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Topic:Equine Research

Equine biomechanics involves the study of the mechanical principles that govern the movement and structure of horses. This field examines the anatomical and physiological aspects that contribute to locomotion, including gait patterns, joint function, and muscle dynamics. Researchers utilize advanced technologies such as motion capture and force plate analysis to assess the efficiency and performance of equine movement. Understanding biomechanics aids in optimizing training regimens, improving performance, and preventing injuries. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanics of equine movement, its applications in sports and rehabilitation, and its impact on overall equine health.
Clinical and research applications of synthetic bone substitutes in equine veterinary medicine: A systematic review.
Equine veterinary journal    February 24, 2026   doi: 10.1002/evj.70151
Skierbiszewska K, Turek B, Jasiński T, Kaczorowski M, Kozłowska N, Higuchi J, Domino M.Bone grafting in equine medicine offers a promising contribution to treating orthopaedic developmental diseases and chondral, osteochondral and segmental bone defects. Among grafts, synthetic bone substitutes-alloplastics-show favourable biological properties addressing numerous limitations presented by autografts, xenografts and allografts. Objective: To compile and disseminate clinical data and research findings from existing publications on the use of alloplastics in horses. Methods: Systematic review. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-analysis 202...
Paternal determinants of Offspring Sex Ratio in horses: A retrospective analysis of stallion breed, age, and breeding method.
Animal reproduction science    February 24, 2026   Volume 289 108150 doi: 10.1016/j.anireprosci.2026.108150
Armangau M, Lurier T, Josson A.Offspring Sex Ratio (OSR) at birth in mammals is generally assumed to follow a 1:1 male-to-female distribution, yet deviations in OSR have been observed and may be influenced by maternal and paternal factors. In this study we have focused on the effect of paternal factors (stallion age and breed) and breeding methods on the OSR. Using a retrospective dataset of 251,783 foal births recorded in France between 2015 and 2024, we applied generalized linear mixed models to evaluate the effects of these variables on the likelihood of producing a female foal. Stallion identity was included as a random...
Spatial Variation in Turf Surface Properties of Polo Pitches: A Case Study of Different Handicaps of Argentina.
Animals : an open access journal from MDPI    February 22, 2026   Volume 16, Issue 4 685 doi: 10.3390/ani16040685
Blanco MA, Peterson ML, Cipriotti PA, Apecechea F.Polo is a high-speed equestrian sport that imposes mechanical demands on horses and turf, yet limited research has examined the functional behavior of polo playing surfaces. This study characterizes the spatial variability of mechanical surface properties across turf polo pitches representing high-, medium-, and low-handicap categories. Three fields were assessed using lightweight field-based instruments, including the Impact Test Device (ITD), Rotational Peak Shear (RPS) tester, Going Stick© for penetration (GSP) and shear (GSS), and a TDR probe for volumetric moisture content (VMC%). A tota...
Influence of parasitic load, breed, age, housing and season on skin and hair coat condition in horses.
Journal of equine veterinary science    February 20, 2026   Volume 159 105818 doi: 10.1016/j.jevs.2026.105818
DeBel NA, Yalavarthi G, Johnson JR, Simoneau AT, Sweeney B, Stearns G, Saliceti A, Rutstein H, Amalaradjou MA, Govoni KE, McBride ZG, Moore TE....Strongyles are nematode parasites that affect the large intestine and cecum of the horse, with symptoms ranging from poor hair coat to colic. This can influence gut health, nutrient absorption, and overall body condition. Objective: Determine the effects of parasitic load, breed, age, housing, and season on skin and hair coat conditions. We hypothesized that horses with low fecal egg counts would have better hair and skin coat condition compared with those with high fecal egg counts. Methods: A total of forty-five Morgan and 11 Thoroughbred horses were included in this study. We tested the eff...
Fragile foal syndrome: manifestations, heterozygous advantage and the future of breeding policies.
Journal of equine veterinary science    February 20, 2026   Volume 159 105816 doi: 10.1016/j.jevs.2026.105816
Gartland KL, Leśniak K, Twigg-Flesner A.Scientific interest in relation to Fragile Foal Syndrome (FFS) has proliferated in the last decade, but before this, many clinical cases were attributed to other similarly presenting equine neonatal disorders. It was thought that FFS-affected foals were mainly miscarried throughout gestation, but recent study results suggest that often, foals are born alive and die shortly after birth. FFS is proposed to have originated as long ago as the Godolphin Arabian, but the definite derivation of the mutant allele is unconfirmed. The discovery that FFS is present in 11-30% of Warmbloods and 2-3% of Tho...
