bluuebunny/crossref_metadata_2025_split huggingface dataset:
El derecho comercial como un fragmento constitucional para efectos de una adecuada protección jurídica del ambiente en la contratación mercantil en Colombia
Authors: Wilches Durán Rafael Eduardo 
Published: January 2019

Frente al fenómeno de la constitucionalización del Derecho privado, el autor propone como solución entender al Derecho comercial como un fragmento constitucional, en los términos propuestos por Gunther Teubner. Tal propuesta surge como resultado de estudios sobre la protección jurídica del ambiente desde el Derecho comercial en Colombia. La conclusión obtenida apunta a señalar que, debido a la dificultad de compaginar los diferentes discursos del Derecho comercial y el Derecho ambiental, es necesario repensar los contenidos del Derecho comercial desde su interior, para efectos de lograr realizar la idea de unitas multiplex o unidad dentro de la diversidad y diversidad dentro de la unidad en el discurso del Derecho.
Geikie and the development of petrography, particularly in Scotland
Authors: Mendum John R. , Howe Michael P. A. 
Published: January 2019

Abstract
The British Geological Survey (BGS) petrology collections contain almost 1500 Scottish rock samples (with thin sections) deposited by Archibald Geikie, including BGSS1, an analcime gabbro from Salisbury Crags, Edinburgh. High-quality thin section images are now available from the BGS's Britrocks online database. The geospatial distribution of these samples is analysed. They reflect the development of geological mapping and igneous petrology in Scotland from the 1850s to the 1890s. Geikie had the opportunity to study Nicol's original thin sections in 1851 and he met both Sorby and Zirkel, early pioneers of petrography. Lacking management support, he cut many of his own thin sections while mapping the Clyde Plateau lavas during the 1860s, leading to publications on Carboniferous and Tertiary volcanism. When appointed Director of the newly formed Geological Survey of Scotland in 1867, he was able to establish a petrological laboratory in Edinburgh. Time pressures resulting from his subsequent promotion to Director-General, and increasing quantities of metamorphic rocks, then necessitated the appointment of Hatch and Teall as petrographers for the Survey. Teall's work was particularly important in the detailed petrography of the gneisses and mylonites associated with the Highlands Controversy.
A Framework for Teaching Security Design Analysis Using Case Studies and the Hybrid Flipped Classroom
Authors: Luburić Nikola , Sladić Goran , Slivka Jelena , Milosavljević Branko 
Published: January 2019

With ever-greater reliance of the developed world on information and communication technologies, constructing secure software has become a top priority. To produce secure software, security activities need to be integrated throughout the software development lifecycle. One such activity is security design analysis (SDA), which identifies security requirements as early as the software design phase. While considered an important step in software development, the general opinion of information security subject matter experts and researchers is that SDA is challenging to learn and teach. Experimental evidence provided in literature confirms this claim.
To help solve this, we have developed a framework for teaching SDA by utilizing case study analysis and the hybrid flipped classroom approach. We evaluate our framework by performing a comparative analysis between a group of students who attended labs generated using our framework and a group that participated in traditional labs. Our results show that labs created using our framework achieve better learning outcomes for SDA, as opposed to the traditional labs. Secondary contributions of our article include teaching materials, such as lab descriptions and a case study of a hospital information system to be used for SDA.
We outline instructions for using our framework in different contexts, including university courses and corporate training programs. By using our proposed teaching framework, with our or any other case study, we believe that both students and employees can learn the craft of SDA more effectively.
Regional brain stem activations during capsaicin inhalation using functional magnetic resonance imaging in humans
Authors: Bautista Tara G. , Leech Jennifer , Mazzone Stuart B. , Farrell Michael J. 
Published: January 2019

