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ReklamaEffective methods for the inactivation of Francisella tularensis
Authors: Mika Azaki aff001; Akihiko Uda aff001; Deyu Tian aff003; Katsuyoshi Nakazato aff002; Akitoyo Hotta aff001; Yasuhiro Kawai aff004; Keita Ishijima aff001; Yudai Kuroda aff001; Ken Maeda aff001; Shigeru Morikawa aff001
Authors place of work: Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo Japan aff001; Department of Correlative Study in Physics and Chemistry, Graduate School of Integrated Basic Sciences, Nihon University, Tokyo, Japan aff002; CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China aff003; Division of Biosafety Control and Research, National Institute of Infectious Diseases, Tokyo, Japan aff004; Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan aff005
Published in the journal: PLoS ONE 14(11)
Category: Research Article
doi: https://doi.org/10.1371/journal.pone.0225177Summary
Francisella tularensis (F. tularensis) is highly pathogenic to humans and must be handled under biosafety level 3 conditions. Samples used for the diagnosis and experimental analysis must be completely inactivated, although methods for the inactivation of F. tularensis are limited. In this study, effective methods for the inactivation of F. tularensis SCHU P9 and five other strains were determined by comparisons of colony-forming units between treated and control samples. The results showed that F. tularensis SCHU P9 was denatured by heat treatment (94°C for 3 min and 56°C for 30 min), filtration with a 0.22 μm filter, and the use of various solutions (i.e. >70% ethanol, methanol, acetone, and 4% paraformaldehyde). F. tularensis SCHU P9 remained viable after treatment with 50% ethanol for 1 min, filtration with a 0.45 μm filter, and treatments with detergents (i.e. 1% lithium dodecyl sulfate buffer, 1% Triton X-100 and 1% Nonidet P-40) at 4°C for 24 h. Additionally, F. tularensis SCHU P9 suspended in fetal bovine serum in plastic tubes was highly resistant to ultraviolet radiation compared to suspensions in water and chemically defined medium. The methods for inactivation of F. tularensis SCHU P9 was applicable to the other five strains of F. tularensis. The data presented in this study could be useful for the establishment of guidelines and standard operating procedures (SOP) to inactivate the contaminated samples in not only F. tularensis but also other bacteria.
Keywords:
Ultraviolet radiation – Ethanol – Heat treatment – Detergents – Acetones – Government laboratories – Francisella tularensis – Filter sterilization
Introduction
Laboratory-acquired infections (LAIs) are caused by accidental exposure to infectious aerosols and contact with mucous membranes, even though LAIs have been decreased due to personal protective measures and biosafety training [1, 2]. Pike et al. reported that 4,079 LAIs resulting in 168 deaths occurred in the United States from 1930 to 1978 [3, 4]. Thereafter, Harding and Byers identified 1,267 LAIs resulting in 22 deaths [5]. According to Siengsanan-Lamont et al., 27 LAIs occurred between 1982 and 2016 in the Asia-Pacific region [6]. In these instances, the LAIs were caused by Brucella spp., Chlamydia psittaci, Coccidioides immitis, Coxiella burnetii, Francisella tularensis, Mycobacterium tuberculosis, Salmonella enterica, Blastomyces dermatitidis, dengue virus, hepatitis B virus, and Venezuelan equine encephalitis virus. However, the causes in many cases of LAI have not been clearly identified in the past [7, 8].
Recently, the detailed causes of each LAI were investigated. In 2004, two laboratory workers at the National Institute of Virology Laboratory of the Chinese Center for Disease Control and Prevention (Beijing, China) were infected with severe acute respiratory syndrome coronavirus (SARS-CoV) due to the handling of the incompletely inactive virus [9]. It was thought that two individuals were the source of a subsequent small outbreak of SARS [9]. In 2014, the Centers for Disease Control and Prevention (Atlanta, GA, USA) announced that approximately 80 staff members had been exposed to Bacillus anthracis when samples were analyzed by matrix-assisted laser desorption ionization-time of flight mass spectrometry after transferring incompletely inactivated samples from a biosafety level (BSL)-3 facility to a lower BSL facility [10]. In 2004, three researchers at Boston University developed tularemia after accidental exposure to F. tularensis supposedly due to their failure to comply with safety protocols [11]. Considering these accidental infections with SARS-CoV, B. anthracis and F. tularensis, laboratory workers should pay careful attention when handling pathogens. Therefore, it seems necessary to educate staff members about methods for complete inactivation of pathogens.
Pathogenic microorganisms that pose a threat to public health are categorized into four risk groups according to the Laboratory Biosafety Manual published by the World Health Organization (Geneva, Switzerland) [12], the National Institutes of Health (NIH)–Office of Biotechnology Activities (Bethesda, MD, USA) publication titled ‘The NIH Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules’ (NIH Guidelines) [13], ‘Biosafety in Microbiological and Biomedical Laboratories Guide’ (The U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and NIH, USA) [14], and Directive 2000/54/EC of the European Parliament and of the Council of 18 September 2000 ‘on the protection of workers from risks related to exposure to biological agents at work’ [15]. These guidelines obeyed at laboratories in the world are being revised based on historical incidents of accidental infection and the experience of the researchers and summarized by Kimman et al. [7]. In Japan, select agents and toxins are strictly classified according to the ‘Act on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases’ adopted by the Ministry of Health, Labour and Welfare in 2007 [16]. All pathogens handled by the National Institute of Infectious Diseases (NIID) are classified into a risk group as determined by the Bio-Risk Committee and experiments conducted with risk group 3 pathogens must be performed in a BSL-3 facility in accordance with the regulations stipulated by the NIID, Japan. To prevent accidental infections, samples prepared at BSL-3 facilities are required to be completely inactivated if the samples are handled in an outside facility with the same or lower BSL.
F. tularensis is a Gram-negative facultative intracellular bacterium that is classified into four subspecies (subsp.): tularensis, holarctica, mediasiatica, and novicida [17]. Of these four subspecies, F. tularensis subsp. tularensis, which was first identified in North America, is the most pathogenic to both humans and animals, as the infectious dose is extremely low (<10 colony-forming units, CFU) [18, 19]. If untreated with antibiotics, the mortality rate is extremely high at around 30%–60% [18–20]. F. tularensis subsp. holarctica and mediasiatica have intermediate virulence and low mortality rates [21], whereas infection with subsp. novicida has only been detected in immunocompromised humans [21, 22]. In Japan, all in vitro and in vivo bacteriological procedures involving F. tularensis, with the exception of subsp. holarctica live vaccine strain (LVS), subsp. tularensis B38 strain and subsp. novicida must be conducted in a BSL-3 facility.
There are several established chemical and physiological techniques to inactive pathogens. Because F. tularensis does not form spores, inactivation is conducted with common methods, such as treatments with heat [23, 24], 4% paraformaldehyde (PFA) in phosphate-buffered saline (PBS) overnight [25], 4% PFA and 1% glutaraldehyde in 0.1M sodium cacodylate after formaldehyde [26], a combination of 10% sodium hypochlorite followed by 70% ethanol [27], and ultraviolet (UV) radiation [28]. F. tularensis subsp. tularensis SCHU S4 dried on acrylic, glass, polyamide, polyethylene, polypropylene, silicone rubber, and stainless steel was easily inactivated by exposure to vaporous hydrogen peroxide [29]. While, F. tularensis SCHU S4 dried on wood would be inactivated hardly by bleach, citric acid, 70% ethanol, quaternary Ammonia, and Pine-Sol [30]. Bone marrow-derived macrophages infected with F. tularensis SCHU S4 was completely fixed with 4% PFA for 5 min and 2% PFA for 15 min, whereas treatment with 1% PFA for 24 h failed to inactive infected cells [31]. However, the methods for the inactivation of F. tularensis differed among reports.
Therefore, the present study aimed to confirm the treatment conditions for the safe and complete inactivation of F. tularensis by comprehensive comparisons of the culturable bacteria between treated and control samples.
Materials and methods
Bacteria
F. tularensis subsp. tularensis SCHU P9 was established in a previous study [32] and cultured in chemically defined medium (CDM) at 37°C until the late logarithmic phase. F. tularensis subsp. tularensis Nevada 14 and subsp. holarctica LVS, Kato, Yama, and Kf Water were kindly provided by Dr. H. Fujita (Ohara Research Laboratory, Ohara General Hospital, Fukushima, Japan) and listed in Table 1. They were cultured under the same conditions as F. tularensis SCHU P9. After centrifugation at 12,000 × g for 2 min at 4°C, bacterial pellets were resuspended in CDM containing 10% glycerol and stored at −80°C until use. All procedures with regard to living bacterial cultures were performed in a BSL-3 facility in accordance with the regulations established by the NIID, Japan.
Tab. 1. The list of F. tularensis strains used in this study. Bacterial viability with short and long incubation periods
Five microliters of F. tularensis SCHU P9 (average, 1.0 × 106 CFU) was suspended in 100 μL of deionized water, CDM and undiluted fetal bovine serum (FBS) (Biosera, Nuaillé, France) and then incubated at 4°C, 23°C and 37°C. After incubation for 0 min, 1 h, 1 day and 2, 4, 6, 8 and 10 weeks, serially diluted bacterial samples were cultured on Eugon chocolate agar plates at 37°C for 4–7 days. The average CFU number in 100 μL was calculated from the average number of colonies of four replicated samples.
Inactivation by heat treatments
Five microliters of F. tularensis SCHU P9 (average, 5.2 × 105 CFU) suspended in 100 μL of deionized water, CDM, PBS (Sigma-Aldrich Corporation, St. Louis, MO, USA) or undiluted FBS was added to a 0.2 mL PCR tube (Bio-Bik Ina Optica, Nagano, Japan) and incubated at 94°C and 56°C using an Astec thermal cycler PC-806 (Astec Co., Ltd., Fukuoka, Japan). The control samples were incubated at 4°C. After the indicated incubation time, the serially diluted bacterial samples were cultured on Eugon chocolate agar plates at 37°C for 4–7 days. The average CFU number in 100 μL was calculated from the average number of colonies of four replicated samples.
Bacterial counts before and after filtration
Fifty microliters of F. tularensis SCHU P9 (average, 2.9 × 106 CFU/ 100 μL) suspended in 1 mL of CDM was screened through Millipore PVDF Hydrophilic Millex-HV Sterile Syringe Filter Unit 0.45 Micron (SLHV033RS, EMD Millipore Corporation, Billerica, MA, USA) and 0.22 Micron (SLGV033RS, EMD Millipore Corporation). Before and after filtration, the samples were serially diluted and cultured on Eugon chocolate agar plates at 37°C for 4–7 days. The average CFU number in 100 μL was calculated from the average number of colonies of four replicated samples.
CFU in supernatants and pellets after centrifugation
Five microliters of F. tularensis SCHU P9 (average, 2.2 × 106 CFU) suspended in 100 μL of CDM was centrifuged at 12,000 × g for 2 min at 4°C, and the supernatant was transferred into a new tube. The remaining pellets were resuspended in 100 μL of CDM. The samples were serially diluted and cultured on Eugon chocolate agar plates at 37°C for 4–7 days. The average CFU number in 100 μL was calculated from the average number of colonies of four replicated samples.
