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Lung cancer is one of the most commonly occurring malignant tumours worldwide. Although some reference methods such as X-ray, computed tomography or bronchoscope are widely used for clinical diagnosis of lung cancer, there is still a need to develop new methods for early detection of lung cancer. Especially needed are approaches that might be non-invasive and fast with high analytical precision and statistically reliable. Herein, we developed a swab "dip" test in saliva whereby swabs were analysed using attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy harnessed to principal component analysis–quadratic discriminant analysis (QDA) and variable selection techniques employing successive projections algorithm (SPA) and genetic algorithm (GA) for feature selection/extraction combined with QDA. A total of 1944 saliva samples (56 designated as lung-cancer positive and 1888 designed as controls) were obtained in a lung cancer-screening programme being undertaken in North-West England. GA-QDA models achieved, for the test set, sensitivity and specificity values of 100.0% and 99.1%, respectively. Three wavenumbers (1422 cm−1, 1546 cm−1 and 1578 cm−1) were identified using the GA-QDA model to distinguish between lung cancer and controls, including ring C–C stretching, C＝N adenine, Amide II [δ(NH), ν(CN)] and νs(COO−) (polysaccharides, pectin). These findings highlight the potential of using biospectroscopy associated with multivariate classification algorithms to discriminate between benign saliva samples and those with underlying lung cancer. [ABSTRACT FROM AUTHOR]

Objective: To determine whether standalone teleconsultation is an effective alternative to face-to-face assessment of patients requiring circumcision. To determine what environmental and efficiency benefits may arise as a result of service alteration. Patients and Methods: All cases listed for circumcision during first UK lockdown (1 February to 30 September 2020) were reviewed. Cases were collated from operative lists, theatre logs and secretarial records. Cancellations and rationale were recorded. Local audit approval was granted for conduct of this study. Statistical analysis was conducted in JASP. Results: A total of 101 patients were listed for circumcision during the study period. The overall odds of cancellation was 0.063. There was no significant difference in odds of cancellation between telephone clinic and face-to-face clinic odds ratio 0.371 (confidence interval (CI): 0.039–3.46). Telephone clinic could achieve a per-patient cost reduction of £81 and a total reduction in CO2 emissions of 637 kg. Discussion: This is the first study to demonstrate teleconsultation as a suitable method to list patients for circumcision without a face-to-face appointment. The COVID pandemic has accelerated transformational change in outpatient service design instigated by the National Health Service (NHS) Long-Term plan. The environmental and efficiency savings demonstrated suggest sustainable change beyond the pandemic. Level of Evidence: Level 3 (cohort study) [ABSTRACT FROM AUTHOR]

E-Verify laws, which have been adopted by 23 states, require employers to verify whether new employees are eligible to legally work prior to employment. This study explores the impact of state E-Verify laws on crime. Using data from the 2004–2015 National Incident Based Reporting System, the authors find that the enactment of E-Verify is associated with a 7% reduction in property crime incidents involving Hispanic arrestees. This finding was strongest for universal E-Verify mandates that extend to private employers and its external validity bolstered by evidence from the Uniform Crime Reports. Supplemental analyses from the Current Population Survey suggest two mechanisms to explain this result: E-Verify-induced increases in the employment of low-skilled natives of Hispanic descent and out-migration of younger Hispanics. Findings show no evidence that arrests were displaced to nearby jurisdictions without E-Verify or that violent crime or arrests of African Americans were affected by E-Verify laws. The magnitudes of the estimates suggest that E-Verify laws averted $491 million in property crime costs to the United States. [ABSTRACT FROM AUTHOR]

Objective: This study aims to assess whether the rate of readmissions after ureterorenoscopy (URS) is dependent on results of urine microscopy, culture and sensitivity (MC&S) or nitrite dipstick test performed before the procedure. Patients and Methods: All patients attending for ureteroscopy for stone disease over 12 months were included and had urine dipstick performed immediately prior to the surgery with mid-stream urine (MSU) sample sent for culture. Asymptomatic bacteriuria (ABU) was not treated before ureteroscopy. All included patients received standard antibiotic prophylaxis. Readmissions within 30 days of the procedure were evaluated. Results: A total 120 ureteroscopies were included, of which 20% had ABU. Eight patients (6.67%) were readmitted due to all procedure-related complications; among them, five (4.17%) were readmitted with urinary tract infection (UTI). Readmission rates with UTIs were similar for patients with sterile urine and those who had untreated ABU. Of those patients who were readmitted with UTI, all had a negative nitrite result on preoperative urine dipstick specimens. Most patients (54.17%) who had ABU also had a negative urinary nitrite test. Conclusions: Screening and routine treatment of ABU before ureteroscopy for urolithiasis may be unnecessary provided patients have standard antibiotic prophylaxis. Moreover, urine nitrite testing before ureteroscopy may not be a useful screening test for ABU before ureteroscopy. Level of evidence: 2 [ABSTRACT FROM AUTHOR]

