Analyze Diet

Topic:Body Weight

Body weight in horses is a fundamental parameter that influences various aspects of equine management and health. It is a measure of the horse's mass, often assessed using scales or estimated through body condition scoring and weight tapes. Body weight is integral for determining appropriate feed rations, medication dosages, and workload capacities. Variations in body weight can indicate changes in health status, nutritional adequacy, or fitness levels. This page compiles peer-reviewed research studies and scholarly articles that explore the methodologies for assessing body weight, its implications on equine health and performance, and its role in management practices.
Relationships between the age and blood test results or body sizes in Noma horses.
Journal of equine science    July 6, 2022   Volume 33, Issue 2 27-30 doi: 10.1294/jes.33.27
Inoue Y, Ono T, Hisaeda K, Yamada Y, Hata A, Shimokawa T, Miyama , Shibano K, Ohzawa E, Kitagawa H, Iwata E.The objective of this study is to analyze the relationships between the age and blood test results or body sizes in Noma horses by using the results of periodical health examination. Out of 45 hematological or physical items examined, statistically significant, but loose correlations were observed in 14 items. Red blood cell count, activities of aspartate aminotransferase, alkaline phosphatase, and creatinine kinase, concentrations of calcium and inorganic phosphorus decreased with aging. Conversely, mean corpuscular volume, mean corpuscular hemoglobin, lipase activity, γ-globulin and chlorid...
An exercise-inducible metabolite that suppresses feeding and obesity.
Nature    June 15, 2022   Volume 606, Issue 7915 785-790 doi: 10.1038/s41586-022-04828-5
Li VL, He Y, Contrepois K, Liu H, Kim JT, Wiggenhorn AL, Tanzo JT, Tung AS, Lyu X, Zushin PH, Jansen RS, Michael B, Loh KY, Yang AC, Carl CS....Exercise confers protection against obesity, type 2 diabetes and other cardiometabolic diseases1-5. However, the molecular and cellular mechanisms that mediate the metabolic benefits of physical activity remain unclear6. Here we show that exercise stimulates the production of N-lactoyl-phenylalanine (Lac-Phe), a blood-borne signalling metabolite that suppresses feeding and obesity. The biosynthesis of Lac-Phe from lactate and phenylalanine occurs in CNDP2+ cells, including macrophages, monocytes and other immune and epithelial cells localized to diverse organs. In diet-induced obese mice,...
Evaluation of peripheral blood polymorphonuclear cell functions after an oral carbohydrate overload in obese and insulin dysregulated horses.
Veterinary immunology and immunopathology    June 13, 2022   Volume 250 110455 doi: 10.1016/j.vetimm.2022.110455
Salinas C, Espinosa G, Morales N, Henríquez C, Morán G, Gajardo G, Burgos RA, Uberti B.Obesity and insulin dysregulation (ID) are increasingly prevalent conditions in equid populations worldwide. Immune impairment is well described in humans with metabolic dysfunction and is reported but still incompletely understood in horses. This study evaluated the effect of acute induced transient hyperglycemia on apoptosis, phagocytosis and oxidative burst activity of peripheral blood polymorphonuclear cells (PMN) of lean and obese adult horses with or without insulin dysregulation. Seventeen adult horses were allocated into three groups based on their body condition score (BCS) and metabo...
Incidence of Severe Hypoxemia in Anesthetized Horses Undergoing Emergency Exploratory Laparotomy.
Journal of equine veterinary science    May 31, 2022   Volume 116 104026 doi: 10.1016/j.jevs.2022.104026
Marchese GA, Crystal J, Louro LF.Prevalence and risk factors of severe hypoxemia in anesthetized horses undergoing emergency exploratory laparotomy are sparsely documented. The aim of this study was to report incidence of severe hypoxemia ( PaO2 < 60 mmHg) in horses undergoing emergency exploratory laparotomy and identify potential risk factors for this complication. A single center retrospective cross sectional designed was used. Clinical data of 714 horses undergoing general anesthesia for emergency explorative laparotomy were reviewed. A backward stepwise elimination procedure was used to determine the final multivariable ...
Welfare Concerns for Mounted Load Carrying by Working Donkeys in Pakistan.
