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Topic:Diagnostic Technique

Diagnostic techniques in equine medicine encompass a range of procedures and tools used to identify diseases, injuries, or other health conditions in horses. These techniques include imaging methods such as radiography, ultrasonography, and magnetic resonance imaging (MRI), as well as laboratory tests like blood work and tissue biopsies. Each diagnostic method provides specific information that can aid in the assessment and management of equine health issues. Radiography is commonly used for evaluating bone structures, while ultrasonography is useful for soft tissue examination. MRI offers detailed images of both soft and hard tissues, though its use is limited by cost and availability. Laboratory tests can detect biochemical and hematological changes indicative of disease. This page compiles peer-reviewed research studies and scholarly articles that explore the development, application, and efficacy of various diagnostic techniques in equine veterinary practice.
Application across species of a one health approach to liquid sample handling for respiratory based -omics analysis.
Scientific reports    July 12, 2021   Volume 11, Issue 1 14292 doi: 10.1038/s41598-021-93839-9
Karagianni AE, Eaton SL, Kurian D, Cillán-Garcia E, Twynam-Perkins J, Raper A, Wishart TM, Pirie RS.Airway inflammation is highly prevalent in horses, with the majority of non-infectious cases being defined as equine asthma. Currently, cytological analysis of airway derived samples is the principal method of assessing lower airway inflammation. Samples can be obtained by tracheal wash (TW) or by lavage of the lower respiratory tract (bronchoalveolar lavage (BAL) fluid; BALF). Although BALF cytology carries significant diagnostic advantages over TW cytology for the diagnosis of equine asthma, sample acquisition is invasive, making it prohibitive for routine and sequential screening of airway ...
Effect of Speed and Surface Type on Individual Rein and Combined Left-Right Circle Movement Asymmetry in Horses on the Lunge.
Frontiers in veterinary science    July 12, 2021   Volume 8 692031 doi: 10.3389/fvets.2021.692031
Pfau T, Persson-Sjodin E, Gardner H, Orssten O, Hernlund E, Rhodin M.Differences in movement asymmetry between surfaces and with increasing speed increase the complexity of incorporating gait analysis measurements from lunging into clinical decision making. This observational study sets out to quantify by means of quantitative gait analysis the influence of surface and speed on individual-rein movement asymmetry measurements and their averages across reins (average-rein measurements). Head, withers, and pelvic movement asymmetry was quantified in 27 horses, identified previously as presenting with considerable movement asymmetries on the straight, during trot i...
Management of Colic in the Field.
The Veterinary clinics of North America. Equine practice    July 11, 2021   Volume 37, Issue 2 421-439 doi: 10.1016/j.cveq.2021.04.010
Rhodes DM, Madrigal R.Colic is one of the most frequent emergencies necessitating veterinary attention. Referral is not an option in many cases; therefore, the ability to diagnose and treat colic in an ambulatory setting is paramount. Portable imaging and point-of-care testing has improved the ability to identify lesions and assess the patient's status. In cases when field management is the only option, practitioners should be aware of the various treatment options available.
Managing Reproduction Emergencies in the Field: Part 1: Injuries in Stallions; Injury of the External Portion of the Reproductive Tract and Gestational Conditions in the Mare.
The Veterinary clinics of North America. Equine practice    July 11, 2021   Volume 37, Issue 2 339-366 doi: 10.1016/j.cveq.2021.04.007
Sprayberry KA, Lu KG.Selected emergency conditions of male and female reproductive tracts in horses are described, including injuries affecting the external genitalia of male horses and emergent conditions arising during gestation in mares. Conditions affecting male horses are discussed in the context of breeding stallions, but kicks or other mechanisms of trauma in the groin can also affect geldings. Priapism, paraphimosis, trauma to the scrotum and testicles, and penile injury are discussed. In mares, traumatic vestibular injury, placentitis, hydropsic conditions, prepubic tendon and abdominal wall compromise, a...
A novel Streptococcus species causing clinical mastitis in a pregnant donkey. Podico G, Gray SM, Wang L, Canisso IF.An 8-y-old jenny was presented because of anorexia and mild depression. The jenny had weaned her colt 10 d before the admission. Upon arrival at the University of Illinois Veterinary Teaching Hospital, the heart rate was elevated, and the right udder was painful and swollen on palpation. Milk stripping of the affected side revealed purulent content; the contralateral udder had normal-appearing milk. Cytology of mammary gland secretions from the affected side revealed a large number of hypersegmented reactive neutrophils with phagocytized bacteria. Complete blood count, serum chemistry, and f...
