106 research outputs found
Customary law before the Conquest
No full textAn article on early English legal history
and customary law by Professor Derek Roebuck (Associate Senior
Research Fellow, IALS). The article is taken from a lecture given
by the author at the Institute of Advanced Legal Studies on
February 1, 2006 and was published in Amicus Curiae – Journal of
the Society for Advanced Legal Studies at the Institute of
Advanced Legal Studies. The Journal is produced by SALS at the
IALS (Institute of Advanced Legal Studies, School of Advanced
Study, University of London)
Customary law before the Conquest
No full textAn article on early English legal history and customary law by Professor Derek Roebuck (Associate Senior Research Fellow, IALS). The article is taken from a lecture given by the author at the Institute of Advanced Legal Studies on February 1, 2006 and was published in Amicus Curiae – Journal of the Society for Advanced Legal Studies at the Institute of Advanced Legal Studies. The Journal is produced by SALS at the IALS (Institute of Advanced Legal Studies, School of Advanced Study, University of London)
The future of Arbitration
No full textConsidering that the proper purpose of private alternative scheme of mediation and arbitration is to satisfy the needs of the parties, Derek Roebuck (Senior Associate Research Fellow, Institute of Advanced Legal Studies) outlines the aims and practice of mediation and arbitration in the reign of Elizabeth I (1558-1603) suggesting possible lessons from the 16th Century for a contemporary scheme. The author has developed this brief paper from a contribution to the debate at the London School of Economics on 13 February 2014 at the launch of Jan Paulsson’s The Idea of Arbitration (Oxford University Press, 2013)
The phanerozoic basin-fill history of the Roebuck Basin / author, Stuart A. Smith.
No full textBibliography: p.149-158.xxii, 198 p. : ill. (chiefly col.), maps (chiefly col.) ; 30 cm.Aims to provide a structural and stratigraphic framework for the evolution of the Roebuck Basin, and to evaluate its future petroleum potential.Thesis (Ph.D.)--University of Adelaide, National Centre for Petroleum Geology and Geophysics, 200
Marginal donor characteristics and outcomes after liver transplantation
No full textINTRODUCTION:
Liver Transplantation across the globe has a supply and demand issue. Ever- advancing improvements in road safety and medical care mean a reduced pool of “ideal donors” and the population age is increasing rapidly over time. There is a growing need for donor livers as the number of critically unwell recipients awaiting liver transplantation increases. The extended criteria donor liver has been increasingly utilised in an attempt to balance the equation. There are many studies looking at combinations of variables associated with complications, graft survival and recipient survival but no universal consensus on how to define the limits for each of these variables when choosing a donor. Matching these marginal liver grafts with an appropriate recipient adds another challenge in the quest to deliver the best outcomes for patients. Increasing donor age and donation after cardiac death (DCD) liver transplantations are variables that are widely studied and reported in the literature to negatively affect graft and recipient survival outcomes and are the focus of this analysis. The aim of this study was to determine the impact of these variables on outcomes and to establish whether other variables as confounders enhanced or limited these effects.
METHODS:
A retrospective analysis of NHSBT (National Health Service Blood and Transplant service) whole liver transplantation data was performed using R studio version 4.1.1. Donor and recipient demographics were scrutinised. Recipients <18 years old and living donors were actively removed from the dataset. Univariable analysis with logistic regression for graft and recipient survival outcomes and Kaplan Meier survival curves for time to event analysis was used to identify variables of interest to pass to multivariable analysis.
Consideration was then given to variables that should be included or excluded on the basis of literature and clinical grounds. Missing data analysis was performed, and data filtered to include transplantation between 2000- 2015. Multivariable analysis was performed using a Cox proportional hazards model. Primary explanatory variables of interest were donor age and DCD transplantation and other variables resulting in significant difference to graft and recipient survival were noted. Variables with significance but not widely reported in the literature were excluded and those with low or no significance were still included if they were felt of importance in the literature.
RESULTS:
Both increasing donor age >60 years old (HR 1.29, CI 1.09-1.53, p=0.004) and DCD liver transplantation (when compared to donation after brainstem death transplantation, HR 1.69, CI 1.40-2.04, p8 hours (HR 1.23, CI 1.05- 1.45, p=0.009). For recipient survival increasing donor age caused poorer recipient survival on both univariable (HR 1.23, CI 1.08-1.40, p=0.002) and multivariate analysis (HR 1.25, CI 1.06-1.46, p=0.007). For DCD transplantations there was no statistically significant difference in recipient survival on univariable or multivariable analysis (HR 1.09, CI 0.89-1.34, p=0.400). Other variables correlating with poorer recipient survival after adjustment for confounding factors in the cox proportional hazards model include HCV positive recipients (HR 1.37, CI 1.20-1.57, p<0.001) and recipient inpatient status pre-op (HR 1.32, CI 1.14-1.52, p<0.001).
DISCUSSIONS:
Donor livers utilised from >60 year olds were more likely to be transplanted to a recipient in better clinical condition when considering variables such as ventilation status, renal support, blood group compatibility and lifestyle scores to indicate fitness. This correlates with many studies which suggest careful recipient characteristic selection to avoid further host stress to the graft. This was also evident in DCD liver transplantations. Older donor livers were also more likely to be CMV positive, to have died from intracranial haemorrhage (rather than trauma causes in younger donors) and were more likely DCD grafts all compounding the risks of poorer outcomes. The arbitrary cut-off chosen for the older group of donors was >60 years and this corresponded with the median in the literature and as a result this study demonstrated similar outcomes. It is possible that choosing an older cohort or cut-off would have resulted in a more significant negative impact on survival.
