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Topic:Veterinary Medicine

Veterinary medicine for horses encompasses the study and application of medical practices to diagnose, treat, and prevent diseases in equine species. This field involves a comprehensive understanding of equine anatomy, physiology, pathology, and pharmacology. Veterinary practitioners employ a range of diagnostic tools and therapeutic interventions to address health issues in horses, including lameness, gastrointestinal disorders, respiratory conditions, and infectious diseases. Preventative care, such as vaccination and deworming programs, is also a significant aspect of equine veterinary medicine. This page gathers peer-reviewed research studies and scholarly articles that explore various aspects of veterinary medicine as it pertains to horses, including advancements in diagnostic techniques, treatment protocols, and preventive health strategies.
Evaluation of an in-clinic dry chemistry analyzer for canine, equine, and feline plasma samples. Boes KM, Sink CA, Camus MS, Werre SR.Method validation studies characterize the performance of new laboratory methods relative to established methods using quality guidelines in order to define the new method's performance characteristics and to identify differences that could influence data interpretation. We investigated the performance of an in-clinic dry chemistry analyzer (Catalyst One, IDEXX) for measuring 19 routine plasma biochemistry analytes in dogs, cats, and horses. We analyzed 2 levels of quality control material (QCM) in duplicate twice daily for 5 d to determine the coefficient of variation (CV), percent bias, ob...
[Use of bisphosphonates in horses – a review].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    October 19, 2018   Volume 46, Issue 5 323-333 doi: 10.15653/TPG-170804
Düsterdieck-Zellmer KF.Systemic administration of tiludronate or clodronate decreases lameness in some horses suffering from navicular syndrome within 2-6 months of treatment. In horses that fail to respond to the first treatment, a follow-up treatment may still improve the lameness. Horses with a lameness duration of less than 6 months have better odds of experiencing improvement in lameness. Bisphosphonate (BP) treatment can result in renal damage, and it is recommended to assess renal function prior to and after treatment. Horses with pre-existing renal compromise should not be treated with BP, as this may promot...
Cardiovascular images: vascular hamartoma of the mitral valve in a horse.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    October 18, 2018   Volume 20, Issue 6 399-404 doi: 10.1016/j.jvc.2018.09.002
DiVincenzo MJ, Bonagura JD, Rings L, Burns TA, Cianciolo RE, Kohnken R.An 8-month-old Hanoverian gelding was presented with a history of cardiac murmurs that were not apparent as a foal nor reported at the time of castration. Major echocardiographic findings included mitral valvular thickening, functional stenosis, and mitral regurgitation of sufficient severity to cause diastolic and systolic cardiac murmurs, left-sided volume overload, and pulmonary hypertension. Due to the hemodynamic severity of the lesion and poor prognosis for future performance and longevity, euthanasia was elected. On gross postmortem examination, there was focal fibrous epicarditis affec...
Equine Wound Management: Bandages, Casts, and External Support.
The Veterinary clinics of North America. Equine practice    October 17, 2018   Volume 34, Issue 3 557-574 doi: 10.1016/j.cveq.2018.07.010
Eggleston RB.Successful management of equine wounds relies on knowledge of the stages of wound healing, factors that can alter those stages, how healing stages can be manipulated, and adherence to the principles of wound healing. Challenges that complicate wound management include the inability to immobilize and/or confine equine patients, and maintain a clean environment during the critical initial stages of healing. Because of these challenges, the equine practitioner relies heavily on bandaging and external coaptation techniques to successfully treat and manage wounds. The type of bandage used is dictat...
Biological variation of routine haematology and biochemistry measurands in the horse.
Equine veterinary journal    October 17, 2018   Volume 51, Issue 3 384-390 doi: 10.1111/evj.13017
Wright ME, Croser EL, Raidal S, Baral RM, Robinson W, Lievaart J, Freeman KP.Clinical pathology results are typically interpreted by referring to population-based reference intervals. The use of individualised (subject-based) reference intervals is more appropriate for measurands with a high degree of variation between individuals. Objective: To determine the biological variation of routinely analysed equine haematology and biochemistry measurands and calculate indices of individuality and reference change values which enable production of individualised reference intervals, in a group of healthy, privately owned horses. Methods: In a prospective cohort study, thirty-n...
