drought dynamics from changing sea surface temperature
- Cloud-computing and machine learning in support of country-level land cover and ecosystem extent mapping in Liberia and Gabon
- An exploratory study on the quality of patient screening and counseling for hypertension management in Tanzania
- Relation of fibroblast growth factor receptor 2 expression to hepatocellular carcinoma recurrence after liver resection
- The Brief Measure of Emotional Preoperative Stress (B-MEPS) as a new predictive tool for postoperative pain: A prospective observational cohort study
- The impact of diabetes mellitus medication on the incidence of endogenous endophthalmitis
- Correction: Chl1 DNA helicase and Scc2 function in chromosome condensation through cohesin deposition
- Clinical and pathological features of thrombotic microangiopathy influencing long-term kidney transplant outcomes
- Multidisciplinary investigation of two Egyptian child mummies curated at the University of Tartu Art Museum, Estonia (Late/Graeco-Roman Periods)
- Occupational exposure to particulate matter from air pollution in the outdoor workplaces in Almaty during the cold season
- Morphological adjustment in free-living Steinernema feltiae infective juveniles to increasing concentration of Nemafric-BL phytonematicide
- Murine Surf4 is essential for early embryonic development
- Using mHealth to improve health care delivery in India: A qualitative examination of the perspectives of community health workers and beneficiaries
- Algorithmic handwriting analysis of the Samaria inscriptions illuminates bureaucratic apparatus in biblical Israel
- Key necroptotic proteins are required for Smac mimetic-mediated sensitization of cholangiocarcinoma cells to TNF-α and chemotherapeutic gemcitabine-induced necroptosis
- Concurrent lipidomics and proteomics on malignant plasma cells from multiple myeloma patients: Probing the lipid metabolome
- Short treatment with antalarmin alters adrenal gland receptors in the rat model of endometriosis
- Is it really always only the others who are to blame? GP’s view on medical overuse. A questionnaire study
- Serum visfatin and vaspin levels in hepatocellular carcinoma (HCC)
- Retraction: SDR9C7 Promotes Lymph Node Metastases in Patients with Esophageal Squamous Cell Carcinoma
- iTRAQ proteomics reveals the regulatory response to Magnaporthe oryzae in durable resistant vs. susceptible rice genotypes
- A smartphone-based test for the assessment of attention deficits in delirium: A case-control diagnostic test accuracy study in older hospitalised patients
- Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: A systematic review and meta-analysis
- Incidence and predictors of loss to follow up among adult HIV patients on antiretroviral therapy in University of Gondar Comprehensive Specialized Hospital: A competing risk regression modeling
- Point-of-care diagnostic (POCD) method for detecting Bursaphelenchus xylophilus in pinewood using recombinase polymerase amplification (RPA) with the portable optical isothermal device (POID)
- Bioluminescent imaging of Arabidopsis thaliana using an enhanced Nano-lantern luminescence reporter system
- Biosynthetic pathway of indole-3-acetic acid in ectomycorrhizal fungi collected from northern Thailand
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- Downscaling NLDAS-2 daily maximum air temperatures using MODIS land surface temperatures
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- Plasma Trimethylamine-N-oxide and impaired glucose regulation: Results from The Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS)
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- Role of donor genotype in RT-QuIC seeding activity of chronic wasting disease prions using human and bank vole substrates
- Influence of flow on phosphorus-dynamics and particle size in agricultural drainage ditch sediments
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- Predictive validation and forecasts of short-term changes in healthcare expenditure associated with changes in smoking behavior in the United States
- An information-based approach to handle various types of uncertainty in fuzzy bodies of evidence
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- Health care professionals’ knowledge of commonly used sedative, analgesic and neuromuscular drugs: A single center (Rambam Health Care Campus), prospective, observational survey
- Campylobacter portucalensis sp. nov., a new species of Campylobacter isolated from the preputial mucosa of bulls
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- Transgenic interleukin 11 expression causes cross-tissue fibro-inflammation and an inflammatory bowel phenotype in mice
- Novel method to measure temporal windows based on eye movements during viewing of the Necker cube
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- Effects of smoke flavoring using different wood chips and barbecuing on the formation of polycyclic aromatic hydrocarbons and heterocyclic aromatic amines in salmon fillets
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- The role of peer, parental, and school norms in predicting adolescents’ attitudes and behaviours of majority and different minority ethnic groups in Croatia
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- The impact of rehabilitation frequency on the risk of stroke in patients with rheumatoid arthritis
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- The effect of mutations derived from mouse-adapted H3N2 seasonal influenza A virus to pathogenicity and host adaptation
- Detection of posttraumatic pneumothorax using electrical impedance tomography—An observer-blinded study in pigs with blunt chest trauma
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- Community’s perception, experiences and health seeking behavior towards newborn illnesses in Debre Libanos District, North Shoa, Oromia, Ethiopia: Qualitative study
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- Reanalysis of the Bridge et al. study of suicide following release of 13 Reasons Why