Bacterial CFU after the inactivation using various solvents
Five microliters of F. tularensis SCHU P9 was mixed with 100 μL of deionized water, 10%–90% ethanol (Sigma-Aldrich), 100% methanol (Nacalai Tesque, Inc., Kyoto, Japan), 100% acetone (Sigma-Aldrich), a mixture of 50% methanol and 50% acetone, 10% formaldehyde neutral buffer solution (Wako Pure Chemical Industries, Ltd., Osaka, Japan), 4% PFA (Wako), 100% acetonitrile (Sigma-Aldrich) and final concentration of 0.001%–1% sodium hypochlorite (Purelux; Oyalox Co., Ltd., Tokyo, Japan), then incubated for 10 min at room temperature (23°C).
Five microliters of F. tularensis SCHU P9 was mixed with 100 μL of 1% Triton X-100, 1% NP-40 and 1% LDS (Nacalai Tesque) buffer supplemented with 1 × sodium dodecyl sulphate buffer, 10% glycerol (Wako) and 0.005% bromophenol blue (63 mM Tris-HCl, pH 6.8; Wako). These mixtures of detergents and bacteria were incubated at 4°C for 10 min, 1 h, and 24 h. All samples were centrifuged at 12,000 × g for 2 min at 4°C. Afterward, the supernatant was discarded to remove the effects of solvents. After the bacterial pellets were resuspended in 100 μL of CDM, the viable bacteria were counted. These experiments were conducted using four replicates.
Mechanical disruption using beads
Fifty microliters of F. tularensis SCHU P9 was added to 1 mL of CDM, undiluted FBS or Roswell Park Memorial Institute (RPMI) 1640 medium containing 10% FBS with and without detergents. Bacterial suspensions were put into 2 mL tubes containing 6.35 mm ceramic spheres (MP Biomedicals, Illkirch-Graffenstaden, France) and Lysing Matrix A (garnet) (MP Biomedicals), shaken for 30 s periods at 4,200 rpm in a Mini Bead Beater (BioSpec Products, Inc., Bartlesville, OK, USA) and then immediately cooled on ice. Live bacteria in 100 μL aliquots were enumerated. These experiments were conducted using four replicates.
The viability of F. tularensis SCHU P9 after treatments with commercial products
The inactive effect of Cell Lysis Buffer (10×) (Cell Signaling Technology, Danvers, MA, USA) was examined. Ninety microliters of F. tularensis SCHU P9 (average, 3.5 × 106 CFU) were mixed with ten microliters of Cell Lysis Buffer (10×) (Cell Signaling Technology), while CDM was added into bacteria as the control sample. Samples were incubated at 4°C for 10 to 60 min.
Bacterial viability suspended in RLT buffer supplied in RNeasy Mini Kit was evaluated. Bacterial pellets (average, 1.1 × 106 CFU) after the centrifugation at 12,000 × g for 2 min at 4°C were suspended in 100 μL of RLT buffer alone, the mixture of an equal volume of RLT buffer and 70% ethanol, and CDM as the control sample. Samples were incubated at room temperature for 10 min.
In these experiments, samples after incubation were centrifugated at 12,000 × g for 2 min at 4°C to remove the commercial buffers. The pellets containing live bacteria were suspended in CDM and the CFU was counted. These experiments were conducted using four replicates.
Bacterial viability after UV radiation
Five microliters of F. tularensis SCHU P9 spiked in 100 μL of deionized water, CDM or undiluted FBS were transferred into 1.5 mL tubes (Sarstedt K.K., Tokyo, Japan) and 0.2 mL PCR tubes (Bio-Bik Ina Optica). These samples were radiated at room temperature (23°C) using a Funa-UV-Linker (FS-800; Funakoshi, Tokyo, Japan) equipped with a low-pressure lamp (254 nm). The average UV energy (3 mW/cm2) was monitored with the sensor of this system during this experiment. After radiation, the CFU in 100 μL of these samples was measured. These experiments were conducted using four replicates.
Bacterial CFU after the treatments in five strains of F. tularensis
Five F. tularensis strains of subsp. tularensis Nevada 14 and subsp. holarctica LVS, Kato, Yama, and Kf Water were prepared to validate the effective inactivation of F. tularensis. Bacteria were heated at 94°C for 3 min and 56°C for 30 min, filtered using Millipore PVDF Hydrophilic Millex-HV Sterile Syringe Filter Unit 0.45 Micron (SLHV033RS, EMD Millipore Corporation) and 0.22 Micron (SLGV033RS, EMD Millipore Corporation), incubated at 4°C for 24 h with detergents (1% LDS buffer, 1% NP-40, and 1% TritonX-100), and radiated at room temperature (23°C) with a low-pressure lamp (254 nm). These procedures were in accordance with the same conditions as those for the treatment of F. tularensis SCHU P9. The CFU of untreated and treated samples were compared. The experiments were conducted in four replicates.
Statistical analysis
All statistical analyses were performed using GraphPad Prism v5 software (GraphPad Software, Inc., La Jolla, CA, USA). All experiments in this study were performed using four replicates. The results are expressed as the mean number of CFU ± SD. Significant differences in CFU between the heat-denatured samples and control samples were determined using the Student’s t-test. Other comparisons of CFU between the treated and control samples were performed using one-way or two-way analysis of variance (ANOVA). When significant differences were found, further comparisons were made using the Bonferroni post hoc test.
Results
Bacterial viability in deionized water, chemically defined medium (CDM), and undiluted fetal bovine serum (FBS) after different incubation periods
To evaluate the stability in F. tularensis SCHU P9, bacteria suspended in deionized water, undiluted FBS, and chemically defined medium (CDM) for F. tularensis were incubated at 4°C, 23°C and 37°C, respectively. In deionized water, the number of live bacteria was approximately 1.2 × 106 CFU at 0 min, which was not significantly different from that at 1 h (p > 0.05). Thereafter, no bacteria incubated at 4°C for 10 weeks (w), 23°C for 2 weeks or 37°C for 1 day (d) were detected (Fig 1A). CDM, which is often used for liquid culture of F. tularensis, promoted long-term bacterial viability at 4°C to 37°C (Fig 1B). In F. tularensis SCHU P9 suspended in undiluted FBS, bacterial viability at 4°C, 23°C and 37°C was slightly improved than in deionized water (Fig 1C). Bacterial viability of this strain was not affected by short incubation of less than 1 h because no significant change in the number of CFU was detected between 0 min and 1 h (p > 0.05).
Fig. 1. Changes to the viability of F. tularensis SCHU P9 by long-term incubation. Bacteria inoculated into deionized water (A), CDM (B) and undiluted FBS (C) were maintained at 4°C (○), 23°C (□) and 37°C (△). After incubation for 0 min, 1 h, 1 day (d) and 2, 4, 6, 8 and 10 weeks (w), the CFU numbers of four replicates of each bacterial sample were counted. The mean CFU ± standard deviations (SD) are shown. Effective inactivation for F. tularensis SCHU P9
Heat treatment has been widely used for the complete inactivation of bacteria. Hence, the thermal resistance of F. tularensis SCHU P9 was examined in this study. Bacterial suspensions in deionized water, CDM and undiluted FBS containing approximately 5.2 × 105 CFU/100 μL of F. tularensis SHCU P9 were incubated at 94°C for 3 min (Fig 2A) and 56°C for 30 min (Fig 2B). In contrast, the control samples were incubated at 4°C for the same time as for the heat treatment. The results revealed that heat treatment at 94°C for 3 min and 56°C for 30 min had completely inactivated F. tularensis SHCU P9, as no live bacteria were detected in any of the heat-treated samples. The minimal time required for heat inactivation of F. tularensis SHCU P9 was estimated. No viable bacteria were detected after incubation at 94°C for 45 s (Fig 2C). As shown in Fig 2D, some live bacteria were detected in CDM (0.8 CFU) and undiluted FBS (0.5 CFU) following heat treatment at 56°C for 5 min, but none that were suspended in deionized water and PBS. No bacteria were detected in heat-treated samples at 56°C for 10 min (S1 Fig.).
Fig. 2. Heat inactivation of F. tularensis SCHU P9. Bacterial suspensions were prepared with deionized water, CDM, PBS, and undiluted FBS. (A and B) The samples were heated at 94°C for 3 min (A) and 56°C for 30 min (B) and then immediately cooled on ice. The control samples were cooled to 4°C for 3 min (A) and 30 min (B). The black and white bars indicate the CFU numbers of the treated and control samples, respectively. Statistical significance was determined by one-way ANOVA with a post hoc test (*p < 0.05, **p < 0.01 and ***p < 0.001). (C and D) Bacterial suspensions heated at 94°C (C) and 56°C (D) for the indicating times in the figure were immediately cooled on ice. In contrast, the control samples were cooled on ice for identical time periods. The white and black symbols indicate the CFU numbers of the treated and control samples, respectively. In all experiments, the CFU number of four replicates of each bacterial sample was counted. The mean CFU ±SD are shown. Statistical significance was determined by two-way ANOVA with a post hoc test (*p < 0.05, **p < 0.01 and ***p < 0.001). A sterilizing filter is often used to remove contaminating bacteria from liquid samples. To evaluate the effectiveness of filter sterilization of F. tularensis SCHU P9, 1 mL of bacterial suspensions in CDM (average, 2.9 × 106 CFU/100 μL) were filtrated using a sterilizing filter with 0.22 (SLGV033RS, EMD Millipore Corporation) and 0.45 μm pores (SLHV033RS, EMD Millipore Corporation) (Fig 3A). The 0.22 μm filter removed all viable bacteria. On the other hand, a small number of bacteria (average, 5.5 CFU/100 μL) was detected in the filtrates through 0.45 μm filter, although the CFU number was significantly decreased (p < 0.001).
Fig. 3. The determinants of effective inactivation of F. tularensis SCHU P9. (A) Bacterial suspensions in 1 mL of CDM were filtrated through 0.45 and 0.22 μm pore size membrane filters (Merck Millipore). The mean CFU ± SD in 100 μL before and after filtration are shown. (B) Bacterial suspensions in CDM were centrifuged at 12,000 × g for 2 min at 4°C. The mean CFU ± SD before and after centrifugation is shown. (C to F) Bacteria suspended in 0%–90% ethanol (C and D), various solvents (E) and the final concentration of 0%–1% sodium hypochlorite (F) were incubated at room temperature for 10 min (C, E, and F) and 0–60 s (D). All experiments were performed using four replicates. The mean CFU ± SD are shown. Statistical significance was determined by one-way ANOVA (A, B, C, E and F) and two-way ANOVA (D) with the post hoc test (*p < 0.05, **p < 0.01 and ***p < 0.001). Using a solution of 70% ethanol is a simple aseptic technique to inactivate pathogens. Hence, the relationships between ethanol concentration and the viability of F. tularensis SCHU P9 were investigated. Bacteria suspended in 0%–90% ethanol were incubated for 10 min at room temperature (23°C) and then centrifuged to discard the ethanol solution. Afterward, the CFU number of pellets was calculated. The preliminary data showed no significant change in CFU number from before centrifugation (Fig 3B). After treatment with >50% ethanol for 10 min, no viable bacteria were detected (Fig 3C). On the other hand, the CFU numbers after treatment with 0%, 10% and 30% ethanol for 10 min were 3.1 × 106, 1.6 × 106 and 1.2 × 104, respectively (Fig 3C). Furthermore, the incubation time required for inactivation with the use of various concentrations of ethanol was determined. Bacteria suspended in 90% and 70% ethanol were rapidly inactivated within 15 s (Fig 3D), whereas those in 0%–50% ethanol had survived for incubation periods for 60 s, although the CFU number was significantly decreased by treatment with 50% ethanol (p < 0.001).