Medical Therapy in Equine Wound Management.
The Veterinary clinics of North America. Equine practice    October 17, 2018   Volume 34, Issue 3 591-603 doi: 10.1016/j.cveq.2018.07.008
Hanson RR.Suitable use of prophylactic antimicrobial drugs for wounds depends on the accurate selection of appropriate antibiotics, dosing regimen, and duration of use. Regional intravenous delivery and intraosseous infusion of antibiotics are pivotal to a successful outcome for deep-rooted infections, inadequately perfused tissue, and infected wounds containing biofilm. Antibiotic-impregnated polymethylmethacrylate beads are predominantly helpful for wounds that have a poor blood supply and for those containing surgical implants that must remain in place.
Choosing the Best Approach to Wound Management and Closure.
The Veterinary clinics of North America. Equine practice    October 17, 2018   Volume 34, Issue 3 499-509 doi: 10.1016/j.cveq.2018.07.005
Kamus L, Theoret C.This article aims to help the practitioner by providing the tools to decide which type of closure or healing is best in a given situation. An overview of the main criteria and the different approaches to wound closure is presented. Each wound must be considered as a unique problem that requires a clinician to take into account all of its characteristics and limits to determine the best management approach.
5′-flanking variants of equine casein genes (CSN1S1, CSN1S2, CSN2, CSN3) and their relationship with gene expression and milk composition.
Journal of applied genetics    October 16, 2018   Volume 60, Issue 1 71-78 doi: 10.1007/s13353-018-0473-2
Cieslak J, Wodas L, Borowska A, Pawlak P, Czyzak-Runowska G, Wojtowski J, Puppel K, Kuczynska B, Mackowski M.Genes encoding casein proteins are important candidates for milk composition traits in mammals. In the case of the domestic horse, our knowledge of casein genes is limited mainly to coding sequence variants. This study involved screening for polymorphism in 5'-flanking regions of four genes encoding equine caseins (CSN1S1, CSN1S2, CSN2, and CSN3) and making a preliminary assessment of their effect on the gene expression (on the mRNA and protein levels) and milk composition traits in selected horse breeds. Altogether, 23 polymorphisms (21 described previously SNPs and two novel InDels) were fou...
Species distribution and seasonal dynamics of equine tick infestation in two Mediterranean climate niches in Israel.
Parasites & vectors    October 16, 2018   Volume 11, Issue 1 546 doi: 10.1186/s13071-018-3093-0
Tirosh-Levy S, Gottlieb Y, Apanaskevich DA, Mumcuoglu KY, Steinman A.Ticks are important ectoparasites of horses that can affect animal welfare and vector several infectious, including zoonotic, diseases. In order to investigate the species distribution, epidemiology and seasonal dynamics of ticks infesting horses in Israel, 3267 ticks were collected from 396 horses in 24 farms across the country from July 2014 to June 2015. Results: Ticks were found on 50% of the farms and on 25% of the horses, with Hyalomma being the most prevalent genus (70% of ticks). Pasture was the most prominent risk factor for tick infestation (99% of ticks, P < 0.001), and is repres...
Klossiella equi infection in a Cheval Canadien Mare.
Veterinary clinical pathology    October 15, 2018   Volume 47, Issue 4 654-659 doi: 10.1111/vcp.12660
Baker RE, Schlipf JW, Brady JV, Gorman ME.A 6-year-old Cheval Canadien mare was presented for clinical signs related to acute kidney injury after receiving a course of nonsteroidal anti-inflammatory therapy. Cytologic examination of concentrated urine revealed small protozoal organisms that were later identified as Klossiella equi. Both sporocysts and free-floating sporozoites were identified in the urine, which has not been previously documented. The mare responded well to intravenous fluid therapy, and as she regained tubular function, the presence of the protozoa in the urine also abated. The mare was discharged from the hospital a...
A survey of Dictyocaulus arnfieldi (Nematoda) infections in equids in Urmia region, Iran.
