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Purpose Brooke is a non-government organisation with working equine welfare programmes across Africa, Asia and Latin America. In 2014, staff from ten country programmes were asked to identify ‘no-win’ situations (subsequently reframed as ‘hard-wins’)—where improving equine welfare is proving difficult, expensive and/or marginal—in order to inform strategic decisions on how to approach, manage and mitigate for such situations. Methods The Delphi-type consultation process had three phases. Round 1 posed five questions in the form of a workshop, survey and semi-structured interviews. Round 2 re-presented key themes and sense-checked initial conclusions. Round 3 reviewed the nature and prevalence of hard-win situations at an international meeting of all participants. Results Reasons given for hard-win situations included: no economic or social benefit from caring for working animals; poor resource availability; lack of empathy for working equids or their owners among wider stakeholders; deep-seated social issues, such as addiction or illegal working; areas with a high animal turnover or migratory human population; lack of community cooperation or cohesion; unsafe areas where welfare interventions cannot be adequately supported. Participants estimated the prevalence of hard-win situations as 40–70% of their work. They suggested some current ways of working that may be contributing to the problem, and opportunities to tackle hard-wins more effectively. Conclusion and animal welfare implications Respondents agreed that if equine welfare improvements are to span generations of animals, interventions cannot rely on relatively simple, technical knowledge-transfer strategies and quick-wins alone. Programmes need to be more flexible and iterative and less risk-averse in their approaches to embedding good equine welfare practices in all relevant actors. Consultation recommendations informed development of Brooke’s new global strategy, a revised organisational structure and redefinition of roles and responsibilities to streamline ways to approach hard-wins in the complex environments and socio-economic contexts in which working equids are found.

Photoacoustic (PA) imaging for biomedical applications has been under development for many years. Based on the many advances over the past decade, a new photoacoustic imaging system has been integrated into a micro-ultrasound platform for co-registered PA?ultrasound (US) imaging. The design and implementation of the new scanner is described and its performance quantified. Beamforming techniques and signal processing are described, in conjunction with in vivo PA images of normal subcutaneous mouse tissue and selected tumor models. In particular, the use of the system to estimate the spatial distribution of oxygen saturation (sO2) in blood and co-registered with B-mode images of the surrounding anatomy are investigated. The system was validated in vivo against a complementary technique for measuring partial pressure of oxygen in blood (pO2). The pO2 estimates were converted to sO2 values based on a standard dissociation curve found in the literature. Preliminary studies of oxygenation effects were performed in a mouse model of breast cancer (MDA-MB-231) in which control mice were compared with mice treated with a targeted antiangiogenic agent over a 3 d period. Treated mice exhibited a >90% decrease in blood volume, an 85% reduction in blood wash-in rate, and a 60% decrease in relative tissue oxygenation.

Hirson and Howard present a case study and analysis of the cockpit voice recorder (CVR) from a South African Airways passenger aircraft off Mauritius on 28 November 1987.

This single case study explored the use of EPG as a therapeutic tool for treating inaccurate articulation of the voiceless alveolar plosive /t/. The participant (M) is an 18-year-old deaf adult who consistently uses hearing aids, and who communicates using a combination of English, Sign Supported English and British Sign Language (BSL). M received traditional phonological therapy targeting his production of /t/ prior to EPG therapy, but without success. He requested further therapy and EPG was offered as an alternative approach. Pre-EPG therapy, M made tongue placement errors for both /t/ and the voiced alveolar plosive /d/. Based on perceptual analysis by M’s speech and language therapist, the first author, his productions were inconsistent, though generally perceived as voiceless and voiced velar plosives respectively. The EPG therapy consisted of 6 bi-weekly therapy sessions, each lasting for one hour, targeting M’s production of /t/ in familiar words, using the visual feedback from the EPG display. Trained and untrained listeners perceptually analysed audio recordings of words and sentences collected at 3 assessment points. Improvements, both over the course of the EPG therapy and during the follow-up period, were found to be statistically significant. Significantly, M was able to generalise his production skills to untaught words containing both /t/ and /d/. Equally significant was the lack of change in M’s production of a control sound, the voiceless dental fricative /θ/. More globally, an improvement was observed in ratings of M’s intelligibility in sentences and in his voice quality (assessed impressionistically).