- Validation of the easyscreen flavivirus dengue alphavirus detection kit based on 3base amplification technology and its application to the 2016/17 Vanuatu dengue outbreak
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- Bioreactor for mobilization of mesenchymal stem/stromal cells into scaffolds under mechanical stimulation: Preliminary results
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- Real-world effectiveness and safety of ranibizumab for the treatment of myopic choroidal neovascularization: Results from the LUMINOUS study
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- The 24-hour urinary cortisol in post-traumatic stress disorder: A meta-analysis
- Parasites modulate the gut-microbiome in insects: A proof-of-concept study
- The dynamics of shapes of vesicle membranes with time dependent spontaneous curvature
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- The shield of self-compassion: A buffer against disordered eating risk from physical appearance perfectionism
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- Drug-eluting versus bare-metal stents for first myocardial infarction in patients with atrial fibrillation: A nationwide population-based cohort study
- Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data
- Health-related quality of life among patients with type 2 diabetes mellitus in Eastern Province, Saudi Arabia: A cross-sectional study
- Photocatalytic biocidal effect of copper doped TiO2 nanotube coated surfaces under laminar flow, illuminated with UVA light on Legionella pneumophila
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- Insights into the strategy of micro-environmental adaptation: Transcriptomic analysis of two alvinocaridid shrimps at a hydrothermal vent
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- The effect of long-term brine discharge from desalination plants on benthic foraminifera
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- Significant changes in synovial fluid microRNAs after high tibial osteotomy in medial compartmental knee osteoarthritis: Identification of potential prognostic biomarkers
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- Ischemia and reperfusion injury in superficial inferior epigastric artery-based vascularized lymph node flaps
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- Switchable resolution in soft x-ray tomography of single cells
- Mitochondrial DNA variations and mitochondrial dysfunction in Fanconi anemia
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- Sex differences in self-regulation in early, middle and late adolescence: A large-scale cross-sectional study
- Interaction between elevated temperature and different types of Na-salicylate treatment in Brachypodium dystachion
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- A brain connectivity characterization of children with different levels of mathematical achievement based on graph metrics
- Quantifying the level of difficulty to treat major depressive disorder with antidepressants: Treatment Resistance to Antidepressants Evaluation Scale
- Occupational gender segregation and economic growth in U.S. local labor markets, 1980 through 2010
- The association of telomere length and telomerase activity with adverse outcomes in older patients with non-ST-elevation acute coronary syndrome
- Construction of a high-density genetic map and fine mapping of a candidate gene locus for a novel branched-spike mutant in barley
- Alterations of aqueous humor Aβ levels in Aβ-infused and transgenic mouse models of Alzheimer disease
- Parameters impacting the live birth rate per transfer after frozen single euploid blastocyst transfer
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- Economic compensation interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review and meta-analysis
- Distinctive effect of anesthetics on the effect of limb remote ischemic postconditioning following ischemic stroke
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- What is the qualitative evidence concerning the risks, diagnosis, management and consequences of gastrointestinal infections in the community in the United Kingdom? A systematic review and meta-ethnography
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- Key barriers and enablers associated with uptake and continuation of oral pre-exposure prophylaxis (PrEP) in the public sector in Zimbabwe: Qualitative perspectives of general population clients at high risk for HIV
- Characterizing the University of California’s tenure-track teaching position from the faculty and administrator perspectives
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- Diagnostic performance of serum interferon gamma, matrix metalloproteinases, and periostin measurements for pulmonary tuberculosis in Japanese patients with pneumonia
- Hesperidin improves insulin resistance via down-regulation of inflammatory responses: Biochemical analysis and in silico validation
- Accuracy of intraocular lens power calculation formulas using a swept-source optical biometer
- Characterization of black patina from the Tiber River embankments using Next-Generation Sequencing
- Comparison of blood lactate and perceived exertion responses in two matched time-under-tension protocols
- Fibrin hydrogels are safe, degradable scaffolds for sub-retinal implantation
- Post-translational modifications of Drosophila melanogaster HOX protein, Sex combs reduced
- Problem gambling, associations with comorbid health conditions, substance use, and behavioural addictions: Opportunities for pathways to treatment
- Liganded T3 receptor β2 inhibits the positive feedback autoregulation of the gene for GATA2, a transcription factor critical for thyrotropin production
- Characterization of METTL16 as a cytoplasmic RNA binding protein
- Impact of long-term storage and freeze-thawing on eight circulating microRNAs in plasma samples
- Nanosheet wrapping-assisted coverslip-free imaging for looking deeper into a tissue at high resolution
- Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?