Organic solvents, such as formalin, methanol, and acetone are commonly used to fix infected tissue samples. The viable number of F. tularensis SCHU P9 following treatment with various fixation solutions was determined. Bacteria spiked into 10% formalin neutral buffer solution, 4% PFA, 100% methanol, 100% acetone, a mixture of 50% methanol/50% acetone and 100% acetonitrile were incubated for 10 min at room temperature. After the incubation periods, the samples were centrifuged to discard the solvents. The viable bacteria in pellets resuspended in CDM were counted. As shown in Fig 3E, there were no viable bacteria in any of the samples treated with organic solvents, whereas abundant bacteria (average, 1.2 × 106 CFU) were found in the control samples. The effective concentration of sodium hypochlorite to inactivate F. tularensis SCHU P9 was also evaluated. The results showed that the final concentration of 0.1% sodium hypochlorite had sufficiently inactivated the bacteria, and there were significant differences in bacterial viability between the treated and control samples (p < 0.001).
Inactivation efficiency of detergents and UV radiation
Detergents are used widely for protein extraction from bacteria and infected cells. In this study, the numbers of live bacteria between detergent-treated and control samples were compared. Combined condition analysis was performed using three incubation periods (10 min, 1 h, and 24 h), three different detergents (1% lithium dodecyl sulphate [LDS] buffer, 1% Nonidet P-40 [NP-40] and 1% Triton X-100) and three solvents (deionised water, CDM and RPMI 1640 containing 10% FBS) at 4°C. After incubation, all samples were centrifuged to remove the detergent solution. As shown by the mean CFU numbers ± standard deviation (SD) presented in Fig 4A–4C, no sample was completely inactivated, although CFU numbers in samples treated with detergents for 24 h were significantly lower than in the control samples (p < 0.001).
Fig. 4. Changes in the viability of F. tularensis SCHU P9 using detergents. (A–C) Bacteria suspended in CDM (A), undiluted FBS (B) and RPMI 1640 containing 10% FBS (C) with and without detergents (1% LDS buffer, 1% NP-40 and 1% TritonX-100) were incubated at 4°C for 10 min, 1 h and 1 day. After incubation, the bacteria were immediately centrifuged, and the CFU number of the pellets was calculated. (D–F) Detergents (1% LDS buffer, 1% NP-40 and 1% TritonX-100) were added to bacterial suspensions in CDM (D), undiluted FBS (E) and RPMI 1640 containing 10% FBS (F). The samples were homogenized at 4,200 rpm for 30 s and then immediately cooled on ice. The mean CFU number ± SD of four replicates are shown. Statistical significance was determined by two-way ANOVA (A–C) and one-way ANOVA (D–F) with a post hoc test (***p < 0.001). The bacterial samples containing the detergents were subjected to mechanical disruption using beads. Bacteria suspended in CDM, undiluted FBS and RPMI1640 containing 10% FBS were homogenated, and the mean CFU numbers ± SD were determined. As shown in Fig 4D–4F, the average CFU number before homogenisation in CDM, undiluted FBS and RPMI 1640 containing 10% FBS were 0.9 × 106 CFU/0.1 mL, 1.3 × 106 CFU/0.1 mL and 1.2 × 106 CFU/0.1 mL, respectively. Bacterial numbers in samples without detergent were reduced by approximately 1/10 by mechanical disruption. After mechanical disruption, live bacteria were detected in samples prepared with 1% LDS buffer but not those containing 1% NP-40 and 1% TritonX-100.
The viability of F. tularensis SCHU P9 after treatment with commercial products was evaluated. Bacterial pellets (3.5 × 106 CFU) suspended in Cell Lysis Buffer (Cell Signaling Technology, Danvers, MA, USA) and the RLT buffer of the RNeasy mini kit (Qiagen Ltd., Valencia, CA, USA) were incubated for 10 min at room temperature. After incubation, there was an abundance of bacteria in the samples treated with Cell Lysis Buffer but none in the samples treated with the RLT buffer (Fig 5).
Fig. 5. The viability of F. tularensis SCHU P9 after treatments of commercial products. Bacterial viability was evaluated after the treatment using Cell Lysis Buffer (Cell Signaling Technology) and the RLT buffer supplied by RNeasy mini kit (Qiagen Ltd.,). (A) Bacteria suspended in Cell Lysis Buffer and CDM (control) were incubated at 4°C for the indicated time. (B) Bacterial pellets after the centrifugation at 12,000 × g for 2 min at 4°C were suspended in RLT buffer alone, the mixture of RLT buffer and 70% ethanol, and CDM (control). The samples were incubated at room temperature for 10 min. All incubated samples were centrifuged at 12,000 × g for 2 min at 4°C and the pellets were suspended in CDM. the mean CFU ± SD of control and the treatment samples are shown. Statistical significance was determined by two-way ANOVA (A) and one-way ANOVA (B) with the post hoc test (***p < 0.001). The UV light is reported to inactivate bacterial cells via thymine dimer formation [33]. The reduction in viable F. tularensis SCHU P9 with UV radiation is shown in Fig 6A. In deionized water and CDM, no live bacteria were detected after UV radiation (1800 mJ/cm2) at room temperature. In undiluted FBS, the numbers of viable bacteria in both the 1.5 mL and 0.2 mL tubes were significantly decreased after UV radiation, but complete inactivation in F. tularensis SCHU P9 was not achieved (Fig 6A). Similarly, bacteria in undiluted FBS had survived after UV radiation at room temperature for 60 min (Fig 6B). On the other hand, F. tularensis SCHU P9 cells spread onto Eugon chocolate agar were completely inactivated by UV radiation at 6.3 mJ/cm2.
Fig. 6. Changes to the viability of F. tularensis SCHU P9 by UV radiation. (A) Bacteria suspended in deionized water, CDM and undiluted FBS were aliquoted into four 1.5 mL tubes and 0.2 mL PCR tubes. These samples were simultaneously radiated with UV light (3 mW/cm2 × 600 s = 1800 mJ/cm2) at 254 nm using FUNA-UV-LINKER FS-800. (B) Bacteria suspended in undiluted FBS were prepared in 1.5 mL tubes and 0.2 mL PCR tubes. After treatment for 5–60 min at 3 mW/cm2, the CFU numbers of these samples were calculated. The mean CFU ± SD of four replicates are shown. Statistical significance was determined by two-way ANOVA with a post hoc test (**p < 0.01 and ***p < 0.001). Viabilities after the various treatments in five strains of F. tularensis
It was evaluated whether the methods for inactivation of F. tularensis SCHU P9 described in this study would be applicable to other strains of Francisella. The CFU between treated and control samples were compared using five strains (subsp. tularensis Nevada 14 and subsp. holarctica LVS, Kato, Yama, and Kf Water). The results are shown in Fig 7. No live bacteria were detected in samples after the treatments with 94°C for 3 min (Fig 7A black bars), 56°C for 30 min (Fig 7A gray bars), 0.22 μm filtration (Fig 7B gray bars), 50% ethanol for 10 min (Fig 7C black bars), 0.1% sodium hypochlorite (Fig 7C gray bars), and UV radiation in deionized water (Fig 7E) and CDM (Fig 7F). On the other hand, live bacteria were remaining in the suspensions filtered through the 0.45 μm filter in strain Nevada 14 (0.25 CFU), LVS (0.75 CFU), Kato (40.50 CFU), Kf Water (1.25 CFU). Although differing sensitivities were observed among the strains, bacteria were found to survive after detergent treatment (Fig 7D) and UV radiation in undiluted FBS (Fig 7G).
Fig. 7. The validation of effective treatments for the inactivation in five F. tularensis strains. (A) Bacterial suspensions in CDM were heated at 94°C for 3 min and 56°C for 30 min and immediately cooled on ice. (B) Bacterial suspensions in 1 mL of CDM were filtered through 0.45 and 0.22 μm pore size membrane filters (Merck Millipore). (C) Bacteria spiked into detergents (1% LDS buffer, 1% NP-40 and 1% TritonX-100) were incubated at 4°C for 1 day. (E-F) Bacteria suspended in deionized water (E), CDM (F), and undiluted FBS (G) were aliquoted into four 0.2 mL PCR tubes. These samples were simultaneously radiated with UV light. All treated samples were compared with the control samples. All experiments were performed in four replicates. The mean CFU ± SD are shown. Discussion
F. tularensis is a Gram-negative, non-spore-forming, highly pathogenic and an intracellular bacterium. Samples infected with F. tularensis must be inactivated completely in a BSL-3 facility before transportation to a laboratory with a lower BSL for analyses of the bacteria and infected cells. The results of the present study showed that F. tularensis SCHU P9 was readily and easily inactivated by heat treatments (94°C for 3 min and 56°C for 30 min), filtration using a 0.22 μm filter, and treatments with 70% ethanol, methanol, acetone, 10% neutral buffered formalin and 4% PFA solution. On the other hand, filtration using a 0.45 μm filter and treatments of detergents could significantly decrease the amount of live F. tularensis SCHU P9 but were insufficient for the complete removal of bacteria. F. tularensis SCHU P9 suspended with undiluted FBS in plastic tubes was resistant to UV radiation but not to deionized water and CDM. The findings of the present study were similar to the common conditions for bacterial inactivation [34]. Here, the actual values of the inactivating condition of F. tularensis are provided in detail.
It is known that F. tularensis can survive for long periods in soil, fodder, live ticks, animal carcasses, and laboratory culture media [35]. F. tularensis is also stable in water and water-borne outbreaks of tularemia caused by F. tularensis subsp. holarctica has been reported in Bulgaria, Georgia, Germany, Italy, Kosovo, Norway, Russia, Sweden, Turkey, the Czech Republic and the Republic of Georgia [36, 37]. Francisella noatunensis NCIMB14265, which was isolated from diseased Atlantic cod held in seawater in Norway [38], was suspended in sterilized seawater microcosms and then culturable bacteria were detected by 40 days at 4°C [39]. In this study, high concentrations of viable bacteria were detected in CDM for up to 10 weeks, and the viability of F. tularensis SCHU P9 suspended in deionized water and undiluted FBS was confirmed at 8 weeks at 4°C (Fig 1). These data indicate that F. tularensis remains viable in CDM and at low temperatures, in agreement with the findings of a previous study [39]. In addition, incubation within 1 h did not affect the viability of F. tularensis SCHU P9, as the CFU number did not significantly change from 0 min to 1 h in deionized water, CDM and PBS (Fig 1).
