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Topic:Equine Health

Equine health encompasses the study and management of diseases, disorders, and overall well-being of horses. It involves understanding various physiological systems, preventive care, and treatment strategies to maintain optimal health in equine populations. Common areas of focus include nutrition, infectious diseases, orthopedic conditions, and reproductive health. Research in equine health aims to advance knowledge on diagnostic methods, therapeutic interventions, and management practices that improve horse welfare and performance. This page collects peer-reviewed research studies and scholarly articles that explore the diverse aspects of equine health, offering insights into current findings and advancements in the field.
Long-Term in Vivo Performance of Low-Temperature 3D-Printed Bioceramics in an Equine Model.
ACS biomaterials science & engineering    February 12, 2020   Volume 6, Issue 3 1681-1689 doi: 10.1021/acsbiomaterials.9b01819
Bolaños RV, Castilho M, de Grauw J, Cokelaere S, Plomp S, Groll J, van Weeren PR, Gbureck U, Malda J.Bone has great self-healing capacity, but above a certain critical size, bone defects will not heal spontaneously, requiring intervention to achieve full healing. Among the synthetic calcium phosphate (CaP) bone replacement materials, brushite (CaHPO·2HO)-based materials are of particular interest because of their degree of solubility and the related high potential to promote bone regeneration after dissolution. They can be produced tailor-made using modern three-dimensional (3D) printing technology. Although this type of implant has been widely tested in vitro, there are only limited in vivo...
Ascarids exposed: a method for in vitro drug exposure and gene expression analysis of anthelmintic naïve Parascaris spp.
Parasitology    February 12, 2020   Volume 147, Issue 6 659-666 doi: 10.1017/S0031182020000189
Scare JA, Dini P, Norris JK, Steuer AE, Scoggin K, Gravatte HS, Howe DK, Slusarewicz P, Nielsen MK.Ascarid parasites infect a variety of hosts and regular anthelmintic treatment is recommended for all species. Parascaris spp. is the only ascarid species with widespread anthelmintic resistance, which allows for the study of resistance mechanisms. The purpose of this study was to establish an in vitro drug exposure protocol for adult anthelmintic-naïve Parascaris spp. and report a preliminary transcriptomic analysis in response to drug exposure. Live worms were harvested from foal necropsies and maintained in RPMI-1640 at 37 °C. Serial dilutions of oxibendazole (OBZ) and ivermectin (IVM) we...
Bit type exerts an influence on self-controlled rein tension in unridden horses.
Scientific reports    February 12, 2020   Volume 10, Issue 1 2420 doi: 10.1038/s41598-020-59400-w
Kau S, Potz IK, Pospisil K, Sellke L, Schramel JP, Peham C.Bit configuration and acting rein forces play a crucial role in oral health and comfort of ridden horses. Although it is a big animal welfare issue, dynamic response of horses to different bits has yet not been thoroughly investigated. This convenience sample experimental study describes a model to overcome the almost uncontrollable influence of riders on rein tension and evaluates self-controlled maximum side rein tension of ten sound horses randomly bitted with a double-jointed (DJS) and a version of a Mullen mouth snaffle-bit under unridden conditions. Horses were exercised at walk and trot...
Selection in Australian Thoroughbred horses acts on a locus associated with early two-year old speed.
PloS one    February 12, 2020   Volume 15, Issue 2 e0227212 doi: 10.1371/journal.pone.0227212
Han H, McGivney BA, Farries G, Katz LM, MacHugh DE, Randhawa IAS, Hill EW.Thoroughbred horse racing is a global sport with major hubs in Europe, North America, Australasia and Japan. Regional preferences for certain traits have resulted in phenotypic variation that may result from adaptation to the local racing ecosystem. Here, we test the hypothesis that genes selected for regional phenotypic variation may be identified by analysis of selection signatures in pan-genomic SNP genotype data. Comparing Australian to non-Australian Thoroughbred horses (n = 99), the most highly differentiated loci in a composite selection signals (CSS) analysis were on ECA6 (34.75-34.85 ...
Computed tomography characteristics of equine paranasal sinus cysts.