Annals of parasitology    October 15, 2018   Volume 64, Issue 3 235-240 doi: 10.17420/ap6403.158
Saadi, A, Tavassoli, M, Dalir-Naghadeh, B, Samiei A.Dictyocaulus arnfieldi is a lungworm commonly found in equids; however, relatively little is known about it. The aim of the present study was to establish the prevalence of equine lungworms in naturally-infected working and sporting horses, donkeys and mules in rural areas of Urmia, northwest Iran. The fecal samples were collected from 299 working horses, 57 sporting horses, 66 donkeys and 37 mules during the period March 2014 to June 2016. The collected fecal samples were processed within 48 hours following rectal sampling. The larval count/g (LPG) of feces was determined using the Baermann t...
Comparison of Metzenbaum scissors and Y-shaped fasciotome for deep metatarsal fasciotomy for the treatment of proximal suspensory ligament desmopathy in horses.
Veterinary surgery : VS    October 15, 2018   Volume 48, Issue 1 57-63 doi: 10.1111/vsu.13111
Sidhu ABS, Rosanowski SM, Davis AM, Griffith JF, Robinson P.To quantitate the iatrogenic injury associated with deep plantar metatarsal fasciotomy performed with Metzenbaum scissors compared with a Y-shaped fasciotome. Methods: Experimental ex vivo surgical study. Methods: Cadaveric hind limbs (n = 20) from 10 sound thoroughbred racehorses. Methods: A plantar metatarsal fasciotomy was performed, extending from the proximal extent of the deep metatarsal fascia, distally. Hind limbs were randomly assigned to 2 groups, undergoing fasciotomy with straight Metzenbaum scissors (n = 10) or a Y-shaped fasciotome (n = 10). Magnetic resonance imaging...
Diffusion of charged and uncharged contrast agents in equine mandibular condylar cartilage is not affected by an increased level of sugar-induced collagen crosslinking.
Journal of the mechanical behavior of biomedical materials    October 14, 2018   Volume 90 133-139 doi: 10.1016/j.jmbbm.2018.10.022
Mirahmadi F, Koolstra JH, Fazaeli S, Lobbezoo F, van Lenthe GH, Snabel J, Stoop R, Everts V.Nutrition of articular cartilage relies mainly on diffusion and convection of solutes through the interstitial fluid due to the lack of blood vessels. The diffusion is controlled by two factors: steric hindrance and electrostatic interactions between the solutes and the matrix components. Aging comes with changes in the cartilage structure and composition, which can influence the diffusion. In this study, we treated fibrocartilage of mandibular condyle with ribose to induce an aging-like effect by accumulating collagen crosslinks. The effect of steric hindrance or electrostatic forces on the d...
κ Light-chain monoclonal gammopathy and cast nephropathy in a horse with multiple myeloma.
Journal of the American Veterinary Medical Association    October 13, 2018   Volume 253, Issue 9 1177-1183 doi: 10.2460/javma.253.9.1177
Eberhardt C, Malbon A, Riond B, Schoster A.CASE DESCRIPTION A 27-year-old Dutch Warmblood mare was evaluated because of a history of lethargy, reluctance to move, weight loss, persistent hyperproteinemia, and recurrent episodes of mild lameness. CLINICAL FINDINGS Hematologic evaluation revealed anemia (RBC concentration, 3.84 × 106 cells/μL), thrombocytopenia (47 × 103 thrombocytes/μL), and hyperproteinemia (total protein concentration, 11.2 g/dL) with hyperglobulinemia and hypoalbuminemia. Results of protein electrophoresis of serum and urine samples indicated a monoclonal gammopathy; the paraprotein was identified as a κ light c...
Gram-negative multi-drug resistant bacteria influence survival to discharge for horses with septic synovial structures: 206 Cases (2010-2015).
Veterinary microbiology    October 13, 2018   Volume 226 64-73 doi: 10.1016/j.vetmic.2018.10.009
Gilbertie JM, Schnabel LV, Stefanovski D, Kelly DJ, Jacob ME, Schaer TP.Bacterial colonization of synovial structures can cause infections that are difficult to treat. Systemic and local antimicrobials and repeated joint lavages are the mainstays of therapy. However, despite aggressive treatments, infection may persist, leading to significant tissue damage or death of the patient. In order to investigate the impact of bacterial culture and antimicrobial resistance on survival to discharge, we reviewed medical records of horses admitted to the University of Pennsylvania's large animal teaching hospital from 2010-2015. Two-hundred and six cases with a definitive dia...
Improvement of recombinant-truncated Burkholderia motility protein A (BimA)-based indirect ELISA for equine glanders.
