Veterinary medicine for horses encompasses the study and application of medical practices to diagnose, treat, and prevent diseases in equine species. This field involves a comprehensive understanding of equine anatomy, physiology, pathology, and pharmacology. Veterinary practitioners employ a range of diagnostic tools and therapeutic interventions to address health issues in horses, including lameness, gastrointestinal disorders, respiratory conditions, and infectious diseases. Preventative care, such as vaccination and deworming programs, is also a significant aspect of equine veterinary medicine. This page gathers peer-reviewed research studies and scholarly articles that explore various aspects of veterinary medicine as it pertains to horses, including advancements in diagnostic techniques, treatment protocols, and preventive health strategies.
Dolby CA, Hannant D, Mumford JA.Five yearling ponies were vaccinated with inactivated Equid herpesvirus type 1 (EHV-1) in Freund's complete adjuvant as a double emulsion and revaccinated 6 weeks later with EHV-1 in Freund's incomplete adjuvant. These ponies and three age-matched controls were challenged intra-nasally after a further 6 weeks with homologous live virus and monitored clinically, biologically and serologically. After challenge, clinical signs were mild in both groups. No cell-associated viraemias were detected in vaccinated ponies. Vaccination induced high levels of complement-fixing (CF) and virus-neutralizing ...
Cummings JF, de Lahunta A, Mohammed HO, Divers TJ, Summers BA, Valentine BA, Jackson CA.Two spontaneous neurodegenerative diseases of the horse, equine motor neuron disease (EMND) and equine degenerative myeloencephalopathy (EDM), have been associated with alpha-tocopherol deficiency, and both were characterized by prominent accumulations of endothelial lipopigment in the small vessels of the spinal cord. These endothelial pigment deposits appear to be reversible. In EMND horses pasture-supplemented for 9 months or more after the progression of weakness and wasting had arrested, there was very little endothelial lipopigment. The origin and the potential effects of these endotheli...
Johannisson A, Gröndahl G, Demmers S, Jensen-Waern M.Methodological aspects of flow-cytometric evaluation of the phagocytic properties of equine neutrophils were elucidated. The kinetics of attachment and ingestion were studied, and the phagocytic process was more rapidly completed when serum-opsonized yeast cells were used than with use of IgG-opsonized yeast cells. Trypan blue was successfully used to quench fluorescence of non-ingested yeast cells. There were only minor differences in the kinetics of phagocytosis between quenched and unquenched samples, indicating that attachment is rapidly followed by ingestion. Trypan blue quenching caused ...
Sammut EB, Kannegieter NJ.Intra-articular injection of sodium monoiodoacetate (MIA) was investigated as an agent for chemical arthrodesis of the distal hock joints in the horse. Five horses diagnosed with either spavin (three horses), a small tarsal bone fracture or a failed surgical arthrodesis, had 150 mg of MIA injected into the tarsometatarsal (TMT) joint of the affected hock(s). Eight joints were treated in the five horses. Follow-up evaluation by clinical and radiological examination took place over 9 to 14 months. Two of the five horses were sound at the conclusion of the study and one horse, although lame after...
Raspanti M, Guizzardi S, Strocchi R, Ruggeri A.Samples of compact bone were deproteinated by heat treatment and analysed by SEM. This technique removes very effectively cells and vascular structures and brings into full view the mineralization front along the wall of the Havers canal. The present study was confined to samples of equine bone that are known to be subjected to different functional requirements. Bone subjected to high tensile stress exhibited collagen fibrils substantially aligned with the stress direction, and the vast majority of its osteons appeared made of almost parallel fibrils crossing at very narrow angles. On the cont...
Steiger R, Feige K.A 13 year old Thoroughbred gelding was presented with a history of a single episode of collapse during mild exercise. Clinical examination revealed a high packed cell volume (PCV) of 72%, a haemoglobin concentration of 24.9 g/l and 15.2 millions erythrocytes/microliters. Despite continuous intravenous infusion therapy with large volumes, the PCV never decreased to a physiological level. The animal showed a normal appetite and no signs of discomfort or syncope. Arterial blood gas values were in the normal range as well as the concentration of erythropoietin (measured by radioimmunoassay, RIA). ...
Singh G.A/eq-1 and A/eq-2 influenza viruses were isolated simultaneously from an epidemic of equine influenza in north India. Evidently, both types of equine influenza viruses circulated in the equine population at the same time.