Sera and plasma samples collected from patients and animals are often used for serological diagnosis by detection of specific antibodies with the agglutination test, enzyme-linked immunosorbent assay, indirect immunofluorescence and western blot analysis. To inactivate complement, samples are generally incubated at 56°C for 30 min. As is widely known, many viruses and non-sporulating bacteria are usually inactivated at 50°C–60°C, with the exception of enterococci [40, 41] and thermophilic bacteria. In this study, no bacteria were detected in CDM and undiluted FBS following heat treatment at 56°C from 10 to 30 min (S1 Fig. and Fig 2B). Moreover, bacterial suspensions in deionized water were quickly inactivated at 56°C within 1 min. Day et al. reported that the time required to reduce the population of F. tularensis LVS by 90% (D10-values) in liquid infant formula, apple juice, mango juice, and orange juice was between 8 and 16 s [42]. In this study, the D10-values for F. tularensis SCHU P9 in CDM, undiluted FBS, and PBS were 40, 40 and 35 s, respectively. Though the efficiency of the inactivation between our findings and previous data seemed to differ, Francisella viability after heat treatment was strongly affected by the solution composition. According to these data, heat treatment at 56°C for 30 min was sufficient to inactivate F. tularensis.
Semipermeable membrane filters with average pore sizes of 0.45 and 0.22 μm are often used to remove bacteria, fungi, cells, aggregated proteins, and debris in liquid samples at microbiological and biomedical laboratories. The separation based on the pore size of the membrane using the filter membrane is a physical removal/separation mechanism and not chemical inactivation. F. tularensis with a diameter ranging 0.2–0.7 μm [43] might pass through the membrane filter having average pore sizes of 0.45 and 0.22 μm and can survive in the filter devices during filtration. In addition, the filter membrane can easily clog if the sample fluid contains abundant aggregated bacteria larger than the pore size of the filter. It is possible that even little pressure can accidentally uncouple the connection between the syringe and the filter. Therefore, the leaked bacteria after filtration and the splashed bacteria during filtration should be paid attention to when filtration methods are applied.
Using 70% ethanol spray is a simple aseptic technique to efficiently inactivate non-sporulating bacteria, but not bacterial spores [44]. However, the most effective concentration of ethanol for the wide spectrum of microbes is 60%–70% [45]. F. tularensis SCHU P9 was able to resist deactivation in a solution of 50% ethanol for at least 1 min, although the viability was significantly reduced (Fig 2F). When attempting to remove F. tularensis using 70% ethanol solution, the reduction in the ethanol concentration along with the incubation time should be considered.
Depending on the wavelength, UV radiation is classified as UVA (315–400 nm), UVB (280–315 nm) or UVC (200–280 nm). UVC radiation can effectively induce mutations and death of bacterial as well as mammal cells [46]. In particular, UV light at 254 nm, which is near the maximum absorbance in DNA [47], can induce the accumulation of dimers between adjacent thymidine residues in the same DNA strand [33]. Rose et al. reported that F. tularensis LVS and NY98 suspended in distilled water were inactivated by UVC treatment at 4 mJ/cm2 [48]. We confirmed that F. tularensis SCHU P9 spread onto Eugon chocolate agar was completely inactivated by UV radiation at 6.3 mJ/cm2. In addition, bacteria suspended in deionized water and CDM into 1.5 mL tubes and 0.2 mL PCR tube were easily inactivated by UV radiation (Fig 6A). On the other hand, inactivation of bacterial suspensions in undiluted FBS was very difficult with UV radiation (Fig 6B), which suggested that UV radiation failed to inhibit bacteria in the solution containing abundant nutrients, including proteins. In Bacillus thuringiensis and B. anthracis spores, effective inactivation by UV radiation was also inhibited under more nutritive germination conditions [49]. It is probable that UV radiation is unable to inactivate bacteria because the solution containing abundant nutrients absorbs the UV light into its compounds [50–52].
F. tularensis subsp. tularensis SCHU P9 was used as a model of the inactivation for F. tularensis in this study. The parental strain of F. tularensis SCHU P9 is a virulent strain that was initially isolated by Foshay from an ulcer of American patient in 1941 [53, 54]. The Ohara Research Laboratory (Ohara General Hospital, Fukushima, Japan) obtained strain SCHU from the Rocky Mountain Laboratory of the National Institute of Allergy and Infectious Diseases (Hamilton, MT, USA) in 1958 [55]. Afterward, F. tularensis SCHU was attenuated by 373 passages in artificial media over 30 years in Japan [55]. Virulent F. tularensis SCHU P9 was isolated by in vivo passages from attenuated SCHU, as described in a previous report [32]. We believe the methods for inactivation of F. tularensis SCHU P9 described in this study would be applicable to other strains of Francisella because the viabilities of the treated samples of F. tularensis SCHU P9 and the other five strains were similar (Fig 7).
Actual data for the inactivation of F. tularensis SCHU P9 are presented in this report. However, it should be noted that the experiments were performed using bacterial suspensions. If the bacteria aggregate in the samples, the conditions required for complete inactivation might differ. Our data are useful for the development of effective inactivation procedures; however, our data cannot be used to confirm the success of other inactivation procedures. We recommend that this study be used as a guide and that each laboratory should validate these procedures in their own laboratory. This is in accordance with current US and Japan law and provides an appropriate perspective of the data reported here. Although there is always a risk of infection of laboratory workers handling F. tularensis, the risk can be controlled by complying with the safety protocols.
Supporting information
S1 Fig [tif]
The viability of F. tularensis SCHU P9 after heated at 56°C for 10 min.
Zdroje
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- The mutational landscape of quinolone resistance in Escherichia coli
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- Development of a novel automatable fabrication method based on electrospinning co electrospraying for rotator cuff augmentation patches
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- The clinicopathological significance of Thrombospondin-4 expression in the tumor microenvironment of gastric cancer
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- Effects of Debaryomyces hansenii treatment on intestinal mucosa microecology in mice with antibiotic-associated diarrhea
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- Evolution of high tooth replacement rates in theropod dinosaurs
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- Investigating reindeer pastoralism and exploitation of high mountain zones in northern Mongolia through ice patch archaeology
- Diversity pattern of Plasmodium knowlesi merozoite surface protein 4 (MSP4) in natural population of Malaysia
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- “What gets measured better gets done better”: The landscape of validation of global maternal and newborn health indicators through key informant interviews
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- Molecular characterisation of genital human papillomavirus among women in Southwestern, Nigeria
- The impact of “male clinics” on health-seeking behaviors of adult men in rural Kenya
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- Effects of an incremental theory of personality intervention on the reciprocity between bullying and cyberbullying victimization and perpetration in adolescents
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- Cooperation with autonomous machines through culture and emotion
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- Breast cancer in Tanzanian, black American, and white American women: An assessment of prognostic and predictive features, including tumor infiltrating lymphocytes
- Intramolecular tautomerization of the quercetin molecule due to the proton transfer: QM computational study
- A global overview of cassava genetic diversity
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- Identifying resurrection genes through the differentially expressed genes between Selaginella tamariscina (Beauv.) spring and Selaginella moellendorffii Hieron under drought stress
- Impact of hemodialysis on the concentrations of sodium and potassium during infusion of sodium thiosulfate using an In Vitro hemodialysis model
- Minimal effects of oyster aquaculture on local water quality: Examples from southern Chesapeake Bay
- Suboptimal infant and young child feeding practices in rural Boucle du Mouhoun, Burkina Faso: Findings from a cross-sectional population-based survey
- High salinity tolerance of invasive blue catfish suggests potential for further range expansion in the Chesapeake Bay region
- From waste to food: Optimising the breakdown of oil palm waste to provide substrate for insects farmed as animal feed
- Quantitative assessment of interstitial lung disease in Sjögren’s syndrome
- Comparative efficacy of tenofovir and entecavir in nucleos(t)ide analogue-naive chronic hepatitis B: A systematic review and meta-analysis
- Reference ranges for ultrasonographic renal dimensions as functions of age and body indices: A retrospective observational study in Taiwan
- Finding phrases: On the role of co-verbal facial information in learning word order in infancy
- Mathematical modeling reveals the factors involved in the phenomena of cancer stem cells stabilization
- Effects of forest management and roe deer impact on a mountain forest development in the Italian Apennines: A modelling approach using LANDIS-II
- Evaluation of comprehensive improvement for mild and moderate soil salinization in arid zone
- Efficacy, acceptability and feasibility of daily text-messaging in promoting glycaemic control and other clinical outcomes in a low-resource setting of South Africa: A randomised controlled trial
- Magnitude and associated factors of postpartum depression among women in Nekemte town, East Wollega zone, west Ethiopia, 2019: A community-based study
- Comparison of continuous wave and cold lateral condensation filling techniques in 3D printed simulated C-shape canals instrumented with Reciproc Blue or Hyflex EDM
- Effect of caffeine on neuromuscular function following eccentric-based exercise
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- Alcohol consumption and survival after breast cancer diagnosis in Japanese women: A prospective patient cohort study
- Selection of reference genes for normalization of cranberry (Vaccinium macrocarpon Ait.) gene expression under different experimental conditions
- The household economic costs associated with depression symptoms: A cross-sectional household study conducted in the North West province of South Africa
- Increased cell size, structural complexity and migration of cancer cells acquiring fibroblast organelles by cell-projection pumping
- Acute low- compared to high-load resistance training to failure results in greater energy expenditure during exercise in healthy young men
- Impact of body mass index and metabolically unhealthy status on mortality in the Japanese general population: The JMS cohort study
- Characterization of two thermophilic cellulases from Talaromyces leycettanus JCM12802 and their synergistic action on cellulose hydrolysis
- Ecohydrology of urban trees under passive and active irrigation in a semiarid city
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- Yeasts affect tolerance of Drosophila melanogaster to food substrate with high NaCl concentration
- The effect of climate change on cholera disease: The road ahead using artificial neural network
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- Improving the antimicrobial efficacy against resistant Staphylococcus aureus by a combined use of conjugated oligoelectrolytes
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- Inflammatory cell infiltrates, hypoxia, vascularization, pentraxin 3 and osteoprotegerin in abdominal aortic aneurysms – A quantitative histological study
- Effects of virtual reality rehabilitation training on gait and balance in patients with Parkinson's disease: A systematic review
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- Investigation of biochemical and physiological parameters of the newborn Saiga antelope (Saiga tatarica) in Gansu Province, China
- One-year follow-up of changes in refraction and aberrations induced by corneal incision
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- An assessment of the Dutch experience with health insurers acting as healthcare advisors
- Perception of potential harm and benefits of HIV vaccine trial participation: A qualitative study from urban Tanzania
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- Cranberry extracts promote growth of Bacteroidaceae and decrease abundance of Enterobacteriaceae in a human gut simulator model
- Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study
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- Optogenetically transduced human ES cell-derived neural progenitors and their neuronal progenies: Phenotypic characterization and responses to optical stimulation
- Ion torrent high throughput mitochondrial genome sequencing (HTMGS)
- Outpatient antibiotic prescription rate and pattern in the private sector in India: Evidence from medical audit data
- Acute Influenza A virus outbreak in an enzootic infected sow herd: Impact on viral dynamics, genetic and antigenic variability and effect of maternally derived antibodies and vaccination
- Prevalence and correlates of low serum calcium in late pregnancy: A cross sectional study in the Nkongsamba Regional Hospital; Littoral Region of Cameroon
- Home-cage monitoring ascertains signatures of ictal and interictal behavior in mouse models of generalized seizures
- CRISPR/Cas9 gene editing in the West Nile Virus vector, Culex quinquefasciatus Say
- Genetic susceptibility to angiotensin-converting enzyme-inhibitor induced angioedema: A systematic review and evaluation of methodological approaches
- Proton pump inhibitor use increases the risk of peritonitis in peritoneal dialysis patients
- Comparative distribution of extended-spectrum beta-lactamase–producing Escherichia coli from urine infections and environmental waters
- Sex differences in thigh muscle volumes, sprint performance and mechanical properties in national-level sprinters
- Maternal serum and cord blood leptin concentrations at delivery
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- Intolerance of uncertainty fuels depressive symptoms through rumination: Cross-sectional and longitudinal studies
- Monitoring exercise-induced muscle damage indicators and myoelectric activity during two weeks of knee extensor exercise training in young and old men
- Can adoption of pollution prevention techniques reduce pollution substitution?