Bilateral hindlimb superficial digital flexor tendinopathy in a sports horse.
Journal of equine veterinary science    February 20, 2026   Volume 159 105819 doi: 10.1016/j.jevs.2026.105819
Mazzucco L, Marcatili M, Withers J, Cantatore F.Superficial digital flexor tendinopathy is a common cause of forelimb lameness in Thoroughbred racehorses and sports horses; however, this condition is rarely observed in the hindlimb. A 16-year-old Irish sports horse gelding was presented with bilateral swelling in the plantar metatarsal region and severe bilateral hindlimb lameness visible at the walk. The lameness occurred after the cross-country phase of an eventing competition. The clinical suspicion of superficial digital flexor tendon (SDFT) injury was confirmed after ultrasonographic examination, which revealed an extensive core lesion...
Facial hair whorl location, behavior, and ocular temperature as a physiological stress indicator in young Pura Raza Española dressage horses.
Frontiers in veterinary science    February 19, 2026   Volume 13 1709706 doi: 10.3389/fvets.2026.1709706
Valera M, Encina A, Sánchez-Guerrero MJ, Rodríguez-Sainz de Los Terreros A, Bartolomé E.Behavioral and emotional reactivity assessment in sport horses is essential for optimizing their management and sports performance, particularly in equestrian disciplines such as Dressage. This study investigates, in Pura Raza Española (PRE) horses, the association between facial hair whorl (FHW) patterns, behavioral traits, and physiological stress responses using ocular temperature (OT) assessed with infrared thermography as, an objective, non-invasive physiological stress indicator. Unassigned: A total of 98 male PRE horses, aged 4-6 years old and all gray coated, were evaluated during the...
Utility of dynamic preload indices of hypovolemia in isoflurane-anesthetized horses.
Veterinary anaesthesia and analgesia    February 19, 2026   Volume 53, Issue 3 101205 doi: 10.1016/j.vaa.2026.101205
Byrne J, Guedes AG, Hickey C, Hatschbach E, Walters B, Rendahl A, Tearney C.To evaluate the utility of the dynamic indices, systolic pressure variation (SPV%), pulse pressure variation (PPV%) and plethysmographic variability index (PVI%) during induced hypovolemia, and to determine their correlation with cardiac output (CO) in anesthetized horses. Methods: Prospective experimental study. Methods: A group of eight healthy adult research horses. Methods: After sedation with intravenous (IV) xylazine, anesthesia was induced with IV ketamine and diazepam and maintained with constant-dose isoflurane delivered in 100% oxygen. Horses were positioned in dorsal recumbency, par...
3D printed aiming device for equine proximal interphalangeal joint arthrodesis: Ex vivo study.
Veterinary surgery : VS    February 18, 2026   doi: 10.1111/vsu.70085
Aimonetti E, Genton M, Lischer CJ, Rossignol F.To determine the benefit of using a three-dimensional (3D)-printed titanium aiming device for placing two 5.5-mm transarticular screws during proximal interphalangeal joint (PIPJ) arthrodesis in equine species. Methods: Ex vivo study. Methods: A total of 40 cadaveric forelimbs from adult horses. Methods: A senior surgeon and a first-year resident each performed 20 constructs: 10 using the device and 10 using a freehand technique. Procedure duration and number of intraoperative radiographs were recorded. Final radiographs were evaluated by an ECVS-certified surgeon unaware of treatment group, b...
Proctectomy with coloanal anastomosis in horses – a cadaveric study.
Journal of equine veterinary science    February 18, 2026   Volume 159 105814 doi: 10.1016/j.jevs.2026.105814
Strugava L, Serighelli-Júnior G, Stadler LM, Flores LADS, Minozzo GA, Dornbusch LPTC, Moreno JCD, Dornbusch PT.Rectal amputation is a surgical approach indicated for the management of severe rectal lacerations or extensive rectal prolapse when transmural compromise or primary repair is unfeasible. These conditions, although uncommon, present substantial challenges in equine practice due to the anatomical complexity of the pelvic region and the potential for life-threatening complications if not adequately addressed. This study aimed to describe and standardize a reproducible surgical technique for rectal amputation in horse cadavers. Six equine cadavers (mean body mass, 441.83± 66.84 kg) were position...