Equine veterinary journal    February 12, 2020   Volume 52, Issue 4 538-546 doi: 10.1111/evj.13212
Ostrowska J, Lindström L, Tóth T, Hansson K, Uhlhorn M, Ley CJ.Computed tomography (CT) is commonly used to investigate equine paranasal sinus disease, however, only limited information is available in the literature about the detailed CT appearance of equine paranasal sinus cysts. Objective: To investigate if paranasal sinus cysts have specific characteristics in CT images that allow differentiation from other sinus diseases. Methods: Retrospective observational study. Methods: Evaluation and comparison of CT studies of eight horses with surgically and/or histopathologically confirmed paranasal sinus cysts and 10 horses with other confirmed paranasal sin...
Annual booster vaccination and the risk of equine influenza to Thoroughbred racehorses.
Equine veterinary journal    February 12, 2020   Volume 52, Issue 4 509-515 doi: 10.1111/evj.13210
Gildea S, Lyons P, Lyons R, Gahan J, Garvey M, Cullinane A.Equine influenza (EI) outbreaks occurred among horses on four racing yards (two National Hunt, one Flat, one mixed National Hunt racing/breeding yard) in Ireland within a 4-week period. Objective: To carry out a detailed analysis of racing yards affected in order to identify the source of infection and monitor virus spread among a vaccinated population. Methods: Observational field study. Methods: Epidemiological and vaccination data along with repeat clinical samples were collected from 118 horses on four premises. Results: Failure to implement appropriate biosecurity measures following the i...
Evaluation of histamine-provoked changes in airflow using electrical impedance tomography in horses.
Equine veterinary journal    February 12, 2020   Volume 52, Issue 4 556-563 doi: 10.1111/evj.13216
Secombe C, Waldmann AD, Hosgood G, Mosing M.Electrical impedance tomography (EIT) generates thoracic impedance images of the lungs and has been used to assess ventilation in horses. This technique may have application in the detection of changes in airflow associated with equine asthma. Objective: The objective was to determine if histamine-induced airflow changes observed with flowmetric plethysmography (Δflow) could also be explained using global and regional respiratory gas flow signals calculated from EIT signals. Methods: Experimental in vivo study. Methods: Six horses, sedated using detomidine were fitted with a thoracic EIT b...
Erratum: Saastamoinen, M.; Särkijärvi, S.; Valtonen, E. The Effect of Diet Composition on the Digestibility and Fecal Excretion of Phosphorus in Horses: A Potential Risk of P Leaching? Animals 2020, 10, 140.
Animals : an open access journal from MDPI    February 12, 2020   Volume 10, Issue 2 285 doi: 10.3390/ani10020285
Saastamoinen M, Särkijärvi S, Valtonen E.The authors wish to make the following corrections to their paper[...].
Lamellar energy metabolism and perfusion in the euglycaemic hyperinsulinaemic clamp model of equine laminitis.
Equine veterinary journal    February 12, 2020   Volume 52, Issue 4 577-584 doi: 10.1111/evj.13224
Stokes SM, Bertin FR, Stefanovski D, Belknap JK, Medina-Torres CE, Pollitt CC, van Eps AW.Hyperinsulinaemia is associated with the development of endocrinopathic laminitis; however, the mechanisms remain unclear. Objective: Evaluate the effects of hyperinsulinaemia on lamellar energy metabolism and perfusion during laminitis development. Methods: In vivo experiment. Methods: Eight Standardbred horses were instrumented with a microdialysis probe in the lamellae of a forelimb. A 24 hours baseline period (BASELINE) was followed by 48 hours of a continuous euglycaemic hyperinsulinaemic clamp (EHC) from 24 to 72 hours (CLAMP). Microdialysate was collected every 6 hours and analysed ...
Inspiratory muscle training and testing: Rationale, development and feasibility.
Equine veterinary journal    February 12, 2020   Volume 52, Issue 4 620-626 doi: 10.1111/evj.13217
Allen KJ, Fitzharris LE, McConnell AK.Inspiratory muscle training applies a training stimulus directly to the inspiratory muscles and is distinct from whole-body training. The potential benefits of inspiratory muscle training have yet to be explored in horses. Objective: The objectives were as follows: (a) to develop an equine-specific method of testing and training inspiratory muscles; (b) to assess tolerance and feasibility in a pilot study in a commercial Thoroughbred training establishment. Methods: Field study. Methods: A mask was used to interface commercial human inspiratory muscle training equipment. Ten horses undertook i...