- The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes
- Poly-arginine-18 peptides do not exacerbate bleeding, or improve functional outcomes following collagenase-induced intracerebral hemorrhage in the rat
- Affective disorders in the elderly in different European countries: Results from the MentDis_ICF65+ study
- Evaluation of forearm vascular resistance during orthostatic stress: Velocity is proportional to flow and size doesn’t matter
- Proton pencil minibeam irradiation of an in-vivo mouse ear model spares healthy tissue dependent on beam size
- Maternal stress in Shank3ex4-9 mice increases pup-directed care and alters brain white matter in male offspring
- Aspartate aminotransferase-to-platelet ratio index (APRI): A potential marker for diagnosis in patients at risk of severe malaria caused by Plasmodium vivax
- Exploiting open source 3D printer architecture for laboratory robotics to automate high-throughput time-lapse imaging for analytical microbiology
- Long non-coding RNAs and latent HIV – A search for novel targets for latency reversal
- Clinical characteristics of neonatal fulminant necrotizing enterocolitis in a tertiary Children's hospital in the last 10 years
- Effects of neuromuscular electrical stimulation training on muscle size in collegiate track and field athletes
- Adaptive fuzzy flow rate control considering multifractal traffic modeling and 5G communications
- Evaluation of four commercial tests for detecting ceftiofur in waste milk bulk tank samples
- A smart tele-cytology point-of-care platform for oral cancer screening
- Vasopressin SNP pain factors and stress in sickle cell disease
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- Microbial metabolisms in an abyssal ferromanganese crust from the Takuyo-Daigo Seamount as revealed by metagenomics
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- The impact of short-term machine perfusion on the risk of cancer recurrence after rat liver transplantation with donors after circulatory death
- Proteomic profiling of the thrombin-activated canine platelet secretome (CAPS)
- Blood metal levels and serum testosterone concentrations in male and female children and adolescents: NHANES 2011–2012
- The effects of prolonged single night session of videogaming on sleep and declarative memory
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- Positive selection and precipitation effects on the mitochondrial NADH dehydrogenase subunit 6 gene in brown hares (Lepus europaeus) under a phylogeographic perspective
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- Enhancement of antibiotics antimicrobial activity due to the silver nanoparticles impact on the cell membrane
- Correction: Smoking, alcohol use disorder and tuberculosis treatment outcomes: A dual co-morbidity burden that cannot be ignored
- Correction: Effect of corruption on perceived difficulties in healthcare access in sub-Saharan Africa
- Knowledge-based best of breed approach for automated detection of clinical events based on German free text digital hospital discharge letters
- Importance of thorough tissue and cellular level characterization of targeted drugs in the evaluation of pharmacodynamic effects
- Integrated value-chain and risk assessment of Pig-Related Zoonoses in Ghana
- Failed sperm retrieval from severely oligospermic or non-obstructive azoospermic patients on oocyte retrieval day: Emergent oocyte cryopreservation is a feasible strategy
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- Pig farmers’ willingness to pay for management strategies to reduce aggression between pigs
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- Diagnostic value of ASVS for insulinoma localization: A systematic review and meta-analysis
- Newly educated care managers’ experiences of providing care for persons with stress-related mental disorders in the clinical primary care context
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- Qualification programmes for immigrant health professionals: A systematic review
- An analytical model to minimize the latency in healthcare internet-of-things in fog computing environment
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- Assessment of energy expenditure during high intensity cycling and running using a heart rate and activity monitor in young active adults
- Evaluating rectal swab collection method for gut microbiome analysis in the common marmoset (Callithrix jacchus)
- Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study
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- The calcium sensor OsCBL1 modulates nitrate signaling to regulate seedling growth in rice
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- Mathematical determination of the HIV-1 matrix shell structure and its impact on the biology of HIV-1
- Contingent negative variation during a modified cueing task in simulated driving
- CAMDI interacts with the human memory-associated protein KIBRA and regulates AMPAR cell surface expression and cognition
- Effect of feeding patterns on growth and nutritional status of children aged 0-24 months: A Chinese cohort study
- A fecal sequel: Testing the limits of a genetic assay for bat species identification
- Measuring the impact of chronic conditions and associated multimorbidity on health-related quality of life in the general population in Hong Kong SAR, China: A cross-sectional study
- Short and long-term clinical effectiveness and cost-effectiveness of a late-phase community-based balance and gait exercise program following hip fracture. The EVA-Hip Randomised Controlled Trial
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- Distinct varieties of aesthetic chills in response to multimedia
- Interaction between apolipoprotein E genotype and hypertension on cognitive function in older women in the Nurses’ Health Study
- Correction: Resistance profile of the HIV-1 maturation inhibitor GSK3532795 in vitro and in a clinical study
- New formulation of the Gompertz equation to describe the kinetics of untreated tumors
- Development of visual perception of others’ actions: Children’s judgment of lifted weight
- Retrospective comparative analysis of intraocular lens calculation formulas after hyperopic refractive surgery
- Human vitreous concentrations of citicoline following topical application of citicoline 2% ophthalmic solution
- Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children
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- Risk factors affecting dairy cattle protective grouping behavior, commonly known as bunching, against Stomoxys calcitrans (L.) on California dairies
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- Characterisation and microbial community analysis of lipid utilising microorganisms for biogas formation
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- Exploring optimization strategies for improving explicit water models: Rigid n-point model and polarizable model based on Drude oscillator
- Artificial insemination with fresh, liquid stored and frozen thawed semen in dromedary camels
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- Minimal genetic differentiation of the malaria vector Nyssorhynchus darlingi associated with forest cover level in Amazonian Brazil
- The impact of leisure activities on older adults’ cognitive function, physical function, and mental health
- scafSLICR: A MATLAB-based slicing algorithm to enable 3D-printing of tissue engineering scaffolds with heterogeneous porous microarchitecture
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- Influences on surgical antimicrobial prophylaxis decision making by surgical craft groups, anaesthetists, pharmacists and nurses in public and private hospitals
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- Investigating cooperation with robotic peers
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- Transgenerational deep sequencing revealed hypermethylation of hippocampal mGluR1 gene with altered mRNA expression of mGluR5 and mGluR3 associated with behavioral changes in Sprague Dawley rats with history of prolonged febrile seizure
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- An outbreak of tuberculosis in a middle school in Henan, China: Epidemiology and risk factors
- Initial clinical radiological findings and staging to predict prognosis of primary hepatic angiosarcoma: A retrospective analysis
- A new early Eocene deperetellid tapiroid illuminates the origin of Deperetellidae and the pattern of premolar molarization in Perissodactyla
- Longevity and marginal bone loss of narrow-diameter implants supporting single crowns: A systematic review
- Impact of UVC-sustained recirculating air filtration on airborne bacteria and dust in a pig facility
- Cold-related Florida manatee mortality in relation to air and water temperatures
- Conceptual fluency in inductive reasoning
- Clinical outcomes and treatment patterns among Medicare patients with nonvalvular atrial fibrillation (NVAF) and chronic kidney disease
- Improvements in the learnability of smartphone haptic interfaces for visually impaired users
- Role of the malic enzyme in metabolism of the halotolerant methanotroph Methylotuvimicrobium alcaliphilum 20Z
- Cyclic loading test study on a new cast-in-situ insulated sandwich concrete wall
- Natural compounds as angiogenic enzyme thymidine phosphorylase inhibitors: In vitro biochemical inhibition, mechanistic, and in silico modeling studies
- Analysis of virulence potential of Escherichia coli O145 isolated from cattle feces and hide samples based on whole genome sequencing
- Pre-clinical medical student reflections on implicit bias: Implications for learning and teaching
- Prognostic significance of non-sustained ventricular tachycardia on stored electrograms in pacemaker recipients
- Determinants of preterm birth among mothers who gave birth at public hospitals in the Amhara region, Ethiopia: A case-control study
- Real-world evidence of the effectiveness of ombitasvir-paritaprevir/r ± dasabuvir ± ribavirin in patients monoinfected with chronic hepatitis C or coinfected with human immunodeficiency virus-1 in Spain
- Unique transcriptomic landscapes identified in idiopathic spontaneous and infection related preterm births compared to normal term births
- Restrained expansion of the recall germinal center response as biomarker of protection for influenza vaccination in mice
- Arabidopsis TRM5 encodes a nuclear-localised bifunctional tRNA guanine and inosine-N1-methyltransferase that is important for growth
- Achievement of weight loss in patients with overweight during dietetic treatment in primary health care
- Autophagy deficiency exacerbates colitis through excessive oxidative stress and MAPK signaling pathway activation
- The impacts of parity on lung function data (LFD) of healthy females aged 40 years and more issued from an upper middle income country (Algeria): A comparative study
- Reorganization of spatial configurations in visual working memory: A matter of set size?