Optimising Camera-ChArUco Geometry for Motion Compensation in Standing Equine CT: A CT-Motivated Benchtop Study.
Sensors (Basel, Switzerland)    February 18, 2026   Volume 26, Issue 4 1310 doi: 10.3390/s26041310
Aliani C, Lorenzetto Bologna C, Francia P, Bocchi L.Standing equine computed tomography (CT) acquisitions are susceptible to residual postural sway, which can introduce view-inconsistent motion and degrade image quality. External optical tracking based on ChArUco fiducials is a promising, low-cost strategy to enable projection-wise motion compensation, yet quantitative guidance on how camera-marker geometry affects pose-estimation performance remains limited. This CT-motivated benchtop study characterizes how the relative camera-ChArUco configuration influences both the accuracy (bias with respect to ground truth) and the precision (repeatabili...
A Survey of Trainers on the Health and Welfare of Standardbred Racehorses in Prince Edward Island.
Journal of applied animal welfare science : JAAWS    February 17, 2026   1-7 doi: 10.1080/10888705.2026.2628477
Burns JJ, MacMillan KM.The Standardbred racing industry plays an important role in the North American economy and is expected to continue operating and growing. However, public perception is often unfavorable, with increasing concern about the health and welfare of Standardbred racehorses. Despite this, limited research has examined Standardbred well-being. To address this gap, a survey of equine trainers on Prince Edward Island (PEI) was conducted to evaluate key health and welfare issues during racing careers. Results showed that over one quarter of respondents had at least one horse displaying stereotypic behavio...
Effect of palmar digital perineural analgesia (as a model for “nerving”) on forelimb loading over varied surfaces at the walk and trot – a pilot study.
Journal of equine veterinary science    February 17, 2026   Volume 159 105812 doi: 10.1016/j.jevs.2026.105812
Zimmerman-Cameron SR, Colbath AC, Caruso MA, Hoffman RM, Logan AA.Navicular syndrome is characterized by palmar foot pain and is a common cause of lameness in horses. Palmar digital neurectomy (nerving) removes sensation to the heel region of the hoof and may serve as a treatment for navicular-afflicted horses, while analgesia (blocking) results in temporary loss of sensation. Objective: The purpose of this pilot study was to examine the effect of loss of sensation in the heel on the forelimb area and force while tracking on soft and hard ground at the walk and trot. Methods: Three horses that scored a 0 or 1 on the AAEP lameness scale were fitted to Tekscan...
Ertapenem Pharmacokinetics in Equine Plasma and Synovial Fluid Following a Single Intravenous Dose.
Journal of veterinary pharmacology and therapeutics    February 16, 2026   doi: 10.1111/jvp.70053
Bish-Jones AR, Papich MG, Orsini JA.This study describes the pharmacokinetics of ertapenem, a carbapenem antimicrobial that has not been previously studied in equids. Administered as a 30 mg/kg intravenous bolus to six healthy horses, serial blood and synovial samples were obtained over 8 h after administration. Pharmacokinetic analysis of plasma and synovial fluid was performed. In plasma, the AUC was 353.10 h × μg/mL (CV = 49.02%), Vss 79.34 mL/kg (CV = 22.85%), CL 84.96 mL/h/kg (CV = 31.31%) and t1/2 2.03 h (CV = 15.32%). In synovial fluid, the AUC was 524.10 h × μg/mL (CV = 16.03...
The majority of proximal sesamoid and condylar fractures occurred in horses identified as high risk by inertial measurement unit sensors.
Journal of the American Veterinary Medical Association    February 13, 2026   1-10 doi: 10.2460/javma.25.08.0556
Hall NP, Sweeney DM, Holmströem M, Kim W, Wang Y, Donahue KD, Palmer SE, Lambert DH, Bayly WM.To determine whether targeted lesion-specific algorithms developed from data collected with accelerometer-based inertial measurement units worn by racing Thoroughbreds could retrospectively identify horses at high risk of incurring forelimb condylar or proximal sesamoid fractures. Unassigned: Fracture-specific algorithms were generated from July 2021 to December 2024 with accelerometer data from 42,623 races by 15,755 horses, including 54 races by 23 horses that subsequently suffered condylar fractures and 90 races by 31 horses that later sustained proximal sesamoid fractures. Fracture-specifi...