Miyazawa T, Matsuda M, Isayama Y, Samata T, Ishida Y, Ogawa S, Takei K, Honda M, Kamada M.Profiles of the genomic DNA of 104 strains of T. equigenitalis isolated from brood mares with contagious equine metritis in Hokkaido during the breeding seasons from 1980 to 1993, as well as those of five strains (SS28, EQ56, EQ59, EQ70 and HH139) previously isolated in Japan were examined after restriction digestion and crossed-field gel electrophoresis. These profiles were essentially identical to each other and the various isolates and strains appeared to have a common genotype, designated 'genotype J', with respect to two restriction enzymes, ApaI and NotI. These results suggest a common s...
Diaz-Espineira M, Escolar E, Bellanato J, Medina JA.The composition and crystal morphology of 141 equine sabulous deposits were determined by infrared spectroscopy (IR), scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX). The IR analysis revealed that all investigated deposits contained calcium carbonates (calcite, CaCO3, and/or vaterite, CaCO3) as major constituents; 42 samples were composed of calcite and vaterite, 33 of calcite, 18 of calcite/vaterite and calcium oxalate, and 17 of vaterite. The remaining specimens contained calcite/vaterite and other compounds (calcium phosphates, sulphate and/or oxalates and/or s...
Meyers SA, Overstreet JW, Liu IK, Drobnis EZ.Mammalian sperm that have completed capacitation are capable of undergoing the acrosome reaction in response to a number of biological and chemical stimuli. In the present report, we have investigated the ability of progesterone to stimulate acrosome reactions of stallion sperm capacitated in vitro. Motile sperm were selected by a two-layer Percoll gradient centrifugation and were incubated in TALP medium modified by the 1:1 (v/v) addition of TEST-yolk medium for 5 hours at 39 degrees C, under 5% CO2 in humidified air. Sperm incubated in vitro in TALP-TEST medium had a higher percentage of acr...
Mair TS.Larval cyathostomiasis was diagnosed as the cause of an outbreak of illness in a group of five young horses. One had the typical clinical signs of larval cyathostomiasis--sudden onset diarrhoea, weight loss, ventral abdominal oedema and pyrexia, but the other four suddenly started to lose weight rapidly and had limb and ventral abdominal oedema and pyrexia, in the absence of diarrhoea. Large numbers of cyathostome larvae were found in the faeces. Four of the five horses recovered after being treated with anthelmintics and steroids.
Blikslager AT, Bowman KF, Levine JF, Bristol DG, Roberts MC.Medical records of horses that underwent surgical treatment for colic between 1990 and 1992 were reviewed. Horses with a pulse rate of > or = 60 beats/min or signs of abdominal pain, which were also accompanied by a volume of > 2 L of material that refluxed from the stomach during the postoperative period (excluding horses with anterior enteritis), comprised the postoperative ileus (POI) group. Horses that had < 2 L of material reflux during the postoperative period and survived > 3 days after surgery comprised the reference population. The association of preoperative and intraoperative clinic...
Collins MB, Hodgson DR, Hutchins DR.Case records of 43 horses with pleural effusion associated with acute pleuropneumonia, chronic pleuropneumonia, or pleuritis secondary to a penetrating thoracic wound were reviewed to determine the predisposing factors, diagnosis, and treatment of this condition. Acute pleuropneumonia was diagnosed in 36 horses, the majority of which were Thoroughbreds (89%). Of 22 (61%) horses that were in race training at the onset of illness, 11 (31%) had been recently transported a long distance and 4 (11%) had evidence of exercise-induced pulmonary hemorrhage. Physical examination findings and hematologic...
Sloet van Oldruitenborgh-Oosterbaan MM, Klein WR, Misdorp W.Dermatophytosis is the most common equine skin disease. Mycotic-like lesions that do not disappear are suspected of being sarcoids. The clinical symptoms and therapeutic interventions for both affections are discussed. A short review of the differential diagnoses is presented.
Komar N, Spielman A.The 20th century emergence in Massachusetts of zoonotic eastern encephalitis was interpreted in terms of recorded environmental change. The main mosquito vector of the infection, Cs. melanura, appears to have been scarce in eastern North America before the 1930s. Its relative scarcity resulted from destruction of the swamps that had been lumbered or drained for farming in the 18th and 19th centuries. When swamps matured once again early in the 1900s, the formation of subsurface pools of water beneath mature trees would have increased the availability of breeding sites for this mosquito. Transm...