Causes, Effects and Methods of Monitoring Gas Exchange Disturbances during Equine General Anaesthesia.
Animals : an open access journal from MDPI    July 9, 2021   Volume 11, Issue 7 doi: 10.3390/ani11072049
Stefanik E, Drewnowska O, Lisowska B, Turek B.Horses, due to their unique anatomy and physiology, are particularly prone to intraoperative cardiopulmonary disorders. In dorsally recumbent horses, chest wall movement is restricted and the lungs are compressed by the abdominal organs, leading to the collapse of the alveoli. This results in hypoventilation, leading to hypercapnia and respiratory acidosis as well as impaired tissue oxygen supply (hypoxia). The most common mechanisms disturbing gas exchange are hypoventilation, atelectasis, ventilation-perfusion (V/Q) mismatch and shunt. Gas exchange disturbances are considered to be an import...
Identification of a Ruminant Origin Group B Rotavirus Associated with Diarrhea Outbreaks in Foals.
Viruses    July 9, 2021   Volume 13, Issue 7 doi: 10.3390/v13071330
Uprety T, Sreenivasan CC, Hause BM, Li G, Odemuyiwa SO, Locke S, Morgan J, Zeng L, Gilsenan WF, Slovis N, Metcalfe L, Carter CN, Timoney P, Horohov D....Equine rotavirus group A (ERVA) is one of the most common causes of foal diarrhea. Starting in February 2021, there was an increase in the frequency of severe watery to hemorrhagic diarrhea cases in neonatal foals in Central Kentucky. Diagnostic investigation of fecal samples failed to detect evidence of diarrhea-causing pathogens including ERVA. Based on Illumina-based metagenomic sequencing, we identified a novel equine rotavirus group B (ERVB) in fecal specimens from the affected foals in the absence of any other known enteric pathogens. Interestingly, the protein sequence of all 11 segment...
Diagnostic testing patterns for Streptococcus equi subsp. equi in Ontario horses during the years 2008 to 2018.
The Canadian veterinary journal = La revue veterinaire canadienne    July 6, 2021   Volume 62, Issue 6 629-636 
Brankston G, Rossi TM, O'Sullivan TL, Greer AL.This retrospective study describes testing patterns and the incidence of subsp. in Ontario to assess the utility of laboratory data for surveillance purposes. Laboratory records for equine infectious disease test submissions were extracted from the Animal Health Laboratory (AHL) at the University of Guelph for the years 2008 to 2018. Yearly and seasonal trends in testing and the proportion of tests that returned positive results were assessed. The number of samples submitted for testing decreased over the 11-year period (odds ratio = 0.96, 95% confidence interval: 0.92 to 0.999; = 0.04). ...
Comparison Between Ultrasonographic and Standing Magnetic Resonance Imaging Findings in the Podotrochlear Apparatus of Horses With Foot Pain.
Frontiers in veterinary science    July 5, 2021   Volume 8 675180 doi: 10.3389/fvets.2021.675180
Evrard L, Joostens Z, Vandersmissen M, Audigié F, Busoni V.This prospective study aimed to blindly compare the ultrasonographic and standing magnetic resonance imaging (sMRI) findings in deep digital flexor tendon (DDFT), navicular bone, and navicular bursa in horses with foot pain, positive digital analgesia, and without definitive radiographic diagnosis. Ultrasonography detected more DDFT abnormalities (32/34 feet vs. 27/34 with sMRI) but identified less palmar navicular abnormalities (23/34 feet vs. 30/34 with sMRI). In suprasesamoidean DDFT lesions, which were mainly dorsally located, changes in echogenicity did not correspond to a particular patt...
Performance of the Parasympathetic Tone Activity (PTA) index to predict changes in mean arterial pressure in anaesthetized horses with different health conditions.