Diet composition influences equine large intestinal motility as measured by transcutaneous ultrasound.
American journal of veterinary research    February 12, 2026   1-6 doi: 10.2460/ajvr.25.11.0400
Starrett A, Arnold CE, Burr A, Sarturi JO, Leatherwood JL, Pilla R, Awosile BB, Chaffin MK.To quantify gastrointestinal motility at 3 anatomic locations of the large colon in healthy horses fed 2 diets. Unassigned: 12 American Quarter Horses were enrolled in a prospective crossover study. Horses received either a complete pelleted diet fed at 1.35% body weight (BW) per day or Coastal Bermudagrass hay fed at 2% BW with 0.5% to 0.7% BW of complete pelleted feed. Each diet was fed for 13 days prior to motility assessment. Two ultrasonographers recorded the frequency of contractions at the sternal flexure of the large colon, left ventral colon, and cecum for 4 consecutive, 1-minute peri...
Thoroughbred Geldings’ Career: Influence of Age at the Start of Training and Racing.
Animals : an open access journal from MDPI    February 12, 2026   Volume 16, Issue 4 576 doi: 10.3390/ani16040576
Hein M, Volkmann N, Probst J, Kemper N, Venner M.This retrospective report investigated whether starting racehorses' training and racing early is associated with a less successful and a shorter racing career. The data of 600 Thoroughbred racehorses from the German Racehorse Association's archiving programme were evaluated. The horses were classified into three groups regarding their different ages when starting training and racing: early training (16-24 months old)/early racing (two years old); early training/late racing (>two years old); and late training (25-30 months). Statistical models investigated effects on the horses' length of caree...
Blood and fecal metabolic responses of mature horses fed rhizoma peanut hay.
Journal of equine veterinary science    February 11, 2026   Volume 159 105805 doi: 10.1016/j.jevs.2026.105805
Vasco ACCM, Warren LK, Silva GM, Cuervo-Vivas W, Brandi RA, Silva VP, Lance JM, Dubeux JC, Wickens CL.Rhizoma peanut (RP, Arachis glabrata Benth) is an alternative legume forage to alfalfa (ALF, Medicago sativa L.) with less non-structural carbohydrates and crude protein. Yet, metabolic responses to consuming RP hay have never been evaluated in horses. Objective: The objective of this study was to investigate the effect of feeding RP 'Florigraze' hay on fecal and blood metabolic variables compared to alfalfa 'Legendary XHD' and bermudagrass (BMG, Cynodon dactylon L. 'Coastal') hays fed to maintenance horses. Methods: Six mature Quarter Horse geldings (596±40 kg) were randomly assigned to one ...
Proteomic profiling of equine airway mucus reveals compositional changes in asthmatic phenotypes.
Scientific reports    February 10, 2026   Volume 16, Issue 1 5880 doi: 10.1038/s41598-026-38766-3
Bartenschlager F, Kuropka B, Schmitz P, Dumke F, Landmann K, Gruber AD, Weise C, Schnabel CL, Gehlen H, Mundhenk L.Mucus hypersecretion and accumulation are hallmark features of equine asthma (EA), a meaningful respiratory disorder in horses occurring in mild to moderate (MEA) and severe (SEA) forms. Changes of the proteomic composition of airway mucus in EA are poorly understood. Using label-free quantitative liquid chromatography-mass spectrometry, we analyzed airway mucus from SEA (n = 10), MEA (n = 6), and healthy (n = 8) horses. We identified and quantified 2,275 proteins including gel-forming mucins MUC5AC and MUC5B and membrane-bound mucins MUC1 and MUC4. Compared with healthy controls, ...
A novel oral immunotherapy strategy using transgenic barley induces Culicoides allergen-specific immune responses in horses.