Frontiers in veterinary science    May 27, 2022   Volume 9 886020 doi: 10.3389/fvets.2022.886020
Bukhari SSUH, Rosanowski SM, McElligott AG, Parkes RSV.Working donkeys () are vital to people's livelihoods. They are essential for carrying goods, however, globally, overloading is one of the primary welfare concerns for working donkeys. We studied mounted load carrying by donkeys and associated factors in Pakistan. A cross-sectional study of donkey owners ( = 332) was conducted, and interviews were undertaken based on a questionnaire. Owners estimated that the median weight of their donkeys was 110 kg [interquartile range (IQR) 100-120 kg], and that they carried a median mounted load of 81.5 kg (IQR 63-99 kg). We found that 87.4% of donkeys carr...
Puberal and Adolescent Horse Riders’ Fitness during the COVID-19 Pandemic: The Effects of Training Restrictions on Health-Related and Functional Motor Abilities.
International journal of environmental research and public health    May 24, 2022   Volume 19, Issue 11 6394 doi: 10.3390/ijerph19116394
The aim of the study was to analyse the fitness level of young horse riders before and after 12 weeks of training restrictions instituted due to the COVID-19 emergency. Anthropometrical measure assessment and an eight-items fitness test battery were administered to 61 puberal and adolescent female amateur horse riders. Subjects were evaluated within 3 weeks before (pre-tests) the period of training restrictions and on the first day of normal training after it (post-tests). Post-test results showed significant increases in body weight (Z: −1.732; p value: 0.001; ES: −0.157) and BMI (F: 9.91...
Body Weight Prediction from Linear Measurements of Icelandic Foals: A Machine Learning Approach.
Animals : an open access journal from MDPI    May 11, 2022   Volume 12, Issue 10 doi: 10.3390/ani12101234
Satoła A, Łuszczyński J, Petrych W, Satoła K.Knowledge of the body weight of horses permits breeders to provide appropriate feeding and care regimen and allows veterinarians to monitor the animals' health. It is not always possible to perform an accurate measurement of the body weight of horses using horse weighbridges, and therefore, new body weight formulas based on biometric measurements are required. The objective of this study is to develop and validate models for estimating body weight in Icelandic foals using machine learning methods. The study was conducted using 312 data records of body measurements on 24 Icelandic foals (12 col...
Epidemiological survey, general blood biochemistry, and histological examination of slaughtered heavy horse breeds with hemorrhage in the adipose tissue in the crest of the neck.
Journal of equine science    April 19, 2022   Volume 33, Issue 1 7-12 doi: 10.1294/jes.33.7
Harada K, Kanemitsu S, Akioka K, Fujita K, Nishi Y, Taura Y, Sasaki N.Fifty-four slaughtered horses were classified into groups having adipose tissue in the crest of the neck with or without hemorrhage (AH and NH groups, respectively). Blood biochemical tests (Alb, TP, T-bil, GOT, GPT, LDH, T-cho, and BUN) and an epidemiological survey (age, gender, weight, origin, breed, BCS, CNS, and hoof disease) were performed. T-bil tended to be high, while the other parameters were normal. Weight, BCS, and CNS were higher in the AH group (P<0.05). GOT was lower in the AH group (P<0.05). It was suspected that the horses in the AH group had lipomatosis. It was assumed ...
Seasonal Insulin Responses to the Oral Sugar Test in Healthy and Insulin Dysregulated Horses.
Journal of equine veterinary science    April 8, 2022   Volume 113 103945 doi: 10.1016/j.jevs.2022.103945
Macon EL, Harris P, Barker VD, Adams AA.Seasonal effects on the oral sugar test (OST), used to monitor insulin dysregulation (ID) status to help reduce laminitis risk, are poorly understood in the ID horse. Resting, (basal) insulin (T0) and 60-minute (T60) OST (0.15 mL/Kg BW Karo Light Corn Syrup) insulin responses were evaluated, once per each season over 2 years, in ID (n = 11 14.9 ± 4.3 years; mean ± SD) and non-insulin dysregulated (NID: n = 11 16.4 ± 5.3 years; mean ± SD) horses housed on the same farm. Seasonal morphometric measurements were collected: bodyweight (BW), body-condition scores (BCS), and cresty neck score...
Reproducibility of the body condition score assessment in Silesian horses, using the 9-point BCS scale.