Research in veterinary science    July 3, 2021   Volume 139 43-50 doi: 10.1016/j.rvsc.2021.07.005
Mansour C, Mocci R, Santangelo B, Sredensek J, Chaaya R, Allaouchiche B, Bonnet-Garin JM, Boselli E, Junot S.The parasympathetic tone activity (PTA) index is based on heart rate variability and has been developed recently in animals to assess their relative parasympathetic tone. This study aimed to evaluate PTA index in anaesthetized horses with different health conditions and the performance of PTA variations (∆PTA) to predict changes in mean arterial pressure (MAP). Thirty-nine client-horses were anaesthetized for elective or colic surgery and divided into "Elective" and "Colic" groups. During anaesthesia, dobutamine was administered as treatment of hypotension (MAP <60 mmHg). In both groups, no...
Effect of Topical Cyclopentolate 1% on Ocular Ultrasonographic Features, Intraocular Pressure, Tear Production, and Pupil Size in Normal Donkeys (Equus Asinus).
Journal of equine veterinary science    July 2, 2021   Volume 104 103700 doi: 10.1016/j.jevs.2021.103700
Hussein KH, Elmeligy E, Khalphallah A, Al-Lethie AA.This study was performed to investigate the effects of cyclopentolate on ultrasonographic parameters of eye structures, intraocular pressure (IOP), tear production, and pupil size in normal donkeys. Sixteen eyes of eight clinically healthy adult donkeys (2-2.5 years old) weighing 295 ± 34 kg (mean ± standard deviation) were used in this study. Cyclopentolate hydrochloride 1% was instilled in a randomly selected eye and the other eye received normal saline drops as a control. The effect of cyclopentolate was evaluated by ultrasonography. Additionally, changes in IOP and tear production were ...
A Standard Scale to Measure Equine Keeper Status and the Effect of Metabolic Tendency on Gut Microbiome Structure.
Animals : an open access journal from MDPI    July 1, 2021   Volume 11, Issue 7 1975 doi: 10.3390/ani11071975
Johnson ACB, Biddle AS.Thriftiness in horses has been associated with more efficient nutrient harvesting in digestion, absorption and/or utilization, but the relative contribution of the gut microbiome to host metabolic tendency is not well understood. Recognizing the unreliability of owner reported assignment of keeper status, this research describes a novel tool for calculating whether a horse is an easy (EK) or hard (HK) keeper and then characterizes microbiome differences in these groups. The Equine Keeper Status Scale (EKSS) was developed and validated based on data gathered from 240 horses. Estimates of dietar...
Deep digital flexor tendon lesions in the pastern are associated with the presence of distal tendinopathy.
Equine veterinary journal    June 28, 2021   Volume 54, Issue 3 502-512 doi: 10.1111/evj.13470
Acutt EV, Contino EK, Frisbie DD, Barrett MF.Correct diagnosis and characterisation of deep digital flexor tendon (DDFT) lesions in equine athletes allows targeted treatment and improved prognostication. Objective: To assess the prevalence and character of pathological change within the DDFT in the pastern with concurrent tendon injury distally. It is hypothesised that tendon lesions in the pastern will be associated with tendinopathy within the hoof capsule. Methods: Retrospective descriptive case series. Methods: Cases with DDFT lesions in the pastern and magnetic resonance imaging (MRI) or ultrasonography of the foot were evaluated re...
Effects of intravenous magnesium sulfate on serum calcium-regulating hormones and plasma and urinary electrolytes in healthy horses.
PloS one    June 28, 2021   Volume 16, Issue 6 e0247542 doi: 10.1371/journal.pone.0247542
Schumacher SA, Kamr AM, Lakritz J, Burns TA, Bertone AL, Toribio RE.Intravenous magnesium sulfate (MgSO4) is used in equine practice to treat hypomagnesemia, dysrhythmias, neurological disorders, and calcium dysregulation. MgSO4 is also used as a calming agent in equestrian events. Hypercalcemia affects calcium-regulating hormones, as well as plasma and urinary electrolytes; however, the effect of hypermagnesemia on these variables is unknown. The goal of this study was to investigate the effect of hypermagnesemia on blood parathyroid hormone (PTH), calcitonin (CT), ionized calcium (Ca2+), ionized magnesium (Mg2+), sodium (Na+), potassium (K+), chloride (Cl-) ...
What makes a good fecal egg count technique?