Photoacoustic microscopy with linear array transducers enables fast two-dimensional, cross-sectional photoacoustic imaging. Unfortunately, most ultrasound transducers are only sensitive to a very narrow angular acceptance range and preferentially detect signals along the main axis of the transducer. This often limits photoacoustic microscopy from detecting blood vessels which can extend in any direction. Rotational compounded photoacoustic imaging is introduced to overcome the angular-dependency of detecting acoustic signals with linear array transducers. An integrate system is designed to control the image acquisition using a linear array transducer, a motorized rotational stage, and a motorized lateral stage. Images acquired at multiple angular positions are combined to form a rotational compounded image. We found that the signal-to-noise ratio improved, while the sidelobe and reverberation artifacts were substantially reduced. Furthermore, the rotational compounded images of excised kidneys and hindlimb tumors of mice showed more structural information compared with any single image collected.

The use of near-infrared wavelengths for photoacoustic (PA) imaging takes advantage of the relatively low inherent absorption of tissues and has encouraged the development of agents which show high contrast in this range. Here, we describe the modification of a commercially available PA imaging system (Vevo LAZR, VisualSonics, Toronto) to take advantage of the 532nm and 1064nm wavelengths inherent in the generation of the currently tuneable range of 680 to 970nm and in the use of these two wavelengths to assess contrast agents. The photoacoustic imaging system generated light from a Nd/YAG laser modified to extract the 532 and 1064nm wavelengths in addition to its OPO-derived tuneable range (680 - 970 nm) and deliver this light through a fiber integrated into a linear array transducer (LZ400, VisualSonics). Gold nanorods (UT Austin), carbon nanotubes (Stanford U), DyLight 550 (Thermo Fisher) and blood were imaged in a phantom (PE20 tubing) and in a hindlimb subcutaneous tumor in vivo to determine their photoacoustic signal intensity at all wavelengths. In the phantom and in vivo, all agents caused an enhancement of the photoacoustic signal at their respective peak absorbance wavelengths. These results show that the 532nm and 1064nm wavelengths could prove useful in biomedical imaging due to the contrast agents customized for them. The 1064nm wavelength in particular has the advantage of having very low generation of endogenous signal in vivo, making agents tuned to this wavelength ideal for targeted contrast imaging.

The main goal of this study was to determine the optimal strategy for a real-time nonlinear contrast mode for small-animal imaging at high frequencies, on a new array-based micro-ultrasound system. Previously reported contrast imaging at frequencies above 15 MHz has primarily relied on subtraction schemes involving B-mode image data. These approaches provide insufficient contrast to tissue ratios under many imaging conditions. In this work, pulse inversion, amplitude modulation and combinations of these were systematically investigated for the detection of nonlinear fundamental and subharmonic signal components to maximize contrast-to-tissue ratio (CTR) in the 18-24 MHz range. From in vitro and in vivo measurements, nonlinear fundamental detection with amplitude modulation provided optimal results, allowing an improvement in CTR of 13 dB compared with fundamental imaging. Based on this detection scheme, in vivo parametric images of murine kidneys were generated using sequences of nonlinear contrast images after intravenous bolus injections of microbubble suspensions. Initial parametric images of peak enhancement (PE), wash-in rate (WiR) and rise time (RT) are presented. The parametric images are indicative of blood perfusion kinetics, which, in the context of preclinical imaging with small animals, are anticipated to provide valuable insights into the progression of human disease models, where blood perfusion plays a critical role in either the diagnosis or treatment of the disease.

