Future aspects of renal transplantation

New and exciting advances in renal transplantation are continuously being made, and the horizons for organ transplantation are bright and open. This article reviews only a few of the newer advances that will allow renal transplantation to become even more widespread and successful. The important and exciting implications for extrarenal organ transplantation are immediately evident. © 1988 Springer-Verlag

Delayed biliary duet obstruction after orthotopic liver transplantation

After orthotopic liver transplantation and biliary reconstruction by cholecystoduodenostomy, four of 40 patients developed delayed obstruction of the cystic duct. The recipients had the clinical syndrome of fulminating cholangitis with jaundice, fever, leukocytosis, toxemia, and bacteremia. All four patients died; of the four, two patients died despite late reoperation and re-establishment of bile drainage by choledochoenterostomy. In all four cases, a factor contributing to the biliary obstruction may have been infection of the extrahepatic biliary ducts with or without ulceration, and in three of the livers, there was evidence of infection of the ducts with CMV. If cholecystoduodenostomy is used in future cases, prompt re-exploration and conversion to choledochoenterostomy should be considered if the diagnosis of duct obstruction, cholangitis, and persistent bacteremia are made. © 1972

Electronic voting to encourage interactive lectures: a randomised trial

Background: Electronic Voting Systems have been used for education in a variety of disciplines. Outcomes from these studies have been mixed. Because results from these studies have been mixed, we examined whether an EVS system could enhance a lecture's effect on educational outcomes. Methods: A cohort of 127 Year 5 medical students at the University of Adelaide was stratified by gender, residency status and academic record then randomised into 2 groups of 64 and 63 students. Each group received consecutive 40-minute lectures on two clinical topics. One group received the EVS for both topics. The other group received traditional teaching only. Evaluation was undertaken with two, 15-question multiple-choice questionnaires (MCQ) assessing knowledge and problem solving and undertaken as a written paper immediately before and after the lectures and repeated online 8–12 weeks later. Standardised institutional student questionnaires were completed for each lecture and independent observers assessed student behaviour during the lectures. Lecturer's opinions were assessed by a questionnaire developed for this study. Results: Two-thirds of students randomised to EVS and 59% of students randomised to traditional lectures attended. One-half of the students in the EVS group and 41% in the traditional group completed all questionnaires. There was no difference in MCQ scores between EVS and traditional lectures (p = 0.785). The cervical cancer lectures showed higher student ranking in favour of EVS in all parameters. The breast cancer lectures showed higher ranking in favour of traditional lectures in 5 of 7 parameters (p < 0.001). The observed higher-order lecturer-students interactions were increased in the EVS lecture for one lecturer and reduced for the other. Both lecturers felt that the EVS lectures were difficult to prepare, that they were able to keep to time in the traditional lectures, that the educational value of both lecture styles was similar, and that they were neutral-to-slightly favourably disposed to continue with the EVS technology. The 2 lecturers disagreed regarding the ease of preparation of the traditional lecture, their ability to keep to time in the EVS lecture, and personal satisfaction with the EVS lecture. The lecturers felt that EVS encouraged student participation and helped identify where students were having difficulty. Conclusion: In this setting, EVS technology used in large group lectures did not offer significant advantages over the more traditional lecture format.Paul M Duggan, Edward Palmer and Peter Devit

The effect of the eye movement desensitization and reprocessing intervention on anxiety and depression among patients undergoing hemodialysis: A randomized controlled trial

Author's accepted version (postprint).This is an Accepted Manuscript of an article published by Wiley in Perspectives in psychiatric care on 29/04/2019.Available online: https://onlinelibrary.wiley.com/doi/epdf/10.1111/ppc.12389acceptedVersio

