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The use of kidneys from controlled donation after circulatory death (DCD) donors has the potential to markedly increase kidney transplants performed. However, this potential is not being realized because of concerns that DCD kidneys are inferior to those from donation after brain-death (DBD) donors. The United Kingdom has developed a large and successful controlled DCD kidney transplant program that has allowed for a substantial increase in kidney transplant numbers. Here we describe recent trends in DCD kidney donor activity in the United Kingdom, outline aspects of the donation process, and describe donor selection and allocation of DCD kidneys. Previous UK Transplant Registry analyses have shown that while DCD kidneys are more susceptible to cold ischemic injury and have a higher incidence of delayed graft function, short- and medium-term transplant outcomes are similar in recipients of kidneys from DCD and DBD donors. We present an updated, extended UK registry analysis showing that longer-term transplant outcomes in DCD donor kidneys are also similar to those for DBD donor kidneys, and that transplant outcomes for kidneys from expanded-criteria DCD donors are no less favorable than for expanded-criteria DBD donors. Accordingly, the selection criteria for use of kidneys from DCD donors should be the same as those used for DBD donors. The UK experience suggests that wider international development of DCD kidney transplantation programs will help address the global shortage of deceased donor kidneys for transplantation.

The acceleration of sea-level rise continues, but this has not been clear in the short altimeter record. This study closes the sea-level rise budget for 1993–2014 and illustrates the increased contribution from the Greenland ice sheet. Global mean sea level (GMSL) has been rising at a faster rate during the satellite altimetry period (1993–2014) than previous decades, and is expected to accelerate further over the coming century 1 . However, the accelerations observed over century and longer periods 2 have not been clearly detected in altimeter data spanning the past two decades 3 , 4 , 5 . Here we show that the rise, from the sum of all observed contributions to GMSL, increases from 2.2 ± 0.3 mm yr −1 in 1993 to 3.3 ± 0.3 mm yr −1 in 2014. This is in approximate agreement with observed increase in GMSL rise, 2.4 ± 0.2 mm yr −1 (1993) to 2.9 ± 0.3 mm yr −1 (2014), from satellite observations that have been adjusted for small systematic drift, particularly affecting the first decade of satellite observations 6 . The mass contributions to GMSL increase from about 50% in 1993 to 70% in 2014 with the largest, and statistically significant, increase coming from the contribution from the Greenland ice sheet, which is less than 5% of the GMSL rate during 1993 but more than 25% during 2014. The suggested acceleration and improved closure of the sea-level budget highlights the importance and urgency of mitigating climate change and formulating coastal adaption plans to mitigate the impacts of ongoing sea-level rise.

To the Editor: B-cell depletion is an effective treatment for a number of autoimmune diseases in which B cells were not previously considered to be important, such as multiple sclerosis. 1 In renal transplantation, acute cellular rejection has been viewed as a T-cell–dependent process, but B cells are required for alloantibody production and may also play other roles, including alloantigen presentation to T cells. 2 Published data on the use of B-cell depletion at induction in nonsensitized patients undergoing organ transplantation are lacking. We conducted an open-label, randomized, controlled trial comparing rituximab, a B-cell–depleting, chimeric, anti-CD20 monoclonal antibody, with an anti-CD25 monoclonal . . .

Intensive management of urban lawns is globally widespread, predominantly for aesthetic reasons. However, a growing body of knowledge demonstrates negative ecological and environmental effects of this practice. We present a meta‐analysis of North American and European studies from 2004 to 2019, which incorporates three previously unpublished datasets from eastern Canada, to investigate how mowing intensity impacts the ecology of urban lawns. The meta‐analysis provides aggregated evidence that invertebrate and plant diversity is lower in urban lawns under increased mowing intensity. This decline is independent of the level of contrast between mowing ‘treatment’ and ‘control’ (e.g. height or frequency of mowing), which differed considerably between studies. Intensive mowing also increases the occurrence of pest species (e.g. herbivorous beetle larvae and allergenic plants), though studies in this group were limited to northern environments. Changes in ecosystem‐level variables (soil temperature, soil moisture deficit and carbon deficit) were less evident and suggest changes in abiotic processes may take longer to become apparent. An economic case study of the mowing costs in Trois‐Rivières, Canada, suggests that cost savings of 36% may be possible with a modest reduction of mowing frequency. Synthesis and Applications. Increasing urban biodiversity and reducing greenhouse gas emissions are strong motivators for reducing lawn management intensity. We also suggest that the benefits of reducing pest species while saving lawn management costs may provide additional social and economic incentives for decision makers to review urban greenspace management practices. Increasing urban biodiversity and reducing greenhouse gas emissions are strong motivators for reducing lawn management intensity. We also suggest that the benefits of reducing pest species while saving lawn management costs may provide additional social and economic incentives for decision makers to review urban greenspace management practices.