- Early diagnosis of sepsis in emergency departments, time to treatment, and association with mortality: An observational study
- Validity of cerebrovascular ICD-9-CM codes in healthcare administrative databases. The Umbria Data-Value Project
- Tuberculoid leprosy: An in vivo microvascular evaluation of cutaneous lesions
- Neuromuscular blockers in the acute respiratory distress syndrome: A meta-analysis
- Identification of putative Type-I sex pheromone biosynthesis-related genes expressed in the female pheromone gland of Streltzoviella insularis
- Redefining transcriptional regulation of the APOE gene and its association with Alzheimer’s disease
- Disease-relevant mutations alter amino acid co-evolution networks in the second nucleotide binding domain of CFTR
- A bushel of viruses: Identification of seventeen novel putative viruses by RNA-seq in six apple trees
- Torque teno virus viral load is related to age, CMV infection and HLA type but not to Alzheimer's disease
- The variability of bacterial communities in both the endosphere and ectosphere of different niches in Chinese chives (Allium tuberosum)
- Tripartite factors leading to molecular divergence between human and murine smooth muscle
- Characterization of dermal skin innervation in fibromyalgia syndrome
- A neonatal nonhuman primate model of gestational Zika virus infection with evidence of microencephaly, seizures and cardiomyopathy
- A scoping review of importation and predictive models related to vector-borne diseases, pathogens, reservoirs, or vectors (1999–2016)
- Assessment of climate change impact on the malaria vector Anopheles hyrcanus, West Nile disease, and incidence of melanoma in the Vojvodina Province (Serbia) using data from a regional climate model
- Associations of cigarette smoking and burden of thoracic aortic calcification in asymptomatic individuals: A dose-response relationship
- Healthcare utilization of Mexican-American Medicare beneficiaries with and without Alzheimer’s disease and related dementias
- Evaluation of questionnaire as an instrument to measure the level of nutritional and weight gain knowledge in pregnant women in Poland. A pilot study
- TranCEP: Predicting the substrate class of transmembrane transport proteins using compositional, evolutionary, and positional information
- Non-Invasive Functional-Brain-Imaging with an OPM-based Magnetoencephalography System
- Expression of acyl-CoA-binding protein 5 from Rhodnius prolixus and its inhibition by RNA interference
- Transforming assessment of speech in children with cleft palate via online crowdsourcing
- High prevalence of off-label and unlicensed paediatric prescribing in a hospital in Indonesia during the period Aug.—Oct. 2014
- General practice management of rotator cuff related shoulder pain: A reliance on ultrasound and injection guided care
- Estimating the population size of female sex workers and transgender women in Sri Lanka
- Can helmet decrease mortality of craniocerebral trauma patients in a motorcycle accident?: A propensity score matching
- Obesity, smoking habits, and serum phosphate levels predicts mortality after life-style intervention
- Treatment of children under 4 years of age with medulloblastoma and ependymoma in the HIT2000/HIT-REZ 2005 trials: Neuropsychological outcome 5 years after treatment
- Can a semi-quantitative method replace the current quantitative method for the annual screening of microalbuminuria in patients with diabetes? Diagnostic accuracy and cost-saving analysis considering the potential health burden
- A two-arm parallel double-blind randomised controlled pilot trial of the efficacy of Omega-3 polyunsaturated fatty acids for the treatment of women with endometriosis-associated pain (PurFECT1)
- Association of benzodiazepines, opioids and tricyclic antidepressants use and falls in trauma patients: Conditional effect of age
- Burden and risk factors of cutaneous leishmaniasis in a peri-urban settlement in Kenya, 2016
- Predicting strike susceptibility and collision patterns of the common buzzard at wind turbine structures in the federal state of Brandenburg, Germany
- Embryonic thermal manipulation has short and long-term effects on the development and the physiology of the Japanese quail
- High-order radiomics features based on T2 FLAIR MRI predict multiple glioma immunohistochemical features: A more precise and personalized gliomas management
- Human-raptor conflict in rural settlements of Colombia
- Regional adaptations and parallel mutations in Feline panleukopenia virus strains from China revealed by nearly-full length genome analysis
- Long-term ecological research in southern Brazil grasslands: Effects of grazing exclusion and deferred grazing on plant and arthropod communities
- Assessment of peritoneal microbial features and tumor marker levels as potential diagnostic tools for ovarian cancer
- Survival analysis of 230 patients with unresectable hepatocellular carcinoma treated with bland transarterial embolization
- Adverse drug reaction reporting practice and associated factors among medical doctors in government hospitals in Addis Ababa, Ethiopia
- TaWAK6 encoding wall-associated kinase is involved in wheat resistance to leaf rust similar to adult plant resistance
- Deficiency syndromes in top predators associated with large-scale changes in the Baltic Sea ecosystem
- The inhibitor of apoptosis proteins antagonist Debio 1143 promotes the PD-1 blockade-mediated HIV load reduction in blood and tissues of humanized mice
- Allele specific expression of Dof genes responding to hormones and abiotic stresses in sugarcane
- Perceived relative social status and cognitive load influence acceptance of unfair offers in the Ultimatum Game
- Quantitative evaluation of choriocapillaris using optical coherence tomography and optical coherence tomography angiography in patients with central serous chorioretinopathy after half-dose photodynamic therapy