Frontiers in immunology    February 10, 2026   Volume 17 1774358 doi: 10.3389/fimmu.2026.1774358
von der Höden FJ, Stefansdottir SB, Torsteinsdottir S, Svansson V, Björnsson JM, Wagner B, Mahmuti D, Marti E, Jonsdottir S.Insect bite hypersensitivity (IBH) is a seasonal, IgE-mediated allergic dermatitis of horses caused by salivary gland proteins of biting midges ( spp.). Current management relies on relief of clinical signs and on physical protection. In a previous pilot study, healthy horses were fed transgenic barley expressing a allergen via a special spiral bit, which successfully induced allergen-specific antibody responses. Building on this concept, the present study aimed to evaluate a more practical feeding approach, delivering transgenic barley expressing the major allergen Cul o 2p in a feed-compat...
Nicotinic acid treatment improves the developmental potential of equine oocytes for cloned embryo production.
Theriogenology    February 6, 2026   Volume 256 117858 doi: 10.1016/j.theriogenology.2026.117858
Cortez JV, Cervi D, Ruiz AJ, Grupen CG.Nicotinic acid (NA) treatment during in vitro maturation (IVM) has been shown to elevate nicotinamide adenine dinucleotide (NAD) levels and improve oocyte developmental competence. Suboptimal equine oocyte IVM systems currently limit the efficiency of viable embryo in vitro production. This study evaluated NA supplementation during IVM for cloned equine embryo production, using oocytes from abattoir-sourced ovaries and live mares via ovum pick-up (OPU). Abattoir-derived oocytes (n = 694) were treated without or with 50 or 200 μM NA during the 18 h holding period (Pre-IVM). Next, OPU-deriv...
Stress Responses in Dressage Horses: Insights from FEI Noseband Measurements Across National Competition Levels.
Animals : an open access journal from MDPI    February 6, 2026   Volume 16, Issue 3 518 doi: 10.3390/ani16030518
Fialová S, Kuřitková D, Sobotková E.This pilot study investigated stress-related behaviors in 238 dressage horse-rider combinations competing at national levels from Elementary (A) to Grand Prix (GP). Noseband tightness was assessed on-site using the FEI noseband measuring device (FNMD), and all but two horses complied with FEI regulations. Video-based analysis quantified conflict behaviors including mouth opening, tail swishing, and changes in head-neck position. Because noseband tightness showed minimal variation, no meaningful association with behavioral expression could be determined. In contrast, competition level had a cle...
Biomechanical assessment of dressage Spanish horses through accelerometry and the immediate effects of a single capacitive resistive electrical transfer session.
BMC veterinary research    January 31, 2026   Volume 22, Issue 1 148 doi: 10.1186/s12917-026-05319-9
Calle-González N, Rivero JL, Argüelles D, Requena F, Muñoz A.Capacitive resistive electrical transfer (CRET) is a non-invasive electromagnetic diathermic technique. The effect of its application 24 h prior to exercise, compared to a sham application performed with the device off, was evaluated in 8 Spanish Purebred dressage stallions. CRET was applied bilaterally on the neck, back, and croup. The horses wore an accelerometer fixed on the sternal area during a dressage test, and spatiotemporal stride parameters, total and dorsoventral (DVAA), longitudinal (LAA), and mediolateral accelerometric activities, as well as dorsoventral displacement, were recor...
Exposure to Subcutaneously Administered Butorphanol in Horses Pre-Treated With Detomidine or Detomidine-Vatinoxan.
Journal of veterinary pharmacology and therapeutics    January 31, 2026   doi: 10.1111/jvp.70051
Honkavaara JM, Karikoski NP, Palvas L, Pypendop BH, Rinne VM, Raekallio MR.The aim of the study was to determine the exposure to subcutaneously administered butorphanol in horses pre-treated with intravenous (IV) detomidine, with or without vatinoxan, a peripherally selective alpha-adrenoceptor antagonist. Five healthy, adult horses received three IV treatments 7 days apart, in a randomized, cross-over design: detomidine 20 μg/kg (DET-B), detomidine 20 μg/kg with vatinoxan 200 μg/kg (DETVAT-B) and saline (S-B), all followed by 0.1 mg/kg of butorphanol administered subcutaneously 30 min later. Venous samples were collected between 10 and 270 min after...
Generation and characterization of an immortalized equine osteoblast cell line.