Performance-based sub-selection of CMIP6 models for impact assessments in Europe

This is the final version. Available on open access from Copernicus Publications via the DOI in this recordCode and data availability: The code used to apply the ClimWIP method is publicly available via the ESMValTool (https://docs.esmvaltool.org/en/latest/recipes/recipe_climwip.html, ESMValTool, 2022). The data used in this study are available through the ESGF data portal at https://esgf-node.llnl.gov/projects/cmip6/ (CMIP, 2022). Further assessment plots for the models used in this paper are available on GitHub at https://github.com/tepmo42/cmip6_european_assessment (https://doi.org/10.5281/zenodo.782884, Palmer et al., 2023), as is a spreadsheet of all available assessments (for Europe) carried out for CMIP6 models to date. The RAPID-MOC monitoring project is funded by the Natural Environment Research Council and data (Frajka-Williams et al., 2021). E-OBS data (v.14.0, Cornes et al., 2018) can be found at https://www.ecad.eu/download/ensembles/download.php, in Cornes et al. (2018). The HadISST dataset (Rayner et al., 2003) is publicly available for download at https://www.metoffice.gov.uk/hadobs/hadisst/data/download.html. The ERA5 data (Hersbach et al., 2020) are available for download through the Copernicus Climate Change Service (2017) at https://cds.climate.copernicus.eu/cdsapp#!/home.We have created a performance-based assessment of CMIP6 models for Europe that can be used to inform the sub-selection of models for this region. Our assessment covers criteria indicative of the ability of individual models to capture a range of large-scale processes that are important for the representation of present-day European climate. We use this study to provide examples of how this performance-based assessment may be applied to a multi-model ensemble of CMIP6 models to (a) filter the ensemble for performance against these climatological and processed-based criteria and (b) create a smaller subset of models based on performance that also maintains model diversity and the filtered projection range as far as possible. Filtering by excluding the least-realistic models leads to higher-sensitivity models remaining in the ensemble as an emergent consequence of the assessment. This results in both the 25th percentile and the median of the projected temperature range being shifted towards greater warming for the filtered set of models. We also weight the unfiltered ensemble against global trends. In contrast, this shifts the distribution towards less warming. This highlights a tension for regional model selection in terms of selection based on regional climate processes versus the global mean warming trend.European Union Horizon 2020Deutsche Forschungsgemeinschaft (DFG)European Research Council (ERC

Study protocol: evaluation of a parenting and stress management programme: a randomised controlled trial of Triple P discussion groups and stress control

&lt;br&gt;Background: Children displaying psychosocial problems are at an increased risk of negative developmental outcomes. Parenting practices are closely linked with child development and behaviour, and parenting programmes have been recommended in the treatment of child psychosocial problems. However, parental mental health also needs to be addressed when delivering parenting programmes as it is linked with parenting practices, child outcomes, and treatment outcomes of parenting programmes. This paper describes the protocol of a study examining the effects of a combined intervention of a parenting programme and a cognitive behavioural intervention for mental health problems.&lt;/br&gt; &lt;br&gt;Methods: The effects of a combined intervention of Triple P Discussion Groups and Stress Control will be examined using a randomised controlled trial design. Parents with a child aged 3?8?years will be recruited to take part in the study. After obtaining informed consent and pre-intervention measures, participants will be randomly assigned to either an intervention or a waitlist condition. The two primary outcomes for this study are change in dysfunctional/ineffective parenting practices and change in symptoms of depression, anxiety, and stress. Secondary outcomes are child behaviour problems, parenting experiences, parental self-efficacy, family relationships, and positive parental mental health. Demographic information, participant satisfaction with the intervention, and treatment fidelity data will also be collected. Data will be collected at pre-intervention, mid-intervention, post-intervention, and 3-month follow-up.&lt;/br&gt; &lt;br&gt;Discussion: The aim of this paper is to describe the study protocol of a randomised controlled trial evaluating the effects of a combined intervention of Triple P Discussion Groups and Stress Control in comparison to a waitlist condition. This study is important because it will provide evidence about the effects of this combined intervention for parents with 3?8?year old children. The results of the study could be used to inform policy about parenting support and support for parents with mental health problems. Trial registration ClinicalTrial.gov: NCT01777724, UTN: U1111-1137-1053.&lt;/br&gt

DADA: data assimilation for the detection and attribution of weather and climate-related events

A new nudging method for data assimilation, delay‐coordinate nudging, is presented. Delay‐coordinate nudging makes explicit use of present and past observations in the formulation of the forcing driving the model evolution at each time step. Numerical experiments with a low‐order chaotic system show that the new method systematically outperforms standard nudging in different model and observational scenarios, also when using an unoptimized formulation of the delay‐nudging coefficients. A connection between the optimal delay and the dominant Lyapunov exponent of the dynamics is found based on heuristic arguments and is confirmed by the numerical results, providing a guideline for the practical implementation of the algorithm. Delay‐coordinate nudging preserves the easiness of implementation, the intuitive functioning and the reduced computational cost of the standard nudging, making it a potential alternative especially in the field of seasonal‐to‐decadal predictions with large Earth system models that limit the use of more sophisticated data assimilation procedures