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Topic:Disease Diagnosis

Disease diagnosis in horses involves the identification and characterization of illnesses through various diagnostic methods and tools. This process is essential for effective veterinary care and management of equine health. Techniques used in diagnosing diseases in horses include clinical examinations, laboratory tests, imaging modalities such as ultrasonography and radiography, and molecular diagnostics. Blood tests are frequently utilized to assess parameters such as complete blood count and biochemical profiles, which can indicate underlying health issues. Additionally, advancements in genetic testing and biomarker identification have enhanced the ability to detect specific diseases early. This page aggregates peer-reviewed research studies and scholarly articles that explore diagnostic methodologies, their applications, and their impact on equine health management.
Serum concentrations of selenium, copper, and zinc in neonatal foals: Influence of failure of passive transfer and age-related changes.
The Canadian veterinary journal = La revue veterinaire canadienne    May 2, 2024   Volume 65, Issue 5 481-487 
Stahl LT, Müller A, Krohn J, Büttner K, Wehrend A.An adequate supply of trace elements is very important for equine neonates, as deficiencies can lead to health problems and even death. Unassigned: This study investigated serum concentrations of selenium (Se), copper (Cu), and zinc (Zn) in neonatal foals up to the 8th day of life. The influences of disease, age, and failure of passive transfer (FPT) on these concentrations were analyzed. Unassigned: Serum concentrations of Se, Cu, and Zn were determined from blood samples of 93 foals by means of inductively coupled plasma mass spectrometry. The foals were divided into 2 groups based on health...
Effect of hospitalization on equine local intestinal immunoglobulin A (IgA) concentration measured in feces.
Journal of equine veterinary science    April 30, 2024   Volume 137 105078 doi: 10.1016/j.jevs.2024.105078
May A, Gerhards H, Wollanke B.During hospitalization horses may develop gastrointestinal conditions triggered by a stress-associated weak local immune system. The prospective, clinical trial was conducted to find out whether fecal immunoglobulin A (IgA) concentrations could be determined in hospitalized horses and how they changed during hospitalization and in response to various stressors. Samples were obtained from 110 horses and a control group (n = 14). At arrival in the hospital, horses were categorized into pain grades (1-5), and elective versus strenuous surgery (> 2 hours, traumatic and emergency procedures). Feces...
Molecular Study of Anaplasma spp. in Horses, Sheep, and Goats with Phylogenetic Analysis in Northwest Iran.
Archives of Razi Institute    April 30, 2024   Volume 79, Issue 2 327-334 doi: 10.32592/ARI.2024.79.2.327
Akbari H, Basaki M, Imani Baran A, Akbarzadeh Z.Anaplasmosis, a tick-borne disease with worldwide distribution, impacts ruminants, equines, carnivores, and humans. This study aimed to investigate Anaplasma phagocytophilum in horses from Ardabil province and Anaplasma ovis in small ruminants from East Azerbaijan province using the Nested Polymerase Chain Reaction (PCR) method. Blood samples were taken from the jugular vein of 100 healthy horses in the Ardabil province and 156 healthy sheep and goats (116 sheep and 40 goats) in the East Azerbaijan province during the spring and summer seasons of 2016 in northwest Iran. The collected blood sam...
Refractory pneumonia caused by Prevotella heparinolytica: a case report.
Journal of medical case reports    April 30, 2024   Volume 18, Issue 1 213 doi: 10.1186/s13256-024-04538-8
Sun J, Xu X, Gao S, Pan Q, Liu Z, Huang Y, Lian Y.Prevotella heparinolytica is a Gram-negative bacterium that is commonly found in the oral, intestinal, and urinary tracts. It has been extensively studied in lower respiratory tract infections in horses, which has heparinolytic activity and can secrete heparinase and further induces virulence factors in cells and causes disease. However, no such cases have been reported in humans. Methods: A 58-year-old male patient from China presented to the respiratory clinic in Suzhou with a productive cough producing white sputum for 20 days and fever for 3 days. Prior to this visit, a chest computed to...
Survey of tick-borne pathogens in grazing horses in Kyrgyzstan: phylogenetic analysis, genetic diversity, and prevalence of Theileria equi.