Multi-kingdom characterization of the core equine fecal microbiota based on multiple equine (sub)species.
Animal microbiome    February 12, 2020   Volume 2, Issue 1 6 doi: 10.1186/s42523-020-0023-1
Edwards JE, Shetty SA, van den Berg P, Burden F, van Doorn DA, Pellikaan WF, Dijkstra J, Smidt H.Equine gut microbiology studies to date have primarily focused on horses and ponies, which represent only one of the eight extant equine species. This is despite asses and mules comprising almost half of the world's domesticated equines, and donkeys being superior to horses/ponies in their ability to degrade dietary fiber. Limited attention has also been given to commensal anaerobic fungi and archaea even though anaerobic fungi are potent fiber degrading organisms, the activity of which is enhanced by methanogenic archaea. Therefore, the objective of this study was to broaden the current knowl...
A Retrospective Survey of Factors Affecting the Risk of Incidents and Equine Injury During Non-Commercial Transportation by Road in the United Kingdom.
Animals : an open access journal from MDPI    February 12, 2020   Volume 10, Issue 2 288 doi: 10.3390/ani10020288
Hall C, Kay R, Green J.The number of equines injured as a result of incidents during road transport is currently unknown in the United Kingdom. Although previous research has identified factors that affect an equine's behavioural and physiological responses to transportation, their contribution to incident occurrence and injury risk is unclear. The aim of this study was to identify factors associated with incident occurrence and equine injury during transportation by road. An online survey was administered between 12th May 2017 and 21st July 2017 in the UK. The survey was open to those transporting equines non-comme...
The effect of continuous digital hypothermia on lamellar energy metabolism and perfusion during laminitis development in two experimental models.
Equine veterinary journal    February 12, 2020   Volume 52, Issue 4 585-592 doi: 10.1111/evj.13215
Stokes SM, Bertin FR, Stefanovski D, Poulsen L, Belknap JK, Medina-Torres CE, Pollitt CC, van Eps AW.Continuous digital hypothermia (CDH) prevents lamellar failure in the euglycaemic hyperinsulinaemic clamp (EHC) and oligofructose (OF) laminitis models, but the mechanisms remain unclear. Objective: To evaluate the effects of CDH on lamellar energy metabolism and perfusion in healthy horses and during EHC and OF laminitis models. Methods: In vivo experiment. Methods: Archived samples were used from Standardbred geldings that received no treatment (CON) (n = 8) or underwent EHC (n = 8) or OF (n = 6) laminitis models. Both forelimbs were instrumented with a lamellar microdialysis system, a...
Application of droplet digital PCR in diagnosing of X monosomy in mares.
Equine veterinary journal    February 12, 2020   Volume 52, Issue 4 627-631 doi: 10.1111/evj.13214
Szczerbal I, Nowacka-Woszuk J, Kopp-Kuhlman C, Mackowski M, Switonski M.X monosomy is the most common disorder of sex development in horses. Although cytogenetic analysis is still the gold standard in the diagnosis of equine X monosomy, novel molecular techniques are being sought to quickly and reliably detect this chromosome abnormality. Objective: The goal of this study was to evaluate the usefulness of a novel variant of the PCR technique-namely, droplet digital PCR (ddPCR)-in the detection of X monosomy in mares. Methods: A proof of concept of the usefulness of ddPCR in diagnosing an abnormal number of X chromosomes in mares. Methods: We examined an infertile ...
Extended-Spectrum β-lactamase-Producing Enterobacteriaceae Shedding in Farm Horses Versus Hospitalized Horses: Prevalence and Risk Factors.
Animals : an open access journal from MDPI    February 11, 2020   Volume 10, Issue 2 282 doi: 10.3390/ani10020282
Shnaiderman-Torban A, Navon-Venezia S, Dor Z, Paitan Y, Arielly H, Ahmad WA, Kelmer G, Fulde M, Steinman A. We aimed to investigate the prevalence, molecular characteristics and risk factors of extended-spectrum β-lactamase (ESBL)-producing (ESBL-E) shedding in horses. A prospective study included three cohorts: (i) farm horses (13 farms, n = 192); (ii) on hospital admission (n = 168) and; (iii) horses hospitalized for ≥72 h re-sampled from cohort (ii) (n = 86). Enriched rectal swabs were plated, ESBL-production was confirmed (Clinical and Laboratory Standards Institute (CLSI)) and genes were identified (polymerase chain reaction (PCR)). Identification and antibiotic susceptibility were determi...