Veterinary research communications    March 22, 2022   Volume 47, Issue 1 273-278 doi: 10.1007/s11259-022-09916-5
Pyrek P, Siwinska N, Zak-Bochenek A.Control of body condition is an important aspect of horse management. Its correct evaluation, and the possibility of using universal indicators are of key importance for preserving the animals' wellbeing and for providing them with proper care. The objective of this study was to evaluate the agreement between body condition scores assessed by teams and individuals, using the 9-point Body Condition Score scale created by Henneke. The evaluation of a herd of 49 healthy adult Silesian horses was conducted by veterinary medicine students with adequate training in body condition assessment. Group a...
Altrenogest treatment reduces the stress response of three-year-old warmblood mares during their initial equestrian training.
Domestic animal endocrinology    March 20, 2022   Volume 80 106728 doi: 10.1016/j.domaniend.2022.106728
Kaps M, Lutzer A, Gautier C, Nagel C, Aurich J, Aurich C.Horse mares are frequently treated with the progestin altrenogest with the aim to suppress estrous behavior and its negative impact on equestrian performance. Progestogens, however, also have sedative effects in males, and females of different species. The aim of our study was therefore to investigate altrenogest-induced changes in the stress response of female horses during initial equestrian training. Three-yr-old Warmblood mares were randomly assigned to treatment with altrenogest (ALT; 0.044 mg/kg once daily; n = 6) or sunflower oil (CON; n = 5) for 12 wk during training. At predefined...
Preliminary Study on the Connection Between the Mineral Profile of Horse Hooves and Tensile Strength Based on Body Weight, Sex, Age, Sampling Location, and Riding Disciplines.
Frontiers in veterinary science    March 7, 2022   Volume 8 763935 doi: 10.3389/fvets.2021.763935
Rueda-Carrillo G, Rosiles-Martínez R, Hernández-García AI, Vargas-Bello-Pérez E, Trigo-Tavera FJ.Hoof mineral profile is important as it could affect locomotion. Factors such as body weight, sex, age, and riding disciplines affect hoof mineral profile. In Mexico and globally, studies are needed on the characterization of mineral profile of hooves and tensile strength, as this could help to prevent overgrowth or microfractures. Therefore, in the present survey, 165 samples of equine hoof cuttings from different sex, ages, breeds, and riding disciplines from different regions of Mexico were analyzed for their mineral composition, and a universal testing machine was used to measure tensile s...
Development of Foals Until One Year of Age When the Dam was Exposed to Blue Monochromatic Light Directed at One Eye During Late Pregnancy.
Journal of equine veterinary science    March 5, 2022   Volume 112 103922 doi: 10.1016/j.jevs.2022.103922
Lutzer A, Nagel C, Aurich J, Murphy BA, Aurich C.In horses, blue LED light directed at one eye of pregnant mares shortens gestation length and results in the birth of foals with lower wither heights, similar weight and reduced hair length compared to controls. In this study, we have therefore analysed postnatal development of foals born to either blue LED light-treated (n = 20) or control mares (n = 20). Size, weight and hair coat changes were determined for 1 year and heart rate, heart rate variability (HRV) and selected haematology parameters for 1 month. Haematocrit decreased (P < .001) and leukocyte and lymphocyte counts increased...
Magnetic resonance imaging of the normal equine pituitary gland. Hobbs KJ, Porter E, Wait C, Dark M, MacKay RJ.Magnetic resonance imaging is increasingly available for evaluation of horses with suspected pituitary adenomas; however, published studies describing the MRI features of normal equine pituitary glands are currently lacking. This retrospective, descriptive, anatomic study describes the MRI appearance and size of presumed normal equine pituitary glands and assesses potential correlations between pituitary size, brain size, and patient weight. These findings serve as a reference for MRI evaluation of the equine pituitary gland. Inclusion criteria consisted of adult horses (2-15 years old), over ...
Associations between styloid process sheath CT sizes and age, body weight, and breed in horses. Whitty JA, Miller AV, Miller AD, Carney PC, Scrivani PV.The styloid process sheath (SPS) is a part of the tympanic temporal bone and an incomplete bony sleeve surrounding the styloid process, tympanohyoid cartilage, and dorsal part of the stylohyoid bone. In horses undergoing head CT, we observed a range of SPS sizes and questioned whether differences were early features of temporohyoid osteoarthropathy (THO) or normal anatomic variations associated with age, body weight, sex, or breed. We hypothesized that SPS sizes were positively correlated with age and body weight, but not with sex or breed. Using a convenience population of horses that underwe...