We report on the design, assembly and evaluation of a dual frequency mechanically scanned transducer for ultrasound bubble manipulation and real time high frequency imaging applications. A low frequency 2 MHz annulus was designed to fit on the outside of a commercially available 30 MHz, 100% bandwidth single element fixed focus transducer such that the axial axes of each transducer would be substantially aligned. The acoustic pressure and beam characteristics of the low frequency transducer were characterized as a function of transmit center frequency and drive voltage. The focal depths of the low and high frequencies were measured to be 11.8–12.1mm and 12.7mm for transmit pulses of 2–3MHz and 30 MHz respectively. The probe was integrated into a commercially available Visualsonics RMV Scanhead and could achieve a frame rate of 20 fps. The dual frequency probe provided an average of ≫ 12dB enhancement of contrast to tissue ratios in rat kidney and rat xenograft Fibrosarcoma models.

Pervasive computing is also called ubiquitous computing, intelligent spaces, adaptive environment, disappearing computer, and ambient intelligence. It comprises of embedded intelligence (μC or μP), connectivity (network: wired/wireless), and the means to interact (applications and services). The world of pervasive computing is here now! In 5 years time, a product that cannot interact will probably be out of date. Most products have a design cycle of 3 or more years. Don't design them to be obsolete. (5 pages)

A case of “spontaneous hypoglycemia” in a diabetic, due to misuse of insulin, is described. Differentiation from insulinoma was difficult. Some of the anomalous results obtained during standard provocative tests are regarded in retrospect, as due to self-administration of exogenous insulin even though the patient was in hospital and apparently under strict supervision at the time of the tests. This may also explain some previously published reports with anomalous results. Distal pancreatectomy was carried out because of persistent unexplained hypoglycemia with temporary relief of symptoms but subsequent relapse. Correct diagnosis was made when an illicit store of insulin was discovered in the false bottom of a jewel box. This was labeled surreptitiously with 131I which was later demonstrated in the urine, blood, and at the site of injection. Though rare in diabetics, factitious hypoglycemia presents difficult problems in diagnosis.

1. The clinical and post-mortem findings are described of a patient who sustained a hyperextension injury of the neck with paraplegia. 2. There was no radiological evidence of fracture: osteoarthritis of the spine was present. 3. Evidence is presented that the cord was damaged from behind by the lamina of the vertebra below a tear in the anterior longitudinal ligament.

Anticoagulation (AC) levels were monitored simultaneously in dogs by 3 whole blood (WB) and 2 plasma CP) clotting assays. Three levels of heparin (50,100 and 200 U/kg were tested in 26 experiments by Intravenous injection. Blood was sampled at 10 and 30 min then repeated every 30 min for 4 hours. The WB clotting tests provided more sensitivity with respect to the kinetics of neutralization of the heparin than did the P assays. The levels of AC determined by each assay method was fit to exponential curves using a computerized iterative least squares method. The points were weighted inversely with the variance and the censored data was used by fitting the known values to a gamma distribution and deriving the average and SEN of the series. The coagulation curves were dependent upon the heparin dose and test methods. Extrapolated levels of initial AC demonstrate from 3 to 67 fold increases in relative clotting times for 50 and 200 U/kg dosages respectively, depending on the assay method. The AC half lives (T½) with the three WB assays varied from 15 to 41 min for the low dosage and 24 to 34 min and 27 to 30 min for 100 and 200 U/kg dosages respectively. The shortness of these T½ is a consequence-of using data acquired at 10 to 30 tnin post injection. Reanalysis of our data using sampling periods >60 min significantly prolonged the derived T½. Finally there was a marked post heparin shortening (less than pre-heparin values) of the WB assays at 2-4 hours. The values appeared to be dose dependent, as the shortest values occurred In those animals receiving the highest heparin dose. Therefore, intravenous heparin can be associated with high Initial AC followed within 2-4 hours by a quicker than normal clot time.