Effects of glucose concentration in semen extender and storage temperature on stallion sperm quality following long-term cooled storage.
Theriogenology    February 11, 2020   Volume 147 1-9 doi: 10.1016/j.theriogenology.2020.02.007
Hernández-Avilés C, Love CC, Serafini R, Ramírez-Agámez L, Friedrich M, Ghosh S, Teague SR, LaCaze KA, Brinsko SP, Varner DD.In Experiment 1, the effects of glucose concentration in extender (0 mM, 67 mM, 147 mM, 270 mM; G0, G67, G147, and G270, respectively) and storage temperature of extended semen (5, 10, 15 and 20 °C) were evaluated after storage for up to 5 days (T0h to T120h). For all time points tested, mean total (TMOT) and progressive (PMOT) sperm motility were lower in G0 than all other treatment groups (P < 0.05). Mean curvilinear velocity (VCL) was lower in G0 than other treatment groups at all time points tested except T0h (P  0.05). Mean TMOT and PMOT, were lower for semen stored at 20 °...
The influence of a simulated digest of an equine dietary feed additive G’s formula on contractile activity of gastric smooth muscle in vitro.
Journal of animal physiology and animal nutrition    February 11, 2020   Volume 104, Issue 6 1919-1926 doi: 10.1111/jpn.13325
MacNicol JL, Murrant C, Pearson W.G's Formula is a novel equine feed additive formulated to promote optimal GI function. The objective of this study was to determine whether the addition of a simulated digest of the composite feed additive G's Formula (FA) would alter the contractile response of gastric smooth muscle to acetylcholine (Ach). Smooth muscle strips from porcine stomachs were excised and attached to an isometric force transducer. An experiment was run to compare tissue contraction between tissue exposed to FA (FA; n = 8, simulated digest of FA was added to the bath) and control tissue (CO; n = 8, no additions m...
Alveolar macrophage phenotypes in severe equine asthma.
Veterinary journal (London, England : 1997)    February 11, 2020   Volume 256 105436 doi: 10.1016/j.tvjl.2020.105436
Wilson ME, McCandless EE, Olszewski MA, Robinson NE.Because the alveolar macrophage (AM) phenotype of horses with severe equine asthma (SEA) is unknown, the cytokines expressed by M1- and M2-polarized AM were determined and the hypothesis that natural hay/straw challenge (NC) induces divergent AM phenotypes in control horses and horses with SEA was tested. Macrophages from control horses were activated either with eIFNγ + lipolysaccharide (LPS) or eIL-4 to characterize M1- or M2-polarized AM gene expression, respectively and determine the response of polarized cells to pathogen-associated molecular patterns (PAMPS): LPS, zymosan, peptidoglycan...
Salivary cortisol measurement in horses: immunoassay or LC-MS/MS?
Domestic animal endocrinology    February 10, 2020   Volume 72 106445 doi: 10.1016/j.domaniend.2020.106445
Sauer FJ, Gerber V, Frei S, Bruckmaier RM, Groessl M.The aim of the present study was to measure salivary cortisol concentrations of horses before and after hypothalamic-pituitary-adrenal (HPA) axis stimulation by means of liquid chromatography-tandem-mass spectrometry (LC-MS/MS) and an immunoassay (cELISA) for method comparison. Nine clinically healthy horses participated in the study. An ACTH stimulation test was performed. Saliva samples were collected before (T0) and 60 (T60) min after intravenous injection of 1 μg/kg BW synthetic ACTH1-24. LC-MS/MS was assessed for the determination of equine salivary cortisol. The results of these measur...
Effect of Linseed (Linum usitatissimum) Groats-Based Mixed Feed Supplements on Diet Nutrient Digestibility and Blood Parameters of Horses.
Animals : an open access journal from MDPI    February 10, 2020   Volume 10, Issue 2 doi: 10.3390/ani10020272
Saastamoinen M, Särkijärvi S.Linseed (Linum usitatissimum) and its by-products are common supplements used in equine diets and are claimed to have beneficial health effects. In this study, the effect of linseed groat-based fibrous feed supplements on diet digestibility was studied. Also, possible detrimental health effects due to continuous feeding of supplemental feeds containing linseed were examined by evaluating blood parameters. The experimental design was arranged as two balanced 3 × 3 Latin Squares. The horses were individually fed at the maintenance energy level, the forage-to-concentrate ratio being 70:30, with ...