Johnson CB, Adam EN, Taylor PM.Hypoxaemia commonly develops during general anaesthesia and in the recovery period in horses. The Hudson demand valve has been used to increase arterial PO2, but it has been found to increase airway resistance considerably when used during spontaneous ventilation. This paper evaluates a modification of the valve designed to reduce this resistance. The effects of the valve and its modification on arterial oxygen (PaO2), and carbon dioxide (PaCO2) tensions were evaluated in four ponies anaesthetised by a total intravenous technique. The valve increased PaO2 from 8.3 +/- 1.1 to 32.7 +/- 7.6 kPa d...
The Journal of nutritionDecember 1, 1994
Volume 124, Issue 12 Suppl 2745S-2753S doi: 10.1093/jn/124.suppl_12.2745S
Kronfeld DS, Ferrante PL, Grandjean D.Four mathematical approaches are proposed to determine optimal ranges of nutrients for specified purposes. For exercise, the diet must provide optimal mixtures of fuels, also optimal amounts of nutrients conducive to a sound structure, a desired power/weight ratio, a water-electrolyte system that resists dehydration and buffers hydrogen ions, a tolerance to the cumulative stress of repetitive competition and tractable attitude. The nutritional strategy of carbohydrate loading risks a variety of abnormalities in dogs and horses. An alternative strategy of fat adaptation (the combination of fat ...
Hawkins JF, Tulleners EP.Epiglottitis was diagnosed and treated in 20 horses (13 Thoroughbreds and 7 Standardbreds) over a 5-year period. Eighteen horses were used for racing, and 2 Standardbreds were broodmares. Primary clinical signs were exercise intolerance, respiratory noise, and coughing. The most common endoscopic diagnosis made by referring veterinarians was epiglottic entrapment (11 horses). In 19 horses, endoscopic evaluation at admission revealed mucosal ulceration and thickening of the lingual surface of the epiglottis. Other endoscopic findings included dorsal displacement of the soft palate (14 horses), ...
Laakkonen UM, Leinonen A, Savonen L.A gas chromatographic-mass spectrometric (GC-MS) screening procedure for 23 acidic drugs in equine urine is described. With the GC-MS method fifteen anti-inflammatory drugs, five barbiturates and three methyl xanthines can be detected with good sensitivity and selectivity. The method consists of alkaline hydrolysis, extraction with organic solvent using salting-out, clean-up extraction, methylation and screening with GC-MS in selected-ion monitoring mode. The limit of detection is 10 micrograms 1(-1) or lower, for most drugs.
The Journal of nutritionDecember 1, 1994
Volume 124, Issue 12 Suppl 2730S-2735S doi: 10.1093/jn/124.suppl_12.2730S
Snow DH.Since the domestication of the horse and its use in various types of athletic competition, its diet has developed from that associated with grazing to feeding of additional energy in the form of grains up to the present situation when numerous supplements are fed in hopes of enhancing performance. Many if not all of these may be considered as ergogenic aids, and under the rules of racing in many countries should be considered as a prohibited substance. Until recently, a blind eye has been turned to whether the rules should be enforced against many nutritional supplements, for example, vitamins...
Davis TA, Nguyen HV, Garcia-Bravo R, Fiorotto ML, Jackson EM, Reeds PJ.To determine whether the amino acid composition of milk changes during lactation, we compared the amino acid pattern (concentration of each individual amino acid relative to the total amino acid concentration) of colostrum with that of mature milk in six mammalian species. In the human, horse, pig and cow, the pattern of amino acids changed between colostrum and mature milk: glutamate, proline, methionine, isoleucine and lysine increased; cystine, glycine, serine, threonine and alanine decreased. In these four species, the total amino acid concentration also decreased 75% between colostrum and...
Perkins NR, Frazer GS.This article briefly reviews the clinical management of emergency conditions likely to be encountered by veterinarians responsible for the reproductive health of mares. The article discusses rectal tears, breeding injuries, uterine torsion, placental hydrops, and prepubic tendon rupture. A major component discusses a recommended approach to dystocias, and the management of such complications as uterine rupture and prolapse and postpartum hemorrhage. Management of retained fetal membranes and septic metritis is addressed.