Use of kidneys donated after controlled circulatory death has increased the number of transplants undertaken in the UK but there remains reluctance to use kidneys from older circulatory-death donors and concern that kidneys from circulatory-death donors are particularly susceptible to cold ischaemic injury. We aimed to compare the effect of donor age and cold ischaemic time on transplant outcome in kidneys donated after circulatory death versus brain death. We used the UK transplant registry to select a cohort of first-time recipients (aged ≥18 years) of deceased-donor kidneys for transplantations done between Jan 1, 2005, and Nov 1, 2010. We did univariate comparisons of transplants from brain-death donors versus circulatory-death donors with χ2 tests for categorical data and Wilcoxon tests for non-parametric continuous data. We used Kaplan-Meier curves to show graft survival. We used Cox proportional hazards regression to adjust for donor and recipient factors associated with graft-survival with tests for interaction effects to establish the relative effect of donor age and cold ischaemia on kidneys from circulatory-death and brain-death donors. 6490 deceased-donor kidney transplants were done at 23 centres. 3 year graft survival showed no difference between circulatory-death (n=1768) and brain-death (n=4127) groups (HR 1·14, 95% CI 0·95–1·36, p=0·16). Donor age older than 60 years (compared with <40 years) was associated with an increased risk of graft loss for all deceased-donor kidneys (2·35, 1·85–3·00, p<0·0001) but there was no increased risk of graft loss for circulatory-death donors older than 60 years compared with brain-death donors in the same age group (p=0·30). Prolonged cold ischaemic time (>24 h vs <12 h) was not associated with decreased graft survival for all deceased-donor kidneys but was associated with poorer graft survival for kidneys from circulatory-death donors than for those from brain-death donors (2·36, 1·39–4·02, p for interaction=0·004). Kidneys from older circulatory-death donors have equivalent graft survival to kidneys from brain-death donors in the same age group, and are acceptable for transplantation. However, circulatory-death donor kidneys tolerate cold storage less well than do brain-death donor kidneys and this finding should be considered when developing organ allocation policy. UK National Health Service Blood and Transplant; Cambridge National Institute for Health Research Biomedical Research Centre.

We present the development of a low-cost Unmanned Aerial Vehicle-Light Detecting and Ranging (UAV-LiDAR) system and an accompanying workflow to produce 3D point clouds. UAV systems provide an unrivalled combination of high temporal and spatial resolution datasets. The TerraLuma UAV-LiDAR system has been developed to take advantage of these properties and in doing so overcome some of the current limitations of the use of this technology within the forestry industry. A modified processing workflow including a novel trajectory determination algorithm fusing observations from a GPS receiver, an Inertial Measurement Unit (IMU) and a High Definition (HD) video camera is presented. The advantages of this workflow are demonstrated using a rigorous assessment of the spatial accuracy of the final point clouds. It is shown that due to the inclusion of video the horizontal accuracy of the final point cloud improves from 0.61 m to 0.34 m (RMS error assessed against ground control). The effect of the very high density point clouds (up to 62 points per m2) produced by the UAV-LiDAR system on the measurement of tree location, height and crown width are also assessed by performing repeat surveys over individual isolated trees. The standard deviation of tree height is shown to reduce from 0.26 m, when using data with a density of 8 points perm2, to 0.15mwhen the higher density data was used. Improvements in the uncertainty of the measurement of tree location, 0.80 m to 0.53 m, and crown width, 0.69 m to 0.61 m are also shown.

Unmanned Aerial Vehicles (UAVs) are an exciting new remote sensing tool capable of acquiring high resolution spatial data. Remote sensing with UAVs has the potential to provide imagery at an unprecedented spatial and temporal resolution. The small footprint of UAV imagery, however, makes it necessary to develop automated techniques to geometrically rectify and mosaic the imagery such that larger areas can be monitored. In this paper, we present a technique for geometric correction and mosaicking of UAV photography using feature matching and Structure from Motion (SfM) photogrammetric techniques. Images are processed to create three dimensional point clouds, initially in an arbitrary model space. The point clouds are transformed into a real-world coordinate system using either a direct georeferencing technique that uses estimated camera positions or via a Ground Control Point (GCP) technique that uses automatically identified GCPs within the point cloud. The point cloud is then used to generate a Digital Terrain Model (DTM) required for rectification of the images. Subsequent georeferenced images are then joined together to form a mosaic of the study area. The absolute spatial accuracy of the direct technique was found to be 65–120 cm whilst the GCP technique achieves an accuracy of approximately 10–15 cm.

