Utility of image-guided external ventriculostomy: analysis of contemporary practice in the United Kingdom and Ireland

2021 ◽  
pp. 1-9
Author(s):  
Aaron Lawson McLean ◽  
Aimun A. B. Jamjoom ◽  
Michael T. C. Poon ◽  
Difei Wang ◽  
Isaac Phang ◽  
...  
Keyword(s):  
United Kingdom ◽  
Image Guidance ◽  
External Ventricular Drain ◽  
Tertiary Care ◽  
Data Set ◽  
Image Guided ◽  
The United Kingdom ◽  
Catheter Malfunction ◽  
Catheter Tip ◽  
The Impact

OBJECTIVEFreehand external ventricular drain (EVD) insertion is associated with a high rate of catheter misplacement. Image-guided EVD placement with neuronavigation or ultrasound has been proposed as a safer, more accurate alternative with potential to facilitate proper placement and reduce catheter malfunction risk. This study aimed to determine the impact of image-guided EVD placement on catheter tip position and drain functionality.METHODSThis study is a secondary analysis of a data set from a prospective, multicenter study. Data were collated for EVD placements undertaken in the United Kingdom and Ireland from November 2014 to April 2015. In total, 21 large tertiary care academic medical centers were included.RESULTSOver the study period, 632 EVDs were inserted and 65.9% had tips lying free-floating in the CSF. Only 19.6% of insertions took place under image guidance. The use of image guidance did not significantly improve the position of the catheter tip on postoperative imaging, even when stratified by ventricular size. There was also no association between navigation use and drain blockage.CONCLUSIONSImage-guided EVD placement was not associated with an increased likelihood of achieving optimal catheter position or with a lower rate of catheter blockage. Educational efforts should aim to enhance surgeons’ ability to apply the technique correctly in cases of disturbed cerebral anatomy or small ventricles to reduce procedural risks and facilitate effective catheter positioning.

Euratom and Brexit: Could the United Kingdom Maintain One Foot in the European Union? Current Scenarios and Future Prospects of British withdrawal from the EAEC

2018 ◽  
Vol 18 (2) ◽  
pp. 134-151
Author(s):  
Andrea Circolo ◽  
Ondrej Hamuľák
Keyword(s):  
European Union ◽  
United Kingdom ◽  
Independent Solution ◽  
Legal Regulation ◽  
The European Union ◽  
The United Kingdom ◽  
The Status ◽  
Long Time ◽  
Energy Community ◽  
The Impact

Abstract The paper focuses on the very topical issue of conclusion of the membership of the State, namely the United Kingdom, in European integration structures. The ques­tion of termination of membership in European Communities and European Union has not been tackled for a long time in the sources of European law. With the adop­tion of the Treaty of Lisbon (2009), the institute of 'unilateral' withdrawal was intro­duced. It´s worth to say that exit clause was intended as symbolic in its nature, in fact underlining the status of Member States as sovereign entities. That is why this institute is very general and the legal regulation of the exercise of withdrawal contains many gaps. One of them is a question of absolute or relative nature of exiting from integration structures. Today’s “exit clause” (Art. 50 of Treaty on European Union) regulates only the termination of membership in the European Union and is silent on the impact of such a step on membership in the European Atomic Energy Community. The presented paper offers an analysis of different variations of the interpretation and solution of the problem. It´s based on the independent solution thesis and therefore rejects an automa­tism approach. The paper and topic is important and original especially because in the multitude of scholarly writings devoted to Brexit questions, vast majority of them deals with institutional questions, the interpretation of Art. 50 of Treaty on European Union; the constitutional matters at national UK level; future relation between EU and UK and political bargaining behind such as all that. The question of impact on withdrawal on Euratom membership is somehow underrepresented. Present paper attempts to fill this gap and accelerate the scholarly debate on this matter globally, because all consequences of Brexit already have and will definitely give rise to more world-wide effects.