Frontiers in veterinary science    April 29, 2024   Volume 11 1359974 doi: 10.3389/fvets.2024.1359974
Altay K, Erol U, Sahin OF, Ulucesme MC, Aytmirzakizi A, Aktas M.Tick-borne pathogens (TBP) are an important group of organisms that can affect animals and humans all over the world. Equine piroplasmosis (EP), caused by and , is considered one of the most important tick-borne diseases and can cause significant clinical symptoms and mortality in horses. Moreover, EP plays a restrictive role in international horse traditions and transportation. Although these species can cause similar symptoms, there are different 18S rRNA genotypes of (five genotypes) and (three genotypes). Besides piroplasma species, and hemotropic mycoplasmas (HM) are known as other im...
First confirmed case of equine pythiosis in Northern Veracruz, Mexico.
Acta tropica    March 27, 2024   Volume 254 107195 doi: 10.1016/j.actatropica.2024.107195
Chagoya-Fuentes JL, Gaona-López J, Hernández-Carbajal GR, Torres-Guerrero H, Lammoglia-Villagómez MA, Huerta-Peña J, Pérez-Brígido CD....A clinical case of an adult horse with invasive, ulcerative, proliferative, pyogranulomatous disease of the skin (tumor) in the shoulder region is presented. The mass had a granulomatous and crater-shaped appearance, with serosanguinous discharge and the presence of fistulas with caseous material. The tumor was removed by surgery and sent to the laboratory for diagnosis. Histopathology was performed using Grocott-Gomori methenamine silver stain. The presence of necrotic material, fibrosis, infiltrated cells, and brown-colored hyphae, characteristic of members of the genus Pythium, were observe...
Equine gamma herpesvirus presence and viral load are not associated with equine glandular gastric disease.
American journal of veterinary research    March 18, 2024   Volume 85, Issue 6 ajvr.23.12.0282 doi: 10.2460/ajvr.23.12.0282
Thompson RN, Pearson E, McDonough SP, Iannitti H, Van de Walle GR, Banse H, Perkins GA, Tomlinson JE.To investigate the role of equine herpesvirus-2 (EHV-2) and equine herpesvirus-5 (EHV-5) in equine glandular gastric disease (EGGD) by visualizing and quantifying these gamma herpesviruses in EGGD-affected and normal glandular gastric mucosa of horses. A secondary objective was to describe the histopathological abnormalities in the equine gastric glandular mucosa in horses with EGGD. Methods: 29 horses (n = 21 postmortem and 8 gastroscopy) categorized as normal (11), EGGD (12), or both EGGD and equine squamous gastric disease (6). Methods: Glandular gastric mucosal samples were collected from ...
Revisiting the genotypes of Theileria equi based on the V4 hypervariable region of the 18S rRNA gene.
Frontiers in veterinary science    March 15, 2024   Volume 11 1303090 doi: 10.3389/fvets.2024.1303090
Nehra AK, Kumari A, Moudgil AD, Vohra S.Equine theileriosis, an economically important disease that affects horses and other equids worldwide, is caused by a tick-borne intracellular apicomplexan protozoa . Genotyping of based on the 18S rRNA gene revealed the presence of two, three, four or five genotypes. In previous published reports, these genotypes have been labelled either alphabetically or numerically, and there is no uniformity in naming of these genotypes. The present study was aimed to revisit the phylogeny, genetic diversity and geographical distribution of based on the nucleotide sequences of the V4 hypervariable regio...
Ulcerative and Spreading Nodular Lesion of Epizootic Lymphangitis in Adult Black Horse in Gondar, Ethiopia: Case Report and Wound Treatment.
Case reports in veterinary medicine    February 26, 2024   Volume 2024 2478774 doi: 10.1155/2024/2478774
Abebaw B.An adult male black horse was presented to the UOG veterinary clinic with swelling, discharge, and skin wounds on the chest wall and the right front leg; then, it goes to the lateral and medial hind leg. Inspection and palpation were carried out, and we revealed that the skin was swelled, thickened and hard on clinical examination. There was also nodule rupture, and discharge on the limb and chest skin. Different therapy was applied starting from washing the wound with water-diluted potassium permanganate and then 0.9% NaCl together with paraffin topically placed on the wound. 10% povidone-iod...
Performance of three techniques for diagnosing equine tapeworm infection.