- Structure-function analyses of candidate small molecule RPN13 inhibitors with antitumor properties
- Extracting lung function measurements to enhance phenotyping of chronic obstructive pulmonary disease (COPD) in an electronic health record using automated tools
- Multiple fragmented habitat-patch use in an urban breeding passerine, the Short-toed Treecreeper
- Histological and immunohistochemical characterization of the porcine ocular surface
- Household environmental tobacco smoke exposure in healthy young children in Hong Kong: Prevalence and risk factors
- Wind energy development and wildlife conservation in Lithuania: A mapping tool for conflict assessment
- Characteristics and prognosis of primary treatment-naïve oral cavity squamous cell carcinoma in Norway, a descriptive retrospective study
- Effect of epoch length on intensity classification and on accuracy of measurement under controlled conditions on treadmill: Towards a better understanding of accelerometer measurement
- Peer distribution of HIV self-test kits to men who have sex with men to identify undiagnosed HIV infection in Uganda: A pilot study
- Error rates of human reviewers during abstract screening in systematic reviews
- Faecal analyses and alimentary tracers reveal the foraging ecology of two sympatric bats
- Urethral realignment with maximal urethral length and bladder neck preservation in robot-assisted radical prostatectomy: Urinary continence recovery
- Error metrics determination in functionally approximated circuits using SAT solvers
- Spatial movement pattern recognition in soccer based on relative player movements
- A novel visual ranking system based on arterial spin labeling perfusion imaging for evaluating perfusion disturbance in patients with ischemic stroke
- Prospective Validation of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score for Necrotizing Fasciitis of the Extremities
- The importance of transporters and cell polarization for the evaluation of human stem cell-derived hepatic cells
- Incidence, trends, and outcomes of infection sites among hospitalizations of sepsis: A nationwide study
- Morphological and functional characteristics of mitral annular calcification and their relationship to stroke
- And the nominees are: Using design-awards datasets to build computational aesthetic evaluation model
- Service delivery interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review
- Multidimensional Scales of Perceived Self-Efficacy (MSPSE): Measurement invariance across Italian and Colombian adolescents
- Diversity of Mycobacteriaceae from aquatic environment at the São Paulo Zoological Park Foundation in Brazil
- A graph-based algorithm for RNA-seq data normalization
- Parents’ underestimation of their child’s weight status. Moderating factors and change over time: A cross-sectional study
- Pharmacokinetics, absolute bioavailability and tolerability of ketamine after intranasal administration to dexmedetomidine sedated dogs
- Spatial variation in fertilizer prices in Sub-Saharan Africa
- Knowledge, beliefs, and concerns about bone health from a systematic review and metasynthesis of qualitative studies
- Successful isolation of Treponema pallidum strains from patients’ cryopreserved ulcer exudate using the rabbit model
- Effects of size and elasticity on the relation between flow velocity and wall shear stress in side-wall aneurysms: A lattice Boltzmann-based computer simulation study
- Pupil response to noxious corneal stimulation
- Incidence, risk factors and healthcare costs of central line-associated nosocomial bloodstream infections in hematologic and oncologic patients
- The impact of computed radiography and teleradiology on patients’ diagnosis and treatment in Mweso, the Democratic Republic of Congo
- Differential effects of synthetic psychoactive cathinones and amphetamine stimulants on the gut microbiome in mice
- Hepatitis B and C virus infection among HIV patients within the public and private healthcare systems in Chile: A cross-sectional serosurvey
- Increased episodes of aspiration on videofluoroscopic swallow study in children with nasogastric tube placement
- Obstructive sleep apnea and hypopnea syndrome in patients admitted in a tertiary hospital in Cameroon: Prevalence and associated factors
- Association of single nucleotide polymorphisms with dyslipidemia in antiretroviral exposed HIV patients in a Ghanaian population: A case-control study
- Sonic Hedgehog upregulation does not enhance the survival and engraftment of stem cell-derived cardiomyocytes in infarcted hearts
- The pharmacokinetic parameters and the effect of a single and repeated doses of memantine on gastric myoelectric activity in experimental pigs
- Blind method for discovering number of clusters in multidimensional datasets by regression on linkage hierarchies generated from random data
- Predictive factors of first dosage intravenous immunoglobulin-related adverse effects in children
- Description and characterization of the artisanal elasmobranch fishery on Guatemala’s Caribbean coast
- Individual and community level determinants of short birth interval in Ethiopia: A multilevel analysis
- Effects of rejection intensity and rejection sensitivity on social approach behavior in women
- The impact of IoT security labelling on consumer product choice and willingness to pay
- The development and validation of a measurement instrument to investigate determinants of health care utilisation for low back pain in Ethiopia
- Validity of the French version of the Autonomy Preference Index and its adaptation for patients with advanced cancer
- The epidemiological characteristics and spatio-temporal analysis of childhood hand, foot and mouth disease in Korea, 2011-2017
- Exponential random graph model parameter estimation for very large directed networks