In DCD liver transplantation it was evident that these grafts less likely to be transplanted to Hepatitis C virus positive recipients or to recipients with poorer clinical state pre-transplantation as with older donors, again all in an effort it seems to reduce increased host stress on a graft already exposed to some ischaemic reperfusion injury. Care was taken when designing statistical analysis to choose variables which were either significant on univariable analysis or important in the literature to allow a condensed model to be chosen and to optimise the fit and predictive power for survival outcomes. It was worth nothing the relationships that naturally occurred between variables, such as CMV status as this was more likely positive in older donors. This means these were difficult to separate in cause and effect analysis.
Future work to enhance this study could include development of a more complete or robust dataset and data recording strategies to eliminate the large volume of missing data. A warm ischaemic time variable would be an essential addition to fully explore the effects of DCD transplantation, but as there are now machine and normothermic regional perfusion techniques that are well established and have developed a good evidence base this has become less relevant.
CONCLUSIONS:
In this study, increasing donor age was found to adversely affect both graft and recipient survival outcomes. DCD transplantation resulted in poorer outcomes for graft survival but had no significant impact on recipient survival. This correlated with much of the wider literature in this field, although the range of analytic methods and strategies across multiple studies makes it difficult to standardise a universal consensus on how to limit these negative outcomes. These extended donor characteristics are the focus of many donor-recipient matching protocols to limit these effects on survival. Machine perfusion and normothermic perfusion procedures help to limit the impact of these donors and are now the focus of the next stage of development of techniques to bridge the waiting list gaps for liver transplantation in the United Kingdom
Health Hazard Evaluation Report: HETA-87-405-1858: Sears, Roebuck and Company; Chicago, Illinois
No full textIn response to a request from Sears, Roebuck and Company (SIC-5311), an evaluation was made of potential exposure of service technicians to optical radiation from a new type of counter cook top. Each of the four cooking areas was 19 centimeters in diameter and contained four infrared radiation (IR) lamps. The lamps had a peak IR wavelength around 1200 nanometers and were able to produce both visible and IR radiation of biological concern. As measured by the spectroradiometer, the cook top with the lid in place did not demonstrate any significant levels of ultraviolet radiation. With the cook top lid removed, luminance values greatly exceeded 1 candela/square centimeter, representing an optical hazard unless protective eyewear or barriers were used. The highest IR level recorded was 128 milliwatts per square centimeter. The author concludes that under certain conditions there may be a hazard to workers servicing the cook top. The author recommends that all servicing of this equipment be done at operating levels less than maximum output. Protective eyewear and gloves should be used if there is a need to operate the equipment at maximum levels. The protective lid should never be lifted with the lamps activated. Broken protective lids should be replaced. Burn hazards as well as eye and skin problems must be guarded against. Vision examinations should be provided for servicemen handling this equipment. Sears may wish to do consumer protection evaluations as well
Diagnostic yield and safety of ultrasound-guided bowel mass biopsies in children
No full textBACKGROUND: Traditionally, ultrasound (US)-guided bowel mass biopsies are avoided in favour of endoscopic or surgical biopsies. However, endoscopy cannot easily reach lesions between the duodenojejunal flexure and the terminal ileum and lesions not involving the mucosa may not be accessible via an endoscopic route. OBJECTIVE: The aim of this study was to report our technique and to assess the diagnostic accuracy and safety of US-guided biopsy of bowel masses in children. MATERIALS AND METHODS: We conducted a 14-year retrospective review of US-guided bowel mass biopsies at a single paediatric hospital. RESULTS: Twenty US-guided bowel mass biopsies were performed in 19 patients (median age: 6 years and 6 months, range: 22 months-17 years, median weight: 22 kg, range: 10.2-48.4 kg). For 14 biopsies, there was no other lesion that could potentially be biopsied. A percutaneous coaxial technique was used for 19 biopsies and a transanal non-coaxial biopsy was performed in 1. A median of 9 (range: 2-15) cores of tissue was obtained at each biopsy. The technical success rate and adequacy of diagnostic yield were 100%. The most common diagnosis was lymphoma, which occurred in 16 biopsies. Three biopsies contained mucosa. There was one complication out of 20 biopsies (5%, 95% confidence interval 0-15%): a self-limiting, post biopsy pyrexia. Nineteen procedures were accompanied by a bone marrow aspirate and/or trephine within 2 weeks of the bowel biopsy, only one of which was diagnostic. CONCLUSION: US-guided bowel mass biopsy can be performed safely in children, with a high diagnostic yield and low complication rate.sponsorship: P.D.C. is supported by National Institute for Health Research. P.A.P. is supported by GIFT-SURG Wellcome Trust/ Engineering and Physical Sciences Research Council programme grant. This study was supported by the Great Ormond Street Hospital Children's Charity and the National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the National Institute for Health Research or the Department of Health in England. (National Institute for Health Research, GIFT-SURG Wellcome Trust/ Engineering and Physical Sciences Research Council programme grant, Great Ormond Street Hospital Children's Charity, National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre)status: Publishe
Wind-tunnel study of Sears Tower, Chicago
No full textCER76-77JAP-JEC65.Prepared for Sears, Roebuck, and Company.Includes bibliographical references (page 22).June 1977
Roald Dahl: the Author for Two Audiences. A comparison of His Writings for Children and Adults
No full textKatedra anglistiky a amerikanistikyDokončená práce s úspěšnou obhajobo
Eastland at ribbon cutting ceremony for Sears Roebuck and Co.
No full textWith A.D. Swift, Fermin DeOca, Glenda Meadows (beauty queen), Mayo Ellis (mayor), and J.P. Galloway (zone manager)https://egrove.olemiss.edu/joephoto_e/1218/thumbnail.jp
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