Maternal effect on first-year growth of Hokkaido native foals kept outdoors all year round.
Animal science journal = Nihon chikusan Gakkaiho    February 12, 2022   Volume 93, Issue 1 e13694 doi: 10.1111/asj.13694
Huricha , Kawai M, Inose Y, Yamada F, Ninomiya S.In this study, we investigated maternal effects on the growth of Hokkaido native horses kept outdoors throughout the year. We used the data on body weight (BW), height at withers (HW), heart girth (HG), and cannon circumference (CC) of 517 foals during the first year of life to (1) examine the growth patterns by comparing six linear mixed models and (2) analyze the maternal effect on BW, HW, HG, and CC for each month by estimating variance components. The segmented polynomial third-order regression equation was selected as the best model for all the traits. The estimated proportion of variance...
Relationship between foal daily gain, suckling behavior, and the distance between foals and their mares in the first 40 days of life of Hokkaido native horses kept outdoors year-round.
Animal science journal = Nihon chikusan Gakkaiho    February 12, 2022   Volume 93, Issue 1 e13692 doi: 10.1111/asj.13692
Huricha , Kawai M, Ninomiya S.In this study, we investigated suckling behavior and the distance between a foal and its mare as indicators of foal growth in Hokkaido native horses (HKD) during the first 40 days of life. Direct observations were made of 22 mare and foal pairs from two consecutive days 1 and 2, 5 and 6, 10 and 11, 20 and 21, 30 and 31, and 40 and 41 after birth by focal animal sampling for 3 h per day. Suckling behavior was continuously recorded, along with the terminator. The distance between the foal and its mare was determined using the instantaneous sampling method (1 min), and the percentage was calc...
On the Description of Equine Somatic Growth Using Nonlinear Functions.
Journal of equine veterinary science    February 5, 2022   Volume 111 103893 doi: 10.1016/j.jevs.2022.103893
Darmani Kuhi H, Hossein-Zadeh NG, France J, López S.A better knowledge of the growth of horses can facilitate sounder intervention in their health control, nutrition and management. This study compared five growth functions with either diminishing returns (monomolecular and Michaelis-Menten) or asymptotic sigmoidal (Gompertz, Richards and Lopez) behavior for describing the growth curves of horses, based on the relationship between a given somatic growth trait (body weight, withers height, or body weight to withers height ratio) and age. Data used in this study were those available in the literature for quarter horse males and thoroughbred foals...
The Effect of Rider:Horse Bodyweight Ratio on the Superficial Body Temperature of Horse’s Thoracolumbar Region Evaluated by Advanced Thermal Image Processing.
Animals : an open access journal from MDPI    January 13, 2022   Volume 12, Issue 2 195 doi: 10.3390/ani12020195
Domino M, Borowska M, Trojakowska A, Kozłowska N, Zdrojkowski Ł, Jasiński T, Smyth G, Maśko M.Appropriate matching of rider-horse sizes is becoming an increasingly important issue of riding horses' care, as the human population becomes heavier. Recently, infrared thermography (IRT) was considered to be effective in differing the effect of 10.6% and 21.3% of the rider:horse bodyweight ratio, but not 10.1% and 15.3%. As IRT images contain many pixels reflecting the complexity of the body's surface, the pixel relations were assessed by image texture analysis using histogram statistics (HS), gray-level run-length matrix (GLRLM), and gray level co-occurrence matrix (GLCM) approaches. The st...
Dominant follicle and gonadotropin dynamics before ovulation in postpartum lactating mares.
Molecular reproduction and development    January 9, 2022   Volume 89, Issue 2 113-124 doi: 10.1002/mrd.23552
Gastal MO, Pastorello M, Godoi DB, Gastal EL.The aim of this study was to compare the dominant follicle (DF) and gonadotropin dynamics for 9 days before ovulation in postpartum lactating (PP Lactating) versus non-postpartum cycling (N-PP Cycling) mares. Every PP Lactating mare on the day of parturition was paired with a N-PP Cycling mare, and the data analyses considered the partum-ovulation interval (POI) and the postpartum interovulatory interval (PPIOI) in PP Lactating mares and two interovulatory intervals in N-PP Cycling mares. The results of the present study revealed several novel and unique aspects of DF development and FSH and L...