Coughing is an airway protective behavior elicited by airway irritation. Animal studies show that airway sensory information is relayed via vagal sensory fibers to termination sites within dorsal caudal brain stem and thereafter relayed to more rostral sites. Using functional magnetic resonance imaging (fMRI) in humans, we previously reported that inhalation of the tussigenic stimulus capsaicin evokes a perception of airway irritation (“urge to cough”) accompanied by activations in a widely distributed brain network including the primary sensorimotor, insular, prefrontal, and posterior parietal cortices. Here we refine our imaging approach to provide a directed survey of brain stem areas activated by airway irritation. In 15 healthy participants, inhalation of capsaicin at a maximal dose that elicits a strong urge to cough without behavioral coughing was associated with activation of medullary regions overlapping with the nucleus of the solitary tract, paratrigeminal nucleus, spinal trigeminal nucleus and tract, cardiorespiratory regulatory areas homologous to the ventrolateral medulla in animals, and the midline raphe. Interestingly, the magnitude of activation within two cardiorespiratory regulatory areas was positively correlated ( r2 = 0.47, 0.48) with participants’ subjective ratings of their urge to cough. Capsaicin-related activations were also observed within the pons and midbrain. The current results add to knowledge of the representation and processing of information regarding airway irritation in the human brain, which is pertinent to the pursuit of novel cough therapies. NEW & NOTEWORTHY Functional brain imaging in humans was optimized for the brain stem. We provide the first detailed description of brain stem sites activated in response to airway irritation. The results are consistent with findings in animal studies and extend our foundational knowledge of brain processing of airway irritation in humans.
Measurement of Tumor Antioxidant Capacity and Prediction of Chemotherapy Resistance in Preclinical Models of Ovarian Cancer by Positron Emission Tomography
Authors: Greenwood Hannah E. , McCormick Patrick N. , Gendron Thibault , Glaser Matthias , Pereira Raul , Maddocks Oliver D. K. , Sander Kerstin , Zhang Tong , Koglin Norman , Lythgoe Mark F. , Årstad Erik , Hochhauser Daniel , Witney Timothy H. 
Published: January 2019

Abstract

Purpose:
Drug resistance is a major obstacle for the effective treatment of patients with high-grade serous ovarian cancer (HGSOC). Currently, there is no satisfactory way to identify patients with HGSOC that are refractive to the standard of care. Here, we propose the system xc− radiotracer (4S)-4-(3-[18F]fluoropropyl)-l-glutamate ([18F]FSPG) as a non-invasive method to measure upregulated antioxidant pathways present in drug-resistant HGSOC.

Experimental Design:
Using matched chemotherapy sensitive and resistant ovarian cancer cell lines, we assessed their antioxidant capacity and its relation to [18F]FSPG uptake, both in cells and in animal models of human ovarian cancer. We identified the mechanisms driving differential [18F]FSPG cell accumulation and evaluated [18F]FSPG tumor uptake as predictive marker of treatment response in drug-resistant tumors.

Results:
High intracellular glutathione (GSH) and low reactive oxygen species corresponded to decreased [18F]FSPG cell accumulation in drug-resistant versus drug-sensitive cells. Decreased [18F]FSPG uptake in drug-resistant cells was a consequence of changes in intracellular cystine, a key precursor in GSH biosynthesis. In vivo, [18F]FSPG uptake was decreased nearly 80% in chemotherapy-resistant A2780 tumors compared with parental drug-sensitive tumors, with nonresponding tumors displaying high levels of oxidized-to-reduced GSH. Treatment of drug-resistant A2780 tumors with doxorubicin resulted in no detectable change in tumor volume, GSH, or [18F]FSPG uptake.

Conclusions:
This study demonstrates the ability of [18F]FSPG to detect upregulated antioxidant pathways present in drug-resistant cancer. [18F]FSPG may therefore enable the identification of patients with HGSOC that are refractory to standard of care, allowing the transferal of drug-resistant patients to alternative therapies, thereby improving outcomes in this disease.
NK Cells Expressing a Chimeric Activating Receptor Eliminate MDSCs and Rescue Impaired CAR-T Cell Activity against Solid Tumors
Authors: Parihar Robin , Rivas Charlotte , Huynh Mai , Omer Bilal , Lapteva Natalia , Metelitsa Leonid S. , Gottschalk Stephen M. , Rooney Cliona M. 
Published: January 2019