397 Intra-tumor immunotherapy injections utilizing image guidance in interventional radiology: clinical trial experience at a tertiary care cancer center

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A422-A422
Author(s):  
Ravi Murthy ◽  
Rahul Sheth ◽  
Alda Tam ◽  
Sanjay Gupta ◽  
Vivek Subbiah ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Interventional Radiology ◽  
Real Time ◽  
Image Guidance ◽  
Tertiary Care ◽  
Cancer Center ◽  
Imaging Guidance ◽  
Image Guided ◽  
Real Time Image ◽  
Time Image

BackgroundImage guided intra-tumor administration of investigational immunotherapeutic agents represents an expanding field of interest. We present a retrospective review of the safety, feasibility & technical nuances of real-time image guidance for injection & biopsy across a spectrum of extracranial solid malignancies utilizing the discipline of Interventional Radiology.MethodsPatients who were enrolled in image guided intratumoral immunotherapy injection (ITITI) clinical trials over a 6 year period (2013–19) at a single tertiary care cancer center were included in this analysis. Malignancy, location, imaging guidance utilized for ITITI & biopsy for injected (adscopal) & non-injected (abscopal) lesions were determined and categorized. Peri-procedural adverse events were noted.Results262 pts (146 female, 61 yrs median) participating in 29 immunotherapeutic clinical trials (TLR & STING agonists, gene therapy, anti CD-40, viral/bacterial/metabolic oncolytics) met study criteria. Malignancies included melanoma 88, sarcoma 32, colorectal 29, breast 23, lung 17, head & neck 15, ovarian 8, neuroendocrine 7, pancreatic adenocarcinoma 6, 3 each (cholangioCA, endometrial, bladder, GI tract), 2 each (RCC, thymicCA, lymphoma, merkel cell, prostate) & others 1 each (CUP, GIST, dermatofibrosarcoma, DSRT, neuroblastoma, thyroid). All 169 & 93 patients received the intended 1371 ITITI in parietal (abdominal/chest wall, extremity, neck, pelvis) or visceral (liver, lung, peritoneum, adrenal) locations respectively; 83 patients received lymph node injections within either location. Imaging guidance was US in 68% of the cohort (US 161, CT+US 19); CT was used in 30% (81) & MRI in 1 patient. Median diameter of the ITITI lesion was 32 mm (8–230 mm). Median volume of the ITITI therapeutic material/session was 2 ml (1–6.9 ml). Lesions were accessed using a coaxial technique. ITITI delivery needles used at operator preference & tailored to lesion characteristics were either a 21G/22G Chiba, 21G Profusion (Cook Medical), 22G Morrison (AprioMed), 25G hypodermic (BD) & 18G Quadrafuse (Rex Medical). 2840 core biopsies (>18G Tru-cut core, Mission, Bard Medical) were performed in 237 patients during 690 procedures; biopsy sessions were often concurrent & of the ITITI site. 137 patients also underwent biopsy of a non-ITITI site (89 parietal location). Dimensions of the non-ITITI lesion were median 10 mm (7–113 mm); US image guidance was used in 97 patients (72%) to obtain a total of 1257, >18G Tru-core samples. 1.3% of injections resulted in SAE (NCI CTC AE >3) and 0.5% of 4097 biopsies developed major complications (SIR Criteria); both categories were manageable.ConclusionsUtilizing real time image guidance, ITITI to the administration of a myriad of investigational immunotherapeutic agents with concomitant biopsy procedures to date are associated with a high technical success rate & favorable safety profile.AcknowledgementsJoshua Hein, Mara Castaneda, Jyotsna Pera, Yunfang Jiang,Shuang Liu, Holly Liu and Anna LuiTrial RegistrationN/AEthics ApprovalThe study was approved by Institution’s Ethics Board, approval number 2020-0536: A retrospective study to determine the safety, feasibility and technical challenges of real-time image guidance for intra-tumor injection and biopsy across multiple solid tumors.Consent2020-0536 Waiver of Informed ConsentReferenceSheth RA, Murthy R, Hong DS, et al. Assessment of image-guided intratumoral delivery of immunotherapeutics in patients with cancer. JAMA Netw Open 2020;3(7):e207911. doi:10.1001/jamanetworkopen.2020.7911

Data protection and passenger name record in judicial criminal matters under the EU–UK Trade and Cooperation Agreement

2021 ◽  
pp. 203228442199492
Author(s):  
Catherine Van de Heyning
Keyword(s):  
United Kingdom ◽  
Data Protection ◽  
Personal Data ◽  
Cooperation Agreement ◽  
Judicial Cooperation ◽  
The United Kingdom ◽  
Record Data ◽  
Criminal Matters ◽  
The Impact ◽  
The Eu

The submission discusses the provisions in the EU–UK Trade and Cooperation Agreement on data protection as well as the consequences for the exchange of passenger name record data in the field of criminal and judicial cooperation. The author concludes that the impact of the Agreement will depend on the resolvement of the United Kingdom to uphold the standards of protection of personal data equivalent to the EU’s in order to reach an adequacy decision.