Risk factors associated with hypoxaemia in horses undergoing general anaesthesia: A retrospective study.
Equine veterinary journal    December 2, 2021   Volume 54, Issue 6 1055-1063 doi: 10.1111/evj.13541
Hovda T, Love L, Chiavaccini L.Hypoxaemia is a common concern during equine general anaesthesia. The prevalence and predictors of hypoxaemia in horses undergoing elective anaesthesia in particular are poorly documented. Objective: To determine and compare the prevalence of hypoxaemia (defined as PaO2  ≤ 80 mm Hg, on the lowest value recorded) in horses undergoing anaesthesia for exploratory laparotomy and elective procedures, and to identify risk factors in both subpopulations. Methods: Retrospective cohort study. Methods: Data were collected from 774 records of 708 horses undergoing general anaesthesia between April 2...
Age and Body Condition Influence the Post-Prandial Interleukin-1β Response to a High-Starch Meal in Horses.
Animals : an open access journal from MDPI    November 24, 2021   Volume 11, Issue 12 3362 doi: 10.3390/ani11123362
Suagee-Bedore J, Shost N, Miller C, Grado L, Bechelli J.Older horses and those prone to obesity may be at a higher risk for inflammation than younger and leaner counterparts. Previous research indicated a postprandial elevation in plasma concentrations of interleukin-1β (IL-1β), a pro-inflammatory cytokine, after consuming 1.2 g of non-structural carbohydrates/kilogram of body weight. However, these studies utilized horses of mixed age and body condition. The current study evaluated post-prandial IL-1β concentrations in horses specifically comparing lean to over-conditioned and middle aged to older. Our results suggest that at least two weeks of...
Yield, nutrient composition, and horse condition in integrated crabgrass and cool-season grass rotational grazing pasture systems.
Translational animal science    October 26, 2021   Volume 5, Issue 4 txab208 doi: 10.1093/tas/txab208
Weinert-Nelson JR, Meyer WA, Williams CA.Integration of warm-season grasses into traditional cool-season pastures can increase summer forage for grazing cattle. The aim of this study was to determine impacts of this practice on yield and nutrient composition of equine rotational pasture systems as well as horse body condition. Two 1.5 ha rotational systems (6 to 0.25 ha sections/system) were evaluated: a control system (CON) (all sections mixed cool-season grass [CSG-CON]) and an integrated rotational grazing system (IRS) (three CSG sections [CSG-IRS] and three Quick-N-Big crabgrass [Digitaria sanguinalis (L.) Scop.; CRB-IRS]). Three...
Digestibility and nitrogen and water balance in horses fed rhizoma peanut hay.
Journal of animal science    October 12, 2021   Volume 99, Issue 11 doi: 10.1093/jas/skab284
Vasco ACCM, Brinkley-Bissinger KJ, Bobel JM, Dubeux JCB, Warren LK, Wickens CL.Rhizoma peanut (RP, Arachis glabrata) hay has the potential to meet horses' crude protein (CP) requirements with less nitrogen excretion than other legumes. This study aimed to evaluate nutrient intake, apparent digestibility, and nitrogen balance of RP "Florigraze" hay compared with alfalfa (ALF, Medicago sativa L. "Legendary XHD") and bermudagrass (BG, Cynodon dactylon L. "Coastal") hays when fed to maintenance horses at 2% body weight/d on a dry matter (DM) basis. We hypothesized that nutrient intake would be comparable between the legume hays and lesser for BG and that RP would result in r...
Effects of forelimb instrumentation on lameness detection in horses using a portable inertial sensor-based system.
Journal of the American Veterinary Medical Association    October 6, 2021   Volume 259, Issue 8 892-898 doi: 10.2460/javma.259.8.892
Lopes MAF, Nichols JT, Dearo ACO, Nelson SR.To investigate the effects of a small sensor attached to the pastern region of a forelimb on lameness detection and quantification with a portable inertial sensor-based system (PISBS) for lameness detection and quantification in horses. 20 adult horses (body weight, 410 to 650 kg) with no visible lameness at the walk. In a crossover study design, horses were evaluated at the trot twice using the PISBS with the gyroscope alternately attached to the right forelimb pastern region (as recommended by the manufacturer) or to the left forelimb pastern region (with the sensor flipped 180° on the fron...