- Unravelling travellers’ route choice behaviour at full-scale urban network by focusing on representative OD pairs in computer experiments
- Evaluating the higher-order structure of the Profile of Emotional Competence (PEC): Confirmatory factor analysis and Bayesian structural equation modeling
- HIV prevalence and correlated factors among male clients of female sex workers in a border region of China
- Next generation sequencing and RNA-seq characterization of adipose tissue in the Nile crocodile (Crocodylus niloticus) in South Africa: Possible mechanism(s) of pathogenesis and pathophysiology of pansteatitis
- Association between advanced maternal age and maternal and neonatal morbidity: A cross-sectional study on a Spanish population
- Ethnic differences in the prevalence, socioeconomic and health related risk factors of knee pain and osteoarthritis symptoms in older Malaysians
- Increasing knowledge of HIV status in a country with high HIV testing coverage: Results from the Botswana Combination Prevention Project
- Friends with benefits: The effects of vegetative shading on plant survival in a green roof environment
- Comparison of the fecal, cecal, and mucus microbiome in male and female mice after TNBS-induced colitis
- Identifying candidate diagnostic markers for early stage of non-small cell lung cancer
- Complex alternative splicing of human Endonuclease V mRNA, but evidence for only a single protein isoform
- Correction: KML001 Induces Apoptosis and Autophagic Cell Death in Prostate Cancer Cells via Oxidative Stress Pathway
- Unique developmental trajectories of risk behaviors in adolescence and associated outcomes in young adulthood
- Enhanced fibrinolysis detection in a natural occurring canine model with intracavitary effusions: Comparison and degree of agreement between thromboelastometry and FDPs, D-dimer and fibrinogen concentrations
- Overexpression of Saussurea involucrata dehydrin gene SiDHN promotes cold and drought tolerance in transgenic tomato plants
- Foxtail millet (Setaria italica (L.) P. Beauv) CIPKs are responsive to ABA and abiotic stresses
- Autonomous drone hunter operating by deep learning and all-onboard computations in GPS-denied environments
- Heterogeneity Diffusion Imaging of gliomas: Initial experience and validation
- Frequency cluster formation and slow oscillations in neural populations with plasticity
- DHP23002 as a next generation oral paclitaxel formulation for pancreatic cancer therapy
- Diagnostic accuracy of SOX11 immunohistochemistry in mantle cell lymphoma: A meta-analysis
- Analytical solution to swing equations in power grids
- Pathways to conspiracy: The social and linguistic precursors of involvement in Reddit’s conspiracy theory forum
- Spatiotemporally random and diverse grid cell spike patterns contribute to the transformation of grid cell to place cell in a neural network model
- Empathic concern and personal distress depend on situational but not dispositional factors
- Who is more susceptible to job stressors and resources? Sensory-processing sensitivity as a personal resource and vulnerability factor
- Cost-effectiveness of integrating postpartum antiretroviral therapy and infant care into maternal & child health services in South Africa
- A substitution mutation in a conserved domain of mammalian acetate-dependent acetyl CoA synthetase 2 results in destabilized protein and impaired HIF-2 signaling
- One step at a time: Physical activity is linked to positive interpretations of ambiguity
- Calreticulin regulates vascular endothelial growth factor-A mRNA stability in gastric cancer cells
- Evaluation of various methods of selection of B. subtilis strains capable of secreting surface-active compounds
- Association between US Pharmacopeia (USP) monograph standards, generic entry and prescription drug costs
- Molecular characterisation of the synovial fluid microbiome in rheumatoid arthritis patients and healthy control subjects
- On sorption hysteresis in wood: Separating hysteresis in cell wall water and capillary water in the full moisture range
- Inbreeding, Allee effects and stochasticity might be sufficient to account for Neanderthal extinction
- Reliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults
- Socioeconomic determinants of nutritional status among ‘Baiga’ tribal children In Balaghat district of Madhya Pradesh: A qualitative study
- Study on characteristics of fire plume in building facade window under lateral blow
- ‘When you talk to someone in a bad way or always put her under pressure, it is actually worse than beating her’: Conceptions and experiences of emotional intimate partner violence in Rwanda and South Africa
- Effects of 6-mercaptopurine in pressure overload induced right heart failure
- The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes
- Implementation and evaluation of an antimicrobial stewardship programme in companion animal clinics: A stepped-wedge design intervention study
- Factors associated with persistently high-cost health care utilization for musculoskeletal pain
- Nitrogen and chlorophyll status determination in durum wheat as influenced by fertilization and soil management: Preliminary results
- Effect of repeated in vivo microCT imaging on the properties of the mouse tibia
- Coupling environment and physiology to predict effects of climate change on the taxonomic and functional diversity of fish assemblages in the Murray-Darling Basin, Australia
- Hematology and plasma biochemistries in the Blanding’s turtle (Emydoidea blandingii) in Lake County, Illinois
- CRISPR-Cas influences the acquisition of antibiotic resistance in Klebsiella pneumoniae
- Phosphorylation-dependent activity-based conformational changes in P21-activated kinase family members and screening of novel ATP competitive inhibitors
- Antidepressant prescriptions, discontinuation, depression and perinatal outcomes, including breastfeeding: A population cohort analysis
- Why men with a low-risk prostate cancer select and stay on active surveillance: A qualitative study
- Imported severe malaria and risk factors for intensive care: A single-centre retrospective analysis
- Combined treatment (image-guided thrombectomy and endovascular therapy with open femoral access) for acute lower limb ischemia: Clinical efficacy and outcomes
- Low-latency single channel real-time neural spike sorting system based on template matching
- Quantifying the scale effect in geospatial big data using semi-variograms
- Paper-and-pencil versus computerized administration mode: Comparison of data quality and risk behavior prevalence estimates in the European school Survey Project on Alcohol and other Drugs (ESPAD)
- Regression adjusted colocalisation colour mapping (RACC): A novel biological visual analysis method for qualitative colocalisation analysis of 3D fluorescence micrographs
- Ostrich eggshell bead diameter in the Holocene: Regional variation with the spread of herding in eastern and southern Africa
- Spatial and temporal variations in female size at maturity of a Southern Rock Lobster (Jasus edwardsii) population: A likely response to climate change
- Inactive USP14 and inactive UCHL5 cause accumulation of distinct ubiquitinated proteins in mammalian cells
- Training rhesus macaques to take daily oral antiretroviral therapy for preclinical evaluation of HIV prevention and treatment strategies
- Left ventricular structural and functional changes in Friedreich ataxia – Relationship with body size, sex, age and genetic severity
- Magnitude and factors associated with anemia among pregnant women attending antenatal care in Bench Maji, Keffa and Sheka zones of public hospitals, Southwest, Ethiopia, 2018: A cross -sectional study
- Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review
- Hydrogen sulphide-induced hypometabolism in human-sized porcine kidneys
- Correction: Comparison of the molecular properties of retinitis pigmentosa P23H and N15S amino acid replacements in rhodopsin
- Retraction: Regulation of gastric smooth muscle contraction via Ca2+-dependent and Ca2+-independent actin polymerization
- Evaluation of neutral oral contrast agents for assessment of the small bowel at abdominal staging CT
- Blood type and breed-associated differences in cell marker expression on equine bone marrow-derived mesenchymal stem cells including major histocompatibility complex class II antigen expression
- Induced abortion and future use of IVF treatment; A nationwide register study
- Psychosocial determinants of sustained maternal functional impairment: Longitudinal findings from a pregnancy-birth cohort study in rural Pakistan
- Measurement of finger joint angle using stretchable carbon nanotube strain sensor
- Determinants of mortality among patients with drug-resistant tuberculosis in northern Nigeria
- Drugs modulating stochastic gene expression affect the erythroid differentiation process
- Efficacy of UB0316, a multi-strain probiotic formulation in patients with type 2 diabetes mellitus: A double blind, randomized, placebo controlled study
- Prognostic value of des-γ-carboxy prothrombin in patients with hepatocellular carcinoma treated with transarterial chemotherapy: A systematic review and meta-analysis
- Avermectin induces the oxidative stress, genotoxicity, and immunological responses in the Chinese Mitten Crab, Eriocheir sinensis
- Antibiotic use in mandarin production (Citrus reticulata Blanco) in major mandarin-producing areas in Thailand: A survey assessment
- Application of CPI cutoff value based on parentage testing of duos and trios typed by four autosomal kits
- Correction: Good and Bad in the Hands of Politicians: Spontaneous Gestures during Positive and Negative Speech
- Adolescents with worse levels of oral health literacy have more cavitated carious lesions
- Effective methods for the inactivation of Francisella tularensis
- Detection of early-stage Alzheimer’s pathology using blood-based autoantibody biomarkers in elderly hip fracture repair patients
- Correlation between internal pudendal artery stenosis and erectile dysfunction in patients with suspected coronary artery disease
- Analysis of HER2 genomic binding in breast cancer cells identifies a global role in direct gene regulation
- Population productivity of shovelnose rays: Inferring the potential for recovery
- Correction: Long-term clinical outcomes in a cohort of patients with solitary plasmacytoma treated in the modern era
- Effects of tetracycline on myocardial infarct size in obese rats with chemically-induced colitis
- Mineral absorption is an enriched pathway in a brain region of restless legs syndrome patients with reduced MEIS1 expression
- Changes in weight and body composition across five years at university: A prospective observational study
- Adeno-associated virus-mediated expression of human butyrylcholinesterase to treat organophosphate poisoning
- Effects of insulin signaling on mouse taste cell proliferation
- Patient-level cost of home- and facility-based child pneumonia treatment in Suba Sub County, Kenya
- TAP: A static analysis model for PHP vulnerabilities based on token and deep learning technology
- Cost-effectiveness of QuantiFERON-TB Gold In-Tube versus tuberculin skin test for diagnosis and treatment of Latent Tuberculosis Infection in primary health care workers in Brazil
- Multifaceted intervention for the prevention and management of musculoskeletal pain in nursing staff: Results of a cluster randomized controlled trial
- Changes over time in creatinine clearance and comparison of emergent adverse events for HIV-positive adults receiving standard doses (300 mg/day) of lamivudine-containing antiretroviral therapy with baseline creatinine clearance of 30–49 vs ≥50 mL/min
- Population dynamics of foxes during restricted-area culling in Britain: Advancing understanding through state-space modelling of culling records
- Impacts of experimental advisory exit speed sign on traffic speeds for freeway exit ramp
- In-hospital outcomes and 30-day readmission rates among ischemic and hemorrhagic stroke patients with delirium
- Monitoring quality indicators for the Xpert MTB/RIF molecular assay in Ethiopia
- Delivering genes across the blood-brain barrier: LY6A, a novel cellular receptor for AAV-PHP.B capsids
- Correction: Using remote sensing to detect whale strandings in remote areas: The case of sei whales mass mortality in Chilean Patagonia
- Comparison of the inoculum size effects of antibiotics on IMP-6 β-lactamase-producing Enterobacteriaceae co-harboring plasmid-mediated quinolone resistance genes
- Contrast-enhanced computed tomography findings of canine primary renal tumors including renal cell carcinoma, lymphoma, and hemangiosarcoma
- Non-invasive in vivo imaging of UCP1 expression in live mice via near-infrared fluorescent protein iRFP720
- Overexpression of pink1 or parkin in indirect flight muscles promotes mitochondrial proteostasis and extends lifespan in Drosophila melanogaster
- Fiber stiffness, pore size and adhesion control migratory phenotype of MDA-MB-231 cells in collagen gels
- Comparison of two experimental ARDS models in pigs using electrical impedance tomography
- Are primary school children attending full-day school still engaged in sports clubs?