Veterinary parasitology    June 27, 2021   Volume 296 109509 doi: 10.1016/j.vetpar.2021.109509
Nielsen MK.The first parasite fecal egg counting techniques were described over 100 years ago, and fecal egg counting remains essential in parasitology research as well as in clinical practice today. Several novel techniques have been introduced and validated in recent years, but this work has also highlighted several current issues in this research field. There is a lack of consensus on which diagnostic parameters to evaluate and how to properly design studies doing so. Furthermore, there is a confusing and sometimes incorrect use of terminology describing performance of fecal egg counting techniques, a...
Investigation of The Usefulness of Serum Amyloid A in Characterizing Selected Disease Forms of Equine Herpesvirus-1 Infection.
Journal of equine veterinary science    June 26, 2021   Volume 104 103699 doi: 10.1016/j.jevs.2021.103699
Pusterla N, Miller J, Varnell S, Armstrong W, Frost L, Michon C, Lambert K, Whitfield S, Cowles B.The objective of this study was to study the SAA response of horses with various forms of EHV-1 infection. Archived serum samples from 153 horses with various disease forms of EHV-1 infection (48 healthy non-infected horses, 48 subclinically infected horses, 40 horses with respiratory EHV-1 infection and 17 horses with neurological EHV-1 infection) were available for SAA testing. SAA values ranged from 0 to 31 µg/mL (median 0 µg/mL) in healthy horses, from 0 to 2,416 µg/mL (median 8.5 µg/mL) in subclinically infected horses, from 0 to 3,000 µg/mL (median 597 µg/mL) in horse with respirat...
Equine Herpesvirus Type 4 (EHV-4) Outbreak in Germany: Virological, Serological, and Molecular Investigations.
Pathogens (Basel, Switzerland)    June 25, 2021   Volume 10, Issue 7 810 doi: 10.3390/pathogens10070810
Pavulraj S, Eschke K, Theisen J, Westhoff S, Reimers G, Andreotti S, Osterrieder N, Azab W.Equine herpesvirus type 4 (EHV-4) is enzootic in equine populations throughout the world. A large outbreak of EHV-4 respiratory infection occurred at a Standardbred horse-breeding farm in northern Germany in 2017. Respiratory illness was observed in a group of in-housed foals and mares, which subsequently resulted in disease outbreak. Out of 84 horses in the stud, 76 were tested and 41 horses were affected, including 20 foals, 10 stallions, and 11 mares. Virological investigations revealed the involvement of EHV-4 in all cases of respiratory illness, as confirmed by virus isolation, qPCR, and/...
Evaluation of the sublingual microcirculation with sidestream dark field video microscopy in horses anesthetized for an elective procedure or intestinal surgery.
American journal of veterinary research    June 25, 2021   Volume 82, Issue 7 574-581 doi: 10.2460/ajvr.82.7.574
Mansour C, Chaaya R, Sredensek J, Mocci R, Santangelo B, Allaouchiche B, Bonnet-Garin JM, Boselli E, Junot SA.To compare the sublingual microcirculation between healthy horses anesthetized for elective procedures and horses with colic anesthetized for abdominal surgery and to determine the effect of mean arterial blood pressure (MAP) on the microcirculation. Methods: 9 horses in the elective group and 8 horses in the colic group. Methods: Sublingual microcirculation was assessed with sidestream dark field video microscopy. Videos were captured at 3 time points during anesthesia. Recorded microvasculature parameters were De Backer score (DBS), total density of perfused vessels (PVD) and small vessels (...
In vitro Validation Assessment of a Fecal Occult Blood Protein Test for Horses.
Journal of equine veterinary science    June 25, 2021   Volume 104 103695 doi: 10.1016/j.jevs.2021.103695
Rebalka IA, Lindinger MI.A commercially available equine fecal blood test (FBT) claims to be able to detect the presence of blood proteins (albumin and hemoglobin) in manure. The purpose of this study was to determine the FBT test sensitivity, specificity, positive and negative predictive values (PPV, NPV), lower threshold of detection, time to obtain a visual positive result, effect of temperature and result stability in lab and field conditions. The FBT was assessed for its sensitivity and specificity for detecting pure albumin and hemoglobin at two temperatures over a range of concentrations. Time to result was mea...
Longitudinal study of the cutaneous microbiota of healthy horses.