- The implementation of community-based diabetes and hypertension management care program in Indonesia
- Effect of temperature variation on hospital admissions and outcomes in dogs with myxomatous mitral valve disease and new onset pulmonary edema
- The development of the Police Practices Scale: Understanding policing approaches towards street-based female sex workers in a U.S. City
- A capability approach to assess aquaculture sustainability standard compliance
- Pre-collecting lymphatic vessels form detours following obstruction of lymphatic flow and function as collecting lymphatic vessels
- Construct validity and reliability of the Talent Development Environment Questionnaire in Caribbean youth track and field athletes
- Optimization of cytotoxic activity of Nocardia sp culture broths using a design of experiments
- Tissue-resident macrophages can be generated de novo in adult human skin from resident progenitor cells during substance P-mediated neurogenic inflammation ex vivo
- Microbiota in foods from Inuit traditional hunting
- Investigating Italian disinformation spreading on Twitter in the context of 2019 European elections
- In vivo expression of peptidylarginine deiminase in Drosophila melanogaster
- Modelling zero-truncated overdispersed antenatal health care count data of women in Bangladesh
- Detection and density of breeding marsh birds in Iowa wetlands
- A lineage-specific rapid diagnostic test (Chagas Sero K-SeT) identifies Brazilian Trypanosoma cruzi II/V/VI reservoir hosts among diverse mammalian orders
- Aromatase deficiency in hematopoietic cells improves glucose tolerance in male mice through skeletal muscle-specific effects
- If host is refractory, insistent parasite goes berserk: Trypanosomatid Blastocrithidia raabei in the dock bug Coreus marginatus
- Antimicrobial resistance patterns and molecular resistance markers of Campylobacter jejuni isolates from human diarrheal cases
- Protective role of brain derived neurotrophic factor (BDNF) in obstructive sleep apnea syndrome (OSAS) patients
- An IL-18-centered inflammatory network as a biomarker for cerebral white matter injury
- Prevalence of antiphospholipid antibodies in Behçet's disease: A systematic review and meta-analysis
- Chemical analysis of snus products from the United States and northern Europe
- Effect of prednisolone on glyoxalase 1 in an inbred mouse model of aristolochic acid nephropathy using a proteomics method with fluorogenic derivatization-liquid chromatography-tandem mass spectrometry
- Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study
- Aggregation of CAT tails blocks their degradation and causes proteotoxicity in S. cerevisiae
- Expression of concern: Compensatory increase of transglutaminase 2 is responsible for resistance to mTOR inhibitor treatment
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- Staging dementia based on caregiver reported patient symptoms: Implications from a latent class analysis
- Health-related quality of life and its determinants among ambulatory patients with epilepsy at Ambo General Hospital, Ethiopia: Using WHOQOL-BREF
- In silico analysis and high-risk pathogenic phenotype predictions of non-synonymous single nucleotide polymorphisms in human Crystallin beta A4 gene associated with congenital cataract
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- Referral decisions and its predictors related to orthopaedic care. A retrospective study in a novel primary care setting
- Readiness to prescribe: Using educational design to untie the Gordian Knot
- Influence of gelation on the retention of purple cactus pear extract in microencapsulated double emulsions
- Factors related to met needs for rehabilitation 6 years after stroke
- Association of cataract and sun exposure in geographically diverse populations of India: The CASE study. First Report of the ICMR-EYE SEE Study Group
- Investigation of injury severity in urban expressway crashes: A case study from Beijing
- Clinical outcomes of incident peritoneal dialysis patients coming from kidney transplantation program: A case-control study
- Evaluation of the factors influencing the housing safety awareness of residents in Shanghai
- Morphometric study of the diaphragmatic surface of the liver in the human fetus
- Food insecurity and dietary diversity among lactating mothers in the urban municipality in the mountains of Nepal
- Genetic characterization of Bacillus anthracis strains circulating in Italy from 1972 to 2018
- Promising antifungal activity of new oxadiazole against Candida krusei
- An atlas of personality, emotion and behaviour
- Long-term effects of intracranial islet grafting on cognitive functioning in a rat metabolic model of sporadic Alzheimer's disease-like dementia
- Compartmentalized profiling of amniotic fluid cytokines in women with preterm labor
- Comparison of the myometrial transcriptome from singleton and twin pregnancies by RNA-Seq
- Adverse reproductive effects of S100A9 on bovine sperm and early embryonic development in vitro
- Functional dynamics of bacterial species in the mouse gut microbiome revealed by metagenomic and metatranscriptomic analyses
- Astrocyte senescence promotes glutamate toxicity in cortical neurons
- Primary ciliary dyskinesia and psychological well-being in adolescence
- Dipeptidyl peptidase-4 is increased in the abdominal aortic aneurysm vessel wall and is associated with aneurysm disease processes
- Primary care physician knowledge, attitudes, and diagnostic testing practices for norovirus and acute gastroenteritis
- Microfluidic-prepared DOTAP nanoparticles induce strong T-cell responses in mice
- Intraocular scattering as a predictor of driving performance in older adults with cataracts
- Reduced bone mineral density among HIV infected patients on anti-retroviral therapy in Blantyre, Malawi: Prevalence and associated factors