Journal of immunoassay & immunochemistry    October 12, 2018   Volume 39, Issue 5 565-575 doi: 10.1080/15321819.2018.1523800
Singh S, Dohre SK, Kamthan A, Pal V, Karothia BS, Singha HS, Kumar S.Glanders is a contagious and highly fatal disease of equines with zoonotic potential. It is caused by a Gram-negative, nonmotile bacterium Burkholderia mallei. Complement fixation test (CFT) is one of the most commonly used tests for diagnosis of glanders; however, it has some limitations. A recombinant-truncated Burkholderia intracellular motility A (BimA) protein-based indirect enzyme-linked immunosorbent assay (iELISA) was previously reported by us for glanders diagnosis, which has been re-optimized in this study using a panel of glanders positive (n = 75) and glanders negative (n = 227...
Sequence variant analysis of RNA sequences in severe equine asthma.
PeerJ    October 11, 2018   Volume 6 e5759 doi: 10.7717/peerj.5759
Tessier L, Côté O, Bienzle D.Severe equine asthma is a chronic inflammatory disease of the lung in horses similar to low-Th2 late-onset asthma in humans. This study aimed to determine the utility of RNA-Seq to call gene sequence variants, and to identify sequence variants of potential relevance to the pathogenesis of asthma. Methods: RNA-Seq data were generated from endobronchial biopsies collected from six asthmatic and seven non-asthmatic horses before and after challenge (26 samples total). Sequences were aligned to the equine genome with Spliced Transcripts Alignment to Reference software. Read preparation for sequenc...
Safety and immunogenicity of plant-produced African horse sickness virus-like particles in horses.
Veterinary research    October 11, 2018   Volume 49, Issue 1 105 doi: 10.1186/s13567-018-0600-4
Dennis SJ, O'Kennedy MM, Rutkowska D, Tsekoa T, Lourens CW, Hitzeroth II, Meyers AE, Rybicki EP.African horse sickness (AHS) is caused by multiple serotypes of the dsRNA AHSV and is a major scourge of domestic equids in Africa. While there are well established commercial live attenuated vaccines produced in South Africa, risks associated with these have encouraged attempts to develop new and safer recombinant vaccines. Previously, we reported on the immunogenicity of a plant-produced AHS serotype 5 virus-like particle (VLP) vaccine, which stimulated high titres of AHS serotype 5-specific neutralizing antibodies in guinea pigs. Here, we report a similar response to the vaccine in horses. ...
Generation of an equine biobank to be used for Functional Annotation of Animal Genomes project.
Animal genetics    October 11, 2018   Volume 49, Issue 6 564-570 doi: 10.1111/age.12717
Burns EN, Bordbari MH, Mienaltowski MJ, Affolter VK, Barro MV, Gianino F, Gianino G, Giulotto E, Kalbfleisch TS, Katzman SA, Lassaline M, Leeb T....The Functional Annotation of Animal Genomes (FAANG) project aims to identify genomic regulatory elements in both sexes across multiple stages of development in domesticated animals. This study represents the first stage of the FAANG project for the horse, Equus caballus. A biobank of 80 tissue samples, two cell lines and six body fluids was created from two adult Thoroughbred mares. Ante-mortem assessments included full physical examinations, lameness, ophthalmologic and neurologic evaluations. Complete blood counts and serum biochemistries were also performed. At necropsy, in addition to tiss...
Freezing, Vitrification, and Freeze-Drying of Equine Spermatozoa: Impact on Mitochondrial Membrane Potential, Lipid Peroxidation, and DNA Integrity.
Journal of equine veterinary science    October 11, 2018   Volume 72 8-15 doi: 10.1016/j.jevs.2018.10.006
Restrepo G, Varela E, Duque JE, Gómez JE, Rojas M.Maintaining the integrity of equine sperm subjected to preservation protocols is essential for the successful development of assisted reproduction procedures. The aim of this study was to assess the mitochondrial membrane potential, lipid peroxidation, and DNA integrity of equine sperm subjected to freezing, vitrification, and freeze-drying. Eight ejaculates obtained from four Colombian Creole horses were subjected to programmable freezing, vitrification, and freeze-drying. After thawing or rehydration, sperm motility and kinetics were assessed through a CASA system. The mitochondrial membrane...