- Stroke risks in women with dysmenorrhea by age and stroke subtype
- Changes in patterns of mortality rates and years of life lost due to firearms in the United States, 1999 to 2016: A joinpoint analysis
- In vitro modeling of Batrachochytrium dendrobatidis infection of the amphibian skin
- Development and validation of LC-MS/MS method for imatinib and norimatinib monitoring by finger-prick DBS in gastrointestinal stromal tumor patients
- Correction: Habitat disturbance and the organization of bacterial communities in Neotropical hematophagous arthropods
- Characterisation of early metazoan secretion through associated signal peptidase complex subunits, prohormone convertases and carboxypeptidases of the marine sponge (Amphimedon queenslandica)
- Time trends between 2002 and 2017 in correlates of self-reported sitting time in European adults
- Performance of patient acuity rating by rapid response team nurses for predicting short-term prognosis
- Changes in HbA1c during the first six years after the diagnosis of Type 2 diabetes mellitus predict long-term microvascular outcomes
- Correction: Antimicrobial resistance genotypes and phenotypes of Campylobacter jejuni isolated in Italy from humans, birds from wild and urban habitats, and poultry
- Correction: Mental health and quality of life outcomes in family members of patients with chronic critical illness admitted to the intensive care units of two Brazilian hospitals serving the extremes of the socioeconomic spectrum
- Correction: Establishing an infrastructure for collaboration in primate cognition research
- Correction: The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review
- Health provider and service-user experiences of sensory modulation rooms in an acute inpatient psychiatry setting
- Comparison of potential drug-drug interactions with metabolic syndrome medications detected by two databases
- The Polish version of the Cultural Intelligence Scale: Assessment of its reliability and validity among healthcare professionals and medical faculty students
- Selection of optimal reference genes for qRT-PCR analysis of shoot development and graviresponse in prostrate and erect chrysanthemums
- Metastasis risk prediction model in osteosarcoma using metabolic imaging phenotypes: A multivariable radiomics model
- Defining hospital community benefit activities using Delphi technique: A comparison between China and the United States
- Establishment of the experimental procedure for prediction of conjugation capacity in mutant UGT1A1
- A robust multi-objective optimization framework to capture both cellular and intercellular properties in cardiac cellular model tuning: Analyzing different regions of membrane resistance profile in parameter fitting
- Sea star wasting disease demography and etiology in the brooding sea star Leptasterias spp.
- Diagnostic plasma miRNA-profiles for ovarian cancer in patients with pelvic mass
- Genetic diversity and drug resistance of HIV-1 among infected pregnant women newly diagnosed in Luanda, Angola
- I’ve been robbed! – Can changes in floral traits discourage bee pollination?
- Visualising statistical models using dynamic nomograms
- Assessing the capacity of Malawi’s district and central hospitals to manage traumatic diaphyseal femoral fractures in adults
- Diagnostic performance of basal cortisol level at 0900-1300h in adrenal insufficiency
- The Mastery Rubric for Bioinformatics: A tool to support design and evaluation of career-spanning education and training
- Microdissection and whole chromosome painting confirm karyotype transformation in cryptic species of the Lariophagus distinguendus (Förster, 1841) complex (Hymenoptera: Pteromalidae)
- Quality of Kangaroo Mother Care services in Ethiopia: Implications for policy and practice
- Gemcitabine potentiates the anti-tumour effect of radiation on medullary thyroid cancer
- iTRAQ-based high-throughput proteomics analysis reveals alterations of plasma proteins in patients infected with human bocavirus
- The detection of a non-anemophilous plant species using airborne eDNA
- Perception and control of low cable operation forces in voluntary closing body-powered upper-limb prostheses
- Neoadjuvant chemotherapy plus surgery versus concurrent chemoradiotherapy in stage IB2-IIB cervical cancer: A systematic review and meta-analysis
- Randomized methods to characterize large-scale vortical flow networks
- Disentangling the coexistence strategies of mud-daubing wasp species through trophic analysis in oases of Baja California peninsula
- Front-of-pack nutritional labels: Understanding by low- and middle-income Mexican consumers
- Distress in patients with end-stage renal disease: Staff perceptions of barriers to the identification of mild-moderate distress and the provision of emotional support
- Pathways to antibiotics in Bangladesh: A qualitative study investigating how and when households access medicine including antibiotics for humans or animals when they are ill
- DOC export is exceeded by C fixation in May Creek: A late-successional watershed of the Copper River Basin, Alaska
- Behavioral observation of prosocial behavior and social initiative is related to preschoolers’ psychopathological symptoms
- Evaluating the impact of citations of articles based on knowledge flow patterns hidden in the citations
- Correction: Economic sanctions and academia: Overlooked impact and long-term consequences
- Correction: A novel association between relaxin receptor polymorphism and hematopoietic stem cell yield after mobilization
- Expression of Concern: Cooperativity of Oncogenic K-Ras and Downregulated p16/INK4A in Human Pancreatic Tumorigenesis
- Price dispersion of generic medications
- Sex differences in body composition but not neuromuscular function following long-term, doxycycline-induced reduction in circulating levels of myostatin in mice
- The emotion regulation effect of cognitive control is related to depressive state through the mediation of rumination: An ERP study
- Comparison of SMS-EPI and 3D-EPI at 7T in an fMRI localizer study with matched spatiotemporal resolution and homogenized excitation profiles
- Left ventricular mass normalization for body size in children based on an allometrically adjusted ratio is as accurate as normalization based on the centile curves method
- Correction: Combining biophysical parameters, spectral indices and multivariate hyperspectral models for estimating yield and water productivity of spring wheat across different agronomic practices
- Correction: Flowers as viral hot spots: Honey bees (Apis mellifera) unevenly deposit viruses across plant species
- 'Small small quarrels bring about happiness or love in the relationships’: Exploring community perceptions and gendered norms contributing to male perpetrated intimate partner violence in the Central Region of Ghana
- The performance of practitioners conducting facial comparisons on images of children across age
- Increased amounts and stability of telomeric repeat-containing RNA (TERRA) following DNA damage induced by etoposide
- Patients with limitation or withdrawal of life supporting care admitted in a medico-surgical intermediate care unit: Prevalence, description and outcome over a six-month period
- Correction: Diverse radiofrequency sensitivity and radiofrequency effects of mobile or cordless phone near fields exposure in Drosophila melanogaster
- Predicting the performance of TV series through textual and network analysis: The case of Big Bang Theory
- Risk of temperature, humidity and concentrations of air pollutants on the hospitalization of AECOPD
- Mixed methods grant applications in the health sciences: An analysis of reviewer comments
- Renal abnormalities among children with sickle cell conditions in highly resource-limited setting in Ghana
- Size matters: How reaching and vergence movements are influenced by the familiar size of stereoscopically presented objects
- Willingness to receive institutional and community-based eldercare among the rural elderly in China
- An improved deep learning method for predicting DNA-binding proteins based on contextual features in amino acid sequences
- Beyond executive functions, creativity skills benefit academic outcomes: Insights from Montessori education
- A LAMP assay for the rapid and robust assessment of Wolbachia infection in Aedes aegypti under field and laboratory conditions
- Nonarteritic anterior ischemic optic neuropathy is associated with cerebral small vessel disease
- Fiber-tract localized diffusion coefficients highlight patterns of white matter disruption induced by proximity to glioma
- The fight against polio through the NO-DO newsreels during the Francoism period in Spain
- Ocean sound levels in the northeast Pacific recorded from an autonomous underwater glider
- Cost-consequence analysis of influenza vaccination among the staff of a large teaching hospital in Rome, Italy: A pilot study
- The relationship among the progression of inflammation in umbilical cord, fetal inflammatory response, early-onset neonatal sepsis, and chorioamnionitis
- How medical professional students view older people with dementia: Implications for education and practice
- An enhanced nonparametric EWMA sign control chart using sequential mechanism
- Land use change, carbon stocks and tree species diversity in green spaces of a secondary city in Myanmar, Pyin Oo Lwin
- Is there a difference in women’s experiences of care with medication vs. manual vacuum aspiration abortions? Determinants of person-centered care for abortion services
- Maternal complications in pregnancy and childbirth for women with epilepsy: Time trends in a nationwide cohort
- Adsorption of oxytetracycline on kaolinite
- Interdisciplinary stratified care for low back pain: A qualitative study on the acceptability, potential facilitators and barriers to implementation
- The role of resource transfer in positive, non-additive litter decomposition
- The impact of language on the interpretation of resuscitation clinical care plans by doctors. A mixed methods study
- Quantum dots reveal heterogeneous membrane diffusivity and dynamic surface density polarization of dopamine transporter
- Genomic analysis of Shiga toxin-producing Escherichia coli from patients and asymptomatic food handlers in Japan
- The heavy metals lead and cadmium are cytotoxic to human bone osteoblasts via induction of redox stress
- Anatomical, taxonomic, and phylogenetic reappraisal of a poorly known ghost knifefish, Tembeassu marauna (Ostariophysi: Gymnotiformes), using X-ray microcomputed tomography
- Matrix-assisted laser desorption/ionization time of flight mass spectrometry identification of Vibrio (Listonella) anguillarum isolated from sea bass and sea bream
- Recommendations of older adults on how to use the PROM ‘TOPICS-MDS’ in healthcare conversations: A Delphi study
- The winner takes it all—Competitiveness of single nodes in globalized supply networks
- Hamsters in the city: A study on the behaviour of a population of common hamsters (Cricetus cricetus) in urban environment
- Correction: Liquid biopsies for omics-based analysis in sentinel mussels
- Size matters! Association between journal size and longitudinal variability of the Journal Impact Factor
- Drug resistance and epidemiology characteristics of multidrug-resistant tuberculosis patients in 17 provinces of China
- A model-based framework for chronic hepatitis C prevalence estimation
- Adding rewards to regulation: The impacts of watershed conservation on land cover and household wellbeing in Moyobamba, Peru
- Clinical determinants of social media use in individuals with schizophrenia
- Arsenic and nutrient absorption characteristics and antioxidant response in different leaves of two ryegrass (Lolium perenne) species under arsenic stress
- An evolution of socioeconomic related inequality in teenage pregnancy and childbearing in Malawi
- A single plasmid based CRISPR interference in Synechocystis 6803 – A proof of concept
- Structural vulnerability to narcotics-driven firearm violence: An ethnographic and epidemiological study of Philadelphia’s Puerto Rican inner-city
- Temporal trends in intracerebral hemorrhage: Evidence from the Austrian Stroke Unit Registry
- Prevalence and risk factors for multi-drug resistant Escherichia coli among poultry workers in the Federal Capital Territory, Abuja, Nigeria
- Prediction of disease-related metabolites using bi-random walks
- Clinical use, efficacy, and durability of maraviroc for antiretroviral therapy in routine care: A European survey
- Biomarker discovery in inflammatory bowel diseases using network-based feature selection
- The Cinderella Complex: Word embeddings reveal gender stereotypes in movies and books
- Exoproteome profiling of Trypanosoma cruzi during amastigogenesis early stages
- Reproducible phenotype alteration due to prolonged cooling of the pupae of Polyommatus icarus butterflies
- Nutritional treatment with an immune-modulating enteral formula alleviates 5-fluorouracil-induced adverse effects in rats
- Pharmacy-based predictors of non-adherence, non-persistence and reinitiation of antihypertensive drugs among patients on oral diabetes drugs in the Netherlands
- Systematic review of the accuracy of plasma preparation tubes for HIV viral load testing
- Circadian clock regulates the shape and content of dendritic spines in mouse barrel cortex
- “Anybody can make kids; it takes a real man to look after your kids”: Aboriginal men’s discourse on parenting
- Correction: A 1D computer model of the arterial circulation in horses: An important resource for studying global interactions between heart and vessels under normal and pathological conditions
- Maternal interpregnancy weight change and premature birth: Findings from an English population-based cohort study
- Correction: Identifying performance benchmarks and determinants for reproductive performance and calf survival using a longitudinal field study of cow-calf herds in western Canada
- Prognostic value of the model for end-stage liver disease excluding INR score (MELD-XI) in patients with adult congenital heart disease
- Treatment of Urethral Pain Syndrome (UPS) in Sweden
- Migration and political polarization in the U.S.: An analysis of the county-level migration network
- Epidemiology and complications of late-onset sepsis: an Italian area-based study
- The relationship between women’s experience of intimate partner violence and other socio-demographic factors, and under-5 children’s health in South Africa
- Association between trunk and gluteus muscle size and long jump performance
- Multimorbidity and complex multimorbidity in Brazilian rural workers
- Correction: Interspecific Phylogenic Relationships within Genus Melilotus Based on Nuclear and Chloroplast DNA
- Insulin-like growth factor (IGF)-II- mediated fibrosis in pathogenic lung conditions
- Wolf diet and prey selection in the South-Eastern Carpathian Mountains, Romania
- In vitro activity of aryl-thiazole derivatives against Schistosoma mansoni schistosomula and adult worms
- Sample size issues in multilevel logistic regression models
- Seed germination ecology of Ageratum houstonianum: A major invasive weed in Nepal
- Experiences of lifestyle change among women with gestational diabetes mellitus (GDM): A behavioural diagnosis using the COM-B model in a low-income setting
- Pharmacologic management of HCV treatment in patients with HCV monoinfection vs. HIV/HCV coinfection: Does coinfection really matter?