Mason DE, Ainsworth DM, Robertson JT.Responding to an equine respiratory emergency requires rapid localization of the problem and appropriate choices for therapy. Localizing the cause of respiratory distress is aided by history and thorough physical examination. When examining the patient, one must focus on the presenting signs as indicators of URT or LRT dysfunction. Table 3 summarizes the characteristic presenting signs based on respiratory tract location and suggests the initial treatment course indicated. Respiratory distress in the absence of signs related to the pulmonary system suggests inadequate oxygen delivery secondary...
Moore BR, Moore RM.Clinical examination of the equine patient with acute abdominal pain should identify the affected body system and yield a provisional diagnosis. Determination of signalment, history, physical examination, and basic laboratory tests should assist in classification of the gastrointestinal disorder and direct the therapeutic plan. Determination of the definitive diagnosis of abdominal pain based on clinical examination is not crucial. For a successful outcome, efforts should be directed toward early recognition of the need for surgery and treatment of cardiovascular compromise in horses with seve...
Braun J.Although foals born after embryo transfer are eligible for registration in the majority of horse breeds, application of embryo transfer is still rare. This is mainly due to the lack of a possibility for superovulation. Uterine stage embryos can be recovered by a non-surgical flushing technique. Transfer can be accomplished by non-surgical as well as surgical methods. In contrast to the situation in cattle, most related technologies are scarcely available. Methods of cryopreservation as well as bisection of embryos are hampered by the fact that suitable embryos (morula) can be collected from th...
Holcombe SJ, Beard WL, Hinchcliff KW, Robertson JT.The effect of transection of the sternothyroideus and sternohyoideus muscles on upper airway mechanics was investigated in exercising horses. Upper airway mechanics of six Standardbred horses were measured at rest and during exercise before and 24 h and 2 wk after sternothyrohyoid myectomy. Transnasal tracheal and pharyngeal catheters connected to differential pressure transducers were used to measure tracheal and pharyngeal pressures. A pneumotachograph mounted on the rostral end of an airtight face mask was used to measure airflow. Horses ran at 50, 75, and 100% of maximal O2 consumption on ...
Sheoran AS, Timoney JF, Tinge SA, Sundaram P, Curtiss R.The aim of this study was to investigate the intranasal immunogenicity for the horse of a Deltacya Deltacrp-pabA mutant (MGN-707) of Salmonella enterica serotype Typhimurium (S. typhimurium). MGN-707 caused no sign of disease, was not detected in feces and a single administration induced strong Salmonella-specific serum and nasal mucosal antibody responses. All ponies had made strong salmonella specific serum IgGa, IgGb, IgA and IgM antibody responses by day 25 after the first immunization. IgM responses to salmonella lipopolysaccharide (LPS) were short lived whereas salmonella specific serum ...
Hardeman LC, van der Meij BR, Back W, van der Kolk JH, Wijnberg ID.In equine laminitis, the deep digital flexor muscle (DDFM) appears to have increased muscle force, but evidence-based confirmation is lacking. Objective: The purpose of this study was to test if the DDFM of laminitic equines has an increased muscle force detectable by needle electromyography interference pattern analysis (IPA). Methods: The control group included six Royal Dutch Sport horses, three Shetland ponies and one Welsh pony [10 healthy, sound adults weighing 411 ± 217 kg (mean ± SD) and aged 10 ± 5 years]. The laminitic group included three Royal Dutch Sport horses, one Friesian, o...
Grosenbaugh DA, Amoss MS, Hood DM, Williams JD.A heterologous radioreceptor binding assay (RRA) has been developed capable of detecting nanogram amounts of epidermal growth factor (EGF) receptor-binding activity in equine urine. The binding parameters of [125I]mEGF (murine EGF) to EGF receptors on equine plasma membranes are in good agreement with values from other EGF-RRA systems. The dissociation constant estimated from equilibrium methods (KD = 4 X 10(-10) M) is in reasonable agreement with that determined from the rate constants (KD = 6 X 10(-10) M) and is in good agreement with values determined in other species. The assay is specific...