Veterinary parasitology    February 24, 2024   Volume 327 110152 doi: 10.1016/j.vetpar.2024.110152
Anderson HC, Warner SF, Ripley NE, Nielsen MK.Tapeworm infection in horses can cause serious health concerns, and recent data have documented treatment failures in the most common species, Anoplocephala perfoliata. The threat of anthelmintic resistance in A. perfoliata is of particular concern because of poor diagnostic performance of standard egg counting techniques for detecting this parasite. This study compared the performance of three diagnostic techniques 1) Mini-FLOTAC, 2) Cornell-Wisconsin, and 3) Proudman and Edwards used to detect and quantify A. perfoliata eggs in naturally infected horses. Eighteen adult female horses from the...
Vesicular Stomatitis Virus.
The Veterinary clinics of North America. Food animal practice    February 23, 2024   Volume 40, Issue 2 251-259 doi: 10.1016/j.cvfa.2024.01.005
Pelzel-McCluskey AM.Vesicular stomatitis (VS) is a vector-borne livestock disease caused by either VS New Jersey virus or VS Indiana virus. The disease circulates endemically in northern South America, Central America, and Mexico and only occasionally causes outbreaks in the United States. During the past 20 years, VS outbreaks in the southwestern and Rocky Mountain regions occurred periodically with incursion years followed by virus overwintering and subsequent expansion outbreak years. Regulatory response by animal health officials prevents spread from lesioned animals and manages trade impacts. Recent US outb...
Serological and Molecular Investigation of SARS-CoV-2 in Horses and Cattle in Switzerland from 2020 to 2022.
Viruses    January 31, 2024   Volume 16, Issue 2 224 doi: 10.3390/v16020224
Hüttl J, Reitt K, Meli ML, Meili T, Bönzli E, Pineroli B, Ginders J, Schoster A, Jones S, Tyson GB, Hosie MJ, Pusterla N, Wernike K....Horses and cattle have shown low susceptibility to SARS-CoV-2, and there is no evidence of experimental intraspecies transmission. Nonetheless, seropositive horses in the US and seropositive cattle in Germany and Italy have been reported. The current study investigated the prevalence of antibodies against SARS-CoV-2 in horses and cattle in Switzerland. In total, 1940 serum and plasma samples from 1110 horses and 830 cattle were screened with a species-specific ELISA based on the SARS-CoV-2 receptor-binding domain (RBD) and, in the case of suspect positive results, a surrogate virus neutralizat...
Molecular characterization of equine herpes viruses type 1 and 4 among Arabian horse populations in Egypt during the period between 2021 and 2022.
Open veterinary journal    January 31, 2024   Volume 14, Issue 1 534-544 doi: 10.5455/OVJ.2024.v14.i1.48
Ali AAH, Abdallah F, Shemies OA, Kotb G, Nafea MR.Equine herpesvirus type 1 (EHV-1) is a major cause of abortion and respiratory disease. Equine herpesvirus type 4 (EHV-4), on the other hand, is exclusively associated with respiratory disease in horse populations worldwide, particularly in Egypt and Arabian countries. Unassigned: This study aims to investigate the circulation of EHV-1 and EHV-4 in the Arabian horse population through molecular detection and genetic characterization of EHV-1 and/or EHV-4 that may threaten the stability of horse industry. Unassigned: A total of 80 samples including 50 nasal swabs, 10 vaginal swabs and 20 whole ...
Measurement of 8-hydroxy-2′-deoxyguanosine in serum and cerebrospinal fluid of horses with neuroaxonal degeneration and other causes of proprioceptive ataxia.
Journal of veterinary internal medicine    January 11, 2024   Volume 38, Issue 2 1207-1213 doi: 10.1111/jvim.16988
Palmisano M, Kulp J, Bender S, Stefanovski D, Robinson M, Johnson A.Eight-hydroxy-2'-deoxyguanosine (8-OHdG), a biomarker of oxidative damage evaluated in human neurodegenerative disease, has potential to correlate with postmortem diagnosis of neuroaxonal dystrophy/degenerative myeloencephalopathy (NAD/DM) in horses. Objective: We hypothesized that 8-OHdG will be higher in CSF and serum from NAD/DM horses compared with horses with other neurologic diseases (CVSM, EPM) and a control group of neurologically normal horses. We also hypothesized that 8-OHdG will be higher in CSF compared with serum from NAD/DM horses. Methods: Fifty client-owned horses with postmor...