Objective: To produce comprehensive and detailed benchmarking data allowing surgeons and patients to compare practice against, by using all recorded radical prostatectomies across a 3-year period in England. Patients and methods: The British Association of Urological Surgeons (BAUS) manages the radical prostatectomy (RP) Complex Operations Database. Surgical departments upload data which they can review and amend before lockdown and data cleansing. Analysis of 2016–2018 data held on the BAUS Complex Operations Database was performed for 21,973 patients undergoing RP in England, producing procedure-specific benchmarking data. General linear models were used to assess differences in patient selection between different operative modalities. Analysis involved assessment of case selection, operative decisions and outcomes, case volume and pathological outcomes. Results: Using national Hospital Episode Statistics, the BAUS RP dataset was estimated 91% complete. Median age was 65 and 96% were American Society of Anesthesiologists (ASA) Grades 1–2. Over 80% had RP performed in a high-volume centre (>100 annual RPs) and 88% had Gleason grade group (GGG) ⩾2 disease on biopsy. Robotic-assisted RP (RARP), laparoscopic RP (LRP) and open RP (ORP) were performed in 85%, 7.2% and 7.7% of cases, respectively. Patient and disease characteristics differed across surgical modalities. Transfusion rates were 0.14% in RARP, 0.38% in LRP and 1.8% in ORP. Increased positive surgical margin (PSM) rates were observed with increasing prostate-specific antigen (PSA), GGG and T-stage, with comparable PSM rates across surgical modalities. Lymph node dissection was performed more commonly in high-risk cases (cT3, PSA > 20, GGG ⩾ 4). Pathological upstaging was common. Median length of stay was 1, 2 and 3 days for RARP, LRP and ORP, respectively. ORP had Clavien–Dindo complications ⩾3 and unplanned hospital readmissions. Conclusion: This analysis has enabled the first set of UK national RP standards to be produced allowing procedure, patient and disease-specific national, centre and individual comparisons. The present degree of service centralisation, operative modalities, and specific aspects of surgical practice can be observed. Level of evidence: 2b [ABSTRACT FROM AUTHOR]

Objective: To analyse the 2016–2018 British Association of Urological Surgeons (BAUS) Complex Operations Reports nephrectomy database, providing a comprehensive description of modern nephrectomy practice. Patients and Methods: Analysis of 2016–2018 data held on the BAUS Complex Operations Reports nephrectomy database was performed for 21,366 patients in England. Data are reported on patient, disease, operation and outcome variables. Results: Using Hospital Episode Statistics (HES) as a comparator, the database captured an estimated 88% of nephrectomies. Benign nephrectomies (BNs) accounted for 11%, 51% were radical nephrectomies (RNs), 14% were nephroureterectomies (NUs) and 22% were partial nephrectomies (PNs). Of the 2399 BNs, 10% were performed for stone disease, 9% for allograft donation and 9% for infective pathology. Aetiology was not specified further than non-functioning kidney in 51% of cases; 80% of cases adopted minimally invasive surgery (MIS). Histology was benign in 96% of cases. Of 10,843 RNs performed, 77% were performed using MIS. Final histology was renal cell carcinoma in 87% of cases and benign histology confirmed in 9% of cases. Of 3038 NUs performed, 88% were performed using MIS. Histology confirmed malignancy in 94% of cases with transitional cell carcinoma accounting for 82% of cases overall. Of 4708 PNs performed, 74% were performed using MIS; 85% of cases were performed for T1 disease; 16% of cases overall returned benign histology. Across the cohort, 30-day mortality was 0.36%. Transfusion rates were 3.3%, 6.1%, 3.3% and 2.0% for BNs, RNs, NUs and PNs, respectively. In malignant disease, positive surgical margins were present in 0.7% of RNs, 1.2% of NUs and 7.3% of PNs. Conclusions: The BAUS nephrectomy dataset provides a real-world description of nephrectomy practice across England, enabling surgeons to compare their practice against a national average. This dataset allows surgeons to share data with patients enhancing informed consent and facilitating shared-decision making. Overall, MIS is widespread, and early mortality after nephrectomy is low. Level of evidence: 2B [ABSTRACT FROM AUTHOR]