López ML, de Souza W.The presence and distribution of cholesterol in mature and immature epididymal spermatozoa was analyzed using filipin as a cytochemical tool in freeze-fracture replicas and thin section preparations. The polyenic-antibiotic filipin formed complexes with 3, beta -OH sterols, producing characteristic protrusions, or pits, that were heterogeneously distributed in the plasma membrane of stallion spermatozoa, revealing a specific organization in a functionally specialized area of the gamete. The acrosomal region of the sperm head presented a significantly higher density of filipin sterol complexes ...
Morrissey NK, Bellenger CR, Ryan MT, Baird AW.To measure the expression of cyclooxygenase-2 (COX-2) mRNA in gastric biopsy specimens serially obtained from horses before, during, and after an 8-day intermittent feed-deprivation trial and to investigate the mucosal location of COX-2. Methods: 9 mixed-breed horses for retrieval of gastric biopsy specimens and 16 additional horses for immunohistochemical analysis. Methods: Gastric biopsy specimens were obtained from 6 horses; 3 of these horses and 3 more participated in an intermittent feed-deprivation trial 9 weeks later. A quantitative PCR assay was used to determine the amount of COX-2 mR...
Berzina I, Trumble NS, Novicki T, Sharkey LC.An 11-year-old American Saddlebred gelding was presented for evaluation of a nonpainful subconjunctival mass involving the lateral canthus of the left eye. Other findings included a central corneal scar and a small central cataract of the lens in the left eye. Fine-needle aspiration of the mass was performed and cytologic examination revealed marked pyogranulomatous inflammation with intralesional fungal hyphae, consistent with mycetoma. The fungal structures were elongated and characterized by nonstaining walls; several bulbous yeast-like structures were also observed. The mycetoma was surgic...
Rossignol F, Vitte A, Boening J.To (1) report a modified transfixation pin cast technique, using dorsal recumbency for fracture reduction, distal positioning of the pins in the epiphysis and distal metaphysis, and a hybrid cast, combining plaster of Paris (POP) and fiberglass casting, and (2) report outcome in 11 adult horses. Methods: Case series. Methods: Adult horses (n = 11) with comminuted phalangeal fractures. Methods: Horses were anesthetized and positioned in dorsal recumbency. The phalangeal fracture was reduced by limb traction using a cable attached to the hoof. Screw fixation in lag fashion of fracture fragments ...
Barrey E, Valette JP, Jouglin M, Picard B, Geay Y, Robelin J.The content in slow and fast myosin heavy chains (MHC 1 and MHC 2) of 5 equine muscles was determined using an enzyme-linked immunosorbent assay. The results obtained with this immunoenzymatic method were compared with complementary techniques: electrophoresis and immunohistochemistry. Slices of masseter, diaphragm, tensor faciae latae, semitendinosus and cutaneus trunci were obtained from a 12-year-old saddle horse after slaughter. Muscular proteins were specifically extracted to be analysed by ELISA. The technique used 2 complimentary monoclonal antibodies (MAb). MAb 1 was prepared from a hu...
Figueras F, Castelo-Branco C, Pons F, Sanjuán A, Vanrell JA.The aim of the present study was to determine whether assignment to continuous estrogen-progestin therapy is more effective in protecting against bone loss than assignment to a sequential regimen. Methods: A total of 104 postmenopausal women were randomly assigned to one of two groups of treatment, Conjugated Equine Estrogens and Medroxyprogestin without interruption (continuous group) and Conjugated Equine Estrogens over 25 days with Medroxyprogestin beyond the 14th day (sequential group). Bone mineral density (BMD) was measured at inclusion, 12 and 24 months later by dual energy X-ray absorp...
Leach DH, Zoerb GC.The mechanical properties of pigmented equine hoof wall tissue were determined for samples taken from the inner and outer portions of the stratum medium of the toe. Two properties, the modulus of elasticity and proportional limit, which are measures of the rigidity and yield point, respectively, of the tissue, were studied for samples compressed in 3 orthogonal directions. All samples tested were anisotropic. Inner wall samples were less rigid and had a lower yield point than outer wall samples.
de Pinho FA, Mendes MO, de Magalhães VLP, Tinôco AAC, Seoane JHL, Rêgo FD, Soares RP, Barrouin-Melo SM.Leishmania infantum infections have long been described in humans and dogs worldwide, but characterization of equine cases remains scarce. We describe the clinical evolution of a natural L. infantum infection to contribute to the diagnostic knowledge and epidemiology of equine leishmaniasis (EL). An auction-acquired four-year-old Mangalarga Marchador mare from Pernambuco state, presented a few subcutaneous nodules on the head and neck upon arrival at the purchaser's stud at Bahia state, in November of 2019. They progressed to multiple ulcerated and non-ulcerated nodules and spread to both righ...