Abstract
Solid tumors are refractory to cellular immunotherapies in part because they contain suppressive immune effectors such as myeloid-derived suppressor cells (MDSCs) that inhibit cytotoxic lymphocytes. Strategies to reverse the suppressive tumor microenvironment (TME) should also attract and activate immune effectors with antitumor activity. To address this need, we developed gene-modified natural killer (NK) cells bearing a chimeric receptor in which the activating receptor NKG2D is fused to the cytotoxic ζ-chain of the T-cell receptor (NKG2D.ζ). NKG2D.ζ–NK cells target MDSCs, which overexpress NKG2D ligands within the TME. We examined the ability of NKG2D.ζ–NK cells to eliminate MDSCs in a xenograft TME model and improve the antitumor function of tumor-directed chimeric antigen receptor (CAR)–modified T cells. We show that NKG2D.ζ–NK cells are cytotoxic against MDSCs, but spare NKG2D ligand–expressing normal tissues. NKG2D.ζ–NK cells, but not unmodified NK cells, secrete proinflammatory cytokines and chemokines in response to MDSCs at the tumor site and improve infiltration and antitumor activity of subsequently infused CAR-T cells, even in tumors for which an immunosuppressive TME is an impediment to treatment. Unlike endogenous NKG2D, NKG2D.ζ is not susceptible to TME-mediated downmodulation and thus maintains its function even within suppressive microenvironments. As clinical confirmation, NKG2D.ζ–NK cells generated from patients with neuroblastoma killed autologous intratumoral MDSCs capable of suppressing CAR-T function. A combination therapy for solid tumors that includes both NKG2D.ζ–NK cells and CAR-T cells may improve responses over therapies based on CAR-T cells alone.
Sex Differences in Acute Complications of Cardiac Implantable Electronic Devices: Implications for Patient Safety
Authors: Moore Katherine , Ganesan Anand , Labrosciano Clementine , Heddle William , McGavigan Andrew , Hossain Sadia , Horton Dennis , Hariharaputhiran Saranya , Ranasinghe Isuru 
Published: January 2019

Background

To date, limited population‐level studies have examined the impact of sex on the acute complications of cardiac implantable electronic devices (
CIED)
, including permanent pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy devices.

Methods and Results

We studied all patients aged >18 years from 2010 to 2015 who were a resident of Australia or New Zealand, undergoing a new permanent pacemaker, implantable cardioverter defibrillator
,
or cardiac resynchronization therapy implant. Standardized variables were collected including patient demographic characteristics, primary and secondary diagnoses, procedures performed and discharge status. Diagnoses and procedures were coded as per the
International Classification of Diseases, Tenth Revision
(
ICD‐10
) and the Australian Classification of Health Interventions. The primary end point was the incidence of major
CIED
‐related complications in‐hospital or within 90 days of discharge, with the effect of sex evaluated using multiple logistic regression. A total of 81 304 new
CIED
(61 658 permanent pacemakers, 12 097 implantable cardioverter defibrillators, 7574 cardiac resynchronization therapy) implants were included (38% women). Overall, 8.5% of women and 8.0% of men experienced a
CIED
complication (
P
=0.008). Differences between women and men remained significant after adjustment for age, procedural acuity, and comorbidities (odds ratio 1.10, 95% CI: 1.04–1.16,
P
<0.001). Differences in
CIED
complication rates were primarily driven by excess rate of in‐hospital pleural drainage (1.2% women versus 0.6% men,
P
<0.001; adjusted odds ratio 1.86, 95% CI: 1.59–2.17,
P
<0.001) and pericardial drainage (0.3% women versus 0.1% men,
P
<0.001; adjusted odds ratio 2.17, 95% CI: 1.48–3.18,
P
<0.001).

Conclusions

Women are at higher risk of acute
CIED
complications. Improvements in implant technique and technologies are required to minimize the risk of implant‐related complications in women.
Otolaryngology Resident Reviewer Development Program: Lessons Learned from Cohort 1
Authors: Schmalbach Cecelia E. 
Published: January 2019

ObjectiveTo implement a quality improvement project addressing the knowledge gap in the otolaryngology resident and fellow scientific peer review process.MethodsThe creation of the Resident Reviewer Development Program, cohort 1 outcomes, and subsequent lessons learned from the inaugural class are outlined using the plan‐do‐study‐act model. Interested otolaryngology residents were paired with seasoned reviewers and conducted a minimum of 3 mentored peer reviews followed by an independent review test if competency was determined.ResultsTwenty‐five residents (postgraduate years [PGYs] 2‐5) were actively enrolled in cohort 1. At 24 months, 18 (72%) graduated, 6 remained actively enrolled, and 1 did not successfully complete the program. The median number of practice reviews prior to testing was 3 (range, 3‐6). The median independent review score was 83 (overall journal mean = 78). Cohort 1 graduates continued on to review 130 articles with a mean score of 85. Five (28%) graduates achieved Star Reviewer status.DiscussionThe inaugural cohort demonstrated that the PGY‐3 and PGY‐4 class is ideal for enrollment given that completion of the program could take up to 24 months. Three mentored reviews were identified as the ideal minimum requirement for education. The accelerated achievement of Star Reviewer status (28%) and mean postgraduation score of 85 demonstrate successful and sustainable outcome measures.Implications for PracticeWith appropriate mentorship and administrative support, scientific peer review can be formally incorporated into an educational program. Lessons learned during the educational program are sustained long term as demonstrated by review scores and Star Reviewer status.
Preoperative Use of Herbal Medicines and Vitamin Supplements
Authors: Grauer R. P. , Thomas R. D. , Tronson M. D. , Heard G. C. , Diacon M. 
Published: January 2019

