As a result of the GDPR and the ePrivacy Directive, European users encounter cookie banners on almost every website. Many of such banners are implemented by Consent Management Providers (CMPs), who respect IAB Europe's Transparency and Consent Framework (TCF). Via cookie banners, CMPs collect and disseminate user consent to third parties. In this work, we systematically study IAB Europe's TCF and analyze consent stored behind the user interface of TCF cookie banners. We analyze the GDPR and the ePrivacy Directive to identify potential legal violations in implementations of cookie banners based on the storage of consent and detect such suspected violations by crawling 1 426 websites that contains TCF banners, found among 28 257 crawled European websites. With two automatic and semi-automatic crawl campaigns, we detect suspected violations, and we find that: 141 websites register positive consent even if the user has not made their choice; 236 websites nudge the users towards accepting consent by pre-selecting options; and 27 websites store a positive consent even if the user has explicitly opted out. Performing extensive tests on 560 websites, we find at least one suspected violation in 54% of them. Finally, we provide a browser extension to facilitate manual detection of suspected violations for regular users and Data Protection Authorities.
Noninvasive positive pressure ventilation (NIPPV) can replace tracheal intubation in acute exacerbations of chronic obstructive pulmonary disease (COPD) with severe hypercapnic respiratory failure. However, the underlying mechanisms by which NIPPV improves pulmonary gas exchange are not known. We studied 10 male COPD patients (68 +/- 8 [SD] yr) with acute severe hypercapnic respiratory failure within 36 h after hospital admission. Measurements of pulmonary gas exchange, hemodynamics, and respiratory mechanics were done: (I) breathing spontaneously (baseline); (2) after 15 and 30 min of NIPPV with pressure support (inspiratory pressure = 12 +/- 2 cm H20, PEEP = 3 +/- 2 cm H20); and (3) 15 min after NIPPV withdrawal. Patients were ventilated using a full face mask, keeping FIO2 constant (0.23 +/- 0.02) in all conditions. Compared with baseline, during NIPPV (15 min) we observed a moderate increase in Pa02 (from 50 +/- 6 to 57 +/- 9 mm Hg; p < 0.05), and a fall in PaCO2 (from 66 +/- 10 to 59 +/- 10 mm Hg; p < 0.0001), but AaPO2 increased (from 39 +/- 13 to 48 +/- 13 mm Hg; p < 0.001). Breathing frequency decreased (from 26 +/- 5 to 19 +/- 3 breaths/min; p < 0.0001), tidal volume increased (from 311 +/- 42 to 520 +/- 133 ml; p < 0.0001), and minute ventilation increased (from 8.0 to 1.7 to 9.6 +/- 2.0 L/min; p < 0.05). Cardiac output fell during NIPPV in all patients (from 6.7 +/- 1.6 to 5.8 +/- 1.3 L/min; p < 0.0025) with no impact on mixed venous PO2. No substantial changes in VA/Q mismatching (multiple inert gas elimination technique) were observed. While oxygen uptake showed a trend to decrease, the respiratory exchange ratio (R) increased (from 0.78 +/- 0.17 to 0.90 +/- 0.22; p < 0.001). The effects of NIPPV were unchanged at 30 min compared with 15 min and were reversed after 15 min of NIPPV withdrawal. We conclude that improvement in respiratory blood gases during NIPPV is essentially due to higher alveolar ventilation (p < 0.001) and not to improvement in VA/Q relationships. The increase in AaPO2 was explained by the rise in R due to an increased clearance of body stores of C02 during NIPPV. Our results indicate that attainment of an efficient breathing pattern rather than high inspiratory pressures should be the primary goal to improve arterial blood gases during NlPPV in this type of patient.
The concept of 'relevance' is crucial to legal information retrieval, but because of its intuitive understanding it goes undefined too easily and unexplored too often. We discuss a conceptual framework on relevance within legal information retrieval, based on a typology of relevance dimensions used within general information retrieval science, but tailored to the specific features of legal information. This framework can be used for the development and improvement of legal information retrieval systems.
The mechanisms and time course of the pulmonary gas exchange response to 100% O(2) breathing in acute respiratory failure needing mechanical ventilation were studied in eight patients with acute lung injury (ALI) (48 +/- 18 yr [mean +/- SD]) and in four patients (66 +/- 2 yr) with chronic obstructive pulmonary disease (COPD). We postulated that, in patients with ALI while breathing 100% O(2), the primary mechanism of hypoxemia, i.e., increased intrapulmonary shunt, would further worsen (increase) as a result of reabsorption atelectasis. Respiratory and inert gases, and systemic and pulmonary hemodynamics were measured at maintenance fraction of inspired oxygen (FI(O(2))-m), at 30 and 60 min while breathing 100% O(2), and then at 30 min of resuming FI(O(2))-m. During 100% O(2) breathing, in patients with ALI, Pa(O(2)) (by 207 and 204 mm Hg; p < 0.01 each), Pa(CO(2)) (by 4 mm Hg each) (p < 0.05 each), and intrapulmonary shunt (from 16 +/- 10% to 22 +/- 11% and 23 +/- 11%) (p < 0.05 each) increased respectively. By contrast, in patients with COPD, Pa(O(2)) (by 387 and 393 mm Hg; p < 0.001 each), Pa(CO(2)) (by 4 and 5 mm Hg) and the dispersion of pulmonary blood flow (log SDQ) (from 1.33 +/- 0.10 to 1.60 +/- 0.20 and 1.80 +/- 0.30 [p < 0.05]) increased, respectively. In patients with ALI, the breathing of 100% O(2) deteriorates intrapulmonary shunt owing to collapse of unstable alveolar units with very low ventilation-perfusion (V A/Q) ratios, as opposed to patients with COPD, in whom only the dispersion of the blood flow distribution is disturbed, suggesting release of hypoxic pulmonary vasoconstriction.