Effects of a nutraceutical supplement in the management of mild equine squamous gastric disease in endurance horses.
The Veterinary record    September 25, 2021   Volume 189, Issue 11 e942 doi: 10.1002/vetr.942
Lo Feudo CM, Stucchi L, Conturba B, Alberti E, Zucca E, Ferrucci F.Equine squamous gastric disease (ESGD) may require prolonged treatments with acid suppressants; therefore, interest in nutraceutical supplements with anti-ulcerogenic properties has increased. This study aims to investigate the efficacy of Trophogast pellet for the treatment of ESGD in endurance horses. Methods: Fifteen endurance horses were included based on their gastroscopic examination and randomly assigned to a treatment group, receiving Trophogast pellet for 30 days together with management changes, or to a control group, only subjected to management modifications. At the end of treatmen...
Development and Evaluation of a Muscle Atrophy Scoring System (MASS) for Horses.
Journal of equine veterinary science    September 20, 2021   Volume 110 103771 doi: 10.1016/j.jevs.2021.103771
Herbst AC, Johnson MG, Gammons H, Reedy SE, Urschel KL, Harris PA, Adams AA.Loss of skeletal muscle mass likely compromises performance and welfare in horses and thus routine monitoring would be valuable. Currently available methods to assess muscle mass require expert knowledge and are often expensive. To provide a simple method, a muscle atrophy scoring system (MASS) was created and tested by three evaluators (raters) in 38 horses of varying age, breed, and health status. Inter-rater agreement on atrophy scores was in the good-to-excellent range for ratings of the neck (ICC = 0.62), back (ICC = 0.62) and hind (ICC = 0.76) regions but was poor for the abdominal...
Osteochondrosis dissecans (OCD) in horses: hormonal and biochemical study (19 cases).
Veterinary research forum : an international quarterly journal    September 15, 2021   Volume 12, Issue 3 325-331 doi: 10.30466/vrf.2020.104046.2495
Ahmadi F, Mirshahi A, Mohri M, Sardari K, Sharifi K.To investigate the hormonal and biochemical profiles of horses with osteochondrosis dissecans (OCD), serum insulin, cortisol, triiodothyronine, thyroxine, fasting blood glucose (FBG), cholesterol, triglyceride (TG), high- and low-density lipoproteins, albumin and uric acid were measured in horses definitely diagnosed with OCD (n=19) as well as clinically normal horses (n=18). Proxies representing insulin sensitivity [reciprocal of square root of insulin concentration (RISQI)] and beta cell responsiveness [modified insulin to glucose ratio (MIRG)] were calculated. Body fat percent (BF%) was est...
Effects of steam-flaked grains on foals’ growth and faecal microbiota.
BMC veterinary research    September 4, 2021   Volume 17, Issue 1 293 doi: 10.1186/s12917-021-02994-8
Li XB, Huang XX, Zang CJ, Ma C, Chen KX, Zhao GD, Li Q, Li XY, Zhang WJ, Yang KL.There is little objective information concerning the effect of steam-flaked grains on foal's growth performance and faecal microbiota. To determine the effects of steam-flaked grains on foal's growth performance and faecal microbiota, faecal samples were collection from 18 foals which had been fed either corn, oat or barley diets over the 60 days of the experiment. Body weight and conformation measurements were collected. Next-generation sequencing of the V3 + V4 region of the 16 S rRNA gene was used to assess the microbial composition of faeces. Alpha diversity, Venn graph, Relative abun...
Cross-sectional study to identify the prevalence of and factors associated with laminitis in UK donkeys.
Equine veterinary journal    September 3, 2021   doi: 10.1111/evj.13505
Menzies-Gow NJ, Wakeel F, Little H, Buil J, Rickards K.Laminitis causes lameness in donkeys, but its prevalence and factors associated with disease remain uncertain. Objective: To determine the prevalence of and identify factors associated with laminitis in donkeys. Methods: Retrospective cross-sectional study. Methods: All donkeys at the Donkey Sanctuary, UK, October 2015 to March 2019 were included. For animals that had laminitis during this period, age, sex, weight, body condition score, and the onset date and type of each episode (first or recurrent, acute or chronic) were recorded. Additionally, management data, foot lesion score, endocrine d...