Veterinary journal (London, England : 1997)    January 30, 2026   Volume 316 106573 doi: 10.1016/j.tvjl.2026.106573
Palomino Lago E, Roberts SJ, Orriss IR, Lumsden ES, Guest DJ.Bone is a dynamic tissue that is maintained through the co-ordination of bone resorption and bone formation. An imbalance of these processes can lead to bone disease. In vitro studies of osteoblasts can help to understand bone formation, but primary cells have a limited lifespan in culture. Herein, we report the successful generation of equine immortalized osteoblasts through the stable overexpression of human telomerase reverse transcriptase (hTERT) and Simian virus 40 (SV40) large T-antigen in osteoblasts isolated from trabecular bone taken from the third metacarpal of a two-year-old Thoroug...
Radiographic Prevalence of Anatomical Variations of the Ventral Lamina of the Sixth Cervical Vertebra, C6/C7 Articular Process Joint Modelling and Competition Outcomes in Warmblood Sport Horses.
Animals : an open access journal from MDPI    January 29, 2026   Volume 16, Issue 3 424 doi: 10.3390/ani16030424
Strootmann T, Peter VG, Körner J.Anatomical variations of the caudal ventral lamina of the sixth cervical vertebra (C6), referred to as equine caudal cervical morphologic variations (ECCMV), and radiographic modelling of the caudal cervical articular process joints (APJ) are commonly identified in sport horses, yet their interrelationship and relevance for athletic performance remain controversial. This retrospective observational study aimed to determine the prevalence of ECCMV and APJ modelling in a clinically sound warmblood sport horse population, to evaluate a potential association and to assess if ECCMV affects competit...
Effects of a rehabilitative whole-body resistance band wrap on equine gait, posture, cortisol, and muscular function.
Frontiers in veterinary science    January 28, 2026   Volume 12 1738766 doi: 10.3389/fvets.2025.1738766
Boger B, Naraian M, Hernandez E, Eaton A, Rockburn R, Tillman I, Payne S, Yob C, Panek C, Manfredi JM.Resistance bands used while horses are exercised with their handlers have shown benefits, but it is unknown if whole-body resistance bands used independently have therapeutic benefits. This study hypothesized that horses with varying gait asymmetries would experience improvements in lameness, muscular function, range of motion, posture, and cortisol following short-term use of a whole-body resistance band wrap (RBW). In this study, nine lame adult horses were evaluated with and without the RBW. The assessment included: objective gait analysis, acoustic myography, postural analysis, gait kinema...
Heritability Estimates of Traits Assessed in Field Performance Tests of Polish Warmblood Mares.
Genes    January 28, 2026   Volume 17, Issue 2 148 doi: 10.3390/genes17020148
Lewczuk D, Borowska A, Maśko M, Bagnicka E.: Knowledge of the genetic background of evaluated traits has been the basis for genetic progress in every horse-breeding population and is essential for precise breeding and up-to-date decision-making. The study aimed to estimate the heritability coefficients for field performance traits in mares. : The research was based on 1408 evaluations of mares conducted during the years 2002-2021 in 51 training centers in Poland. The preliminary analyses of the effects, significant for the investigated traits, were obtained using analysis of variance, and these additional data are also presented (SAS p...
Identifying Host-Characteristics and Management Risk Factors in a California Equine Herpesvirus Myeloencephalopathy (EHM) Outbreak.
Veterinary sciences    January 27, 2026   Volume 13, Issue 2 121 doi: 10.3390/vetsci13020121
Gordon S, Pusterla N, Finno CJ, Young A, Martínez-López B.Equine alphaherpesvirus-1 (EHV-1) is a highly contagious virus that can cause the neurological form, equine herpesvirus myeloencephalopathy (EHM). Understanding transmission-related risk factors is crucial for improving prevention strategies and guiding effective control measures. In this study, we collected data from 63 horses that had previously participated in the February 2022 winter horse show season at the Desert International Horse Park (DIHP) (26 cases and 37 controls) to identify host and management factors associated with EHV-1 infection and/or EHM development during the February 202...
Correction: Wang et al. Multi-Omics Analysis Reveals Biaxial Regulatory Mechanisms of Cardiac Adaptation by Specialized Racing Training in Yili Horses. Biology 2025, 14, 1609.
Biology    January 23, 2026   Volume 15, Issue 3 209 doi: 10.3390/biology15030209
Wang T, Li M, Ren W, Meng J, Yao X, Chu H, Yao R, Zhai M, Zeng Y. [...].