There has been a definite increase in the popularity and use of complementary and alternative medicines, including herbal medicines, in the last ten years. The aim of this study was to determine the prevalence and patterns of use of herbal medicines and vitamin supplements by patients in the preoperative period. A questionnaire was offered to all patients attending the pre-admission clinics at St. Vincent's Hospital and Box Hill Hospital, Melbourne, over an eight-month period in 2002. In all, 1102 questionnaires were completed (91.8% response rate). The prevalence of herbal medicine use was 14.3%, with an average user age of 54.0 years and 61.4% female predominance. The five most popular herbs were Garlic, Evening Primrose, Gingko, St. John's Wort and Echinacea. The commonest reasons for herbal medicine use were acute and chronic medical conditions. 63.2% of patients had self-prescribed. 27.8% of herbal remedy users had informed the hospital doctors and 41.8% had notified their general practitioner. The prevalence of vitamin supplement use was 20.4%, with an average user age of 54.8 years and 66.2% female predominance. The five most popular vitamins were multivitamins, followed by vitamin B, C, E and D. The commonest reasons for vitamin use were maintenance of general well-being and health. The use of herbal medicines and vitamin supplements preoperatively by patients is common. Clinicians should endeavour to familiarize themselves with the more popular and significant herbal medications and, as part of the routine preoperative assessment, ask all their patients about their consumption of herbal remedies.
A Comparison of Open and Laparoscopic Approaches to Adrenalectomy in Patients with Phaeochromocytoma
Authors: Davies M. J. , McGlade D. P. , Banting S. W. 
Published: January 2019

We compared the perioperative profiles of patients undergoing unilateral phaeochromocytoma resection performed by open adrenalectomy with those performed by laparoscopic adrenalectomy. Data was collected prospectively on 24 patients (12 open, 12 laparoscopic). All patients underwent extensive preoperative medical preparation with phenoxybenzamine and β-blockers. The final preoperative dose of phenoxy-benzamine was similar in each group (laparoscopic 119±60 mg/day, open 100±25 mg/day). Intraoperative haemodynamic instability was assessed by the requirement for therapeutic intervention. More haemodynamic instability was observed in the laparoscopic group but the differences were not statistically significant. Sodium nitroprusside use to treat hypertension (systolic blood pressure >180 mmHg) was more frequent and the duration of the infusions longer in the laparoscopic group; high dose β-blocker therapy with atenolol and/or esmolol to treat intraoperative tachycardia (heart rate >90) was also more frequent in the laparoscopic group. The small sample size of the study limited the ability to detect a true difference. Blood loss was greater in the open adrenalectomy group but the difference was not significant. The operating time was significantly longer (236±78 vs 147±47 min, P<0.01) but the duration of postoperative hospitalization was significantly shorter (5±2 vs 11±4 days, P<0.01) in the laparoscopic group. Postoperative complications were not significantly different. There were no perioperative deaths. Overall, we observed more haemodynamic instability in patients undergoing laparoscopic resection but were unable to demonstrate a statistically significant difference. In our experience, laparoscopic adrenalectomy has the advantage of a shorter time to discharge from hospital.
Predictors of Physician Confidence to Diagnose Pneumonia and Determine Illness Severity in Ventilated Patients. Australian and New Zealand Practice in Intensive Care (ANZPIC II)
Authors: Boots R. J. , Lipman J. , Bellomo R. , Stephens D. , Heller R. F. 
Published: January 2019

