Voluntary No. 7 - Organ

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More By Giuseppe Galante

A lmost 40 years ago, I interviewed a charming year-old girl who was on dialysis — or a kidney machine, as it was quaintly called then. My newspaper was backing a campaign to increase the then paltry number of people carrying donor cards. Her operation came in , thanks to a kidney from a year-old man who had died in Leeds of a head injury. We later lost touch. Ever wondered why you feel so gloomy about the world - even at a time when humanity has never been this healthy and prosperous?


Could it be because news is almost always grim, focusing on confrontation, disaster, antagonism and blame? This series is an antidote, an attempt to show that there is plenty of hope, as our journalists scour the planet looking for pioneers, trailblazers, best practice, unsung heroes, ideas that work, ideas that might and innovations whose time might have come.

Readers can recommend other projects, people and progress that we should report on by contacting us at theupside theguardian. But recently I thought I would try to find out how long Claire, with her eminently Google-able name, had survived after the transplant. The answer was uplifting. Not only was she very much alive 38 years on, but she is now Dr Claire Corps, a senior researcher in transplant medicine, and a key member of staff at the hospital that saved her life. Corps has several academic papers to her name and lectures around the world. She sits on five official medical committees at national level — and is helping develop a new way of preserving donor organs pre-transplant for much longer than is currently possible.

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If you have fixed a notation mistake, then we would be grateful if you could inform us as such. Please indicate here which file and what have you improved. View more. Similar compositions. Series: Operas, Theme: 0-miscellaneous. Orchestration: Organ, Difficulty: medium. Adagio in G-minor edit. Albinoni, Tomaso.

William Goodwin (? - 1784): Voluntary No. 7 in G major (Little Waldingfield)

Air "on the G String", arr. Series: Suites, Theme: 0-miscellaneous. Series: Individual Works, Theme: 0-miscellaneous. Series: Dances, Theme: 0-miscellaneous. Organ Concerto No. There are two points at which the number of registered volunteers increased significantly, at the end of and Growth in volunteers was modest and gradual through , before doubling at the end of the year with an increase of 88, in a 6-day period.

Subsequently through the total consistently increased at a rate far in excess of rates during previous years. Subsequent to the incorporation of COTRS into our analysis, Red Cross officials released the total for deceased donors, which had the value of We note that the final figure, , is extremely close to the value predicted by Dr. When the two datasets are compared to one another, they are found to diverge in important respects, and in ways that do not accord with official explanations of how the datasets are generated. There are two forms of divergence: discrepancies in donors and discrepancies in number of organs transplanted.

The number of donors in the two datasets differs slightly until end , when they converge; the number of organs transplanted is the opposite, with the figures corresponding at the beginning of before diverging at the beginning of The gap is to be expected, given that COTRS data included only deceased liver and kidney transplants, whereas Red Cross data covers all solid organ transplants, including hearts and lungs.

This is a significant inconsistency between the two datasets. While the analyzed transplant data presented in this manuscript raises severe doubts about the veracity of the claims of ethical reform in China, it is important to highlight qualitative indications that some hospitals in China are clearly engaged in the lifesaving work of voluntary organ procurement, allocation, and transplantation.

On December 31, , Shanghai reported its th voluntary deceased donor. A television documentary featured the case of the th donor in the city, whose organs were procured at Huashan Hospital in November ; 40 doctors were involved in the procurement of organs from the donor; family members, doctors, and nurses were all interviewed [ 43 ]. Wuhan Tongji Hospital in Hubei Province reported the establishment of a full-time post for a transplant coordinator from January , outlining the curriculum, the hours studied, the day to day work, and the increase in donations that resulted: from 98 donors in , to in [ 44 ].

Wuhan Tongji is one of the most advanced transplant hospitals in China, having acquired organs from brain dead donors since [ 45 ]. Modest success in organ transplant reform at a few key hospitals, however, is not all that Chinese medical officials have claimed. They have claimed a revolution in transplant practice across the country, with numbers of allegedly voluntary deceased donors growing at geometric rates and the cessation of all sourcing of organs from prisoners.

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It is these claims that are assessed in this report. The management of a voluntary organ donation, allocation, and transplantation system involves a highly complex set of processes and interactions between thousands of individuals at hundreds of locations over many years.

Almost all instances of donation first require the occurrence of a brain injury, the diagnosis of brain death, the absence in the donor of numerous disqualifying diseases or contraindicating medications, preservation of the donor, gaining consent from the family to donate, blood and tissue typing, crossmatching, location of the recipient through COTRS , their rapid conveyance to the hospital, multiple organ procurements, and then transplantations by separate medical teams. In many cases each donor triggers activities requiring the coordination of multiple hospitals.

In China at the time of this study, hospitals are licensed to perform voluntary donations, with thousands of doctors, nurses, and support staff, in a country of 1. Moreover, during the years in question the donation system was still being constructed.