X chromosome aneuploidy and micronuclei in fertile mares.
Theriogenology    February 10, 2020   Volume 147 34-38 doi: 10.1016/j.theriogenology.2020.02.020
Pieńkowska-Schelling A, Kaul A, Schelling C.Abnormalities of chromosomes are an important and well documented cause of disorders of sexual development, fertility problems and congenital anomalies in mammals. Detection of low-level 63,X/64,XX mosaicism during routine cytogenetic evaluation is a challenge because its clinical significance is not yet fully clear. This study describes the prevalence and levels of 63,X mosaicism for a cohort of fertile mares and compares the results with eight problem mares for which no clinical cause of sub-fertility was found. The study design allowed for the analysis of micronuclei which are biomarkers of...
Science-in-brief: Report on the Havemeyer Foundation workshop on acute colitis of the adult horse.
Equine veterinary journal    February 9, 2020   Volume 52, Issue 2 163-164 doi: 10.1111/evj.13223
No abstract available
Synovial fluid lubricin and hyaluronan are altered in equine osteochondral fragmentation, cartilage impact injury, and full-thickness cartilage defect models.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society    February 9, 2020   Volume 38, Issue 8 1826-1835 doi: 10.1002/jor.24597
Peal BT, Gagliardi R, Su J, Fortier LA, Delco ML, Nixon AJ, Reesink HL.The objectives of this study were to evaluate temporal changes in lubricin, hyaluronan (HA), and HA molecular weight (MW) distributions in three distinct models of equine joint injury affecting the carpal (wrist), tarsal (ankle), and femoropatellar (knee) joints. To establish ranges for lubricin, HA, and HA MW distributions across multiple joints, we first evaluated clinically healthy, high-motion equine joints. Synovial fluid was collected from high-motion joints in horses without clinical signs of joint disease (n = 11 horses, 102 joints) and from research horses undergoing carpal osteo...
Equine-Assisted Therapy for Veterans with PTSD: Manual Development and Preliminary Findings.
Military medicine    February 9, 2020   Volume 185, Issue 5-6 e557-e564 doi: 10.1093/milmed/usz444
Arnon S, Fisher PW, Pickover A, Lowell A, Turner JB, Hilburn A, Jacob-McVey J, Malajian BE, Farber DG, Hamilton JF, Hamilton A, Markowitz JC, Neria Y.Equine-assisted therapy (EAT) for post-traumatic stress disorder (PTSD) has attracted great interest despite lacking empirical support, a manual, and a standardized protocol. Our team of experts in EAT and PTSD developed an eight-session group EAT treatment protocol for PTSD (EAT-PTSD) and administered it to two pilot groups of military veterans to assess initial effects. We describe the development of the treatment manual, which was used with two pilot groups of veterans. Protocol safety, feasibility, and acceptability were assessed by reported adverse events, treatment completion rates, and ...
Plasma disposition of gabapentin after the intragastric administration of escalating doses to adult horses.
Journal of veterinary internal medicine    February 8, 2020   Volume 34, Issue 2 933-940 doi: 10.1111/jvim.15724
Gold JR, Grubb TL, Green S, Cox S, Villarino NF.In humans, gabapentin an analgesic, undergoes non-proportional pharmacokinetics which can alter efficacy. No information exists on the pharmacokinetics of dosages >20 mg/kg, escalating dosages or dose proportionality of gabapentin in horses. Objective: Gabapentin exposure in plasma would not increase proportionally relative to the dose in horses receiving dosages ≥20 mg/kg. To assess the plasma pharmacokinetics of gabapentin after nasogastric administration of gabapentin at dosages of 10 to 160 mg/kg in adult horses. Methods: Nine clinically healthy adult Arabian and Quarter Horses....
Inter-user and intra-user variation of two tonometers in horses.