- The association between cigarette smoking and serum thyroid stimulating hormone, thyroid peroxidase antibodies and thyroglobulin antibodies levels in Chinese residents: A cross-sectional study in 10 cities
- Mouse movement measures enhance the stop-signal task in adult ADHD assessment
- Ecosystem functioning in urban grasslands: The role of biodiversity, plant invasions and urbanization
- Correction: KETOS: Clinical decision support and machine learning as a service – A training and deployment platform based on Docker, OMOP-CDM, and FHIR Web Services
- Does craniofacial morphology affect third molars impaction? Results from a population-based study in northeastern Germany
- Hyperconnectivity during screen-based stories listening is associated with lower narrative comprehension in preschool children exposed to screens vs dialogic reading: An EEG study
- Weight loss is associated with improved quality of life among rural women completers of a web-based lifestyle intervention
- Long-term high-grain diet altered the ruminal pH, fermentation, and composition and functions of the rumen bacterial community, leading to enhanced lactic acid production in Japanese Black beef cattle during fattening
- Beyond detoxification: Pleiotropic functions of multiple glutathione S-transferase isoforms protect mice against a toxic electrophile
- Golgi reassembly and stacking protein 65 downregulation is required for the anti-cancer effect of dihydromyricetin on human ovarian cancer cells
- SSR marker development in Clerodendrum trichotomum using transcriptome sequencing
- Risk factors for the carriage of Streptococcus infantarius subspecies infantarius isolated from African fermented dairy products
- Development of an intervention tool for precision oral self-care: Personalized and evidence-based practice for patients with periodontal disease
- Personal values in adolescence and psychological distress in adults: A cross-sectional study based on a retrospective recall
- Overactive bladder and bladder pain syndrome/interstitial cystitis in primary Sjögren’s syndrome patients: A nationwide population-based study
- Clinical utility of combined preimplantation genetic testing methods in couples at risk of passing on beta thalassemia/hemoglobin E disease: A retrospective review from a single center
- Hip stress distribution - Predictor of dislocation in hip arthroplasties. A retrospective study of 149 arthroplasties
- Mortality, morbidity, and cardiac surgery in Injection Drug Use (IDU)-associated versus non-IDU infective endocarditis: The need to expand substance use disorder treatment and harm reduction services
- Pup mortality in New Zealand sea lions (Phocarctos hookeri) at Enderby Island, Auckland Islands, 2013-18
- In vitro endothelial cell migration from limbal edge-modified Quarter-DMEK grafts
- Liquid Chromatography/Mass Spectrometry based serum metabolomics study on recurrent abortion women with antiphospholipid syndrome
- Gut carriage of antimicrobial resistance genes among young children in urban Maputo, Mozambique: Associations with enteric pathogen carriage and environmental risk factors
- Prepubertal nutrition alters Leydig cell functional capacity and timing of puberty
- Reliability of the Swedish version of the Evidence-Based Practice Attitude Scale assessing physiotherapist’s attitudes to implementation of evidence-based practice
- Mitochondrial alarmins are tissue mediators of ventilator-induced lung injury and ARDS
- Complete Chloroplast Genomes of Vachellia nilotica and Senegalia senegal: Comparative Genomics and Phylogenomic Placement in a New Generic System
- Retraction: Over-Expression of Superoxide Dismutase Ameliorates Cr(VI) Induced Adverse Effects via Modulating Cellular Immune System of Drosophila melanogaster
- Effect of pre-season training phase on anthropometric, hormonal and fitness parameters in young soccer players
- Exosomes from conditioned media of bone marrow-derived mesenchymal stem cells promote bone regeneration by enhancing angiogenesis
- Outcome of patients with heart failure after transcatheter aortic valve implantation
- Fatty acid profile of Romanian’s common bean (Phaseolus vulgaris L.) lipid fractions and their complexation ability by β-cyclodextrin
- Appropriate empirical antibiotic therapy and mortality: Conflicting data explained by residual confounding
- Treatment of corneal endothelial damage in a rabbit model with a bioengineered graft using human decellularized corneal lamina and cultured human corneal endothelium
- Telbivudine on IgG-associated hypergammaglobulinemia and TGF-β1 hyperactivity in hepatitis B virus-related liver cirrhosis
- Correction: Axial variation of deoxyhemoglobin density as a source of the low-frequency time lag structure in blood oxygenation level-dependent signals
- Correction: Mobile health-based physical activity intervention for individuals with spinal cord injury in the community: A pilot study
- Retraction: Placental expression of CD100, CD72 and CD45 is dysregulated in human miscarriage
- Correction: Use of IoT sensing and occupant surveys for determining the resilience of buildings to forest fire generated PM2.5
- Correction: The modulation of facial mimicry by attachment tendencies and their underlying affiliation motives in 3-year-olds: An EMG study
- Correction: Cognitive impairment in multiple sclerosis: An exploratory analysis of environmental and lifestyle risk factors
- Discovering novel disease comorbidities using electronic medical records
- Glutathione contributes to efficient post-Golgi trafficking of incoming HPV16 genome
- Epidemiology and antimicrobial resistance of methicillin-resistant Staphylococcus aureus isolates colonizing pigs with different exposure to antibiotics
- Social information use in adolescents: The impact of adults, peers and household composition
- Public practices on antibiotic use: A cross-sectional study among Qatar University students and their family members
- Effects of Topper Training on psychosocial problems, self-esteem, and peer victimisation in Dutch children: A randomised trial
- Comparative studies of two generations of NanoString nCounter System
- General practitioners’ perceptions of delayed antibiotic prescription for respiratory tract infections: A phenomenographic study
- Can altered magnetic field affect the foraging behaviour of ants?
- Parasitic infections and medical expenses according to Health Insurance Review Assessment claims data in South Korea, 2011–2018
- A prospective observational study of on-treatment plasma homocysteine levels as a biomarker of toxicity, depression and vitamin supplementation lead-in time pre pemetrexed, in patients with non-small cell lung cancer and malignant mesothelioma
- A strategy to identify protein-N-myristoylation-dependent phosphorylation reactions of cellular proteins by using Phos-tag SDS-PAGE
- Expression profile of sonic hedgehog signaling-related molecules in basal cell carcinoma
- Seasonal alternation of the ontogenetic development of the moon jellyfish Aurelia coerulea in Maizuru Bay, Japan
- Reliability of measurement of active trunk movement in wheelchair basketball players
- Chinese SLE Treatment and Research group (CSTAR) registry: Clinical significance of thrombocytopenia in Chinese patients with systemic lupus erythematosus
- Does source credibility matter for point-of-decision prompts? A quasi-experimental field study to increase stair use
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- Correction: Transcriptome profiling of mouse brain and lung under Dip2a regulation using RNA-sequencing
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- Correction: The C-reactive protein/albumin ratio as an independent predictor of mortality in patients with severe sepsis or septic shock treated with early goal-directed therapy
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- Correction: Dietary polyphenols as a safe and novel intervention for modulating pain associated with intervertebral disc degeneration in an in-vivo rat model
- Correction: Phylogenetic analysis of hepatitis C virus among HIV/ HCV co-infected patients in Nigeria
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- Correction: Clonality analysis of pulmonary tumors by genome-wide copy number profiling
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- Correction: Intensive longitudinal modelling predicts diurnal activity of salivary alpha-amylase
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- Influence of season and social context on male giant panda (Ailuropoda melanoleuca) vocal behaviour
- Development of an intravaginal ring for the topical delivery of Aurora kinase A inhibitor, MLN8237
- Differential phosphorylation determines the repressor and activator potencies of GLI1 proteins and their efficiency in modulating the HPV life cycle
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- Interleukin-38 interacts with destrin/actin-depolymerizing factor in human keratinocytes
- Correction: Fast, quantitative, murine cardiac 19F MRI/MRS of PFCE-labeled progenitor stem cells and macrophages at 9.4T
- Persistent post-discharge opioid prescribing after traumatic brain injury requiring intensive care unit admission: A cross-sectional study with longitudinal outcome
- Genome-wide histone modification profiling of inner cell mass and trophectoderm of bovine blastocysts by RAT-ChIP
- Aerobic exercise increases post-exercise exogenous protein oxidation in healthy young males
- Selection for tandem stop codons in ciliate species with reassigned stop codons
- Research ethics in inter- and multi-disciplinary teams: Differences in disciplinary interpretations
- Correction: Analyzing data from the digital healthcare exchange platform for surveillance of antibiotic prescriptions in primary care in urban Kenya: A mixed-methods study
- Correction: People making deontological judgments in the Trapdoor dilemma are perceived to be more prosocial in economic games than they actually are
- LFRET, a novel rapid assay for anti-tissue transglutaminase antibody detection
- Effects of isotemporal substitution of sedentary behavior with light-intensity or moderate-to-vigorous physical activity on cardiometabolic markers in male adolescents
- Topical estrogen application to wounds promotes delayed cutaneous wound healing in 80-week-old female mice
- Correction: An international randomised placebo-controlled trial of a four-component combination pill (“polypill”) in people with raised cardiovascular risk
- Correction: Evaluation of lung toxicity risk with computed tomography ventilation image for thoracic cancer patients
- Retraction: Pathological Roles of Interleukin-22 in the Development of Recurrent Hepatitis C after Liver Transplantation
- Correction: Elevational Distribution and Ecology of Small Mammals on Tanzania's Second Highest Mountain
- Correction: Decreased breast cancer-specific mortality risk in patients with a history of thyroid cancer
- Correction: Fecal microbiota dysbiosis in macaques and humans within a shared environment
- Correction: The center of pressure and ankle muscle co-contraction in response to anterior-posterior perturbations
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