- Correction: Extraversion personality, perceived health and activity participation among community-dwelling aging adults in Hong Kong
- A rainwater control optimization design approach for airports based on a self-organizing feature map neural network model
- Influence of inflammasome NLRP3, and IL1B and IL2 gene polymorphisms in periodontitis susceptibility
- 18F-FDG-PET/MRI in the diagnostic work-up of limbic encephalitis
- The socioeconomic impact of orthopaedic trauma: A systematic review and meta-analysis
- Treatment patterns among patients with moderate-to-severe ulcerative colitis in the United States and Europe
- City to city learning and knowledge exchange for climate resilience in southern Africa
- Nuclear translocation of Atox1 potentiates activin A-induced cell migration and colony formation in colon cancer
- Activity-dependent switches between dynamic regimes of extracellular matrix expression
- Molecular sequencing and morphological identification reveal similar patterns in native bee communities across public and private grasslands of eastern North Dakota
- A mathematical model for assessing the effectiveness of controlling relapse in Plasmodium vivax malaria endemic in the Republic of Korea
- Cryo-focused ion beam preparation of perovskite based solar cells for atom probe tomography
- Physiological and transcriptomic responses of Lanzhou Lily (Lilium davidii, var. unicolor) to cold stress
- Unusual genome expansion and transcription suppression in ectomycorrhizal Tricholoma matsutake by insertions of transposable elements
- Estimating associations between antidepressant use and incident mild cognitive impairment in older adults with depression
- The use of telephone communication between nurse navigators and their patients
- CNP mediated selective toxicity on melanoma cells is accompanied by mitochondrial dysfunction
- HIV RNA measurement in dried blood spots of HIV-infected patients in Thailand using Abbott m2000 system
- Retraction: Oncogenic Fibulin-5 Promotes Nasopharyngeal Carcinoma Cell Metastasis through the FLJ10540/AKT Pathway and Correlates with Poor Prognosis
- Ultra-rapid cooling of ibex sperm by spheres method does not induce a vitreous extracellular state and increases the membrane damages
- Some animals are more equal than others: Validation of a new scale to measure how attitudes to animals depend on species and human purpose of use
- Observation and quantification of the morphological effect of trypan blue rupturing dead or dying cells
- The visual perception of emotion from masks
- Hexavalent chromium removal and total chromium biosorption from aqueous solution by Quercus crassipes acorn shell in a continuous up-flow fixed-bed column: Influencing parameters, kinetics, and mechanism
- The predictive value of anthropometric indices for cardiometabolic risk factors in Chinese children and adolescents: A national multicenter school-based study
- Lean back and wait for the alarm? Testing an automated alarm system for nosocomial outbreaks to provide support for infection control professionals
- Regional disparities in health care resources in traditional Chinese medicine county hospitals in China
- Analysis on hydraulic characteristics of improved sandy soil with soft rock
- Development and use of a scale to assess gender differences in appraisal of mistreatment during childbirth among Ethiopian midwifery students
- Factors for starting biosimilar TNF inhibitors in patients with rheumatic diseases in the real world
- Correction: Force field generalization and the internal representation of motor learning
- Prevalence and foetomaternal effects of iron deficiency anaemia among pregnant women in Lagos, Nigeria
- Socioeconomic risk factors for fatal opioid overdoses in the United States: Findings from the Mortality Disparities in American Communities Study (MDAC)
- Microbiome signatures in neonatal central line associated bloodstream infections
- Interventions for incarcerated adults with opioid use disorder in the United States: A systematic review with a focus on social determinants of health
- Opening gap width influences distal tibial rotation below the osteotomy site following open wedge high tibial osteotomy
- The impact of lowbush blueberry (Vaccinium angustifolium Ait.) and cranberry (Vaccinium macrocarpon Ait.) pollination on honey bee (Apis mellifera L.) colony health status
- Surveys of knowledge and awareness of antibiotic use and antimicrobial resistance in general population: A systematic review
- Managerial capacity among district health managers and its association with district performance: A comparative descriptive study of six districts in the Eastern Region of Ghana
- Knee joint distraction in regular care for treatment of knee osteoarthritis: A comparison with clinical trial data
- Reconstruction of a regulated two-cell metabolic model to study biohydrogen production in a diazotrophic cyanobacterium Anabaena variabilis ATCC 29413
- Cochlear dysfunction is associated with styrene exposure in humans
- Intra-individual variation of particles in exhaled air and of the contents of Surfactant protein A and albumin
- Revisits, readmissions, and outcomes for pediatric traumatic brain injury in California, 2005-2014
- Enhanced handover mechanism using mobility prediction in wireless networks
- Association between regular exercise and asthma control among adults: The population-based Northern Finnish Asthma Study
- Pharyngeal microbiome alterations during Neisseria gonorrhoeae infection
- Assessment of the clinical utility of four NGS panels in myeloid malignancies. Suggestions for NGS panel choice or design
- Assessment of time management practice and associated factors among primary hospitals employees in north Gondar, northwest Ethiopia
- Genetic diversity and population structure of feral rapeseed (Brassica napus L.) in Japan
- Are the current gRNA ranking prediction algorithms useful for genome editing in plants?