Equine veterinary journal    February 8, 2020   Volume 52, Issue 4 572-576 doi: 10.1111/evj.13208
Lewin AC, Liu CC, Camacho-Luna P, Alling C, Carter RT.It is currently unknown which of the two devices most commonly used in equine ophthalmology for intraocular pressure (IOP) estimation demonstrates the lowest inter-user and intra-user variation. Objective: To assess the inter-user and intra-user variation of two tonometers in sedated and unsedated horses. Methods: Randomised masked cross-over trial. Methods: Four examiners used the rebound (ICare TonoVet) and applanation (TonoPen ) tonometers to measure the intraocular pressure (IOP) in triplicate in 10 normal horses before and after sedation with xylazine. For inter-user variation, coefficien...
Biogenic silver nanoparticles in the treatment of experimental pythiosis Bio-AgNP in pythiosis therapy.
Medical mycology    February 8, 2020   Volume 58, Issue 7 913-918 doi: 10.1093/mmy/myz141
Valente JSS, Brasil CL, Braga CQ, Zamboni R, Sallis ESV, Albano APN, Zambrano CG, Franz HC, Pötter L, Panagio LA, Reis GF, Botton SA, Pereira DIB.Pythiosis is a rapidly progressing disease that can be lethal to affected individuals due to resistance to available therapeutic protocols. The disease affects mammals, with the largest number of reports in horses and humans. The present study investigated the activity of biogenic silver nanoparticles (bioAgNP) in the treatment of experimental pythiosis. The disease was reproduced in nine female 90-day-old New Zealand rabbits. Animals were divided into three groups: group1 (control, n = 3) daily and topically treated with a nonionized gel-based formulation and 1 ml of sterile distilled wate...
Allo-antibody production after intraarticular administration of mesenchymal stem cells (MSCs) in an equine osteoarthritis model: effect of repeated administration, MSC inflammatory stimulation, and equine leukocyte antigen (ELA) compatibility.
Stem cell research & therapy    February 7, 2020   Volume 11, Issue 1 52 doi: 10.1186/s13287-020-1571-8
Barrachina L, Cequier A, Romero A, Vitoria A, Zaragoza P, Vázquez FJ, Rodellar C.Antibody production after allogeneic administration of mesenchymal stem cells (MSCs) could impact their clinical application. Proinflammatory priming of MSCs can potentiate their regulatory ability in vivo but increased expression of major histocompatibility complex (MHC) might augment their immunogenicity, potentially leading to immune memory thus limiting repeated allogeneic administration. This study aimed at evaluating the production of cytotoxic allo-antibodies directed against donor's ELA (equine leukocyte antigen) in mismatched and halfmatched horses receiving repeated intraarticular ad...
Subchondral lucencies of the proximal tibia in 17 horses.
Veterinary surgery : VS    February 7, 2020   Volume 49, Issue 4 778-786 doi: 10.1111/vsu.13387
Santschi EM, Whitman JL, Prichard MA, Lopes MAF, Pigott JH, Brokken MT, Jenson PW, Johnson CR, Morrow C, Brusie RW, Juzwiak JS, Morehead JP.To describe subchondral lucencies (SCL) in the equine proximal tibia, several treatment options, and clinical outcomes. Methods: Retrospective study. Methods: Seventeen horses with proximal tibial SCL. Methods: Medical record and radiograph review. Follow-up was obtained via examination and radiography when possible and by telephone and race records when required. The median duration of follow-up was 20 months (range, 0-48). Results: Proximal tibial SCL were associated with lameness in 14 of 17 horses. Subchondral lucencies were primary in 11 horses and secondary to an ipsilateral medial fem...
Differences in ultrasound-derived arterial wall stiffness parameters and noninvasive blood pressure between Friesian horses and Warmblood horses.
Journal of veterinary internal medicine    February 7, 2020   Volume 34, Issue 2 893-901 doi: 10.1111/jvim.15705
Vera L, De Clercq D, Van Steenkiste G, Decloedt A, Chiers K, van Loon G.Aortic rupture is more common in Friesians compared to Warmbloods, which might be related to differences in arterial wall composition and, as such, arterial wall stiffness (AWS). Currently, nothing is known about differences in AWS between these breeds. Objective: Comparison of AWS parameters and noninvasive blood pressure between Friesians and Warmbloods. Methods: One hundred one healthy Friesians and 101 age-matched healthy Warmbloods. Methods: Two-dimensional and pulsed-wave Doppler ultrasound examination was performed of the aorta, common carotid artery, and external iliac artery to define...