Decision Making in Severe Equine Asthma-Diagnosis and Monitoring.
Animals : an open access journal from MDPI    December 16, 2023   Volume 13, Issue 24 3872 doi: 10.3390/ani13243872
Simões J, Tilley P.Decision making consists of gathering quality data in order to correctly assess a situation and determine the best course of action. This process is a fundamental part of medicine and is what enables practitioners to accurately diagnose diseases and select appropriate treatment protocols. Despite severe equine asthma (SEA) being a highly prevalent lower respiratory disease amongst equids, clinicians still struggle with the optimization of routine diagnostic procedures. The use of several ancillary diagnostic tests has been reported for disease identification and monitoring, but many are only s...
Development and evaluation of specific polymerase chain reaction assays for detecting Theileria equi genotypes.
Parasites & vectors    November 25, 2023   Volume 16, Issue 1 435 doi: 10.1186/s13071-023-06045-z
Ahedor B, Otgonsuren D, Zhyldyz A, Guswanto A, Ngigi NMM, Valinotti MFR, Kothalawala H, Kalaichelvan N, Silva SSP, Kothalawala H, Acosta TJ....Theileria equi causes equine piroplasmosis, an economically significant disease that affects horses and other equids worldwide. Based on 18S ribosomal RNA (18S rRNA sequences), T. equi can be classified into five genotypes: A, B, C, D, and E. These genotypes have implications for disease management and control. However, no conventional polymerase chain reaction (PCR) assays are available to differentiate the genotypes of T. equi. To overcome this limitation, we developed and evaluated PCR assays specific for the detection of each T. equi genotype. Methods: A pair of forward and reverse primers...
First report of Amblyomma sculptum (Amblyomma cajennense complex) in a Brazilian state classified as a silent area for human rickettsiosis.
Veterinary world    November 1, 2023   Volume 16, Issue 11 2200-2204 doi: 10.14202/vetworld.2023.2200-2204
da Gama BC, Martins TF, Labruna MB, Vieira RFDC, de Almeida JC.Studies on ticks of public health concern in equine husbandry are scarce in the Northeastern region of Brazil. This study aimed to investigate the presence of ticks on horses in the State of Alagoas, which is classified as a silent area for human rickettsiosis. Unassigned: Ticks infesting horses were collected using anatomical tweezers or a commercial hook and kept in ethanol-labeled tubes for taxonomic identification. Unassigned: A total of 2,238 ticks were found. Ticks were identified as 2,215 (98.89%, 95% CI: 98.41-99.28) , 19 (0.98%, 95% CI: 0.05-1.38) , and 4 (0.18%; 95% CI: 0.007-0.46) ....
Phylogenetic analysis of Ehrlichia species isolated from horses and dogs in Iran.
Comparative immunology, microbiology and infectious diseases    October 24, 2023   Volume 103 102080 doi: 10.1016/j.cimid.2023.102080
Molazadeh S, Tukmechi A, Hadian M, Dalir-Naghadeh B.This study aimed to determine the prevalence and phylogenetic analysis of Ehrlichia spp. in horses and dogs in Iran. Blood samples were collected from 400 animals, including 200 horses and 200 dogs, from five different provinces in Iran. Polymerase chain reaction (PCR) was used to detect Ehrlichia spp. based on amplification of the 16S rRNA gene. The semi-nested PCR method was used to amplify the dsb, TRP36, and gltA genes. The results showed that 4.5 % of the samples (3 % horses and 6 % dogs) were positive for Ehrlichia sp. The highest prevalence was observed in Kerman and Khuzestan, while th...
European Inter-Laboratory Proficiency Test for Dourine Antibody Detection Using the Complement Fixation Test.
Veterinary sciences    September 26, 2023   Volume 10, Issue 10 592 doi: 10.3390/vetsci10100592
Hébert L, Froger D, Madeline A, Lecouturier F, Lemans C, Zientara S.Dourine is a sexually transmitted parasitic disease affecting equids. Its causative agent is referred to as and the prescribed serodiagnosis method is the complement fixation test (CFT). In the context of our European Reference Laboratory mandate for equine diseases (excluding African horse sickness), we organised dourine CFT inter-laboratory proficiency tests (ILPTs) in 2015, 2018 and 2022 to evaluate the performance of the European Union network of National Reference Laboratories (NRLs) for dourine. ILPT panels were composed of horse sera with or without antibodies against spp. originating...