scholarly journals The impact of the COVID-19 pandemic on the mental health of young people: A comparison between China and the United Kingdom

2021 ◽  
Author(s):  
Ming-Bo Liu ◽  
Géraldine Dufour ◽  
Zhuo-Er Sun ◽  
Julieta Galante ◽  
Chen-Qi Xing ◽  
...  
Keyword(s):  
Mental Health ◽  
United Kingdom ◽  
Young People ◽  
The United Kingdom ◽  
The Impact

scholarly journals Do Environmental Stringency Policies and Human Development Reduce CO2 Emissions? Evidence from G7 and BRICS Economies

2021 ◽  
Vol 18 (13) ◽  
pp. 6727
Author(s):  
Funda Hatice Sezgin ◽  
Yilmaz Bayar ◽  
Laura Herta ◽  
Marius Dan Gavriletea
Keyword(s):  
United States ◽  
United Kingdom ◽  
Human Development ◽  
Co2 Emissions ◽  
United States Of America ◽  
The United States ◽  
Cointegration Analysis ◽  
Causality Analysis ◽  
The United Kingdom ◽  
The Impact

This study explores the impact of environmental policies and human development on the CO2 emissions for the period of 1995–2015 in the Group of Seven and BRICS economies in the long run through panel cointegration and causality tests. The causality analysis revealed a bilateral causality between environmental stringency policies and CO2 emissions for Germany, Japan, the United Kingdom, and the United States of America, and a unilateral causality from CO2 emissions to the environmental stringency policies for Canada, China, and France. On the other hand, the analysis showed a bilateral causality between human development and CO2 emissions for Germany, Japan, the United Kingdom, and the United States of America, and unilateral causality from CO2 emissions to human development in Brazil, Canada, China, and France. Furthermore, the cointegration analysis indicated that both environmental stringency policies and human development had a decreasing impact on the CO2 emissions.

The Covid-19 lockdown in the United Kingdom and subjective well-being: Have the self-employed suffered more due to hours and income reductions?

2021 ◽  
pp. 026624262098676 ◽  
Author(s):  
Wei Yue ◽  
Marc Cowling
Keyword(s):  
United Kingdom ◽  
Rare Events ◽  
Well Being ◽  
The Self ◽  
Subjective Well Being ◽  
Data Set ◽  
The United Kingdom ◽  
Hours Of Work ◽  
Period Data ◽  
The Uk

It is well documented that the self-employed experience higher levels of happiness than waged employees even when their incomes are lower. Given the UK government’s asymmetric treatment of waged workers and the self-employed, we use a unique Covid-19 period data set which covers the months leading up to the March lockdown and the months just after to assess three aspects of the Covid-19 crisis on the self-employed: hours of work reductions, the associated income reductions and the effects of both on subjective well-being. Our findings show the large and disproportionate reductions in hours and income for the self-employed directly contributed to a deterioration in their levels of subjective well-being compared to waged workers. It appears that their resilience was broken when faced with the reality of dealing with rare events, particularly when the UK welfare support response was asymmetric and favouring waged employees.

A National Treasure? The Role of Civil Society in Promoting and Enforcing Human Rights in the United Kingdom

2020 ◽  
Author(s):  
Harriet Samuels
Keyword(s):  
Human Rights ◽  
United Kingdom ◽  
Civil Society ◽  
Negative Attitude ◽  
Civil Society Organizations ◽  
Economic Rights ◽  
The United Kingdom ◽  
The Impact ◽  
Social And Economic Rights

Abstract The article investigates the negative attitude towards civil society over the last decade in the United Kingdom and the repercussions for human rights. It considers this in the context of the United Kingdom government’s implementation of the policy of austerity. It reflects on the various policy and legal changes, and the impact on the campaigning and advocacy work of civil society organizations, particularly those that work on social and economic rights.

"The Queen has been dreadfully shocked": aspects of teaching experimental physiology using animals in Britain, 1876-1986.

1998 ◽  
Vol 274 (6) ◽  
pp. S18
Author(s):  
E M Tansey
Keyword(s):  
United Kingdom ◽  
Case Studies ◽  
Undergraduate Students ◽  
Animal Experimentation ◽  
Archival Data ◽  
The United Kingdom ◽  
Legislative Control ◽  
The Impact

Animal experimentation has been subject to legislative control in the United Kingdom since 1876. This paper reviews the impact of that legislation, which was replaced in 1986, on the teaching of practical physiology to undergraduate students. Highlights and case studies are also presented, drawing on Government reports and statistics, published books and papers, and unpublished archival data.

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