- Difference between physical therapist estimation and psychological patient-reported outcome measures in patients with low back pain
- Heterogeneity in the distribution of 159 drug-response related SNPs in world populations and their genetic relatedness
- Metabolic and lipidomic profiling of steatotic human livers during ex situ normothermic machine perfusion guides resuscitation strategies
- Investigating cumulative effects of pre-performance routine interventions in beach volleyball serving
- Dispensing of antibiotics without prescription and associated factors in drug retail outlets of Eritrea: A simulated client method
- MicroRNA expression and DNA methylation profiles do not distinguish between primary and recurrent well-differentiated liposarcoma
- Assessment of acyl-CoA cholesterol acyltransferase (ACAT-1) role in ovarian cancer progression—An in vitro study
- Cytoplasmic factories, virus assembly, and DNA replication kinetics collectively constrain the formation of poxvirus recombinants
- The wavelet power spectrum of perfusion weighted MRI correlates with tumor vascularity in biopsy-proven glioblastoma samples
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- The role of moral reasoning & personality in explaining lyrical preferences
- Would you like to participate in this trial? The practice of informed consent in intrapartum research in the last 30 years
- Correction: Mutation spectrums of TSC1 and TSC2 in Chinese women with lymphangioleiomyomatosis (LAM)
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- Challenges associated with homologous directed repair using CRISPR-Cas9 and TALEN to edit the DMD genetic mutation in canine Duchenne muscular dystrophy
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- Human and climatic drivers affect spatial fishing patterns in a multiple-use marine protected area: The Galapagos Marine Reserve
- Correction: Leisure-time physical activity and sports in the Brazilian population: A social disparity analysis
- Application of the mixture item response theory model to the Self-Administered Food Security Survey Module for Children
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- Correction: Association between workplace bullying and burnout, professional quality of life, and turnover intention among clinical nurses
- Correction: Estimation of membrane bending modulus of stiffness tuned human red blood cells from micropore filtration studies
- Correction: Limited indirect effects of an infant pneumococcal vaccination program in an aging population
- Correction: Targeting of the Plzf Gene in the Rat by Transcription Activator-Like Effector Nuclease Results in Caudal Regression Syndrome in Spontaneously Hypertensive Rats
- Fieldwork-based determination of design priorities for point-of-use drinking water quality sensors for use in resource-limited environments
- Young women’s reproductive health conversations: Roles of maternal figures and clinical practices
- Correction: Differential recordings of local field potential: A genuine tool to quantify functional connectivity
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- Novel MscL agonists that allow multiple antibiotics cytoplasmic access activate the channel through a common binding site
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- Changes in oak (Quercus robur) photosynthesis after winter moth (Operophtera brumata) herbivory are not explained by changes in chemical or structural leaf traits
- Mutual interaction between motor cortex activation and pain in fibromyalgia: EEG-fNIRS study
- Evaluation of liposomal ciprofloxacin formulations in a murine model of anthrax
- Analysis of cholesterol in mouse brain by HPLC with UV detection
- Sugar, amino acid and inorganic ion profiling of the honeydew from different hemipteran species feeding on Abies alba and Picea abies
- Exploring prior diseases associated with incident late-onset Alzheimer’s disease dementia
- Hypertension prevalence in patients attending tertiary pain management services, a registry-based Australian cohort study
- SRL pathogenicity island contributes to the metabolism of D-aspartate via an aspartate racemase in Shigella flexneri YSH6000
- Correction: Comprehensive genome-wide analysis of the pear (Pyrus bretschneideri) laccase gene (PbLAC) family and functional identification of PbLAC1 involved in lignin biosynthesis
- Epilepsy in a melanocyte-lineage mTOR hyperactivation mouse model: A novel epilepsy model
- Water consumption and prevalence of irritable bowel syndrome among adults
- Mixed evidence for the relationship between periodontitis and Alzheimer’s disease: A bidirectional Mendelian randomization study
- Correction: Health conditions associated with overweight in climacteric women
- Correction: Determining Glomerular Filtration Rate in Homozygous Sickle Cell Disease: Utility of Serum Creatinine Based Estimating Equations
- Modelling the number of antenatal care visits in Bangladesh to determine the risk factors for reduced antenatal care attendance
- Correction: Cumulative viral load as a predictor of CD4+ T-cell response to antiretroviral therapy using Bayesian statistical models
- Dominant negative effects by inactive Spa47 mutants inhibit T3SS function and Shigella virulence
- ICOS-deficient and ICOS YF mutant mice fail to control Toxoplasma gondii infection of the brain
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- Life history of northern Gulf of Mexico Warsaw grouper Hyporthodus nigritus inferred from otolith radiocarbon analysis