Doctors were being trained in the new diagnostic criteria for brain or circulatory deaths, nurses were being trained as transplantation coordinators, the public was being educated in the need to donate, families were making culturally difficult decisions about the disposition of the bodies of their deceased relatives, and the infrastructure for connecting potential donors with recipients, transplant teams, and other hospitals, was still being built.

Genuine data generated from a complex, growing system with all the above caveats is not expected to exhibit such a sustained, extremely smooth growth curve. Thus, the fundamental behavior of the Chinese data — not just the rapid growth rate in transplants it depicts — is qualitatively different to every other country for which there is comparable data.

We propose that the most plausible explanation for the COTRS data is manual and deliberate manipulation in order to fit a target donor rate, with a mathematical function selected as the most efficient way to both 1 reach this goal in an apparently natural manner, and 2 provide a common reference and guide for derivative data through the Chinese system. It is the exquisite precision of the fit of the data to the Procrustean Bed of a smooth mathematical formula that we believe rules out competing explanations. A unique window of opportunity for the testing of our initial hypothesis was opened when Chinese authorities published updated COTRS data in July The statistical analysis of COTRS data demonstrates that the extra datapoint strengthens the initial hypothesis of data falsification.

Stanley Trumpet Voluntary for D Trumpet & Organ (Pro-version) - PDF

While we are aware that a range of values for would be in conformance with the model, it is highly significant that the value that did appear — — allowed for a major simplification and therefore strengthened the hypothesis of a mathematical model being used. This model simplification significantly increases the leverage of the argument that the data was not generated from real world transplant activity.

In the Results, we further asked: how surprising is it that b and c should become so insignificant? Would this have happened for other values, or is in some sense special? The resulting graph Fig. We extended the analysis yet further, probing whether the power function also appeared to be the result of a manmade mathematical model. Thus, we fitted a.

Ten Voluntaries for Organ (or Harpsichord), Op.7

The simpler the model required to explain the data, the more difficult it becomes to argue that it was generated through a random and complex series of organ donation and transplantation events — and the stronger the leverage in the argument that the data was in fact generated by a simple model in the first place.

The Red Cross data was found to remain consistent with a quadratic formula. Data from the China Organ Donation Administration Center, managed by the Red Cross Society of China, is supposed to provide third party witness to and registration of every voluntary transplant. It contains five identified internal anomalies, at least three of which we believe are extremely difficult to explain without human-directed manipulation of the dataset.

Tissues, organs, & organ systems

Anomaly A1, where only the date but not the data was updated between April 23 and 30 on china-organdonation. It could be interpreted in multiple ways. On its face, if the codac. Or, again disregarding the conflicting data, it could be that the date change was merely a clerical error. Alternatively, the April 23 www. We have no way of adjudicating between these possibilities, though we believe the accrual of such anomalies speaks to data integrity problems.

Anomalies B, C, and D, while potentially having innocent explanations, have the effect of vectoring the internal relationship in the data for transplants per donor back to an arbitrary ratio of 2. Anomaly C is the most remarkable, in which for a day period in March , the dataset reports that This anomaly cannot be discounted, because each subsequent cumulative number has built into it this clearly impossible figure.

While these anomalies now appear obvious, it is understandable that they have not been discovered until now, as the Central Red Cross data did not previously exist in a series. It is only after the full series was captured, archived, logged, and analyzed that these anomalies revealed themselves. The extraordinary growth in registered volunteer donors also raises questions. Given the paucity of data on this at the local level, no other metric exists with which to compare the figures, and thus they cannot be invalidated outright.

These two sudden changes to the data raise questions about the integrity of the series. Collectively, we maintain that these apparent human-directed alterations of the Central Red Cross data are consistent with the contention that, like the COTRS dataset, the data was not formed by the accretion of individual cases of successful voluntary organ donation and allocation, but instead was manually manipulated to fit the formula-derived COTRS master version, albeit with imperfect results.

The comparison between the two datasets revealed two important discoveries. The first is that, in confirmation of official statements, they tend to have identical numbers of donors. Although this is not the case for several years, for reasons detailed later, the convergence is very close by the end of with a discrepancy of 54 donors and identical by the end of , where the Central Red Cross database is updated to donors on the last day of the year, in line with COTRS.

Thus, by end the datasets are in agreement to the day. In contrast, the number of transplanted organs diverges, even after adding the national heart and lung transplants, which are not reported in the COTRS data. There is an inexplicable gap of transplants for the year A potential explanation for this gap that preserves the integrity of the data would be that it is filled by other solid organs — pancreatic and small intestine transplants.

This explanation does not appear to hold, however. While data on transplants of these organs in China is difficult to come by, according to a Chinese medical paper, only pancreas transplants had been performed since [ 48 ]. The vast majority, if not all of these, would have used organs from prisoner sources. Small intestine transplants are far rarer still. There is no subsequent data suggesting that pancreas transplants increased at the extremely high rate that would have been required to close the gap between the Red Cross and COTRS datasets, in particular under the more constrained conditions of voluntary donor sourcing.

Thus, the gap in reports of the transplanted organs remains.