Adaptation strategies of the Icelandic horse with induced forelimb lameness at walk, trot and tölt.
Equine veterinary journal    September 7, 2023   Volume 56, Issue 3 617-630 doi: 10.1111/evj.13998
Smit IH, Hernlund E, Persson-Sjodin E, Björnsdóttir S, Gunnarsdottir H, Gunnarsson V, Rhodin M, Serra Braganca FM.Lameness assessment in the gaited Icelandic horse is complex. We aimed to describe their kinematic and temporal adaptation strategies in response to forelimb lameness at walk, trot and tölt. Methods: In vivo experiment. Methods: Ten clinically non-lame Icelandic horses were measured before and after reversible forelimb lameness induction. Upper body and limb kinematics were measured using 11 inertial measurement units mounted on the poll, withers, pelvis (tubera sacrale) and all four limbs and hoofs (Equimoves®, 500 Hz). Horses were measured on a straight line at walk and trot in-hand and ...
Detection of adeno-associated viral DNA in equine post-administration frozen blood and plasma samples after long-term storage.
Drug testing and analysis    September 6, 2023   doi: 10.1002/dta.3569
Maniego J, Pesko B, Habershon-Butcher J, Hincks P, Taylor P, Stewart G, Proudman C, Ryder E.Gene doping in horses is a threat to the fairness in sport and has serious implications for animal welfare. To investigate the effect of long-term storage on the detection of AAV in plasma and whole blood, samples from an administration study using an adeno-associated virus serotype 6 expressing green fluorescence protein (AAV6-GFP) were stored at -20°C for 8 months before analysis. The AAV vector was detected in stored plasma samples, following the same detection profile as the fresh plasma samples. The stored blood showed lower overall DNA detection but followed the same detection profile ...
Unilateral right mammary gland enlargement in a multiparous, pregnant 14-year-old American Quarter Horse mare.
Journal of the American Veterinary Medical Association    September 4, 2023   1-2 doi: 10.2460/javma.23.08.0459
Castillo J, Hilburger L, Rosenberg L, Cheong SH, Duhamel GE, de Amorim MD.No abstract available
First identification and characterization of ovine gammaherpesvirus type 2 in horses and artiodactyla from an outbreak of malignant catarrhal fever in Mexico.
PloS one    September 1, 2023   Volume 18, Issue 9 e0290309 doi: 10.1371/journal.pone.0290309
Madrigal-Valencia TL, Saavedra-Montañez M, Pérez-Torres A, Hernández J, Segalés J, Hernández YD, Candanosa-Aranda IE, Pérez-Guiot A....Ovine gammaherpesvirus 2 (OvHV-2), a member of the genus Macavirus, causes sheep-associated malignant catarrhal fever (SA-MCF), a fatal lymphoproliferative disease affecting a wide variety of ungulates in addition to horses. This study described an outbreak of SA-MCF in Mexico and the identification of the OvHV-2 virus in primary rabbit testis cultures through the generation of intranuclear inclusion bodies, syncytia, immunofluorescence (IF), immunocytochemistry (ICC), immunohistochemistry (IHC), endpoint polymerase chain reaction (PCR), and partial sequencing of the ORF75 gene. The animals in...
The prevalence of equine odontoclastic tooth resorption and hypercementosis and the role of interincisal angulation in disease severity in a representative cohort of horses in Switzerland.
Schweizer Archiv fur Tierheilkunde    August 30, 2023   Volume 165, Issue 9 564-572 doi: 10.17236/sat00401
Igel P, Fürst AE, Jackson MA.Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is an increasingly diagnosed degenerative dental disease in aged horses. The primary aim of this retrospective study was to determine the prevalence of EOTRH in horses admitted to the Equine Hospital, University of Zurich, for dental procedures from 2004 to 2017. A secondary goal was to measure and compare interincisal angles on two-dimensional radiographs of horses with EOTRH to determine whether the interincisal angle is associated with age and severity of the disease. Radiographs were assessed for the presence of lysis and/or...
Clinical implications of imprecise sampling time for 10- and 30-min thyrotropin-releasing hormone stimulation tests in horses.