- Physiology education for intensive care medicine residents: A 15-minute interactive peer-led flipped classroom session
- Strengthening capacity for natural sciences research: A qualitative assessment to identify good practices, capacity gaps and investment priorities in African research institutions
- Systematic scoping review of the concept of ‘genetic identity’ and its relevance for germline modification
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- Improvement of classification performance of Parkinson’s disease using shape features for machine learning on dopamine transporter single photon emission computed tomography
- Comparative pharmacokinetics and pharmacodynamics of the advanced Retinol-Binding Protein 4 antagonist in dog and cynomolgus monkey
- Correction: A handy method to remove bacterial contamination from fungal cultures
- Correction: Effect of statin on life prognosis in Japanese patients undergoing hemodialysis
- Retraction: Outer Membrane Protein A (OmpA) of Shigella flexneri 2a Induces TLR2-Mediated Activation of B Cells: Involvement of Protein Tyrosine Kinase, ERK and NF-κB
- Retraction: Biofabrication of streptomycin-conjugated calcium phosphate nanoparticles using red ginseng extract and investigation of their antibacterial potential
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- Correction: Drivers of deforestation in the basin of the Usumacinta River: Inference on process from pattern analysis using generalised additive models
- Efficacy of fertilizing method for different potash sources in cotton (Gossypium hirsutum L.) nutrition under arid climatic conditions
- Podocyte autophagy is associated with foot process effacement and proteinuria in patients with minimal change nephrotic syndrome
- Effect of Lactobacillus acidophilus D2/CSL (CECT 4529) supplementation in drinking water on chicken crop and caeca microbiome
- Retraction: MiR-30a-5p Antisense Oligonucleotide Suppresses Glioma Cell Growth by Targeting SEPT7
- Correction: Dynamics of plasma micronutrient concentrations and their correlation with serum proteins and thyroid hormones in patients with paracoccidioidomycosis
- Impact of lower limb osteoarthritis on health-related quality of life: A cross-sectional study to estimate the expressed loss of utility in the Spanish population
- Correction: Prevalence of damaged and missing teeth among women in the southern plains of Nepal: Findings of a simplified assessment tool
- Correction: Tissue-Specific Expressed Antibody Variable Gene Repertoires
- Retraction: Immunoglobulin G Expression in Lung Cancer and Its Effects on Metastasis
- Correction: Causal knowledge promotes behavioral self-regulation: An example using climate change dynamics
- Retraction: Use of Granulocyte Colony-Stimulating Factor for the Treatment of Thin Endometrium in Experimental Rats
- Correction: Dynamic mechanical and nanofibrous topological combinatory cues designed for periodontal ligament engineering
- Correction: Evaluating the foundations that help avert antimicrobial resistance: Performance of essential water sanitation and hygiene functions in hospitals and requirements for action in Kenya
- From seed to flour: Sowing sustainability in the use of cantaloupe melon residue (Cucumis melo L. var. reticulatus)
- Core Scientific Dataset Model: A lightweight and portable model and file format for multi-dimensional scientific data
- Accounting for measurement error to assess the effect of air pollution on omic signals
- Leucine zipper transcription factor-like 1 binds adaptor protein complex-1 and 2 and participates in trafficking of transferrin receptor 1
- Barriers for tuberculosis case finding in Southwest Ethiopia: A qualitative study
- Genetic predisposition to celiac disease in Kazakhstan: Potential impact on the clinical practice in Central Asia
- A lower psoas muscle volume was associated with a higher rate of recurrence in male clear cell renal cell carcinoma
- Two angles of overqualification-the deviant behavior and creative performance: The role of career and survival job
- Cost-utility analysis of de-escalating biological disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis
- Efficient estimation of stereo thresholds: What slope should be assumed for the psychometric function?
- Learning efficient haptic shape exploration with a rigid tactile sensor array
- Effects of dietary supplementation with a microalga (Schizochytrium sp.) on the hemato-immunological, and intestinal histological parameters and gut microbiota of Nile tilapia in net cages
- Regional versus local wind speed and direction at a narrow beach with a high and steep foredune
- Fragmented QRS complex in patients with systemic lupus erythematosus at the time of diagnosis and its relationship with disease activity
- Severe thiamine deficiency in eastern Baltic cod (Gadus morhua)
- Transfer entropy as a variable selection methodology of cryptocurrencies in the framework of a high dimensional predictive model
- Psychometric validation of Czech version of the Sport Motivation Scale
- Correction: Multiple innate antibacterial immune defense elements are correlated in diverse ungulate species
- Recognition of personality disorder and anxiety disorder comorbidity in patients treated for depression in secondary psychiatric care
- Correction: Strategies for achieving high sequencing accuracy for low diversity samples and avoiding sample bleeding using illumina platform
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