Pharmacokinetics of Intrarectal Altrenogest in Horses.
Journal of equine veterinary science    October 10, 2018   Volume 72 41-46 doi: 10.1016/j.jevs.2018.10.001
Ellis KE, Council-Troche RM, Von Dollen KA, Beachler TM, Bailey CS, Davis JL, Lyle SK.Hospitalized pregnant mares being held nil per os (PO) because of medical or surgical events present a dilemma for pregnancy maintenance therapy, which commonly includes oral altrenogest. Rectal administration of medications is a recognized route for achieving systemic concentrations, but there are no data on the pharmacokinetics of rectal altrenogest administration in horses. The purpose of this study was to determine the pharmacokinetics of altrenogest following PO or per rectum (PR) administration in mares. Using a randomized two-way crossover study design, six horses received altrenogest (...
Digital PCR detection of plasmid DNA administered to the skeletal muscle of a microminipig: a model case study for gene doping detection.
BMC research notes    October 10, 2018   Volume 11, Issue 1 708 doi: 10.1186/s13104-018-3815-6
Tozaki T, Gamo S, Takasu M, Kikuchi M, Kakoi H, Hirota KI, Kusano K, Nagata SI.Doping control is an important and indispensable aspect of fair horse racing; genetic doping has been recently included to this. In this study, we aimed to develop a detection method of gene doping. A plasmid cloned with human erythropoietin gene (p.hEPO, 250 μg/head) was intramuscularly injected into a microminipig. Subsequently, p.hEPO was extracted from 1 mL of plasma and detected by droplet digital polymerase chain reaction. Results: The results confirmed that the maximum amount of plasmid was detected at 15 min after administration and the majority of the plasmid was degraded in the b...
Validation of a new experimental model for assessing drug efficacy against infection with Trypanosoma equiperdum in horses.
Veterinary parasitology    October 9, 2018   Volume 263 27-33 doi: 10.1016/j.vetpar.2018.10.005
Hébert L, Guitton E, Madeline A, Géraud T, Carnicer D, Lakhdar L, Pitel PH, Coste M, Laloy E, Giraudet A, Zientara S, Büscher P, Laugier C, Hans A....Trypanosoma equiperdum, the causative agent of dourine, may affect the central nervous system, leading to neurological signs in infected horses. This location protects the parasite from most (if not all) existing chemotherapies. In this context, the OIE terrestrial code considers dourine as a non-treatable disease and imposes a stamping-out policy for affected animals before a country may achieve its dourine-free status. The use of practices as drastic as euthanasia remains controversial, but the lack of a suitable tool for studying a treatment's efficacy against dourine hampers the developmen...
Genotype imputation accuracy in multiple equine breeds from medium- to high-density genotypes.
Journal of animal breeding and genetics = Zeitschrift fur Tierzuchtung und Zuchtungsbiologie    October 9, 2018   Volume 135, Issue 6 420-431 doi: 10.1111/jbg.12358
Chassier M, Barrey E, Robert C, Duluard A, Danvy S, Ricard A.Genotype imputation is now a key component of genomic analyses as it increases the density of available genotypes within a population. However, many factors can influence imputation accuracy. The aim of this study was to assess and compare the accuracy of imputation of high-density genotypes (Affymetrix Axiom Equine genotyping array, 670,806 SNPs) from two moderate-density genotypes (Illumina Equine SNP50 BeadChip, 54,602 SNPs and Illumina Equine SNP70 BeadChip, 65,157 SNPs), using single-breed or multiple-breed reference sets. Genotypes were available from five groups of horse breeds: Arab (A...
Multivariable analysis to determine risk factors associated with early pregnancy loss in thoroughbred broodmares.
Theriogenology    October 9, 2018   Volume 124 18-23 doi: 10.1016/j.theriogenology.2018.10.008
de Mestre AM, Rose BV, Chang YM, Wathes DC, Verheyen KLP.Early pregnancy loss (EPL) between days 15-65 after breeding has been shown to occur in 7.9% of equine pregnancies with substantial economical, welfare and safety implications. Whilst maternal age has been recognised as an important risk factor in relation to the incidence of EPL, few other risk factors have been conclusively identified. Further, multivariable data analysis of risk factors for EPL is sparse. A prospective cohort investigation of thoroughbred broodmares in the United Kingdom was conducted over the 2013 and 2014 breeding seasons. Information relating to 28 factors including mare...