Veterinary dermatology    June 24, 2021   Volume 32, Issue 5 467-e128 doi: 10.1111/vde.12983
O'Shaughnessy-Hunter LC, Yu A, Rousseau JD, Foster RA, Weese JS.Next-generation sequencing techniques have revealed that human and animal skin is colonised by a rich and diverse population of bacteria, and that microbial composition varies between different body sites and individuals. Very little is known about the normal microbiota of healthy equine skin. Objective: To describe the taxonomic distributions of cutaneous bacterial microbiota in a population of healthy horses in Ontario, Canada, and to evaluate the effects of body site, individual and time of year on microbial diversity and community composition. Methods: Samples were collected from four body...
Study design synopsis: Omics studies of fractures in the horse – Which technology is best?
Equine veterinary journal    June 23, 2021   Volume 53, Issue 6 1091-1093 doi: 10.1111/evj.13467
Taylor SE, Matika O, Lee S, Baker M, Watson KA.No abstract available
Evaluation of intramuscular anesthetic protocols in healthy domestic horses.
Veterinary anaesthesia and analgesia    June 23, 2021   Volume 48, Issue 5 663-670 doi: 10.1016/j.vaa.2021.06.006
Willette C, Aarnes TK, Lerche P, Ricco-Pereira C, Ballash GA, Bednarski RM.To assess anesthetic induction, recovery quality and cardiopulmonary variables after intramuscular (IM) injection of three drug combinations for immobilization of horses. Methods: Randomized, blinded, three-way crossover prospective design. Methods: A total of eight healthy adult horses weighing 470-575 kg. Methods: Horses were administered three treatments IM separated by ≥1 week. Combinations were tiletamine-zolazepam (1.2 mg kg), ketamine (1 mg kg) and detomidine (0.04 mg kg) (treatment TKD); ketamine (3 mg kg) and detomidine (0.04 mg kg) (treatment KD); and tiletamine-zolazepam (2.4 mg ...
[Methodical investigation of mineral and trace element concentrations in equine feces with special consideration of the sampling location].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    June 22, 2021   Volume 49, Issue 3 178-188 doi: 10.1055/a-1482-7379
Staufenbiel L, Müller AE, Gehlen H.Objective measurements of the mineral supply in horses are rarely performed. As a result, incorrect elements or an improper amount of elements are provided. The analysis of feces could represent a novel method to evaluate the nutritive supply. The prerequisite is a knowledge of methodological factors influencing the mineral concentration in the fecal samples. Within the scope of this investigation, the effects of different kinds of mineral supply and the influence of the sampling location on the concentration of minerals in equine feces samples were analyzed. Additionally, the methodical error...
Accelerometry-Based Step Count Validation for Horse Movement Analysis During Stall Confinement.
Frontiers in veterinary science    June 22, 2021   Volume 8 681213 doi: 10.3389/fvets.2021.681213
Steinke SL, Montgomery JB, Barden JM.Quantitative tracking of equine movement during stall confinement has the potential to detect subtle changes in mobility due to injury. These changes may warn of potential complications, providing vital information to direct rehabilitation protocols. Inertial measurement units (IMUs) are readily available and easily attached to a limb or surcingle to objectively record step count in horses. The objectives of this study were: (1) to compare IMU-based step counts to a visually-based criterion measure (video) for three different types of movements in a stall environment, and (2) to compare three ...
The examination of biophysical parameters of the skin in Polish Konik horses.
PloS one    June 21, 2021   Volume 16, Issue 6 e0250329 doi: 10.1371/journal.pone.0250329
Cekiera A, Popiel J, Siemieniuch M, Jaworski Z, Slowikowska M, Siwinska N, Zak A, Niedzwiedz A.This study aimed to assess the biophysical parameters of the skin in Polish Konik horses (Polish primitive horses). According to the authors, this is the first assessment performed on such a wide scale in this group of animals. The evaluation carried out is innovative both with regards to the breed of the animals and the wide scope of the physicochemical skin assessment. The study group comprised mares, stallions and geldings, and the evaluations concerned transepidermal water loss, corneometry, pH, skin temperature assessment and mexametry. These parameters were assessed in five skin regions:...
Intratendinous Fibroma of the Superficial Digital Flexor Tendon within the Carpal Sheath of a Horse.