Introduction Intimate partner violence (IPV) and depression are global health concerns with high prevalence rates and substantial negative impacts on individuals and the wider community. Women are particularly vulnerable to both IPV victimization and depressive disorders, and both are recognized worldwide as priorities for women's health. The aim of this systematic review and meta‐analysis was to determine whether recent longitudinal empirical evidence supports exposure to IPV as a contributing factor to the subsequent onset of depression in women. Methods A search was performed in August 2024 of the Medline, PsychInfo, and EBSCOHost databases for longitudinal studies published after the year 2013, and 1193 studies were identified. Studies were included if they were written in English and measured IPV as an independent variable with depression as a dependent variable. Studies were excluded if depression was not measured separately from other variables or did not report primary quantitative data. Eleven studies with 118,544 female participants met the inclusion criteria for review. Results Ten of the 11 reviewed studies reported a statistically significant positive association between exposure to IPV and depression in women. A random effects meta‐analysis was used to generate pooled odds ratios from nine estimates, which demonstrated that female IPV survivors have significantly increased odds of developing subsequent depression (OR = 1.92, (95% CI: 1.28, 2.86); although, there was high heterogeneity across studies (I2 = 98.3%, p < 0.001). Ten of the 11 studies were from high‐income, industrialized countries, which limits the global application of these findings. Conclusions These findings suggest that IPV may be one of many contributing factors for depression in women. However, variability in the definition of IPV and inconsistent adjustment for confounders across studies limits firm conclusions. The findings of this review suggest that strategies to prevent IPV could play a role in reducing the prevalence of depression. They also support the inclusion of depression screening for survivors of IPV in clinical approaches and a review of the effectiveness of IPV‐related depression intervention strategies. The aim of this systematic review and meta‐analysis was to determine whether recent longitudinal empirical evidence supports exposure to intimate partner violence as a contributing factor to the subsequent onset of depression in women. Findings suggest a positive association; however, high heterogeneity across studies limits firm conclusions.

Background Liver disease is the third leading cause of premature death in the UK. Transplantation is the only successful treatment for end-stage liver disease but is limited by a shortage of suitable donor organs. As a result, up to 20% of patients on liver transplant waiting lists die before receiving a transplant. A third of donated livers are not suitable for transplant, often due to steatosis. Hepatic steatosis, which affects 33% of the UK population, is strongly associated with obesity, an increasing problem in the potential donor pool. We have recently tested defatting interventions during normothermic machine perfusion (NMP) in discarded steatotic human livers that were not transplanted. A combination of therapies including forskolin (NKH477) and L-carnitine to defat liver cells and lipoprotein apheresis filtration were investigated. These interventions resulted in functional improvement during perfusion and reduced the intrahepatocellular triglyceride (IHTG) content. We hypothesise that defatting during NMP will allow more steatotic livers to be transplanted with improved outcomes. Methods In the proposed multi-centre clinical trial, we will randomly assign 60 livers from donors with a high-risk of hepatic steatosis to either NMP alone or NMP with defatting interventions. We aim to test the safety and feasibility of the defatting intervention and will explore efficacy by comparing ex-situ and post-reperfusion liver function between the groups. The primary endpoint will be the proportion of livers that achieve predefined functional criteria during perfusion which indicate potential suitability for transplantation. These criteria reflect hepatic metabolism and injury and include lactate clearance, perfusate pH, glucose metabolism, bile composition, vascular flows and transaminase levels. Clinical secondary endpoints will include proportion of livers transplanted in the two arms, graft function; cell-free DNA (cfDNA) at follow-up visits; patient and graft survival; hospital and ITU stay; evidence of ischemia-reperfusion injury (IRI); non-anastomotic biliary strictures and recurrence of steatosis (determined on MRI at 6 months). Discussion This study explores ex-situ pharmacological optimisation of steatotic donor livers during NMP. If the intervention proves effective, it will allow the safe transplantation of livers that are currently very likely to be discarded, thereby reducing waiting list deaths. Trial registration ISRCTN ISRCTN14957538. Registered in October 2022.

The Surface Water and Ocean Topography (SWOT) mission offers new insights into submesoscale ocean processes. Realizing this requires careful consideration of other geophysical signals such as the signal delay induced by water vapor in the troposphere. Over short spatial scales (<∼80 km), this signal is not well‐captured by radiometer observations. Here we investigate the wet troposphere in Australian coastal regions during SWOT's 3‐month calibration phase. Using a high‐resolution atmospheric model and a novel in situ array of GNSS observations, we find the SWOT error budget for wet troposphere is regularly exceeded, with signal magnitudes up to double the error budget at small scales. We also find centimeter level biases in radiometer derived delays within ∼50 km of the coast. We suggest that, given the low radar noise and high resolution of SWOT KaRIn observations, wet troposphere errors can bias geophysical interpretation and hence have increased significance for ocean topography. Plain Language Summary The new Surface Water and Ocean Topography (SWOT) mission is the first satellite altimeter to observe changes in the height of the sea surface over broad swaths at high resolution. To obtain high accuracy measurements various corrections are needed for the raw radar measurements. One of the required corrections accounts for the water vapor in the atmosphere which delays the radar signal. Although SWOT sea surface measurements are at high resolution, the correction available for the water vapor in the atmosphere is at a lower resolution, which could possibly affect interpretation of SWOT observations. Here we use a high‐resolution atmospheric model and a set of GNSS buoys to investigate the variations of atmospheric water vapor over shorter distances in Australian coastal waters. We find that the variation is higher than the SWOT error budget and that a higher‐resolution correction for moisture in the atmosphere is often needed to ensure the correct interpretation of SWOT observations. Key Points A GNSS buoy array and high‐resolution atmospheric model are used to assess small scale wet troposphere signals near the coast Tropospheric signal over <80 km scales is shown to exceed the Surface Water and Ocean Topography wet troposphere error budget in the coastal domain The impact of small scale troposphere signals on submesoscale interpretation is important to consider for wide swath altimetry missions