Retrospective evaluation of the effect of intravenous fluid administration on development of postoperative reflux in horses with colic (2004-2012): 194 horses.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    October 9, 2018   Volume 28, Issue 6 566-572 doi: 10.1111/vec.12776
Hoaglund EL, Hess AM, Hassel DM.To evaluate the role of intravenous fluid volume and electrolyte supplementation on the development of postoperative reflux (POR) in horses undergoing celiotomy for colic. Methods: Case-control study spanning 2004-2012 for horses undergoing celiotomy for colic. Methods: University teaching hospital. Methods: Sixty-seven client-owned horses >1 year of age with POR were each matched to 2 controls with similar surgical lesions that did not demonstrate POR. Results: Survival was significantly lower in cases (65.7%) than controls (96.1%). Factors found to be associated with POR included decrease...
Equine bone marrow-derived mesenchymal stem cells: optimization of cell density in primary culture.
Stem cell investigation    October 9, 2018   Volume 5 31 doi: 10.21037/sci.2018.09.01
Zahedi M, Parham A, Dehghani H, Kazemi Mehrjerdi H.The primary cell seeding density of bone marrow-derived mononuclear cells (BM-MNCs) affects several cellular behaviors, including attachment to the culture dish, proliferation, and differentiation. Methods: The aim of this study was to determine the best density of equine BM-MNCs in primary culture (P0) for obtaining the maximum bone marrow-derived mesenchymal stem cell (BM-MSC) yields at the end of P0. Bone marrow samples of two healthy mares were aspirated. The MNCs were isolated and cultured at different densities (1×10, 2×10, 4×10, 8×10, and 1×10 cells/cm). Within the 7 and 14 days af...
Phylogenetic analysis of the cytochrome P450 (CYP450) nucleotide sequences of the horse and predicted CYP450s of the white rhinoceros (Ceratotherium simum) and other mammalian species.
PeerJ    October 9, 2018   Volume 6 e5718 doi: 10.7717/peerj.5718
Leiberich M, Marais HJ, Naidoo V.The plight of the white rhinoceros () and the increasing need of treatment options for injured poaching victims led to the necessity to expand the knowledge on applicable drugs in this endangered species. With very little information available on drug pharmacokinetics in rhino, veterinarians have to rely on information generated from other species. The horse being a closely related species, has served as the model for dose extrapolations. However, from recent research on enrofloxacin and carprofen, the white rhino showed considerable differences in the pharmacokinetic properties of these drugs...
Objective pain assessment in horses (2014-2018).
Veterinary journal (London, England : 1997)    October 9, 2018   Volume 242 1-7 doi: 10.1016/j.tvjl.2018.10.001
van Loon JPAM, Van Dierendonck MC.In recent decades, much effort has been invested in scientific studies of objective and reliable assessment of pain in horses. Various types of pain assessment tools have been described and (partly) validated for different types of pain in horses. Currently, composite pain scales and facial expression-based pain scales seem to be the most promising tools for pain assessment in horses and numerous studies have recently been published on the use of these pain scales in horses. Therefore, this narrative review mainly focusses on these two types of pain scales and on the studies that have appeared...
Characterization of Apoptosis, Autophagy and Oxidative Stress in Pancreatic Islets Cells and Intestinal Epithelial Cells Isolated from Equine Metabolic Syndrome (EMS) Horses.
International journal of molecular sciences    October 8, 2018   Volume 19, Issue 10 3068 doi: 10.3390/ijms19103068
Kornicka K, Śmieszek A, Szłapka-Kosarzewska J, Irwin Houston JM, Roecken M, Marycz K.Endocrine disorders are becoming an increasing problem in both human and veterinary medicine. In recent years, more and more horses worldwide have been suffering from equine metabolic syndrome (EMS). This metabolic disorder is characterized by pathological obesity, hyperinsulinaemia, hyperglycaemia and insulin resistance. Although metabolic disorders, including diabetes, have been extensively studied, there are still no data on the molecular effects of EMS in horses. Thus, the aim of this study was to evaluate apoptosis, oxidative stress, autophagy and microRNA (miR) expression in multipotent ...