Journal of equine veterinary science    June 21, 2021   Volume 105 103693 doi: 10.1016/j.jevs.2021.103693
Rich AF, Ricci E, Gates S, Hinnigan GJ, Owen KR.A 20-year-old British Warmblood gelding was presented for a progressively worsening right forelimb lameness which developed following an intense dressage training session. Initial ultrasound examination revealed a triangular, intrathecal, hypoechoic region within the superficial digital flexor tendon (SDFT) in the proximal, palmar carpal region distal to the accessory carpal bone (ACB), extending 7cm distally into the proximal metacarpal region. No significant improvement in clinical presentation was observed following an eight-week rehabilitation programme. Repeat ultrasound examination revea...
18 Fluorine-fluorodeoxyglucose positron emission tomography for assessment of deep digital flexor tendinopathy: An exploratory study in eight horses with comparison to CT and MRI. Wilson S, Spriet M, Mur PE, Anishchenko S, Beylin D, Katzman S, Galuppo L.Lesions of the deep digital flexor tendon (DDFT) are a cause for foot lameness in horses. Positron emission tomography (PET) could provide valuable information regarding the metabolic activity of these lesions. The aims of this exploratory, prospective, methods comparison study were to assess the ability of fluorine-fluorodeoxyglucose ( F-FDG) PET to detect DDFT lesions and to compare the PET findings with CT and MRI findings. Eight horses with lameness due to pain localized to the front feet were included. Both front limbs of all horses were imaged with F-FDG PET, noncontrast CT, and arteri...
Diagnostic applications of molecular and serological assays for bluetongue and African horse sickness.
Revue scientifique et technique (International Office of Epizootics)    June 19, 2021   Volume 40, Issue 1 91-104 doi: 10.20506/rst.40.1.3210
Mayo CE, Weyer CT, Carpenter MJ, Reed KJ, Rodgers CP, Lovett KM, Guthrie AJ, Mullens BA, Barker CM, Reisen WK, MacLachlan NJ.The availability of rapid, highly sensitive and specific molecular and serologic diagnostic assays, such as competitive enzyme-linked immunosorbent assay (cELISA), has expedited the diagnosis of emerging transboundary animal diseases, including bluetongue (BT) and African horse sickness (AHS), and facilitated more thorough characterisation of their epidemiology. The development of assays based on real-time, reverse-transcription polymerase chain reaction (RT-PCR) to detect and identify the numerous serotypes of BT virus (BTV) and AHS virus (AHSV) has aided in-depth studies of the epidemiology ...
Adrenal Gland Ultrasonographic Measurements and Plasma Hormone Concentrations in Clinically Healthy Newborn Thoroughbred and Standardbred Foals.
Animals : an open access journal from MDPI    June 19, 2021   Volume 11, Issue 6 1832 doi: 10.3390/ani11061832
Lauteri E, Mariella J, Beccati F, Roelfsema E, Castagnetti C, Pepe M, Peric T, Barbato O, Montillo M, Rouge S, Freccero F.Adrenal hormones, ACTH plasma concentrations and the ultrasonographic evaluation of the adrenal glands are considered complementary in clinical evaluations of the hypothalamic-pituitary-adrenal (HPA) axis function in several species. In dogs, age, size and weight have a significant effect on the ultrasonographic size of the adrenal glands. In neonatal foals, ultrasonographic evaluation and measurements of the adrenal glands have been demonstrated to be reliable; however, the effect of individual variables on ultrasonographic features has not been investigated, and the clinical usefulness of ad...
Case report: The case of a 17 kg ovarian granulosa cell tumor in a Breton draft mare.
Journal of equine science    June 18, 2021   Volume 32, Issue 2 67-72 doi: 10.1294/jes.32.67
Tsogtgerel M, Tagami M, Watanabe K, Murase H, Hirosawa Y, Kobayashi Y, Nambo Y.Granulosa cell tumor (GCT) is a benign tumor which affects the mare's ovaries. In this report, a case of unilateral GCT in an ovary, which weighed 17.04 kg, of a 9-year-old Breton draft mare is described. A transrectal ultrasonography exam revealed a unilateral multi-cystic enlarged ovary. Laparoscopic ovariectomy was difficult due to enlargement of blood vessels in the ovarian broad ligament. The mare was necropsied, and the pathological changes in the GCT-affected ovary and unaffected ovary were evaluated. The ovarian mass in the GCT-affected ovary had a cribriform pattern and was positive f...
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