Keay G, Doxey DL.Samples of serum from both young and adult normal cattle, sheep and horses were subjected to protein electrophoresis on agarose gel films. After processing, the stained electrophoretic patterns and densitometric traces of each species exhibited certain specific characteristics. The separations also revealed differences between young and adult animals of the same species. These age-related differences are described here.
Art T, Lekeux P.In order to study the in vitro mechanical properties of the equine trachea submitted to the compressive pressures observed in vivo, the pressure-volume relationship was determined in intra- and extra-thoracic tracheal segments taken post mortem from 29 healthy horses (one to 15 years old; 352 to 651 kg). At the same time, the cross-sectional lumen area (X-SA) at the mid-point of the segment was measured using a slit-lamp transillumination and photographic measurement by endoscopy. The tracheal specific compliance (Cs) as well as the relative changes in X-SA and in the sagittal and transverse d...
Jarvis GE, Evans RJ.Endotoxin has previously been shown to induce platelet aggregation in equine heparinised whole blood. This study aimed to determine whether platelet-activating factor or products of cyclo-oxygenase metabolism (thromboxane A2 or prostaglandins) were important in mediating the response of platelets to endotoxin. The effects of the following drugs on endotoxin-induced aggregation were investigated: aspirin, flunixin meglumine and carprofen (non-steroidal anti-inflammatory drugs); CV-3988 and WEB2086 (platelet-activating factor receptor antagonists); quinacrine (phospholipase A2 inhibitor). The ef...
Arias MS, Piñeiro P, Hillyer GV, Francisco I, Cazapal-Monteiro CF, Suárez JL, Morrondo P, Sánchez-Andrade R, Paz-Silva A.The utility of an enzyme-linked immunosorbent assay to determine the sensitization against the trematode Fasciola hepatica in horses from an endemic area (NW Spain) was assessed. Blood samples were collected from 536 horses and tested against a 2.9-kDa recombinant surface protein (FhrAPS) to estimate the presence of IgG antibodies. Data were analysed regarding several intrinsic (age, gender and breed) and extrinsic factors (aptitude and housing). The farm size (number of horses/farm) was also considered. Sixty percent (95% CI 56, 64) of the horses were positive to the FhrAPS-ELISA, with a sign...
Saulez MN, Dzikiti B, Voigt A.Two of 348 horses that underwent gastrointestinal surgery under general anaesthesia developed perforations in their tracheas caused by the endotracheal tube. In one case the damage was probably caused when the horse was being moved from the induction room for surgery and excessive traction was exerted on the tube when the anaesthetic machine was moved too far ahead of the horse. The trachea of the other horse may have been damaged when it was intubated.
Moudgal NR, Papkoff H.The ability of equine luteinizing hormone (eLH) to promote follicular growth and maturation in hypophysectomized rats has been assessed. A single injection of equine LH has been shown to promote the growth of a large number of antral and preovulatory follicles. In addition, equine LH markedly increased serum estrogen levels and uterine weight. Furthermore, equine LH, like equine chorionic gonadotropin (eCG; PMSG) was able to significantly enhance the incorporation of [3H]thymidine into ovarian DNA, an activity shown to be specific to hormones having follicle-stimulating hormone (FSH) activity....
Chidlow H, Giguère S, Camus M, Wells B, Berghaus R, McConachie Beasley E.Serial cerebrospinal fluid (CSF) analysis might be required in clinical neurologic disease. The effect of lumbosacral (LS) or cervical (C1-C2) centesis on subsequent CSF cytologic analyses has not been investigated in horses. Objective: To evaluate the effect of thecal puncture on subsequent CSF analyses ANIMALS: Ten healthy adult horses. Methods: Prospective study. Horses were randomly assigned to undergo CSF collection twice, 14 days apart, from either the C1-C2 or LS space. After a 4-month washout period, CSF collection was repeated from the alternate site. Continuous data were analyzed u...