The manner in which elements of clinical history, physical examination and investigations influence subjectively assessed illness severity and outcome prediction is poorly understood. This study investigates the relationship between clinician and objectively assessed illness severity and the factors influencing clinician's diagnostic confidence and illness severity rating for ventilated patients with suspected pneumonia in the intensive care unit (ICU). A prospective study of fourteen ICUs included all ventilated admissions with a clinical diagnosis of pneumonia. Data collection included pneumonia type – community-acquired (CAP), hospital-acquired (HAP) and ventilator-associated (VAP), clinician determined illness severity (CDIS), diagnostic methods, clinical diagnostic confidence (CDC), microbiological isolates and antibiotic use. For 476 episodes of pneumonia (48% CAP, 24% HAP, 28% VAP), CDC was greatest for CAP (64% CAP, 50% HAP and 49% VAP, P<0.01) or when pneumonia was considered “life-threatening” (84% high CDC, 13% medium CDC and 3% low CDC, P<0.001). “Life-threatening” pneumonia was predicted by worsening gas exchange (OR 4.8, CI 95% 2.3–10.2, P<0.001), clinical signs of consolidation (OR 2.0, CI 95% 1.2–3.2, P<0.01) and the Sepsis-Related Organ Failure Assessment (SOFA) Score (OR 1.1, CI 95% 1.1–1.2, P<0.001). Diagnostic confidence increased with CDIS (OR 16.3, CI 95% 8.4–31.4, P<0.001), definite pathogen isolation (OR 3.3, CI 95% 2.0–5.6) and clinical signs of consolidation (OR 2.1, CI 95% 1.3–3.3, P=0.001). Although the CDIS, SOFA Score and the Simplified Acute Physiologic Score (SAPS II) were all associated with mortality, the SAPS II Score was the best predictor of mortality (P=0.02). Diagnostic confidence for pneumonia is moderate but increases with more classical presentations. A small set of clinical parameters influence subjective assessment. Objective assessment using SAPS II Scoring is a better predictor of mortality.
Effectiveness of a Patient Blood Management Data System in Monitoring Blood use in Western Australia
Authors: Mukhtar S. A. , Leahy M. F. , Trentino K. , Koay A. , Semmens J. B. , Tovey J. , Jewlachow V. , Farmer S. L. , Hofmann A. , Roberts H. A. , Towler S. C. 
Published: January 2019

The aim of this paper is to describe a linked patient blood management (PBM) data system and to demonstrate its usefulness by presenting the blood usage data obtained. Our existing datasets already collected much of the required information in relation to PBM. However, these datasets were not linked. A patient identifier was used to link the Patient Administration System with the Laboratory Information System. Data linkage was achieved by linking the Laboratory Information System with the Patient Administration System records where blood transfusion or laboratory result date/time fell between admission and discharge date/time. The two datasets were then consolidated into the PBM data system. Blood usage data obtained from the system showed that between August 2008 and July 2009 there were 59,627 patient completed separations in the pilot hospital. Of the total transfused units, 62% were red blood cells (RBC), followed by fresh frozen plasma (22%), cryoprecipitate (9%) and platelets (8%). Around 50% of RBC transfusions were administered to patients >70 years of age. General medicine represented 21% of RBC usage, followed by haematology (19%), orthopaedics (17%) and general surgery (16%). Patients with 100 g/1 pre-transfusion haemoglobin received 9% of RBC transfusions and patients with 71–100 g/1 pre-transfusion haemoglobin received 73% of RBC transfusions. The post-transfusion haemoglobin in RBC transfusions exceeded 100 g/1 in 33% of patients. Databases were successfully linked to produce a powerful tool to monitor blood utilisation and transfusion practices within a pilot PBM program. This will facilitate effective targeting of PBM strategies and ongoing monitoring of their impact.
Physiological Aspects of Intermittent Positive Pressure Ventilation
Authors: Hillman D. R. 
Published: January 2019

The mechanical properties of the lungs and chest wall dictate the relationship between tidal volume, flow rate and airway pressure developed during intermittent positive pressure ventilation (IPPV). The increase in intrathoracic pressures associated with IPPV has consequences for the intrapulmonary distribution of ventilation and perfusion (hence gas exchange), cardiac output and regional blood flows. Barotrauma is a potential hazard. IPPV also affects the homeostatic mechanisms that keep the air spaces dry. Strategies to maximise the benefits and minimise the side effects of IPPV include positive end-expiratory pressure, intermittent mandatory ventilation, differential lung ventilation and high frequency ventilation. Understanding the physiological effects of IPPV and associated therapies allows a rational approach to the adjustment of ventilation against pulmonary, cardiovascular and systemic responses so as to optimise gas exchange and peripheral oxygen delivery.