User engagement with data privacy and security through consent banners has become a ubiquitous part of interacting with internet services. While previous work has addressed consent banners from either interaction design, legal, and ethics-focused perspectives, little research addresses the connections among multiple disciplinary approaches, including tensions and opportunities that transcend disciplinary boundaries. In this paper, we draw together perspectives and commentary from HCI, design, privacy and data protection, and legal research communities, using the language and strategies of "dark patterns" to perform an interaction criticism reading of three different types of consent banners. Our analysis builds upon designer, interface, user, and social context lenses to raise tensions and synergies that arise together in complex, contingent, and conflicting ways in the act of designing consent banners. We conclude with opportunities for transdisciplinary dialogue across legal, ethical, computer science, and interactive systems scholarship to translate matters of ethical concern into public policy. CCS CONCEPTS• Human-centered computing → User interface design; • Social and professional topics → Governmental regulations; Codes of ethics; • Security and privacy → Social aspects of security and privacy.
Recent work in patients with acute respiratory failure (ARF) due to exacerbation of chronic airflow obstruction (CAO) suggests that application of low degrees of positive end-expiratory pressure (PEEP) can improve rather than impair respiratory mechanics, because PEEP replaces intrinsic PEEP (PEEPi). However, the impact of PEEP on pulmonary gas exchange has not been fully investigated. We designed this study to examine the effects of PEEP and those of PEEPi on ventilation/perfusion (VA/Q) mismatching in mechanically ventilated patients with CAO. Eight patients were studied under four conditions: (1) during controlled mechanical ventilation with the ventilatory setting established by the attending physicians (PEEPi-100%), according to standard criteria; (2) after application of PEEP amounting to 50% (PEEP-50%), and then (3) to 100% (PEEP-100%) of the original PEEPi; and finally, (4) after reduction of PEEPi to 50% of the initial value (PEEPi-50%), obtained by increasing expiratory time and decreasing respiratory rate and tidal volume. Respiratory mechanics, hemodynamics, respiratory blood gases, and VA/Q distributions were measured during each ventilatory mode. At low values of PEEP (PEEP-50%) no changes in respiratory mechanics nor in hemodynamics were observed, but PaO2 moderately increased (from 103 +/- 25.2 to 112 +/- 29.6 mm Hg) and PaCO2 slightly decreased (from 42 +/- 3.7 to 40 +/- 3.3 mm Hg) essentially because of an increase in the mean VA/Q ratio (first moment) of both flood flow (Q, from 0.65 +/- 0.28 to 0.78 +/- 0.29) and ventilation (V, from 4.02 +/- 1.55 to 4.93 +/- 2.00) distributions (p < 0.05, each).(ABSTRACT TRUNCATED AT 250 WORDS)
To investigate the potential effects of inhaled platelet-activating-factor (PAF) (12 micrograms) to perturb pulmonary gas exchange in bronchial asthma, six patients (mean +/- SE, 23 +/- 2 yr) with intermittent asthma (FEV1, 90% predicted) were studied before and 5, 15, and 45 min after challenge. Circulating white blood cells, respiratory system resistance (Rrs), systemic and pulmonary hemodynamics, and respiratory and inert pulmonary gas exchange were measured. Five minutes after PAF leukocytes fell, Rrs increased (by 27%). PaO2 decreased (by 15 mm Hg), and AaPO2 increased (twofold) (p < 0.05 each). Ventilation-perfusion (Va/Q) distributions worsened in a pattern similar to that commonly observed in patients with moderate to severe asthma. Dispersions of pulmonary blood flow (log SD Q) and of alveolar ventilation (log SD V), and an overall index of Va/Q heterogeneity (DISP R-E*) increased significantly (123% for DISP R-E*; p < 0.05, each). Gas exchange indices and Rrs were still minimally abnormal at 15 min but returned towards baseline at 45 min. Ventilatory and hemodynamic variables remained unaltered throughout the study. These results suggest that endogenous PAF may be implicated in the arterial blood gas abnormalities shown during exacerbations of bronchial asthma.
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