Objective: To produce comprehensive standards for cystectomy using contemporary data collected across a nation. Patients and methods: Surgical departments upload cystectomy data to the British Association of Urological Surgeons (BAUS) Complex Operations Database. Analysis of 2016–2018 data was performed for all recorded 5288 patients undergoing cystectomy in England. Logistic regression with general linear models was used to assess differences in patient selection between operative modalities. Analysis involved assessment of case selection, operative decisions and outcomes, case volume and pathological outcomes. Results: Using national Hospital Episode Statistics, the BAUS cystectomy dataset was estimated 93% complete. Median age was 70 years (interquartile range 63–75) and 75% were male. Charlson comorbidity index ⩽2 was reported in 87%. Primary treatment of muscle-invasive bladder cancer accounted for 46% of cases. Commonest preoperative disease stages were T2N0 and T1N0 (35% and 25% respectively). Robotic-assisted (RAC), laparoscopic (LC) and open cystectomy (OC) were performed in 41%, 5.5% and 54% of cases respectively. T-stage distribution differed by operative modality. Transfusion rates were 3.7% for RAC, 6.0% for LC and 18% for OC. Increasing positive surgical margin rates were observed with increasing T-stage, up to T3. The conversion-to-open rate for minimally-invasive surgery was 1.7%. Median annual centre and surgeon case volumes were highest for RAC. Median length of stay was 7, 10 and 10 days for RAC, LC and OC respectively. Postoperative histological upstaging was common (33% of cT1, 50% of cT2 cases). Lymph node positive rates were 28% for muscle-invasive bladder cancer. Conclusion: Analysis of this data provides understanding of 'real-world' cystectomy practice. Presentation of data specific to operative modality allows surgeons and centres to benchmark their respective practices. These findings offer to enhance patient and public understanding beyond that currently facilitated by publicly-facing information sources. They carry relevance by describing a near-complete and large volume of modern practice in a publicly funded healthcare system. Level of evidence: 2b [ABSTRACT FROM AUTHOR]

This article traces the development of the adjudicatory jurisdiction of the English courts between the seventeenth and twentieth centuries. The account provides, it is submitted, a number of valuable insights, which call into question current accounts of the common law rules governing both the adjudicatory jurisdiction of local courts and the recognition and enforcement of foreign judgments. The author's principal contention is that the so-called 'principles' of presence and submission, which are central tenets of English private international law, are not only unsatisfactory in principle, but lacking in historical support as elements of the common law landscape. Keywords: Legal history, law reform, private international law, conflict of laws, jurisdiction, recognition and enforcement of judgments, adjudicatory jurisdiction, Albert Venn Dicey, principle of presence, principle of submission, submission to the jurisdiction, voluntary appearance, default judgments, service out of the jurisdiction, waiver of irregularity, Court of King's Bench, Court of Common Pleas, Court of Chancery, Supreme Court of Judicature., I. INTRODUCTION Jurisdiction based on presence of the defendant is a central tenet of private international law in common law systems, including England and Wales. It defines both the in [...]

Objectives: To report the results of a clinical audit conducted by the British Association of Urological Surgeons (BAUS) of ureteric stone care pathways, with results reported with reference to national quality standards. Patients and Methods: The BAUS conducted a clinical audit of all patients presenting as an emergency to 107 hospitals in England during November 2020 with ureteric stones. All patients were followed up until 31 March 2021 and the inpatient and outpatient management received was recorded. Results: Data for 2192 patients across 117 units were submitted. The median (interquartile range [IQR]) number of patients per unit was 16 (9–27); 70% of patients were male and the median (IQR) patient age was 46 (34–59) years. Initial management was conservative treatment for 70% of patients. Overall, primary shockwave lithotripsy was performed in 34% of patients and primary ureteroscopy in 23% of cases when surgical intervention was required to treat the stone. However, 40% of patients in whom active intervention was appropriate underwent placement of a temporizing ureteric stent rather than undergo definitive surgical intervention at the outset. Female patients were less likely to have a computed tomography (CT) scan of the kidneys, ureters and bladder performed within 24 h of presentation (13% vs 7.3% for men [chi‐squared P = 0.01]) and to be given correct analgesia (66% vs 73% for men [chi‐squared P = 0.03]). Patients aged 60 years or older were also significantly less likely to be offered nonsteroidal anti‐inflammatory drug analgesia appropriately. In total, 87% of patients had their calcium measured within the last 2 years and 73% of patients had evidence of being offered stone prevention diet and fluid advice. Conclusions: The audit demonstrates that the National Institute of Health and Care Excellence Quality Standards are both measurable and achievable. However, there was considerable variation in the delivery of these standards, including with regard to sex and age, highlighting inequalities for patient care across the UK. [ABSTRACT FROM AUTHOR]