Comparison of transcutaneous ultrasound over the right flank with transrectal ultrasonography in the diagnosis of pregnancy in New Zealand dairy herds : a thesis presented in partial fulfillment of the requirements for the degree of Master of Veterinary Science at Massey University

Application of a 3.5 MHz sector transducer over the right flank allows the rapid and clear visualization of bovine pregnancy (ie: fetus, fetal membranes, fetal fluid and/or placentomes). A total of 1736 cows in ten commercial, pasture-based New Zealand dairy herds were examined for pregnancy by transcutaneous ultrasound across the right flank and transrectal ultrasound between 37 and 198 days of gestation. The gold standard was derived from calving records or examination at slaughter. The overall sensitivity of transrectal ultrasound (96.24%) was markedly higher than flank ultrasound (58.55%) and the overall probability of a correct diagnosis of pregnancy status was also significantly higher (p<0.0001). From 155 days of gestation, however, flank ultrasound represented a more accurate method of pregnancy diagnosis and the probability of a correct diagnosis was significantly higher (p<0.0001) after this gestational age. The gestational age of 225 cows from four Spring-calving dairy herds was determined and ultrasound pregnancy test recorded, to determine possible fetal characteristics able to be visualized via transcutaneous ultrasound over the right flank in order to age pregnancy during mid to late gestation. Linear or quadratic equations and curves were formulated from 60 to 198 days of gestation. The fetal characteristics of thoracic diameter, abdominal diameter or umbilical diameter can be used to age pregnancy from 60 days of gestation. Placentome height and length were not significant in the determination of gestational age

Characterising the Robustness of Reinforcement Learning for Continuous Control using Disturbance Injection

In this study, we leverage the deliberate and systematic fault-injection capabilities of an open-source benchmark suite to perform a series of experiments on state-of-the-art deep and robust reinforcement learning algorithms. We aim to benchmark robustness in the context of continuous action spaces -- crucial for deployment in robot control. We find that robustness is more prominent for action disturbances than it is for disturbances to observations and dynamics. We also observe that state-of-the-art approaches that are not explicitly designed to improve robustness perform at a level comparable to that achieved by those that are. Our study and results are intended to provide insight into the current state of safe and robust reinforcement learning and a foundation for the advancement of the field, in particular, for deployment in robotic systems.Comment: 18 pages, 15 figure

Connected clusters: landscaping study

This study presents evidence from five dynamic, city region-based climate innovation clusters. Here businesses, academics, communities and government work together to deliver low-carbon innovation. We believe this concentration of resources, expertise and initiative is our best chance of meeting the Paris climate targets while also reaping social and economic benefits that come with the development and delivery of cleantech solutions. Climate-KIC’s ConnectedClusters project is an alliance of five city regions – Birmingham, Edinburgh, Frankfurt, London and Valencia – committed to sharing, replicating and scaling what works in developing innovation ecosystems for delivering effective climate action. Between now and 2020, the project will work hard to accelerate and enable transformation of the places we live into clean, prosperous and thriving cities and regions by developing new collaborative approaches to technology, procurement, investment and training. ConnectedClusters will help inform a transition away from product and technology innovation in isolation, towards a systemic, regionally-embedded approach to climate innovation. Paris shows that for our continued prosperity, transformation on a scale never witnessed before is imperative. Only by working together can we achieve that change

CHronic hypERtension and L-citRulline studY (CHERRY): an Early-Phase Randomised Controlled Trial in Pregnancy.

Oral supplementation with L-citrulline, which is sequentially converted to L-arginine then nitric oxide, improves vascular biomarkers and reduces blood pressure in non-pregnant, hypertensive human cohorts and pregnant mice with a pre-eclampsia-like syndrome. This early-phase randomised feasibility trial assessed the acceptability of L-citrulline supplementation to pregnant women with chronic hypertension and its effects on maternal BP and other vascular outcomes. Pregnant women with chronic hypertension were randomised at 12-16 weeks to receive 3-g L-citrulline twice daily (n = 24) or placebo (n = 12) for 8 weeks. Pregnant women reported high acceptability of oral L-citrulline. Treatment increased maternal plasma levels of citrulline, arginine and the arginine:asymmetric dimethylarginine ratio, particularly in women reporting good compliance. L-citrulline had no effect on diastolic BP (L-citrulline: - 1.82 95% CI (- 5.86, 2.22) vs placebo: - 5.00 95% CI (- 12.76, 2.76)), uterine artery Doppler or angiogenic biomarkers. Although there was no effect on BP, retrospectively, this study was underpowered to detect BP changes < 9 mmHg, limiting the conclusions about biological effects. The increase in arginine:asymmetric dimethylarginine ratio was less than in non-pregnant populations, which likely reflects altered pharmacokinetics of pregnancy, and further pharmacokinetic assessment of L-citrulline in pregnancy is advised.Trial Registration EudraCT 2015-005792-25 (2017-12-22) and ISRCTN12695929 (2018-09-20) In pregnant women with chronic hypertension, L-citrulline is an acceptable intervention which increased plasma L-citrulline bioavailability but did not affect BP, potentially due to altered pharmacokinetics of pregnancy

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p&lt;0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p&lt;0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p&lt;0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP &gt;5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

CHronic hypERtension and L-citRulline studY (CHERRY):an Early-Phase Randomised Controlled Trial in Pregnancy

Oral supplementation with L-citrulline, which is sequentially converted to L-arginine then nitric oxide, improves vascular biomarkers and reduces blood pressure in non-pregnant, hypertensive human cohorts and pregnant mice with a pre-eclampsia-like syndrome. This early-phase randomised feasibility trial assessed the acceptability of L-citrulline supplementation to pregnant women with chronic hypertension and its effects on maternal BP and other vascular outcomes. Pregnant women with chronic hypertension were randomised at 12-16 weeks to receive 3-g L-citrulline twice daily (n = 24) or placebo (n = 12) for 8 weeks. Pregnant women reported high acceptability of oral L-citrulline. Treatment increased maternal plasma levels of citrulline, arginine and the arginine:asymmetric dimethylarginine ratio, particularly in women reporting good compliance. L-citrulline had no effect on diastolic BP (L-citrulline: - 1.82 95% CI (- 5.86, 2.22) vs placebo: - 5.00 95% CI (- 12.76, 2.76)), uterine artery Doppler or angiogenic biomarkers. Although there was no effect on BP, retrospectively, this study was underpowered to detect BP changes &lt; 9 mmHg, limiting the conclusions about biological effects. The increase in arginine:asymmetric dimethylarginine ratio was less than in non-pregnant populations, which likely reflects altered pharmacokinetics of pregnancy, and further pharmacokinetic assessment of L-citrulline in pregnancy is advised.Trial Registration EudraCT 2015-005792-25 (2017-12-22) and ISRCTN12695929 (2018-09-20) In pregnant women with chronic hypertension, L-citrulline is an acceptable intervention which increased plasma L-citrulline bioavailability but did not affect BP, potentially due to altered pharmacokinetics of pregnancy.</p