Equine veterinary journal    August 30, 2023   doi: 10.1111/evj.13991
Vorster DM, Wang W, Kemp KL, Bamford NJ, Bertin FR.The thyrotropin-releasing hormone (TRH) stimulation test is used to diagnose pituitary pars intermedia dysfunction (PPID) using 10- or 30-min protocols. Imprecise sampling time for the 10-min protocol can lead to misdiagnoses. Objective: To determine the effect of imprecise sampling time for the 30-min protocol of the TRH stimulation test. Methods: In vivo experiment. Methods: Plasma immunoreactive adrenocorticotropin (ACTH) concentrations were measured 9, 10, 11, 29, 30 and 31 min after intravenous administration of 1 mg of TRH in 15 control and 12 PPID horses. Differences in ACTH concent...
Regulatory T lymphocytes and selected cytokines in horses with mild to severe equine asthma and different inflammatory cytology profiles.
Research in veterinary science    August 25, 2023   Volume 163 104998 doi: 10.1016/j.rvsc.2023.104998
Hamouzová P, Drábková Z, Stehlíková Š, Řeháková K, Čížek P, Dobešová O, Jahn P, Doubek J.This study determined Tregs and inflammatory cytokines in BALF and peripheral blood (PB) of adult horses with mild and severe asthma and different BALF cytological inflammation profiles. Horses of diverse breeds with asthma (age range: 2-20 years, n = 24) were divided into groups according to the number of points obtained in a standardized clinical scoring system (mild-moderate equine asthma - MEA, severe equine asthma - SEA) and according to the inflammation type based on cytological finding. Plasma levels of IFN-γ, IL-4, IL-10, IL-17 and MMP-9 in the BALF were determined by ELISA. Tregs ...
Partial Genome Characterization of Novel Parapoxvirus in Horse, Finland.
Emerging infectious diseases    August 23, 2023   Volume 29, Issue 9 1941-1944 doi: 10.3201/eid2909.230049
Virtanen J, Hautaniemi M, Dutra L, Plyusnin I, Hautala K, Smura T, Vapalahti O, Sironen T, Kant R, Kinnunen PM.We report a sequencing protocol and 121-kb poxvirus sequence from a clinical sample from a horse in Finland with dermatitis. Based on phylogenetic analyses, the virus is a novel parapoxvirus associated with a recent epidemic; previous data suggest zoonotic potential. Increased awareness of this virus and specific diagnostic protocols are needed.
Ferret Models for Henipavirus Infection.
Methods in molecular biology (Clifton, N.J.)    August 23, 2023   Volume 2682 205-217 doi: 10.1007/978-1-0716-3283-3_15
Rockx B, Mire CE.Henipaviruses are emerging zoonotic viruses that can cause outbreaks of severe respiratory and neurological disease in humans and animals such as horses. The mechanism by which these viruses can cause disease remain largely unknown and to date there are no therapeutics or vaccines approved for use in humans. Nipah virus is listed on the World Health Organization R & D Blueprint list of epidemic threats. In order to advance the availability of effective therapeutics and vaccines and medicines that can be used to save lives and avert large scale crises, animal models are required which recap...
Interleukin 5-dependent inflammatory eosinophil subtype involved in allergic insect bite hypersensitivity of horses.
Allergy    August 22, 2023   doi: 10.1111/all.15859
Pantelyushin S, Rhiner T, Jebbawi F, Sella F, Waldern N, Lam J, Chemnitzer A, Fricker A, Schoster A, Birkmann K, Widmer D, Canonica F....No abstract available
History, Rest and Exercise Score (HRE-S) for assessment of disease severity in horses with trigeminal-mediated headshaking.
Equine veterinary journal    August 22, 2023   doi: 10.1111/evj.13986
Kloock T, Pickles KJ, Roberts V, Uhlendorf F, Twele L, Wilkens HL, Stehle E, Feige K, Niebuhr T.In horses with trigeminal-mediated headshaking (TMHS), clinical signs are likely to be expression of neuropathic facial pain. Currently, subjective assessment of disease severity is used as measure of compromise of animal's welfare. Objective: To develop and validate a precise scoring system for TMHS: History, Rest and Exercise Score (HRE-S). The HRE-S consists of three subscores: history score (H-S), resting score (R-S) and exercise score (E-S). Methods: Retrospective observational study. Methods: Seven masked observers with different experience used HRE-S to score 40 video recordings taken d...
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